OBJECTIVETo evaluated the safety and effect of the 120-W GreenLight HPS laser photoselective vaporization of the prostate (PVP) in different BPH populations.

METHODSThis study included 174 BPH patients treated by PVP using 120-W Green-Light HPS laser. According to the prostate volume (PV) ( < 80 or ≥ 80 ml), history of 5-alpha reductase inhibitor (5-ARI) medication, and history of acute urinary retention (AUR), we divided the patients into a PV < 80 ml, a PV ≥ 80 ml, a 5-ARI, a no 5-ARI; an AUR, and a no AUR group. We collected the baseline, perioperative, and follow-up data about the patients, and compared them among different groups.

RESULTSThe patients were aged 69.4 ± 7.7 years, of whom PVP was successfully performed for 136 and PVP was intraoperatively converted to transurethral resection of the prostate (TURP) in the other 38, with a mean operation time of (49.4 ± 16.3) min. The preoperative PV averaged (67.9 ± 29.8) ml. There was no intraoperative blood transfusion, transurethral resection syndrome, or capsule perforation. Bladder neck contracture occurred in 2 cases and urethral stricture developed in another 2 postoperatively. All the patients showed a significant improvement in the prostatic function parameters and no significant differences were observed between the PV < 80 ml and PV ≥ 80 ml, 5-ARI and no 5-ARI, or AUR and no AUR groups.

CONCLUSIONPVP with 120-W GreenLight HPS laser is safe and efficient for the treatment of BPH and the its effect is not influenced by the prostate volume, history of 5-ARI medication, or history of AUR. However, preoperative urinary catheterization may increase the difficulty of surgery and the risk of conversion to TURP.

5-alpha Reductase Inhibitors ; therapeutic use ; Aged ; Humans ; Laser Therapy ; adverse effects ; methods ; Male ; Operative Time ; Organ Size ; Prostate ; pathology ; surgery ; Prostatic Hyperplasia ; pathology ; surgery ; Transurethral Resection of Prostate ; Treatment Outcome ; Urethral Stricture ; etiology ; Urinary Bladder ; Urinary Retention

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal human cancers. Cur-rent studies on the relationship between complicated type 2 diabetes mellitus (T2DM) and PDAC prognosis have demonstrated inconsis-tent results. The present study aimed to determine the relationship between complicated T2DM and the clinicopathological characteris-tics of PDAC, and evaluate whether complicated T2DM is a significant predictor for overall survival in patients with resectable PDAC. Methods: In this study, clinicopathological characteristics were observed in 136 patients who underwent surgery for PDAC at the Shengjing Hospital of China Medical University between January 2009 and February 2011. The relationship between complicated T2DM and overall survival of PDAC patients was analyzed using univariate and multivariate analyses. Results:The median age of pa-tients was 60 years (range: 35-80 years). Among the 136 patients, 76(55.9%) were male. The prevalence of complicated T2DM was 27.9%in 136 PDAC cases. Preexisting T2DM was not associated with any of the clinicopathological characteristics (all P>0.05). Uni-variate analysis showed that complicated T2DM (P=0.045), maximum diameter (P=0.011), histological differentiation (P=0.013), pT stage (P=0.034), vessel invasion (P=0.032), and pTNM stage (P=0.030) were significantly associated with the overall survival of PDAC patients. The median overall survival time was 14.2 months for T2DM patients, and 18.8 months for non-T2DM patients. In mul-tivariate analysis, complicated T2DM [hazard ratio (HR), 1.873;95%confidence interval (CI), 1.187-2.954;P=0.007], poorly differenti-ated tumor (HR, 2.647;95%CI, 1.413-4.957;P=0.002), and maximum diameter≥4.0 cm (HR, 1.699;95%CI, 1.094-2.640;P=0.018) were the independent predictors associated with poor overall survival. Conclusion:Complicated T2DM was associated with poor prog-nosis. It could be used as a prognostic predictor in patients with resectable PDAC. If confirmed, these findings may provide a novel ap-proach for individualized adjuvant therapy.

