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Objective:To investigate the diagnostic value of Chinese-thyroid imaging reporting and data system (C-TIRADS) combined with shear wave elastography (SWE) in thyroid microcarcinoma.Methods:The clinical data of 270 patients (367 nodules) who underwent thyroid ultrasound examination and confirmed by pathology from January 2019 to June 2021 in the Affiliated Hospital of Jining Medical University were analyzed retrospectively. All patients were assisted by SWE in preoperative ultrasound examination to measure the maximum elastic modulus (E max), the average elastic modulus (E mean) and the minimum elastic modulus (E min). The receiver operating characteristic (ROC) curve was drawn to get the optimal threshold of SWE according to the pathological results. The diagnostic value of C-TIRADS, SWE and their combined in different diameters thyroid micronodules was analyzed. Results:Among 367 thyroid nodules, 119 nodules were benign and 248 nodules were malignant. The area under the curve (AUC) of E max in diagnosing TMC was significantly larger than that of E mean and E min (0.883 vs. 0.822 and 0.706), and there was statistical difference ( P<0.05); the best cut-off value of E max was 29.5 kPa. The ROC curve analysis results showed that the AUC of C-TIRADS combined with SWE in diagnosis of TMC was significantly larger than that of C-TIRADS and SWE alone (0.884 vs. 0.800 and 0.853), and there was statistical difference ( P<0.05); the sensitivity, accuracy and negative predictive value of C-TIRADS combined with SWE in diagnosis of TMC were significantly higher than those of C-TIRADS alone (90.32% vs. 80.24%, 89.10% vs. 80.11% and 81.10% vs. 65.97%), and there were statistical differences ( P<0.05). Thyroid nodules were divided into ≤0.5 cm nodules (56 nodules) and 0.5 to 1.0 cm nodules (311 nodules) according to the maximum diameter, the sensitivity and accuracy of C-TIRADS combined with SWE in diagnosing TMC in 0.5 to 1.0 cm nodules were significantly higher than those in ≤0.5 cm nodules: 91.82% (202/220) vs. 78.57% (22/28) and 90.68% (282/311) vs. 80.36% (45/56), and there were statistical differences ( χ2 = 4.99 and 5.20, P<0.05), but there was no statistical difference in specificity between 2 groups ( P<0.05). Conclusions:C-TIRADS combined with SWE can further improve the diagnostic value of TMC, which is worth popularizing and applying in clinic.
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Objective To explore the sen sation recovery of superficial palmar branc h of the radial artery flap with palmar branch of median nerve and donor si te. Methods From January, 2014 to June, 2016, 12 cases of finger soft tissue defects were repaired with sup erficial palmar branch of the radial artery flap with palmar branch of median nerve. The 2 g tactile sensation, 5 g pain sen sation, 30 g pressure sensation and static two-point discrimination (S2 -PD) of the flap was tested regularly. The S2 -PD of the palmar cutaneous branch of the median nerve were recorded respectively on the affected side and the unaffected side. The results were applied comparative t-test to perform statistical analysis, to observe the sensory recovery of the flap and donor site. Results The flaps survived.Twelve cases was followed-up for 6-18 mont hs. The pressure sensation of about 83.3％ of patients recovered after 2 months and 100％ of patients recovered after 3 months. The tactile sensation of about 91.7％ of patients recovered after 3 months and 100％ of patients recovered after 4 months. The pain sensation of about 91.7％ of patients recovered after 4 months of and 100％ of patients recovered after 5 months. S2-PD of the flap was the average of 8.3 mm in 6 months after operation. There were no significant differences in the S2-PD between the affected group [(12.08±2.15)mm] and unaffected group [(10.58±2.11)mm](P>0.05). And the sensory recovery of the control area of the palmar branch of the median nerve was S4 in 2 cases, S3+ in 9 cases, and S3 in 1 case. The sensory recovery was good. Conclusion Superficial palmar branch of the radial artery flap with palmar branch of median nerve can be used repair the skin defect of the fingers. The flap has a good sensery recovery, and the sensation of the donor area is gradually restored.
