[Objective] To compare the clinical efficacy of super pulse thulium laser enucleation of the prostate (SPThuLEP) with "open tunnel" and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), in order to provide reference for the treatment options of BPH. [Methods] The clinical data of 112 BPH patients treated in our hospital during Jan.2023 and Jul.2023 were retrospectively analyzed, including 65 treated with SPThuLEP with "open tunnel" and 57 with HoLEP.The operation time, postoperative hemoglobin decrease, postoperative bladder irrigation, catheter indwelling time, hospitalization time and complications were compared between the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), postvoid residual (PVR) and prostate-specific antigen (PSA) were compared between the two groups before operation and one month after operation. [Results] All operations were successful without conversion to open or transurethral plasmakinetic resection.The postoperative decrease of hemoglobin in SPThuLEP group was lower than that in HoLEP group [(13.12±6.72) g/L vs. (21.02±6.51) g/L], with statistical difference (P<0.05). There were no significant differences in the operation time [(63.35±15.73) min vs.(61.02±17.55) min], postoperative bladder irrigation time [(1.07±0.45) d vs. (1.06±0.36) d], catheter indwelling time [(2.98±0.56) d vs. (3.01±0.63) d] and hospitalization time [(3.63±0.61) d vs.(3.79±0.76) d] between the two groups (P>0.05). No blood transfusion, secondary bleeding or unplanned hospitalization occurred, and there were no serious complications such as transurethral electroresection syndrome (TURS), urethral stricture and urinary incontinence.One month after operation, the Qmax, IPSS, QoL, PVR and PSA of the two groups were significantly improved compared with those before operation (P<0.05), but with no statistical difference between the two groups (P>0.05). [Conclusion] SPThuLEP with "open tunnel" has comparable efficacy as HoLEP in the treatment of BPH.With advantages of small amount of bleeding and high safety, this minimally invasive technique can be widely popularized in clinical practice.

Scars are classified into 5 types:Superficial scars,hypertrophic scars,atrophic scars,depressed scars,and keloid.These types are primarily characterized by abnormal production of fibroblasts and collagen,as well as the disorderly arrangement of connective tissue.Laser treatment for scars involves the coordinated activation of various signaling pathways and cytokines.However,the exact pathological mechanism for scar formation remains unclear,leading to a lack of radical treatment.Recently,laser treatment has gained popularity as a new minimally invasive approach for scar treatment.The emergence of new theories such as fractional,picosecond laser,and laser-assisted drug delivery has led to continuous advance in laser treatment.Up to now,it has been developed numerous novel treatments,including combined with drug,physical,and other treatments,which have shown superior therapeutic effects.In order to optimize laser treatment in the future,it is crucial to combine new materials with postoperative care.This will help clinicians develop more comprehensive treatment strategies.Therefore,it is important to explore treatment options that have broader applicability.

Objective: To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations. Methods : Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model. Results: A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years. Conclusion Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.

Atherosclerotic plaque rupture is the main cause of many cardiovascular diseases, and biomechanical factors play an important role in the process of plaque rupture. In the study of plaque biomechanics, there are relatively few studies based on fatigue fracture failure theory, and most of them mainly focus on the whole fatigue propagation process from crack initiation to plaque rupture, while there are few studies on the influence of crack on plaque rupture at a certain time in the process of fatigue propagation. In this paper, a two-dimensional plaque model with crack was established. Based on the theory of fracture mechanics and combined with the finite element numerical simulation method, the stress intensity factor (SIF) and related influencing factors at the crack tip in the plaque were studied. The SIF was used to measure the influence of crack on plaque rupture. The results show that the existence of crack can lead to local stress concentration, which increases the risk of plaque rupture. The SIF at the crack tip in the plaque was positively correlated with blood pressure, but negatively correlated with fibrous cap thickness and lipid pool stiffness. The effect of the thickness and angle of lipid pool on the SIF at the crack tip in the plaque was less than 4%, which could be ignored. This study provides a theoretical basis for the risk assessment of plaque rupture with cracks.
Biomechanical Phenomena ; Computer Simulation ; Humans ; Plaque, Atherosclerotic ; Stress, Mechanical

Objective:To explore the feasibility and preliminary effect of improving the comprehensive quality of medical students by introducing the teaching model of cleft lip and palate treatment platform in medical education.Methods:A total of 40 grade two undergraduates of Shantou University medical college were randomly divided into experimental group ( n=20) and control group ( n=20). The students in the experimental group were the volunteers of Cleft lip and palate treatment center, receiving the characteristic idea and methods in clinical teaching. The control group received conventional teaching. The evaluation indicators, including the intellectual quality (60 points), moral quality (15 points), humanistic quality (5 points), physical and mental quality (10 points), social practice (10 points), were quantified by fuzzy evaluation method and a professional evaluation team was set up to evaluate the effect of teaching. SPSS 19.0 was used to perform t test for comparison between the two groups. Results:The average scores of the above items in the experimental group were respectively (51.477±2.381), (10.613±0.169), (4.228±0.124), (8.677±0.296), and (8.565±0.421), and the average total score was (83.559±2.333); the average scores of above items in the control group were respectively (49.746±3.176), (10.268±0.266), (4.008±0.195), (8.207±0.354), and (7.575±0.321), and the average total score was (79.804±3.510). Statistical difference was found in all scores except the intellectual quality score between the two group ( P<0.05). Conclusion:Though no significant difference was found in the intellectual quality, the other qualities have played important roles in improving medical students' comprehensive quality. It is significant to improve the medical students' comprehensive quality by the method of cleft lip and palate treatment platform.

