Predicting prostate cancer recurrence: Introducing PCRPS, an advanced online web server.

Background: Prostate cancer (PCa) is one of the leading causes of cancer death in men. About 30% of PCa will develop a biochemical recurrence (BCR) following initial treatment, which significantly contributes to prostate cancer-related deaths. In clinical practice, accurate prediction of PCa recurrence is crucial for making informed treatment decisions. However, the development of reliable models and biomarkers for predicting PCa recurrence remains a challenge. In this study, the aim is to establish an effective and reliable tool for predicting the recurrence of PCa. Methods: We systematically screened and analyzed potential datasets to predict PCa recurrence. Through quality control analysis, low-quality datasets were removed. Using meta-analysis, differential expression analysis, and feature selection, we identified key genes associated with recurrence. We also evaluated 22 previously published signatures for PCa recurrence prediction. To assess prediction performance, we employed nine machine learning algorithms. We compared the predictive capabilities of models constructed using clinical variables, expression data, and their combinations. Subsequently, we implemented these machine learning models into a user-friendly web server freely accessible to all researchers. Results: Based on transcriptomic data derived from eight multicenter studies consisting of 733 PCa patients, we screened 23 highly influential genes for predicting prostate cancer recurrence. These genes were used to construct the Prostate Cancer Recurrence Prediction Signature (PCRPS). By comparing with 22 published signatures and four important clinicopathological features, the PCRPS exhibited a robust and significantly improved predictive capability. Among the tested algorithms, Random Forest demonstrated the highest AUC value of 0.72 in predicting PCa recurrence in the testing dataset. To facilitate access and usage of these machine learning models by all researchers and clinicians, we also developed an online web server (https://urology1926.shinyapps.io/PCRPS/) where the PCRPS model can be freely utilized. The tool can also be used to (1) predict the PCa recurrence by clinical information or expression data with high accuracy. (2) provide the possibility of PCa recurrence by nine machine learning algorithms. Furthermore, using the PCRPS scores, we predicted the sensitivity of 22 drugs from GDSC2 and 95 drugs from CTRP2 to the samples. These predictions provide valuable insights into potential drug sensitivities related to the PCRPS score groups. Conclusion: Overall, our study provides an attractive tool to further guide the clinical management and individualized treatment for PCa.

The learning curve and experience of a novel multi-modal image fusion targeted transperineal prostate biopsy technique using electromagnetic needle tracking under local anesthesia.

Background: Prostate cancer is the most common malignant tumor of male genitourinary system, and the gold standard for its diagnosis is prostate biopsy. Focusing on the methods and skills of prostate biopsy, we explored the learning curve and experience of a novel magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion transperineal biopsy (TPB) technique using electromagnetic needle tracking under local anesthesia. Methods: The clinical and pathological data of 92 patients who underwent targeted TPB from January 2023 to July 2023 in our center were prospectively collected. The cumulative sum (CUSUM) analysis method and the best fitting curve were used to analyze the learning curve of this novel technique, and the clinical characteristics, perioperative data and tumor positive rate of prostate biopsy of patients at different stages of the learning curve were compared. Results: With the increase of the number of surgical cases, the overall operative time showed a downward trend. The best fitting curve of CUSUM reached its peak at the twelfth case, which is the minimum cumulative number of surgical cases needed to cross the learning curve of the operation. Taking this as the boundary, the learning curve is divided into two stages: learning improvement stage (group A, 12 cases) and proficiency stage (group B, 80 cases). The surgical time and visual analog scale score during prostate biopsy in group A were significantly higher than those in group B. The visual numerical scale score during prostate biopsy in group A was significantly lower than that in group B. There was no statistically significant difference between group A and group B in the detection rate of csPCa and the incidence of perioperative complications. Conclusion: The novel targeted TPB technique is divided into learning improvement stage and proficiency stage, and 12 cases may be the least cumulative number.

Appendiceal vesical fistula first presenting as giant bladder calculi: A case report and review of literature.

