Integration of quantitative diffusion kurtosis imaging and prostate specific antigen in differential diagnostic of prostate cancer.

ABSTRACT: This study aimed to evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) and prostate-specific antigen (PSA) biomarkers in differentiating prostate cancer (PCa) and benign prostatic hyperplasia (BPH).A total of 43 cases of prostate diseases verified by pathology were enrolled in the present study. These cases were assigned to the BPH group (n = 20, 68.85±10.81 years old) and PCa group (n = 23, 74.13 ±â€Š7.37 years old). All patients underwent routine prostate magnetic resonance imaging and DKI examinations, and the mean diffusivity (MD), mean kurtosis (MK), and fractional anisotropy (FA) values were calculated. Three serum indicators (PSA, free PSA [fPSA], and f/t PSA) were collected. We used univariate logistic regression to analyze the above quantitative parameters between the 2 groups, and the independent factors were further incorporated into the multivariate logistic regression model. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic efficacy of the single indicator and combined model.The difference in PSA, f/t PSA, MK, and FA between PCa and BPH was statistically significant (P < .05). The AUC for the combined model (f/t PSA, MK, and FA) of 0.972 (95% confidence interval [CI]: 0.928, 1.000) was higher than the AUC of 0.902 (95% CI: 0.801, 1.000) for f/t PSA, 0.833 (95% CI: 0.707, 0.958) for MK, and 0.807 (95% CI: 0.679, 0.934) for FA.The MK and FA values for DKI and f/t PSA effectively identify PCa and BPH, compared to the PSA indicators. Combining DKI and PSA derivatives can further improve the diagnosis efficiency and might help in the clinical setting.

Study on diagnostic value of quantitative parameters of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in prostate cancer.

OBJECTIVE: To investigate the diagnostic value of quantitative parameters of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in prostate cancer. METHODS: From January 2019 to June 2020, 96 patients with prostatic tumor admitted in the department of urological surgery of our hospital were selected as subjects. Magnetic resonance imaging data of 48 cases of benign prostatic hyperplasia and 48 cases of prostate cancer were retrospectively analyzed. The patients included in this study received conventional MRI and IVIM-DWI examinations. Quantitative parameters of IVIM-DWI including D value, D* value, apparent diffusion coefficient (ADC) value and f value in lesions of prostatic tumor were calculated through the double exponential model fitting algorithm. D value, D* value, ADC value and f value were compared between benign prostatic hyperplasia (BPH) group and prostate cancer group. Quantitative parameters of IVIM-DWI were also compared among patients from different Gleason scores groups. The correlation of quantitative parameters of IVIM-DWI with Gleason scores and PSA concentration was analyzed. Diagnostic efficiency of quantitative parameters of IVIM-DWI for prostate cancer was evaluated by ROC curve. RESULTS: Compared with those in BPH group, D value, ADC value and f value in prostate cancer group were significantly lower, but D* value was obviously higher. With the Gleason score increased, D value, ADC value and f value gradually decreased, while D* value gradually increased. The diagnostic efficiency of parameters ADC and D was higher among other parameters. D value, ADC value and f value of prostate cancer were negatively correlated with Gleason score and PSA concentration, respectively (all P<0.05), while D* value was positively correlated with Gleason score and PSA concentration. CONCLUSIONS: Quantitative parameters of IVIM-DWI could be used for the diagnosis and evaluation of prostate cancer, and quantitative parameters of IVIM-DWI were associated with Gleason score and PSA concentration.

[A comparative study of incidence and prevalence of Crohn's disease in mainland China in different periods].

OBJECTIVE: To collect data and analyze the current status and prevalence changes of Crohn's disease (CD) in mainland China in recent decades. METHODS: A computer-based literature search was previously performed by using 50-year (1950 to 2002) of records of CD from the Chinese Database of Biology and Medicine (CBM) (1979 to 2002) and a manual year-by-year search of the literature (1950 to 1978). Using similar method, descriptive epidemiological data from 2003 to 2007 were collected, analyzed and compared with previous research. RESULTS: Four hundred and seventeen relevant papers during 2003 and 2007 were collected and 62 papers were eligible for inclusion. Within 62 papers, a total of 2149 cases with CD from 2003 to 2007 have been reported nationwide, comprising 1288 male and 861 female patients, with a 1.50:1 male predominance, and indicating 1.41 time of increment as compared with our previous result (ie, 1526 cases from 1950 - 2002). There were no obvious changes in incidence age (younger and middle age were main components) and sex ratio (number of male was still larger than that of female). The extrapolated CD incidence and prevalence rates were 1.21/100 000 person·year and 2.29/100 000, respectively, which were higher than that of year 1950 - 2002, 0.28/100 000 person·year and 1.38/100 000, respectively. CONCLUSIONS: The incidence and prevalence rates of CD have been increasing rapidly, but these rates are still lower than those in Western world.

[A study of efficiacy of infliximab treatment for Crohn's disease.].

