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 role of HLA class II antigen of human monocytes in pathogenesis of herpes simplex virus-2 (HSV-2) infection. Methods Human monocytes were infected by HSV-2 (333 Strain). The cultured cells were collected at the first, third, 5th, and 7th days of post-infection. The expression of HLA class II antigen of the infected monocytes was measured by alkaline phosphotase anti-alkaline phosphotase method (APAAP). Results The expression of HLA class II antigen on the monocytes significantly decreased at the first day of post-infection,and then gradually increased and reached to the normal control level at the 7th day of post-infection. Conclusion HLA class Ⅱ antigen expression of monocytes was inhibited by HSV-2 infection at early stage, which may be one of means of virus escaping host immunity. The expression of HLA class Ⅱ antigen may play an important role in HSV-2 pathogenicity and immunity.

Ambulatory blood pressure monitor (ABPM) was done on 103 hypertensive patients according to clinical stages and left ventricular measure (LVM) was randomly done on a portion of the patients. The results showed that the variability of stage-Ⅱ-group's 24 hour systolic pressure and stage-Ⅲ-group's systolic and diastolic pressures was significantly higher than that of stage-Ⅰ-group (P

Objective To investigate the changes in the abilities of invasion and metastasis in surviving human lung adenocarcinoma (A549) cells after X-ray irradiation and the related mechanism.Methods The change in radiosensitivity after X-ray irradiation was determined by colony formation assay.The abilities of invasion and metastasis were evaluated by MTF adhesion assay and Transwell invasion and migration assay in vitro.The mRNA and protein expression of E-cadherin,vimentin,tumor growth factor (TGF)-β1,matrix metalloproteinase (MMP)-2,and MMP-9 was measured by real-time RT-PCR using SYBR Green fluorescence and Western blot.Results The colony formation assay showed that the surviving A549 cells after X-ray irradiation were more resistant to irradiation (ratio of D0 values =0.94).Their abilities of adhesion,invasion,and migration were significantly increased by 1.46 times,1.40 times,and 1.45 times,respectively.In addition,the surviving cells showed enlarged intercellular spaces and had many long pseudopodi.Compared with those in the control group,the mRNA expression levels of vimentin,TGF-β1,MMP-2,and MMP-9 of surviving cells were increased by 1.37 times,2.37 times,1.80 times,and 1.50 times,respectively,the protein expression levels of the above substances were increased by 1.60 times,1.80 times,1.10 times,and 1.20 times,respectively,and the mRNA and protein expression levels of E-cadherin were decreased by 59.4％ and 74.6％.Conclusions The surviving A549 cells after X-ray irradiation have significantly increased abilities of invasion and metastasis.This may be due to radiationinduced TGF-β1 expression increase that in turn promotes epithelial-mesenchymal transition and also due to radiation-induced MMP-2 and MMP-9 expression increase.

Objective To explore the clinicopathologic features,diagnostic criteria and clinical prognostic factors of Goblet cell carcinoid (GCC) of the appendix.Methods The clinical and pathological data from 6 GCC patients were analyzed including age,clinical stage,surgical procedure,outcome,macroscopic features,histological sections and immunohistochemistry.Results The median age was 49.67 years old.Clinically,4 patients presented the signs and symptoms of acute appendicitis,while 2 patients presented the signs and symptoms of abdominal pain.4 patients of them undergone the simple appendectomy,the other 2 undergone the right hemicolectomy.All patients who had undergone the operation treatment survived.One patient was lost to the follow-up.Macroscopically,no masses were found in the appendix.Microscopically,4 cases showed that the tumor cells were identical to the goblet cell normal small intestinal crypts morphologically.The atypia,necrosis and mitotic figures of neoplasm cells were absent.2 cases were composed of small,discrete acini,tubules lined by a single layer of cuboidal or columnar cell,the signet-ring cells were uniform with pattern of infiltration being nests,rosrttes,or clumps without a dintinct lumen.All GCC cases were positive to Syn,4 cases were positive to CgA,some cases expressed NSE,CD56,CK7,CK20,Ki-67 index of 5 cases was under 2 ％,the other 1 was 3 ％.None had lymph node metastases,intestinal metastases or ovary metastases.Conclusions GCC of appendix is a rare neoplasm,and has more aggressive behaviour than classic carcinoids.Positive expression of Syn and CgA is necessory for the diagnosis of GCC,Ki-67 index may suggest the grading of tumor.

