经尿道等离子前列腺分叶剜除术的技术要点及并发症的预防（附光盘）

良性前列腺增生是老年男性的常见病之一,严重影响了老年男性的生活质量。经尿道前列腺电切术被认为是经尿道微创手术治疗良性前列腺增生的金标准。为了缩短青年医生的学习曲线,减少各种并发症的发生,本文详细阐述了最新的经尿道等离子前列腺分叶剜除术的精准手术步骤、技术要点及相关并发症预防。

驻某礁部队战士心理素质及影响因素分析

目的研究远海驻礁部队战士的心理素质状况及其影响因素,分析其心理素质、健康主观评价、社会支持三者之间的关系。方法使用军人心理素质量表、自测健康评定量表和领悟社会支持量表对驻某礁100名部队战士进行问卷调查。军人心理素质量表包括聪慧、忠诚、勇敢、自信和耐挫5个维度,自测健康评定量表包括生理健康、心理健康、社会健康3个维度,领悟社会支持量表包括家庭支持、朋友支持、其他支持3个维度。采用独立样本t检验对远海驻礁部队战士军人心理素质量表得分与总体军人心理素质常模进行比较,采用Pearson相关分析对3个量表中各维度得分及总分之间的相关性进行分析,采用多元线性回归分析探讨社会支持、健康主观评价和远海驻礁部队战士心理素质之间的相互影响。结果远海驻礁部队战士军人心理素质量表自信维度(沉着+独立+乐群)得分优于总体常模(P=0.030),其余4个维度得分与常模相比差异均无统计学意义(P均>0.05)。Pearson相关分析显示,除远海驻礁部队战士军人心理素质量表忠诚维度得分与自测健康评定量表社会健康维度得分无相关性(P=0.366)外,军人心理素质量表、自测健康评定量表和领悟社会支持量表3个量表之间其余各维度得分及总分均呈正相关(P均<0.01)。多元线性回归分析结果显示,心理健康是耐挫的影响因素(P=0.006),家庭支持和生理健康是心理健康的影响因素(P=0.022,P<0.001),家庭支持是生理健康的影响因素(P=0.025)。结论远海驻礁战士心理素质易受岛礁环境的影响,需要从加强社会支持、提高自身健康认识两方面入手改善远海驻礁战士的心理素质。

持续施用生石灰对早竹笋品质及竹材力学性质的影响

研究生石灰用量对早竹笋品质及竹材物理力学性质的影响,为早竹林土壤修复中石灰的合理施用提供科学依据。采用随机区组设计,在早竹林中建立10 m×10 m的小区12个,分别设置CK、SH1、SH2、SH3等4个处理,生石灰用量分别为0、1 500、4 500、7 500 kg·hm-2,重复3次。连续施用后3 a后,采集竹笋、竹秆样品,分析笋样中的营养元素和竹材样品的物理力学性质。结果表明,石灰施用后早竹笋中钙含量显著提高了32.46%~48.5%(P<0.05),竹笋铜、铅、镉含量显著下降了15.1%~20.8%,16.6%~19.5%,17.1%~21.0%(P<0.05);施用石灰显著降低了1 a生竹材径向、弦向干缩系数(P<0.05);竹材顺纹抗拉强度和顺纹抗弯强度则表现为SH3处理的1 a生竹材显著高于CK(P<0.05),而2 a的SH2、SH3显著高于CK(P<0.05)。早竹笋钙、镁营养元素含量与土壤交换性钙、镁含量之间具有显著(极显著)正相关,笋中铜、铅、镉含量与土壤有效态元素的相关性达极显著水平,竹材顺纹抗拉强度、顺纹抗弯强度与土壤交换性钙之间有显著性正相关。

Transurethral seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle stones

Background Seminal vesicle stones are one of the main causes of persistent hemospermia. Treatment requires removal of the stone, generally through open vesiculectomy. The purpose of this study was to apply a transurethral seminal vesiculoscopy for diagnosis and treatment of the seminal vesicle stones with an ureteroscope. We assessed whether this transurethral endoscopic technique is feasible and effective in the diagnosis and treatment of the seminal vesicle stones with intractable hemospermia. Methods Totally 12 patients with intractable hemospermia underwent transurethral seminal vesiculoscopy through the distal seminal tracts using a 7.3-French rigid ureteroscope. Age of patients ranged from 25 to 57 years （mean age （43.7±10.5） years）. The patients＇ symptoms ranged in duration from 4 to 180 months （mean duration （47.8±45.3） months）. All patients underwent transrectal ultrasonography, pelvic computed tomography or magnetic resonance imaging before the operation. Positive imaging findings were observed in patients with seminal vesicle stones and dilated seminal vesicle size. A 7.3-French rigid ureteroscope entered the lumen of the verumontanum, and then the seminal vesicle under direct vision. Seminal vesicle stones were found unilaterally in 11 cases and bilaterally in one case. Results All 12 patients successfully underwent transurethral seminal vesiculoscopy. The seminal vesicle interior with single or multiple yellowish stones ranging from 1 to 5 mm in diameter was clearly visible. All the stones were easily fragmented and endoscopically removed using a grasper. The operative time was 30 to 120 minutes （mean （49±22） minutes）. The mean follow-up period was （6.9±3.0） months （range 3-13 months）. Symptoms of hemospermia disappeared after one month in 10 patients and after three months in two patients. Three patients with painful ejaculation could completely be relieved postoperation. There was also improvement in one patient with erectile dysfunction. There were no postoperative complications. Conclusions Transurethral seminal vesiculoscopy is safe and effective in the diagnosis and treatment of seminal vesicle stones. This endoscopic technique can be performed with minimal complications.

