Objective To investigate the relationship between relevant obstetrical factors and postnatal stress urinary incontinence. Methods Standard questionnaire on international urinary incontinence was applied, which was recommended by International Continence Society(ICS). Seven hundred and eighteen primiparas from the Obstetrical Department of Hebei United University Affiliated Hospital and Qinhuangdao Maternity and Child Care Hospital were randomly selected as our subject and fill out the survey. Six hundred and seventy-three primiparas were re-examined after delivery. Their postnatal situation of urinary incontinence after 42 days was recorded. Results ( 1 )Forty-one( 6. 09% ) primiparas of 673 primiparas were diagnosed with urinary incontinence after 42 days of their parturition. There were relationship between postnatal urinary incontinence with the mode of delivery,fetus body weight,progestational body weight and body mass index,and anal contraction movements(P < 0. 05).(2)The probability of the vaginal delivery group was 7. 76%(34 / 438), higher than that in primiparas with selective cesarean section group(2. 97%(7 / 235);χ2 = 6. 1;P < 0. 05).(3) The postnatal urinary incontinence in vaginal delivery group was closely related with fetus body weight, progestational body weight,body mass index( t = 4. 316,2. 093,2. 654;P < 0. 05). Conclusion (1)The postnatal urinary incontinence is more easily appeared in vaginal delivery.(2)Progestational primiparas with light body weight,fetus with less body weight,and anal contraction movements conducted in the postpartum period,can reduce the probability of postnatal urinary incontinence.(3)Mild urinary incontinence is more likely appeared during pregnancy and in the postpartum period. Therefore,more pelvic floor muscle exercise will have a better effect on preventing and curing postnatal urinary incontinence.

Familial spontaneous pneumothorax(FSP) is a specific type of primary spontaneous pneumothorax.FSP means there are more than one individuals develop pneumothorax and is a rare inherited disease.FSP is different from primary spontaneous pneumothorax in several clinical manifestations.So far the genetic basis and inheritance pattern of this disease are not clear.Progress in this field are reviewed here.

Objective To explore the therapeutic effects of Montelukast for bronchial asthma combined with allergic rhinitis(AR) in children.Methods Ninety asthmatic children with AR rhinitis were randomly divided into group A,group B and control group.The children in control group were treated only with Symbicort Turbuhaler.In addition to inhalation of Symbicort Turbuhaler,the children in group A were given Montelukast 5 mg/d orally,while the children in group B were given Budesonide Nasal Spray 64 ?g/d.All the children were observed for 6 months.Daytime and night asthma symptom scores,rhinitis symptom scores,the number of days with or without acute asthma symptoms were recorded every 4 weeks.FEV1%,as one of the lung function parameters,was also recorded in the pre-treatment and 8th week,24th week after the treatment.Results After the treatment,the daytime and night asthma symptom scores and rhinitis symptom scores of group A and group B were significantly reduced(group A:F=3.45,3.35 Pa0.05).However,there was better improvement of FEV1%,more days without symptoms and fewer acute asthma attacks in group A than those in group B (t=3.83,3.76,4.26 Pa

Objective To study the changes of learning-memory ability and synapse of hippocampus after radiation injuries. Methods Sprague-Dawley rats were grouped according to radiation dose to 20Gy group,30Gy group radiated by linear accelerator and control group were used before radiation and 120 days after radiation. Morris maze test were taken to study the learning and memory ability of rats in each group. Average escape latency and search strategy were scaled and analyzed in each group. The parameters of synapse in CA3 area of hippocampus were studied by using electron microscope and image analyzer. Results AEL of 20Gy group was (41. 17 ±10.76 ) s and score of SS was 27.13 ± 2.34 after 120 days' radiation but AEL of 30 Gy group was (78.49 ± 9.32)s and the score of SS was (23.19 ± 7.65 ) nm. There were significant statistic differences Compared with control group and before radiation (P ＜ 0.05 ). The thickness of PSD of 20 Gy group was ( 22.03 ± 6.84 ) nm after 120days' radiation and (23.19 ± 7.65 )nm in 30 Gy group. There were significant statistic differences compared with control group and before radiation. It was observed that both in 20 Gy and 30 Gy group' s the length of synaptic activity area was shorter,the curvature of synaptic interface was smaller,the width of synaptic cleft and the thickness of PSD was narrower than that of control group. Conclusion There was close relation between the changes of learning-memory ability and synapse of hippocampus after radiation injuries.

