Objective To compare the safety and efficacy of holmium laser enucleation of the prostate (HoLEP), one of the minimally invasive treatments available for men with benign prostatic hyperplasia (BPH),with transurethral resection of the prostate (TURP). Methods A total of 337 cases of BPH were divided into 2 groups;of them 185 cases underwent HoLEP and 152,TURP.The volume of irrigating fluid absorption and blood loss,and other therapeutic results were measured and compared between the 2 groups. Results Comparison between HoLEP group and TURP group included the following:irrigating fluid absorption was (604.8?97.6)ml vs (1095.0?209.8)ml;blood loss,(124.3?24.1)ml vs (330.3?36.9)ml;resected prostate weight,(17.4?2.2)g vs (25.2?3.4)g;operating time,(54.9?20.0) min vs (45.1?18.0) min;catheterization time,(2.2?0.2) d vs (3.4?0.3)d;and length of hospital stay after operation, (5.2?1.1) d vs (8.8?1.3) d. Significant differences were found between the 2 groups (P

ObjectiveTo present the innovative transurethral resection of the distal ureter and bladder cuff by Holmium laser and to compare the perioperative and oncological outcomes following nephroureterectomy using three different methods of managing the distal ureter and bladder cuff.Methods From January 2000 to December 2010,162 patients underwent excision of the distal ureter and bladder cuff by transurethral Holmium laser (32 cases,Group A),transurethral electric resection (51 cases,Group B) or open procedure (79 cases,Group C) combined with open or retroperitoneal laparoscopic nephroureterectomy.5 French ureteral balloon catheter was inserted into the targeted ureter to prevent possible microscopic tumor seeding.The therapeutic effectiveness,perioperative complications,postoperative recovery and oncologic outcomes were compared among groups.The follow-up time was 3 -96 months.ResultsGroup A and B showed statistically significant better results on the operative time (203.6 ± 31.5 min and 207.2 ±24.3 min),blood loss ( 127.4 ± 63.2 ml and 135.0 ± 82.7 ml) and postoperative hospital stay (5.8 ± 1.3d and 5.6 ±1.2 d) than those of Group C (248.0 ±42.9 min,484.5 ±217.7 ml,8.7 ±3.5 d),respectively ( P ＜ 0.01 ).Six cases of obturator nervous reflex occurred in Group B,with 3 cases of bladder peroration and 2 conversions to open procedure.There were no difference in bladder tumor occurrence,retroperitoneal recurrence,tumor cell seeding and cancer-specific survival among the 3 groups.ConclusionsOur data have validated the superiority of transurethral approach over conventional open procedure including perioperative index,recovery and comparable oncologic outcomes with open group.Holmium laser demonstrated better results including fewer complication,cleaner surgical vision and operating accuracy than that of electric resection.Transurethral Holmium laser resection of the distal ureter and bladder cuff has been proved to be a technically innovative minimally invasive and oncological safe method.

Objective To study the changes of serum protein spectrum in patients with systematic lupus erythematosus (SLE) in order to screen specific protein markers. Methods Serum samples from 72 patients with SLE and 85 age- and sex-matched controls were assessed using surface-enhanced laser desorp-tion/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) with weak cation exchange (CM10) pro-rein chip. Forty samples from the patients and 50 control samples were randomly selected to serve as a pre-liminary training set; significantly different protein peaks were automatically chosen for the system training and development of a decision classification tree model. The validity of the model was then challenged with a blind test set (including another 32 samples from patients and 35 from human controls). Results A total of 73 effective protein peaks were detected within the mass/charge ratio (m/z) interval 2000 - 50000, among which, 15 protein peaks significantly differed between patients with SLE and controls (P < 0.01). Three pro-tein peaks with an m/z value of 4001, 6305 and 7356 were automatically chosen as a biomarker pattern in the training set that discriminated patients with SLE from controls with a sensitivity of 90.0% (36/40), speci-ficity of 92.0% (46/50) and accuracy rate of 91.1% (82/90). When the SELDI marker pattern was tested with the blinded test set, it yielded a sensitivity of 87.5% (28/32), specificity of 91.4% (32/35) and accuracy rate of 89.6% (60/67). Conclusions SELDI-TOF-MS protein chip could be used to screen serum protein for SLE, and the decision classification tree model with these biomarkers may favor the diagnosis of SLE.

In recent years, researchers have become more interested in fish scrap collagen collection .Fish collagen, thanks to its low antigenic and hypoallergenic properties , is superior to that of higher animals .Meanwhile , fish collagen derives from a wealth of sources and has a moderate price .Based on recent fish collagen extraction and modification , this article summarizeds extraction technologies , such as hot-water, chemistry, bio-enzyme, compound extraction and such modification methods as physical and chemical processes to improve the thermal stability .

