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Objective:To explore the consistency between modified 12+ X prostate biopsy under transrectal interventional ultrasound and postoperative Gleason score in prostate cancer patients.Methods:A retrospective study was conducted on 312 patients diagnosed with prostate cancer and underwent radical resection at Zhongshan People′s Hospital from January 2020 to December 2022. All patients underwent modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound before surgery. Using the Gleason score of postoperative pathological specimens as the " gold standard", the detection rates of prostate cancer and clinically significant prostate cancer using modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound were compared, and the consistency between the two methods alone or in combination and postoperative Gleason score was compared.Results:Among 312 patients, the positive detection rate of the improved 12+ X puncture biopsy combined with the system puncture biopsy was significantly higher than that of the individual detection (95.51% vs 80.77% vs 76.92%), with a statistically significant difference ( P<0.05). The improved 12+ X puncture biopsy combined with system puncture biopsy showed a clinically significant higher detection rate of prostate cancer in positive patients compared to the two tests alone (94.63% vs 77.78% vs 80.00%), with a statistically significant difference ( P<0.05). There was no statistically significant difference in the detection rate of clinically significant prostate cancer among patients who missed diagnosis, either alone or in combination with biopsy ( P>0.05). The upgrade rate of Gleason score after prostate improvement 12+ X puncture biopsy (25.00%) was significantly lower than that of prostate system puncture (44.17%), which was significantly higher than combined puncture biopsy (11.74%), with a statistically significant difference ( P<0.05). After 312 patients received combined puncture biopsy, urinary retention was found in 14 cases (4.49%), hematuria in 30 cases (9.62%), fever in 28 cases (8.97%), and blood in stool in 18 cases (5.77%). After symptomatic treatment, they basically improved within 3 days after puncture. Conclusions:The combination of modified 12+ X prostate biopsy with systematic biopsy under transrectal interventional ultrasound can improve the detection rate of prostate cancer, and has good consistency with the postoperative Gleason score of prostate cancer patients, which has good clinical application value.
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Prostate cancer poses a serious threat to the health of men with an increasing incidence in China. In recent years, great progress has been made in surgical and pharmaceutical treatment, but there are few promising techniques for early diagnosis of prostate cancer or therapeutics for advanced prostate cancer. Engineered nanomaterials have emerged and shown great potential in early diagnosis, precisely targeted therapies and synergistic therapeutics for prostate cancer because of unique physicochemical properties, such as size on the nanoscale, large specific surface area, high drug loading efficiency, fluorescence excitation ability and photothermal/photodynamic effect. This review focused on the new diagnoses and treatment strategies in prostate cancer with engineered nanomaterials, by summarizing the advancement of engineered nanomaterials in improving the sensitivity of molecular biology and imaging diagnosis, targeted guidance in surgery, sensitization of radiotherapy and chemotherapy, and targeted drug delivery.
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OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONS:The target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.
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Objective To investigate the utilization of ultrasound monitoring the renal blood flow during extracorporeal membrane oxygenation (ECMO).Methods Twentry one cases,who received veinartery ECMO for heart failure,were examinated by bed-side ultrasound before the ECMO initiated,right after the ECMO initiated,each day after the ECMO initiated,and right after the ECMO weaned.The renal interlobar artery peak velocity (Vmax) was measured,and the renal interlobar artery resistant index (RI) was calculated,as well as the values of the serum creatinine (SCr) and blood urea nitrogen (BUN) were recorded.All the data were compared.Results Compared to the variables right after the ECMO initiated,thc Vmax incrcascd (P ＜ 0.05) two days after ECMO initiated and right after the ECMO weaned,while RI (P ＜ 0.05),SCr (P ＜ 0.05) and BUN (P ＜ 0.05) decreased,there being significant differences (P ＜ 0.05).Conclusions While treating patients with extracorporeal membrane oxygenation,the ultrasound can monitoring the renal blood flow effectively,and provide important parameters for the clinical doctors as the basis of the diagnosis and treatment.
