Objective To evaluate the efficacy and safety of TUEVP vs TURP for treating benign prostatic hyperplasia(BPH).MethodsLiferatures on randomized controlled trials(RCT),non-randomized controlled trials(NRCT) and retrospective controlled trials of both Chinese and English studies about TUEVP vs TURP for the treatment of BPH all over the world were searched by Pubmed,Ovid,ScineceDirect,NGC,EBSCO,EMBASE,CNKI,CBM,as well as manual search of four Chinese journals: Chinese of Journal of Androloy,National Journal of Androlgy,Chinese Journal of Urology,Journal of Clinical Urology.Two reviewers independently screened the studies for eligibility,evaluated the quality and extracted the data from the eligible studies,with confirmation by cross-checking.Divergences of opinion were settled by discussion or consulted by the expert.Meta-analysis was processed by Rev Man 5.0,fail-safe number(Nfs) was performed by SAS8.0.ResultsSeventeen RCTs involving 2413 men were enrolled the inclusion criteria in Meta analysis.The baseline of patients' characteristics was comparable in all the studies.By evaluating the relevant indicators,side effects and complications between TUEVP and TURP,the statistically significant differences of pooled estimates suggested a benefit of TUEVP over TURP for bladder wash-out time,catheterization time,hospital stay,incidence of ED(20.6% vs 29.0%).In contrast,pooled estimates of the difference favoured TURP over TUEVP for MFR and incidence of postoperative secondary hemorrhage(7.9% vs 3.6%).ConclusionThis formal meta-analysis suggests that both TUEVP and TURP in patients with BPH provide comparable improvements,whose efficacy and safety is similar.While comparative analysis is limited by the methodological shortcomings of the underlying studies and the short follow-up,both TURP and TUEVP may offer distinct advantages.More high quality trials with large sample and longer follow-up are proposed,which will provide more evidence about evidence based medicine.

Objective To investigate the feasibility in screening of normal ovarian tissues by evaluating the expressions of tumor-associated genes in tissues adjacent to human epithelial ovarian cancer of orthotopic implantation in nude mice.Methods Human epithelial ovarian cancer cell lines OVCAR3 were grown in subcutaneous tissues,and the tumor tissues were orthotopic implanted.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were detected by immunohistochemical staining in proximal tissues,middle tissues,distal tissues adjacent to tumor,tumor tissues,and normal ovarian tissues of nude mice.Results 35 samples ovarian tissues with normal biopsy were gained from 40 cases of human epithelial ovarian cancers of orthotopic implantation model in nude mice.The expression rate of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were 95.0％ (38/40),95.0％ (38/40),75.0％ (30/40),85.0％ (34/40),77.5％ (31/40),and 77.5％ (31/40) in tumor tissues,respectively; 71.4％ (25/35),68.6％(24/35),57.1％ (20/35),62.9％ (22/35),60.0％ (21/35),and 57.1％ (20/35) in proximal tissues adjacent to tumor,respectively; 34.3％ (12/35),31.4％ (11/35),31.4％ (11/35),31.4％ (11/35),34.3％ (12/35),and 31.4％ (11/35) in middle tissues adjacent to tumor,respectively; and 25.7％ (9/35),22.9％ (8/35),25.7％ (9/35),25.7％ (9/35),28.6％(10/35),and 31.4％ (11/35) in distal tissues adjacent to tumor,re respectively.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 23 samples normal ovarian tissues adjacent to tumor.The expressions of CK-7,CA125,P53,survivin,MMP-2 and TIMP-2 in proximal tissues adjacent to tumor were lower than those in tumor tissues(P＜0.05),and higher than those in middle tissues and in distal tissues adjacent to tumor(P＜0.01).There were no expression difference between in middle tissues and in distal tissues (P＞0.05).The strong positive expressions of CK-7,CA125,and survivin were higher than those of P53,MMP-2,and TIMP-2 (P＜0.01).No significant difference was found in those expressions in the normal ovarian tissues adjacent to tumor gained from orthotopic implantation model with different severity.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 20 normal ovarian tissues of nude mice.Conclusions The expression of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 showed decreasing trend to non-cancer direction.Negative expressions of these tumor-associated genes can be used as standard in screening of normal ovarian tissues adjacent to tumor.Relative safe normal ovarian tissues can be obtained from the tissues adjacent to tumor.

