ABSTRACT
The present study retrospectively analyzed the clinical data of 137 patients who underwent prostate in North Jiangsu People's Hospital from June 2020 to May 2021. All patients underwent peripheral prostatic nerve block anesthesia (PPNB). The observation group received 1% ropivacaine 32 ml local, and the control group received the same dose of lidocaine. There was no significant difference in general data before puncture between the two groups ( P>0.05). All 137 cases were performed by the same surgeon. The number of puncture needles in the observation group and the control group was (20.2±2.8) and (20.2±2.9), respectively, and the difference was not statistically significant ( P>0.05). The visual analogue scores (VAS-1) of pain during puncture in the observation group and the control group were (2.62±0.74) and (2.48±0.79) points, respectively. The visual numeric score (VNS-1) was (3.03±0.88) points and (3.15±0.80) points, respectively, and there was no significant difference ( P>0.05). 30 min after puncture, VAS-2 was (0.48±0.53) points and (0.30±0.47) points, VNS-2 was (3.31±0.48) points and (3.55±0.71) points, respectively.The differences were statistically significant ( P<0.05). There was no significant difference in overall complication rate between the two groups ( P=0.661).
ABSTRACT
Objective:To analyze the risk of missed diagnosis in patients with PI-RADS score>3 and negative prostate initial biopsy and to explore its risk factors.Methods:The clinical data of 268 patients with negative prostate biopsy in Northern Jiangsu People's Hospital from May 2013 to December 2018 were retrospectively analyzed. The patients were divided into observation group (PI-RADS score>3) and control group (PI-RADS score≤ 3) according to different PI-RADS scores. There were insignificant differences in age [(67.4(60.0, 74.0)years and 65.6(66.5, 72.0)years], prostate volume of initial biopsy [62.4(40.0, 72.0)ml and 60.8(38.0, 77.0)ml], biopsy cores [ 20.6(18.0, 22.0)cores and 20.4(18.0, 22.0)cores] between the observation group (n=124) and the control group(n=144)(all P>0.05). But there were significant differences in PSA [17.5(6.5, 23.0)ng/ml and 11.5(6.3, 12.0)ng/ml], PSAD[0.316(0.128, 0.363)ng/ml 2 and 0.211(0.106, 0.256)ng/ml 2], prostate inflammation of the initial biopsy [70 (56.5%) and 32 (22.2%)] between the observation group and the control group(all P<0.05). According to the follow-up results after the initial biopsy, the two groups of repeated biopsy were compared.Furthermore, Logistic regression was used to conduct univariate and multivariate analysis to explore the risk factors of patients with PI-RADS>3 for positive repeated biopsy. At the same time, the receiver operating characteristic curve (ROC curve) was used to analyze the accuracy of the risk factors. Results:There were significant differences in repeated biopsy rate [ 27.4%(34/124)and 14.6%(21/144)], CsPCa detection rate[ 41.4%(14/34) and 4.8%(1/21)]between the observation group and the control group(all P<0.05). The positive rate of repeated biopsy in the observation group (41.1%) was higher than that in the control group (23.8%), but there was no statistical difference ( P=0.248). The risk of positive repeated biopsies in the observation group was 2.24 times than that in the control group. Univariate analysis found repeated biopsy PSA ( P =0.02, OR=1.438, 95% CI 1.161-1.896), PSA ratio (repeated biopsy PSA/initial biopsy PSA) ( P=0.011, OR=10.087, 95% CI 1.714-59.36) were risk factors for positive of repeated biopsy in patients with PI-RADS score >3. Multivariate analysis also found that repeated biopsy PSA ( P=0.017, OR=1.15, 95% CI 1.076-2.123), PSA ratio ( P=0.032, OR=10.2, 95% CI 0.883-116.168) were risk factors for positive repeated biopsy. ROC curve analysis, the accuracy of repeated biopsy PSA (AUC=0.971, P<0.001, 95% CI 0.926-1.000), PSA ratio (AUC=0.839, P=0.001, 95% CI0.707-0.971) to predict positive of repeated biopsy were high. The cut-off values were 21.3 ng/ml and 1.4, respectively. The accuracy was higher when combines repeated biopsy PSA with PSA ratio (AUC=0.993, P<0.001, 95% CI 0.974-1.000). Conclusions:Patients with negative PI-RADS score > 3 have a higher risk of missed diagnosis of CsPCa than those with PI-RADS score≤3. When PSA>21.3 ng/ml and PSA ratio>1.4 during follow-up, the possibility of missed diagnosis in the initial biopsy is high.
