1.Network structure characteristics of trait aggression in children and adolescents based on psychometric network analysis
WANG Xu, LIU Yanling, WEI Mingchen, ZHU Ni, GENG Yibo, LIU Weijun, CHEN Shuai
Chinese Journal of School Health 2025;46(7):975-979
Objective:
To explore the core features of trait aggression in children and adolescents, so as to provide a theoretical basis for behavioral interventions targeting the central psychological characteristics of aggression in children and adolescents.
Methods:
From March to May 2020, a simple random convenience sampling method was employed to recruit 39 165 students from grades 4 to 12 in Sichuan, Chongqing, Guizhou, and Shandong. Data were collected via online questionnaires, with all participants completing the Chinese Version of the Aggression Questionnaire. Psychometric network analysis was utilized for data processing.
Results:
Trait aggression among Chinese children and adolescents was at a moderately low level. The core nodes of the network structure included physical aggression [if someone intentionally causes trouble for me, I will hit them severely (AGG6); if someone hits me, I will retaliate (AGG11)] and self aggression [When I am very irritable, I think of hurting myself (AGG5); when I am in a bad mood, I engage in behaviors that harm my health, such as overeating (AGG25)]. Across grade levels, core nodes primarily originated from the anger dimension [When I m angry, I feel like a powder magazine that could explode at any moment (AGG13); I can t control my temper (AGG18); I am prone to getting angry when I see things that are not pleasing to the eye (AGG23); I will get angry for no reason (AGG27)]. Except for grades 7 and 9, core nodes in other grades included the verbal aggression dimension [I am prone to arguments with people (AGG22)]. Before grade 8, core nodes incorporated the self aggression dimension (AGG 5, AGG 25); after grade 8, core nodes included the physical aggression dimension [AGG 6, AGG 11, I fight slightly more than others (AGG16), and if people around me make things difficult for me to a certain extent, I will fight with them (AGG26)]. No statistically significant differences were found in the trait aggression network structures across grades, genders, or within gender comparisons of different grades.
Conclusion
These findings broaden our understanding of aggression in children and adolescents, suggesting that behavioral interventions can effectively reduce aggressive behaviors in this population.
2.Promoting Innovative Development of Traditional Chinese Medicine Case Report Based on China Clinical Cases Library of Traditional Chinese Medicine
Kaige ZHANG ; Hongcai SHANG ; Yong ZHU ; Weijun HUANG ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):190-195
China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value, ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction, in order to further consolidate the foundation and ensure the quality and authority of case reports, we need to fully understand the origin and development of Chinese medical cases. Therefore, we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports, comparing the differences between Chinese and western medical case reports in terms of content and writing requirements, finally formed the main points of systematic case report norms and quality evaluation system, aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development, scientific research innovation, clinical practice and guidance, talent evaluation and training, so as to promote its innovative development in a broader direction.
3.The effect of Bushen Huoxue prescription on proliferation and extracellular matrix synthesis of nucleus pulposus cells by regulating circ_0036763/miR-583 axis
Canrong LIANG ; Junjie HE ; Xueyuan ZHU ; Haojian FENG ; Weijun GUO ; Dongling CAI ; Chenghua ZHU ; Xiaofeng CHEN
Journal of Chinese Physician 2024;26(1):63-69
Objective:To explore the possible effects of Bushen Huoxue Formula (the kidney tonifying and blood activating prescription) on the proliferation and extracellular matrix synthesis of nucleus pulposus cells by regulating the circ_0036763/miR-583 axis.Methods:Real time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression levels of circ0036763 and miR-583 in normal and intervertebral disc degeneration (IDD) nucleus pulposus cells; IDD nucleus pulposus cells were divided into pcDNA group, pcDNA circ_0036763 group, pcDNA circ_0036763+ mimic NC group, and pcDNA circ_0036763+ miR-583 mimic group. qRT-PCR was used to detect the expression levels of circ_0036763 and miR-583 in nucleus pulposus cells in each group, methyl thiazolyl tetrazolium (MTT) was used to detect cell proliferation (A value), and Western blot was used to detect the expression of proliferating cell nuclear antigen (PCNA), collagen Ⅰ, and collagen Ⅱ proteins in nucleus pulposus cells, The dual luciferase assay reported experimental validation of the targeting relationship between circ_0036763 and miR-583. 