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Prostate biopsy is the gold standard for the diagnosis of prostate cancer. In order to reduce misdiagnosis and complications, the method of prostate biopsy has undergone tremendous changes, and is developing to be more accurate, safe and convenient. This article reviews the progress of clinical application of prostate biopsy.
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【Objective】 To evaluate the efficacy of ultrasound-guided transperineal puncture and drainage in the treatment of pelvic lymphatic cyst. 【Methods】 A total of 26 patients with pelvic lymphocele who failed with conservative treatment received transperineal puncture and drainage guided by rectal ultrasound. 【Results】 All operations were successful without serious complications. The symptoms in 24 patients relieved within 48 hours after catheter drainage, and 2 patients had the catheter removed after continuous drainage for 3 weeks. Of the 26 patients, 19(73.1%) were cured and 7(26.9%) were relieved. The total effective rate was 100%. 【Conclusion】 Transperineal drainage guided by rectal ultrasound is a safe and effective treatment for pelvic lymphocele.
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【Objective】 To investigate the current situation concerning volume control of red blood cells in additive solution produced by blood service in Chongqing, and to lay a foundation for promoting the homogenization of preparation process of red blood cells in additive solution. 【Methods】 A questionnaire was designed to investigate the factors related to the preparation of red blood cells in additive solution. The questionnaire was sent by Chongqing Association of Blood Transfusion via E-mail to 18 blood services in the city, and the collected data was sorted, revised and analyzed by research team. 【Results】 A total of 18 blood services(including 1 blood center + 1 sub-center, 6 central blood stations and 11 central blood banks) returned the questionnaires. The results showed that there were differences among blood services across Chongqing, regarding the centrifugal parameters during preparation, the operation mode and monitoring situation of the capacity control during preparation, and the formulation of the capacity standard of red blood cells in additive solution etc. 【Conclusion】 The preparation process of red blood cells in additive solution, produced by Chongqing blood services, should be further standardized, and the capacity control method of this product in Chongqing should be gradually unified to achieve regional homogeneity and to ensure blood safety.
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Objective:To investigate the efficacy of maintenance electroconvulsive therapy (MECT) combined with quetiapine treatment for manic episodes of bipolar disorder.Methods:A total of 103 patients with manic episodes of bipolar disorder received treatment in Kangci Hospital of Jiaxing from January 2019 to August 2020 and were included in this study. They were randomly divided into observation ( n = 46) and control groups ( n = 57). The observation group was given MECT combined with quetiapine treatment and the control group was treated with magnesium valproate sustained-release tablets combined with quetiapine. All patients received 4 weeks of treatment. Clinical efficacy, total hospital cost, drug cost during hospitalization, drug proportion, adverse reactions, and scores of the Bech-Rafaelsdn Mania Rating Scale and the Wisconsin Card Sorting Test pre- and post-treatment were compared between the two groups. Results:After 4 weeks of treatment, total response rate was significantly higher in the observation group than in the control group [76.09% (35/46) vs. 56.14% (32/57), χ2 = 4.45, P < 0.05]. In the observation group, total hospital cost, drug cost during hospitalization, and drug proportion were (16074.52 ± 1019.81) yuan, (1374.52 ± 619.81) yuan, and 8.70% respectively, which were not significantly different from those in the control group [(15618.14 ± 1550.34) yuan, (1261.14 ± 750.34) yuan, 10.53%, t = 1.71, 0.82, χ2 = 0.09, all P > 0.05]. After 4 weeks of treatment, Bech-Rafaelsdn Mania Rating score was significantly lower in the observation group than in the control group [(7.36 ± 3.04) points vs. (10.23 ± 2.37) points, t = 5.38, P < 0.001]. The number of wrong responses and the number of perseverative errors in the Wisconsin Card Sorting Test in the observation group were (40.45 ± 3.61) counts and (9.56 ± 1.39) counts, respectively, which were significantly lower than those in the control group [(48.59 ± 4.51) counts, (12.08 ± 1.25) counts, t = 10.17, 9.56, both P < 0.001]. The number of perseverative errors in the Wisconsin Card Sorting Test was significantly higher in the observation group than in the control group [(33.85 ± 2.50) counts vs. (29.71 ± 2.14) counts, t = 8.90, P < 0.001]. There was no significant difference in total incidence of adverse reactions between observation and control groups (21.74% vs. 22.81%, χ2 = 0.01, P > 0.05). Conclusion:MECT combined with quetiapine treatment is highly effective on the manic episodes of bipolar disorder. The combined therapy is worthy of clinical application.
