Objective To investigate the effect of naftopidil in the treatment of prostatitis in the elderly on MIP-2 and MIP-1αin serum and succus prostaticus.Methods 78 elderly patients with chronic prostatitis were randomly divided into the control group and the observation group, 39 cases in each group.The control group were treated with Diosmin routine treatment, the observation group were treated on the basis of the control group combined with naftopidil tablets in the treatment,2 groups were treated continuous for 8 weeks.MIP-2 and MIP-1αin serum and prostatic fluid before and after treatment were compared, and the maximum urine flow rate and clinical efficacy were compared after the treatment.Results compared with pre-treatment, MIP-2, MIP-1αin serum and prostate fluid in 2 groups after treatment decreased, NIH-CPSI and QOL scores in 2 groups decreased, the maximum urinary flow rate increased (P<0.05);compared with the control group, the levels of MIP-2, MIP-1αin the serum and prostatic fluid, NIH-CPSI and QOL of observation group were lower, and the maximum urine flow rate was higher (P<0.05);Compared with the control group, the total efficiency of the observation group was higher (P<0.05).Conclusion Naftopidil can significantly reduce the elderly patients with chronic non bacterial prostatitis and serum of patients with prostatic fluid MIP-2, MIP-1αlevel and improve pain in urination, dysuria symptoms.

Objective:To detect the value of utilizing bpMRI in prostate biopsy in the detection of prostate cancer with PSA≤20ng/ml.Methods:The clinical data of 394 patients who underwent prostate biopsy in the First Affiliated Hospital of Nanjing Medical University from November 2017 to October 2019 were retrospectively analyzed. Of all the patients, 177 underwent modified systematic biopsy, named TRUS group, 217 patients accepted pre-biopsy bpMRI examination, undergoing modified systematic biopsy if Prostate Imaging Reporting and Data System (PI-RADS) score < 3 or MRI-TRUS cognitive fusion targeted prostate + systematic biopsy if PI-RADS score ≥ 3, named MRI group. The median age of TRUS group was 66 (61, 74) years old, prostate specific antigen (PSA) was 9.52 (7.26, 12.30) ng / ml, and prostate volume (PV) was 36.84 (28.95, 57.72)ml. The median age of MRI group was 66 (59, 72) years old, PSA was 8.84 (6.65, 12.16) ng/ml, and PV was 39.45 (29.25, 58.69)ml. There was no difference in above parameters between the two groups. The χ 2 test was used to compare the detection rate of prostate cancer and clinically significant prostate cancer (CsPCa) between the two groups. Results:There was no significant difference in the detection rates of prostate cancer between TRUS group and MRI group [51.41% (91/177) vs. 48.39% (105/ 217), P = 0.550], but the detection rates of CsPCa were significantly different [26.55% (47/177) vs. 36.41% (79/217), P = 0.037]. In patients with PSA ≤ 10 ng / ml, there was no significant difference in the detection rates of prostate cancer between the two groups [43.62% (41/94) vs. 43.08% (56/130), P = 0.936], but there was a significant difference in the detection rates of CsPCa [17.02% (16/94) vs. 28.46% (37/130), P = 0.047]. There was no significant difference in the detection rates of prostate cancer [60.24% (50/83) and 56.17% (48/87), P= 0.504] and the detection rates of CsPCa [37.35% (31/83) vs. 48.28% (42/87), P = 0.150] between the two groups. The total detection rates of the last two needles in TRUS group and MRI group were 23.16% (41/177) and 36.63% (86/217), respectively, with significant difference ( P=0.001); the detection rates of CsPCa in the last two needles were 11.86% (26/177) and 29.03% (63/ 217), respectively, with significant difference ( P < 0.001). In MRI group, the detection rates of prostate cancer in patients with PI-RADS score <3, 3, 4, 5 were 21.21% (7/33), 25.84% (23/89), 73.24% (52/71), 95.83% (23/24), respectively; the detection rates of CsPCa were 12.12% (4/33), 17.98% (16/89), 54.93% (39/71), 83.33% (23/24), respectively. Conclusions:In patients with PSA ≤ 20 ng / ml, prostate biopsy based on bpMRI may improve the detection of CsPCa, especially in patients with PSA ≤ 10 ng/ml.

