The effect of transurethral plasma enucleation of prostate with bladder neck and prostatic apex urethral mucosa preservation on the ejaculation function in the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To investigate the effect of transurethral plasma enucleation of prostate with bladder neck and prostatic apex urethral mucosa preservation on the incidence of retrograde ejaculation after surgery.Methods:The clinical data of 77 patients with benign prostatic hyperplasia (BPH) admitted to Jinhua people's Hospital from January 2018 to June 2020 were retrospectively analyzed. The ages of the two groups [(62.06±2.01)years old and (62.36 ± 2.12)years old] were comparable. There were no significant differences between the groups( P>0.05) in term of the prostate volume (72.91±17.57) ml vs. (68.07±17.28)ml, Q max [(7.33±2.02)ml/s vs. (7.79±2.09)ml/s)], and IPSS (25.51±5.66) vs.(25.17±4.90). The conventional operation group was treated with " trefoil" enucleation of prostate. The modified operation group underwent the following three improved techniques. Firstly, the anterior mucosa of the verumontanum was cut 1.5 cm away from the medial surface of the verumontanum to prevent the external sphincter injury. Secondly, part of the prostate tissue was retained by exceeding the verumontanum when cutting off the bilateral lobes. Thirdly, the middle lobe of the prostate was bluntly stripped to the bladder neck with the sheath of the electroscope in order to protect the transverse muscle fibers as well as the integrity of the bladder neck. The outcome and the ejaculation function of the two groups were analyzed. Results:There was no significant difference in operation time [(66.74±9.29)min vs. (71.29±15.32) min], catheter indwelling duration [(5.31±0.76)d vs.(5.00±1.06)d], and hospital stay [(7.57±0.88) d vs. (7.17±1.45)d] between the two groups ( P>0.05) after more than 6 months of follow-up. According to IIEF score, mild erectile dysfunction occurred in both groups, with the incidence rate of 20.7%(6/29) and 13.5%(5/37) respectively, and there was no significant difference between the two groups ( P>0.05). The postoperative maximum urinary flow rate (Q max) [(23.51±4.25) ml/s vs.(24.05±3.81)ml/s] and IPSS score (6.46±2.72 vs. 6.55±2.99) was significantly different from that before the operation ( P<0.05). However, there was no significant difference between the two groups ( P>0.05). The incidence of retrograde ejaculation in conventional operation group and modified operation group was 23/35(65.7%) and 13/42(31.0%), and the difference was statistically significant ( P<0.05). Immediate urinary continence were 24/35(68.6%) and 36/42(85.7%) in the conventional operation group and the modified operation group respectively, and there was no significant difference between the two groups( P>0.05). After 6 months of follow-up, urinary continence in both groups was 100.0%. Conclusions:Transurethral plasmakinetic enucleation of the prostate with the preservation of bladder neck and urethral mucosa of prostate apex is the same effective as conventional operation in the treatment of benign prostatic hyperplasia, but the incidence of retrograde ejaculation after operation is significantly reduced, which is suitable for those patients who desire to retain their ejaculation function.

Clinical practice of transperineal minimally invasive abdominoperineal excision / 中华消化外科杂志

The abdominoperineal excision (APE) is still one of the standard operations for low rectal cancer. The exralevator APE can reduce the positive rate of circumferential margin and perforation rate of rectal cancer, but the incidence of postoperative complications is relatively high. With the continuous development of minimally invasive surgery, the transperineal minimally invasive Abdominoperineal excision (Tpm-APE) is proposed. Compared with traditional APE, the Tpm-APE has potential technical advantages, but there is a lack of large sample and multicenter clinical research evidence. The authors share the design and results of an international multicenter clinical study to investigate the clinical practice of Tpm-APE in the treatment of low rectal cancer.