Objective:To investigate the relationship between Helicobacter pylori(Hp)infection and carotid atherosclerosis(CAS)in the elderly, in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods:A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University, who underwent the 13C-urea breath test( 13C-UBT), carotid color and two-dimensional Doppler ultrasonography from October 2015 to January 2019, were retrospectively enrolled.Patients were divided into the Hp infection group(n=137)and the non-Hp infection group(n=150). Common high-risk pathogenic factors, blood biochemical indicators, carotid intima-media thickness(IMT)and detection rate of carotid plaque were compared between the two groups. Results:Common high-risk pathogenic factors including age, gender, hypertension, diabetes, obesity, smoking, alcohol consumption, dyslipidemia, and hyperuricemia showed no significant difference between the two groups( P>0.05). The level of high-density lipoprotein cholesterol(HDL-C)was lower in the Hp infection group than in the non-Hp infection group( P<0.05). There was no difference in levels of white blood cells, neutrophils, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine, fasting blood glucose, creatinine or uric acid between the two groups( P>0.05). The detection rates of increased carotid IMT and carotid plaques were higher in the Hp infection group than in the non-Hp infection group(65.0% or 89 cases vs.48.7% or 73 cases, 76.6% or 105 cases vs.64.7% or 97 cases, P<0.01 and 0.05). The detection rate of carotid plaques in the Hp-infected group was higher than that in the non-Hp-infected group( P<0.05). The combined detection rate of increased carotid IMT and plaques was higher in the Hp infection group than in the non-Hp infection group(56.2% or 77cases vs.32.7% or 49 cases, P<0.01). Conclusions:Hp infection may play a role in the occurrence and progression of carotid atherosclerosis through initiating abnormal lipid metabolism.Early intervention and treatment may reduce the incidence of carotid atherosclerosis in patients with Hp infection.

Objective To explore the clinical value of the contrast-enhanced ultrasound (CEUS) in the diagnosis of renal artery stenosis(RAS).Methods A total of 20 patients(12 males and 8 females) including 40 renal arteries,who were suspected to have RAS were enrolled in Department of Renal,Beijing Hospital.All patients were examined by color doppler ultrasound,CEUS and digital subtraction angiography (DSA).The results of conventional ultrasound and CEUS were compared with the DSA results,respectively.Results All patients had history of hypertension,aged (65 ± 5)years.12 branches (mild 6,moderate 4,severe 2) were RAS by regular ultrasound,17 branches (mild 8,moderate 6,severe 3)were RAS by by CEUS,while 19 branches (mild 9,moderate 7,severe 3) were diagnosed as RAS by DSA.The measure of agreement Kappa between conventional ultrasound and DSA was lower than that between CEUS and DSA (0.77 vs.0.96,P＜0.01).The diagnostic accuracy of mild,moderate and sever RAS with CEUS were 88.9％,94.1％ and 100％,respectively.Conclusions CEUS shows the renal artery more clearly than conventional ultrasound,and has a high consistency with DSA in the diagnosis of RAS.