ABSTRACT
Objective@#To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer.@*Methods@#A total of 217 patients were enrolled in this study. All the patients were randomly divided into 2 groups. The control group (n=112) underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy. On the basis of the control group, the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB). The positive rate of apex and the incidence of complications were analyzed. The prostatic specimens from the radical prostatectomy underwent whole mount sections examination. The prostate biopsy results were compared with the postoperative pathological results.@*Results@#The average age of the control group and the observation group were (68.5±7.9) years and (67.3±8.5) years, PSA were (31.2±18.9) ng/ml and (29.7±19.5) ng/ml, prostate volume were (44.6±15.2) ml and (41.3±17.3) ml, respectively. In the control group, the positive rates of prostate cancer in 1-10 region were 24.1% (27/112), 27.7%(31/112), 23.2% (26/112), 28.6% (32/112), 26.8% (30/112), 25.0% (28/112), 26.8% (30/112), 19.6% (22/112), 25.9% (29/112), 25.0% (28/112), respectively, with an average of 25.3%. In the observation group, the positive rates in 1-10 region were 27.6% (29/105), 28.6% (30/105), 22.9% (24/105), 26.7% (28/105), 25.7% (27/105), 24.8% (26/105), 27.6% (29/105), 21.9% (23/105), 27.6% (29/105), 26.7% (28/105), respectively, with an average of 26.0%. There was no statistical difference between the two groups (P=0.904). The positive rate of apical prostate cancer in the control group and observation group was 37.5% (42/112) and 44.8% (47/105), respectively, and there was no statistical difference between the two groups (P=0.277). Patients were grouped according to PSA>20 ng/ml and PSA≤20 ng/ml. When PSA>20 ng/ml, the positive rate of apex was 58.6% (34/58) and 56.6% (30/53) respectively in the control group and the observation group, and there was no statistical difference between the two groups (P=0.830). When PSA≤20 ng/ml, the positive rate of apex was 14.8% (8/54) in the control group and 32.7% (17/52) in the observation group, with statistically significant differences (P=0.030). Before radical prostatectomy, 12 cases (57.1%) in the control group and 19 cases (73.1%) in the observation group showed apical invasion by biopsy. Results of whole mount sections examination in the control group showed that there were 19 cases (90.5%) with apical invasion, which was statistically different from that before surgery (P=0.035). The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5%) with apex invasion, which had no statistical difference compared with that before surgery (P=0.291). There were no significant differences in the incidence of hematuria, fever, urinary retention and perineal discomfort between the observation group and the control group (all P>0.05).@*Conclusions@#mTTPB can significantly improve the detection rate of apical prostate cancer without increasing the incidence of complications, especially for patients with PSA≤20 ng/ml. Hence is safe and efficacious.
