Objective To evaluate the clinical value of transrectal ultrasound(TRUS)guided biopsies of the prostate cancer(PCA)with serum prostate specific antigen(PSA)level less than 4 μg/L.Methods Fifty-nine patients suspected PCA were underwent TRUS guided-biopsy.The ultrasonographic features of lesions and prostate gland were observed.The PSA,PSA density(PSAD),F/T(free/total PSA ratio),prostatic volume(PV)were compared between PCA group and non-PCA group,and further analyzed the sensitivity and specificity of PSAD and F/T at different thresholds for PCA diagnosis.Results In 59 patients,16 were proved to be cancer by pathological examination,the positive detection rate was 27%.In these 16 patients,12 had lesions on ultrasound,which locatqed in outer gland.The rich vascularity was observed in PCA more than in benign and precancerous lesion.There were statistical significant differences in PSA,PSAD,F/T,PV between PCA and non-PCA groups.When selecting threshold of PSAD and F/T were 0.09 and 0.20,respectively,there were the highest diagnostic specificity and sensitivity.The diagnostic specificity and sensitivity of PSAD were higher than those of F/T.Conclusions TRUS guided biopsies of the prostate is one of the most efficient methods for detection of PCA with PSA level less than 4μg/L.Combining TRUS features with PSA parameters can further increase positive detection rate of PCA.

BACKGROUND:Apoptin is a protein which is synthesized in vitro or expressed by genetic engineering, without toxic and transformation activity of normal cel s. Apoptin can specifical y induce the apoptosis of tumor cel s and provide the opportunity of inhibiting the growth of cancer.
OBJECTIVE:To construct a prokaryotic expression vector for apoptin, optimize the expression conditions, and detect the activity of the purified protein.
METHODS:The apoptin gene that had been constructed was cloned into prokaryotic expression vector pET-28b (+), which was transformed into E.coli host bacteria. Apoptin was induced by isopropyl-beta-D-thiogalactoside, and analyzed by polyacrylamide gel electrophoresis. The inhibition activity of apoptin on tumor cel s was detected.
RESULTS AND CONCLUSION:Apoptin gene was successful y cloned into pET-28b (+). Apoptin protein was induced to express in form of inclusion body by isopropyl-beta-D-thiogalactoside (0.5 mmol/L) at 26 ℃. And the expression of apoptin with relative molecular mass of about 15 000 was identified by polyacrylamide gel electrophoresis. The target protein was purified by denaturation-renaturation and affinity chromatography, which has pro-apoptotic effect on lung cancer cel s H460 and H1299. The prokaryotic expression vector pET-28b-apoptin is successful y constructed. The apoptin protein with bioactivity is obtained, which al ows further functional study of apoptin.

According to the basic theory of traditional Chinese medicine (TCM), the pathogenetic factors such as platelet activation, adhesion, congregation and thrombosis fall into the category of blood stasis, while the pathological changes such as tissue necrosis, oxidative stress injury and inflammation, etc, are far beyond the etiological category of blood stasis. The toxin or the combination and transformation of toxin and blood stasis of TCM are involved in the pathogenesis of thrombotic cerebro-cardiovascular diseases. It is significant to recognize and stress the combination and transformation of toxin and stasis in pathogenicity so as to enrich TCM etiology and improve TCM clinical efficacy in the treatment of cerebro-cardiovascular and thrombotic diseases.

Objective To observe the change endoplasmic reticulum stress in renal injury of fluorosis rats,and explore the effect of endoplasmic reticulum stree in the mechanism of renal injury of fluorosis.Methods 48 Wistar rats were divided into 4 groups:control,fluoride-treated,low calcium,and low calcium plus fluoride-treated.The rats in fluoride-treated and low calcium plus fluoride-treated groups were treated with sodium fluoride (NaF,221 mg?L-1) through drinking water for 3 months.The pathological slice of rat kidney was made and the morphological changes were observed under optical microscope.The transcription levels of Grp78,Xbp1,CHOP and PDI in the kidney tissues were determined by reverse transcription-polymerase chain reaction (RT-PCR).Results Edema and vacuolar degeneration of the proximal tubule and distal tubule cells in the kidney tissues in fluoride-treated group were observed;and cell edema,vacuolar degeneration,scattered necrosis,minor regeneration repair and interstitial hyperemia in the kidney tissues in low calcium plus fluoride-treated group were found.The mRNA expressions of Xbp1 in the kidney tissues in fluoride-treated and low calcium plus fluoride-treated groups were markedly higher than that in the responding control groups(P

10.3969/j.issn.2095-4344.2013.23.013

Objective To determine the rate of hemorrhagic complications and the possible risk factors in transrectal ultrasound(TRUS)guided prostate biopsies.Methods TRUS guided prostate biopsies were carried out in 252 patients.Chi-aquare test,t test,conditional Logistic regression were used to comparatively analyze the risk factors(age,presence of prostate cancer,the volume of prostate,arterial hypertension,diabetes mellitus,use of acetylsalicylic acid and anticoagulant,number of samples)between hemorrhagic patients and non-hemorrhagic groups.Results Hematuria was the most frequent sing in all complications,corresponding to 19.1% of the cases.According to the general feature analysis between two groups,age and the volume of the prostate were significant different.Multiple factor Loigistic regression analysis showed that patients with or without hemorrhagic complications were significant differences in age(OR=0.97,95% CI:0.942～1.000)and the volume of the prostate(OR=0.989,95% CI:0.9790～0.999).Patients with or without hematuria were significant differences in presence of prostate cancer(OR=0.479,95% CI:0.236～0.975),the volume of the prostate(OR=0.987,95% CI:0.976～0.999)and use of acetylsalicylic acid and anticoagulant(OR=3.589,95% CI:1.133～11.366).Conclusions TRUS guided prostate biopsy is a safe and effective procedure.Age and the volume of prostate are influencing factors for hemorrhagic complications.Presence of prostate cancer and the volume of prostate are influencing factors for hematuria.Use of acetylsalicylic acid and anticoagulant are risk factors for hematuria after biopsy.

