Objective To explore the CCR7 expression status in bladder urothelial carcinoma (BUC) and the relationship between CCR7 expression and lymph node metastasis,and analyze the impact of CCR7 expression on prognosis.Methods The expression levels of CCR7 in 57 BUC tissues and 10 normal bladder tissues were estimated by immunohistochemistry technique,and the correlation between CCR7 with lymph node metastasis,tumor stage,grade,number,size,relapse or not,and patients' age/sex of BUC was analyzed.The influence factors of lymph node metastasis were tested,and so were the influence factors of prognosis.Results The positive rate of CCR7 expression among 57 patients was 82.5％ (47/57) (high expression rate was 45.6％),which was higher than that in normal bladder tissue (20.0％,all were low expression,P ＜ 0.05).The high expression rate of CCR7 in lymph node metastasis group was 68.2％ (15/22),higher than that in none lymph node metastasis group (31.4％,11/35,P ＜ 0.01).The expression level of CCR7 had no significant correlation with tumor stage,grade or other parameters.CCR7 expression,tumor stage and tumor grade were correlated with lymph node status (P ＜ 0.05),but only the first was an independent one.High CCR7 expression had a significant link with low relapse free survival (P ＜ 0.05).Conclusion The expression of CCR7 was highly expressed in BUC,which may be a positive independent influence factor of lymph node metastasis,and a predictor of poor prognosis.

Objective To compare the effects of laparoscopic surgery and open surgery of inguinal lymphadenectomy in patients with penis carcinoma.Methods A retrospective case-control study was carried out.The retrospective analysis of clinic data of 10 patients with penis carcinoma who had laparoscopic inguinal lymphadenectomy and 13 who had open inguinal lymphadeneetomy were collected from June 2007 to June 2011,with an average age of 57 (40-75 years),and the average follow-up of 18.6 months (7 days to 9 years).Preoperative clinical stage were T1 in 10 cases,T2 in 7 cases,T3 in 6 cases,with 10 patients detecting inguinal lymph nodes enlargement,while three of which have two enlarged lymph nodes.The age of patients,duration of disease,tumor stage and lymph node enlargement have no statistically significant difference between laparoscopic surgery (LS) group and open surgery (OS) group.The mean operation time,intraoperative blood loss,time of postoperative drainage,hospitalization duration,mean number of excised lymph nodes and postoperative complications were analyzed.Results The mean operative time,intraoperative blood loss,time of postoperative drainage,and hospitalization duration of LS group and OS group were (103.6 ± 15.2) min,(56.5 ±6.8) ml,(5.8±0.8) d,(8.5±1.1) d versus (156.8±18.3) min,(88.5±9.5) ml,(12.5±1.3) d,(15.7±1.9) d,respectively.There was significantly different between the two groups (P＜0.05).However,the mean number of lymph nodes and the mean number of positive lymph nodes excised were not statistically different between the two groups (P＞0.05).There was no transfusion,and no severe complications occurred in either group.With the follow-up of 12-48 months,only one case of lung metastasis detected in OS group.Conclusions Compared with the open inguinal lymphadenectomy,laparoscopic inguinal lymphadenectomy is more safe and effective.It leads to less intraoperative blood loss,less hospitalization duration,less postoperative complications and quick postoperative recovery.

