Objective To evaluate the safety and efficacy of transrectal ultrasound guided prostatic nerve blockade for pain control during transrectal prostate biopsy.Methods Seventy-three patients requiring systematic 13 cores biopsy of the prostate were randomized into two groups.Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance,and group B(36 cases) received 5 ml saline ( 0.9% sodium chloride) at the same way.Pain during biopsy was assessed using a 10-point linear visual analog pain scale immediately after this procedure.Results The mean pain scores during transrectal prostate biopsy were significantly lower in group A than that in group B( 1.1? 0.6 vs 5.9? 3.1,t= 4.81,P

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 13 cores prostate biopsy. Methods A total of 160 patients referred for abnormal digital rectal examination and (or) prostate specific antigen 4ng/ml or greater underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.That was,in addition to the standard sextant biopsies,cores were taken from the far lateral and middle regions of the gland as described by Eskew.Pathological findings of the additional regions were compared with those of the sextant regions. Results Of the patients 35 % had cancer on biopsy(56 /160).Of the 56 patients with prostate cancer 12(21%)had carcinoma only in the additional regions,which would be undetected on the sextant biopsy technique (P

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound(TRUS) for prostate cancer detection Methods 438 patients referred to our hospital between August 1999 and August 2006 for biopsy of the prostate.Every patient received 6～13 biopsy cores of the prostate.If a hypoechoic was identified,the biopsy was taken from this lesion.Correlation between hypoechoic lesions,isoechoic areas and cancer detection for each core was performed.Results Among 438 patients,cancer was detected in 112(25.6%) patients.Hypoechoic lesions were seen in 75(67%)patients with prostate cancer,the isoechoic areas in 37(33%).A total of 3504 biopsy cores were obtained from 438 patients.Among them,636 biopsy cores were taken from hypoechoic lesions.163(25.6%)biopsy cores taken from hypoechoic lesions harbored cancer and 473(74.4%) had no cancer.The cancer detection rate was similar in patients with hypoechoic lesions on TRUS or not,25.4%(75/298)and 26.4%(37/140)respectively.The difference was not statistically significant(P

Objective To investigate the changes of platelet aggregation rate and platelet surface CD 41+CD62P+ expression af-ter clopidogrel discontinuation in the patients with percutaneous coronary interventions (PCI)) .Methods The platelet aggregation rates and platelet surface CD41+CD62P+ in 52 PCI patients with oral clopidogrel for near 12 months and discontinuation soon were measured before clopidogrel therapy(T0 ) ,in 1 week after clopidogrel therapy(T1 ) ,1 week before clopidogrel discontinuation(T2 ) , 1 week(T3 ) and 1 month after clopidogrel discontinuation (T4 ) .Results Compared with T0 ,the platelet aggregation rate and the expression of platelet CD41+CD62P+ at T1 were significantly decreased ,the difference showing statistical significance (P<0 .05) , which at T2 maintained the lower levels ;which at T3 were increased ,which at T4 were recovered to those at T0 .The platelet aggre-gation rates at various time points were (44 .20 ± 18 .36)% ,(25 .38 ± 12 .10)% ,(23 .74 ± 8 .15)% ,(51 .79 ± 10 .55)% and(45 .97 ± 16 .42)% respectively ,and the positive rates of CD41+ CD62P+ were(12 .96 ± 11 .48)% ,(3 .93 ± 3 .33)% ,(4 .72 ± 3 .14)% , (13 .90 ± 10 .38)% and(10 .84 ± 8 .13)% ,respectively .Conclusion In the patients treated with 12-month clopidogrel after PCI ,the platelet aggregation rate and the CD41+CD62P+ positive rate are mildly increased at 1 week after clopidogrel discontinuation and gradually returned to the level before discontinuation at 1 month after clopidogrel discontinuation .

Aim To investigate the anti-inflammatory molecular mechanism of chlorogenic acid extracted from Lonicera confusa DC in vitro.Methods PM? of a rat was segregated.MTT assay was used to detect the effects of the chlorogenic acid on PM? cells growth activities. PM? was stimulated with LPS for a prolonged period,ELISA was used to detect the level of TNF-?,IL-6 and PGE2 in the supernatant;COX-2 activity was determined by the level of PGE2 in the supernatant.After stimulating PM? with A23187 for a short time,the 6-keto-PGF1? level in the supernatant was measured by radioimmunoassay to express COX-1 activity.Results Chlorogenic acid had no inhibitive effects between 31.25 mg?L-1 and 1000 mg?L-1.The level of TNF-?,IL-6 and PGE2 in drug groups was lower than that of LPS-induced group,and the difference was significant,in a dose-dependent manner.The concentration of 50 mg?L-1 group was ineffective in the expression of TNF-?.Low concentration chlorogenic acid inhibited the expression of 6-keto-PGF1?,while high-concentration induced it.Conclusions The anti-inflammatory effect of chlorogenic acid may be related to inhibiting TNF-?,IL-6 activity and affecting exogenous AA metabolism.

