OBJECTIVETo develop a nomogram for predicting the probability of prostate cancer at transrectal ultrasound-guided repeat prostate biopsy in Chinese men.

METHODSWe performed repeat biopsy for 170 patients with benign prostate diseases diagnosed on the first biopsy, and analyzed the correlation of positive repeat biopsy with age, prostate volume, PSA, free-to-total PSA (f-PSA/t-PSA), PSA velocity, PSA density, results of digital rectal examination (DRE) and previous histology. We entered the variables stepwise into logistic regression models, and established a nomogram for the risk score on the probability of positive repeat biopsy, whose predictive value was assessed by receiver operating characteristic (ROC) analysis.

RESULTSProstate cancer was detected in 31.8% of the repeat biopsies (54/170). The most accurate predictive nomogram comprised age, PSA, f-PSA/t-PSA, PSA velocity, prostate volume, DRE and previous prostatic intraepithelial neoplasia (PIN) findings. The nomogram exhibited a high predictive value, with the area under the ROC curve (AUC) of 82.4%, significantly greater than that of the prediction based on PSA density (AUC: 66.9%), prostate volume (AUC: 72.6%), PSA velocity (AUC: 69.6%), f-PSA/t-PSA (AUC: 69.3%), or DRE (AUC: 58.5% ) alone.

CONCLUSIONThe nomogram is an accurate multi-variable predicting tool to determine the probability of positive repeat prostate biopsy.

Aged ; Aged, 80 and over ; Area Under Curve ; Asian Continental Ancestry Group ; Biopsy, Needle ; methods ; Humans ; Logistic Models ; Male ; Middle Aged ; Nomograms ; Predictive Value of Tests ; Prostate ; pathology ; Prostatic Diseases ; pathology ; Prostatic Neoplasms ; diagnosis ; diagnostic imaging ; ROC Curve ; Ultrasonography

OBJECTIVETo evaluate transrectal ultrasound-guided systematic 12-core biopsy of the prostate for the detection and characterization of prostate cancer in different age and prostate specific antigen (PSA) groups.

METHODSTotally 210 patients were divided into four age groups (< or = 59 yr, 60-69 yr, 70-79 yr, and > or = 80 yr) and five PSA groups (0-4 microg/L, 4.1-10 microg/L, 10.1 -20 microg/L, 20.1-50 microg/L, and > 50 microg/L), and underwent transrectal ultrasound-guided systematic 12-core biopsy of the prostate at various sites for detecting prostate cancer. Clinical data and the results of various biopsy schemes were analyzed and compared.

RESULTSNinety-one cases of prostate cancer were detected among the 210 patients, with a total detection rate of 43.3%, and the percentage was higher with the increase of age and PSA level. Larger and higher-grade tumors were associated with older age and higher PSA level, and higher detection rates were related to laterally directed and apical biopsies. The 12-core biopsy outperformed other biopsy schemes in detecting prostate cancer in patients under 60 years of age and with PSA < 20 microg/L.

CONCLUSIONThe 12-core biopsy scheme can make up for the inadequacy of sextant biopsy in detecting prostate cancer, and less influenced by the age and PSA level of the patients. Generally larger and higher-grade tumors are associated with older age and higher PSA level.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostate-Specific Antigen ; metabolism ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo investigate the role of contrast-enhanced ultrasound in the differential diagnosis of high- and low-grade urothelial carcinoma.

METHODSThe radiological data of 96 patients with urothelial carcinomas who had undergone gray-scale contrast-enhanced ultrasound from August 2010 to April 2011 were analyzed retrospectively. Pathological examination demonstrated that the tumors were high-grade in 55 cases (high-grade group) and low-grade in 41 cases (low-grade group). The dynamic images were analyzed by time-intensity curve, and the arrival time (AT), peak intensity (PI), time to peak (TTP), and washout time (WT) were measured. The enhancement patterns of different urothelial carcinomas were analyzed.

RESULTSBoth PI (P=0.005) and WT (P=0.002) were significantly higher in high-grade group than in low-grade group, whereas AT (P=0.374) and TTP (P=0.386) showed no significant difference between these two groups. In the high-grade group, 47 cases (85.5%) were identified as fast wash-in and slow wash-out; in the low-grade group, 35 (85.4%) were identified as fast wash-in and fast wash-out. When the enhancement pattern was used as a diagnostic indicator for differentiating urothelial carcinomas, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 85.5%, 90.2%, 87.5%, 92.2%, and 82.2% for high-grade tumor and 85.4%, 90.9%, 88.5%, 87.5%, and 89.3% for low-grade tumor.

