Objective To evaluate the short-term safety and efficacy of transurethral plasma kinetic enucleation of the prostate (PKEP)for benign prostatic hyperplasia (BPH)larger than 60 ml. Methods A retrospective analysis was carried out on clinical data and treatment outcomes of 87 cases of BPH with prostate volume larger than 60 ml in Fuzhou General Hospital of Nanjing Military Command from September 2013 to August 2015.The patients were divided into either PKEP group (45 cases)or plasma kinetic resection of prostate (PKRP)group (42 cases).The operation time,resected adenoma weight,decline in hemoglobin 1 day after operation,and catheterization and irrigation duration were recorded and analyzed.The international prostate symptom score (IPSS), quality of life score (QOL),post-void residual urine volume (PVR),maximum urinary flow rate (Qmax)before surgery and 1 ,3,6 months after operation respectively were evaluated. Results As compared with the PKRP group,the PKEP group excelled in greater resected prostate weight [(52.4 ±15.2)g vs.(40.0 ±14.1 )g,t =3.94,P =0.00],less decline in hemoglobin [(9 ±4)g /L vs. (17 ±6)g /L,t =-7.36,P =0.00],shorter irrigation duration [(1 .1 ±0.3)d vs.(1.4 ±0.5)d,t =-3.42,P =0.00],and shorter catheterization duration [(3.3 ±0.5)d vs.(5.5 ±0.5 )d,t =-20.50,P =0.00].There were no significant differences between the two groups in terms of operation time and operative complications such as transient incontinence and hematuria (P >0.05).Postoperative improvements in IPSS,QOL,PVR,and Qmax were similar between the two groups (P >0.05)but significantly improved as compared with before operation (P <0.05). Conclusion PKEP is a new,safe,and effective minimal invasive surgical option for the treatment of BPH larger than 60 ml.

Objective To evaluate outcomes of endovascular procedures for atherosclerosis obliterans (ASO) patients with diabetes mellitus (DM).Methods Data of patients undergoing endovascular procedures for atherosclerosis obliterans at the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2014 were retrospectively analyzed,disease characteristics,technical success rate,perioperative complications,ankle brachial index (ABI) improvement,clinical success rate,rest pain alleviating rate,limb salvage rate and survival rate were compared between the two groups.Results There were 144 patients (153 limbs) who received endovascular procedures,including 52 patients (56 limbs) with DM and 92 patients (97 limbs) without DM.Mean follow-up was 15 months.All patients experienced significant ABI improvement (P ＜ 0.05).There was no significant difference in technical success rate (80.4％ vs 90.7％),perioperative complications rate(19.6％ vs 24.7％),1 year rest pain alleviating rate (75.0％ vs 85.6％),1 year limb salvage rate (91.1％ vs 95.6％) and 1 year survival rate (92.3％ vs 90.2％) between diabetic and non-diabetic groups (P ＞ 0.05),but there was less 1 year clinical success rate in diabetic group (78.6％ vs 88.6％,P ＜ 0.05).Conclusions Compared to nondiabetic paitents,endovascular procedures for patients with DM has similar efficacy,when the procedures are properly undertaken and postoperative correct medication are given.

Objective To explore the effect of particulate matter (PM) 2.5 on the expression of pigment epithelium-derived factor (PEDF) protein in bronchial epithelial cells (BEAS-2B). Methods Human BEAS-2B were subcultivated, followed by low, medium and high concentrations of PM2.5 (25μg/ml, 50μg/ml, 100μg/ml) stimulation for 24 hours. The expression of PEDF protein in supernatant was ana-lyzed by enzyme-linked immunosorbent assay (ELISA), and the expression in BEAS-2B cells was detected by Western blotting. Results Compared with the control group, the expression of PEDF protein in supernatant and BEAS-2B cells induced by PM2.5 (25 μg/ml) in-creased, but no significance was found (t=-0.730, t=-1.840, P>0.05), and the expression induced by PM2.5 with the concentrations of 50μg/ml and 100μg/ml significantly increased (t>5.798, P<0.05). Conclusion PM2.5 with the concentrations of 50μg/ml and 100μg/ml could increase the expression of PEDF protein in a concentration-dependent manner both in supernatant and BEAS-2B cells.

