Objective To evaluate the safety and efficacy of transurethral resection of the prostate(TURP)for high-risk benign prostatic hyperplasia(BPH).Methods Form January 2001 to July 2007,we performed TURP on 303 patients with high-risk BPH.The patients aged form 65 to 89 years with a mean of 76.3.Among them,151 were complicated with cardiovascular diseases,67 had pulmonary diseases,37 had diabetes mellitus,26 had brain disease,16 showed renal inadequacy,and 6 showed abnormal liver function.Results The procedure was completed successfully in all of the 303 cases without death,dysuria,or severe complications.Compared to the examinations carried out before the procedure,the IPSS and QOL scores,and RU decreased significantly,while the Qmax increased 3 months after the prosedure[IPSS:(19.6?7.9)points vs.(6.4?3.3)points,t=26.838,P=0.000;QOL:(4.7?1.5)points vs.(2.3?1.1)points,t=22.459,P=0.000;Qmax:(4.1?2.6)ml/s vs.(13.9?7.1)ml/s,t=-22.561,P=0.000;and RU:(139.0?32.5)ml vs(13.5?8.6)ml,t=55.143,P=0.000].ConclusionsTURP is a safet and effective procedure for high-risk BPH with a low rate of postoperative complications.Proper peri-operative individual management and operation skills are important for the success of the procedure.

For uncontrolled hemorrhagic shock the traditional method and target of resuscitation may be harmful. The existing data supported a strategy of less aggressive interventions to those shock with uncontrolled hemorrhage until a decisive surgery begin. The choice of liquor for resuscitation remains in controversy. A combined application of crystalloid and colloid liquor seems to be reasonable and may be accepted by most physicians. It should be noted that the new resuscitation strategy may not be suitable to some kinds of trauma, such as traumatic brain injury, and its long-term effects on to the prognosis should be further evaluated.

Objective To evaluate the methods and efficacy of retroperitoneal laparoscopic nephron-sparing surgery for the treatment of renal tumor. Methods A total of 6 patients with renal tumors underwent retroperitoueal laparoscopie nephron-sparing surgery during warm ischacmia. Among the 6 eases, 2 had malignant tumor with the diameter of 2.5 cm and 2.2 cm,and 4 had renal angiomyolipoma with the diameter from 2.5 cm to 3.5 cm.The renal yes,Is were secured by a self-made equipment. Tumors were excised with a cold Endo-shear. Parenehymal edges were approximated using a absorbable hemostatic gauze. Results All procedures were successfully completed without open conversion. Mean surgical time was 150 minutes (range 120-210 minutes). Mean ischaemia time was 22 minutes (range 18-33 minutes) and the mean blood loss was 170 ml (range 150-200 ml). Surgical margins were negative in all patients.During a follow-up for 6-12 months, no patient had local or port site recurrence. Conclusions Betroperitoneal laparoscopic nephron-sparing surgery for renal tumor by using serf-made equipment is safe and effective. This procedure has the advantages of minimal invasion, less blood loss, good vision, and rapid convalescence and so on.

OBJECTIVE: To discuss the clinical features, diagnosis and endoscopic surgical intervention for small steoma of nasal sinuses causing nasal and facial pain. METHOD: A retrospective review was performed on 21 patients with nasal and facial pain caused by small osteoma of nasal sinuses, and nasal endoscopic surgery was included in the treatment of all cases. RESULT: The nasal and facial pain of all the patients was relieved. Except for one ase exhibiting periorbital bruise after operation, the other patients showed no postoperative complications. CONCLUSION Nasal and facial pain caused by small osteoma of nasal sinuses was clinically rare, mostly due to the neuropathic pain of nose and face caused by local compression resulting from the expansion of osteoma. Early diagnosis and operative treatment can significantly relieve nasal and facial pain.
Endoscopy ; Face ; Facial Pain ; Humans ; Nasal Surgical Procedures ; Osteoma ; surgery ; Paranasal Sinuses ; pathology ; Postoperative Complications ; Retrospective Studies

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

OBJECTIVE:To study clinical effect of argatroban for progressive stroke patients of different cerebral ischemic ranges. METHODS:A total of 116 progressive stroke patients selected from neurology department of our hospital during Feb. 2015-May 2016 were divided into anterior circulation (ischemia) group (n=60),posterior circulation (ischemia) group (n=50) and lacunar(cerebral infarction)group(n=6)according to cerebral ischemic ranges. They all received routine treatment combined with argatroban,and given continuous intravenous infusion of argatroban 60 mg/d on the day and 2nd day of disease aggravation, and then continuous intravenous infusion of argatroban 5th day after relieving,3 h/time,bid,7 d as a treatment course. NIHSS scores,modified RANKIN (mRS) scores,APTT and ADR were compared among 3 groups. RESULTS:Forteen days after treat-ment,NIHSS scores and mRS scores of 3 groups were decreased significantly compared to before treatment,with statistical signifi-cance (P<0.05). There was statistical significance between anterior circulation group and posterior circulation group (P<0.05). Two hours after treatment,APTT of 3 groups were prolonged significantly,especially in lacunar group,with statistical significance (P<0.05). Forty hours after treatment,APTT of 3 groups were recover to normal,without statistical significance (P>0.05). No obvious ADR was found in 3 groups. CONCLUSIONS:Argatroban shows significant therapeutic efficacy for progressive stroke of different ischemic ranges with good safety;especially for the patients with anterior circulation ischemics stroke,the effect is quick and anticoagulant effect is significant.

Objective To evaluate the clinical efficacy of hypocaloric enteral nutrition in patients with acute severe traumatic brain injury (TBI).Methods A total of 100 patients with severe TBI [Glasgow Coma Scale (GCS) 3-8 points] were enrolled and randomly divided into hypocaloric enteral nutrition group (hypocaloric group, 41.86-62.79 kJ · kg-1 · d-1) and traditional caloric enteral nutrition group (traditional caloric group, 104.65-125.58 kJ · kg-1 · d-1) ,50 patients per group.The enteral nutrition was given at 24-72 hours postoperatively.The changes of total serum protein (TP), serum-albumin (ALB), plasma hemoglobin (Hb), fasting blood glucose (Glu) and major gastrointestinal tract complications were observed and compared at 7 and 14 days after enteral nutrition support.Results Levels of TP, ALB and Hb were lowered in both groups at 7 and 14 days after nutritional support but showed no statistical difference (P ＞ 0.05).Glu was (6.37 ± 1.02) mmol/L in hypocaloric calorie group, significantly lower than (7.35 ± 1.70) mmol/L in traditional caloric group at day 7 after nutritional support (P ＜ 0.05).At 7 and 14 days after nutrition support, nausea, regurgitation, vomiting and complication incidence showed no significant difference between hypocaloric calorie group and traditional caloric group after nutritional support (P ＞ 0.05), but abdominal distension, diarrhea and stomach retention rate in hypocaloric group were significantly lower than those in traditional caloric group (P ＜ 0.05).Conclusion Hypocaloric enteral nutrition can significantly reduce the stress hyperglycemia, abdominal distention, diarrhea, gastric retention and other gastrointestinal symptoms in patients with acute severe TBI.

Objective:The occurrence of numerous tumors, particularly classical Hodgkin's lymphoma (CHL), is related with Ep-stein-Barr virus (EBV) infection. However, the incidence of CHL and its association with EBV varies significantly with ethnicity, geo-graphic location, sex, and age. This study investigated the association of EBV infection with CHL in Northern Chinese Han population. Methods:EBV-encoded small RNA (EBER) was detected in 136 cases of CHL through in situ hybridization. Results:A total of 37 cas-es were EBER positive (28%). The mixed cellularity (MC) subtype had the highest positive EBER rate of 49%(23/47;P<0.001), fol-lowed by lymphocyte-rich subtype with 30%(3/10), nodular sclerosis (NS) subtype with 14%(10/73), and 1ymphocyte depletion with 0%(0/2). Our study identified a single age distribution in the third decade. Moreover, NS subtype showed an evident single peak in the third decade. However, MC subtype had a lower peak in the fifth decade. The incidence of EBER showed a bimodal age distribution with two peaks in the first and fifth decades (21.6%and 24.3%, respectively). Conclusion:CHL in Northern Chinese Han population was associated with EBV infection, particularly the MC subtype.

BACKGROUND:The methods used to repair articular cartilage defects currently have the cons and pros. Fibrocartilages are commonly used to repair tissues, and the fibrocartilage lacks of the tissue biomechanical properties and chemical properties of normal hyaline cartilage. OBJECTIVE:To investigate the feasibility of biological osteochondral xenogenic graft transplantation to repair articular cartilage defects. METHODS:The normal goats were randomly divided into two groups. The donor pig knee joints were the experimental group. Cylindrical osteochondral with the diameter of 4.5 mm and length of 10 mm were col ected with the Smith&Nephew osteochondral transplantation device, and the patented technology was used for deantigen. The donor goat knee joint osteochondrals were the control group and preserved with cryopreservation. The lesions on femoral trochlea and weight-bearing surface of medial condyle were selected respectively for osteochondral implantation, and the animals were sacrificed at 16 and 32 weeks after operation for the general and pathological section observation. RESULTS AND CONCLUSION:General observation in the experimental showed that the lesions were covered by fibroid tissue;some cartilage of the grafts turned yel ow and there was clear boundary between the surface and the peripheral cartilages;the general and section observation under microscope showed that lesions of the control group were covered by the grafts basical y, and cracks could be seen on the edge of the transplant part. The results show that there is difference between effects of biological osteochondral xenogenic graft transplantation and osteochondral al ograft transplantation for the repairing of articular cartilage defects, and osteochondral al ograft transplantation bas better effect.

Objective To analyze the composition of urinary stones in Taizhou of Zhejiang province.Methods Clinical data of 1 022 patients with urinary stones admitted in Taizhou Hospital of Zhejiang province were retrospectively reviewed.The samples of urinary stones were collected and analyzed by infrared spectrophotometry.Results There were 722 males and 300 females with a male to female ratio of 2.4:1 and with a mean age of (53.4±13.6) years (14-88 years).Among 1 022 patients,the stones with single composition were found in 299 cases (29.3%);the most common single-component was anhydrous uric acid (15.9%),followed by calcium oxalate monohydrate (12.0%).The mixed stones were found in 723 cases (70.7%);the most common mixture was calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite mixture (316 cases,30.9%).Calcium oxalate (58.9%,602/1 022) was the most common major component and frequently seen in upper urinary tract stones,followed by uric acid (21.8%,223/1 022).Uric acid calculi was predominant component in male patients(χ2=30.97,P=0.00),while the rate of infection stones was higher in women (χ2=60.69,P=0.00).The mean age of patients with uric acid stones was 59.4 years,which was older than that with other components (t=7.62,P=0.00).The uric acid stones were more common in upper urinary tract stones(χ2=42.97,P=0.00).The mean age of patients with infection stones was 49 years,which was younger than that with other types of stones(t=4.87,P=0.00).Conclusion Mixed stones with calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite are the predominant urinary stones in Taizhou of Zhejiang province,while the most common single-component stones are anhydrous uric acid stones.Location,age and sex are associated with the types of urinary stones.