Objective The aim of this study is to retrospectively analyze the clinical and imaging characteristics,treatment and prognosis of 13 patients with granulomatous prostatitis(GP),and to provide reference for the diagnosis and treatment for GP.Methods The clinical information of 13 GP patients extracted from electronic medical records including demographic characteristic risk factors,clinical symptoms,laboratory findings,imaging findings(ultrasound,CT,MRI,FDG-PET-CT),treatment and outcomes were analyzed retrospectively from January 2018 to August 2023 at our center.Results The average age of 13 patients with GP was(65.69±6.46)years.And the average score of IPSS was(23.40±5.8).Five patients appeared positive results,of which 11 cases received digital rectal examination.The average level of pre-biopsy tPSA was(23.28±44.94)μg/L with fPSA/tPSA ratio of 0.11±0.05 and PSAD of(0.55±1.07)μg/l/mL.The pre-biopsy mean MRI PI-RADS 2.0 was(4.6±0.6)in this group of patients.Extraprostatic invasion was shown on imaging in 4 patients.The average number of biopsy needles was(19.6±3.9),and the pathological results showed tuber-culous granulomas in 2 cases(15.4％)and non-specific granulomatous inflammation in 11 cases(84.6％).Five patients received local treatment of the prostate after pathological confirmation(PVP in 4 cases,TURP in 1 case),2 patients re-ceived anti-tuberculosis therapy,and 3 cases were given antibiotics.Average follow-up was(20.6±11.2)months,and the average tPSA were(6.94±4.96)μg/L at 3-6 months after biopsy and/or surgery,with no obvious signs of malignancy during the follow-up period.Conclusion GP is the great mimicker of prostate cancer clinically and radiologically.Pros-tate biopsy is the method for confirming the diagnosis.For patients who are considering biopsy-free radical prostatectomy,it is important to consider the possibility of GP.

Objective The aim of this study is to retrospectively analyze the clinical and imaging characteristics,treatment and prognosis of 13 patients with granulomatous prostatitis(GP),and to provide reference for the diagnosis and treatment for GP.Methods The clinical information of 13 GP patients extracted from electronic medical records including demographic characteristic risk factors,clinical symptoms,laboratory findings,imaging findings(ultrasound,CT,MRI,FDG-PET-CT),treatment and outcomes were analyzed retrospectively from January 2018 to August 2023 at our center.Results The average age of 13 patients with GP was(65.69±6.46)years.And the average score of IPSS was(23.40±5.8).Five patients appeared positive results,of which 11 cases received digital rectal examination.The average level of pre-biopsy tPSA was(23.28±44.94)μg/L with fPSA/tPSA ratio of 0.11±0.05 and PSAD of(0.55±1.07)μg/l/mL.The pre-biopsy mean MRI PI-RADS 2.0 was(4.6±0.6)in this group of patients.Extraprostatic invasion was shown on imaging in 4 patients.The average number of biopsy needles was(19.6±3.9),and the pathological results showed tuber-culous granulomas in 2 cases(15.4％)and non-specific granulomatous inflammation in 11 cases(84.6％).Five patients received local treatment of the prostate after pathological confirmation(PVP in 4 cases,TURP in 1 case),2 patients re-ceived anti-tuberculosis therapy,and 3 cases were given antibiotics.Average follow-up was(20.6±11.2)months,and the average tPSA were(6.94±4.96)μg/L at 3-6 months after biopsy and/or surgery,with no obvious signs of malignancy during the follow-up period.Conclusion GP is the great mimicker of prostate cancer clinically and radiologically.Pros-tate biopsy is the method for confirming the diagnosis.For patients who are considering biopsy-free radical prostatectomy,it is important to consider the possibility of GP.

