Objective To evaluate the safety and efficacy of transobturator tension-free vaginal tape(TVT-O)by 1-year follow-up.Methods The data of 112 female patients with stress urinary incontinence(SUI)were analyzed retrospectively.Preoperative and postoperative evaluations included physical examination,and urinary symptom,Qmax,post-voiding residual(PVR),and quality of life scale questionnaires.The anti-incontinence procedure was TVT-O through the anterior vaginal wall.Results All cases clinically improved,one patient experienced recurrence after 2 weeks,and got another TVT procedure 8 weeks later,and got well after the operation.All cases were followed up for 2～20 months in good result.The complete dryness rate was 94.64%(106/112),5.36% of patients(6/112)showed significant improvement.No leakage occurred.Most patients reported a significant decrease in incontinence severity and improvement in quality of life(P<0.01).Conclusion The TVT-O procedure is a safe and efficient surgical treatment method for female SUI.

Objective To evaluate the surgical approaches,complications,safety and efficacy of the suprapubic arc sling(SPARC) applied for stress urinary incontinence(SUI).Methods 30 female patients with SUI accepted SPARC through the anterior vaginal wall.Results All the cases clinically improved.1 patient experienced bladder injury,and get well 5 d after the operation;1 patient experienced post-procedure voiding dysfunction,but got well after the tape was cut 2 weeks later.All of the cases were followed up for 12～20 months with good results.Complete dryness was seen in 93.3%(28/30),6.7%(2/30) showed significant improvement.No leakage occurred.Conclusion SPARC is a simple,reliable procedure for anti-incontinence with good results.

Objective To investigate changes in symptoms and quality of life (QOL) score before and after transurethral resection of the prostate ( TURP), and their related factors. Methods Forty-seven elderly male patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms were enrolled in the study, with an average age of 72 years. They all were undergone with TURP and evaluated with international prostate symptoms score (IPSS), QOL score, maximal urine flow rate (Qmax), residual urine volume, pressure-urine flow rate and prostate size before and after the procedure. Changes in these parameters and their related factors were analyzed. Results No complication was observed during TURP in the 47 patients. After TURP, two patients suffered from distal urethra stricture, one from retrograde ejaculation and six from aggravated urgent incontinence, and symptoms relieved with symptomatic treatment in all of them. Significant difference in overall IPSS, irritant score and obstructive score pre- and post-operation was observed P ＜ 0.01, i. e. , 22.7 ±4.9 and 10.5 ± 5.8, 10.5 ± 5.8 and 6.3 ± 3.5, and 12.1± 3.9 and 4.2 ± 3.3, respectively. QOL score was 4.6 ± 0.9 and 2.3 ± 1.3, Qmax (5.8 ± 2.9 ) ml/s and (12.4 ±5.2) ml/s and residual urine volume (99 ± 16) ml and (34 ± 19) ml pre- and post-operation,respectively ( all P ＜ 0.01 ). Follow-up time after the procedure, prostate volume and bladder volume at urgent urination desire all correlated with post-operation IPSS ( r = 0.751, P ＜ 0.05 ), and follow-up time after the procedure and age also significant correlated with post-operation QOL score (r = 0.470, P ＜ 0.05 ).Conclusions Overall IPSS, irritant score, obstructive score and QOL score improved significantly after TURP in symptomatic BPH patients, probably by varied related factors.

Objective To elucidate if detrusor overactivity(DO)has influence on patients with benign prostate hyperplasia.Methods Forty-seven patients who were suspected to suffered from BPH were divided into two groups according to whether have DO in pre-operative urodynamic analysis.There were 22 patients in DO group and 25 in non-DO group.All patients received transurethral resection of prostate (TURP).Pre-operative variables such as relevant clinical data,International Prostate Symptom Score (IPSS),quality of life (QOL) index,maximum urine flow rate(Q~(max)) and pressure-flow study data were recorded.Patients were monitored after operation and the corresponding data were recorded.Results Prostate size in DO group was (77±25)ml,and in non-DO group was (56±27) ml,P=0.02;first desire bladder volume in DO group was (104±36) ml,and in non-DO group was (161±54) ml,P=0.001;urgent desire bladder volume in DO group was (245±73) ml,and in non-DO group was (328±94)ml,P=0.006;pre-operative residual urine in DO group was (71±49)ml,and in non-DO group was (149±125)ml,P=0.015;linPURR obstruction grade in DO group was 4.63±0.95,and in non-DO group was 3.35±1.90,P=0.014.The IPSS and QOL before and after operation had no significant differences between the 2 groups.Conclusions The patients with larger prostates and more severe bladder outlet obstruction are more likely to have DO.Patients with DO had smaller bladder volume and residual urine volume before operation.DO has no significant effect on BPH patient's IPSS and QOL.

