Objective To investigate the efficacy and safety of plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB). Methods 158 patients with BPH were randomly divided two groups: 81 patients treated by plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB), 77 patients treated by plasmakinetic resection of the prostate (PKRP). All patients were evaluated preoperatively and at 1, 6, 12 months after surgery by IPSS, QOL, Qmax and PVR. Operation time, resected adenoma weight, catheterization time, hospital stay and complications were documented. Results There were no significant differences in preoperative parameters. The resected adenoma weight in the PKERPADPB group was heavier than that in the PKRP group, the difference was significant. Compared with PKRP, PKERPDPB required a longer operation time, but resulted in less hemoglobin decrease, less catheterization time and hospital time. During the 1, 6, 12 months of follow-up, there was no significant difference in Qmax, IPSS, PVR and QOL between the groups. Conclusion PKERPDPB was statistically superior to PKRP in blood loss, catheterization time, hospital stay but inferior in operation time. It was a safe and effective treatment for BPH.

Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

Objective To investigate the occurrence of p16 gene methylation in the population chronically exposed to arsenic in Inner Mongolia,and to study the molecular mechanisms of carcinogenesis associated with arsenic exposure.Methods The study group was composed of 40 cases of typical arseniasis selected from the epidemic area,and the two control groups consisting respectively of 40 non-arseniasis cases selected from the same epidemic area,and 40 healthy persons enrolled from non-epidemic area.Methylation of p16 gene in the blood specimens were analyzed for all the subjects with MS-PCR techniques,and statistical analysis was performed using chi square test.Results The positive rates of p16 hypermethylation in blood specimens were 65.0%,47.5% and 20.0% respectively in study group and two control groups,and the rate of hypermethylation increased with the increase in arsenic exposure with drinking water in epidemic areas.The positive rate of p16 hypermethylation showed significant differences(P

Objective To evaluate the clinic role of diffusion tensor imaging in diagnosis of central nervous system diseases with damage of white matter fibro bands.Methods Ten healthy volunteers and sixty-four patients(31 cases of cerebral vascular disease, 7 cases of demyelinating disease, 7 cases of inflammatory disease, 10 cases of tumor, 2 cases of degenerative disease, 2 cases of congenital brain dysgenesis, 3 cases of brain atrophy, and 2 cases of others) underwent MRI examination, which included conventional T 1WI, T 2WI, T 2 Flair and diffusion tensor. Fractional anisotropy(FA) were measured in white matter tracts and gray matter.Results Ablation of white matter fibro tracts and reduction of FA could be found in 59 patients(92.1%).Erosion like alteration was seen in 12 patients(20.3%).In all the patients with tumors showed push and displacement of the white matter fibro tracts.Conclusion Diffusion tensor imaging can show lesions in white matter at early stage of some diseases.It is better in displaying damage or displacement of white matter tracts than conventional MRI.

The future war will inevitably to be in the land,the sea and the sky and so on hyperspace,and electromagnetic environment is very complex.How to eliminate interference of medical equipment under the complex electromagnetic environment,to promote the performance of the medical support,these is austerity and reality questions in current every level of medical and health organization.Only based on the existing,bold practice,independent innovation,the comprehensive medical support exercise under the complicated electromagnetic environment,to master various types of medical equipment in a complex electromagnetic environment of the characteristics and laws in order to give full play to existing health technologies and equipment performance,improve the timeliness of medical support.

Objective To observe the effect of intravenous anesthesia (IVA) with propofol (P),ketamine (K) and fentanyl (F) in different ways in children. Methods 90 pediatric patients were divided into three groups ( n =30) randomly according to the drug used for IVA. Ⅰgroup used compounds of P, F and K; Ⅱgroup used compounds of P and F; Ⅲ group used compounds of P and K. All the drugs were injected intravenously with micro-pump. Total dosage of anaesthetics, awaken time after operation and variation of circulation and breath were observed and sedative and analgesic effect during operation were evaluated. Results Compared with Ⅱ or Ⅲ group, Ⅰgroup showed less dosage, shorter awaken time and smaller degree of change in circulation and breath with complete sedation and analgesia ( P

