[Clinical observation of pre-suture ligation and suture knot positioning in single-operator circumcision with the stapler for children].

OBJECTIVE: To observe the clinical effects of pre-suture ligation and suture knot positioning in single-operator circumcision with the stapler. METHODS: Totally 120 six to fourteen years old children with phimosis or redundant prepuce were equally and randomly assigned to receive traditional single-operator circumcision with the stapler (group 1), single-operator circumcision with double suture knots for positioning the cutting plane with the stapler (group 2), or pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler (group 3). We recorded and comparatively analyzed the operation time, intraoperative blood loss and hematoma, the number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon. RESULTS: Statistically significant differences were observed among the three groups in the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon (P < 0.05). Compared with group 1, group 3 showed obviously less operation time and intraoperative blood loss and lower incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeons, and higher rates of patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics. The intraoperative blood loss, incidence of intraoperative hematoma, and the rates of severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon were lower in group 3 than in group 2. CONCLUSION: Pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler helps reduce the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeon, and increase the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics.

[Single- versus double-suture knot for positioning the cutting plane in circumcision with a stapler].

OBJECTIVE: To observe the clinical effect of single-suture versus that of double-suture knot in positioning the cutting plane in circumcision with a stapler. METHODS: We randomly assigned 120 patients with redundant prepuce or phimosis into three groups of an equal number to receive traditional circumcision without suture knot (group 1), circumcision with single-suture knot (group 2), and circumcision with double-suture knot (group 3) for positioning of the cutting plane. We recorded and compared the operation time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, postoperative ecchymosis, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance among the three groups. RESULTS: There were statistically significant differences among the three groups in the surgery time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance, (P < 0.05), but not in postoperative ecchymosis (P = 0.849). The rate of satisfaction with the retained dorsal prepuce was remarkably higher in group 3 than in group 2 (P = 0.003), and the intraoperative anxiety rate of the doctors was lower in the former than in the latter group (P = 0.003). CONCLUSIONS: Both single- and double-suture knots for positioning the cutting plane in circumcision with a stapler can help reduce the operation time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance, and double-suture knot positioning has an even higher application value in decreasing the intraoperative anxiety of the doctors and increasing the satisfaction with the retained dorsal prepuce.

[Modified urethral reconstruction with lingual mucosa for complicated anterior urethral stricture].

OBJECTIVE: To investigate the efficiency and complications of modified urethral reconstruction with lingual mucosa in the treatment of complicated anterior urethral stricture (CAUS). METHODS: We retrospectively studied the clinical data on 10 cases of CAUS treated by modified urethral reconstruction with lingual mucosa from December 2017 to June 2019 concerning the age of the patients and the causes, location and length of urethral stricture. We statistically analyzed the pre- and post-operative maximum urine flow rate (Qmax), scores on Mental Status Scale in Non-psychiatric Settings (MSSNS) and quality of life (QOL) scores and observed post-operative complications such as abnormal taste, tongue numbness, urinary tract infection, urethral diverticulum, and urethral stricture. RESULTS: Compared with the baseline, Qmax was significantly improved and the MSSNS and QOL scores dramatically decreased at 3, 6 and 12 months after surgery (P < 0.01). Paraurethral infection developed in 1 case postoperatively, which was cured after dressing change, external urethral orifice stenosis occurred in another, which was improved after regular urethral orifice expansion, and mild tongue numbness was found in 2 cases at 1 month but gradually restored to abnormal. Urethrography showed no urethral diverticulum before catheter removal. CONCLUSIONS: Lingual mucosa is an ideal alternative material for urethral reconstruction in the treatment of CAUS, and lateral lingual mucosa can be easily obtained. Modified urethral reconstruction by embedding lingual mucosa in the dorsal base of the urethra, with the advantages of definite effectiveness and few postoperative complications, is worthy of clinical application.

[Prostatic artery embolization for high-risk patients with benign prostatic hyperplasia: A clinical effect observation].

