Objective To explore the efficacy and safety of artificial urinary sphincter in the treatment of real urinary incontinence. Methods The implantation of AMS 800 sphincter prostheses was conducted on 4 patients with urinary incontinence.The voiding diaries were recorded and urodynamic examinations were done before and after the implantation.The adverse reactions were recorded after the procedure. Results In the 4 cases,the sphincter pump was activated 4 to 6 weeks after the implantation.The urinary incontinence was well controlled and automatic urination was recovered.No infection-related complication leading to failure of the artificial urinary sphincter occurred.Follow-up for 17 to 46 months showed no leakage of urine at daytime or at night. The mean score of quality of life was 1.Urodynamic examination showed satisfactory compliance and stability of the bladder.The urethral pressure profiles (UPPs) being 8.2 to 9.4 kPa (1 kPa=10.20 cmH 2O);and the mean was 8.7 kPa.Three cases had no residual urine,while only 1 case had 60 ml of residual urine.Only 1 patient had to change the control pump due to mechanical failure 27 months after the operation. Conclusions Artificial urinary sphincter implantation is an effective and safe therapy for real urinary incontinence.The proper use of AM 800 and improved technique result in good long-term outcomes.

Objective:To find out the problems still existing in the teaching reform through the investigation and research of eight-year program graduates of clinical medicine.Methods:In 2017, 118 questionnaires were issued to Batch 2005-2006 graduates of eight-year program in clinical medicine, and 103 valid questionnaires were retrieved. The questionnaire was based on that of the Fuyi Design of the Education Department in Zhongshan Hospital affiliated to Fudan University. The questionnaire was revised on the basis of the pre-survey and the statistical analysis was carried out on the data using Excel 2010.Results:We found that 60.2% of the graduates were satisfied with the training mode of eight-year program, 69.9% of the graduates gave a satisfactory evaluation on the teaching quality in the teaching hospital, and 63.1% of the graduates believed that the curriculum still need partial adjustment.Conclusion:Based on the finding, medical talent training mode is relatively mature in Batch 2005-2006 eight-year program of clinical medicine. The future medical education reform of the eight-year program should be more embodied in innovating the grafting mode of professional medical degree system, strengthening enrollment publicity, adopting diversified enrollment, strictly controlling procedure, carrying out integrated curriculum reform, enhancing clinical teaching design, at the same time further improving teachers' comprehensive quality, and speeding up the construction of clinical teaching staff.

Objective:To demonstrate the feasibility of the osteosarcoma devitalization method by vacuum dehydration at room tem-perature. Methods:For the in vivo study, the VX2 tumor mass was treated by vacuum dehydration, rehydrated in ice water, and im-planted in the rabbit to determine the safety time to deactivate the tumor. For the in vitro study, the osteosarcoma mass was devital-ized by vacuum dehydration, and the dehydration rate and ATPase activity were determined. Histopathological changes in the tumor were also observed. The change in the biomechanical strength of rabbit bone and tendon after vacuum devitalization treatment was detected. Results:At room temperature, the safety time to deactivate the VX2 tumor was 60 min, and the dehydration rate was 93.8%at this time point. After vacuum dehydration, the tumor mass evidently shrunk, presenting a porous structure. The osteosarcoma cell became small, and cell structure damage was observed under light microscope. Disrupted cell membrane and organelles were seen un-der transmission electron microscope as well as broken down chromosomes. The activity of ATPase was evidently lower than in the control group. The strength of bone and tendon did not decrease significantly after vacuum dehydration. Conclusion:Treatment by vacuum dehydration at room temperature for 60 min does not result in differences of the bone and tendon strength. However, it can inactivate both soft tissue and bone tumor mass completely.

Objective To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Sci?ence Foundation of China(NSFC),explore the hotspot and development trend,and offer a reference for researchers in this field. Methods Based on the NSFC database,the projects on the infectious disease epidemiology(H2609)sponsored from 1987 to 2014 were analyzed. The changes of fund numbers,amounts and research fields were described. Results During the study period,NSFC sponsored 373 projects,including 228 general projects(61.1%),78 youth projects(20.9%)and 67 other projects(18.0%). The average amount of the grant was 358.2 thousand Yuan(20 thousand?8 million). The main sponsored re?search fields were mechanisms of pathogen and immunity(36.2%)and population?based epidemiological studies(33.0%). The top three diseases were hepatitis,HIV/AIDS and tuberculosis. Conclusion The amount of funding on researches of infectious disease epidemiology has increased continuously,which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.

Objective To observe attenuated store-operated Ca2+ entry in superior mesenteric artery endothelial cells of aged rat.Methods The pressure myograph was applied to measure the vasodilation of superior mesenteric artery induced by bradykinin (BK) in aged versus non-elder rats.Primarily cultured MAECs were treated by thapsigargin (TG) and BK to deplete intracellular Ca2+ stores for comparing SOCE.SOCE of MAECs was detected by calcium imaging technology and was compared between aged and non-elder rats.The expression levels of Orai 1 and stromal interaction factor 1 (STIM 1) were observed by immunofluorescence method.Results Compared with the nonelder rats (70.0 ± 4.1 ％),BK-induced vasodilation in aged rats (27.0 ± 4.9)％ was declined by (60.7±4.3) ％.SOCE induced by BK and TG in primarily cultured MAECs was attenuated by 37.6％ and 39.2％ in aged rats (1.71±0.18 and 1.06±0.03) respectively as compared with non-elder rats (2.72±0.39 and 1.75±0.06).The expressions of SOCE's components Orai 1 and STIM 1 in MAECs were decreased obviously in aged rats than in non elder rats.Conclusions SOCE of MAECs and SOCE-induced vasodilation are significantly attenuated in aged rats.The decreased expression level of Orai 1 and STIM 1 may contribute to this alteration.

