OBJECTIVETo compare the effectiveness and safety of transurethral resection of the prostate (TURP) and transurethral enucleative resection of the prostate (TUERP) in the treatment of benign prostate hyperplasia (BPH).

METHODSA total of 630 BPH patients with indication of surgery were randomly assigned to receive TURP (n = 305) and TUERP (n = 325), respectively. There were no significant differences preoperatively in age, prostate volume, International Prostate Symptom Score (IPSS), and Qmax between the two groups (P > 0.05). The prostate resection rate, operation time, postoperative complications, and quality of life (QOL) of the patients were recorded and statistically analyzed.

RESULTSCompared with TURP, TUERP showed a significantly higher rate of prostate resection ([47.0 +/- 13.3] vs [60.1 +/- 12.3]%, P < 0.05), shorter operation time ([57.9 +/- 15.9] vs [40.4 +/- 14.2] min, P < 0.05), and shorter bladder irrigation time ([2.7 +/- 0.6] vs [2.2 + 1.1] d, P < 0.05). Significant differences were found between the pre- and post-operative levels of serum sodium and hemoglobin in the TURP group ([141.2 +/- 3.5 ] vs [136.9 +/- 4.7] mmol/L, P < 0.01; [137.6 +/- 8.8] vs [124.8 +/- 9.6] g/L, P < 0.01), but not in the TUERP group. Three months after operation, IPSS, QOL, and Qmax were all markedly improved in both groups (P < 0.01), but with no significant differences between the two groups (P >0.05).

CONCLUSIONTUERP is better than TURP in the treatment of BPH for its advantages of higher resection rate of the prostate, shorter operation time and bladder irrigation time, less intraoperative blood loss, fewer postoperative complications, and faster recovery.

Objective To explore the application value of self-made directional arcuate bone drill during vertebroplasty by observing its operative effects for osteoporosis in vitro . Methods EDTA-Na2 was used to soak the prepared vituline osteoporotic vertebral bodies in vitro .A total of 40 osteoporotic vertebral bodies were randomly divided into Group A and B , with each group having 20 vertebral bodies for vertebroplasty .The Group A underwent a puncture by routine straight bone drill , while the Group B received a puncture by self-made directional arcuate bone drill with the arc directing toward the contralateral , which terminated when the drill reached the first 1/3 of vertebral body .Finally, statistical analysis was conducted on the distance between the bone drill bit and exterior margin of contralateral vertebral body , as well as whether bone cement reached or went over the vertebral sagittal midline . Results The osteoporotic vertebral bodies were successfully prepared in vitro by using EDTA-Na2 immersion decalcifying for 9 days. In the Group A, the drill bit was (2.50 ±0.32) cm away from contralateral exterior margin of vertebral bodies , which was significantly different from that in the Group B (0.90 ±0.26) cm (t=17.354, P=0.000).The bone cement reached or went over the vertebral sagittal midline in 11 vertebral bodies in the Group A and in 19 vertebral bodies in the Group B , with statistical difference ( Fisher’ s test,P=0.004).The intraspinal bone cement leakage occurred in 9 vertebral bodies in the Group A and 4 in the Group B, without significant difference between the two groups (Fisher’s test,P=0.176). Conclusion The self-made directional arcuate bone drill can build an osseous channel that reach or go over the vertebral sagittal midline and guide bone cement distributed to contralateral puncture , which avoids the disadvantages of bilateral vertebral pedicular puncture .The result shows that the self-made directional arcuate bone drill has more adventages in vertebroplasty than that of traditional straight bone drill but doesn ’ t have significant advantages in preventing bone cement leakage .

Objective: To investigate the association between the left ventricular hypertrophy (LVH) and blood pressure load (BPL) and circadian rhythm in hypertensive patients. Methods:Sixty patients with hypertension were studied by 24-hour ambulatory blood pressure monitoring ( ABPM) and colour Doppler echocardiography. Results: Daytime、 nighttime and 24-hour systolic blood pressure load (d-SBPL、n-SBPL、24h-SBPL) in hypertensive patients with LVH were significantly higher than those without LVH[(88.4?11.6) vs (79. 8?13. 4) ,P

