F4.8 visual miniature nephroscope for the diagnosis and treatment of hematospermia / 中华男科学杂志

<p><b>Objective</b>To explore the practicability and safety of the F4.8 visual miniature nephroscope in the diagnosis and treatment of hematospermia.</p><p><b>METHODS</b>This study included 12 cases of refractory hematospermia accompanied by perineal or lower abdominal pain and discomfort. All the patients failed to respond to two months of systemic anti-inflammatory medication and local physiotherapy. Seminal vesicle tumor and tuberculosis were excluded preoperatively by rectal seminal vesicle ultrasonography, MRI or CT. Under epidural anesthesia, microscopic examination was performed with the F4.8 miniature nephroscope through the urethra and ejaculatory duct orifice into the seminal vesicle cavity, the blood clots washed out with normal saline, the seminal vesicle stones extracted by holmium laser lithotripsy and with the reticular basket, the seminal vesicle polyps removed by holmium laser ablation and vaporization, and the seminal vesicle cavity rinsed with diluted iodophor after operation.</p><p><b>RESULTS</b>Of the 10 patients subjected to bilateral seminal vesiculoscopy, 3 with unilateral and 2 with bilateral seminal vesicle stones were treated by holmium laser lithotripsy, saline flushing and reticular-basket removal, 2 with seminal vesicle polyps by holmium laser ablation and vaporization, and the other 3 with blood clots in the seminal vesicle cavity by saline flushing for complete clearance. The 2 patients subjected to unilateral seminal vesiculoscopy both received flushing of the seminal vesicle cavity for clearance of the blood clots. The operations lasted 10－55 (25 ± 6) minutes. There were no such intra- or post-operative complications as rectal injury, peripheral organ injury, and external urethral sphincter injury. The urethral catheter was removed at 24 hours, anti-infection medication withdrawn at 72 hours, and regular sex achieved at 2 weeks postoperatively. The patients were followed up for 6－20 (7 ± 2.3) months, during which hematospermia and related symptoms disappeared in 10 cases at 3 months and recurrence was observed in the other 2 at 4 months after surgery but improved after antibiotic medication.</p><p><b>CONCLUSIONS</b>The F4.8 visual miniature nephroscope can be applied to the examination of the seminal vesicle cavity and treatment of seminal vesicle stones and polyps, with the advantages of minimal invasiveness, safety and reliability.</p>

TRUS-guided transperineal biopsy with 9 + X method for the diagnosis of prostate carcinoma: retrospective analysis of 420 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the clinical value and safety of TRUS-guided transperineal biopsy with the 9 + X method in the diagnosis of prostate carcinoma.</p><p><b>METHODS</b>A total of 420 men underwent TRUS-guided transperineal biopsy with the 9 + X method for suspected prostate carcinoma. Their clinical data were retrospectively analyzed.</p><p><b>RESULTS</b>Prostate carcinoma was detected in 160 (38.1%) of the 420 cases, accounting for 7.4%, 17.8% and 65.4% in those with PSA < 4.0 microg/L, 4 -10 microg/L and > 10 microg/L respectively, 25.0% in those with abnormal findings on digital rectal examination (DRE), and 22.2% in those with abnormal echoes on TRUS or abdominal ultrasound examination. Complications after prostatic biopsy included gross hematuria in 79 cases (18.8%), acute urinary retention in 13 (3.1%) and fever in 9 (2.1%), but no other serious complications were observed.</p><p><b>CONCLUSION</b>TRUS-guided transperineal biopsy with the 9 + X method, with high accuracy and fewer complications, is an ideal approach to the diagnosis of prostate carcinoma.</p>

Diagnosis and treatment of primary epididymal tumor: a report of 35 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of primary epididymal tumor.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 35 cases of pathologically confirmed primary epididymal tumor. Of the total number of patients, 10 underwent tumor excision, 23 received epididymectomy, 1 was treated by simple orchidoepididymectomy, and by radical orchidoepididymectomy with second-stage retroperitoneal lymph node dissection.</p><p><b>RESULTS</b>Postoperative pathology confirmed 33 cases of benign tumor (including 21 adenomatoid tumor, 7 leiomyoma, 4 fibroma, and 1 papillary cystadenoma), and 2 cases of malignancy (1 malignant fibrous histiocytoma and 1 adenocarcinoma). The follow-up lasted 10 months to 6 years, which revealed no recurrence, metastasis and death.</p><p><b>CONCLUSION</b>Primary epididymal tumor is difficult to be definitely diagnosed preoperatively. Surgical exploration is the first choice for those highly suspected of the disease. Tumor excision or epididymectomy can be considered for benign cases, while radical orchidoepididymectomy with retroperitoneal lymph node dissection is recommended in case of malignancy.</p>