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Objective@#To investigate the occurrence of lymph node micrometastasis in pancreatic head carcinoma and analyze its effect on the prognosis of patients.@*Methods@#The lymph nodes in 40 patients who received pancreatoduodenectomy with regional lymphadenectomy were dissected by surgical magnification microscopy. The expression of cytokeration(AE1/E3) were detected by immunohistochemical staining in the pathologically negative lymph nodes. The frequency of lymph nodes metastases and micrometastases, as well as the relationship between metastasis and prognosis were analyzed.@*Results@#1 550 lymph nodes were dissected from 40 patients. Lymph node metastases was pathologically detected in 27 patients (67.5%) and in 199 lymph nodes(12.8%). No.13(24.1%, 68/282), No.14(18.1%, 58/321), No.12(12.7%, 31/245), No.16(12.3%, 30/243) and No.17(11.4%, 12/105) lymph nodes groups had higher frequency of metastases. Lymph node micrometastases was immunohistochemically detected in 6 patients and 130 lymph nodes. No.14(16.5%, 53/321), No.13(15.2%, 43/282), No.16(6.2%, 15/243), No.12(4.9%, 12/245) and No.8(5.0%, 7/141) lymph nodes groups had higher frequency of micrometastases. The total ratio of patients with postive lymph nodes invasion and the ratio of positive lymph nodes invasion were 82.5% and 21.2%. 11 patients survived more than one year. 29 patients died of recurrence or metastasis within 8~11 months after surgery. The 1-year survival rate was 27.5%. 1-year survival rate was 14.9% in HE (+ ) patients, and 33.3% in HE (-) AE1/E3 (+ ) patients (P=0.632). AE1/E3 (-) HE (-) patients had a 1-years survival rate of 71.4%, which was statistically higher than that in HE (+ ) group patients (P=0.010).@*Conclusions@#AE1/E3 combined with pathological examination can significantly improve the detection rate of lymph nodes micrometastasis in pancreatic head carcinoma patients. Micrometastasis is commonly found in No 13, 14, 12, 16, 8 lymph nodes groups. Lymph nodes micrometastasis had a significant effect on the prognosis of patients. Special attention should be payed to No 13, 14, 16, 12, 17 lymph nodes groups during radical duodenopancreatectomy.
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BACKGROUND/AIMS: Gastric hypersensitivity contributes to abdominal pain in patients with functional dyspepsia. Recent studies showed that hormones induced by stress are correlated with visceral hypersensitivity. However, the precise mechanisms underlying gastric hypersensitivity remain largely unknown. The aim of the present study was designed to investigate the roles of corticosterone (CORT) on excitability of dorsal root ganglion (DRG) neurons innervating the stomach. METHODS: DRG neurons innervating the stomach were labeled by DiI injection into the stomach wall. Patch clamp recordings were employed to examine neural excitability and voltage-gated sodium channel currents. Electromyograph technique was used to determine the responses of neck muscles to gastric distension. RESULTS: Incubation of acutely isolated DRG neurons with CORT significantly depolarized action potential threshold and enhanced the number of action potentials induced by current stimulation of the neuron. Under voltage-clamp mode, incubation of CORT enhanced voltage-gated sodium current density of the recorded neurons. Pre-incubation of GF109203X, an inhibitor of protein kinase C, blocked the CORT-induced hyperexcitability and potentiation of sodium currents. However, pre-incubation of H-89, an inhibitor of protein kinase A, did not alter the sodium current density. More importantly, intraperitoneal injection of CORT produced gastric hypersensitivity of healthy rats, which was blocked by pre-administration of GF109203X but not H-89. CONCLUSIONS: Our data strongly suggest that CORT rapidly enhanced neuronal excitability and sodium channel functions, which is most likely mediated by protein kinase C but not protein kinase A signaling pathway in DRG neurons innervating the stomach, thus underlying the gastric hypersensitivity induced by CORT injection.
