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 deeply understand the real experience of family members of patients in the neurosurgery intensive care unit during the period of accompanying them, and to provide reference for managers to formulate nursing countermeasures to improve the coping ability of family members.Methods:Descriptive phenomenological research method in qualitative research was adopted to conduct in-depth interviews with family members of 12 patients admitted to a neurosurgery intensive care unit in Shanghai, manage the interview data with Nvivo11 software, and use Colaizzi's seven-step analysis method to summarize and analyze the topic.Results:There were four themes: adhere to and do not give up, adhere to was due to the trust and affirmation of the medical care, do not give up was because it was difficult to give up blood kinship, adhere to the hope of life because of patients; timing change of emotional experience, first aid period: helpless to rescue and expecting the condition to stabilize, complication peak: understanding the characteristics of the disease and paying attention to the treatment progress, stable period: uncertain prognosis and desire for emotional companionship.The powerlessness of the future; learn to self psychological adjustment.Conclusions:The family members of patients with severe neurological diseases have both negative experience and positive feelings, and the accompanying experience and needs at different stages of the disease are changing dynamically. According to the cognition and needs of the family members, exploring and developing palliative medicine, tapping the potential of the family members from a positive perspective and improving coping ability are one of the ways to maintain the stable mental health of the family members.

Objective To investigate and evaluate the changes of PYK2 expression in hippocampal neurons and microglial cells in Kainate acid-induced status epilepticus. Methods Kainate acid-induced status epilepticus was established in rats, and by using immunostaining, changes of PYK2 expression in hippocampal neurons and microglial cells was investigated. Results Expression of PYK2 in hippocampal pyramidal neurons was markedly decreased after kainate acid-induced status epilepticus. However, 24h after the epileptic onset, a pronounced up-regulation of PYK2 and phosphor-PYK2 immunoreactivities were evident in amoeboid microglial cells. The upregulation of PYK2 and phosphor-PYK2 was in accordance with the morphological changes of the activated microglial cells. Conclusion PYK2 was activated in microglial cells after seizure. Furthermore, the activation of PYK2 in microglial cells after seizure might be related to the morphological and behavioral changes of microglial cells after activation.

Objective To investigate and evaluate the changes of phospho PYK2 and phospho p38MAPK expression in neurons after focal cerebral ischemia. Methods Focal ischemia reperfusion model was established in rats, and by using immunostaining, the changes of phospho PYK2 and phospho p38MAPK expression in neurons was observed. Results Faint phospho PYK2 and phospho p38MAPK immunoreactivity were revealed in normal cortical neurons. Fifteen minutes after the ischemia onset, a pronounced upregulation of phospho PYK2 and phospho p38MAPK immunoreactivities were evident in these ischemia attacked neurons. The immunoreactivities of phospho PYK2 and phospho p38MAPK reached its peak at 30min after ischemia, and decreased 60min after ischemia. Conclusion Cerebral ischemia was able to induce neuronal PYK2 phosphorylation. The activation of PYK2 might link ischemia attack to the p38MAPK signaling pathway to initiate the neuronal response to the stress stimuli

Objective To evaluate the agreement between contrast-enhanced ultrasound imaging and histopathology in rabbit model of abdominal aortic atherosclerosis (AS)in early and development period.Methods Twenty-four healthy Japanese white rabbits were randomly divided into three groups:control group,hypercholesterolemic diet group for 8 weeks and 16 weeks (each for 8 rabbits).Contrast-enhanced ultrasonography for abdominal aorta was performed using sonicated perfluorocarbon albumin contrast agent.Imaging characteristics of abdominal aorta plaque of rabbits were monitored by two-dimensional mode,ultrasound visual grades were analyzed quantitatively before and after injection of contrast agent.Histopathologic changes were observed by HE staining.Results Contrast-enhanced ultrasound imaging allowed early detection of AS and showed gradual progression of atherosclerosis over time.After contrast agent injected,intimal indentification and plaques checking-out ratio were improved.The ultrasound visual grades were increased after contrast imaging in hypercholesterolemic diet group for 8 weeks [(2.26± 0.27)vs.(1.79 ±0.25)] and 16 weeks [(3.54 ±0.43) vs.(3.20 ±0.25)] (all P＜0.05).The plaque detection rate was improved after contrast-enhanced ultrasound imaging than before angiography in hypercholesterolemic diet group for 8 weeks [77.8％ (7/9) vs.55.6％ (5/9)] and 16 weeks [88.2％ (15/17) vs.70.6％ (12/17)](P ＞ 0.05).The imaging of ultrasound agreed well with pathological examination results.Conclusions Contrast-enhanced ultrasonography can effectively improve intimal and plaque imaging,and increase the detection accuracy of early and progressive pathology.

