Repeat prostate biopsy is of great significance for missed diagnosis of prostate cancer. We make a review on the independent risk factors, route selection and new techniques to improve clinicans’ cognition of prostate biopsy indications. MpMRI targeted biopsy is recommended for patients who are eligibile for repeat biopsy for higher detection rate of clinically significant prostate cancer and lower rate of non-clinically significant prostate cancer.

10.3969/j.issn.1000-8179.2013.12.016

Objective To explore the efficacy of ZPLATE TM anterior fixation systems in the treatment of thoracolumbar fractures and dislocations.Methods 13 cases with old thoracolumbar fractures and dislocations accompanied with spinal cord injury have been treated by anterior decompression,implanting bone union and internal fixation with ZPLATE TM anterior fixation systems.Results After an average of 15 5 months followup,No plate and screw was loose and fragmentized,there is no pseudoarticulation formation,average union time are 3 7 months, and paraplegia showed different degrees of recovery.Conclusion It suggests that anterior approach provids thorough decompression and ZPLATE TM anterior fixation systems is a good spinal fixation system for the treatment of old thoracolumbar fractures and dislocations with the characteristics of strong fixation.

Objective To evaluate the different effects of the treatment of thoracolumbar fractures by pedicle of vertebral arch Tenor system and Harrington device.Methods The clinical data of 35 cases of thoracolumbar fractures were analyzed retrospectively, 23 of them were operated with Harrington device and 12 with Tenor system.Results These cases were followed up for 6 months to 2 years. The fractures treated with Tenor system got satisfied reduction, reached about 96 7% of normal vertebral height. The deformities were completely corrected and complications were significant lower than those derived from Harrington device treatment, and no delayed neurologic damage was found. Most cases got reduction with one to three Frankel grades of neurologic recovery.Conclusion The Tenor pedicle system is more effective in treatment of thoracolumbar fracture than non-pedicle device. It can get satisfied fracture reduction , reliable fixation and less complications.

Pseudomonas aeruginosa. Ziying granule can protect the mice infected by colibacillus and staphylococcus aureus and increase animal survival rate. Conclusion Ziying granule has broad-bacteriostasis effect on common pathogenic bacteria in pelvic cavity.

Objective:To investigate the existence of side population cells with the potency of stem cells in human gallbladder carcinoma cell line GBC-SD and the differences in ABCG2,Oct-4 and CD34 expression among SP cells,non-SP cells and GBC-SD cells.Methods:SP and non-SP cells were sorted from GBC-SD cells by fluorescence-activated cell sorting(FACS).The expression of ABCG2,Oct-4 and CD34 in SP cells,non-SP cells,and GBC-SD cells was detected by reverse transcription-polymerase chain reaction(RT-PCR),Western blot,flow cytometry(FCM)and immunofluorescence chemistry.Results:SP cells with stem cell potency were isolated from GBC-SD cells with a proportion of(0.64±0.08)%.The metastatic ability of SP cells was obviously higher than that of non-SP cells and GBC-SD cells(P<0.05).The expression of ABCG2 was significantly higher in SP cells than in non-SP cells and GBC-SD cells[(89.56±3.86)%vs.(1.32±0.49)%and(12.37±1.61)%,P=0.001].The expression of Oct-4 in these cells was(94.87±1.40)%,(88.16±2.34)%and(90.17±1.61)%,respectively(P>0.05).CD34 was neady absent in these cells on protein level[(1.78±0.51)%vs.(0.63±0.21)%and(0.96±0.381)%,P>0.05)],but it was highly expressed in non-SP cells and GBC-SD cells and absent in SP cells off mRNA leve;.Conclusion:SP calls which hava the potency of stem cells,exist in human gallbladder carcinoma GBC-SD cell line and have the phenotype of ABCG2+Oct-4+CD34-.

ObjectiveTo evaluate the clinical effects of surgery using scar flap in situ combined with radiotherapy in 24 hours in the restorative treatment of keloids on the auricula and the preventive effects of the therapy in the recurrence of the keloids.MethodsThe scar flap in situ was designed,its size was large enough for covering the wound of the keloid on the auricula.The keloids along the designed lines were excised using local anesthesia,the flap was clipped into the one with even thickness and suitable size which covered the wound tensionlessly to ensure that the scar flap in situ survived well,and then the wound was bandaged with pressure and drained when necessary.18-24 hours after the surgery the wound was perpendicularly irradiated by the 5 MeV high energy electron beam (beta particle) of the Siemens Primus linear accelerator.After the dressing change was performed and the drain was removed; the wound was exposed to the irradiation,3-4 Gy segmentation dose per time,and the wound was then bandaged with pressure.The radiation was performed every two days and four times altogether with a total irradiation dose of 12-16 Gy.Stitches were removed 8-10 days after the surgery.ResultsThere were no avascular necrosis in the 25 scar flaps in situ and the wounds were all primary healing with normal color and fine appearance.All the patients were satisfied with the surgery.There was no recurrence of the 23 patients during the 8 to 42 months' follow-up,but there was a tendency to recur in 2 patients after 4-6 months,and the recurrence was controlled after the beta methasone was locally injected for 2-4 times.ConclusionsIt is not necessary to harvest the flaps on the other sites applying the sear flap in situ in the restorative treatment of keloids on the auricula,and therefore it prevents the formation of the keloids on the donor sites.Furthermore,the surgery is simple and the appearance of the auricula is fine,and it presents satisfactory clinical effects to irradiate the wound in 24 hours after the surgery.

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

The paper introduced the general picture of Xiangya Hospital in the past five years in its development of ahigh-level research hospital of international influence.Aiming at this strategic goal, the hospital proceeds by means of discipline development,talent training,research platform building, international academic exchange,performance appraisal and incentive,budget guarantee and system development.All these efforts contribute to the building of a mutual-supportive,efficient and sustainable medical science innovation system tailored to large hospitals.

Objective: To investigate the clinical efficacy of two different anterior cervical surgeries in treatment of multi-segmental cervical spondylosis. Methods: A total of 86 patients with multi-segmental cervical spondylosis were treated by anterior cervical surgery procedure. Among them, 62 and 24 cases were involved in three and four gap, respectively. Each patient underwent the surgery of long or segmented anterior cervical decompression and fixation. Preoperative and postoperative cervical curvature change, internal if xation stability, fusion rate and nerve function were evaluated. Results: All patients were successfully completed the operation, segmented surgery showed better cervical lordosis recovery, but there were no significant difference between long and segmented anterior cervical surgery in blood loss and recovery of neurological function (P>0.05). Conclusion: The segmented anterior cervical surgery has advantages in the treatment of multi-segmental cervical spondylosis.