Objective To investigate the risk factors of uroschesis in patients with cervical cancer after extensive hysterectomy.Methods The clinical data of 92 patients with cervical cancer who had undergone extensive hysterectomy plus pelvic lymph node dissection from August 2008 to June 2011 were analyzed retrospectively.The incidence rate and related risk factors of uroschesis after operation were analyzed.Results Thirty-one of 92 cases had postoperative uroschesis.The incidence rate of uroschesis was 33.70％.Univariate analysis showed that age,intraoperative blood loss,time of indwelling urinary catheter and urinary tract infection had significant correlation with postoperative uroschesis (P ＜0.05).While operative time,clinical stage,pathological type,preoperative adjuvant therapy,postoperative wound infection or fat liquefaction had no obvious correlation with postoperative uroschesis (P＞ 0.05).Multivariate Logistic regression analysis showed that age,time of indwelling urinary catheter and urinary tract infection were risk factors of postoperative uroschesis.Conclusions Age,time of indwelling urinary catheter and urinary tract infection are independent factors of postoperative uroschesis.The key method to reduce the incidence rate of postoperative uroschesis is to shorten the continuous catheterization time with comprehensive measure,to prevent and control urinary tract infection in early time.

Objective To assess the efficacy and safety of two kinds of arterial suture-mediated closure devices (Angioseal and Perclose) in patients after coronary arteriography(CAG) and percutaneous coronary intervention (PCI). Methods 1?020 patients (672 male, 348 female, mean age 57.8?2.4 yr) undergoing CAG or PCI were randomized into either the Angioseal group (CAG 380, PCI 120) or the Perclose group (CAG 392, PCI 128). The procedural success rate and occurance of local complications were compared between the two groups. Results Both kinds of devices had a high success rate (Angioseal 94% vs Perclose 96%) and there was no statistical difference between them. There were five cases of hematoma and no pseudoaneurysm in the Angioseal group. On the other hand, there were four cases of hematoma and three cases of pseudoaneurysm in preclose group. There was no statistal difference in terms of local complications between the 2 groups. Conclusion Both kinds of arterial suture-mediated closure devices (Angioseal and Perclose) are feasible and safe for patients undergoing CAG and PCI.

Objective To investigate the effect of tirofiban on myocardial necrosis biomarker after percutaneous coronary interventions(PCI)in patients with aspirin resistance(AR).Methods 374 consecutive patients with aspirin 100 mg≥1 week,receiving no other antiplatelet therapy,scheduled for PCI were enrolled.all patients were given an loading dose of 300 mg clopidogrel at least 12 hours before PCI and an 75 mg maintenance dose per day.Patients were randomized into tirofiban group(n=38)and control group(n=45)after PCI.The levels of CKMB,TnI at 8,12,and 24 hours after PCI were measured in all patients;if the CK-MB,TnI value was above normal upper limitation,it was considered elevated.Results 83 patients were AR(22.2%)and 54.2%of them are females.The frequencies of CK-MB elevation were 15(39.5%)in tirofiban group and 19(42.2%)in control group,and TnI elevation was 18(47.4%)and 23(51.1%)in the two groups respectively.Conclusion Tirofiban can not decrease the elevation level of CK-MB and TnI in patients with AR after PCI.

Objective To investigate the value of serum high sensitive C-reactive protein (hs-CRP) together with total cholesterol(TC)/high-density lipoprotein cholesterol (HDL-C) as a predictor risk factor for future coronary heart disease (CHD). Methods TC,HDL-C and hs-CRP were measured in 260 patients. Results The serum hs-CRP levels in patients with coronary heart disease were significantly increased than those in normal group, P