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Animals , Humans , Rats , Abdominal Pain , Action Potentials , Corticosterone , Cyclic AMP-Dependent Protein Kinases , Diagnosis-Related Groups , Dyspepsia , Ganglia , Ganglia, Spinal , Hypersensitivity , Injections, Intraperitoneal , Neck Muscles , Neurons , Protein Kinase C , Protein Kinases , Sodium , Sodium Channels , Spinal Nerve Roots , Stomach , Visceral PainABSTRACT
Objective To Compare the postoperative recovery of continence after 3D and 2D laparoscopic radical prostatectomy.Methods A retrospective analysis of 72 patients underwent radical prostatectomy in our department from January 2013 to December 2015,including 38 cases underwent 3D laparoscopic radical prostatectomy,3D group's mean age was (64.2 ± 6.0)years,mean of preoperative PSA was (14.5±7.6)ng/ml,Gleason score (13 cases≤6,17 cases =7,8 cases ≥8),the mean prostate volume (41.4 ±9.1) ml,the classification of clinical stage in 3D group included 2 cases in cT1,26 cases in cT2,9 cases in cT3a,1 cases in cT3b,mean body mass index was (22.8 ± 2.2) kg/m2,mean of MUL (membranous urethral length) was (15.6 ±2.6) mm;34 cases in the 2D group,3D group's mean age was (61.9 ±6.6)years,mean of preoperative PSA was (16.7 ±6.8) ng/ml,Gleason score (10 cases≤6,18 cases =7,6 cases ≥8),the mean prostate volume (42.1 ± 10.6) ml,the classification of clinical stage in 3D group included 1 cases in cT1,28 cases in cT2,5 cases in cT3a,mean body mass index was (21.7 ± 1.9) kg/m2,mean of MUL(membranous urethral length) was (15.5 ± 2.5) mm.All patients got a good function of micturition and urinary continence before the surgery.We compared surgical time,bladder neckurethral anastomosis time and blood loss in two groups.Membranous urethral length(MUL) were measured on preoperative and postoperative magnetic resonance imaging (MRI).Postoperative continence rate was analyzed at 2 weeks,4 weeks,8 weeks,12 weeks,24 weeks and 36 weeks after the remove of the catheter.Results All the operations were completed successfully by the same surgeon and none was transferred to open surgery.The age,PSA value,Gleason score,prostate volume,TNM stage,BMI (body mass index)and other relevant aspects of the clinical data showed no significant difference (P ＞ 0.05).The time of bladder neck-urethral anastomosis is less than the 2D group [(12.9 ± 1.7) min and (15.7 ±2.6) min,P =0.021],MUL loss in the 3D laparoscopic surgery group is less than that of 2D laparoscopic [(0.5 ±0.1) ml vs.(0.6±0.2) ml,P =0.044],the two groups in operative time [(162.7 ± 17.1) min vs.(175.7 ± 15.7) min,P =0.802],intraoperative blood loss[(191.1 ± 31.6) ml vs.(211.8 ±43.2) ml,P =0.021],intraoperative blood transfusion rate [5.2％ (2/38) vs.8.8％ (3/34),P =0.662],postoperative incidence of urine leakage [7.9％ (3/38) vs.14.7％ (5/34),P =0.463],postoperative the MUL [(15.1 ± 2.6) mm vs.(15.0 ± 2.6) mm,P =0.767),there was no statistically significant differen.All patients were followed up for urinary function at least 36 months.The continence rate between two groups at 8 weeks (60.5％ vs.35.3％),12 weeks (73.7％ vs.47.1％) got significantly difference.Conclusions Compared with 2D laparoscopic,3D laparoscopic may help early postoperative recovery of urinary continence after laparoscopic radical prostatectomy.
