Objective To explore the optimum exposure factors in digital chest radiography.Methods Chest phantom was exposed under auto exposure control model with 73, 90, 125kV and S200,400,800 plus or minor 4 micro-adjust for each sensitivity grade. Meanwhile dose area product (DAP) was recorded and the value of IQFinv was analyzed automatically by Artinis CDRAD Analyzer 1.1. Ten volunteers were exposed with 73 kV, S800 - 2; 90 kV, S800 + 2 and 125 kV, S400 + 2. Two radiologists evaluated and scored image quality. Statistical analysis was performed using one way ANOVA test by SPSS 12. 0. Results ( 1 ) The quality scores of volunteers' images obtained with three combinations of exposure factors were 2. 7 ± 0. 5 for 73 kV group, 2. 9 ± 0. 3 for 90 kV group and 2. 8 ± 0. 4 for 125 kV group. The difference among them was not statistically significant ( F = 0. 587, P ＞ 0. 05 ). Whereas the DAP values were (29. 1 ± 7.9) mGy · cm2 for 73 kV group, ( 30. 5 ± 4. 5 ) mGy ·cm2 for 90 kV group and (40. 4 ±7.6) mGy · cm2 for 125 kV group, with statistically significant difference among them ( F = 9. 803, P ＜0. 01 ). (2) In all three kV conditions, DAP value of phantom declined when sensitivity increased. There was a difference of DAP value by 11％ between two successive sensitivity grades. Under the condition of same sensitivity, DAP value changed with kV in the following order: 73 kV ＞90 kV ＞ 125 kV. (3) The value of IQFinv decreased when sensitivity increased. Under the condition of same sensitivity, IQFinv changed with kV as follow: 73 kV ＞90 kV ＞ 125 kV. Conclusion The combination of exposure factors of 90 kV and S800 + 2-S800 +4 is optimum for digital chest radiography.

Objective To investigate the radiation doses for the patients undergoing interventional radiology and to analyze the dose - influencing factors.MethodsThe clinical data of 461 patients undergoing interventional radiology,including cerebral angiography ( CEA ),cerebral aneurysm embolism ( CAE ),superselective hepatic arterial chemoembolization ( SHAG ),coronary angiography ( COA ),percutaneous intracoronary stent implantation ( PIS1 ),cardiac radiofrequency catheter ablation ( RFCA ),and permanent cardiac pacemaker implantation(PCPI) were collected to observe the cumulative air kerma (CAK),dose area product (DAP),and fluoroscopy time,and effective dose was estimated using the conversion factors.Results The effective doses for CEA,CAE,SHAG,COA,PISI,RFCA,and PCPI were (0.33 ±0.20),(0.49 ±0.35),(6.92 ±4.19),(0.76 ±0.91),(2.35 ± 1.47),(0.50 ±0.74),and (0.67 ±0.70) Sv,respectively.In 126 of the 416 patients (26%),the effective doses were greater than 1 Sv,and the effective doses of 10 person-times were greater than 10 Sv,all of which were observed in the patients undergoing SHAG.The CAK values for CEA,CAE,SHAG,COA,PISI,RFCA,and PCPIwere (0.55 ±0.43),(1.34 ± 1.11),(0.95 ±0.57),(0.32 ±0.31),(0.91 ±0.33),(0.16 ±0.22),and (0.15 ±0.14) Gy,respectively.The CAK values were greater than 1 Gy in 59 of the 461 patients ( 12.8% ),greater than 2 Gy in 11 cases (2.4%) ,and greater than 3 Gy in 1 CEA cases and 1 CEA case,respectively.Conclusions There is a wide variation range in radiation dose for different procedures.As most interventional radiology procedure can result in clinically significant radiation dose to the patient,stricter dose control should be carried out.

