Reconfigurable moiré nanolaser arrays with phase synchronization.

Miniaturized lasers play a central role in the infrastructure of modern information society. The breakthrough in laser miniaturization beyond the wavelength scale has opened up new opportunities for a wide range of applications1-4, as well as for investigating light-matter interactions in extreme-optical-field localization and lasing-mode engineering5-19. An ultimate objective of microscale laser research is to develop reconfigurable coherent nanolaser arrays that can simultaneously enhance information capacity and functionality. However, the absence of a suitable physical mechanism for reconfiguring nanolaser cavities hinders the demonstration of nanolasers in either a single cavity or a fixed array. Here we propose and demonstrate moiré nanolaser arrays based on optical flatbands in twisted photonic graphene lattices, in which coherent nanolasing is realized from a single nanocavity to reconfigurable arrays of nanocavities. We observe synchronized nanolaser arrays exhibiting high spatial and spectral coherence, across a range of distinct patterns, including P, K and U shapes and the Chinese characters '' and '' ('China' in Chinese). Moreover, we obtain nanolaser arrays that emit with spatially varying relative phases, allowing us to manipulate emission directions. Our work lays the foundation for the development of reconfigurable active devices that have potential applications in communication, LiDAR (light detection and ranging), optical computing and imaging.

The multiple reference range of mean uterine artery pulsatility index for natural and in vitro fertilization singletons during 11-14 gestational weeks.

Background: Ultrasonography of the uterine artery (UtA) in the first and second trimesters of pregnancy can assess uterine-placental blood perfusion and guide early clinical prevention. Establishing normal ranges of the UtA pulsatility index (UtA-PI) at 11-14 weeks of pregnancy is helpful for the early identification of high-risk pregnant women and improving the prognosis. This study aimed to establish a reference range of UtA-PI based on crown-rump length (CRL) for spontaneous and in vitro fertilization (IVF) singleton pregnancy during 11-14 weeks, respectively. Methods: A prospective study was performed at Peking Union Medical College Hospital. Healthy, low-risk women with a singleton pregnancy at 11-14 gestational weeks were consecutively recruited for this study from December 2017 to December 2020. All participants underwent routine prenatal ultrasound examination. The CRL of the fetus and the UtA-PI were measured in both uterine arteries, and average values were calculated. The LMS method was used to fit the percentile (P)5, P10, P25, P50, P75, P90, and P95 curves of the UtA-PI value of spontaneous and IVF singleton pregnancy with CRL changes, respectively. Results: A total of 1,962 pregnant women with normal fetuses were included in this study, including 1,792 pregnancies conceived naturally and 170 IVF fetuses. The UtA-PI reference range in the spontaneous pregnancy group was consistently higher than that in the IVF group during 11-14 weeks, and showed a statistically significant difference in UtA-PI for spontaneous and IVF pregnancies (P<0.001). According to the LMS method, each percentile curve of UtA-PI decreased with the increase of CRL in both the natural pregnancy group and the IVF group. The P95 range of UtA-PI for pregnant women with naturally conceived and IVF pregnancy was 2.74 to 2.11 and 2.50 to 1.94, respectively. The overall change of UtA-PI differentials of the two groups showed a downward trend and decreased slightly with the increase of CRL. Conclusions: This study provided a single-center, large sample of data and constructed a CRL-based reference value of UtA-PI for spontaneous and IVF singleton pregnancy, which provides a reliable basis for early UtA evaluation and early clinical decision-making during 11-14 gestational weeks.

Topological polarization singular lasing with highly efficient radiation channel.

Bound states in the continuum (BICs) in photonic crystals describe the originally leaky Bloch modes that can become bounded when their radiation fields carry topological polarization singularities. However, topological polarization singularities do not carry energy to far field, which limits radiation efficiencies of BICs for light emitting applications. Here, we demonstrate a topological polarization singular laser which has a topological polarization singular channel in the second Brillouin zone and a paired linearly polarized radiation channel in the first Brillouin zone. The presence of the singular channel enables the lasing mode with a higher quality factor than other modes for single mode lasing. In the meanwhile, the presence of the radiation channel secures the lasing mode with high radiation efficiency. The demonstrated topological polarization singular laser operates at room temperature with an external quantum efficiency exceeding 24%. Our work presents a new paradigm in eigenmode engineering for mode selection, exotic field manipulation and lasing.

