Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

Animals ; Hippocampus ; pathology ; physiopathology ; Male ; Motor Activity ; Rats ; Rats, Wistar

Objective To investigate the application value of Atlas titanium cable in the treatment of comminuted patellar fractures (CPF).Methods 80 patients with CPF in our hospital from January, 2010 to January, 2013 were randomly selected and divided into observation group (n=40) and control group (n=40) by digital random method.Observation group adopted Atlas tita-nium cable internal fixation treatment while control group adopted the improved tension band steel wire in the hollow compression screws fixation treatment.Preoperative (t0), postoperative 1 month (t1), 6 months (t2) and 1 year (t3) Bostman patellar injury curative effect score (BPICES), operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay, treatment costs and complications of two groups were compared.Results Preoperative BPICES of two groups had no statistical significant difference (p>0.05).Compared with t0, t2 and t3 BPICES and the rate of optimal curative effects, two groups increased; Compared with the control group, t2 and t3 BPICES and the rate of optimal curative effects of observation group also increased, and the difference was statistically significant (p<0.05).Operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay of observation group were (52.26 ±10.29) min, (70.48 ±10.49) ml, (4.78 ±1.48) d and (5.98 ±1.06) d respectively, which were lower than the (79.95 ±8.42) min, (123.36 ±21.18) ml, (9.14 ±4.48) d and (11.18 ±2.68) d of the control group;Therapy cost of observation group was (16 284.47 ±2 145.78) Yuan, which was higher than the (9 892.48 ±1 456.42) Yuan of the control group (p <0.05).Compared with control group, peptide wire/wire Piercing the skin, pain, infection, skin irritation, slippery bursa phlogistic, internal fixation of fracture parted, fracture end separation and other complications total incidence of observation group were lower (p<0.05).Conclusion Atlas titanium wire trea-ting of patients with CPF had shorter operation time and hospitalization time , less postoperative complications.It can promote the rapid recovery of knee joint function, but its cost is higher.Thus it is suitable for CPF patients with better economic conditions .

120 g?L-1. The estimated intraoperative blood loss was 1 000-1 500 ml. The patients were randomly divided into 3 groups ( n = 16 each): group Ⅰ lactated Ringer's solution (LR); group Ⅱ LR-6% HES and group Ⅲ colloid (6% HES). Blood was removed from radial artery after induction of anesthesia. The target Hct was 28% . The volume of blood removed = body weight (kg)?7.5 ? (preop Hct -target Hct) / 0.5?(preop Hct + target Hct). The removed whole blood was replaced with lactated Ringer's solution in a three to one ratio in group Ⅰ or with 6% HES in a one to one ratio in group Ⅲ. In group Ⅱ half of the removed whole blood was replaced with LR and the other half with 6% HES. The EVLW, HR, BP, Cardiac index (CI) and dp/dtmax were monitored by PiCCO and recorded before induction of anesthesia (T0), immediately after induction of anesthesia (T1), immediately after and 15 min after ANH (T2,3), immediately before and after reinfusion (T4,5) . Hct, colloid osmotic pressure and blood gases were also measured and recorded. Results The 3 groups were comparable with respect to M/F ratio, age, body weight and the volume of whole blood removed. MAP, HR, SpO2 and CVP were stable during operation in all 3 groups. Hct was significantly decreased after ANH as compared with the baseline at T0 in all 3 groups. The osmotic pressure was significantly decreased after ANH in group Ⅰ and Ⅱ and was significantly higher in group Ⅱ and Ⅲ than in group Ⅰ after ANH. CI and dp/dtmax were significantly decreased after ANH as compared to the baseline at T0 in all 3 groups. There was no significant difference in EVLW, PaO2 and [ HCO3- ] among the 3 groups. Conclusion Moderate ANH with crystalloid or colloid has little effect on EVLW and oxygenation in patients with normal cardio-pulmonary function.

Objective To evaluate the efficacy of the flexible ureteroscopy and Holmium and FREDDY laser lithotripsy for renal calculi at various locations.Methods From May 2002 to May 2007,338 cases of renal calculi(sized less than 20 mm in diameter)were treated by flexible ureteroscopy and laser lithotripsy in our hospital.The data of the patients were analyzed retrospectively.Among the cases,the calculi were located at the upper or middle calyx or the renal pelvis in 288 patients,at the lower calyx in 37,and in multiple calyxes in 13.All the patients received KUB and IVU before the procedures.With the TerumoTM settled in place,a F8/9.8 Wolf rigid ureteroscope was inserted to observe and dilate the ureteral lumen.Then,an Olympus P3 6.9F flexible ureteroscope was used.When the insertion of the rigid ureteroscope was difficult,a re-ureteroscopy would be tried 2 weeks later with a pig-tail stent in place.The WOM U-100 FREDDY laser and the Lumenis Holmium laser were used to perform the procedure and a pig-tail stent would be set at the end of the procedure.The urethral catheter was removed in the first postoperative day and an intravenous antibiotic prophylaxis was administrated during the first 2 days postoperatively.A follow-up by KUB or non-contrast CT scan was done 4 weeks after the procedure to evaluate the result of the endoscopic nephrolithotripsy.Any residual calculi larger than 4 mm in diameter was taken significant.Results In 28 patients the rigid ureteroscope or the ureteral sheath couldn't be inserted in the first time,and the success rate of the ureteroscopic insertion was 91.7%(310/338).The re-ureteroscopy was successful in the patients after 2 weeks.The calculi were detected in 97.3%(329/338)of the patients,and the procedures succeeded in 306 of them(306/329,93.0%).The success rate of laser nephrolithotomy was 78.0%(32/41)for the lower calyx calculi,which was significantly lower than that for the middle,upper calyxes or renal pelvic calculi 95.1%(274/288),?2=13.601,P=0.000].After 4 weeks,the total evacuation rate of the calculi was 87.6%(296/338).For the calculi in the upper or middle pole or in the renal pelvis,the complete evacuation rate was 90.1%(264/293),which was significantly higher than that for the lower pole 71.1%(32/45),?2=12.929,P=0.000].No patient had ureteric perforation or active bleeding after the surgery.The mean operation time was 35 min(12-55 min).After the operation,11 cases developed nephritic colic.None of them had septicemia or acute renal failure.Gross hematuria disappeared in 1-2 days postperation.Conclusions The flexible ureteroscopy and Holmium and FREDDY laser lithotripsy are safe and effective for renal calculi sized less than 20 mm in diameter,especially for those in the upper,middle poles and renal pelvis.A re-ureteroscopy with the pig-tail stent in place is suggested in two weeks after the failure of the first procedure.

