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ABSTRACT Background: This study aimed to explore the prevalence and clinical risk factors in patients diagnosed with incidental prostate cancer (IPC) during certain surgeries (transurethral resection of the prostate [TURP], open prostatectomy [OP], and holmium laser enucleation of the prostate [HoLEP]) after clinically suspected benign prostatic hyperplasia (BPH). Materials and Methods: Literature search of the MEDILINE, Web of Science, Embase, and Cochrane Library databases was performed to identify eligible studies published before June 2021. Multivariate adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) of the prevalence and clinical risk factors of IPC were calculated using random or fixed-effect models. Results: Twenty-three studies were included in the meta-analysis. Amongst the 94.783 patients, IPC was detected in 24.715 (26.1%). Results showed that the chance of IPC detection (10%, 95% CI: 0.07-4.00; P<0.001; I2=97%) in patients treated with TURP is similar to that of patients treated with HoLEP (9%, 95% CI: 0.07-0.11; P<0.001; I2=81.4%). However, the pooled prevalence estimate of patients treated with OP was 11% (95% CI: −0.03-0.25; P=0.113; I2=99.1%) with no statistical significance. We observed increased incidence of IPC diagnosis after BPH surgery amongst patients with higher prostate-specific antigen (PSA) level (OR: 1.13, 95% CI: 1.04-1.23; P=0.004; I2=89%), whereas no effect of age (OR: 1.02, 95% CI: 0.97-1.06; P=0.48; I2=78.8%) and prostate volume (OR: 0.99, 95% CI: 0.96-1.03; P=0.686; I2=80.5%) were observed. Conclusions: The prevalence of IPC was similar amongst patients undergoing TURP, HoLEP, and OP for presumed BPH. Interestingly, increased PSA level was the only independent predictor of increasing risk of IPC after BPH surgery rather than age and prostate volume. Hence, future research should focus on predictors which accurately foretell the progression of prostate cancer to determine the optimal treatment for managing patients with IPC after BPH surgery.
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Objective @#To explore the imaging characteristics of the mandibular nerve canal in adults to provide a reference for clinical mandibular surgery.@*Methods@# One thousand adult patients in Guiyang Stomatological Hospital from January 2018 to January 2021 were randomly selected. Cone beam CT (CBCT) was used to observe the anterior mandibular canal and other branches, and the incidence of anterior canal in the mandibular ramus area, posterior molar area and molar area and the distance to each point of the mandible were measured.@*Results@#Of the 901 patients (1 802 sides) included in the study, 386 patients (42.84%) found branches of the mandibular canal, and 182 patients (97 males and 85 females) found the Anterograde Canal 20.20% (182/901). In total, 225 mandibles were found to have anterior canals. There were 101 cases of left mandible and 124 cases of right mandible. The forward canal mainly occurred in the molar area, the molar posterior area and the ascending branch area, and the ascending branch area was the best starting point of the forward canal and the molar stopping point (P < 0.05). The average length of the forward canal (L1) was (10.364 ± 3.833) mm, the average height of the forward canal to the main trunk of the mandibular nerve (L2-RRB) was (3.623 ± 2.035) mm, and the average height of the forward canal to the crest of the alveolar ridL3 (l3) was (9.280 ± 3.240) mm.@*Conclusion@#Mandibular nerve canal branches are common, and there were no differences in male, female and lateral distribution. In this study, the incidence of mandibular anterior canal was the highest, and it often occurred in the molar area.
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As a treatment option for cancer, thermal ablation has satisfactory effects on many types of solid tumors (such as liver and renal cancers). However, its clinical applications for the treatment of thyroid nodules and metastatic cervical lymph nodes are still under debate both in China and abroad. In 2015, the “Zhejiang Expert consensus on thermal ablation for thyroid benign nodules, microcarcinoma, and metastatic cervical lymph nodes (2015 edition),” was released by the Thyroid Cancer Committee of Zhejiang Anti-Cancer Association, China. To further standardize the application of thermal ablation for thyroid tumors, the Thyroid Tumor Ablation Experts Group of Chinese Medical Doctor Association has organized many seminars and finally produced a consensus to formulate the “Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition).”
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To make a systematic study on acupoints selection and medication rules for allergic rhinitis treated with acupoint application, literature regarding clinical researches on acupoint application for allergic rhinitis since 2000 has been retrieved; medication and acupoints involved were preprocessed and cluster analysis technique was applied to classify the data. As a result, a total of 37 pieces of literature were included, involving 27 types of herbs and 33 acupoints. The results showed Baijiezi (Brassica alba Boiss), Xixin (Radix et Rhizoma Asari), Gansui (Radix Kansui), Yanhusuo (Corydalis), Jiangzhi (Ginger juice) and Baizhi (Radix angelicae) constituted the main herb prescription, and the layer was increased along with frequency of use. Feishu (BL 13), Dazhui (GV 14), Shenshu (BL 23), Pishu (BL 20), Gaohuang (BL 43), Fengmen (BL 12) constituted the main acupoint prescription, which were clustered into 4 classes; Feishu (BL 13) and Dazhui (GV 14) constituted the first class; Pishu (BL 20) and Shenshu (BL 23) constituted the second class; the first and second class merged into the third class, Including Feishu (BL 13), Dazhui (GV 14), Shenshu (BL 23) and Pishu (BL 20); Gaohuang (BL 43) and Fengmen (BL 12) constituted the fourth class; the fourth class and the third class constituted the whole acupoint prescription. It was showed that for the allergic rhinitis treated with acupoint application, the medication was mainly epispastic herbs with pungent nature that belonged to the lung, spleen and kidney meridian, which presented the principle of simultaneous treatment of principal and subordinate symptoms; also the medication can be selected from core layer to supporting layer based on clinical needs; for the selection of acupoints, acupoints in lung and bladder meridian were mainly selected to assist exterior and resist the pathogenic qi, which could treat allergic rhinitis fundamentally by joint use with acupoints in soleen and kidney meridian.