Objective To evaluate the clinical effect of endovascular embolization for the treatment of cerebellar arteriouvenous malformations (AVMs) associated with aneurysm, and to discuss its technical points. Methods The clinical data of 142 patients with cerebellar AVMs were retrospectively analyzed. Of the 142 patients, 42 had concomitant aneurysms. The patients were divided into concomitant aneurysm group and without aneurysm group. Using univariate and multivariate statistical models, the patient’s gender and age, the presence or absence of hemorrhage, the lesion’s location and size, and the presence or absence of deep venous drainage were analyzed. Results A total of 61 concomitant aneurysms were detected in the 42 patients, which were located within the malformation mass (n=14) or on the feeding artery (n=47). The concomitant aneurysms located in the malformation were closely related to AVM hemorrhage and the deep venous drainage. During the follow-up period after endovascular embolization, no recurrence of bleeding was observed in all the 42 patients. Conclusion In order to reduce the relapse rate of hemorrhage, the formulation of therapeutic measures should be based on the management of the concomitant aneurysm when endovascular embolization treatment is employed for AVM associated with aneurysm.

BACKGROUND:Bone mesenchymal stem cells have immunological regulation function both in vitro and in vivo, while the effect of bone marrow mesenchymal stem cells on CD4+T cellimmune function in patients receiving kidney transplantation remains unclear. OBJECTIVE:To explore the monitoring significance of CD4+T-cellimmune function by ImmuKnow assay and to determine the effect of induction therapy with bone marrow mesenchymal stem cells on cellimmune function in patients receiving kidney transplantation. METHODS:From January 2011 to June 2013, 24 patients receiving al ograft renal transplantation with autologous bone marrow mesenchymal stem cells were included and another 48 patients receiving al ograft renal transplantation and Simulect induction therapy with various matched preoperative characters served as controls. In both groups, adenosine triphosphate levels in CD4+T cells in the peripheral blood were determined by the ImmuKnow assay preoperatively and at 14, 30, 60, 90, 180 days postoperatively, as wel as during acute rejection and infection episodes. RESULTS AND CONCLUSION:During the 180 days postoperatively, fewer patients in the bone marrow mesenchymal stem cellgroup had acute rejection and injection than the Simulect group, but no significant differences were observed. Postoperative adenosine triphosphate levels in CD4+T cells were significantly lower than those determined preoperatively in both groups (P<0.05), while no significant differences were observed between the two groups. A total of 12 patients in the bone marrow mesenchymal stem cellgroup and 26 patients in the Simulect group had infection episodes, and the adenosine triphosphate levels in CD4+T cells during the infection episodes were lower than clinical stable patients in both groups (P<0.01). For patients receiving renal transplantation, induction therapy with bone marrow mesenchymal stem cells can effectively decrease the cellimmune function, which can be reflected by the adenosine triphosphate levels in CD4+T cells in the peripheral blood determined by the ImmuKnow assay.

Objective:To investigate the application value of lauromacrogol in the treatment of varicose veins of lower limb.Methods:The medical records of 75 patients (75 affected limbs) with varicosis of great saphenous vein of lower limbs confirmed between September 2013 and September 2015 were analyzed retrospectively.According to the treatment regimen,the patients were divided into two groups.Among them,33 cases (33 limbs) treated by ultrasound guided injection of foam sclerosing agent lauromacrogol were included in the lauromacrogol group while 42 cases (42 limbs) treated by high ligation of great saphenous vein combined with stripping were included in the operation group.The operation time,intraoperative blood loss,off-bed time,treatment costs and incidence of postoperative complications were recorded.Patients were followed up for 6 to 12 months after operation,and the recurrence rate was recorded.Results:The operation time,off-bed and length of hospital stay of the lauromacrogol group were shorter than those of the operation group;the intraoperative blood loss and hospitalization expenses were less than those of the operation group (P＜0.05);The incidence rates of subcutaneous hematoma and skin numbness in the lauromacrogol group were significantly lower than those in the operation group (P＜0.05);The 12-month recurrence rate in the lauromacrogol group (12.12％) was lower than that in the operation group (33.33％)(P＜0.05).Conclusion:Injection of foam sclerosing agent lauromacrogol is an alternative minimally invasive therapy for treating varicosis of great saphenous vein of lower limbs.

