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

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

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.

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 .

s: Objective To investigate the efficacy and safety of ultrasound-guided upper-pole access percutaneous nephrolithotomy (PCNL) for the treatment of renal staghorn calculi. Methods From October 2008 to July 2012,193 cases of renal staghorn calculi treated with ultrasound-guided upper-pole access PCNL were reviewed. Among the 193 cases,74 cases were complete staghorn calculi while the other 119 cases were partial staghorn calculi, and the calculi diameter was 2. 5 to 9. 0 cm. All the 193 cases were treated through upper-pole ac-cess successfully,70 accesses were accomplished below the 12th rib,while the other 123 accesses were accomplished between the 11th adn 12th rib. Disintegration of the stone was accomplished using Holmium laser. Results The mean operative time was 70 min (45~150 min), single tract was used in 186 cases, and double tracts were used in the other 7 cases. The stone clearance rate for one session was 72. 0%(139/193),and the total stone clearance rate was 88. 1%(170/193). Transfusion was required in 6 patients, while 2 patients with signifi-cant bleeding were treated with selective renal arterial embolization. Hydrothorax occured in 4 patients, and closed thoracic drainage was re-quired in 2 of them. 20 patients had fever, and they recovered after effective antibiotic treatment. No patients had injury to the lung or other viscera. Conclusion Upper-pole access offers optimal visibility and convenience for rigid ureteroscope to achieve a high rate of stone-free status and operating time reduce. Ultrasound guided upper-pole access PCNL should be attempted in selected cases of renal staghorn stone.

ObjectiveTo investigate the MRI features of placenta accreta.MethodsFrom Apr 2009 to Jun 2011,15 patients with placenta accrete received MRI examination.In them,placenta accrcta was diagnosed based on clinical manifestations or postoperative histopathologv.The MR features of placenta accreta in thcm( study group) were retrospectively analyzed and compared with those in 15 pregnant women without placenta accreta (control group)with Fisher exact test.ResultsIn the 15 patients with placenta accreta,uterine bulging and(or) a focal outward contour bulge was detected in 14 patients; heterogeneous signal intensity in the placenta was detected in 15 patients; dark intraplacental bands on T2-weighted images was detected in 15 patients; and increased subplacental vascularity was detected in 11 patients on T1- weighted images.In the study group,14 patients showed at least three of the above four features,and in all of them uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images were detected; one patient showed heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity.In the control group,none patient had three of the above features.Uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta,dark intraplacental bands on T2-weighted images and increased subplacental vascularity were detected in 3,6,3 and 4 patients (P=0.000,0.001,0.000 and 0.027 ),respectively.ConclusionsThe main MRI features of placenta accreta are uterine bulging and(or) a focal outward contour bulge,heterogeneous signal intensity in the placenta and dark intraplacental bands on T2-weighted images Besides,increased subplacental vascularity also could provide useful information for the diagnosis of placenta accreta.

ObjectiveTo observe the effect of pulsed electromagnetic fields (PEMFs) on bone mineral density (BMD) of spinal cord injuried (SCI) patients. MethodsThe PEMFs group was composed of 12 SCI patients received regular PEMFs treatment as the treatment group, 12 SCI patients treated without PEMFs were as the control group.BMD of total proximal femur, Ward's trigonum and great trochanter of all patients were detected by dual-energy X-ray absorptiometry before and after treatment.ResultsBMDs of total proximal femur and great trochanter of patients of the treatment group were a little increased after PEMFs treatment, with no significant difference (P>0.05), but BMD change was significantly different compared with the control group (P<0.05～0.01).ConclusionPEMFs treatment along with routine exercise may help to reduce the loss of bone after SCI.

