Objective To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of prostate (PKEP).Methods A retrospective review was conducted of PKEP performed in 326 patients with BPH.According to the prostate size on preoperative transrectal ultrasonography measurement,patients were divided into three groups:groupl:＜40ml (n =92),group2:40～80ml (n =155),and group3:＞80ml (n =79).Intraoperative and perioperative parameters were evaluated.Patient perioperative data and postoperative outcomes were compared.Patients were followed up at 1,3,6 and 12 months after surgery.Early and late complications were recorded.Results There were significant differences among three groups regarding the mean operative time (P ＜ 0.01) and the mean resected tissue weight (P ＜ 0.01).However,enucleation efficiency (P ＜ 0.01) in gm tissue per minute increased significantly as prostate size increased.Mean hemoglobin decrease (P ＞0.05),mean serum sodium decrease (P ＞0.05),mean postoperative irrigation time (P ＞ 0.05),mean catheter time (P ＞ 0.05) and mean hospital stay (P ＞0.05) did not differ significantly among three groups.Three groups had a similar and significant postoperative improvement in international prostate symptom score (IPSS),quality of life (QOL),maximum urine rate (Qmax),and post-void residual urine volume(PVR) independent of prostate size (P ＜ 0.01),but no significant difference was found among three groups during 1,3,6 and 12-month follow-up (P ＞ 0.05).Perioperative and postoperative complications did not depend on prostate size (P ＞ 0.05).Conchsions Although patients with a larger BPH required significantly longer operation time in PKEP,prostate size did not affect perioperative and postoperative complications or micturition improvement.

Objective To determine the effect of primary realignment of posterior urethral injury associated with pelvic fracture on length and delayed operative treatment of ensuing urethral stricture.Methods A retrospective review was made on the clinical data of 64 patients with posterior urethral injury after pelvic fracture treated from January 2008 to January 2012.Of those patients,43 underwent primary endoscopic realignment (early realignment group) and 30 received primary suprapubic cystostomy (cystostomy group).All were evaluated postoperatively for the late stricture rate,stricture length,types of delayed repair,and operation frequency.Results Rate of stricture was 53％ (18/34) in early realignment group and 100％ (30/30) in cystostomy group,but all were corrected by delayed urethroplasty.Mean length of the stricture was (1.8±0.6) cm in early realignment group and (2.9±0.7)cm in cystostomy group(t=6.7,P＜0.05).Of the urethrostenosis patients in early realignment group,83％ (15/18) were successfully corrected with a simple endoscopic cold incision and 17％ (3/18) with open surgery.In contrast,only 60％ (18/30) in cystostomy group were successfully corrected by endoscopic cold incision.Patients in cystostomy group underwent (2.8 ± 0.5) procedures for cure compared with (1.6 ± 0.6) procedures in early realignment group (t =9.2,P＜0.05).Conclusion Primary endoscopic realignment for posterior urethral injury pelvic fracture offers the decrease in stricture incidence,stricture length,operation difficulty and operation frequency.

Objective To investigate the intellectual characteristics and related factors for patients with mental retardation. Methods 118 patients with mental retardation and 118 normal subjects were assessed with Wechsler Adult Intelligence Scale-fourth edition of Chinese (WAIS-Ⅳ). Results The full intelligence quotient (FIQ), index and scores of subtests were significantly lower in the patients than in the controls (P<0.01), especially for those of working memory and processing speed index. The difference in percentage of significance between verbal comprehension and working memory was higher (P<0.05). The FIQ and some index of patients positively correlated with age, education level and their parents' education level (P<0.01). Conclusion The patients with mental retardation present an overall decline in intelligence,especially in the working memory and processing speed. The mental development is unbalanced in some patients, that the verbal comprehension is relatively better than working memory. The intelligence of patients with mental retardation may be related with their age, education level and their parents' education level.

Objective To investigate the memory characteristics and related factors of patients with mental retardation. Methods 73 patients with mental retardation (patient group) and 73 normal subjects (control group) matched with the patient group were respectively tested with Wechsler Memory Scale-Fourth Edition of Chinese Version (WMS-IV). Results The scores of each subtest and composite scores of WMS-IV were significantly lower in the patient group than in the control group (P<0.01). All the composite scores positively correlated with each other in the patient group (r=0.38-0.90, P<0.01) and in the control group (r=0.31-0.94, P<0.01). Age and education level positively correlated with all the composite scores (except the Visual Working Memory Index) in the patient group (P<0.05). Conclusion The patients with mental retardation present an overall decline in memory, especially in the immediate memory. The memory function in patients is related with their ages and education levels.

Anaplastic lymphoma kinase (ALK) is the most common fusion gene involved in non-small cell lung cancer (NSCLC), and remarkable response has been achieved with the use of ALK tyrosine kinase inhibitors (ALK-TKIs). However, the clinical efficacy is highly variable. Pre-existing intratumoral heterogeneity (ITH) has been proven to contribute to the poor treatment response and the resistance to targeted therapies. In this work, we investigated whether the variant allele frequencies (VAFs) of ALK fusions can help assess ITH and predict targeted therapy efficacy. Through the application of next-generation sequencing (NGS), 7.2% (326/4548) of patients were detected to be ALK positive. On the basis of the adjusted VAF (adjVAF, VAF normalization for tumor purity) of four different threshold values (adjVAF < 50%, 40%, 30%, or 20%), the association of ALK subclonality with crizotinib efficacy was assessed. Nonetheless, no statistical association was observed between median progression-free survival (PFS) and ALK subclonality assessed by adjVAF, and a poor correlation of adjVAF with PFS was found among the 85 patients who received first-line crizotinib. Results suggest that the ALK VAF determined by hybrid capture-based NGS is probably unreliable for ITH assessment and targeted therapy efficacy prediction in NSCLC.
Humans ; Carcinoma, Non-Small-Cell Lung/pathology* ; Anaplastic Lymphoma Kinase/therapeutic use* ; Crizotinib/therapeutic use* ; Lung Neoplasms/pathology* ; Protein Kinase Inhibitors/pharmacology* ; Gene Frequency