Objective:To investigate the effects of red laser versus plasma transurethral enucleation of the prostate (TUEP) on urinary and sexual function in patients under 65 years of age with benign prostatic hyperplasia (BPH).Method:This study was a retrospective analysis. Eighty BPH patients under 65 years old, admitted to the Affiliated Hospital of Yan'an University between January 2020 and January 2023 were selected. Among them, 40 patients who underwent 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum at the prostatic apex and preservation of bladder neck integrity were assigned to the Red Laser Group. Another 40 patients who underwent conventional TURP with a plasma resectoscope were assigned to the Plasma Group. Clinical data and 6-month postoperative follow-up data were collected. Changes in the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), International Index of Erectile Function-5 (IIEF-5) score, ejaculatory function score, and ejaculatory discomfort score before and after surgery were compared between the two groups. The incidence rates of decreased semen volume, retrograde ejaculation, and painful ejaculation at 6 months postoperatively were also compared.Results:At 6 months postoperatively, IPSS decreased in both groups compared to preoperative levels and was lower in the Red Laser Group than in the Plasma Group [(4.7±1.3) points vs. (6.3±2.2) points, t=-4.46, P<0.001]. Qmax increased in both groups compared to preoperative levels and was higher in the Red Laser Group than in the Plasma Group [(25.7±1.3) ml/s vs. (22.6±1.2) ml/s, t=10.76, P<0.001]. The ejaculatory function score in the Plasma Group was lower than its own preoperative level [(5.9±0.7) points vs. (11.1±1.6) points, t=5.33, P<0.001] and lower than that in the Red Laser Group [(5.9±0.7) points vs. (11.4±0.9) points, t=7.56, P<0.001]. The ejaculatory discomfort score in the Plasma Group was higher than its own preoperative level [(3.0±1.5) points vs. (0.8±0.6) points, t=4.26, P<0.001] and higher than that in the Red Laser Group [(3.0±1.5) points vs. (0.8±0.6) points, t=5.83, P<0.001]. The incidence rates of decreased semen volume and retrograde ejaculation in the Red Laser Group were lower than those in the Plasma Group [12.5% (5/40) vs. 50.0% (20/40), 10.0% (4/40) vs. 45.0% (18/40), χ2=15.84, 12.65, respectively, both P<0.001]. Conclusions:Using 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum and preservation of bladder neck integrity can improve urinary and sexual function in BPH patients under 65 years of age.

Objective To investigate the glucose and lipid metabolism,Mayo adhesion probability(MAP)score and perirenal function in patients with laparoscopic partial nephrectomyThe relationship between fat adhesion and prognosis.Methods A total of 84 patients who underwent laparoscopic resection in our hospital from December 2019 to December 2022 were retrospectively selected as the research subjects.According to whether perirenal fatty adhesion(APF)occurred during the operation,the patients were divided into APF group(44 cases)and non-APF group(40 cases).The results of 1-year follow-up were divided into good prognosis group(68 cases)and poor prognosis group(16 cases)The patient's gender,age,body mass index(BMI),fasting blood glucose(FPG),serum triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and MAP score were recorded before surgery.All patients underwent laparoscopic partial nephrectomy,and the receiver operating curve(ROC)was used to analyze the evaluation value of glucose and lipid metabolism and MAP score for APF.Multivariate Logistic regression was used to analyze the influencing factors of LPN.Results There were statistically significant differences in gender,age,BMI,APF,FPG,TG,HDL-C and MAP scores between the APF group and the non-APF group(P＜0.05);ROC curve analysis showed that FPG,TG,HDL-C and MAP Scoring APF has certain evaluation value,and the overall performance of the combined evaluation of the four was better.There were significant differences in gender,age,BMI,FPG,TG,HDL-C and MAP scores between the good prognosis group and the poor prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that FPG,TG,HDL-C and MAP scores,APF were all risk factors for ineffective LPN surgery.Conclusion FPG,TG,HDL-C and MAP scores have a certain value for APF evaluation,with high sensitivity and specificity,and the overall efficiency of the combined evaluation is better.FPG,TG,HDL-C and MAP scores were all risk factors for ineffective LPN surgery.

