目的 比较经尿道前列腺剜除术（TUEP）与经尿道前列腺电切术（TURP）的疗效。 方法 2010年11月－2011年3月，收治前列腺增生（BPH）患者58例，分别采用TUEP（30例）、TURP（28例）治疗。患者年龄55～87岁，平均73岁；病程1～12年，平均5年。术前常规行直肠指检前列腺光滑无结节；经直肠前列腺彩色超声多普勒检查，测得前列腺体积为50～80 mL，平均62 mL；血清前列腺特异性抗原＜10 ng/mL。 结果 TUEP组术中出血量、术后冲洗时间均短于TURP，切除前列腺组织体积大于TURP组，差异均有统计学意义（P＜0.05）。术后拔除尿管后发生暂时性尿失禁TUEP组1例，TURP组发生2例，两组比较差异无统计学意义；两组均无永久性尿失禁发生。 结论 TUEP与TURP相比较，TUEP手术疗效好，出血少、恢复快，且并发症少。
ObjectiveTo systematically review the effectiveness and safety of transurethral ureteroscopy lithotripsy in the treatment of upper ureteral calculi. MethodsWe electronically searched The Cochrane Library (Issue 3, 2013), PubMed (1966 to 2013.8), EMbase (1990 to 2013.8), CNKI (1949 to 2013.9), CBM (1978 to 2013.9), VIP (1989 to 2013.8) and WanFang Data (1990 to 2013.8) for the randomized controlled studies (RCTs) related to retroperitoneoscopy ureterolithotomy versus transurethral ureteroscopy lithotripsy for upper ureteral calculi. Two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 410 patients (transurethral ureteroscopy lithotripsy:747 cases; etroperitoneal laparoscopic ureterolithotomy:663 cases) were included. The results of meta-analysis showed that, transurethral ureteroscopy lithotripsy was lower than retroperitoneoscopy ureterolithotomy in success rates of surgery (OR=0.26, 95%CI 0.14 to 0.51), 3-day stone clearance rates (OR=0.06, 95%CI 0.03 to 0.11), and 1-month stone clearance rates (OR=0.21, 95%CI 0.08 to 0.53), while it showed superiority in operation time (MD=-22.35, 95%CI-35.29 to-9.41) and postoperative hospital stay (MD=-1.84, 95%CI-3.44 to-0.24). ConclusionCurrent evidence shows that, in the treatment of upper ureteral calculi, transurethral ureteroscopy lithotripsy causes less operation time and postoperative hospital stay, but it had no advantage in success rates of surgery, 3-day stone clearance rates, and 1-month stone clearance rates.
目的 探讨前列腺体积＞60 mL的前列腺增生症患者的手术安全性，提高部分合并尿道狭窄前列腺增生症患者的手术实施率。 方法 2009年3月－2010年3月，行耻骨上膀胱穿刺引流下经尿道前列腺电切术（TURP）治疗前列腺增生58例。年龄54～93岁，平均72岁，病程8个月～12年，平均7.2年；前列腺体积35～128 mL，平均78 mL；国际前列腺症状评分24～35分，平均30.2分 ；最大尿流率1.2～4.8 mL/s，平均1.8 mL/s；残余尿量84～210 mL，平均160 mL。术前无尿潴留28例。 结果 58例顺利完成手术，其中2例伴包膜穿孔，9例前尿道狭窄者通过去外鞘电切镜完成手术。所有患者切除前列腺组织体积18～86 mL，平均58 mL；术中冲洗液为5%葡萄糖液，用量18 600～42 500 mL，平均23 500 mL；手术时间45～185 min，平均70 min。术后病理检查均示良性前列腺增生，术后住院时间3～8 d，平均5 d。术后患者最大尿流率为18～46 mL/s，平均32 mL/s。 结论 耻骨上膀胱穿刺引流能降低膀胱内压，减少水、糖分吸收，增加手术安全性，提高了部分合并前尿道狭窄的前列腺增生患者的手术几率。
Objective To investigate the effectiveness of double EndoButton suture fixation Latarjet procedure in the treatment of shoulder anterior dislocation with glenoid bone defect caused by military training injuries.MethodsThe clinical data of 14 patients with anterior shoulder dislocation with glenoid bone defect due to military training injuries who met the selection criteria and admitted between August 2021 and December 2022 were retrospectively analyzed. All patients were male, the age ranged from 21 to 38 years, with an average of 26.8 years. The time from initial dislocation to operation was 6-15 months, with an average of 10.2 months. Anterior shoulder dislocation occurred 5-12 times, with an average of 8.2 times. All glenoid bone defects were more than 10%, including 5 cases of 10%-15%, 8 cases of 15%-20%, and 1 case of 24%. All patients were treated by double EndoButton suture fixation Latarjet procedure. The operation time and complications were recorded. The shoulder function and pain were evaluated by the American Association for Shoulder and Elbow Surgery (ASES) score, Rowe score, Instability Severity Index Score (ISIS), and visual analogue scale (VAS) score before and after operation. The range of motion of the