Objective To survey cognitive and processing mode of urethral distraction defect associated with pelvic fracture (PFUDD) in China and hope to find a reasonable treatment scheme for (PFUDD).Methods From Jan 2011 to Dem 2015,a questionnaire on surgical treatment for PFUDD was sent to 286 Chinese consultant urologists in more than 56 comprehensive hospitals throughout the China.The investigation includes the age of urologsit,the type of hospital,the number of patients treated during the last 5years,operation mode and optional time to do the surgery,the selection of operation approach,evaluation of the treatment effect were analyzed.At same time,we also investigated the methods of 260 cases about PFUDD.Results The age of the urologist were 30-55 years old.Over the past five years,229 urologists had fewer than 10 patients diagnosed each year,and only 57 had 10 patients diagnosed each year.There were many different kinds of operation method,including urethral realignment 36 (14％),direct vision internal urethrotomy 121 (46％),internal urethrotomy plus laser 57 (22％),trans-perineal urethral anastomosis 46(18％).The success rates were 58％ (21/36),50％ (60/121),46％ (26/57),76％ (35/46)respectively.70％ (200/286) of specialists did an open exploration urethral realignment or cystostomy when patients were injured in 2-6 hours.28％ (80/286) of specialists did urethral realignment with endoscopic surgery.About 75％ (216/286) of specialists believed that the treatment of patients with posterior urethral atresia should follow the ladder principle.Minimally invasive methods at the start,including urethral dilation,direct vision internal urethrotomy was the first choice.They would prefer open surgery only after intial treatment failure.65％ (186/286) of doctors believed that the overall outcome of the surgery was moderated.Conclusions Urethral distraction defect associated with pelvic fracture (PFUDD) was rare to be done.The direct vision internal urethrotomy was the first choice for most of the urologists(75％).They considered the urethroplast only after the failure of initial mini-invasive surgery.Trans-perineal urethral anastomosis had the best results.

Procalcitonin (PCT), a precursor of hormone calcitonin, is used as an indicator of bacterial infections in recent years. PCT plays an important role in early identiifcation of pathogens, evaluation of the severity of infection, medication guidance and prognosis judgment in children with community acquired pneumonia.

CD4 Antigens ; metabolism ; CD56 Antigen ; metabolism ; Dendritic Cells ; pathology ; Diagnosis, Differential ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Hematologic Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Leukemia, Myeloid ; pathology ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Skin Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; surgery

Objective:To investigate the curative effects and mechanism of Shuxuetong injection (疏血通注射液) on treating coronary heart disease(CHD).Methods:The treated group (n=20) based on conventional therapy was treated with Shuxuetong injection infused intravenously,meanwhile the control group treated with conventional therapy only.Before and after therapy the changes in concentrations of plasma endothelin(ET),thromboxin B2(TXB2),6ketoprostaglandin F1α(6ketoPGF1α) and blood rheology between two groups were compared.Results:After therapy the clinical symptoms were convalescent,the ET and TXB2 reduced,the 6ketoPGF1α increased,and the parameters of blood rheology improved.Conclusions:Shuxuetong injection is able to dilate vessels,increase blood flow volume,anticoagulate,and improve blood rheology so that it is effective drug to treat CHD.

Objective To analyze the level of satisfaction and its influencing factors in emergency patients, and to improve the satisfaction level of emergency patients. Methods The patients who visited the emergency department with the triage number ended with 1 from August 1 to August 15, 2015 in Second Affiliated Hospital of Zhejiang University School of Medicine were selected by the method of convenience and equidistant sampling, to take the Press Ganey′s Patient Satisfaction Questionnaires which were collected and analyzed at the end of the patient's emergency treatment. Results A total of 200 cases were investigated. Patient experience overall satisfaction was (91.64 ± 8.74) points. There were no significant differences in satisfaction between the gender, age, place of residence, the investigator, the clinic department, the time to wait, whether the first visit and the previous stay in hospital (P>0.05). The correlation between the satisfaction score and the patient's education, prognosis was less (r=-0.251,0.262, P =0.009,0.018) , but more higher correlated with the service attitude of ancillary hospital staff, nursing staff in the provision of nursing instructions, nursing staff can protect the privacy, the waiting time of the triage and the doctor′s explanation of the treatment of the disease (r=0.79-0.84, P<0.05). Conclusions The service attitude of the ancillary hospital staff, nursing staff in the provision of care instructions and privacy protection, and the waiting time of the triage and the doctor′s explanation of the treatment are the most important factors influencing the patients′ satisfaction in emergency department which also will be the key content for us to improve the patients′experience and satisfaction inemergency patients.

