OBJECTIVETo evaluate the safety and effectiveness of a modified method of holmium laser enucleation of the prostate (HoLEP)--6-o'clock tunnel HoLEP for the treatment of benign prostate hyperplasia (BPH).

METHODSWe included 112 cases of BPH in this study, 57 treated by 6-o'clock tunnel HoLEP (experimental group) and the other 55 by conventional HoLEP (control group). We compared the operation time, volume of the resected prostatic tissue, intraoperative blood transfusion, volume of bladder irrigation solution, postoperative hemoglobin change, and incidence of urinary incontinence between the two groups.

RESULTSStatistically significant differences were observed between the experimental and control groups in the operation time ([56.01 ± 8.62] min vs [68.65 ± 9.08] min), cases of intraoperative blood transfusion (0 vs 2), volume of bladder irrigation solution ([27.51 ± 3.67] L vs [36.89 ± 6.47] L), postoperative hemoglobin decrease ([10.70 ± 2.50] g/L vs [12.60 ± 3.30] g/L), and cases of postoperative stress-induced urinary incontinence (2 vs 7) (all P <0.05). One-month follow-up revealed smooth urination in both groups of patients but no true urinary incontinence or secondary bleeding in either.

CONCLUSIONModified 6-o'clock tunnel HoLEP can significantly reduce the operation time, bladder irrigation, and intraoperative bleeding, and therefore can be used as a safe and effective option for the treatment of BPH.

Case-Control Studies ; Hemorrhage ; prevention & control ; Holmium ; Humans ; Laser Therapy ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Operative Time ; Postoperative Period ; Prostatic Hyperplasia ; surgery ; Therapeutic Irrigation ; statistics & numerical data ; Urinary Bladder ; Urinary Incontinence ; epidemiology ; etiology ; Urinary Incontinence, Stress ; etiology

Objective To analyse the influencing factors of quality of life (QOL)among postoperative children with congenital anorectal malformation (ARM), so as to provide evidence for developing comprehensive interventions and improve QOL of children with ARM.Methods The QOL of 100 children aged at 2 and 5 years old were evaluated by using the Chinese version of PedsQLTM4.0 scale, and the total and 4 dimensions scores of QOL were calculated.Univariate and multiple stepwise regression model was applied to analyse the influencing factors of the QOL.Results The results of univariate analysis among ARM children aged at 2 years old showed that the clinical classification, bowel disorders and family residence have different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of univariate analysis among ARM children aged at 5 years old showed that the clinical classification, bowel disorders and maternal education had different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of multiple stepwise regression model among ARM children aged at 2 years old showed that the major influence factor of QOL scores in physical function was family residence and bowel disorders(P ＜ 0.05), the major influence factor of QOL scores in social functioning was bowel disorders(P ＜ 0.05), the major influence factor of the total scores was bowel disorders and family residence(P ＜0.05).The results of multiple stepwise regression model among ARM children aged at 5 years old showed that the major influence factor of QOL scores in physical function was maternal occupation and clinical classification(P ＜ 0.05), the major influence factor of QOL scores in emotional functioning was bowel disorders(P ＜ 0.05) ,the major influence factor of QOL scores in social functioning was clinical classification and bowel disorders (P ＜ 0.05), the major influence factor of QOL scores in school performance was maternal occupation(P ＜ 0.05), the major influence factor of total scores was bowel disorders and clinical classification(P ＜ 0.05).Conclusion Family residence and bowel disorders have effct on QOL of ARM children aged at 2 years old.Maternal occupation, clinical classification and bowel disorders have effct on QOL of ARM children aged at 5 years old.We should take positive interventions on these influencing factors to improve QOL of children with ARM.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.

