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Objective:To investigate the feasibility and safety of suprapubic bladder puncture and gland fixation in transurethral enucleation of the prostate.Methods:The clinical data of 15 patients with benign prostatic hyperplasia admitted to the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2020 were retrospectively analyzed. The age was (70.27±5.35) years old, preoperative serum prostate-specific antigen (PSA) level was (3.03±1.37) ng/ml, preoperative total prostate weight was 80.3(70.49, 96.78)g, preoperative postvoid residual urine volume(PVR)was 80 (55, 108)ml, and the maximum urine flow rate (Q max) was (6.13±2.25) ml/s. The international prostate symptom score(IPSS) was 25(22, 27), quality of life (QOL)score was 5(5, 6), international erectile function index-5 (IIEF-5) score was (15.38±5.10). All 15 patients underwent conventional transurethral plasma enucleation of prostate by using the three-lobe method, and the enucleated gland was pushed into the bladder completely. Then a laparoscopic pneumoperitoneum needle was used to perform suprappubic cystipuncture, and ureteral grasping forceps were inserted through the outer sheath. The forceps were used to fix the enencied gland. A rapid harvesting electric resection was performed in the broad space of the bladder, and the Ellick was rinsed to remove the tissue fragments. Surgical indicators and complications were recorded. The improvement of subjective score (IPSS, QOL, IIEF-5) and objective index (Q max, PVR) was compared between preoperative and postoperative. Results:All the 15 operations were completed successfully and there were no complications such as blood transfusion, capsule perforation, transurethral resection syndrome, bladder injury, bladder puncture site laceration and bleeding. The weight of resected prostate tissue was 44(40, 60)g, with blood loss (79.20±18.93)ml.The time of enucleation operation was (54.13±10.88)min, with harvest cutting time (14.67±2.50)min, evisceration efficiency (0.89±0.08)g/min, harvesting efficiency (3.26±0.36)g/min, bladder irrigation time (2.47±0.52) d. The time of indwelling catheter was (3.73±0.80)d.The postoperative hospital stay was (4.40±0.91) d. Temporary urinary incontinence occurred in 1 case after operation. All patients were followed up for 6 months after operation. The IPSS score was 3(2, 3), QOL score was 0(0, 1), IIEF-5 score was (20.12±2.30), Q maxwas (21.80±2.14) ml/s and PVR was 10(5, 15)ml, which were all significantly different compared with those before surgery ( P<0.05). The symptoms of the patients were significantly improved. Conclusions:Transurethral plasma enucleation of prostate combined with suprapubic bladder puncture and fixed gland is effective in the treatment of benign prostatic hyperplasia. The subjective symptoms and objective examination of patients have been significantly improved, and no adverse operation-related complications have occurred. It is a suitable method for enucleation of prostate in units which are not equipped with transurethral tissue planer.
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Ureteral artery fistula (UAF) is a rare complication after long-term indwelling of ureteral stent. In this study, two cases were presented. Both of them underwent pelvic tumor surgery and radiotherapy, and had a history of cutaneous terminal ureterostomy and long-term indwelling of ureteral stents. The first case, a 52-year-old female, was admitted to hospital because of intermittent bleeding from ureteral dermostomy for 1 week on April 2, 2020. CT examination revealed hematocele in the left upper urinary tract, and left nephrectomy was performed.However, bleeding still presented and the distal ureteral resection was performed at the same time, and partial ureteral was ligated. Postoperative diagnostic was ureteral artery fistula. After 8 months of follow-up, no recurrent bleeding presented. Another case, a 82-year-old male, was admitted to hospital because of bleeding at the ureteral dermostomy for an hour on June 15, 2020. Contrast enhanced CT examination revealed intersecting of the left ureter and common iliac artery, and interventional surgery was performed, by which UAF was diagnosed. Embolization of left internal iliac artery and stent implantation of common iliac artery and external iliac artery were performed intraoperatively. The bleeding stopped immediately after the operation, and there was no further bleeding during follow-up of 6 months.
