Objective To investigate the clinical value of individualization of transrectal ultrasound guided prostate biopsy strategies for prostate cancer detection.Methods Ninety-seven patients who were considered having prostate cancer underwent individualization prostate biopsy strategies as individualization group.Fifty-two patients who were considered having prostate cancer underwent systemic 6-core prostate biopsy as control group.The detection rate of prostate cancer and rate of complications were compared between two groups.Results The detection rate of prostate cancer in individualization group was 43.3 ％(42/97),there was no significant difference in age and prostate volume between the prostate cancer patients and the non-prostate cancer patients(P＞0.05),but the prostate specific antigen(PSA)level of the prostate cancer patients was significantly higher than that of the non-prostate cancer patients[(26.4±2.9)μ g/L vs.(11.2±3.1)μ g/L,P=0.0000].The detection rate of prostate cancer in control group was 23.1％(12/52),the detection rate of prostate cancer in individualization group was significantly higher than that in control group(P=0.014).There was no significant difference in the rate of complications between two groups(P＞0.05).Conclusions The first detection rate of prostate cancer in individualization of transrectal ultrasound guided prostate biopsy strategies is higher than that by systemic 6-core prostate biopsy,and the rate of complications is not increased.The individualization of transrectal ultrasound guided prostate biopsy strategies for prostate cancer is good,safety,deserve clinical expansion.

BACKGROUND: Most cases of early-onset familial Alzheimer disease (AD) are associated with presenilin-1 mutation, which mainly occurs in the 5th and 8th exons. Except for the onset age and family history, sporadic AD is basically the same as early-onset familial AD regarding clinical manifestations and pathological characteristics. Is its pathogenesis also related to the mutation of presenilin-1 gene?OBJECTIVE: To probe into the relationship between sporadic AD and presenilin-1 mutation.DESIGN: Case control analysis based on clinical diagnosis.SETTING: Neurology Department of the First Hospital Affiliated to Sun Yat-sen University.PARTICIPANTS: Outpatients who came to the Memory Obstacle Clinic of the First Hospital Affiliated to Sun Yat-sen University between April 1998 and June 2000 but without familial history of AD were selected and divided into 3 groups: [1] AD group: There were 68 cases confirmed as probable having AD according to the clinical diagnostic standard of NINCDS-ADRDA. [2] Vascular dimentia (VaD) group: There were 25 cases confirmed as probable having vascular dimentia according to the clinical diagnostic standard of NINCDS-ADRDA. [3] Normal control group: There were 20 healthy elders (spouses of some patients in the above two groups)without dimentia.METHODS: The conventional phenol extraction method was used to withdraw DNA from peripheral blood, and polymerase chain reaction-single strand conformation polymorphism analysis (PCR-SCCP) was applied to detect the mutation of the 5th and 8th exons in presenilin-1 gene.RESULTS: All the 5th and 8th exons in presenilin-1 gene were proved to be composed of two single strands and a double strand by PCR-SCCP analysis.No abnormal electrophoresis was found, suggesting no that mutation occurred.CONCLUSION: Sporadic AD differs from familial AD in pathogenicity;mutation does not occur or seldom occurs in the 5th and 8th exons in presenilin-1 gene, thereby cannot be considered as an important causive factor for sporadic AD.

Objective To explore the relationship between the endogenous plasma cortisol and the airway remodeling associated cytokines which was infected respiratory syncytial virus (RSV) through measuring the levels of them.Methods Forty-two infants diagnosed as acute RSV infection were divided into two groups,severe group(21 cases) and mild group(21 cases),as well as 21 healthy infants for control group.The levels of matrix metalloproteinase-9 (MMP-9),tissue inhibitor of metalloproteinase-1 (TIMP-1) and transforming growth factor- β1 (TGF- β 1) were determined by ELISA,the levels of plasma cortisol were determined by radio immunoaasay.Results The levels of plasma cortisol in severe group [(236.25 ± 119.87)μg/L] were significantly higher than those in mild group [(130.62 ±73.04)μg/L] and control group [(56.35 ±34.52)μg/L],there were significant differences (P ＜0.05),and the mild group was significandy higher than the control group(P＜ 0.05).The levels of TIMP-1 and TGF- β 1 in severe group were significantly higher than those in mild group(P＜ 0.05),and the mild group was significantly higher than the control group (P ＜ 0.05 ); the ratio of MMP-9 and TIMP-1 in severe group was significantly lower than that in control group (P ＜0.05);the levels of MMP-9 in severe group were significantly higher than those in mild group (P ＜0.05).The levels of lymphocytes,eosinophilic cells and CD4+,CD8+ in severe group were significantly lower than those in mild group (P＜0.05),and significantly lowerthan those in control group (P ＜ 0.05 ).The levels of eosinophilic cells and CD8+ in mild group were significantly lower than those in control group(P ＜ 0.05 ).Conclusion The infection of RSV results in the imbalance of the airway remodeling associated cytokines,which is a danger factor,and the imbalance may be related to the increased level of the plasma cortisol.

