BACKGROUND: At present, biopsy is essential for the diagnosis of prostate cancer (PCa) before radical prostatectomy (RP). However, with the development of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and multiparametric magnetic resonance imaging (mpMRI), it might be feasible to avoid biopsy before RP. Herein, we aimed to explore the feasibility of avoiding biopsy before RP in patients highly suspected of having PCa after assessment of PSMA PET/CT and mpMRI. METHODS: Between December 2017 and April 2022, 56 patients with maximum standardized uptake value (SUVmax) of ≥4 and Prostate Imaging Reporting and Data System (PI-RADS) ≥4 lesions who received RP without preoperative biopsy were enrolled from two tertiary hospitals. The consistency between clinical and pathological diagnoses was evaluated. Preoperative characteristics were compared among patients with different pathological types, T stages, International Society of Urological Pathology (ISUP) grades, and European Association of Urology (EAU) risk groups. RESULTS: Fifty-five (98%) patients were confirmed with PCa by pathology, including 49 (89%) with clinically significant prostate cancer (csPCa, defined as ISUP grade ≥2 malignancy). One patient was diagnosed with high-grade prostatic intraepithelial neoplasia (HGPIN). CsPCa patients, compared with clinically insignificant prostate cancer (cisPCa) and HGPIN patients, were associated with a higher level of prostate-specific antigen (22.9 ng/mL vs . 10.0 ng/mL, P = 0.032), a lower median prostate volume (32.2 mL vs . 65.0 mL, P = 0.001), and a higher median SUVmax (13.3 vs . 5.6, P <0.001). CONCLUSIONS It might be feasible to avoid biopsy before RP for patients with a high probability of PCa based on PSMA PET/CT and mpMRI. However, the diagnostic efficacy of csPCa with PI-RADS ≥4 and SUVmax of ≥4 is inadequate for performing a procedure such as RP. Further prospective multicenter studies with larger sample sizes are necessary to confirm our perspectives and establish predictive models with PSMA PET/CT and mpMRI.
Humans ; Male ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis* ; Middle Aged ; Aged ; Positron Emission Tomography Computed Tomography/methods* ; Biopsy ; Multiparametric Magnetic Resonance Imaging ; Prostate-Specific Antigen/metabolism*

Objective:To investigate the effect of HSM on the inflammation and pulmonary fibrosis in mice with cecal ligation and puncture ( CLP) . Methods: Both 5 day and 10 day timepoint pulmonary fibrosis were induced by CLP;mice were randomly divided into three groups,including sham group (sham,n=5),model group (CLP,n=11),therapy group (HSM,n=11). HSM extract (200 mg/kg,less than human dose of 0. 27 g/kg) was orally administered to HSM group 2 hour before surgery and repeated everyday, while sham group and model group were given the same dose of normal saline. We used Q-PCR assay to analyze the expression of in-flammatory molecules ( IL-1β and TNF-α) and fibrogenic cytokines ( TGF-β, MMP9 and TIMP1 ) from lung tissues , we used FACS assay to analyze the amount of Th1 cells in PBMC and spleen sections,as well as Treg in spleen sections. Besides,lung sections were subjected to HE stain and immunohistochemical staining withα-SMA and fibronectin. Results:The amount of model group's Th1 cells in PBMC and spleen sections,as well as Treg in spleen sections were significantly lower than sham group's,whereas HSM succeeded in raising them. By day 5, the expression of inflammatory molecules IL-1β and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from CLP group's lung sections were remarkably improved,by day 10,the expression had decreased but was higher than sham group's;HSM inhibited these cytokines' expression. The expression of TNF-α of CLP group and HSM group had no significant changes. The CLP group's HE results showed obvious pulmonary inflammatory damage,by day 10,the situation had improved,whereas HSM reduced the histopathologic alterations;contrast to sham group,model group's expression of α-SMA and fibronectin was remarkably improved,while HSM group showed lower expression. Conclusion: HSM extract can suppress inflammation, balances immune system and relieves pulmonary fibrosis.

Objective:To investigate the effect of HSM on the immunoreaction and renal fibrosis in mice with cecal ligation and puncture (CLP).Methods: Renal fibrosis was induced by CLP;mice were divided into three groups,including sham group (sham,n =5),model group (CLP,n =11),therapy group (HSM,n =11).HSM extract [200 mg/(kg?d)] was orally administered to HSM group2 hour before surgery and repeated everyday throughout 10 days,while sham group and model group were given the same dose of normalsaline.FACS assay was used to analyze the amount of macrophages ,neutrophils and Treg in PBMC,as well as macrophages in peritonealfluid;we used Q-PCR assay to analyze the expression of inflammatory molecules (IL-1βand TNF-α) and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from renal sections.Besides,renal sections were subjected to HE stain and immunohistochemical staining with α-SMA and fibronectin.Results: The amount of model group′s macrophages and neutrophils in PBMC,as well as macrophages in theperitoneal fluid were significantly higher than sham group ′s,whereas HSM succeeded in lowering them;contrast to sham group,Tregs′amount of CLP group and HSM group in PBMC had no significant changes .The expression of inflammatory molecules (IL-1βand TNF-α) and fibrogenic cytokines (TGF-β,MMP9 and TIMP1) from CLP group′s renal sections were remarkably improved ,whereas HSM inhibitedthat.The CLP group′s HE results showed obvious renal inflammatory damage ,whereas HSM reduced the histopathologicalterations;contrast to sham group,model group′s expression of α-SMA and fibronectin was remarkably improved,while HSM groupshowed lower expression.Conclusion: HSM extract could regulate immunity response and had effect in improving renal fibrosis .

Objective To explore the lipid metabolism in patients with hypertension and obstructive sleep apnea-hypopnea syndrome.Methods A total of 896 patients (655 cases of male; 241 cases of female) was recruited who were hospitalized in our department,and were classified into four groups based on the finding of polysomnography (PSG):hypertensive without obstructive sleep apnea-hypopnea syndrome (OSAS) (n =243),hypertensive with mild OSAS (n =245),hypertensive with moderate OSAS (n =195),and hypertensive with severe OSAS (n =213).Multiple indices including apnea-hypopnea index (AHI),lowest arterial oxygen saturation(lowest SaO2),body mass index (BMI),blood pressure,total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDLC),triglycerides (TG),fasting blood glucose(FBG),uric acid (UA),and high-sensitivity C-reactive protein(hs-CRP) were assessed,and the relevant risk factors of lipid metabolism were analyzed.Results (1)Male patients had more opportunities to suffer OSAS than female (P ＜0.01).Compared with the group without hypertensive,patients in severe OSAS group had higher levels of AGE (48.09 ± 9.48,BMI (29.46 ±3.83),AHI[45.90(37.55,63.65)],MSpO2 (89.08 ±4.93),LSpO2 (67.36 ± 12.60),TC (4.68 ±1.00),TG[2.03(1.54,2.88)],UA (371.85 ±99.29),and hs-CRP[1.43(0.82,3.056)] (P ＜0.05),and had lower levels of HDL-C (1.09 ± 0.28).(2) Two and more than two lipids abnormal metabolic indices increased prevalence with the increase of the severity of OSAS.(3)The prevalence of high TG,high TC in AHI ≥ 15/h was significantly higher than AHI ＜ 15 group.(4) After adjustment for BMI,gender,age and other common risk factors,it confirmed that AHI was still related to lipid metabolism.AHI was an independent risk factor for abnormal lipid metabolism.Conclusions AHI was an independent risk factor for abnormal lipid metabolism.With increasing severity of OSAS,the levels TC,TG,and the category of abnormal lipid metabolism were also increased.