Prediction of Prostate Cancer Risk Stratification Based on A Nonlinear Transformation Stacking Learning Strategy / 대한배뇨장애요실금학회지

Purpose@#Prostate cancer (PCa) is an epithelial malignancy that originates in the prostate gland and is generally categorized into low, intermediate, and high-risk groups. The primary diagnostic indicator for PCa is the measurement of serum prostate-specific antigen (PSA) values. However, reliance on PSA levels can result in false positives, leading to unnecessary biopsies and an increased risk of invasive injuries. Therefore, it is imperative to develop an efficient and accurate method for PCa risk stratification. Many recent studies on PCa risk stratification based on clinical data have employed a binary classification, distinguishing between low to intermediate and high risk. In this paper, we propose a novel machine learning (ML) approach utilizing a stacking learning strategy for predicting the tripartite risk stratification of PCa. @*Methods@#Clinical records, featuring attributes selected using the lasso method, were utilized with 5 ML classifiers. The outputs of these classifiers underwent transformation by various nonlinear transformers and were then concatenated with the lasso-selected features, resulting in a set of new features. A stacking learning strategy, integrating different ML classifiers, was developed based on these new features. @*Results@#Our proposed approach demonstrated superior performance, achieving an accuracy of 0.83 and an area under the receiver operating characteristic curve value of 0.88 in a dataset comprising 197 PCa patients with 42 clinical characteristics. @*Conclusions@#This study aimed to improve clinicians’ ability to rapidly assess PCa risk stratification while reducing the burden on patients. This was achieved by using artificial intelligence-related technologies as an auxiliary method for diagnosing PCa.

Feasibility and safety of robotic-assisted laparoscopic adrenalectomy with the assistance of three-dimensional reconstruction of computed tomography image to treat huge adrenal tumors / 中华泌尿外科杂志

Objective:Efficacy and safety of robot-assisted laparoscopic adrenalectomy as a treatment for large adrenal tumors.Three-dimensional(3D) reconstruction can effectively assist in preoperative planning of robotic adrenalectomy and reduce potential complications.Methods:We retrospectively reviewed the relevant information of patients who had a preoperative 3D reconstruction and underwent RA for adrenal masses larger than 10 cm. Thirteen male patients and sixteen female patients were included. The median(range) age was 43(25, 57) years old and the median tumor diameter was 12.1(10.3, 16.2) cm. The patients underwent preoperative CT enhancement scanning, and three-dimensional images were reconstructed based on the examination data. Robot-assisted laparoscopic adrenalectomy was performed under general anesthesia in 29 cases in this cohort.Results:All surgeries were completed successfully without major complications such as massive bleeding, secondary surgery, or even patient death. The median operative time was 131 (80, 245) min, and the median intraoperative bleeding was 330 (50, 2 200 ml) ml. 9 patients received blood transfusions. There were 11 cases of pheochromocytoma (37.9%), 10 cases of adenocarcinoma (34.5%) as well as 2 cases of teratoma (6.9%) and 6 cases of cortical carcinoma (20.7%). The patients were followed up for a median of 30 months after surgery. Except for 3 cases lost to follow-up and 2 patients with cortical cancer who developed recurrence or metastasis after surgery and died at 16 and 23 months after surgery, respectively, the remaining 24 cases have survived to date.Conclusions:RA is a safe and effective treatment for huge adrenal tumors. The 3D reconstruction could help the preoperative planning of RA and reduce potential complications.

Dermatomyositis with kidney neoplasm: two cases report and literature review / 中华泌尿外科杂志

Objective:To investigate the clinical characteristics, diagnosis and treatment of dermatomyositis with kidney neoplasm.Methods:The data of two patients with dermatomyositis complicated with kidney neoplasm in Tongji Hospital from January to February 2022 were retrospectively analyzed. The first case was a 55-year-old female, who was admitted with the chief complaints of recurrent erythema of upper extremities for 2 months and facial erythema for 1 month. Physical examination: erythema can be seen on upper limbs and face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Mi-2 antibody and anti-SSA /Ro-52 antibody were positive. Contrast CT showed nodular uneven enhancement in the right kidney with a size of 50 mm×41 mm. The second case was a 58-year-old female, who was admitted with the chief complaints of kidney occupying for a month. Physical examination: flaky erythema on face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Ro-52 antibody and anti-MDA5 antibody were positive. Contrast CT showed a significantly uneven enhanced mass with a size of about 50 mm×41 mm on left kidney. Both patients were diagnosed with kidney neoplasm before surgery and underwent laparoscopic partial nephrectomy in Tongji Hospital.Results:Both patients received regular oral prednisone after surgery. The pathological presentation of case 1 was papillary renal cell carcinoma, the facial erythema subsided 1 month after surgery, and there was no tumor recurrence for 13 months. The pathological presentation of case 2 was clear cell renal cell carcinoma, facial erythema subsided 2 weeks after surgery, and there was no tumor recurrence for 12 months.Conclusions:The diagnosis of dermatomyositis should be combined with clinical manifestations and laboratory examination, and the possibility of malignant tumor should be excluded due to the high likelihood of concomitant malignancy. For patients with dermatomyositis with kidney neoplasm, the main treatment is still surgery, and supplemented with glucocorticoid therapy.

Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study / 医学前沿

The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (⩾ 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (⩾ 0.5 µg/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.

Research Progress on Immunoregulation of Chemotherapeutic Agents / 肿瘤防治研究

Chemotherapeutic drugs are the mainstay of treatment on mid-advanced tumors. In recent years, more and more studies have shown that chemotherapeutic drugs also have immunomodulatory effects. Some chemotherapeutic drugs can enhance anti-tumor immunity by inducing tumor cell immunogenic cell death or performing "immunogenic modulation". In addition, chemotherapeutic drugs can also act on immune cells and even the intestinal flora. A number of clinical trials of chemotherapy combined with immune checkpoint inhibitors are currently underway. This article focuses on the immunomodulatory effect of chemotherapeutic drugs, as well as the potential of chemotherapy combined with ICI on cancer, to provide guidance for the clinical application of chemotherapeutic drugs.

Metachronous bilateral renal pelvic carcinomas: a case report with literature review / 中华泌尿外科杂志

A case of metachronous bilateral renal pelvic carcinoma was reported. A 55-year-old women underwent left nephroureterectomy for the left renal pelvis cancer in 2011, then she was diagnosed with right renal pelvis carcinoma because of intermittent hematuria in 2014.A transurethral ureteroscopic holmium laser resection of the right renal pelvic tumor, partial right pelvis resection and nephrostomy, instillation with hydroxycamptothecin were taken sequentially to delay the dialysis for 53 months. In 2018, the patient underwent right nephroureterectomy because of recurrence of right renal pelvic carcinoma. The patient was followed up for 17 months postoperatively and there was no recurrence. In this case, patient's renal function was protected by the premise tumor control through a variety of minimally invasive and pharmaceutical therapy, which can provide a reference for the kidney-preserving treatment of high-grade renal pelvis cancer.

Establishment of screening models for nonalcoholic fatty liver disease in the adult Blang population / 临床肝胆病杂志

Objective To establish simple screening models for nonalcoholic fatty liver disease (NAFLD) in the adult Blang population. Methods Based on the survey data of metabolic diseases in the Blang people aged 18 years or above in 2017, 2993 respondents were stratified by sex and age (at an interval of 5 years) and then randomly divided into modeling group with 1497 respondents and validation group with 1496 respondents. Related information was collected, including demographic data, smoking, drinking, family history of diseases and personal medical history, body height, body weight, waist circumference, and blood pressure, and related markers were measured, including fasting plasma glucose, 2-hour postprandial plasma glucose or blood glucose at 2 hours after glucose loading, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase. The chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to establish the screening model. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value were used to evaluate the screening performance of established models versus existing models in the study population, and the DeLong method was used for comparison of AUC. Results Three screening models for NAFLD were established based on physical and biochemical measurements, i.e., simple noninvasive model 1 (age, body mass index, and waist circumference), noninvasive model 2 with the addition of blood pressure, and model 3 with the combination of hematological parameters (diabetes and ALT/AST). In the modeling group, the three models had an AUC of 0.881 (95% confidence interval [ CI ]: 0.864-0.897), 0.892 (95% CI : 0.875-0.907), and 0.894 (95% CI : 0.877-0.909), respectively, and there was a significant difference between model 1 and models 2/3 ( P =0.004 0 and P 0.05). Based on the overall consideration of screening performance, invasiveness, and cost, the simple noninvasive model 1 was considered the optimal screening model for NAFLD in this population. Model 1 had the highest Youden index at the cut-off value of 5 points, and when the score of ≥5 points was selected as the criteria for NAFLD, the model had a sensitivity of 86.5%, a specificity of 79.7%, a positive predictive value of 50.3%, and a negative predictive value of 96.1% in the modeling group and a sensitivity of 85.6%, a specificity of 80.6%, a positive predictive value of 51.7%, and a negative predictive value of 95.8% in the validation group. Conclusion The NAFLD screening models established for the adult Blang population based on age and obesity indicators have relatively higher sensitivity, specificity, and negative predictive value, and this tool is of important practical significance for the intervention of NAFLD and its closely related metabolic diseases in this population.

