Clinical efficacy and complications of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate.

BACKGROUND: Benign prostatic hyperplasia (BPH) is a common disease in elderly males, and many kinds of minimally invasive procedures can be used for the treatment of BPH. However, various procedures have caused some controversies regarding clinical outcomes, so more studies are needed to validate these controversial topics. AIMS: This study aimed to explore differences of clinical efficacy, surgical features, and complications between transurethral resection of the prostate (TURP) and plasmakinetic enucleation of the prostate (PKEP) for BPH. METHODS: A total of eligible 850 cases of BPH underwent TURP (the TURP group, 320 cases) or PKEP (the PKEP group, 530 cases) in the urology department of our hospital from March 2015 to 2018 were involved in this study. Then, the baseline data, surgical characteristics, IPSS, QoL, PVR, Qmax, IIEF-5, and documented complications were compared between the two groups. RESULTS: The operative time, intraoperative irrigation volume, postoperative hemoglobin, decrease in hemoglobin, postoperative irrigation time and volume, catheterization time, and hospital stay of the PKEP group were significantly less than those of the TURP group (all P < 0.05). At 3 months, 1, 2, and 3 years after operation, no significant differences were observed in IPSS, QoL, PVR, but the results of Qmax and IIEF-5 in the PKEP group were significantly higher than those parameters in the TURP group (all P < 0.05). The incidences of massive blood loss, postoperative secondary bleeding, blood transfusion, capsular perforation, urinary tract irritation, bladder spasm, clot retention, urinary tract infection, transient incontinence, erectile dysfunction, and the incidences of II, III grade of Clavien-Dindo classification in the PKEP group were significantly lower than those of the TURP group (all P < 0.05). CONCLUSION: The clinical efficacy of PKEP is compared favorably with TURP during midterm follow-up. Given the merits such as less blood loss and hospital stay, lower complications, PKEP should be given a priority for BPH.

Perceived stigma in burn survivors: Associations with resourcefulness and alexithymia.

OBJECTIVE: Burn survivors often have severe scarring and distorted body image, and they are commonly given new perceptions and even receive a variety of negative labels from individuals, families and society. This study aimed to explore the association between stigma, resourcefulness and alexithymia, and identifies whether resourcefulness in burn survivors is mediating the relationship between resourcefulness and alexithymia. METHOD: This correlational study was conducted from December 2021 to July 2022 in a comprehensive tertiary Grade A hospital in Ningxia, China. A convenience sample of 159 burn survivors was recruited. Data were collected using demographics, Social Impact Scale(SIC),Toronto Alexithymia Scale, and Resourcefulness Scale (RS). Descriptive analysis, Hierarchical Regression analysis, Pearson Correlation analysis, and Mediation analysis were used for data analysis. RESULTS: Finally, a data set of 148 responses was determined for analysis. The effective rate was 95.9%. We found significant correlation between stigma, resourcefulness and alexithymia. Sociodemographic characteristics (gender, spouse states), clinical characteristics (body surface burned area, scar areas), resourcefulness and alexithymia of burn survivors were significant predictors of stigma among burn survivors. The mediating effect of resourcefulness between stigma and alexithymia in burns survivors accounted for 36.03% of the total effect. CONCLUSION: Resourcefulness partially mediates the relationship between stigma and alexithymia. These findings suggest medical staff should strengthen the management of the mental health of burn survivors and eliminate the negative cognition and tendency of burn survivors by regularly promoting stigma counseling measures based on cognitive behavioral therapy. Based on the resourcefulness theory, psychological counseling and intervention are carried out in various ways to fully mobilize their internal factors for positive emotional regulation and enhance the ability of individuals to cope with adversity. In addition, an attempt was made to establish an "anti-stigma coalition" or "peer support group" for burn survivors to provide networked information support and emotional support to facilitate further the smooth return of patients to their families and society.

A study on the puncture method of extrapedicular infiltration anesthesia applied during lumbar percutaneous vertebroplasty or percutaneous kyphoplasty.