Development of an H2S emission model for wastewater treatment plants.

Modeling and prediction of H2S emission from wastewater are important since gaseous H2S will induce significant corrosion and odor problems. Most previous studies focused on H2S emission of wastewater in pipeline systems, which may not be fit for H2S emission in wastewater treatment plants (WWTPs). This study provided a two-phase mass transfer model for prediction of H2S emission concentrations. The model is based on the mass transfer rate equation of the mass transfer impetus, expressed by the concentration difference. The main parameters of the model are the mass transfer coefficient, the carrier gas flow rate and the concentration of H2S in liquid phase. The results showed that the model can simulate and predict H2S emission concentrations of various processes in WWTPs. Moreover, the model can analyze and predict the influences of different pH values, mass transfer coefficients and carrier gas flow rates on H2S emission concentrations and loads. Therefore, the model provides theoretical guidance for design of WWTPs regarding H2S emissions.Implications: Modeling and prediction of H2S emission from wastewater are quite important since gaseous H2S will induce significant corrosion and odor problems. Most of previous studies are focused on H2S emission from wastewater in pipeline system, which may not be fit for H2S emission in wastewater treatment plants (WWTPs). Thus in this study, a model for predicting H2S emission from typical units of WWTPs is established and verified. Moreover, the influences of pH values, mass transfer coefficients and carrier gas flow rates on H2S emission are analyzed. The model can be a useful tool to predict the H2S concentration in odor gas collection system of WWTP and understand the behaviors of H2S emission under different WWTPs operating conditions.

Variations in grain cadmium and arsenic concentrations and screening for stable low-accumulating rice cultivars from multi-environment trials.

In order to help mitigate widespread cadmium (Cd) and arsenic (As) co-contamination in paddy soils in China, screening and breeding of low-accumulating rice (Oryza sativa L.) cultivars (excluders) have been widely adopted. However, the performance of rice cultivars for grain Cd and As accumulation may vary in different growing environments. The inability to identify stable low-accumulating cultivars has largely hindered their application. In this study, 51 rice cultivars were evaluated at four Cd- and As-contaminated paddy sites in two crop seasons in northern Guangdong Province, China. The aim was to investigate the effects of cultivar, environment and their interactions in determining grain Cd and As concentrations, and so to identify stable low-accumulating cultivars. Results showed that environment effects dominated the Cd and As concentrations in rice grains, explaining 87% of the total variations. The crop season played a vital role; compared to early season, grain Cd levels increased and As levels lowered significantly in late season. Large variations in grain Cd, total As, inorganic As concentrations and the percentage of inorganic As were observed between different cultivars. Conventional japonica cultivars exhibited lower Cd levels but higher As levels in the grains than did indica cultivars. The cultivar × environment interaction (CEI) was significant, and its importance was comparable to the cultivar effect. By measuring and interpreting such an interaction, stable Cd and As excluder cultivars were identified based upon the yield, grain Cd and As levels as well as the stabilities of cultivars across the trial environments. Two stable Cd and As co-excluders were found among the hybrid indica cultivars. These results demonstrated that the variations in grain Cd and As concentrations could mainly be attributed to the environment effects and cultivar selection practices should include the analysis of CEI to identify stable low-accumulating rice cultivars.

Adducted thumb as an isolated morphologic finding: an early sonographic sign of impaired neurodevelopment: A STROBE compliant study.

Fetal adducted thumbs have been described in association with hydrocephalus and other abnormalities, but in cases without other structural malformations the determination of prognosis and recurrence risk is challenging. The aim of our study is to analyze the characteristics, natural history, and postnatal outcome of such cases.A retrospective study was conducted over a period of 4 years in a tertiary referral center. All fetuses diagnosed as adducted thumbs without other structural malformations comprised the study group. Prenatal sonographic features and neonatal outcome are documented.There were 4 cases of fetal adducted thumbs diagnosed during the study period. No cases demonstrated other structural malformations throughout the gestation. A smaller head was noted in 2 cases during the follow-up, and all cases presented with polyhydramnios on the first or ensuing scans. Three cases died after birth due to swallowing or breathing difficulty, and the surviving 1 showed convulsion and mental retardation.Fetal adducted thumb might be an early and specific sonographic marker of impaired neurodevelopment. Close follow-up and genetic investigation should be performed in these cases. Ultrasound examination plays an important role in the prenatal diagnosis and counseling of cases without detailed prenatal genetic analysis.

