Objective To improve the diagnosis and treatment of hermaphroditism.Methods The data of 138 cases of hermaphroditism who were hospitalized in our department between March 2005 and April 2008 were reviewed and and analyzed to summarize our experience in the diagnosis and treatment.Results Among the 138 cases with a age ranging from 2 to 36(mean 17 years old),42 were socially male and 96 were socially female.With the help of medical examination,,laboratory examination,ultrasonic examination,radiological examination and pathologic diagnosis,54 patients were diagnosed as female pseudohermaphroditism,66 as male pseudohermaphroditism,10 patients as true hermaphroditism,2 patients as pure gonadal dysgenesis,2 as testicle degeneration,and the left 4 patients as Klinefelter syndrome.Among the 138 patients,132 patients were received surgery operation,including 76 of them receiving laparoscopy.After operation,121 patients were maintained female sex,11 patients were maintained male sex.Female pseudohermaphroditism were all maintained female sex.Fifty-nine patients of male pseudohermaphroditism were maintained female sex.There were 4 patients being maintained male sex,and 3 patients having not received operation.Of the cases of the true hermaphroditism,8 patients were maintained female sex and 2 patients were maintained male sex.Conclusion Early accurate diagnosis is very important to the treatment of hermaphroditism.Etiologic diagnosis is useful in the course.Although it is good for the hermaphroditism to maintain female sex,the decision of the patients and the family should be considered.

Prostate cancer, bladder cancer, and rectal cancer are common malignancies in the male pelvis. The incidence rate of erectile dysfunction (ED) following radical prostatectomy, cystectomy or rectal cancer surgery is about 25% - 100%. The main cause of post-surgery ED is mainly attributed to injury of neurovascular bundles, which may lead to reduced oxygenation in and fibrosis of the penile tissue. Early penile rehabilitation after surgery can improve or restore the erectile function of the patients. This article focuses on penile rehabilitation after radical pelvic surgery.
Cystectomy ; Erectile Dysfunction ; etiology ; rehabilitation ; Humans ; Male ; Pelvic Neoplasms ; surgery ; Penile Erection ; Penis ; Postoperative Complications ; rehabilitation ; Postoperative Period ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rectal Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

Objective The purpose of our study was to report the results of using arthroscopic Remplissage and Bankart repair in patients who had an engaging Hill-Sachs lesion with significant glenoid bone loss. Methods We retrospectively reviewed 49 consecutive patients who underwent arthroscopic Remplissage and Bankart repair for anterior shoulder instability with a mean duration of follow-up of 29.0 months (24-35 months). At the time of surgery the mean age of 42 men and 7 women was 28.4 years. All patients were diagnosed as recurrent anterior shoulder dislocation with a bony lesion of glenoid and an engaging HillSachs lesion. An arthroscopic Remplissage and Bankart repair using metal anchor was performed in all cases.ASES score, Constant-Murley score and Rowe score were used to evaluate the stability and the function of the shoulder. Results Patients' active forward elevation significantly(P=0.007) improved from 162.9°±17.1°preoperatively to 170.9°±7.4° at final follow-up. The external rotation was 56.0°±17.6° before the surgery compared with the 54.1°±17.1° postoperatively(P=0.511 ). The ASES score, Constant-Murley score and Rowe score was 84.7±11.3, 93.3±8.7 and 36.8±8.5 preoperatively compared with 96.0±3.4, 97.8±3.6 and 89.8±12.5 postoperatively. Significant difference could be found with regard to ASES score (P=0.000), ConstantMurley score (P=0.005) and Rowe score (P=0.000). One redislocation happened and a subluxation was noticed in three patients (8.3%). Conclusion Arthroscopic Remplissage combined with Bankart repair can achieve satisfactory for recurrent anterior shoulder dislocation accompany with engaging Hill-Sachs lesion.

Objective:To evaluate the antimicrobial effectiveness of Zhenzhu Mingmu eye drops according to the requirements de-scribed in Chinese pharmacopoeia (2010 edition). Methods:Totally 7 batches of Zhenzhu Mingmu eye drops from 7 enterprises were evaluated. All the samples were tested according to the requirements described in Chinese pharmacopoeia, and the testing points of 6h and 24h were added. Results:As for bacteria, the reduction value of staphylococcus aureus in 7 days treated with Zhenzhu Mingmu eye drops from enterprise e was 0. 61g, and that in 14 days was 1. 01g. That in 7 days treated with the eye drops from the other enter-prises was all above 1. 01g, that in 14 days was above 3. 01g, and that in 14-28 days kept stable. As for fungi, the number was stable from the beginning with the treatment of the eye drops from the seven enterprises. Conclusion:Although the type and content of bacte-riostatic agent in domastic Zhenzhu Mingmu eye drops are the same, there is difference in the antimicrobial effectiveness of the product from different enterprise. The eye drops from one enterprise can't meet the requirements for type I product described in Chinese pharma-copoeia,and the others meet the requirements.

The research data at home and abroad show that the overall burnout rate of clinical professional graduate students was high. They are vulnerable to burnout because of long duty hours, learn-ing pressure, intense and overloading work and especially the significantly reduced personal accomplish-ment in the situation of the contradiction between doctors and patients in our country. Burnout not only re-sults in psychological distress and physical symptoms, but also has negative effect on the quality of graduate medical education during residency training. Therefore, educators need to develop an active awareness of burnout and ought to perform interventions such as formulating the appropriate learning goals, improving the work efficiency, reducing work hours, positive psychological counseling and stress management training to prevent such occurrences.

Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.

