The preliminary application of thulium laser enucleation of the prostate by laser controller / 中华泌尿外科杂志

Objective:To compare the efficacy and safety of transurethral thulium laser enucleation of prostate for benign prostatic hyperplasia (BPH) with laser controller and sheath.Methods:The clinical data of 128 BPH patients who underwent transurethral thulium laser enucleation of prostate (THuLEP) in our hospital from January to June 2020 were retrospectively analyzed. Prostatic enucleation by laser controller was performed in 66 patients (LC-THuLEP group). The prostatic urethral mucosa was cut into Ω shape at 0.5 cm in front of the verumontanum to expose the prostate capsule, and then the fiber was retracted into the laser controller. Push the gland directly between the prostate gland and the prostate surgical capsule and expand along the capsule by the laser controller. In case of bleeding or prostate adhesive cord, the fiber was extended to coagulate or cut off, and the prostate was eventually en bloc removed. THuLEP by sheath was performed in 62 cases (THuLEP group). The ages of patients in LC-THuLEP group and THuLEP group were (71.00±8.72) years and (70.32±7.80) years, respectively. The prostate volumes were (74.80±40.88) ml and (73.14±36.31) ml, respectively. Prostate specific antigen (PSA) was (4.67±4.99) ng/ml and (4.89±4.59) ng/ml, International Prostate Symptom Score (IPSS) was (19.48±5.30) points and (18.50±5.05) points, respectively. The quality of life (QOL) scores were (4.17 ± 0.78) points and (4.18± 0.67) points, the maximum urine flow rate (Q max) was (9.82± 2.58) ml /s and (9.98± 2.91) ml/s, respectively. Postvoid residual (PVR) was (60.20±39.19) ml and (61.11±52.83) ml, respectively. The international index of erectile function (IIEF-5) score was (5.58±4.50) and (5.60±4.16), respectively.There was no significant difference in preoperative baseline data between 2 groups ( P>0.05). The operation time, the reduced level of hemoglobin, the weight of removed tissue, The time to postoperative bladder irrigation, the time to indwelling catheter and complications were compared between the two groups. IPSS, QOL score, Q max, PVR, and complications were compared between the two groups at 1, 3 and 6 months after surgery, while IIEF-5 score were compared only at 6 months after surgery. Results:The operative time of LC-THuLEP group and THuLEP group was (71.85±25.68) min and (80.65±29.64) min, respectively, and the decrease of postoperative hemoglobin was (6.42±9.89) g/L and (9.47±10.79) g/L, respectively, the weight of the removed tissue was (56.73±31.21) g and (48.11±24.50) g, respectively, and the time to postoperative bladder irrigation was (14.73±2.71) h and (16.06±2.71) h, respectively, the time to indwelling catheter was (4.41±1.92)d and (4.31±1.66)d, respectively, with no statistically significant differences between the two groups. IPSS scores of LC-THuLEP group were (6.52±2.46) points, (5.83±2.43) points and (5.30±2.49) points at 1, 3 and 6 months after surgery, respectively. QOL scores were (2.36±0.85) points, (2.27±1.02) points and (1.98±0.77) points, Q max were (22.89±2.41) ml/s, (23.61±2.62) ml/s and (23.83±3.53) ml/s, respectively. In THuLEP group, IPSS were (7.60±1.89) points, (6.86±1.81) points and (6.44±1.78) points at 1, 3 and 6 months after surgery, and QOL scores were (2.68±0.67) points, (2.74±1.01) points and (2.35±0.68) points, respectively. Q max were (21.31±2.52) ml/s, (22.13±2.51) ml/s and (22.11±2.49) ml/s, respectively. Those indexes (except Qmax at 6 months)were better in LC-ThuLEP group than THuLEP group, and the differences were statistically significant ( P<0.05). PVR of LC-THuLEP group were (15.95±12.31) ml, (14.83±12.19) ml and (13.67±15.03) ml, respectively, PVR of THuLEP group were (21.89±21.14) ml, (20.03±21.51) ml and (19.69±21.19) ml, respectively, and there were no significant differences. There was no bladder injury, severe bleeding, blood transfusion or secondary operation. The incidence of urinary incontinence 1 month after surgery was 6.1% (4/66) in the LC-THuLEP group and 19.4% (12/62) in the THuLEP group, the difference was statistically significant ( P<0.05). There was no significant difference at 3 months (3/66 vs. 4/62) and 6 months (1/66 vs. 2/62) after surgery ( P>0.05). There were no significant differences in the incidence of epididymitis, urethral stricture and bladder neck contracture between the two groups ( P>0.05). Conclusion:Compared by sheath, THuLEP by laser controller could be a safe and effective surgical method with better curative effect and lower complication rate.

