Diagnostic efficiency and result of prostate biopsy for patients with t-PSA between 4.0 and 10 ng/ml / 军事医学

Objective To investigate the diagnostic efficiency and result of prostate biopsy for patients with t -PSA between 4.0 and 10 ng/ml.Methods This analysis was based on 20 qualified research papers from such lectronic databases as PubMed, MEDLINE, EMBASE and Cochrane from January 2010 until September 2017.Data extracted was analyzed using classic Meta-analysis with R software .The random or fixed effect model analysis was used to estimate the rate.Heterogeneity was analyzed using I 2 statistic.Results Totally 5481 patients were included in the 20 research papers. The positive rate of prostate biopsy was 20.6％, with t-PSA between 4.0 and 10 ng/ml, which was higher than the rate in the data from CUA Guide(2014).The difference was statistically significant .Conclusion Patients should be subjected to prostate biopsy if their t-PSA ranges 4.0 from 10 ng/ml regardless of the rate of f/t-PSA.The Gleason grade is relatively low when PSA is in the gray area , and the risk is also low.

Analysis of operative complications of photoselective vaporization of prostate (120 W) for treatment of benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore operative complications of photoselective vaporization of prostate (120 W) for treatment of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>The clinical data of 186 cases who underwent photoselective vaporization of prostate (120 W) for the treatment of BPH from May 2010 to April 2012, was statistically analyzed.</p><p><b>RESULTS</b>The operative time ranged from 7 to 147 minutes, and the average time was (37.7 ± 21.5) minutes. No patient accepted intraoperative blood transfusion, and occurred transurethral resection syndrome or capsular perforation. The time of postoperative indwelling catheter ranged from 1 to 11 days, and average time was (4.3 ± 2.2) days. Surgical outcome was satisfactory. Early postoperative complications included bladder spasm (3 cases), transient dysuria (19 cases), urinary tractirritation (94 cases), secondary hemorrhage (26 cases), transient urge incontinence (19 cases), all cases were relieved after treatment. Long-term complications, including recurrence (1 case), bladder neck stenosis (2 cases) and urethral stricture (2 cases), who had required reoperation. Postoperative patients with international prostate symptom score (29.4 ± 3.4), maximum urinary flow rate ((6.0 ± 1.6) ml/s) and residual urine ((167 ± 150) ml) had improved (t = -76.0 - 61.4, P < 0.01).</p><p><b>CONCLUSIONS</b>With less invasive, less bleeding and rapid postoperative recovery, photoselective vaporization of prostate (120 W) is a safe and effective minimally invasive treatment techniques for BPH. But there is still some complications after surgery and proper handling is required.</p>

Kidney injury and heme oxygenase-1 / 解放军医学杂志

Heme oxygenase-1 (HO-1) is one of the main pathways to degrade heme in mammals, and the main degradation products are free iron (Fe2+), carbon monoxide (CO), and bilirubin. Heme plays an important role in promoting cell survival, circulation of intracellular substrates, and immune regulation. Previous studies suggest that HO-1 pathway is an important internal factor in determining the susceptibility and severity of acute kidney injury (AKI). The induction of HO-1 expression can attenuate the severity of renal ischemia-reperfusion injury (IRI), and the inhibition of HO-1 expression will aggravate IRI. The present article summarizes the latest advances in research abroad and at home on protective mechanism by which HO-1 prevents AKI to further deepen our understanding of the role of HO-1 in the treatment of AKI.

Adenovirus-mediated CTLA4 immunoglobulin based conditioning for non-myeloablative allogeneic hematopoietic cell transplantation to induce tolerance to hind limb allografts in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate a non-toxic AdCTLA4-Ig-based protocol for non-myeloablative allogeneic hematopoietic cell transplantation to induce donor-specific tolerance to hind limb allografts in rats.</p><p><b>METHODS</b>Fully mismatched, 4 to 8 week old Brown Norway (RT1(n)) and Lewis (RT1(1)) rats were used as cell/organ donors and recipients, respectively. Recipients were treated with AdCTLA4-Ig (5 x 10(9) PFU, day -30, 0, 30), standard immunosuppressive therapy (MP: 10 mg x kg(-1) x d(-1), MMF: 20 mg x kg(-1) x d(-1), RAPA: 0.2 mg x kg(-1) x d(-1);day -33 - 100), soon after total body irradiation (3 Gy, day -30) and donor bone marrow (100 x 10(6), day -30) transplantation (BMT). Thirty days after BMT, chimeric animals received hind limb transplantations. And 100 days after hind limb transplantations, immunosuppressive therapy was changed for low-dosed CsA (8 mg x kg(-1) x d(-1), day 100-), until the allografts were rejected.</p><p><b>RESULTS</b>In Group C, hematopoietic chimerism was (38.8 +/- 10.6)% at day 0, and was stable (29.3 +/- 11.9)% at 330 days post-BMT. There was no graft versus host disease in both Group C and Group D. When the standard immunosuppressive therapy was stopped and changed for low-dosed CsA, chimeric recipients (Lewis, RT1(1)) permanently accepted (> 200 days) donor specific (Brown Norway, RT1(n)) hind limb allografts in Group C, yet rapidly rejected in Group A (8 +/- 2) d, Group B (18 +/- 3) d and in Group C (20 +/- 2) d. Lymphocytes of graft tolerant animals' demonstrated hyporesponsiveness in mixed lymphocyte cultures in a donor-specific manner in Group C. Tolerant graft histology showed no obliterative arteriopathy or chronic rejection.</p><p><b>CONCLUSION</b>The AdCTLA4-Ig based conditioning regimen with donor BMT produce stable mixed chimerism and induce donor-specific tolerance to hind limb allografts.</p>