Objective To study the effect of finasteride on preventing prostate hyperplasia with acute urinary retention.Methods Totally 626 patients with benign prostatic hyperplasia (BPH) were randomly divided into treatment group (316 cases) and control group (310 cases),followed up for 3 years.The incidence of acute urinary retention and prostate volume changes were analyzed.Results There were 3 cases of acute urinary retention in treatment group (1.0 ％),9 cases in control group (2.9％) (x2 ＝5.37,P＜0.05).In treatment group,the average prostate volume was reduced about 23.6％ compared with before taking the medicine,on the contrary,prostate volume was averagely increased 12.3％ in control group.Conclusions Finasteride can reduce the risk of acute urinary retention by narrowing the prostate volume in patients of benign prostatic hyperplasia.

ObjectiveTo study the feasibility,safety and efficacy of laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for adult congenital choledochal cyst.MethodA retrospective study was conducted on 7 adult patients with congenital choledochal cyst who received total laparoscopic cyst excision and Roux-en-y hepaticojejunostomy from May 2008 to February 2011 in the Department of General Surgery of Shengjing Hospital,China Medical University.ResultsAll the laparoscopic surgery was successful.The mean operation time was 210 minutes.The average intraoperative blood loss was 80 ml.All patients were out of bed within the first 24 h after surgery.The mean time to first flatus/bowel motion was 2.4 days.Except 1 patient who had small amount of bile leakage,all patients recovered smoothly without any major postoperative complications.The average hospital stay was 8.1 days.No patients suffered from abdominal pain,fever or jaundice during follow-up from 3 to 30 months.ConclusionTotal laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy was a safe,efficacious,and minimally invasive procedure.

OBJECTIVETo observe the clinical efficacy of BO's abdominal acupuncture for obese type-2 diabetes mellitus (T2DM).

METHODSSixty patients of obese T2DM were randomly divided into an acupuncture group and a medication group, 30 cases in each one. Patients in the medication group were treated with basic treatment combined with oral administration of regular antidiabetics, three weeks as one session. Patients in the acupuncture group, based on the medication group, were treated with abdominal acupuncture at Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanguan (CV 4)], Fusiguan [Huaroumen (ST 24), Wailing (TE 5)], Tianshu (ST 25), Daheng (SP 15), Qixue (KI 13), etc.; the treatment was given three times per week, 3 weeks as one session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, waist circumference (WC), hip circumference, body mass index (BI) were observed before and after treatment in the two groups, and fasting plasma glucose (FPG), fasting insulin (FINS), 2-hours postprandial blood glucose by oral glucose tolerance test (OGTT) and insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), HOMA-IR of insulin resistance index were calculated and adverge events were recorded.

RESULTSCompared before the treatment, SBP, WC, body weight, BMI, FPG, OG-TT2hBG, FINS, GTT2h insulin, HOMA-IR, TC and LDL-C in the acupuncture group were all significantly reduced (all P <0. 05), while FPG, OGTT2H insulin and TG were increased in the medication group (all P<0. 05)'. The differences of reducing SBP, WC, FPG, OGTT2H insulin, HOMA-IR, TC, TG and LDL-C were statistically significant between the two groups (all P<0. 05). The total effective rate was 93. 3% (28/30) in the acupuncture group, which was significantly superior to 23. 3% (7/30) in the medication group (P<0. 01).

CONCLUSIONBO's abdominal acupuncture has obvious clinical efficacy for obese type-2 diabetes mellitus, featuring in lowering blood pressure, reducing weight, decreasing blood glucose, im- proving insulin resistance and lowering lipid, which has no adverse effects and is worthy of clinical popularization and application.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Body Weight ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; physiopathology ; therapy ; Female ; Humans ; Insulin ; blood ; metabolism ; Lipoproteins, LDL ; blood ; metabolism ; Male ; Middle Aged ; Triglycerides ; blood ; Waist Circumference

Objective To analyze the common and individual training needs of palliative care among nurses in different level hospitals. Methods The self-designed questionnaire about training needs of palliative care was used to investigate 340 nurses in different level hospitals. The data were analyzed by Ridit analysis method. Results There were 24 important items and 26 unimportant items in the common training needs. Regarding the individual training needs,the concept of palliative care,basic nursing care and bereavement support were preferred by the primary-level hospital nurzes,while the principles of palliative care,basic nursing care and pain management in secondary-level hospital nurses,radiotherapy and chemotherapy care and the ethical and moral problems in palliative care in third-level hospital nurses. Conclusion Different level hospital nurs-es have beth common and individual needs in the training contents of palliative care. Ridit analysis can distinguish the differ-ences and provide reference for the training.

ObjectiveThrough the examination of Clostridium difficile (Cd) in the stool of inflammatory bowel disease (IBD) patients to investigate its infection status in IBD patients and the relationship with IBD.MethodsFrom December 2009 to January 2011,a total of 130 diagnosed IBD patients were collected in the Department of Gastroenterology,Ruijin Hospital,Shanghai Jiaotong University School of medicine,including 60 ulcerative colitis (UC) patients and 70 Crohn's disease (CD) patients.At same time.60 irritable bowel syndrome patients and 60 healthy volunteers were collected as control.Stool samples were tested by PCR and Cd toxin A/B test kit (CDTK).SPSS statistical software was used for statistical analysis.ResultsIn 130 enrolled IBD patients,16 cases (12.3％) were Cd infected,of which 10 were UC cases (16.7％) and 6 were CD cases (8.6％).No Cd infection was found positive in control group (x2 =15.779,P=0.000).The infection rate of Cd in the patients of active stage was higher than that in the patients of inactive stage (x2 =10.092,P=0.001).The infection rate of coion-type CD patients was 4/14,which was significantly higher than those of other types CD patients (x2 =13.125,P=0.001).The infection rate of Cd was 4.5％ in mild UC patients,14.3％ in moderate and 6/17 in severe (x2 =6.667,P=0.037) ; the infection rate were 0％ in mild CD patients,4.2％ in moderate and 5/16 in severe.The infection rate increased along with the increase of The disease severity (x2 =13.907,P=0.000).There was no significant difference in the infection rate of Cd between broad-spectrum antibiotics used and not used patients (x2 =1.414,P =0.378), or between patients with broad-spectrum antibioticsused aloneand combinedwith immunosuppressant (x2 =0.330,P=0.962).ConclusionsThere was certain infection rate of Cd in IBD patients,especially the patients in active stage. The infection rate increased along with the increase of the IBD severity.

