Objective To explore the high-risk patients with benign prostatic hypeiplasia using bipolar transurethral resection of prostate for the treatment of dual-loop electrosurgical excision of the safety .effectiveness.Methods To retrospectively analyze of 56 cases with high-risk BPH patients with United States bicyclol CIRCON ion bipolar TURP TURP mirror line.Results Operation time was 50～100 minutes,an average of 70 minutes.1 case of mild postoperative incontinence,1PSS score from(28.2 ±1.5)to(7.0 ±1.0).voiding patency,fewer complications.Conclusion 1.Lavage using normal saline to avoid TURS syndrome,operative time can be extended accordingly.2.The current through the body,suitable for patients with special diseases.3.Reducing the incidence of capsularperforation.4.Less bleeding and reduce the occurrence of postoperative complications.5.TURP plasma removal of prostate tissue without charring,suitable for histopathological examination,to avoid the TURP and TUVP undetected pathological examination,increased prostate cancer detection rate.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.