Neutrophilic granulocyte percentage is associated with anxiety in Chinese hospitalized heart failure patients.

BACKGROUND: In patients with heart failure, anxiety disorder is common and associated with adverse prognosis. This study intended to find more confounding factors of Chinese heart failure patients. METHODS: We enrolled 284 hospitalized heart failure patients, whose New York Heart Association (NYHA) classed as II-IV and left ventricular ejection fraction (LVEF) ≤ 45%. All the patients were scaled in Hamilton Rating Scale for Anxiety (14-items) (HAM-A14). Ordinal logistic regression analysis was performed to examine the association of correlated factors with anxiety disorder. RESULTS: There were 184 patients had anxiety accounting for 64.8% of all 284 hospitalized heart failure patients. The neutrophilic granulocyte percentage, urea nitrogen, total bilirubin and brain natriuretic peptide were positively associated with HAM-A14 score, meanwhile, the hemoglobin, red blood cells counts, albumin and LVEF were negatively associated with HAM-A14 score (All P < 0.05). After the adjustments of sex, hemoglobin, urea nitrogen, total bilirubin, albumin and brain natriuretic peptide, the neutrophilic granulocyte percentage was significantly associated with anxiety (OR = 43.265, P = 0.012). The neutrophilic granulocyte percentage was 0.616 ± 0.111, 0.640 ± 0.102, 0.681 ± 0.106 and 0.683 ± 0.113 in heart failure patients with no anxiety, possible anxiety, confirmed anxiety and obvious anxiety, respectively. CONCLUSIONS: Neutrophilic granulocyte percentage as well as the traditional risk factors such as sex, urea nitrogen and brain natriuretic peptide is associated with anxiety in hospitalized heart failure patients.

Performing Precise Biopsy in Naive Patients With Equivocal PI-RADS, Version 2, Score 3, Lesions: An MRI-based Nomogram to Avoid Unnecessary Surgical Intervention.

PURPOSE: The primary objective of the present study was to avoid unnecessary prostate biopsy in biopsy-naive patients with Prostate Imaging Reporting and Data System, version 2 (PI-RADS v2), score 3, lesions. MATERIALS AND METHODS: We reviewed our prospectively maintained database from January 2012 to July 2018. Logistic regression analyses were performed to test different clinical factors as predictors of clinically significant prostate cancer (CSPCa) and build nomograms. Calibration curves were used to assess the concordance between the predictive value and the true risk. Decision curves were created to measure the overall net benefit. RESULTS: The prostate cancer (PCa) and CSPCa detection rates were 37.2% (81 of 218) and 23.9% (52 of 218) in the PI-RADS v2, score 3, cohort. More PCa cases (61.7%; 50 of 81) and CSPCa cases (75%; 39 of 52) were found in the peripheral zone than in the transitional zone. Multivariate analysis showed that age, prostate-specific antigen density, lesion region, and apparent diffusion coefficient (ADC) were predictive factors for CSPCa and PCa. Internally validated calibration curves showed that the predicted risk of CSPCa was closer to the actual probability when the threshold was > 60%. Decision curves showed that a better net benefit was achieved when the model was used to guide clinical practice. CONCLUSIONS: More cases of PCa and CSPCa were seen in the peripheral zone than in the transitional zone among patients with PI-RADS v2, score 3. The positive predictive value for a positive ADC (< 900 µm2/s) for the detection of CSPCa and PCa improved with an increasing prostate-specific antigen density. Biopsy can be avoided if the equivocal lesion has a negative ADC (> 900 µm2/s) and was in the transition zone.

[Study on commercial specification of Gardenia jasminoides].

