[Objective] To explore the safety and efficacy of submucosal injection of glycerol and fructose saline in bladder tumor endoscopic submucosal dissection (BT-ESD) with a 450 nm blue laser semiconductor treatment machine in the treatment of non-muscular invasive bladder cancer (NMIBC). [Methods] Clinical data of 20 patients with bladder tumor treated with submucosal injection of glycerol and fructose saline BT-ESD via a 450 nm blue laser semiconductor treatment machine at our hospital during Nov.2023 and Apr.2024 were retrospectively analyzed.The patients included 13 males and 7 females, aged (64.95±6.89) years, tumor diameter (1.02±0.24) cm, and preoperative hemoglobin (Hb) (130.55±4.36) g/L.The operation time, Hb the next day after operation, positive rate of tumor basal biopsy, postoperative bladder irrigation time, catheter indwelling time, postoperative hospital stay, complications and recurrence rate were recorded. [Results] All operations were successful, and 28 lesions were removed.The postoperative pathological results confirmed that all cases were NMIBC, and the basal mucosa biopsies were negative.The operation time was (9.40±3.14) min, postoperative Hb (130.15±4.59) g/L, bladder irrigation time (17.70±1.34) h, catheter indwelling time 1 day, and postoperative hospital stay 1 day.There were no complications such as obturator nerve reflex, bladder perforation.There were no need for blood transfusion, no conversion to open surgery, and no secondary bleeding after operation.No tumor recurrence was found during 6-month postoperative follow up. [Conclusion] Submucosal injection of glycerol and fructose saline BT-ESD with a 450 nm blue laser semiconductor treatment machine is a safe and effective method for the treatment of NMIBC.It has advantages of whole enucleation of bladder tumor, clear basal layer, small amount of bleeding, short operation time and few complications.It can be used as a day surgery and is worthy of clinical promotion.

【Objective】 To investigate the efficacy and safety of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate, in order to promote the clinical application of this surgery. 【Methods】 Clinical data of 20 patients with middle lobe hyperplasia of prostate treated with 450 nm blue laser with 6 o’clock positioning during Mar.and Aug.2023 were retrospectively analyzed.The operation time, postoperative bladder irrigation time, catheter indwelling time, hospital stay, and complications were recorded.The maximum urinary flow rate (Qmax), post-void residual volume (PVR), quality of life scale (QoL), international prostate symptom score (IPSS) before surgery and 1 month after surgery were compared. 【Results】 The operation time was (26.80±7.22) min, and bladder irrigation time was (20.50±1.79) h.The catheter was removed on the next day after surgery and all patients were discharged 2 days after operation.Compared to preoperative, one month after surgery, the Qmax [(7.40±1.05) mL/s vs.(19.60±1.76) mL/s] was significantly higher, PVR [(73.50±12.26) mL vs.(9.25±4.94) mL], QoL [(4.55±1.19) vs.(1.95±0.95)], and IPSS [(26.55±1.88) vs.(10.05±1.36)] were significantly lower, the differences being statistically significant (P<0.05).No complications occurred during operation and 1-month follow-up. 【Conclusion】 The 450 nm blue laser with 6 o’clock positioning is a new, safe and effective surgical treatment of middle lobe hyperplasia of prostate, which is worthy of clinical promotion and application.

In order to achieve the goal of integration, homogeneity, a net and a center of medical groups in Hainan province, Hainan province built an integrated management information platform of urban medical alliances and county medical communities based on projects such as the provincial three medical linkage information platform in February 2022. The overall architecture of the medical alliance and medical community platform was divided into system integration layer, data center layer, service layer and application layer. The service layer included four major systems: unified operation management platform, business center, performance evaluation management platform and comprehensive supervision subsystem, which was the core hub connecting the data center layer and application layer, and also was the unified operation and closed-loop management platform of the medical alliance and medical community. As of November 2022, the platform had covered 31 medical alliances or medical communities in 19 cities and counties of Hainan province, achieving information exchange, personnel interaction, resource sharing, business collaboration, and data integration among member units, narrowing the gap between urban and rural medical and health services, which had preliminarily achieved homogeneous management of the medical alliances and medical communities throughout the province, for a reference for the integrated management of medical alliances and medical communities within the regional scope of China.

