Objective To study role of color Doppler ultrasonography in predicting the benignity and malignancy of the peripheral hypoechoic lesion of the prostate.Methods Seventy-seven patients who had peripheral hypoechoic lesions were detected with transrectal color Doppler ultrasonography.The black and white color ratio (BCR) in peripheral hypoechoic was calculated by color histogram and compared with prostate BCR.The amount of flow signal was considered increasing if BCR in the lesions was higher than 5% in their prostate.Results Transrectal ultrasound-guilded biopsy of the hypoechoic lesions revealed prostate cancer in 51 patients and benign prostate hypertrophy in 26 patients.The increase of flow signal was in 50 patients,41 of them were prostate cancer.For an increased flow signal within a peripheral hypoechoic lesion as a signal of prostate cancer,color Doppler ultrasonography has a sensitivity of 80.4% ,a specificity of 65.4% ,and a positive predictive value of 82.0% .Conclusions Color Doppler ultrasonography through rectum on blood flow in peri-prostate hypoechoic nodules with BCR account for their rich degree in malignancy and benignity differentiation.

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy (oxaliplatin +capecitabine,XELOX) for the resectable locally advanced adenocarcinoma of esophageal-gastric junction (AEG).Methods The prospective study was conducted.The clinicopathological data of 106 locally advanced AEG patients who were admitted to the Cancer Hospital of Shantou University Medical College from January 2011 to December 2014 were collected.All the patients were divided into the treatment group and control group by single blind,randomized,controlled random number table.Patients underwent preoperative neoadjuvant chemotherapy (XELOX) + surgery + postoperative adjuvant chemotherapy (XELOX) in the treatment group and surgery + postoperative adjuvant chemotherapy (XELOX) in the control group.Total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy were applied to patients by the same team of doctors.Observation indicators:(1) treatment situations;(2) results of postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination was performed to detect the postoperative tumor recurrence or metastasis and patients' survival up to February 2017.Measurement data with normal distribution were represented as (-x)±s,and comparisons between groups were evaluated with the t test.Measurement data with skewed distribution were described as M (range) and analyzed by the nonparametric test.Comparisons of count data were analyzed using the chi-square test.The ordinal data were compared using the nonparametric test.Survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method and survivals were compared using the Long-rank method.Results One hundred and six patients were screened for eligibility,including 54 in the treatment group and 52 in the control group.(1) Treatment situations:① preoperative neoadjuvant chemotherapy:54 in the treatment group received 2-4 cycle neoadjuvant chemotherapy.During the chemotherapy,gastrointestinal reaction,grade 1-2 granulocytopenia,elevated alanine transaminase (ALT) and grade 3 granulocytopenia were detected in 21,17,8,1 patients,and 7 patients had no adverse reaction.The complete response(CR),partial response (PR),stable disease (SD) and progressive disease (PD) of neoadjuvant chemotherapy in the treatment group were detected in 4,27,20 and 3 patients,respectively.Of 54 patients in the treatment group,4,13,25 and 12 were in grade 0,1,2 and 3 of response to preoperative chemotherapy,respectively.② Surgical situations:preoperative carcinoembryonic antigen (CEA) in the treatment and control groups were respectively 4.71 μg/L (range,0.20-36.19 μg/L) and 14.09 μg/L (range,0.71-178.20 μg/L),with a statistically significant difference between groups (Z =-1.92,P＜ 0.05).All patients underwent total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy.Operation time in the treatment and control groups were respectively (210± 31) minutes and (195 ±26) minutes,with a statistically significant difference between groups (t =-2.45,P ＜ 0.05).Volume of intraoperative blood loss,cases with intraoperative blood transfusion,time to postoperative anal exsufflation,time to defecation,time for initial diet intake,cases with postoperative complications and duration of hospital stay were respectively (216± 172) mL,6,(4.3± 1.0) days,(4.5±0.8)days,(3.1±0.5)days,11,(15.0±5.0)days in the treatment group and (174±108)mL,4,(4.2± 1.0) days,(4.4± 0.8) days,(3.1 ± 0.5) days,15,(15.0± 5.0) days,with no statistically significant difference between groups (t=-1.01,x2 =0.36,t=-0.31,-0.88,-0.36,x2 =1.03,t=-0.38,P＞0.05).③Postoperative adjuvant chemotherapy:all the patients completed the postoperative adjuvant chemotherapy.The granulocytopenia,elevated ALT and gastrointestinal reaction occurred in 25,5,28 patients in the treatment group and 21,7,30 patients in the control group,respectively,with no statistically significant difference between groups (x2 =0.38,0.47,0.36,P＞0.05).Some of the patients were merged with multiple adverse reactions.(2) Results of postoperative pathological examination:maximum tumor dimension,cases with lymphovascular invasion,perineural invasion,T0,T2,T3,T4 (T stage),stage 0,Ⅰ,Ⅱ and Ⅲ1 (TNM stage) were respectively (3.6±1.4)cm,5,10,4,10,20,20,4,7,15,28 in the treatment group and (4.5±1.7)cm,24,30,0,2,13,37,0,1,12,39 in the control group,with statistically significant differences between groups (t=-2.88,x2 =18.14,17.30,Z=14.74,8.13,P＜0.05).(3) Follow-up and survival situations:of 54 patients in the treatment group,52 were followed up for 4-72 months,with a median time of 32 months;of 52 patients in the control group,49 were followed up for 5-71 months,with a median time of 36 months.The postoperative diseasefree survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 26 months (range,3-72 months),79.5％,64.7％,61.3％,27 months (range,5-72 months),88.3％,69.2％ and 62.1％ in the treatment group.Seventeen patients had tumor recurrence,including 2 with intraperitoneal local recurrence and 15 with distant metastasis.The postoperative disease-free survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 33 months (range,2-71 months),89.7％,55.4％,55.4％,33 months (range,5-71 months),91.8％,72.1％ and 59.7％ in the control group.Nineteen patients had tumor recurrence,including 8 with intraperitoneal local recurrence and 11 with distant metastasis.There was no statistically significant difference in disease-free survival and overall survival between groups (x2 =0.018,0.596,P＞0.05).There was a statistically significant difference in cases with local recurrence between groups (x2=4.41,P＜ 0.05) The tumor-free survival time and overall survival time in the treatment group were respectively 29 months (range,8-72 months),38 months (range,10-72 months) in 31 patients with CR and PR and 11 months (range,3-68 months),18 months (range,4-68 months) in 23 patients with SD and PD,showing statistically significant differences in tumor-free and overall survival times (x2=5.27,7.72,P＜0.05).Concluslon Neoadjuvant chemotherapy with oxaliplatin and capecitabine is safe and effective for patients with the resectable locally advanced AEG,it can also decrease tumor stage and reduce local recurrence,but fail to demonstrate a survival benefit.