Objective To investigate the safety and feasibility of laparoscopic removal of exogenous caesarean scar pregnancy (CSP).Methods From January 2009 to May 2011,71 patients with CSP treated in Shengjing Hospital of China Medical University were studied retrospectively.Thirty-nine patients were treated with hysteroscopic excision of CSP,while 32 patients were treated with laparoscopic surgery.The following clinical parameters were compared,including intraoperative blood loss,quantity of postoperative uterine drainage,postoperative hospital days,the time for the mass absorption and the return of β-hCG to normal were studied.Results Two cases in the hysteroscopic group were transformed to abdominal surgery because of introperative bloody loss,the 37 cases underwent hysteroscopic surgery successfully with the ultrasound supervision and guidance.Laparoscopic surgery were successfully completed in all 32 cases.In hysteroscopic group,the operation time,the time for the return of serum β-hCG to normal,postoperative uterine drainage volume and the postoperative hospital stay were (44 ± 18) minutes,(27 ±5) days,(38 ± 12) ml,(3.8 ±0.7) days.While,in laparoscopic group,they were (100 ±21) minutes,(17 ±4) days,(19 ± 6) ml,(3.5 ± 0.6) days,respectively,the differences reached statistically significant (all P ＜ 0.05).But the amount of intraoperative bleeding were was (113 ± 63) ml in hysteroscopic group and (109 ±59) ml in laparoscopic group,the difference was not statistically significant (P ＞0.05).The duration of absorption of mass were (88 ± 17) days in hysteroscopic group.In laparoscopic group,the mass were completely removed.Conclusions Laparoscopic exicion of CSP could be suitable in treatment of exogenous CSP which offers advantages including prompt recovery,blood loss and hospital stays.This management could repair the uterine scars,reduce the reoccurring risk and conservate the fertility potential.

Objective To investigate the clinical efficacy of modified YV-plasty for refractory bladder neck contracture (BNC) caused by transurethral resection of prostate (TURP).Methods From June 2013 to March 2016,11 patients with BNCs secondary to TURP were included in this study.Their mean age was 63.7 years (range,56-73 years).All patients presented voiding difficulty and failed after 2 or more prior endoscopic treatments.Modified YV-reconstruction of bladder neck was performed,by incising the anterior wall of bladder neck in a T-shaped manner,and creating two well-vascularized and tension-free flaps,which offer the possibility to reconstruct a wide bladder neck.Results After a mean follow-up of 14.6 months (ranging 3-24 months),successful outcome was achieved in 9 patients without incontinence secondary by surgery.Recurrent voiding difficulty developed in 2 patients,which was cured after a following endoscopic treatment.Conclusion A wider bladder neck can be obtained through modified YV-reconstruction of bladder neck,while avoiding external urethral sphincter injury.It is an available option for refractory bladder neck contracture.

ObjectiveTo observe the preventive effect of type Ⅱ collagen on experimental rat articular cartilage damage induced by T-2 toxin,to explore molecular biomarkers of articular cartilage damage and repair,and to provide a theoretical basis for control of articular cartilage damage.MethodsEighty Wistar rats were randomly divided into 4 groups according to their body weights:negative control,positive control,high-dose intervention,and low-dose intervention groups,20 rats in each group.Animals in negative control group were fed with standard rat chow,and animals in other three groups were fed with T-2-toxin-contaminated chow( 100 ng/kgfeed).Animals in negative and positive control groups drank distilled water,animals in high-dose intervention and low-dose intervention groups drank water containing type Ⅱ collagen(0.5,5.0 g/L,respectively).These rats were sacrificed after 3 and 5 months,respectively,and bilateral knee joints were collected.Histopathologic changes in hyaline cartilage were examined by light microscope,serum levels of type Ⅱ collagen carboxyl terminal peptide (CTX-Ⅱ ),cartilage oligomeric matrix protein (COMP) and urinary deoxypyridinoline (DPD) were determined by enzyme-linked immunosorbent assay(ELISA).ResultsHE staining showed,that the positive control articular chondrocytes were disarranged,deformated,degenerated,with necrosis and extensive areas of chondrocyte loss;but the two intervention groups only showed fibril formation and swelling and surface cartilage cells became round,flat cartilage cells decreased in number,and cartilage cells clustered and so on early pathological changes of osteoarthritis.At the ends of 3 month and 5 month experiment,the levels of serum CTX- Ⅱ in different groups were,negative control[(18.77 ± 4.61),(25.07 ± 9.17)μg/L],high-dose intervention[ (21.11 ± 5.02),(33.20 ± 9.74)μg/L ],low-dose intervention [ ( 19.87 ± 4.53 ),( 29.73 ± 9.32 ) μg/L ] and positive control [ ( 24.43 ± 5.23 ),( 39.17 ±10.49 ) μg/L ] ; the levels of serum COMP were,negative control group [ (5.43 ± 2.75 ),( 6.38 ± 2.23 ) μg/L ],highdose intervention group[ (17.27 ± 4.77),(20.32 ± 4.74)μg/L],low-dose intervention group[(20.13 ± 5.07),(19.44 ± 4.92)μg/L] and positive control group[ (21.37 ± 4.72),(24.52 ± 4.26)μg/L].At the end of 3 month,compared with negative control group,the level of serum CTX- Ⅱ in other three groups increased,but only positive control group increased significantly(P ＜ 0.05) ; at the end of 5 month,compared with negative control group,the level of serum CTX-Ⅱ in other three groups increased significantly,and the difference was statistically significant (all P ＜ 0.05),and the level of CTX-Ⅱ in the two intervention groups was significantly lower compared with that of positive control group(all P ＜ 0.05).Compared with negative control group,the level of serum COMP in other groups increased significantly at the end of 3 month (all P ＜ 0.05) and only the level of serum COMP in high-dose intervention group was significantly lower compared with that of positive control group(P ＜ 0.05).At the end of 5 month,compared with negative control group,the level of serum COMP in other three groups increased significantly,the difference were statistically significant (all P ＜ 0.05) ; the levels of serum COMP in the two intervention groups were significantly lower than that of positive control group(all P ＜ 0.05).At the ends of 3 month and 5 month,the content of urinary DPD in negative control group were[ (3.47 ± 2.20),(4.14 ± 1.06)μg/L],positive control group[ (4.09 ± 2.48),(4.33 ± 3.43)μg/L],high-dose intervention group[ (3.86 ± 2.31 ),(5.72 ± 3.89)μg/L] and low-dose intervention group[ (3.58 ± 2.77),(4.23 ± 2.90)μg/L].The difference between the 4 groups were not statistically significant (F =2.608,2.436,all P ＞ 0.05).ConclusionsType Ⅱ collagen could effectively reduce the level of serum CTX-Ⅱ and COMP in experimental rats and delay the process of articular cartilage damage induced by T-2 toxin.