shoulder was recorded, including forward flexion, 0° external rotation, and abduction 90° external rotation. The position, healing, and resorption of the bone mass were evaluated by three-dimensional CT of shoulder joint after operation. Results All patients successfully completed the operation, and the operation time was 100-150 minutes, with an average of 119.7 minutes. There was no complications such as infection, vascular and nerve injury. All patients were followed up 12-20 months, with an average of 15.6 months. During the follow-up, 4 patients had bone mass separation, absorption, and recurrent anterior dislocation, and the shoulder joint fear test was positive. Imaging of the remaining patients showed that the bone mass healed well, no anterior dislocation recurrence occurred, and the healing time was 3-7 months (mean, 4.7 months). At last follow-up, the range of motion, ASES score, Rowe score, ISIS score, and VAS score of the patients significantly improved when compared with those before operation (P<0.05). ConclusionThe effectiveness of double EndoButton suture fixation Latarjet procedure for the treatment of anterior shoulder dislocation with glenoid bone defect caused by military training injury is satisfactory.
ObjectivesTo introduce the formulating methods and implementing steps of search strategy of systematic reviews (SRs)/meta-analysis (MAs) of animal experiments, so as to provide a reference for domestic related researchers, and promote the development and implementation of high quality SRs/MAs of animal experiments in China. MethodsPubMed, EMbase and CNKI databases were searched online to retrieve studies on the search strategy of SRs/ MAs of animal experiments from inception to October 2017. A descriptive analysis was then conducted using the evidence-based medicine theory and method.ResultsA total of 5 studies were included. The 5 basic steps on how to design and carry out comprehensive search strategies to identify potentially relevant animal experiments on a specific research question were as follow: 1) Formulate research question; 2) Identify appropriate databases and sources of studies; 3) Transform research question into search strategy; 4) Collect search results and remove duplicates; 5) Identify potentially relevant papers. The report of search strategy needs to state its search method and search results clearly.ConclusionThese 5 steps can provide an effective method, which will assist researchers in performing a comprehensive literature search.
ObjectivesTo survey the current research situation, methodological and reporting quality of the systematic review/meta-analysis (SRs/MAs) of animal studies.MethodsPubMed, EMbase, BIOSIS Previews, CNKI, WanFang Data, CBM and VIP databases were searched to collect SRs/MAs of animal studies from inception to June 2016. Two reviewers independently screened literature, extracted data, a descriptive analysis was then conducted.ResultsA total of 609 SRs/MAs of animal studies were included, which were from 27 countries and published in 526 journals. Merely 36.8% (224/609) studies assessed the risk of bias in the original animal experiments. Less than 50% studies reported the method of literature selection (41.9%, 255/609), data abstraction (32.0%, 195/609) and study characteristics (41.2%, 251/609).ConclusionsThe published SRs/MAs of animal studies is poor in both methodological and reporting quality. Thus, we hope to improve awareness and actual use rates of these guidelines by basic medical researchers and journal editors, thereby improving the quality of animal experimental methods and reporting standards.