The application and outcomes of C.R.P.C.four-step radical prostatectomy under extraperitoneal laparoscopy / 中华泌尿外科杂志

Objective To summarize the preliminary experience of extraperitoneal laparoscopic radical prostatectomy (C.R.P.C.four-step) for localized prostate cancer and the outcomes based on early follow-up.Methods A total of 102 prostate cancer patients were screened by prostate specific antigen (PSA) and diagnosed by prostate magnetic resonance imaging and prostatic puncture biopsy with cT1c-cT3b,with average age of (67 ±5) years old,average preoperative total PSA value of (45.32 ± 18.33) ng/ml,and average prostate volume was (42 ± 12)cm3.All these patients underwent extraperitoneal laparoscopic radical prostatectomy by the four-step technique,abbreviating as C.R.P.C.[C:control DVC (dorsal deep venous complex).R:recognize three anatomical layers (prostate and bladder junction,seminal vesicle,and Denonvilliers' fascia surface).P:preserve urethral sphincter and bladder neck.C:continuous anastomosis between urethra and bladder neck (4 key needles at 3,5,7 and 9 o'clock)].The operative time,estimated blood loss,length of hospital stay and postoperative complications were recorded,and the postoperative PSA was followed up.Results All the 102 cases were successfully treated by iaparoscopic radical prostatectomy.The operative time was from 55 to 156 min (mean 92 min),and the estimated blood loss was from 55 to 185 ml (mean 105 ml).There was no case converted of open surgery,only one case received blood transfusion for postoperative hemorrhage (0.98％),and positive surgical margin was found in 15 case (14.70％) by pathological examination.Postoperative urinary extravasation within one week occurred in 2 (1.96％) cases,and resolved after tensioning the catheter and prolonging the indwelling time.During the follow-up period of 12 to 45 months,2 cases were incontinent (grade I-II),and the other cases(98.04％) had no incontinence or dysuria.However,11 cases (10.78％) developed to biochemical recurrence within 6 months after the operation.Conclusions The C.R.P.C.four-step technique of lparoscopic radical prostatectomy is easily to be grasped and performed by the greenhand urologists,and was efficient and safe.

A comparison of the transnasal and transoral approaches to balloon dilatation in treating cricopharyngeal achalasia among stroke survivors / 中华物理医学与康复杂志

Objective To compare the effect of treating cricopharyngeal achalasia in stroke survivors using transnasal or transoral balloon dilatation.Methods Thirty stroke survivors with cricopharyngeal achalasia were randomly divided into a transnasal and a transoral balloon dilatation group (group N and group O),each of 15.Both groups were given routine swallowing rehabilitation training as well as the transnasal or transoral balloon dilatation.Their heart rate was monitored during the dilatation.Nasal bleeding,mucous membrane swelling and pain were also observed.Their swallowing function was evaluated using the Fujishima Ichiro swallowing efficacy score (FISE) and videofluoroscopy (VFSS) before and after the intervention.Results After the treatment,the average FISE and VFSS scores of both groups had improved significantly comnpared to before the treatment but there were no significant differences between the groups.During the treatment,the average heart rate of group O increased significantly less than that of group N.The treatment acceptance of group O was 98.2％,significantly higher than that of group N (80.1％).One case of mucosal bleeding was observed in group O,and laryngeal edema occurred significantly less often than in group N (9 cases vs.7).The average pain score was also significantly lower in group O.Conclusions Balloon dilatation facilitates swallowing among stroke survivors with cricopharyngeal achalasia.The transoral approach can help to reduce the occurrence of complications such as mucosal bleeding,laryngeal edema and pain,and has better patient acceptance.

