Disinfection ; Escherichia coli ; isolation & purification ; Hospitals ; Medical Waste ; Sewage ; Waste Products ; Water Microbiology

Introduction: Transurethral resection of the prostate (TURP) has been considered as the gold standard treatment for obstructive voiding dysfunction in men with benign prostatic hyperplasia. This standard treatment has been challenged by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). We review summarizes the literature comparing HoLEP to traditional therapies TURP, open prostatectomy (OP) for BPH these are widely used and have long term efficacy data. Patients undergoing HoLEP have significant shortened catheterization times, decreased length of hospital stay, fewer serious postoperative complications, greater reduction in post-operative IPSS, greater improvements in post-operative Qmax and lower rates of repeat endoscopic procedures for recurrent symptoms compared with TURP and OP. Furthermore, HoLEP can be used to resect more than 100 grams tissue and it is equivalent efficacy to open prostatectomy. Conclusion: HoLEP as the new gold standard treatment for surgical BPH therapy further. HoLEP remains its difficult learning curve when compared with traditional transurethral resection.

Objective To investigate the effect of propofol on cognitive function in young obese rats, and to explore its relationship with heme oxygenase 1 (HO-1), superoxide dismutase 1 (SOD1) protein expression and plasma S100 calciumbinding protein β (S100β) expression. Methods A total of 140 male SD rats aged 21 days were randomly divided into normal diet group (n=40) and high-fat diet group (n=100), and the rats were fed with a normal diet and a high-fat diet, respectively. After 4 weeks of feeding, 40 rats of the high-fat diet group with body mass≥the average body mass ≥1.4 times of the standard deviation of the normal diet group were designated as obese rats. The rats in the normal diet group were randomly divided into the normal lipid emulsion solvent group (NL group) and the normal propofol group (NP group), and the 40 obese rats were randomly divided into the obese lipid emulsion solvent group (OL group) and the obese propofol group (OP group), with 20 rats in each group. The rats in the propofol groups were intraperitoneally given propofol 100 mg/kg, and those in the lipid emulsion solvent groups (control groups) were intraperitoneally given lipid emulsion solvent 100 mg/kg, once a day for 7 days. On the first day after drug withdrawal, Morris water maze test was performed to evaluate the spatial learning and memory abilities of rats in each group. Meanwhile, the plasma S100β protein content of each group was detected by enzyme-linked immunosorbent assay, the expression levels of HO-1 and SOD1 protein in hippocampus were detected by Western blotting, and the changes of neurons in hippocampus CA1 area were observed by hematoxylin-eosin staining. Results Compared with the OL group, the escape latency time was significantly prolonged on 1-5 days (all P<0.05), the third quadrant residence time was significantly shortened (P<0.05), the times of crossing platform was significantly decreased (P<0.05), the expression of plasma S100β protein was significantly increased (P<0.05), the relative expression levels of HO-1 and SOD1 protein in hippocampus were significantly decreased (both P<0.05), and the number of neurons in hippocampal CA1 area was significantly decreased (P<0.01) in the OP group. Compared with the NL group, the escape latency time of the NP group was significantly prolonged on 1-2 days (both P<0.05), and there were no significant differences in other indexes mentioned above (all P>0.05). Conclusion Propofol can down-regulate the expression of anti-oxidant factors HO-1 and SOD1 in the hippocampus of young obese rats, leading to increase of S100β expression and oxidative stress and eventually causing cognitive impairment..

Objective To analyze the influence of topographic anatomy on brachial plexus block anesthesia, and to provide reference for clinical research and application. Methods Total of 20 cadavers were selected and located through the modified method of inferior brachial plexus block of the coracoid process. The nerve blocking points were marked with blue dye, and the nerve concentration sites and marking points were dissected and exposed at the same time. The anatomical relationship between nerve concentration points and body surface markers were explored. Results The distances from the upper margin of the left centralization to the midpoint of the subclavian border, the inferior margin of the sternoclavicular joint, the shoulder peak and the inferior edge of the coracoid process were (3. 62±0. 24) cm, ( 10. 39± 0.25) cm, (6. 67 ±0.18) cm and (2. 80±0.19) cm, respectively. The distances from the upper edge of the right centralization to the midpoint of the subclavian border, the inferior margin of the sternoclavicular joint, the shoulder peak and the inferior edge of the coracoid process were (4. 24±0. 27) cm, (11. 10±0. 28) cm, (6. 35±0. 19) cm and (3. 03± 0. 15) cm, respectively. Conclusion The application of anatomy improves the accuracy of brachial plexus block, thus improves the effect of brachial plexus block anesthesia, and provides a powerful reference for clinical research and application.

