Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective:To investigate the health status, health-related behaviors and health needs of elderlies in eastern, central and western China and to understand their health experience, for exploring an efficient medical service model, and optimizing allocation of medical resources.Methods:This study used the 2008-2018 database from Chinese longitudinal healthy longevity survey organized by Peking University. It described the concentration trend of medical distance by median, compared the health status, health-related behaviors and health needs of the elderly in eastern, central and western China by χ2 tests, and analyzed time-distribution trends of the poor health status, negative health behaviors and health needs by linear relation test. Results:Among 49 611 subjects included in the study, 7 881 of them self-evaluated their health status as poor, 19 445 evaluated their recent health status as deteriorated, while 14 954 lack routine physical examination, 35 141 lack physical exercise, 8 178 smoked, 7 859 drunk, 35 814 had no access to health education services in their communities, 35 676 expressed their health education needs, and 2 637 lack adequate medical services. The difference of distribution of health status, health-related behaviors and health needs of the elderly in eastern, central and western China was statistically significant ( P<0.05). The health status, negative health behaviors and health needs of the elderly in 2008-2018 presented a linear time distribution trend( P<0.05), while the overall medical distance in eastern, central and western China was 1.02 km, 1.00 km and 1.56 km respectively, and the medical distance in the rural area further than that in the urban areas. Conclusions:The health status of the elderly in China needed to be further improved, the proportion of negative health behaviors was high, and the health needs of the elderly in central and western China were large. Promoting an active medical service mode in central and western China, strengthening the interactions between medical institutions and residential communities will contribute to health needs fulfillment and medical resource utilization.

Rotator cuff disease and degenerative osteoarthritis are caused by many factors. Several studies had shown that rotator cuff disease was related to lateral extension of the acromion and glenoid inclination. A new parameter, critical shoulder angle (CSA), which is defined as the angle between a line connecting the superior to the inferior margins of the glenoid and a line connecting the inferior margin of the glenoid to the inferolateral edge of the acromion measured on anteroposterior (AP) shoulder radiographs, is proposed to comprehensively reflect the relationship between abnormal anatomical structure and rotator cuff injury. There is a close relationship between CSA and the injury of rotator cuff and the osteoarthritis of glenohumeral joint: the injury of rotator cuff is often accompanied by a larger CSA (> 35 °), and a smaller CSA (< 30 °) is closely related to the occurrence of glenohumeral arthritis. Therefore, CSA is helpful for the diagnosis of rotator cuff injury and glenohumeral osteoarthritis. Correction of abnormal CSA by arthroscopic lateral acromial osteotomy also provides a new idea for the treatment of shoulder diseases. In this paper, we reviewed the research progress of the angle from five aspects: definition, measurement, biomechanical significance, treatment and ethnic differences.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.

This paper reports a case of atypical cholesterol side chain enzyme deficiency caused possibly by CYP11A1p.A359V heterozygous mutation. The patient was diagnosed as congenital adrenal hyperplasia because he was born with gonadal dysplasia and there were manifestations of salt losing and pigment changing, combined with high level of plasma ACTH. Further genetic screening revealed CYP11A1p.A359V heterozygous mutations in patients with a final diagnosis of cholesterol side chain enzyme deficiency which was treated effectively to glucocorticoid.

Objective: To evaluate the elastic modulus of Beagle's periodontal ligament(PDL) by means of nanoindentation, and to help build constitutive model of PDL precisely. Methods: 24 cross sections were obtained from the tooth root of lower first molars of beagle dog. With nanoindentation, intrusion and unloading to PDL sites on different planes of long axial and in different directions on the same plane of tooth root were achieved, and the load-displacement curves were obtained, from which the elastic modulus was calculated and analyzed. Results: The elastic modulus of the beagle's periodontal ligament varied from 0. 452-1. 542 Mpa. There was no significant difference in elastic modulus of the beagle's lower first premolar PDL in relation to different planes of long axial, while significant difference was found in different directions (buccal/lingual sides and mesial/distal sides) on the same plane of tooth root(P＜ 0. 05). Conclusion: There was a difference in the elastic modulus of periodontal ligament in buccal/lingual sides and mesial/distal sides of the same tooth root.

With regard to teaching of gynecology, the integrated medical pattern should be built up and applied, which could help culturing students' ability of active thinking, analyzing and solving clinical problems. To set up the concept of individual-based treatment, we applied the concept of holistic integrated medicine in clinical teaching of gynecology, combing the aspects of teaching, clinic and resources. A reform in teaching content design and teaching mode had been carried out. The results showed that the students are highly satisfied with teaching process, their enthusiasm of learning has been effectively boosted, their clini-cal thinking has been initially cultivated. In a word, this teaching reform has achieved good results in practice.

Objective: To investigate the possibility of heart rate as an optimum index for evaluating physical labor intensity. Methods: From September to October, 2015, a total of 111 male young adults were selected as study subjects. A cycle ergometer was used for exercise at different intensities (20, 40, 60, 80, 100, 120, 140, 160, and 180 W) , and the exercise at each intensity lasted for 6 minutes. The subjects wore the K4b2 portable cardiopulmonary function testing instrument for the real-time monitoring of heart rate (HR) , pulmonary ventilation volume (Ve) , oxygen consumption (VO₂) , and energy metabolic rate (E) . The origin software was used for correlation and regression analyses of HR, Ve, VO₂, and E collected at different intensities to establish Ve-HR, VO₂-HR, and E-HR regression equations. Results: At different intensities, HR was positively correlated with Ve, VO₂, and E (r=0.8985, 0.8733, and 0.8973, all P<0.01) . There was a significant difference in the R² value of Ve-HR, VO₂-HR, and E-HR regression equations (R²=0.8070, 0.7625, and 0.8049, all P <0.01) . The validation results showed that there was no significant difference between the calculated values and the measured ones (P>0.05) . Conclusion HR can replace Ve, VO₂, and E and be used as an optimum index for evaluating physical labor intensity.