Collecting different commodity grade Gardenia jasminoides of wild and cultivated varieties all over the country, obtaining color information from each batch of G. jasminoides by the standard D65 light source and image acquisition system, quantifing the gardenia plumpness information by the digital display vernier caliper, determinating 6 kinds of effective components of G. jasminoides by HPLC, classifing from ten indicators by two step clustering analysis and correspondence analysis method of statistics, clearing the importance of the traditional identification indexes, establishing multiple corresponding relation between the skin color and commercial specification of G. jasminoides,exploring the correlation of the skin color and chemical composition, to provide the reference for the reasonable division of commercial specifications and grades of G. jasminoides. Medicine is divided into two classes and has obvious distinguish meaning, The importance of the skin color is greater than the plumpness in traditional identification characteristics, it can accurately distinguish the specifications of G. jasminoides. We improve and rebuild the standard of commodity specifications and grades of Gardenia jasminoides Ellis and establish the rapid evaluation method by the study, it provide a new way and idea for the comprehensive evaluation of G. jasminoides quality.

[Comparison of chemical constituents in different parts of Gardenia jasminoides based on multiple wavelength HPLC-DAD].

Seven compounds(deacetylasperulasidic acid methyl ester, gardenoside, chlorogenic acid, geniposide, crocin-Ⅰ, crocin-Ⅱ, chikusetsu saponin Ⅳa)were determined simultaneously by multiple wavelength HPLC with diode array detector(DAD) in different parts of Gardenia jasminoides. The results showed that these components in different parts of G. jasminoides had a different distribution, and there was a large difference in content of each component. Geniposide was mainly distributed in fruits and leaves; chikusetsu saponin Ⅳa was mainly distributed in roots and stems; crocus glycosides existed mainly in fruits; chlorogenic acid had a higher distribution in leaves and stems; gardenoside had a higher distribution in leaves and roots, while ceacetylasperulasidic acid methyl ester had a higher distribution in roots and stems. Based on the analysis of the chemical composition and content difference in different parts of G. jasminoides, the basis for the comprehensive utilization and quality evaluation of resources of G. jasminoides was provided.

[Cloning and Expression Analysis of Acetyl-CoA C-acetyltransferase Gene in Isodon rubescens].

Objective: To clone the acetyl-CoA C-acetyl transferase( AACT) gene from Isodon rubescens, and to analyze the bioinformatics and expression of the gene. Methods: According to the IrAACT gene sequence of Isodon rubescens transcriptome,a pair of primers was designed, and the ORF of cDNA sequence was obtained by reverse transcription PCR. Bioinformatic analysis of this gene and its corresponding protein were performed. Real-time quantitative PCR( q PCR) was used to detect the relative expression levels of IrAACT different tissues of Isodon rubescens. Results: The IrAACT cDNA sequence contained a 1 254 bp open reading frame and encoded a predicted protein of 417 amino acids. IrAACT had extensive homology with AACTs from other plant species, such as Salvia miltiorrhiza, et al. Bioinformatic analysis showed that IrAACT-encoding protein contained the thiolase Ⅱ catalytic domain. q PCR analysis showed that the expression of IrAACT was tissue-specific, and accumulation of transcripts was greater in flowers and leaves, followed by stems, roots and callus. Conclusion: It is the first time to report IrAACT gene and its relative expression level. The results will provide a groundwork for studying the function of IrAACT in terpenoid biosynthesis of Isodon rubescens.

[Treatment of local low/intermediate risk prostate cancer with low dose rate brachytherapy: a report of 133 cases at a single center].

OBJECTIVE: To investigate the safety and efficacy of low dose rate brachytherapy in local low and intermediate risk prostate cancer patients. METHODS: All 133 local prostate cancer patients were included and divided into low and intermediate risk groups respectively according to Memorial Sloan Kettering Group (MSKG) definition followed by brachytherapy. All the data including prostatic specific antigen (PSA), international prostatic symptomatic score (IPSS), post-operation complications and image evaluation were collected and recorded. RESULTS: The average radiation dose delivered to 90% of the prostate (D90) of (152.0±17.3) Gy was performed in the patients with a mean pre-operation PSA level of (13.45±7.1) µg/L and prostate volume of (44.37±21.43) mL. Neoadjuvant therapy was performed in 24 patients with prostate volume larger than 60 mL for 3-6 months. There was no difference in the mean age, prostate volume and D90 between low risk group and intermediate risk group. The mean IPSS reached its peak at the end of the 2nd month post-brachytherapy and compared with the baseline at the end of the 4th month. PSA failure occurred at the end of the mean 31.7 months in 4 patients during the follow-up (1 in low risk group and 3 in intermediate risk group) and no metastasis occurred. CONCLUSION: Lower urinary tract symptom (LUTS) is the most common complication post-operation. Brachytherapy associates with an encouraging tumor progress-free survival in local low and intermediate risk prostate cancer patients.

