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Objective To explore the effect and safety of magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia. Methods We retrospectively analyzed the clinical and pathological data of 81 patients with mpMRI-TRUS image fusion targeted transperineal prostate biopsy using electromagnetic needle tracking under local anesthesia. Visual analog scale (VAS) and visual numeric scale (VNS) were used to evaluate the pain level and satisfaction of patients during prostate biopsy (VAS-1 and VNS-1), one hour after puncture (VAS-2 and VNS-2), and one day after surgery (VAS-3 and VNS-3). The perioperative clinical data and tumor positive rate of postoperative biopsy were recorded. Results The average prostate volume of 81 patients was 53.39±29.46 cm3. The PSA values of patients with PI-RADS scores of 2, 3, 4, and 5 were 9.14±2.31, 9.95±4.10, 14.77±6.36, and 32.17±24.39 ng/ml, respectively. The scores of VAS-1, VAS-2, and VAS-3 were 1.70±0.73, 1.16±0.58, and 0.53±0.55, respectively; the scores of VNS-1, VNS-2, and VNS-3 were 2.74±0.44, 3.69±0.46, and 3.84±0.37, respectively. The average surgical time was 17.47±3.44 minutes. Postoperative pathological results showed that the tumor positive rate of targeted prostate biopsy was 64.20%. According to the PI-RADS score for subgroup analysis, the tumor positive rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 21.43%, 44.44%, 61.11%, and 96.77%, respectively. After transperineal prostate biopsy, gross hematuria occurred in 19.75% patients, and urinary retention occurred in 3.70%. The latter were relieved after symptomatic treatment. All patients did not experience complications, such as perineal puncture area hematoma, urinary tract infection, hematospermia, hematoma in perineal puncture area, urinary tract infection, hematospermia, vagus nerve reaction, or septic shock. Conclusion For suspected prostate cancer patients, mpMRI-TRUS image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia is a feasible and easily tolerated surgical procedure. It has good safety and high tumor positive-detection rate, indicating that this technique is worthy of further clinical promotion and application.
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Bladder cancer (BC) is a common malignant tumor of the urinary system. Common white light cystoscopy is the most important method in the diagnosis and treatment of BC, but its ability to identify small tumors and residual tumors at surgical sites is limited, so it is urgent to develop new diagnosis and treatment techniques. With the rise of the concept of precision medicine, a group of targeted molecules that can specifically bind to BC at the cellular and molecular levels have been discovered in recent years, and the molecular image and targeted therapy based on them can significantly improve the diagnosis and treatment efficiency of BC, with a great potential for clinical application. Based on the latest progress and the research work of our research group, this paper comprehensively analyzes and systematically summarizes the application of targeted molecular carriers in the diagnosis and treatment of BC.
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Objective:To analyze the serum anti-Müllerian hormone (AMH) levels in women of childbearing age in different age groups in Henan, and establish the medical reference intervals based on measurement results from this population.Methods:From January to June 2017, 620 healthy women of childbearing age (20-34 years old), who underwent pre-pregnancy eugenics and pre-marital checkups in 13 project sites in Henan, were included in this study. Participants were divided into 3 age groups: 20-24 years group ( n=210), 25-29 years group ( n=207), and 30-34 years group ( n=203). Spearman correlation coefficient was used to evaluate the correlation between serum AMH level and age; Kruskal-Wallis H test was used to compare the serum AMH levels of different age groups; Wilcoxon test was used for comparison between pairs; the percentile method ( P2.5, P97.5) was used to establish medical reference interval of serum AMH in women of childbearing age for the whole population and different age groups, respectively. Results:The correlation coefficient between serum AMH and age in women of childbearing age (20-34 years old) is -0.17 ( P<0.001). There was a statistically significant difference in the overall frequency distribution of serum AMH levels among the three different age groups ( H=21.978, P<0.05). Among them, there is a statistically significant difference between the 20-24 years group and the 30-34 years group ( Z=4.292, P<0.05). There is a statistically significant difference between the 25-29 years group and the 30-34 years group ( Z=3.803, P<0.05). The reference range of serum AMH is 0.281-9.693 μg/L in this cohort; the reference range of serum AMH is 0.524-10.760, 0.229-9.200, 0.115-8.200 μg/L for women of childbearing age at 20-24, 25-29 and 30-34 years, respectively. Conclusion:The serum AMH level of women of childbearing age (20-34 years old) decreases with age. It is of great significance to establish the serum AMH reference interval for women of childbearing age in different age groups in Henan.
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Laparoscopic subtotal gastrectomy has become the main treatment of early gastric cancer. The 4K laparoscopic system has the advantage of enhancing the operator′s recognition of various anatomical levels and blood vessels in radical gastrectomy. The authors discussed the reconstruction of digestive tract with Billroth Ⅱ anastomosis in totally laparoscopic distal radical gastrectomy with the aid of 4K laparoscopic technique.
