[Coiling method combined with bloodletting from the corpus cavernosum for penile incarceration with a metal ring: A case report and literature review].

OBJECTIVE: To explore the treatment of penile incarceration with a metal ring. METHODS: Based on our experience in the successful management of a case of penile incarceration with a metal ring by coiling and bloodletting from the corpus cavernosum, we reviewed the relevant literature and analyzed the indications, advantages and disadvantages of different methods for the treatment of penile incarceration with a circular foreign body. RESULTS: The clamping and cutting methods were non-invasive, fast, effective, and with few complications, which could be applied to the treatment of penile strangulation at all levels. However, clamping was not desirable enough for a hard metal ring and the cutting method took a longer time and might increase the risk of unnecessary damage to the penile skin, urethra and cavernous body. Prepuce edema decompression and the thin tube-coiling method, with the advantages of minimal invasiveness, simple operation and no need of special tools, were suitable for penile strangulation injury under level 3, but might cause penile skin injury and potential postoperative erectile dysfunction. Surgical resection, as an invasive procedure, could be applied to severe penile strangulation at level 4 or 5. CONCLUSIONS: The principle for the treatment of penile incarceration with a circular foreign body is to remove the foreign object as soon as possible and not to add secondary damage.

[Transrectal ultrasound conductance-guided administration of traditional Chinese medicine for histological prostatitis in men with small-size BPH and LUTS after TURP].

OBJECTIVE: To investigate the effects of transrectal ultrasound conductance (TRUSC)-guided administration of traditional Chinese medicine on histological prostatitis in men with small-size BPH and low urinary tract symptoms (LUTS) after transurethral resection of the prostate (TURP). METHODS: This study included 167 BPH patients without surgical contraindications. We randomized the patients into an experimental group (n = 84) and a control group (n = 83), with no statistically significant differences between the two groups in age, prostate volume, International Prostate Symptom Score (IPSS), and quality of life (QoL) (P >0.05). The patients of the experimental group received TRUSC-guided administration of traditional Chinese medicine, qd, for 7 days before TURP, while those of the control group underwent TURP only. After treatment, we compared the results of postoperative pathological examination of the prostate tissue, the histological grade of inflammation, IPSS, and QoL scores between the two groups of patients. RESULTS: In the experimental group, there were 12 cases of non-inflammation (14.3%), 43 cases of mild inflammation (51.2%), 28 cases of moderate inflammation (33.3%), and 1 case of severe inflammation (1.2%), as compared with 8 cases of non-inflammation (9.6%), 28 cases of mild inflammation (33.7%), 45 cases of moderate inflammation (51.8%), and 2 cases of severe inflammation (2.4%) in the control group (P <0.05). Compared with the baseline, both the experimental and control groups showed significant improvement at 4 weeks after surgery in IPSS (22.20±4.14 vs 4.26±2.64 and 23.05±4.11 vs 7.02±4.15, P <0.05) and QoL scores (4.33±0.83 vs 1.25±1.64 and 4.25±0.91 vs 2.05±1.95, P <0.05). CONCLUSIONS: TRUSC-guided administration of traditional Chinese medicine can significantly alleviate histological inflammation and improve QoL in men with small-size BPH and LUTS after TURP.

[Distribution and Source Analysis of Nitrate in Surface Waters of China].

The nitrate pollution of surface water has attracted worldwide attention, and it is not optimistic in China. To identify the distribution, sources, and transformation mechanisms of nitrate in China's surface waters, the nitrate data of 71 major rivers from 7 regions were systematically collected. The spatial distribution of nitrate concentrations in surface water was analyzed, and the main nitrate pollution sources were revealed based on nitrogen and oxygen isotopes of nitrate. The results show that approximately 7.83% of rivers in China exceeded the Chinese drinking water standard for nitrate (45 mg·L-1). The concentrations of nitrate in Mudanjiang, Haihe River, and the estuary of Yangtze River was even more than 90 mg·L-1, which indicates a serious pollution phenomenon. The isotopic compositions of surface water in China ranged from -23.5‰ to 26.99‰ for δ15N-NO3 and from -12.7‰ to 83.5‰ for δ18O-NO3. The main sources of nitrate are domestic sewage in Northeast, Central, and East China, while those are inorganic fertilizers and domestic sewage in Southwest and South China. The nitrate sources of surface water in Northwest and North China are complex, mainly from domestic sewage, inorganic fertilizer, and nitration of soil organic matter. Through correlation analysis, it is found that the nitrate concentrations of surface water have a positive relationship with population, wastewater discharge, agricultural nitrogen fertilizer application, and GDP per capita in China. It is urgent to solve the problem of pollution and prevent the further pollution of China's surface waters. The new "10-Point Water Plan" issued by the Chinese government solved the previous problems, but it will take decades to control and repair the polluted surface waters. In Northwest, North China, Southwest, and South China, not only the scale of sewage treatment plants in cities and counties should be increased but also the use of agricultural fertilizers should be controlled and managed by the government. Northeast, Central, and East China need to further control point source pollution and reduce the discharge of industrial wastewater and domestic sewage into rivers.