Activation of mTOR signaling pathway in cancer stem cells of nasopharyngeal carcinoma and inhibitive effect of rapamycin against the cancer stem cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the mTOR expression of cancer stem cells(CSCs) in nasopharyngeal carcinoma and preliminarily explore the mechanism of inhibiting its proliferation with rapamycin.@*METHOD@#Nasopharyngeal carcinoma spherical cells were gathered by using serum-free suspension culture method, CCK8 assay was used to detect cell proliferation, Western blot assay was used to detect the expression of CD44, OCT4, SOX2 and mTOR signaling. The spherical cells and CNE2 were treated with rapamycin in concentrations of 0, 0.1, 1.0, 10.0, 100.0, 1000.0 nmol/L, CCK8 assay was used to detect cell inhibition ratio, Western blot assay was used to detect the expression of mTOR signaling of nasopharyngeal carcinoma spherical cells.@*RESULT@#Compared with CNE2, the spherical cells exhibited a high proliferation rate in RPMI 1640 medium supplemented with fetal bovine serum, and overexpressed in OCT4, SOX2 (P 0.05). Although the expression levels of mTOR, P70S6, 4EBP1 were not significantly different between the two kinds of cells (P > 0.05) the proteins of phosphorylation activation form of them (P-mTOR, P-P70S6, P-4EBP1) were highly expressed in spherical cells (P < 0.05). The spherical cells and CNE2 were treated with rapamycin in different concentrations, the concentrations for 50% of maximal effect of spherical cells and CNE2 were 2.59 nmol/L and 78.12 nmol/L respectively, rapamycin inhibited the spherical cells more strongly compared with CNEZ. The expression levels of P-mTOR, P-70S6, P-4EBP1 in spherical cells were gradually decreased with increasing of the concentrations of rapamycin, but the difference of the expression levels of mTOR, P70S6, 4EBP1 were not significant.@*CONCLUSION@#The proteins of mTOR signaling pathway of CSCs in nasopharyngeal carcinoma are overexpressed, and rapamycin can effectively inhibit cell proliferation of CSCs in nasopharyngeal carcinoma by blocking mTOR signaling pathway.

Quantitative detection of minimal residual leukemia cells in peripheral blood and clinical application / 吉林大学学报(医学版)

Objective To explore the clinical application significance of quantitative detection of minimal residual leukemia cells in peripheral blood in acute leukemia patients.Methods Using PCR amplification of quantitative method of limited dilution,the FLT3 gene was detected in blast cells of peripheral blood from 25 newly diagnosed cases of acute leukemia,and the number of minimal residual leukemia cells in newly diagnosed cases and the cases after one course of chemotherapy was calculated respectively.10 healthy subjects were used as control group.Results ①The positive rate of FLT3 gene in 25 newly diagnosed cases of acute leukemia sample was 80%(20/25),the positive rate in acute myeloblastic leukemia(AML) patients was 88.2%(15/17)and in acute lymphocytic leukemia(ALL)was 62.5%(5/ 8).②The mean DNA content in peripheral blood in 20 cases with FLT3 positive expression in newly diagnosed group was(2.36?1.25)?108 ?g?L-1,being equal to(18.66?8.79)?106 leukemia cells in every microliter peripheral blood.After one course of chemotherapy ,there was 1 case without remission,the DNA content in peripheral blood was 1.69?107?g?L-1,being equal to 1.01?106 leukemia cells in every microliter peripheral blood;there were 3 cases with partial remission,the mean DNA content in peripheral blood was(0.57?0.24)?106 ?g?L-1,being equal to(1.82?0.19)?103 leukemia cells in every microliter peripheral blood.There were 9 cases with complete remission with FLT3 negtive expression,and 7 cases with complete remission with FLT3 positive expression,the mean DNA content in peripheral blood was(0.16?0.06)?106 ?g?L-1,being equal to(1.86?1.31)?102 leukemia cells in every microliter peripheral blood.Conclusion The quantitative and periodic detection of minimal residual leukemia cells would help to evaluate leukemia chemotherapy efficiency and to adjust treatment scheme in time.

Metrology Measurement and Quality Analysis of Medical Oxygen Flowmeter / 医疗卫生装备

Objective To check some medical oxygen flowmeters in use in the military area command. Methods According to JJG 917-1996 buoy oxygen inhalant measuring rules, 930 oxygen flowmeters in the military area command were measured. Results The unqualified reasons of medical oxygen flowmeter mainly lay in the capability decline of pressure resistance of humid bottle, the poor airproof of the interface, the overflow of pressure, and the overflow of flux value. Conclusion To improve the quality situation of medical oxygen flowmeter, the department of technical supervision, hospital and manufacturer need to make efforts together.

