目的 比較經尿道前列腺剜除術（TUEP）與經尿道前列腺電切術（TURP）的療效。 方法 2010年11月－2011年3月，收治前列腺增生（BPH）患者58例，分別采用TUEP（30例）、TURP（28例）治療。患者年齡55～87歲，平均73歲；病程1～12年，平均5年。術前常規行直腸指檢前列腺光滑無結節；經直腸前列腺彩色超聲多普勒檢查，測得前列腺體積為50～80 mL，平均62 mL；血清前列腺特異性抗原＜10 ng/mL。 結果 TUEP組術中出血量、術后沖洗時間均短于TURP，切除前列腺組織體積大于TURP組，差異均有統計學意義（P＜0.05）。術后拔除尿管后發生暫時性尿失禁TUEP組1例，TURP組發生2例，兩組比較差異無統計學意義；兩組均無永久性尿失禁發生。 結論 TUEP與TURP相比較，TUEP手術療效好，出血少、恢復快，且并發癥少。
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 探討前列腺體積＞60 mL的前列腺增生癥患者的手術安全性，提高部分合并尿道狹窄前列腺增生癥患者的手術實施率。 方法 2009年3月－2010年3月，行恥骨上膀胱穿刺引流下經尿道前列腺電切術（TURP）治療前列腺增生58例。年齡54～93歲，平均72歲，病程8個月～12年，平均7.2年；前列腺體積35～128 mL，平均78 mL；國際前列腺癥狀評分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；殘余尿量84～210 mL，平均160 mL。術前無尿潴留28例。 結果 58例順利完成手術，其中2例伴包膜穿孔，9例前尿道狹窄者通過去外鞘電切鏡完成手術。所有患者切除前列腺組織體積18～86 mL，平均58 mL；術中沖洗液為5%葡萄糖液，用量18 600～42 500 mL，平均23 500 mL；手術時間45～185 min，平均70 min。術后病理檢查均示良性前列腺增生，術后住院時間3～8 d，平均5 d。術后患者最大尿流率為18～46 mL/s，平均32 mL/s。 結論 恥骨上膀胱穿刺引流能降低膀胱內壓，減少水、糖分吸收，增加手術安全性，提高了部分合并前尿道狹窄的前列腺增生患者的手術幾率。
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 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.
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.