A 34-year-old man was admitted to the hospital presenting repeatedly urinary urgency for 3 years and yellow-green lithotripsy foreign body in urine for 1 month. Initially, he was diagnosed with a giant bladder calculi. After a cystoscopy exam and a lithotripsy for bladder calculi, Appendiceal vesical fistula was finally diagnosed and treated with a laparoscopic surgery. We report a rare case of appendiceal vesical fistula，first presenting as giant bladder calculi，and successfully treated with minimal invasive surgery We report this case and reviewed literature to improve the understanding of this disease and reduce misdiagnosis and missed diagnosis.

Shu Fu Pai® Protein Short Peptides Beverage for the treatment of hypoalbuminemia in liver cirrhosis.

OBJECTIVE: To investigate the clinical efficacy of Shu Fu Pai® Protein Short Peptides Beverage in the treatment of hypoalbuminemia in liver cirrhosis. METHODS: A retrospective analysis was conducted on 289 patients with liver cirrhosis and hypoalbuminemia who were admitted to Deyang People's Hospital between April 2021 and April 2023. Among them, 148 patients treated with Shu Fu Pai® Protein Short Peptides Beverage were assigned as an observation group and 141 patients treated with intravenous human albumin were the control group. Liver function, coagulation function before and after treatment, and complications after treatment were compared between the two groups. The patients whose albumin levels did not increase after treatment were counted, and the influencing factors were analyzed using univariate and multivariate analyses. RESULTS: After treatment, there was a significant improvement in liver function, serum albumin level, Child-Pugh score, inflammatory markers, and coagulation function in both groups (all P=0.001). However, no significant difference was found in the peripheral blood indicators between the two groups (P>0.05). Also, there was no significant difference in complications between the two groups (P=0.194). Logistic regression analysis showed that age, pre-treatment serum albumin level, disease type, and abnormal liver function markers were independent factors affecting the treatment outcome of hypoalbuminemia, and treatment regimen was not an influencing factor. CONCLUSION: Shu Fu Pai® Protein Short Peptides Beverage for hypoalbuminemia in liver cirrhosis is not inferior to intravenous human albumin for improving liver function, inflammatory markers, and coagulation function. The therapeutic effect on hypoproteinemia is independent of type of treatment regimen, which suggests that Shu Fu Pai® Protein Short Peptides Beverage is an effective treatment for hypoalbuminemia in liver cirrhosis, without an increased risk of complications.

CLINICAL APPLICATION OF RT-PCR IN TUBERCULOSIS DNA DETECTION COMBINED WITH TB-IGRA IN THE DIAGNOSIS OF SPUTUM SMEAR-NEGATIVE PULMONARY TUBERCULOSIS.

The aim was to investigate detection of pulmonary alveolar lavage fluid tuberculosis DNA by real-time fluorescent polymerase chain reaction (RT-PCR) combined with clinical application of the sputum smear-negative pulmonary tuberculosis diagnosis with TB interferon-γ release assay (TB-IGRA). From October 2014 to October 2015, 632 outpatients and inpatients treated in our hospital were randomly selected, of which 459 patients as the research group managed with RT-PCR detection combined with TB-IGRA and 173 patients as the control group undergoing electronic bronchoscopy alveolar lavage fluid detection, with detection results statistically evaluated. The positive rate in the research group was 96.51%, i.e. significantly higher than that in the control group (66.47%), yielding a statistically significant difference (χ2=109.68, p=0.00). The true positive rate was 97.7% in the research group and 67.92% in the control group; the true positive rate was significantly higher in the research group patients as compared with the control group, yielding a statistically significant difference (χ2=112.04, p=0.00). The sensitivity and specificity, as well as Youden index were significantly higher in the research group as compared with the control group. In conclusion, TB DNA detection by RT-PCR combined with TB-IGRA is a very good method of diagnosing tuberculosis, and it can be implemented in clinical diagnosis of pulmonary tuberculosis.