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Humans , Acupuncture Points , Data Mining , Databases, Bibliographic , Drugs, Chinese Herbal , Chemistry , Meridians , Rhinitis, Allergic , Drug TherapyABSTRACT
Microthrombosis may be involved in the pathogenesis of cardiac microangiopathy due to diabetes. Recent studies have shown that fibrinogen-like protein 2 (fgl2) plays a pivotal role in microthrombosis in viral hepatitis, acute vascular xenograft rejection and cytokine-induced fetal loss syndrome. The current study was designed to examine the expression of fgl2 in microvascular endothelial cells and investigate the effects of microthrombi due to fgl2 on cardiac function and structure in rats with type 2 diabetes. Following induction of type 2 diabetes, 24 rats were observed dynamically. Fgl2 expression and related cardiac microthrombosis were examined. Local or circulating TNF-a was measured. Coronary flow (CF) per min was calculated as an index of cardiac microcirculation. Cardiac function and morphology were evaluated. It was found that Fgl2 was highly expressed in cardiac microvascular endothelial cells of rats with type 2 diabetes, which was promoted by local or circulating TNF-α. The Fgl2 expression was associated with cardiac hyaline microthrombosis. In parallel with the fgl2 expression, CF per min, cardiac diastolic or systolic function and cardiac morphology were aggravated to some extent. It was concluded that in rats with type 2 diabetes, microthrombosis due to fgl2 contributes to the impairment of cardiac diastolic or systolic function and morphological changes.
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Autoimmune is involved in the pathogenesis of ventricular remodeling in acute myocardial infarction (AMI). In the present study, we investigated the effect of anti-cardiac myosin heavy chain antibodies (AMHCA) from patients with AMI on rat cardiomyocyte apoptosis. Cardiomyocyte apoptosis was observed and measured by DNA end labeling and Annexin- V/PI double-staining assay.The expression of apoptosis related p53 and Bcl-2 protein and the second messenger calcium were detected respectively by Western blotting, patch clamp and confocal calcium imaging. The results showed that AMHCA was able to induce cardiomyocyte apoptosis in a dose dependent manner.Apoptosis-accelerating nucleoprotein p53 was up-regulated, while apoptosis-inhibiting cytoplasmic protein Bcl-2 was down-regulated. In parallel, cytoplasmic calcium concentration was elevated.There was no effect on L-type calcium currents. It is concluded that AMHCA in patients with AMI as a novel triggering factor can induce cardiomyocyte apoptosis, which contributes to ventricular remodeling.
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The cytokine repertoire of ADP/ATP carrier-specific humoral immune responses and the cytokine-dependent anti-ADP/ATP carrier antibody IgG subclasses were examined in a cohort of ADP/ATP carrier-immunized BALB/c mice treated with anti-CD4 monoclonal antibody. Eighteen male BALB/c mice (6-8 weeks old) were randomized into 3 groups: dilated cardiomyopathy (DCM)group, DCM-tolerance (Tol) group and control group. The mice in DCM group were immunized with the peptides derived from human ADP/ATP carrier protein for 6 months and mice in the control group were sham-immunized, while the mice in DCM-Tol group were immunized with ADP/ATP carrier protein and anti-CD4 McAb simultaneously. Serum autoantibody against ADP/ATP carrier and IgG subclasses were measured by ELISA, intracellular cytokines IFN-γ and IL-4 of Th cells were monitored with flow cytometry, and splenic T cell cytokines IFN-γ, IL-2, IL-4 and IL-6 were detected by using real-time fluorescent quantitative PCR. The results showed that the autoantibody against ADP/ATP carrier was found in all mice in DCM group, and the antibody level, serum IgG1 and IgG2a subclasses, cytokines in T cells and Th cells were all elevated in DCM group, as compared with those in control group (P＜0.01). On the other hand, in DCM-Tol group, the autoantibody level and contents of all the cytokines were significantly different from those in DCM group (P＜0.01), and were close to those in control group. And the levels of IgG1, IgG2a, IgG2b and IgG3 were influenced,to varying degrees, by anti-CD4 McAb as compared with those in DCM group. All these four types of IgG subclasses were substantially decreased in DCM-Tol group as compared with DCM group. It is concluded that the treatment with anti-CD4 McAb could prevent the activation of T cells, reverse the abnormal secretion of cytokines and the imbalance between Th1/Th2 cell subsets and abnormal production of autoantibody against ADP/ATP carrier, and eventually avoid myocardial injuries.