Objective To explore the safety and effectiveness of transurethral resection of the prostate (TURP) for large benign prostatic hyperplasia.Methods A total of 56 cases of patients with large benign prostatic hyperplasia were analyzed retrospectively.Results The weight of prostate tissue resected with TURP was 60.2 g (48-122 g).The resection rate was 60％,operation time 113.4 min (70-180 min).The lower urinary tract symptoms (LUTS) after TURP was improved significantly.The international prostate symptom scores (IPSS) of 38 cases were decreased from (25.6±1.5) before operation to (6.0± 2.0) after operation.The maximum urine flow rate were increased from (5.0±1.9) ml/s to (18.0±4.5) ml/s.The mean residual urine volume of 22 cases were reduced from 95 ml (40-250 ml) to 10 ml (0-60 ml).Conclusions Skilled TURP technology for large benign prostatic hyperplasia is a safe treatment with good effect and low complications rates.

Fetal heart sound is nonlinear and non-stationary, which contains a lot of noise when it is colleced, so the denoising method is important. We proposed a new denoising method in our study. Firstly, we chose the preprocessing of low-pass filter with a cutoff frequency of 200 Hz and the resampling. Secondly, we decomposed the signal based on empirical mode decomposition method (EMD) of Hilbert-Huang transform, then denoised some selected target components with wavelet soft threshold adaptive noise cancellation algorithm. Finally we got the clean fetal heart sound by combining the target components. In the EMD, we used a mask signal to eliminate the mode mixing problem, used mirroring extension method to eliminate the end effect, and referenced the stopping rule from the research of Rilling. This method eliminated the baseline drift and noise at once. To compare with wavelet transform (WT), mathematical morphology (MM) and the Fourier transform (FT), the SNR was improved obviously, and the RMSE was the minimum, which could satisfy the need of the practical application.
Algorithms ; Fetal Heart ; physiology ; Heart Sounds ; Humans ; Signal Processing, Computer-Assisted ; Signal-To-Noise Ratio ; Wavelet Analysis

We proposed a research of a heart sound envelope extraction system in this paper. The system was implemented on LabVIEW based on the Hilbert-Huang transform (HHT). We firstly used the sound card to collect the heart sound, and then implemented the complete system program of signal acquisition, pretreatment and envelope extraction on LabVIEW based on the theory of HHT. Finally, we used a case to prove that the system could collect heart sound, preprocess and extract the envelope easily. The system was better to retain and show the characteristics of heart sound envelope, and its program and methods were important to other researches, such as those on the vibration and voice, etc.
Heart Sounds ; Humans ; Signal Processing, Computer-Assisted

Objective To investigate the possibility of establish a combined regimen of Chinese medicine and suicide gene therapy,we observed the killing action of medicated serum of Liuwei Dihuang Bolus (LDB)combined with HSV-tk/GCV suicide gene therapy system on rats hepatoma cell line CBRH7919.Methods The HSV-tk/GCV suicide gene therapy system was constructed and the working solution of ganciclovir (GCV)at 39.2 ?mol/L was detected firstly.Then medicated or non-medicated serum was prepared from SD rats treated with or without LDB by gavage.Meanwhile,the effects of medicated and non-medicated serum on cell proliferation were detected.The control groups without serum added were blank control group,GCV group and suicide gene therapy (SGT)group.Blank serum groups,blank serum + GCV groups,blank serum + SGT groups,medicated serum groups,medicated serum+GCV groups and medicated serum+SGT groups all had two serum concentrations of 5% and 7.5%,respectively.Six double holes were set for each group.CBRH7919/ tk+ and CBRH7919/ tk-were mixed together,and the tk+ cell percentage was adjusted to 0%,5% and 10%,respectively.Then the mixture of CBRH7919/ tk+ and CBRH7919/ tk-was implanted into the 96-hole plates at a density of 3?103 cells/hole,cultured with complete medium for 24 hours,and then treated with medicated or non-medicated serum for 12 hours and sequentially with GCV at 39.2?mol/L for another 60 hours.The number of surrival cells was determined by MTT assay.Q value (the ratio of measured and theoretical pharmacological action)was used to analyze the synergism of Chinese medicine and suicide gene therapy:additive action when 0.85≤Q1.15.Results No cytotoxicity was found when blank serum or medicated serum was below the concentration of 20% (volume fraction).When the concentration of serum was at 5% and 7.5%,the killing action of SGT + medicated serum group was stronger and the cell survival rate was higher those that of medicated serum group and SGT + blank serum group (P1.15).Conclusion HSV-tk/GCV suicide gene therapy system combined with LDB has a synergistic killing action on rats hepatoma cells.

