Search Results

Objective To detect the expression of peripheral blood free prostate specific antigen (fSPA),total prostate specific antigen (tSPA),prostate specific antigen density (PSAD) and prostate cancer gene 3 (PCA3) in prostate disease,and the significance of combined detection of fSPA,tSPA and PCA3.Methods 67 patients with prostate cancer,75 patients with prostatic hyperplasia and 70 healthy male were selected as the research objects from Dec.2014 to Jul.2016.The serum level of fSPA and tSPA was detected by chemiluminescence immune staining method.The prostate volume was tested by ultrasonic sound and PSAD value was calculated.The total RNA was extracted by Trizol,and the serum PCA3 mRNA expression was detected by RT-PCR.The specificity and sensitivity of combined detection of fSPA,tSPA and PCA3 were analyzed.Results The serum levels of fSPA,tSPA,PSAD and PCA3 in prostate cancer were significantly higher than those in patients with prostatic hyperplasia and healthy male,and they were higher in patients with hyperplasia of prostate than in healthy male,and the differences had statistical significance (P＜0.01).The serum levels of fSPA,tSPA,PSAD and PCA3 were higher in patients with Gleason score ≥7 points and in T3-T4 stage than in patients with Gleason score ＜7 and in T1-T2 stage,and the difference had statistical significance (P＜0.01).The serum levels of fSPA,tSPA,PSAD and PCA3 were positively correlated with Gleason score and TMN pathological stage,and the difference had statistical significance (P＜0.01).The AUC value of fSPA,tSPA,PSAD and PCA3 in diagnosis of prostate cancer was 0.53,0.57,0.63 and 0.75,and the AUC value of combined detection was 0.92.The combined detection efficiency was higher than the single index.The specificity of fSPA,tSPA,PSAD and PCA3 was 67.16％,68.66％,73.13％ and 85.07％,and the sensitivity was 71.64％,70.15％,74.63％ and 82.09％ respectively.The specificity of combined detection was 97.01％,the sensitivity was 92.54％,and the difference had statistical significance (P＜0.01).Conclusion The serum level of fSPA,tSPA,PSAD and PCA3 is increased in prostate disease,and is negatively correlated with Gleason score and TMN pathological stage.The combined detection of fSPA,tSPA,PSAD and PCA3 can improve the sensitivity and specificity of prostate disease diagnosis,and is of high clinical value.

9.Combined use of posterior unilateral open-door laminoplasty and leverage fixation for treatment of multi-segmental cervical spondylotic myelopathy

Weitao ZHONG ; Zhengda KUANG ; Qibin YE ; Guanjun WANG ; Dawei GUAN

Military Medical Sciences 2016;40(7):579-582

Objective To evaluate the clinical efficiency of posterior unilateral open-door laminoplasty and leverage titanium plate internal fixation in the treatment of cervical spondylotic myelopathy ( CSM ) with multi-segmental spinal stenosis.Methods Between Mar 2011 and May 2015, 25 patients with multi-segmental CSM with multi-segmental spinal stenosis were treated by posterior unilateral open-door laminoplasty and leverage fixation .There were 16 males and 9 females, whose mean age was 60.6 ±9.9 years during the surgery.The change of clinical symptoms and signs was recorded during follow-up,and they all received X-ray and MRI.In all the patients, the preoperative and postoperative neurological function, the cervical curvature,cervical vertebra tube volume and axial symptoms were measured , recorded and analyzed. There was statistically significant difference (P<0.05) in the mean Japanese Orthopaedic Association (JOA) score, and Visual Analogue Scale ( VAS) .Results All the 25 patients were followed up for more than 6 months ( 6-24 months ) .No symptoms of C5 nerve root were found in our series .According to the JOA score and VSA score ,the neurological functions of each patient were significantly improved .The preoperative JOA score was 10.16 ±1.35 and the improvement rate 61.24%. There was statistically significant difference between the preoperative VSA score and the postoperative one (6.68 ±1.12 vs 2.32 ±0.84) ( P<0.05).The preoperative and postoperative meansurement of the spinal vertebrai canal diameter was (9.22 ±2.01) and (15.64 ±2.08) mm, respectively,so there was statistically significant difference (P <0.05), indicating that the cavical spinal canal was increased after operation .Conclusion Leverage titanium plate internal fixation can effectively help maintain the expanded vertebral canal after unilateral open -door laminoplasty ,reduce the incidence of postoperative axial symptoms , and maintain the cervical physical curvature .