A lean management practice had been in place in Taizhou Enze Medical Center during the COVID-19 epidemic period, featuring the " principle-system-tool" theory of the Shingo model, in an effort to build a new model of COVID-19 prevention and control. The center upheld such five principles of lean management as overall planning, total involvement, system collaboration, concern with process and continuous improvement, and people-oriented practice. Under such principles, the center set up five supportive systems of lean management tools, namely risk identification, rapid screening, homogeneous treatment, customized follow-up and employee care. Integrated use of multiple tools of lean management, had improved the hospital′s crisis response ability, achieving desirable outcomes in stages in combating COVID-19 epidemic.

We present a case of vaginal ectopic ureter with ipsilateral partial duplication of the upper ureter (Y-type ureter), ipsilateral hypoplastic pelvic kidney and bicornuate uterus in a 20-year-old woman who presented with mild urinary incontinence since infancy. Ultrasonography, computed tomography and intravenous pyelography examination showed a left kidney with no evidence of a right kidney. Cystourethroscopy showed absence of the right hemitrigone. Magnetic resonance (MR) urography demonstrated the presence of a bicornuate uterus, an ectopic dysplastic right kidney in the pelvic cavity, and a right ureter that terminates in the vaginae fornix. The patient underwent right nephroureterectomy and urinary continence was restored completely. Although congenital malformations of the urinary tract are frequently associated with genital tract abnormalities, to best our knowledge, this is the first report of the coexistence of all of these anomalies in an individual. Our report also highlights the importance of MR urography in the diagnosis of such rare and complex anomalies.
Female ; Humans ; Kidney ; abnormalities ; pathology ; Kidney Diseases ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Ureter ; abnormalities ; pathology ; Urinary Incontinence ; etiology ; Uterus ; abnormalities ; pathology ; Vagina ; abnormalities ; pathology ; Young Adult

Objective:To study the improvement of medical service quality in a public hospital by integrating Kano and quality function deployment(QFD)technology, so as to provide reference for the improvement of service quality in hospitals.Methods:The Kano questionnaire of patients′ needs was designed, the attributes of patients′ needs were identified, and the importance of patients′ needs was calculated and determined. Then, using the house of quality technology in QFD, the patient needs were transformed into corresponding medical service quality assurance elements, and the improvement priority of each assurance element was determined through calculation.Results:The six quality assurance elements most expected to be improved by patients in the hospital were to improve medical level, strengthen service management, improve supervision and review mechanism, standardize complaint process, ensure drug safety and guidance, and track treatment effect.Conclusions:The integrated Kano-QFD technology can provide an effective methodological reference for improving the quality of medical service.

Objective:To investigate the effect of alogliptin on bone loss in ovariectomized(OVX)mice.Methods:For animal experiments, thirty 8-week-old C57BL/6J female mice were divided into Sham group, OVX group, and OVX+ alogliptin group. OVX+ alogliptin group were administered with alogliptin in a dosage of 20 mg·kg -1·d -1 by gavage, Sham and OVX groups with equivalent saline. After 12 weeks intervention, serum bone anabolism indicators were detected, and Micro CT and HE staining were used to observe and analyze the bone trabecular structure of femur and tibia in mice. For in vitro experiments, bone marrow mesenchymal stem cells(BMSCs)were incubated with 100 μmol/L alogliptin for osteoblast differentiation. Alkaline phosphatase(ALP)and alizarin red S staining were used to determine the ALP activity and mineralization after osteogenic induction and culture. Real-time fluorescence quantitative PCR and Western blot were used to detect mRNA and protein expressions of osteoblast related genes. Results:Alogliptin intervention improved the biochemical indexes of bone anabolism and protected against bone microstructure deterioration to alleviate bone loss in OVX mice. Alogliptin stimulated osteoblast differentiation and elevated expression levels of Runt-related transcription factor 2(Runx2), ALP, osteocalcin, and osterix in in vitro experiments. Conclusion:Alogliptin can alleviate bone loss in OVX mice.