【Objective】 To evaluate the clinical efficacy of 200 W blue laser vaporization of prostate and the possibility of developing such surgery into day surgery. 【Methods】 The clinical data of 30 patients treated during Aug. and Sep.2022 were retrospectively reviewed. The residual urine volume, urine flow rate, International Prostate Symptom Score (IPSS) and Quality of Life Scale(QoL) score before and after surgery were compared. The operation time and postoperative routine urinary red blood cell count were recorded. 【Results】 All surgeries were successful and the catheter was moved 1 day after surgery. The operation time was (12.2±5.1) min, postoperative bladder irrigation time (20.0±4.2) h, and urinary red blood cell count (806.2±16.3)/μL. Recatheter was needed in 1 patient. The urinary flow rate before surgery, immediately and 1-month after surgery were (10.6±3.5) mL/s, (24.2±5.6) mL/s, and (27.2±3.1) mL/s, respectively. The residual urine was (57.3±3.2) mL before surgery and (5.6±3.1) mL 1-month after surgery. The average preoperative IPSS and QoL scores were (25.1±1.6) and (5.4±0.7), and were (9.5±1.4) and (2.9±0.6), respectively, 3-months after surgery. 【Conclusion】 Transurethral 200 W blue laser vaporization of the prostate is a practical and feasible surgical technique for the treatment of benign prostatic hyperplasia. It is effective, rapid and safe, and can greatly shorten the length of hospital stay and improve perioperative safety. With the improvement of clinical application technology, it can be a choice of prostatic day surgery.

【Objective】 To explore the effects of sexual function-preserving 450 nm blue laser vaporization of the prostate on the postoperative sexual function of patients with benign prostatic hyperplasia (BPH), and to evaluate the clinical efficacy, safety and feasibility of this procedure. 【Methods】 The clinical data of 20 BPH patients treated in our department during Jan. and Mar.2023 were analyzed. The International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and International Index of Erectile Function (IIEF-5) data were compared before and after the operation. The operation time, postoperative catheter indwelling time, and hospital stay were recorded. The ejaculation status 2 months after operation was followed up. 【Results】 All 20 patients completed the operation successfully. The operation time was (13.41±4.30) min, catheter indwelling time (1.2±0.4) d, and hospital stay (3.0±0.6) d. The IPSS, QoL, PVR and Qmax data 1 month after operation were significantly improved compared with those before operation (P<0.01). Two months after operation, all patients had sex and ejaculated, and no retrograde ejaculation occurred. The erection function remained unchanged (P>0.05). 【Conclusion】 The modified 450 nm blue laser vaporization of the prostate can improve the urination symptoms of BPH patients while retaining sexual function. It is a safe and feasible technique for BPH patients who have sexual needs, and provides an alternative surgical approach for those looking to preserve sexual function.

【Objective】 To observe the efficacy of blue laser side light in the vaporization and enucleation of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A retrospective analysis was performed on the data of NMIBC patients who received transurethral enucleation of bladder tumor (TURBT) using a 50 W blue laser treatment device. The efficacy and safety of surgery were evaluated by observing the application of blue laser in the treatment of bladder cancer in different locations, operation time, presence of bladder perforation and postoperative urine routine indicators. 【Results】 A total of 16 patients completed the surgery, including 5 cases with multiple bladder tumors, 9 with single bladder tumor, and 2 with lichenoid lesions. The postoperative pathological results showed all of them were NMIBC. The operation time was (10.4±4.7) min, postoperative urinalysis was (689.4±316.7)/μL, and no intraoperative bladder perforation occurred. 【Conclusion】 The lateral infusion mode of 50 W blue laser therapy device can be applied to the surgical treatment of NMIBC. The basal vaporization and enucleation of bladder cancer can be performed under direct vision conditions, and the multi-angle enucleation is suitable for bladder cancer in different positions. The tissue penetration depth of blue laser is shallow, which is conducive to the diagnosis and grading of pathological tissues.