[Effects of Vegetation Restoration on Soil Nitrogen Pathways in a Karst Region of Southwest China].

Nitrogen (N) is an important element for plant growth in terrestrial ecosystems. Studying soil N cycling is crucial for understanding the structures and functions of an ecosystem. However, our knowledge of soil N dynamics in karst regions is still limited. In addition, while China's karst regions have conducted a series of vegetation restoration projects, the vegetation restoration effects on soil N pathways are still largely unknown. Therefore, this study selected four typical ecosystems representing four main vegetation restoration stages (i. e., cropland, grassland, shrubland, and forest) in a karst region in Huanjiang Province, southwest China. In these ecosystems, soil N pathways, including net ammonization rate (net ammonization, fungal ammonization, and bacterial ammonization), net nitrification rate (i. e., net nitrification, heterotrophic nitrification, autotrophic nitrification, fungal nitrification, and bacterial nitrification), net N mineralization rate (net N mineralization, fungal mineralization, and bacterial mineralization), and soil properties were measured. Our results showed that nitrification rate was high in all ecosystems, but the ammonization rate was low, resulting in nitrite being the main inorganic N form in karst soil. Autotrophic and heterotrophic nitrification rates accounted for 80% and 20% of the net nitrification rate, respectively. After the addition of fungal and bacterial inhibitors, ammonization rates increased for all treatments, but the nitrification rates decreased. Following vegetation restoration, soil N mineralization and nitrification rates all increased, but the ammonization rates significantly decreased. This pattern was significantly correlated with soil organic carbon, total nitrogen, nitrate, microbial biomass, and the activity of N-acquisition enzymes in these ecosystems. Our findings provide very useful information for understanding soil N cycling in the karst regions.

Cellulose nanocrystals obtained from office waste paper and their potential application in PET packing materials.

Annually a tremendous amount of office waste paper (OWP) is discarded creating environmental pollution. Therefore, how to make this paper from waste to wealth and use it in new approaches have become a meaningful and challenging work. In this work, OWP being a cellulose rich biomass was employed for the production of cellulose nanocrystals (CNCs) by acid hydrolysis with different acid concentrations but without subjecting OWP to alkali and bleaching treatments. The testing results showed that CNCs prepared using sulfuric acid concentration of 59% with respect to OWP had the highest crystallinity and this concentration was the transition concentration for the production of opaque CNCs film with convoluted nanofibers to transparent one with orientated nanofibers. Besides, CNCs prepared using acid concentration of 65% coated on PET sheet not only had a better water vapor barrier property but also was on a par with the transparency of PET, which was hopeful to be used as coating materials in packaging materials.

Combination of mesenchymal stem cell injection with icariin for the treatment of diabetes-associated erectile dysfunction.

The present study was aimed to examine whether icariin, a traditional Chinese medicine, could improve therapeutic effects of adipose derived mesenchymal stem cells (ADSCs) for diabetes-associated erectile dysfunction (DMED). DMED were induced in rats by intraperitoneal injection of streptozotocin and confirmed by erectile function measurement. Then, rats of diabetic ED were randomly divided to receive the treatment of saline, ADSCs, icariin or ADSCs combined with icariin respectively. Compared with the treatment by ADSCs or icariin alone, intracavernosum injection of ADSCs combined with the following daily gastric gavage of icariin significantly augmented the value of ICP and ICP/MAP (p<0.01). Meanwhile, the survival of transplanted ADSCs was much improved due to the application of icariin. Similarly, immunofluorescent staining analysis demonstrated that the improved erectile tissue structure by combination of ADSCs and icariin was significantly associated with the increased expression of endothelial markers (vWF) (p<0.01) and smooth muscle markers (α-SMA) (p<0.01). Furthermore, the structure changes in corpus cavernosum were further confirmed by the Masson's trichrome staining. To explore the possible mechanism underlying icariin-enhanced therapeutic efficacy of MSCs, we employed an in vitro testing system by introducing H2O2 to imitate oxidative stress condition considering the oxidative environment faced by engrafted ADSCs and anti-oxidative capacity of icariin. In vitro, we found that the addition of icariin considerably reduced the apoptosis of ADSCs, and attenuated the intracellular reactive oxygen species (ROS), the superoxidase dismutase (SOD) activity and the lactate dehydrogenase (LDH). Subsequently, we examined the expression of apoptosis-related proteins and explored the potential signaling pathway through which icariin promoted the survival of ADSCs against oxidative stress. It was demonstrated that icariin significantly inhibited the upregulation of apoptosis-related proteins under oxidative condition, including Bax and cleaved caspase-3, while promoted the expression of anti-apoptotic factor BCL2. These effects were accompanied with the activation of signal molecules, PI3K/Akt and STAT3. The further signal protein inhibition assays exhibited that the suppression of STAT3 abrogated the icariin-mediated anti-apoptotic effects observed above, while did not influence the expression of PI3K/Akt. However, PI3K inhibition could abrogate icariin-mediated STAT3 activation and achieved a similar effect as STAT3 inhibition. Our results suggested that icariin was an effective adjuvant for enhancing ADSC-based therapy of DMEM, which may be ascribed to their protection of ADSCs against oxidative stress via the regulation of PI3K/Akt-STAT3 signal pathway.