Objective To apply gastrointestinal ultrasound to evaluate the gastrointestinal function of patients with acute gastrointestinal injury(AGI)and to determine the timing of starting enteral nutrition(EN)therapy to guide clinical enteral nutrition therapy.Methods One hundred and three critically ill patients with AGI level 2(AGI Ⅱ)were prospectively screened at the Department of Intensive Care Medicine(ICU)of the Second People's Hospital of Anhui Province from March 2022 to May 2023,and the following data were recorded,including ultrasound gastric sinus cross-sectional area(CSA),diameter of the descending or ascending colon(CD),peristaltic frequency(CPF),time of EN initiation,prealbumin(PA),EN dose and EN complications.Recovery of gastrointestinal function after EN treatment was judged as successful,and failure was judged if there were complications of EN treatment.Changes in gastrointestinal function after EN treatment were analyzed to determine the timing of enteral nutrition.Results There were 68 cases in the successful group and 35 cases in the failed group.There were no statistically significant differences between the two groups in terms of age,intra-abdominal pressure(IAP),Acute Physiology and Chronic Health Status Score Ⅱ(APACHE-Ⅱ),PA,and disease composition(all P＞0.05).The EN initiation time[(14.71±8.89)h],CSA[(9.24±1.30)cm2]and CD[(2.86±0.41)cm]in the successful group were earlier or smaller than the failed group[(19.52±13.53)h,(10.82±1.96)cm2 and(3.38±0.46)cm](all P＜0.05),whereas the CPF[(2.84±0.96)times/min]in the successful group was faster than thefailed group[(2.32±0.98)times/min](P＜0.05).ROC analysis showed greater value for CSA,CD and CPF to predict EN success,with thresholds of CSA≤9 cm2(AUC=0.892),CD≤2.8 cm(AUC=0.858)and CPF＞3 times/min(AUC=0.744);when the combination of CSA,CD and CPF was predicted to generate PRE_1,the AUC was the largest(0.968)and had the highest predictive value,which could determine the best time to initiate EN.Conclusion Ultrasound monitoring of the cross-sectional area of the gastric sinus,the internal diameter of the colon,and the frequency of colonic peristalsis can predict the efficacy of enteral nutrition therapy in critically ill patients with grade Ⅱ acute gastrointestinal injury and guide the optimal timing of initiating enteral nutrition therapy.

Traumatic spinal cord injury (SCI) has devastating effects on patients′ physical and mental health. Autophagy is widely involved in various physiological and pathological processes of the body and plays a key role in spinal cord injury. The mammalian target of rapamycin (mTOR) is the main regulator of autophagy. mTOR regulation of autophagy is closely related to the pathological process of spinal cord injury, and can effectively promote the recovery of spinal cord injury. Therefore, mTOR is a promising target for treatment of spinal cord injury. This article reviews the role of mTOR signal transduction pathway in the regulation of autophagy in spinal cord injury, in order to provide reference for follow-up research.

Objective:To discuss the surgical efficacy of neuroendoscopic transsphenoidal approach for the removal of pituitary cystic lesion.Methods:Clinical data and efficacy of 32 patients with neuroendoscopic transsphenoidal surgery and pathological diagnosis of pituitary cystic lesion in the Affiliated Hospital of Jining Medical University from March 2013 to May 2019 were retrospectively analyzed.Results:Of the 32 patients, 29 patients were pathologically diagnosed with Rathke cysts and 3 patients with pituitary arachnoid cysts. The content of cyst could be completely removed and the relationship between cyst and sellarseptum and subarachnoid space could be clearly observed by using endoscopy. After followed-up for 0.5-1.0 year, headic, dizziness and visual impairment were improved. One patient relapsed, without serious complications or death.Conclusions:Transsphenoidal neuroendoscopic surgery is a safe and effective treatment for pituitary cystic lesion.

Non-functioning pituitary adenoma (NFPA), lack of the clinical and biochemical characteristics of hormone overexpression, is a common type of pituitary adenoma. It could bring enormous suffering to the patients on account of the tendentiousness of being invasive macroadenoma and oppressing surrounding tissue. At present, the pathogenesis of NFPA is still unclear, thus there is no effective medical management for the disease. Although transsphenoidal surgery is the first-line treatment for NFPA, it is very difficult to achieve a cure effect. It has been found that the abnormal expression of cyclooxygenase-2 (COX-2) affects the survival and progression of cancer. Recent studies have detected the expression of COX-2 in pituitary tumors, and the expression of COX-2 in NFPA is stronger, suggesting that COX-2 may be involved in the occurrence and development of NFPA. This article reviews the pathogenesis of NFPA and the tumorigenicity of COX-2, and provides new ideas for clinical drug treatment of NFPA.

