According to the latest data from the National Cancer Center of China, prostate cancer (PCa) has become the highest incidence tumors of urinary since 2008, and its incidence and mortality has occupied great attention in the past decades. Therefore, the choice of safe and effective diagnostic method, to detect the occurrence of PCa, is necessary. The way of clinical diagnosis mainly includes digital rectal examination, serum PSA, transrectal ultrasound, MRI spectroscopy imaging, and prostate biopsy, ect. Prostate biopsy is the most reliable diagnosis method and agold standardfor the diagnosis of PCa. The systematic use of the prostate biopsy has greatly improved the diagnosis of PCa. However, there are several prostate biopsy scheme and scholars proposed a variety of programs on the choice of puncture point. It has not yet formed a standard method at this stage. In this study, we will review the development of prostate biopsy and the status recent research to explore application value of different method.

Objective To construct eukaryotic expression vector of antisense MBD1 gene fragment and to provide a tool for studying MBD1 gene function. Methods PCR primers were designed according to the coding sequence of MBD1 gene. Xba I and Kpn I recognition sequences and cutting sites were added to the 5' end of the sense and antisense primer respectively. The 342 bp specific PCR fragment was obtained from the cDNA of biliary tract carcinoma cell line QBC-939 using RT-PCR, the purified PCR fragment was then inserted reversely into the multiple cloning site of eukaryotic expression vector pcDNA3. 1 ( + ). The constructed recombinant plasmid was identified by PCR confirmation, Xba I and Kpn I double enzyme digestion and DNA sequencing. Results The 322 bp specific DNA band was obtained by PCR, Xba I and Kpn I double digestion produced a 327 bp and a 5. 4 kb DNA band which represent the inserted target gene fragment and the vector respectively. The sequencing result confirmed that the sequence of inserted fragment was correct. Conclusion The eukaryotic expression vector of antisense MBD1 gene fragment was constructed successfully by using gene cloning technique. It will be a useful tool for studying MBD1 gene function in DNA methylation and tumorigenesis.

Objective To study the reliability of Gleason score by prostate biopsy with prostatic cancer(PCa)in prediction of tumor location and analyse related influencing factors of positive surgical margins after radical prostatectomy.Methods The retrospective study recruited 72 patients with PCa who had been diagnosed by trans rectal ultrasound-guided prostate biopsy,and eventually treated with laparoscopic radical prostatectomy.The correlation of each index were analyzed by statistical software.Results In this study,Kappa test indicated a good agreement that Gleason score between prostate biopsy and radical prostatectomy.Biopsy positive more focused on four peripheral points near the bottom.Biopsy tumor location was not suitable for predicting tumor distribution.Biopsy Gleason score and biopsy positive percentage in biopsy specimen were independent predictors of positive surgical margins.F and L points had good correlation with the positive surgical margins.Conclusion The biopsy Gleason score is a good evidence to pathological grading in patients.These information will lead to positive surgical margins rise possibly:needle biopsy Gleason score exceed 7.25,positive biopsy percentage more than 45% and the location positive biopsy close to prostate apex.

OBJECTIVETo introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.

METHODSA clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.

RESULTSThe treatment was effective and the patient achieved disease remission.

CONCLUSIONEvidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.

Objective The study was to evaluate DWI for quantifying liver fibrosis. Methods A total of 12 volunteers, 47 patients who had chronic HBV or HCV hepatitis and underwent liver biopsy [Scheuer score for fibrosis(S) and inflammation(G)] were enrolled in this study. They were scanned using a 1.5 T MR unit with b value of 0,250,500,750, 1000 s/mm~2. ADCs at b_(250-1000) and b_(500-1000) were the average ADCs of b=250, 500, 750, 1000 s/mm~2 and b=500, 750, 1000 s/mm~2. The studied the correlation between Scbeuer scores and ADC values, and conducted Mann-Whitney U test and Logistic regression to evaluate ADC for prediction of fibrosis scores. Results The average ADCs were (1.41± 0.11),(1.37±0.09), (1.27±0.05), (1.26±0.04), (1.22±0.06) mm~2/s respectively from SO to S4, stage at b=750 s/mm~2 (F=18.31, P<0.01). With the increase of fibrosis score, the average ADC decreased gradually, the two were better negatively correlated at b_(250-1000)(r=-0.727, P<0.01) than other b values. Using b_(750) and the two combined b values, the found significantly lower ADCs in S2 or greater versus S1 or less and in S3 or greater versus S2 or less fibrosis (P<0.01). The best predictor for S2 or greater was b_(750) with the largest AUC of 0.909, sensitivity of 85.7%, and specificity of 100.0% (ADC ≤1.35×10~(-3) mm~2/s). The best predictor for S3 or greater was b_(250-1000) with the largest AUC of 0.864, sensitivity of 69.6%, and specificity of 95.8% (ADC≤1.53×10~(-3) mm~2/s). Conclusion DWI can be a good predictor for scoring liver fibrosis for S2 or S3 stage above, while b_(750) and the combined b values are suitable for evaluation.

