Objective To evaluate the treatment of bilateral hydronephrosis caused by prostate cancer. Methods Twenty-four eases with mean age of 71 years old (ranging from 64--81 years old) were diagnosed with bilateral hydronephrosis caused by prostate cancer and treated with complete androgen deprivation. Surgical castration plus Bicalutamide 50 mg/d was offered to 18 eases and medical castration (Goserelin, 3. 6 mg/month) plus Bicalutamide 50 mg/d was offered to 6 cases. There were 19 cases developed severe lower urinary tract symptoms. Among these 19 cases, 13 cases had accepted Foley catheter and 6 cases accepted suprapubic tube drainage. Results Before and after the treatment, the prostate volume decreased from (70. 3±11.2)ml to (42.6±15.8)ml(P=0. 001). Total PSA decreased from (40. 3±27.2)ng/ml to (9.5±8.3)ng/ml(P=0.02). Of the 24 cases, hydrone phrosis improved in 18 cases, remained unchanged in 3 cases and deteriorated in 3 cases. There were 14 patients developed renal insufficiency. After the treatment, Serum urea nitrogen decreased from (12. 8±6. 5) mmol/L to (6. 3 ± 4. 2) mmol/L (P = 0. 004) and serum ereatinine decreased from (206.8±152.3)μmol/L to (85.3±43.6)μmol/L(P=0.03), respectively. For those 6 cases with hy dronephrosis unchanged or deteriorated during the treatment, 4 cases accepted percutaneous nephros tomy and 2 cases accepted chtaneous ureterostomy. Conclusion The combination of complete androgen deprivation and bladder drainage through Foley catheter or suprapubic tube is an effective option in the treatment of bilateral hydronephrosis caused by prostate cancer.

Objective To quantitative the changing information of estrogen receptor βgene which was in tissue and organ of sex gland during oestrus and dioestrus of Beagles, and to show the different expression situation of hypothalamus-pituitary-gonad axis during oestrus and dioestrus, and providing the basic of theory to research deeply the mechanism of heat of Beagles. Methods As the key gene in regulation reproduction, ERβgene is located in hypothalamus-pituitary-gonad axis, so using Beagles which was in oestrus and dioestrus, and extract the RNA from hypothalamus、pituitary、ovary and uterus respectively,after reverse transcription we detected the expression of ERβgene by real-time quantitative PCR.Results The expression of ERβgene mRNA from ovary、uterus、pituitary、hypothalamus of Beagles which was in dioestrus was 0.35 times, 0.17 times, 0.44 times and 0.43 times than the expression of ERβgene mRNA from ovary, uterus, pituitary, hypothalamus of Beagles which was in oestrus.Conclusion The expression of ERβgene was up-regulation in hypothalamus-pituitary-ovary axis of Beagles which was in oestrus.

Objective:To deeply explore the real experience, source and coping style of stigma in patients with diabetic foot, so as to provide a reference for nurses to formulate targeted intervention measures.Methods:From January to April 2021, 12 diabetic foot patients from the Department of Endocrinology, the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine were selected as the research object by objective sampling. The in-depth patient interview was conducted using the phenomenological method in qualitative research. The interview data were analyzed according to the Colaizzi 7-step analysis in phenomenology, and the themes were refined with the Nvivo 12.0.Results:The stigma experienced by diabetic foot patients was grouped into three themes. Theme one was the real experience of stigma, including shame, anxiety, depression, self-blame and regret, and low self-esteem. Theme two was the source of stigma, including family, friends and colleagues, media, and treatment costs. Theme three was stigma coping styles, including positive response, concealment, avoidance, and rejection.Conclusions:Diabetic foot patients have a strong sense of stigma and cannot take effective coping styles. Medical and nursing staff and family members of patients should pay full attention to the stigma of diabetic foot patients and provide them with nursing interventions and psychological support.