Involvement of over-production of IP 3R-Grp75-VDAC1-MCU calcium axis molecules accompanied with mTORC1 hyper-activation in Adriamycin induced nephropathy rat / 中华实用儿科临床杂志

Objective:To investigate the expression of inositol 1, 4, 5-triphate receptor (IP 3R)-glucose-regulated protein 75 (Grp75)-voltage dependent anion channel 1 (VDAC1)-mitochondrial Calcium uniporter (MCU) Calcium axis molecules in proteinuria and to explore its upstream regulator. Methods:Sixteen Sprague Dawley rats were divided into control group (6 rats) and Adriamycin (ADR) group (10 rats). Nephropathy rat model was established by single injection of ADR through tail vein.The glomerular expression of IP 3R, Grp75, VDAC1, MCU and the activation marker of mammalian target of Rapamycin complex 1 (mTORC1) were analyzed by immunohistochemical staining.In cultured mouse podocyte, ADR was used to induce podocyte injury, and the Everolimus of different concentrations was applied for intervention.The expression of the Calcium axis molecules and apoptosis marker was analyzed. Results:Compared with control group, the glomerular expression of IP 3R (0.02±0 vs.0, P<0.001), Grp75 (0.04±0 vs.0, P<0.001), VDAC1 (0.04±0 vs.0.01±0, P<0.001), and MCU (0.05±0.01 vs.0.01±0, P<0.001) were significantly increased in ADR-induced nephropathy rats, and the activation marker of mTORC1 (0.57±0.01 vs.0.18±0, P<0.001) was increased as well.In cultured mouse podocytes, compared with control group, the expression of Grp75 (1.89±1.17 vs.0.16±0.08, P=0.001), VDAC1 (1.59±0.34 vs.0.20±0.07, P=0.006), and MCU (1.56±0.38 vs.0.46±0.35, P=0.014) were obviously increased in ADR induced podocytes, and the activation marker of mTORC1 (2.12±0.08 vs.0.39±0.09, P<0.001) was also increased.Compared with the ADR induced podocytes, the expression of Grp75 (0.26±0.20 vs.1.89±1.17, P=0.001), VDAC1 (0.40±0.26 vs.1.59±0.34, P=0.014) and MCU (0.60±0.32 vs.1.56±0.38, P=0.029) in podocytes treated with ADR and 1.0 nmol/L Everolimus were remarkably decreased, accompanied with the decrease of mitochondrial calcium [(2 664.00±140.57) U vs.(3 025.16±180.92) U, P=0.023] and apoptosis marker cleaved Caspase-3 (0.55±0.28 vs.1.48±0.45, P=0.011). Conclusions:The over-production of IP 3R-Grp75-VDAC1-MCU Calcium axis molecules accompanied with the hyper-activation of mTORC1 was involved in ADR induced nephropathy rats.mTORC1 inhibitor decreased the expression of Calcium axis molecules in mouse podocytes, which might involve in the mechanism of mTORC1 inhibitor′s effects on podocyte.

The experience of using various lasers in transurethral prostate surgery / 中华泌尿外科杂志

In recent years, with the in-depth research and application of laser technology, transurethral prostate laser surgery has gradually become the mainstream for surgical treatment of benign prostatic hyperplasia (BPH) because of less trauma, less bleeding, quick recovery and fewer complications. Due to the different performance of the various laser equipment, surgical methods and surgical indications are different accordingly. How to choose the best laser equipment and surgical method based on the patient's condition and the experience of the operators? This article summarized the application of various lasers in transurethral prostate surgery.