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After the institutional repository system was constructed using the open-source software Drupal, the team collaboration platform and institutional repository platform were integrated into a Web 2.0-based network plat-form on which the users can create their project groups and other users can be formed as dynamic virtual groups by joining the team group in which they work in collaboration.The team members submit the files to the project group in a sustained manner for its share and use during the ongoing project, and the files become the intellectual proper-ties of project group.The whole project group was sealed as a part of institutional repository after the project was completed, and the users can see how the project is completed at any time, thus helping the collection, store and use of intellectual properties.
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The paper analyzes the current status and existing problems of citation retrieval work, puts forward the design principle, overall structure and function of cited references integration tools, demonstrates the key technologies of system realization.An integrated retrieval platform for online literature citations is constructed for the following functions:one-stop retrieval of various citation databases, automatic removal of duplications, so as to reduce the burden of staffs and improve efficiency effectively.
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Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.
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Resveratrol has several neuroprotective effects in cerebral ischemia, including reductions of oxidative stress, inflammatory responses and apoptosis. Recent studies have shown that these neuroprotective effects of resveratrol may be involved in activation of silent information regulator 1.
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Objective To study the effect of estrogen on cardiac injury and cardiomyocyte apoptosis of rat induced by isoprotere-nol by modeling cardiac inj ury induced by bilateral ovariectomized (OVX)and isoproterenol (ISO).Methods Fifty female SD rats with bilateral ovariectomy and sham operation (Sham)were randomly divided into 5 groups:sham operation group (Sham group), bilateral ovariectomy group (OVX group),cardiac injury group (OVX+ISO+Vehi group),low dose estrogen treatment group (OVX+ISO+E2 a group,4μg·kg-1 ·d-1 ),high dose estrogen treatment group (OVX+ISO+E2 b group,40μg·kg-1 ·d-1 ). these status were separately measured:rats′general features,hemodynamics parameters monitored of carotid artery,morphological observation and cardiomyocyte contraction change of single-cardiomyocyte separate cultured,cardiomyocyte apoptosis protein ex-pression were detected by immunoblotting.Results ISO significantly reduced myocardial pump function,increased hypertrophy and apoptosis of cardiomyocytes,reduced contractility of single cardiomyocytes (P<0.05).High-dose estrogen (40μg·kg-1 ·d-1 ) replacement therapy significantly improved ISO induced cardio inj ury and cardio functions decreasing,also inhibited Bax expression and caspas-3 activation and decreased myocardial hypertrophy and cardiomyocytes apoptosis through increasing Bcl-2 expression (P<0.05),significantly.while low dose estrogen (4μg·kg-1 ·d-1 )treatment showed marginally protection effects on ISO in-duced cardio inj ury with no statisticly significance.Conclusion Appropriate dose estrogen replacement therapy can decrease cardio-myocyte apoptosis,improve cardiomyocytes contractility,so as to protect ISO-induced cardiomyocyte apoptosis.
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Objective To study the morphology of normal liver and tumors by breathing motion of hepatocellular carcinoma patients,through comparing the modified demons algorithm and FFD algorithm based on B-spline,and combing four-dimensional computed tomography (4DCT).Methods The 4DCT images of 8 HCC patients were segmented into 10-series which were named CT0,CT10 … CT80,CT90 according to the respiratory phases,CT0 and CT50 are defined to be end-inhale and end-exhale respectively.CT50 was chosen as the reference image.We used the modified demons algorithm and FFD algorithm based on B-spline to deform the images.Linear interpolation was used in both mode 1 and mode 2.The normalized mutual information (NMI),Hausdorff distance (dH) and registration speed were used to verify the registration performance.Results The average NMI for the end-inhale and end-exhale images of 8 HCC patients after demons registration in mode 1 improved 4.75％ with FFD algorithm based on B-spline(P =0.002).And the difference of dH after demons reduced 15.2％ comparing with FFD model algorithm (P =0.02).In addition,demons algorithm has the absolute advantage in registration speed(P =0.036).Conclusions The breathing movement for deformation of normal liver and tumor targets is significant.These two algorithms can achieve the registration of 4DCT images and the modified demons registration can deform 4DCT images effectively.
