Objective To investigate the safety and efficacy of holmium laser transurethral enucleation of the prostate (HoLEP) for large volume of prostatic hyperplasia (BPH) with navigation of ultrasonic anatomical landmarks.Methods Data of 242 patients with BPH (≥ 80 cm3) underwent domestic HoLEP from Jan.2016 to Jan.2018 were retrospectively analyzed.General data,IPSS,QOL,prostate volume,PSA were assessed.Their average volume of prostate was (103.2 ± 21.4) cm3,the average PSA was (2.6 ± 1.4) ng/ml,the residual urine volume was (105 ± 75) ml,Qmax was (6.4 ± 5.2) nd/s,IPSS score was 22.5 ± 5.3 and QOL score was 4.8 ± 1.2.Result All patients were completed the operation successfully and their LUTS indicators were greatly improved.The enucleation time was between 25 and 80 min,average (49.0 ± 12.2) min;the mass of wet weight of gland was (70.5 ± 15.3) g;the removal efficiency was (1.6 ±0.3) g/min.The IPSS score dropped to 14.8 ± 6.5,P ＜ 0.01;QOL score dropped to 2.6 ± 1.5,P ＜ 0.01;PSA dropped to (1.1 ± 1.2) ng/ml,P ＜ 0.01;the maximum urinary flow rate growth to (16.5 ±7.1) ml/s,P ＜0.01.Conclusion For large volume of prostatic hyperplasia,holmium laser transurethral enucleation with ultrasonic navigation surgery is safe and efficient.

Ohjective To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of sinusoidal obstruction syndrome (SOS) caused by gynura segetum.Methods The clinical data of 9 patients with SOS caused by gynura segetum (5 males and 4 females) who underwent TIPS were retrospectively analyzed from February 2017 to June 2018.The Child-Pugh scores were (9.5 ± 1.3) and the MELD scores were (12.5 ± 5.0).The success rates,complications and follow-up results were evaluated.Results TIPS was performed successfully in all the 9 patients.The portal venous pressure gradient dropped from (22.4 ± 2.7) mmHg to (10.4 ± 3.2) mmHg (P ＜ 0.05).There was no complication such as abdominal hemorrhage and biliary peritonitis.Nine patients were followed-up for 1 ～17months,mean 7.8 ± 6.0 months.One month after treatment,the Child-Pugh scores were (7.1 ± 1.8),compared with that of the preoperative scores,the difference was statistically significant (P ＜ 0.05).The MELD scores were (5.3 ± 4.6),compared with that of the preoperative scores,the difference was also statistically significant (P ＜ 0.05).At the end point of the follow-up,color Doppler ultrasound and portal CTA showed that the TIPS shunt was patent and hepatic congestion was relieved in all the 9 patients.All patients were alive.Conclusion TIPS was a safe and efficacious treatment for SOS caused by gynura segetum.

Severe skin damage not only causes a mass of tissue defect, but also leads to the loss of various sensory functions. Tissue engineering skin provides a new way for high-quality wound repair, while there are still many problems in the recovery of sensory function, such as abnormality or loss of sensation of pain, touch, and temperature. Therefore, when tissue engineering skin is used to promote wound healing, regeneration and functional recovery of sensory nerve have attracted more and more attention. This article introduces the kind, distribution, regeneration, and factors influencing regeneration of sensory nerve in skin, and explores strategies in promoting regeneration of sensory nerve from dermal scaffold, seed cell, and neurturin of tissue engineering skin.

Objective: To observe the material basis and mechanism of action of Kai-Xin-San (KXS) in regulating antidepression of neurotrophic factors. Methods: KXS eluted by ethanol on macroporous resin was prepared. The antidepressive effect of different components was compared by tailing suspension test and forced swimming test of mice. The levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in hippocampus were determined by ELISA. The rat astrocyte glioma C6 cell line and the rat adrenal pheochromocytoma PC12 cell line were used to evaluate the effects of different ethanol elution sites on the expression of NGF and BDNF and the differentiation of PC12 cells.Results: All of the ethanol elution components from KXS exerted anti-depressive effects by shorting the immobile time of tailing suspension and forced swimming of mice and 70％ ethanol elution components exerted best efficacy. This site also could increase expressions of NGF and BDNF on C6 glioma cell line. The 10％ ethanol elution site had the strongest ability to promote PC12 cell differentiation. Ginsenosides were the main effectuve ingredients for promoting the expression of neurotrophic factors. Conclusion: Regulation of neurotrophic factors might be the prominent action mechanism of KXS exerting anti-depressive effects.

Objective To evaluate the safety and efficacy of Viabahn covered stent in treatment of hepatic artery pseudoaneurysm (HAPA) caused by surgery.Methods Clinical data of 7 patients with postoperative massive intra-abdominal hemorrhage and diagnosed as HAPA with emergency angiography were collected from November 2015 to May 2016.All the patients underwent Viabahn covered stent implantation.Perioperative and postoperative clinical data of the patients were recorded,and with 1-month follow-up.Results All the 7 cases were diagnosed as extrahepatic HAPA and successfully completed Viabahn covered stent procedure,and curative rate was up to 100％.One case experienced transient vasospasm in the hepatic artery proximal to the stent.All the patients repeated hepatic artery CT angiography scans one week after surgery,with no evidence of bleeding.With 1-month follow-up,all the patients were in stable conditions.Conclusion Viabahn covered stent is minimally invasive,simple and effective interventional approach for HAPA.

