Objective To explore the curative effect and nursing of gastrointestinal bleeding of somatostatin combined with omeprazole in the treatment of liver cirrhosis. Methods 40 cases of gastrointestinal bleeding in patients with cirrhosis using somatostatin combined with omeprazole treatment, at the same time using conventional nursing (control group), the other 40 patients used somatostatin combined with omeprazole treatment, and comprehensive nursing (observation group); two group intervention. The patients were in our hospital from March 2015 to January 2017 were treated. Results The effective rate of treatment group was two, obviously higher in the observation group, the observation group was 95.0 ％, the control group was 70.0 ％; the satisfaction rate is obviously higher in patients in the observation group, the observation group total the satisfaction rate was 97.5 ％, the control group was 72.5 ％; comparison shows obvious differences(P<0.05). Conclusion Somatostatin combined with omeprazole in the treatment of liver cirrhosis of digestive tract hemorrhage, the treatment can improve the patient's condition, but also the implementation of comprehensive nursing, is conducive to improve the treatment effect of patients, and improve the satisfaction rate of patients for nursing care, it is worthy of reference.

Objective To observe the effects of bolus volume on pharyngeal and upper esophageal sphincter pressures and durations in healthy volunteers by using high-resolution manometry (HRM).Methods Twentyfour health subjects were recruited and asked to swallow three volumes of bolus (3 ml,5 ml and 10 ml) in the neutral head position.Pressure and duration measurements were acquired by utilizing a high-resolution solid-state manometer,with an emphasis on the hypopharynx and upper esophageal sphincter (UES).Variables including UES residual pressure,UES relaxation duration,maximum hypopharygeal pressure and hypopharyngeal pressure duration were analyzed across bolus volumes and consistencies by using three-way repeated measures analysis of variance (ANOVA) to investigate influence of bolus volume.Results UES residual pressure [-1.71 mmHg(3 ml thick liquid)vs.-4.68 mmHg(10 ml thick liquid)],UES relaxation duration[590.45 ms(3 ml thick liquid) vs.702.49 ms (10 ml thick liquid)],maximum hypopharygeal pressure [169.91 mmHg (3 ml thick liquid) vs.204.42 mmHg (10 ml thick liquid)] and hypopharyngeal pressure duration(P ＜0.05) varied significantly across bolus volumes when swallowing water or thick liquid.The UES relaxation duration,UES residual pressure and maximum hypopharyngeal pressure had a direct positive relationship with bolus volume.There was significant differences with regard to UES relaxation duration [685.75 ms(3 ml paste)vs.772.27 ms (10 ml paste)] but not to UES residual pressure (P ＞ 0.05) and maximum hypopharyngeal pressure (P ＞ 0.05) across bolus volume when swallowing paste.Conclusions Difference in hypopharyngeal pressure and duration,UES residual pressure and duration were detected across varying bolus volumes.Consideration of these variables is paramount in understanding normal and pathological swallowing.

Objective To screen and identify International Classification of Functioning,Disability and Health (ICF) core sets for spasticity and make a dedicated and comprehensive assessment tool for spasticity after stroke.MethodsFifty patients with spasticity after stroke were involved in this study.Information about them was collected by clinical investigation and self-completed questionnaires.The ICF scale was used to assess the severity of each item.Each item's frequency was calculated and those items with frequencies ≥ 30％ were selected as the first ICF core set for spasticity.The ICF check list was designed as a questionnaire and 8 doctors and 5 therapists were consulted.Items with frequency ≥50％ were chosen as the second level ICF core set for spasticity.The two results (termed ICF core sets Ⅰ and Ⅱ) were integrated with the initial ICF core sets for spasticity and sent to 42 experts in the area of neurological rehabilitation.Items with a frequency ≥80％ were chosen as the final ICF core set for spasticity.ResultsA total of 32 ICF items were included in the ICF core set for spasticity after stroke.There were 10body function items,4 body structure items,13 activity and participation items and 5 environmental items involved.ConclusionThe ICF core set for spasticity was identified in this study.The selected items covered content broader than other common spasm assessment scales.The result is a comprehensive description of spasticity.

Objective To test the reliability and validity of the brief International Classification of Functioning, Disability and Health (ICF) core sets for Chinese stroke patients using Rasch model analysis. Methods The body functions of 38 Chinese stroke patients were measured using the brief ICF core sets. The qualifiers of the 20items were measured by two raters and analyzed using FACETS statistical software. The intra-rater reliability and validity were tested by using the separation index and separation reliability and fit analysis. Results The brief ICF core sets had good internal consistency and reliability (person separation index = 6.02, person separation reliability = 0.94 ) with these Chinese patients. The raters showed significantly different strictness in rating, but their ratings had good internal self-consistency. The construct validity was good for the body functions of the ICF component ( separation index = 10.50, separation reliability = 0.80) , but misfitting and overfitting were found in items b117, b152and b755. Conclusion The body function of the brief ICF core sets has good reliability and validity for Chinese stroke patients. A many-facet Rasch measurement model can provide comprehensive information and has good application prospects for testing the reliability and validity of ICF core sets.