Objective To determine the prevalence of renal artery stenosis (RAS) and the efficacy of percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with documented coronary artery disease.Methods Selective renal artery angiography or abdominal digital subtraction angiography was performed immediately after coronary angiography to detect and quantify RAS in 200 consecutive patients with known or suspected coronary artery disease. Eight severe stenotic renal arteries in 7 patients were treated with PTRA and stenting. All the lesions are considered to be atherosclerotic. Results RAS (defined as ≥50% diameter stenosis) was detected in 21 of 200 patients (10.5%) and 19 of 99 patients with coronary artery disease (19.2%) who had at least one coronary artery of ≥50% diameter stenosis. Procedure success rate was 100% in the 7 patients received PTRA and stenting. Blood pressure control improved in 74.1% patients with hypertension. Angiographic follow up was done in 3 patients in 3 to 9 months and no restenosis was found in the vessels.Conclusions It is necessary to routinely perform RAS for the patients with coronary artery discase undergoing coronary angiography to identify RAS, especially in those associated with hypertension, so as to diagnose and treat RAS in early stage. PTRA and stenting carries high success rate and appears to be an effective and safe treatment for RAS.

Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Humans ; Stents ; Treatment Outcome ; Vascular Surgical Procedures ; methods

With the development of tertiary treatment system,the higher quality of inter-hospital transport is the most critical factor for the prognosis of the critically ill pediatric patients,especially for pediatric patients whose condition is deteriorating rapidly.Improving the quality,creating the guideline,and establishing the network platform of inter-hospital will provide complete guarantee for inter-hospital transport of critically ill pediatric patients.With the development of information technology,the purpose of this study was to analyze the function of the network platform of inter-hospital transport in Hunan Children′s Hospital.

Objective To explore the effects of different period of insulin-like growth factor-1(IGF-1)on B cell lymphoma/leukeamia-2 gene(BCL-2)and BCL-2 associated X protein(BAX)of myocard in mice with viral myocarditis.Methods Male Balb/c mice were randomly divided into control group,coxsackie viral B3(CVB3)infection group(infection group),IGF-1-treated group in earlier stage(0-6 d)and acute stage(7-13 d),injected IGF-1 of exogenous in abdominal cavity [30 ?g/(kg?d)].Animals were killed at the 14 day.The immunohistochemical studies and medical imagine analysis system were performed to evaluate the expression of BCL-2 and BAX in myocardial tissue.Results In infection group,the expression of BCL-2 reduced and BAX increased than those of control and treatment group(Pa

Objective:To explore the effect of different tidal volumes (VT) on the hemodynamics of right heart in acute respiratory distress syndrome (ARDS) rats induced by oleic acid (OA).Methods:Sixty adult male Sprague-Dawley (SD) rats were divided into control group ( n = 20), ARDS model group ( n = 20), low VT (LVT) group ( n = 10) and high VT (HVT) group ( n = 10) by random number table. ARDS model was reproduced by injecting OA 0.15 mL/kg through a jugular vein. The control group was given the same amount of normal saline. The success of modeling was judged by the oxygenation index (PaO 2/FiO 2) 2 hours after modeling, at the same time, the lung tissues were collected, the wet/dry weight (W/D) ratio was determined, and the lung histopathological changes were measured by lung injury score. The rats in the LVT group and HVT group were given mechanical ventilation with VT of 6 mL/kg or 20 mL/kg for 4 hours, respectively at 2 hours after modeling. The rats in the control group and the ARDS model group maintained spontaneous breathing. After mechanical ventilation for 4 hours, the heart rate (HR), right ventricular systolic pressure (RVSP), the maximum rate of rising of right ventricular pressure (dp/dt max), and the blood pressure (BP) were measured. Meanwhile, arterial blood samples were collected for blood gas analysis, including pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2) and PaO 2/FiO 2. Results:The rats in the ARDS model group showed symptoms of respiratory distress 1 hour after modeling, and the lung tissue samples showed obvious patchy bleeding 2 hours after modeling, while the control group showed no such changes. The PaO 2/FiO 2 in the ARDS model group was significantly lower than that in the control group [mmHg (1 mmHg = 0.133 kPa): 294.3±5.9 vs. 459.0±4.4, P < 0.01], and the lung W/D ratio and lung injury score were significantly higher (lung W/D ratio: 8.24±0.25 vs. 4.48±0.13, lung injury score: 0.60±0.03 vs. 0.12±0.02, both P < 0.01). It indicated that ARDS model was successfully reproduced. The arterial blood gas analysis and hemodynamic parameters of the ARDS model group were significantly worse than those of the control group. After 4-hour mechanical ventilation, the blood gas parameters of the LVT group were better than those of the ARDS model group and the HVT group [pH value: 7.36±0.02 vs. 7.24±0.02, 7.13±0.01; PaO 2 (mmHg): 92.4±2.1 vs. 61.8±2.3, 76.6±2.2; PaCO 2 (mmHg): 49.6±1.7 vs. 61.8±1.8, 33.6±1.3; PaO 2/FiO 2 (mmHg): 440.0±10.2 vs. 274.3±21.4, 364.7±10.5; all P < 0.05]. HR, BP and dp/dt max in the LVT group were significantly higher than those in the ARDS model group and the HVT group [HR (bpm): 346.9±5.4 vs. 302.3±10.1, 265.5±12.2; BP (mmHg): 125.4±2.2 vs. 110.0±2.5, 89.2±2.8; dp/dt max (mmHg/s): 1 393.3±30.3 vs. 1 236.4±20.5, 896.1±19.5; all P < 0.05], and RVSP was significantly lower than that in the ARDS model group and the HVT group (mmHg: 31.3±0.4 vs. 34.0±1.0, 38.8±0.9, both P < 0.05). Conclusion:Mechanical ventilation with low VT can improve the hemodynamic parameters of the right ventricle and protect the function of the right heart in ARDS rats.

