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Objective:To analyze the clinical features and magnetic resonance imaging of non-malignant patients assigned to Prostate Imaging Reporting And Data System (PI-RADS) 5 score.Methods:We performed a retrospective review of 289 patients who underwent magnetic resonance ultrasound targeted combined system biopsy with PI-RADS 5 lesions in the First Affiliated Hospital of Nanjing Medical University between May 2019 and July 2021. The median age 72 (66, 77)years, median body mass index 24.4(22.3, 27.1)kg/m 2, median prostate volume (PV) 37.39(29.39, 48.86) ml, median PSA 22.24(10.91, 62.69) ng/ml, and median PSAD 0.53(0.30, 1.52)ng/ml 2 were recorded. According to the biopsy pathological results, all patients were divided into benign lesion group and prostate cancer group. PSA, PSAD, PV, and apparent diffusion coefficient (ADC) values were compared, and magnetic resonance imaging and clinical characteristics of patients with biopsy benign lesions were analyzed. Results:There were 11 cases (3.8%) with benign lesion and 278 cases (96.2%) with prostate cancer. The characters of 11 negative biopsy cases were displayed as follows: median age 69(66, 79)years, median body mass index 22.0(21.0, 25.5)kg/m 2, median PV 62.90(38.48, 71.96)ml, median PSA 5.55(2.99, 20.52)ng/ml, median PSAD 0.16(0.07, 0.24) ng/ml 2, median ADC 714.47(701.91, 801.26)×10 -6 mm 2/s, abnormal digital rectal and amination in 5 cases, smoking in 7 cases, and alcohol consumption in 4 cases. The median PV [62.90(38.48, 71.96) vs. 37.21(29.22, 47.82)ml, P<0.01], the PSA value [5.55(2.99, 20.52) vs. 23.53(11.14, 65.98)ng/ml, P<0.01], and the PSAD value [0.16(0.07, 0.24) vs. 0.58(0.31, 1.57)ng/ml 2, P<0.01] were significantly different between benign condition group and prostate carcinoma group. Benign condition group included 5 chronic prostatitis, 2 acute prostatitis (1 with focal adenocarcinoma), 2 granulomatous inflammation, and 2 tuberculous granulomatous inflammation. In 7 benign cases, PSA was less than 10 ng/ml, combined with frequent urination, urgency of urination and incontinence were founded. In 8 benign cases, the area of lesion was more than 50% of the total prostate area in the axial position and the imaging of magnetic resonance were diffused, with regular shape and uniform signal. The imaging of symmetrical distribution was in 6 cases. Conclusions:The benign condition with PI-RADS 5 lesions included chronic prostatitis, acute prostatitis, granulomatous inflammation and tuberculous granulomatous inflammation, among which prostatitis was the most common cause. The PSA value were less than 10 ng/ml in most benign cases, with symptoms such as frequent urination, urgency of urination and incontinence. The imaging of magnetic resonance were diffused, symmetrically distributed, with regular shape and uniform signal.