CONCLUSIONSDifferent grade urothelial carcinomas show different enhancement finding on contrast-enhanced ultrasound. The enhancement pattern can serve as an important diagnostic indicator.

Aged ; Aged, 80 and over ; Carcinoma ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography ; Urologic Neoplasms ; diagnostic imaging

This paper was aimed to study the effect of genistein (GST) on L-type calcium current (I(Ca,L)) in isolated guinea pig ventricular myocytes using whole cell patch-clamp recording technique. The results are as follows. (1) GST (10, 50, 100 micromol/L) reduced the voltage-activated peak amplitude of I(Ca,L) in a concentration-dependent manner. Daidzein (100 micromol/L), a structural analogue of GST which has little or no inhibitory effect on tyrosine kinase, produced no effect over the same concentration range on I(Ca,L) (n=5, P>0.05). (2) GST up- shifted the current-voltage (I-V) curve, but the characteristics of I-V relationship were not significantly altered, and the maximal activation voltage of I(Ca,L) was not different from that of control. GST did not affect the activation kinetics of I(Ca,L). (3) GST markedly shifted the steady-state inactivation curve of I(Ca,L) to the left, and accelerated the voltage-dependent steady-state inactivation of I(Ca,L). V(0.5) value was -28.6 +/-0.6 mV in the control and -32.8 +/-1.1 mV in the presence of GST. The kappa values were 5.8 +/-0.5 mV and 6.5 +/-0.9 mV, respectively (n=6, P<0.05). (4) GST markedly shifted the curve of time-dependent recovery of I(Ca,L) from the steady-state inactivation to the right, and slowed down the recovery of I(Ca,L) from inactivation (n=7, P<0.01). (5) Sodium orthovanadate (1 mmol/L), a potent inhibitor of tyrosine phosphatase, significantly inhibited GST-induced inhibition (n=6, P<0.01). From the results obtained it is concluded that genistein inhibits I(Ca,L) and acts on the inactivated state of L-type calcium channel. This inhibitory effect of GST involves protein tyrosine kinase inhibition in guinea pig ventricular myocytes.
Animals ; Calcium Channel Blockers ; pharmacology ; Calcium Channels, L-Type ; drug effects ; Genistein ; pharmacology ; Guinea Pigs ; Heart Ventricles ; cytology ; Male ; Myocytes, Cardiac ; cytology ; drug effects ; Patch-Clamp Techniques ; Protein-Tyrosine Kinases ; antagonists & inhibitors

OBJECTIVETo develop a predictive nomogram for predicting the prostate carcinoma among Chinese population.

METHODSTotally 556 Chinese male patients who had undergone an initial prostate biopsy in our hospital from July 2004 to February 2009 were enrolled in this study. Variables including age, volume, prostate specific antigen (PSA) level, and free PSA (f-PSA)/total PSA (t-PSA) were collected. Logistic regression analysis was performed to estimate the relative risk. Regression equation was established for variables via stepwise regression, via which a nomogram for assessing the positive biopsy results was established, and then the predictive value of this nomogram was evaluated using receiver area under curve (ROC) analysis.

RESULTSOf these 556 patients, cancer was detected in 205 patients (36.87%) via biopsies. Univariate analysis showed that age, prostate volume, PSA levels, and f-PSA/t-PSA were the influencing factors of the nomogram. The risk model performed well in an independent sample, with an AUC(ROC) of 0.8767, which was significantly larger than that of the prediction based on age (AUC(ROC) : 0.6397), prostate volume (AUC(ROC) : 0.7255), PSA (AUC(ROC) : 0.7111), or f-PSA/t-PSA (AUC(ROC) : 0.6973) alone.

CONCLUSIONA preliminary nomogram with high predictive value for Chinese population was successfully established.

