Objective To evaluate the efficacy and safety of silodosin in the treatment of benign prostatic hyperplasia (BPH).Methods Randomized controlled trials (RCT) on the efficacy and safety of silodosin for the treatment of BPH were retrieved from Medline (1966-2012),Embase (1988-2012),Cochrane liberary,CMCC (1979-2012),CNK1 (1979-2012) and the quality of the included RCTs were evaluated using Cochrane systematic evaluation to analyze the data statistically using Rev Man 5.1.0 software.Results Six RCTs involving 2543 participants were included for the meta-analysis.Results of analysis showed that silodosin was effective in the treatment of BPH in term of total international prostate symptom score (IPSS) (standard mean difference (SMD) =2.92,95 ％ CI =2.19-3.65,P ＜ 0.05),voiding symptom score (SMD =1.92,95％ CI =1.44-2.39,P ＜0.05),storage symptom score (SMD =0.92,95％ CI=0.60-1.24,P ＜0.05),and maximum flow rate (Qmax) score (SMD =1.56,95％ CI=1.38-1.75,P ＜ 0.05),compared with the placebo.Silodosin 8 mg was more effective than tamsulosin 0.2 mg in term of IPSS-related parameters and Qmax (P ＜ 0.05).Silodosin 8mg and tamsulosin 0.4 mg were similarly effective in all the efficacy analyses.Abnormal ejaculation was less common with tamsulosin 0.2 mg and 0.4mg (P＜0.05); overall adverse events were similar with tamsulosin 0.2 and 0.4 mg (P ＜0.05).Conclusions Silodosin was significantly more effective than placebo and tamsulosin 0.2 mg in improving symptoms and as effective as tamsulosin 0.4 mg.For adverse events,abnormal ejaculation was more common with silodosin.

OBJECTIVE: To investigate feasibility and effectiveness of pedicle screw bi-cortical fixation in lumbar spondylolisthesis or destabilization of aged people. METHODS: The statistical significance of the distance between the anterior edge of vertebral body and the anterior major blood vessels at the level of pediculus arcus vertebrae by CT scan at random were measured and analyzed. 82 cases of lumbar spondylolisthesis or destabilization, aged 65 years (range 51 to 75 years), including 35 males and 47 females, were treated pedicle screw bi-cortical fixation, with the anterior edge of the vertebral body penetrated by one screw thread. The function was evaluated by Macnab backleg pain scale standards. RESULTS: There was significant difference in the distance of the anterior edge and the major vessels between the old and the young (P< 0.05). All the 82 cases were operated successfully, and the mean time was 145 minutes and the mean amount of bleeding was 530 mL. The 43 cases including 15 males and 28 females were followed up for 18 months (range 3 to 53 months). There was one case of rupture of the spinal dura mater with no sequela after the suture. There were 3 cases of transient paralysis and pain of lower limbs, which were alleviated after 2 months' treatment. No complications of nerve root or vessel injuries were found. All incisions healed well at the primary stage. The lumbocrural pain of all 43 cases was alleviated to a certain content. There were 31 cases of excellent, 10 of good, and 2 of fair; the excellent and good rate was 97%. CONCLUSION: It is feasible and safe to treat the lumbar spondylolisthesis or destabilization in the old with the pedicle screw bi-cortical fixation.

Objective:To explore the application value of three-dimensional visualization technique based on CT data in the analysis of renal vascular anatomical variation.Methods:The clinical data of 210 patients with renal tumors, adrenal tumors and renal cysts who underwent renal enhanced CT from October 2020 to June 2021 were retrospectively analyzed. Among the patients, there were 114 males and 96 females with an average age of (56.5±13.2) years. The CT data were reconstructed by 3D slicer software. According to the three-dimensional visualization model, the renal vascular anatomy was analyzed from the perspective of whether it needs to be treated during laparoscopic radical nephrectomy and laparoscopic partial nephrectomy. The variation of renal artery can be divided into multiple renal arteries, premature branches of renal artery and the mixed type with the above two variations. Renal vein variation can be divided into multiple renal veins, late confluence of renal veins and mixed type with the above two variations.Results:Among the 210 patients in this study, there were no statistically significant differences in anatomical variations of renal arteries and veins between males and females ( P=0.914 and P=0.121). Among 420 kidneys, renal artery variation (174/420, 41.4%) was more common than renal vein variation (121/420, 28.8%) ( P<0.01). 32 (7.6%) right kidneys and 38 (9.0%) left kidneys have multiple renal arteries ( P=0.432). Eighty-nine cases (42.4%) had premature branches in the right renal artery, while 37 cases (17.6%) in the left kidney ( P<0.01). 24 kidneys (5.7%) showed mixed renal artery variation. 53 (12.6%) right kidneys and 3 (0.7%) left kidneys had multiple renal veins ( P<0.01). Late confluence of renal veins was found in 41 right kidneys (9.8%) and 33 left kidneys (7.9%), respectively ( P=0.306). 8 (1.9%) mixed renal vein variants were all right kidneys.. From the perspective of laparoscopic renal surgery, there were 71 cases (33.8%) of the left kidney to deal with ≥ 2 renal arteries, as well as 103 cases (49.1%) of the right kidney ( P<0.01). There were 44 cases (21.0%) of the left kidney to deal with ≥ 2 renal veins, as well as 78 cases (37.1%) of the right kidney ( P<0.01). Conclusions:The three-dimensional visualization technique based on renal CT data is helpful to accurately evaluate the renal vascular anatomy before operation. Right renal vascular variants are more common.