Objective To analyze the data on hearing of recruited students from a teenager aviation school according to both the standards of PLA and those of the US Armed Forces , to learn about their differences in hearing standards in medi-cal selection, and to raise suggestions on establishing hearing standards for medical selection of flying cadets from teenager aviation schools .Methods The data collected on the first hearing test about hearing of students from Hebei Teenager Aviation School were collected .The validity of the data was determined according to the medical selection standards both of PLA and of the US Armed Forces respectively .The cases of qualified or unqualified recruits at high frequency and middle -low frequency were counted respectively and analyzed statistically .Results The unqualified recruits determined by PLA′s standards tended to be unqualified too when determined by the US Armed Forces standards .During the screening of high frequency hearing and the general hearing condition , the proportion of unqualified cases determined by the US selection standards was higher than that determined by PLA′s selection standard .In the screening of middle-low frequency hearing , no statistically significant difference was found in the proportion of unqualified cases when the two different selection standards were used.Conclusion The hearing standard for medical selection of flying cadets at high frequency in the US Armed Forces is stricter than that in the PLA .Meanwhile, the hearing standard at middle-low frequency in the US Armed Forces is different from that in the PLA , though there are no statistically significant differences in the proportion of unqualified cases.The hearing standards of the US Armed Forces are recommended in recruiting flying cadets for teenager flying schools .

Objective To analyze the results of the final aviation medical examination of 1281 students recruited into Air Force youth aviation schools in Hunan and Hubei provinces in order to provide reference for establishing the items and standards of medical selection .Methods The data of 1281 students who participated in final aviation medical examination of Air Force youth aviation schools in 2016 were collected , who came from 28 cities in the above two provinces .The disqualification rate and related unqualified medical items were calculated , and the differences of the disqualification rate and medical geographical areas in the 28 cities were analyzed .Results According to the disqualification rate , the top five departments were ophthalmology , otolaryngology, surgery, radiology and ultrasonic departments .The top 10 unqualified items were the lack of distant vision , fundus diseases , nasal anomaly , ametropia and strabismus , spine abnormality , audition abnormality, vestibular function badness , vitreous opacity, and lens abnormalities.There was no significant difference between the 28 cities in the disqualification rate (P >0.05) or between the two provinces (P >0.05). Conclusion The results of the final aviation medical examination reflect the quality and efficiency of the initial aviation medical examination .To improve the quality of medical selection , further research is needed to set a scientific standard for the initial aviation medical examination while strengthening the scientific protection and intervention of distant vision .The efficiency of selection depends on improving the accuracy of initial aviation medical examination in nasal cavity structure, body shape ,and lens opacity .With a better understanding of the disqualification rate and abnormal items in different cities , a scientific arrangement of professional staff and technical force can make the initial aviation medical examination better, thus effectively reducing the rate of false elimination rate and misdiagnosis .

Objective To study the safety and efficacy of accessory hepatic vein (AHV) stenting to treat primary Budd-Chiari syndrome (BCS).Methods The clinical data of 20 BCS patients with AHV ostial stenosis or occlusion were retrospectively analyzed.These 20 patients underwent balloon dilation and AHV stenting.Thirteen patients underwent AHV stenting via the right jugular vein approach,5 patients via the right femoral vein approach,and 2 patients via the percutaneous transhepatic combined with the right femoral vein approach.On follow-up,patency of the AHV stent was evaluated by color Doppler ultrasound.The cumulative primary and secondary patency rates were assessed with the Kaplan-Meier curves.Results AHV stenting was successful in 20 patients.Angiography showed that the AHV was patent after stenting.The mean pressure gradient between the AHV and the inferior vena cava reduced from (19.2 ± 4.8) cmH2O (1 cmH2O =0.098 kPa) before treatment to (4.5 ± 1.9) cmH2O after treatment (t =7.119,P ＜ 0.01).During the procedure,rupture of the AHV caused by balloon dilation occurred in one patient.This was treated successfully by a covered stent placement.On follow-up from 1 to 80 months [(32.1 ±27.4) months]after treatment for the 20 patients,re-stenosis of the AHV were found in 5 patients.They were treated successfully with re-dilation.The cumulative 1-,3-,and 5-year primary patency rates were 100％,85.1％ and 74.5％,respectively.The cumulative 1-,3-,and 5-year secondary patency rates were 100％,90.9％ and 90.9％,respectively.One patient died of hepatic failure 3 years after the treatment.Conclusion AHV stenting was a safe and efficacious treatment for BCS and it provided good mid-and long-term results.

Objective To compare the physical examination results of nephroptosis in the second stage and the final stage, to find the underlying reasons, and to explore better ways to detect nephroptosis.Methods A total of 1334 subjects participated in both the second stage and final stage of PLA air force medical selection of flying cadets, and physical examination results of both stages were compared.Results All the subjects recruited denied a history of abdominal pain or recurrent urinary tract infection, and urine tests were normal.The positive rate of nephroptosis in the second stage was 10.2%, compared to 5.5% in the final stage.The difference of physical examination results in the two stages was significant, and so was that of disqualification rates.Conclusion Results of physical examination of nephroptosis in the second stage are different from those in the final stage.It′s necessary to find better ways of detection of nephroptosis.

Objective To compare the medical selection standards of flying cadets in the nervous and mental system between Air Force of PLA(PLAAF) and the US Air Force(USAF), and to offer suggestions on revising PLAAF medical standards for flying cadets .Methods All our candidates who had participated in the final medical selection of flying cadets were subjected to neurological examinations , and determined as qualified or not according to USAF Medical Standards Directory.Results 123 people were disqualified during the neurological examination , accounting for 1.1% of the total. According to USAF Medical Standards Directory , 13 of them were disqualified , 24 of them were qualified , and 86 of them needed a second examination .There was marked difference between disqualification rates of PLAAF and USAF .Conclusion There are some differences in medical selection standards for flying cadets in the nervous and mental system between PLAAF and USAF, and we could revise PLAAF standards using USAF standards for reference .