Objective:To study the risk factors for diabetic retinopathy(DR)in patients with coronary artery disease(CAD).Methods:353 patients with diabetes mellitus hospitalized at Beijing Anzhen Hospital between 2013 and 2015 were enrolled, including 96 patients with coronary artery disease(27%)and 156 patients with DR(44%).Medical history and examination/laboratory results of all patients were collected for analysis.Coronary artery disease was diagnosed according to coronary angiography.DR was diagnosed via ophthalmological examinations.The clinical characteristics of patients with and without DR were compared and contrasted between the groups.Results:Compared with patients without DR, patients with DR had a longer duration of diabetes, [15 years(10, 20) vs.8 years(4, 13), P<0.001]and a higher urine albumin/creatine ratio(UACR)[12.1 mg/g(3.2, 71.9) vs.4.8 mg/g(2.2, 3.5), P<0.001].Logistic regression analysis suggested that duration of diabetes( OR=1.107, 95% CI: 1.063~1.153, P<0.001)and UACR( OR=0.003, 95% CI: 1.001~1.006, P=0.008)were independent risk factors for DR.ROC curves revealed that a duration of diabetes >9.5 years or UACR>7.1 mg/g was significantly associated with DR.Also, of all patients with CAD, those with DR had a longer duration of diabetes[15 years(10, 20) vs.10 years(6, 15), P=0.002]and a higher percentage with hypertension(88.1% vs.67.6%, P=0.014).Hypertension history( OR=4.049, 95% CI: 1.099~14.925, P=0.036)and duration of diabetes( OR=1.159, 95% CI: 1.044~1.287, P=0.005)were independent risk factors for DR in patients with CAD.History of hypertension or a duration of diabetes>11.5 years was significantly associated with DR. Conclusions:In patients with coronary heart disease, hypertension history or a long duration of diabetes is significantly associated with an increased risk of DR.

Objective:To explore effects of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) on the 5-year prognosis after percutaneous coronary intervention (PCI) for coronary heart disease.Methods:A total of 165 patients receiving PCI from December 2011 to September 2013 were selected by the convenient sampling method. According to the results of oral glucose tolerance test, they were divided into T2DM group (54 cases) , IGT group (52 cases) , and non-diabetes mellitus (NDM) group (59 cases) . The patients were followed up in the outpatient clinic after discharge and recorded the occurrence of major adverse cardiovascular events (MACE) of patients within 5 years after PCI, including cardiogenic death, non-fatal reinfarction, non-fatal stroke and re-hospitalization for heart failure.Results:The 5-year follow-up results showed that 72 patients had MACE, of which 15 died of cardiogenic death, 11 were admitted to the hospital due to heart failure, 5 had non-fatal stroke and 41 had non-fatal reinfarction. Among the 72 patients with MACE, there were 17 cases in the NDM group, 30 cases in the IGT group and 25 cases in the T2DM group. The IGT group was higher than the NDM group, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference between the IGT group and the T2DM group ( P>0.05) . Among the 41 non-fatal reinfarction patients, there were 10 cases in the NDM group, 19 cases in the IGT group and 12 cases in the T2DM group. The IGT group was higher than the NDM group and the T2DM group, and the differences were statistically significant ( P<0.05) . Conclusions:IGT increases the risk of myocardial infarction in patients after PCI, which is a risk factor for MACE events.