OBJECTIVETo investigate the effect of transcatheter hepatic arterial chemoembolization (TACE) therapy on the survival and prognosis of recurrent hepatocellular carcinoma (HCC) after surgical resection.

METHODSThe data of 130 surgically resected but recurrent HCC patients treated by TACE were reviewed retrospectively. The survival and influencing factors on the prognosis were analyzed.

RESULTSThe overall 1-, 3-, 5-year survival rates of these 130 patients were 83.0%, 45.5% and 17.6% respectively (median survival time 2.4 years). Ninty-four of the series were treated with TACE alone, which gave the 1-, 3- year survival rates of 76.4% and 37.1%, respectively (median survival time 2.1 years). Thirty-six out of 130 patients treated with TACE plus percutaneous ethanol injection (PEI), the 1-, 3-year survival rates were 100.0% and 66.5% respectively with a median survival time (MST) of 3.5 years. The survival of TACE plus PEI group was significantly better, and the mortality risk was significantly lower than that of TACE alone group (P < 0.05). The mortality risk of those with > 5 cm diameter recurrent tumor or with distant metastasis was significantly higher than those with < or = 5 cm diameter tumor or without metastasis (P < 0.05).

CONCLUSIONTACE combined with PEI may improve the survival of recurrent HCC patients.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Carcinoma, Hepatocellular ; pathology ; therapy ; Chemoembolization, Therapeutic ; Child ; Cisplatin ; administration & dosage ; Ethanol ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Hepatic Artery ; Humans ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Recurrence, Local ; therapy ; Postoperative Period ; Treatment Outcome

OBJECTIVETo evaluate the effect of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC) patients with residual tumor.

METHODSThe patients were classified into intervention group (with adjuvant TACE) and control group (without adjuvant TACE) who were further stratified to those with high risk (patients with single tumor > 5 cm in diameter, or with multiple tumors, invasion to blood vessels), and low risk factors. Univariate analysis and Cox model were used to analyse prognostic factors.

RESULTSIn low risk patients with residual tumor, the 1-, 2-, 3-, 4-year survival rate was 97.2%, 78.0%, 66.5% and 66.5% in the intervention group, and 91.2%, 81.4%, 70.3% and 54.4% in the control group, respectively. There was no statistical difference between the two groups in survival (log-rank P = 0.7667). Comparing with the control group, the 1-, 2-, 3-, 4-year survival rate was 89.5%, 73.4%, 59.2% and 53.8% in the intervention group, and 70.5%, 61.9%, 46.8% and 46.8% in the control group, respectively. Postoperative adjuvant TACE significantly prolonged the survival in high risk patients with residual tumor (P = 0.0029). Cox model revealed that the benefit of adjuvant TACE was significantly increased by the high risk factors in HCC patients with residual tumor.

CONCLUSIONThe beneficial effect of postoperative TACE was only observed in high risk patients with residual tumor but not in the low risk patients with residual tumor.

Adult ; Aged ; Carcinoma, Hepatocellular ; mortality ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Hepatic Artery ; Humans ; Liver Neoplasms ; mortality ; therapy ; Male ; Middle Aged ; Neoplasm, Residual ; Survival Rate

