Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).MethodsThe clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.ResultsThe bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).ConclusionsThe clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.

ObjectiveTo explore the clinical application of video-assisted mini-thoracotomy lobectomy for radical resection of lung cancer.MethodsThirty-five patients with lung cancer treated with video-assisted mini-thoracotomy lobectomy as experiment group,40 patients with lung cancer treated with open thoracic operation as control group.The length of incision,operation time,lymph node number,peri-operative bleeding,drainage time,postoperative analgesia time,length of hospital stay were observed and compared between two groups.ResultsThe length of incision,operation time,lymph node number,peri-operative bleeding,drainage time,postoperative analgesia time,length of hospital stay were(5.8 ± 1.5) cm,( 146.5 ± 26.4) min,7.8 ± 0.6,(257.5 ± 79.5) ml,(3.2 ± 0.6) d,(2.0 ± 0.4) d,(9.5 ± 2.6) d in experiment group,and (28.7 ± 3.1 ) cm,( 142.3 ± 28.6) min,8.2 ± 0.7,(495.3 ± 97.6) ml,(5.7 ± 1.0) d,(3.6 ± 0.8) d,(16.3 ± 2.7) d in control group.There was no significant difference in the operation time,lymph node number between two groups(P ＞ 0.05).There were significant differences in the length of incision,peri-operative bleeding,drainage time,postoperative analgesia time,length of hospital stay between two groups (P ＜ 0.01 or ＜ 0.05).ConclusionsThe radical resection of lung cancer under video-assisted mini-thoracotomy lobectomy is safe,effective,microinvasive.It can achieve the better efficacy under the similar operation time as open thoracic operation,thus it is worthy of being widely used in the clinic and promotion.

ObjectiveTo investigate the risk factors of early postoperative complications after pancreaticoduodenectomy.MethodsThe clinical data of 159 patients undergoing pancreaticoduodenectomy from March 2005 to October 2010 was analyzed retrospectively.The related factors of early postoperative complications were analyzed.ResultsThe incidence rate of early postoperative complications was 30.8％ (49/159).Univariate analysis showed that preoperative fasting blood glucose level,total serum bilirubin level,serum albumin level,high density lipoproteins level and intraoperative bleeding were closely correlated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＜ 0.05),but gender,age,preoperative jaundice,history of diabetes mellitus,operation time and whether portal vein reconstruction were no significantly associated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＞ 0.05).Multivariate analysis showed that preoperative fasting blood glucose level( ≥6.1 mmol/L),total serum bilirubin level ( ≥ 171 μ mol/L) and serum albumin level( ＜ 35 g/L) were the important independent risk factors of early postoperative complications in patients undergoing pancreaticoduodenectomy.ConclusionThe risk factors of pancreaticoduodenectomy should be fully recognized and dealt with promptly.

ObjectiveTo analyze the changes of imaging and the efficacy of sympathetic cervical spondylosis before and after treatment and discuss the correlation of them.Methods Seventy-one sympathetic cervical spondylosis inpatients who examined by X-ray,CT,transcranial Doppler (TCD) or color Doppler flow imaging(CDFI) were collected.After comprehensive treatment,the efficacy was evaluated according to the recovery of patients' symptoms,and the cases with imaging abnormalities were examined again.Then the correlation between the changes of imaging and the efficacy was analyzed.ResultsAfter treatment,all 71 cases,including 45 cases with excellent efficacy,18 cases with good effect and 8 cases turned effective,showed a fine rate 88.7％ (63/71) and an effective rate 100.0％ (71/71).The rechecked imaging results showed:in 36 lantoaxial subluxation cases by CT scanning,26 cases turned to be normal,6 cases were improved and 4 cases had finally no change; in 68 cases with abnormal X-ray imaging,67 cases were improved and 1 case had finally no change; in 38 cases with abnormal TCD results,24 cases turned to be normal,2 cases were improved,10 cases showed changes and 2 cases had finally no change;in 36 cases with abnormal cervical CDFI results,9 cases turned to be normal,10 cases were improved,15 cases showed changes and 2 cases had finally no change.The analysis of correlation between the changes of imaging and the efficacy showed:changes count by the value 0,r =0.388,t =3.500,P＜ 0.01 ; changes count by the value 0.5,t =0.361,t =3.211,P ＜0.01.ConclusionsThe efficacy of sympathetic cervicalspondylosis has positive correlation with the changes of imaging and the causes of this disease are complex.So complete and well inspection can help the syndrome differentiation treatment and confirm the efficacy.