Objective To study the relationship between P450 (CYP6 and CYP4) genes and deltamethrin resistance in Anopheles anthropophagus. Methods The real-time RT-PCR technique was used for semi-quantitative analysis of mRNA copy numbers of CYP6 and CYP4 gene from susceptible and deltamethrin-resistant strains. Results It is found that the mRNA copy numbers of CYP6 gene in deltamethrin-resistant strain were about 1. 39 times higher than those in susceptible strain, and the mRNA copy numbers of CYP4 gene in deltamethrin-resistant strain were about 3. 63 times higher than those in susceptible strain of Anopheles anthropophagus. Conclusion The higher expressions of CYP6 and CYP4 mRNA are observed in deltamethrin resistance strain and indicate that both CYP6 and CYP4 genes may be involved in the deltamethrin resistance in Anopheles anthropophagus.

ObjectiveTo observe the clinical characteristics and influential factors of pulmonary hypertension (PH) in maintenance hemodialysis (MHD) patients.MethodsOne hundred and two patients with MHD patients whose therapy time were all more than one year were enrolled from June 2008 to May 2009.Pulmonary arterial systolic pressure (PASP) and parameters related with cardiac structure and function were checked out by echocardiography.These patients were divided into two groups according to PASP:PH group[PASP≥35 mm Hg( 1 mm Hg =0.133 kPa)] and non-PH group(PASP ＜ 35 mm Hg).Gender,age,dialysis time,dialysis access and urine volume during dialysis was recorded.The blood biochemistry,parathyroid hormone(PTH),hemoglobin,postdialysis urea nitrogen was recorded too and Kt/V was calculated.ResultsPH was detocted in 26 MHD patients (25.5％,26/102).Right atrium transverse diameter,right atrium long diameter and pulmonary artery internal diameter in PH group [(32.00 ± 8.13),(41.00 ±9.15),(24.38 ± 3.88) mm] were higher than those in non-PH group [(27.44 ± 4.43),(36.45 ±8.88 ),(21.78 ± 2.46) mm] and LVEF in PH group [(55.59 ± 7.88 )％] was lower than that in non-PH group [(59.09 ± 5.69)％] (P ＜ 0.01 or ＜ 0.05).There were significant differences in calcium-phosphorus product,PTH,serum phosphorus and hemoglobin between PH group and non-PH group [(61.36 ± 17.83)mg2/dl2 vs.(53.24 ± 18.28) mg2/dl2,(365.95 ± 178.65) ng/L vs.(287.02 ±209.91 ) ng/L,(2.24 ±0.60)mmol/L vs.( 1.95 ± 0.68) mmol/L,(98.65 ± 25.69) g/L vs.( 114.29 ± 22.31 ) g/L] (P ＜ 0.05 ).Logistic regression found that PTH levels,hemoglobin and calcium-phosphorus product were the major risk factors for PH.ConclusionsMorbidity of PH in MHD patients is obviously high.Secondary hyperparathyroidism,anemia and high calcium-phosphorus product level may take part in the pathogenesis of PH in MHD patients.

Objective To explore the method for detecting the connexin 43(Cx43) in detrusor of bladder in rats with detrusor instability.Methods The model of rats with detrusor instability was established.Ten rats in unstable bladder group were determined by filling cystonetry method controlled by 10 normal rats.The fluorescein isothiocyanate(FITC) was used to label the Cx43 and the tritin conjugated rhodamine was used to label the cell membrane of detrusor muscle.The Cx43 and the cell membrane of detrusor muscle were detected by laser scanning confocal microscopy(LSCM),and the images were analyzed by the image analysis program.Results The distinct images of Cx43 and cell membrane of detrusor muscle could be obtained by the LSCM.The expression of Cx43 and pixel density were increased significantly in rats of unstable bladder group than those of the control group(all P