27 mice were divided into sham surgery group, IDD group, and kidney tonifying and blood activating formula group. IDD models were established in all groups except for the sham surgery group. After successful modeling, the sham surgery group and IDD group were given physiological saline by gavage, while the kidney tonifying and blood activating formula group was given 1.5 g/ml of kidney tonifying and blood activating formula by gavage for 3 consecutive weeks. QRT-PCR was used to detect the expression levels of circ0036763 and miR-583 in the nucleus pulposus cells of mice in each group, MTT was used to detect cell proliferation, and Western blot was used to detect the expression of PCNA, collagen Ⅰ, and collagen Ⅱ proteins.Results:The expression level of circ_0036763 in IDD nucleus pulposus cells decreased, while the expression level of miR-583 increased (all P<0.05); Overexpression of circ_0036763 can promote proliferation and extracellular matrix synthesis of nucleus pulposus cells (all P<0.05); Circ_0036763 targets miR-583 and upregulates miR-583 reversible overexpression. Circ_0036763 enhances the proliferation and extracellular matrix synthesis ability of IDD nucleus pulposus cells. Compared with the sham surgery group, the IDD group showed an increase in collagen Ⅰ protein expression and miR-583 expression levels (all P<0.05), while the cell A value, PCNA and collagen Ⅱ protein expression, and circ_0036763 expression levels decreased (all P<0.05); Compared with the IDD group, the Kidney Tonifying and Blood Activating Formula group showed a decrease in collagen Ⅰ protein expression and miR-583 expression levels (all P<0.05), while the cell A value, PCNA and collagen Ⅱ protein expression, and circ_0036763 expression levels increased (all P<0.05). Conclusions:The kidney tonifying and blood activating formula (Bushen Huoxue) may induce proliferation and extracellular matrix synthesis of nucleus pulposus cells by regulating the circ_0036763/miR-583 axis.
4.Promoting Reform of Talent Evaluation Based on China Clinical Cases Library of Traditional Chinese Medicine
Kaige ZHANG ; Yong ZHU ; Jisheng WANG ; Liangzhen YOU ; Weijun HUANG ; Jie YANG ; Candong LI ; Genping LEI ; Chuan ZHENG ; Shuzhen GUO ; Longtao LIU ; Zhining TIAN ; Xinping QIU ; Wenli SU ; Zuo LI ; Wei YAN ; Hongcai SHANG ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):220-226
Talents are the main force for the development of traditional Chinese medicine(TCM), and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present, we are still exploring and developing in the fields of the formulation, implementation and evaluation indicators of TCM talent evaluation system. However, there are shortcomings and difficulties. For instance, insufficient stratification in the evaluation, excessive emphasis on the quantity of achievements, neglecting the quality of the achievements and the actual contribution, imperfect assessment indicators, and the weak characteristics of TCM. Therefore, national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard, in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value, ability and contribution. For the evaluation of TCM clinical talents, China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM(CCCL-TCM), which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry, and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.
5.Effects of cardiorespiratory fitness on physical activity and cardiometabolic health among obese adolescents
LIANG Manna, ZHU Lin, ZHENG Li, XIE Weijun
Chinese Journal of School Health 2024;45(12):1780-1784
Objective:
To explore the effect of cardiorespiratory fitness (CRF) on cardiometabolic health and physical activity among obese adolescents, in order to provide a scientific basis for health promotion of obese adolescents.
Methods:
From July to August 2021 and 2022, 140 obese adolescents aged 10-17 were recruited in a residential weight loss camp. Sedentary behavior (SB), low intensity physical activity (LPA), total physical activity (TPA) and moderate to vigorous physical activity (MVPA) were measured by ActiGraph GT3X+ triaxial motion accelerometer, and CRF levels were measured by 20 meter shuttle run test. Cardiometabolic risk Z score (CMR- Z ) was constructed by measuring the cardiometabolic health indicators of obese adolescents, including waist circumference (WC), sagittal abdominal diameter (SAD), systolic blood pressure (SBP), diastolic blood pressure (DBP), average blood pressure (ABP), fasting insulin (FINs), fasting plasma glucose (FPG), total cholesterol (TC), and high density lipoprotein cholesterol (HDL-C). The mediating effect analysis was conducted by using the SPSS Process plug in compiled.