OBJECTIVE: To observe the clinical effect of prostatic artery embolization (PAE) in the treatment of high-risk patients with BPH. METHODS: Nine high-risk patients with BPH underwent PAE in the Third Affiliated Hospital of Anhui Medical University from January 2016 to June 2018. We followed up the patients and obtained their IPSS, quality of life score (QOL), postvoid residual urine volume (PVR), maximum urinary flow rate (Qmax), prostate volume (PV), hours of undisturbed sleep (HUS), Self-Rating Anxiety Scale score (SAS) and incidence of postoperative complications before and at 6, 12 and 24 months or longer after surgery, followed by comparative analysis of the parameters. RESULTS: Compared with baseline, IPSS, QOL, PVR, Qmax, PV, HUS and SAS were all significantly improved in the patients at 6, 12 and ≥24 months after PAE (P < 0.05). Only 1 case complained of mild numbness in the buttocks, which was gradually relieved after acupuncture therapy. CONCLUSIONS: Prostatic artery embolization is definitely effective for the treatment of high-risk patients with BPH with the bladder volume ≥200 ml, with few postoperative complications, and can be used as an effective therapeutic supplementary for improving the urination symptoms of the patients.

[Correlation between the phenotypic domains of the UPOINT system and sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome].

OBJECTIVE: To investigate the correlation of the six phenotypic domains of the UPOINT (urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness) system with premature ejaculation (PE) and ED in male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We collected the clinical data on 453 cases of CP/CPPS from December 2016 to December 2017, including the general information, CP symptoms, sexual life history, intravaginal ejaculatory latency time (IELT), NIH-CPSI, and IIEF-5 scores. We classified the patients according to the UPOINT system. RESULTS: The CP/CPPS patients were aged 32.75 ± 6.85 years, of whom 45.03% (204/453) were diagnosed with ED and 43.27% (196/453) with PE. The positive rates of the six phenotypic domains of the UPOINT system were 68.78% (U), 60.21% (P), 77.45% (O), 20.34% (I), 46.83% (N), and 65.12% (T), respectively. Multivariate logistic regression analysis showed psychosocial (P) abnormality to be an independent risk factor for PE (OR = 4.55, 95% CI: 2.75－8.06, P < 0.05) and ED (OR = 3.35, 95% CI: 2.02－6.25, P < 0.05). CONCLUSIONS: The psychosocial (P) factor in the UPOINT system plays an important role in the pathogenesis of PE and ED in patients with CP/CPPS.

A simple replacement of tungsten filament hot cathodes by DC heated LaB6 rod and its noise characteristics with laser-induced fluorescence.

Hot cathode discharges are common plasma sources for fundamental plasma physics studies and other applications due to their quiescent and relatively simple properties, and tungsten filaments are commonly used for the ease of heating them. Recently, tungsten filaments are increasingly being replaced by less luminous alternatives, such as barium oxide or lanthanum hexaboride. These materials can emit electrons at temperatures close to 1000 K lower than tungsten, greatly reducing their blackbody radiations. This results in significant improvement in signal recovery for active spectral diagnostic, such as laser-induced fluorescence. However, these less luminous cathodes often come in vastly more complicated designs than those of tungsten hot cathodes and are much more expensive to procure and difficult to operate. In this paper, we present a simple, low cost direct current heated design of a LaB6 cathode that is manufactured at suitable dimensions and make a comparison of the laser-induced fluorescence (LIF) signal-to-noise ratio of this LaB6 hot cathode discharge with that of a typical tungsten filament discharge, revealing that LaB6 has, indeed, an improved LIF signal-to-noise ratio compared with the tungsten filament.

Plant uptake and enhanced dissipation of di(2-ethylhexyl) phthalate (DEHP) in spiked soils by different plant species.

This study was conducted to investigate the uptake, accumulation and the enhanced dissipation of di(2-ethylhexyl) phthalate (DEHP) spiked in soil (with a concentration of 117.4 +/- 5.2 mg kg(-1)) by eleven plants including eight maize (Zea mays) cultivars and three forage species (alfalfa, ryegrass and teosinte). The results showed that, after 40 days of treatment, the removal rates of DEHP ranged from 66.8% (for the control) to 87.5% (for the maize cultivar of Huanong-1). Higher removal rate was observed during the first 10 days than the following days. Plants enhanced significantly the dissipation of DEHP in soil. Enhanced dissipation amount in planted soil was 13.3-122 mg pot(-1) for DEHP, and a net removal of 2.2%-20.7% of the initial DEHP was obtained compared with non-plant soil. The contribution of plant uptake to the total enhanced dissipation was < 0.3%, and the enhanced dissipation of soil DEHP might be derived from plant-promoted biodegradation and sorption stronger to the soil. Nevertheless, the capability in accumulation and enhanced dissipation of DEHP from spiked soils varied within different species and cultivars.