ABSTRACT
Objective To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer.Methods A total of 217 patients were enrolled in this study.All the patients were randomly divided into 2 groups.The control group (n =112)underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy.On the basis of the control group,the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB).The positive rate of apex and the incidence of complications were analyzed.The prostatic specimens from the radical prostatectomy underwent whole mount sections examination.The prostate biopsy results were compared with the postoperative pathological results.Results The average age of the control group and the observation group were (68.5 ± 7.9) years and (67.3 ± 8.5) years,PSA were (31.2 ± 18.9) ng/ml and (29.7 ± 19.5) ng/ml,prostate volume were (44.6 ± 15.2) ml and (41.3 ± 17.3) ml,respectively.In the control group,the positive rates of prostate cancer in 1-10 region were 24.1％ (27/112),27.7％ (31/112),23.2％ (26/112),28.6％ (32/112),26.8％ (30/112),25.0％ (28/112),26.8％ (30/112),19.6％ (22/112),25.9％ (29/112),25.0％ (28/112),respectively,with an average of 25.3％.In the observation group,the positive rates in 1-10 region were 27.6％ (29/105),28.6％ (30/105),22.9％ (24/105),26.7％ (28/105),25.7％ (27/105),24.8％ (26/105),27.6％ (29/105),21.9％ (23/105),27.6％ (29/105),26.7％ (28/105),respectively,with an average of 26.0％.There was no statistical difference between the two groups (P =0.904).The positive rate of apical prostate cancer in the control group and observation group was 37.5％ (42/112) and 44.8％ (47/105),respectively,and there was no statistical difference between the two groups (P =0.277).Patients were grouped according to PSA ＞ 20 ng/ml and PSA ≤ 20 ng/ml.When PSA ＞ 20 ng/ml,the positive rate of apex was 58.6％ (34/58) and 56.6％ (30/53)respectively in the control group and the observation group,and there was no statistical difference between the two groups (P =0.830).When PSA≤20 ng/ml,the positive rate of apex was 14.8％ (8/54) in the control group and 32.7％ (17/52) in the observation group,with statistically significant differences (P =0.030).Before radical prostatectomy,12 cases (57.1％) in the control group and 19 cases (73.1％) in the observation group showed apical invasion by biopsy.Results of whole mount sections examination in the control group showed that there were 19 cases (90.5％) with apical invasion,which was statistically different from that before surgery (P =0.035).The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5％) with apex invasion,which had no statistical difference compared with that before surgery (P =0.291).There were no significant differences in the incidence of hematuria,fever,urinary retention and perineal discomfort between the observation group and the control group (all P ＞ 0.05).Conclusions mTTPB can significantly improve the detection rate of apical prostate cancer without increasing the incidence of complications,especially for patients with PSA≤20 ng/ml.Hence is safe and efficacious.
ABSTRACT
Objective To study the anatomical location and pathology of membranous obstruction of the inferior vena cava(IVC)in Budd-Chiari syndrome(BCS)with research on the etiologic mechanism and pathology.Methods Analysis of 100 normal adults was performed including the gross anatomy of IVC segment from the level of diaphragm up to right atrium.The conventional,microscopic pathologic examination of the biopsy sampling IVC obstruetice mambrane tissue in 70 cases toghther with the complete resected membrane from the radical therapy for 20 cases of BCS,were collected and under investigation.Results The macroscopic examination revealed the obstructive membrane in one case(1%)localizing at the diaphragmatic level,approximately 28 mm,away from the IVC entrance into the right atrium and a newly found valvula was seen on the left lateral wall of the upper part of the hepatic vein orifice.Simultaneously,47% adults showed Eustachiun valve existing in IVC near the entrance to right atrium.Microscopy confirmed all the forementioned membranes consisting of vascular valvular structures.Among them(21/70),30% showed additional organized thrombus formations,and 9%(6/70)with a few amount of inflammatory cellular infiltrations.The total intact resection membrane was continuous with the vascular wall under microscopic examination.Conclusions The first newly report of the existence of a special valvula at the diaphragmatic level of IVC reveals the possibility of high correlation with the occurance of IVC membranous obstruction type in BCS.
ABSTRACT
AIM: To study the alteration of expression of iNOS mRNA and ecNOS mRNA in peripheral leukocytes of Wistar rats fed with fructose. METHODS: Wistar rats were randomly divided into the control group ( n =10) and the fructose feeding group( n =10). The fructose feeding group drank 12% fructose water for 6 months. The blood glucose, blood insulin, and the expression of iNOS mRNA and ecNOS mRNA in peripheral leukocytes of rats were determined. RESULTS: The levels of blood insulin ( P
ABSTRACT
AIM: To clarify the relationship between expression of leukocyte iNOS-mRNA and pancreatic islet function in the diabetic rats induced by streptozocin(STZ). METHODS: Wistar rats were randomly divided into the control group ( n =10) and the diabetic group ( n =15). Expression of iNOS-mRNA in the peripheral blood leukocyte, liver and lung were detected with in situ hybridization and the blood sugar and insulin were also measured. RESULTS: It showed that the blood glucose content increased from (8 95?1 80) to (22 84?4 90) mmol?L -1 ,however, the plasma insulin content decreased from (81 76?20 12) to (58 92?18 20) mU?L -1 at the third day after the ? cell was disfunctioned by STZ injection. No expression of leukocyte iNOS-mRNA in normal rat was detected. The percent rate of positive cells were significantly increased in the rats with diabetes. CONCLUSION: The expression of leukocyte iNOS-mRNA is positively related to the damage of ? cells caused by STZ.
