New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study / 亚洲男科学杂志(英文版)

This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.

Anti-human leukocyte antigens and anti-major histocompatibility complex class I-related chain A antibody expression in kidney transplantation during a four-year follow-up / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Humoral immunity is an important factor for long-term survival of renal allograft. Here we performed a four-year follow-up to explore the clinical significance of monitoring anti-human leukocyte antigens (HLA) and anti-major histocompatibility complex class I-related chain A (MICA) antibody expression after kidney transplantation.</p><p><b>METHODS</b>We obtained serial serum samples from 84 kidney transplant patients over a four-year period. All patients were followed up at least 6 months after transplantation and had at least two follow-up points. Anti-HLA and anti-MICA antibody titres and serum creatinine (SCr) levels were evaluated at each follow-up. Patients were divided into 4 groups: HLA(+) MICA(-), HLA(-)MICA(+), HLA(+)MICA(+) and HLA(-)MICA(-). The impact of post-transplant antibody level on kidney allograft function was evaluated.</p><p><b>RESULTS</b>Antibodies were detected in 38.1% (32/84) of the renal allograft recipients. HLA, MICA and HLA+MICA expression was observed in 18.89%, 14.44% and 5.93% of the recipients respectively. The most frequent anti-HLA and anti-MICA specific antibodies identified were A11, A24, A29, A32, A33, A80; B7, B13, B37; DR17, DR12, DR18, DR52, DR53, DR1, DR4, DR9, DR51; DQ7, DQ4, DQ8, DQ2, DQ9, DQ5, DQ6 and MICA02, MICA18, MICA19, MICA07, MICA27. As the time after transplantation elapsed, more recipients developed de novo antibody expression. Total 11.91% (10/84) of the recipients had de novo antibody expression during the follow up. The average level of SCr and the percentage of recipients with abnormal allograft function were significantly higher in recipients with anti-HLA and/or anti-MICA antibody expression than those without. The appearance of anti-HLA and anti-MICA antibody expression always preceded the increase in SCr value.</p><p><b>CONCLUSIONS</b>Anti-HLA and anti-MICA antibody expression has predictive value for early and late allograft dysfunction. The presence of donor specific antibody is detrimental to graft function and graft survival.</p>

Clinical significance of C-reactive protein concentration in the expressed prostatic secretion from chronic prostatitis patients / 中华男科学杂志

<p><b>OBJECTIVES</b>To discuss the correlation of C-reactive protein (CRP) concentration in the EPS of chronic prostatitis (CP) patients with CP types, WBC count in EPS, lecithin corpuscles (LLZXT) and chronic prostatitis symptom index (CPSI).</p><p><b>METHODS</b>According to the NIH classification standard, 196 cases of CP were diagnosed by the pro and post massage test (PPMT) and EPS routine, of which 68 were chronic bacterial prostatitis (Type II ), 76 inflammatory chronic non-bacterial prostatitis/chronic pelvic pain syndrome (Type III A) and 52 non-inflammatory chronic non-bacterial prostatitis/chronic pain syndrome (Type III B). Another 50 healthy volunteers were enrolled as normal controls. The CRP concentration in the EPS of all the patients was determined by immunoturbidimetry and 196 groups of data were obtained.</p><p><b>RESULTS</b>The average concentration of CRP was significantly higher in the CP group ( [2.945 +/- 1.996] mg/L) than in the control ( [1.101 +/- 0.440] mg/L) (P < 0. 01) , and it decreased progressively from the Type II to Type III A and Type III B group, with statistical difference between Type III B and Type II or Type III A (P < 0. 01 ), but not between Type II and Type III A (P = 0.058). The CRP concentration was correlated negatively with LLZXT (r = -0.33, P < 0.01) and positively with WBC count (r = 0.63, P < 0.01) and the score on the first 6 items of CPSI (r = 0. 28, P < 0. 01).</p><p><b>CONCLUSION</b>The CRP concentration in EPS, with its significant role in the pathogenesis of CP, may serve as a basis for the diagnosis and classification of CP as well as an objective index for assessing the therapeutic effect on the disease.</p>