Objective:To investigate the prognostic significance of tumor architecture in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy.Methods:A retrospective study was performed on 958 patients who underwent nephroureterectomy in Second Affiliated Hospital of Zhejiang university (156) and Renji Hospital (802) between January 1998 and June 2019. There were 630 males and 328 females with median age 67 years old, ranging 30-89 years old. Among them, 499 patients suffered with preoperative hydronephrosis, 370 patients suffered with hypertension, 120 patients suffered with diabetes, 252 patients had history of smoking and 119 patients had history of non-muscle invasive bladder cancer (NMIBC) or with NMIBC. 489 patients had tumor in renal pelvic, 394 patients had tumor in ureter and 75 patients had tumor in both sites. Laparoscopic surgery was performed in 543 patients while open surgery was performed in 415 patients. The χ 2 test was used to detect the association between tumor architecture and several clinicopathological features. Kaplan-Meier method with the log-rank test was used to assess survival analysis. Multivariate analyses were conducted using Cox proportional-hazards regression model. Results:516 cases (53.9%) showed papillary architecture(Group A) and 442 cases (46.1%) showed sessile architecture(Group B). 543 patients had a tumor ≤3 cm and 415 had a tumor >3 cm. Low pathological grade and high grade was diagnosed in 275 and 683 patients, respectively. The distribution of pathological stage was pT a-1 in 441 cases, pT 2 in 180 cases, pT 3 in 308 cases and pT 4 in 29 cases. Lymphadenectomy was performed in 227 patients and 62 patients were pathologically confirmed lymph node metastasis. 48 patients were found squamous or glandular differentiation. Lymphovascular invasion (LVI) was observed in 150 patients. 134 patients were multifocality. Positive surgical margin was found in 43 patients. Median follow-up was 39 (ranging, 2-206) months. During follow-up, a total of 304 patients died and 236 died of UTUC. 5-year OS and CSS were 76.6% and 81.8%, respectively, in patients with papillary architecture (group A), which were significantly higher than 54.4% and 60.5% in patients with sessile architecture (group B, all P<0.001). Patients in group B had more female patients (38.9% vs.30.3%, P=0.005), ureteral location (47.1% vs. 36.1, P=0.002), hydronephrosis (55.9% vs.48.8%, P=0.030) and postoperative adjuvant chemotherapy (27.1% vs. 14.7%, P<0.001), higher pathological grade (89.6% vs.55.6%, P<0.001) and stage (79.4% vs.32.4%, P<0.001), lymph node metastasis rate (12.0% vs.1.7%, P<0.001), squamous or glandular differentiation (9.5% vs.1.2%, P<0.001) and LVI (24.4% vs.8.1%, P<0.001) than patients in group A. Cox multivariate regression analysis showed that sessile architecture ( P=0.022, 0.028), age ≥65 years ( P<0.001, <0.001), history of diabetes ( P=0.008, 0.043), history of NMIBC or with NMIBC ( P<0.001, <0.001), higher grade ( P=0.002, <0.001), advanced tumor stage ( P=0.003, 0.005), lymph node metastasis ( P=0.003, 0.044), squamous or glandular differentiation ( P=0.008, 0.027) and positive surgical margin ( P=0.003, 0.010) were independent risk factors for OS and CSS. However, tumor >3 cm ( P=0.013, 0.131) and positive LVI ( P=0.045, 0.174) were independent risk factors for CSS rather than OS. Conclusions:UTUC is high malignancy. Tumor architecture was one of an independent risk factor for OS and CSS in UTUC patients and sessile tumors were more malignant, more aggressive and have worse prognosis.

Objective : To investigate whether fenoldopam (FNDP) ( an agonist of type 1 dopamine receptor) has a protective effect on thoracic aortic aneurysm ( TAA) in mice . Methods : Three-week-old male C57BL/6J mice were treated with β-aminopropionitrile (BAPN) to induce TAA . The mice were divided into three groups : the con- trol group , the BAPN group , and the BAPN + FNDP group (FNDP inj ected intraperitoneally) . The incidence and survival rate of TAA were recorded . Gross anatomy of the whole aortae was ob served . Elastin staining was per- formed to assess morphological change , while immunohistochemistry was employed to evaluate the expressions of matrix metalloproteinase 2(MMP2) , matrix metalloproteinase 9( MMP9) and cluster of differentiation 68( CD68) respectively. Gelatin zymography was conducted to assess MMP2 and MMP9 activity. Reverse transcription-poly- merase chain reaction (RT-PCR) was performed to measure the mRNA expression levels of dopamine receptor D1(D1DR) , dopamine receptor d2 (D2DR) , dopamine receptor d3 (D3DR) , dopamine receptor d5 (D5DR) , in- terleukin-1β(IL-1β) , interleukin-6 (IL-6) , tumour necrosis factor-α (TNF-α) , monocyte chemoattractant pro- tein-1 (MCP-1) , alpha-smooth muscle actin ( α-SMA) and smooth muscle protein 22 -alpha (SM22α) . Results: Compared to the control group , the BAPN group exhibited significant formation of TAA . Elastic fiber disruption was also ob served in the thoracic aortic wall , along with a significant decrease in the mRNA levels of D1DR and D5DR. The BAPN + FNDP group showed a significant reduction in the incidence of TAA formation and the rate of aneu- rysm rupture compared to the BAPN group . The disruption and rupture of elastic fibers in the thoracic aortic wall were significantly improved in the BAPN + FNDP group . The levels of MMP2 and MMP9 in the thoracic aortic wall significantly decreased , and the enzymatic activity of MMP2 in the serum was significantly reduced . Moreover , macrophage infiltration in the thoracic aortic wall was significantly reduced and the mRNA levels of IL-1β, IL-6 , TNF-αand MCP-1 also significantly decreased after FNDP treatment. There was no statistically significant differ- ence in the mRNA levels of α-SMA and SM22α. Conclusion FNDP shows an inhibitory effect on TAA progres- sion in mice , suggesting a potential of FNDP as a therapeutic agent for TAA .