Objective: To explore the clinical characteristics of glucocorticoid induced eye damage in children with primary nephrotic syndrome. Methods: The clinical data of steroid-induced high intraocular pressure or cataract in 49 children who were from Zhengzhou Children′s Hospital with primary nephrotic syndrome admitted from September 2016 to April 2018 were analyzed retrospectively in order to observe the relationship between relevant eye damage and clinical medication. Results: There were 37 boys and 12 girls in the 49 cases, of which the average age of onset was (7.6±3.0) years old, and among them there were 22 cases with glucocorticoid high intraocular pressure, 19 cases with glucocorticoid cataract, 8 cases with glucocorticoid high intraocular pressure combined with cataract, but no glaucoma in 49 cases.The shortest time of using glucocorticoid was 15-3 240 days[(863.33±871.46) days]; the cumulative dose of glucocorticoid was (7 865±3 691.66) mg/m², the left eye pressure was (26.68±5.95) mmHg(1 mmHg=0.133 kPa) and the right eye pressure was (27.71±5.82) mmHg.There was no significant correlation between glucocorticoid using time, cumulative dose and high intraocular pressure(r=-0.158, -0.264, -0.237, -0.361, all P>0.05). All the 19 patients with glucocorticoid cataract and 8 patients with glucocorticoid high intraocular pressure combined with cataract presented posterior capsular opacity, including 23 males and 4 females, and their time of using glucocorticoid was(1 296.67±903.35)days, who were followed up continuously. Conclusions Glucocorticoid-induced high intraocular pressure and cataract should be paid attention to by clinicians.Once high intraocular pressure or cataract occurs, the dosage of glucocorticoid should be gradually reduced or stopped, at the same time, ophthalmologic treatment should be actively performed to avoid serious eye diseases.

Objective:To explore the prognostic significance of thrombospondin 2 (THBS2) expression and its effects on the proliferation and migration of pancreatic cancerASPC-1 cells for patients with pancreatic cancer, and to investigate its possible molecular mechanism. Methods: The expression of THBS2 in pancreatic cancer tissues and its effects on overall survival rate in patients were analyzed by online database. THBS2 expression in pancreatic cancerASPC-1 cells was detected by Western Blotting; RNAinterference was used to knockdown the expression of THBS2 inASPC-1 cells, and then the effects of THBS2 knockdown on cell proliferation and migration were detected by MTT and Transwell assays, while its effects on protein expression levels (MMP, E-cadherin,AKT and PI3K) were detected by Wb. Results: Expression of THBS2 in pancreatic cancer tissues was significantly higher than that in normal pancreatic tissues (P<0.01), and the high expression of THBS2 could lead to the decrease of overall survival rate in pancreatic cancer patients. The expression of THBS2 in pancreatic cancer cell lines was significantly up-regulated; however, after interference on the expression of THBS2, the proliferation (P<0.01) and migration ability (P<0.01) of ASPC-1 cells were significantly decreased, and the expression of AKT and PI3K in cells was significantly down-regulated (P<0.01). Conclusion: THBS2 is highly expressed in pancreatic cancer tissues and cells, and is negatively correlated with the prognosis of patients. The mechanism is possibly related with the proliferation and migration of ASPC-1 cells that regulated byAKT/PI3K signaling pathway.

INTRODUCTIONIncidental reports collected in clinical trials suggest that amongst participants, omega-3 fatty acids derived from fish oil ('omega-3') may be difficult to blind.

MATERIALS AND METHODSWe conducted a systematic evaluation of blinding success in a 24-week trial of omega-3 versus an oil-based placebo. Within 1 week of supplement commencement (Week 1), a blinding questionnaire was completed by 131 children enrolled in a trial of omega-3 for the treatment of disruptive behaviour disorders. A version of the questionnaire was also completed by their parents at Week 1, and by the children at the end of supplement administration (Week 24).

RESULTSParticipants were unable to differentiate omega-3 from placebo, and accuracy did not improve as a function of: the confidence of guesses, reason for guesses, notice of any change, beliefs about what should change, or time. Child and parent guesses also showed high concordance.

CONCLUSIONTaken together, these data provide strong evidence that the identity of omega-3 can be blinded to participants.