Objective To evaluate the inflammatory response in the airway of healthy rats following exposure to motor vehicle exhaust. Methods Sixty healthy SD rats(30 males and 30 females,aged 6 weeks) were randomly divided into 6 groups. The rats in the exposed groups were placed by the main traffic road and those in the control group were placed in the normal laboratory environment. The bronchoalveolar lavage fluid(BALF) was analyzed on the 14th,30th and 90th day of exposure .WBC,NO,TNF-?,and IL-8 in BALF of the rats in each group were tested. Results The NO content [(9.75?4.78) ?mol/L] in BALF of the rats in the group exposed for 30 days was obviously higher than that in the control group [(4.40?1.45) ?mol/L],but there was no any obvious difference between the two groups in terms of the content of TNF-? and IL-8 in BALF. Conclusion This study demonstrates that exposure to vehicle exhaust can induce inflammatory response in healthy rats,the on-the-spot experiment on animal exposure can be used to observe early respiratory tract inflammation and 30 days of exposure is the sensitive period for the change of the inflammatory indicators.

Objective To evaluate the relationship between Helicobacter pylori antigen in saliva and the activity of gastritis and like intestinal metaplasia(IM)or atypical hyperplasia(AH).Methods From June 2004 to June 2005 Helicobacter pylori antigen were detected in saliva of 246 persons by enzyme-linked immunosorbent assay(ELISA),and the Hp-positive rates in saliva in patients with different gastritis were compared.Results The Hp-positive rate in saliva in patients with active chronic gastritis was 74.29%(26/35),which was significantly higher(P

Objective:To explore the effect of continuous pumping normal saline at same infusion speed before flushing or sealing the tube on the hemodynamics of patients with hypovolemic shock receiving norepinephrine.Methods:A total of 56 cases of hypovolemic shock patients receiving norepinephrine via micro-pump were randomly assigned to the observation group and the control group (28 cases in each group). Patients in the control group received conventional operation method to flush or seal the tube, while patients in the observation group continued pumping normal saline at the same infusion speed, followed by flushing or sealing the tube based on the control group. The changes of hemodynamics after flushing or sealing the tube was compared between two groups.Results:After 30 s, 1 min, 2 min, 3 min, 5 min of flush or seal the tube, the systolic blood pressure were (105.4±17.4) mmHg, (106.3±21.3) mmHg, (102.1±14.5) mmHg, (100.6±16.9) mmHg, (101.0±14.3) mmHg (1 mmHg=0.133 kPa), mean arterial blood pressure were (81.1±8.6) mmHg, (82.4±9.9) mmHg, (78.6±7.3) mmHg, (76.9±6.7) mmHg, (75.7±6.5) mmHg in the observation group, lower than those in the control group [(150.6±26.7) mmHg, (151.8±30.1) mmHg, (139.7±29.8) mmHg, (125.3±25.3) mmHg, (114.4±21.6) mmHg and (107.4±11.6) mmHg, (106.1±11.5) mmHg, (98.1±11.1) mmHg, (88.9±9.6) mmHg, (79.5±8.0) mmHg], the differences were statically significant ( P<0.05). After 30 s, 1 min, 2 min, 3 min of flush or seal the tube, the diastolic blood pressure were (69.0±10.50)mmHg, (70.5±10.7)mmHg, (66.9±8.3)mmHg, (65.1±6.2)mmHg in the observation group, lower than those in the control group [(85.9±11.6) mmHg, (83.3±8.7) mmHg, (77.3±7.4)mmHg, (70.7±7.2) mmHg], the differences were statically significant ( t value was 10.199-18.464, P<0.05). Conclusions:Before flushing or sealing the tube, continue pumping normal saline at same infusion speed can reduce the risk of abnormal hemodynamics for the hypovolemic shock patients receiving norepinephrine via micro-pump.