ABSTRACT
Objective To investigate the character and risk factors of coronary artery disease in prediabetes. Methods The 193 patients with coronary artery disease were divided into 3 groups according to the American diabetes associations (ADA) standard of diabetic diagnoses. (1) Normal glucose tolerance group(NGT group,122 cases). (2) Impaired glucose tolerance group (IGT group,39 cases). (3) Diabetes mellitus group (DM group,32 cases). All patients were checked by the coronary angiographic semiquantitative (CAG) and the 75g oral glucose tolerance test. Blood glucose, insulin, TG, TC, HDL C, blood pressure, BUN and Cr were determined. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis were evaluated by AHA standards. The risk factors in coronary artery disease were analysed by pluralized straight line statistics. Results The coronary multivessel changes and the severity of coronary artery stenosis and calcification were more frequent in IGT group than in NGT group (66 5% vs 35 1%,8 9?3 6 vs 6 5?3 9,6 6?6 1 vs 3 9?4 1,P
ABSTRACT
Objective To study the effects of iodine on the proliferation activity of fibroblasts at different doses. Methods The cultured fibroblasts were treated with different dose iodine(100 ?g/L, 500 ?g/L, 1 000 ?g/L, 3 000 ?g/L, 5 000 ?g/L, 7 000 ?g/L, 9 000 ?g/L, 11 000 ?g/L)for 24 h and observe the morphology of fibroblast. MTT colorimetry was used to detect the fibroblast proliferation activity. Results Iodine could significantly increase the fibroblast proliferation activity at certain range of concentration (7 000 ?g/L). The proliferation activity was highest from 5 000 ?g/L to 7 000 ?g/L, the differences were significant compared with the iodine free control. Conclusion Iodine, the exposure level is 7 000 ?g/L.
ABSTRACT
AIM: To investigate differentiation of CD34~+ cells in human umbilical blood into eosinophils under the condition of cell culture in vitro.METHODS: CD34~+ cells were separated and purified from human umbilical blood.The cells were divided into negative group,IL-5 group and allergic rhinitis serum group.The differentiation ability of the cells was measured by flow cytometry,HE staining and electron microscope at the first day,second day, 7th day,14th day and 28th day culture.RESULTS: The proportion of CD34~+ cells in IL-5 group and allergic rhinitis serum group were decreased at the second day.The proportion in allergic rhinitis serum group was lower than that in IL-5 group significantly.The typical structure of eosinophils was observed at the second day.CONCLUSION: The allergic patient serum and IL-5 induce differentiation of CD34~+ cells in human umbilical blood to eosinophils.
ABSTRACT
Objective: To investigate the effects of different concentrations of vitamin E (VE) on angiogenesis and its possible mechanism. Methods: The rings of rat aorta were embedded in gels of collagen and cultured in a serum free medium for 28 days. Curves of microvessels growth were generated by counting the number of newly formed microvessels every day with an inverted microscope. Photos were taken at the same time. Expression of factor FVIII related antigen (FVIII RAg) in newly formed microvessels was detected by immunohistochemistry. Concentration change of FVIII R in medium was evaluated by ELISA. Results: Both 0.2 g/L and 0.1 g/L VE showed significant inhibitory effect on angiogenesis (P0.05). The inhibitory effect of VE was expressed in the phases of microvessel growth and decline (10-25 d). Conclusion: 1.Three dimensional collagen gels culture of microvessel in serum free medium can be used as a sensitive assay for study of soluble and solid phase angiogenic agonists and antagonists. 2. Both 0.1 g/L and 0.2 g/L VE inhibit angiogenesis, and VE has no toxicity and no drug resistance.