1.Comparison of therapeutic effects between transurethral plasma kinetic enucleation of prostate and transurethral resection of prostate on benign prostatic hyperplasia
Xin CHEN ; Xiao GUO ; Huan SHAO
Chinese Journal of Geriatrics 2009;28(5):397-400
Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groups:TUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.
2.Analysis of risk factors and treatment of postoperative delirium in patients with benign prostatic hyperplasia
Xiao GUO ; Huiping CHENG ; Xin CHEN
Chinese Journal of Geriatrics 2009;28(2):122-124
Objective To investigate the risk factors and treatment of postoperative delirium in patients with benign prostatic hyperplasia(BPH). Methods For 256 postoperrative BPH patients in our department,the clinical parameters including age,hypoxemia,preoperative infection,postoperative pain,and introvert were analyzed,and the treatment were summarized. Results The incidence of postoperative delirium was higher in patients aged≥75 years than<75 years[17.4%(19/109)vs.5.4%(8/147),X2=8.307,P=0.0043,higher in patients with preoperative infection (pulmonary or urinary)versus without the infection[15.0%(17/113)vs.7.0%(10/143),X2=4.337,P=0.037],higher in patients with hypoxia versus without hipoxia[16.5%(16/97).vs.6.9%(111159),X2=4.885,P=0.027]and higher in patients with post-operative pain versus without the pain(16.9%(10/59)vs.1.2%(1/85),X2=10.146,P=0.0014].Hematocrit and hemoglobin in patients with postoperative delirium were lower after operation versus pre-operation[(0.29±0.04)vs.(0.42±0.04),t=12.2314,P<0.001;(102.39±6.58)g/L vs.(114.58±8.36)g/L,t=5.9537,P<0.001].All delirium patients were recovered after sedation treatment,improving the quality of sleep,controlling the infection and correcting electrolyte turbulence. Conclusions Advanced age,hypoxemia,preoperative infection,postoperative pain are important risk factors for delirium.
3.Analysis of incidental prostatic carcinoma in 42 cases after transurethral plasmakinetic enucleation of prostate
Xin CHEN ; Xiao GUO ; Zhiqiang BAI
Chinese Journal of Geriatrics 2013;32(8):847-849
Objective To investigate the correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma.Methods From 2004 to 2010,a total of 1076 patients diagnosed as BPH underwent transurethral plasma kinetic enucleation of prostate (TUPKEP) in our hospital,and their clinical data were respectively analyzed.Among them,42 cases were found to have incidental prostatic carcinoma.The correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma were observed.Results Among 1076 BPH patients undergoing TUPKEP operation,42 cases (3.9%) aged 56-88 years were found to have incidental prostatic carcinoma,which all displayed as prostatic adenocarcinoma including 18 cases at T1 a stage and 24 cases at T1b stage.10 cases received endocrinal therapy,14 cases received bilateral orchiectomy,14 cases underwent radical prostectomy and 4 cases were treated with watchful waiting.Patients were followed up for 24 to 96 months.The survival rates were 100.0% and the rates of progression were 0.0%,20.0%,0.0% in T1 a patients received watchful waiting,androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 100.0% and total rate of progression was 11.1% in T1a patients.The survival rates were 71.4%,100.0% and the rates of progression were 42.9%,0.0% in T1 b patients received androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 83.3 % and total rate of progression was 25.0 % in T1 b patients.Compared with T1 b patients,the total survival rate was higher (x2=18.19,P<0.01) and the rate of progression was lower in T1 a patients (x2 =6.52,P<0.05).Conclusions The survival rate in T1 a patients accepted androgen-deprivation therapy is similar to that in T1 a patients with watchful waiting.Compared with T1a patients,the survival rate is lower but the rate of progression is higher in T1 b patients received active androgen-deprivation therapy.The survival rate is higher in T1 b patients treated with radical prostectomy than in those received other treatments.Watchful waiting is acceptable for T1 a patients.T1 b patients should be treated with radical prostectomy for a better effect.
