Objective To evaluate the efficacy of greenlight photoselective vaporization of the prostate(PVP) for benign prostatic hyperplasia(BPH) in aged patients.Methods A total of 90 aged patients with BPH underwent PVP with an 80 W KTP laser(Laserscope Company) under sacral or peridural anesthesia.Results The operative time was(42.5?18.4)min;the postoperative urinary catheter time was(2.5?0.8)d.Qmax increased significantly from(4.8?1.2)ml/s preoperatively to(18.6?1.4)ml/s postoperatively(t=22.566,P=0.000).International prostate symptom score decreased from(25.5?2.4)points preoperatively to(13.2?1.9)points postoperatively(t=12.286,P=0.000).Residual urine decreased from(76.3?9.4)ml preoperatively to(16.5?2.4)ml postoperatively(t=21.901,P=0.000).Transient dysuria occurred in 4 cases and postoperative delayed hemorrhage in 2 cases.No urinary incontinence occurred.Conclusions PVP for BPH is a safe and effective procedure,and suitable for aged and high-risk patients with BPH.

Objective To study the anti-oxidative stress effects of benazepril and candesartan.Methods SHRs of 12 weeks old were given benazepril(10 mg/kg?d,n=9)or candesartan(4 mg/kg?d,n=9)or combina- tion(Ben:10 mg/kg?d+Can:4 mg/kg?d)for 12 weeks.The tail arterial pressure was measured every two weeks.At end of study,pathological changes in the thoracic aorta,activity of SOD,serum contents of NO and hydroxy radicals,plasma Ang Ⅱ and cGMP,eNOS and P22~(phox)protein expressions in aortic tunica intima were de- termined.Results The thoracic aorta wall was thickened markedly in SHRs,and blood pressure,hydroxy radi- cal,Ang Ⅱ and P22~(phox)protein expression were increased significantly,while the serum NO,level of cGMP and eNOS expression were decreased.Benazepril(Ben)or Candesartan(Can)inhibit the thickening of vessel wall, enhance the activity of SOD(Ben:68.7?2.1,Can:65.6?4.2 vs SHR:48.8?3.2 U/mL,P

Objective To investigate the relationship between job burnout and psychological health diathesis of the senior medical workers in Tianjin.Methods 263 medical workers were tested by Psychological Health Diathesis Scale (PHDS) and Chinese Maslach Burnout Inventory (CMB[).Results (1) Total detection rate of burnout was 69.3％.Detection rate of mild burnout was 43.0％,moderate 20.2％,and severe 6.1％.(2) Explain rate of self-concept and emotionality to the job burnout was 31.5％.Conclusion Job burnout is prevalent in the senior medical workers in Tianjin.Emotionality,interpersonal diathesis and self-concept,to some extent,can forecast job burnout.

Background Dry eye syndrome is a frequent postoperative complication of laser in situ keratomileusis (LASIK).Some studies reported that the hinge location of corneal flap has influence on dry eye syndrome following LASIK,but others showed inverse views.Objective This systematic review was to evaluate and compare the effects of a superior-and nasal/temporal-hinge location on dry eye syndrome after LASIK.Methods A systematic literature retrieval was conducted in the Medline,Embase,Cochrane Library and CNKI from 1990 to 2011 according to designed searching strategy and relevant words.Published randomized-controlled clinical trial (RCT) data of the effect of superior-and nasal/temporal-hinge location on dry eye syndrome were extracted by two researchers separately.The outcome parameters,such as tear film breakup time (BUT),Schirmer Ⅰ test and corneal sensation were analyzed 1 week,3 months and 6-12 months postoperatively.The statistical analysis was performed using a RevMan 5.0 software and the quality of included literatures were graded according to the Jadad scale.Fixedeffect model was used for the inhomogeneity multiple studies (P≥0.1,homogeneity test I2 ＜50％),and random-effect model was used for the homogeneity studies.Results Ten pieces RCT papers were searched and 3 of them were rejected because of the lack of outcome data.In 7 included studies,652 eyes of 331 patients were involved in the Meta analysis,with the Jadad scores ≥ 3.BUT assessment was performed in 5 trials (530 eyes),Schirmer Ⅰ test evaluation was in 7 trials (652 eyes) and corneal sensation observation was in 4 trials (320 eyes),without significant homogeneity among the relevant literature(I2＜50％).Meta analysis revealed that BUT in the eyes with superior-hinge group was obvious shorter than that in the eyes nasal/temporal-hinge group at 1 week (WMD =-0.42,95％ CI:-0.79 to-0.06,P=0.020),but there was no signifieant difference in 3 months and 6-12 months duration postoperatively.Better corneal sensation was found at postoperative 3 months (WMD=-0.62,95％CI:-l.09 to-0.19,P=0.005) in the nasal/temporal-hinge group,but there was no difference in 1 week and 6-12 months duration postoperatively.No significant difference was seen between the two groups in Schirmer Ⅰ test during the follow-up period (P＞0.05).Conclusions LASIK with nasal/temporal-hinge corneal flap can improve the corneal sensation and relief the dry eye syndrome after LASIK to some extent.More high-quality evidence-based studies are still needed for the further clinical evaluation.

