Nomogram predicting the efficacy of transurethral surgery in benign prostatic hyperplasia patients.

PURPOSE: This study aimed to develop and validate a nomogram for predicting the efficacy of transurethral surgery in benign prostatic hyperplasia (BPH) patients. METHODS: Patients with BPH who underwent transurethral surgery in the West China Hospital and West China Shang Jin Hospital were enrolled. Patients were retrospectively involved as the training group and were prospectively recruited as the validation group for the nomogram. Logistic regression analysis was utilized to generate nomogram for predicting the efficacy of transurethral surgery. The discrimination of the nomogram was assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots were applied to evaluate the calibration of the nomogram. RESULTS: A total of 426 patients with BPH who underwent transurethral surgery were included in the study, and they were further divided into a training group (n = 245) and a validation group (n = 181). Age (OR 1.07, 95% CI 1.02-1.15, P < 0.01), the compliance of the bladder (OR 2.37, 95% CI 1.20-4.67, P < 0.01), the function of the detrusor (OR 5.92, 95% CI 2.10-16.6, P < 0.01), and the bladder outlet obstruction (OR 2.21, 95% CI 1.07-4.54, P < 0.01) were incorporated in the nomogram. The AUC of the nomogram was 0.825 in the training group, and 0.785 in the validation group, respectively. CONCLUSION: The nomogram we developed included age, the compliance of the bladder, the function of the detrusor, and the severity of bladder outlet obstruction. The discrimination and calibration of the nomogram were confirmed by internal and external validation.

Enhanced recovery after surgery in transurethral surgery for benign prostatic hyperplasia.

Enhanced recovery after surgery (ERAS) measures have not been systematically applied in transurethral surgery for benign prostatic hyperplasia (BPH). This study was performed on patients with BPH who required surgical intervention. From July 2019 to June 2020, the ERAS program was applied to 248 patients, and the conventional program was applied to 238 patients. After 1 year of follow-up, the differences between the ERAS group and the conventional group were evaluated. The ERAS group had a shorter time of urinary catheterization compared with the conventional group (mean ± standard deviation [s.d.]: 1.0 ± 0.4 days vs 2.7 ± 0.8 days, P < 0.01), and the pain (mean ± s.d.) was significantly reduced through postoperative hospitalization days (PODs) 0-2 (POD 0: 1.7 ± 0.8 vs 2.4 ± 1.0, P < 0.01; POD 1: 1.6 ± 0.9 vs 3.5 ± 1.3, P < 0.01; POD 2: 1.2 ± 0.7 vs 3.0 ± 1.3, P < 0.01). No statistically significant difference was found in the rate of postoperative complications, such as postoperative bleeding (P = 0.79), urinary retention (P = 0.40), fever (P = 0.55), and readmission (P = 0.71). The hospitalization cost of the ERAS group was similar to that of the conventional group (mean ± s.d.: 16 927.8 ± 5808.1 Chinese Yuan [CNY] vs 17 044.1 ± 5830.7 CNY, P =0.85). The International Prostate Symptom Scores (IPSS) and quality of life (QoL) scores in the two groups were also similar when compared at 1 month, 3 months, 6 months, and 12 months after discharge. The ERAS program we conducted was safe, repeatable, and efficient. In conclusion, patients undergoing the ERAS program experienced less postoperative stress than those undergoing the conventional program.

[Impacts of acupuncture at Hegu (LI 4) on facial EMG in rhesus monkeys under the physiological state].

OBJECTIVE: To observe the specificity relationship between acupuncture at "Hegu" (LI 4) and the facial muscular movement in rhesus monkeys under the physiological state by using neuromuscular electrical measurement technique. METHODS: Eighteen rhesus monkeys were randomized into a Hegu group, a Houxi group and a Waiguan group, 6 monkeys in each one. Under the physiological state, EMG was detected on the frontal muscle, zygomatic muscle and orbicular muscle before and after acupuncture at different acupoints. The impacts of acupuncture on the facial EMG were studied and compared among different acupoints. RESULTS: With acupuncture at "Hegu" (LI 4), the latency was reduced (P < 0.01) and the peak value and area were increased (P < 0.05, P < 0.01) in the frontal EMG; the area and the peak value were increased (P < 0.01, P < 0.05) and latency was reduced (P < 0.05) in the zygomatic EMG; the frequency was increased (P < 0.01) and the latency was reduced (P < 0.05) in the orbicular EMG. Before and after acupuncture at "Hegu" (LI 4), the change rates of EMG frequency, peak value, area and latency on the frontal, zygomatic and orbicular muscles were higher than those at "Houxi" (SI 3) and "Waiguan" (TE 5) (P < 0.05, P < 0.01) separately. CONCLUSION: The relative specificity presents between Hegu (LI 4) and facial muscular movement.