Objective To evaluate the effects of pulsed ultrasound at different intensities on the healing of standardized contusions in an animal model. Methods Forty-eight 3-month-old, male Sprague-Dawley rats were given experimental contusions of the right gastrocnemius muscle before being divided into four groups randomly ( n =12 in each group): (1) a muscle injury control group (muscle injury without treatment); (2) a muscle injury and pulsed ultrasound (0.25 W/cm2 ) group; (3) a muscle injury and pulsed ultrasound ( 0.5W/cm2 ) group; and (4)a muscle injury and pulsed ultrasound ( 0.75 W/cm2 ) group. Pulsed ultrasound treatment ( frequency 3 mega Hz)was started 24 hours post injury and delivered 5 min daily for 14 days on the injured right hindlimb. At days 4, 7 and 14 after injury, muscle samples were analyzed through hematoxylin-eosin staining and immunohistochemistry for the detection of muscle satellite cells and desmin. Results The average optical density (IOD) of desmin-positive mononucleated cells had increased significantly at days 4, 7 and 14 post injury in the treatment groups compared to the control group, but with no statistically significant difference among the 3 ultrasound treatment groups. Conclusions The pulsed ultrasound treatment played a beneficial role in skeletal muscle regeneration after contusion. There was no significant dose-dependent effect over the intensity range of 0.25-0.75 W/cm2.

Objective To explore the distribution and drug resistance of pathogens isolated from patients with cholesteatoma otitis media so as to provide guidance for clinical use of antibiotics.Methods This survey analyzed the spectrum of organisms causing cholesteatoma otitis media and their sensitivities to commonly antimicrobial agents from Hebei province eye hospital in 2014.Results There was 86 positive speciments were cultured from 89 samples,the positive rate was 96.6％.A total of 90 strains of pathogens have been isolated,including 52 strains of gram-positive coccus (57.8％),35 strains of gram-negative bacilli (38.9％),3 strains of gram-positive bacilli (3.3 ％),and 0 strain of fungi.Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus chromogenes ranked the top three species of pathogens,accounting for 20.0％,16.7％,and 12.2％,respectively.The gram-positive cocci were susceptible to vancomycin,rifampicin and amikacin,and showed higher drug-resistancerate to penicillin,amoxicillin and azithromycin.When applied to gram-negative bacilli,the drugs with best resistance were penicillin and cefazolin,and the drugs with the highest sensitivity were levofloxacin and pipercillin/ sulbactam.Conclusion Staphylococcus is the predominant pathogens of cholesteatoma otitis media in hospital,and the bacteria have a high antibiotic resistance.Enhanced monitoring on pathogenic bacteria distribution and drug resistance analysis of cholesteatoma otitis media could benefitthe guide of clinical rational use of antimicrobial agents.

Summary: Structural nasal obstruction（SNO） is a series of diseases caused by congenital or acquired structural anatomical abnormalities of nasal airway and its surrounding tissues, which leads to increased nasal ventilation resistance. The effect of medication drugs for SNO is poor and surgical intervention is often needed. However, the abnormal structure of nasal airway is very complex, including the periphery of nasal airway, internal nasal airway, the front and rear of nasal airway and complex factors. These abnormal structures may interfere with the nasal airflow mechanics by changing the nasal ventilation volume and disrupting the symmetry of the bilateral nasal cavity, and finally lead to subjective feeling of nasal obstruction. In addition, the structure of nasal airway has plasticity. After the abnormal structure appears, the corresponding compensation of nasal airway can occur to ensure normal nasal ventilation and bilateral nasal cavity symmetry. Therefore, the SNO is the result of the failure of nasal airway remodeling after the appearance of abnormal structures. The etiology of SNO is complex, involving original structural abnormalities, nasal symmetry changing and nasal airway structure remodeling. Therefore, accurate identification of the main factors leading to SNO is the vitalpremise of making personalized nasal ventilation surgery.