Study on Quality Standard for Kazakhstan Medicine Peganum harmala / 中国药房

OBJECTIVE： To establish the quality standard for Kazakhstan medicine Peganum harmala. METHODS： Ten batches of P. harmala collected in Xinjiang Kazakh region were selected as research objects to investigate their characteristics. Qualitative identification of harmaline and harmine was conducted by TLC. The contents of water， total ash， acid-insoluble ash and ethanol extract were tested according to Chinese Pharmacopoeia（2015 edition）. The contents of harmaline and harmine were determined by HPLC. The determination was performed on X-bridge C18 column（250 mm×4.6 mm，5 μm） with mobile phase consisted of acetonitrile-ammonium acetate buffer （adjusted to 6 with glacial acetic acid， gradient elution） at the flow rate of 1 mL/min. The detection wavelength was set at 267 nm， and column temperature was 25 ℃. The sample size was 5 μL. RESULTS： TLC identification results showed that 10 batches of medicinal material showed clear spots at the same position as harmaline and harmine reference substances. Water， total ash， acid-insoluble ash should not be more than 12％，22％，2％， respectively； ethanol extract must not be less than 16％. HPLC results showed that the linear ranges of harmaline and harmine were 15.22-301.40，15.09-301.80 μg/mL； RSDs of precision， reproducibility and stability tests were all lower than 4％； average recoveries were 100.22％ and 100.94％（all RSD＜2％）. The determination results showed that the content of total alkaloids （harmaline and harmine） should not be less than 6.5 mg/g. CONCLUSIONS： Based on the original standard， test items are added in this study. TLC method is established to identify harmaline and harmine. HPLC method is established to determine their contents. Established quality standard can be used for comprehensive quality control of P. harmala from Xinjiang Kazakh region.

The clinical significance of detecting renal urinary proteins through nephrostomy tube in children with extremely severe hydronephrosis / 中华泌尿外科杂志

Objective To explore the change of urine proteins from nephrostomy tube and renal function in patients with very severe hydronephrosis after nephrostomy in order to determine the treatment strategy of either renal preservation or resection.Methods Retrospective analysis of clinical data from March 2015 to March 2017 of 28 cases with congenital unilateral severe hydronephrosis in children's hospital affiliated to Zhejiang University,including 19 boys and 9 girls,with 20 cases on the left and 8 on the right,an average age of 26.6 (0.3 to 122.0) months at the first consultation and 2 cases of urinary biochemical abnormalities.Front to rear diameter for puncture were between 5.7 and 7.6 cm,with an average of 6.7 cm,and the differential renal function (DRF) for the affected kidneys were 6.98 ％-9.89 ％ (average 8.65 ％) before puncture.The children underwent percutaneous renal perforation fistula.According to the recovery of renal function after perforation fistula,those who underwent nephrectomy were recruited as a nephrectomy group and the children whose kidney were preserved as kidney preservation group.Comparison 24 hours before and 3 months after puncture was made beteween groups regarding the proportion of urine,pH of the renal pelvis urine,oαl microglobulin (α1-MG),albumin (Alb),β2 microglobulin (β2-MG),immunoglobulin G (IgG),transferrin (TRF),and the recovery of the damaged renal function (direnal function DRF).Results Twenty-eight cases of percutaneous nephrolithotomy were successful without puncture complications,with 10 cases in the nephrectomy group and 18 cases in the renal preservation group.The difference of renal pelvis urine from the affected kidney of the nephrectomy group showed no statistical significance 24 hours before and 3 months after the procedure when comparing the following parameters,including urinary specific gravity (1.006 ± 0.007 vs.1.009 ± 0.005),pH value (7.74 ± 0.41 vs.7.70 ± 0.32),urine creatinine value [(462.20 ± 158.01) μmol/L and (449.20 ± 143.41) μmol/L],αl microglobulin [(14.03 ± 4.360) mg/L vs.(13.84 ± 2.55) mg/L],β2 microglobulin [(0.76 ± 0.28) mg/L vs.(0.65 ±0.14) mg/L],immunoglobulin G [(1 292.20 ± 303.50) mg/L vs.(1 175.33 ± 376.67) mg/L],and kidney function (DRF) [(8.86 ±0.67) ％ vs.(9.90 ± 1.26)％].While microalbumin [(8 644.40 ± 829.54) mg/L vs.(3 145.10 ± 1 445.02) mg/L] and transferrin [(445.70 ± 46.71) mg/L vs.(214.30 ± 40.13) mg/L,P ＜ 0.05] were significantly increased 3 months after than 24 h before the procedure in nephrostomy group.There were no significant differences of the urine specific gravity 24h before and 3 months after the procedure in the kidney preserved group (1.003 ± 0.003 vs.1.005 ± 0.003,P ＞ 0.05).The creatinine value of 3 months after the procedure was significantly increased than that 24 hours within the procedure [(654.50 ± 154.52tμmol/L) vs.(423.94 ± 172.74) μmol/L],and the urine pH (7.28 ± 0.32 vs.7.91 ± 0.56),α1 microglobulin [(5.85 ± 0.38) mg/L vs.(12.58 ± 3.40) mg/L],microalbumin [(571.50 ± 167.14) mg/L vs.(2 343.28 ± 576.22) mg/L],β2 microglobulin [(0.14 ±0.05)mg/L vs.(0.53 ±0.13) mg/L],immunoglobulin G [(247.38 ±75.29) mg/L vs.(1 026.44 ±245.42)mg/L],and transferrin [(67.64 ± 16.34) mg/L vs.(249.17 ±78.62) mg/L] were significantly decreased 3 months after than 24 hours before the procedure.The renal function was higher 3 months after than 24 hours within the procedure [(8.53 ± 0.80) ％ vs.(20.50 ± 7.87) ％,P ＜ 0.05].Conclusions The increase of creatinine value and the decrease of urine pH,α1 microglobulin,microalbumin,β 2 microglobulin,immunoglobulin G and transferrin in renal pelvis urine suggested that renal function recovered after renal puncture,which is important for next-step plan of treatment strategy.

