Exploring the Risk Factors for Deep Vein Thrombosis after Percutaneous Nephrolithotomy.

BACKGROUND: Deep vein thrombosis (DVT), a frequent complication following percutaneous nephrolithotomy (PCNL), may lead to severe conditions like pulmonary embolism. Current knowledge on postoperative DVT risk factors is, however, limited. The aim of our study was to investigate the risk of DVT after PCNL. METHODS: A retrospective study was conducted on patients who underwent PCNL from March 2020 to March 2023 at our institution. Patient demographics and clinical data, including, DVT-specific information, preoperative labs, and surgical details, was evaluated. RESULTS: One hundred patients were included. Thirty-two (20 males, 12 females, mean age 52.5 ± 7.4 years) developed lower limb DVT post-surgery, while the remaining 68 (48 males, 20 females, mean age 51.1 ± 5.5 years) had no DVT symptoms. Analysis revealed significant correlations between hyperlipidemia, operating time, postoperative bed rest duration, D-dimer level on the first day after surgery, Caprini risk assessment model (RAM) score, and DVT risk. D-dimer on the first day after percutaneous nephrolithotomy, postoperative bed rest time and Caprini RAM scores were independent risk factors for DVT after PCNL. Sex, age, hypertension status, diabetes status and smoking and drinking habits were not significantly associated with DVT risk. CONCLUSIONS: D-dimer on the first day after PCNL, postoperative bed rest time and Caprini RAM scores were independent risk factors for DVT after PCNL.

Therapeutic effects of finasteride: inhibition of disease progression and serum prostate-specific antigen reduction in patients with prostatic intraepithelial neoplasia.

The objective of this study was to evaluate the impact of finasteride on the progression of prostate intraepithelial neoplasia and levels of prostate-specific antigen (PSA) in patients. A total of 120 patients with high-grade prostatic intraepithelial neoplasia were included in this study from January 2013 to January 2018. All patients underwent prostate biopsies. Among them, 60 patients were assigned to the observation group and received a daily dosage of 5 mg finasteride for 60 months, while the remaining 60 patients were assigned to the control group and did not receive finasteride. PSA levels were measured every six months, and imaging scans were conducted throughout the five-year study period. Additional biopsies were performed if PSA levels exceeded 10 ng/mL or imaging suggested the presence of prostate cancer. Statistical analysis was applied to the collected data. In total, 25 cases of prostate cancer were identified in this study. Of these cases, 7 patients belonged to the observation group, whereas the remaining 18 patients were from the control group. The observation group exhibited significantly lower levels of total serum PSA (p < 0.001) and Gleason scores (p < 0.001) compared to the control group. Our study, which involved 120 participants, demonstrated that finasteride effectively reduces serum PSA levels and mitigates the severity of prostate cancer. These findings suggest that finasteride holds potential as a treatment option for patients with -high-grade prostatic intraepithelial neoplasia.

Gender and Age Differences in Performance of Over 70,000 Chinese Finishers in the Half- and Full-Marathon Events.

(1) Background: The aim of the present study was to examine the characteristics of over 70,000 long-distance finishers over the last four years in Chinese half- and full-marathon events; (2) Methods: The available data of all finishers (n = 73,485; women, n = 17,134; men, n = 56,351) who performed half- and full-marathon events in Hangzhou from 2016 to 2019 were further analyzed for the characteristics of gender, age and average running speed; (3) Results: The total men-to-women ratio was the lowest in the half-marathon event (1.86) and the highest in the full-marathon event (17.42). Faster running performance in males than in females and faster average running speed in short-distance runners were shown. Gender and race distance were observed to have the most significant effects on average running speed (p < 0.01). For both male and female finishers, the slowest running speed was shown in older age groups (p < 0.01) during the full marathon. Our results indicated that the gender difference in performance was attenuated in the longer race distances and older age groups; (4) Conclusions: Understanding the participation and performances across different running distances would provide insights into physiological and biomechanical characteristics for training protocols and sports gear development in different groups.

Comparison between toric and spherical phakic intraocular lenses combined with astigmatic keratotomy for high myopic astigmatism.

