Objective To evaluate the efficacy and safety of modified transurethral plasmakinetic enucleation of prostate (M-TPEP) combined with cystolithectomy in elderly patients with high risk of large volume benign prostatic hyperplasia (BPH) complicated with large urinary bladder calculi. Methods Seventy-one patients with high risk of large volume BPH complicated with large urinary bladder calculi were selected, and the patients were treated with M-TPEP combined with cystolithectomy. The operation time, intraoperative blood loss, hospitalization time, complications, and the maximum urinary flow rate (Qmax), post-void residual volume (PVR), serum potassium, international prostate symptom score (IPSS), quality of life (QOL) score preoperative and postoperative 3 months were recorded. Results Seventy-one patients successfully completed the operation, and no death occurred. The operation time was (75.48 ± 6.51) min, intraoperative blood loss was (82.63 ± 10.08) ml, and postoperative hospitalization time was 5-7 d. Incidence of intraoperative capsule perforation was 2.82% (2/71), incidence of postoperative temporary urinary incontinence was 7.04% (5/71), incidence of urethral and bladder irritation after operation was 8.45% (6/71), and incidence of postoperative wound infection was 2.82% (2/71). The PVR, IPSS and QOL score 3 months after operation were significantly lower than those before operation: (6.89 ± 0.74) ml vs. (205.13 ± 40.08) ml, (2.71 ± 0.45) scores vs. (28.62 ± 3.57) scores and (1.36 ± 0.24) scores vs. (4.93 ± 0.38) scores, the Qmaxwas significantly higher than that before operation: (22.46 ± 2.97) ml/s vs. (5.24 ± 0.43) ml/s, and there were statistical differences (P＜0.01);there was no statistical difference in serum potassium between before operation and 3 months after operation (P＞0.05). Conclusions M-TPEP combined with cystolithectomy has short operation time, quick recovery after operation and low complication rate. It is a proper operative method for the elderly patients with high risk of large volume BPH and large urinary bladder calculi.

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.

Objective To explore risk factors of early lung infection after liver transplantation and to construct a prediction model of early lung infection after liver transplantation.Methods The clinical data of 269 patients who underwent orthotopic liver transplantation for the first time were retrospectively analyzed.Patients were divided into the infected group(n=97)and the non-infected group(n=172)according to whether pulmonary infection occurred within 30 days after operation.The preoperative general data,preoperative laboratory examination results,intraoperative and postoperative data of the patients were collected.Multivariate Logistic regression analysis were used to screen risk factors of pulmonary infection.Based on the results of multivariate analysis,the prediction model was constructed and the prediction efficiency of the model was evaluated.Results Univariate and multivariate Logistic regression analysis showed that preoperative PNI≤41.70(OR=1.972,95%CI:1.047-3.714,P=0.036),LMR≤1.52(OR=2.020,95%CI:1.102-3.705,P=0.023),MELD score＞10.72(OR=1.985,95%CI:1.103-3.573,P=0.022),operative time＞448.00 min(OR=2.676,95%CI:1.515-4.727,P=0.001)and intensive care unit(ICU)hospitalization time＞4.0 days(OR=2.623,95%CI:1.335-5.154,P=0.005)were independent risk factors for early pulmonary infection after liver transplantation.The ROC area under the curve(AUC)of the prediction model based on the results of multivariate Logistic regression analysis was 0.768,the sensitivity was 80.41%and the specificity was 60.47%.Conclusion The prediction model based on PNI,LMR,MELD score,operation time and ICU hospitalization time can effectively predict the occurrence of early pulmonary infection after liver transplantation.