To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.

OBJECTIVE To study the isolation rate,distribution characteristics and antimicrobial resistance of Acinetobacter baumannii infection.METHODS Surveillance data of A.baumannii infection,distribution and resistance rates to 12 kinds of antibiotics in our hospital for 3 years were analyzed.RESULTS During the 3-year infection surveillance,194 strains of A.baumannii were isolated in our hospital.The isolation rate was 7.8% in 2006,though 2.4% in 2004.Eighty strains(41.2%) of A.baumannii were from intensive care unit;95 strains were from over 60-year-old sufferers;compared with 2004 and 2005,the resistance rates of A.baumannii in 2006 to 12 kinds of antibiotics were increasing at different degree.The antibacterial susceptibility to imipenem/meropenem was the highest.CONCLUSIONS The isolation rate of A.baumannii and antimicrobial resistance rate are increasing year by year.The A.baumannii strains shows obvious multiple antibacterial resistance.We must keep monitoring of A.baumannii infection and drug-resistant changes in order to prevent nosocomial infections.

OBJECTIVE To study the clinical species distribution and drug resistance of Enterococcus.METHODS We had collected 201 isolates of Enterococcus by cultured in normal methods in our hospital from July 2005 to June 2008,and analyzed the characteristics of species distribution,drugsensitive test,drug resistance of high concentration aminoglycoside antibiotics and measured the ?-lactamase.RESULTS There are 106 E.faecalis strains(52.7%),76 E.faecium strains(37.8%) and 19 the other Enterococcus strains(9.5%).There were 102 Enerococcus strains separated from urine and 46 separated from sputamentum.The drug resistance rate of Enterococcus faecalis to erythromycin,tetracycline,rifampin and ciprofloxacin were more than 75.0% and the resistance rate of E.faecium to penicillin,ampicillin,erythromycin,rifampin,ciprofloxacin and nitrofurantoin were more than 93.0%;the total resistance rate of Enterococcus to vancomycin and teicoplanin were 14.4% and 10.4%,respectively.The number of the isolates resistant to high concentration aminoglycoside antibiotics was 151(75.1%);Enterococcus with positive ?-lactamase were 74(36.8%).CONCLUSIONS The infection in urinary system and respiratory system were mainly caused by E.faecalis and E.faeciumwith multidrug resistance.

Objective To understand the awareness status of knowledge on malaria control among residents and students,so as to evaluate the effectiveness of health education during the elimination phase of malaria in Jinshan District ,Shanghai City. Methods In 2010 and 2014,the stratified sampling and cluster sampling methods were taken to select the investigation sites, including 3 villages,1 middle schools,1 primary school,then the residents above 15 years old and the students in the above se?lected sites were investigated by questionnaires to understand their awareness status on malaria control. Results In 2010,the general awareness rates of malaria control knowledge of the study objects were 74.22%,and those of the residents,middle school students,and primary school students were 75.68%,61.86%and 72.20%,respectively. There was no significant differ?ence between the awareness rates of objects with different gender(χ2=1.755,P>0.05). The rate of the residents was higher than that of the students(χ2=59.838,P<0.01). From 2010 to 2014,a series of health education on malaria control was car?ried out. In 2014,the general awareness rate of knowledge on malaria control was 96.03%,and those of the residents,middle school student,and primary school students were 92.28%,98.59%and 99.49%,respectively. The awareness rate of the stu?dents was higher than that of the residents(χ2=275.794,P<0.01). Conclusion Through the health education and communi?ty advocacy,the awareness rates of knowledge on malaria control among residents and students have improved and met the quali?fication of malaria elimination in Jinshan District.

OBJECTIVE:To improve the level of rational drug use,and to reduce the workload of clinical pharmacists. METH-ODS:Established“Intelligent Management and Solution for Clinical Rational Drug Use”of our hospital was introduced,including post-prescription review(all prescriptions review)system, self-maintenance system for rational drug use knowledge base,pre-pre-scription review (rational drug use real-time review) early warning system. The effects of intelligent system were evaluated. RE-SULTS & CONCLUSIONS:After the application of the system,the following aspects could be achieved,including“all prescrip-tions review”,“multi-prescriptions/longitudinal review”,system knowledge base real-time update and autonomous definition of re-view rules,effective communication and intervention between physicians and pharmacists before printing prescription by Yaozhidao instant messaging system. Through related trial evaluation,the proportion of false positive prescriptions decreased by 17.65% after 4 months of the application of the system;drug consultation prescriptions review average score of outpatient pharmacists increased from 81 to 94.85;the time of prescription review decreased by 4.72-5.46 times. Through mandatory interception of unqualified pre-scriptions,severe warning,timely prompt and pharmacists’intervention,the rate of unqualified prescriptions pre-reviewed by the system in respiration department decreased from 32% in Jan. 2015 and 21% in May to 4.62% in Dec. So,the application of the system promotes rational drug use in outpatient department,reduces the workload of pharmacists and ensures the safety of drug use comprehensively.