Objective:To determine the diagnostic performance of dynamic contrast-enhanced MRI (DCE-MRI) in patients with recurrent or residual prostate cancer after radical prostatectomy. Methods:Studies were systematically searched in the PubMed, EMBASE, Cochrane library, SCI, CBM, CNKI, VIP, WanFang, and other databases. Additional studies were manually searched using the references of the retrieved articles. The retrieved deadline time was June 6th, 2013. Studies were eligible for inclusion based on the inclusion and exclusion criteria, and the qualities of the studies were reviewed based on the QUADAS criteria. The Meta Disc 1.4 software was used for meta-analysis, and a summary receiver operating characteristic (SROC) curve was constructed. The patient-based pooled weighted estimates of the sensitivity, specificity, diagnostic odds radio, and 95%confidence interval were calculated. Results:Among the 118 eligible studies, 7 articles (12 studies) were included in the meta-analysis. The pooled weighted estimates of the sensitivity, specificity, and the area under the curve were 0.88 (95%confidence interval:0.84 and 0.91), 0.87 (95%confidence interval:0.81 and 0.92), and 0.939 1, respectively. The pooled diagnostic radio (dOR) was 50.4 (95%confidence interval:26.0 and 97.6) and Q*was 0.876 4. Conclusion:DCE-MRI has high sensitivity and specificity in the evaluation of locally recurrent or residual prostate cancer after radical prostatectomy, in which the diagnostic efficiency of DCE-MRI combined with magnetic resonance spectroscopy is much better.

anthracycline-induced cardiotoxicity in patients with lymphoma.Methods Thirty-two adult patients with nonHodgkin' s lymphoma who received chemotherapy including anthracyclin were studied.After anthracyclin reached the cumulative doses of 200 and 400 mg/m-2,the changes in plasma BNP and echocardiography indices were investigated.Results After the cumulative anthracyclin reached doses of 200 and 400 mg/m2,serum BNP were respectively (292±7) ng/ml and (387±4) ng/ml,and were significantly increased when compared to the untreated (134±6) ng/ml (P ＜ 0.05).The parameter of diastolic functions ratio of peak early to peak late low velocity (E/A ratio)were 1.14±0.37 and 0.90±0.06,both showing significant decreases compared to the control (1.33±0.27) (P ＜ 0.05).In contrast,systolic function parameters left ventricular ejection fraction (EF) and fractional shortening (FS) remained unchanged (P ＞ 0.05).After the cumulative anthracyclin reached 200 and 400 mg/m2,significant negative correlations were observed between the plasma BNP and the E/A ratio (r =-0.689,P=0.042; r=-0.557,P =0.006),but no associations between EF and FS were found (P ＞ 0.05).Conclusion Plasma BNP concentration appears to be a sensitive parameter for the early assessment of anthracycline-induced cardiotoxicity.

Objective To explore the antiemetic mechanism of propofol in patients subjected to laparoscopic cholecystectomy under general anesthesia Methods Sixty ASA Ⅰ Ⅱ patients of either sex undergoing elective laporoscopic cholecystectomy were randomly assigned to three groups : control group (group C), ondansetron group (group O) and propofol group(group P) Anesthesia was induced with thiopental 5 7 mg?kg -1 and intubation was facilitated with succinylcholine 1 1.5mg?kg -1 In group C and O anesthesia was maintained with inhalation of 1 0% 1 5% isoflurane and intermittent bolus of vecuronium In group O ondansetron 4 mg was given intravenously before induction of anesthesia In group P anesthesia was maintained with continuous intravenous infusion of 1% propofol at a rate of 50 150 ?g?kg -1 ?min -1 and intermittent bolus of vecuronium At the end of operation neostigmine 1mg and atropine 0 5 mg were regularly given to antagonize the residual neuromuscular blockade Venous blood samples were taken before anesthesia (baseline), after intubation, at the end of operation and 6h after operation for determination of plasma motilin(MTL) level Postoperative nausea and vomiting (PONV) was assessed according to WHO standard in four grades from no nausea to severe vomiting with gastric content Results In group C the plasma MTL level at the end of operation was significantly higher than that before anesthesia (P

Objective To find a safe and effective management for upper ureteral calculi after failure of extracorporeal shock wave lithotripsy(ESWL).Methods Under a F20.8 endoscope(EMS Ⅲ,Switzerland),percutaneous nephrolithotripsy was performed with pneumatic and ultrasonic power on 43 patients with upper ureteral calculi after having been treated by ESWL for 1 or 2 times.Results The procedure was completed in 42 of the patients with a mean operation time of 60 min(35 to 75 min),mean time for calculi removal of 12 min(5 to 20 min),and mean blood loss of 50 ml(20 to 150 ml).One patient was converted to open surgery because of failure of percutaneous renal puncture.One patient developed haematoma after the procedure and then was cured by conservative therapy without receiving blood transfusion.One patient had fever due to infection and was cured after antibiotic therapy.42 patients were followed up for 2 to 18 months(mean,6.4 months);none of them had massive hemorrhage,infection,hydronephrosis,or recurrence of the calculi during the period.Conclusions Percutaneous nephrolithotripsy with pneumatic and ultrasonic power is safe,minimally invasive,and effective for upper ureteral calculi after failure of ESWL.