Objective To evaluate the clinical results of arthroscopic repair of massive rotator cuff tear. Methods The study involved 16 patients with massive rotator cuff tears treated arthroscopically from September 2007 to June 2009. There were 6 males and 11 females at average age 61.5 years (45-75 years). The rotator cuff tears was repaired with arthroscopic double-row reconstruction. The range of motion, pain, strength of flexed elevation and function evaluation score were all recorded before operation and at final follow-up. The results were evaluated by t test and compared according to age and course of disease. Results All patients were healed without complications and the outcome was improved significantly ( P < 0.01 ). The mean VAS score was improved from preoperative 5.6 to postoperative 1.7,the average forward flexion from 69. 1°to 151.2°, the average external rotation from 14.7° to 32.2°, and internal rotation from L1 level to T10, the mean Constant-Murle from 39 to 85, the mean UCLA from 10.4 to 28, the mean SST from 2.8 to 8.8 and the strength of flexed elevation from 10.7% of normal side to 65.0%. Compared with preoperation, there was statistical difference in aspects of pain, range of motion, muscle strength and function in postoperation (P < 0.01 ). Conclusion Arthroscopic doublerow fixation can attain satisfactory results in repair of massive rotator cuff tear.

Objective To analyze the bacterial distribution and resistance in upper urinary tract stone patients, then choose suitable antibiotics and reduce infectious complications accordingly.Methods Middle flow urine, infectious stone and the end of kidney drainage tube were taken for culture in 148 patients who underwent percutaneous nephrolithotomy between January 2009 to September 2010. Antibiotics were used according to the culture results and the complications secondary to infection were analyzed. Results Urinary pathogens presented in 38 (25.7%) patients before operation.There were 112 strains of bacteria. The predominant strains included: Escherichia coli (17 cases,11.5%), Staphylococcus epidermidis (4 cases) and Proteus mirabillis (4 cases). Escherichia coli and Proteus mirabillis were common in stone culture. Staphylococcus epidermidis (5 cases),Pseudomonas aeruginosa (5 cases) and Staphylococcus haemolytcus (5 cases) were found in renal drainage tube culture which were positive in 25 patients. Imipenem, cefepime, vacomycin, nitrofurinton were sensitive and commonly used antibiotics. Forty-one patients (27.7 %) had fever postoperatively, including 10 positive for middle urine culture and 9 positive for drainage tube culture. One infective shock was diagnosed postoperatively. Conclusions Gram-negative bacilli are predominant in the upper urinary tract stone patients preoperatively. Gram-positive ones are common postoperatively.Suitable antibiotics, based on middle flow urine culture, could reduce urinary infective complications.

Objective To investigate the prevalence of fecal incontinence (FI) among adult women in Beijing area, and to analysis risk factors associated with FI. Methods A stratified multiple-cluster systemic method was used to recruit women ≥ 20 years old in 6 districts of Beijing. A self-administrated questionnaire was used to collect information about Fl and possible risk factors. Results There were three thousand and 58 women participated in the survey, the average age was (48 ± 16 ) years (range 20 -79 years). The prevalence of FI was 1.28% ( 39/3058 ), which was related to age. There were five factors entered the logistic regress model, which were included age ≥40 years old ( OR = 3.3, 95% CI: 1.7 -6. 8), urinary incontinence ( OR = 3.0, 95% CI: 1.5 - 6. 1 ), vaginal delivery ( OR = 2.4, 95% CI:1.2 -4. 9), household per capita income ≤2000 RMB per month ( OR = 3. 3, 95 % CI: 1.6 - 6. 5 ), and feeling fatigue ( OR = 3.0, 95% CI: 1.5 - 5.8). Conclusion Prevalence of FI is low among adult women in Beijing area, while risk factors associated with Fl are complicated and further studies are necessary to be conducted.

OBJECTIVETo develop and evaluate scaling and scoring assumptions, and the reliability and the validity of a Chinese version of the SF-36 scales.

METHODSA multi-stage mixed sampling procedure was used to select a representative sample of the general population. The sample size was 1 000 households. All family members of a selected household, aged 18 and older, completed a survey by self-administration. Formal psychometric methods for testing assumptions underlying item scoring and scale construction were used according to the standard procedure of the IQOLA Project.

RESULTSOf the 1 985 collected questionnaires, 1 972 were qualified. Of them, 1 688 (85.6%) were respondents. 1 316 respondents answered all 36 items, while the remaining (372 respondents) answered with one or several missing responses. Among the non-respondents, 65.5% were illiteracy or quasi-illiteracy. The assumption of equal intervals was violated for the VT and MH scales. The recoded item values were used to calculate scale scores. The clustering and ordering of the item means were approximately the same as that of the source version and other two Chinese versions. The items in each scale had similar standard deviations except those in the PF, BP, SF scales. The correlations between an item and its hypothesized scale were identical for all except the SF and VT scales. The scaling success rates of convergent validity were 0% for the SF scale, 75% for the VT scale, and 100% for the other six scales. The scaling success rates of discriminat validity ranged from 87.5% to 100% for all scales except for the SF scale. The Cronbach' alpha coefficients of internal consistency reliability ranged from 0.72 to 0.88, which were satisfactory for group comparison except 0.39 for the SF scale and 0.66 for the VT scale. The two-weeks test-retest reliability coefficient ranged from 0.66 to 0.94. Factor analysis identified two principal components: a "physical" factor and a "mental" factor. Taken together, these two factors could be used to explain 56.3% of the total variance.

CONCLUSIONThe Chinese version of the SF-36 Health Survey Scale has achieved conceptual equivalence and satisfied the psychometric scaling assumptions well enough to warrant wide use in China. Known-groups validity will give more meaningful evidences of the validity of the Chinese SF-36 scales.