Results:
Cardiovascular health indicators WC, SAD, SBP, DBP, ABP, FINs, FPG, TC, HDL-C and CMR-Z were (93.21± 11.51 )cm, (21.77±2.71)cm, (111.24±11.86)mmHg, (66.08±9.03)mmHg and (88.66±8.97)mmHg, (8.98±6.42)μU/mL, ( 4.42 ±0.62)mmol/L, (4.43±0.97)mmol/L, (1.29±0.28)mmol/L, -0.43(-1.83,1.78)min, respectively. In the daily activity behavior indicators, the duration of SB, LPA, MVPA and TPA were (345.16±78.47, 267.35±62.65, 64.77±39.52, 677.30±57.63)min, respectively. SB, LPA and MVPA accounted for 50.96%, 39.47% and 9.56%, respectively. The indicator VO 2max of CRF was (37.95±4.96)mL/(kg min). Mediation analysis showed that CRF played a fully mediating role between LPA and waist to height ratio (WHtR), accounting for 44.2%. It exhibited a suppressing effect between LPA and ABP accounting for 31.5%, with a suppressing effect between MVPA and SAD accounting for 43.2% and a suppressing effect between MVPA and CMR- Z accounting for 96.0%.
Conclusions
CRF may be an important factor in the relationship between physical activity and cardiometabolic health of obese adolescents. Improving CRF level may be conducive to promoting cardiometabolic health of obese adolescents.
6.Identification, expression and DNA variation analysis of high affinity nitrate transporter NRT2/3 gene family in Sorghum bicolor.
Shanshan ZHAO ; Zhiqiang GUO ; Lixun ZHU ; Jiali FAN ; Bohui YANG ; Wenting CHAI ; Huiqiong SUN ; Fan FENG ; Yuexiu LIANG ; Chunlei ZOU ; Xiaodong JIANG ; Weijun ZHAO ; Jinhui LÜ ; Chunlai ZHANG
Chinese Journal of Biotechnology 2023;39(7):2743-2761
Nitrate is the main form of inorganic nitrogen that crop absorbs, and nitrate transporter 2 (NRT2) is a high affinity transporter using nitrate as a specific substrate. When the available nitrate is limited, the high affinity transport systems are activated and play an important role in the process of nitrate absorption and transport. Most NRT2 cannot transport nitrates alone and require the assistance of a helper protein belonging to nitrate assimilation related family (NAR2) to complete the absorption or transport of nitrates. Crop nitrogen utilization efficiency is affected by environmental conditions, and there are differences between varieties, so it is of great significance to develop varieties with high nitrogen utilization efficiency. Sorghum bicolor has high stress tolerance and is more efficient in soil nitrogen uptake and utilization. The S. bicolor genome database was scanned to systematically analyze the gene structure, chromosomal localization, physicochemical properties, secondary structure and transmembrane domain, signal peptide and subcellular localization, promoter region cis-acting elements, phylogenetic evolution, single nucleotide polymorphism (SNP) recognition and annotation, and selection pressure of the gene family members. Through bioinformatics analysis, 5 NRT2 gene members (designated as SbNRT2-1a, SbNRT2-1b, SbNRT2-2, SbNRT2-3, and SbNRT2-4) and 2 NAR2 gene members (designated as SbNRT3-1 and SbNRT3-2) were identified, the number of which was less than that of foxtail millet. SbNRT2/3 were distributed on 3 chromosomes, and could be divided into four subfamilies. The genetic structure of the same subfamilies was highly similar. The average value of SbNRT2/3 hydrophilicity was positive, indicating that they were all hydrophobic proteins, whereas α-helix and random coil accounted for more than 70% of the total secondary structure. Subcellular localization occurred on plasma membrane, where SbNRT2 proteins did not contain signal peptides, but SbNRT3 proteins contained signal peptides. Further analysis revealed that the number of transmembrane domains of the SbNRT2s family members was greater than 10, while that of the SbNRT3s were 2. There was a close collinearity between NRT2/3s of S. bicolor and Zea mays. Protein domains analysis showed the presence of MFS_1 and NAR2 protein domains, which supported executing high affinity nitrate transport. Phylogenetic tree analysis showed that SbNRT2/3 were more closely related to those of Z. mays and Setaria italic. Analysis of gene promoter cis-acting elements indicated that the promoter region of SbNRT2/3 had several plant hormones and stress response elements, which might respond to growth and environmental cues. Gene expression heat map showed that SbNRT2-3 and SbNRT3-1 were induced by nitrate in the root and stem, respectively, and SbNRT2-4 and SbNRT2-3 were induced by low nitrogen in the root and stem. Non-synonymous SNP variants were found in SbNRT2-4 and SbNRT2-1a. Selection pressure analysis showed that the SbNRT2/3 were subject to purification and selection during evolution. The expression of SbNRT2/3 gene and the effect of aphid infection were consistent with the expression analysis results of genes in different tissues, and SbNRT2-1b and SbNRT3-1 were significantly expressed in the roots of aphid lines 5-27sug, and the expression levels of SbNRT2-3, SbNRT2-4 and SbNRT3-2 were significantly reduced in sorghum aphid infested leaves. Overall, genome-wide identification, expression and DNA variation analysis of NRT2/3 gene family of Sorghum bicolor provided a basis for elucidating the high efficiency of sorghum in nitrogen utilization.