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After an overall introduction of the novel functions of the CMCI institutional knowledge version developed by Medical Library of Chinese PLA , its coverage of institutions, authors, funds, journals and literature was de-scribed in terms of RDE semantics.The contents in literature were mined and analyzed in depth based on the litera-ture-marked information with the institutions database, funds database, journals database and literature database as their cores, the association of information resources in biomedical field was thus realized.The CMCI institutional knowledge version can be used to search published papers and citations, write citation reports, enforce bibliometric visualization analysis, issue different top-ranked statistical data, push associated information, increase institutional literature management modules, and provide personal literature management and assessment service for different in-stitutions.
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An integrated retrieval platform for online biomedical literature citations with the functions of one-stop retrieval, automatic removal of duplications, automatic grouping, and rapid output of standard citation report, was constructed on the basis of CMCI, with the C/S structure as its model and the NET framework as its development platform, in order to solve the problems of different citation databases in our library, such as inconsistent retrieval methods, inconsistent displaying methods of retrieval outcomes, and non-standard citation description, which can thus improve the efficiency of searching and citing biomedical literature.
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Silibinin, from milk thistle (Silybum marianum), is a flavonolignan with anti-oxidative and anti-inflammatory properties. It has been therapeutically used for the treatment of hepatic diseases in China, Germany and Japan. Recently, increasing evidences prove that silibinin is also a potent antitumor agent, and the major anti-tumor mechanism for silibinin is the prominent inhibition of the activities of receptor tyrosine kinases (RTKs) and their downstream signal molecules in a variety of tumor cell lines, such as epidermal growth factor receptor 1 (EGFR) and insulin-like growth factor 1 receptor (IGF-1R) signaling pathways. Meanwhile, the evidences that silibinin selectively scavenges hydroxyl free radical (*OH) and specifically inhibits the action of nuclear factor kappaB (NF-kappaB) provide more complicated explanations for its antioxidant and anti-inflammatory effects. Some new findings such as that silibinin attenuating the cognitive deficits induced by amyloid beta protein (Abeta) peptide through its antioxidative and anti-inflammatory properties is valuable to broad the medical prospect of silibinin. In this review, we discuss the molecular pharmacological mechanisms of silibinin, focusing on its inhibition of tyrosine kinases, actions of antioxidation, free radical scavenging, immunoregulation and anti-inflammation.
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Objective To evaluate the quality of life(QOL)of Hazak patients with hypertension in Urumqi Nanshan pasturing area.Methods Totally 900 Hazak hypertensive patients were investigated by using questionnaire of SF-36 quality of life,Stepwise regression analysis was used to study the correlated factors.Results The scores of the quality of life was (413.98±146.31),Their physical function,bodily pain,general health and mental health dimensions had lower scores.The factors which had influenced the QOL of patients was age,education level,the per capita monthly income,the payment of medical expenses,medical treatment,the nearest clinique,energy,sleep quality,availability of negative life events,compliance,whether or not having chronic diseases,social support,pain and others.Conclusions The quality of life of Hazak hypertensive patients in Urumqi Nanshan pasturing area was poor,medical workers should pay high attention to health eduction for these patients,and improve their life quality through increasing cognition of hypertension-related knowledge and simplify treatment protocol.
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@#Objective To explore the manner of the community-based rehabilitation(CBR)on the disabled affected by leprosy(DAL).Methods Two towns with more DALs were selected as pilot areas to set up a station for CBR in township hospital respectively.Under the leadership of governments on local county and township levels and using the health resources of township hospital recovery service was offered freely to DALs periodically.Certainly,the DALs were willing to participate the program,the township hospital and doctors offered service should be paid by local county health bureau.Results The station for CBR had run in right path and its range of service expanded around the 2 towns.Most part of DALs had cured or distinctly improved their exposure conjunctivitis,cracks of in numb hands and feet,foot ulcers.The style of the station for CBR had been accepted by local people and DALs.Finally,the township hospital and doctor offered service also earned from the station for CBR service.Conclusion CBR should be the most important part of leprosy rehabilitation.The general health services offering the rehabilitation of leprosy work is feasible,which only need pay a little.It also reflects and deepens the strategy advocated by WHO on the sustainability of Leprosy Control Program.