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@#An HPLC-DAD wavelength switching method(240 nm, 280 nm, 316 nm, 403 nm)was developed for simultaneous determination of seven index components: hydroxysafflor yellow A, paeoniflorin, ferulic acid, salvianolic acid B, kaempferol, formononetin and tanshinone IIA in Naoxintong capsule. The qualities of different batches of Naoxintong capsules were evaluated by statistical analysis. Seven index components in 20 batches of Naoxintong capsules were simultaneously determined by HPLC wavelength switching method with Capcell PAK C18 MG II column(250 mm × 4. 6 mm, 5. 0 μm). The mobile phase consisted of methanol-acetonitrile(25 ∶75, A)-0. 1% formic acid aqueous solution(B)with a gradient elution program and a flow rate of 1. 0 mL/min, and the column temperature was 30 °C. The results were analyzed by statistical analysis to evaluate the differences in the quality of Naoxintong capsules. Results showed that the seven active components were well separated and showed good linearity hydroxysafflor yellow A(403 nm)2. 30- 11. 50 mg/L(r=0. 999 2), paeoniflorin(240 nm)8. 81- 44. 05 mg/L(r=0. 999 6), ferulic acid(316 nm)1. 22- 6. 10 mg/L(r=0. 999 6), salvianolic acid B(280 nm)11. 61- 58. 05 mg/L(r=0. 999 4), kaempferol(403 nm)1. 16-5. 80 mg/L(r=0. 999 4), formononetin(240 nm)0. 12- 0. 60 mg/L(r=0. 999 5)and tanshinone IIA(280 nm)2. 28- 11. 40 mg/L(r=0. 999 5). The precision was good and RSD was less than 2. 0%, The repeatability was good and RSD was less than 2. 0%. The stability was good in 24 h. The average recoveries were between 97. 35%- 101. 02% and RSD was less than 2. 0%. The contents of target components in Naoxintong capsules, hydroxysafflor yellow A was 0. 213- 0. 369 mg/g, paeoniflorin was 1. 535- 3. 217 mg/g, ferulic acid was 0. 153- 0. 236 mg/g, salvianolic acid B was 2. 563- 3. 271 mg/g, kaempferol was 0. 103- 0. 181 mg/g, formononetin was 0. 022- 0. 028 mg/g, and tanshinone IIA was 0. 466- 0. 698 mg/g. HPLC wavelength change and gradient elution method was established for simultaneous determination of seven index components in Naoxintong capsule. The method is accurate, sensitive, reliable, and repeatable, and can be used for the quality control of Naoxintong capsule.
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Objective@#To investigate the molecular-cytogenetic characterization and impact on tyrosine kinase inhibitors (TKIs) therapy in chronic phase of chronic myeloid leukemia (CML-CP) patients with variant Ph chromosome (vPh).@*Methods@#The clinical data of 32 patients with vPh chromosomes were collected and compared with 703 patients with typical Ph chromosome in newly diagnosed CML-CP who were on first-line imatinib (IM) and with BCR-ABL transcript of P210.@*Results@#There was no significant difference in demographic and hematological characteristics between vPh and classic Ph patients. 3(9.4%) of the 32 vPh cases were simple variant translocations. Among the remaining 29 cases with complex variant translocations, 28 cases (87.5%) involved 3 chromosomes, and only 1 (3.1%) involved 4 chromosomes. Except for 8, 15, 18, X, and Y chromosomes, the other chromosomes were involved. The frequency of chromosome 12q(15.5%) and 1p (12.1%) were higher involved. The most common FISH signal pattern was 2G2R1Y (74.1%), followed by 1G1R2F (14.8%), 2G1R1Y (3.7%), 1G2R1Y (3.7%), 1G1R1Y (3.7%). The comparison of complete cytogenetic response (CCyR) (P=0.269), major molecular response (MMR) (P=0.391) were carried out between simple and complex mechanisms, without difference. Compared with the classic Ph, the patients with vPh had higher IM primary resistance rate (χ2=3.978, P=0.046), especially primary hematological resistance (χ2=7.870, P=0.005), but the difference of CCyR (χ2=0.192, P=0.661), MMR (χ2=0.822, P=0.365), EFS (χ2=0.509, P=0.476), OS (χ2=3.485, P=0.062) were not statistically significant, and multivariate analysis showed that the presence of vPh did not affect OS (RR=0.692, 95%CI 0.393-1.765, P=0.658)、EFS (RR=0.893, 95%CI 0.347-2.132, P=0.126) and PFS (RR=1.176, 95%CI 0.643-2.682, P=0.703).@*Conclusion@#CML-CP patients with vPh and classic Ph had similar demographic and hematological characteristics. Except for 22q11, 9q34, the frequency of chromosome 12q and 1p were higher involved. The most common FISH signal pattern was 2G2R1Y, and different mechanisms had no impact on TKIs therapy. Compared with cases with classic Ph chromosomes, the patients with vPh chromosomes had higher risk of IM primary resistance, especially primary hematological resistance, which can obtain deeper molecular response quickly after changing to second-generation TKIs and didn’t affect long-term outcomes and OS.
