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.

Objective　To investigate the efficacy and safety of endovascular treatment technology in patients with anterior circulation acute ischemic stroke (AIS) with different pathogenesis.Methods　Seventy-seven patients with AIS in our hospital from February 2019 to October 2020 were enrolled,and divided into three groups according to the different pathogenesis,IAD group (intracranial atherosclerotic disease,n=32) and CE group (cardioembolism,n=45).Endovascular therapy was given to patients.Then the clinical efficacy and safety were compared between different treatments.Results　Gender,NIHSS score and primary history showed no significant difference between groups at baseline (P>0.05).The rate of multimodal combined therapy,Utilization rate of angioplasty,the use of antiplatelet drugs during operation,and the time of emergency operation in IAD group were significantly longer than those in CE group (P<0.05).No significant difference was found in final recanalization rate,24-hour NIHSS,good prognosis rate,intracranial hemorrhage,embolism complication rate and 3-month mortality (P>0.05).Conclusion　Application of endovascular treatment technology in patients with anterior circulation AIS with different pathogenesis is an effective and safe treatment method.

Objective To analyze the influence of patients with multiple cerebral infarction complicated with vascular Parkinsonism (VaP) on cognitive function, and to provide a theoretical basis for the diagnosis and treatment of patients with multiple cerebral infarction complicated with VaP. Methods A toatl of 206 patients with multiple cerebral infarction admitted to Ningde municipal hospital of ningde normal university from January 2020 to January 2022 were selected and divided into VaP group (n=58) and control group (n=148) according to whether they were complicated with VaP. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of patients. The scale included 8 cognitive domains including attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation and orientation. Pearson was used to analyze the correlation between VaP and MoCA score in patients with multiple cerebral infarction. Age, sex, years of education, white matter disease, diabetes mellitus, coronary heart disease and other vascular risk factors were compared between the two groups. The independent risk factors for VaP in multiple cerebral infarction were analyzed by multiple linear regression. Results MoCA score in VaP group was significantly lower than that in control group (P<0.05). In terms of each item, scores of attention and concentration, memory, language and computation in VaP group were significantly lower than those in control group (P<0.05). Pearson correlation analysis showed that attention and concentration, memory, language and computational scores were correlated with VaP in patients with multiple cerebral infarction (r=-0.475, -0.314 , -0.302 , -0.389, P<0.05). There were statistically significant differences between the two groups in white matter lesions, lesion sites in left hemisphere and frontal lobe, diabetes mellitus and carotid artery plaque (P<0.05).White matter lesions (OR=2.571), diabetes mellitus (OR=2.369) and lesion location in the left hemisphere (OR=2.958) were independent risk factors for VaP in patients with multiple cerebral infarction (P<0.05). Conclusion The risk of VaP in multiple cerebral infarction is high, which is related to the cognitive function of patients. Early intervention such as brain function training should be given to patients with white matter lesions, diabetes and lesions in the left hemisphere. , can significantly improve patients' cognitive function and reduce the occurrence of VaP.