Objective To investigate the curative effects of Retzius sparing robotic assisted laparoscopic radical prostatectomy(RARP) through anterior path.Methods From July 2015 to July 2017,75 patients undergoing Retzius sparing RARP(Rs-RARP group) and 75 patients undergoing conventional anterior approach RARP(CA-RARP group) were retrospectively reviewed.Preoperative data of patients was collected as follows:age of (68.6 ± 5.3) years,median prostate volume of 38.9 (20.6-60.1) m1,tPSA of (15.7 ± 3.3) ng/ml,BMI of (25.2 ± 3.6) kg/m2,biopsy Gleason score of 3 + 3 in 24 cases,3 + 4 in 28 cases,4 + 3 in 23 cases,cTMN T1c in 11 cases,T2a-T2b in 59 cases,T2c in 5 cases,in Rs-RARP group;age of (69.6 ± 5.6) years,median prostate volume of 38.3 (18.4-59.8)ml,tPSA of (17.6 ± 4.4) ng/ml,BMI of (27.5 ± 2.7) kg/m2,biopsy Gleason score of 3 + 3 in 29 cases,3 + 4 in 26 cases,4 + 3 in 20 cases,cTMN T1c in 17 cases,T2a-T2b in 51 cases,T2c in 7 cases,in CA-RARP group.The clinical data of the two groups,including operation time (OT),intraoperative blood loss,perioperative blood transfusion rate,24h/1m/3m/6m/12m continence situation and erectile function recovery,and postoperative oncological results were analyzed statistically.Results All cases were successfully performed robotically without conversion or major intraoperative or postoperative complications.For operative time,Rs-RARP group was (125.3 ± 15.6) mins and CA-RARP group was (108.4 ± 21.7) mins,and the difference was not statistically significant (P ＞ 0.05).For estimated blood loss (EBL),Rs-RARP group was (106.1 ± 10.3) ml,with perioperative blood transfusion in 2 cases (2.67％),and CA-RARP group was (82.2 ± 18.4)ml,with perioperative blood transfusion in 1 cases(1.33％).The Rs-RARP group had more EBL than the CA-RARP group(P ＜0.05).No difference was found in perioperative blood transfusion rate(P ＞ 0.05).The postoperative oral intake time was (1.5 ± 0.6) d,postoperative hospital stay was (8.0 ± 1.2) d,total hospitalization expense was (58.4 ± 13.2) thousand Yuan,and there were 5 cases (6.67％) with postoperative complications in Rs-RARP group,and was (2.0 ±0.6) d,(9.0 ± 1.8) d,(60.2 ± 16.4)thousand Yuan and 3 cases (4.00％) in corresponding items in CA-RARP group.No significant difference was found in the above mentioned parameters (all P ＞ 0.05).Postoperative pathology confirmed pT1c of 18 cases,T2a-T2b of 52 cases,and pT2c of 5 cases in Rs-RARP group and pT1c of 12 cases,T2a-T2b of 56 cases,pT2c of 7 cases in CA-RARP group (P ＞ 0.05).There was no significant difference between RsRARP and CA-RARP groups in the surgical positive margin (5 cases vs.4 cases,P ＞ 0.05).No tumor recurrence appeared for all cases (tPSA ＜0.2 ng/ml) during 12 months follow-up.The continence rate for Rs-RARP group and CA-RARP group were 84.0％ (63/75) vs.28.0％ (21/75) (24h postoperatively),90.7％ (68/75) vs.46.7％ (35/75) (1 month postoperatively),93.3 ％ (70/75) vs.57.3％ (43/75)(3 months postoperatively),96.0％ (72/75) vs.89.3％ (67/75) (6 months postoperatively) and 100％ (75/75) vs.96.3％ (72/75) (1 year postoperatively).Rs-RARP group showed superiority in continence recovery at 24 h and 1,3 months postoperatively (all P ＜ 0.05),but no statistical differences at 6,12 months postoperatively(all P ＞ 0.05).On erectile function,Rs-RARP group was significantly better than the conventional group at 1,3,6,12 months postoperatively in ≤75-year-old patients(all P ＜ 0.05).But in ＞ 75-year-old patients,two groups had no difference during the follow-up (all P ＞ 0.05).Conclusions Retzius sparing RARP through anterior path can treat early and intermediate stage prostate cancer effectively,and continence and erectile function recovered shortly.

Objective:To examine the risk factors for neuropathic pain (NP) after a spinal cord injury (SCI).Methods:A total of 115 patients with a SCI were analyzed retrospectively. They were divided into an NP group of 53 and a non-NP group of 62 according to the occurrence of NP. Gender, age, length of stay, occupation, level of education, cause of injury, spinal fracture, degree of SCI, the injury′s plane and complications at admission (diabetes, hypertension, anemia, venous thrombosis, pressure sores, urinary tract infection or hypoproteinemia) were recorded. T-tests and chi-squared tests were used to compare those factors between the two groups, and multivariate logistic regressions were evaluated to identify the risk factors for NP.Results:Twenty-three of the 53 cases of NP (43%) had developed within 1 month of the SCI. Thirty-seven (75%) experienced pain below the plane of the SCI. The main features reported were squeezing (34%) and numbness (26%). The multivariate logistic regression showed that the occurrence of NP was most strongly related to gender (women being particularly at risk) and venous thrombosis at admission.Conclusions:Women are at particular risk of feeling NP after an SCI, and venous thrombosis is an independent risk factor. NP should be diagnosed and treated quickly to reduce the negative impact on patients′ life quality.

Objective To establish the drug use evaluation(DUE)standard of bivalirudin for injection,and to evaluate the use of the drug by weighted TOPSIS method,so as to provide a reference for rational use of bivalirudin.Methods Based on the package insert,clinical guidelines and consensus of experts of bivalirudin,the DUE standards were developed,and the weighted TOPSIS method was used to evaluate the rationality of the discharge medical records of Shanxi Bethune Hospital from January 1st to June 30th in 2022.Results Incorporating 108 medical records involving the use of bivalirudin for injection,88 cases(81.48％)exhibited a high degree of adherence(Ci≥0.8)between the prescribed drug regimens and the optimal recommendations,which is considered reasonable.Additionally,19 cases(17.59％)fell within the range of 0.6＜Ci＜0.8,indicating a generally reasonable adherence.Only one case(0.93％)had a Ci＜0.6,suggesting an unreasonable level of adherence.The irrational situations about various evaluation indicators in the DUE were mainly manifested in the inappropriate dosages of administration(12.04％),inappropriate disposal of adverse reactions(11.11％),using medicine with contraindications(3.70％),using medicine without indication(1.85％),inappropriate monitoring of adverse reactions(0.93％),etc.Conclusion The established DUE standards for bivalirudin are intuitive and comprehensive,and the evaluation results show that there are some unreasonable situations in the use of bivalirudin in the hospital,and it is necessary to standardize the use of bivalirudin in terms of dosages,disposal of adverse reactions,indication and contraindication.