Objective To systematically evaluate the curative effect and safety of treating winter diseases in summer acupoint application therapy for asthma in children.Methods The domestic and international databases were retrieved till Feb 2017.The randomized controlled trials about treatment of treating winter diseases in summer acupoint application therapy for children with asthma were identified.The methodology quality of included trials was assessed.Results A total of 3 RCT involving 146 patients were included.The compositions of Chinese medicines and acupuncture points used were quite diverse,which inhibited us to conduct meta-analysis.The methodological quality of included RCT was generally lower.The results showed that treating winter diseases in summer acupoint application therapy might have advantage in reducing asthma acute attack times and improving clinical symptoms and respiratory function.Conclusion treating winter diseases in summer acupoint sticking therapy for asthma in children may have some advantages,however,due to the lack of a number of trials and poor methodology quality,the claimed benefits of treating winter diseases in summer acupoint sticking therapy for for children with asthma are inconclusive;more rigorous studies are warranted to support clinical practice.

Apolipoproteins A ; therapeutic use ; Coronary Disease ; drug therapy ; prevention & control ; Humans ; Recombinant Proteins ; therapeutic use

Adult ; Ear Neoplasms ; Eustachian Tube ; Humans ; Male ; Neurilemmoma

Objective To investigate pulmonary infect flora distribution characteristics of stroke patients with tracheotomy in Intensive care unit (ICU) and analyze the risk factors.Methods A total of 792 cases of ICU stroke patients was selected,including 426 cases of tracheotomy patients,and 366 cases of non-tracheotomy patients.The incidence of lung infections was compared.Bacteriological examination was used for tracheotomy bacteriological studies for lung infected stroke patients with tracheotomy.Bacteria infection's characteristics was observed.The risk factors were analyzed.Results (1) The tracheotomy patient 's lung infection rate was 23.00％,higher than 9.56％ of the non-tracheotomy patients,the difference was statistically significant (X2 =19.125,P ＜0.05);(2) For lung infection-occurred patients with tracheotomy of ICU,gram-negative bacteria infection rate was 63.97％,significantly higher than 19.85％ of gram-positive bacteria and 16.18％ of fungi,the difference was statistically significant (x2 =18.255,17.042,P ＜ 0.01);(3) Lung infection rate of ICU stroke tracheotomy patients with unconscious,dysphagia,hospitalization time ＞ 14 d,blood glucose levels ≥≥7.8 mmol/L,and based diseases was significantly higher than that of patients with conscious,non-dysphagia,hospitalization time ≤＜14 d,blood sugar level ＜7.8 mmol/L,and no based diseases (P ＜ 0.05);(4) Consciousness,dysphagia,hospitalization,blood sugar levels,and the underlying disease were the independent risk factors of lung infection in ICU stroke tracheotomy patients (OR1 =11.528,OR2 =8.046,OR3 =15.174,OR4 =7.795,ORs =10.784,P ＜0.05).Conclusions Gram-negative bacteria is the main reason for pulmonary infections in ICU stroke tracheotomypatients patients with stroke.State of consciousness,invasive treatment,hospitalization,blood sugar levels,and the underlying disease are the independent risk factors.

Objective To discuss the management of renal vein trauma in the percutaneous ne-phrostomy (PCN) procedure.Methods Three cases with renal vein trauma by PCN or malposition of nephrostomic catheter were reviewed.Case 1 was a patient with staghorn calculi.There was mas-sive hemorrhage after the puncture and the dilatation during PCN.Then the nephrostomy catheter was clamped.The post-operative CT scan showed the nephrostomy catheter passed the inferior vena cava to the right external jugular vein.Case 2 was a patient with a 3 cm calculus in the inferior calice of the right kidney.A massive haemorrage occurred after the dilatation by the 16 F sheath guided by ultra-sound during PCN.The nephrostomic catheter was found in the renal vein by X-ray film.Case 3 was a patient with bilateral hydronephrosis complicating chronic renal failure,which caused by the meta-static of the gastric carcinoma.After the puncture,the massive hemorrage appeared and a nephros-tomic catheter was placed and then clamped.The catheter was seen in the renal vein confirmed by the X-ray.For all 3 patients,the catheter was withdrawn carefully monitored by the X-ray until the place of the renal vein perforation during the first 24-48h.Then it was withdrawn 3 to 4 cm each time un-til reach the pelvic.Results The hemorrhage was well controlled and nobody needed the surgical in-tervention.There was no renal function aggravation in these 3 patients.Conclusions The renal vein trauma during the echo-guide PCN procedure can be treated by clamping the nephrostomy catheter and withdrawing it gradually.Thus,the surgical intervention can be avoided and this method will not im-pair the renal function.