Extrapedicular infiltration anesthesia (EPIA) was reported for percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) and provided good local anesthetic effects. Because of differences in anatomical morphology at each lumbar level, the puncture method of EPIA is not uniform in each lumbar vertebrae. To accurately insert the anesthetic needle into the extrapedicular region, we researched the puncture method of EPIA at each lumbar level.We retrospectively analyzed computed tomography (CT) images in 230 patients with lumbar osteoporotic fractures, including 59 L1 fractures, 54 L2 fractures, 50 L3 fractures, 36 L4 fractures, and 31 L5 fractures. The puncture of EPIA was simulated in every fractured vertebrae through CT, and the skin puncture point, puncture direction, and puncture depth of the anesthetic needle were observed. These specific parameters were the distance from the skin puncture point to the superior border of the pedicle projection on the skin (distance AD), distance from the skin puncture point to the lateral border of the pedicle projection on the skin (distance BC), sagittal section angle (SSA), transverse section angle (TSA), and depth of EPIA.As the lumbar ordinal number increased, the SSA, distance AD, TSA, and distance BC for each lumbar level gradually increased, and the puncture depth gradually decreased, all these parameters showed significant differences among the 5 lumbar levels (P < .001). The recommended puncture methods for EPIA at each lumbar level, including distance AD, distance BC, SSA, and TSA, were as follows: in L1, 4 mm, 8 mm, 9° and 8°; in L2, 6 mm, 10 mm, 11° and 10°; in L3, 9 mm, 13 mm, 12° and 12°; in L4, 12 mm, 18 mm, 16° and 18°; and in L5, 20 mm, 26 mm, 24° and 24°. The depth of EPIA was 13 mm in L1-L3 and 11 mm in L4-L5.By confirming the skin puncture point and puncture direction of the anesthetic needle, from an anatomical perspective, EPIA is feasible for lumbar PVP (PKP).

Clinical Effectiveness of the Posterior Affected-Vertebrae Fixation Method in Posterior-Anterior Surgery to Treat Thoracic Spinal Tuberculosis.

OBJECTIVE: The present retrospective comparative analysis was conducted to assess the effectiveness of affected-vertebrae fixation versus short-segment fixation to treat thoracic spinal tuberculosis. METHODS: The present study included 110 patients receiving treatment for thoracic spinal tuberculosis at our hospital from January 2006 to June 2013. All cases involved the use of posterior spinal correction, posterior lateral fusion, internal fixation, anterior decompression, radical debridement, and intervertebral supporting bone grafts. The cases were divided by the scope of posterior internal fixation into the affected-vertebrae fixation group (n = 62) and the short-segment fixation group (n = 48). Statistical analysis was used to compare the clinical effectiveness, laboratory test results, and imaging findings. RESULTS: The mean surgical blood loss, mean operating time, and mean inpatient expenditures were all significantly less in the affected-vertebrae fixation group than in the short-segment fixation group (P < 0.05). The affected-vertebrae fixation group had a lower mean graft fusion time (5.21 vs. 5.06 months), mean healing time (5.73 vs. 5.91 months), mean degree of correction of thoracic vertebrae kyphosis Cobb angle (16.9° vs. 18.4°), and mean loss of angle (2.6° vs. 2.1°) compared with the short-segment fixation group. However, these differences all lacked statistical significance. Postoperatively, neurological deficits and pain were effectively relieved in all patients, and the lesion had healed at the final follow-up evaluation (≥5 years postoperatively). CONCLUSIONS: As long as the surgical indications are strictly observed, posterior affected-vertebrae fixation in posterior-anterior surgery for thoracic spinal tuberculosis is safe, effective, and feasible; entails minimal surgical trauma; and has a lower inpatient cost.

Iatrogenic Lumbar Artery Injury in Spine Surgery: A Literature Review.