Objective To clarify the MRI characteristics and outcomes of patients with end stage hypertrophic cardiomyopathy (ES-HCM).Methods Clinical and MRI data of 57 ES-HCM patients were retrospectively analyzed.ES-HCM pa tients were divided into dilated phenotype group (D-ES group,n=39) and restrictive phenotype group (R-ES group,n=18).MRI characteristics and outcomes of patients were compared between both groups.Results The incidence of atrial fi brillation and edema of lower extremity was significantly higher in R-ES than those in D-ES (72.22％ [13/18] vs 30.77％ [12/39];50.00％ [9/18] vs 23.08％ [9/39];both P＜0.05).The left ventricular ejection function,left and right atrial anteroposte rior diameter of D-ES group were significant smaller than those of RRES group (all P＜0.05),while the left ventricular (LV) short axis diameter,LV end diastolic/systolic volume and LV end diastolic/systolic volume index of D-ES were significantly greater than those of R-ES group (all P＜0.05).Log-rank test found no significant difference between both groups in cardiovascular death/ heart transplant events (x2 =1.135,P=0.287).Late gadolinium enhancement (LGE) volume fraction was significantly larger in D-ES ([36.1±14.8]％) than in R-ES ([21.0±9.0]％;P＜0.05).There was a significant correlation between LGE volume fraction and cardiovascular death/heart transplant events (HR:1.054,P＜0.05).Conclusion ES-HCM patients have expanded clinical expression and MRI characteristics,including dilated phenotype and restrictive phenotype.MRI has an important application value in the diagnosis and prognosis evaluation of ES-HCM.

ObjectiveTo study the value of C-reactive protein (CRP) and interleukin-6(IL-6) in the (diagnosis) of acute pancreatitis (AP) associated with infection. MethodsSixty SD rats were randomly (assigned) into group AP (n=40) and sham-operation group (S, n=20). Plasma CRP and IL-6 were detected before AP(0h), and at 12h, 24h and 48h after AP. Serum amylase detection and ascitic bacteria culture were carried out at 48h. Results(1)In AP group, 36 rats were alive. Ascitic infection developed in 16 cases (group AP1), and not in the other 20 cases (group AP2). (2)Plasma CRP and IL-6 levels in group AP1 and AP2 were significantly higher than those in group S (all, P0.05). (3)In group AP1, IL-6 and CRP elevated significantly at all time periods after the model setup (P0.05). (Conclusions)Plasma CRP has predictive value in the diagnosis of early infection in acute pancreatitis, but plasma IL-6 is not sensitive to secondary bacteria infection in acute pancreatitis.

Objectives To discuss the characteristics of late gadolinium enhancement (LGE) magnetic resonance (MR) imaging in patients with hypertrophic cardiomyopathy (HCM) and left ventricular apical aneurysm (LVAA) and its related prognostic value. Methods Thirty HCM patients with LVAA were collected from August 2004 to August 2013. All cases with coronary artery diseases were ruled out, and all patients underwent LGE derived by cardiac MR (CMR). Five cases of LVAA were pathological confirmed. Atrial and ventricular diameters, apical aneurysm diameters and left ventricular ejection fraction were measured, and apical aneurysm LGE was evaluated. All patients were then followed up. Comparisons in continuous parameters between patients with or without LGE were performed by independent t test. A Cox proportional hazard model was used to estimate the hazard rate for adverse cardiovascular events. Results LGE was identified in 21 LVAAs and non-LGE in 9 LVAAs. Between two groups, there was no significant difference in the size of LVAA [(16.4 ± 11.5) mm vs. (20.3 ± 9.8) mm, P=0.63]. In particular, the complete transition from non-LGE to LGE LVAA was recorded during follow-up in one patient. Pathological findings confirmed that LGE indicated fibrous tissue in LVAA, and LVAA without LGE indicated viable myocardium. The follow-up suggested that the patterns and the size of LVAA were associated with the adverse events in these patients (LGE of LVAA, HR=7.94, P=0.064; the size of LVAA, HR=1.08, P=0.009). Conclusions LGE-MR had important clinical significance in HCM patients with LVAA. LGE in LVAA corresponded with the fibrous tissue and was associated with the prognosis.

Objective To study the early prediction of infection in acute pancreatitis in rats by plasma procalcitonin (PCT) and c-reactive (CRP) detection.Methods Eighty SD rats were randomly assigned into acute infected pancreatitis group (I, n=20), pancreatitis control group (C, n=40) and sham-operated group (S, n=20). Blood samples were collected pre- (0h) and post-operatively (12h, 24h and 48h). Plasma CRP was analyzed by ELISA. Plasma and liver PCT was detected by Western blot.Results (1). Ascitic infection occurred in all the group B rats and 16 of 40 rats of group C (analyzed as group C1), and did not occur in the other 20 of 40 rats of group C (analyzed as group C2) and group S. (2). The plasma CRP concentrations elevated gradually after the model setup in group B and C1, which were significantly higher at 48h than those in group C2 and group S. (3). PCT was detected in high levels in plasma and liver tissues in group B and C1 at 48h post-operatively, and they were sighificantly higher than those in group C2 and group S.Conclusions PCT can predict early infection of acute pancreatitis, and detection of PCT combined with plasma CRP may help in the differentiation of acute infected pancreatitis. The liver may be an important organ for synthesis of PCT.

Objective To explore the clinical usefulness of low-dose dual-source CT (DSCT) angiography in detecting coronary artery anomaly (CAA) in patients with complex congenital heart disease (CHD). Methods A total of 615 consecutive patients with complex CHD who underwent DSCT angiography between 2008 and 2012 were retrospectively reviewed. According to the ultrasonic results, a total of 312 patients with tetralogy of Fallot (n=176 cases) or double outlet right ventricle (n=72 cases) or pulmonary artery atresia (n=64 cases) were included. Scans were divided into 3 groups: retrospective electrocardiogram (ECG)-triggered spiral scanning in 75 cases, prospective ECG?triggered spiral scanning in 158 cases, and prospective ECG?triggered high?pitch spiral scanning in 79 cases. The subjective image quality was evaluated with a four?point scale by two radiologists. Radiation dose values were calculated. Interobserver agreement in subjective image quality grading was assessed by using Kappa statistics. The scanning groups were compared with the Kruskal?Wallis test. Results The incidence of CAA was 8.0 %(25/312). CAA was detected in 7.9%(14/176)patients with tetralogy of Fallot, 8.3%(6/72)patients with double outlet right ventricle, 7.8%(5/64)patients with pulmonary artery atresia. In 76%(19/25)of the patients, the anomalous vessels were crossing the right ventricular outflow tract (RVOT). Thirty of 312 CT examinations were nondiagnostic (9.6%). Two radiologists acquired good agreement (Kappa=0.72,P<0.01). The median subjective image quality score of three scan groups was 3 (range 1—4). The score in high?pitch spiral scanning group was significantly lower than those in other two groups (H=29.1,P<0.01). Retrospective ECG?triggered scans had a median dose of 1.19 mSv(range 0.52—3.29 mSv), prospectively ECG?triggered scans had a median dose of 0.51 mSv(range 0.27—2.13 mSv), and prospectively ECG?triggered high?pitch spiral scans had a median effective dose of 0.30 mSv(range 0.18—0.62 mSv). The difference between groups was statistically significant (H=160.0, P<0.01). Conclusions DSCT angiography is a reliable diagnostic method for the assessment of CAA with complex CHD and low?dose prospectively ECG?triggered DSCT scan is the best choice.

Objective To evaluate the imaging diagnosis of anomalous origin of coronary artery from the pulmonary artery(ACAPA).Methods A total of 11 cases with ACAPA were included in the present study.Chest films,echocardiography,cardioangiography,and electron beam computed tomography (EBCT) were employed as diagnostic modalities.Macroscopic anatomy at operation was referred. Results Ten cases were classified as anomalous origin of left coronary artery from the pulmonary artery(ALCAPA) and 1 case as anomalous origin of right coronary artery from the pulmonary artery(ARCAPA).They could not be diagnosed by chest films,but could be diagnosed by echocardiography in 3 cases,by EBCT in 1 case,and by cardioangiography in all cases.In ALCAPA,cardioangiography showed that the left coronary arteries arising from the posterior sinus or posterior wall of the pulmonary artery were perfused retrogradely via the collaterals from the dilated right coronary artery.In ARCAPA,the right coronary artery originated from the right sinus of the pulmonary artery.Gross anatomy at operation showed that the sites of the anomalous origins were the same as that of cardioangiography.Ischemic fibrosis of the anterior papillary muscles,mitral valve annulus enlargement,and prolapse of mitral valve,which led to mitral valve insufficiency,were found in 3 cases.Conclusion Chest film has limitation in the diagnosis and echocardiography should be further improved.Cardioangiography remains the “gold standard” of the preoperative diagnosis.

ObjectiveTo assess the value of free-breathing 3D phase sensitive inversion recovery (PSIR) turbo FLASH for demonstrating the left ventricular myocardial scar in patients with myocardial infarction.MethodsTwenty-three patients with myocardial infarction underwent 2D and 3D phase sensitive inversion recovery (PSIR) Turbo FLASH sequences 10-15 minutes after injection of dimeglumine gadopentetate.The image quality,the area,location and volume of hyperenhanced scar were independently assessed by two experienced radiologists.Student′s t test or rank sum test and Pearson linear correlation were used for the statistics.ResultsThere were no significant differences in the overall image quality (2.57 ±0.59 vs 2.39 ±0.66,Z=-0.93,P =0.35),the area (24.48 ±10.83 vs 29.00 ± 11.56,Z=-1.41,P =0.16) and location ( 16.78 ± 6.51 vs 18.87 ± 6.76,Z =- 1.17,P =0.24) of hyperenhanced scar between 2D and 3D PSIR sequences.The mean volume of hyperenhanced scar was significantly greater in 3D PSIR sequence than that in 2D PSI R sequence [(23.46 ± 10.61 ) vs (31.65 ±　 13.86) cm3,t =-2.25,P =0.03].There was a good correlation in the volume of hyperenhanced scar between 2D PSIR and 3D PSIR sequences (r=0.940,P＜0.01 ;y =2.851 + 1.228x,R2 =0.883).ConclusionFree-breathing 3D PSIR Turbo FLASH is a promising new imaging technique for accurate assessment of myocardial scar.

marked hi-atrial dilation, near-normal ventricular chambers and near-normal ventricular thickness were presented. Conclusion MRI is an excellent imaging modality for the diagnosis of restrictive cardiomyopathy.