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To use a visualized method,tipping-point analysis to address missing data in clinical study and discuss related problems.All the possible outcomes caused by missing data were listed and the tipping points where P-values of hypothesis test changed at 0.05 significant level were found out,then the ratio of P＜0.05 was calculated,reflecting the reliability of the study's result.Tipping-point analysis can be applied to both continuous and binary data to help find points where p-values are changed.The area of P＜0.05 of continuous data is 93.6％,indicating that the reliability of success of the study is large;and the area of P＜0.05 of binary data is 29.7％,reflecting that the reliability of success of the study is small.Tipping-point analysis,which provides a visualized evidence for decision making,is suitable for analyzing clinical studies with missing data.
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To use a visualized method,tipping-point analysis to address missing data in clinical study and discuss related problems.All the possible outcomes caused by missing data were listed and the tipping points where P-values of hypothesis test changed at 0.05 significant level were found out,then the ratio of P＜0.05 was calculated,reflecting the reliability of the study's result.Tipping-point analysis can be applied to both continuous and binary data to help find points where p-values are changed.The area of P＜0.05 of continuous data is 93.6％,indicating that the reliability of success of the study is large;and the area of P＜0.05 of binary data is 29.7％,reflecting that the reliability of success of the study is small.Tipping-point analysis,which provides a visualized evidence for decision making,is suitable for analyzing clinical studies with missing data.
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Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.
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Objective To evaluate the dosimetry accuracy and clinical efficacy of 125I radioactive seed implantation using coplanar template (CPT) in the treatment of metastatic or recurrent chest wall tumor.Methods Thirty-one patients with metastasis or recurrence of chest wall tumor,who had been diagnosed with pathology between July 2005 and July 2015,were retrospectively studied.All patients underwent CPT-assisted 125I radioactive seed implantation.Brachytherapy radiation treatment planning system (BTPS) was used to make preoperative plans,and the prescribed dose (PD) was 110 Gy.CPT was used to assist CT guided 125I radioactive seeds implantation.Dose evaluation was performed immediately after implantation.The difference of dose parameters was compared between preoperation and postoperation,including Dg0,D100,V90,V100 and the numbers of seeds.Postoperative chest CT was conducted regularly to assess the treatment efficacy based on the response evaluation criteria in solid tumors (RECIST Version 1.1).The patients were followed up till July 2016.Results All patients went through implantation procedure successfully and there was no significant statistical difference between preoperative and postoperative dose parameters (P ＞ 0.05).The conformal index (CI) was 0.951 ± 0.13,external index(EI) was 6.5％ ±0.9％.Six months after implantation,CR,PR,SD and PD were 25.8％ (8/31),51.6％ (16/31),6.5％ (2/31) and 16.1％ (5/31),respectively.The effective rate was 77.4％,and local control rate was 83.9％ (26/31).Skin pigmentation occurred in 13 patients during the follow-up period,without any special treatment.Conclusions The auxiliary of CPT in the treatment of metastatic or recurrent chest wall tumor under the guiding of CT could achieve quality control,safety and effectiveness.