Objective:To analyze the relationship among hypertensive cardiac change,kidney disease and hyperten-sive retinopathy (HRP).Methods:A total of 100 patients with hypertension,who were diagnosed and treated in our hospital from Jan 2012 to Dec 2013,were enrolled,including 90 HRP patients (34 cases of class Ⅰ,49 cases of class Ⅱ,six cases of class Ⅲ and one case of class Ⅳ)and 10 cases with normal fundus (normal control group). Clinical data of all patients were analyzed,left ventricular mass index (LVMI),carotid intima-media thickness (IMT)and glomerular filtration rate (GFR)etc.were measured.Results:Compared with normal control group, there were significant thickening in IMT [(0.62±0.30)mm vs.(0.87±0.16)mm vs.(1.10±0.28)mm]in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the IMT of class Ⅲ+Ⅳ group was significantly thickened than that of class Ⅰ+Ⅱ group (P <0.01 all);Compared with normal control group,the incidence rates of cardiac dilation (0%vs.12.05% vs.71.43%)and kidney function damage (0% vs.24.10% vs.85.71%)significantly rose in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the incidence rates of cardiac dilation and kidney function damage in HRP class Ⅲ+Ⅳ group significantly rose than those of class Ⅰ+Ⅱ group (P <0.01 all).Conclusion:Severity of hyper-tension retinopathy is closely related to hypertensive cardiac dilation and kidney function damage.

Objective:To explore the cerebral hemodynamic changes of patients with hypertension complicated reti-nopathy.Methods:A total of 77 patients with hypertension complicated retinopathy were enrolled as study group, another 70 patients,who received physical examination during the same period and its results were normal,were treated as normal control group.Index changes of middle cerebral artery (MCA)and anterior cerebral artery (ACA)were compared between two groups,and hemodynamic difference of ophthalmic artery (OA)and central retinal artery (CRA)were recorded.Results:Compared with normal control group:① Mean velocity of MCA and ACA [(64.28±13.29)cm/s,(20.12±7.21)cm/s vs.(129.18±20.14)cm/s,(89.35±10.98)cm/s]signifi-cantly rose in study group ,P <0.01 all;②There were significant reductions in peak systolic velocity (PSV)and end-diastolic velocity (EDV)of OA and CRA,P <0.05 all,and resistance index significantly rose in all classes of study group (P <0.05 all);③There were significant reductions in mean blood flow velocity [(21.62±7.36)ml/s vs.(13.47±5.13)ml/s],maximum blood flow velocity and minimum blood flow velocity ,and significant rise in pulse wave velocity,peripheral resistance,critical pressure,vascular characteristic impedance [(17.35±5.36)kPa ·s-1 ·m-1 vs.(31.68±6.47)kPa· s-1 · m-1 ],and dynamic resistance [(30.59 ± 6.98)kPa· s-1 · m-1 vs. (64.48±12.38)kPa·s-1 ·m-1 ],in basilar artery in study group,P <0.01 all.Conclusion:In patients with hy-pertension complicated retinopathy,cerebral blood supply indexes reduce along with blood pressure rises,CRA blood flow changes can be regarded as a judging basis for disease course development,which deserves highly atten-tion for patients and physicians.

A case of mandible plasma cell myeloma is reported.Plasma cell myeloma is a monoclonal neoplastic proliferation of plasma cells of bone-marrow derivation,usually multi-centric but jaw bones are rarely involved.The treatment requires precise pathological diagno-sis.The prognosis of solitary jaw bone lesions can be good after treatment.

Objective To compare the applications of half-Fourier acquisition single-shot turbo spin-echo(HASTE)sequence and true fast imaging with steady state precession(True FISP)sequence for the delineation of structures and diseases in several twin pregnancy with comorbidities and to explore the clinical value of two series of fast imaging for MRI of fetus.Methods 27 twin preg-nancy women with comorbidities were imaged with HASTE and True FISP sequences.All images were statistically analyzed in re-spect of imaging qualities and artifacts.MR signs of fetal brain were analysized.Results There were abnormal changes in brains in 7 of 27 cases.Both sequences could demonstrate the structures and lesions of the fatus.Imaging quality scores of HASTE were higher than that of True FISP,but with more respiratory blurring.Conclusion There might be varying abnormalities in central nervous system in twin pregnancy with comorbidities.Combining the demonstration abilities of HASTE and True FISP is needed when de-tecting fetus lesions,especially the brain.

Education of medical morality is an important part of medical education and must be through the whole career life of medical workers.Now our society is in the period of transition,but education of medial morality fails to get enough attention.Based on the present situation,the paper first makes a systematic exposition of the importance,intension,element and process of the reception of medical morality education of medical workers,then points out the rule of this reception and the approach to realize the validity of medical morality education.