Objective To investigate the effects of three procedures for benign prostatic hyperplasia (BPH) on neuroendocrine and immune responses and its clinical significance. Methods Patients were divided into three groups with 20 patients in each group: the Group Ⅰreceived the transuretheral resection of prostate (TURP), the Group Ⅱ received the suprapubic transvesical prostatectomy (SPP) and the Group Ⅲ underwent the retropubic prevesical prostatectomy (RPP). The pre- and post- operative serum concentrations of Interleukin-6 (IL-6) and cortisol as well as changes of T-cell subgroups in the three groups were analyzed , respectively. Results Serum IL-6 concentrations remarkably increased at the third postoperative hour in patients of all the three groups, but those in Group Ⅱ and Group Ⅲ were significantly higher than those in Group Ⅰ( P 0 05). The ratio of CD 4 +/CD 8 + decreased markedly on the second postoperative day in Group Ⅱ and Group Ⅲ ( P

Background and purpose: Urothelial cancer is the most common malignant neoplasm in the urinary system. Urine cytology is the standard morality to diagnose urothelial cancer. Although cytology has been shown to have a high specificity, the sensitivity is unacceptably low. The count of copies of chromosomes in interphase cells by fluorescence in situ hybridization (FISH) assays has been successfully used as a screening tool in genetic and cancer studies. In this study, we investigated the value of FISH assay for diagnosis of urothelial cancer. Methods:Voided urine samples from 100 patients with haematuria were analyzed by FISH and cytology; labeled probes for chromosomes 3, 7, 9 and 17 were used to assess chromosomal abnormalities. The gold standard was pathology diagnosis. The overall sensitivity and specificity of FISH were evaluated and compared with cytology. Results: The sensitivity of FISH and cytology in detection urothelial cancer were 74.7% and 46.0% respectively; the specificity was 92.3% and 100% respectively (different not significant). There was a significant difference between the sensitivity of FISH and cytology in detection. Conclusion. The FISH assay has a higher sensitivity than cytology and a similar specificity in the detection of urothelial cancer, and could be used as a new method for diagnosis of urothelial cancer.

Objective:To systematically review the efficacy and safety of acid-suppressive therapy including proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) and compare with those of placebo or blank control in the postoperative patients with stress ulcer bleeding (SUB) to provide evidence-based reference for clinical practice.Methods:The Cochrane library,Medline,Embase,CBM,CNKI,VIP,Wan Fang Data,clinicaltrials.gov,ISRCTN Register and WHO ICTRP were searched.Only randomized controlled trials (RCTs) of acid-suppressive therapy compared with placebo or blank control for postoperative stress ulcer bleeding were selected with bleeding rate,mortality,adverse drug reactions,gastric juice pH and length of stay as the indices.After the quality evaluation and data extraction,Meta-analysis was performed by using Stata12.0 statistics software.The results were expressed as relative risk(RR) and its corresponding 95% confidence interval(CI).Funnel plot and Eggers test were used to determine the publication bias;and then Grade approach was applied to assess the confidence in the evidence for each outcome.Results:Totally 15 trials enrolling 971 patients were selected,and acid-suppressive therapy was more effective than placebo or blank control in reducing the risk of stress ulcer bleeding,overt upper gastrointestinal bleeding and clinical important bleeding(RR 0.29,95% CI:0.19-0.45;RR 0.25,95%CI:0.10-0.64;RR 0.36,95%CI:0.17-0.77)(moderate),however,there was no statistical significance in the incidence of occult bleeding,mortality and adverse drug reactions (RR 0.79,95%CI:0.41-1.50;RR 0.49,95%CI:0.17-1.38;RR 0.78,95%CI:0.33-1.85,very low confidence).The subgroup analysis of drug classification,operation types and administration juncture showed that the incidence of SUB using PPI (RR=0.27) was lower than that using H2RA (RR=0.33);that of heart surgery (RR=0.20) was lower than that of general surgery (RR=0.31) and neurosurgery(RR=0.37);that of postoperative administration (RR=0.26) was lower than that of preoperative administration (RR=0.23).Conclusion:Acid-suppressive drugs seem to be more effective than placebo or blank control in reducing the risk of bleeding without significant increase of the risk of mortality or adverse drug reactions.The robustness of the conclusion is limited because of the low quality of the trial methodology,incomplete outcome indicators and lack of safety indices for pneumonia and clostridium diffcile-associated infection.Trials with high-quality and larger sample size are still needed to verify its clinical effects.