OBJECTIVE: To investigated the potential and safety of the monoclonal antibody to TNFalpha infliximab (IFX) in the treatment of active Crohn's disease (CD). METHODS: Patients who were confirmed diagnosis of CD and were unresponsive to the conventional treatments, or recurred after surgeries, or discontinued treatment due to drug intolerance, were treated with IFX intravenously in a dose of 5 mg/kg at week 0, 2, 6 (IFX infusion continued at an interval of every 8 weeks if respond to initial dosing). Clinical assessments, including disease activity, blood biological markers and colonoscopic findings, were performed at baseline (week 0) and each week (4 weeks or later for colonoscopy) after IFX infusion were conducted until the week before 4(th) infusion from initiated. RESULTS: Ten patients (8 male, 2 female) with mean age of 31.4 years (ranged from 15 to 65 years old) were included in the analysis. The mean subjective score from baseline to week 14 was decreased from 2.2 +/- 0.6 to 1.2 +/- 0.4 (P < 0.05). The mean Harvey-Bradshaw index was 6.6 +/- 1.6 at baseline and 2.1 +/- 1.0 at week 14. The levels of ESR, CRP, serum total protein (TP) and albumin (Alb) were significantly improved during the 14-week period. Colonoscopy showed a remarkable improvement of Crohn's Disease Endoscopic Index of Severity (CDEIS). No infusion-related reaction was observed in all patients during the treatment. Mild or transient skin itching and headache were respectively reported in two patients. Transient elevation of serum ALT and AST after 3(rd) infusion in one patient, and severe anemia including leucopenia and thrombocytopenia at week 35 after 1(st) infusion in one male patient were observed. CONCLUSIONS: Treatment with three infusions of IFX in a dose of 5 mg/kg was effective for induction of remission for active and complex CD patients who failed to respond to conventional treatment. Long-term safety of the therapy effect was warranted in further investigations.

Curcumin regulated shift from Th1 to Th2 in trinitrobenzene sulphonic acid-induced chronic colitis.

AIM: To investigate the therapeutic effects of curcumin (Cur) on trinitrobenzene sulphonic acid (TNBS)-induced colitis and the effects of Cur on the balance of Th1/Th2 cytokines. METHODS: Colitis was induced by TNBS and treated with Cur (30 mg/kg/d, ip), dexamethasone (Dex, 2 mg/kg/d), or Cur plus dexamethasone (Cur+Dex, 30 mg/kg/d Cur ip+2 mg/kg/d Dex,ip). mRNA in colon mucosa were detected by real-time quantitative polymerase chain reaction. Intracellular cytokines were detected by flow cytometry and concentrations of cytokines in sera were detected by enzyme-linked immunosorbent analysis. RESULTS: Both Cur and Dex improved body weight loss, ameliorated histological images and decreased macroscopic score and myeloperoxidase activity. Cur decreased the expression of Th1 cytokines (IL-12, IFN-gamma, TNF-alpha, IL-1) and increased the expression of Th2 cytokines (IL-4 and IL-10) in colon mucosa. Cur also increased the proportion of IFN-gamma/IL-4 in splenocytes and circulation. Dex and Cur+Dex decreased the expression of Th1 cytokines but could not increase the expression of Th2 cytokines and the proportion of IFN-gamma/IL-4. CONCLUSION: Cur exerted therapeutic effects on colitis by regulating the shift from Th1 to Th2.

Curcumin inhibits trinitrobenzene sulphonic acid-induced colitis in rats by activation of peroxisome proliferator-activated receptor gamma.

Curcumin is a widely used spice with anti-inflammatory and anti-cancer properties. It has been reported that curcumin held therapeutic effects on experimental colitis by inhibition of nuclear factor kappa B (NF-kappaB). The peroxisome proliferator-activated receptor gamma (PPARgamma) is a nuclear receptor with anti-tumor and anti-inflammatory effects and its activation may inhibit the nuclear translocation of NF-kappaB. Several studies have shown that PPARgamma ligands had an important therapeutic effect in colitis. However there is no report about the alteration of PPARgamma in trinitrobenzene sulphonic acid (TNBS)-induced colitis treated with curcumin. In this study, we administered curcumin (30 mg/kg/day) by intraperitoneal injection immediately after colitis was induced and the injection lasted for two weeks. have evaluated the effects of curcumin on the colitis induced by trinitrobenzene sulphonic acid (TNBS). Curcumin (30 mg/kg d) was administered by intraperitoneal just after colitis was induced and lasted for two weeks. Therapeutic effects of dexamethasone (Dex, 2 mg/kg d) alone and the combined effects of curcumin+Dex were also examined. We found that curcumin improved long-term survival rate of disease-bearing rats, promoted rat body weight recovery, and decreased macroscopic scores of the colitis. The expression levels of PPARgamma, 15-deoxy-D12,14-prostaglandin J(2) (15d-PGJ(2)) and prostaglandin E(2) (PGE(2)) were all increased, but the expression level of cyclooxygenase-2 (COX-2) was decreased in rats after administration of curcumin. Treatment with Dex improved PPARgamma expression and inhibited the expression of COX-2, 15d-PGJ(2) and PGE(2). Combined effects of curcumin+Dex were similar to that of Dex. In summary, curcumin showed therapeutic effects on TNBS-induced colitis and the mechanisms by which curcumin exerts its effects may involve activation of PPARgamma and its ligands.