Objective To explore the characteristics of calf muscle movement of the normal volunteer in vivo by velocity encoded phase contrast MRI (VE-PC MRI ).MethodsTwenty four healthy subjects were divided into the young group (30-40 years) and the elderly group (60—78 years).All subjects were positioned on the scanner table and did ankles flexion-extension voluntary movement,the moving images of tibialis anterior muscles (TA),medial gastrocnemius (MG) and soleus muscle (SOL)on the left were scanned with VE-PC MRI.The calf muscles contraction velocity were analyzed by software.The Mann-Whitney U test was used for comparison of calf muscles contraction velocity in vivo between the young group and the elderly group. Results During cyclic ankle flexion-extension,dorsiflexion phase (1—10 phases)in the two groups,TA showed concentric contraction,plantar flexion phase (11—20 phases),MG and SOL did concentric contraction. At 3-6 phases during dorsiflexion,velocity of TA (M value:-37.66,-53.00, -60.66, -56.00 mm/s) in the young group is higher than in the elderly group (M-value:- 30.33, - 42.49, - 53.00, - 48.67 mm/s),at 13—15 phases during plantar flexion,velocity of MG (M-value:- 47.66, - 60.00, - 66.33 mm/s) in the young group showed higher velocity than in the elderly group (M-value:-25.17,-37.99,-50.98 mm/s),at 12—14 phases during plantarflexion,SOL showed higher velocity in the young group (M-value:-27.21, -40.10, -49.13 mm/s) than in the elderly group (M-value:- 20.66,- 29.61,- 37.16 mm/s) ( all P ＜ 0.05).Conclusions During active ankle cyclic flexion-extension movement,velocity of TA,MG and SOL in the elderly group are decreased as compared to the young group. VE-PC MRI can reflect biomechanical characteristics of calf muscle in vivo,and provide a new kind of measurement for lower extremities.

Objective To assess the effects of rehabilitation training on lower extremity muscle function in stroke patients using velocity-encoded phase-contrast MRI ( VE-PC MRI). Methods Twenty-nine stroke patients at the convalescence stage were divided into a treatment group (14 cases) and a control group (13 cases).The subjects performed calf muscles stretches supine in a scanner bed with voluntary ankle flexion-extension movements.Imaging data were collected from the tibialis anterior muscle (TA),the medial head of the gastrocnemius (MG) and the soleus muscle (SOL) of the affected side.The treatment group also underwent rehabilitation including treadmill training,while the control group received only walking training without the treadmill.Barthel index (BI) and Berg balance scale (BBS) scores were measured after rehabilitation. Results Compared with baseline,the contraction velocity of the TA (phases 2 to 7),the MG (phases 12 to 18 ) and the SOL (phases 13 to 16) on the affected side increased significantly in the treatment group.In the control group,the contraction velocity of the calf muscles on the affected side improved,but fewer phases were significant-for the TA phase 4,for the MG phases 13 to 15 and for the SOL phase 15.In both groups,BBS and BI scores improved significantly compared with baseline.The average improvement in the treatment group was significantly greater than that in the control group. Conclusions Rehabilitation including treadmill training can improve calf muscle contraction function on stroke patients' affected side,and also their ADL performance and balance.VE-PC MR1 can provide quantitative in vivo measurements of the contraction function of stroke patients' calf muscles.

Objective To investigate the minimal invasive management of cystitis glandularis with invasion of the ureteric meatus.Methods The clinical data of 18 cases were reviewed.Among the 18 cystitis glandularis patients,12 cases were invasion of bilateral ureteric meatus and 6 of unilateral ureteric meatus.Operation or drug treatment was performed on the diseases that can cause cystitis glandularis such as bladder stone,bladder neck stegnosis,external urethral meatus stegnosis and benign prostate hyperplasia.Sensitive antibiotic was administrated in all cases.After placing ureter catheter,transurethral plasma electro-resection was carried out in five patients whose ureteric meatus could be identified.In addition,of thirteen patients with ureteral orifice unable to be identified,there were ten cases with normal renal function,mitomycin was injected under affected membrana mucosa,and then the patient with ureteral orifice identified underwent transurethral plasma electro-resection after placing ureter catheter.On the other hand,the patient whose ureteral orifice still could not be recognized undertaken transurethral electro-resection at first,during which the ureter catheter was put once ureteral orifice had been detected,otherwise,the ureter catheter should be placed through cystoscope if nephritic colic emerged and hydronephrosis aggravated after operation.In those patients with kidney dysfunction,the ureter catheter was put by ureter discission or ureter replantation at first,the transurethral electro-resection could not be executed until the renal function recovered.Following all these procedure above,bladder instillation of drugs regularly,anti-infection and symptomatic treatment were administrated.Results One patient combined with bladder adenocarcinoma received cystectomy,of the other patients,six cases recurred and underwent electrotomy again resulting in no relapse.All nephrohydrops vanished or relieved obviously,nevertheless,urinary tract infection,haematuria and bladder-ureter backstreaming as the cardinal complication developed in some cases.Conclusion In the management of cystitis glandularis encroaching ureteric meatus,total or partial cystectomy can be avoided if ureter draining freely can be ensured,motivation removal,antiinfection,injection of drug under mucosa and preoperative diuresis conduce to the achievement of ureter catheter placing,transurethral plasma electro-resection is still effective methods in treating these cystitis glandularis.

