Objective To evaluation the value of fusion images of dynamic contrast enhanced MRI (DCE MRI) with transrectal ultrasound(TRUS) and conventional TRUS in prostate biopsy for prostate cancer.Methods The clinical data of 127 patients suspected as early-stage prostate cancer were retrospectively analyzed.79 patients underwent prostate biopsy guided by conventional TRUS(group A).48 patients underwent prostate biopsy guided by fusion images of DCE MRI with TRUS(group B).Then the diagnostic rates,puncture times and complications in the two groups were compared.Results The cases with confirmed prostate cancer were 31 in group A and 22 in group B.The first time diagnostic rates of biopsy were 20.2％(16/79) in group A,and 39.3％ (19/48) in group B respectively(P ＜0.05).The first time sensivity,specifity,positive predictive value and negative predictive value of biopsy were 51.6 ％,100 ％,100％,77.4％ in group A and 86.3％,100％,100％,89.6％ in group B.Puncture times was 15.40 ± 4.67 and 13.01 ± 3.87 respectively.The Gleason score was 6.21 ± 0.91 and 6.35 ± 0.81 respectively.The complication rates were 19.0％(15/79) in group A and 12.5％(6/48)in group B.Conclusions For patients with earlystage prostate cancer,the combination of DCE-MRI and TRUS to guide transrectal prostate biopsy was recommended.It showed an increase in the first time diagnostic rate of biopsy while a reduction in the times and complications of prostated biopsy.

Objective To investigate the separate and combined detection value of serum carbohydrate antigen 125 (CA125),human epididymis protein 4 (HE-4) and D dimer (D-dimer) in the diagnosis of ovarian cancer.Methods One hundred and twenty ovarian cancer patients were selected as the observation group,one hundred and twenty patients with ovarian benign tumor as the benign group,eighty women with healthy physical examination results as the control group,then the chemiluminescence immunoassay was used to detect the expression of serum CA125 and HE-4 of the three groups,and the immune turbidimetric method was applied to examine the expression of D-dimer.At last,the diagnosis efficiency of CA125,HE-4 and D-dimer in separate and combined detection was calculated.Results CA125 in the observation group was (623.07±274.18) U/ml,HE-4 was (594.22±329.068) ng/ml and D-dimer was (418.57±276.75) ng/L,CA125 in the benign group was (45.09±32.58) U/ml,HE-4 was (97.92±57.52) ng/ml and D-dimer was (204.52±80.07) ng/L;CA125 in the control group was (40.23±28.16) U/ ml,HE-4 was (85.65±37.27) ng/ml and D-dimer was (187.57±65.74) ng/L,the differences between the three groups were statistically significant (F=122.82,89.91,54.46;P<0.05).The level of CA125 in the serum of patients with advanced stage (stage III-IV) was (586.10±278.33) U/ml,HE-4 was (437.49±238.06) ng/ml,D-dimer was (493.78±274.45) ng/L,in the early stage (stage I-II),the level of CA125 in the serum of patients with ovarian cancer was (372.12±265.31) U/ml,HE-4 was (673.64±301.68) ng/ml,D-dimer was (364.84±267.54) ng/L,and the difference was statistically significant (t=4.244,4.78,2.560,P<0.05).The detection sensitivity and specificity of CA-125 were 71.67% and 62.50% respectively.The sensitivity of HE-4 was 74.17% and the specificity was 75.00%.The sensitivity of D-dimer was 62.5% and the specificity was 60.00%.The combined detection sensitivity of the three was 80.00% and the specificity was 77.5%.Conclusion The sensitivity and specificity of the three tumor markers in combined detection were higher than those of separate detections,so the combined detection of CA125,HE-4 and D-dimer can further improve the diagnosis level of ovarian cancer.