Objective To investigate the glucose and lipid metabolism,Mayo adhesion probability(MAP)score and perirenal function in patients with laparoscopic partial nephrectomyThe relationship between fat adhesion and prognosis.Methods A total of 84 patients who underwent laparoscopic resection in our hospital from December 2019 to December 2022 were retrospectively selected as the research subjects.According to whether perirenal fatty adhesion(APF)occurred during the operation,the patients were divided into APF group(44 cases)and non-APF group(40 cases).The results of 1-year follow-up were divided into good prognosis group(68 cases)and poor prognosis group(16 cases)The patient's gender,age,body mass index(BMI),fasting blood glucose(FPG),serum triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and MAP score were recorded before surgery.All patients underwent laparoscopic partial nephrectomy,and the receiver operating curve(ROC)was used to analyze the evaluation value of glucose and lipid metabolism and MAP score for APF.Multivariate Logistic regression was used to analyze the influencing factors of LPN.Results There were statistically significant differences in gender,age,BMI,APF,FPG,TG,HDL-C and MAP scores between the APF group and the non-APF group(P＜0.05);ROC curve analysis showed that FPG,TG,HDL-C and MAP Scoring APF has certain evaluation value,and the overall performance of the combined evaluation of the four was better.There were significant differences in gender,age,BMI,FPG,TG,HDL-C and MAP scores between the good prognosis group and the poor prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that FPG,TG,HDL-C and MAP scores,APF were all risk factors for ineffective LPN surgery.Conclusion FPG,TG,HDL-C and MAP scores have a certain value for APF evaluation,with high sensitivity and specificity,and the overall efficiency of the combined evaluation is better.FPG,TG,HDL-C and MAP scores were all risk factors for ineffective LPN surgery.

Objective:To investigate the effects of red laser versus plasma transurethral enucleation of the prostate (TUEP) on urinary and sexual function in patients under 65 years of age with benign prostatic hyperplasia (BPH).Method:This study was a retrospective analysis. Eighty BPH patients under 65 years old, admitted to the Affiliated Hospital of Yan'an University between January 2020 and January 2023 were selected. Among them, 40 patients who underwent 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum at the prostatic apex and preservation of bladder neck integrity were assigned to the Red Laser Group. Another 40 patients who underwent conventional TURP with a plasma resectoscope were assigned to the Plasma Group. Clinical data and 6-month postoperative follow-up data were collected. Changes in the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), International Index of Erectile Function-5 (IIEF-5) score, ejaculatory function score, and ejaculatory discomfort score before and after surgery were compared between the two groups. The incidence rates of decreased semen volume, retrograde ejaculation, and painful ejaculation at 6 months postoperatively were also compared.Results:At 6 months postoperatively, IPSS decreased in both groups compared to preoperative levels and was lower in the Red Laser Group than in the Plasma Group [(4.7±1.3) points vs. (6.3±2.2) points, t=-4.46, P<0.001]. Qmax increased in both groups compared to preoperative levels and was higher in the Red Laser Group than in the Plasma Group [(25.7±1.3) ml/s vs. (22.6±1.2) ml/s, t=10.76, P<0.001]. The ejaculatory function score in the Plasma Group was lower than its own preoperative level [(5.9±0.7) points vs. (11.1±1.6) points, t=5.33, P<0.001] and lower than that in the Red Laser Group [(5.9±0.7) points vs. (11.4±0.9) points, t=7.56, P<0.001]. The ejaculatory discomfort score in the Plasma Group was higher than its own preoperative level [(3.0±1.5) points vs. (0.8±0.6) points, t=4.26, P<0.001] and higher than that in the Red Laser Group [(3.0±1.5) points vs. (0.8±0.6) points, t=5.83, P<0.001]. The incidence rates of decreased semen volume and retrograde ejaculation in the Red Laser Group were lower than those in the Plasma Group [12.5% (5/40) vs. 50.0% (20/40), 10.0% (4/40) vs. 45.0% (18/40), χ2=15.84, 12.65, respectively, both P<0.001]. Conclusions:Using 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum and preservation of bladder neck integrity can improve urinary and sexual function in BPH patients under 65 years of age.