Objective To observe the effect of emotion regulation on anxiety in patients undergoing functional endoscopic sinus surgery (FESS) under acupuncture-drug compound anesthesia.Method Ninety patients who were going to receive FESS were randomized into group A, B and C, 30 cases in each group. Acupuncture-drug compound anesthesia [electroacupuncture at Yingxiang (LI 20) and Yintang (GV 29)] was adopted in the three groups, ordinary doses of anesthetic drugs for group A and B (1% Tetracaine hydrochloride injection 100 mg+2% Lidocaine hydrochloride injection 0.1 g+Adrenaline hydrochloride injection 2 mL) and reduced doses for group C (1% Tetracaine hydrochloride injection 70 mg+2% Lidocaine hydrochloride injection 0.1 g+Adrenaline hydrochloride injection 2 mL). Conventional nursing was applied to group A, while specific emotion regulation was additionally adopted in group B and C during the perisurgical period. The three groups were evaluated by using Zung's Self-rating Anxiety Scale (SAS) prior to the surgery, 24 h and 48 h after the surgery, and the satisfaction ratings of the patients towards the surgery, anesthesia and nursing were compared.Result The SAS score 48 h after the surgery was significantly different from that before the surgery in group A (P<0.05). The SAS scores 24 h and 48 h after the surgery were significantly different from the score before the surgery in group B and C (P<0.05); the score 48 h after the surgery was significantly lower than that 24 h after the surgery in group B and C (P<0.05). 24 h and 48 h after the surgery, the SAS scores in group B and C were significantly different from those in group A (P<0.05). The satisfaction ratings of nursing in group B and C were significantly higher than the rating in group A (P<0.05). Conclusion Specific emotion regulation can effectively mitigate the anxiety of patients undergoing FESS under acupuncture-drug anesthesia, and improve the satisfaction rate of patients towards nursing.

Objective To investigate the clinical efficacy of inserting a ureteral access sheath under direct view in flexible ureteroscopy with the help of rigid ureteroscope.Methods From March 2013 to July 2015,there were 68 patients accepted a ureteral access sheath in flexible ureteroscopy with the help of rigid ureteroscope for the treatment of kidney stones.There were 46 cases male,22 cases female,aged from 22 to 76 years old,average 43.9 years.There were 68 cases with backaches or hematuria.There were 48 cases with single stone,20 patients with multiple stones.There were 5 cases with stones on both sides.The stone diameter were from 1.2 to 2.5 cm,the average (1.83 ± 0.16) cm.There was no hydronephrosis in 18 cases,mild hydronephrosis 42 cases.The operations were carry out under general anesthesia.By using rigid ureteroscope placed zebra guidewire,then intercept F8 single lumen tip to 1.0 cm section on rigid ureteroscope,was placed into a modified 42 cm ureteral access sheath.Then the modified 42 cm ureteral access sheath was inserted under direct view with the help of rigid ureteroscope.Preoperative patient characteristics,radiographic stone size,operation time,success rate of lithotripsy,serious complications especially ureteral injury was recorded.4 weeks and 12 weeks after operation,ultrasound and/or CT were reexamined to assess the success rate of lithotripsy and the incidence ureteral stricture.Results All the procedures were successful.The operation time was (62.2 ± 6.5)min,the hospital stay was (3.1 ± 0.2) d.The success rate of ureteral access sheath completely placement was 97.1％,partially placement was 2.9％.Postoperative complications included Clavien classification grade Ⅰ 6 cases and grade II 2 cases.The postoperative follow-up averaged (12 ± 1.2) months for all case.The success rate of lithotripsy was 76.5％ in 4 weeks postoperative,and it was 95.6％ in 12 weeks.During the follow-up,compared with the preoperative cases,62 cases were not found to increase the degree of hydronephrosis.There were 58 cases (58/62) without hydronephrosis.4 cases were mild hydronephrosis (4/62).CT showed normal ureter 52 cases (52/52).Conclusions It was safe and reliable procedure with good results.It would be a safe procedure to inserting a ureteral access sheath under direct view in flexible ureteroscopy with the help of rigid ureteroscope.

Humans ; Periodontal Diseases ; therapy

Objective To investigate the effects of eardiopulmonary bypass(CPB)on plasma nitric oxide (NO)and asymmetric dimethyl arginine(ADMA)concentrations in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.Methods Eighteen ASA Ⅱ or Ⅲ patients aged 11-40 yr weighing 26-59 kg undergoing open heart surgery under CPB were divided into 3 groups according to pulmonary arterial systolic pressure(PASP)(n=6 each):group Ⅰ PASP<30 mm Hg;group Ⅱ PASP 30-50 mm Hg and group Ⅲ PASP>50 mm Hg.Arterial blood samples were taken before induction of anesthesia (To,baseline),at the start and termination of CPB(T1,2)and 3,6,24 h after CPB(T3-5)for determination of plasma NO and ADMA concentrations.Results The three groups were comparable with respect to M/F sex ratio,age,body weight and CPB time.The plasma ADMA concentrations were significantly increased while NO concentrations were significantly decreased at termination of CPB(T2)and 3 and 6 h after CPB(T3,4)as compared with the baseline at T0 in group Ⅱ and Ⅲ.The plasma ADMA concentration were significantly higher and No concentrations were significantly lower at all time points in groupⅡand Ⅲthan in group Ⅰ.Conclusion CPB can increase plasma ADMA concentration and decrease plasma NO concentration in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.