Clinical effects of autologous stem cell transplantation as consolidation treatment in 70 multiple myeloma patients： a case-controlled study

Background Autologous stem cell transplantation （ASCT） is a part of the standard induction therapy of multiple myeloma （MM）. This case-controlled clinical trial aimed to further evaluate the therapeutic effects of ASCT as a consolidation therapy for MM and discuss factors influencing the prognosis.Methods Clinical data of 70 patients diagnosed as MM who received ASCT as a consolidation therapy in our hospital between October 1998 and August 2010 were analyzed retrospectively （ASCT group）. Other 70 MM patients receiving routine chemotherapy without ASCT （non-ASCT group） during the same period were used as controls. Differences in the degree and duration of remission, progression-free survival （PFS） and overall survival （OS） were compared to explore factors that may influence the prognosis.Results The median follow-up period was 38 months （range 1-128 months）. The complete response （CR） rate of ASCT group increased from 27.1% （19/70） before ASCT to 51.4% （36/70） after ASCT. The median PFS of ASCT group was significantly higher than non-ASCT group （45 months vs. 25 months, P 〈0.001）. The median OS of ASCT group was also significantly higher （55 months vs. 30 months, P=0.016）. Single-factor analysis showed that International Staging System （ISS） stage, very good partial response （VGPR） or better outcome were significantly correlated with PFS and OS （P 〈0.001）. Multi-factor analysis showed that whether or not VGPR or better outcome was achieved were independent factors influencing the disease prognosis.Conclusion Used as a consolidation therapy, ASCT can achieve better responses and higher OS and PFS of MM patients.

A surface-modified biodegradable urethral scaffold seeded with urethral epithelial cells

Background Efficient cell adhesion and proliferation is a central issue in cell-based tissue engineering, which offers great promise for repair of urethral defects or strictures. This study evaluated the adhesion and growth of rabbit uroepithelium on a surface-modified three-dimensional poly-L-lactic acid （PLLA） scaffold.Methods Urethral mucosa were harvested from male New Zealand rabbits and the urothelium were dissociated and then cultured. Immunocytochemistry on cultured uroepithelium for pancytokeratin and uroplakin Ⅱ and TE-7 confirmed pure populations. After in vitro proliferation, cells were seeded onto a surface-modified urethral scaffold with non-knitted filaments. The morphology and viability of the cells were examined by immunohistochemical and fluorescence staining.Inverted and scanning microscopes were used to document cell growth and adhesion.Results Three to five days after primary culture, the uroepithelial cells gradually became confluent, assuming a cobblestone pattern. The filaments of the urethral scaffold had excellent biocompatibility and allowed growth of the uroepithelium, without affecting viability. The uroepithelial cells adhered to and grew well on the scaffold. After 3-7 days,the cells grew vigorously and meshes of the scaffold were full of uroepitheliums.Conclusions The surface-modified urethral scaffold with non-knitted filaments allows the growth of uroepithelium and can serve as a carrier for the tissue engineering of urethra.

In vivo and in vitro anti-sepsis effects of physcion 8-O-β- glu- copyranoside extracted from Rumexjaponicus

The present study was designed to investigate the anti-sepsis effects of physcion 8-O-β-glucopyranoside (POG) isolated from Rumex japonicas and explore its possible pharmacological mechanisms. POG was extracted from R. japonicas by bioactivity-guided isolation with the anti-sepsis agents. Survival analysis in septic mouse induced by LPS and heat-killed Escherichia coli were used to evaluate the protective effect of POG(40 mg·kg^(-1), i.p.) on sepsis. Cytokines including TNF-α, IL-1β and IL-6 in RAW 264.7 cells induced by LPS(100 ng·mL^(-1)) were determined by ELISA. In addition, the proteins expressions of TLR2 and TLR4 were determined by Western blotting assay. Our results demonstrated that POG(40 mg·kg^(-1), i.p.) possessed significant protective activity on the endotoxemic mice. The POG treatment(20, 40, and 80 μg·mL^(-1)) significantly decreased the TNF-α, IL-1β and IL-6 induced by LPS(P < 0.01) in a concentration-dependent manner. Furthermore, the TLR4 and TLR2 proteins were also down-regulated by POG at 20(P < 0.01), 40(P < 0.01), and 80 μg·mL^(-1)(P < 0.01). The present study demonstrated that the POG extracted from R. japonicas possessed significant anti-sepsis effect on endotoxemic mice, and can be developed as a novel drug for treating sepsis in the future.

Modified one-cut circumcision technique by clamp： reports of 2000 cases

In the western countries, circumcision has been .performed for a long time. However, because of religious and cultural differences, circumcision was rare in China before the 20th century. As a result, penile cancer, accounting for 17% of all cancers, was more common.With the introduction of western medicine in the 1920s, especially after the establishment of urology as a separate department, gradually more circumcisions were carried out.