Efficacy and safety in chronic hepatitis B adolescent patients with lamivudine therapy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To analysis the efficacy and safety of lamivudine (made in China) therapy for 52 weeks in adolescent patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>One hundred and five teenage CHB patients were treated with lamivudine 100 mg once daily for 52 weeks. Patients with elevated ALT at baseline were in group 1 and those with normal ALT were in group 2. The changes of HBV DNA, HBV seromarkers and ALT at the end of 12, 24 and 52 weeks after lamivudine therapy were compared with those at baseline. Adverse events were recorded and evaluated.</p><p><b>RESULTS</b>At the end of 52 weeks of lamivudine therapy, HBV DNA-ve, HBeAg loss and anti-HBe seroconversion were observed in 92.0%, 24.4% and 22.0% in group 1 patients and 76.1%, 14.2% and 14.2% in group 2 patients respectively. No significant differences were found between two groups. At 12, 24 and 52 weeks, normalization rates of ALT were 59.0%, 66.7% and 76.0%, normal ALT with undetectable HBV DNA were 44.9%, 64.1% and 70.7% at the same time. During 52 weeks lamivudine treatment 26 mild adverse events were observed in 18 patients.</p><p><b>CONCLUSION</b>Lamivudine can inhibit HBV replication rapidly and normalize ALT in majority adolescent CHB patients. HBeAg loss or seroconversion of anti-HBe was observed in some of these patients. All patients in this study were safety and well tolerated.</p>

Chronic hepatitis B treated with domestic manufactured lamivudine in 2200 patients: a phase IV study / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To further verify the efficacy and safety of locally manufactured lamivudine on patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>2200 patients with CHB were recruited and received lamivudine orally 100 mg once daily for 12 months. The efficacy assessments included virologic response rate (defined by the absence of serum HBV DNA, HBeAg loss and HBeAg/HBeAb seroconversion), percentage of patients with normalization of alanine aminotransferase (ALT). Meanwhile improvement of quality of life (QOL) measured by mos SF-36 QOL questionnaire and liver histology evaluation were conducted in some patients. The safety assessments included adverse events, serious adverse events and laboratory abnormalities. All 2200 patients received at least one dose of medication and were all included in the safety population.</p><p><b>RESULTS</b>Ninety seven percent of patients (2137/2200) recruited were HBV DNA positive by dot blot (sensitivity GRT or equal to 1.0 pg/ml) at baseline. At the end of 12 months treatment, HBV DNA was undetectable in 80% patients (1538/1920) with HBV DNA positive before treatment. Among the 79%(1744/2200) of the patients recruited had positive HBV DNA accompanied abnormal ALT levels at baseline, 72% patients became ALT normal. And among the 84% (1843/2200) of the patients recruited were HBV DNA and HBeAg positive, anti-HBe negative, 16% (269/1650) patients achieved HBeAg/HBeAb seroconversion after 12 months of lamivudine treatment. The HBeAg/HBeAb seroconversion rate was positive correlation to the ALT level before treatment. A total of 304 patients completed the health-related QOL questionnaire. After 12 months treatment, lamivudine improved both their physical and mental health, especially for their mental health. 133 evaluable, paired liver biopsies were obtained for histological assessment, among whom 115 patients had abnormal ALT levels at baseline. Compared with pre-treatment most of their liver injury got alleviated (51.9%) or no further deterioration (36%), only 12% worsening. During the 12 months treatment, 9% patients withdrew from the study and 17% patients showed at least one adverse event, mild or moderate. There were no obvious difference between this study and the previously reported lamivudine Phase II or III study with regard to the kinds, incidence and severity of adverse events.</p><p><b>CONCLUSION</b>The efficacy and safety profile of the locally manufactured lamivudine 100 mg tablets are similar with those of the previously reported available lamivudine tablets imported in treating Chinese chronic hepatitis B patients.</p>