Objective To investigate the efficacy and safety of plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB). Methods 158 patients with BPH were randomly divided two groups: 81 patients treated by plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB), 77 patients treated by plasmakinetic resection of the prostate (PKRP). All patients were evaluated preoperatively and at 1, 6, 12 months after surgery by IPSS, QOL, Qmax and PVR. Operation time, resected adenoma weight, catheterization time, hospital stay and complications were documented. Results There were no significant differences in preoperative parameters. The resected adenoma weight in the PKERPADPB group was heavier than that in the PKRP group, the difference was significant. Compared with PKRP, PKERPDPB required a longer operation time, but resulted in less hemoglobin decrease, less catheterization time and hospital time. During the 1, 6, 12 months of follow-up, there was no significant difference in Qmax, IPSS, PVR and QOL between the groups. Conclusion PKERPDPB was statistically superior to PKRP in blood loss, catheterization time, hospital stay but inferior in operation time. It was a safe and effective treatment for BPH.

Background and purpose: The prognosis of completely resected stage ⅢA(N2) non-small cell lung cancer (NSCLC) remains a significant concern. The 5-year overall survival (OS) rates range from 10% to 30%. This study aimed to analyze the patterns of first failure in completely resected stage ⅢA(N2) NSCLC and to assess the actuarial risk of developing metastasis at different sites and to guild standard clinical practice. Methods: Patients withⅢA(N2) NSCLC who had undergone radical surgery in our hospital from Jan. 2005 to Jul. 2012 were retrospectively reviewed. The progression-free survival (PFS), the OS, patterns of first failure, the actuarial risk were analyzed. The cumulative incidence of first failure was determined using the Kaplan-Meier analysis. Results: Among 357 patients who met the eligibility criteria with completely resected stage ⅢA(N2) NSCLC, 5-year OS was 36.9%. There were 284 (77.6%) patients experiencing disease failure: 61 with local failure, 197 with local and distant failures, and 26 patients with local recurrence as the first failure. Brain, bone and lung were the main sites of distant failure as the first failure, while brain was the most common site. There were 67 patients developing brain metastases (BM) as the first site of failure. The median time of local failure as the first site of failure was 13.6 months, and the time to develop distant recurrence was 15.1 months. 92.5% BM developed in 3 years after the complete resection. Conclusion: As the first failure, the rate of distant failure was much higher than that of local failure in completely resected stage ⅢA(N2) NSCLC. Brain was the most common site of distant failure as the first failure. These results can be helpful in guiding standard clinical practice and evaluating the outcome of comprehensive treatment.

Bosentan is a non-selective endothelin receptor antagonist,which plays an important role in the treatment of children with pulmonary arterial hypertension.Bosentan has shown to improve exercise capacity,hemodynamics and reduce pulmonary vascular resistance in pediatric patients.The main adverse effect is less severely comparing with the adult.The combination of bosentan with other drugs can improve the life quality furtherly.Further study of large-scale trials needs focus on the long-effects of bosentan,the ideal period of therapy and the effects of combination therapy in children.

Objective To observe the difference of bone mineral den sity(BMD )between the young and the aged people,old healthy people and old patients with hip fra cture;the incidence of hip frac-ture in the aged was also observed in order t o find out the relationship of hip fracture with osteoporosis in the aged.Met hods BMDof lumbar(L 2~4 ),femoral neck,Wards triangle and trochanteric area was measured in the healthy males(63case)and fe males(58cases)with in the age range of 20t o35years,and the BMD was evalu ated in the healthy male and female over60y ears with hip fractures.The445cases of hip fracture were reviewed from19 91to2000,of them218were males and226females with the average age o f 73.6years in males and71.9years in fe males.Results Allof quantitati ve data was analysed sta tistically.There was sig nificant difference in BMD between the young and the aged people(P

Objective To observe the effect of combination of traditional Chinese medicine and western medicine on the treatment of post-operation endometriosis.Methods 60 cases with post-operation endometriosis were randomly divided into two groups.Patients in control group(n=30)were treated only by routine therapy (gestrinone twice a week).Patients in treatment group(n=30)were treated by combination of traditional Chinese medicinc(a decoction promoting blood flow)and western medicine.The effects were observed before and after treat- merit in both groups for 3 months.Results The accumulative total recurrence rate in treatment group(13.33 %) was lower than that in control group(30.00%,P

The future war will inevitably to be in the land,the sea and the sky and so on hyperspace,and electromagnetic environment is very complex.How to eliminate interference of medical equipment under the complex electromagnetic environment,to promote the performance of the medical support,these is austerity and reality questions in current every level of medical and health organization.Only based on the existing,bold practice,independent innovation,the comprehensive medical support exercise under the complicated electromagnetic environment,to master various types of medical equipment in a complex electromagnetic environment of the characteristics and laws in order to give full play to existing health technologies and equipment performance,improve the timeliness of medical support.