Prenatal diagnosis and postnatal management of fetal hydronephrosis / 中华围产医学杂志

Objective To investigate the prenatal diagnosis and postnatal management of fetal hydronephrosis.Methods One hundred and two cases (87 unilateral and 15 bilateral,with a total of 117 kidneys) of fetal hydronephrosis in singleton pregnancy were diagnosed by prenatal ultrasonography in Jinhua People's Hospital between January 2011 and December 2014.During pregnancy and postpartum,all cases were routinely examined by genitourinary ultrasound for the classification of severity of hydronephrosis.The age of gestation at diagnosis of fetal hydronephrosis,the classification of hydronephrosis and postnatal follow-up outcome were recorded and retrospectively analyzed by descriptive statistical analysis.Results Of the 102 pregnancies,the mean gravida age and gestational age at diagnosis of fetal hydronephrosis was (28.1 ± 3.7) years (20-39 years) and (30.44-4.9) gestational weeks (16-40 gestational weeks),respectively.One hundred and two cases (35 right,52 left and 15 bilateral) of fetal hydronephrosis were diagnosed by antenatal ultrasonography.In the second trimester,59 cases (11 bilateral) of fetal hydronephrosis were diagnosed,including 28 mild (five bilateral),24 moderate (three bilateral),four severe (one bilateral) and three terminated ones.In the third trimester,43 cases (four bilateral) were diagnosed,including 22 mild (two bilateral),17 moderate (one bilateral),two severe and two terminated ones.All these patients were re-examined by ultrasonography at 48 hourspostpartum,and hydronephrosis was still present in 41 cases (five bilateral),including 19 grade 1 (two bilateral),11 grade 2 (two bilateral),seven grade 3 and four grade 4 (one bilateral).From the second and third trimester to postnatal period,there were 18 (two bilateral) and 23 (three bilateral) cases of hydronephrosis,respectively.The regression rate of prenatal hydronephrosis was 53.8％ (63/117),including 64.3％ (45/70) in the second trimester and 38.3％ (18/47) in the third trimester.During postnatal follow-up period,two cases (6.7％,2/30,unilateral) of grade 2,four grade 3 (4/7,unilateral) and four grade 4 (one bilateral) underwent surgery.Eleven cases of grade 3-4 hydronephrosis (one bilateral) were followed up and nine kidneys were treated with surgery due to ureteropelvic junction obstruction (6/9),ureter stricture (1/9),vesicoureteral stricture (1/9) and posterior urethral valves (1/9).Conclusions Although the majority of cases of fetal hydronephrosis spontaneously regress,postnatal hydronephrosis should be monitored timely and continuously by ultrasound.In particular,grade 3-4 hydronephrosis should be followed up to evaluate renal functions.If hydronephrosis presents with symptoms,progressive aggravation,pathological obstruction,or differential renal function ＜ 40％,early surgical intervention should be provided to improve renal functions.