ObjectiveTo evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.MethodsThe clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).ResultsAll the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score(KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.ConclusionsThe intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up.

ObjectiveTo study the changes of related hormone levels using hormone replacement therapy in patients with perimenopausal syndrome,and its clinical significance.Methods Eighty-five patients with perimenopausal syndrome received continuous sequential estrogen and progesterone treatment.Daily oral conjugated estrogen 0.625 mg,28 days as one cycle.In each cycle the 19-28th d combined with medroxyprogesterone acetate 4 mg,once a day,a total of 3 cycles.Observed the changes of hormone levels before and after treatment.ResultsThe levels of estradiol and progesterone were obviously increased after treatment compared with those before treatment [ (83.6 ± 1.9) ng/L vs.(10.0 ± 1.1 ) rng/L,(0.32 ± 0.10)μ g/L vs.(0.22 ± 0.20) μ g/L,P ＜ 0.05 ],and follicles stimulating hormone,luteinizing hormone,total cholesterol and triglyceride were obviously decreased [ (40.8 ± 11.0) U/L vs. (57.1 ± 10.8) U/L, (24.9 ±13.6) U/L vs.(46.2 ± 13.8) U/L,(4.6 ±0.9) mmol/L vs.(6.1 ± 1.0) mmol/L,(1.1 ±0.2) mmol/L vs.( 1.6 ± 0.1 ) mmol/L,P ＜ 0.05 ].Body mass index was no obviously different[ (23.9 ± 1.9) kg/m2 vs.(22.5 ± 2.2)kg/m2,P ＞ 0.05 ].ConclusionApplication of hormone replacement in treatment of perimenopausal syndrome is safe.

Objective To analyze the correlation between serum antinucleosome antibody (AnuA) and renal pathological characteristic,disease activity as well as some laboratory tests in patients with lupus nephritis (LN).Methods Serum AnuA levels were detected by enzyme-linked immunosorbant assay in 40 patients with LN (observation group) and 40 healthy people (control group).Renal biopsy was examined in all LN patients.The relationships between serum AnuA level and systemic lupus erythematosus disease activity index (SLEDAI),renal pathohistology,laboratory parameters were analyzed.Results The serum AnuA level in observation group before treatment was significantly higher than that in control group [ ( 110.23 ± 80.48) kU/L vs. ( 10.45 ± 8.20) kU/L,P ＜ 0.05 ].Four cases of renal biopsies were class Ⅱ,8 cases were class m,23 cases were class Ⅳ,and 5 cases were class V.Serum AnuA level had significant difference between each class by Kruskal-Wallis rank sum test (P ＜ 0.05),and serum AnuA level of class Ⅳ was the highest (P ＜ 0.05).Serum AnuA level had positive correlation with SLEDAI,urine protein quantitation and anti-double strands DNA antibody (r =0.462,0.521,0.394,P ＜0.05),negative correlation with complement C3 and C4 levels (r =-0.403,-0.489,P ＜ 0.05 ).Serum AnuA level after treatment [ (32.45 ± 18.31) kU/L] was significantly decreased than that before treatment [(110.23 ± 80.48) kU/L](P＜0.05).Conclusions Serum AnuA level is not only a good index of LN activity,but also reflect renal involvement.That serial measurement of serum AnuA level may provide better clinical strategies for the therapy.