Objective:To investigate whether endoplasmic reticulum aminopeptidase 1 ( ERAP1) is a susceptible gene for pre-eclampsia (PE) and the possible mechanism in the pathogenesis. Methods:This retrospective study included 990 PE patients (case group) and 1 240 healthy pregnant women (control group) in six prefecture-level tertiary hospitals in Shandong Province, including the Affiliated Hospital of Qingdao University and Zaozhuang Maternal and Child Health Hospital, from September 2018 to April 2021. Peripheral blood were collected for DNA extraction. Single-nucleotide polymorphisms in the ERAP1 gene (rs30187, rs27044, and rs469783 loci) were analyzed by Taqman probe polymerase chain reaction (PCR). Two missense mutant plasmids, rs30187(c.1583A>G) and rs27044(c.2188C>G), were constructed by point mutation induction based on wild-type plasmids. Six groups (knock-down control, knock-down, over-expression control, over-expression, variant 1 and 2 groups) were set up in this study. After transfecting Htr8 cells with different transfection molecules, the expression of ERAP1 at mRNA and protein levels were detected. Besides, the effects of different transfections on cell function were detected using Transwell migration assay, Transwell invasion assay, cell scratch assay, and CCK-8 assay. Statistical analysis was performed using two independent samples t-test, rank sum test, and Chi-square test. Results:(1) There were significant differences in the genetic distribution of rs30187 (Genotype: χ2=29.25, Allele: χ2=4.68) and rs469783 (Genotype: χ2=7.01, Allele: χ2=6.45) as well as the genotype distribution of rs27044 ( χ2=28.95) between the case group and the control group (all P<0.05). Statistical analysis of the genetic model revealed that rs30187 and rs27044, both recessive models, were statistically different between the two groups with a higher frequency of CC genotypes in the case group ( χ2=20.82 and 19.97, both P<0.05), but a lower frequency in CC dominant gene pattern for rs469783 ( χ2=5.82, P=0.016). (2) Compared with the knock-down control group, the knock-down group showed significantly inhibited expression of ERAP1 (mRNA: 0.5±0.1 vs 1.0±0.0, t=7.49; protein: 0.4±0.1 vs 0.7±0.1, t=2.81; both P<0.05), reduced cell migration rate after 48 h of scratching [(16.5%±1.8%) vs (23.8%±2.4%), t=3.33, P=0.031] and decreased number of cells crossing Transwell chambers after 24 h of culture (423.7±21.3 vs 499.0±24.6, t=3.29, P=0.031). Compared with the over-expression group, variant 1 group and variant 2 group showed significantly inhibited expression of ERAP1 at mRNA (both P<0.001) and protein ( P=0.003 and 0.006) levels after transfection, decreased number of cells crossing Transwell chambers ( P=0.001 and 0.032) and down-regulated cell migration rate after 48 h of scratching [variant 1: P=0.004; variant 2: (21.1±4.6)% vs (28.3±1.1)%, t=2.10, P=0.099]. ERAP1 expression at both mRNA ( P<0.001) and protein ( P=0.008) levels, as well as cell proliferation ( P<0.001) and invasion ability ( P<0.001), were all enhanced in the over-expression group than those in the over-expression control group. Moreover, the migration rate of cells after 48 h of scratching ( P=0.002) and the number of cells crossing Transwell chambers after 24 h of culture ( P=0.001) were also increased. Conclusions:The rs30187, rs27044, and rs46978 on ERAP1 gene were all associated with PE susceptibility, with more carriers of the CC genotype in PE patients at rs30187 and rs27044 loci and more carriers of the CC genotype in healthy gravida at rs469783 locus. ERAP1 may be involved in the pathogenesis of PE by affecting the migratory and invasive ability of trophoblast cells.

Objective:To explore the safety and effectiveness of the Renaissance spine surgery robot in the middle and upper thoracic spine fractures.Methods:62 patients with middle and upper thoracic vertebra fractures from March 2015 to March 2019 were prospectively analyzed. These patients were randomly divided into robot group (Renaissance robot-assisted nailing) and free hand group (unarmed nailing under perspective). There were 32 patients in robot group, including 25 males and 7 females with an average age of 43.1±8.91 years (range, 18-65 years). Body mass index (BMI) was 26.15±3.97 kg/m 2 (range, 16.3-41.7 kg/m 2). The preoperative Cobb angle was 20.9 °±2.83° (range, 10.7 °-33.9°). In the free hand group, there were 30 cases, including 24 males and 6 females; Age 44.2±9.10 years (range, 20-67 years), BMI 25.97±4.02 kg/m 2 (range, 17.1-43.2 kg/m 2); The preoperative Cobb angle was 21.3°±3.01° (range, 11.6°-35.1°). The 2 groups were compared in terms of accuracy of screw placement, one-time success rate of screw placement, completion time of screw placement, time of total operation and penetration rate of anterior vertebral margin. The robot group also compared the consistency of screw placement angle with preoperative planning. Results:All patients completed the operation successfully. The number of fractured vertebrae in the robot group was 37; the screw placement time was 16.11±5.82 min; the total number of screws was 230, of which 227 were successfully placed at one time, with a success rate of 98.70% (227/230); 1 screw was inserted through the anterior edge of the vertebral body, and the penetration rate was 0.43% (1/230). The number of fractured vertebrae in the free hand group was 35; the nail placement time was 21.09±7.31 min; the total number of screws was 216, of which 195 were successfully placed at one time, with a success rate of 90.28% (195/216); 12 screws was inserted through the anterior edge of the vertebral body, and the penetration rate was 5.56% (12/216). There were significant differences in the time, success rate and penetration rate between the two groups. There was no significant difference in the total operation time between the robot group and the unarmed nail group 137.23±12.68 min and 140.23±13.13 min, respectively. There was no significant difference in the angle of screw placement between pre-operative planning image and post-operative CT scan in the robot group.Conclusion:Renaissance spinal surgery robot in the treatment of middle and upper thoracic vertebra fractures has the advantages of high accuracy, low intraoperative risk, high safety and satisfactory effect of pedicle screw placement.