Effect of organic manure on Cd and As accumulation in brown rice and grain yield in Cd-As-contaminated paddy fields.

Large areas of paddy fields in mining areas in south China have been contaminated by mixed Cd and As. To test the possibility of using organic manure (OM) as a method of reducing Cd and As accumulation in brown rice and increase the grain yield in such paddy fields, two rice cultivars [Jianyou G2 (JY) and Fengyousimiao (FY)] and three amounts of OM (0, 0.5, 1.5 kg/m2) were examined in three Cd-As-contaminated paddy fields (Fogang, Dabaoshan, Fankou) in Guangdong Province. The results show that the application of OM can effectively increase the grain yield and reduce Cd. However, the As concentration was found to increase in brown rice, especially when high levels of OM were used. The addition of OM increased the soil pH and organic matter content in the soils and enhanced the activities of superoxide dismutase (SOD) and catalase (CAT) in plant tissues. Our results suggest that OM can be used as an amendment to effectively decrease Cd accumulation in brown rice in Cd-contaminated paddy fields. However, it is necessary to consider the negative effects of OM amendments when adding OM to As-contaminated paddy fields.

Removal of dissolved sulfides in aqueous solution by activated sludge: mechanism and characteristics.

Activated sludge recycling has been developed as a novel technique to directly prevent volatile sulfides emission from wastewater influents. In this study, mechanisms and characteristics of dissolved sulfides removal in aqueous solution by activated sludge were investigated. When DO content in water was 0.49mg/L, 70% of removed dissolved sulfides were released back from the activated sludge by lowering pH to 1. The SEM/EDS result revealed that removed sulfur was fixed in activated sludge and the XPS result showed that fixed sulfur had an oxidation state of -2. FTIR results showed that primary amine group (R-NH2) could be one of the radical groups bonding sulfides. All these results verified that sulfides removal by activated sludge is primarily attributed to adsorption, rather than biodegradation, under low DO conditions in 40min. The equilibrium isotherm data fit the Langmuir isotherm model well. The maximum adsorption capacity (q0) ranged in 25-38mg/g at temperatures of 10-40°C. The adsorption kinetic data fit the pseudo-second-order model well. The amounts of adsorbed sulfides at equilibrium (qe) were positively proportional to temperature, initial sulfides concentration and agitation speed. These results indicate that sulfides adsorption could be a chemical sorption or ion exchange process.

Prognostic value of CD44 expression in renal cell carcinoma: a systematic review and meta-analysis.

CD44 is a marker of cancer stem-like cells in renal cell carcinoma (RCC). However, the prognostic value of CD44 in RCC remains controversial. This study evaluated the correlation of CD44 expression with the clinicopathological features of RCC through a meta-analysis. We systematically searched PubMed, ISI Web of Science and Embase for relevant studies until February 2015. We collected and analysed data on clinical stage, Fuhrman grade, microvascular invasion, recurrence, five-year overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Twenty studies involving 1672 patients satisfied the inclusion criteria. Results showed that high CD44 expression in RCC was a poor prognostic marker for five-year OS (RR = 0.69, 95% CI 0.60-0.78) in a fixed-effects model and for five-year DSS (RR = 0.46, 95% CI 0.27-0.80) and five-year DFS (RR = 0.63, 95% CI 0.43-0.93) in a random-effects model. CD44 expression also correlated with Furhman grade (RR = 0.61, 95% CI 0.48-0.77), tumour recurrence (RR = 7.42, 95% CI 3.74-14.70) and MVI (Microvascular invasion) (RR = 3.63, 95% CI 1.97-6.71). This meta-analysis suggests that CD44 is a prognostic marker in RCC. High CD44 expression correlates with high Fuhrman grade, recurrence, MVI and poor prognosis.