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Laparoscopic subtotal gastrectomy has become the main treatment of early gastric cancer. The 4K laparoscopic system has the advantage of enhancing the operator′s recognition of various anatomical levels and blood vessels in radical gastrectomy. The authors discussed the reconstruction of digestive tract with Billroth Ⅱ anastomosis in totally laparoscopic distal radical gastrectomy with the aid of 4K laparoscopic technique.
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Objective:To explore the effect of the virulence factor OatA during Staphylococcus aureus infection.Methods: In vitro,wild type of Staphylococcus aureus USA300,OatA gene deletion strain or OatA gene complemented strain were used to infect mice bone marrow divided macrophages (BMDMs).Subsequently BMDMs were separated and the case of cell death were detected.In vivo,mice pulmonary infection model was constructed with nasal inhalation of Staphylococcus aureus.Alveolar macrophages were isolated and the case of cell death were detected.Results: In contrast to wild type and OatA gene complemented strain,OatA gene deletion strain induced severer macrophage death both in vitro and in vivo.Conclusion: The virulence factor OatA inhibits Staphylococcus aureus infection-induced macrophage death.
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Objective To investigate the regulatory effects and possible mechanisms of autophagy induction and bactericidal activity in muring bone marrow derived macrophages ( BMDMs) . Methods Murine BMDMs were isolated and cultured in vitro. Then standard strain of E. coli was used to infect BMDMs and cellular autophagy levels and AMPK activation were detected. We next modulated functions of AMPK by pretreating cells with the specific agonist or antagonist of AMPK. Then cellular AMPK activation, autophagy levels and bactericidal activity were observed after E. coli infection. Results In E. coli infected BMDMs,autophagy related molecules like LC3B and Beclin1 were upregu-lated,accompanied with elevated LC3Ⅱ/Ⅰratio. Phosphorylation of AMPK was also upregulated by E. coli treatment. Enhanced AMPK activi-ty by its agonist leads to increased cellular autophagy and bactericidal activity,whereas inhibition of AMPK by its suppressor downregulated autophagy and dampened bactericidal activity. Conclusion AMPK and its related signaling pathway is required for anti-bacterial response in macrophage,which is dependent on its function in upregulating autophagy related molecules and inducing autophagy.
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Objective To investigate the morphological and immunophenotypic characteristics of phyllodes tumors (PT) and explore their significance in differential diagnosis and evaluation of prognosis.Methods 48 specimens with PT were observed under light microscope with HE and immunohistochemical staining (EnVision method).The antibodies including CD34,CD10,CD117,p53,and Ki-67 were used.10 cases of fibroadenoma were compared and the clinical data and follow-up results were analyzed retrospectively.Results All of 48 cases with PT presented as well-circumscribed masses with typically leaflike structures composed of double-layered epithelial component arranged in clefts and overgrowing hypercellular mesenchymal component.31 benign,12 borderline,and 5 malignant PT were diagnosed based on stromal overgrowth,cellular pleomorphism,mitosis,margins,and others.Focal necrosis was detected in 3 malignant cases and liposarcoma component existed in 1 case.Immunohistochemical staining showed that the positive rates of CD34 were 93.5 ％,58.3 ％,0 in benign,bordline,and malignant PT respectively,there were significant differences between each groups (P ＜ 0.05).The expression of CD10 were 25.8 ％,83.3 ％,80.0 ％,its expression in benign group was significantly different compared with bordline and malignant PT (P ＜ 0.05).p53 was expressed in three groups with no significant difference (P ＞ 0.05).CD117 and Ki-67 had high expression comparatively in malignant PT.All cases were treated surgically with a local recurrence rate of 22.9 ％.Conclusions Reasonable surgery pattern based on accurate histopathological diagnosis is crucial to reduce the local recurrence rate of PT.Immunohistochemistry examination in PT is helpful to the differential diagnosis and evaluation of prognosis.
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OBJECTIVE: To investigate the effects of arc-track private lock pedicle orthopedic fixation system Ⅱ (ALPF Ⅱ) on treatment of spinal diseases. METHODS: A total of 86 patients with spinal diseases were treated using self-made ALPF in the Wendeng Orthopaedic Hospital and were included in this study. Of these patients, 14 suffered from cervical spinal stenosis complicated by cervical vertebral destabilization, 29 from thoracolumbar fractures and dislocations, 15 from lumbar spinal stenosis complicated by lumbar vertebral destabilization, 2 from lumbar spondylolisthesis, 8 from spinal tuberculosis, 6 from ankylosing spondylitis, 9 from idiopathic scoliosis, and 3 from congenital scoliosis. According to conditions, different therapeutic regimens were selected. Postoperatively, regular follow-up was performed to observe vertebral healing, intervertebral height, spinal column sequence, and neurological function recovery. RESULTS: All patients were followed up for 9-30 months (average 12 months). The improvement rate of neurological function, spinal mobility, back pain, and melosalgia was 94.1%, 65.9%, 92.1%, and 87.4%, respectively. The postoperative anterior and posterior vertebral heights were apparently recovered, and kyphotic angle was well corrected. No screw, rod loosening or breakage was found. CONCLUSION: Self-made ALPF Ⅱ is an internal fixation method for treatment of spinal diseases. It provides good reduction, reliable curative effects, less complications, and no biocompatibilities.
