Objective To compare the efficacy of testicular repositioning and fixation combined with decompression of the testicular fascial compartment (testicular leucotomy+sheath flap repair) versus conventional testicular repositioning and fixation in surgery for testicular torsion in children. Methods Fifty-six patients with testicular torsion admitted to Hebei Provincial Children's Hospital from January 2019 to October 2023 were selected and divided into the observation group (26 cases) and the control group (30 cases),and the observation group was treated with testicular reorientation and fixation+testicular fascial compartment decompression,while the control group was treated with conventional testicular reorientation and fixation. There was no statistically significant difference in the age and left and right sides of the patients in the two groups (P>0.05). The intraop-erative bleeding,postoperative testicular atrophy,the presence of postoperative scrotal infection and postoperative hospitalization time of the two groups were compared. Results All patients successfully completed the operation without intraoperative complications. There was no statistically significant difference between the observation group and the control group in terms of intraoperative bleeding,postoperative scrotal infection rate and postoperative hospitalization time (P>0.05);the postoperative testicular atrophy rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusions Testicular restoration and fixation+testicular fascial compartment decompression can effectively reduce the pressure of testicular fascial compartment,reduce the ischemia-reperfusion injury of testis,and reduce the occurrence of testicular atrophy,which is safe and effective in the treatment of testicular torsion in children.

Objective To evaluate the safety and efficacy of needle grasper(hernia needle)assisted two-port laparoscopic cyst fenestration with deroofing combined with high ligation of the processus vaginalis for pediatric abdominoscrotal hydrocele.Methods Clinical data of 15 patients undergoing two-port laparoscopic surgery between January 2019 and January 2023 were retrospectively analyzed.Two 5-mm ports were created at bilateral umbilical margins.The needle grasper was introduced through the abdominal wall projection of the cyst,grasping the avascular area to facilitate cyst deroofing using endoscopic scissors or electrocautery hooks.High ligation of the processus vaginalis was achieved via traction-assisted double silk ligation under laparoscopic guidance.Results All the procedures were successfully completed laparoscopically.The mean operative time was(28.2±6.8)min for unilateral cases(n=9)and(35.2±4.6)min for bilateral cases(n=6).No postoperative complications such as hematoma or infection occurred.The patients were followed up for 12-16 months after surgery.Ultrasound showed no recurrence of hydrocele and no complications such as iatrogenic cryptorchidism or testicular atrophy.Conclusion The application of needle grasper in conjunction with two-port laparoscopic procedures effectively achieves intracorporeal cyst deroofing with fenestration and double ligation of the internal inguinal ring during abdominoscrotal hydrocele repair,demonstrating high safety profiles.

Objective To compare the efficacy of testicular repositioning and fixation combined with decompression of the testicular fascial compartment (testicular leucotomy+sheath flap repair) versus conventional testicular repositioning and fixation in surgery for testicular torsion in children. Methods Fifty-six patients with testicular torsion admitted to Hebei Provincial Children's Hospital from January 2019 to October 2023 were selected and divided into the observation group (26 cases) and the control group (30 cases),and the observation group was treated with testicular reorientation and fixation+testicular fascial compartment decompression,while the control group was treated with conventional testicular reorientation and fixation. There was no statistically significant difference in the age and left and right sides of the patients in the two groups (P>0.05). The intraop-erative bleeding,postoperative testicular atrophy,the presence of postoperative scrotal infection and postoperative hospitalization time of the two groups were compared. Results All patients successfully completed the operation without intraoperative complications. There was no statistically significant difference between the observation group and the control group in terms of intraoperative bleeding,postoperative scrotal infection rate and postoperative hospitalization time (P>0.05);the postoperative testicular atrophy rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusions Testicular restoration and fixation+testicular fascial compartment decompression can effectively reduce the pressure of testicular fascial compartment,reduce the ischemia-reperfusion injury of testis,and reduce the occurrence of testicular atrophy,which is safe and effective in the treatment of testicular torsion in children.

