Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.

Objective To evaluate the role of Src tyrosine kinase in damage to alveolar epithelial cells caused by mechanical stretch.Methods MLE-12 cells cultured in vitro were randomly divided into 3 groups using a random number table:mechanical stretch group (group S),dimethyl sulfoxide control group (group D),and Src tyrosine kinase inhibitor PP2 group (group P).In D and P groups,dimethyl sulfoxide 30 μl/ml and PP2 100 μmol/L were added to the culture medium,respectively,and the cells were then cultured for 30 min.The cells underwent mechanical stretch for 8 h with frequency of0.5 Hz and amplitude of 20％ in the three groups.At 0,2,4 and 8 h of mechanical stretch,MLE-12 cells in 3 wells of each group were collected for determination of cell apoptosis with flow cytometry and expression of occludin using Western blot.The apoptosis rate was calculated.Results Compared with S group,no significant changes were found in the apoptosis rate and expression of occludin at each time point in group D,and the apoptosis rate was significantly decreased,and the expression of occludin was up-regulated at 2,4 and 8 h of mechanical stretch in group P.Conclusion The activation of Src tyrosine kinase is involved in damage to alveolar epithelial cells caused by mechanical stretch.

Objective To investigate the impact ofα?lipoic acid(ALA)treatment on sepsis?induced acute kidney injury in rats and explore the mechanisms. Methods A total of 32 male SD rats were randomized into 4 groups:normal control group(group A),ALA?treated control group (group B),sepsis group(group C)and sepsis with ALA treated group(group D). Group A and B underwent sham operation,while CLP operations were conducted in group C and D. Rats in both group B and group D were then administered with 200 mg/kg ALA by oral gavage immediately after the surgical procedure. Twenty?four hours after the surgical procedure blood samples were obtained for the evaluation of creatinine,BUN,TNF?α,IL?6 and IL?1β. Rat kidneys were rapidly removed for PAS stain. Western blot was employed to determine the expression of NF?κB. Results Pathologi?cal changes of kidney were induced by sepsis and the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly increased by 178%,66%, 55%,114%and 110%(P<0.01). respectively;simultaneously the phosphorylation and nuclear expression of NF?κB p65 in kidney tissues were significantly increased by 144%and 102%(P<0.01). Sepsis?induced acute kidney injury also significantly reduced the expression of IκBαby 61%(P<0.01). These changes were significantly suppressed by early ALA treatment. Compared with C group,the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly decreased by 48%,26%,25%,37%and 40%(P<0.05),respectively,and the relative expression of IκBαwas increased by 103%(P<0.05). Conclusion The present study demonstrated that ALA can suppress the activation of NF?κB,thus ameliorat?ing sepsis?related acute kidney injury.

ObjectiveTo investigate the effects and indication of intermittent catheterization(IC) by relative safe bladder capacity(RSBC) to treat vesical-ureteral reflux(VUR).MethodsThere were 23 male complete SCI patients, aged between 7～45 years, including 15 patients without vesicao-ureteral reflux injuried 1～3 months as control group, 3 patients in mild group affected only ureter, and 5 patients in severe group affected not only ureter but also the pelvis. All the patients were taken intermittent catheterrization according to their own RSBC companied with supersonic device. The times of IC per day is that the average total urine volume one day was divided by RSBC. The observation time is over 2 years. During the oberservation some medicine was used to enlarge some patients bladder capacity.ResultsThere were no reflux in the control group; the reflux in the mild group improved a lot, some even disappeared, and there were no change in the severe group.ConclusionIC by RSBC is effective to prevent and cure vesical-ureteral reflux in some SCI patients.

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.

A 46-year-old male patient developed scatterred reddish-brown plaques and nodules on the back 6 years prior to the presentation. Then, the lesions gradually spread to the axillary fossa and protothorax, and became indurated with slight itching in winter. Laboratory examination revealed hypergammaglobulinemia. Computed tomography(CT)scan showed multiple nodular or patchy shadows in both lungs, lymphadenectasis in axillary, mediastinal and inguinal regions, and spleen enlargement. Histopathological examination of skin lesions showed granulomatous infiltrates with plenty of lymphocytes, histiocytes and mature plasma cells in the middle and lower dermis with the presence of lymphoid follicle-like structures, but no cell atypia was observed. Immunohistochemical study showed positive staining for CD38, CD138, CD79a, κ and λ light chains. According to clinical manifestations and laboratory examination results, the patient was diagnosed with cutaneous and systemic plasmacytosis.

