Effect of finasteride on intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate: a quantitative study / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the effect of pretreatment with finasteride in decreasing intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate (TURP).</p><p><b>METHODS</b>Eighty patients with benign prostate hypertrophy undergoing TURP were divided into two groups: 40 patients were pretreated with finasteride for 7 to 14 days before TURP and 40 patients without pretreatment. Absorption of irrigating fluid was quantified by analyzing the serum concentration of gentamycin. Intraoperative blood loss was calculated based on hemoglobin concentrations before and after operation.</p><p><b>RESULT</b>The whole blood loss, hemoglobin concentration of irrigating fluid used, blood loss per minute, blood loss per gram tissue resected, whole irrigation absorption, irrigation absorption per minute and per gram tissue resected in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05). The blood transfusion volume, the incidence of hypotension and hyponatremia in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05).</p><p><b>CONCLUSION</b>Pretreatment with finasteride is of value in reducing intraoperative bleeding, irrigation absorption and perioperative complication during TURP.</p>

Prostaglandin E1 reduces reperfusion injury of myocardium by inhibiting cytokines production during cardiac surgery / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of prostaglandin E1 (PGE1) on the cytokines (IL-6, IL-8, IL-10) levels and ischemic -reperfusion injury of myocardium during cardiac surgery.</p><p><b>METHODS</b>A total of 30 patients undergoing cardiac surgery (mitral valve replacement) under extracorporeal circulation were randomized into two groups: PGE1 group (receiving 0.04 microg.kg(-1). min(-1) of Lipo-PGE1 from the beginning of surgery to the end of study, n=15) and control group (no PGE1 given, n=15). Levels of serum IL-6, IL-8 and IL-10 were measured by enzyme-linked immunosorbent assays (ELISA). Isoenzyme of creatine kinase with muscle and brain subunits(CKMB) and troponin-T (cTn-T) were measured by ultraviolet absorption spectrophotometry method and enzyme immunoassay on 5 time-points during the study.</p><p><b>RESULT</b>In both groups serum IL-6, IL-8, CK-MB and cTn-T levels increased significantly after aorta declamping (especially from 2 h after aorta declamping) compared with preoperative levels (P<0.05).However,the elevations of these cytokines and enzymes were more prominent in the control group than in the PGE1 group (P<0.05). Serum IL-10 concentration increased significantly from 2 h after aorta declamping compared with preoperative value (P<0.05); but there were no differences between the two groups. IL-6 and IL-8 levels were correlated with CK-MB and cTn-T concentrations (r2=0.40, r2=0.38 P>0.05 and r2=0.56, r2=0.14; P>0.05, respectively).</p><p><b>CONCLUSION</b>During cardiac surgery (mitral valve replacement) PGE1 may suppressed the production of IL-6, IL-8 but not IL-10, which may be related to its myocardial protection effect.</p>

Muscle-sparing thoracotomy in chest surgery / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To review the clinical experience of muscle-sparing thoracotomy in intrathoracic surgery.</p><p><b>METHODS</b>Thoracotomy was performed in 386 patients from 1998 to 2002, during the procedure lateral-transverse incision, free dissection of muscular flap and entering to the thoracic cavity through certain intercostal space were applied. Two sets of rib retractors were used to ensure the excellent field exposure.</p><p><b>RESULTS</b>Intrathoracic surgery was carried out by this method with the advantage of excellent surgical field exposure, less pain and relative quick recovery.</p><p><b>CONCLUSION</b>Muscle-sparing thoracotomy has the merits of less injury and the same good exposure as routine thoracotomy and it can be carried out in majority of chest surgery.</p>