AIM： On the basis of in vitro study， a preliminary survey of the stability of diclofenac lysine sustained-release tables(DLST) was carried out to identify the period of validity.METHODS： To observe the changes of DLST under high temperature， blaze， high humidity and room temperature(for long period) and to perform accelerating test for 3 months.RESULTS： The drug release was accelerated under high temperature， and the tablet was apt to absorb moisture because of its hydrophilic matrix and the drug release became faster at day 10 under blaze， and therefore DLST should be stored away from high temperature， high humidity and blaze.CONCLUSION： DLST is stable and the period of validity is tentatively fixed at 2 years.

With wide range applications of the ultra-large-scale integrated circuits, multilayer circuit board and components surface welding technology, clinical medical engineers have been confronted with challenges in the service and maintenance of largescale medical equipments and the traditional model has faced the great challenges too. The clinical medical engineers should be actively get involved in operation, maintenance and service of large-scale medical equipment, in the same time; it's necessary for buying suitable service supply, protecting the smooth function of large- scale equipment and meets the clinical needs.

Objective:To analyze the clinical manifestations and esophageal motility characteristics of patients with gastroesophageal reflux disease (GERD) and extra-esophageal symptoms.Methods:From January 1 to October 30, 2018, at PLA Rocket Force Characteristic Medical Center, 180 hospitalized patients diagnosed with GERD and extra-esophageal symptoms were retrospectively analyzed. The patients were divided into laryngopharyngeal symptom group (65 cases), airway symptom group (58 cases) and mixed symptom group (57 cases). General data, clinical symptoms, gastroscopic manitestations, the results of high-resolution esophageal manometry and 24-hour multichannel intraluminal impedance and pH monitoring of each group were analyzed and compared. Chi-square test and one-way analysis of variance were used for statistical analysis.Results:The patients aged <40, 40 to 60 and >60 years accounted for 12.8% (23/180), 53.3% (96/180) and 33.9% (61/180), respectively, and the difference was statistically significant ( χ2=12.030, P=0.017). There were 18.9%(34/180) of patients without typical reflux symptoms. There were statistically significant differences in the incidence of ectopic esophagogastric mucosa or Barrett esophagus under gastroscopy between laryngopharyngeal symptom group, airway symptom group and mixed symptom group (21.5%, 14/65; 5.2%, 3/58 and 8.8%, 5/57, respectively) ( χ2=8.578, P=0.014). There were no statistically significant differences in the lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure or distal contractile integral between laryngopharyngeal symptom group, airway symptom group and mixed symptom group ((8.57±0.76), (8.87±0.79), and (10.51±0.97) mmHg (1 mmHg=0.133 kPa); (44.75±2.86), (42.81±4.06), and (39.14±3.20) mmHg; (506.13±64.30), (432.59±78.10), and (682.99±82.28) mmHg·s·cm)(all P>0.05). The DeMeester score of laryngopharyngeal symptom group , mixed symptom group and airway symptom group was (14.33±2.09), (21.94±5.30) and (30.47±5.85) points, respectively, and the difference was statistically significant ( F=3.226, P=0.043). The results of multi-channel impedance monitoring showed that acid reflux and weak acid reflux were the main reflux in the patients, which accounted for 55.5% (76/137) and 34.3% (47/137), respectively. Among 87.6% (120/137) of the patients, reflux mainly occurred in the upright position while 12.4% (17/137) of the patients had reflux in the supine position. Conclusions:The extra-esophageal symptoms of GERD is associated with age. Ectopic esophagogastric mucosa or Barrett esophagus are more common in GERD patients with laryngopharyngeal symptoms. There are more acid exposure and pathologic acid reflux in GERD mainly with airway symptoms. Weak acid reflux at upright position plays an important role in the reflux mechanism of GERD with extra-esophageal symptoms.

Objective To explore the application value of lung volumes from 64 multi-slice CT (MSCT) images in patients with chronic obstructive pulmonary disease (COPD) and study the correlation between lung volumes measured by MSCT and pulmonary function test (PFT) results. Methods 24 patients clinically diagnosed with COPD (COPD group) and 22 healthy people (control group) were selected and underwent both chest MSCT scans and PFT within one week. The total lung was scanned at full inspiration and full expiration with MSCT,respectively. The total lung volumes were measured by CT Pulmo software (Siemens,Forchheim,Germany). The quantitative total lung volumes from MSCT images were compared with PFT and SPSS13.0 was applied to assess the correlation. Results Compared with control group,the full inspiration volume (Vin) (P