[Importance of colonoscopy combined with biopsy in the diagnosis of colonic Crohn's disease].

OBJECTIVE: An attempt was made to provide a better insight into endoscopic and histological features and/or problems encountered when establishing a diagnosis of colonic Crohn's disease (Crohn's colitis). METHODS: As presented in our 27 cases with Crohn's colitis, the endoscopic findings and histological changes of biopsy specimens were summarized. As collated with correspondent results of biopsy and surgical specimens, the diagnostic accuracy of endoscopy was evaluated. RESULTS: twenty-six involvements of the large intestine (combined with other sites of the intestine) was found (96.3%). However, involvement limited to the colon alone was seen in only 4 cases (14.8%). Endoscopically, overlapped lesions with multistaged-segmental distributed and multi-sited diverse patterns (destructive and proliferative/regenerative) of inflammatory changes were observed. Endoscopic accuracy was 66.7%. The characteristic features of mucosal biopsy include focal distribution of the lesions, a thickened and edematous submucosa, deep fissuring ulcers, lymphoid aggregate, and hyperplasia, fibrosis and granulomas (detected in 30% of the group), etc. CONCLUSIONS: Colonic involvement of Crohn's disease is common. Colonoscopy may be valuable in establishing the diagnosis and in assessing the extent and severity of colonic involvement, and CDEIS was value in the follow up of patients. Colonoscopic biopsies are helpful for verification of the diagnosis in difficult cases. Colonoscopy has replaced radiology as the initial test of choice in many clinical situations.

Clinical features and management of Crohn's disease in Chinese patients.

BACKGROUND: An increasing incidence of Crohn's disease has been found in China in recent years. Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn's disease in order to improve early diagnostic accuracy and therapeutic efficacy. METHODS: Thirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease. RESULTS: Most patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract (from the mouth to the anus). In this study, the colon and small bowel were the major sites involved. Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host's nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported. CONCLUSION: Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.

[Lactobacillus casei microbiological assay of plasma and RBC concentrations of folic acid with 96-well microtiiter plates].

To investigate the plasma and RBC concentrations of folic acid in normal persons. Microbiological assay was used to determine the plasma and RBC folic acid in 59 normal persons by using of 96-well microtiter plasma. The results showed that the plasma and RBC folio acid concentration were (8.2 +/- 2.9) microgram/L and (337.5 +/- 91.0) microgram/L in male and female normal persons (aged 18 to 32) respectively. The coefficient Variations determined within assay and between assay were 2.2% and 4.7% respectively. This method may reduce reagent costs, shortened the assay time, increase the sensitivity and improve the reproducibility. It can be used for large scale survey.

[Clinical features of Crohn's disease: its diagnosis and treatment].

OBJECTIVE: To enhance our understanding of Crohn's disease and improve its early diagnostic accuracy and therapeutic efficacy. METHODS: Thirty-one patients with active Crohn's disease were studied. All their diagnostic and therapeutic results were analyzed. RESULTS: Most patients were young adults, with a 1.14:1 female predominance in prevalence. The disease affects any segment or a combination of segments of the alimentary tract from the mouth to the anus. However, the colon and the small bowel were the major sites involved. Recurrent episodes of abdominal pain and watery diarrhea were the most common symptoms. In addition, low grade fever, emaciation, anemia, and symptoms with skin, joints or perianal complications could be discovered if attention was paid. An endoscopy combined with histologic examination in biopsy specimens provided characteristic features with a diagnostic accuracy of 62.9%. Granulomas were identifiable in 30.8% of all biopsy specimens. Transabdominal bowel sonography (TABS) accurately detected intestinal complications. Factors causing misdiagnosis were: insufficient attention of the disease, diverse clinical presentations, or over emphasis of the diagnostic value of granulomas. Oral prednisone therapy for mild to moderate disease was more rapid to receive clinical remission when compared to oral aminosalicylates (SASP or 5-ASA). Nutrition support therapy was given in 20 cases with active disease and received beneficial effects on host nutritional status. Immunosuppressives were used on an individual basis, and showed variable effects with limited experience. Sixteen patients had operations due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after operations was achieved. CONCLUSIONS: Crohn's diseases not uncommon in China. Abdominal pain and watery diarrhea are two hallmark symptoms. Endoscopy (with biopsy), and TABS were both valuable procedures for diagnosis. Prednisone and SASP/5-ASA were effective as inductive therapies. Surgery, as an alternative and effective treatment, provided another choice in well selected patients.