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<p><b>OBJECTIVE</b>To evaluate the use of free/total prostate-specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer.</p><p><b>METHODS</b>fPSA/tPSA ratio in the serum was analyzed prospectively in 187 men with tPSA ranging between 4.0 and 20.0 microg/L. All of them underwent ultrasound-guided sextant prostatic biopsies. Sensitivity, specificity, positive and negative predictive values were calculated by SPSS 10.0 software.</p><p><b>RESULTS</b>Prostate cancer detection rates were 18.1% and 22.5% when tPSA was within the ranges of 4.0-10.0 g/L and 10.0-20.0 g/L respectively. fPSA/tPSA ratio was more significant than tPSA in all the men. When the cut-off value of fPSA/tPSA ratio was set at 0.25, 90.5% and 87.5% of cancers could be detected; and 26.7% and 11.3% of biopsies could be avoided within the tPSA ranges of 4.0-10.0 g/L and 10.0-20.0 g/L, respectively.</p><p><b>CONCLUSION</b>The use of fPSA/tPSA ratio can improve prostate cancer detection and reduce unnecessary biopsies when tPSA is within the range of 4.0-10.0 microg/L and 10.0-20.0 microg/L.</p>
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Area Under Curve , Early Diagnosis , Mass Screening , Prospective Studies , Prostate-Specific Antigen , Blood , Prostatic Neoplasms , Diagnosis , Sensitivity and SpecificityABSTRACT
Objective To observe the clinical effect of non-invasive positive pressure ventilation(NIPPV) in the treatment of chronic obstructive pulmonary disease at acute exacerbation phase(AECOPD) combined with typeⅡrespiratory failure.Methods Fifty-three patients of therapeutic group were treated with NIPPV,as well as conventional therapeutic managements,such as antibiotic,pacifying gasp,eliminating phlegm,taking respiratory stimulants,and receiving continual low-flow oxygen.Whereas,53 controls only received conventional intervention.Results There was no significant difference between the 2 groups before the treatment,but significance was found in pH value,PaCO2,PaO2,HR and RR in them.The therapeutic group showed significantly improvement in PaCO2,RR and PaO2 compared with control group.Conclusion NIPPV intervention can effectively lower PaCO2 and RR,improve PaO2,shorten the course of hospitalization.
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Objective:To study the effect of CsA on CD4+CD25+T cells from DO11.10 mice after immunization with OVA.Methods:The amount of spleen CD4+CD25+T cells and Foxp3+T cells was detected by means of flow cytometry (FCM).Results:After immunization with OVA,the ratios of CD4+CD25+T cells to CD4+T cells and Foxp3+T cells to CD4+CD25+T cells elevated in spleen,but CsA significantly decreased the percentage of CD4+CD25+T cells and CD4+CD25+Foxp3+T cells under either naive state or immune reaction state.Conclusion:CsA inhibits immune responses,while it also suppresses immune tolerance.
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AIM: To study the relationship between serum prostate specific antigen (PSA) and sex hormones as well as PSA change with aging and volume of prostate. METHODS: Volume of prostate was measured by supersonic diagnostic set. Serum PSA content was determined by ELISA. Serum testosterone and luteinizing hormone (LH) contents were measured by radioimmunoassay. The relationship between volume of prostate, PSA , sex hormones and PSA with aging was analyzed. RESULTS: (1) Serum PSA increased with aging. (2) Declined serum levels of testosterone with aging were detected. Serum LH contents increased with aging. (3) PSA and LH contents were positively correlated with aging and volume of prostate. (4) The testosterone levels were negatively correlated with the volume of prostate (r=-0.45,P