Efficacy and Safety of Transurethral Photoselective Greenlight(™) Laser Vaporization for the Treatment of Orthotopic Ureteroceles in Adults.

OBJECTIVE: This study aimed to retrospectively evaluate the safety and efficacy of transurethral photoselective Greenlight(™) laser vaporization in adult patients with orthotopic ureterocele. MATERIALS AND METHODS: Thirty adult patients diagnosed with orthotopic urecterocele were recruited at our center. Transurethral photoselective Greenlight laser vaporization was used as the exclusive technique for endoscopic management during the study period. Information, including age, gender, mode of presentation, ureterocele size, vesicoureteral reflux, hydronephrosis status, and incidence of reoperation, were collected for evaluation. RESULTS: Our series included 12 men and 18 women. The mean patient age at presentation was 30.5 years (range, 18-62 years). The mean size of ureterocele was 18 mm (range, 10-41 mm). All patients successfully underwent transurethral photoselective Greenlight laser to vaporize the ureterocele. The operation ranged from 13 min to 38 min (mean 19.6 min). The average blood loss was <10 mL. No patient had intraoperative complications. The average postoperative hospital stay was 18.3 h. All patients were voided after postoperative catheter removal. None of the patients demonstrated any residual ureterocele and/or hydronephrosis when evaluated with ultrasonography after 3 months. Only one patient with a duplex collecting system presented asymptomatic low-grade reflux at 3 months, which was spontaneously resolved after 6 months of follow-up. All patients were free of any symptoms. No reoperative procedures were required at a mean follow-up of 14.2 months (range, 8-16). CONCLUSIONS: Transurethral photoselective Greenlight laser vaporization is safe, effective, and efficient for the management of orthotopic urecteroceles in adults. Therefore, this technique should be considered as the initial treatment in most patients.

Comparing the treatment outcomes of potassium-titanyl-phosphate laser vaporization and transurethral electroresection for primary nonmuscle-invasive bladder cancer: A prospective, randomized study.

BACKGROUND AND OBJECTIVES: In urology, potassium-titanyl-phosphate (KTP) laser is mainly used in the treatment of benign prostatic hyperplasia with a low rate of intraoperative and postoperative complications. A prospective, randomized study was undertaken to investigate the treatment outcomes of KTP laser vaporization for primary non-muscle-invasive bladder tumors (NMIBTs) as compared with conventional monopolar transurethral resection of bladder tumors (TURBT). MATERIALS AND METHODS: This study was designed as a prospective, randomized trial. After institutional review board approval, 229 consecutive patients with NMIBTs were randomized to 2 groups. Among them, 116 patients underwent KTP laser vaporization of a bladder tumor (laser group) and 113 patients underwent standard transurethral electroresection of the bladder tumors using monopolar loop electrode (TURBT group). According to the prognostic factors for recurrence, all patients were divided into low, intermediate or high risk subgroups. The clinical data were recorded and compared between the two groups. RESULTS: Eighty-nine patients in laser group and 94 in TURBT group were evaluable for the study end points. The preoperative characteristics of the patients were comparable in the two groups. There was no statistical difference in operation time between the two groups. Patients in the laser group had fewer perioperative complications and more patients needed bladder irrigation in the TURBT group. Compared with laser group, patients in the TURBT group had longer catheterization time and hospitalization duration. There were no statistical differences in the oncologic results in term of 2-year recurrence rates as compared between the two groups. CONCLUSIONS: Our study demonstrated that using KTP laser, transurethral vaporization is an effective and safe treatment for the patients with primary NMIBT. Compared with traditional TURBT, the KTP laser surgery had fewer perioperative complications and similar oncological results.

Impact of 160 W Greenlight laser vaporization of the prostate on erectile function: a prospective randomized controlled trial with 1-year follow-up.

