An analysis on the clinical application value of MR-DWI in the early diagnosis of PCa / 中国医学装备

Objective: To explore the value of magnetic resonance (MR) diffusion weighted imaging (DWI) in the early diagnosis of prostate cancer (PCa). Methods: 61 patients with PCa were enrolled in the observation group, and 70 patients with benign prostatic hyperplasia were divided into the control group. DWI scan (b=800 s/mm2) was performed on each patients of two groups, and all of patients of two groups were confirmed by aspiration biopsy or pathology of operation. Results: Pathological results found that there were 81 PCa lesions, which including 32 central glandular lesions and 49 surrounding lesions, and 118 benign prostatic hyperplasia nodules. The sensitivity, specificity and accuracy of DWI for diagnosing PCa were 80.25%, 75.42% and 77.39%, respectively. The detection rates of central glandular lesions and surrounding lesions detected by DWI were 78.13% and 81.63%, respectively, and the difference was not statistically significant (x2=0.150, P>0.05). The apparent diffusion coefficient (ADC) value of PCa lesions was (0.90±0.21)×10-3mm2/s, which was significantly lower than that of benign prostatic hyperplasia nodules (1.52±0.26) ×10-3mm2/s, and the difference was statistically significant (t=17.833, P<0.05). While there was no significant difference for the ADC value between central glandular lesions and surrounding lesions (t=1.143, P>0.05). The area under the curve (AUC) of receiver operating characteristic (ROC) of PCa lesions that diagnosed by using ADC was 0.977(P<0.05), and when cut-off value of ADC was 1.22×10-3mm2/s, the sensitivity and specificity of diagnosing PCa of ADC were 91.60% and 92.59%, respectively. Conclusion: DWI has a certain value in the early diagnosis of PCa, and the diagnostic value of ADC is higher.

Curative effect analysis on improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture / 局解手术学杂志

Objective To discuss the clinical effects of improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture( PMF-TP) . Methods 60 patients with PMF-TP were selected from June 2014 to June 2017 in our hospital;according to the surgical methods,all patients were divided into improved group (30 cases) and medial group (30 cases);the medial group was treated with routine medial approach, while the improved group was treated with improved medial parapatellar approach. The operation, complications, fracture reduction and knee joint function were compared between the two groups. The amount of bleeding,the incidence of complications and the operation,hospitalization,weight bearing exercise and fracture healing time of improved group were significantly lower than those in the after the operation, the knee flexion and extensional activity of improved group was significantly higher than that in the medial group,the difference was statistically significant(P<0. 05). The fracture re-duction and knee joint function excellent rate 6 months after operation of improved group were significantly higher than those in the medial group,the difference was statistically significant(P<0. 05). Results Compared with the posteromedial approach of the knee joint, the im-proved medial parapatellar approach features simple and safe operation. It is beneficial to early functional exercise, fracture reduction and re-habilitation of knee joint function.

miR-125a-5p suppresses epithelial-mesenchymal transition via GSK-3β/Snail signaling pathway in breast cancer cells / 中国病理生理杂志

AIM:To investigate the function of microRNA-125a-5p (miR-125a-5p) on epithelial-mesenchy-mal transition ( EMT) of breast cancer cells via GSK-3β/Snail signaling pathway. METHODS:The expression of miR-125a-5p in normal breast epithelial cells and breast cancer cells, as well as the transfection efficiency of miR-125a-5p plas-mid in MDA-MB-231 cells was detected by RT-qPCR. The chemotaxis ability and invasion ability were detected by chemo-taxis assay and Transwell invasion assay. The changes of EMT-related markers, the protein level of phosphorylated glycogen synthase kinase-3β (p-GSK-3β) and the nuclear translocation of Snail were determined by Western blot. RESULTS:The expression of miR-125a-5p in the breast cancer cells was significantly lower than that in the normal breast epithelial cells. The expression of miR-125a-5p was significantly higher in MDA-MB-231/miR-125a-5p cells than that in MDA-MB-231/NC cells. The ability of epithelial growth factor (EGF) at 10 μg/L to induce chemotaxis of MDA-MB-231 cells was the stron-gest. Compared with MDA-MB-231/NC group, stimulation of EGF decreased the invasion ability of MDA-MB-231/miR-125a-5p cells, and resulted in the increase in E-cadherin expression, while significantly decreased the protein levels of vi-mentin and p-GSK-3β. Meanwhile, the nuclear localization of Snail was significantly inhibited. The invasion capacity of MDA-MB-231/miR-125a-5p+GAB2 cells was significantly enhanced compared with MDA-MB-231/miR-125a-5p +Con cells, the expression of E-cadherin was decreased, and the protein levels of vimentin and p-GSK-3β were significantly in-creased, while the nuclear localization of Snail was promoted. CONCLUSION:miR-125a-5p suppresses EMT via GSK-3β/Snail signaling pathway, thus inhibiting the invasion ability of breast cancer cells.

Outcomes of Chinese Patients with End-stage Pulmonary Disease while Awaiting Lung Transplantation: A Single-center Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The factors affecting the outcome of patients referred for lung transplantation (LTx) still have not been investigated extensively. The aim of this study was to characterize the patient outcomes and identify the prognostic factors for death while awaiting the LTx.</p><p><b>METHODS</b>From January 2003 to November 2013, the clinical data of 103 patients with end-stage lung disease that had been referred for LTx to Department of Thoracic Surgery, Shanghai Pulmonary Hospital were analyzed retrospectively. The relationship between predictors and survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards model.</p><p><b>RESULTS</b>Twenty-five patients (24.3%) died while awaiting the LTx. Fifty patients (48.5%) underwent LTx, and 28 patients (27.2%) were still on the waitlist. Compared to the candidates with chronic obstructive pulmonary disease (COPD), patients with idiopathic pulmonary fibrosis (IPF) had a higher mortality while awaiting the LTx (40.0% vs. 12.3%, P = 0.003). Patients requiring mechanical ventilation (MV) had a higher mortality while waiting than others (50.0% vs. 20.2%, P = 0.038). Two variables, using MV and IPF but not COPD as primary disease, emerged as significant independent risk factors for death on the waitlist (hazard ratio [HR] = 56.048, 95% confidence interval [CI]: 3.935-798.263, P = 0.003 and HR = 14.859, 95% CI: 2.695-81.932, P = 0.002, respectively).</p><p><b>CONCLUSION</b>The type of end-stage lung disease, pulmonary hypertension, and MV may be distinctive prognostic factors for death while awaiting the LTx.</p>