ObjectiveTo evaluate the applicection value of ultrasonically guided percutaneous puncture and drainage of gallbladder (PPDG) in treating elderly patients with acute cholecystitis.MethodsThe clinical data of 59 elderly patients with acute cholecystitis treated by ultrasonically guided PPDG were retrospectively analyzed and compared with 37 patients treated by cholecystectomy or 13 cases by cholecystostomy.ResultsThe rates of complication and fatality and average hospital days were 32.4 ％ (12/37),5.4 ％ (2/37) and (25.4 ± 16.5 ) d in patients by cholecystectomy and 7.7％(1/13),7.7％(1/13) and (32.0± 12.5) d in patients by cholecystostomy,respectively,while the complication and mortality were not found in patients by ultrasonic ally guided PPDG with average hospitalization of(19.5 ±9.8)d. The rates of the complication and average hospital days were significantly higher in patients by cholecystectomy and cholecystostomy than in patients by ultrasonically guided PPDG (P＜0.05).ConclusionsUltrasonically guided PPDG is effective,safe and convenient for the treatment of acute cholecystitis in elderly patients.

Objective To evaluate the clinical application of color Doppler ultrasound in monitoring the complications of arterialvenous fistula in elderly patients. Methods The 36 hemodialysis patients over the age of 60 were enrolled, including 27 cases of autologous arteriovenous fistula and 9 cases of artificial vascular graft arteriovenous fistula. The ideal vascular access could not be established in the 9 cases due to their own conditions. Color Doppler ultrasonography was used to test the function of arteriovenous fistula and to observe its complications. Results The arteriovenous fistula in 26 cases (72.2 %) was patent in 36 elderly hemodialysis patients. The 6 cases (22.2 % ) in 27 of autogenous arteriovenous fistula and 4 cases (44.4 % ) in 9 of artificial arteriovenous fistula had complications. Conclusions Ultrasound can clearly show the position, pathway, lumen and blood flow dynamics of the transplanted autologous or artificial blood vessels in arteriovenous fistula so as to evaluate the effects of blood dialysis in elderly patients and to detect the complications for clinical reference.

Objective To discuss the feasibility of quantitive tissue velocity imaging(QTVI) to quantify regional myocardial dysfunction induced by acute ischemia and reperfusion.The results derived from this study provide experimental foundation for QTVI in estimating the segment of myocardial ischemia and evaluating viable myocaridium after reperfusion.Methods Note the peak velocity of the systolic wave(Vs) and the peak velocity of the early diastolic wave(Ve) of regional wall segments of seven dogs with left anterior descending coronary artery(LAD) ligated under the different examination time points(i.e.,pre ligation,basic state;post ligation 5 min,15 min,30 min,60 min,120 min and reperfusion) by using QTVI technique.Postoperation, the myocardial specimen was stained by 1% triphenylatetrazolium chlorde(TTC) solution and tissue structure was analyzed by transmissible electrical microscope to identify whether myocardium was necrosis or not.Results Vs,Ve of every segmental myocardium of the dogs at ligation 5 min,10 min falled evidently in comparison with the basic state of the dogs (P

OBJECTIVE To investigate the nosocomial infection knowledge nurses in graduating class. METHODS 286 nurses of graduating class were investigated by questionnaires. RESULTS The students were lacked of knowledge about nosocomial infection and 61.70% nurses of graduating class had never participated in the training of nosocomial infection knowledge (the average score only 58.67). They were interested in the disinfection and sterilization of infection diseases. And they wanted to get it through clinical infection control group (81.56% students selected this educational methods). CONCLUSIONS It is necessary to strengthen the training and education of nosocomial infection. And adjust the training mode and content according object.

Objective To investigate the clinical characteristics and surgical management of adult presacral tumors.Methods The clinical data of 24 patients with adult presacral tumors from 2007 to 2012 were retrospectively analysed.All patients were diagnosed by digital rectal examination and imaging examination before operation.Seventeen patients with via sacrococcygeal approach,4 patients with via abdominal approach,and 3 patients with via combined abdominal and sacrococcygeal approach.Results The incision of 22 patients primary healing.There were 2 patients with postoperative incision infections,after dressing change cure.No patients died during perioperative period.Twenty patients were followed up for 3-17 months,1 patient with via abdominal approach recurrenced,and was healed after a second surgical resection.Conclusions Digital rectal examination and imaging examination are the main methods for diagnosis of adult presacral tumors.Most adult presacral tumors can be resected through sacrococcygeal route.