Clinical study of congenital heart disease accompanied by hypospadias / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the concurrence of congenital heart disease and hypospadias and the relationship between the two diseases.</p><p><b>METHODS</b>We investigated the incidence and types of congenital heart disease accompanied by hypospadias in male children received in our hospital from January 2002 to December 2012, compared them with those in the general population, and analyzed the correlation of different types of heart disease with the incidence rate of hypospadias.</p><p><b>RESULTS</b>Of the 7 385 male children with congenital heart disease, 134 (1.81%) were found with hypospadias, with a significantly higher morbidity than in the general population (0.33% -0.40%) (P < 0.01). The incidence rates of hypospadias were significantly higher in the groups of ventricular septal defect (65/3 275, 1.98%), Fallot's tetralogy (17/770, 2.21%), macroangiopathy (15/788, 1.90%) and other congenital heart abnormalities (21/972, 2.16%) than in the atrial septal defect (10/1 015, 0.99%) and patent ductus arteriosus (6/565, 1.06%) groups (P < 0.05). There were no statistically significant differences in the type of hypospadias among different heart disease groups (P > 0.05).</p><p><b>CONCLUSION</b>Hypospadias is a common concurrent condition in male children with congenital heart disease. The incidence rate of hypospadias is related with the type of congenital heart disease, and the two conditions may have some common pathogenic or susceptive factors.</p>

Factors influencing finasteride medication compliance in outpatients with benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the factors influencing the compliance, discontinuation and switching of finasteride medication in patients with benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We retrospectively analyzed the electronic clinical data of 655 outpatients with BPH treated with finasteride from January 2008 to June 2010. Using the medication possession ratio (MPR), we measured their medication compliance and the rates of discontinuation and switching after an average observation of 12 months. We identified and evaluated the influencing factors by multivariate logistic regression analysis.</p><p><b>RESULTS</b>The crude rates of medication compliance, discontinuation and switching were 32.4%, 58.0% and 9.6%, respectively. In those aged > or = 60 years, combination therapy of finasteride with alpha-receptor blockers and chronic comorbidities were positively associated with good compliance, while younger age was significantly associated with drug discontinuation or switching. Finasteride monotherapy was significantly associated with discontinuation of the drug.</p><p><b>CONCLUSION</b>Patients aged < 60 years and those receiving monotherapy were less likely to be compliant with newly initiated finasteride medication, and therefore more efforts should be made to increase their medication adherence.</p>

Treatment of medial malleolus fractures with closed reduction and percutaneous internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of minimally invasive, effective and economic operational method for the treatment of medial malleolus fractures.</p><p><b>METHODS</b>From March 2008 to August 2010, 19 patients (12 males and 7 females, ranging in age from 17 to 42 years, averaged 31.7 years) with medial malleolus fractures were reviewed. Closed reduction and percutaneous internal fixation were applied, with a hollow compression screw inserted at the centre and perpendicularly to the fracture surface. A Kirschner wire was inserted through the cortical bone of opposite side and in accordance with the axis of inner malleolus. Postoperative therapeutic effect was evaluated by Kaikkonen sprained ankle scoring system and imageology examination.</p><p><b>RESULTS</b>All the patients got primary healing of incisions and were followed up, the duration ranged from 6 to 30 months, with an average of 18.7 months. All the patients obtained bone union. Clinical healing time ranged from 2.6 to 3.8 months, averaged 3.2 months. According to Kaikkonen scoring system, the results were rated as excellent in 5 cases, good in 10 cases, moderate in 3 cases, and poor in 1 case.</p><p><b>CONCLUSION</b>It is a minimally invasive, effective and economic method to treat medial malleolus fractures by closed reduction and percutaneous internal fixation with hollow compression screw and Kirschner wire.</p>

Effects of prostate manipulation on serum total and free prostate specific antigen, and free-to-total prostate specific antigen ratio