Objective To investigate the role of P2Y1 purinergic receptors in the spinal cord in a rat model of bone cancer pain. Methods Ninety female SD rats weighing 150-180 g were randomly divided into 5 groups (n = 18 each): Ⅰ group sham operation; Ⅱ group bone cancer pain; Ⅲ group sham operation + MRS2179 (a specific P2Y1 purinergic receptor antagonist); Ⅳ group BCP + vehicle (group NS); Ⅴ group BCP+ MRS2179.Bone cancer pain was induced by inoculating Walker 256 mammary gland carcinoma cells into medullary cavity of tibia. In group Ⅲ, Ⅳ, Ⅴ MRS2179 100 pmol/10 μl or NS 10 μl was injected intrathecally once a day for 3 days starting from the 7th day after operation. Mechanical pain threshold to von Frey stimuli was measured before and every other day after operation. The anirnals were sacrificed on the 9th day after operation. The L4-6 segment of the spinal cord was removed for detection of expression of P2Y1 receptor and phosphorylated extracellular signal-regulated protein kinase 1/2 (p-ERK1/2) in the spinal dorsal horn. Results P2Y1 receptors and p-ERK1/2 coexisted in spinal dorsal horn. Inoculation of cancer cells into tibia significantly decreased mechanical pain threshold at postoperative day 6-18 and increased the expression of P2Y1 receptor and p-ERK1/2 on the 9th day after operation in group Ⅱ and Ⅳ as compared with group Ⅰ . Intrathecal MRS 2179 significantly increased pain threshold and decreased expression of P2Y1 receptor and p-ERK1/2 in group Ⅴ compared with group Ⅱ and Ⅳ. Conclusion P2Y1 receptors in the spinal cord are involved in the development of bone cancer pain, which may be related to the activation of ERK1/2.

To identify the prevalence and the distribution of ticks infected with spotted fever group rickettsiae (SFGR) in Xunke Area of Heilongjiang Province ,China ,partial outer membrane protein A gene (ompA) and citrate synthase gene (gltA) specific fragments were assessed using the PCR method .The positive products were sequenced .Result showed that the pres-ence of SFGR was 14 of 60 in detection Dermacentor silvarum cases ,while the overall positive rate was 23 .33% .Its nucleotide sequence of ompA showed 99 .3% and 99 .18% similarity with nucleotide sequence of Rickettsia sp .JL-02 and Rickettsia rao-ultii respectively .And the evolutionary positions of SFGR species were similar with Rickettsiamontana and Rickettsiamassili-ae .It's concluded that the nature focus of tick-borne spotted fever did exist in the area of Xunke Area of Heilongjiang Province , China .