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@#ObjectiveTo study the relation between premature and cerebral palsy(CP).MethodsTo sample all the children between the age of 1 to 6 years old for investigating CP situation in Nanning city, Heng county and Qinbei region of Qinzhou city (once named Qinzhou county ) from May to December, 1998 by qualified pediatricians.ResultsThe total investigating cases were 150,806,in which diagnosed CP were 193 cases and the incidence of CP was 1.28‰. Among them, premature infants were 872 and diagnosed CP were 46,the incidence of CP was 52.75‰ in this group. While term laboring infants were 149,934 with CP 142 and the incidence of CP was 0.95‰. The difference between two groups was very significant(P<0.001).The shorter the gestational weeks were, the higher the incidence of the CP was. Among 46 premature infants with CP, there were 18 cases' mothers(26 person times) involved in abnormal pregnancy and delivery history, accounted for 39.1%, while 36 with pregnancy complications(78.3%). There were 23 cases (30 person times) suffered from the disease during neonate, accounted for 50%.ConclusionThe premature delivery is a risk factor associated with childhood CP.
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<p><b>OBJECTIVE</b>To study the prevalence of cerebral palsy (here in after referred to CP) in children aged 1 - 6 in Guangxi, China, and its epidemiologic characteristics and relevant risk factors.</p><p><b>METHODS</b>Investigations on the prevalence and etiology of CP in children at ages of 1 - 6 were conducted in Nanning, Hengxian and Qinzhou of Guangxi from June to December in 1998, with a cluster sampling.</p><p><b>RESULTS</b>Totally, 150 806 children aged 1 - 6 were investigated in Nanning, Hengxian and Qinzhou of Guangxi, with 89 418 boys and 61 388 girls. Among them, 193 children were diagnosed as CP, with a prevalence rate of 1.28 per thousand, higher in boys (136 cases, 1.52 per thousand ) than in girls (57 cases, 0.93 per thousand ), with statistical significance (chi(2) = 9.536 7, P = 0.02). Logistic regression analysis showed that risk factors for CP were children who could not cry after birth (neonatal asphyxia), Apgar score less than eight, delivery at lower level of maternity hospital, number of mother's gravidity, no prenatal checks for mothers, and taking antipyretics and preserved food with salt during pregnancy.</p><p><b>CONCLUSIONS</b>Prevalence of CP in children of Guangxi was at a lower level in comparison with that in other areas at home and abroad, which, maybe, was related with the lower neonatal survival and higher infant mortality.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Pregnancy , Cerebral Palsy , Classification , Epidemiology , China , Epidemiology , Logistic Models , Pregnancy Trimesters , Prevalence , Risk FactorsABSTRACT
0.05) . [Conclusion] RAI has certain therapeutic effect on peripheral blood leukopenia caused by viral infection in children.
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Objective To investigate the relations between low birth weight and infantile cerebral palsy. Methods Population based survey was done in townships in Nanning city, Heng county and northern district of Qinzhou city from May to December in 1998. All children in the project townships, from 1 to 6 years old, was investigated for cerebral palsy(CCP). The pediatricians were well trained and qualified before participated. Results One hundred and fifty thousand eight hundred and six infants were enrolled, and 193 infants with cerebral palsy were diagnosed, and the morality of CP was 1.28‰. Sixty one infants with cerebral palsy were found among 1 450 low birth weight infants(42.07‰. One hundred and twenty five cerebral palsy infant were diagnosed among 148 599 infants with normal birth weight(0.84‰). The cerebral palsy rates were significantly different between low birth weight and normal birth weight infants. The lower the birth weight was, the higher the morality. Among the 61 cases of the cerebral palsy infants with low birth weight, there were different conditions of the mothers in the aspects of environment and nutrition during their pregnant period. Among these mothers, 1/3 of them had been got the unhealthy factors;26 cases of them (42.6%) had had complications of pregnancy;38 cases of them(62.3%)had been ill during the neonatal period;20 case of them(32.8%) had been got the abnormal pregnant and delivering history or the premature labor history. Conclusions The low birth weight is a highly risk factor related to cerebral palsy, the mothers have similar disease in the pregnant period. Low birth weight infants should get intensive care, and the illness neonates should be prevented.