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Objective:To investigate the efficacy and safety of transurethral Moses holmium laser enucleation of the prostate (MoLEP) in the treatment of small-volume benign prostatic hyperplasia (BPH).Methods:The clinical data of 132 patients with small BPH (prostate volume <40 ml) who underwent MoLEP from October 2017 to April 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.The age of the patients was (63.93±5.21) years old, including 12 patients with cystolithiasis. The prostate volume of 132 patients was (32.16±7.81) ml, the preoperative international prostate symptom score (IPSS) was 23.00(15.00-34.00), the quality of life score (QOL) was 5(2-6), the maximum urinary flow rate (Q max) was 7.80(0.80-9.80)ml/s and residual urine volume (PVR) was 158(51-409) ml. 89 patients had the preoperative maximum detrusor contractility (64.23±8.11) cmH 2O. Surgical methods: the 120 W Moses laser platform(Lumenis Inc)was used, the cutting power was adjusted to 80 W (2.0J×40Hz) (narrow pulse width mode), and the hemostatic power 24W (0.8J×30Hz) (wide pulse width mode). Patients with bladder calcifications underwent Moses laser bladder stone lithotripsy.After the initial resection by the level of verumontanum was performed, an anatomic plane was exposed and carried forward until the bladder neck. If prostate stones were found, Moses holmium laser lithotripsy can be performed directly. After operation, the bladder was continuously flushed with normal saline. The catheter was removed 24 hours after the operation. The operation status, intraoperative and postoperative complications were recorded. IPSS, QOL, Q max and PVR were followed up 3 months after surgery. Postoperative urinary incontinence is defined as the need for 2 pads or more within 24 hours. Results:The operations of 132 cases (including 12 cases with bladder stones) were successfully completed. 30 cases with prostate calcifications were found during the operation. The operation time (enucleation time) was (16.83±4.03) min. There were no perioperative complications such as blood transfusion, transurethral resection syndrome, urinary retention and venous thromboembolism. No bladder neck contracture or recurrence of bladder stones was found after surgery. Postoperative urethral stricture occured in 2 cases (1.5%), and postoperative urinary incontinence in 27 cases (20.5%). There were 102 cases (77.3%) with chronic interstitial inflammatory cell infiltration. Three months after operation, IPSS was 7(0-14), QOL was 2(0-5), Q max was 17.55(9.40-26.50)ml/s and PVR was 27(0-46) ml, which were significantly improved compared with preoperatively( P<0.05). Conclusions:MoLEP can significantly improve lower urinary tract symptoms (LUTS) and life quality of patients with small-volume BPH.At the same time, the incidence of complications such as urethral stricture and urinary incontinence is lower. The operation is safe and reliable, and bladder stone lithotripsy can be performed at the same time.
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Objective:To investigate the effect of cocaine- and amphetamine-regulated transcript peptide (CART) on the synapse structure of mice cortical neuron subjected to oxygen-glucose deprivation (OGD).Methods:Primary neurons of the embryonic cerebral cortex obtained from healthy and clean Kunming mice at gestational age of 16-17 d were cultured. They were divided into control group, CART group, OGD group, and OGD+ CART group. 0.4 nmol/L CART 55-102 was added and cultured for 12 h after OGD treatment in the OGD+ CART group; the CART group was given the same dose of CART 55-102. The neuronal mortality was measured by the flow cytometry. The changes of synaptic structure were observed by immunofluorescence analysis, and the axon length and synapsin Ⅰ positive area were quantitatively analyzed. Real-time fluorescent quantitative polymerase chain reaction and Western blot analysis were used to identify the brain-derived neurotrophic factor (BDNF) mRNA and protein expression. Results:Compared with the control group, the mortality of neurons in the OGD group was significantly increased, the neuronal synapse growth was significantly inhibited, the positive area of synapsin Ⅰ was significantly reduced, and the expression levels of BDNF mRNA and protein were significantly down-regulated (all P<0.05). Compared with the OGD group, adding CART 55-102 significantly reduced the mortality of OGD neurons ( P<0.05), reversed the inhibitory effect of OGD on neuronal synapse growth, significantly increased the length of neuron axons and the positive area of synapsin Ⅰ (all P<0.05), and significantly up-regulated BDNF mRNA and protein expression levels (all P<0.05). Conclusion:CART can protect the synaptic structure of mice cortical neuron subjected to OGD, and its mechanism may be related to the up-regulation of BDNF expression.
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Objective To compare the application of the 2013 Chinese Diabetes Society (CDS 2013) criteria, the 2009 joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention(JIS)criteria, the 2005 International Diabetes Federation(IDF)criteria and the 2005 US National Cholesterol Education Program Adult Treatment PanelⅢ (ATPⅢ) criteria among the elderly in Nanjing. Methods A total of 1 832 elderly (≥60 years old) were recruited in Nanjing using cluster random sampling and were surveyed with questionnaires, physical examination, and laboratory test between March and December 2013. The different prevalence under CDS 2013, JIS, IDF and ATPⅢ criteria were calculated respectively. SPSS 19.0 was used to conduct t test, chi-square test and kappa test to compare the prevalence of metabolic syndrome and the consistency of four diagnostic criteria in the elderly. Results According to CDS 2013, JIS, IDF, and ATPIII, prevalence of MS in the elderly in Nanjing was 39.9%, 58.2%, 46.5%, and 54.5%, respectively. The highest value of kappa was 0.920 between JIS and ATPⅢ, with a compliance rate of 96.1%．The value of kappa was 0.841 between ATPⅢ and IDF, with a compliance rate of 92.0%. Conclusions The prevalence of metabolic syndrome among the elderly in Nanjing is relatively high under different criteria. The higher detection rate of MS by the JIS standard and ATPIII standard can help to find MS earlier and reduce the cardiovascular damage.