BACKGROUND: To compare the outcomes of a toric phakic intraocular lens (PIOL) and a spherical PIOL combined with astigmatic keratotomy (AK) for the correction of high myopic astigmatism. METHODS: This study enrolled patients with high myopic astigmatism, including 30 eyes (22 patients) that received a toric PIOL implantation (TICL group), and 32 eyes (24 patients) that received combined AK and a spherical PIOL implantation (AK+ ICL group). The outcomes were compared between the two groups before surgery, and at the following time points after surgery: 1 week, 1, 3, 6 months, and 1, 2 years. RESULTS: Preoperatively, the mean manifest spherical equivalent (SE) was -14.14 ± 2.12 D in the TICL group and -14.83 ± 2.79 D in the AK + ICL group (P = 0.28), and the mean manifest refractive cylinder, -2.87 ± 1.09 D and -2.58 ± 0.85 D, respectively (P = 0.28). Two years postoperatively, the mean safety index was 1.53 ± 0.55 in the TICL group and 1.60 ± 0.70 in the AK + ICL group (P = 1.00), and the mean efficacy index, 1.18 ± 0.45 and 1.38 ± 0.52, respectively (P = 0.86). The mean manifest refractive cylinder correction was 1.94 ± 1.07 D in the TICL group and 1.39 ± 0.71 D in the AK + ICL group (P = 0.02). The mean changes in SE and refractive cylinder from 1 week to 2 years were less than 0.50 D in both groups. CONCLUSIONS: Both TICL implantation and AK + ICL implantation are a good alternative for correction of astigmatism in addition to high myopia. TICL implantation has better predictability in correction of high myopic astigmatism. TRIAL REGISTRATION: NCT03202485.

Preliminary clinical investigation of cataract surgery with a noncontact femtosecond laser system.

BACKGROUND AND OBJECTIVE: Femtosecond laser-assisted cataract surgery (FLACS) is rapidly gaining popularity due to the improved consistency and predictability for capsulorhexis. This study aimed to investigate the preliminary clinical outcomes of FLACS with a noncontact femtosecond laser system. PATIENTS AND METHODS: This prospective study enrolled 25 eyes in the trial group underwent FLACS (LLS-fs 3D, LENSAR, USA), and 29 eyes in the control group underwent conventional cataract surgery (Stellaris, Bausch & Lomb, USA). The phacoemulsification time, energy, and complications during operation were recorded. Postoperative refraction at 1 day, 1 week, 1 and 3 months, the capsulorhexis size and corneal endothelial density at 1 and 3 months were also measured. RESULTS: Compared to the control group, reduction in phacoemulsification time was 51.5% (P = 0.02), and in overall energy, 65.1% (P = 0.02) in the trial group. In the trial group and the control group, total time of cataract procedure was 10.04 ± 1.37 minutes, 10.52 ± 1.92 minutes, respectively (P = 0.31); the absolute difference between attempted and achieved capsulorhexis diameter at 1 month was 192.9 ± 212.0 µm, 626.9 ± 656.6 µm, respectively (P = 0.04), and at 3 months, 256.6 ± 181.9 µm, 572.1 ± 337.0 µm, respectively (P= 0.03); the absolute difference between attempted and achieved spherical equivalent at 3 months was 0.16 ± 0.16 D, 0.74 ± 0.65 D, respectively (P < 0.01); mean corneal endothelial cell loss at 1 month was 15.6% and 14.2%, respectively (P = 0.77), and at 3 months, 2.9%, 4.2%, respectively (P = 0.50). CONCLUSIONS: With the noncontact femtosecond laser system, FLACS can significantly improve the accuracy and repeatability of capsulorhexis, reduce the phacoemulsification time and overall energy, and enhance the predictability and stability of postoperative refraction.

[Three-year follow-up of iris-claw phakic intraocular lens implantation for high myopia].

OBJECTIVE: To investigate long-term efficacy and safety of an iris-claw phakic intraocular lens (ICPIOL) implantation for high myopia. METHODS: A consecutive group of 86 eyes in 49 patients with -15.33±3.81 diopters (D) of myopia was implanted with the Artisan ICPIOL (Ophtec), and was evaluated preoperatively and 1, 2, 3 years postoperatively. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, intraocular pressure, and complications were evaluated. RESULTS: The implantation was successful in all of 86 eyes. Compared with preoperative data, UCVA, BCVA, and spherical equivalent (SE) were improved significantly (F=513.68, 20.88, 827.65; P<0.01). At 3-year postoperatively, UCVA in 85% eyes was 0.5 or better, in 35% was 0.8 or better; No loss of BCVA was found, 17% gained 1 line, and 59% gained 2 lines or more; SE in 81%, 54% eyes was within ±1.00 D, ±0.50 D of attempted, respectively. At 1-, 2-, 3-year follow-up, the corneal endothelial loss was 3.60%, 5.78%, 7.74%, respectively. There were 2 macular haemorrhages resulted from CNV, and 1 ICPIOL repositioning due to inappropriate iris capture. No other severe complications occurred. CONCLUSION: At 3-year follow-up, the implantation of the ICPIOL proved to be safe and effective for the correction of myopia in phakic eyes.