OBJECTIVETo investigate the factors upgrading the International Society of Urological Pathology (ISUP) Gleason score using the specimens from preoperative prostatic biopsy and radical prostatectomy.

METHODSA total of 164 patients diagnosed with prostate cancer by biopsy underwent radical prostatectomy. We retrospectively analyzed their age, prostate volume, preoperative PSA level, PSA density (PSAD) , the time interval between biopsy and surgery, the number of positive punctures, positive surgical margin, seminal vesicle invasion, lymphatic invasion, and Gleason scores from biopsy and prostatectomy. We also determined the predictors of Gleason score upgrading by logistic regression analysis.

RESULTSOf the 164 cases analyzed, 95 (57.93% ) showed a consistency between the Gleason score of preoperative prostatic biopsy and that after radical prostatectomy, 55 (33.54% ) increased and 14 (8.52%) decreased after prostatectomy as compared with preoperative biopsy. The prostate volume (P < 0.01) and biopsy score (P < 0.05) were independent predictors of Gleason score upgrading. The risk of Gleason score upgrading was 27 times higher in the patients with the prostate volume ≤ 25 ml and 9 times higher in the 25-40 ml group than in the > 60 ml group (P < 0.05).

CONCLUSIONLow Gleason score of biopsy (≤ 6) and small prostate volume (≤ 40 ml) may be the predictors of Gleason score upgrading after radical prostatectomy.

Biopsy ; Humans ; Male ; Neoplasm Grading ; Organ Size ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; classification ; surgery ; Retrospective Studies ; Risk Factors

OBJECTIVETo establish fluorescent quantitative PCR method for detecting human herpes virus type 6 (HHV6).

METHODSAccording to the specific sequence of human herpes virus type 6 genes, the primers and the fluorescent probe (TaqMan) were designed and synthesized. The fragment generated from HHV 6 gene as template was cloned into the pMD18-T vector which was constructed from the pUC 18. And the positive recombinant plasmid was 1:10 diluted and used as standard quantitative template to make the standard curve for sample detection.

RESULTSThe standard curve indicated the linear relationship between Ct (cycle threshold) and template concentration. The clinical samples from 135 cases were detected by this system, 16 cases among 135 were positive.

CONCLUSIONThe fluorescent quantitative PCR method for the detection of human herpes virus type 6 is simple and accurate, and this method may be helpful to clinical diagnosis.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; DNA Primers ; DNA Probes ; DNA, Viral ; genetics ; Female ; Herpesvirus 6, Human ; genetics ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; virology ; Reproducibility of Results ; Roseolovirus Infections ; diagnosis ; virology ; Sensitivity and Specificity ; Young Adult

Adult ; Fatty Liver ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Waist-Hip Ratio

OBJECTIVETo explore reasonable clinical decision in treating carotid artery stenosis under different conditions.

METHODSThe data of 133 carotid artery stenosis patients were retrospectively analyzed. Of the patients, 46 cases were treated with carotid angioplasty and stenting (CAS), 87 patients received carotid endarterectomy (CEA). The length of hospital stay and National Institutes of Health Stroke Scale (NIHSS) grade before and after treatment in both groups were observed; the forward flow were assessed by digital subtraction angiography (DSA) before and after treatment; the degree of carotid artery stenosis were determined by using ultrasound during 3 to 24 months after treatment in both groups; the cumulative incidence of major cardiovascular events was concentrated, including appearance of death, stroke or myocardial infarction during 30 days after CAS and CEA and death or homonymy stroke during 31 days to 2 years.

RESULTSSignificant difference was found in hospital stay and when NIHSS exceed 20 after treatment between the two groups (P < 0.05); there was no significant difference in the forward flow before and after treatment in both groups; the carotid artery stenosis had been improved significantly after the operation in both groups; the cumulative incidence of major cardiovascular events in CEA group was significantly higher than in CAS group in 30 days after the operation (P < 0.05), but no statistical difference in 31 days to 2 years after the operation.

CONCLUSIONSCAS and CEA has equivalent effects in treating carotid artery stenosis, and should be selected according to the location of stenosis, etiological factors and the condition of opposite carotid artery.

Adult ; Aged ; Angioplasty, Balloon ; Carotid Stenosis ; surgery ; Endarterectomy, Carotid ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

ObjectiveTo investigate the clinical efficacy and surgical experience of hermo-expandable metallic prostate stent in the treatment of elderly high-risk BPH patients.MethodsRetrospective analysis was performed on 38 patients with BPH who underwent implantation of hermo-expandable metallic prostate stent from January 2017 to October 2018 in the General Hospital of Eastern Theater Command. The patients were 72 to 89 years old, with preoperative international prostatic symptom score (IPSS) of 25.6±4.1 points, maximum flow rate of urine (MRF) of (4.8±1.2) mL/s, and residual urine volume (RUV) (160.7±70.5) mL. Urinary catheters were placed in 7 patients for 4-8 days due to acute urinary retention.ResultsExcept for the failure in one case, all 37 patients were successfully implanted with the prostate stent at one time, and they urinated immediately after the operation without serious operation-related complications. Follow-up was conducted for 3 months, and the IPSS and RUV of the 37 patients were (15.6±4.3) and (40.7±12.9) mL respectively, which were significantly lower than those before the operation (P<0.05). MRF was (11.1±4.3) mL/s, significantly higher than that before surgery (P<0.05). 22 cases in this group were followed up for 2 years, and their IPSS, MRF and RUV were all stable.ConclusionThe thermo-expandable metallic prostate stent for the treatment of dysuria caused by BPH is effective, reliable and less traumatic. It is a preferred choice for the treatment of the aged BPH patients who are at a high risk and not suitable for surgery.

Objective: To investigate the surgical techniques and clinical effect of Memokath transurethral spiral thermo-expandable prostatic stent (STEPS) implantation in the treatment of BPH. METHODS: From January 2017 to January 2018, 26 BPH patients underwent Memokath transurethral STEPS implantation, 9 under the flexible cystoscope and the other 17 under the rigid cystoscope. The patients were aged 62－91 years old, with a prostate volume of 32－78 ml, postvoid residual urine volume (PVR) of (67.3 ± 11.2) ml, maximum urinary flow rate (Qmax) of (6.3 ± 1.8) ml/s, and IPSS score of 26.7 ± 5.7. Eight of the patients had preoperative urinary retention, of whom, 6 received catheterization and 2 had undergone cystostomy for bladder fistula before STEPS implantation. RESULTS: The operations lasted 15－30 minutes and were successfully completed in 24 cases while stent-shedding occurred in the other 2. Twenty-two of the patients achieved spontaneous urination immediately after surgery and 2 experienced bladder clot embolism. At 3 month after surgery, 24 of the patients showed significant improvement in PVR (［21.4 ± 7.7］ ml), Qmax (［18.3 ± 4.7］ ml/s) and IPSS (8.3 ± 2.1), and 13 exhibited no statistically significant difference from the baseline in the IIEF-5 score (14.1 ± 1.1 vs 14.3 ± 1.0, P > 0.05). At 12 months, all the patients were found with markedly improved urination but no adverse events except recurrent urinary tract infection in 2 cases. CONCLUSIONS Memokath STEPS implantation, with its advantages of simple operation, high safety, definite effectiveness, non-influence on sexual function, is a new effective surgical option for the treatment of BPH.