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Objective To evaluate the efficacy and safety of microscopic ligation of spermatic vein in the treatment of nutcracker syndrome (NCS) with only left spermatic vein (LSV) varicocele. Methods The clinical data of 34 patients with moderate and severe LSV varicocele caused by NCS who were admitted to our hospital from February 2016 to November 2020 were retrospectively analyzed, and the preoperative and postoperative clinical symptoms and examination results of the patients were evaluated and compared. Results Low-position ligation of LSV under microscope was successfully performed in all 34 cases. Of the 19 patients with preoperative discomfort and pain of swollen testicle, 17 were significantly relieved after the surgery. No complications such as testicular hydrocele and scrotal edema occurred in all the patients, and during the follow-up of 3-15 months, no recurrence was found. Among the patients, the left spermatic vein diameter (LSVD), sperm density, forward motility sperm count, total testosterone and follicle-stimulating hormone (FSH) were significantly improved 3 months after the surgery (P < 0.05). By contrast, there were no significant differences between pre- and post-surgery (P>0.05) in sperm motility, luteinizing hormone (LH) and following ultrasonographic indicators: velocity of the left renal vein (LRV) at the angle between the abdominal aorta (AO) and the superior mesenteric artery (SMA) (PV1), velocity of the LRV near the renal hilum (PV2), PV1/PV2; inner diameter of the LRV at the angle between the AO and SMA (LRVD1), inner diameter of the LRV near the renal hilum (LRVD2), and LRVD1/LRVD2. Conclusion Microsurgical ligation of LSV is safe and effective in the treatment of moderate and severe left varicocele caused by NCS, which can significantly improve the clinical symptoms and semen quality, without aggravating the nutcracker phenomenon or causing other clinical manifestations of NCS.

Objective To compare the safety and efficacy of transurethral laser and transurethral resection for treatment of non-muscle invasive bladder cancer (NMIBC). Methods Randomized controlled trials, cohort studies and case-control studies comparing transurethral laser and transurethral resection of NMIBC were retrieved from PubMed, Medline, Embase, Cochrane Library, Web of Science, Social Science Citation Index, China Journal Full-text Database (CNKI), Chinese Biomedical Literature Database and VIP medical database. RevMan 5.3 software was used for meta-analysis of the data extracted from the eligible studies. Results We retrieved 16 eligible studies involving a total of 2 570 patients from the databases. Meta-analysis of the data from these studies showed no significant difference between the 2 surgical modalities in terms of the operation time (MD=-0.70, 95%CI: -2.78~1.38, P=0.51) or the occurrence of postoperative urethral stricture (OR=0.70, 95%CI: 0.24~2.06, P=0.52). Compared with transurethral resection, transurethral laser surgery was associated with significantly lower incidences of intraoperative obturator nerve reflex (OR=0.05, 95%CI: 0.02~0.10; P < 0.001) and bladder perforation (OR=0.11, 95%CI: 0.04~0.29, P < 0.001), shorter postoperative catheterization time (MD=-1.08, 95%CI: -1.46~-0.71, P < 0.001) and length of hospital stay (OR=0.05, 95%CI: 0.02~0.10, P < 0.001), and lower rates of bladder irrigation (OR=0.21, 95%CI: 0.13~0.35, P < 0.001) and postoperative recurrence at 12 months (OR=0.67, 95%CI: 0.48~0.93, P=0.02) and 24 months (OR=0.60, 95%CI: 0.41~0.86, P=0.005). Conclusion Transurethral laser surgery for NMIBC, as compared with transurethral resection, is associated with lower incidences of intraoperative complications (obsessive nerve reflex and bladder perforation), a lower postoperative recurrence rate, and faster postoperative recovery.

The coal water mixture atomization before firing plays an important part in its combustion and gasification. Through experiment, investigate the process of twin fluid air-blast nozzle atomization under high ambient pressure. The LS-2000 laser particle analyzer is used to measure the change of Sauter Mean Diameter(dd32) and atomization angle with environmental stress and gas liquid mass ratio. The results show that'd32 and atomization angle decrease with environmental stress increase while keeping the gas liquid mass ratio unchanged. The dd32 is proportional to the n power of environmental stressing lines between -0.9 and -1.5. The d32 decrease with gas liquid mass ratio increase under constant environmental stress. [ABSTRACT FROM AUTHOR]