OBJECTIVE To study the characteristic of nosocomial pulmonary infection to find out the measures for prevention and control.METHODS The patients with radiation brain injuries(RIB) from Oct 2004 to Jun 2007 underwent retrospective investigation.The reasons and sites of pulmoary infection were analyzed.RESULTS The incidence of pulmonary infection of patients with RIB after radiotherapy was 68.5%.Major factors of infection were bulb palsy,invasive treatment and hormone usage.The Gram-negative bacteria were the predominant pathogens.CONCLUSIONS The nosocomial pulmonary infection is related to many factors.Antibiotic usage according to drug susceptibility results and controlling of the risk factors are important measures to reduce the rate of infection.

Objective To discuss the clinical significance of internal fixation through anterolaterel and posteromedial approaches in the treatment of closed sagittal Pilon fractures of Topliss classification and compare the effects of the two approaches.Methods The study involved 57 patients with closed sagittal Pilon fractures treated with open reduction and internal fixation from 2007 to 2010,including 29 patients treated through anterolateral approach (Group A) and 28 through posteromedial approach (Group B).All patients were with closed fractures,and all surgery time windows were 10-19 days.The two groups were compared in aspects of gender,age,type of fractures,soft tissue graduation,injury factors,condition of combined fibula fracture,surgery time window,operation time,intra-operative blood loss,ambulation time,infection and necrosis rate of skin and soft tissue,length of stay,ankle joint function recovery after internal fixation,and intra-operative X-ray reduction.Results All patients were followed up for 12-26 months (mean,20 months) except for one patient in the Group A,with total follow-up rate of 98％.The two groups showed no significant differences regarding the gender,age,type of fractures,soft tissue graduation,injury factors,condition of combined fibula fracture,surgery time window selection,operation time,intra-operative blood loss,and ambulation time (P ＞0.05).While,the infection and necrosis incidence of skin and soft tissue,and the hospital stay we re significantly lower and shorter in the Group A than that in the Group B (P ＜ 0.05 ).Two patients in the Group A were complicated with toe extensor tendon adhesion,which was released by removing the fixation.Fifteen patients had wound infection during hospitalization,including three patients in the Group A and 12 in the Group B,but they were all cured after treatments like dressing.Fifteen patients were treated with stage Ⅰ allogeneic bone graft and 11 with autologous iliac bone graft.All the patients obtained bone union.Conclusions Topliss classification of closed sagittal Pilon fractures has clear clinical significance in surgical plan selection and operative procedures.Both of the anterolateral and posteromedial approaches can achieve good effects in the treatment of closed sagittal Pilon fractures due to high energy injury.However,the anterolateral approach is relatively a better choice,for it brings in a lower incidence of infection and necrosis of skin and soft tissue and a shorter length of hospital stay.

Objective To explore the correlation of E-cadherin expression and the sensitivity to EGFR-TKI molecular targeted therapy. Methods Eight kinds of cells,MCF-7,MDA-MB-231,T24,SiHa,H460,SK-HEP-1,MHCC97-H and THP-1 were treated with EGFR-TKI PD153035 and gefitinib,respectively,for 48 hours. The drug-sensitivity was detected by MTT,and the IC50 of cells were calculated. The E-cadherin protein were detected and compared. Results Followed with PD153035 and gefitinib treatment,the survival rates of MCF-7,MDA-MB-231,T24 and SiHa significantly reduced,and more E-cadherin protein expressed. However, the survival rates of the H460, SK-HEP-1, MHCC97-H, and THP-1 cells showed opposite results. Conclusion The sensitivity of epithelial cancer cells to EGFR-TKI is correlated with E-cadherin expression. E-cadherin may play a significant role on regulateing the sensitivity to EGFR-TKI molecular targeted therapy. E-cadherin is a key biomarker for recruiting appropriate patients for EGFR-TKI molecular targeted therapy.