Objective:To evaluate the molecular diagnosis marker of papillary thyroid carcinoma (PTC),the relationship between lymphatic metastasis of central neck compartment PTC,and the opera-tion indication of prophylactic central neck dissection.Methods:We conducted a retrospective study, including 275 PTC patients and detected their BRAF mutation rates during 201 2 and 201 4 and explored the risk factors of the central node lymphatic metastasis by Logistic regression model.Results:Of the 275 PTC patients,224 (81 .5%)were female and 51 (1 8.5%)were male.BRAF mutational rates were 53.8% (1 48 /275)and lymphatic metastasis 57.8% (1 59 /275).Multivariate analysis showed calcifica-tion (ORadjusted =1 .47,95%CI:1 .1 0 -1 .98,P =0.01 ),tumor diameter (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)and age (ORadjusted =1 .48,95%CI:1 .04 -2.30,P =0.048)were associa-ted with lymphatic metastasis.In stratified analysis,BRAF mutation (ORadjusted =3.1 9,95%CI:1 .1 8 -9.43,P =0.023 )in clear boarder group and BRAF mutation (ORadjusted =4.84,95% CI:1 .68 -1 3.84,P =0.003)in calcification group were more likely to have lymphatic metastases.Conclusion:Central neck metastasis takes up a high ratio in papillary thyroid cancer patients,BRAF mutation in pa-pillary thyroid carcinoma is a characteristic molecular event.Furthermore,patients with calcification un-der ultrasound detection,lower age group and longer tumor diameter are more susceptible to suffer central neck metastasis.Especially for stratified analysis,non-calcified BRAF mutation or BRAF mutation with clear border under ultrasound detection are more susceptible to suffer central neck metastasis,and radical prophylactic central neck dissection should be carried on for these patients.

Objective: To investigate the factors affecting the development of non-proliferative diabetic retinopathy (NPDR) among patients with type 2 diabetic mellitus (T2DM), so as to provide insights into manangement of NPDR. Methods: T2DM patients without obvious eye discomfort at ages of 18 years and older admitted to Department of Endocrinology, Jining No. 1 People's Hospital during the period from December 2019 to May 2021 were enrolled. Participants' demographics, smoking, alcohol consumption, medical history of diabetes and use of medicines were collected, and the height, weight and blood pressure were measured. The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose, blood C-peptide, lipid and creatinine were tested, and retinopathy was examined with a non-mydriatic fundus camera. The factors affecting the development of NPDR were identified among T2DM patients using a multivariable logistic regression model. Results: A total of 486 T2DM patients were enrolled, including 354 men (72.84%), with a median age of 48.00 (15.25) years, and median diabetes duration of 35.00 (104.25) months. The prevalence of NPDR was 19.34% among the participants. multivariable logistic regression analysis identified an educational level of senior high school and above (OR=0.546, 95%CI: 0.325-0.918), duration of diabetes (OR=1.008, 95%CI: 1.005-1.012), HbA1c (OR=1.183, 95%CI: 1.034-1.354) and use of non-sulfonylurea insulin secretagogues (OR=1.859, 95%CI: 1.082-3.196) as factors affecting the risk of NPDR among T2DM patients. Conclusion A high risk of NPDR is found among T2DM patients with a low educational level, long duration of diabetes, poor HbA1c control and use of non-sulfonylurea insulin secretagogues.

Experiments were conducted to investigate the suitability of the multistage in-situ reaction analyzer based on a micro fluidized bed ( MFB-MIRA) for measuring the rapid change of the gas concentration during gas-solid reactions. The results showed that the control performance of capillary temperature had a great impact on the stability of on-line measurement. Based on the observed regular patterns, the capillary temperature control system was equipped with a precision temperature controller. The control precision of capillary temperature reached ± 0 . 2℃, which guaranteed the high stabilities of the sampling flow rate and the chamber vacuum. The measured results of the modified gas monitoring system showed the periodic fluctuations of the on-line measurement were eliminated. The stability of measurement was significantly improved. The fluctuating range and relative standard deviation of the measured response to O2 in air changed from 1. 9% and 0. 5% to 1. 4% and 0. 2%, respectively. A pressure regulating device was also developed to control the absolute pressure at the gas sampling point. The control precision reached ± 0. 02 kPa. The measured results showed that the response of the process mass spectrometer was positively correlated with the absolute pressure at the sampling point, indicating the necessity of the pressure regulating device. The accuracy and repeatability of process mass spectrometer were improved. This study has enhanced the suitability of MFB-MIRA for studying rapid gas-solid reactions and broadened the scope of reliable applications of MFB-MIRA and process mass spectrometer.