Nitrate Transporters
;
Nitrates/metabolism*
;
Sorghum/metabolism*
;
Anion Transport Proteins/metabolism*
;
Phylogeny
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Protein Sorting Signals/genetics*
;
Nitrogen/metabolism*
;
DNA
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Gene Expression Regulation, Plant
;
Plant Proteins/metabolism*
7.Yinjia Tablets Improve Infertility in Rats with Chronic Salpingitis by Correcting Peripheral Blood Th17/Treg Balance
HUANG Yefang ; ZHU Boyu ; WANG Yan ; DING Weijun ; HUANG Shujie
Chinese Journal of Modern Applied Pharmacy 2023;40(19):2635-2642
OBJECTIVE To explore whether Yinjia tablets improve infertility in rats with chronic salpingitis by correcting the peripheral blood Th17/Treg balance. METHODS One hundred female Wistar rats, 82 of which were constructed as a rat model of chronic salpingitis. After successful modeling, the rats were randomly divided into model group, levofloxacin group (20 mg·kg-1), low-dose Yinjia tablets group(0.38 g·kg-1·d-1), medium-dose Yinjia tablets group(0.76 g·kg-1·d-1) and high-dose Yinjia tablets group(1.52 g·kg-1·d-1), 16 rats in each group, and other 16 rats were set up as control group. The treatment groups were administered by gavage at different doses, and the model group and the control group were given the same amount of saline(20 mL·kg-1·d-1), once a day. The gavage was stopped for 1 d after 7 d, and 7 d was one cycle, with a total of 3 cycles of gavage. After administration, the rats were observed for conception and blood samples and oviductal tissues were collected. HE staining was used to observe the pathological changes of fallopian tube tissues; transmission electron microscopy was used to observe the ultrastructural changes of fallopian tube tissues; ELISA was used to detect TNF-α and IL-6 in serum; flow cytometry was used to detect the ratio of Treg and Th17 cells in peripheral blood; RT-qPCR and Western blotting were used to detect IL-17, IL-10, Foxp3, RORγt mRNA and protein expression. RESULTS Compared with the control group, the cilia and microvilli in the model group were sparse and the mitochondria were swollen; the TNF-α and IL-6 contents, the proportion of Th17 cells, and the expression of IL-17 and RORγt mRNA and protein in the oviduct tissues were significantly higher, and the fertility rate, IL-10, the proportion of Treg cells, and the expression of Foxp3 mRNA and protein in the rats were significantly lower(P<0.05). Compared with the model group, the high-dose group of Yinjia tablets improved the structure of oviduct of rats; significantly reduced the TNF-α, IL-6 content, Th17 cell proportion and IL-17, RORγt mRNA and protein expression in oviduct tissue of model rats; and significantly increased the conception rate and IL-10, Treg cell proportion and Foxp3 mRNA and protein expression of rats(P<0.05). CONCLUSION Yinjia tablets can effectively regulate Th17/Treg balance, which in turn regulates Treg and Th17 cell-mediated inflammatory responses and improves the conception rate in chronic salpingitis rats.