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OBJECTIVE:To observe the anesthesia effect and safety of hypoxia flow sevoflurane combined with propofol for el-derly abdominal tumor surgery in saturation. METHODS:128 elderly patients took abdominal tumor surgery under general anesthe-sia were randomly divided into observation group(64 cases)and control group(64 cases). After routine anesthetic induction,the oxygen flow was adjusted to 6 L/min,vaporizer was adjusted to 2%,10 minutes after inhalation,the observation group was adjust-ed to 0.5 L/min,and control group was 1.5 L/min,all received 0.5 mg/L propofol by target-controlled infusion,continuous infu-sion of remifentanil,intermittent bolus injection of vecuronium 1-2 mg/times based on the intraoperative muscle relaxation. Heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2),central venous pressure(CVP),inspired oxygen concentra-tion(FiO2),end-tidal carbon dioxide partial pressure [p(CO2)] in 10 min(T0),intraoperative 1 h(T1),intraoperative 2 h(T2), end of surgery(T3)in 2 groups were observed;sevoflurane dosage,recovery time,restlessness,and blood urea nitrogen(BUN), serum creatinine (Cr),alanine aminotransferase (ALT) levels,incidence of early cognitive dysfunction before and after surgery and the incidence of adverse reactions in 2 groups were recorded. RESULTS:There were no significant differences in the HR, MAP,SpO2,CVP,FiO2 and p(CO2)in 2 groups at different time points(P>0.05). The sevoflurane dosage,recovery time,the incidences of cognitive dysfunction postoperative 3 h and 6 h and adverse reactions in observation group were significantly lower than control group,the differences were statistically significant (P0.05). After surgery,ALT levels in 2 groups were significantly higher than before,the difference was statistically significant(P0.05). There were no significant differences in preoperative ALT and preoperative and postoperative BUN and Cr between 2 groups(P>0.05). CONCLUSIONS:Hypoxia flow sevoflurane combined with propofol shows obvious anesthe-sia effect for elderly abdominal tumor surgery in saturation,with stable hemodynamics,it can reduce sevoflurane dosage,shorten the recovery time and reduce the incidence of early postoperative cognitive dysfunction,with good safety.
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OBJECTIVE:To investigate the cardiac-protective effects and safety of dexmedetomidine on cardiac muscle of elder-ly patients with non-coronary artery bypass grafting (OPCABG). METHODS:50 elderly patients underwent OPCABG were se-lected and randomly divided into observation group and control group,with 25 cases in each group. Both groups received mor-phine 0.2 mg/kg+scopolamine 0.3 mg/kg intramuscularly 30 min before operation,and were given sulfentanyl 1 μg/kg+etomidate 0.1-0.2 mg/kg+pipecurium bromide 0.1 mg/kg for anesthesia induction. Observation group was given Dexmedetomine hydrochloride injection 1 μg/kg,ivgtt,within 15 min,and then by pump injection at 0.5 μg/(kg·h) till the end of operation;control group was given constant volume of 0.9% Sodium chloride injection,ivgtt. cTnⅠ,IMA,SOD and MDA levels and the occurrence of ADR were observed in 2 groups after entering the operation room(T1),at the end of vascular anastomosis(T2),6(T3),12(T4),24 h (T5) after operation. RESULTS:IMA of observation group at T2,T3 and T4 were significantly lower than those of control group, and cTnI at T2,T3,T4 and T5 were significantly lower than those of control group,with statistical significance (P0.05). Serum level of MDA in 2 groups at T4 and T5 were decreased significantly,and the observation group was lower than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Dexmedetomidine can protect cardiac muscle of elderly pa-tients with OPCABG to certain extent,and relieve myocardial injury with good safety.