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound (TRUS) for prostate cancer detection.Methods Four hundred and thirty-eight patients referred for biopsy of the prostate from August 1999 to August 2004. Every patient received 6-13 biopsy cores of the prostate. If a hypoechoic was identified, the biopsy was taken from this lesion. Correlation between hypo-echoic lesions, isoechoic areas and cancer detection for each core was performed. Results Among 438 patients, cancer was detected in 112(25.6%). Hypo-echoic lesions were seen in 75 (67%) patients with prostate cancer, the isoechoic were as in 37 (33%). A total of 3504 biopsy cores were obtained from 438 patients, and 636 biopsy cores were taken from hypoechoic lesions. Among 636 biopsy cores, 163 (25.6%) were cancer and 473(74.4%)were not. The cancer detective rate in patients with hypoechoic lesions (75/298, 25.2%) was similar to non-hypoechoic lesions (37/140, 26.4%) on TRUS. There was no statistically significant difference between them (P

To create a comparative referential system for syndrome classification study by viewing from the thinking characteristics of TCM on syndrome differentiation dependent therapy (SDDT), through analyzing the thinking process of SDDT, and the basic features of disease, syndrome and prescription, combining the basic principles of modern evidence-based medicine and feasibility of establishing integrative disease-syndrome animal model. The practice of creating a comparative referential system based on clinical efficacy of prescription was discussed around syndrome pathogenesis and its relationship with disease and prescription, which was one of the important scientific problems in TCM syndrome study. The authors hold that, it may be one of the available approaches for the present study on integration of disease with syndrome by way of insisting on the thinking pathway of stressing the characteristics of TCM and intermerging with modern scientific design; on taking the efficacy of prescription as the comparative reference system to accumulate and improve unceasingly according to the TCM method of syndrome diagnosis inferred from effect of prescription with reverse thought (i.e., to differentiate syndrome from the effect of prescription), and thus build up the syndrome diagnostic standard on the solid clinical and scientific base.
Clinical Medicine ; methods ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; methods ; standards

Objective To explore the mechanism of immunoregulation by investigating the effects of polysaccharides from Millettia speciosa Champ (MSC) on proliferation of spleen lymphocyte and secretion of cytokine in mice.Methods The effects of MSC polysaccharides on Con A-induced spleen T lymphocyte proliferation were determined by MTT.The contents of TNF-α, IL-6 and PGE2 were determined by ELISA.Results The Con A-induced T lymphocyte proliferation was significantly increased by MSC polysaccharides at the concentrations from 50 to 200 μg·mL-1.Coupled with TNF-α and IL-6 were significantly increased while PGE2 was significantly decreased.Conclusion MSC polysaccharides could increase proliferation of spleen lymphocyte and enhance the immune responses by increasing the secretion of TNF-α and IL-6 in mice.

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.

OBJECTIVETo determine the influence of androgen deprivation therapy (ADT) on bone mineral density (BMD) in men with prostate cancer.

METHODSForty-nine men with prostate cancer underwent BMD determination and then were classified into two groups: non-ADT group (21 cases), who were about to receive ADT, and ADT group (28 cases), who had received ADT for more than 1 year. BMD was determined by dual energy X-ray absorptiometry (DEXA) in the lumbar spine (L2-4) and femoral neck in all the patients. The Age-Matched Z scores were used as the reference standard for controlling the difference of age, sex and weight.

RESULTSThirteen (62%) of the non-ADT group and 23 (82%) of the ADT group fulfilled the BMD criteria for osteopenia or osteoporosis. Z scores for the Age-Matched control in the lumbar spine and femoral neck were -(0.9 +/- 0.7) and -(0.6 +/- 0.5) in the non-ADT group, and -(1.8 +/- 1.1) and -(1.6 +/- 1.0) in the ADT group, respectively (P<0.01). The men of the ADT group had significantly lower BMD in the lumbar spine and femoral neck than those of the non-ADT group.

CONCLUSIONPre-existing osteopenia and osteoporosis are common in men with prostate cancer before ADT. ADT is significantly associated with the loss of BMD and the evaluation of BMD is necessary before ADT for men with prostate cancer.

Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Bone Density ; Humans ; Male ; Middle Aged ; Orchiectomy ; Osteoporosis ; complications ; physiopathology ; Prostatic Neoplasms ; complications ; physiopathology ; surgery