Objective To evaluate the safety and efficacy of needle grasper(hernia needle)assisted two-port laparoscopic cyst fenestration with deroofing combined with high ligation of the processus vaginalis for pediatric abdominoscrotal hydrocele.Methods Clinical data of 15 patients undergoing two-port laparoscopic surgery between January 2019 and January 2023 were retrospectively analyzed.Two 5-mm ports were created at bilateral umbilical margins.The needle grasper was introduced through the abdominal wall projection of the cyst,grasping the avascular area to facilitate cyst deroofing using endoscopic scissors or electrocautery hooks.High ligation of the processus vaginalis was achieved via traction-assisted double silk ligation under laparoscopic guidance.Results All the procedures were successfully completed laparoscopically.The mean operative time was(28.2±6.8)min for unilateral cases(n=9)and(35.2±4.6)min for bilateral cases(n=6).No postoperative complications such as hematoma or infection occurred.The patients were followed up for 12-16 months after surgery.Ultrasound showed no recurrence of hydrocele and no complications such as iatrogenic cryptorchidism or testicular atrophy.Conclusion The application of needle grasper in conjunction with two-port laparoscopic procedures effectively achieves intracorporeal cyst deroofing with fenestration and double ligation of the internal inguinal ring during abdominoscrotal hydrocele repair,demonstrating high safety profiles.

Objective To evaluate the efficiency and safety of transurethral plasmakinetic enucleation of prostate(PKEP) in the treatment of patients with benign prostate hyperplasia(BPH) after transrectal prostate biopsy(TRPB).Methods A total of 88 BPH patients who underwent PKEP in our hospital during Jan.2012 to May 2015 were retrospectively analyzed and followedup.38 patients underwent TRPB before PKEP were defined as TRPB group,and 50 patients underwent PKEP with no TRPB were defined as control group.The baseline data,perioperative data and postoperative follow-up outcomes were recorded and compared between the two groups.Results The mean age of the 88 patients were 69.7 years.Compared with control group,TRPB group showed that age was younger(t=2.62,P＜ 0.05)and prostate specific antigen(PSA) level was higher(t=13.64,P＜0.01).Operation duration was longer in TRPB group than in control group (93.6 ± 31.0) min vs.(77.9 ± 17.3) min (t =2.6 4,P ＜ 0.05).There were no significant differences in the preoperative data,blood loss,continuous bladder irrigation duration after operation and period of catheterization between two groups (all P ＞ 0.05).Trans-operative time was significantly shortened when the time interval between TRPB and PKEP is more than 4 weeks(P＜ 0.01),while blood loss was similar in the two groups(P＞ 0.0 5).There were no adverse events of blood transfusion,transurethral resection syndrome and injury of bladder or rectal in both two groups.There were no significant differences in maximum flow rate(Qmax),international prostate symptom score(IPSS) or quality of life(QOL) scores between the two groups at 3,6 and 12 months of follow up(all P＞ 0.05).Conclusions PKEP after TRPB is a safe and effective treatment for BPH patient.When the time interval between TRPB and PKEP is more than 4 weeks,the performing of PKEP operation would reduce the difficulty of operative procedure and increase the safety.

Objective To investigate the non-alkaloid constituent of Hippeastrun vittatum (Amaryllidaceae). Methods Solvent extraction and column chromatography were used to isolate the non-alkaloid constituents, and physicochemical constants and spectroscopic analysis were employed for structural elucidation. Results Five glycosphingosilipids were isolated, and their structures were elucidated to be (2S,3R, 4E, 8Z)-2-[(2R-2-hydroxyhexadecanoyl) amido ]-4, 8-octadecadiene-1, 3-diol 1-O-β-D-glucopyranoside ( Ⅰ ), (2S, 3R, 4E, 8E)-2-[(2R-2-hydroxyhexadecanoyl) amido]-4, 8-octadecadiene-1, 3-diol 1O-β-D-glucopyranoside ( Ⅱ ), (2S, 3R, 4E, 8Z)-2-[(2R-2-hydroxyoctadecanoyl) amido]-4, 8-octadecadiene-1, 3-diol 1-O-β-D-glucopyranoside (Ⅲ), (2S, 3R, 4E, 8E)-2-[(2R-2-hydroxyoctadecanoyl)amido]4, 8-octadecadiene-1, 3-diol 1-O-β-D-glucopyranoside ( Ⅳ ), (2S, 3R, 4E, 8Z)-2-[(2R-2-hydroxyeicosadecanoyl) amido]-4, 8-octadecadiene-1, 3-diol 1-O-β-D-glucopyranoside (Ⅴ), respectively. Conclusion They are all isolated from the fresh bulbs of H. vittatum for the first time.