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Objective To explore the quality control and the short-term curative efficacy of 125Ⅰ radioactive seeds implantation in the treatment of spinal metastases by using co-planar template ( CPT ) assisted CT guidance. Methods Totally 12 cases of primary tumor were diagnosed by pathology, imaging changes for 16 lesions were consistent with the characteristics of spinal metastatic tumor. The prescription dose (PD) was 80 Gy, seed activity was 1. 48 × 107 -2. 59 × 107Bq(0. 4 -0. 7 mCi). According to preoperative plan, spinal metastases were treated with CPT assisted CT guided 125Ⅰ radioactive seeds implantation. The distribution of seeds was observed immediately after operation and the dose was assessed. Patients were followed up by CT to determine the change of tumor diameter and evaluate the efficacy. Follow-up time ranged from 3 to 29 months. And the improvement of pain was evaluated by pain grading. Results All of the 16 spinal metastases lesions were successfully implanted by the preoperative planning. After the implantation, quality verification showed the average dose of target region was (209. 21 ± 37. 16) Gy, D90 ( 115. 29 ± 7. 87 ) Gy, D100 ( 76. 59 ± 5. 53 ) Gy, V90 ( 99. 30 ± 0. 51 )%, V100 ( 98. 06 ± 1. 15 )%, conformal index (CI) 0. 981 ± 0. 012, external index (EI) 0. 012 ± 0. 007. And the average dose of the spinal cord was ( 30. 47 ± 4. 83 ) Gy. There was no significant difference in the mean dose between the target area and the spinal cord and the preoperative plan ( P>0. 05 ) . 3 months after surgery, among 16 spinal metastases lesions, complete response ( CR ) was 18. 8% ( 3/16 ) , PR ( partial response ) rate 62. 5% (10/16), PD(progressive disease) rate 6. 25%(1/16),SD(stable disease) rate 6. 25%(1/16), effective rate ( CR + PR ) 81. 3%. The were 3 cases in pain complete remission, 7 cases in partial remission, 2 cases in mild remission. The survival time range from 11 to 39 months. The median survival time was 24 months. No radiation damage of spinal cord was found. Conclusions CT guided CPT can be used to control the position and radiation dose of the seeds implantation before the operation, so as to achieve the objective of treating tumor with fewer complications and improvement of patients′tolerance.
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Objective To explore the quality control and the short-term curative efficacy of 125Ⅰ radioactive seeds implantation in the treatment of spinal metastases by using co-planar template ( CPT ) assisted CT guidance. Methods Totally 12 cases of primary tumor were diagnosed by pathology, imaging changes for 16 lesions were consistent with the characteristics of spinal metastatic tumor. The prescription dose (PD) was 80 Gy, seed activity was 1. 48 × 107 -2. 59 × 107Bq(0. 4 -0. 7 mCi). According to preoperative plan, spinal metastases were treated with CPT assisted CT guided 125Ⅰ radioactive seeds implantation. The distribution of seeds was observed immediately after operation and the dose was assessed. Patients were followed up by CT to determine the change of tumor diameter and evaluate the efficacy. Follow-up time ranged from 3 to 29 months. And the improvement of pain was evaluated by pain grading. Results All of the 16 spinal metastases lesions were successfully implanted by the preoperative planning. After the implantation, quality verification showed the average dose of target region was (209. 21 ± 37. 16) Gy, D90 ( 115. 29 ± 7. 87 ) Gy, D100 ( 76. 59 ± 5. 53 ) Gy, V90 ( 99. 30 ± 0. 51 )%, V100 ( 98. 06 ± 1. 15 )%, conformal index (CI) 0. 981 ± 0. 012, external index (EI) 0. 012 ± 0. 007. And the average dose of the spinal cord was ( 30. 47 ± 4. 83 ) Gy. There was no significant difference in the mean dose between the target area and the spinal cord and the preoperative plan ( P>0. 05 ) . 3 months after surgery, among 16 spinal metastases lesions, complete response ( CR ) was 18. 8% ( 3/16 ) , PR ( partial response ) rate 62. 5% (10/16), PD(progressive disease) rate 6. 25%(1/16),SD(stable disease) rate 6. 25%(1/16), effective rate ( CR + PR ) 81. 3%. The were 3 cases in pain complete remission, 7 cases in partial remission, 2 cases in mild remission. The survival time range from 11 to 39 months. The median survival time was 24 months. No radiation damage of spinal cord was found. Conclusions CT guided CPT can be used to control the position and radiation dose of the seeds implantation before the operation, so as to achieve the objective of treating tumor with fewer complications and improvement of patients′tolerance.