Mechanical ventilation is regarded as an effective means of replacing artificial ventilation during cardiopulmonary resuscitation (CPR), and has been widely used in the treatment of cardiac arrest (CA) patients. However, there are still some controversial issues remaining to be settled, such as the assessmentof the effectiveness of mechanical ventilation, the selection of the optimal oxygen concentration (FiO2), tidal volume (VT), respiratory frequency, and mode of ventilation during the CPR process. The pros and cons of positive pressure ventilation are also inconclusive. We reviewed and summarized the related research in recent years, and recommended that the intermittent positive pressure ventilation (IPPV) of volume controlled with small VT (6-7 mL/kg), low ventilation rates (10 times/min), and pure oxygen could be applied during the mechanical ventilation of CPR. The best mechanical ventilation strategy still needs further experimental researches to discover and explore.

Objective To investigate the effects of eardiopulmonary bypass(CPB)on plasma nitric oxide (NO)and asymmetric dimethyl arginine(ADMA)concentrations in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.Methods Eighteen ASA Ⅱ or Ⅲ patients aged 11-40 yr weighing 26-59 kg undergoing open heart surgery under CPB were divided into 3 groups according to pulmonary arterial systolic pressure(PASP)(n=6 each):group Ⅰ PASP<30 mm Hg;group Ⅱ PASP 30-50 mm Hg and group Ⅲ PASP>50 mm Hg.Arterial blood samples were taken before induction of anesthesia (To,baseline),at the start and termination of CPB(T1,2)and 3,6,24 h after CPB(T3-5)for determination of plasma NO and ADMA concentrations.Results The three groups were comparable with respect to M/F sex ratio,age,body weight and CPB time.The plasma ADMA concentrations were significantly increased while NO concentrations were significantly decreased at termination of CPB(T2)and 3 and 6 h after CPB(T3,4)as compared with the baseline at T0 in group Ⅱ and Ⅲ.The plasma ADMA concentration were significantly higher and No concentrations were significantly lower at all time points in groupⅡand Ⅲthan in group Ⅰ.Conclusion CPB can increase plasma ADMA concentration and decrease plasma NO concentration in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.

Objective To observe the expression of stromal cell derived factor-1?(SDF-1?) in vessels after common carotid artery balloon injury. Methods Sixty male SD rats were randomly divided into control group(group C) and balloon injury group(group S).The latter was subdivided into group S0(just after surgery),group S1(1 d after surgery),group S4(4 d after surgery) and group S7(7 d after surgery).Rats in group S were performed left common carotid artery balloon injury.For all the rats,peripheral blood samples were taken,and CD34+CXCR4+cells were detected with flow cytometer.The left common carotid arteries were obtained to detect the expression of SDF-1? mRNA and protein by RT-PCR and Western blotting,respectively. Results The number of CD34+CXCR4+ cells increased significantly in peripheral blood(P

Objective To determine the outcome of the combined use of flaps transfer and ilizarov technique reconstruct the large soft tissue defects and bone lose in the lower leg.Methods Sixteen patients were identified from a retrospective review from July,2008 to July,2013,who suffered the large soft tissue defects and bone lose in the lower leg and underwent single-stage soft tissue and osseous reconstruction using the flap technique and Ilizarov method.There were 12 males and 4 females aged from 22 to 62 years old (average 42.6 years old).The size of soft tissue defect ranged from 8 cm×9 cm to 30 cm×20 cm.The length of the bone discrepancy ranged from 2 to 14 cm.According to the local condition of the lower leg and the size of the composite tissue defects,10 patients received the free flap covering,6 patients repaired by the saphenous neurocutaneous perforator flap (3 cases) and sural nerve neurocutaneous flap (3 cases).Daily monitoring the skin temperature postoperative.Distraction was commenced on postoperative day 10 to 14 at the rate of 1 mm/day and continued in 4 equal increments.Results The follow-up time ranged from 18 to 36 months.Sixteen flaps survived completed,only 1 flap was observed the venous congestion in postoperative day 2.The duration of ilizarov application ranged from 3.5 to 18.0 months.All patients achieved final union.All patients were satisfied with the outcome of the surgery.Conclusion The combined use of neurocutaneous flap and Ilizarov technique for reconstruction of large composite soft tissue defect in the lower leg.Significantly reduce patient treatment time,improving traction osteogenesis of long bones and the ability of resistance to infection.