Objective:To analyze the characteristics of cardio-metabolic risk factors coronary artery disease(CAD)patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:A total of 169 patients undergone primary(T1)PCI and followed up and rechecked by coronary angiography(T2)in our hospital from 2010 to 2017 were enrolled.According to the results of coronary angiography during follow-up, patients were divided into the ISR group(n=66)and the control group(non-ISR or NISR, n=103). Patients were sub-grouped into the elderly ISR group(the E-ISR group, n=17), the elderly non-ISR group(the E-NISR group, n=19), the young ISR group(the Y-ISR group, n=49)and the young non-ISR group(the Y-NISR group, n=84). Clinical data including medical history, laboratory results, and coronary angiography records during the two hospital stays were collected.Cardio-metabolic risk factors and clinical features of coronary artery disease were analyzed for the groups.Results:The levels of systolic blood pressure, glycated hemoglobin A1c(HbA1c), fasting blood glucose(FBG), the percentage of patients with diabetes or myocardial infarction(MI)history, the coronary Gensini score and the percentage of patients with triple vessel disease were higher in the ISR group than in the NISR group(128.6±16.4) mmHg vs.(123.4±10.7) mmHg, P=0.023; (7.0±1.6)% vs.(6.2±0.9)%, P<0.001; 6.6 mmol/L vs.5.7 mmol/L, P<0.001; 53.0% vs.31.1%, P=0.004; 36.4% vs.20.4%, P=0.022; 40 vs.29, P=0.01; 57.6% vs.40.8%, P=0.033). The E-ISR group had higher systolic blood pressure and a lower glomerular filtration rate than the E-NISR group(135.9±27.2) mmHg vs.(124.1±10.8) mmHg, P=0.013; 77.5±14.4 ml·min -1·1.73 m -2vs.(84.8±9.4) ml·min -1·1.73 m -2, P=0.033), but the Y-ISR group had longer hypertension history, higher levels of low-density lipoprotein and HbA1c, and higher Gensini scores than the Y-NISR group[129.7 months vs.83.1 months, P=0.008; (2.78±1.08) mmol/L vs.(2.31±0.65) mmol/L, P=0.002; (7.2±1.7)% vs.(6.1±0.9)%, P<0.001; 41 vs.29, P=0.009]. Conclusions:Clinical features are different between elderly CAD patients and young and middle-aged CAD patients with ISR after PCI, and metabolic risk factors such as blood pressure, blood lipid and blood glucose levels should be proactively controlled

OBJECTIVE: To identify the key biochemical indicators that affect the clinical type and outcomes of COVID-19 patients and explore the application of neutrophil/lymphocyte ratio (NLR) in COVID-19. METHODS: Ninety-three patients with confirmed diagnosis of COVID-19 admitted in Ezhou Central Hospital from February to April in 2020 were analyzed. Among them, 43 patients were selected from Intensive Care Unit (ICU) with the diagnosis of critical type of COVID-19, and 50 cases of common type were selected from the Department of Respiratory Medicine. The baseline data, blood routine test and biochemical indexes of the patients were collected on the first day of admission. NLRs of the patients were calculated, and COX survival analysis according to the NLR 4-category method was performed. The patients' outcomes were analyzed with receiver operating curves (ROCs). The patients were divided into two groups according to NLR cutoff value for comparison of the biochemical indexes. Based on the patients' outcomes, NLR cutoff value classification and clinical classification, multiple binary logistics regression was performed to screen the key variables and explore their significance in COVID-19. RESULTS: The NLR four-category method was not applicable for prognostic evaluation of the patients. The cut-off value of NLR for predict the prognosis of COVID-19 was 11.26, with a sensitivity of 0.903 and a specificity of 0.839; the laboratory indicators of the patients with NLR < 11.26 were similar to those in patients of the common type; the indicators were also similar between patients with NLR≥11.26 and those with critical type COVID-19. NLR, WBC, NEUT, PCT, DD, BUN, TNI, BNP, and LDH had significant effects on the clinical classification and outcome of the patients ( < 0.05); Cr, Ca, PH, and Lac had greater impact on the outcome of the patients ( < 0.05), while Na, PCO had greater impact on the clinical classification of the patients ( < 0.05). CONCLUSIONS NLR can be used as an important reference for clinical classification, prognostic assessment, and biochemical abnormalities of COVID-19. Patients of critical type more frequently have bacterial infection with more serious inflammatory reactions, severer heart, lung and kidney damages, and much higher levels of DD and LDH than those of the common type. NLR, NEUT, DD, TNI, BNP, LDH, Ca, PCT, PH, and Lac have obvious influence on the prognosis of COVID-19 and should be observed dynamically.
Betacoronavirus ; Blood Cell Count ; standards ; Coronavirus Infections ; blood ; diagnosis ; physiopathology ; Humans ; Lymphocytes ; cytology ; Neutrophils ; cytology ; Pandemics ; Pneumonia, Viral ; blood ; diagnosis ; physiopathology ; Prognosis ; ROC Curve ; Retrospective Studies ; Severity of Illness Index