[Comparison of the diode laser and the thulium laser in transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia].

OBJECTIVE: To compare the validity and safety of diode laser and thulium laser transurethral enucleation of the prostate in benign prostatic hyperplasia (BPH) patients. METHODS: In our study, 63 BPH patients treated with transurethral enucleation of the prostate were divided randomly into 2 groups by diode laser (Di group) or thulium laser (Thu group) respectively. The operation time, bleeding volume, electrolyte, international prostatic symptomatic score (IPSS), post-voiding residual volume (PVR) and maximum urine flow rate (Qmax) were recorded and compared. RESULTS: No difference was found in the 2 groups in basic preoperative characteristics. Di group was superior to Thu group in mean operation time [(61.5±19.6) min vs. (71.4±16.5) min, P=0.026] notwithstanding little clinical sense. The mean time of removing catheter was 2.1 d and 2.3 d respectively. No difference in either electrolyte decrease or hemoglobin decrease [(5.0±1.1 g/L) vs. (4.4±0.9) g/L, P=0.32] peri-operation between the 2 groups were found and no transurethral resection (TUR) syndrome was encountered. Lower urinary tract symptom (LUTS) in both the groups were released the 1st and 3nd months post-operation effectively in IPSS, PVR and Qmax respectively and comparable (P>0.05). CONCLUSION: Both the Diode laser and the Thulium laser transurethral enucleation of the prostate released the LUTS effectively in BPH patients and comparable in the short-time follow-up. Further study about late complications related to enucleation is necessary.

[Intermittent androgen deprivation for aggressive prostate cancer: 8 years of clinical experience].

OBJECTIVE: To investigate the safety and medication cycles of intermittent androgen deprivation (IAD) in the treatment of aggressive prostate cancer. METHODS: Based on prostate cancer clinical staging, we divided 178 patients with aggressive prostate cancer into groups A (T3-4N0M0), B (TXN1M0) and C (TXNXM1) to receive maximum androgen blockage for at least 6 months till the PSA level remained at < or = 0.2 microg/L for 3 months, followed by an off-period (without medication). The on-period was initiated when the PSA level was > 4 microg/L, and then stopped again when it was < or = 0.2 microg/L. We recorded and compared the patients' age, baseline PSA levels, Gleason scores, duration of on- and off-period, and time to tumor progression. RESULTS: The baseline PSA levels of the 3 groups were (27.5 +/- 14.6), (43.4 +/- 21.8) and (62.8 +/- 44.6) microg/L, P < 0.01; the follow-ups averaged (38.4 +/- 9.6), (33.1 +/-14.0) and (28.3 +/- 14.3) months; and the times from medication initiation to tumor progression were (37.4 +/- 6.6), (27.4 +/- 10.2) and (16.6 +/- 4.4) months, respectively. Group A showed a longer off-period and more medication cycles than B and C (P < 0.01). Nineteen patients completed 5 cycles and 2 died of cardiovascular events in group A. PSA elevation and cancer progression occurred after 3 cycles at most in group C. Six died in group B, 1 of metastatic prostate cancer, and 36 died in group C, 21 of metastasis. CONCLUSION: For local aggressive prostate cancer, IAD can effectively slow down tumor progression, reduce adverse events and improve patients' quality of life.