Objective To evaluate the swallowing function of patients with dysphagia after brainstem injury using manofluorography (MFG),analyzing the abnormal biomechanical and kinematic parameters as well as any correlation between changes in the pharynx and the upper esophageal sphincter (UES) measured manometrically and changes in the kinematics of the hyoid bone.Methods Thirteen patients with dysphagia after brainstem injury (the patient group) and 13 healthy participants (the control group) underwent manofluorography.Kinematics and biomechanical changes during swallowing were compared between the two groups and the correlations between the observations were analyzed.Results The patient group showed significantly lower maximum pressure and rate of pressure change at the base of the tongue and in the hypopharynx,as well as less hyoid anterior displacement,smaller and briefer UES opening,but significantly higher minimum pressure at UES relaxation.The duration of tongue root elevation and hypopharynx pressure was also shorter than in the control group,on average.There was a negative correlation between hyoid anterior displacement and the minimum pressure on UES relaxation in the control group,and a positive correlation between hyoid anterior displacement and the maximum pressure at the base of the tongue and in the hypopharynx in the patient group.Conclusions The concurrent use of manometry and video-fluorography for evaluating dysphagia can be an objective and effective diagnostic tool for the comprehensive evaluation of swallowing function.

Objective To study the influence of post-void residual volume on prostate specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH).Methods One hundred and sixty BPH patients who diagnosed by postoperative pathologic manifestations were selected.The patients were divided into 4 groups according to post-void residual volume with 40 cases each:non post-void residual volume (post-void residual volume ＜ 60 ml) group,less post-void residual volume (60 ml≤post-void residual volume ＜ 120 ml) group,middle post-void residual volume (120 ml ≤post-void residual volume ＜ 180 ml) group,mass post-void residual volume (post-void residual volume ≥180 ml) group.The serum PSA levels of 4 groups were observed.Results The PSA level in mass post-void residual volume group [(8.52 ± 6.72) iμ g/L] was significantly higher than that in non post-void residual volume group [(5.26 ± 4.16) μ g/L] and less post-void residual volume group [(5.93 ± 5.20) μ g/L],there were statistical differences (P ＜ 0.05),there was no statistical difference between non post-void residual volume group and less post-void residual volume group (P ＞ 0.05).Conclusions The serum PSA level in BPH patients with non post-void residual volume has no change,while the serum PSA level in BPH patients with mass post-void residual volume is significantly elevated.

Objective To investigate the clinical effect of elastics drawing off balloon catheter for 24 hours on preventing bleeding after transurethral plasmakinetic resection of prostate (TUPKRP).Methods Seven hundred patients with benign prostatic hyperplasia (BPH) underwent TUPKRP in the Eighth People's Hospital of Shanghai from Jan.2005 to Jun.2013 were randomly divided into control group (298 cases) and experiment group (402 cases).Patients in control group after transurethral resection of the bladder were given treatment as follow:the bladder was placed with F22 cavity catheter,which were fixed on the medial femoral traction;prostate wound edge was pressed for 2-3 d and saline continuous irrigated bladder for avoiding infection.Patients in experiment group were given the same treatment with control group beside prostate wound pressed for 24 h.The days (1st,3rd,5th) of bleeding after operation,cases of hematuria turn clear,cases of postoperative blood transfusion and operation bleeding were recorded.Results Cases of hematuria disappeared postoperation at 1 st,3rd,5th days after operation were 52,42,24 cases in control group and 34,22,10 cases in experiment group.The differences were significant(x2 =6.608,9.279,7.624 ;P =0.010,0.002,0.006).Cases of blood transfusion and reoperation in experiment group were 6 and 2 cases,lower than that in control group(15,9 cases ; x2 =4.955,5.264 ; P =0.026,0.022).Conclusion The method of elastics drawing off balloon catheter for 24 hours improved the effect of preventing bleeding after TUPKRP.