Objective To evaluate the effect of preoperative oral finasteride on patients with benign prostate hyperplasia (BPH) undergoing holmium lasterenucleation of prostate (HoLEP).Methods A total of 156 BPH patients from Department of Urology in Shanghai Ninth People's Hospital from Sep.2010 to Mar.2012 was analyzed retrospectively.79 patients receiving oral 5 mg/d finasteride before operation were selected as medication group,and the 77 patients without taking finasteride were selected as control group.The perioperative data,including operation time,amount of washing fluid during operation,preoperative and postoperative changes of hemoglobin level and postoperative bladder washing time were compared between two groups.Results Compared with control group,the changes of hemoglobin level after HoLEP,amount of washing fluid during operation,and postoperative bladder washing time with normal saline were significantly decreased in experimental group[(1.08±0.27) g/L vs.(1.55±0.32) g/L,(27.51±3.67) L vs.(36.89±6.47) L,(24.85±4.17) h vs.(35.87±5.10) h,all P＜0.05].Conclusions Oral finasteride before HoLEP can reduce perioperative bleeding and the volume of bladder irrigation with normal saline.

Objective To assess the long-term surgical outcomes,patient's satisfaction and functional results of correction for patients with penile curvature by 16-dot minimal tension plication.Methods Between August 2004 and December 2010,92 patients with penile curvature underwent surgical correction of penile curvature by 16-dot minimal tension plication.Of them,86 patients (53 patients with congenital penile curvature and 33 patients with Peyronie's disease (PD)) were reached for long-term follow-up.Indications for operation included patients with 30 to 90 degrees of penile curvature,penile length greater than 10 cm and patients who had one or more symptoms,such as difficulty or inability to vaginal penetration and partner discomfort during sexual intercourse.Patients were excluded from study if they had severe penile curvature (greater than 90 degrees),hourglass deformities or large plaques.Preoperative evaluation included international index of erectile function 5 (IIEF-5) questionnaire score,pain on erection and physical examination.Patients were recommended daily low dose phosphodiesterase type 5 (PDE-5) inhibitors 2 weeks after surgery and maintained for 2 to 3 months.At follow-up,recurrence rate,complications,erectile function,patients and partner's satisfaction with the surgery were assessed.Results The mean time of follow-up was 79 months (range,35-107 months).Of 86 patients who had been reached for long-term follow up,82 patients (95.3％) and 77 partners (89.5％) reported overall satisfaction after the surgery.Complete penile straightening was achieved in 79 patients (91.8％).Slight residual curvatures were observed in 7 patients,but did not affect their sexual intercourse.Postoperative penile length shortening (median penile length loss 1.3 cm) was noted in 35 patients (40.7％),which did not affect their sexual intercourse.In addition,no de novo erectile dysfunction was observed,and sexual function was significantly improved evidenced by the IIEF-5 scores,especially in the patients who had received PDE-5 inhibitors for 2 to 3 months.There were no surgery-related complications,such as hematoma,urethral injury,or infection.Conclusion The longterm results demonstrate that correction of penile curvature using 16-dot plication is a simple and safe method to achieve cosmetic and functional satisfaction in patients with mild to moderate penile curvature.

Objective To study the the causes, management and preventive measures for complications of holmium laser ureterolithotripsy. Methods Three hundred and seven cases of uteteral calculi from Jan. 2006 to Jan. 2010 were reported (203 men and 104 women, age ranged from 18-83 years,mean age 51.6 years). One hundred thirty-three patients had calculi in the lower ureter,94 in the middle part and 80in the upper ureter. Results The overall comminution rate was 89.9% (276/307 cases). sixteen cases (5.2%) were followed by ESWL due to the shift of the stones to the renal pelvis. The operation failed in 9 cases(2.9%), 3 cases(1%) had perforation,and recoveried after open operation. Deep infection was found in 3(1%)cases,which recoveried after anti-infective therapy. Conclusions Holmium laser ureterolithotripsy is an effective method for treating ureteral calculi, with advantage of high efficiacy,safety and minimal invasion. To master the operating induction, to raise operating technique and to take correct measure could reduce complications effectually.

Prostaglandin E2 (PGE2) is a bioactive polyunsaturated fatty acid produced by arachidonic acid, and it is mainly metabolized in the liver and has an important regulatory effect on various liver diseases. Prostaglandin E synthases (PGESs) are important terminal rate-limiting enzymes in the PGE2 synthesis pathway and are involved in the development and progression of liver disease. This article mainly summarizes the role of PGESs in liver injury, hepatitis, and liver cancer in existing studies, hoping to provide a reference for further research on the role of PGESs in liver diseases.