Background Nowadays,keratoplasty is widely used in the treatment of keratoconus.Deep lamellar keratoplasty(DLKP)is one of the research hotspots.However,its effacacy and safety are still concerned.Objective This paper was to evaluate and compare the therapeutic outcomes between DLKP and penetrating keratoplasty(PKP) for keratoconus.Methods The peer-reviewed and published literature was searched from PubMed database,Cochrane Library,EMBase and CNKI to identify relevant trails comparing DLKP with PKP for keratoconus.Methodological quality and Meta-analysis were carried out according to the principle of evidence-based medicine.The statistical analysis was performed using Review Manager 5.0 software.Results Eleven studies with 2950 eyes were identified that compared the results of DLKP and PKP procedures for keratoconus directly.Of those studies reporting vision and refractive data,less patients underwent DLKP achieved a best corrected visual acuity (BCVA)of≥0.5 than DLKP(RR=0.91,95％ CI:0.84-0.99,P=0.030) ;patients with DALK had severer myopia that those with PKP(RR =-0.60,95％ CI:-1.43-0.23,P =0.150),but the astigmatism was comparative (WMD =0.21,95％ CI:-0.48-0.91,P =0.550).Endothelial cell density values were higher in the DLKP group and the differences were significant.Endothelial immune graft rejection did not occur after DALK,and PKP had a higher overall graft rejection rate than DLKP(RR=0.06,95％ CI:0.01-0.31,P=0.001).Conclusions According to the available data,PKP can imporve the BCVA and refractive results,but DLKP can avoid the risk of endothelial rejection and reduce the risk of late endothelial failure for keratconus.

OBJECTIVE: Discussing the use of endoscopy in the operation of microvascular decompression of cranial nerves to treat trigeminal neuralgia (TN), hemifacial spasm (HFS), glosspharyngeal neuralgia (GN) and some tumors of the cerebellopontine angle (CPA). METHOD: Since 2006, 973 cases (including 420 cases of TN, 487 cases of HFS, 66 cases of GN) had received the operation of nervous decompression by approach of postauricular suboccipital to the CPA. All cases who used the endoscopy and the material was described in detail. RESULT: In 420 TN patients, 390 (92.9%) were found responsible blood vessels. Two (0.5%) were found no responsible blood vessels but arachnoid adhesion, 28 were found CPA tumor secondary trigeminal neuralgia. In 487 HFS patients, 486 were found responsible blood vessels. Between the vascular and trigeminal nerve, teflon was used to decompress and isolate the facial nerve. In 66 GN, the glossopharyngeal nerve were cut and vagus nerve were decompressed. The short-term cure rate was 100%. Cerebrospinal fluid rhinorrhea occurred in 3 cases, 1 case of cerebellar infarction, 2 patients of cerebellar hemorrhage, 2 cases of pneumatosis. All complications were cured at last. There were no deaths. All cases were followed-up for 1 to 5 years. Four cases of TN and 4 cases of HFS recurrent, and none of GN recurrence. CONCLUSION The microneurosurgery of nervous decompression endoscopy technology for the treatment of TN, HFS, GN and some tumors of the CPA is an ideally functional and etiotropic operation. It is helpful to detect the responsible blood vessel and to protect the brain tissue and nerve function with endoscope, which can improve the success rate of the operation and avoid the complications. This technology has clinical application value.
Adult ; Aged ; Aged, 80 and over ; Cerebellopontine Angle ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Neuroendoscopy ; Retrospective Studies ; Young Adult

Objective To explore the relationship between the endemic arsenism and the liver,renal damage.Methods Some permanent residents were selected as investigated subjects who lived at 3 villages in Datong in Shanxi Province,an arseniasis-endemic areas,These objects were divided into arsenic poisoning and control group on the basis of Diagnosis Standard for Endemic Arsenism(WS/T 211-2001).Then blood and urine samples were collected in the surveyed people.Serum glutamate pyruvic transaminase(ALT)were detected by Enzyme-linked immunosorbent assay as the indicator of the impaired hepatic function.The microdosis albumen (mAlb)and acetylglucosaminidase(NAG)in urine were detected by end-point method and alkaline picric acid as the renal damage indicators.Results A total of 661 people investigated,of which 144 cases were arsenic poisoning patients.The rates of abnormal liver function were significant hisher in arsenic poisoning group[10.42% (15/144)]than that in control[5.22%(27/517)],and both wag significant[X2=5.107,P＜0.05;OR=2.11,95%CI (1.09-4.08)].The geometric mean of mAlb/Ucr was 2.16 mg/g Cr in control,and 2.31 mg/g Cr in arsenic poisoning group,and both was not significant(t=-1.71,P＞0.05).The geometric mean of NAG waft higher in arsenic poisoning group(2.43 U/g Cr)than that in the control(2.22 U/g Cr),and both was significant(t=-3.55, P＜0.05).Conclusions The damage of the liver and renal function were related with endemic arsenism,and NAG is the early indicators suggesting impaired renal function due to endemic arsenism.