The clinical pathological analysis of intestinal neuronal dysplasia type B / 中国小儿急救医学

Objective To investigate the clinicopathological features and diagnosis of intestinal neu-ronal dysplasia type B.Methods Between January 2004 and August 2014 , 9 patients ( 5 males and 4 females) were treated for constipation and abdominal distention,and in all of them an intestinal neuronal dys-plasia type B was confirmed histopta holoig cally.The age of 9 patients ranged from 3 months to 1 year old ( mean 7.8 months) .The specimen of 9 patients was routinely takne by paraffin-embedded full-circumference sections of lesional bowel,hematoxylin and eosin and immunohits ochemical stainign were carried out on the specimen.The patholgo ical morphology and quantitative of inet stinal en urons and ganglia were retrospectively analyzed.Results Total of the 9 patients,the number and density of myenteric ganglia increased significant-ly increased in the lesional bowel,the pathological findings included giant nerve plexus,isolated and ectopic ganglia.In the proximal bowel,the number and density of myenteric ganglia were observed abnormal on giant nerev plexus, isoal ted and ectopci ganglia was osb erved.Combinated these pathological findings and symp-toms,intestinal neuronal dysplasia type B was diagnosed.Conclusion The diagnosis of ni testinal neuronal dysplasia type B relies on typical presentations of allied disorders of Hirschsprung′s disease,giant ganglia, isolated and ectopic ganglia,and increasing the density of giant submucosal ganglia of pathologic morpholo-gy,meanwhile,excludingo thers prima ry etiologies.

Different frequencies of vibration strains affect the early proliferation and differentiation of osteoclasts / 中国组织工程研究

BACKGROUND:Studies have shown that low-intensity and short-time vibration with a certain frequency can reduce the absorption of bone tissue and increase the quantity and quality of bone through promoting the proliferation and differentiation of osteoblasts. OBJECTIVE:To investigate the effects of different frequencies of vibration strains on cycle, proliferation and differentiation potency of RAW264.7 cel s cultured in vitro. METHODS:Passage 6 RAW264.7 cel s in good conditions were randomly divided into six groups, and each group was induced cultured with Dulbecco’s modified Eagle’s medium containing receptor activator of nuclear factor kappa B ligand. The final concentration of receptor activator of nuclear factor kappa B ligand was adjusted to 50μg/L, and then kept without changes. The non-loading group did not loaded with vibration strain, and the other five groups were loaded with 3-10 Hz, 15-35 Hz, 35-45 Hz, 50-70 Hz and 70-90 Hz vibration strains on the RAW264.7 cel s respectively. The other vibration parameters were consistent;the vibration time was 15 min/time with the vibration intensity of 0.3 g, twice per day. The cel cycle and cel proliferation were detected at 3 and 6 days after loading of vibration strains. RESULTS AND CONCLUSION:After composite vibration loading for 6 days, the cel cycle phase in the vibration groups was changed to some extent when compared with the non-loading group. Compared with non-loading group, the cel number in the G 1 phase of the vibration group was significantly increased (P<0.01);the cel number in the S phase and G 2+M phase of the vibration group was significantly decreased (P<0.01);the vibration parameters in the vibration group were significantly decreased (P<0.01). The results indicate that different frequencies of vibration strains can affect the cel cycle and proliferation, and can inhibit the proliferation and differentiation of osteoblasts.