OBJECTIVE: Our aim was to evaluate the impact of 160 W Greenlight laser vaporization of the prostate on erectile function by the International Index of Erectile Function (IIEF-5) in 1-year follow-up in patients with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). BACKGROUND DATA: Although high-power Greenlight laser has greatly improved the efficiency of vaporization of the prostate, the impact of it on erectile function remains uncertain. MATERIALS AND METHODS: A total of 80 BPH patients with normal erectile function or mild erectile dysfunction (IIEF-5 ≥12) were included in this study. They were randomly assigned to two equal groups: 80 or 160 W. Both groups were compared regarding all relevant preoperative, operative, and postoperative parameters. Urinary function in terms of International Prostate Symptom Score (IPSS), quality of life (QOL) score, maximum flow rate (Qmax), and residual urinary volume (RUV) were evaluated at 1, 3, 6, and 12 months postoperatively. Erectile function was evaluated by IIEF-5 at 3, 6, and 12 months postoperatively. RESULTS: Baseline characteristics of the two groups were comparable. Mean operative time was significantly shorter for the 160 W group. Urinary function in terms of IPSS, QOL, Qmax, and RUV were all significantly improved over baseline in both groups. There were no significant differences in these urinary functional parameters between the two groups at any point of follow-up. IIEF-5 scores of both groups significantly decreased at 3 months postoperatively compared with baseline, but at 6 and 12 months postoperatively, IIEF-5 score of either group increased to baseline, and was not different from baseline. At any point of follow-up, IIEF-5 scores of the two groups were comparable. CONCLUSIONS: Greenlight laser (160 W) vaporization of the prostate will not increase the risk of impairing erectile function.

Selenium addition alters mercury uptake, bioavailability in the rhizosphere and root anatomy of rice (Oryza sativa).

BACKGROUND AND AIMS: Mercury (Hg) is an extremely toxic pollutant, especially in the form of methylmercury (MeHg), whereas selenium (Se) is an essential trace element in the human diet. This study aimed to ascertain whether addition of Se can produce rice with enriched Se and lowered Hg content when growing in Hg-contaminated paddy fields and, if so, to determine the possible mechanisms behind these effects. METHODS: Two cultivars of rice (Oryza sativa, japonica and indica) were grown in either hydroponic solutions or soil rhizobags with different Se and Hg treatments. Concentrations of total Hg, MeHg and Se were determined in the roots, shoots and brown rice, together with Hg uptake kinetics and Hg bioavailability in the soil. Root anatonmy was also studied. KEY RESULTS: The high Se treatment (5 µg g(-1)) significantly increased brown rice yield by 48 % and total Se content by 2·8-fold, and decreased total Hg and MeHg by 47 and 55 %, respectively, compared with the control treatments. The high Se treatment also markedly reduced 'water-soluble' Hg and MeHg concentrations in the rhizosphere soil, decreased the uptake capacity of Hg by roots and enhanced the development of apoplastic barriers in the root endodermis. CONCLUSIONS: Addition of Se to Hg-contaminated soil can help produce brown rice that is simultaneously enriched in Se and contains less total Hg and MeHg. The lowered accumulation of total Hg and MeHg appears to be the result of reduced bioavailability of Hg and production of MeHg in the rhizosphere, suppression of uptake of Hg into the root cells and an enhancement of the development of apoplastic barriers in the endodermis of the roots.

A retrospective evaluation of benign prostatic hyperplasia treatment by transurethral vaporization using a 1470 nm laser.

OBJECTIVE: This article aims to evaluate the safety and efficacy of a new diode laser at a wavelength of 1470 nm, in the surgical treatment of benign prostatic hyperplasia (BPH). BACKGROUND DATA: BPH is very common. Laser surgeries, such as photoselective vaporization of the prostate (PVP), have gained interest over the past decade because of their satisfying clinical results and reduced morbidity. METHODS: A total of 24 patients who underwent transurethral vaporization of the prostate with a new diode laser prototype at a wavelength of 1470 nm were included in this retrospective study. The baseline characteristics of patients and treatment outcomes were evaluated at 4 weeks after the operation with the International Prostate Symptoms Score (IPSS), duration of catheterization, and maximum urinary flow rate (Qmax). RESULTS: The mean age of patients was 69 ± 8.6 years. The mean time of operation and hospitalization were 97 ± 39 min and 5.3 ± 5.2 days, respectively. The mean duration of catheterization after surgery was 3.1 ± 2.7 days. No recatheterizations or secondary surgeries were required. IPSS and Qmax at 4 weeks postoperatively were significantly changed compared with the baseline (p<0.001). CONCLUSIONS: Transurethral vaporization of the prostate using a 1470 nm laser is effective to treat benign prostatic hyperplasia.