Objective To analyse the efficacy of lamivudine(LAM) combined adefovir dipivoxil(ADV) and entecavir(ETV) in the treatment of naive patients with chronic hepatitis B (CHB) .Methods Cochrane Library ,MEDLINE ,Web of Science ,CNKI (China National Knowledge Infrastructure ) ,WANFANG database and VIP database were searched and the references of eligible studies were screened .All relevant literatures published before March 6th ,2012 were reviewed .Comparison of the efficacy of lami-vudine combined adefovir dipivoxil and entecavir in the treatment of naive patients with chronic hepatitis B was included and Rev Man 5 .1 software was used for Meta analysis .Results Four eligible studies (587 patients in all) were included for the analysis .In the entecavir monotherapy group ,the serum ALT normalization rate was a little higher at the 12 weeks and 24 weeks of the treat-ment compared to the combination group[OR=0 .52 ,95% CI(0 .28 ,0 .97) ,Z=2 .04 ,P=0 .04] ,[OR=0 .45 ,95% CI(0 .22 ,0 .95) , Z=2 .11 ,P=0 .04] ,respectively .But after 36 weeks there was no significance between the two groups .For HBV DNA undetect-able rate ,there were no significant differences between the two groups at the 12 weeks ,24 weeks ,36 weeks ,48 weeks ,18 months , 24 months and 30 months of the treatment (P=0 .22 ,P=0 .30 ,P=0 .86 ,P=0 .31 ,P=0 .93 ,P=0 .84 and P=0 .83 respectively) . At the 48 weeks ,HBeAg negative rate has no significant difference between the two groups [OR=0 .93 ,95% CI(0 .29 ,2 .95) ,Z=0 .13 ,P=0 .90] .Conclusion Both LAM+ADV combination therapy and ETV monotherapy are effective in the treatment of naive patients with CHB ,but further studies are still needed to obtain long term results and safety by high quality ,large scale randomized controlled trials .

Objective To analyze the clinical features of severe pneumonia complicated with congenital heart disease (CHD) . Methods The clinical data of 270 children patients with severe pneumonia complicated with CHD (CHD group) were collected to analyze the relative medical history ,etiology ,bacterial drug resistance and clinical outcomes .Moreover ,636 age-matched children pa-tients with pure severe pneumonia were selected as the control group .Results In the CHD group ,250 cases were infants and 35 ca-ses suffered from repeated pneumonia .Compared with the control group ,the CHD group was earlier in onset and more prone to re-peated pneumonia .Among 270 cases ,totally 220 cases were checked out the pathogens ,but no statistically significant difference in the detection rates of pathogens between the CHD group and the control group was found (P>0 .05);179 cases were infected by bacteria ,in which 126 cases were Gram-negative bacteria ,the positive rate of bacterial infection and the detection rate of Gram-nega-tive bacterial were relatively higher than those in the control group ,the difference was statistically significant (P<0 .05);95 cases were infected by virus ,with respiratory syncytial virus being the most common pathogen ,30 cases were infected by fungi ,with Can-dida albicans being predominant ,the infection rates of virus and fungus had no statistical difference between two groups (P>0 .05);in the drug sensitive test ,the detection rate of extended spectrum beta lactamase (ESBLs)-producing positive bacteria in the CHD group was higher than that in the control group ,the difference was statistically significant (P<0 .05) .Main Gram-negative bacteria Pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus inf luenzae were highly sensitive to imipenem ,mero-penem ,levofloxacin and ciprofloxacin ;main Gram-positive bacteria Staphylococcus aureus and streptococcus pneumoniae were highly sensitive to vancomycin and gentamicin .Especially ,pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus influenzaewere100% resistanttopenicillin.TheaveragelengthofhospitalstayintheCHDgroupwas (20.9±12.5)d,207cases developed the respiratory failure ,88 cases appeared the heart failure and 205 cases were effective in treatment ;compared with the control group ,the CHD group had a longer length of hospital stay ,higher occurrence rate of heart and respiratory failure and lower treatment effective rate (P<0 .05) .Conclusion Because of the earlier onset ,more prone to repeated pneumonia ,more sensitive to bacterial infection ,esp .Gram-negative bacteria ,more ESBLs production ,longer hospital stay and more prone to complications ,com-pared with the control group ,children with severe pneumonia complicated with CHD require active treatment .