Objective To investigate the effect of ulinastatin on the expression of serum inflammatory mediators in pa tients with acute myocardial infarction (AMI) after thrombolysis. Methods 84 patients with AMIin our hospital from January 2017 to December 2017 were selected and randomly divided into the control group and the experimental group with 42 cases in each group. The control group received recombinant streptokinase intravenous thrombolytic therapy, while the experimental group was given intravenous infusion of ulinastatin in the foundation of thrombolytic therapy. Two groups of patients were extracted venous blood to measure the expression levels of inflammatory mediators including hs-CRP, IL-1, IL-10 and TNF-a before treatment, 24 h and 72 h after treatment. Results 24 h after treatment, the expression levels of hs-CRP, IL-1, IL-10 and TNF-a in the two groups were higher than those before the treatment, and the difference was statistically significant (P＜0. 05). However, the increase in the experimental group was lower than that of the control group (P＜0. 05). 72 h after treatment, the levels of inflammatory mediators in the two groups were significantly lower than those before and 24 h after the treatment(P＜0. 05). The decrease in the experimental group was higher than that of the control group and the difference between the two groups was statistically significant(P＜0. 05). There was no significant difference in the incidence of adverse reactions and adverse cardiovascular events between the two groups during hospitalization after thrombolysisP＞0. 05). Conclusion The use of ulinastatin before and after thrombolytic therapy can effectively inhibit the expression levels of inflammatory mediators and relieve myocardial ischemia reperfusion injury in patients with AMI.

Objective To explore gene polymorphism of the G/C genotype of-173G/C(rs755622)in the promoter of macrophage migration inhibitory factor(MIF)gene in male population,and thus to investigate the relationship between gene polymorphism of MIF and gout.Methods A total of 380 gout patients and 378 healthy controls were enrolled.The possible association between the polymorphism of MIF-173G/C and gout in Chinese were investigated and genotype frequencies and allelic frequencies were analyzed by polymerase chain reaction with sequence-specific primers(PCR-SSP)method.Hardy-Weinberg was used to verify the representativeness of the samples.Comparisons between the groups were performed with x2 test.The gene polymorphism of MIF and gout was performed by t test.Results The frequencies of GG,GC,CC genotypes were 62.1％(236 cases),34.2％(130 cases)and 3.7％(14 cases),respectively among gout patients,while they were 66.5％(252 cases),29.8％(113 cases)and 3.7％(14 cases),respectively among the controls.There was no statistical difference in MIF-173G/C genotype frequencies between gout patients and controls(x2=1.713,P=0.425).The allele frequencies of G and C in gout cases were 79.2％(602 cases)and 20.8％(158cases),while the controls were 81.4％(617 cases)and 18.6％(141 cases),and no significant difference between them could be found(x2=1.148,P=0.302).Combine GG and GC of gout into GG+GC,the association analysis of the two groups showed that,mean age,leves of glucose,TG,TC,BUN,Cr and UA of the GG+GC group and the CC group were(51±13)and(50±15)t=0.369,P=0.712;(7.1±8.8)and(6.1±1.2)mmol/L,t=0.352,P=0.725;(2.3±1.6)and(2.9±3.4)mmol/L,t=-1.207,P=0.228;(5.3±1.2)and(5.7±1.4)mmol/L,t=-1.207,P=0.228;(5.8±2.9)and(6.2±2.2)mmol/L,t=-0.513,P=0.608;(92±52)and(84±17)μmol/L,t=0.537,P=0.592;(472±103)vs(557±154)μmol/L,t=-2.949,P=0.03 respectively;no significant difference was found in the two group.Moreover,no association between MIF-173G/C genotypes and risk factors for gout were detected in gout cases by t-test.Conclusion Results of the present study suggest that the G/C genotype of-173G/C in the promoter of MIF gene is not associated with gout in male population.

Objective To investigate the clinic effectiveness of self-managing on stable chronic obstructive pulmonary disease (COPD).Methods 60 stable COPD patients were divided into the experiment group and control group according to their compliance to the management. The compliant patients (experiment group) received the rehabilitation education. They were assessed with the St. George's respiratory questionnaire (SGRQ) before and a year after treatment. Results After treatment, the scores of activity restriction and the total score of SGRQ in the experiment group improved more than that in the control (P<0.05). Conclusion Self-management is important for improving quality of life in stable COPD.