Objective To explore the feasibility ,effectiveness ,recurrence rate and complications ,etc .of endoscopic retrograde stenting in treating acute appendicitis .Methods A retrospective analysis was conducted on seven patients with the clinical diagnosis of acute appendicitis ,complying with the following treatment steps :(1) normal saline for high cleansing enema in 2-3 times ;(2) en-doscopically douching ileocecal junction and observing the opening of appendix ;(3) placing the guide wire into the opening of appen-dix under the guidance of imaging tube ,and then conducting angiography imaging ;(4) repeatedly douching with metronidazole;(5) implant the appendix stent ,draining the inflammatory secretions out and then douching ;(6 ) observing postoperative abdominal pain ,fever ,bowel and other conditions;(7) reviewing with the enteroscopy and removing the stent 2 weeks later .At 2 before the surgery and 48 after it ,all patients were administrated with antibiotics for anti-infective treatment .The follow-up was made from 8-15 months after the surgery .Results Among these 7 patients ,4 patients had successful appendix stenting :the abdominal pain sig-nificantly alleviated after the surgery ;the proportional level of white blood cells(WBC)recovered during 24-48 after the surgery .15 after discharge ,two patients returned to hospital and their appendix stent removal was successful;during the operation ,smooth mu-cosa at the opening of appendix was observed .The stents of two patients spontaneously fell off ,and normal morphology of the ap-pendix opening was observed at review .During the postoperative follow-up of 8-15 months ,one patient relapsed and underwent sur-gical treatment in the general surgery department .The other three patients did not undergo appendix stenting due to the unsuccess-ful intubation .Conclusion The treatment of acute appendicitis with endoscopic stenting has the advantages of little trauma ,high safety and significant efficacy .However ,this method still requires large-scale and multicenter randomized controlled clinical trials to evaluate its feasibility and long-term efficacy .

Objective:To observe the clinical effect of spinal manipulation on chronic, non-specific neck pain.Methods:Thirty patients with chronic, nonspecific neck pain were divided randomly into an observation group ( n=15) and a control group ( n=15). Patients in the observation group were given 20 minutes of a novel 4R spinal manipulation (resetting joint malalignment, resetting abnormal muscle, resetting joint stabiliazation, resetting sensorimotor control) twice a week for 2 weeks while the control group were given 20 minutes of medium frequency and high frequency conventional physiotherapy 4 times a week, also for 2 weeks. Before the treatment, right after, and one and three months later, both groups were evaluated using a visual analogue scale (VAS) and a neck disability index (NDI). Right before and after the treatment, cervical flexion and extension range of motion (ROM) were measured. The surface electromyography was employed to record the root mean square (RMS) of the EMG amplitude and the median frequency (MF) from the erector spinae and upper trapezius. Results:Before the treatment no significant differences were found in any of the measurements between the two groups. Afterward and one and three months later the average VAS, NDI and cervical ROM results of both groups had improved significantly, with the improvements in the observation group significantly greater than those in the control group on average. After 2 weeks of treatment, the average RMS and MF values had improved in both groups, again with the observation group′s average values significantly better than those of the control group.Conclusion:Spinal manipulation can effectively improve the strength and stamina of cervical muscle groups in patients with chronic, non-specific neck pain.

