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 investigate the impact of multi-drug transporters including P-glycoprotein (PGP) and multi-drug resistance associated protein (MRP) on concentration of lamotrigine in the extracellular fluid in hippocampus of epilepsy rat models induced by pilocarpine, and to deduce the multi-drug resistance mechanisms in refractory epilepsy. Methods The epilepsy rat models were established by repeated administration (by ip) of pilocarpine. A microdialysis probe was placed into the hippocampus of the epileptic rats and dialysate was collected at five time-points from 30--150 minutes after systemic injections of lamotrigine (10 mg/kg). The concentration of lamotrigine in the extracellular fluid in the hippocampus was determined by high-performance liquid chromatography (HPLC). Then PGP inhibitor verapamil and MRP inhibitor probenecid was added individually through microdialysis probe and the concentration of lamotrigine was detected again. Results Compared with control group (0. 41 ± 0. 10 in 60 minutes, 0. 50 ±0.04 in 90 minutes, 0. 39 ±0. 09 in 120 minutes and 0. 30±0.06 in 150 minutes), verapamil significantly increased the concentration of lamotrigine in extracellular fluid of the hippocampus 60--150 minutes (0. 65 ±0. 11, 0. 84 ± 0. 09, 0. 70± 0. 09 and 0. 58 ± 0. 08 respectively) after injection (F value were 5.01, 8.61, 10. 23 and 7.89, all P < 0. 05) and probenecid also enhanced the concentration of lamotrigine 90--150 minutes (0. 75 ± 0. 09, 0. 58±0. 10 and 0. 49±0. 07) after injection (F = 6. 58, 4. 56, 4. 75, all P < 0. 05). Conclusions Penetration of lamotrigine through blood-brain barrier in pilocarpine induced epilepsy rats is restricted by PGP and MRP, resulting in decreased concentration of lamotrigine in the extracellular fluid of the hippocampus. Therefore, increasing expression of PGP and MRP in brains of epilepsy patients might be an important mechanism involved in multi-drug resistance in refractory epilepsy.

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 study the effect of inhibitors of the multidrug transporters including P-glycoprotein (PGP)and multi-drug resistance-associated protein(MRP)on the regulation of concentration of oxcarbazepine in the extra-cellular fluid of the hippocampus after pilocarpine induced seizures in rats.To investigate whether oxcarbazepine are sub-strate for PGP and MRP and whether brain expressions of PGP and MRP are involved in muhidrug resistance mechanisms of refractory epilepsy.Methods The epileptic rats model were established by repeated peritoneal injection treatment with pi-locarpine.Thirty-two Wistar rats were divided into four groups:control group,pilocarpine epileptic model group,verapamil treated group and probenecid treated group.At 30,60,90,120 and 150 min following systemic injection of oxcarbazepine (80 mg/kg),dialysate was collected and the concentration of oxcarbazepine in the extracellular fluid of hippocampus was determined by microdialysis and high-performance liquid chromatography technique.Results After systemic injection of oxcarbazepine,the concentration of oxcarbazepine in extracellular fluid of the hippocampus during 90～150 min(1.26±0.09、0.93±0.10)were much higher in verapamil treated group than in pilocarpine epileptic model group(0.87±0.06、0.66±O.04)(P<0.05)and the concentration of oxcarbazepine in the hippocampus during 60～150 min(1.07 4±0.11、1.32±O.13、1.02±0.10、0.87±0.08)were higher in probenecid treated group than in pilocarpine epileptic model group (0.81±0.08、0.87±0.06、0.66.4±0.04、0.58±0.06)(P<0.05).Conclusions Oxcarbazepine are substrates for PGP and MRP and,penetration of oxcarbazepine through blood-brain barrier are restricted by PGP and MRP.Increased expres-sions of PGP and MRP in brain maybe involved in the mechanisms of multidrug resistance of refractory epilepsy.

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.