4.Change of Serum Neuron Specific Enolase in Neonates with Asphyxia before and after Head Mild Hypothermia Treatment
jun, CHEN ; yan, GUO ; xiao-li, SUN
Journal of Applied Clinical Pediatrics 2006;0(14):-
Objective To explore the change of serum level of neuron specific enolase (NSE) in neonates with asphyxia before and after head mild hypothermia.Methods Eighty-two asphyxial neonates were selected,including 39 mild asphyxial neonates and 43 severe asphy-xial neonates,and 29 healthy neonates were selected as control group.Forty-three severe asphyxial neonates were randomly assigned into mild hypothermia treatment group and traditional treatment group.Neonates in traditional treatment group were just given traditional treatment.While neonates in mild hypothermia treatment group received head mild hypothermia therapy and their nasopharyngeal temperature were maintained at(34.0 ? 0.5) ℃ for 72 h.Before treatment and 72 h after treatment,2 mL blood was collected,and the serum NSE was determined by radio immunoassay.Results NSE levels in mild asphyxial neonates group[(34.83?6.17) ?g/L] and severe asphyxial group[(59.58?8.87) ?g/L] were significantly higher than that of control group[(30.57?4.88) ?g/L](t=3.07 P0.05).The level of NSE at 72 h in severe asphyxial neonates with head mild hypothermia therapy[(40.97?6.55) ?g/L] was significantly lower than that of traditional treatment group [(48.15?5.57) ?g/L](t=3.86 P
5.Study of quality of life in patients with stroke at the acute stage and the suitability of SF-36
Tie-Cheng GUO ; Xiao-Hong CHEN ;
Chinese Journal of Physical Medicine and Rehabilitation 2003;0(12):-
Objective To assess the quality of life(QOL)in patients with stroke at the acute stage,and to determine whether all the dimensions of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)are applicable to the stroke patients.Methods Fifty stroke patients at the acute stage were studied.The SF-36 was employed to assess the quality of life of the patients,and a self-designed questionnaire was used to record the general information of them.The data obtained from the patients was compared with the Chinese norm reported in literature. We also calculated the percentage of subjects who achieved the lowest possible score(score of 0,floor effect)and the percentage of subjects who achieved the highest possible score(score of 100,ceiling effect).Results The QOL of the acute stroke patients,as reflected by scores with all the dimensions of the SF-36 scale,was significantly reduced when compared with the norm data(P
6.The Usage of Conventional Teaching Combined with PBL in Microbiology Teaching
Chun-Yan CHEN ; Xiao-Kui GUO ;
Microbiology 2008;0(09):-
PBL is a modern model of classroom teaching. We have introduced it into the teaching of Microbiology. As a result, the students’ learning abilities have been raised to a higher level, and their learning autonomy and achievement have been improved. The combination of PBL method with traditional teaching methods achieved a good effect.
8.Targeted transfection of Ang-1 gene via microbubbles carrying ICAM-1 antibody to acute myocardial infarction
Xiao WANG ; Ruiqiang GUO ; Qing ZHOU ; Qian CHEN ; Jinling CHEN
Chinese Journal of Ultrasonography 2011;20(5):436-440
Objective To explore the capability of Ang-1 gene delivery to acute myocardial infarction using targeted microbubbles carrying ICAM-1 antibody.Methods Thirty-seven rabbits' left circumfles branch coronary arteries were ligated for models.Three rabbits were injected with microbubbles carrying ICAM-1 to detect the ability of targeting.Thirty-four rabbit models were divided into 3 groups randomly as follow:IM group (n=12,accept direct intramuscular injection),ICAM-1 group (n=12,accept intravenous injection of targeted microbubbles and Ang-1) and control group (n=10,without any treatment).Ultrasonography were executed on all animals before and 2 weeks after the treatment.All rabbits were killed after 2 weeks and examined for Ang-1 mRNA and protein by RT-PCR and Western-Blot respectively.Microvessel density (MVD) counting of infracted myocardium,observed by factor Ⅷ immunochemical staining,was performed to value the proangiogenesis effect of Ang-1 delivered by targeted microbubbles carrying ICAM-1 antibody.The liver and the kidney in ICAM-1 group were taken to assess the systemic delivery.Results IM and ICAM-1 group showed significantly improvement in the ejection fraction (P<0.05) while control group did not.Ang-1 mRNA and protein could be detected in IM and ICAM-1 group;however,the expression between the two groups showed no siginificant difference.None of the control animals showed Ang-1 expression.compared with ICAM-1 group,the MVD was greater in IM group.Ang-1 was not detected either in liver or in kidney in ICAM-1 group.Conclusions Targeted microbubbles carrying ICAM-1 antibody can deliver Ang-1 gene to ischemic myocardium directly.Meanwhile,it's as effective as IM injections besides the greater angiogenesis effect.This strategy improves the perfusion of acute myocardial infarction and the function of heart.