Objective: To assess the clinical efficacy of Xuebijing injection in the prevention of postoperative systemic inflammatory response syndrome (SIRS) in the patients with ureteral stones and urinary tract infection during the perioperative period of ureteroscopy.Methods: Totally 64 cases with ureteral stones complicated with urinary tract infection treated with ureteroscopy were selected as the subjects and divided into two groups according to the digital method.The 32 cases in the control group were given the conventional antibiotics during the perioperative period for preventing the incidence of SIRS, and the observation group was given 500ml Xuebijing added to 100ml normal saline for intravenous drip additionally.The incidence of SIRS and the laboratory indicators after the operation were observed and compared between the groups.Results: The incidence of postoperative SIRS of the observation group was 9.38% , which was lower than that of the control group (34.38% , P <0.05);the incidence of sepsis of the observation group was 0%, while there was no statisticcally difference bettween the two groups(P＞0.05).The C-reactive protein (CRP), procalcitonin (PCT), leucocyte count and endotoxin in the observation group on the 2nd, 4th and 6th day after the operation were better than those in the control group, and the difference was statistically significant (P＜0.05).Conclusion: Xuebijing injection combined with antibiotics has significant clinical effect on the incidence of SIRS after ureteroscopy in the patients with ureteral stones and urinary tract infection, which can effectively improve the clinical indicators and reduce the incidence of sepsis, and is worthy of clinical promoted application.

Objective To investigate the different biochemical testing system inter laboratory comparability of results,provide reference for promoting inter laboratory test results of the recognition.Methods Five patients with laboratory detection of fresh mixed serum,20 consecutive determination of 10 biochemical items,precision analysis.According to America clinical and Laboratory Standards Institute (CLSI)Document EP9-A2,the Panzhihua Iron and Steel Group General Hospital detec-tion system as the reference system,the remaining four hospital detection system as the detection system,with a fresh mixed serum,determination of five biochemical items (Urea,Cr),(AST,ALT),(TP,ALB),(TG,TC)and (HDL-C,LDL-C),the determination results were compared and analyzed,calculated reference system and the correlation coefficient,linear regres-sion equation between the system and the various medical decision level relative deviation (SE%),and to America Clinical Laboratory Improvement Amendment ability test (CLIA’88)allowed total error of 1/2 as the standard,to the assessment system and the reference system between the comparability and clinical acceptability.Results In Urea,Cr determination for example,CV of five laboratories on Urea and Cr two project was less than CLIA’88 allowed total error of 1/3,the precision could meet the clinical requirements.The detection results significantly correlated (r2 >0.975).The evaluation of clinical ac-ceptability,in Urea low at medical decision level,there were two laboratory determination results that could not be accepted for clinical.In Urea high at medical decision level,there was a laboratory measurement result that could not be accepted for clinical.In the low Cr at medical decision level,there were two laboratory determination results that could not be accepted for clinical.The rest of the system Urea,Cr projects in various medical decision level compared with the system,the SE% was less than CLIA’88 allowed total error of 1/2,for clinical acceptable.Conclusion Laboratory determination results between different biochemical testing system had bias in different degrees,bias part of the project exceeds the allowed error range.

OBJECTIVETo evaluate the therapeutic efficacy and adverse reaction of Aidi Injection (ADI) combined with FOLFOX4 regimen for treatment of patients with advanced colorectal cancer, and controlled with those of FOLFOX4 regimen alone.

METHODSOne hundred and seventeen patients were randomized into two groups. All received FOLFOX4 regimen, i.e. Oxaliplatin 85 mg/m2 intravenous dripping in 2 h on day 1, leucovorin CF 200 mg/m2 intravenous dripping and 5-FU 400 mg/m2 intravenous injection followed with 600 mg/m2 continuous infusion by micro-pump in 22 h on day 1 and 2, 14 days as one cycle. Besides, to the treatment group (65 patients), ADI was administered additionally by adding 60 mL ADI in 250 mL 5% glucose for intravenous dripping every day for 10 successive days, while to the control group (52 patients), no additional medication was given.

RESULTSThe response rate in the treatment group was 44.62%, and in the control group 30.77% (P = 0.126), the KPS score improving rate in the two groups was 66.15% and 40.38% respectively (P = 0.005), the 1-year survival rate was 53.85% and 40.38% respectively (P = 0.148), and the adverse reaction presented in the treatment group was greatly less than that in the control group (P < 0.05).

CONCLUSIONADI in combining with FOLFOX4 regimen can enhance the efficacy, reduce the adverse reaction of chemotherapy in treating advanced colorectal cancer, and could also improve the quality of life and prolong the survival time of patients.

