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Abstract@#Female stress urinary incontinence (SUI) is a major global public health problem, and its involuntary urinary leakage may seriously affect patients' quality of life. The pathophysiological changes in muscle, connective and nerve tissues induced by diabetes have been found to be strongly correlated with the development and progression of SUI. This review summarizes the association between diabetes and SUI in women and the underlying pathophysiological mechanisms, so as to provide insights into prevention of SUI among female patients with diabetes.
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Objective:To investigate the multi-sites high frequency ultrasound features of rectus diastasis (RD) in early postpartum women and their relationships with different delivery modes.Methods:Total of 571 primiparas who gave birth in the Obstetrics and Gynecology Hospital Affiliated to Zhejiang University Medical College from March to May 2020 and underwent 6-week postpartum examination were chosen, they were divided into vaginal delivery group (336 cases) and the cesarean section group (235 cases). The inter-rectus distance(IRD) of five loci (umbilical on 4.5 cm, umbilical on 3 cm, umbilical edge, edge of umbilical, umbilical down 3 cm) at resting state and two loci (umbilical edge, edge of umbilical) at curling state as well as the rectus thickness on the right side of umbilical level were observed by high frequency ultrasound. The impacts of the two delivery modes on IRD at each site and the changes of IRD under the two conditions were analyzed. Spearman correlation analysis was used to evaluate the correlation between the thickness of rectus abdominis and IRD at each site.Results:The incidence of early postpartum RD was 79.7% (455/571), most of which occurring at 3 cm above the umbilicus and the umbilicus levels. At resting state, the IRDs at the 5 loci of vaginal delivery group were (1.62±0.79)cm, (2.03±0.84)cm, (2.65±0.94)cm, (2.09±0.93)cm, and 0.54(0.00, 1.13)cm respectively, while the IRDs at 5 loci of the cesarean section group were (1.75±0.85)cm, (2.26±0.99)cm, (2.99±1.14)cm, (2.57±1.21)cm, and 1.00(0.41, 1.59)cm, with statistical differences at all the levels between groups ( P<0.05). Under the curling state, the IRDs at the 2 loci of vaginal delivery group were (2.10±0.84)cm and (1.66±0.86)cm respectively, while the IRDs at the 2 loci of cesarean section group were (2.28±0.87)cm and (1.91±0.87)cm, with statistical differences between groups( P<0.05). The incidences of increased IRD when compared between resting and curling states at the upper and lower umbilicus in the vaginal delivery group were 16.1% and 26.5%, with 17.4% and 20.4% in the cesarean section group. At the resting state, there was a significant difference in the thickness of rectus abdominis between the vaginal delivery and cesarean section groups [(0.74±0.12)cm vs (0.67±0.12)cm, P<0.05]. At the curling state, the difference between two groups was statistically significant [(1.11±0.23)cm vs (0.99±0.22)cm, P<0.05]. The thickness of rectus abdominis was negatively correlated with IRD(all the 5 loci at resting state, rs=-0.116, -0.140, -0.185, -0.143, -0.144, all P<0.01; and the upper umbilical loci at curling state, rs=-0.091, P<0.05). There was no significant correlation between the thickness of rectus abdominis and IRD at the lower umbilical edge at the curling state ( P>0.05). Conclusions:High frequency ultrasound can evaluate the morphological characteristics of the abdominal rectus muscle in early postpartum stage. Compared with vaginal delivery, rectus abdominis thickness, the IRD is larger in cesarean section primiparas, but less affected by the curling state.
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Objective To strengthen human genetic resource management in clinical trials.Methods This article analyzes the common problems in the process of reviewing human genetic resources application by the drug clinical trial institute in our hospital,and proposes solutions for solving the problems.Results Common questions are also the key points for future review of human genetic resources applications,including the collection of sample and consistency with clinical trial plan,ethical review and informed consent,intellectual property rights etc.Conclusions Strictly reviewing applications of human genetic resources,as well as strengthen the management of human genetic resources in clinical trials,are not only make traceability of human genetic resources traceable,but also have important significance for the authenticity and scientific validity of trial results.
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Objective The funding management of drug clinical trials is one of the most important step in the management of clinical trials.Strengthening the management of clinical trial funds can improve the efficiency of fund utilization and ensure the smooth implementation of clinical trials.Methods This paper summarizes the problems of clinical trial fund management,proposes some main strategies for fund management based on root cause analysis.Results Through the establishment and improvement of the drug clinical trial fund management system in our hospital,the management of funds is strengthened,the trial carry out more smoothly and the result is more accurate.Conclusions Improving the management system of drug clinical trial funds and standardizing the management of clinical trials is of great significance to ensure the quality of clinical trials.Also it will improve the clinical trial management level of our hospital.
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Objective To compare Vecchietti′s and Davydov′s laparoscopic techniques for vagino-plasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Methods From January 2010 to December 2013, 13 patients underwent the Vecchietti′s laparoscopic procedure (Vecchietti group), and 15 patients underwent the Davydov′s laparoscopic procedure (Davydov group). Intraoperative parameters and postoperative results were compared. Results Both of the two groups were successfully treated. The neovagina in both groups were wide with good elasticity, softness and smoothness. The operation time [(39± 7) versus (73 ± 11) minutes], the intraoperative blood loss [(21 ± 6) versus (63 ± 10) ml], the anal exsufflation time after surgery [(19 ± 5) versus (28 ± 6) hours] and the recovery period of body temperature after surgery [(35 ± 10) versus (46 ± 10) hours] of the Vecchietti group were less than those of the Davydov group (all P0.05]. No intraoperative complication occurred. After surgery, 2 patients were found vaginal polyps and 8 patients were suffered from pain in the Davydov group, while all patients were suffered from pain in the Vecchietti group. Conclusions Both Vecchietti′s and Davydov′s laparoscopic techniques are simple, safe and effective surgical methods for vaginal reconstruction. In contrast, the Vecchietti′s procedure is more time efficient and minimally invasive, while the Davydov′s procedure can get less pain, longer vagina and higher sexual satisfaction.
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Objective To observe the effect of therapeutics of invigorating spleen and kidney, removing blood stasis and clearing away turbidness on lipid metabolism and renal function in patients with chronic renal failure (CRF). Methods Fifty-eight patients with CRF were randomly divided into the treated group (30 cases) and the control group (28 cases). Both groups were treated with low-protein diets, controlling hypertension and symptomatic treatment. And Chinese drugs for invigorating spleen and kidney, removing blood stasis and clearing away turbidness were given additionally to the treated group. The curative effect, renal function and lipid metabolism were observed after two months. Results TC, TG and APOB in the treated group lowered significantly, HDL-C and APOAⅠraised significantly after treatment (P0.05). The total effective rate and the improvement of renal function in the treated group were better than those in the control group (P
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Objective:To explore the regulation of Recipe Xiaoban No.1 on the expression of p53 in dystrophy of vulva.Methods:Expression of p53 was determined by immunohistochemical technique in skin lesion of prior treatment and posttreatment from 30 cases with chronic vulvar dystrophy,and normal skin from 23 health adults were served as controls.Results: Expression of p53 in various of chronic dystrophy of vulva before treatment was obviously higher than control group(P0.05).Conclusion:Recipe Xiaoban No.1 can obviously improve the clinical symptoms and decrease the expression rate of P53.