Objective To investigate the effect and possible mechanism of erlotinib,an epidermal growth factor recceptor inhibitor,on human pancreatic cancer cell lines BxPC3 in vitro.Methods Methyhhiazolyhetrazolium(MTT)assay was used to detected the proliferation of BxPC3 after exposure to erlotinib,apoptosis and cell cycle changes were studied by flow eytometry and terminal deoxynucleotidyl transferase-mediated nick end labeling assay(TUNEL).The expressions of bcl-2 mRNA,bax mRNA,bcl-xL mRNA and bak mRNA were determined by reverse transcriptase polymerase chain reaction(RT-PCR). Results Edotinib inhibited BxPC3 cells growth in a dose and time dependent manner in vitro.The cell viabilities in erlotinib 1 μmol/L and 100 μmol/L groups 72 h later were(90.25 ±2.62)%and(40.75 ±2.98)%,and the difference was statistically significant(P<0.01).The cell viability in edotinib 50 μmol/L groups 24 h and 96 h after BxPC3 exposure were(74.0±4.08)%and(49.50 ±1.29)%,and the difference was statistically significant(P<0.01).Cell apoptosis rate in erlotinib 50 μmol/L group was(11.0 μ1.1)%,which was significantly higher than(6.2 ±1.1)%in control group(P<0.01).G_0/G_1 cell accounted for (73.4±1.3)%of all the cells,which was significantly higher than(63.3 ±1.O)%in control group.With transmission electron microscope,the morphology of BxPC3 ceils showed typical apoptosis and apoptotic body. The expressions of bcl-2 mRNA,bel-xl mRNA were down-regulated,while the expression of bax mRNA was slightly up-regulated,and the expression of bak mRNA was not affected.Conclusions The growth of BxPC3 cells could be suppressed by erlotinib and possible mechanisms involved blocking cell cycle,up-regulating apoptosis proteins and down-regulating apoptosis inhibitor proteins.

Objective:To prepare Dermatophagoides farinae (Der f) crude protein to establish BALB/c bronchial asthma model , and to observe the morphology and degranulation of mast cells and detect related cytokines .Methods: Dermatophagoides farinae ( Der f) crude protein were prepared by trituration .30 BALB/c mice were randomly divided into 3 groups:PBS control group (A), asthma model group (B) and Der f crude protein treatment group (C).Group A were treated with PBS(100 μl) all the time, group B and group C were treated with 50 μg Der f crude protein mixed with 50μl alum adjuvant on day 0,day 7 and day 14.On day 28 group A and B were subcutaneous injected with PBS (100 μl) and group C were subcutaneous injected with Der f crude protein (350μg) in PBS(100 μl) at 1-day intervals.One week after the last treatment ,group A,B and C were intranasally challenged with 50 μg Der f crude protein daily for seven days .Twenty-four hours after the last challenge , airway hyper-responsiveness ( AHR) was assessed by using whole-body plethysmography .Two days post challenged , mice were sacrificed and bronchoalveolar lavage fluid ( BALF) was collected.Number of the total cells and eosinophil was determined .Level of IL-4,IL-10 and IFN-γcytokines in the BALF and the su-pernatant of splenocyte culture was assayed by ELISA .Level of Der f specific IgE and histamine in the sera was determined by ELISA . Airway inflammation was analyzed by HE staining .Observation of the morphology and degranulation of mast cells was analyzed by tolui -dine blue staining.Results:Compared with group B,AHR and the lung inflammation in group C were greatly reduced (P<0.01). Numbers of total cells and eosinophils in BALF of group C were significantly lower than that of group B ( P<0.01 ) .Compared with group B, the observation of degranulation of mast cells was insignificant in group C .Compared with group B(IgE:1.905), the level of specific IgE was significantly lower in groups C (IgE:1.278)(P<0.01).The level of IL-4 in BALF of group C was significantly lower than that of group B(P<0.01).Compared with group A and B, the level of IL-10 in BALF was significantly higher in group C (P<0.01) and the level of IFN-γin BALF of group C was significantly higher than that of group A and B (P<0.01).Compared with group B, the level of IL-4 in cultured splenocytes was significantly lower in group C (P<0.01), and the level of IL-10 and IFN-γin cultured splenocytes of group C was significantly higher than that of group B (P<0.01).Compared with group B, the level of histamine in BALF was slightly lower in groups C (P<0.05), and the level of histamine in sera was significantly lower in groups C (P<0.05). Conclusion:The degranulation of mast cells of murine bronchial asthma model was suppressed after the desensitization therapy .