Application of PSA and related indicators in early screening of prostate cancer / 上海预防医学

Objective Serum total prostatic specific antigen (tPSA), free prostatic specific antigen (fPSA), fPSA/tPSA ratio, and prostate cancer-specific antigen density (PSAD) were determined to explore the best identification point, thus improving the specificity of early screening of prostate cancer. Methods The tPSA, fPSA, fPSA/tPSA, and PSAD of patients with benign prostatic hyperplasia group (n=250) and prostate cancer group (n=92) were tested, and the receiver operating characteristic (ROC) curve was drawn to determine the best cutoff value for the evaluation. Results When the cutoff values of tPSA, fPSA/tPSA, and PSAD were at 11.3 mg/L, 0.16, and 0.18 mg/(L·cm3), respectively, the specificity and sensitivity were the best:82.4% and 84.2% for tPSA, 76.9% and 81.7% for fPSA/tPSA, and 83.1% and 80.4% for PSAD.When the best cutoff values of tPSA, fPSA/tPSA, and PSAD were combined in analysis, the specificity and sensitivity of fPSA/tPSA and PSAD combination showed the best result (92.4% and 81.4%, respectively).When the tPSA value was in the range of 4-10 mg/L, the optimal cutoff values of PSAD and fPSA/tPSA were 0.21 mg/(L·cm3) and 0.15, and the specificity and sensitivity reach the best, which were 84.1% and 80.1%, 81.0 % and 80.3%, respectively. Conclusion Combination of tPSA, fPSA/tPSA and PSAD analysis is better than any single of them in early screening of prostate cancer.The specificity and sensitivity of combined use of fPSA/tPSA and PSAD could serve as an optimal screening reference value.

Analysis on epidemic characteristics of COVID-19 in Qingpu District of Shanghai / 上海预防医学

Objective To analyze epidemic characteristics of COVID-19 epidemic in Qingpu District of Shanghai and provide evidence for prevention and control of COVID-19. Methods The COVID-19 cases diagnosed in the medical facilities in Qingpu District were included in the study.Descriptive epidemiology was employed to describe diagnosis, clinical symptoms and possible exposure. Results There were 53 suspected cases identified in Qingpu District, 47 of which were excluded and 6 were confirmed.Two confirmed cases were identified when seeking medical treatment and 4 by other means.Of the confirmed cases, 83.3% were male and 66.7% were imported.Their initial symptom was mainly cough.The 75.0% of the confirmed cases had underlying diseases.By PCR testing of SARS-CoV-2, 100.0% of the sputum specimens tested positive, 50.0% of the nasopharyngeal swabs were positive, whereas 100.0% of the throat swabs were negative. Conclusion COVID-19 is more common in men than in women.The positive rate of SARS-CoV-2 in sputum samples is highest, followed by nasopharyngeal swabs and throat swabs.It is crucial to implement the countermeasures at earlier stages, such as strengthening the road entrance monitoring, at-home or intensive health observation of foreign visitors for early identification of suspected COVID-19 cases.

Clinical observation on the prevention and treatment of perioperative delayed cerebrovasospasm in patients with aneurysmal subarachnoid hemorrhage by the comprehensive protocol of integrative medicine / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of the comprehensive protocol of integrative medicine in preventing and treating perioperative delayed cerebrovasospasm (DCVS) in patients with aneurysmal subarachnoid hemorrhage (aSAH).</p><p><b>METHODS</b>Using a prospective randomized controlled trial design, 63 aSAH inpatients were assigned to the treatment group (31 cases, 24 treated by intervention treatment and 7 by craniotomy) and the control group (32 cases, 26 treated by intervention treatment and 6 by craniotomy). All patients were treated with basic therapy and nimodipine. Those in the treatment group additionally took naomai jiejing decoction No. 1 and No. 2. The incidence and the mortality of DCVS, re-bleeding, hydrocephalus were compared on the 180th day. The middle cerebral artery mean flow velocity (Vm), PI value, linde-gard index on day 1, 3, 7, and 14 were compared. The Chinese medicine syndrome score, NIHSS, and revised Rankin questionnaire on day 1, 14, and 180 were compared.</p><p><b>RESULTS</b>The DCVS occurred in 9 cases (29. 0%) of the treatment group and 17 patients (53.1%) of the control group, showing statistical difference (P < 0.05). The occurrence of re-hemorrhage was obviously lower in the treatment than in the control group (3.2% vs. 6.2%), showing statistical difference (P < 0. 05). There was no statistical difference in the mortality (6.4% vs. 9.4%) or the occurrence of hydrocephalus (29.0% vs 25.0%, P > 0.05). The Vm, PI, and linde-gard index on day 7, the Vm and linde-gard index on day 14 were obviously lower in the treatment group than in the control group (P < 0.05). The Chinese medicine syndrome score and NIHSS on day 14 and 180 were lower in the treatment group than in the control group, showing statistical difference (P < 0.05).</p><p><b>CONCLUSION</b>The comprehensive protocol of integrative medicine could reduce the incidence of aSAH patients' DCVS, the Chinese medicine syndrome score and NIHSS, and improve their clinical symptoms.</p>

Mechanical embolectomy with the Solitaire AB device after acute basilar artery thrombosis: A report of 6 cases / 中国脑血管病杂志

Objective: To evaluate the efficacy and safety of arterial embolectomy with the Solitaire AB stent after acute basilar artery thrombosis. Methods: Six patients performed arterial embolectomy with the Solitaire AB stent after acute basilar artery thrombosis in the Encephalopathy Center, Guangdong Province Hospital of Traditional Chinese Medicine from May to November 2010 were analyzed retrospectively. Stent angioplasty was performed for patients with residual stenosis ≥50%. Their immediate effect of thrombectomy and postoperative bleeding were analyzed. The National Institutes of Health Stroke Scale (NIHSS) scores and the prognosis were compared before and after the treatment. Results: Circled digit oneAfter 1 to 2 embolectomies, the basilar arteries of the 6 patients were revascularized, in 5 patients with residual stenosis were treated in combination with balloon angioplasty and stenting. Circled digit twoOne patient had acute in-stent thrombosis after the release of stent. The angioplasty re-examination showed that the basilar artery was patent after the treatment. Circled digit three5 patients were re-examined by MRI 3 to 7 days after procedure. There were no significant expansion of cerebral infarction, and their basilar arteries were patent. One patient had cerebral hemorrhage 1 day after procedure, and he died after 7 days. Circled digit fourThe NIHSS scores were lowered 2-15 at dischange than at admission in 5 patients. The modified Rankin Scale (mRS) scores in 5 patients were 0(1 patient), 1(2 patients) , and 2(2 patients) at discharge. Conclusion: Using Solitaire AB stent and embolectomy are relatively safe and effective in patients with acute basilar artery thrombosis, and the prognosis of patients is good.