Objective To explore the changes of placental growth factor (PLGF) in patients with acute coronary syndrome (ACS).Methods One hundred and twelve patients were divided into four groups according to clinical data and coronary angiography:non-coronary artery disease (non-CAD) group (27 cases),stable angina (SA) group (28 cases ),unstable angina (UA) group (29 cases) and acute myocardial infarction (AMI) group (28 cases).Fifty-seven patients with ACS were divided into single lesion group (19 cases),twice lesion group ( 16 cases) and triple lesion group (22 cases) by coronary angiography,and 0-7 scores group (23 cases),8-15 scores group (27 cases) and 16-32 scores group (7 cases) by Jenkins scores.The serum PLGF levels of all the cases were determined on admission.The serum PLGF levels of 40 cases receiving percutaneous coronary intervention (PCI) were determined at 30 min before operation,the first and second day after operation.Results The serum PLGF levels of AMI group and UA group were (38.33 ±10.14) ng/L and (37.44 ± 13.32) ng/L respectively,which were significant higher than that of SA group [(20.90 ± 3.88) ng/L] and non-CAD group [(20.34 ±4.53) ng/L](P＜ 0.01),and there was no significant difference between AMI group and UA group,SA group and non-CAD group (P ＞0.05).There was no significant difference in the serum PLGF level among triple lesion group,twice lesion group and single lesion group (P ＞ 0.05 ).There was no significant difference in the serum PLGF level among 0-7 scores group,8-15scores group and 16-32 scores group (P ＞ 0.05).The serum PLGF level of patients receiving PCI on the first day after operation [ (32.03 ± 7.41 ) ng/L] was significantly higher than that before operation [ (23.86 ± 6.91 ) ng/L](P＜ 0.05 ),and on the second day after operation the serum PLGF level [ (29.37 ± 6.99) ng/L] was less than that on the first day after operation,showing a fall tendency(P＞ 0.05).Pearson correlation analysis showed that the serum PLGF levels in patients with ACS were not related with cardiac troponin T and creatine kinase isozyme-MB (r =-0.158,P=0.421;r =0.302,P=0.118).Conclusion The serum PLGF level of ACS patients is an inflammatory marker reflecting coronary atherosclerotic plaque destabilizing or plaque ruptured,and may also play an important role in early diagnosis of the borderline case of ACS.

Objective To discuss incidence and related risk factors of vascular cognitive impairment (VCI) after acute subcortical infarction (SI).Methods One hundred and eighty-two patients with acute SI were divided into two groups:VCI group (81 cases) and no-VCI group ( 101 cases) according to VCI diagnostic standard.Sex proportion,age,culture degree between two groups were compared,and correlation was analyzed between the quantity of risk factors and the incidence of VCI.Results The incidence of VCI after acute SI was 44.5％(81/182).According to age stratification,the incidence of VCI in the patients of 56-65 years was 35.4％ (23/65),in the patients of 66-75 years was 45.3％ (48/106),and in the patients of 76-85 years was 90.9％ (10/11 ).The age in VCI group was significantly higher than that in no-VCI group [(69.93 ±6.91) years vs. (67.62 ±5.56) years,P =0.014],and culture degree was significantly lower than that in no-VCI group (P =0.028).The sex proportion between two groups had no significant difference (P =0.876).The more accompanying risk factors,the higher incidence of VCI.Conclusions Along with the increase of age,the incidence of VCI after acute SI is higher.The more accompanying risk factors,the higher incidence of VCI.

ObjectiveTo investigate the risk factors and pathogenic characteristics of catheterrelated infection (CRI) in intensive care unit (ICU),so as to find a better way for its treatment.Methods Retrospective analysis was performed on 247 deep-venous catheter (DVC) from January 2007 to December 2010.ResultsAmong 247 patients,positive results of 41 patients diagnosed CRI,negative results of 206 patients undiagnosed CRI.Compared with undiagnosed CRI patients,found the correlation of the underlying infectious diseases,indwelling time of catheter and puncture sites associated with CRI occurred(P ＜ 0.05 ).CRI major pathogen was gram-positive bacteria (58.5％,24/41 ),in which Staphylococcus epidermis was the major pathogenic bacteria(22.0％,9/41).The drug resistance occurred in most pathogen.Conclusions The occurrence of CRI is related with multiple clinical factors.The gram-positive bacteria is the major pathogen.The etiological monitor should be enforced in patients with DVC.