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【Objective】 To compare the efficacy and safety of thulium laser enucleation of the prostate (ThULEP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were searched in PubMed, Embase, Cochrane Library, CNKI and Wanfang Database from Jan.1,2010 to May 30,2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. All divergences were resolved by a third researcher. RevMan 5.4 software was used for Meta analysis. 【Results】 A total of 7 studies were included, involving 1 726 patients, 750 in the ThULEP group and 976 in the HoLEP group. Meta analysis showed that, compared with HoLEP group, the ThULEP group had shorter catheter indwelling time [MD=-0.10, 95%CI (-0.17--0.03), P=0.004] , shorter hospital stay [MD=-0.43, 95%CI (-0.60--0.25), P<0.000 01] , lower IPSS score 12 months after surgery [MD=-1.13, 95%CI (-1.95- -0.30), P=0.007] , lower QoL score 12 months after surgery [MD=-1.00, 95%CI (-1.19- -0.81), P<0.001] ,lower transfusion rate [OR=0.11, 95%CI (0.03-0.36), P=0.000 3] and lower incidence of urinary incontinence [OR=0.24, 95%CI (0.09-0.66), P=0.006] . 【Conclusion】 ThULEP may have similar efficacy and safety as HoLEP in the treatment of BPH, and has more advantages in some aspects.
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Objective To investigate the effects of different doses of dexmedetomidine (Dex) combined with ropivacaine continuous transverse abdominal plane (TAP) block on analgesia and immune function in patients with laparoscopic colon cancer surgery. Methods Fifty colon cancer patients who had underwent laparoscopic radical resection from January 2017 to May 2018 in Wenzhou People′s Hospital were selected. The patients were divided into group A and group B according to random digits table method with 25 cases each. Group A was treated with 0.75 μg/kg Dex before operation; group B was treated with 1.00 μg/kg Dex before operation, then 2.00 μg/kg Dex continuous analgesia 48 h after operation. Both groups were given 0.375% ropivacaine 40 ml before operation for TAP block, and 0.2% ropivacaine 5 ml/h continuous analgesia 48 h after operation. The visual analogue score (VAS), interferon γ (IFN-γ), interleukin 10 (IL-10), T lymphocyte subsets (CD4+and CD8+) 12, 24 and 48 h after operation and adverse reactions were observed. Results The VAS 12, 24 and 48 h after operation in group B was significantly lower than that in group A: (2.2 ± 0.6) scores vs. (3.1 ± 0.9) scores, (1.6 ± 0.4) scores vs. (2.3 ± 0.8) scores and (1.1 ± 0.3) scores vs. (1.9 ± 0.6) scores, and there was statistical difference (P＜0.05). The IFN-γ and CD4+12, 24 and 48 h after operation in group B were significantly higher than those in group A, IFN-γ: (281.6 ± 42.1) ng/L vs. (213.5 ± 37.4) ng/L, (335.7 ± 42.5) ng/L vs. (244.2 ± 36.3) ng/L and (362.4 ± 42.8) ng/L vs. (258.6 ± 36.8) ng/L; CD4 +: 0.186 ± 0.047 vs. 0.163 ± 0.045, 0.265 ± 0.058 vs. 0.215 ± 0.052 and 0.314 ± 0.062 vs. 0.226 ± 0.053. The IL-10 and CD8+were significantly lower than those in group A, IL-10: (263.5 ± 28.7) ng/L vs. (314.2 ± 35.6) ng/L, (225.4 ± 26.9) ng/L vs. (279.5 ± 29.8) ng/L and (206.3 ± 26.1) ng/L vs. (272.1 ± 29.2) ng/L; CD8 +:0.268 ± 0.062 vs. 0.295 ± 0.064, 0.217 ± 0.048 vs. 0.266 ± 0.061 and 0.164 ± 0.036 vs. 0.243 ± 0.055. There were statistical differences (P＜0.05). There was no statistical difference in the incidence of adverse reactions between 2 groups (P＞0.05). Conclusions Different doses of Dex combined with ropivacaine continuous TAP block has good analgesic effect on colon cancer patients who had underwent laparoscopic radical resection. However, high first dose load and continuous combination is better and has less effect on immune function.