Aged ; Aged, 80 and over ; Area Under Curve ; Asian Continental Ancestry Group ; Biopsy, Needle ; Humans ; Male ; Middle Aged ; Nomograms ; Prostate ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology ; ROC Curve

Objective To evaluate the application of “OmniView”, a new three-dimensional ultrasound technology, in displaying the fetal palate. Methods The three-dimensional volume data was acquired from 100 normal fetuses, analysed by OmniView technology with the facial midsagittal plane as the starting plane. The imaging of fetal palate was obtained in axial plane (through maxilla, oral cleft), coronal plane, oblique coronal plane (through piriform aperture, oral cleft, submental triangle), and the palate′s curved plane tiled imaging by drawing the anatomical lines on referenced sagittal plane (facial midsagittal plane). The volumes of ifve fetuses with cleft lip and palate were obtained and analysed by the same technology. Results The volume dataset of 91 (91.0%, 91/100) normal fetuses were acquired successfully, and analyzed by OmniView technology, the results of 91 normal fetal palate in different plane were: (1) In axial plane through maxilla, the visualization of alveolar process bow was 91 (100%, 91/91). It was shown as“C”shaped arcuate structure, the anechoic structure of alveolar socket could be seen on the bow, and the ifrst 6 alveolar sockets were displayed clearly. The visualization number of hard palate was 91 (100%, 91/91), it was shown as hyperechoic lfake between two sides of alveolar bones. In axial plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91), it was shown as a strip of soft tissue echo band. (2) In coronal plane, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a strip of hyperechoic band and separated the oral and nasal cavity. (3) In oblique coronal plane through piriform aperture, the visualization number of hard palate was 91 (100%, 91/91), it was shown as a short strip of hyperechoic band. In oblique coronal plane through oral cleft, the visualization number of hard palate was 91 (100%, 91/91). In oblique coronal plane through submental triangle, the visualization number of hard palate was 91 (100%, 91/91). In the above two planes, the hard palate was shown as a strip of hyperechoic band, due to acoustic shadow behind the hard palate, the nasal cavity and nasal septum above the hard palate couldn’t be displayed. (4) In oblique coronal plane through piriform aperture, the visualization number of soft palate was 81 (89.0%, 81/91). The visualization number of uvula was 25 (27.5%, 25/91). The soft palate was shown as a lfake of soft tissue echo behind the hard palate, and the uvula was shown as papillary protrusions on the edge of the soft palate in the midline. In oblique coronal plane through oral cleft, the visualization number of soft palate was 81 (89.0%, 81/91). In oblique coronal plane through submental triangle, the visualization number of soft palate was 81 (89.0%, 81/91). In the above two planes, the soft palate was shown as a strip of soft tissue echo band, the soft tissue echo of fetal tongue was in the lower front of soft palate, and the anechoic region of nasopharynx was superior behind the soft palate. (5) In the curved plane tiled imaging of palate, the visualization number of alveolar process bow (primary palate) was 91 (100%, 91/91). The visualization number of hard palate was 91 (100%, 91/91). The visualization number of soft palate was 81 (89.0%, 81/91). the visualization number of uvula was 25 (27.5%, 25/91), the planar panorama of alveolar process bow, hard palate and soft palate could be visualized intuitively, the alveolar arch and hard palate were shown as bone-like hyperecho, and the soft palate was shown as soft tissue hypoecho. In iffteen cases′volume involved cleft lip and palate, all five cases of malformations were detected through three-dimensional data analysis, the position and range of the cleft palate could also be conifrm. Abnormal fetuses were all veriifed after induction of labor. Conclusions By three-dimensional ultrasound technology-“OmniView”, the axial and coronal plane of fetal palate could be obtained easily which was dififcult by two-dimensional ultrasound, and the special oblique coronal plane of secondary palate could be displayed easily. The panorama of the palate could be visualized intuitively though curved plane tiled imaging by drawing a line tracking the structure of the palate. This technology could simplify the ultrasound examination procedure of the fetal palate, reduce the operators′skill-dependence, and quickly evaluated the integrity of the fetal primary palate and secondary palate. For the cleft lip fetus, this technology can determine whether the cleft palate exist or not, together with their position and range.

