Objective To study the causes, prophylaxis, and treatment of the severe complications due to transurethral electrovaporization of the prostate (TVP). Methods We analyzed the complications found in 1 910 men with moderate and severe symptoms of prostatism treated with TVP from August 1997 to February 2003 and studied the causes, prophylaxis, and treatment of the severe complications due to TVP. Results Severe complications were found in 78 cases (4.1%). Late mass bleeding in 35 cases (0.18%) was resulted from the abscission of coagulated necrotic tissue of the prostate after TVP. Extraperitoneal water extravasation (hydrocele) in 27 cases (0.14%) was caused by the early incision of the peritoneum in TVP and could be prevented by avoiding early incision of the peritoneum and stopping operation in time. Severe urethral stricture in 9 cases (0.05%) was caused by using thick sheath of cystoscope and cutting the neck of urinary bladder improperly. Urinary bladder explosion in 2 cases (0.01%) was caused by accumulation of air during the process of TVP, but could be protected by removing the air and water in urinary bladder at intervals. Incontinence in 2 cases (0.01%) was resulted from the injured urinary sphincter muscle. Acute renal failure in 3 cases (0.015%) was caused by hypotension. Conclusion Severe complications due to TVP can be prevented and treated. The occurrence rate of severe complications can be decreased by the proper preventive measures and skilled techniques of the operators.

The association between serum fetuin A and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM) was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria (NA group),87 patients with microalbuminuria (MA group),44 patients with overt albuminuria (OA group),and 130 normal control subjects (NC group).Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups(P＜0.05 or P＜0.01).Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio (ACR),fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein(CRP,P＜0.05 or P＜0.01),but was negatively associated with age and adiponectin (all P＜ 0.01).Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR (all P ＜ 0.01).Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.

Objective To investigate serum alpha2-Heremans-Schmid glycoprotein ( AHSG ) level and its relationship with associated clinical parameters in subjects with simple overweight and obesity. Methods Forty-nine subjects with obesity ( OB group) , 176 subjects with overweight ( OW group) , and 327 individuals with normal weight ( NW group) were randomly enrolled. The clinical data were collected and serum levels of AHSG and adiponectin ( APN) were determined by ELISA. The associations of serum AHSG level with other clinical parameters were assessed by Pearson correlation analysis and multiple linear regressive model. Results Serum AHSG levels were higher in OW and OB groups than that in NW group[(276. 30 and 302. 10 vs 241. 60)μg/ml], being especially higher in OB group (P<0. 05 or P<0. 01). Serum AHSG level in NW group was positively associated with fasting plasma glucose, homoeostasis model assessment of insulin resistance index, C-reactive protein (CRP), triglycerides, and free fatty acids ( FFA ) , but negatively associated with age and APN. In OW and OB groups, AHSG was also positively associated with body mass index, waist hip ratio(WHR), and low density lipoprotein cholesterol(P<0. 05 or P<0. 01) except the aforementioned clinical parameters. In multiple linear regression model, AHSG was positively associated with WHR, CRP, and FFA, and was negatively associated with APN ( P<0. 05 or P<0. 01). Conclusion The raised AHSG level in overweight and obese subjects may be a risk factor for obesity-related diseases.

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.