Adenocarcinoma ; drug therapy ; Adult ; Aged ; Antineoplastic Agents, Phytogenic ; administration & dosage ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; Humans ; Infusions, Intravenous ; Leucovorin ; administration & dosage ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Phytotherapy ; Survival Analysis ; Treatment Outcome

PURPOSE: This study is intended to investigate the effects of plants or plant-derived antioxidants on prevention of osteoporosis through the maintenance of reactive oxygen species (ROS) at a favorable level. MATERIALS AND METHODS: In this study, a novel antioxidant, namely 3,4,5-Trihydroxy-N-[4-(5-hydroxy-6-methoxy-pyrimidin-4-ylsulfamoyl)-phenyl]-benzamide (ZXHA-TC) was synthesized from gallic acid and sulfadimoxine. Its effect on osteoblast metabolism was investigated via the detection of cell proliferation, cell viability, production of ROS, and expression of osteogenic-specific genes including runt-related transcription factor 2 (RUNX2), bone sialoprotein (BSP), osteocalcin (OCN), alpha-1 type I collagen (COL1A1), and osteogenic-related proteins after treatment for 2, 4, and 6 days respectively. RESULTS: The results showed that ZXHA-TC has a stimulating effect on the proliferation and osteogenic differentiation of primary osteoblasts by promoting cell proliferation, cell viability, and the expression of genes BSP and OCN. Productions of bone matrix and mineralization were also increased by ZXHA-TC treatment as a result of up-regulation of COL1A1 and alkaline phosphatase (ALP) at the early stage and down-regulation of both genes subsequently. A range of 6.25x10(-3) microg/mL to 6.25x10(-1) microg/mL is the recommended dose for ZXHA-TC, within which 6.25x10(-2) microg/mL showed the best performance. CONCLUSION: This study may hold promise for the development of a novel agent for the treatment of osteoporosis.
Alkaline Phosphatase/metabolism ; Bone Morphogenetic Proteins/pharmacology ; Cell Differentiation/*drug effects ; Cell Proliferation/*drug effects ; Collagen Type I/genetics ; Core Binding Factor Alpha 1 Subunit ; Down-Regulation ; Gallic Acid ; Osteoblasts/*drug effects ; Osteocalcin/metabolism ; Osteogenesis/drug effects ; Osteoporosis/*prevention & control ; Reactive Oxygen Species ; Up-Regulation

Objective To observe the effect of Renshen(ginseng)-Yuzhu(fragrant solomonseal rhizome)on inflammatory factors and inflammasomes in depression rats,and to explore the antidepressant mechanism of Renshen-Yuzhu.Methods Fifty male SD rats were divided into the blank group,model group,fluoxetine group(2.1 mg/kg),Renshen-Yuzhu low-dose group(1.89 g/kg),and Renshen-Yuzhu high-dose group(5.67 g/kg),with ten rats in each group.Except for the blank group,the rats in the other groups were treated with chronic unpredictable mild stress to establish a depression rat model.On the second day after the end of modeling,the rats in each group were given the corresponding drugs once daily for 14 days.After modeling and dosing,body weight,forced swimming immobility time,and sucrose preference rate were measured.After dosing,hematoxylin-eosin staining was used to detect neuronal damage in the cerebral cortex,enzyme-linked immunosorbent assay was used to detect the contents of interleukin-4(IL-4),interleukin-23(IL-23),and interleukin-27(IL-27)in cortex,real-time PCR was used to detect the mRNA expression of interleukin-24(IL-24)in cortex,and the protein expressions of nucleotide-binding oligomerization domain-like receptor protein 1(NLRP1),absent in melanoma 2(AIM2),and nucleotide-binding oligomerization domain-like receptor protein 4(NLRC4)were detected by Western blotting.Results After dosing,compared with the blank group,the body weight of the model group decreased,the sucrose preference rate decreased,the swimming immobility time was prolonged,the neuronal tissue in cortex was destroyed,the content of IL-4 in cortex decreased,the contents of IL-23 and IL-27 in cortex increased,and the protein expressions of NLRP1,AIM2 and NLRC4 in cortex increased(P＜0.01).Compared with the model group,the body weight of rats in each administration group increased,the sucrose preference rate increased,the swimming immobility time was shortened,the damage of neuronal tissues in cortex improved,the content of IL-4 in cortex increased,the contents of IL-23 and IL-27 in cortex decreased,and the protein expressions of NLRP 1,AIM2 and NLRC4 in cortex decreased(P＜0.05).Conclusion Renshen-Yuzhu couplet medicines can improve the depressive-like behavior and exert antidepressant effect in chronic stress rats,and its mechanism may be related to the inhibition of NLRP 1,NLRC4,AIM2 inflammasome activation and its mediated inflammatory response in cortex,reducing pro-inflammatory cytokines,and increasing the level of antiinflammatory cytokines.