Objective:To explore the application value of artificial intelligence (AI) model based on deep learning in breast nodules classification of Breast Imaging Reporting and Data System of ultrasound (BI-RADS-US).Methods:The ultrasound images of 2 426 breast nodules from 1 558 female patients with breast diseases at Beijing Tongren Hospital, Capital Medical University between December 2006 and December 2019 were collected . The image data sets were divided into training (63%), verification (7%), and test (30%) subsets for the construction of AI model. The diagnostic efficiencies of AI model, doctors' arbitration results and doctors' diagnosis with or without AI model assistance were analyzed by using receiver operating characteristic (ROC) curve. The Cohen weighted Kappa statistic was used to compare the consistency of BI-RADS-US classification among 5 ultrasound doctors' diagnosis with or without AI model assistance. And the changes of BI-RADS-US classification were analyzed before and after each doctor adopted AI model assistance.Results:The differences in diagnostic efficiencies of AI model, doctors' arbitration results and doctors' diagnosis with or without AI model assistance were statistically significant (all P > 0.05). The consistency among 5 ultrasound doctors was improved due to AI model assistance and Kappa value was increased from 0.433 (category 3), 0.600 (category 4a), 0.614 (category 4b), 0.570 (category 4c) and 0.495 (category 5) to 0.812, 0.704, 0.823, 0.690 and 0.509 (all P < 0.05), respectively. The upgrade and downgrade of BI-RADS-US classification occurred in 5 doctors after the classification of AI model assistance. Downgrade from category 4 to 3 in benign nodules of 56.6% (47/76) and upgrade from category 4 to 5 in malignant nodules of 69.4% (34/49) were mostly observed. Conclusions:AI-assisted BI-RADS-US classification can effectively improve the consistency of classification among the doctors without reducing the diagnostic efficiency. AI model shows clinical values in reducing unnecessary biopsy of partial benign lesions and increasing diagnostic accuracy of partial malignant lesions through the adjustment of breast nodule classification.

Objective To analyze the literature on artificial intelligence in forensic research from 2012 to 2022 in the Web of Science Core Collection Database,to explore research hotspots and developmen-tal trends.Methods A total of 736 articles on artificial intelligence in forensic medicine in the Web of Science Core Collection Database from 2012 to 2022 were visualized and analyzed through the litera-ture measuring tool CiteSpace.The authors,institution,country(region),title,journal,keywords,cited references and other information of relevant literatures were analyzed.Results A total of 736 articles published in 220 journals by 355 authors from 289 institutions in 69 countries(regions)were identi-fied,with the number of articles published showing an increasing trend year by year.Among them,the United States had the highest number of publications and China ranked the second.Academy of Forensic Science had the highest number of publications among the institutions.Forensic Science Inter-national,Journal of Forensic Sciences,International Journal of Legal Medicine ranked high in publica-tion and citation frequency.Through the analysis of keywords,it was found that the research hotspots of artificial intelligence in the forensic field mainly focused on the use of artificial intelligence technol-ogy for sex and age estimation,cause of death analysis,postmortem interval estimation,individual identification and so on.Conclusion It is necessary to pay attention to international and institutional cooperation and to strengthen the cross-disciplinary research.Exploring the combination of advanced ar-tificial intelligence technologies with forensic research will be a hotspot and direction for future re-search.

Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
Humans ; Antibodies, Monoclonal/therapeutic use* ; Apoptosis ; China ; Disease-Free Survival ; East Asian People ; Immunotherapy ; Interferon-alpha/therapeutic use* ; Lymphatic Metastasis ; Melanoma/pathology* ; Programmed Cell Death 1 Receptor/therapeutic use* ; Skin Neoplasms/pathology* ; Melanoma, Cutaneous Malignant

Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
Humans ; Antibodies, Monoclonal/therapeutic use* ; Apoptosis ; China ; Disease-Free Survival ; East Asian People ; Immunotherapy ; Interferon-alpha/therapeutic use* ; Lymphatic Metastasis ; Melanoma/pathology* ; Programmed Cell Death 1 Receptor/therapeutic use* ; Skin Neoplasms/pathology* ; Melanoma, Cutaneous Malignant

Many patients with large-area tooth defect need cast post-core crown restoration. However, the color defect of the cast post-core will affect the final restorative result, especially that of the anterior teeth. A new technology of color masking by applying CERAMAGE polymeric porcelain to the cast metal post-core surface improves the color of a full-ceramic restoration of anterior teeth and may provide a new alternative for the aesthetic repair of anterior teeth with a large area of defective tooth.
Ceramics ; Crowns ; Dental Porcelain ; Esthetics, Dental ; Humans ; Post and Core Technique