[Ultrasound-guided transperineal 24-core saturation prostate biopsy is superior to the 14-core scheme in detecting prostate cancer in patients with PSA < 20 microg/L].

OBJECTIVE: To compare the detection rates of prostate cancer (PCa) and complications of the transrectal ultrasonography (TRUS)-guided 24-core saturation scheme versus 14-core scheme for transperineal prostate biopsy in patients with total PSA < 20 microg/L. METHODS: We performed TRUS-guided 24-core saturation transperineal biopsy for 136 patients suspected of PCa (24-core group) and 14-core biopsy for another 116 (14-core group). We compared the PCa detection rates and post-biopsy complications, such as gross hematuria, urinary system infection, and acute urinary retention between the two groups. RESULTS: The baseline characteristics of the two groups were comparable with regard to the mean age, prostate volume and PSA level (P>0.05). The positive rates of PCa detection were 48.53% (66/136) in the 24-core group and 17.24% (20/116) in the 14-core group (P<0.001), and the positive rates of samples were 8.09% and 2.83%, respectively (P=0.012). The detection rate of PCa in the apex zone was significantly higher in the former (11.76%) than in the latter (1.72%) (P<0.05). There were no statistically significant differences in such post-biopsy complications as gross hematuria, urinary system infection, and acute urinary retention between the two groups (P>0.05). CONCLUSION: TRUS-guided 24-core saturation transperineal biopsy of the prostate is superior to the 14-core scheme for its higher detection rate of PCa, particularly PCa in the apex zone, and lower incidence of complications in patients with PSA < 20 microg/L.

[Comparison of holmium and thulium laser in transurethral enucleation of the prostate].

OBJECTIVE: To investigate and compare the effect and safety of Holmium laser and Thulium laser in transurethral enucleation of the prostate in BPH patients. METHODS: Ninety-eight BPH patients were divided into 2 groups and underwent transurethral enucleation of the prostate with holmium laser (Ho group) and thulium laser (Th group) respectively. Comparisons were made between the 2 groups in operation time, bleeding volume, electrolyte, IPSS score, PVR and Qmax. RESULTS: No statistically significant differences were noted between the 2 groups in age and preoperative prostate volume, IPSS, PVR and Qmax (P > 0.05). The mean operation time was shorter in the Th group ([84.6 +/- 10.2] min) than in the Ho group ([70.5 +/- 7.5] min) (P = 0.032); blood loss was less in the former ([126.5 +/- 14.6] ml) than in the latter ([176.5 +/- 14.1] ml) (P = 0.071), with no blood transfusion necessitated; and the mean times of catheter indwelling were 2.4 d and 2.5 d respectively. There were no significant differences in the levels of hemoglobin and electrolyte before and after operation between the two groups, and no TURP syndrome was observed. IPSS, PVR and Qmax before operation were significantly different from those obtained 3 months after it (P < 0.05) in both the groups, but none of the indexes exhibited statistically significant differences when compared in the same period (P > 0.05). CONCLUSION: Both holmium and thulium laser transurethral enucleation of the prostate can alleviate LUTS in BPH patients with similar short-time effectiveness. Thulium is superior to holmium laser in hemostasis, but inferior to it in anatomical distinctness.

[Xuanju compound capsule combined with erogenous focus exercise is effective for premature ejaculation].

OBJECTIVE: To investigate the effect of the Chinese medicine Xuanju compound capsule combined with erogenous focus exercise on premature ejaculation. METHODS: Fifty-two patients with premature ejaculation were divided into a treatment group (n = 28) and a control group ( n = 24) , both treated by erogenous focus exercise and the former given Xuanju compound capsule in addition. After four weeks of treatment, comparisons were made of the sexual satisfaction between the two groups. RESULTS: The cure rate and the rate of improvement of sexual satisfaction were 21.43% and 67. 86% respectively in the treatment group, significantly higher than in the control group. CONCLUSION: Xuanju compound capsule combined with erogenous focus exercise is highly effective in the treatment of premature ejaculation, with few adverse effects.