Objective To analyze the influencing factors of having clinical meaningful recanalization (CMR)after revascularization therapy in acute phase of ischemic stroke. Methods A total of 267 consecutive patients with ischemic stroke admitted to the Department of Neurology,Xuanwu Hospital, Capital Medical University and received intravenous thrombolysis or endovascular intervention in acute stage from March 2011 and March 2015 were enrolled retrospectively. CMR was used as a primary endpoint event. They were divided into either a CMR group (n = 92)or a non-CMR group (n = 175)according to whether they had CMR. The baseline data of the patients in both groups were compared by using the Rank sum test and Pearson Chi-Square test. A multivariate logistic regression model was established to analyze the independent influencing factor of CMR. Results The median (interquartile range)age of 267 patents was 60 (51 -69)years,and 69 of them were females (25. 8%);the median (interquartile range)time from onset to treatment was 250 (195 -305)min,and the median (interquartile range)NIHSS score was 10 (6 -15). The baseline NIHSS score,body mass index,blood glucose level,and proportion of diabetes of the CMR group were significantly lower than those of the non-CMR group (all P≤0. 05). The results of multivariate logistic regression analysis showed that the baseline NIHSS (OR,0. 93,95% CI 0. 88 -0. 98;P = 0. 01),intravenous thrombolysis (with respect to endovascular intervention)(OR,0. 35, 95% CI 0. 17 -0. 73;P = 0. 01),and baseline blood glucose (OR,0. 87;95% CI 0. 77 -0. 98;P =0. 02)were the independent negative predictors of CMR. Conclusion The baseline NIHSS,intravenous thrombolysis (with respect to endovascular intervention),and high blood glucose are the negative influencing factors for achieving CMR in the acute phase of ischemic stroke,suggesting blood sugar intervention and endovascular intervention in acute phase may contribute to the improvement of clinical prognosis.

Objective To evaluate the efficacy, advantages and shortcomings of micro-percutaneous nephrolithotomy in treatment of uncomplicated ureteral calculi.Methods Clinical data were collected from 126 patients with a failure treatment of history by ESWL (extracorporeal shock wave lithotripsy) and RIRS (retrograde intrarenal surgery) in treatment of upper ureteral calculi (< 3.0 cm) from June 2015 to May 2016. Antegrade percutaneous access was obtained by B-type ultrasound guidance. Micro-PCNL was done using YAG laser fiber or pneumatic through the ureteroscope (F4.5~F6.5、F6.0~F7.5, 315 mm) to disintegrate the stones. The calculi clearance rate, operation time, operative hemorrhage, length of hospital stay and complications of the patients were analyzed after operation.ResultsThe calculi clearance rate was 88.9%, the operation time was 15~75 min, the operative hemorrhage was 15~35 ml, the length of hospital stay was 5~10 d. Only one patient need the second stage surgery because of intraoperative hemorrhage affected the surgical ifeld. No patients occurred massive hemorrhage, pneumothorax, bowel and other complications such as organ damage.Conclusion Micro-PCNL had a good clinical curative effect and security in treatment of uncomplicated ureteral calculi, which was worthy of promoting clinically.

Objective To investigate the relationship between BRAF V600E mutation and clinicopathological features of papillary thyroid carcinoma (PTC) combined with chronic lymphocytic thyroiditis (CLT). Methods The clinical data of 168 PTC patients combined with Hashimoto thyroiditis who received radical surgery treatment in Beijing Caner Hospital from November 2013 to July 2016 were analyzed retrospectively. Sanger sequence was used to detect the status of BRAF V600E mutation. Then the patients were divided into BRAF V600E mutation positive (the observation group) and the mutation negative group (the control group). The clinicopathological features between the two groups were compared. Results The proportion of gender, age, calcification, lymphatic metastasis and extra gland invasion incidence had no significant difference between the observation group and the control group (χ2= 0.234, 1.139, 0.650, 1.262 and 1.665 respectively, all P＞0.05). Moreover, the differences of tumor size, tumor shape and tumor number in both groups were statistically significant (χ2= 7.071, 3.877 and 6.968 respectively, all P＜ 0.05). Logistic regression analysis showed that there was no statistical difference between the patients with BRAF V600E mutation or without in tumor number and central lymph node metastasis ( OR= 0.263, 95 % CI 0.049-1.402, P=0.118; OR=2.152, 95 % CI 0.666-6.956, P=0.200). Conclusion BRAF V600E mutation has no significant effect on clinicopathological features of PTC patients combined with CLT.