Objective To elucidate whether taking Ⅱ b/Ⅲ a receptor antagonist instead of oral antiplatelet drugs during perioperative in patients with drug-eluting stent implantation undergoing non-cardiac surgery would play a preventive role of stent thrombosis,without increasing surgical bleeding.Methods Six patients aged 60 -75 years old with drug-eluting stent implantation within 1 year taking dual antiplatelet drugs without any chest pain,and whose heart function classification for two (NYHA) were enrolled.They underwent surgical treatment due to ineffective conservative treatment of surgical disease,5 days before surgery intravenous infusion tirofiban 0.1 μg/( kg · min) micro pumps continuously instead of oral dual antiplatelet drugs,2 hours before surgery stop tirofiban and re-application of tirofiban 0.1 μg/( kg · rain) after surgery in the intensive care unit,and replacing tirofiban with oral dual antiplatelet as soon as possible according to the situation.Analyze cardiovascular events,especially stent thrombosis events and seriously bleeding,tirofiban adverse drug events during perioperative.Results Six patients have no perioperative malignant ischemic ventricular arrhythmia,angina,myocardial infarction,sudden cardiac death,no massive bleeding and adverse drug reactions.Conclusion Substitution of oral dual antiplatelet drugs for Ⅱ b/Ⅲ a receptor antagonists to prevent stent thrombosis treatment during perioperative in patients with drug-eluting stent implantation undergoing non=cardiac surgery may be feasible and safe,but needs to be further confirmed through large sample of randomly controlled trials.

Objective To evaluate the effect of 3D printing models applied to Medical Imaging Di-agnosis Undergraduate Teaching. Methods Students in the year 2012/2013 of Shanghai Jiao Tong Univer-sity School of Medicine stomatology specialty were chosen for this study, including 38 students in the exper-imental group (2013) and 40 students in the control group (2012). All of them were taught by the same group of teachers, including 28 core curriculum hours and 5 practice class hours. 3D printing technology with PPT was applied to the experimental group in the medical imaging diagnostic teaching, and conventional teaching including PPT and usual models in the control group. Medical students were given a test about cardiovascular system and tasked with completion of drawing hand and foot bones. Students in experimental group were also asked to complete a questionnaire about their experience. Results The questionnaire showed that 3D printing teaching molds with PPT was of great significance to improve the students interest in learning imaging anatomy, to meet the vast majority of students' learning requirements, and to achieve satis-factory results. The average scores of the circulatory system test in the experimental group were higher than that of the control group [(8.32 ±2.352) vs. (6.15 ±1.284), P<0.05)]. Students in experimental group per-formed better than students in the control group on the Locomotor system test [(6.81 ±1.347] vs. (3.84 ± 0.985), P<0.01]. Conclusions 3D printing mold combined with PPT teaching method can promote the med-ical imaging anatomy structure, learning effect and teaching quality, and has practical value in the under-graduate teaching of medical imaging diagnosis.

Objective:To evaluate the safety and efficacy of antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary in-tervention. Methods:In the study, 96 patients suffering from acute ST segment elevation myocardial infarction onset within 12 h undergoing primary percutaneous coronary intervention from May to October in 2013 were randomly divided into ticagrelor group (n=48) and clopidogrel group (n=48) by using the method of random number table. Ticagrelor and clopidogrel antiplatelet treatment were used before and after operation. Their baseline data, coronary artery disease characteristics, platelet count, adenosine diphosphate(ADP)-induced platelet inhibition rate by thrombelastograph after 5 days of treatment, the major adverse cardiovascular events of the follow up for 6 months and bleeding complications were observed and compared in the two groups. Re-sults:The differences between the two groups of patients with their baseline data, the features of coronary ar-tery lesions, platelet count before and after 5 days of treatment had no statistical significance (P>0. 05). ADP induced platelet inhibition rate [(80. 2 ± 10. 7)%] after 5 days of treatment in ticagrelor group was sig-nificantly higher than that in clopidogrel group [(75. 3 ± 12. 1)%, P<0. 05]. The two groups of patients were followed up for 6 months, 8 cases of major adverse cardiovascular events occurred in clopidogrel group, 2 ca-ses of major adverse cardiovascular events occurred in ticagrelor group, and there was significant difference between the two groups (P<0. 05). The two groups (7 cases of 48 patients in ticagrelor group vs. 3 cases of 48 patients in clopidogrel group ) had no statistically significant difference in bleeding complications ( P>0. 05). Conclusion: Antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing emergency PCI has good efficacy and safety.

