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Objective To investigate the relationship between preoperative albumin-to-alkaline phosphatase ratio and overall survival (OS) after radical cystectomy of bladder cancer.Methods The clinical date of patients with bladder cancer who underwent radical cystectomy and urinary diversion and confirmed by pathology from Jan 2007 to Dec 2015 were analyzed retrospectively,with 140 cases undergoing laparoscopic surgery and 26 cases undergoing open surgery.There were 148 males and 18 females,aged was 33-85 years,with an ayerage ageof (65.1 ± 9.4) years.There were 55 cases of cutaneous ureterostomy,96 cases of Brick diversior with ileum,and 15 cases of ileal neobladder.The AAPR range 0.03-1.67,with an average 0.62 ± 0.23,and body mass index (BMI) was 16.79-32.65 kg/m2,with an average of (24.00 ± 3.32) kg/m2.There were 33 cases with hydronephrosis and 133 no hydronephrosis,31 cases with hypertension and 135 cases no hypertension,and 14 cases with diabetes and 152 cases no diabetes.Four cases were classified as grade0,65 cases as grade 1,86 cases as grade 2,and 11 cases as grade 3.Based on the preoperative AAPR(0.62 ±0.23),they were divided into three groups,with 55 cases in the low AAPR (0.42 ± 0.09) group,55 cases in the middle AAPR (0.58 ± 0.05) group,and 56 cases in the high AAPR (0.86 ± 0.21)group.Cox proportional hazards regression methodology were used to evaluate the relationship between preoperative AAPR and overall survival.Survival analysis was conducted using the Kaplan-Meier method and compared with the log-rank test.Results 166 patients were followed up for 1-144 months,with a median of 63 months,and 71 cases died and 95 survived.The median serum AAPR level in all cases was 0.59 (range 0.03-1.67).Results of univariate Cox regression model revealed that AAPR(HR =0.09,95％ CI 0.022-0.391,P =0.001),high AAPR (HR=0.40,95％CI0.216-0.742,P=0.003),age (HR =2.42,95％ CI 1.294-4.531,P =0.006),tumor size (HR =2.11,95％ CI 1.112-4.014,P =0.023),pT3 stage (HR=8.93,95％CI3.173-25.114,P＜0.001),pT4 stnge(HR =10.39,95％ CI 3.110-34.707,P ＜0.001),pN1 stage(HR =2.80,95％ CI 1.422-5.531,P =0.003),pN3 stage (HR =17.06,95％ CI2.192-132.863,P =0.007),pathological grade (HR =0.30,95％ CI 0.113-0.817,P =0.019),hydronephrosis (HR =2.36,95 ％ CI 1.406-3.939,P =0.001),adjuvant chemotherapy (HR =2.66,95％ CI 1.674-4.247,P ＜ 0.001)were associated with OS.Compared with patients in the lowest of AAPR,the risk for death in the highest AAPR group decreased about 59％ (HR =0.406,95％ CI 0.200-0.822,P =0.012)after adjustment for age,BMI,tumor size,number of tumor,T category,N category,pathological grade,hydronephrosis,ASA level,adjuvant chemotherapy in multiple Cox regression models.Each unit increase in the AAPR was associated with about 80％ decreased risk of death (HR =0.199,95％ CI 0.051-0.779,P =0.020) after adjusting for the confounding variables.After adjusting for age,BMI,tumor size,number of tumor,T category,N category,pathological grade,hydronephrosis,ASA level,adjuvant chemotherapy,the curve fitting results showed that with the increase of AAPR,the risk of death decreased and the overall survival prolonged.Consistent with the linear trend test results,the relationship between AAPR and OS is linear.Conclusions AAPR was associated with overall survival of patients who underwent radical cystectomy of bladder cancer.
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Objective: To investigate the value of transrectal ultrasound combined with seminal plasma elastase (SPE) in diagnosis of male infertility caused by chronic seminal vesiculitis (CSV). Methods Transrectal ultrasonography was performed in 106 patients with male infertility caused by CSV (infertility group) and 106 healthy men (control group), and SPE was detected in two groups. The differences of seminal vesicle ultrasound parameters and SPE were compared between two groups. The correlations between SPE and seminal vesicle parameters were analyzed. ROC curves were used to evaluate the diagnostic efficiency of SPE combined with seminal vesicle ultrasound parameters on male infertility caused by CSV. Results: The short diameter of seminal vesicle, inner diameter of gland tube, the peak systolic velocity (PSV), resistance index (RI) and SPE level in infertility group were higher than those in control group (all P<0.01). The short diameter of seminal vesicle, inner diameter of gland tube, PSV, RI and SPE were impact factors of male infertility caused by CSV (all P<0.05). SPE was positively correlated with PSV, RI and short diameter of seminal vesicle (r=0.732, P<0.001; r=0.647, P=0.004; r=0.526, P=0.007). SPE combined with PSV, RI and short diameter of seminal vesicle could be used to diagnose male infertility caused by CVS (all P<0.05), among which SPE combined with PSV had the most effective diagnostic value, the area under ROC was 0.73, the sensitivity and specificity was 0.73 and 0.70, respectively. Conclusion: Transrectal ultrasound combined with SPE have certain clinical diagnostic value for male infertility induced by CSV.
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Objective To explore the feasibility and effectiveness of otoacoustic emission (OAE) in hearing screening for preschool children .Methods A total of 616 preschool children aged 3～6 (mean age 4 .6 years old) were included in this study .All the subjects received transiently evoked otoacoustic emission (TEOAE) test by trained personnel .The children who failed the hearing screening received diagnostic examination in the hearing ex-amination center .Results Of 616 children ,66 (10 .71％ ) failed the hearing screening and 16 children received audi-ological assessment .In these 16 children ,8 had otitis media with effusion (5 with mild conductive hearing loss ) ,5 had impacted cerumen ,3 had normal hearing ,and none had sensorineural hearing loss .Conclusion OAE can be used effectively in the hearing screening for preschool children .But how to improve the referral rate of children who failed the hearing screening needs further discussion .