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@#Gut microbiota-mediated deglycosylationplays an important role in the metabolism of ginsenoside Rb1. Thus, a lincomycin-induced gut microbiota dysbiosis rat model was selected to explored the pharmacokinetics and deglycosylation metabolism of ginsenoside Rb1. An UPLC-MS/MS analytical method was developed to detect ginsenoside Rb1 and its deglycosylated metabolite, Rd in rat plasma. The triple quadruple mass spectrometer was set in negative electrospray ionization mode by multiple reaction monitoring. The method was validated to meet the requirements of biological applications, by evaluating specificity, linearity, lower limits of quantification(LLOQ), precision, accuracy, matrix effect, recovery and stability. Gut microbiota dysbiosis rats were induced by oral administration of lincomycin(5 000 mg/kg)for 7 continuous days. The in vitro and in vivo results reveal that the reduced β-D-glucosidase activity significantly decreases the Rd formation rate in lincomycin-induced gut microbiota dysbiosis rats, leading to the pharmacokinetic alteration of ginsenoside Rb1 and Rd in gut microbiota dysbiosis rats.
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Objective To analysis the modified Gleason scoring system for predicting the prognosis after radical prostatectomy.Methods A total of 242 patients who received radical prostatectomy from April,2006 to October 2011 were recruited.The patients who lost follow-up or had adjuvant radiation or hormonal therapy or had visceral or bone metastasis were excluded,the remaining 168 patients were evaluated in the present study.The patients' age ranged from 53 to 85 years old (mean age 69 years old).The mean PSA level was 13.31ng/ml (ranging from 4.59 to 36.12 ng/ml).According to the traditional Gleason scoring system,there were 50 patients in Gleason ≤ 6 group,86 patients in Gleason 7 group and 32 patients in Gleason≥8 group.Patients were divided in five groups according to the modified Gleason scoring system.There were 50 patients in Gleason ≤6 group,67 in Gleason 3 + 4 group,19 in Gleason 4 + 3 group,15 in Gleason 8 group and 17 in Gleason 9-10 group.The biochemical-free-survival curve was drawn by Kaplan-Meier method and the multivariate Cox regression models were used to evaluate the clinical and pathological variables for the development of biochemical recurrence.ROC curve analysis was used to determine the predicted value for 5-year BCR of modified and traditional Gleason scoring.Results Significant differences were noted between the modified Gleason scoring groups and traditional Gleason scoring groups in PSA value (P =0.005),pathological stage (P =0.002),extraprostatic extension (P =0.003),seminal vesicle invasion (P =0.004),lymph node involvement (P =0.049) and positive surgical margin (P =0.006).With a median follow-up of 68 months(ranging from 7 to 98 months),5-year BFS rates for men with Gleason grade ≤6,3 + 4,4 + 3,8 and 9-10 tumours on RP pathology were 84.0％ (42/50),76.1％ (51/67),57.9％(11/19),40.0％ (9/15),29.4％ (5/17),respectively.On multivariate analysis,the HR value of Gleason 3 + 4 group and Gleason 4 + 3 group were 1.736 and 2.075 (P ＜ 0.05).The area under the curve in modified and traditional Gleason scoring were 0.698 (95％ CI 0.609-0.788) and 0.674 (95％ CI O.584-0.764),respectively.Conclusions The modified Gleason scoring system is related to the prostate cancer grade and its survival rate.Therefore,it can predict prognosis accurately in patients with prostate cancer.It can potential to reduce overtreatment in patients with Gleason 3 +4 prostate cancer.
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OBJECTIVE: To discuss the use of antibacterials and the bacterial drug resistance for reference of rational use of antibacterials.METHODS: The DDDs of 18 commonly used antibacterials in one hospital during the period from 2005 to 2006 were analyzed statistically,and the correlation between the use of antibacterials and the bacterial drug resistance were derived by computing the correlation coefficient.RESULTS: The correlation coefficient r between DDDs of 18 antibacterials and the bacterial drug resistance rate ranged from 0.610 1 to 0.973 0,and which was of significant difference.CONCLUSION: There is a positive correlation between DDDs of antibacterials and the bacterial drug resistance.Hospital should strengthen the administration of antibacterials at different angle to promote rational use of antibacteirals,reduce bacterial resistance and enhance the curative effect of anti-infective therapy.
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0.05).The costs of the 3 groups were 5.21,293.16 and 430.08yuan,respectively,showing significant differences among groups(P