The effect of limb ischemic preconditioning (LIP) on ischemia-reperfused myocardium was examined in the urethane-anesthetized rats to determine whether LIP produces cardioprotection and to observe the roles of adenosine and neural reflex in this effect. The area at risk (AR) and infarct area (IA) were determined using Evans blue and nitro-blue tetrazolium staining respectively. Infarct size (IS) was defined as 100xIA/AR (%). The results obtained are as follows: (1) During 30 min myocardial ischemia and subsequent 120 min reperfusion, the myocardial infarct size occupied 51.48+/-0.82% of the area at risk. (2) LIP significantly reduced the myocardial infarct size to 35.14+/-0.88% (p<0.01 ), indicating the cardioprotective effect of such an intervention. (3) Femoral nerve section (FNS) completely abolished the cardioprotection afforded by LIP. (4) Intrafemoral artery injection of adenosine (10 nmol/kg) produced a similar effect to that of LIP, reducing the myocardial infarct size to 37.28+/-1.68%, while intrafemoral vein injection of the same dose of adenosine showed no effect. (5) Pretreatment with a selective adenosine A(1) receptor antagonist 8-cyclopentyl-1,diproylxanthine (DPCPX ) (32 nmol/kg) partially abolished the cardioprotection of LIP on myocardium. Taken together, it is concluded that LIP reduces infarct size following myocardial ischemia-reperfusion, and that the locally released adenosine and thereby the activated relevant neural pathway play an important role in the cardioprotection provided by LIP.
Adenosine ; metabolism ; Animals ; Extremities ; blood supply ; Ischemic Preconditioning ; Male ; Myocardial Infarction ; pathology ; prevention & control ; Myocardial Reperfusion Injury ; pathology ; prevention & control ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the role of transrectal real-time tissue elastography (TRTE) in the diagnosis of prostate cancer (PCa).

METHODSEighty-four patients with suspected PCa and scheduled for prostate biopsies underwent TRTE, digital rectal examination (DRE), transrectal ultrasonography (TRUS), and magnetic resonance imaging (MRI). The findings of TRTE were compared with those of other examinations and pathological findings.

RESULTSOf these 84 patients, 36 had benign lesions and 48 had PCa. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 91.7%, 72.2%, 83.3%, 81.5%, and 86.7% for TRTE and 85.4%ì63.9%ì76.2%, 75.9%, and 76.7% for TRUS (P>0.05), while its specificity (72.2%) was significantly higher than that of MRI (44.4%) (P=0.03). The TRTE findings were not significantly correlated with the pathological findings and serum total prostate specific antigen (P>0.05), and the diagnostic sensitivity of TRTE decreased along with the enlargement of prostate. However, the diagnostic specificity of TRTE was higher than MRI for nodules with soft to medium texture (P=0.04).For PCa, the diagnostic sensitivity of TRTE increased when the Gleanson scores of tumors increased (P<0.05).

CONCLUSIONTRTE can be used as a diagnostic test to supplement clinical diagnosis of PCa.

Adult ; Aged ; Aged, 80 and over ; Elasticity Imaging Techniques ; methods ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Neoplasms ; diagnostic imaging ; Rectum ; diagnostic imaging ; Sensitivity and Specificity

OBJECTIVESTo establish the testicular fibrosis model in rats.

METHODSWistar rats were divided into control group(n = 12) and model group(n = 40) randomly. Testicular fibrosis model was built with the classical method of establishing experimental autoimmune orchitis (EAO) combined with injecting Bacille Calmette-Guerin (BCG) into left testis.

RESULTSThe incidence rate of EAO and the rate of testicular fibrosis were 100%, 11.1% and 100%, 81.5% at 80, 140 days after the first infection, respectively.

CONCLUSIONSThe model of rat testicular fibrosis was established successfully.

Animals ; Autoimmune Diseases ; pathology ; Disease Models, Animal ; Fibrosis ; Male ; Mycobacterium bovis ; Orchitis ; pathology ; Rats ; Rats, Wistar ; Testis ; pathology

OBJECTIVETo investigate the value of strain index (SI) by transrectal real-time tissue elastography (TRTE) for differentiation of the prostate peripheral zone lesions.

METHODSTotally 83 patients with suspected prostate cancer underwent the quantitative analysis by TRTE examination. The SI of total lesions (ASI) and peak elasticity in lesion (PSI) were calculated, and the pathologic findings were compared. Then the values of ASI and PSI in the differential diagnosis of prostate lesions were assessed. The influence of Gleanson scores on SI was evaluated.

RESULTSThe area under the Receiver Operating Characteristic curves (or ROC curves) of ASI and PSI were 0.62 (P=0.06) and 0.92 (P=0.00) respectively for the differential diagnosis of prostate peripheral lesions. When a cutoff point of 17.44 was used,PSI had a sensitivity of 74.5% and a specificity of 83.3%. Gleason scores showed no significant difference between PSIü 17.44 group and PSIþ17.44 group ( P>0.05).

CONCLUSIONPSI is helpful for the differential diagnosis of prostate peripheral zone lesions.

Aged ; Aged, 80 and over ; Diagnosis, Differential ; Elasticity Imaging Techniques ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Prostatic Neoplasms ; diagnostic imaging ; Sensitivity and Specificity