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Objective To investigate the change of serum CD62p of coronary heart disease (CHD) patients after different doses of clopidogrel administration.Methods One hundred and ninety-one patients with CHD were selected as our subjects.Of which,95 cases were with SAP and 66 cases were with non ST segment elevation acute coronary syndrome (NST-ACS).SAP patients were randomly given clopidogrel at dose of 75 mg/d or 150 mg/d and served as A and B groups.NST-ACS patients were randomly given 300 mg clopidogrel,then randomly divided into C and D groups with sequentially taking clopidogrel at dose of 75 mg/d or 150 mg/d respectively.Thirty healthy peoples were served as E group without drug intervention.Concentrations of serum CD62p were detected by Elisa before taking clopidogrel,24 h and the fifty day of after taking clopidogrel.Results (1) Before taking clopidogrel,the serum concentrations of CD62p in CHD patients were higher (A group:(7.62 ± 2.99) ng/L,B group:(8.48 ± 3.13) ng/L,C group:(9.50 ± 3.32) ng/L,D group:(10.22 ± 5.14) ng/L than that of healthy control group ((5.49 ± 1.99) ng/L,P ＜ 0.05).The Serum CD62p levels in SAP patients were lower than that of NST-ACS patients (P ＜ 0.05).(2)The serum concentrations of CD62p in A and B groups at before taking clopidogrel were (7.62 ±2.99) ng/L and (8.48 ±3.13) ng/L respectively,higher than that four days after taking clopidogrel ((6.79 ± 2.51) ng/L,(6.37 ± 1.80) ng/L;t =2.390,4.520;P ＜0.05 or P ＜0.01).There was no statistical significant difference between A and B groups(P ＞0.05).(3) In C and D groups,the serum CD62p at before taking clopidogrel were (9.50 ±3.32) ng/L and (10.22 ±5.14) ng/L,higher than that after taking clopidogrel for four days ((8.21 ± 2.62) ng/L,(8.17 ± 2.37) ng/L; t =2.084,2.157 ; P ＜ 0.05).No significant difference was seen between C and D groups (P ＞ 0.05).Conclusion The serum CD62p in patients with CHD was higher than that in the healthy control.Clopidogrel administration can decrease serum CD62p in CHD patients.
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Objective This retrospective study is designed to analyze the cardiovascular events of CTO to provide new information on secondary prevention of CHD in patients after hospital discharge. Methods 272 patients with definite diagnosis of CTO were enrolled in this study. Patients were divided into two groups according to whether suffering from cardiovascular events, with 167 patients in group A who had not suffered from the cardiovascular events and 105 patients in group B who had suffered from the cardiovascular events. We com-pared the clinical data, severity of coronary artery lesion, treatment in two groups. Results Between two groups, there was statistic signifi-cance in LDL -C, EF, Gensini scots, the number of coronary artery lesion, the number of chronic total coronary occlusion and PCI success. Logistic regression analysis revealed that Gensini scots was the independent factors for prognosis of CTO. Conclusion Gensini scors was the independent factor for prognosis of CTO.
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OBJECTIVE: To introduce advances of cerebrovascular stent at home and abroad, analyze causes for complications following stenting and explore the biocompatibility of cerebrovascular stent and host.METHODS: A computer-based online search of Medline database (1989/2009) and CNKI (1989/2009) was performed to select related articles. According to inclusion and exclusion criteria, the collected articles were selected and evaluated. The treatment advances, complications, and stent biocompatibility were described and summarized to explore the current status, complication and biocompatibility of various cerebrovascular stents.RESULTS: The content of articles was summarized. Intracranial stent is commonly used in clinic. The diameter of vessels confines diameter of stent, so different diseases have different requirements for diameter of stents. The complications following stenting include retroperitoneal hematoma, carotid sinus, hypertransfusion syndrome, cerebral angio spasm and thrombosis. In various stents, polymer, eluting and drug stents have better biocompatibility compared with metal stent, and can effectively prevent restenosis.CONCLUSION: Cerebrovascutar stenting is one of the treatments for cerebrovascular diseases. During the treatment, sufficient operative preparation, appropriate stent and indication are important to avoid complications. Of various stents, polymer and drug stents have good biocompatibility, and the biocompatibility of other stents requires improvement.