OBJECTIVE To analyze the clinical features of 8 patients with sigmoid sinus diverticulum and to improve the level of diagnosis and treatment. METHODS The tinnitus patients were asked in detail about the history, and performed a series of routine hearing tests (pure tone audiometry, acoustic impedance audiometry, otoacoustic emission inspection and brainstem auditory evoked potential (BAEP) etc.) and temporal bone HRCT scan. Eight cases were diagnosed with sigmoid sinus diverticulum, in which six cases undertook a surgery to reconstruct the sinus wall while the other 2 cases chose conservative treatment. RESULTS The diagnosis of 6 cases was proved to be correct by surgery, and the pulsatile tinnitus disappeared after reconstructing the sinus wall. No one recurred after following up from 2 to 12 months. Two cases of conservative treatment had no obvious improvement in symptoms. CONCLUSION Clinical manifestation, hearing examination, temporal bone CT/HRCT and Cranial CTA/CTV contributed to the diagnosis of sigmoid sinus diverticulum. Sinus wall reconstruction is a better approach.

Objective To investigate the change of eNOS,the spermatogenic cell proliferation,apoptosis in mouse testis exerted by alcohol. Methods The immunohistochemical staining method for detecting of eNOS,PCNA,TUNEL method for detecting of apoptotic cells and the satistics analysis were used in the present study. Results With the increase of alcohol concentration,the structure of seminiferous tubule changed,the diameter of seminiferous tubule decreased,the surface density of postive eNOS cells increased gradually,and the number of positve PCNA cells and apoptosis cells also increased.There were significant difference in 15% alcohol concentration group compared with the other groups(P

This paper discussed the current status of hearing aids fitting practitioners in China and proposed some proposals on how to cultivate qualified practitioners.The proposals includes setting up short-term training program,launching hearing aids fitting major in occupational schools and cultivating the hearing aids fitting practitioners from the would-be audiologists or otologists in an aim to meet the urgent hearing aids fitting need of Chinese deafness.

Coronary heart disease is one of the most important causes of death in human, and consumes vast medical resources. Percutaneous coronary intervention (PCI) has been a significant breakthrough for its treatment. However, clinical application has been hampered by in-stent restenosis (ISR). Although drug eluting stent (DES) has reduced the occurrence of restenosis, incidence of ISR is still about 5% to 10%. The main reasons for restenosis after PCI are hyperplasia of vascular endothelial cells and smooth muscle cell migration. The exact mechanism of personalized differences in restenosis is not clear yet, but there may be a variety of risk factors. In addition to aging, smoking and diabetes, an increasing number of studies have found that genetic and epigenetic factors play an important role in ISR. In this article, authors have reviewed genetic and epigenetic factors on the progression of ISR, which may help to determine the genetic risk factors in patients with ISR after PCI.
Angioplasty, Balloon, Coronary ; methods ; Coronary Restenosis ; etiology ; genetics ; Disease Progression ; Epigenomics ; methods ; Humans ; Stents ; Treatment Outcome

OBJECTIVETo identify the original plant of "Daibaijie", commonly used Dai herb.

METHODThe literature review, morphology and anatomy, pharmacognosy, molecular biology, chemistry were used to analysis.

RESULTDaibaijie's historical scientific name, Dregea sinensis Hemsl., was mistakenly given "Daibaijie" and D. sinensis have significant differences from the distribution, morphology and anatomy, pharmacognosy, molecular biology and chemical composition. "Daibaijie" matches with the characteristics of Marsdenia tenacissima (Roxb.) Moon in Flora of China in English.

CONCLUSIONDaibaijie's original plant is M. tenacissima (Roxb.) Moon. The description and illustration of M. tenacissima (Roxb.) Moon in Flora of China in China are wrong. The illustration of M. tenacissima in Flora of China in English is wrong too.

China ; ethnology ; Herbal Medicine ; Marsdenia ; anatomy & histology ; classification ; Medicine, Chinese Traditional ; Plant Components, Aerial ; anatomy & histology ; classification

AIM: To investigate the genes differential expression in cortex during rat focal cerebral ischemia. METHODS: cDNA microarray chips containing numerous cDNAs were used to investigate the gene expression pattern between samples of focal cerebral ischemia and sham-control operation rats. RESULTS: Two hundred and eleven genes differentially expressed were screened out, among these genes, up-and down-regulated genes were 199 and 12, respectively. CONCLUSIONS: The analysis of gene expression pattern of focal cerebral ischemia based on cDNA microarray can realize high-throughput screening of the genes associated with the focal cerebral ischemia. The differential expression of genes may be related to the pathogenesis of focal cerebral ischemic diseases.