Objective To study the change characteristics of erythrocyte parameters in carriers of deletional alpha-thalassemia gene.Methods 389 patients with deletional alpha-thalassemia gene determined by the gap-PCR technique were classified into three groups based on different genotypes of alpha-thalassemia including silent thalassemia group,alpha-thalassemia trait group (265 ca-ses)and intermediate thalassemia group,and contemporaneous 188 healthy adults were randomly selected as the normal control-group(NC).The erythrocyte parameters including RBC,Hb,MCV,MCH,RDW were retrospectively analyzed and their differences were compared among aboved-mentioned groups by the analysis of variance and the multiple comparison.Results Alpha-thalasse-mia manifested by different degrees of microcyte hypochromia.There were statistically significant differences in the erythrocyte pa-rameters among various genotypes and phenotypes about erythrocyte indices(P <0.05).Moreover,the Hb,MCV and MCH values were lower than those in the control group,and had the decreasing tendency with the increase of deletedα-globin gene numbers;but the RDW value was higher than that in the control group,showing the increasing tendency,the differences had statistical siginifi-cance(P <0.05).Conclusion With the increase of deleted α-globin gene number,the characteristic of small-cell low-hemoglobin is more and more remarkable.RBC has a overall increase,while Hb,MCV and MCH have a decreasing tendency,and the heterogeneity of erythrocyte volume is increased.When MCV and MCH decreasing in high risk region,thalassemia should be highly suspected, but normal MCV and MCH can not exclude silent thalassemia and alpha-thalassemia trait.

To analyze the relationships among syndrome, therapeutic method and Chinese herbal medicine in patients with coronary artery disease (CAD).

Objective To examine the levels of plasma tissue factor pathway inhibitor (TFPI) in patients with acute pancreatitis (AP) to assess the clinical value of diagnosis for severe acute pancreatitis ( SAP).Methods Sixty-eight patients were divided into mild acute pancreatitis (MAP)group (n=36) and SAP group (n=32), and twenty volunteers were chosen into normal group ( n=20 ) .Clinical data of these patients were collected, including APACHEⅡscore and Ranson score.Plasma levels of TFPI were measured by ELISA.Results The plasma levels of TFPI in SAP group, MAP group and control group were (4274.25 ±639.83),(3026.81 ±465.76) and (2468.73 ±262.39)pg/ml, respectively(P<0.05).There were significant positive correlations between TFPI and WBC, AST, ALT, TBIL, Cr, PT, APTT, PCT, APACHEⅡscore and Ranson score (P<0.05).The area under the curve (AUC) of TFPI for SAP was 0.902(95%CI=0.845 -0.959, P<0.05 ) .The cutoff value was 4028.83 pg/ml for plasma TFPI with a sensitivity of 87% and a specificity of 78%.Conclusion Plasma levels of TFPI in patients with SAP are significantly increased, which maybe help diagnose SAP.

Objective:To construct a primary health care institutions performance evaluation index system from the perspective of health value orientation under the background of countywide medical alliances construction.Methods:From May 2021 to February 2022, preliminary screening was made on core performance evaluation indexes via literature review; purposive sampling was used to select the dean/vice dean, persons in charge of medical service, and those in charge of public health service responsible for performance evaluation at the community health service center. Then semi-structured interviews were made on the existing performance evaluation and assessment plans as well as existing problems of primary medical and health institutions. Based on the " input-process-output" performance evaluation model, the thematic framework analysis method was used to analyze the interview data, and combined with literature research results, a preliminary performance evaluation index system for primary medical and health institutions was built under the guidance of health value. From March to May 2022, the Delphi expert consultation method was used to evaluate the importance and operability of indexes. The threshold method was used to screen indexes, and analytic hierarchy process was used to calculate the weights of evaluation indexes.Results:The health value oriented performance evaluation index system for primary healthcare institutions included 3 first-level indexes, 9 second-level indexes, and 50 third-level indexes. The first-level indexes were output (0.377 3), input (0.336 3), and process (0.286 4) in descending order of weight. The top three weighted second-level indexes were health manpower(0.177 8), health literacy and health outcomes (0.157 6), as well as responsiveness and satisfaction (0.142 6). The third-level indexes included 17 medical indexes, 16 prevention indexes, and 17 medical prevention integration indexes. The top three weighted indexes for inpatient services were resident satisfaction with medical treatment (0.052 4), medical staff satisfaction (0.050 1), and responsiveness of residents seeking medical treatment (0.040 1); The top three weighted third-level indexes excluding inpatient services were resident satisfaction with medical treatment (0.052 4), medical staff satisfaction (0.050 1), and surplus funds used for personnel incentives (0.045 5).Conclusions:The performance evaluation index system of primary health care institutions built under the health value orientation is scientific, conducive to promoting the health-orientated transformation and improving the efficiency of primary health care services.