ObjectiveTo study the impact of jogging mode on T-2 toxin-induced articular cartilage injury in rats,and to evaluate the role of movement in the development of bone and joint disease.MethodsA hundred Wistar rats were randomly divided into five groups:negative control group(free activities in the cage),positive control group(firee activities in the cage),high-regulation group(regular exercise,the treadmill speed of 24 m/min),lowregulation group (regular exercise,the treadmill speed of 12 m/min) and the random group(random exercise,the treadmill speed of 12 or 24 n/min).The negative control group was fed on commercial grain fodder and other groups were fed on grain fodder contaminated with T-2 toxin.At the end of 5,10 weeks,the histopathological changes of hyaline cartilage were detected by optical microscope,and the level of serum cartilage oligomeric matrix protein (COMP) was determined.ResultsArticular cartilage lesions in each experimental group was evident,presented as cartilage cell degeneration,necrosis,karyopyknosis deeply stained,cells arranged in disorder and cell proliferation,articular dryness,and so on.Compared with the positive control group,the cartilage surface cells of rats in the movement groups showed degeneration,necrosis and loss of cells obviously.The injury in high-regulation group was the most serious than that in other movement groups,with the surface and the middle layer lesions,and a large area of cartilage necrosis,and loss of matrix collagen; cartilage degeneration,polarity disappeared,cell proliferation-based disorder showed in random group.The pathological changes of rat articular cartilage damage worsened with the extension of experimental period.The serum levels of COMP at week 5 in experimental groups were higher than that of both the negative control group and the positive control group,and the difference was statistically significant (F =15.733,P ＜ 0.05 ); compared with negative control group [ (11.55 ± 0.89)μg/L],the COMP levels in high-regulation group,low-regulation group,random group[(13.95 ± 1.23),(14.96 ± 1.29),( 12.99 ± 1.43)μg/L] were significantly higher(all P ＜ 0.05); compared with the positive control group[(12.32 ± 1.38) μg/L],the COMP levels in high-regulation group and low-regulation group were significantly higher(all P ＜ 0.05) ; and compared between the exercise groups,the COMP levels in low-regulatinn group were higher than that of random group(P ＜ 0.05).At week 10,the changes were in the same trend as that of week 5,and the difference between groups was statistically significant (F =6.144,P ＜ 0.05) ; and compared with the negative control group [(10.59 ± 1.93)μg/L],the COMP levels in high-regulation group,low-regulation group,random group [ ( 13.72 ± 2.67 ),( 14.94 ± 1.06 ),( 13.21 ± 1.58 ) μg/L] were significantly higher(all P ＜ 0.05) ; compared with the positive control group[ (11.45 ± 0.12)μg/L],the COMP levels in low-regulation group were significantly higher (P＜0.05); but compared with the exercise groups,the difference were not statistically significant(all P＞0.05).ConclusionsHigh-intensity regular running and irregular intensity running can increase the articular cartilage damage,and injury of articular cartilage by low-intensity treadmill exercise is not significant.

Acute Disease ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Myocarditis ; diagnosis ; diagnostic imaging ; Ultrasonography ; methods ; Virus Diseases ; diagnosis ; diagnostic imaging