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OBJECTIVE:To evaluate effects of dexmedetomidine hydrochloride on cardiovascular response of middle aged and elderly patients during tracheal extubation period. METHODS:110 general anesthesia patients with colorectal cancer were collected and randomly divided into observation group and control group,with 55 cases in each group. All patients received general anesthe-sia with same dose. Observation group was given intravenous pump of dexmedetomidine hydrochloride 0.5 μg/kg after surgery,and control group was given intravenous pump of propofol 0.5 μg/kg. HR and MAP of 2 groups were compared 10 min before tracheal extubation,at the moment of tracheal extubation,5 and 10 min after tracheal extubation. The oxygen saturation of blood,the time of respiration recovery,opening eyes and extubation were recorded in 2 groups. RESULTS:There was no statistical significance in HR and MAP between 2 groups 10 min before extubation and 10 min after extubation (P>0.05). HR and MAP of observation group were significantly lower than those of control group at the moment of extubation and 5 min after extubation,the levels of HR and MAP were significantly increased in the 2 groups with statistical significance (P0.05). The time of open-ing eyes in observation group was significantly shorter than in control group,with statistical significance (P<0.05). CONCLU-SIONS:Dexmedetomidine hydrochloride could significantly decrease cardiovascular stress response and shorten recovery time of middle age and elderly patients with colorectal cancer during tracheal extubation period.
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Objective To investigate the sore-throat-relieving, anti-inflammation and antitussive actions of Qingyan mixture on the animal models. Methods Sore-throat-relieving action of Qingyan mixture was observed in SD rats with acute pharyngitis induced by spray of ammonia water at volume fraction of 15%. Anti-inflammation action of Qingyan mixture was observed on mice model of xylene-induced ear edema, and antitussive action of Qingyan mixture was carried out in mice with cough induced by concentrated ammonia spray. Results (1) The results of sore-throat-relieving action of Qingyan mixture showed that the infiltration of inflammatory cells did not happen in the blank control group, but moderate/severe inflammatory cell infiltration was shown in the model group. In the positive group, 4 rats had slight inflammatory cell infiltration while the left 6 rats had no inflammatory cell infiltration. Low-dose Qingyan mixture group had no inflammatory cell infiltration in one rat, and had slight infiltration in 9 rats. In middle-and high-dose Qingyan mixture groups, 4 rats had no infiltration and 6 had slight infiltration, inflammatory cell infiltration was markedly relieved ( P0.05). ( 2) The anti-inflammation rate was 69.8% in the positive control group, and was 27.3%, 60.4%, 60.0% in low-, middle- and high-dose Qingyan mixture groups respectively. The inhibitory effect of middle-and high-dose Qingyan mixture on xylene-induced mice ear edema was similar to that of the positive control group ( P>0.05) . ( 3) The cough-relieving rate was 42.6%, 139.0%, 64.3%, 104.0% in positive control group, and low-, middle-and high-dose Qingyan mixture groups respectively. Mice cough latent was obviously prolonged and cough frequency was decreased in the three Qingyan mixture groups, the differences being significant compared with the model group ( P<0.05 or P<0.01) . Conclusion Qingyan mixture has certain sore-throat-relieving, anti-inflammation and antitussive actions, which can be used for the treatment of patients with actue/chironic laryngitis and the complication of cough.
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Objective To investigate the therapeutic effect of Qingyan Mixture for laryngeal cough patients with lung dryness due to yin deficiency. Methods Sixty laryngeal cough patients with lung dryness due to yin deficiency were evenly randomized into treatment group and control group. The treatment group was given oral use of Qingyan Mixture, and the control group was given oral use of Ketotifen and Carbetapentane. The course of treatment for both groups lasted for 10 days. The overall therapeutic effect, and the effect on individual symptom or sign were evaluated after treatment. Results ( 1) In the treatment group, six patients were cured, 14 were markedly effective, 8 were improved, 2 were ineffective and the total effective rate was 93.3%. In the control group, one case was cured, 7 were markedly effective, 17 were improved, 5 were ineffective and the total effective rate was 83.3%. The overall clinical effect in the treatment group was significantly higher than that in the control group (P0.05) . (3) After treatment, the total scores of main symptoms were decreased in both groups (P<0.05 or P<0.01) compared with those before treatment. Conclusion Qingyan Mixture shows certain effect on relieving symptoms and signs of laryngeal cough patients with lung dryness due to yin deficiency.