Objective To discuss primary experience the clinical use of "All-seeing needle set" combined with Holmium laser to treat the single renal stone lesser than 2 cm in diameter through a super minimal tract (F12).Methods From January 2015 to December 2016,43 patients were enrolled into this retrospective study.There were 23 males and 20 females who were diagnosed as single renal stone less than 2 cm in diameter(age range from 23-65 years).There were 8 upper pole renal stones,13 lower pole renal stones and 22 renal pelvis stones.The mean stone size was (1.63 ± 0.32) cm in diameter (range from 1.2 cm to 2.0 cm)."All-seeing needle system" was applied during percutaneous puncture.After building a F12 minimal tract by fascia dilator,all patients received lithotripsy with Holmium laser.Indwelling catheters for 3 days and an F6 double-J tube was left for 2 weeks without a tube in the percutaneous tract after operation.Finally,KUB and/or urinary CT were used to check the results on day 1.Result All operations were completed successfully.The operation time was 23-65min [averaged (31.0 ±9.2) min].41 cases' renal stones were store free,and the 2 stone residues was clear with later extracorporeal shock wave lithotripsy.No severe complications occurred.Conclusion As an alternative to standard procedures for treatment of renal stones less than 2 cm in diameter,adopting "All-seeing needle set" with Holmium laser through a super minimal tract (F12) is safe,minimally invasive,fast and effective with a low complication rate.

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

Objective To investigate the value of neuronavigation in microsurgery for medically refractory epilepsy. Methods The clinical data of 137 patients with medically refractory epilepsy who underwent epilepsy surgery with neuronavigation in our hospital from September 2008 to September 2016 were analyzed retrospectively. In these patients, 17 accepted temporal parietal occipital dissection, 23 accepted corpus callosum subtotal dissection, 11 accepted functional cerebral hemispheric dissection, and 86 accepted epilepsy foci resection. The surgical efficacies were analyzed. Results All patients uneventfully underwent the operations as planned. The mean follow-up period was 52 months (12-108 months). Engel grade I was achieved in 71 patients, grade II in 32, grade III in 25, and grade IV in 9 patients. The total satisfaction rate reached to 75.18％ (103/137), including 100％ patients (11/11) accepted functional cerebral hemispheric dissection. There were no severe operative complications. Conclusion Neuronavigation helps to locate intracranial targets, accurately resect the epileptogenic foci or disconnect the epilepsy conduction pathway, preserve the neurologic function, and avoid the operative complications.

Objective To investigate the different memory outcomes in temporal lobe epilepsy patients underwent different surgical approaches.Methods Two hundred forty-eight patients with temporal lobe epilepsy and hippocampal scle-rosis underwent standard anterior temporal lobectomy ( ATL, n=83 ) or selective amygdalohippocampectomy ( SAH, n=165) from 2009 to 2013.All the patients underwent clinical memory function assessment before surgery, 3 months and 2 years after surgery respectively.Results The memory quotient ( MQ) of patients who underwent brain surgery in the domi-nant hemisphere significantly decreased 3 months after surgery (74.5 ±16.2, 75.6 ±19.5) compared to presurgery MQ (82.9 ±15.8, 83.2 ±21.2) in both ATL and SAH groups (P<0.05).Although MQ was slightly recovered at 2 years af-ter surgery, MQ (75.1 ±14.1, 76.1 ±17.6) was still significantly lower compared with presurgery MQ (P<0.05).A-mong this, both the decrease extent of the MQ 3 months after surgery and 2 years after surgery were smaller in the SAH group than in the ATL group (7.6 vs.8.4;7.1 vs.7.8).The MQ of patients who underwent brain surgery in the non-dominant hemisphere (either ATL or SAH ) increased slightly 3 months after surgery (87.2 ±15.1, 88.1 ±16.9) com-pared to presurgery MQ (85.5 ±13.5, 85.3 ±19.7) although the difference was not statistically significant.The MQ of these two groups improved significantly 2 years after surgery (92.8 ±12.7, 93.7 ±17.1)(P<0.05).The improvement extent of the MQ was larger in the SAH group than in the ATL group (8.4 vs.7.3).Conclusions SAH may be better than ATL in the maintenance of memory function in patients with temporal lobe epilepsy and hippocampal sclerosis.

This article was aimed to rapidly analyze chemical composition in A loe Barbadensis Mill, and to compare the chemical composition of commercial aloe vera medicinal materials with that of fresh aloe yellow exudate. An opti-mized liquid chromatography-mass spectrometry-ion trap-time-of-flight (LCMS-IT-TOF) method was applied for the analysis of commercial aloe vera medicinal materials and fresh aloe yellow exudates. The Agilent TC-C18 column (4.6 í 250 mm, 5 m) was used. The gradient elution was a solvent system of water(A)-methanol(B). ESI source was operated in both positive and negative ion modes. The results showed that chromones, pyrones, naphthalene deriva-tive, anthrones and anthraquinones were separated successfully, 30 compounds were characterized by the comparison of characteristic MS/MS fragment ions data with the literature. The diagnostic fragmentation patterns of different chemical compositions were also discussed on the basis of EST-IT-TOF MS data. It was concluded that the chemical composition of commercial aloe vera medicinal materials were significantly different from that of fresh aloe yellow ex-udate in terms of types and contents: the former one mainly contains isoaloeresin D and aloin, and few aloesin; but the latter is mainly composed of aloesin and aloin, and the content of aloesin is the highest. The LCMS-IT-TOF analysis can be used to rapidly obtain rich structural information of different chemical compositions, which improves the efficiency of qualitative analysis of chemical composition, and is of great significance to the quality control, eval-uation and the utilization of A loe Barbadensis Mill.