Research on Applications of Transurethral Plasmakinetic Enucleation of the Prostate in Elderly Patients Aged ≥80 Years

Objective: To evaluate the safety and efficacy of transurethral plasmakinetic enucleation of the prostate (PKERP) vs. transurethral resection of the prostate (TURP) in elderly patients aged ≥80 years with benign prostate hyperplasia.Materials and Methods: We conducted a retrospective analysis of the PKERP (n = 123) and TURP (n = 143) in patients aged ≥80 years at urology department of The Third Xiangya Hospital of Central South University from January 2016 to October 2019. Then the preoperative, intraoperative, and postoperative data of different indicators were compared between the two groups. The follow-up was done at 3 months, 1 year after surgical treatment.Results: No significant differences were observed between the two groups for the baseline characteristics, including age, prostate volume, prostate-specific antigen (PSA) level, concurrent disease, maximum urinary flow rate (MFR), international prostate symptoms score (IPSS), and quality of life (QoL) score. The operative time, hemoglobin decrease, and postoperative flushing time were significantly lower in the PKERP group compared with the TURP group. However, no significant differences were observed between both groups for postoperative hospital stay, incidence of transurethral resection syndrome (TURS), prostatic capsular perforation, and genuine urinary incontinence. The follow-up results showed that the MFR of the PKERP group was significantly higher than the TURP group at 1 year after surgery.Conclusion: Compared with TURP, PKERP is a safe and efficacious method for treating patients aged ≥80 years with benign prostate hyperplasia, and it may improve long-term urination symptoms.

Prolonged flushing and locking interval for totally implantable vascular access device: A systematic review and meta-analysis

The objective of this systematic review is to evaluate the safety ad feasibility of the totally implantable vascular access devices (TIVADs) flushed more than 4 weeks. We searched the following electronic databases from the date their build-up to February 2020: PubMed, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The final selection resulted in 14 trials fulfilling the inclusion criteria and being included in our review. A pooled frequency of port-related late complications with longer flushing intervals (>4 weeks) was 8.0%, and the pooled frequency of occlusions, infections, and mechanical complications was 5.0%, 2.0%, and 3.0%, respectively. Then, we compared the frequency of port-related complications between standard and longer flushing intervals. There were no differences between the group’s changes in the frequency of total late complications, occlusions, infections, and mechanical complications. This systematic review and meta-analysis demonstrates that longer flushing intervals for ports are safe. However, more prospective, power appropriated randomized trials are needed to explore the specific flushing time for ports.

Modelling the variability of hydrological parameters of the Sasyk reservoir impoundment under various options of its operation

This paper highlights the results of adaptation and verification of the Delft3D Flexible Mesh numerical model under the conditions of the Sasyk reservoir. The objective of this work is to evaluate the expected spatio-temporal variability of water salinity in the Sasyk reservoir after completion of the Sasyk renaturalization project by means of establishing a constant water exchange with the sea through the artificial channel. The Sasyk Lagoon was separated from the sea and transformed into a freshwater reservoir in the late 1970s. However, due to the poor water quality in the Sasyk reservoir in the modern period, the solution of the problem of transforming the reservoir to its original coastal conditions, i.e. the renaturalization, has acquired particular importance. Model results, obtained under conditions of 2019, indicate the possibility of using a hydrodynamic model to evaluate the effectiveness and possible consequences of various scenario-based decisions to be implemented for the management of the hydrological regime of the reservoir under various options of its operation. The model runs were used to evaluate the flushing time of the Sasyk Lagoon and the pattern of the salinity fluctuations in the reservoir after the restoration of the artificial channel in the sand bar with a width of 100 m and a depth of 1.5 m and the establishment of the constant “sea-lagoon” interconnection. Applying the hydrometeorological conditions of 2019, a scenario-based modelling for two consecutive years was performed. For the first year of the simulation, a variant of water management under the absence of freshwater inflow from the Danube and the presence of sea water inflow throughout the year was considered. The model results at the end of the first year of the simulation were set as the initial conditions for the second year, and the rest of the external forcing remained unchanged. Additionally, the variant considering the Danube discharge into the lagoon during May-July for the second year of simulation was investigated. Based on the simulation results, it was found that in the case of a constant water exchange with the sea through the connecting “sea-lagoon” channel (with the abovementioned morphometric characteristics) and under the absence of the Danube freshwater inflow throughout the year: 1) the flushing time of the lagoon will be 1 year and 5 months; 2) stabilization of water salinity in the lagoon will not occur, i.e. the salinization of the lagoon water takes place in the long-term perspective; 3) the time period from the moment of initiating the water exchange with the sea, during which the lagoon reaches the water salinity limit of 7-8 ‰, that is critical for the existence of freshwater species of flora and fauna, is expected to amount to 4 months for the southern part and to 5.5 months for the northern part of the lagoon; after which the formation of the marine ecosystem of the reservoir will begin. It is shown that the stabilization of water salinity in the lagoon in the second year of the simulation can be achieved under conditions of ensuring the Danubian freshwater discharge in the period of significantly higher water level in the Danube River, compared to the lagoon water level (May-July 2019).