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Clinical skill competition based on objective structured clinical examination could evalu-ate students' clinical abilities effectively and fairly in a comprehensive way. The competition results not only reflected the learning effectiveness of the competitors but all the medical students. Analysis and exploration of the inspiration from the competition could promot the all-round development of students and boost the continuous growth and progress of clinical teaching.
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Objective To observe the characteristics of collateral circulation blood flow of ipsilateral ophthalmic artery in patients with internal carotid artery occlusion. Methods The imaging data of 20 patients with internal carotid artery occlusion were analyzed retrospectively. There were 11 males and 9 females, aged from 30 to 65 years, with an average age of (45±3) years. All the patients underwent digital subtraction angiography and transcranial Doppler examination, and 6 patients underwent simultaneous magnetic resonance angiography. The blood supply and collateral circulation of the ipsilateral ophthalmic artery were observed . Results All the patients had unilateral internal carotid artery occlusion. The blood supply of the ipsilateral internal carotid artery and ophthalmic artery comes from the collateral circulation between the middle meningeal artery branches of the external carotid artery and the ophthalmic artery in 18 patients (90.0%); it also comes from the anterior communicating artery of the contralateral internal carotid artery in 16 patients (80.0%); and the posterior communicating artery of the contralateral internal carotid artery in 12 patients (60.0%), respectively. Conclusion The blood flow of the ipsilateral ophthalmic artery mainly comes from the middle meningeal artery branch of the ipsilateral external carotid artery, also comes from the anterior and posterior communicating arteries of the contralateral internal carotid artery.
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Objective To observe the characteristics of collateral circulation blood flow of ipsilateral ophthalmic artery in patients with internal carotid artery occlusion. Methods The imaging data of 20 patients with internal carotid artery occlusion were analyzed retrospectively. There were 11 males and 9 females, aged from 30 to 65 years, with an average age of (45±3) years. All the patients underwent digital subtraction angiography and transcranial Doppler examination, and 6 patients underwent simultaneous magnetic resonance angiography. The blood supply and collateral circulation of the ipsilateral ophthalmic artery were observed . Results All the patients had unilateral internal carotid artery occlusion. The blood supply of the ipsilateral internal carotid artery and ophthalmic artery comes from the collateral circulation between the middle meningeal artery branches of the external carotid artery and the ophthalmic artery in 18 patients (90.0%); it also comes from the anterior communicating artery of the contralateral internal carotid artery in 16 patients (80.0%); and the posterior communicating artery of the contralateral internal carotid artery in 12 patients (60.0%), respectively. Conclusion The blood flow of the ipsilateral ophthalmic artery mainly comes from the middle meningeal artery branch of the ipsilateral external carotid artery, also comes from the anterior and posterior communicating arteries of the contralateral internal carotid artery.
