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Objective To investigate the clinical value of high-resolution magnetic resonance imaging(HR-MRI)combined with nomogram model in predicting the risk factors of positive circumferential resection margin(CMR)in rectal cancer surgery.Methods A retrospective analysis was conducted on preoperative data from 107 rectal cancer patients who underwent surgery and were confirmed by pathology.SPSS 2 5.0 software was used for univariate statistical analysis of potential risk factors for positive CRM,and after independent risk factors were selected,multivariate logistic regression analysis was performed to classify the risk factor categories.R software(4.2.0 version)was used to establish the nomogram model,and a curve was drawn to evaluate the model.The receiver operating characteristic(ROC)curve was used to show specificity and sensitivity,the area under the curve(AUC)was used to evaluate discriminative ability,the calibration curve was used to evaluate calibration,the decision curve analysis(DCA)was used to evaluate clinical benefit,and the model was internally validated using the Bootstrap method.Results Tumor located in the lower rectum[P=0.01,odds ratio(OR)=8.71],maximum diameter of tumor perpendicular to the intestinal tube(≥18.86 mm±5.32 mm)(P=0.01,OR=1.24),extramural vascular invasion(EMVI)(P＜0.01,OR=0.03),and mesorectal lymph node metastasis(P=0.01,OR=0.15)were independent risk factors for positive CRM in rectal cancer.The nomogram model established based on these factors had a training set AUC of 0.921(sensitivity 0.83,specificity 0.93),a validation set AUC of 0.912(sensitivity 0.87,specificity 0.82),a Bootstrap internal validation corrected AUC of 0.92,and a consistency index(C-index)of 0.92,indicating good discriminative ability,calibration,and clinical benefit value.Conclusion HR-MRI combined with nomogram model predicted that tumor located in the lower rectum,maximum diameter of tumor perpendicular to the intestinal tube ≥(18.86±5.32)mm,EMVI,and mesorectal lymph node metastasis are closely related to positive CRM in rectal cancer.
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Objective To evaluate the therapy effect of pneumatic lithotripsy treatment under ureteroscopic on urinary catheter encrustation(CE).Methods Eight patients with difficulty in pulling catheter tube crustcaused were enrolled as our subjects.They were performed pneumatic lithotripsy under ureteroscope operation.The information related to operation was recorded.Results Eight cases were successful in terms of crushing catheter encrustations,and the catheters were removed smoothly.Conclusion The therapy of pneumatic lithotripsy treatment under ureteroscopic is proved to be a minimally invasive treatment with small damage,and higher safety.
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Objective To evaluate the relationship between urodynamics and ultrastructure of bladder detrusor in patients with benign prostatic hyperplasia(BPH). Methods The ultrastructure of detrusor was studied by transmission electron microscopy in 43 cases of BPH(mean age 69.5±6.0 years)and 21 cases(mean age 65.4±7.2 years)of geriatric without bladder outlet obstruction(the controls).All the cases were performed urodynamic test. Results The IPSS(21.1±3.0 VS 7.6±1.4),maximum flow rate(7.7±1.3 ml/s VS 14.9±2.3 ml/s)and AG(44.8±9.9 VS 19.0±5.9)showed significant differences between the the BPH group and control group(P<0.01).Pdet-Qmax in the BPH group(60.1±11.0 cm H20)was higher than that in the control group(48.7±7.1 cm H2o) (P<0.05).The relative density of mitochondria in the BPH group(0.81±0.24)was lower than that in the control group(1.03±0.11)(P<0.05).The intercellular linkage in the BPH group(19.4±4.8 rim)was larger than the control group(14.1±2.0 nm)(P<0.05). Conclusions The swelling and reduction of the relative density of mitochondria could be seen in the bladder detrusor of BPH patients.The large intercellular linkage might be the reason of decrease the coordinate contractility of the blad-der detrusor.