Objective To investigate the long-term prognostic factors and the significance of serum cardiac troponin T (cTnT) and C-reactive protein (CRP) in maintenance hemodialysis (MHD) patients.Methods Clinical data of 76 MHD patients in our hospital from January 2002 to January 2003 were retrospectively analyzed.Time and cause of death in the next 10 years were recorded.Survival rate was calculated by Kaplan-Meier and impact factors of long-term prognosis were explored.Significance of cTnT and CRP was elucidated by COX regression analysis.Results CRP was positive in 28 cases (36.8％) and cTnT was positive in 22 cases (28.9％) among 76 patients.The median survival time was 37.9 months,2-year survival rate was 65.9％ and 10-year survival rate was 24.2％.Univariate analysis found positive CRP,positive cTnT,old age,diabetes,cardiocerebrovascular disease,anemia,low serum albumin,Kt/V decline were associated with long-term prognosis.Multivariate analysis showed that increased age (P =0.010),cardiocerebrovascular disease (P =0.048),positive cTnT (P =0.036),positive CRP (P =0.009) were independent risk factors of the 10-year survival of MHD patients.Ten-year mortality of cardiocerebrovascular diseases in positive cTnT group was not significantly different as compared with negative cTnT group (50.0％ vs 35.4％,P =0.248).But the positive cTnT group had higher 2-year mortality than negative cTnT group (40.9％ vs 14.6％,P =0.015).Mortality of cardiocerebrovascular disease was higher in positive CRP group as compared to negative CRP group at both 2-year and 10-year time (48.1％ vs 7.0％,P =0.000; 66.7％ vs 23.3％,P =0.000).Compared with both negative cTnT and CRP group,both positive cTnT and CRP group had much higher all-cause mortality (92.9％ vs 55.6％,P =0.030),higher mortality of cardiocerebrovascular disease at 10-year (64.3％ vs 25.0％,P =0.009),and higher mortality of cardiocerebrovascular disease at 2-year (57.1％ vs 5.6％,P =0.000).Conclusions Aging,cardiocerebrovascular disease,positive cTnT and positive CRP are independent risk factors of long-term prognosis for MHD patients.Positive cTnT can predict cardiocerebrovascular mortality of MHD patients in 2 years,while positive CRP can predict short-and long-term cardiocerebrovascular mortality.Positive cTnT combined with positive CRP may be more valuable in predicting the poor prognosis of MHD patients.

Objective To investigate the clinical significance of (CAG)n repeats length of androgen receptor (AR) among the patients with metastatic prostate cancer (TxNxM1),and to analyze their relevance to survival.Methods This study retrospectively investigated fifty-three metastatic prostate cancer patients aged 65 years (range 45-87) who were initially treated with endocrine therapy.The length of the (CAG) n repeats of blood samples was determined by both PCR sequencing and fragment analysis.The clinical significance of (CAG)n repeats and its correlation with biochemical progression free survival (bPFS)and overall survival (OS) were investigated.Results The median length of CAG repeats was 21,ranged from 14 to 32.According to the median (CAG)n repeats length,two groups were divided as (CAG)n ≤ 21and(CAG) n≥ 22.The median follow-up was 36 months.Patients with (CAG)n ≤ 21 had significantly shorter OS and bPFS than those with (CAG)n ≥ 22 (P ＜0.05).Shorter CAG repeats remained significant bPFS (HR 2.820,95％CI 1.466-5.427,P=0.002) and OS (HR 5.245,95％CI 1.293-21.27,P=0.020) predictor in multivariate analysis.Conclusions The efficacy of endocrine therapy for metastatic prostate cancer patients maybe influenced by the AR-CAG repeats length,and short (CAG) n repeats predict bad prognosis.