Objective This study evaluates the effectiveness for using acute plateletpheresis (APP) as a blood conservation method to reduce the need of blood transfusion and increase coagulation function in aortic arch surgery with deep hypothermic circulatory arrest (DHCA ). Methods Thirty-six type-A aortic dissections patients (male 31,female 5,age 23-65 years,ASA physical status II-IV)undergoing frozen elephant trunk with total arch replacement (Bentall plus Sun's surgery)were enrolled in the prospective randomized trial.The patients were randomized into two groups:regular blood conservation group (group control,n = 18)and group APP (n = 18).Blood sample was collected respectively after anesthesia induction (T1 ),before heparinization (T2 ),by the end of surgery (T3 )and 24 hours after surgery (T4 ).Data was collected and reviewed in terms of perioperative transfusion needs,normal laboratory examination,clinical outcomes including blood routine analysis (Hb,Plt,MPV,P-LCR)and thrombelastography (TEG-R,TEG-K,TEG-α,TEG-A,TEG-MA,TEG-EPL).Kaolin and heparinase detections were performed for TEG.Results Com-pared with T1 ,TEG-R,TEG-K,TEG-A,TEG-MA,TEG-EPL and Plt were significantly decreased while TEG-CI,MPV,P-LCR significantly increased in T4 in group APP (P <0.05 ).TEG-A,TEG-MA and Plt were significantly greater(P <0.05)in group APP than in group control at T2 ,and TEG-K,TEG-ELP and HBG were significantly less (P <0.05)in group APP than in group control at T3 . Conclusion The utilization of APP technique was associated with the improved coagulation function in aortic arch surgery with DHCA.

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 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 summariz e the expe rience of the ability training of prescription-auditing pharmacists in prescription pre-audit，and introduce the typical cases of the prescription-auditing pharmacists participating in the drug intervention. METHODS From October ，2020 to October ，2021，under the audit mode of “prescription pre-audit system+prescription-auditing pharmacists ” adopted by Yuxi People ’s Hospital （hereinafter referred to as “the hospital ”），the abilities of prescription-auditing pharmacists were cultivated from the aspects of training in pharmaceutical related professional knowledge ，training in the use of Chinese and English medical retrieval tools ，databases and websites ，and clinical thinking and communication ability ；through the construction of ability evaluation form of prescription-auditing pharmacists ，their abilities were assessed. RESULTS & CONCLUSIONS After one year ’s ability training ，the rational rate of prescription （doctor’s order ），the proportion of doctors ’active revision of problem prescription （doctor’s order ）and the doctor ’s acceptance rate of intervention by prescription-auditing pharmacists showed an upward trend ，the average time of irrational prescription （doctor’s order ）by prescription-auditing pharmacists showed a shortening trend ，and the intervention rate of prescription （doctor’s order ）showed a downward trend. In addition to the publication of papers （belonging to the bonus item ），the average score of the ability evaluation form of prescription-auditing pharmacists had significantly increased ， from 45.2 in October 2020 to 97.6 in October 2021.

AIM: To delineate the specific mutation responsible for retinitis pigmentosa(RP)in a Yi pedigree, and to analyze the correlation of RHO gene mutation with clinical phenotype.METHODS:A comprehensive clinical evaluation was conducted on the proband diagnosed with RP and other familial members, complemented by a thorough ophthalmic examination. Peripheral blood samples were obtained from the proband and familial members, from which genomic DNA was extracte. Subsequent whole exome sequencing(WES)was employed to identify the variant genes in the proband. The identified variant gene was validated through Sanger sequencing, then an in-depth analysis of the mutation genes was carried out using genetic databases to ascertain the pathogenic mutation sites. Furthermore, an exhaustive analysis was performed to delineate the genotype and phenotype characteristics.RESULTS:The RP pedigree encompasses 5 generations with 42 members, including 19 males and 23 females. A total of 13 cases of RP were identified, consisting of 4 males and 9 females, which conforms to the autosomal dominant inheritance pattern. The clinical features of this family include an early onset age, rapid progression, and a more severe condition. The patients were found to have night blindness around 6 years old, representing the earliest reported case of night blindness in RP families. The retina was manifested by progressive osteocytoid pigmentation of the fundus, a reduced visual field, and significantly decreased or even vanished a and b amplitudes of ERG. The combined results of WES and Sanger sequencing indicated that the proband had a heterozygous missense mutation of the RHO gene c.1040C>T:p.P347L, where the 1 040 base C of cDNA was replaced by T, causing codon 347 to encode leucine instead of proline. Interestingly, this mutation has not been reported in the Chinese population.CONCLUSION:This study confirmed that the mutant gene of RP in a Yi nationality pedigree was RHO(c.1040C>T). This variant leads to the change of codon 347 from encoding proline to encoding leucine, resulting in a severe clinical phenotype among family members. This study provides a certain molecular, clinical, and genetic basis for genetic counseling and gene diagnosis of RHO.