Objective To study the changes of the symptoms and quality of life (QOL) in patients after the Transvaginal tape-obturator (TVT-O) treatment and weather would this treatment lead to bladder outlet obstruction (BOO) and bladder function change. Methods A total of 82 stress urinary incontinence (SUI) women who had underwent TVT-O were included, age from 39-82 years, 3-60 months after operation. All patients were divided into 5 groups by the time post-operation. The ICI-Q-SF scores were collected to study the change of the symptoms and QOL of each group perioperation. Qmax, PVR, bladder weight, wall thickness of each group were collected to study whether would TVT-O lead to BOO and bladder function change. Results Forty-five (55%) patients were cured and 33(40 %) improved after TVT-O. Total cure rate was 95 %. There was a significant improvement of average symptom and QOL in all of the 5 groups (3-month, 6-month, 1-year, 2-year, above-2-year) (P＜0. 05). Qmax changed from (32. 17±10.74), (25.64±6.05), (25.68±11.36), (25.70±10. 28), (25.29±15. 10)ml/s pre-operation to (28.30±15.21), (25.64±10. 48), (24. 49±7.96),(25.43±11.92), (25. 92± 10. 17)ml/s post-operation in 5 groups(P＞0. 05). PVR changed from (0.04±0.20), (0. 00±0.00), (0. 17±0. 39), (2.70±6.01), (1. 96±5.10)ml pre-operation to (1. 79±6.16), (0.00±0.00), (12. 50±29.89), (5.00±15. 54), (33. 70±92.10)ml post-operation in 5 groups(P＞0.05). The bladder weight changed from (43. 62±7.81), (41. 57±8. 63), (46.11±8.12), (42. 50±3. 85), (44. 52±4. 38)g pre-operation to (45. 62±5.32), (47.21±5. 47),(44.89±4. 65), (45. 14±4. 13), (46. 70±5.84)g post-operation, which differed significantly in 6-month, 2-year, above-2-year groups (P＜0. 05). The bladder wall thickness changed from (2.23±0.51), (2.22±0.47), (2.04±0.38), (2. 19±0. 43), (2. 19±0. 38)mm pre-operation to (2.25±0. 40), (2. 18±0.47), (2. 07±0.47), (2.22±0. 47), (2. 20±0. 44)mm post-operation(P＞0. 05).Conclusions TVT-O has a high cure rate for SUI and there was a significant improvement of average symptom and QOL of all patients after the treatment. But TVT-O may lead to BOO and bladder function change since bladder weight increases significantly in some patients.

Objective To study the influence of overactive bladder (OAB) on the symptoms and quality of life (QoL) in patients after Transvaginal Tape-Obturator (TVT-O) treatment for stress urinary incontinence (SUI).Methods Eighty-two SUI women underwent TVT-O were included in this study.The perioperative ICI-Q-SF scores,including frequency of leakage,volume of leakage,and QOL scores,were collected to study the perioperative OAB prevalence and the influence of OAB on the improvement on the symptoms and QOL after TVT-O.Results The total efficacy of TVT-O was 95%.The average symptom and QOL scores in all patients decrease from (8.17±2.29)and (7.95±2.16)to (1.84±2.34)and(1.32±2.24)after TVT-O,P＜0.05.The prevalence of OAB decreased from 46% to 24% after TVT-O,P＜0.05.The average post-operation symptom and QOL scores of the pre-operation non-OAB group were (1.09±1.60)and(0.82±1.45),while those of the OAB group were (2.71±2.75) and (1.89±2.82),P＜0.05.The average post-operation symptom and QOL scores of the post-operation non-OAB group were (1.06±1.68) and (0.56±1.15),while those of the OAB group were (4.25±2.49) and (3.65±3.10),P＜0.05.Conclusions TVT-O is effective for female stress urinary incontinence and contributes to the significant improvement of symptoms and QOL in patients with OAB.The treatment will not raise the prevalence of OAB in itself.

Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was (11.5±3.6) ml/s,and the mean maximal detrusor pressure was (39.1±17.8) cmH2O.Combining with the voiding radiography,19 patients were diagnosed as bladder neck obstruction,and the other 2 were diagnosed as urethral stricture.All patients were accepted the hydrodistension under the epidural anesthesia.The bladder biopsy was performed if the typical glomerulations were observed under the cystoscopy.Bladder neck incision and urethral dilatation were performed on these patients respectively.Symptom changes of bladder pain were recorded by using O'Leary-Sant scale,the pain,urgency,frequency symptom (PUF) scale and quality of Life (QOL) Scale.The data were collected within 48 months postoperation,respectively.Results The pathological findings of bladder mucosa biopsy showed acute or chronic inflammation in all patients.The mean follow-up was 6.7±5.9 months.We compared the corresponding data such as:voiding times per day,nocturnal frequency,O'Leary Sant scores,PUF and QOL between pre and post-treatment.Significant differences were observed during all corresponding data (P＜0.05).The voiding times per day changed from 24.3± 11.8 to 13.0±5.9.The nocturnal frequency decreased from 6.5±2.7 to 3.3± 1.6.O'Leary Sant scores changed from 24.6±7.3 to 14.7±7.4.The PUF scores changed from 22.9±6.2 to 12.0± 7.1.And the QOL scores changed from 5.0±0.8 to 2.9±1.5.Conclusions Free urinary flow rate and residual urine combined with VUD are very important in diagnosing female BOO with bladder pain as major symptom.Bladder pain symptoms will be significantly improved after the obstruction was relieved according to VUD results.