Objective To explore the clinical effect of Habib 4X bipolar radiofrequency ablation assisted laparoscopic partial nephrectomy without blockage of renal artery for treatment of renal cell carcinoma (RCC).MethodsBetween October 2010 and June 2011, 14 patients with exophytic RCC (T1N0M0) were treated with Laparoscopic Partial Nephrectomy with (LRA) or without (LPN) Habib 4X Bipolar Radiofrequency ablation assisted.The LRA group included 6 patients,and the maximum tumor diameter was 2.1 - 3.5 cm (mean,3.1 cm).The LPN group included 8 patients,and the maximum tumor diameter was 2.0 -3.7 cm (mean,3.0 cm).The operative time,average intra-operative blood loss,postoperative hospital stay and incidence of postoperative complications were recorded.Changes of hemoglobin (Hb),serum creatinine (SCr) and ipsilateral glomerular filtration rate (GFR) before and after operation were analyzed and compared. Results The 14 surgical procedures were successful without conversion to open operation.In LRA group,renal artery blocking was unnecessary,the Hb,SCr and GFR before and after operation were (127 ± 19) g/L vs.(124 ± 19) g/L、(96 ±39) μmol/L vs.(92 ±29) μmol/L and (42 ± 12) ml/min vs.(40 ± 13) ml/min,respectively,and the difference was not significant (P ＞0.05).In LPN group,the renal artery blocking time was 20-52 min (mean,32 min),the Hb,SCr and GFR before and after operations were (130±17) g/L vs.(112±15) g/L,(92 ±31) μ mol/L vs.(110±28)μmol/L and (43 ± 14) ml/min vs.(30 ± 11 ) ml/min respectively,and the difference was significant (P ＜0.05 ).The operative time was ( 86 ± 20) min and ( 112 ± 43 ) min,the estimated blood loss was (94 ± 18)ml and (256 ± 58) ml,and the postoperative hospital stay was (5.0 ± 0.8) d and (7.8 ± 1.2 ) d,respectively.The difference between the two groups was significant (P ＜ O.05).Complications such as bleeding,gross hematuria,and leakage of urine were noted in LRA group. Conclusions Habib 4X Bipolar Radiofrequency ablation assisted LPN without blockage of renal artery is a safe and effective intervention with a relatively low incidence of complications.And it is superior to LPN in operative time,intraoperative blood loss and postoperative recovery.

Uveitic glaucomas (UG) are complex in cause or disease and response to treatment.UG typically is associated with very high intraocular pressure and more intense optic nerve damage than other glaucoma types.This secondary glaucoma requires an early diagnosis and adequate management of both uveitis and glaucoma.Recently,a multitude of novel medical therapies and surgical techniques have been added to the armamentarium of existing therapeutic modalities.This article reviews the surgical treatment of UG,including Trabeculectomy,laser peripheral iridotomy,nonperforating deep sclerectomy,glaucoma drainage implants,minimally invasive glaucoma surgery,and also briefly discusses the application and effect of these surgical treatments.

Objective To assess the mortality,complications and major morbidity of pneumonectomy for non -small cell lung cancer(NSCLC)and to establish the importance of various prognostic factors.Methods The data of 64 consecutive patients who underwent pneumonectomy for NSCLC were retrospectively reviewed.Results The 30 -day mortality rate was 7.8%(5 /64).Complications developed in 29.7%(1 9 /64)and overall 5 -year survival was 1 9.0%.Pathological stage Ⅲ(P =0.030)and right pneumonectomy(P =0.01 0)were independent risk factors of an adverse outcome.Survival was not significantly influenced by histological types (P =0.1 25)or curability (P =0.587).Conclusion Pneumonectomy is associated with acceptable overall morbidity and mortality.However,the patients with pathological stage Ⅲ or right pneumonectomy require special consideration.Pneumonectomy should be performed only in selected patients.

Objective Our retrospective study was aimed to analyze the clinical significance of microsurgical clipping and intravascular embolization in patients with intracranial aneurysm (IA).Methods Clinical data of 86 patients with IA received treatment at our hospital from February 2010 to November 2014 was retrospectively analyzed.Patients were divided into two groups according to the treatment method, IE group (intravascular embolization,43 cases)and MC group (microsurgical clipping,43 cases).The general information,treatment effect, hospitalization expenses and time and the rate of complication of the patients between two groups were compared.Results There was no sta-tistical difference in general information between two groups (P >0.05).The cure rate of patients in IE group was obviously better than that in MC group (P <0.01).The hospitalization expenses in IE group was lower than that in MC group,and the hospitalization time was shorter than that in MC group,all the differences had statistical significance (P <0.01).The rate of complication in IE group was obviously lower than that in MC group (P <0.01).Conclusion The clinical effect of intravascular embolization was significantly better than microsurgical clipping,which is worth promoting in clinic.