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BACKGROUND: In animal experiments, ultrasound-mediated microbubbles can promote the homing of transplanted stem cells to the ischemic area, enhance angiogenesis and small arterial formation, improve local blood flow in the ischemic myocardium and restore myocardial contractility.OBJECTIVE: To investigate the effect of ultrasound-mediated microbubbles on intravenously transplanted bone marrow mesenchymal stem cell (BMSC) homing and the therapeutic efficiency on ischemic stroke. METHODS: A middle cerebral artery occlusion (MCAO) model was induced by plug wire preparation. At 72 hours after MCAO, model rats were randomized into four groups: PBS group (n=15), BMSCs group (n=18), ultrasound+BMSCs group (n=18), ultrasound+microbubble+BMSCs group (n=18). Corresponding treatment was done in each group: 2 mL of PBS was injected via tail vein in the PBS group; about 3×106 BMSCs diluted by 2 mL of PBS were injected via tail vein slowly in the BMSCs group; after skull ultrasound radiation (1 MHz, 2 W/cm2) for 120 seconds, BMSCs were injected via tail vein slowly in the ultrasound+BMSCs group; the same process as the ultrasound+BMSCs group was done following intravenous injection of 0.1 mL/kg microbubbles in the ultrasound+microbubble+BMSCs group.RESULTS AND CONCLUSION: (1) Forty-eight hours after BMSCs transplantation, the BMSCs homing rate in the brain was significantly higher in the ultrasound+microbubble+BMSCs group than the other two groups (P < 0.05). (2) Twenty-eight days after MCAO, nerve damage was significantly milder in the ultrasound+microbubble+BMSCs group than the other two groups (P < 0.05). (3) Seven days after transplantation, the water content in the brain tissue was significantly lower in the ultrasound+microbubble+BMSCs group than the other two groups (P < 0.05). (4) Seven days after transplantation, the cerebral infarction volume was significantly reduced in the ultrasound+microbubble+BMSCs group compared with the other two groups (P < 0.05). To conclude, ultrasound-mediated microbubbles can enhance the homing effect of intravenously transplanted BMSCs, reduce cerebral edema and cerebral infarction volume, improve the neurological function, and increase the therapeutic effect of BMSCs transplantation on ischemic stroke.
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Objective To evaluate the association between 8 single nucleotide polymorphisms (SNPs)of vascular endothelial growth factor (VEGF ) gene and the risk of Alzheimer’s disease (AD ) in Shaanxi Han population.Methods We examined the potential association between AD and 8 SNPs of VEGF gene using the MassARRAY system.The participants enrolled in this study included 214 patients with AD and 249 healthy controls from Shaanxi Han population.SPSS16.0 and Haploview 4.2 were employed to analyze differences in genotypes, alleles and haplotypes between the two groups.Results The results showed that rs3025039 (3’UTR)were significantly associated with AD (P0.9).There were no significant haplotypes in block 1 and block 2 (P=0.034)found between the patients and controls.Conclusion These findings point to the role for VEGF gene polymorphisms (rs3025039)in AD of a Shaanxi Han population. Individuals with T allele of rs3025039 may be at a higher risk for AD.
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ABSTRACT:Objective To study the effect of curcumin on the learning and memory ability in a rat model of Alzheimer’s disease (AD).Methods AD rat model was prepared using intraventricular injection of Aβ1-42. Curcumin was acutely (single injection before the behavioral tests)or chronically (injected for 6 consecutive days) injected intraperitoneally at doses of 50,100 or 300 mg/kg.Brain-derived neurotrophic factor (BDNF)protein (1 μg/side)or BDNF shRNA (2×10 5 units/side)was infused into the hippocampus.The behavioral changes in Y-maze,open field test and Morris water maze and the expression of BDNF in the hippocampus were analyzed. Results Acute treatment with curcumin had no significant effects on the spontaneous alteration,locomotor activity or water maze latency of AD rats.AD rats treated chronically with curcumin (300 mg/kg ) showed significant elevation in the spontaneous alternation (P <0.000 1)in Y-maze and memory ability in the water maze test (P <0.05 )compared with those in the saline group.Chronic treatment with 100 and 300 mg/kg of curcumin induced an increased level of BDNF in the hippocampus as compared with the saline controls (P <0.05 and <0.000 1). Intrahippocampal injection of BDNF significantly decreased the escape latency of AD rats in the water maze (F 4,2 9 5=5.813,P <0.01 ).Rats chronically injected with curcumin combined with shBDNF showed no difference in the swimming time in Ⅱ quadrant as compared with saline controls (P =0.657).However,rats in 100 mg/kg curcumin group,BDNF group and sham group had significantly increased swimming time than the saline controls (P <0.05, P <0.05 and P <0.000 1,respectively).Conclusion Curcumin may activate the downstream signaling pathways by upregulating the expression of BDNF and ultimately contribute to the improvement of learning and memory in AD rats.