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Objective:To explore the efficacy and safety of transurethral anatomical vapor incision technique of prostate (VIT) with six-step method high power side-emitting greenlight laser in the treatment of benign prostatic hyperplasia (BPH).Methods:A retrospective analysis of 82 patients with BPH who used high power side-out green laser in the treatment from October 2018 to June 2020 in Gongli Hospital of Naval Medical University was performed. Among them, 40 patients were treated with six-step method VIT, and 42 patients were treated with photoselective vaporization of prostate (PVP). The two groups of patients were compared in age [(71.1±8.7)years vs.(72.1±7.0)years], prostate volume [75 (68.25, 89.00) ml vs. 73 (63.25, 85.00) ml], and peak urinary flow rate (Q max) [6.20 (5.20, 8.20) ) ml/s vs. 5.9 (4.75, 7.50) ml/s], post-void residual volume (PVR) [74.00 (42.50, 103.75) ml vs. 67.00 (58.00, 84.50) ml], international prostate symptom score (IPSS) [(21.2±5.2) vs. ( 21.0±3.9)], quality of life score (QOL) [5 (4, 6) vs. 5 (4, 6) ], prostate specific antigen (PSA) [6.20 (4.12, 8.43) ng/ml vs. 5.40 (3.88, 7.13) ng/ml ]. In general, there was no statistical difference ( P>0.05). The VIT group adopts the six-step method of marking, removing film, grooving, excision, trimming and crushing. In the PVP group, the prostate tissue was uniformly vaporized layer by layer from the inside to the outside. Perioperative indexes and complications were compared between the two groups. The Q max, IPSS, QOL, PVR and PSA between the two groups before and 3 months after surgery were compared. Results:All patients in the VIT group and PVP group successfully completed the surgery, and there was no case of transfer to TURP or open surgery. The average operation time was [60.00(50.00, 73.75)min vs. 70.00(50.00, 73.75)min] ( P<0.05). There was no significant difference in the amount of postoperative hemoglobin decline[15.00(10.00, 17.75)g/L vs. 16.00(14.00, 19.25)g/L], average bladder irrigation time[1(1, 1)d vs. 1(1, 1)d], indwelling catheterization time[3(3, 3)]d vs. 3(3, 3)d] and hospitalization time in patients after operation[4(3, 4)d vs. 4(4, 4)d] ( P>0.05). All patients had no blood transfusion, second bleeding, readmission, TURS, urethral stricture and urinary incontinence.There were 2 cases (5.0%) of postoperative urinary tract infection in the VIT group and 9 cases (21.4%) of postoperative urinary tract infection in the PVP group ( P<0.05), and they were cured after anti-inflammatory treatment. Three months after operation, Q max, IPSS, QOL, PVR and PSA in the two groups were significantly improved compared with preoperatively. Among them, the differences of IPSS [(5.7±2.5) points vs. (7.5±2.8) points] and PSA [2.65(2.10, 3.90)ng/ml vs. 4.00(2.45, 4.45)ng/ml] in the VIT group and PVP group after operation were statistically significant ( P<0.05). Conclusions:Applying the six-step method high power side-emitting greenlight laser transurethral anatomical VIT to treat BPH, there is less intraoperative and postoperative bleeding, short operation time, significant decrease in PSA, and fewer complications. It is a safe and effective minimally invasive technology for the treatment of BPH.
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Objective To examine the epidemiology of kidney stone in Pudong New Area ofShanghai and analyze its risk factors. Methods 12 565 residents with the age above 16 years weresurveyed. All subjects needed to answer a questionnaire concerning their sex,age,geographic loca tions,occupation,education status and family history of renal calculi,etc. Ultrasound examinationwas used to diagnose the kidney stone. Results The average prevalence of kidney stone was 3.15%(396/12565),4. 05%(247/6096)in the men and 2.30%(149/6469) in the women,respectively (P<0. 05). The prevalence increased significantly with age of men,whereas the prevalence was highest forwomen aged 50-59. The prevalence between city and rural was not significantly different before age60 (2.58% vs 2. 62%,P>0. 05),whereas the prevalence were significantly different after age 60(6.28% vs 3.36%,P<0.05). The prevalence of subjects with a family history of renal calculi washigher than that without family history (32.02% vs 2.06%,P<0. 01). The prevalence in manage ment staff and vehicle drivers were the highest. Conclusions The prevalence of kidney stone in Pud ong New Area of Shanghai was lower than that in south of China. The relative risk increased in sub jects of aged men,women aged 50 59,with family history of renal calculi,management staff and ve hicle drivers. An understanding of the epidemiology particularly the interactions among different fac tors,may help lead to approach that reduce the risk of stone formation.
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Objective To investigate the diagnosis and treatment of primary hyperparathyroidism (PHPT) with urolithiasis.Methods The clinical data of 9 PHPT patients who were evaluated with simple metabolic evaluation in 881 urolithiasis from 2000 to 2005 were summarized and the references were reviewed.Results The level of serum calcium was (2.96±0.48)mmol/L before operation, (1.94±0.42) mmol/L after operation.The level of parathyroid hormone(PTH) was(1133.53±788.21)pmol/L before op-eration,(74.52±49.17)pmol/L after operation.The level of serum calcium and PTH changed significantly after the parathyroidectomy (P<0.01).Follow-up for 14 months to 6 years.the ureteral stones fragments with lithotripsy were clear after 3 months and followed without recurrence,although the renal stones without lithotripsy were followed with no significant change.Conclusions Increase of serum calcium or increase of PTH above double with normal serum calcium may be helpful for diagnosis of PHPT with urolithiasis.Ureteral stone with PHPT should be treated together.Renal stone with PHPT may be followed up after the parathv-roidectomy,and be treated until the complications were occurred.It suggests that the maidend diagnosed pa-tient with urolithiasis should be added with simple metabolic evaluation,including serum calcium, phospho-nium and PTH.
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Objective To elucidate the functional changes of E-cadherin (ECD) and ?-Catenin in the process of invasion and metastasis in renal cell carcinoma (RCC). Methods The expressions were investigated in 41 RCC by immunohistochemical staining of SP methods. Results Decreased expression of ECD and ?-Catenin correlate with the progression and higher clinical stage and poorer outcomes (P