A preliminary study on reducing the formation of intra-abdominal hernia and postoperative intestinal obstruction in laparoscopic Bricker operation / 现代泌尿外科杂志

【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.

Analysis of exercise density and exercise load in different physical classes for second year junior high school students from Beijing City / 中国学校卫生

Objective@#To explore the exercise intensity and effective exercise load of different physical fitness classes for second year junior high school students in Beijing, so as to provide a reference for optimizing the teaching content of physical fitness classes, reasonably regulating exercise load and the scientific development of physical fitness.@*Methods@#From October to November 2022, 30 second year junior high school students from a middle school in Xicheng District, Beijing were selected to have their heart rate monitored during physical fitness classes using Polar heart rate monitors. Heart rate intervals and training impulse (TRIMP) were used to quantify exercise intensity and load. Independent sample t-test was used to statistically analyze differences in heart rate across different dimensions.@*Results@#The average heart rate of students in physical fitness classes was (140.62±9.41) counts/min, with effective exercise load (heart rates ≥120 counts/min) time accounting for 77.2%, and heart rate load of moderate to vigorous physical activity (MVPA) time accounting for 51.9%. The average heart rates for speed, speed endurance, and endurance physical fitness classes were (137.89±8.82) (137.67±11.27) and (145.35±8.98) counts/min, respectively. The average heart rates of male and female students in physical education class were (144.22±24.95) and (136.31±28.78) counts/min, and the difference was not statistically significant ( t=4.04, P >0.05). The cumulative durations of effective exercise load among male and female students were (34.08± 7.52 ) and ( 28.43 ±5.39) min, respectively. The average TRIMP value for physical fitness classes were (100.46±16.56), with a exercise density of 72.06%.@*Conclusions@#The exercise intensity of physical fitness classes for secondyear junior high school students in Beijing is appropriate, mainly with moderate to vigorous intensity, and the accumulated time of MVPA is sufficient. The average heart rate and exercise density of students meet the requirements. Scientific setting of physical fitness class exercise load should be based on individual differences in students physical fitness, in order to improve the physical health level of middle school students.

Predictive factor analysis of time to progression of castration-resistant prostate cancer after androgen deprivation therapy / 北京大学学报(医学版)

Objective: To explore risk factors including prostate-specific antigen (PSA) kinetics for the prediction of castration-resistant prostate cancer (CRPC), and to build a practical model for predicting the progression to CRPC after androgen deprivation therapy(ADT) so as to facilitate clinicians in decision-making for prostate cancer patients receiving ADT.Methods: A total of 185 patients with prostate cancer who had received ADT as the primary therapy in Department of Urology of Peking University First Hospital from 2003 to 2014 were enrolled retrospectively.All the patients were diagnosed with prostate cancer via prostate biopsy and followed up every four weeks from the initiation of ADT.All the patients received ADT with luteinizing hormone-releasing hormone agonists (LHRH-A) or surgical castration accompanied with an antiandrogen (bicalutamide or flutamide, combined androgen blockade).The clinical information of the patients were collected including age, clinical TNM stage, Gleason score (GS), risk groups of prostate cancer, PSA at the initiation of ADT, PSA nadir after ADT, PSA decline velocity, and the time to PSA nadir.The end point of this study was the diagnosis of CRPC, which was based on the European Association of Urology (EAU) Guideline 2016.Cox proportional hazards regression models were established to analyze and estimate their effects on the time of progression to CRPC.Results: In this study, 185 patients with prostate cancer who had received ADT as the primary therapy were included.The mean age was (71.02±8.67) years.The median time to progression to CRPC in this cohort was 38 months (ranging from 4 to 158 months).On univariate analysis, we found clinical T stage, N stage, the metastasis state before ADT, risk groups of prostate cancer, PSA decline velocity, and PSA nadir were all related to the time to CRPC progression, P11 μg/(L·month) (HR=2.124, 95% CI: 1.195-3.750, P=0.001), and time to PSA nadir ≤ 9 months (HR=3.623, 95% CI: 1.640-4.817, P=0.004) were found to be significantly associated with an increased risk of progression to CRPC.Conclusion: Patients with rapid decreasing of PSA in the initial ADT were more likely to progress to CRPC.