Objective This retrospective study compared the detection rates of prostate cancer between freehand transperineal biopsy (FTPB) and template-guided transperineal biopsy (TYPB) in the patients with PSA levels ＜ 20 ng/ml.Methods From April 2017 to April 2019,768 patients with PSA levels ＜ 20 ng/ml were included into this study.Of these patients,406 underwent FTPB procedures and 362 underwent TTPB procedures.There were no significant differences of median age [66.00(61.00,70.00)vs.66.00 (61.00,71.25) years],height [170.00 (165.00,172.00) vs.170 (165.00,173.00) cm],weight [70.00 (63.88,75.00) vs.70.00 (63.75,75.00) kg],BMI [24.22 (22.22,25.95) vs.24.22 (22.49,25.82) kg/m2],PSA [8.75 (6.49,12.40) vs.8.69 (6.49,11.96) ng/ml],fPSA [1.18 (0.33,2.15) vs.1.15(0.76,1.88)ng/ml],prostate volume [39.79(25.55,53.94)vs.39.88(24.46,55.11)ml] between two groups.Patients' biopsy results were recorded,the differences of prostate cancer detection rates between these two groups were analyzed,specifically including the cancer with Gleason score ≥ 7 and the anterior zone cancer.Results The total prostate cancer detection rates were 33.7％ (137/406) and 39.0％ (141/362,P =0.134) in FTPB group and TTPB group respectively,and the detection rates of cancer with Gleason score≥7 were 23.9％ (97/406) and 32.0％ (116/362,P =0.012) respectively.The detection rates of anterior zone prostate cancer were 15.5％ (63/406) and 27.3％ (99/362,P ＜0.001).Moreover,in thepatients with PSA ＜ 10 ng/ml,the prostate cancer detection rates were 29.8％ (74/248) and 36.2％ (81/224,P =0.144) respectively,while the detection rates of cancer with Gleason score ≥7 were 19.4％ (48/248) and 29.9％ (67/224,P =0.008) respectively.Conclusions There was no significant difference in the total prostate cancer detection rates between 12-core TTPB group and 20-core FTPB group in the patients with PSA ＜ 20 ng/ml,but for the detection rate of cancer with Gleason score ≥ 7,TTPB group was significantly higher than FTPB group,especially in the patients with PSA ＜ 10 ng/ml.In addition,for anterior zone prostate cancer,the detection rate of TrPB group was also higher than FTPB group.

OBJECTIVETo compare the efficacy differences between abdominal acupuncture and western medication for diarrhea irritable bowel syndrome (IBS-D).

METHODSSixty-one patients with IBS-D were randomly assigned into an acupuncture group (30 cases after 1 dropping) and a western medication group (28 cases after 2 dropping). Acupuncture was used atpoints [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4)],points [bilateral Huaroumen (ST 24), Wailing (ST 26)],point [bilateral Daheng (SP 15)], once every other day, 3 times a week. Pinaverium bromide tablet was used orally in the western medication group, 50 mg a time, 3 times a day. All the treatment was given for 4 weeks in the two groups. IBS symptom severity score (IBS-SSS) and clinical symptom scores for abdominal pain and distension, diarrhea, poor stool output, defecation urgency and stool abnormality were observed before and after the treatment as well as 3 months after treatment. Adverse reactions were recorded and the effects were evaluated.

RESULTS①After treatment and at follow-up, the IBS-SSS scores of the two groups were lower than those before treatment (all<0.01). Compared with the western medication group, the scores and the improvements between the two time points and before treatment were better in the acupuncture group (<0.05,<0.01). ②The symptom scores in the two groups after treatment were lower than those before treatment including abdominal pain, abdominal distension, diarrhea, poor stool output, defecation urgency and stool abnormality (<0.05,<0.01), and the scores of abdominal pain, abdominal distension, diarrhea, poor stool output and stool abnormality in the acupuncture group were lower than those in the western medication group (<0.05,<0.01). ③The total effective rate and the cured and remarkable effective rate of the acupuncture group were higher than those of the western medication group [(86.7% (26/30) vs 64.3% (18/28),<0.05; 70.0% (21/30) vs 35.7% (10/28),<0.01)], and the therapeutic efficacy of the acupuncture group was better than that of the western medication group (<0.05). There was no adverse reaction.

CONCLUSIONAbdominal acupuncture is more effective for IBS-D than western medication and can relieve abdominal pain, abdominal distension, diarrhea, poor stool output, stool abnormality, with long-term effect.