Objective To explore the clinical characteristics of patients with Moyamoya disease in the southwest of Shandong province and evaluate the efficacy of cerebral revascularization treatment in it.Methods Clinical data of 96 patients with Moyamoya disease,admitted to our hospital form March 2011 to December 2013,were analyzed retrospectively and compared with those in Japan,South Korea and Inland.Results The clinical characteristics of patients with Moyamoya disease in the southwest of Shandong province were similar with that in Japan,South Korea and Inland,but enjoyed their own particularity:the age distribution showed two peaks (aged 0-10 and aged 31-50) and the sex ratio (female＞male) was similar to those among Japanese and Korean patients,but the age distribution was more concentrated;the incidence of children (12.5％) was significantly lower than that of Japan and South Korea;the main type of Moyamoya disease was the ischemic one (80.2％);the occurrence of transient ischemic attack was higher than that in Japan,South Korea and Inland;the incidences of epilepsy and cerebral infarction were lower than those in Japan,South Korea and Inland;the incidence of cerebral hemorrhage (19.8％) was similar to Japan and Inland,and significantly lower than that in Korea.The clinical symptoms of most Moyamoya disease patients were improved with the treatment of extracranial-intracranial revascularization;and the treatment outcomes showed no significant difference between Chinese,Japanese and Korean.Conclusions The clinical features and pathogenesis mechanism of Moyamoya disease in the southwest of Shandong province may be different form Japan and South Korea.Extracranial-intracranial revascularization is a effective treatment for Moyamoya disease.

Objective To compare of intervention embolization and operation in the treatment of brain aneurysms.Methods 60 cerebral aneurysm patients using random number table method were divided into two groups each 30 cases,group A given intervention embolization;group B given surgical operation treatment.They were followed for 3months,the bleed Glasgow results score,matrix metalloproteinases 2(MMP-2) level change and the length of time were recorded.Results After treatment,A group total effective rate was 73.4％,postoperative treatment to bleed again rate was 10.0％ (3/30),B group was 76.7％,6.7％ (2/30),two groups had no statistically significant differences (x2 =0.09,0.22,all P ＞ 0.05 ) before treatment M MP-2 level between ;The two groups was statistically significant ( t =1.21,P ＞ 0.05 ) ;Two groups after surgical treatment 3 d MMP-2 levels were ( 20.1 ± 8.7 ) μg/L,( 35.7 ±8.9 ) μg/L respectively,which was statistically significant ( t =3.33,P ＜ 0.05 ).A group of hospitalization time (8.6 ±1.5 ) d,group B ( 13.2 ± 1.3 ) d,the difference between two groups was statistically significant ( t =3.18,P ＜ 0.05 ).Conclusion For brain aneurysm patients,the intervention embolization had no obvious difference in curative effect with operation,but could reduce the time in hospital and significantly reduced MMP-2 level.

Objective To study the effects of embryonic neural stem cells transplantion on trauma of red nucleus neu-rons of the rats with spinal cord injury.Methods NSCs in logarithmic phage were labeled with BrdU,a Sprague Dawley rat mode of spinal cord injury (SCI) was developed with electrocircuit control spinal cord injuring device.Thirty SD rats were randomly divided into three groups: sham group,SCI group and NSC group.The NSCs were trans-planted into injured site three days after SCI.Then NSCs labeled with Brdu were detected by immunohistochemisty,rubrospinal tract (RST) neurons were labeled by retrograde transport of the horseradish peroxidase (HRP) from the lesion site,which were taken by damaged axons and remained in the neurons,then the labeled red nucleus (RN) neurons were counted.Hind limb function of experimental rats was evaluated by a blinder observer using BBB open field locomotion rating score.Results BrdU positive NSCs were detected in the spinal cord after transplantation,the number of RST neurons labeled by HRP in NSC group was more than that in SCI group (P <0.01),the BBB score of NSC group was higher than SCI group (P <0.01).Conclusion The transplanted NSCs can survive in the injured site of spinal cord and protect RN,then promote more remarkably functional recovery after SCI.