Objective To explore the local application of immunosuppressant in improving the survival rate of the transplanted islet cells and systemic side effects.Methods The streptozocin of 200 ms/kg was injected into the abdominal cavity of the Wistar rats，the blood sugar was tested after 48，and 72 hours，and the rats with two consecutive measurements ≥20 mol/L were taken as the experimental animal model.The dose of pancreatic islet cells transplanted into the abdominal cavity was 8 000 IE,/kg，and that of cyclosporine dosage was 1.5 mg/(100 g·d).The pancreatic islet cells were divided into three groups：(1)systemic immunosuppressive agents through stomach lavage with the intraperitoneal injection of microencapsulated islet cells；(2)pure intraperitoneal injection of microencapsulated islet cells；(3)intraperitoneal injection microencapsulated activated carbon particles loaded with immunosuppressants，and mieroencapsulated islet cells.Changes of blood glucose and pathological in rats after transplantation were detected.Results The blood glucose of group 3 and group 1 showed no significant difference(P＞0.05)，as well as compared with group 2(P＞0.05).But the local application of immune agents could prolong the effective time of the islet cells and attenuate the fibrotic extent of the surrounding islets when compared with the control group,the C peptide level in applicating immunosuppressive agents group was significantly hisher in the immunosuppressive group than the pure transplantation group.ConclusionCompared with the systemic immune suppression via stomach lavage，local application of slow-release immunosuppressive agents showed the same effects of activated carbon particles，with a prolonged the effective time of islet cell and reduced topical side effects in the latter.

Zuckerkandl tubercle is the extension of thyriod gland. For the past few years, more and more surgeons and anatomists have become interested in it. Clinically, surgeons usually rely on specified anatomical landmarks to avoid injuries to the recurrent laryngeal nerve, including the laryngeal branches and the superior parathyroid in thyroid surgery, such as the bottom corner of the thyroid cartilage, the inferior thyroid artery, lower pole of thyroid, tracheoesophageal groove, suspensory ligament of thyroid gland and so on. As the specified landmarks, they have several common characteristics:on the one hand, their location should be constant; on the other hand, they should be easy to observe and touch, meanwhile convenient and practical.As a new anatomical landmark, Zuckerkandl tubercle is in accordance with the above characteristics and prevalent in the population. Therefore, Zuckerkandl tubercle could become an important landmark to identify the the recurrent laryngeal nerve, including the laryngeal branches and the superior parathyroid in thyroid surgery. This essay aims to briefly analyze the role of Zuckerkandl tubercle in thyroid surgery.

Objective To study the expression of thymic stromal lymphopoietin(TSLP) and the activation of DCs in OVA-induced murine asthma model, and investigate the effects and underlying mecha-nisms of TSLP on lung inflammation. Methods Thirty BALB/c mice were randomly divided into control group, OVA group and TSLP neutralizing antibody treated group. The asthma model was evaluated by airway responsiveness and histological analysis of lung tissues ; The levels of TSLP mRNA in lungs were determined by quantitative real-time PCR; The expression of TSLP in lungs were determined by immunohistochemistry and Western blot; The expression of CD40, CD80, CD86 in BALF was detected by FACS. Results Both the histological analysis of lung tissues and the airway responsiveness were all consistent with the characteris-tic of murine asthma model. The expression of TSLP and TSLP mRNA in the OVA group was significantly in-creased compared with blank group. The expression of CD40, CD80, CD86 in BALF from OVA group was increased significantly compared with the control group. Furthermore, treating mice with TSLP neutralizing antibody reduced the expression of CD40, CD80, CD86 on dendritic cells, and IL-4, IL-5, IL-13 in the OVA group. Conclusion Our study indicate that TSLP was highly expressed in the bronchial epithelia of murine asthma model, via upregulation of CD40, CD80, CD86, induce DCs to active CD4~+ T cells and pro-duce type 2 responses, so that aggravating the lung inflammation of asthma. Blocking TSLP is capable of in-hibiting the production of Th2 cytokines, thus presents a promising strategy for the treatment of asthma.