[Application of video endoscopic inguinal lymphadenectomy in radical vulvectomy for carcinoma].

OBJECTIVE: To evaluate the feasibility and safety of applying video endoscopic inguinal lymphadenectomy via hypogastric subcutaneous approach (VEIL-H) in the treatment of vulvar carcinoma. METHODS: From September 2009 to December 2012, 15 patients with vulvar carcinoma underwent VEIL-H plus radical vulvectomy at many participating hospitals. RESULTS: All were treated surgically. Two of them underwent laparoscopic pelvic lymphadenectomy (LPL) upon the positive results of parotid operations with frozen section. The mean operative duration of VEIL-H (bilateral groin) were (80.8 ± 2.9) minutes. The mean total volume of blood loss in VEIL was (5.5 ± 0.4) ml, the mean drainage duration (6 ± 2) days and the average postoperative hospitalization (11 ± 4) days. The mean follow-up period was 13.0 months. One patient suffered local recurrence at Month 2 postoperation. CONCLUSION: VEIL-H is both feasible and safe in inguinal lymphadenectomy.

A prospective, randomized controlled trial of circumcision in adult males using the CO2 laser: modified technique compared with the conventional dorsal-slit technique.

OBJECTIVE: The purpose of this study was to investigate the safety and efficacy of a modified CO2 laser technique for circumcision in adult males as compared with the conventional dorsal-slit method. BACKGROUND DATA: Circumcision is one of the most commonly performed surgeries in the world. Although present techniques produce a good long-term result, there is a continuing need to improve the safety and efficacy of the circumcision procedure. MATERIALS AND METHODS: Data were analyzed from a prospective randomized controlled clinical study comparing two different operative techniques for adult circumcision: the modified CO2 laser circumcision technique, and the conventional dorsal-slit technique. A total of 300 patients >18 years of age were recruited in this study. Several perioperative data, including age, indications, operation time, intraoperative blood loss, complications, and postoperative pain were analyzed. Differences between the CO2 laser technique and the conventional technique were compared. RESULTS: There was no statistically significant difference in age distribution and indications between the two groups. Compared with the conventional group, there were shorter operative time, less blood loss and lower postoperative complication rate in the laser group. The CO2 laser technique was associated with much less pain, as quantitated by a 10 point visual analogue scale (VAS) pain score at both 1 day and 7 days postoperatively. CONCLUSIONS: The modified CO2 laser technique that we introduced offers a simple, safe, faster, and effective alternative method to the conventional technique in adult male circumcision, with decreased blood loss, pain, and complications.

[Follow-up observation of photoselective vaporization of prostate for treatment of benign prostatic hyperplasia within five years].

OBJECTIVE: To evaluate the efficacy and safty of photoselective vaporization of prostate (PVP) in the treatment of benign prostatic hyperplasia with obstruction within 5 years. METHODS: From December 2004 to December 2009, there were 782 cases have been except for neurogenic bladder dysfunction and prostate cancer, who received PVP surgical treatment of BPH. The surgical conditions and postoperative follow-up data were recorded and the follow-up cut-off time for surgery after 5 years. RESULTS: A total of 782 patients with BPH who underwent PVP were included in this retrospective study. The operation in 740 cases was successfully completed at one time. But in other 42 cases, the twice operation was performed. The mean operation time was (85 ± 38) minutes, and the mean energy delivery was (355 ± 124) kJ. The mean catheterization and postoperative hospitalization time was (2.3 ± 1.7) days and (5.2 ± 2.6) days, respectively. No severe intraoperative complications were observed. The mean follow-up was (44.1 ± 19.3) months. The shortest follow-up was 6 months. The longest follow-up was 5 years. Complete follow-up data were available for 398 of the 782 patients. Of the 398 patients followed up for 5 years, the mean international prostate symptom score after 5 years was 12.8 ± 6.9, quality of life score was 2.2 ± 1.6, maximal flow rate was (14.5 ± 2.4) ml/s, and residual urine volume was 58 ml (M50). The retreatment rate because of BPH was 2.3% (9/398). Urethral stricture and bladder neck contracture were observed in 1.5% and 0.5% of the patients, respectively. CONCLUSIONS: PVP has demonstrated remarkably consistent results for objective and subjective voiding parameters. Its late complication is rare and retreatment rate is low.