Modified biological training model for percutaneous renal surgery with ultrasound and fluroscopy guidance / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The 12th rib is an important anatomic marker in the process of percutaneous renal surgery; while the previous models without ribs can not provide close simulation conditions to human upper abdomen. To facilitate the learning and training of percutaneous renal access and intrarenal procedures under ultrasound and fluoroscopy guidance, we reported a biological bench model for percutaneous renal surgery.</p><p><b>METHODS</b>The model was developed using an ex vivo porcine kidney with a longer than 3 cm ureter, a flap of full thickness of thoracic wall with skin, subcutaneous fascia, muscle and two ribs, as well as the standard equipment for percutaneous nephrolithotomy. The porcine kidney with a catheterized ureter was placed within the porcine flap and fixed to a wooden board with two long steel nails. Afterward, contrast medium or physiological saline (0.9% sodium chloride solution) was injected through the ureter, and the urinary system was examined with a fluoroscopy unit or an ultrasound. Artificial stone material was implanted in the renal pelvis. After practicing, the model could be dissected for kidney examination and a technical analysis.</p><p><b>RESULTS</b>The advantage of this model was simple to set up and inexpensive, by using widely available material. The biological bench model can be employed for percutanous renal access, tract dilation, nephroscopy, and stone disintegration in the training and learning of clinical practice. Imaging is feasible under fluoroscopic and ultrasound guidance. The kidney models were utilized in hands on courses with over 100 people, and 90.5% attendants rated the porcine kidney model for simulation of percutaneous renal surgery as "very helpful" or "helpful".</p><p><b>CONCLUSION</b>This biological training model simulates realistically the clinical procedure of percutaneous nephrolithotomy under fluoroscopic and ultrasound guidance.</p>

Sexual function of aging males in Beijing: a primary investigation / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the mean age of sexual activity termination, the prevalence of erectile dysfunction (ED), and their related factors in the old male population in Beijing.</p><p><b>METHODS</b>We included in this study 764 males aged over 60 years old received in the health examination clinic and investigated the prevalence of ED and the related factors using the sexual health assessment resource (SHARE) and IIEF-5 questionnaires.</p><p><b>RESULTS</b>The average age of sexual activity termination (no sexual intercourse in over 2 years) was 68.4 +/- 5.2 years among the subjects. The prevalence of ED was 89.4% , of which the rates of mild, moderate and severe ED and non-sexuality were 6.7, 18.6, 28.4 and 35.7% , respectively. Those who had no sexual intercourse for over 2 years because of severe ED accounted for 26.8% among the 60-64 years old males and more than 50% in the >70 yr group. The main risk factors for ED-induced sexual activity termination included age, diabetes, cardiovascular and cerebrovascular diseases, obesity, and low urinary tract symptoms (LUTS).</p><p><b>CONCLUSION</b>ED is a common problem as well as the main risk factor for sexual activity termination, and age and general health status are significantly associated with the prevalence of ED among aging males.</p>

Comparison of different drugs on the treatment of benign prostate hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the differences of the efficacy and different therapeutic drugs on the treatment of benign prostatic hyperplasia (BPH) in order to ensure the optimal indication for different BPH patients.</p><p><b>METHODS</b>A randomized, parallel-controlled, multicenter clinical trial was conducted. From September 2002 to December 2003 906 BPH patients were enrolled into 7 therapeutic groups, including selective-adrenoceptor antagonist (terazosin, doxazosin tamsulosin and naftopidil), 5 alpha-reductase inhibitor (finasteride and epristeride) and natural product (cernilton). International Prostate Symptom Score (IPSS) and Quality of Life (QOL), uroflowmetry, total prostatic volume (TPV) and transitional zone volume and residual urine were used as efficacy criteria.</p><p><b>RESULTS</b>According to the baseline, the IPSS and Qmax were significantly correlated to the prostatic volume and transitional zone volume (P < 0.01). At average follow-up of 6 months, significant improvements in IPSS, QOL, Qmax and residual urine volume were observed in each therapeutic group, and no difference in IPSS improvement was found among the groups. Prostatic volume and transitional zone volume were significant decreased in 5alpha-reductase inhibitor groups (P < 0.05). In patients with baseline TPV greater than 35.5 cm3, the improvement of Qmax was more significant than that in patients with TPV less than 35.5 cm3 in finasteride group (P < 0.01) (5.7 ml/s and 2.2 ml/s respectively), and more significant symptomatic improvements were also found in cernilton, doxazosin and naftopidil group. In each group, the improvement of symptom were more significant in patients with IPSS higher than 20 points (P < 0.01).</p><p><b>CONCLUSIONS</b>Each drug observed in this study can improve the subjective and objective symptoms significantly for BPH patients, especially for patients with higher IPSS baseline. When using 5alpha-reductase inhibitor, prostatic volume can be decreased significantly and more obviously subjective and objective improvement can be found in the patients with TPV greater than 35.5 cm3.</p>