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Objective To detect the clinical factors related with liver metastasis in young patients with rectal cancer.Methods Three hundred and fifty young patients with rectal cancer were collected to set up the database.Single and multi-factor Logistic regression was applied to indicate the independent factors relating to liver metastasis.The regression equation to predict probability of liver metastasis from rectal cancer was established.Results Liver metastasis was 120 cases (34.3%).Single-factor analysis revealed that patho-organization type,pathologytype,infiltration extent,blood vessel invasion (BVI),TNM stage,operation character,the preoperative level of carcino-embryonic antigen,histology grading were related with liver metastasis.Multi-factor analysis revealed that only BVI (P=0.001),TNM stage (P=0.001),pathoorganization type (P=0.005),the preoperative level of CEA (P=0.008) and operation character (P=0.032) were independent factors to predict probability of liver metastasis.Conclusions Rectal cancer of young patients who being with BVI,advanced phase,high preoperative level of CEA,radical operation or poor differentiation degree,are apt to develop liver metastasis.They should be given further individualized intensive adjuvant treatment.
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<p><b>BACKGROUND</b>To evaluate and compare the effects and toxicity of the domestic product of nrhTNF combined with chemotherapy in the trial group and chemotherapy alone in the control group in the treatment of patients with non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Ninety patients with NSCLC in multicenter were randomly devided into trial group and control group. Each group had 45 patients. Chemotherapy with CAP regimen was given for the patients in the trial group. Meanwhile, nrhTNF injection of 4×10⁶U/m ² was also given from the 1st to 7th days, the 11th to 17th days on the chemotherapy course. Twenty-one days were as a cycle, 2 cycles were given each patients. Chemotherapy alone with CAP regimen was given in the control group. The chemothepeutic effects and toxicity were observed and compared between the two groups after the therapy.</p><p><b>RESULTS</b>Of the 90 patients, 3 cases in each group were out of the trial because of economy. The other 84 cases (each group had 42 patients) could be used to analyze and evaluate the clinical effects and toxicity. The response rate of chemotherapy was 47.62% (20/42) in the trial group and 19.05% (8/42) in the control group (P=0.002) respectively. The KPS was 85.02±10.74 in the trial group, and 81.35±9.63 in the control group (P=0.038). No significant difference of degree III+IV toxicity was observed between the trial group and control group (P > 0.05). The side effects related to nrhTNF included slight fever, cold like symptoms, pain, and red and swelling in injection site. All of them were mild and didn't need any treatment and disappeared after the therapy.</p><p><b>CONCLUSIONS</b>The results demonstrate that the effects of domestic nrhTNF combined with chemotherapy can remarkably higher than that of chemotherapy alone in the treatment of NSCLC. It is able to increase the sensitivity to chemotherapy and improve the quality of life of the patients. The toxicity is also slight and is worth to expand clinical use, so as to further evaluate its effect and toxicity.</p>
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PURPOSE To explore an efficacious therapy for liver metastasis of colorectal carcinomas. METHODS Basing on excision of primary lesions. 86 cases of colorectal carcinomas metastasize to liver were treated in four different manners, namely: sole resection of the metastasis lesions, chemoembolization-resection, sole chemoembolization. and chemotherapy. We also analyze the efficacy in curing single metastatic liver cancer, multiple metastatic cancer that is confined to one section or both left and right sections of liver. RESULTS One year survival rates in the groups of sole resection and chemoembolization-resection are better than that of sole chemoembolization P