Quality management of POCT for cardiovascular biomarkers in medical institution / 中华检验医学杂志

Recently point-of-care testing (POCT) for cardiovascular biomarkers is sharply increasing among subdivision field of POCT,however the relevant quality control is not matched.In this paper,the present situation and problems about selecting biomarkers,managing quality and reporting results during clinical application were expounded.The difference between POCT for cardiovascular biomarkers and routine biomarkers was elaborated.The domestic and international rules and standards about POCT for cardiovascular biomarkers were summarized.Finally,this paper included some rationalization proposal to solve the noticeable problems of quality control in POCT for cardiovascular biomarkers.

Clinical efficacy of tip-flexible ureterorenoscope with holmium laser for one-stage management of parapelvic cyst / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of tip-flexible ureterorenoscope (tf-URS) with holmium laser for one-stage management of parapelvic cyst.Methods The clinical data of 26 patients treated with tf-URS incision and drainage using holmium laser from February 2016 to August 2018 were reviewed.The study were including 15 male and 11 female patients,ranging from 32 to 68 years old,with an average of 53.5 years old.There were 24 cases of unilateral single renal parapelvic cyst and 2 cases of bilateral single renal parapelvic cyst.There were 4 cases in 26 cases with unilateral single renal parapelvic cyst and contralateral single renal cyst,2 cases with unilateral single renal parapelvic cyst and ipsilateral kidney of stones.The diameter of parapelvic cyst was 3.4-5.6 cm,average 4.8 cm.All patients had undergone holmium laser endo-decortication of parapelvic cyst by tf-URS.With general anesthesia,tf-URS accessed pelvis retrogradely and decorticated parapelvic cyst with 200 μm Holium laser to drainage the cyst to pelvis.If the tf-URS was not placed successfully for the first time,Double-J tubes were retained for 1-2 weeks before treatment.The operative time,hospitalization time,blood loss,postoperative complications and clinical symptoms were collected and analyzed.Results The one-time access success rate of insertion of ff-URS was 88.5％ (23/26).All operations were successful without severe complications.The average time of operation was 17.2 min,ranging from 11 to 25 min.In 3-30 months follow-up,the cysts disappeared in 22 patients and reduced by more than one half in 1 patients.Flank pain relieved in 19 patients.Conclusions Holmium laser endo-decortication of parapelvic cyst by tf-URS could be a simple,minimally invasive,safe and effective method for parapelvic cyst,which is worthy of further promotion and application in clinical practice.

Transurethral frontfiring photoselective vaporization over transurethral bipolar plasmakinetic resection for the treatment of cystitis glandularis / 中华泌尿外科杂志

Objective To evaluate the safety and efficacy of transurethral frontfiring photoselective vaporesection for the treatment of cystitis glandularis,by comparing with the transurethral bipolar plasmakinetic resection.Methods From January 2014 to July 2016,41 patients with pathologically diagnosed cystitis glandularis in our hospital,were divided into two groups,including 22 cases underwent transurethral frontfiring photoselective vaporesection(the observation group),and the other 19 cases underwent transurethral bipolar plasmakinetic resection(the control group).All patients were regularly treated with postoperative intravesical instillation chemotherapy with pirarubicin.The clinical data of two groups were statistically analyzed to compare the differences of the safety and efficacy.Results All the surgeries were performed successfully.There were no statistical significances in perioperative data,the operation time,the decreased concentration of hemoglobin(Hb)and Na+,operative related complications, indwelling catheter duration and hospitalization duration between the two groups.The first-time cure rate and the effective rate of transurethral frontfiring photoselective vaporesection showed significantly better than those of transurethral bipolar plasmakinetic resection(P<0.05 for each).Conclusion Comparing the traditional transurethral bipolar plasmakinetic resection for the treatment of cystitis glandularis,tansurethral frontfiring photoselective vaporesection with postoperative intravesical instillation chemotherapy with pirarubicin,is a safer,simpler,and more effective method,which could be a new optional method in the conditional hospitals,deserving the worthy of clinical popularization.