Detection of minimal residual disease in childhood acute lymphoblastic leukemia by multi-parameter flow cytometry / 中华检验医学杂志

Objective To establish a flow cytometric measurement of detecting minimal residual disease(MRD) according to the leukemia-associated immunophenotypes in children with acute lymphoblastic leukemia(ALL) and to explore the significance of MRD detection in ALL children for a individualized treatment. Methods A variety of four-color fluorescent antibody combinations were used to investigate the children's normal bone marrow. The normal bone marrow pattern at two-parameter plots was established to identify the residual tumor cells, seventy-five bone marrow samples from newly diagnosed ALL children were analyzed with four-color cytometry to determined the optimal combinations which can clearly distinguish the tumor cells from normal cells. The bone marrow samples were monitored with the combination panel in 60 patients at the end of induction therapy and follow-up treatment. Cytomorphology test, PCR amplification of 29 fusion genes as well as IgG and TCR gene rearrangements were performed simultaneously. Results Sixty-nine cases (92.0%) could be identified for effective antibody combinations to monitor MRD by four-color cytometry. Fusion genes or IgG and T cell receptor (TCR) gene rearrangements can be detected in 21 cases (28.0%) to monitor MRD by PCR. No MRD can be detected in 25 bone marrow samples at the end of induction therapy and follow-up treatment. Four-color cytometry could detect as low as 0.021%-4.130% residual leukemia cells. Conclusion MRD can be monitored by flow cytometry which is faster than PCR, and the sensitivity is superior to morphology method.

Studies on dynamic change of total ginkgolic acids in Ginkgo biloba leaves of different aged trees and different collecting seasons / 中国中药杂志

<p><b>OBJECTIVE</b>To study dynamic change of total ginkgolic acids in Ginkgo biloba leaves of the different aged trees and different collecting seasons.</p><p><b>METHOD</b>The content of total ginkgolic acids in G. biloba leaves was determined by HPLC. A Alltima C18 (4.6 mm x 250 mm, 5 microm) and the mobile phase of methanol and 1% acetic acid (90:10) were used, the flow rate was 1.0 mL x min(-1), and the wavelength was 310 nm. The content were calculated with external standard method.</p><p><b>RESULT</b>The content of total ginkgolic acids in G. biloba leaves was in the range of 0.48% to 2.51% in different collecting seasons. The content reached maximum at the end of May and the beginning of June, and then declined gradually. In different aged trees, the content in the older ages was lower than that in the younger ages.</p><p><b>CONCLUSION</b>The results provide scientific basis for the collecting season of G. biloba leaves.</p>

The observation of effect of family nursing intervention on brain injury rehabilitation therapy in infants / 中国基层医药

Objective To investigate the effect of family nursing intervention on infant brain injury rehabili-tation therapy. Methods 102 cases of brain injury infants were randomly divided into observation group(32 cases),intervention group(38 cases) and control group (32 eases), respectively. The patients in observation group received routine treatment, while those in intervention group received family nursing intervention based on routine treatment.The children in control group whose parents refused the comprehensive rehabilitation therapy. All subjects were as-sessed by Gesell test before and after rehabilitation treatment. Results Compared with the control group patients, all indicators in the observation group and the intervention group were significantly improved. There were also signifi-cant differences between observation group and the intervention group( P < 0.01 ). Conclusion Family nursing in-tervention can significantly improve the effect on infant brain injury rehabilitation therapy.

Early Intervention of Systematic Rehabilitation for Elbow Joint Dysfunction after Trauma / 中国康复理论与实践

@# Objective To investigate the early rehabilitation for elbow joint dysfunction after trauma.Methods26 cases who accepted rehabilitation 7～30 d after trauma were determined as Group A,other 20 cases who accepted rehabilitation more than 30 d after trauma as Group B.They were evaluated with Mayo Elbow-Performance Score and range of motor(ROM)after systematic rehabilitation.ResultsThe scores of Mayo Elbow-Performance Score and the ROM were better in group A than in group B(P<0.05).ConclusionEarly rehabilitation is important for the elbow joint function recovery after trauma.