Experience about Filter Maintenance and Replacing in Purifying Operating Room / 医疗卫生装备

The purifying operating room with tidiness, antisepsis and easy operation is widely used in more hospitals. The same time, depurative flow, manufacturing skill and technical standards of it are still developing. But filter maintenance and replacing as key component has major difference in different region and season. Through four-year exploration and practice, the methods of filter maintenance and replacing were explained, which carry out the questions of consumption and energy efficiency.

Temperature Control and Surface Cooler Reform in Operating Room Air Decontamination System / 医疗卫生装备

The principle of temperature control in operating room air decontamination system and the main reasons with difficulties of regulating temperature in transformation period of spring and autumn are analyzed. The reconstructed approaches of circulating water line on surface cooler are adopted appropriately, not only to solve the question of long temperature decreasing response time in operating room but also to save substantially a lot of expenditures and reduce the running loss.

Protective effects of Naokangning on cerebral ischemia / 中成药

AIM: To study the protective effects of Naokangning (Rhizoma Chuanxiong, Radix salviae miltiorrhizae, Hirudo, etc.) against cerebral ischemia. METHODS: We observed the effect of Naokangning on mice's resistance to cerebral ischemia when bilateral common carotid arteries and vagus nerves were ligated and hypoxia under normal pressure and airtight circumstance; With the model of partial cerebral ischemia by blocking rats'middle cer ebral artery (MACO):the effects of Naokangning on the activity of superoxide dismutase (SOD) and creatine kinas e(CK), the content of malondialdehyde (MDA) and nitric oxide (NO) were measured. RESULTS: Naokangning significantly raised mice's ability of anti-cerebral ischemia and prolonged span of life in hypoxia, Moreover, it also obviously improved the activity of SOD, reduced content of MDA in cerebrum, content of NO and activity of CK in blood serum after ischemia. CONCLUSION: Naokangning could strikingly protect brain caused by cerebral ischemia.

Analysis of geographic information system on transmission of schistosomiasis in Yunnan Province / 中国血吸虫病防治杂志

Objective To understand the epidemiologic trend and characteristics of the distribution of schistosomiasis in Yunnan Province, China. Methods The data of two sampling surveys on schistosomiasis in Yunnan in 1995 and 2003 were collected, and the database of GIS was set up. The spatial status of rates of human infection and cattle infection were analyzed by using the GIS software, ArcView 3.2, contours method. The relationships between rates of human infection and cattle infection in 1995 and 2003 were analyzed with SPSS statistical software. Results The high-risk areas of schistosomiasis in Yunnan were Dali City, Yongsheng, Heqing, Eryuan, Weishan and Nanjian counties, and those areas contained different infection grades which were intertwine. The rate of human infection was descendent and the distribution of high-risk areas of schistosomiasis was decreasing. The infection rate of cattle was higher than before in the south of epidemic areas in Yunnan. Those epidemic areas of schistosomiasis could be identified as three spatial distributions. Conclusions The control and prevention of schistosomiasis in Yunnan should be focus on Dali City, Eryuan, Weishan, Yongsheng, Heqing and Nanjian counties, and the key is synchronistical chemotherapy in human and cattle.

Increased expression of 5-hydroxytryptamine transporter gene in monocrotaline-induced pulmonary hypertension in rats / 中国药理学通报

Aim To study the relationship between pul-monary hypertension (PHT) and 5-hydroxytrapta-mine transporter (5-HTT) in the pulmonary arteries (PAs) from normal and monocrotaline (MCT) induced pulmonary hypertension rats. Methods MCT-treated rats were used as a model for chronic PHT.Concentration-response curves of 5-hydroxytraptamine induced pulmonary vasoconstriction were established. The medial wall thickness of pulmonary arteries was measured. Semi-quantitative RT-PCR was performed to identify the expression of 5-HTT mRNA in rat PAs.Results 5-HT induced vasoconstriction response of PAs from MCT rats was significantly increased.The thickness of pulmonary vascular medial walls was increased in MCT rats. A significantly higher level of 5-HTT mRNA expression was detected in PAs from MCT rats. The ratio of the PCR products of 5-HTT gene to those of ?-actin gene was higher in MCT rats than in control rats. 5-HTT mRNA expression of pulmonary arteries correlated with the thickness of pulmonary vascular medial walls in rats.Conclusions MCT-induced pulmonary vascular remodeling and increased vascular contractile response to 5-HT were accompanied with enhanced level of 5-HTT mRNA expression and there existed correlation between the wall thickness of pulmonary arteries and 5-HTT mRNA expression,indicating 5-HTT is an important mechanism involved in pulmonary hypertension.