ABSTRACT
The overdiagnosis of prostate cancer (PCa) caused by nonspecific elevation serum prostate-specific antigen (PSA) and the overtreatment of indolent PCa have become a global problem that needs to be solved urgently. We aimed to construct a prediction model and provide a risk stratification system to reduce unnecessary biopsies. In this retrospective study, clinical data of 1807 patients from three Chinese hospitals were used. The final model was built using stepwise logistic regression analysis. The apparent performance of the model was assessed by receiver operating characteristic curves, calibration plots, and decision curve analysis. Finally, a risk stratification system of clinically significant prostate cancer (csPCa) was created, and diagnosis-free survival analyses were performed. Following multivariable screening and evaluation of the diagnostic performances, a final diagnostic model comprised of the PSA density and Prostate Imaging-Reporting and Data System (PI-RADS) score was established. Model validation in the development cohort and two external cohorts showed excellent discrimination and calibration. Finally, we created a risk stratification system using risk thresholds of 0.05 and 0.60 as the cut-off values. The follow-up results indicated that the diagnosis-free survival rate for csPCa at 12 months and 24 months postoperatively was 99.7% and 99.4%, respectively, for patients with a risk threshold below 0.05 after the initial negative prostate biopsy, which was significantly better than patients with higher risk. Our diagnostic model and risk stratification system can achieve a personalized risk calculation of csPCa. It provides a standardized tool for Chinese patients and physicians when considering the necessity of prostate biopsy.
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the influence of the rhizome of Cibotium barametz on the heamorheology index in mice with adjuvant arthritis and to compare the effect of raw medicinals with that of the processed ones.</p><p><b>METHOD</b>Mice was injected with Freund's complete adjuvant on the rihgt behind foot to make model of adjuvant arthritis (AA). Hydroxyacrbamide tablets were orally administrated by mice with AA to make model of AA due to deficiency in the kidney (DK-AA). And then we determined the heamorheology index of the normal group, positive control group, AA group, DK-AA group and medicinals-treated groups.</p><p><b>RESULT</b>In the groups of AA, and DK-AA, the heamorheology index, such as high shearing, middle shearing, low shearing, plasma viscosity, whole blood reduction viscosity, erythrocyte aggregation exponent, erythrocyte degeneration exponent, sedimentation, sedimentation equation K value, erythrocyte rigidity exponent, erythrocyte electrophoresis time, casson viscosity, casson yield stress, increased significantly. After treated with Cibotium barametz, the heamorheology index except red blood count, packed cell volume, fibrinogen decreased obviously to get normal.</p><p><b>CONCLUSION</b>Rhizome of Cibotium barametz could promote heamorheology in mice with AA and DK-AA to exhibit effect of promoting blood circulation and remove blood stasis. The medicinal rhizomes processed with sand have the effect enhanced.</p>