Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition).

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline "2018 Standard Edition". However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons' surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy; the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons' skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.

The association between rs16917496 T/C polymorphism of SET8 gene and cancer risk in Asian populations: a meta-analysis.

Epidemiological studies have demonstrated close associations between SET8 rs16917496 T/C polymorphism and cancer risk, but the results of published studies were not consistent. We therefore performed this meta-analysis to explore the associations between rs16917496 T/C polymorphism and cancer risk. Five online databases were searched. Odds ratios (ORs) with a 95% confidence interval (CI) were calculated to assess the association between rs16917496 T/C polymorphism and cancer risk. In addition, heterogeneity, accumulative, sensitivity analysis, and publication bias were conducted to check the statistical power. Overall, 13 publications involving 5878 subjects were identified according to included criteria. No significant cancer risk was observed in genetic model of SET8 rs16917496 T/C polymorphism in Asian populations (C vs. T: OR = 1.04, 95%CI = 0.88-1.23, P = 0.63%; TC vs. TT: OR = 1.17, 95%CI = 0.96-1.24, P = 0.11%; CC vs. TT: OR = 0.90, 95%CI = 0.60-1.37, P = 0.63; TC+CC vs. TT: OR = 1.11, 95%CI = 0.90-1.38, P = 0.33; CC vs. TT+TC: OR = 0.92, 95%CI = 0.65-1.30, P = 0.63). Furthermore, similar associations were found in the subgroup analysis of race diversity, control design, genotyping methods, and different cancer types. In summary, our meta-analysis indicated that the SET8 rs16917496 T/C polymorphism may not play a critical role in cancer development in Asian populations.

[Evaluation of diagnosis and prediction of degree of coronary stenosis by CAVI].

OBJECTIVE: To investigate the relationship between CAVI (Cardio-Ankle vascular Index) and the degree of coronary artery stenosis in elderly patients with type 2 diabetes, the predictive value of CAVI were evaluated using the degree of coronary artery stenosis. METHODS: Relevant clinical data including CAMI, BMI, blood pressure, smoking, age, Sbp, Dbp, history and blood biochemistry test were collected in 60 years or older patients with coronary artery stenosis diagnosed by coronary angiography, and the 298 cases were divided into two groups, A group (CAVI > or = 9), B group (CAVI < 9), to investigate the correlativity among the level of CAVI and cardiovascular risk factors; at the same time all cases were assigned to group C (diabetes group) and group D (non-diabetic group), to analyse the change of CAVI in coronary artery stenosis patients complicated with diabetes mellitus. RESULTS: A total of 298 eligible patients with coronary artery stenosis were enrolled, including 163 non diabetics and 135 type 2 diabetics. The analysis result shows that there was a positive correlation among CAVI, old age, BMI, LDL-C, multi-vessel lesion, diabetes. CONCLUSION: The increase of CAVI was most highly related to the coronary artery stenosis. The level of CAVI might be a helpful predictive indexes to the severity of coronary atherosclerosis.