Clinical and biological characteristics in childhood acute myeloid leukemia with 8;21 translocation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and biological characteristics of childhood acute myeloid leukemia(AML)with 8;21 translocation.</p><p><b>METHODS</b>A retrospective analysis including clinical information, cell morphology, chromosome, immunophenotype and molecular biology was performed on 41 cases of childhood t(8;21)AML. The control group included 19 cases of AML without t(8;21) translocation detected during the same period.</p><p><b>RESULTS</b>The 41 cases of t(8;21)AML accounted for 68.3% of 60 continuous childhood AML patients. Among them, classical t(8;21) translocation was seen in 29 cases; variant t(8;21) translocation, simple 8q-, near-tetraploidy characterized by the duplication of t(8;21) translocation each came into view in 2 cases; and cryptic t(8;21) translocation was seen in 6 cases. Thirty seven cases (80.4%) belonged to M2 subtype of AML. Most of them had the morphological changes such as the leukemia cells' indent nucleus with a light stain region of perinucleus, basophilic cytoplasm, differentiation with maturation, megaloblastoid changes and nuclear-cytoplasm imbalance; the high expression of CD13 antigen; and the AML1/ETO fusion transcript in 23 cases examined by reverse transcription-polymerase chain reaction (RT-PCR) assay, including 6 cases with normal karyotype. The difference in complete remission rate between t(8;21) positive patients group and t(8;21) negative patients group was not significant in statistics (82.4% vs 75%, P>0.05). However the difference in recurring rate of the leukemia was statistically significant (10.7% vs 41.7%, P<0.05).</p><p><b>CONCLUSION</b>t(8;21)AML is the most frequent type of childhood AML. It is predominantly associated with M2 subtype of AML and has unique morphological, immunological prognostic features .</p>

Effects of Different Extraction Methods on the Content of Cholalic Acid from Artificial Bezoar / 中国药房

OBJECTIVE:To study the effects of different extraction methods on the content of cholalic acid from Artificial Bezoar. METHODS: Artificial Bezoar from 3 different habitats was used to extract cholalic acid by hydrolization vs. hydrolization-free method, and the content of cholalic acid was determined by HPLC-ELSD(high performance liquid chromatography with evaporative light scattering detection). RESULTS: The content of cholalic acid in the hydrolyzed sample was higher than that in the non-hydrolyzed sample of the same batch. CONCLUSION: Through hydrolization, the binding cholalic acid in the artificial bezoar was transformed into free cholalic acid so that the content of cholalic acid was increased. Therefore, it is more reasonable to control the quality of Artificial Bezoar by taking the contents of total cholalic acid and free cholalic acid as indexes.

Extraction of Swertia chirayita(Roxb.ex Flemi) Karsten / 中成药

AIM:To determine the optimal extraction of effective component from Swertia chirayita(Roxb.ex Flemi) Karsten in Tibet. METHODS: HPLC method was used to determine the yield rate and mango glucoside content,the preference extract methods,extraction solvents and extraction method of Swertia chirayita(Roxb.ex Flemi) Karsten were chose by parallel comparative method. RESULTS: 75% ethanol was used to extract medicine materials by Percolate,the flow rate was 4 mL/min/kg,collecting 6 times liquor after percolate. CONCLUSION: The extraction method is simple and convenient,furthermore the extract stability is good too.

Study on HPLC fingerprint of Compound Renshen Injection / 中成药

Objective: To establish the fingerprint chromatogram of Compound Renshen Injection (CRSI). Methods: HPLC with ZORBAX SB-C18[4.6(i.d)?250mm] column was used, the acetonitrile-water (gradient elution) as a mobile phase and detection wavelength at 203nm. Results: Indicating 27 peaks on the HPLC-fingerprint of CRSI. Conclusion: The method is simple and accurate with a good reproducibility and can be used as a quality control method for CRSI.