Timescale Methods for Simplifying, Understanding and Modeling Biophysical and Water Quality Processes in Coastal Aquatic Ecosystems: A Review

In this article, we describe the use of diagnostic timescales as simple tools for illuminating how aquatic ecosystems work, with a focus on coastal systems such as estuaries, lagoons, tidal rivers, reefs, deltas, gulfs, and continental shelves. Intending this as a tutorial as well as a review, we discuss relevant fundamental concepts (e.g., Lagrangian and Eulerian perspectives and methods, parcels, particles, and tracers), and describe many of the most commonly used diagnostic timescales and definitions. Citing field-based, model-based, and simple algebraic methods, we describe how physical timescales (e.g., residence time, flushing time, age, transit time) and biogeochemical timescales (e.g., for growth, decay, uptake, turnover, or consumption) are estimated and implemented (sometimes together) to illuminate coupled physical-biogeochemical systems. Multiple application examples are then provided to demonstrate how timescales have proven useful in simplifying, understanding, and modeling complex coastal aquatic systems. We discuss timescales from the perspective of “holism”, the degree of process richness incorporated into them, and the value of clarity in defining timescales used and in describing how they were estimated. Our objective is to provide context, new applications and methodological ideas and, for those new to timescale methods, a starting place for implementing them in their own work.

Study on Reasonable Amount of Flushing Fluid and Flushing Time

Oil-based drilling fluid has many advantages, such as stable performance, strong anti-pollution ability, and strong inhibition, and it has been widely used in the world. However, at present, there is no unified evaluation standard for the effect of flushing fluid under this condition, and most of them are based on the flushing effect evaluation of water-based drilling fluid. However, there are few studies on wetting reversal phenomenon, reasonable dosage, and flushing time between oil-based drilling fluid and flushing fluid on the two-phase interface. Therefore, it is necessary to establish a comprehensive evaluation method for the effect of flushing fluid under oil-based drilling fluid, and explore the relationship between the amount of flushing fluid and flushing efficiency, so as to determine the reasonable range of flushing fluid consumption. In this paper, using the existing experimental instruments, a type A oil-based flushing fluid commonly used in oil fields was selected for the experiment, and on the basis of the high-temperature and high-pressure filtration meter, a flushing fluid evaluation device was developed. Based on the principle of equal shear rate, the flushing displacement and flushing time were determined, and then the flushing effect was evaluated. In order to comprehensively consider the influencing factors of the well wall flushing effect, five experimental factors, including different core, flushing displacement, flushing time, flushing fluid type, and surfactant concentration, were selected to formulate the flushing experiment scheme. The contrast method was used to test the cementation strength of core and cement slurry under different conditions, and the microscopic morphology of the interface was observed and analyzed to explore the reasons for the change of cementation strength between core and cement slurry due to the existence of oil-based drilling fluid. The conclusion obtained has very important practical significance to guide the field practice.