To evaluate the effects of the different types of manipulation on prostate total specific antigen [tPSA], free prostate specific antigen [fPSA], and free-to-total prostate specific antigen [f/tPSA]. A total of 160 males were enrolled from January 2006 to December 2009 in the Urology Department, Beijing Anzhen Hospital affiliated to the Capital Medical University, Beijing, China. Of these patients, 23 had digital rectal examination [DRE], 21 had urethral catheterization, 28 had rigid cystoscopy, 35 had prostate biopsy, 35 underwent transurethral resection of the prostate [TURP], and 18 underwent suprapubic prostatectomy. Blood samples were taken before, at 24 hours, and 4 weeks after the manipulation for PSA tests. The DRE had no significant effect on PSA. Catheterization and cystoscopy exerted significant increases in tPSA at 24 hours. However, these small increases may not be clinically significant. The fPSA and f/tPSA were not significantly changed. There was a marked increase in tPSA and fPSA, associated with a decrease in f/tPSA at 24 hours after biopsy. No significant alterations were found in tPSA, fPSA, and f/tPSA at 4 weeks after catheterization, cystoscopy, and biopsy. The TURP and prostatectomy caused significant increases in tPSA and fPSA at 24 hours, associated with decreases in f/tPSA. The tPSA and fPSA values were below the baseline levels at 4 weeks after TURP and prostatectomy, however, f/tPSA remained constant. The DRE, catheterization, and cystoscopy had no crucial effect on PSA. Prostatic biopsy, TURP and prostatectomy significantly affected the PSA levels, and their longitudinal courses should be considered while evaluating different forms of PSA levels

Nedaplatin combined with tegafur in the treatment for advanced esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and toxicity of nedaplatin combined with tegafur in the treatment for patients with advanced esophageal cancer.</p><p><b>METHODS</b>Among the 65 patients with advanced esophageal cancer, 27 had no history of prior chemotherapy and the other 38 had ever received postoperative adjuvant chemotherapy before. The median age of those cases was 58.0 years. Nedaplatin was given daily by intravenous infusion at a dose of 20 mg/m(2) for 2 hours and tegafur at a dose of 500 mg/m(2) for 8 hours on D1 approximately D5, every 21 days as a cycle.</p><p><b>RESULTS</b>193 cycles of chemotherapy were accomplished in the 65 patients, and 63 patients were evaluable for response evaluation. Of 27 patients with no prior history of chemotherapy, 6 achieved complete response and 16 partial response, with a response rate (CR + PR) of 81.5%. Among the 36 patients who had ever received postoperative adjuvant chemotherapy, 6 obtained complete response and 10 partial response with a response rate (CR + PR) of 44.4%. The overall median time to tumor progression in this series was 5.6 months. The overall median actuarial survival was 9.3 months, and the one-year survival rate was 24.9%. Nausea and vomiting were the major toxicities, but were mild and well tolerable. Grade 3 to 4 neutropenia was only observed in two patients (3.2%).</p><p><b>CONCLUSION</b>The regimen of nedaplatin combined with tegafur is effective and tolerable for the treatment of advanced esophageal cancer.</p>

Preoperative diagnosis and treatment of primary non-specific ureteritis(report of 3 cases) / 中华泌尿外科杂志

Objective To evaluate the preoperative diagnosis and treatment of primary non-specific ureteritis,and to better understand this disease.Methods Three cases of primary non-specific ureteritis (1 man and 2 women)were reported.Their age was 28,38,68 years,respectively.One ease was found to have hydronephrosis on B-ultrasound at physical examination with no symptoms,and 2 had abdominal pain. The lesions were detected in lower part of the ureter in 2 cases,and in middle in I.The patients were diag- nosed preoperatively with combined use of MRU and ureteroscopy.Partial resection of the diseased part of the ureter was performed in all the cases.Results Pathological findings confirmed the diagnosis of non-spe- cific ureteritis.Microscopy showed necrotic tissue and inflammatory cell infiltration of ureteral mucosa,dilated and congested blood vessels,hypertrophic muscular layer,and proliferation of fibrous tissue.During the fol- low-up of 2 years,the patients had no symptoms and were free from hydronephrosis.Conclusions The eti- ology of primary non-specific ureteritis is unclear,and no typical symptoms can be found clinically.Combined use of MRU and ureteroscopy is helpful for definite diagnosis of the disease.Partial resection of the diseased part of the ureter has good results.