Objective: To investigate the prevalence, awareness, treatment and control rates of diabetes among residents in Fangshan District, Bejing Municipality, so as to provide reference for strengthening the prevention and control of diabetes. Methods: The residents aged 18 to 79 years were selected in Fangshan District using multistage stratified cluster sampling method from March to June 2023. Demographic information, lifestyle, body mass index, fasting blood glucose, and blood lipid were collected through questionnaire surveys, physical examinations and laboratory tests. The prevalence, awareness, treatment and control rates of diabetes among residents were analyzed and their influencing factors were identified using a multivariable logistic regression model. Results: A total of 4 438 residents were enrolled, including 2 367 males (53.33%) and 2 071 females (46.67%), and had a mean age of (44.99±14.90) years. The prevalence, awareness, treatment and control rates of diabetes were 15.75%, 57.37%, 56.22% and 22.90%, respectively. Multivariable logistic regression analysis showed that age (aged 30 to 39 years, OR=1.624, 95%CI: 1.011-2.609; aged 40 to 49 years, OR=3.469, 95%CI: 2.163-5.561; aged 50 to 59 years, OR=4.202, 95%CI: 2.595-6.803; aged 60 to 69 years, OR=7.229, 95%CI: 4.406-11.862; aged 70 to 79 years, OR=7.929, 95%CI: 4.665-13.479), obesity (OR=1.368, 95%CI: 1.071-1.748), hypertension (OR=1.943, 95%CI: 1.601-2.359) and dyslipidemia (OR=2.754, 95%CI: 2.287-3.317) were the factors affecting the prevalence of diabetes. Sex (women, OR=1.529, 95%CI: 1.019-2.293), age (aged 40 to 49 years, OR=4.971, 95%CI: 1.681-14.698; aged 50 to 59 years, OR=6.070, 95%CI: 2.045-18.020; aged 60 to 69 years, OR=6.902, 95%CI: 2.287-20.832; aged 70 to 79 years, OR=6.954, 95%CI: 2.191-22.070) and hypertension (OR=1.906, 95%CI: 1.337-2.718) were the factors affecting the awareness of diabetes. Age (aged 40 to 49 years, OR=4.699, 95%CI: 1.594-13.855; aged 50 to 59 years, OR=5.990, 95%CI: 2.023-17.732; aged 60 to 69 years, OR=7.134, 95%CI: 2.370-21.470; aged 70 to 79 years, OR=6.639, 95%CI: 2.102-20.964) and hypertension (OR=1.857, 95%CI: 1.304-2.645) were the factors affecting the treatment of diabetes. Age (aged 40 to 49 years, OR=2.948, 95%CI: 1.349-6.438; aged 60 to 69 years, OR=2.344, 95%CI: 1.049-5.234) was the factor affecting the control of diabetes. Conclusions The prevalence rate of diabetes among residents in Fangshan District was high, and the improvements of awareness rate, treatment rate and control rate were not obvious. Health education and management of diabetes should be strengthened for elderly, hypertensive and dyslipidemic residents.

Objective Excimer laser coronary atherecomy ( ELCA) has been recently used for the treatment of complex coronary lesions including calcified stenosis , chronic total occlusions and in-stent restenosis. Such complex lesions are difficult to adequately treat with balloon angioplasty and /or intracoronary stenting.The aim of this study was to introduce our early experiences in using ELCA in China . Methods Fifteen patients were enrolled through our center from March 2015 to April 2016 , and excimer laser coronary angioplasty was performed on 15 lesions.Eleven patients were previously failed cases either from uncrossable balloon ( 9 lesions ) or expandable balloon ( 6 lesions ) . The procedure and clinical endpoints were recorded .Results Laser catheter with 0.9 mm diameters were used in all 15 coronary lesions.All the lesions were successfully crossed with laser catheter and finally dilated with balloon .The procedural success rate was 100%.Drug eluting stents ( DES ) were implanted in 86.7% lesions and 2 cases were treated with drug eluting balloon .Clinical success was obtained in all patients (100%).There was no dissection , major side branch occlusion , spasm, no-reflow phenomenon nor acute vessel closure . Conclusions This study shows that laser-facilitated coronary angioplasty is a simple , safe and effective device for the management of complex coronary lesions .

Objective To evaluate the utilization efficiency of beds in clinical departments based on time consumption index.Methods Selecting data from the 2019 annual report of medical work statistics and data from the Beijing inpatient medical service performance evaluation platform of a tertiary grade A general hospital of Traditional Chinese Medicine,the time consumption index of departments was calculated,based on which the regional average inpatient day of each department was calculated.and the number of standard bed turnover was calculated based on the target bed utilization rate.The bed utilization model was constructed based on the actual bed utilization in the department.Results Beds are open for a certain number of days,based on the target bed occupancy rate of each department and the average inpatient days within the DRG region of each department can be calculated based on the annual standard bed turnover number of the department based on the DRG disease group,on the basis of which the bed utilisation model is constructed.59.09%of the departments were efficiency departments,and the departments of press bed type,idle type and weekly transition all accounted for 13.64%respectively.Conclusion Introducing the time consumption index into the evaluation of bed utilization efficiency is in line with the actual work situation.Shortening the time consumption index is the most important thing to improve the bed utilization efficiency.The evaluation results can be used as the basis for the allocation of hospital bed resources.

Purpose: This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs). Methods: This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values. Results: Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II). Conclusion The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.