ObjectiveTo study the technique and therapeutic effect of percutaneous cannulate screw fixation to treat the traumatic diastasis of the pubic symphysis.MethodsFrom February 2003 to December 2010,46 patients (27 men and 19 women,mean age of 34.6 years) with unstable pelvic fractures and diastasis of the pubic symphysis were admitted.All the patients were treated by closed reduction and percutaneous cannulate screw fixation of the symphysis pubis.Then to complete the fixation of posterior ring,by percutaneous screw inserted through the sacroiliac joint or posterior iliac wing.According to Tile's classification,the patients were classified into type B1.1 in 4 cases,B1.2 in 7,B2 in 2,B3 in 2,C1.1 in 7,C1.2 in 7,C1.3 in 10,C2 in 5 and C3 in 2.All patients were performed posterior ring fixation except 4 cases of type B1.1.Anteroposterior,inlet and outlet X-ray radiographs and CT scans of the pelvis were taken preoperatively to evaluate the stability and deformities,and after surgery the plain radiographs and CT scans were taken to evaluate the reduction and the location of screws.ResultsThe average operative time was 45 min (range,15-65 min),and the average intraoperative blood loss was 25 ml (range,15-50 ml).Each patient was inserted one screw in the symphysis pubis.Thirty-five patients underwent postoperative pelvic CT scan and 3screws of them penetrated the wall of symphysis pubis.The average follow-up period was 23.5 months (range,5-48 months).In the follow-up period,no infection and displacement were found.The last follow-up result:according to Matta and Tornetta's standard,the result was excellent in 43 cases and good in 3.Among all patients,31 cases (67.39％) had returned to their original works,6 were to give up their original works as complicating injuries; 28 cases had no pain,13 cases had slight pain of the symphysis pubis while to make an effort,5 cases had pain of sacroiliac joint.There were no iatrogenic injury of nerve.ConclusionClosed reduction and percutaneous cannulate screw fixation of the traumatic diastasis of the pubic symphysis is a safe,feasible and easy manipulated method.The operative injuries is small and the clinical outcome is satisfactory.

Objective To evaluate the effects of stepwise and fine-grained dietary management on the diet control of liver cirrhosis patients complicated with gastrointestinal hemorrhage. Methods Eighty liver cirrhosis patients complicated with gastrointestinal hemorrhage were assigned to experimental group (41 cases) and control group(39 cases) by random digits table method. The patients in experimental group were treated with stepwise and fine-grained dietary management and the patients in control group were given conventional dietary treatments. The compliance diet, mastery of nutrition knowledge, malnutrition risk at admission, intake food, discharge and 2 months after discharge between two groups were monitored. The incidence of rebleeding was tracked after 1 year of discharge. Results The incidence of malnutrition risk in Child-Pugh class C was higher than that in Child-Pugh class B( Z=-4.3, P<0.05 ) . The incidence of malnutrition risk in patients with high education level was lower than that in patients with lower education( r=-0.453, P<0.05 ). The experimental group significantly outperformed control group in mastery of nutrition knowledge at discharge:80(70, 84) points vs. 52(42, 64) points, in compliance diet and malnutrition risk after 2 months after discharge:86(76, 91)%vs. 53(46,57)%, 1(1, 2) points vs. 2(1,3) points, the rebleeding rate in experimental group was significantly less than that in control group within 1 year after discharge 14.6%(6/41) vs. 35.9%(14/39), and the differences were statistically significant between two groups ( χ2 = 4.226- 51.232, all P < 0.05 ). Conclusions Stepwise and fine-grained dietary management can improve the mastery of nutrition knowledge, compliance diet and nutritional status, and reduce the occurrence of rebleeding, worth popularizing further in clinical care of liver cirrhosis patients complicated with gastrointestinal hemorrhage.

Adult ; Endocarditis ; complications ; microbiology ; Female ; Humans ; Pulmonary Embolism ; etiology ; Pulmonary Valve ; microbiology

Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Humans ; Postoperative Complications ; etiology ; prevention & control ; Stents

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods