Transrectal ultrasonography is one of the early diagnostic approaches of prostate cancer.In this article,the recent study progression of conventional transrectal ultrasonography with combination of new techniques,such as contrast-enhanced ultrasonography,elastography,image fusion,and so on,in diagnosis of prostate cancer was summarized on the basis of a review of the literatures.

Objective To explore the relationship between the quantitative parameter in transrectal power Doppler ultrasonography (PDUS) and angiogenesis of prostate nodules in pathology. Methods PDUS and the analytic software of color flow were used, and peak vascularization indexs (PVIs) of 94 prostate nodules in 73 patients were recorded. The biopsy specimen was stained with CD34 antibody, and the microvessel density (MVD) was calculated. The correlation between PVI and MVD was statistically analyzed. Results PVI and MVD of the malignant nodules, in both transition zone (TZ) and peripheral zone (PZ), were significantly higher than those of the benign nodules, respectively (P＜0.05). There was positive correlation between PVI and MVD of the malignant nodules (rTZ=0.76;rPZ=0.79), but no correlation between PVI and MVD was found in TZ of benign nodules (r=0.18), while there was correlation between PVI and MVD in PZ (r=0.44). In TZ, the sensitivity and speciality of differentiation malignant nodules from benign nodules were 78.57% and 80.77%, respectively, and in PZ they were 62.07% and 91.00%, respectively. Conclusion As a quantitative parameter in PDUS, PVI can indirectly reflect the angiogenesis of prostate cancerous nodules, providing a new method for differentiation malignant nodules from benign nodules.

Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.

Objective To observe the characteristics of normal prostate gland and benign prostatic hyperplasia (BPH) on transrectal real-time elastography (TRTE). Methods A total of 77 BPH patients and 17 normal subjects underwent TRTE. The elastographic images were analyzed with the five-point subjective elastic scale. The strain ratio of transition zone, peripheral zone, and transition zone to peripheral zone were respectively measured to compare the stiffness of each zone. Results The elasticity scores of both BPH group and normal prostate group were 1 and 2 in scoring system. There was no significant difference of elasticity scores between BPH group and normal prostate group (P=0.2252), as well as in strain ratio of transition zone (P=0.9793), peripheral zone (P=0.8986), and transition zone to peripheral zone (P=0.5233). Conclusion The stiffness of normal prostate gland and BPH could be offered by TRTE.

Objective To evaluate the value of transrectal real-time tissue elastography (RTE) targeted prostate biopsy in the peripheral zone combined with peak strain index.Methods One hundred and forty-one patients with suspicious prostate lesions in the peripheral zone were evaluated from February 2011 to February 2014.All the patients underwent RTE with a mean age of 71.6 years,PSA of 30 ng/ml,prostate volume of 50.3 ml and measured peak strain index (PSI).The diagnostic value of PSI was assessed by receiver operating characteristic (ROC) curve.Two-core RTE combined with PSI targeted prostate biopsy was taken and subsequently a 10-core systematic biopsy was taken.The value of RTE was evaluated.The data of targeted biopsy and systematic biopsy in prostate were both reviewed and statistically compared.Results Cancer was detected in 72 of 141 patients (PSI,mean 24.79),and 69 patients had benign prostate disease (PSI,mean 3.02).PSI value of prostate cancer was significantly higher than that of the benign lesions (P ＜ 0.05).Prostate cancer could be predicted with the highest sensitivity (87.5％) and specificity (88.6％) using the cutoff value of PSI ≥ 5.97 with an area under the curve of 0.95.RTE targeted biopsy combined with PSI could detect 95.6％ of moderate or high risk prostate cancer.One hundred and fifty-nine suspicious areas detected by RTE in 141 patients were biopsied with 2 cores for each area.The positive incidence of prostate cancer in RTE-targeted biopsy cores was 44％ and in systematic biopsy was 30.2％ (P ＜ 0.05).Among the 72 prostate cancer patients,63 cases (87.5％) were detected by RTE-targeted biopsy,62 cases (86.1％) by systematic biopsy (P ＞ 0.05).Conclusions RTE combined PSI can improve the detection rate of prostate cancer in the peripheral zone and likewise guide targeted biopsy combined with svstematic biopsy to detect more moderate or high risk prostate cancer.

Adult ; Biopsy ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; Male ; Melanoma ; diagnosis ; pathology

Objective To identify potential serum biomarkers specific for hepatocellular carcinoma (HCC).Methods Eighty-one patients wilh hepatitis B-related HCC and 80 healthy controls were randomly divided into a training set (48 HCC,47 controls) and a testing set (33 HCC,33 controls).Serum proteomic profiles were measured using surface-enhanced laser desorption/ionization time-offlight mass spectroscopy (SELDI-TOF-MS).A classification tree was established by the Biomarker Pattern Software.Candidate biomarkcrs were separated by HPLC and identified by MA1DI-MS/MS and database searching.Forty-eight patients with HCC,54 cirrhotic patients and 42 healthy subjects were clinically validated using candidate biomarkers by SELDI-Immunoassay.Real-time reverse transcriptase-polymerase chain reaction was performed to observe GRO-1 and Thrombin in 55 HCC tissues and 13 normal hepatolage tissues.Results Two up-regulated protein peaks were automatically chosen as a classification tree in the training set.These biomarkers were identified as thrombin light chain and CXC chemokines ligand 1 (GRO-1).The sensitivity and specificity of this classification tree were 89.6％.The multivariate model using the two biomarkers and alpha-fetoprotein (AFP) resulted in a sensitivity of 91.7％ and specificity of 92.7％,which was significantly better than AFP alone.The mRNA expression of GRO-1 and Thrombin were found in all HCC tissues.There were significant associations between GRO-1 gene expression and some clinical and pathological findings such as metastasis and recurrence (P＜0.05).Significant differences of 5-year survival rates wee observed among subgroups according to the expression of GRO-1 (P＜0.05).There were significant associations between Thrombin gene expression and some clinical and pathological findings such as recurrence and AFP (P＜0.05).Significant differences of 5-year survival rates were observed among the subgroups according to the expression of THROMBIN (P＜0.05).A positive correlation was found between GRO-1 and Thrombin (r=0.73,P＜0.01).Conclusion Thrombin light chain and GRO-1 are potential biomarkers of HCC.The expression of GRO-1 in HCC tissues was a valuable indicator in estimating metastasis and recurrence in HCC patients.

Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6)and soluble IL-6 receptor (sIL-6R)with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD)patients.Methods A total of 522 CHD patients were recruited and divided into three groups:stable angina pectoris (SAP),unstable angina pectoris (UAP)and acute myocardial infarction (AMI)groups.Another 102 healthy individuals served as normal controls (NCs).We calculated Gensini score according to the result of coronary angiography (CAG),collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP,IL-6 and sIL-6 R with Gensini score.Results The plasma hs-CRP,IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP,UAP and AMI groups than in NC group (P<0 .0 5 ).There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6 R and Gensini score presented by multiple linear regression analysis (P<0.05 ).Conclusion In CHD patients,plasma hs-CRP,IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis.These indicators may help predict the severity of CHD.

Objective To explore the trend of preductal pulse oxygen saturation (SpO2) during 10 min after birth in newborns born at different gestational age and through different delivery mode.Methods From May 2014 to August 2014,319 neonates,born in Tianjin Central Hospital of Obstetrics and Gynecology and whose Apgar score at 1 min after birth ≥ 8,were included into the study.Term infants were grouped into vaginal delivery group (n=102) and caesarean group (n=117) according to the delivery mode.Infants born through caesarean section were divided into three groups,including 30-33+6 weeks (n=50),34-36+6 weeks (n=50) and 37-41+6 weeks (n=117) group according to the gestational age at birth.Immediately after the umbilical cord clamped,preductal SpO2 was recorded at each minute from one to ten minutes using the pulse oximetry.Oneway analysis of variance and two independent sample t test were applied for statistical analysis.Results At each time point within ten minutes after birth,the preductal SpO2 for preterm infants of 30-33+6 weeks gestation in the caesarean group were (54± 3)％,(59± 3)％,(65 ±4)％,(70±4)％,(75 ±4)％,(80±4)％,(84± 3)％,(89± 3)％,(91 ± 3)％ and (93 ± 2)％,respectively,which were significant lower than those of the 34-36+6 weeks group [(57 ± 5)％,(66 ± 4)％,(72 ± 6)％,(78 ± 6)％,(83 ± 6)％,(87 ± 6)％,(90± 5)％,(92 ± 4)％,(94± 4)％ and (95 ± 4)％,respectively] and of the term infants [(58 ± 3)％,(67 ± 4)％,(73 ± 5)％,(78 ± 6)％,(83 ± 6)％,(87 ± 6)％,(90± 5)％,(92± 5)％,(94± 3)％ and (95± 3)％,respectively] (all P ≤ 0.05).While the corresponding preductal SpO2 for term infants in the vaginal delivery group were (61 ± 6)％,(69± 7)％,(75 ± 6)％,(81 ± 7)％,(86± 6)％,(90 ± 6)％,(93 ± 5)％,(94± 4)％,(95 ± 4)％ and (96 ± 3)％,respectively,which were all higher than those of term infants in the caesarean group (all P ≤ 0.05).Conclusions The preductal SpO2 for preterm infants of 30-33+6 weeks of gestation is lower than that of preterm and term infants of ≥ 34 weeks of gestation at all time points within ten minutes after birth.The preductal SpO2 for term infants born through vaginal delivery is higher and rising faster than that of term infants born through caesarean section at all times.

Objective To investigate the effect of sarcopenia and vitamin D deficiency on osteoporosis (OP) in patients with rheumatoid arthritis (RA).Methods Six hundred and forty-eight patients with RA were enrolled into the study,while 158 normal subjects were recruited as the control group.Bone mineral density (BMD) at total hip and lumbar vertebra 2-4 were measured by dual energy X-ray absorptiometry (DEXA),limbs skeletal muscle mass was determined in 267 patients with RA and 156 normal subjects by bioelectrical impedance method.Serum 25-hydroxy vitamin D [25(OH)D] levels were determined by electrochemiluminescence in 234 RA patients and 68 normal subjects.Clinical and laboratory features,daily dosage and duration of glucocorticoid (GC) were recorded.Numerical data and categorical data comparisons were analyzed using t test,x2 test,linear correlation analysis,single factor analysis of variance test and Logistic regression analysis test.Results ① Incidence of OP in RA (37.8％,245/648) was significantly higher than that in the controls (13.9％,22/158)(x2=32.712,P＜0.01).Incidence of sarcopenia was evidently higher in RA,compared with normal subjects [55.8％(149/267),9.0％(14/156),x2=91.176,P＜0.01].Percentage of sarcopenia was higher in RA with OP compared with RA without OP group [76.6％(49/64),39.3％(35/89),x2=20.848,P＜0.01].②Compared to control group,serum 25 (OH)D levels were significantly lower in RA group [(13.4±9.7) ng/ml,(22.4±6.3) ng/ml,t=9.063,P＜0.01].Rate of vitamin D deficiency iu RA was also higher than that in controls [80.8％(189/234),36.8％(25/68),x2=49.412,P＜0.01].③The differences of serum 25 (OH)D levels among different bone metabolic state groups at lumbar vertebra in RA (normal bone mass,osteopenia,OP) were statistically significant (F=6.263,P=0.003),whichrepresented a clearly decreasing trend along with the decreasing of serum 25 (OH)D levels (P=0.001).④Linear correlation analysis found that skeletal muscle mass indexes at limbs in RA were positively correlated with BMD and serum 25 (OH)D levels (P＜0.05).⑥Logistic Regression analysis revealed that sarcopenia (OR=4.373,P=0.002),age (OR=1.083,P=0.001) and duration of disease (OR=1.074,P=0.029) were the risk factors for occurrence of OP in patients with RA.Conclusion Sarcopenia generally exists in patients with RA,which is correlated with decreasing of serum 25 (OH)D levels,and also is the risk factor for the occurring of OP in RA.