9.The primary study of optimization parameters of ultrasonic microbubbles delivery hAng -1 gene into 2 9 3 T cells in vitro
Qing ZHOU ; Qian CHEN ; Xiao WANG ; Jinling CHEN ; Ruiqiang GUO
Chinese Journal of Ultrasonography 2009;18(12):1076-1079
Objective To certificate the effects on transfection ratio and cells viability of ultrasound (US) acoustic intensity, radiation duration, microbubbles concentration and DNA concentration in delivery human angiopioetin-1 gene (hAng-1) into 293T cells by SonoVue microbubbles and decide the optimal transfection parameters. Methods Mix 293T cells and SonoVue microbubbles linked with eGFP-C_3-hAng-1 in a different way, detect the gene transfection ratio and cells viability under the various US intensity, radiation duration, microbubbles and DNA concentrations. Results The gene expression would be increased if enhanced the intenstiy of US,radiation time,microbubbles and DNA concentrations,and the cells viability would be kept more than 90% ( P <0. 01). Whereas,if the US intensity increased over 1. 5 W/cm~2 ,the duration over 30 s and microbubbles and DNA concentrations over 20% and 15 mg/L respectively,the gene expression would not increase significantly ( P > 0. 05),whereas coupled with obviously decreased cells viability( P <0. 01). Conclusions The optimal conditions of deliver hAng-1 gene into 293T cells by SonoVue microbubbles was mixing cells and microbubbles in a cell wall-sticky way,US intensity was 1. 5 W/cm~2, duration 30 s,20% microbubbles and 15 mg/L DNA concentration.
10.Transfection of Ang-1 gene via ultrasound-mediated SonoVue microbubble destruction in vitro and in vivo
Xiao WANG ; Qing ZHOU ; Qian CHEN ; Jinling CHEN ; Ruiqiang GUO
Chinese Journal of Ultrasonography 2012;21(1):65-70
Objective To investigate the transfection efficacy and expression of Ang-1 gene and proangiogenesis in vitro and vivo by ultrasound-mediated microbubble destruction.Methods 293T cells were divided into three groups:group A was given hAng-1 plasmid and microbubbles plus ultrasonic irradiation,group B was given hAng-1 plasmid and ultrasound,group C was given hAng-1 plasmid only (without ultrasound).Forty-eight hours after transfection,the transient expression rate was observed under fluorescence microscopy and flow cytometry.RT-PCR and Western blot analysis were taken to evaluate the mRNA and protein expression of Ang-1 respectively.Twenty-seven rabbit models of ligated left circumflex branch coronary artery were divided into 3 groups randomly as follow:group Ⅰ (accepted intravenous injection of SonoVue microbubble and Ang-1 plus ultrasonic irradiation),group Ⅱ (accepted intravenous injection of Ang-1 with ultrasound),group Ⅲ (control group).Myocardial contrast echocardiography (MCE) was executed on all animals before and after the treatment.Two weeks after gene delivery,RT-PCR and Western blot analysis were taken to evaluate mRNA and protein expression of Ang-1 respectively.Microvessel density (MVD) counting of infracted myocardium,observed by Factor Ⅷ immunochemical staining,was performed to value the proangiogenesis effect of Ang-1 delivered by ultrasound mediated cavitation of microbubble.Results Green fluorescence was observed in group A and B by fluorescence microscopy,which was negative in group C.The transfection expression rate was significantly improved in group A ( P < 0.01).In vivo,Microbubbles could be observed in former ischemic myocardium in MCEexamination and the Ang-1 mRNA and protein could be detected in group Ⅰ.On the other hand,the contrast agent was defected obviously and none of the animals showed Ang-1 mRNA and protein expression in other two groups.The MVD counting showed significant improvement in group Ⅰ whereas other two groups didn't.ConclusionsMicrobubble-enhanced ultrasound exposure can improve the Ang-1 gene transfection expression rate observably both in vitro and in vivo.This strategy for delivering has great proangiogenesis effect in vivo.