Adolescent ; Attention Deficit and Disruptive Behavior Disorders ; diet therapy ; Child ; Dietary Supplements ; Fatty Acids, Omega-3 ; therapeutic use ; Female ; Humans ; Male ; Parents ; Single-Blind Method ; Surveys and Questionnaires

Objective: To study the characteristics of clinical diagnosis and treatment for 3 children with phytosterolemia. Methods: The different clinical manifestations of 3 children with phytosterolemia were retrospectively reviewed. The case 1 and case 2, who were 7 years and 2 months old twin sisters, hospitalized for frequent epistaxis and abdominal pain. The case 3, who was 5 years and 7 months old male, came to the hospital for cutaneous xanthoma. The phytosterol levels in serum of the children were analyzed by gas chromatography-mass spectrometry, and the second generation sequencing method was used to analyze the disease-causing gene. Sanger sequencing method was used to verify the ABCG5 gene mutation and parental source. Results: (1) The case 1 and case 2 showed moderate anemia, raised reticulocytes, total bilirubin and indirect bilirubin as well as splenomegaly. The blood smear showed that there were more irregular red blood cells, such as oral red blood cells, increased large/giant platelets, and ristomycin-induced platelet aggregation test was decreased. The urine routine examination indicated that there was bleeding in the urinary system. The results of blood lipid test were almost normal. The case 3 showed mild anemia with normal shape of erythrocyte and normal size of spleen. The large/giant platelets increased. The results of platelet aggregation test, bilirubin and urine routine examination were in normal range, but the levels of total cholesterol and low-density lipoprotein cholesterol increased significantly. (2) The levels of serum phytosterol were significantly increased in all the 3 children. (3) Two heterozygous mutations were detectable in ABCG5 gene of case 1 and 2 which were complex heterozygous mutation, i.e., c.9041G＞A and c.751C＞T. The variations were from their father and mother respectively. In case 3, only one homozygous mutation was detectable in ABCG5 gene which originated from their parents. Conclusion When the child showed increased large/giant platelets, hemolytic anemia, erythrocytosis or xanthoma of skin and rised total cholesterol and low-density lipoprotein cholesterol at first visit, the possibility of phytosterolemia should be considered. The blood phytosterol content and gene detection should be carried out as early as possible in order to treat early and improve prognosis.

Objective: To evaluate the effect of thoracic paravertebral nerve block (TPVB) at different time points on postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer. Methods: One hundred and fifty patients of both sexes, aged 25-64 yr, with body mass index of 18-24 kg/m², of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective radical resection of lung cancer, were divided into 3 groups (n=50 each) by a random number table method: preoperative TPVB group (P₁ group), TPVB at the end of operation group (P₂ group) and preoperative TPVB combined with TPVB at the end of operation group (P₃ group). In group P₁, TPVB was performed at T_{4, 6} points on the affected side under ultrasound guidance before anesthesia induction, and 0.5% ropivacaine 10 ml was injected in total.In group P₂, TPVB was performed at T_{4, 6} points on the affected side under ultrasound guidance at the end of operation, and 0.5% ropivacaine 10 ml was injected in total.In group P₃, TPVB was performed at T_{4, 6} points on the affected side under ultrasound guidance before anesthesia induction and at the end of operation, and 0.5% ropivacaine 10 ml was injected each time.The analgesia pump was connected at the end of operation in three groups.The patients were followed up after operation, and 5 ml solution extracted from the analgesic pump was intravenously injected when VAS score was greater than or equal to 4.The occurrence of postoperative chronic pain in the 3 groups was recorded though telephone follow-up at 6 and 12 months after surgery, and the effect of pain on daily life and treatment measures were scored.A concise health-related quality of life scale was used to evaluate patients′ quality of life, and the physical and mental health scores were calculated. Results: There was no significant difference in the incidence of chronic pain at 6 and 12 months after surgery among the three groups (P>0.05). The physical and mental health scores were significantly decreased at 12 months after surgery than at 6 months after surgery in the three groups (P<0.05). Compared with P₁ and P₂ groups, the scores of effect of pain on daily life and treatment measures were significantly decreased, and the physical and mental health scores were increased at 12 months after surgery in group P₃ (P<0.05). Conclusion The combination of preoperative TPVB and TPVB at the end of operation can effectively improve postoperative long-term quality of life in the patients undergoing thoracoscopic radical resection of lung cancer.

Objective: To explore the application value of digital 3D printing technology for repairing mandibular defects with fibular flaps and to provide a basis for accurate repair mandibular defects. Methods: Nine cases of mandibular defects were selected, and spiral CT and CTA of the lower limbs were performed before the operation. The osteotomy guide plate and plastic guide plate were created using computer software, and the titanium plate was rebuilt according to the printed mandibular model. During the operation, an osteotomy guide plate was used for mandibular resection; a fibula bone plastic guide plate was used to reconstruct the fibular flap and reconstruct the mandibular defects. Results: The entire fibula flap survived, and the occlusal relationship was good. There was no complications in the donor site. The patients were satisfied with the appearance of the repair. All patients were followed up for 3 to 6 months, at which point the bone was basically healed. Conclusion Using a digital 3D printing technique to repair mandible defects with a fibular flap can shorten the operation time, reduce the risks of operation, and better restore the maxillofacial shape and the function of the jaw, which is consistent with the concept of appropriate medical treatment. Additionally, this process provides a better method for the treatment of mandibular defects.