Objective:To investigate clinical efficacy of parasacral perforator flap (PPF) on postoperative wound healing in pilonidal sinus diseases (PSDs).Methods:The surgery steps were as follows: (1) To preoperatively detect parasacral perforator arteries with the handhold Doppler probe and mark them; (2) To remove the infected and necrotic tissues of PSDs completely; (3) To design the PPF according to the wound size and the parasacral perforator arteries' localization; (4) To harvest the flap from the gluteus maximus muscle surface and transfer it to the wound without tension. Several data were documented, including surgical duration, flap length, flap width, drainage tube placement duration, hospital stay, duration from operation to stitch removal, postsurgical complications and recurrence.Results:There were six patients with PSDs whose postoperative wound healing was repaired by PPF, admitted in our department from March 2021 to March 2023. Of them, five were male and one was female. Their median age was 24 (range: 18-33) years old. Their median surgical duration was 165 (range: 134-207) minutes, median length of PPF was 8 (range: 7-11) cm, median width of PPF was 3 (range: 3-4) cm, mean duration of drainage tube placement was 8 (range: 4-17) days, mean hospital stay was 13 (range: 6-23) days, mean duration from operation to stitch removal was 14 (range: 14-17) days, median follow-up time was 6-16 months. Incisions of all six cases achieved first-intention healing without early- or late-stage complications. No recurrence occurred during follow-up. All patients involved were satisfied with their clinical efficacy.Conclusion:The utility of PPF in postoperative wound healing of PPDs was effective, safe and reliable.

Objective:To investigate clinical efficacy of parasacral perforator flap (PPF) on postoperative wound healing in pilonidal sinus diseases (PSDs).Methods:The surgery steps were as follows: (1) To preoperatively detect parasacral perforator arteries with the handhold Doppler probe and mark them; (2) To remove the infected and necrotic tissues of PSDs completely; (3) To design the PPF according to the wound size and the parasacral perforator arteries' localization; (4) To harvest the flap from the gluteus maximus muscle surface and transfer it to the wound without tension. Several data were documented, including surgical duration, flap length, flap width, drainage tube placement duration, hospital stay, duration from operation to stitch removal, postsurgical complications and recurrence.Results:There were six patients with PSDs whose postoperative wound healing was repaired by PPF, admitted in our department from March 2021 to March 2023. Of them, five were male and one was female. Their median age was 24 (range: 18-33) years old. Their median surgical duration was 165 (range: 134-207) minutes, median length of PPF was 8 (range: 7-11) cm, median width of PPF was 3 (range: 3-4) cm, mean duration of drainage tube placement was 8 (range: 4-17) days, mean hospital stay was 13 (range: 6-23) days, mean duration from operation to stitch removal was 14 (range: 14-17) days, median follow-up time was 6-16 months. Incisions of all six cases achieved first-intention healing without early- or late-stage complications. No recurrence occurred during follow-up. All patients involved were satisfied with their clinical efficacy.Conclusion:The utility of PPF in postoperative wound healing of PPDs was effective, safe and reliable.

Objective To identify risk factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL).Methods We retrospectively reviewed 438 renal calculi patients after PCNL from August 2015 to July 2016.Among them,there were 251 men and 187 women,the mean age was (49.4 ± 11.1) years.The positive preoperative urine WBC,culture and nitrite rates were 29.7％ (130),12.1％ (53) and 15.1％ (66),respectively.The stone size was (851.2 ± 663.6) mm2,the stone CT value was (960.4 ± 303.4) HU,the operative time was (63.5 ± 33.4) min,124 (28.3 ％) were infection stones and multiple-tracts PCNL was performed in 69 (15.8％) patients.Univariate and multivariate logistic regression analysis were used to analyze perioperative predictors after PCNL.Results Thirty-nine patients developed SIRS (8.9％) after PCNL.The univariate analysis showed that positive preoperative urine WBC,nitrite,culture,operation time,stone size and transfusion had significantly impacts on the outcome of postoperative SIRS after PCNL (P ＜ 0.05).Multivariable logistic analysis showed that positive preoperative urine nitrite (OR =5.990,P ＜ 0.001),stone size (OR =2.251,P =0.027) and transfusion (OR =7.501,P =0.007) were independently related to the postoperative SIRS.Conclusion The positive preoperative urine nitrite,stone size and transfusion are independent risk factors for postoperative SIRS after PCNL.