Objective The clinical manifestations of cerebral infarction caused by acute basilar arterial occlusion are complex.The purpose of this study is to explore the relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Methods Fifty three patients diagnosed with cerebral infarction caused by acute artery occlusion were collected from Nanjing Stroke Registry.They were hospitalized in Jinling Hospital from January 2007 to July 2016 and were divided into sudden onset group and progressive onset group.Their clinical and digital subtraction angiography data were analyzed retrospectively.Results Middle and distal segment of the basilar artery occlusions were usually found in sudden onset group.Patients in progressive onset group were more likely to present with proximal segment of the basilar artery occlusions.Significant statistical difference was found between two groups (P<0.05).Logistic regression analysis showed that the symptoms of patients with proximal segment basilar artery occlusion tended to be progressive onset, compared with patients affected by distal segment occlusion (OR=14.77,95%CI:1.57-139.00, P=0.019).Conclusion There was significant relationship between lesion location and onset symptoms of cerebral infarction caused by acute basilar arterial occlusion.Early diagnosis and timely treatment may improve clinical prognosis in patients.

Objective To improve the method of blood collection from external jugular vein in rats,so as to repeatedly obtain blood samples of high quality and to meet the special requirements of the experiment.Methods The experimental rats were anesthetized by intraperitoneal anesthesia,and the jugular vein was fully exposed with special fixed method.Whereafter,the blood samples were collected by disposable vacuum blood vessels.Results This method had little traumatic effect.The blood samples were collected from 60 rats at an interval of 14 days with 1.8 to 2.5 mL each time.The success rate was above 95％,and the normal activities of the rats were not apparently affected.This vacuum blood collection method guaranteed the quality of serum,and the veracity of blood detection and analysis were also significantly improved.Conclusion On the basis of the principle of animal welfare,the improved rat jugular vein blood collection method has the advantages of simple operation,less trauma,large blood collection,high blood sample quality aod so on,which can ensure the effect of the special experiment.

Objective To investigate the metabolite changes in the preschool children with autism spectrum disorder (ASD) using MR spectroscopy (MRS) and explore the associations between image findings and clinical variables, which may provide a noninvasive brain biochemical method for the early diagnosis and prevention of autism. Methods Twenty one cases of preschool ASD children (3-6 years old) and age-and sex-matched 20 preschool healthy controls underwent single voxel short (SVS) short TE (TE=30 ms) MRS. The absolute metabolite concentrations in the anterior cingulate cortex (ACC) , anterior middle anterior cingulate cortex (aMCC) and posterior cingulate (PCC) were quantitatively analyzed using LCModel software. Two independent sample t tests were used for analysis. The relationships between metabolite concentrations and diagnostic and statistical manual of mental disorders (DSM-IV) , childhood autism rating scale (CARS) and autism behavior checklist (ABC) were analyzed by Pearson correlation analysis. Results Compared to control subjects, ASD patients had significantly lower N-acetylaspartate (NAA) values (4.35 ± 0.80, 6.34±0.82, 8.04±0.97 mmol/L respectively) in ACC, aMCC and PCC (t=2.640, P=0.012;t=2.182, P=0.035;t=3.343, P=0.002) , had significantly lower choline (Cho) 1.32±0.22 mmol/L (t=2.905, P=0.006) and glutamine and glutamate complex (Glx) 10.02 ± 0.88 mmol/L (t=2.090, P=0.043) in PCC. Cho, total creatine (tCr) , myo-Inositol (MI) and Glx levels did not differ between groups in other aforementioned regions (P>0.05). Negative correlations between the NAA ualues in the PCC and CARS (r=-0.504, P=0.020) were detected, and no significant correlation among DSM-IV, CARS, ABC and other metabolite values (P>0.05). Condnsions The biochemical changes in the preschool children with ASD in cingulate reflect the neuronal loss, structural or functional damage and cell membrane enzyme metabolic dysfunctions, may reveal the pathological basis of ASD. These results may provide noninvasive and quantitative methods for the diagnosis and prognosis evaluation of ASD child.

Objective: To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods: Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results: Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.