Clinical study on transurethral laser shovel type vapor-resection-enucleation of the prostate based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of transurethral laser shovel type vaporresection-enucleation of the prostate (LS-VREP) based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia (BPH),which was less 80 g weight.Methods From September 2013 to August 2016,a retrospective study was performed including 1 369 cases of BPH patients,who were treated by 120-160 W transurethral laser (straight green-light) shovel type vapor-resection-enucleation of the prostate (LS-VREP group,n =1 008) and transurethral resection of the prostate (TURP group,n =361).The preoperative data,including average age,prostate weight,IPSS,QOL,Qmax and PVR was reviewed.There was no significant difference of the above data between the two groups (P ＞ 0.05).Operative time,changes of hemoglobin and serum sodium concentration,postoperative bladder irrigation time,catheter indwelling duration,hospital stay,pre-and 3 months post-operative IPSS,QOL,Q PVR were recorded.In addition,complications were monitored.Results Mean operation time of LS-VREP group was (46.1 ± 18.6) min,while TURP group was (48.2 ± 15.2) min,and there was no difference between the two groups (P ＞ 0.05).Post-operative mean hemoglobin concentration and serum sodium concentration of LS-VREP group decreased (1.6 ± 1.2) g/L and (1.2 ± 0.6) mmol/L respectively,while those of TURP group decreased (5.7 ± 3.6) g/L and (3.2 ± 1.2) mmol/L,and the differences were statistically significant (P ＜ 0.05).Mean post-operative catheter indwelling time,and post-operative hospital stay of LS-VREP group was (42.9 ± 12.7) h and (3.2 ± 0.6) d,while TURP group was (65.7 ± 15.4) h and (5.4 ± 1.2) d,and the differences were statistically significant (P ＜ 0.05).Comparatively IPSS,QOL,Qmax and PVR were all improved significantly in both groups at 3 months after operation (P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After three months' follow-up of post-operation,as for the complication rate,including TURS,bleeding requiring reoperation,incontinence,dysuria and erectile dysfunction,LS-VREP group (15/1 008) was less than that of TURP group (30/361,P ＜ 0.05).Conclusions The LS-VREP based on the inter-layer of surgical capsule is safe and effective for the treatment of BPH patients whose prostate weight was less than 80 g.LS-VREP showed less intraoperative bleeding,faster postoperative recovery,and high safety,which is considered a safe,effective and optimized minimally invasive surgery.

Impacts of two different approaches of modified multichannel single-port laparoscopic radical prostatectomy on immune function in patients with prostate cancer / 实用医学杂志

Objective To explore the clinical efficacy of modified single-portlaparoscopic radical prostatec-tomy(LRP) by atransperitoneal or extraperitoneal approach, and the impact of either approach on immune function in patients with prostate neoplasms. Methods The clinical data on 39 patients who had undergoneextraperitoneal LRP(group A) and 20 patients who had receivedtranperitoneal LRP (group B) in our department from January 2012 to December 2015 were retrospectivelyanalyzed. The prostate neoplasms were preoperatively diagnosed as cancer by ultrasound, CT or MRI, and pathological examinations. The clinical stage was T1-T2c , N0M0 in all patients.The efficacy was assessed by surgical duration, intraoperative blood loss, timeto intestinal function recovery, and post-operative hospital stay in both groups. The indicators for immune function including prostate specific antigen (TPSA and FPSA), immunoglobulin (IgG, IgA, lgM, C3, and C4) and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) in patientswith prostate neoplasms before and after surgery were detected. Results 59 patients were operat-ed successfully, without converting to open approach. The mean surgical duration, blood loss, time to intestinal function recovery, and postoperative hospital stay were (133.8 ± 68.6) min, (75.6 ± 51.3) mL, (2.2 ± 0.7) days, and (14.7 ± 3.6) days in group A, while (159.4 ± 78.1) min, (102.2 ± 70.8) mL, (2.9 ± 1.1) days, and (15.2 ± 4.1) days in group B. There were significant differences between the two groups (P0.05). Average postoperative follow-up was 15 months (range 3-36) in 36 patients. No recurrence or metastasis was found in all the patients by imaging studies,and no long-term complications were found. Conclusions Extraperitoneal LRP, as compared with tranperitoneal LRP, has clearer vision, fewer effects on abdominal organs, shorter surgical duration, less blood loss, faster postoperative recovery, and better protection of immune function. It is worth popularizing clin-ically.