Objective To evaluate the safety and feasibility of hepatic resection for huge primary liver carcinoma (PLC). Methods 216 cases of huge PLCs(mean diameter of 14.2cm) were resected. The hepatectomies were performed under intermittent occlusion of hepatic inflow. Results All 216 cases were successfully resected. The mean time of occlusion of hepatic inflow was 19min, the mean blood loss was 743 ml. No serious complications occurred, and only seven patients died of hepatic failure and upper gastrointestinal haemorrhage postoperatively in this series. Conclusions Although resection of huge PLC is quite difficult, but if suitable surgical techique and perioperative management are adopted ,it is safe and feasible .

OBJECTIVETo observe the therapeutic effect and safety of retention enema with compound glutamine entero-soluble Capsule (CGC) on active ulcerative colitis (UC).

METHODSOne hundred and sixty-eight patients with active UC were randomly assigned to the treatment group (86 patients) and the control group (82 patients). Besides the basic treatment of oral taking salicylazosulfapyridine or mesalazine, they were treated by retention enema with predisolone plus metronidazole injection. In addition, the patients in the treatment group were treated by retention enima with GGC and orally took CGC, 0.8 g each time, thrice a day. The efficacy of treatment and the changes in the principal symptoms 2 months after treatment were evaluated.

RESULTSThe total effective rate in the treatment group was 94.2% (81/86 cases), and that in the control group was 82.9% (68/82 cases), the difference between the two groups was significant (P <0. 05). The symptoms of hemafecia and abdominal pain were improved, the disease active index (DAI) was lowered after treatment in both groups (P <0.01), but the improvement of hemafecia, time of disappearance of mucous bloody stool and decrease of DAI in the treatment group were superior to those in the control group (P <0.05 or P <0.01). No adverse reaction was found in all patients.

CONCLUSIONThe retention enema with glucocorticoid plus metronidazole combined with CGC shows an immediate effect obviously superior to that treated with glucocorticoids and metronidazole alone, and with no adverse reaction.

Adolescent ; Adult ; Aged ; Capsules ; Colitis, Ulcerative ; drug therapy ; Drug Therapy, Combination ; Enema ; Female ; Glucocorticoids ; therapeutic use ; Glutamine ; therapeutic use ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical basis for prevention and treatment of this complication.Methods The term DGE was searched in Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated with a high incidence of DGE.Conclusions Hypoalbuminemia,cholangitis,large blood loss,and postoperative abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.

Objective To investigate the influence of electroacupuncture(EA) in different points combined with spinal anesthesia on acute stress response and mechanisms related with expression of spinal c-fos protein. Methods Fifty adult male Sprague-Dawley rats were randomly divided into 5 groups:groupⅠwere normal rats receiving only 50μL saline intrathecal IT injection;groupⅡwere docked rats receiving IT with 50 μL saline;groupⅢ were docked rats receiving IT injection of 50 μL, 2.5 μg fentanyl; group Ⅳwere docked rats receiving IT injection of fentanyl 50μL and EA at′zu-san-li′;groupⅤwere docked rats receiving EA at′er xue′and IT fentanyl. Serum corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels were measured by ELISA. Determined the c-fos protein expression levels of L4-6 spinal by western blotting. Result GroupⅡACTH, CORT levels and c-fos expression was significantly higher than those in groupⅠ(P<0.01). Compared with groupⅡ, groupⅢ,ⅣandⅤhad higher ACTH and CORT levels (P<0.05). However, c-fos expression in the spinal cord between groupⅡandⅢshowed no difference (P>0.05). Between groupⅢandⅣ, no differences in serum hormone levels (P > 0.05) were detected. In group Ⅴ the c-fos expression was lower than that of the Ⅳ group (P < 0.01). Conclusion Body acupuncture and auricular electrical stimulation combined with intrathecal anesthesia were effective to reduce pain in rats with acute stress reactions. Under intrathecal anesthesia, auricular stimulation played a better role of non-nerve block region, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in spinal cord.