Objective:To understand the current status of the use of aspirin in perioperative period of thoracic surgery in China and the awareness of thoracic surgeons on the prevention and treatment of arterial thromboembolic diseases during the perioperative period.Methods:A survey was conducted among thoracic surgeons nationwide using an electronic questionnaire through a software platform from January 20, 2024 to February 29, 2024. The questionnaire mainly included three parts: basic information, aspirin use, and awareness of arterial thromboembolic diseases, with a total of 27 questions.Results:A total of 1318 valid questionnaires were collected, covering all 33 provincial administrative regions except Taiwan. 69.7%(919/1 318) of thoracic surgeons stopped using aspirin for all patients before surgery; differences could be found in the timing of aspirin withdrawal before surgery and resumption after surgery. 65.1%(858/1 318) of surgeons made perioperative medication decisions based on domestic guidelines or consensus, while 20.9%(276/1 318) of surgeons based their decisions on departmental or personal experience. 87.9%(1 159/1 318) of surgeons believed that it is necessary to develop guidelines for the prevention of arterial thromboembolic diseases in the perioperative period of thoracic surgery.Conclusion:The current use strategy of aspirin in the perioperative period of thoracic surgery in China shows a high degree of inconsistency, and there are also significant differences in the awareness of arterial thromboembolic diseases. It is necessary to establish guidelines for the prevention and treatment of arterial thromboembolic diseases in the perioperative period.

Objective:To develop a risk prediction model for identifying bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH) in very premature infants.Methods:This was a retrospective cohort study. The clinical data of 626 very premature infants whose gestational age <32 weeks and who suffered from BPD were collected from October 1 st, 2015 to December 31 st, 2021 of the Seventh Medical Center of the People′s Liberation Army General Hospital as a modeling set. The clinical data of 229 very premature infants with BPD of Hunan Children′s Hospital from January 1 st, 2020 to December 31 st, 2021 were collected as a validation set for external verification. The very premature infants with BPD were divided into PH group and non PH group based on the echocardiogram after 36 weeks′ corrected age in the modeling set and validation set, respectively. Univariate analysis was used to compare the basic clinical characteristics between groups, and collinearity exclusion was carried out between variables. The risk factors of BPD associated PH were further screened out by multivariate Logistic regression, and the risk assessment model was established based on these variables. The receiver operating characteristic (ROC) area under curve (AUC) and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the model′s discrimination and calibration power, respectively. And the calibration curve was used to evaluate the accuracy of the model and draw the nomogram. The bootstrap repeated sampling method was used for internal verification. Finally, decision curve analysis (DCA) to evaluate the clinical practicability of the model was used. Results:A total of 626 very premature infants with BPD were included for modeling set, including 85 very premature infants in the PH group and 541 very premature infants in the non PH group. A total of 229 very premature infants with BPD were included for validation set, including 24 very premature infants in the PH group and 205 very premature infants in the non PH group. Univariate analysis of the modeling set found that 22 variables, such as artificial conception, fetal distress, gestational age, birth weight, small for gestational age, 1 minute Apgar score ≤7, antenatal corticosteroids, placental abruption, oligohydramnios, multiple pulmonary surfactant, neonatal respiratory distress syndrome (NRDS)>stage Ⅱ, early pulmonary hypertension, moderate-severe BPD, and hemodynamically significant patent ductus arteriosus (hsPDA) all had statistically significant influence between the PH group and the non PH group (all P<0.05). Antenatal corticosteroids, fetal distress, NRDS >stage Ⅱ, hsPDA, pneumonia and days of invasive mechanical ventilation were identified as predictive variables and finally included to establish the Logistic regression model. The AUC of this model was 0.86 (95% CI 0.82-0.90), the cut-off value was 0.17, the sensitivity was 0.77, and the specificity was 0.84. Hosmer-Lemeshow goodness-of-fit test showed that P>0.05. The AUC for external validation was 0.88, and the Hosmer-Lemeshow goodness-of-fit test suggested P>0.05. Conclusions:A high sensitivity and specificity risk prediction model of PBD associated PH in very premature infants was established. This predictive model is useful for early clinical identification of infants at high risk of BPD associated PH.