Objective To analyze the MSCT manifestations of septic pulmonary embolism(SPE)to explore the diagnosis value of MSCT.Methods The MSCT findings of eight patients with SPE were analyzed retrospectively.Results ① Of all 177 lesions,84 lesions located in both upper lobes,25 lesions located in right middle lobe and 68 lesions located in both lower lobes.② There were 106 nodules and 44 wedge shaped opacities in all the 8 cases,of which the 88 nodules (83.0%)and all of the wedge shaped opacities located in sub-pleural zones of the lung and the 18 nodules (1 7.0%)located in the inner and middle lung fields.In 6 cases,the 26 nodules (24.5%)and the 1 6 wedge shaped lesions (38.1%)had “feeding vessels”.③ There were 27 patchy shadows in 6 patients,of which 12 patchy shadows (44.4%)had air bronchogram.④ There were 18 cavities in 6 patients,of which 14 cavities (13.2%)located in nodules and 4 cavities (9.1%) in the wedge shaped lesions.There were 8 cysts in 4 patients,of which 6 cysts located in nodules (5.7%)and 2 cysts in the wedge shaped lesions (4.5%).⑤ The nodules and the wedge shaped lesions were enhanced slightly.⑥ Pleural effusion and pericardial effusion were found in 4 and 3 patients,repectively.⑦ Of 6 patients the follow-up MSCT scan in a short period showed the disease progressions. Conclusion SPE has characteristic manifestations in MSCT,and MSCT can provide valuable information for the diagnosis of SPE.

Objective:To investigate the effect of different postoperative nutritional support on the gastrointestinal function and nutritional status in acute colon peforation patients.Methods:60 cases of acute emergency operation patients with perforation of the colon,according to the given nutritional support treatment of the different ways,were divided into enteral parenteral joint nutrition (EN + PN) group and total parenteral nutrition (TPN) group.Clinical therapeutic effects of two groups were compared.Results:The results of EN + PN group were significantly better than the those in TPN group (P ＜ 0.05).Conclusion:EN + PN model can improve the postoperative nutritional status and accelerate the recovery of patients with acute colonic perforation.

ObjectiveTo investigate the effectiveness and toxicity of CyberKnife in the treatment of lung metastases.MethodsTreatment details and outcomes were reviewed for 93 targets of 48 histologically verified patients treated by CyberKnife at the CyberKnife Center of Tianjin between September 2006 and June 2010.The median tumor volume was 6.0(0.2 - 135.2) cm3,the median biological equivalent dose was 140.8(53 - 180) cGy (α/β =10),the median fraction was 3(1-7) times and the median isodose line was 81％ (71％-91％ ).ResultsThe rate of follow-up is 96％.33 cases were followed up for more than 2years.The effective rate was 90.3％.Two targets of 2 patients locally progressed.The 1-and 2-year local control rates,overall survival (OS) rates and progression-free survival (PFS) rates were 98％ and 98％,83％ and 63％,and 64％ and 37％,respectively.Univariate analyses showed that age older than 60 versus ≤60 years tended to be predictor for PFS ( x2 =3.45,P =0.063 ) ;The PFS of patients who had single lesion was better than patients with multiple lesions ( x2 =4.49,P =0.034 ) ; patients with disease-free interval longer than 18 months had better OS ( x2 =6.50,P =0.011 ).Five patients were reported to experience treatment-related grade 1 radiation pulmonary injury,and one each for subcutaneous fibrosis with pigmentation,grade 2 and grade 3 adverse event.ConclusionsFor patients with lung metastatic lesion,CyberKnife is an effective option with high local control rate and little acute reaction.The long-term outcome and toxicity need further study.

Animals ; Biofilms ; Caenorhabditis elegans ; metabolism ; Genes, Bacterial ; Yersinia pestis ; genetics ; metabolism

Objective To analyze the situation of smoking control calls at 12345 citizens′ hotline in Shanghai and investigate the smoking control hotspots concerned by citizens, the handling efficiency and quality of the hotline management, especially after the tobacco control ordinance was amended. Methods Statistical analysis was made on 48 945 smoking control calls, and data model established by natural language processing. Results After amendment of the tobacco control ordinance, there was a great increase in the number of smoking control calls, which reached a peak in 2017, and became 6.7 times that of 2016.Complaint report was the most important part of tobacco control calls, accounting for 76.24% of the total.Work and dining places were the main venue for complaints, while restaurants and offices were with the largest number of calls.The proportion of health departments in all responsible departments was the largest, accounting for 29.71%.Criticism and education were still the main way to deal with the problem, which was far from meeting the demands of citizens in this regard. Conclusion Publicity can mobilize the enthusiasm of the citizens to participate in tobacco control.The working efficiency and quality of responsible departments still needs to be improved.Citizen′s appeal can serve as a reference for future amendments to the law.