Objective To assess the application of Chinese children's intelligence equation (CCIE) and Bayley Scales of infant and toddler development-Ⅲ (BSID-Ⅲ) in screening of postoperative cognitive dysfunction (POCD) in children after general anesthesia.Methods The study group (Group A),including 50 ASA-Ⅰ participants of 1-3 years old who would undergo hernia repair laparoscopic surgery,was assessed on one day (1 d) before and three days (3d) after the surgery respectively by both of CCIE and BSID-Ⅲ according to their ages of month.The control group (Group C),including 50 healthy participants with the matched age,was assessed in the same period by the same method.Both of Group A and C were assessed by the Z score method to diagnose POCD and both scales were used to analyze the results of POCD screening and their agreement.Results (1) Compared with preoperative 1 d,the CCIE score of Group A on 3d after surgery was relatively decreased (21.22±4.96 vs 18.65±4.74,P＜0.05) and the POCD rate was 12.0％.While in Group C,the CCIE score and the POCD rate had no statistical significance (20.83±4.97 vs 21.22±5.21,P＞0.05).(2) Compared with preoperative 1d,the scores of cognition,language,motion,social-emotion and adaptive behaviors in BSID-Ⅲ of Group A decreased (100.00±4.58 vs 96.44± 4.20,103.22±4.99 vs 96.24± 5.75,102.06±4.01 vs 95.28±4.27,101.22±7.38 vs 91.06±7.10,98.52±9.11 vs 90.5±8.47,P＜0.05) and the POCD incidence was 20.0％.While in group C,the BSID-Ⅲ score and the POCD rate had no statistical significance (104.61±5.48 vs 103.79±5.38,107.68±5.60 vs 107.11 ±6.05,108.29±5.91 vs 108.29±4.21,101.11±7.61 vs 101.86±6.99,99.00±7.99 vs 100.82±7.36,P＞0.05).(3)Reasonable agreement of the CCIE and BSID-Ⅲ was observed (Kappa value was 0.70;P＜ 0.05).Conclusion There is considerable agreement between BSID-Ⅲ and CCIE.While BSID-Ⅲ is relatively more sensitive to the POCD and more efficient in the diagnosis of POCD than the CCIE.Thus,BSID-Ⅲ is more likely to provide better evaluation of the postoperative cognitive functions of children within 1-3 years old and should be recommended to the health professionals in China.

Objective To investigate and compare the effects of etomidate or propofol on spatial cognitive,exploring,learning and memory abilities and hippocampus tissue in rapid development period of rats.Methods Thirty-nine SD rats with anage from 17 to 18 days were randomly divided into group C(10 ml/kg of normal saline),group E(5 mg/kg of etomidate),group P(50 mg/kg of propofol)(n=13).They were all single injected intraperitoneally.The tests of cognitive function were performed in Open Field Test(OFT),Hole Board Test and Ymaze Test at 3 hours postanesthesia awake.HE staining method was uesed to observe the morphology of hippocampus neuron tissue and immunohistochemistry(IHC) method was uesed to detect the expression of aspartic acid specificity cysteine protease (caspase-3) in hippocampal neurons.Results In the OFT,there was no significant difference between group C((3.70 ± 1.06)s,(39.10 ± 11.89)s)and group E,P((4.40 ±2.01)s and (4.60 ± 1.96) s,(37.90 ± 11.88) s and (36.30 ± 15.68) s) about the retention time in central check and the locomotion (P ＞ 0.05).In the Hole Board Test,the rats of groups E and P(12.00 ± 3.13,10.00 ± 2.79) about the times of rats stretch into the hole were significant different comparing with group C(16.30 ±4.62) (P＜0.05).In the Ymaze Test,compared with group C,the group E in the right number and total reaction time were no significant differences (P ＞ 0.05).The right number of group P (9.80 ± 2.39) were obviously decreased as compared with group C(13.30 ±2.00)(P ＜ 0.01),and there also had significant difference between group E and group C (P ＜0.05).In addition,the total reation time between group P ((82.30 ± 10.20) s) and group C ((67.70 ± 12.18) s) was significant difference(P ＜ 0.05).In HE staining,there were obvious changes in group E and P.In IHC,the expression of caspase-3 between groups C,E and P,there were no significant differences (P ＞ 0.05).Conclusion Single intraperitoneal injection of etomidate can make a transient effects for the rapid development period of rats ' ability of exploration,but have no obvious influence of the spatial cognition and learning and memory abilities.And etomidate lead less influence on newborn rat behavior and hippocampal tissue than propofol.