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Objectives:The time of Carotid intervention for recently symptomatic,severe carotid stenosis which cause a transient ischemic attack or minor stroke is still a controversial issue.Early studies showed that carotid endarterectomy (CEA) caused a high risk if performed within days follow an acute ischemic stroke.However,The National Stroke Strategy posted by UK Department of Health advocated that this situation should be regarded as an emergency procedure,and carotid intervention should ideally be performed within 48 hours.We designed this study to discuss the effect of urgent CEA on operative risk and benefit.Methods: we analyze 12 urgent CEA with primary closure performed during 1996 to 1998.All 12 patients were underwent CEA within 2 weeks,and 2 of them within 2 days.Operative risks and overall benefit from surgery were discussed in relation to the time from the last symptomatic event to CEA.Results: 2 urgent CEA performed in 2 days are recovery uneventful.1 of 12 patients,who underwent urgent CEA within 2 weeks,occurred restenosis after 3 months follow up.No 30-day perioperative recurrent TIA,stroke and death.Conclusions:CEA performed within 2 weeks is feasible and reliable procedure in preventing recurrent TIA and stroke after presenting manifestations.The future aim is to perform CEA within 48 hours after TIA or stroke symptoms.
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Objective To investigate the clinical and pathological characteristics as well as immunophenotypes of subcutaneous panniculitis-like T-cell lymphoma for its differential diagnosis with other similar diseases.MethodsThe clinical、histological and immunophenotypic features of 6 cases were described in detail and related literatures were reviewed.Results All of 6 patients presented with subcutaneous nodules or /and erythematous plaques without lymph nodes swelling and with 5 cases had fever,one case developed to ulcer from its nodules.All of 6 patient presented typical histological changes and 2 of them associated with prominent hemophagocytic syndrome.The neoplastic cells were of T-cell phenotype.Two patients under went an aggressive clinical course with short survival period of 9～16 months and four patients who treated with chemotherapy have an improved survival state,but two of them had recurrence.Conclusion SPTCL is a uncommon type of T-cell lymphoma with clinical and pathological characteristics,and it needs to be differentiated from benign panniculitis or other lymphomas of the skin.
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[Objective]To explore the feasibility and outcome of posterior single open-door and pedicle screw in treating canal stenosis and instability of cervical vertebrae at one time.[Method]The preoperative radiographs of 15 patients were measured and were diagnosed to be developmental spinal canal stenosis and instability of cervical vertebrae.MRI showed the spinal cords were compressed obviously.Posterior C_(3~7) single open-door decompression and canal-plasty was adopted.Self-designed pedicle screws and intertransverse fusion were used in the unstable segments.[Result]Complications were not found after the operation.The postoperative radiographs showed that the screws were in the right places.The average follow-up time was 13 months,ranging from 7 to 18 months.The short-term radiographs showed firmly fixed screws.[Conclusion]It is a simple and reliable method to treat canal stenosis and instability of cervical vertebrae at one time with posterior single open-door and pedicle screw.Anterior and posterior operations have been avoided and the short-term outcome is satisfied.
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?Objective:To study the inductive effect of absorbable crystalline glass (ACG) and absorbable crystalline glass powder(ACGP) , in osteogenesis.Methods:Samples of ACG,ACGP and ? TCP in the size of 10 mm?3 mm?2.5 mm were prepared and implanted subperiosteally into the mandible deffects in 48 rabbits .Specimens obtained 2,4,12,and 24 weeks after implantation were observed with X ray film,measurement of area of crosssection energy dispersive X ray analysis(EDX),light and scanning electron microscopes.Results:Bone formation was found in 12 weeks and increased in 24 weeks in all implannts.The degradation (%) of ACG,ACGP and ? TCP in 24 weeks were 33,80 and 40 respectively.24 weeks after implantation the Ca ++ content (% of wt)in ACG,ACGP,? TCP and rabbit mandible were 20.54,20.29,19.96 and 19.71;the P ++ content (% of wt)10.54,10.51,10.72 and 10.96,respectively.Conclusion:ACG and ACGP are degradable,biocompatible and osteoinductive.