Objective To investigate the expression of RECK gene in placentas of patients with preeclampsia and its correlation with MMP-2 activation,and explore the possible roles of RECK gene in the placental trophoblast invasion mechanism.Methods RT-PCR and Western blot were used to detect the expression of RECK mRNA and protein respectively in the placental tissues of normal late pregnant women (normal pregnant group,22 cases) and pre-eclamptic patients(22 mild cases and 20 severe cases).Gelatinase zymography was used to determine MMP-2 activation ratio.Results The expression levels of RECK mRNA and protein from placenta tissues in mild,severe pre-eclamptic group were both significantly higher than those in nomal pregnant group.Moreover,the expression levels of RECK mRNA and protein in severe pre-eclamptic group were obviously increased as compared with those in mild pre-eclamptic group.There was significant difference among the three groups (all P<0.01).MMP-2 activation ratio in mild,severe pre-eclamptic group was significantly lower than that in normal pregnant group.MMP-2 activation ratio in severe pre-eclamptie groups was obviously reduced as compared with mild pre-eclamptic group.There was significant difference among the three groups(all P<0.01).The expression leVels of RECK mRNA and protein were significantly negatively correlated with MMP-2 activation ratio (both P<0.01).Conclusion The abnormal high expression of RECK and inhibition of MMP-2 activation in placentas of pre-eclamptic patients may participate in the process of placental trophoblast shallow invasion.

Objective To investigate the short-term clinical outcome of one-level degenerative diseases for a single surgeon during his initial phase of performing a minimally invasive surgery oblique lumbar interbody fusion (OLIF) on the basis of perioperative parameters and follow-up data.Methods A prospective analysis of 49 consecutive patients that underwent a OLIF between November 2014 and March 2016 by corresponding author was performed.Only those patients that were single level,index surgeries were included.Every patient had a diagnosis of degenerative lumbar diseases including lumbar spondylolisthesis (25 cases),discogenic low back pain (14 cases) or segmental instability (10 cases).Patients underwent an indirect decompression and fusion using an expandable tubular retractor and single intervertebral cage with bilateral percutaneous pedicle screw fixation.49 patients were divided into the A group (the first 24 patients) and the B group (25 patients after the initial 24 patients).The following data were compared between the two groups:surgical time for Skin-Skin (minutes),estimated blood loss (ml),radiograph exposure time (seconds),the clinical and radiographic results,and intra-/postoperative complications.All intraoperative parameters only included the measurement and findings related with the OLIF procedure.The short-term clinical outcome of single level degenerative lumbar diseases treated by OLIF was assessed on the basis of follow-up data.The learning curve was measured using a logarithmic curve-fit regression analysis.Results Average operative time was significantly longer in the A group 47.1±10.6 min compared with the B group 37.2± 10.0 min.In comparison with the B group,the A group had significantly more X-ray exposure time (25.3±6.1 s versus 17.1±6.9 s).The operative and X-ray exposure time gradually decreased as the series progressed,and an asymptote was reached after about 20 cases.There was no statistically significant difference in intraoperative blood loss between the A group (28.1± 18.2) ml and the B group 24.4± 10.9 ml.The most observed complication was donor site pain (11 cases,45.8％),followed by thigh numbness/pain (5 cases,20.8％) and psoas/quadriceps weakness (2cases,8.3％),paralytic ileus (one case,4.2％) and sympathetic nerve injury (one case,4.2％) in the A group.Donor site pain occurred in four patients (16.0％),thigh numbness/ pain in three patients (12.0％),psoas/quadrieeps weakness in one patient (4.0％) and sympathetic nerve injury in one patient (4.0％) in the B group.All complications were transient and resolved within 3 months.The incidence of complications excluding donor site pain in the early period (A group) and the later period (B group) was 37.5％ and 20.0％,respectively,although there were no significant differences in perioperative complications between both groups.Forty nine patients were followed up for more than 1 year,and the average follow-up period was 18.5±3.9 months.The back pain VAS and ODI scores decreased respectively from 6.4±2.3 before surgery to 1.5±0.9 in final follow-up and from 37.1 ±9.4 before surgery to 11.8±3.9 in the last follow-up time.Total fusion rate was 89.8％ (44/49 cases)in final follow-up.Radiographic evaluation showed similar bony fusion in the A group (22 of 24 cases) with the B group (22 of 25 cases) in the last follow-up time.Conclusion Single level degenerative lumbar diseases can safely and effectively be treated by using OLIF with a good short-term clinical outcome.The procedure presents a learning curve to the practicing spine surgeon with regards to operative time,X-ray exposure time and intra-/postoperative complications.Intraoperative parameters improved with understanding the minimally invasive technique.Close attention to details can minimize complications that may be associated with the learning curve.