BACKGROUND: Diabetic cardiomyopathy, a serious complication of diabetes, is an important factor of increased mortality in patients with diabetes. Therefore, providing an effective experimental animal model is particularly important for studying the pathogenesis and treatment methods of diabetic cardiomyopathy. OBJECTIVE:To explore the method of establishing Wistar rat models of diabetic cardiomyopathy. METHODS:Forty rats were randomly divided into the control group (n=10) and diabetic cardiomyopathy group (n=30). The rats in the diabetic cardiomyopathy group were intraperitonealy injected with 60 mg/kg streptozotocin at a time to establish rat models of diabetic cardiomyopathy. The rats in the control group were given the same dosage of citric acid buffer by the same way. The rats in these two groups were al fed with non-fat high-sugar normal diet. RESULTS AND CONCLUSION:Compared with the control group, after 3 weeks of injection with streptozotocinin in rat models of diabetic cardiomyopathy, blood glucose level was significantly increased, myocardial cels arranged in disorder, the nuclei were of different sizes, colagen content in the myocardial tissue was significantly increased, and colagen fibers were thick and disordered. In addition, the mRNA and protein levels of transforming growth factorβ1 and type I colagen, two indices reflecting myocardial fibrosis, were markedly increased. These results indicate that intraperitonealy injecting large doses of streptozotocin (60 mg/kg) at a time and feeding with non-fat high-sugar normal diet could establish a stable rat model of type 1 diabetic cardiomyopathy. This method is safe and effective with high feasibility.

Objective To evaluate the feasibility of dual energy spectral CT with 270 mg/ml iodixanol in coronary CT angiography (CCTA).Methods A total of 60 patients with suspected coronary heart disease underwent CCTA.They were randomly divided into 3 groups.Prospectively ECG gated CCTA with 120 kVp were performed on the controlgroup (Group A,n=20).In group B (n=20) and group C (n=20),gemstone spectral imaging(GSI) technique were used and monochromatic images from 60 to 80 keV with increment of 5 keV were obtained to divide into 5 subgroups(B1-B5,C1-C5).Group A and group B used the same contrast medium (iodixanol 350 mg/ml) while Group C used low concentration contrast medium (iodixanol 270 mg/ml).One-way ANOVA analysis was used to compare objective evaluation indices (CT values,image noise,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the left main coronary artery,proximal segment of left anterior descending branch,proximal segment of left circumflex branch and proximal segment of right coronary artery) of group A and B1-B5.Statistical t-test was performed between group A and C2(with optimal keV).Results CNR of the group B1-B5[(21.2± 3.4),(21.5 ±4.0),(21.5 ±4.0),(21.8 ±4.2),(20.7 ± 3.5)]were increased significantly than group A(16.6± 3.8).No significant differences were found among groups B 1-B4 (P＞0.05).Compared withgroup A,group B2 showed higher CT values of the vessels [(481.4±43.2),(466.7±69.3),(434.1±48.8),(436.3±42.5),(427.4±48.6)HU] and decreased image noise[(28.2±7.3)HU versus (31.1±9.9) HU,P＜0.01].The optimal keV was 65 keV.Compared with group A,group C2 showed no significant differences in CT values[(396.3± 76.3),(390.4 ± 74.4),(359.5±83.1),(358.3±67.7),(365.4±68.2)HU)],image noise[(29.1±5.6)HU],SNR(14.6±4.2) and CNR [(18.4±4.8),t=-1.29-1.40,P＞ 0.05].Conclusion Dual-energy spectral CT with monochromatic reconstruction at 65 keV can provide same good image quality as the routine method while reduce iodine concentration to 270 mg/ml.

Osteoarthritis (OA) is the main reason of joint pain and dysfunction in the elderly in China, and its incidence is increasing year by year. In addition to the joint peripheral osteophyte formation and degeneration of articular cartilage, in?flammation, as one of the dominant pathological changes in OA, is causing more and more attention. Pro-inflammatory cyto?kines (PIC) are important mediators of inflammation. The increased level of PIC in OA can lead to systemic and local inflam?mation, results in further destruction of many kinds of tissues in joint (such as cartilage), and accelerates the development of OA. Besides, the severity of inflammation is closely related to the clinical symptoms of OA. Therefore, it is important to un?derstand the role of PIC in the pathogenesis of OA. From the perspective of the relationship between pro-inflammatory fac?tors and OA and the molecular mechanism, this article reviews the research progress in this field, which provides new con?cepts for diagnose and treatment of OA.