BACKGROUND: We reviewed the reported data related to iatrogenic lumbar artery injury (ILAI) in spine surgery with a focus on which iatrogenic procedure might cause lumbar artery injury. METHODS: We conducted a comprehensive search in the Web of Science, PubMed, EMBASE, and Chinese biomedical databases in July 2018. RESULTS: A total of 20 reports on ILAI were selected for the present study. Most of these were case reports, with a total of 26 cases. The causes of ILAI were as follows: puncture injury in 9 cases, transforaminal endoscopic operation in 5 cases, pedicle screw injury in 3 cases, intervertebral foramen decompression in 2 cases, disc rongeur injury during discectomy in 2 cases, lumbar artery tear caused by transverse process fracture in 1 case, vertebral fracture restoration in 1 case, retractor injury in 1 case, cage insertion or pedicle screw injury in 1 case, and drainage tube stimulation in 1 case. The treatment methods included transarterial embolization in 20 cases, percutaneous embolization in 2 cases, surgical ligation in 1 case, and steroid and cyclophosphamide treatment in 1 case. All patients were treated successfully. One patient died during antishock therapy, and another patient died because her family refused any further intervention. CONCLUSIONS: Attention should be given to the surgical procedures that are likely to cause ILAI, such as percutaneous vertebroplasty/percutaneous kyphoplasty, vertebral biopsy, pedicle screw implantation, discectomy, transforaminal endoscopic operation, and intervertebral foramen decompression. Once a diagnosis of ILAI has been confirmed, selective endovascular transarterial embolization is the preferred treatment.

Mapping Soil Alkalinity and Salinity in Northern Songnen Plain, China with the HJ-1 Hyperspectral Imager Data and Partial Least Squares Regression.

In arid and semi-arid regions, identifying and monitoring of soil alkalinity and salinity are in urgently need for preventing land degradation and maintaining ecological balances. In this study, physicochemical, statistical, and spectral analysis revealed that potential of hydrogen (pH) and electrical conductivity (EC) characterized the saline-alkali soils and were sensitive to the visible and near infrared (VIS-NIR) wavelengths. On the basis of soil pH, EC, and spectral data, the partial least squares regression (PLSR) models for estimating soil alkalinity and salinity were constructed. The R² values for soil pH and EC models were 0.77 and 0.48, and the root mean square errors (RMSEs) were 0.95 and 17.92 dS/m, respectively. The ratios of performance to inter-quartile distance (RPIQ) for the soil pH and EC models were 3.84 and 0.14, respectively, indicating that the soil pH model performed well but the soil EC model was not considerably reliable. With the validation dataset, the RMSEs of the two models were 1.06 and 18.92 dS/m. With the PLSR models applied to hyperspectral data acquired from the hyperspectral imager (HSI) onboard the HJ-1A satellite (launched in 2008 by China), the soil alkalinity and salinity distributions were mapped in the study area, and were validated with RMSEs of 1.09 and 17.30 dS/m, respectively. These findings revealed that the hyperspectral images in the VIS-NIR wavelengths had the potential to map soil alkalinity and salinity in the Songnen Plain, China.

Hybrid nonlinear surface-phonon-plasmon-polaritons at the interface of nolinear medium and graphene-covered hexagonal boron nitride crystal.

The properties of hybrid nonlinear surface-phonon-plasmon-polaritons (SP3) at the interface of nonlinear medium and graphene-covered hexagonal boron nitride (hBN) are investigated theoretically. It is demonstrated that the hybrid nonlinear SP3 can be tuned by controlling the chemical potential, layer number and relaxation time of graphene. The real and imaginary parts of the propagation constant increase by decreasing the Fermi energy or the layer number of the graphene in the frequency outside of the upper Reststrahlen band of hBN. Moreover, we show that the nonlinear dielectric permittivity has great effect on the propagation constant. The real part of the propagation constant increases with positive nonlinear dielectric permittivity at different frequency for low frequency mode; while the imaginary part of the propagation constant decreases in the upper Reststrahlen band of hBN, keeps nearly constant in the lower band, and increases outside the Reststrahlen band with positive nonlinear dielectric permittivity for low frequency mode.