Objective To explore the clinical characteristics of renal transplantation in patients with diabetes mellitus (DM)-induced end-stage nephropathy.Methods The clinical data of 408 cases who underwent renal transplantation in our center from 2009 to 2013 were retrospectively analyzed.The patients were divided into DM group (n =82) and non-DM group (n =326).The postoperative infection,delayed graft function (DGF),adverse events,and the survival rate of patients/kidneys were comparatively analyzed.Results The incidence of postoperative infection,DGF and adverse events was significantly higher in DM group than in non-DM group (23.2％ vs.15.6％,P =0.04;17.1％ vs.8.6 ％,P =0.04;13.4％ vs.8.3 ％,P =0.03).No significant difference was found in the 1-,2-,and 3-year survival rate of patients and kidneys between the two groups after operation (P＞ 0.05).Conclusion The incidence of postoperative infection,DGF and adverse events is higher in DM patients.The DM does not affect the survival rate of patients/kidneys through appropriate treatment.It is important to prevent complications in DM patients after renal transplantation.

Objective:To investigate the clinical pathologic features of high-grade squamous intraepithelial lesions (HSIL) in postmenopausal women.Methods:The clinical data of hospital patients with HSIL admitted to the Department of Gynecology of The First People's Hospital of Lianyungang, Jiangsu Province from January 2019 to December 2020 were retrospectively analyzed. Patients undergoing liquid-based thin-layer cytology, high-risk human papillomavirus (HR-HPV), colposcopy, cervical biopsy and Endocervical curettage (ECC), pathological diagnosis of HSIL, followed by cold knife conization (CKC). The diagnosis and treatment process conformed to the cervical cancer diagnosis and treatment norms, and there were a total of 594 patients with no previous cervical surgery history,including 463 cases in the premenopausal group and 131 cases in the menopausal group, and the age, contact bleeding, gynecological examination, HR-HPV, liquid-based thin layer cytology, colposcopy and biopsy results, and post-cervical cone surgery pathological results were compared and analyzed, and multivariate Logistic regression analysis was carried out for statistically different factors to identify the clinical pathological characteristics of postmenopausal HSIL patients. T-test was used for the comparison between measurement data groups with normal distribution, and rank sum test was used for the comparison between measurement data groups with non normal distribution. Counting data use χ 2 test or Fisher exact probability method. Logistic regression analysis was used in multivariate analysis. Results:There was no significant difference in the positive rate of contact bleeding (12.98%(17/131)) and HR-HPV (77.86%(102/131)) between postmenopausal group and non postmenopausal group (11.45%(53/463) and 80.56% (373/463))(χ 2 values were 0.23 and 0.46; P values were 0.632 and 0.496). The proportion of cervical columnar epithelium displacement (43.51% (57/131)) and abnormal liquid-based thin-layer cytology (87.79%(115/131)) in the postmenopausal group were lower than those in the non postmenopausal group (64.36%(298/463) and 93.74%(434/463)). There was significant difference between the two groups (χ 2 values were 18.46 and 5.16; P values were < 0.001 and 0.023). The positive rate of ECC (62.60%(82/131)), cervical type Ⅲ transformation area (73.28%(96/131)), the proportion of pathological upgrading after conization (9.92%(13/131)) and the positive rate of cutting edge after conization (24.43%(32/131)) in menopausal group were higher than those in non menopausal patients (46.22%(214/463), 26.78%(124/463), 1.73%(8/463) and 5.40%(25/463)). There were significant differences between the two groups (χ 2 values were 10.95, 94.68, 20.11 and 42.62; P values were 0.001, <0.001, <0.001 and <0.001). Multivariate Logistic regression analysis showed a high proportion of cervical type Ⅲ transformational zones ( OR=6.569, 95% CI 4.130-10.446), high ECC positivity ( OR=1.978, 95% CI 1.250-3.128), the positive rate of cone incision margins was high ( OR=4.581, 95% CI 2.386-8.794), the proportion of pathological escalation after cone surgery ( OR=4.612, 95% CI 1.557-13.668) and the proportion of smooth cervical appearance were high ( OR=0.464, 95% CI 0.294-0.731), which was the clinicopathological feature of postmenopausal HSIL ( P values were <0.001, 0.004, <0.001, 0.006 and 0.001). Conclusion:There were differences in HSIL in patients before and after menopause, clinical symptoms and screening manifestations were atypical, and lesions are easy to involve the cervical canal, the positive rate of the cut margin after coneectomy was high, and the proportion of pathological escalation was high, so more aggressive intervention should be taken for women diagnosed with precancerous cervical lesions after menopause