Objective To investigate the safety and efficacy of holmium laser transurethral enucleation of the prostate (HoLEP) for large volume of prostatic hyperplasia (BPH) with navigation of ultrasonic anatomical landmarks.Methods Data of 242 patients with BPH (≥ 80 cm3) underwent domestic HoLEP from Jan.2016 to Jan.2018 were retrospectively analyzed.General data,IPSS,QOL,prostate volume,PSA were assessed.Their average volume of prostate was (103.2 ± 21.4) cm3,the average PSA was (2.6 ± 1.4) ng/ml,the residual urine volume was (105 ± 75) ml,Qmax was (6.4 ± 5.2) nd/s,IPSS score was 22.5 ± 5.3 and QOL score was 4.8 ± 1.2.Result All patients were completed the operation successfully and their LUTS indicators were greatly improved.The enucleation time was between 25 and 80 min,average (49.0 ± 12.2) min;the mass of wet weight of gland was (70.5 ± 15.3) g;the removal efficiency was (1.6 ±0.3) g/min.The IPSS score dropped to 14.8 ± 6.5,P ＜ 0.01;QOL score dropped to 2.6 ± 1.5,P ＜ 0.01;PSA dropped to (1.1 ± 1.2) ng/ml,P ＜ 0.01;the maximum urinary flow rate growth to (16.5 ±7.1) ml/s,P ＜0.01.Conclusion For large volume of prostatic hyperplasia,holmium laser transurethral enucleation with ultrasonic navigation surgery is safe and efficient.

Ureteral artery fistula (UAF) is a rare complication after long-term indwelling of ureteral stent. In this study, two cases were presented. Both of them underwent pelvic tumor surgery and radiotherapy, and had a history of cutaneous terminal ureterostomy and long-term indwelling of ureteral stents. The first case, a 52-year-old female, was admitted to hospital because of intermittent bleeding from ureteral dermostomy for 1 week on April 2, 2020. CT examination revealed hematocele in the left upper urinary tract, and left nephrectomy was performed.However, bleeding still presented and the distal ureteral resection was performed at the same time, and partial ureteral was ligated. Postoperative diagnostic was ureteral artery fistula. After 8 months of follow-up, no recurrent bleeding presented. Another case, a 82-year-old male, was admitted to hospital because of bleeding at the ureteral dermostomy for an hour on June 15, 2020. Contrast enhanced CT examination revealed intersecting of the left ureter and common iliac artery, and interventional surgery was performed, by which UAF was diagnosed. Embolization of left internal iliac artery and stent implantation of common iliac artery and external iliac artery were performed intraoperatively. The bleeding stopped immediately after the operation, and there was no further bleeding during follow-up of 6 months.

【Objective】 To evaluate the efficacy of transurethral resection of bladder tumor (TURBT) in treating cystitis glandularis (CG), and to explore the influencing factors. 【Methods】 A retrospective analysis was conducted on 243 CG patients treated with TURBT during Jan.2013 and Dec.2020 in our hospitals.Postoperative efficacy was assessed using global response assessment (GRA).The correlation between GRA score and the demographic characteristics, comorbidities, initial complaints, and postoperative recurrence was determined with logistic regression analysis. 【Results】 Among the 243 patients, 3.70% (9/243) had dysplasia, 2.47% (6/243) had exuberant hyperplasia of Brinell’s nest, and 2.06%(5/243) had intestinal metaplasia.The mean GRA score was (2.02±0.72) after a follow-up of (47.10±28.53) months.Re-operation was performed in 10.29% (25/243) of the patients due to recurrence, and the improvement of hydronephrosis and dysuria was 70.59% (12/17) and 50.00% (15/30), respectively.Pelvic fat increase developed in 1 patient (0.41%) after surgery.Logistic regression analysis showed that postoperative GRA score was not significantly correlated with demographic characteristics, body mass index, comorbidities, alcoholism and postoperative recurrence (P>0.05). 【Conclusion】 TURBT is an effective method in the treatment of CG, which can significantly improve patients’ hydronephrosis and dysuria.However, approximately 10% of the patients experience recurrence, necessitating further surgery, which suggests the need for vigilance regarding potential recurrence during treatment.