Comparison of Effect on Antioxidative Stress Between Benezepril and Tranilast in Diabetic Nephropathy Rat / 医药导报

Objective To investigate ACEI ( benazepril ) and tranilast exert renoprotective properties in diabetic nephropathy( DN) through the inhibition of thioredoxin( Trx) . Methods Forty male SD rats were randomly divided into normal control group,model control group,tranilast group and benazepril group (n=10 each).Normal control group was fed with normal diet. Other groups were fed with high-glucose high-fat diet to make DN models. Rats in model control, tranilast, and benazepril groups were fed with normal diet,400 mg??kg-1??d-1 tranilast plus normal diet,and 10 mg??kg-1??d-1 benazepril plus normal diet,respectively,via oral gavage for 12 weeks.The 24-hour proteinuria,blood glucose(BG),blood urea nitrogen (BUN),serum creatinine ( Scr) and renal pathology changes were detected. Expression of Trx was measured by Western-blot. Results The 24 h urine protein, BG, BUN, Scr, kidney/body weight, and glomerular sclerosis index were significantly decreased in tranilast group and benazepril group,as compaired with model control group ( P0.05).Both tranilast and benazepril can reduce renal pathological changes,and can increase the expression of Trx of DN rats, but benazepril had a more significant effect on increasing Trx expression. Conclusion Both tranilast and benazepril have renoprotective function in DN, and benazepril is more effective than tranilast in delaying the progression of diabetic nephropathy by increasing Trx expression and decreasomg oxidative stress.

Analysis of microwave-induced thermoacoustic signals and research-development preprocessor / 生物医学工程学杂志

According to the results of analyzing the microwave-induced thermoacoustic signals, the amplitude and frequency were estimated and the designing parameters of preprocessor were decided. Based on the parameters, the signals preprocessor was designed with the band pass frequency ranging from 50 KHz to 3MHz, the gain ranging from 55 dB to 105 dB and the output noise being 1.32 V when the input was zero and the gain was 105 dB. The de-noising method of thermoacoustic signals was also discussed. The signals can be picked up by the preprocessor combined with the digital multipoint average method. The amplitude of signals is only 5 microV or even less. The results indicated that the preprocessor can meet the needs of thermoacoustic signals acquisition in bandwidth, gain and noise control.

Study on second filtering algorithm based on tracing the interfering spectral peaks of radar non-contact life-parameter detection system / 生物医学工程学杂志

To develop a filtering algorithm which could trace the spectral peaks of the interference and which was used to extract the breath signal with the same band interference in radar non-contact life-detecting system, second filtering algorithm was studied. Through first filtering,the probable interfering spectral peaks (ISP) could be detected by Yule-Walker spectrum estimating and could be located by calculating the coefficients of normalized cross-correlation function according to standard breath signal. Thus the breath signal could be extracted through a second filtering. By using the second filtering algorithm (SFA), the same band interfering spectral peaks with breath signal could be recognized and inhibited. So we conclude that the same band mono-ISP could be inhibited by using SFA and breath signals could be effectively extracted.

Measurement and amendment of complex-permittivities of distilled water and NaCl solution / 生物医学工程学杂志

In this experiment, the complex-permittivities at 2 450 MHz of distilled water and various NaCl solutions were measured separately, and acquired data were analyzed and amended. The system develooped on the basis of this experiment is of great significance to studying the measurement of complex-permittivities of high-loss biologic tissues by perturbational method.

Simulation study based on models of cerebral hemorrhage in electrical impedance tomography / 医疗卫生装备

Objective To build finite-element models of cerebral hemorrhage on which a simulation study of electrical impedance tomography(EIT) is based.Method With a kind of four-layer concentric circle model of head,finite-element method and dynamic NOSER algorithm are performed to reconstruct the images.Result As to the single-focus model of the cerebral hemorrhage,the focus can be clearly imaged,while to the several-focus model,the focuses can be imaged with vaguely adjacent boundaries.Conclusion The dynamic NOSER algorithm is an effective method to image cerebral hemorrhage in EIT.

Development of soldier information database based on ADO technology / 医疗卫生装备

This paper introduces ADO technique of exploiting database in VC ++.Through the design of soldier information database,it presents the realization of SQL Server database programming technology based on ADO in VC++,then dwells on the essential steps of database programming.

Establishment of the animal model of induced high-cholesterol-atherosclerotic erectile dysfunction and the mechanisms of atherosclerotic erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish the animal model of atherosclerotic erectile dysfunction induced by high-cholesterol diet and explore the mechanisms of atherosclerotic erectile dysfunction.</p><p><b>METHODS</b>Thirty male rabbits were divided into two groups randomly: normal diet (ND) group (n = 10) and high-cholesterol (HCH) group fed with 1.5% cholesterol diet (n = 20). Serum total cholesterol, plaque areas of the ascending aorta, the ratio of intima/media thickness and level of vascular cell adhesion molecule 1 (VCAM-1) mRNA expression of internal pudendal artery were determined after twelve weeks.</p><p><b>RESULTS</b>After twelve weeks, all rabbits of the HCH group got hyperlipemia, 9 of which presented typical atherosclerosis (ATH). The rate of atherosclerosis induced by high-cholesterol diet was 52.9%. Serum total cholesterol levels of the ATH and HCH groups were higher than that of the ND group (P<0.01). The penile erection times and rate in the ATH and HCH groups decreased significantly, compared with the ND group (P<0.01). Both the ratio of intima/media thickness and the level of VCAM-1 mRNA expression of internal pudendal artery in the ATH group were higher than those in the HCH and ND groups (P<0.01).</p><p><b>CONCLUSION</b>It is easy, prectuable and reliable to establish the animal model of atherosclerotic erectile dysfunction induced by high-cholesterol diet. And one of the main causes of atherosclerotic erectile dysfunction is hypercholesterolemia, which through VCAM-1 may induce the structural and functional modifications of the endothelium of the internal pudendal artery and make the corpus cavernosum ischemia.</p>

On excellent education mode of biomedical engineering in USA / 生物医学工程学杂志

Based on the rankings of the best undergraduate/graduate biomedical engineering programs from the USA News & World Report, we have made a comprehensive analysis on the excellent education mode in USA 2002. It is hoped that the results as reference materials will be useful to our biomedical education at home.

Small-signal pre-amplifying circuit for microwave-induced thermoacoustic tomography / 医疗卫生装备

In order to improve the noise ratio and stability of the amplified small-signal in microwave-induced thermoacoustic tomography,an amplifying circuit with wide band and high voltage gain is designed in this paper.The results show that the voltage gain is up to 80dB and the bandwidth is about 7MHz.

Progress of the detection technology of the respiratory signal / 医疗卫生装备

Respiration is an important physiological process. The detection of th e respiratory signal is a main part of the modern wardship. This paper discusses the detection methods of the respiratory signal and compares their performances and application ranges.

Research progress of noninvasive continuous blood pressure measurement methods / 医疗卫生装备

Research progress of noninvasive continuous blood pressure measurement methods is presented in this paper. The principles and characteristics of such methods are introduced as arterial tonometry, volume-compensation method, pulse wave velocity method and blood pressure measurement method using characteristic parameters of pulse wave. The perspective of noninvasive continuous blood pressure measurement is also mentioned.

Improving the measurement precision of the phantom model by network decomposition method / 医疗卫生装备

It is a kind of precise method tomeasure the complex permittivities of the phantom model by vector network analyzer.But it is difficult tomeasure them accurately because the phantom model is jelly-like gel and is hard tobe shaped.Network decompositon method can be used toresolve it and it has great meaning tostudy the phantom model simulating the biologic tissue.