8.A qualitative study of the expectations and value of patients with malocclusion for participation in shared decision making in orthognathic surgery options.
Xiangying HU ; Bixia WANG ; Yan XIAO ; Weijun YUAN ; Min ZHU ; Xudong WANG
Chinese Journal of Practical Nursing 2022;38(32):2543-2547
Objective:To explore the expectations and values of patients with malocclusion on participation in shared decision-making of orthognathic surgical protocols, and to provide references for further development of clinical shared decision-making models.Methods:Based on the expected value theory and descriptive qualitative research methods, using purposive sampling, 13 patients with malocclusion in the Ninth People's Hospital of Shanghai Jiao tong University School of Medicine from May to August in 2021 were selected for semi-structured interviews. The interview data were sorted, classified and refined by traditional content analysis.Results:Two themes were extracted: patients' ability beliefs about their ability to participate in shared decision making for orthognathic surgery(decision support ability, psychological coping ability and environmental adaptability), and task values for shared decision making for orthognathic surgery(interest value, acquisition value).Conclusions:Low level of patients′ ability beliefs in shared decision-making, active physician guidance facilitates patient participation, but the depth of patient participation is influenced by factors such as information support, cultural climate, and physical space for shared decision making. It is suggested that the magnetic role of physicians should be actively played, the shared decision-making team should be strengthened, at the same time, hospital manager should enhance shared decision making propaganda to increase the acceptance and participation of patients in shared decision making so as to improve the quality of shared decision-making.
9.Analysis of risk factors for hematoma enlargement or rebleeding in the short term after decompressive craniectomy in patients with cerebral hemorrhage
Di WANG ; Zhoule ZHU ; Rong CHEN ; Gangming SHAN ; Weijun MA
Chinese Journal of Postgraduates of Medicine 2022;45(9):818-823
Objective:To investigate the risk factors of hematoma enlargement or rebleeding in the short term after decompressive craniectomy in patients with cerebral hemorrhage.Methods:The clinical data of 209 cerebral hemorrhage patients underwent decompressive craniectomy from January 2019 to October 2021 in the Second Affiliated Hospital of Zhejiang University and Keqiao District Traditional Chinese Medicine Hospital of Shaoxing City were retrospectively analyzed. According to the head CT result at the time of consultation and 24 h after the onset, the patients were divided into hematoma enlargement and rebleeding group (group A, 28 cases), hematoma enlargement group (group B, 47 cases), rebleeding groups (group C, 13 cases), non-hematoma enlargement and non-rebleeding group (group D, 121 cases). The gender, age, body mass index, time of first CT examination, first bleeding volume, admission Glasgow coma score (GCS), admission systolic pressures, admission diastolic pressure, admission activated partial thromboplastin time (APTT), admission alanine aminotransferase (ALT), admission white blood cell count, hematoma site, broken into the ventricle, irregular hematoma, timing of operation, maximum body temperature of 24 h after admission, intraoperative hemostasis and unsatisfactory on postoperative blood pressure control were collected. Multifactor Logistic regression analysis was used to analyze the independent risk factors of hematoma enlargement or rebleeding in the short term after decompressive craniectomy in patients with cerebral hemorrhage.Results:There were no statistical difference in sex composition, age and body mass index among 4 groups ( P>0.05). The incidences of admission systolic pressures ≥140 mmHg (1 mmHg = 0.133 kPa), admission diastolic pressure ≥90 mmHg, admission APTT≥37 s, admission ALT≥40 U/L, admission white blood cell count ≥10 × 10 9/L, admission GCS, maximum body temperature of 24 h after admission ≥ 37 ℃, first bleeding volume ≥ 60 ml, time of first CT examination ≥3 h, time from onset to operation ≥ 12 h, irregular hematoma, hematoma in the thalamus, broken into the ventricle, intraoperative hemostasis, unsatisfactory on postoperative blood pressure control in group A were significantly higher than those in group B, group C and group D: 92.86% (26/28) vs. 55.32% (26/47), 7/13 and 23.97% (29/121); 89.29% (25/28) vs. 51.06% (24/47), 6/13 and 17.36% (21/121); 92.86% (26/28) vs. 48.94% (23/47), 6/13 and 14.88% (18/121); 78.57% (22/28) vs. 42.55% (20/47), 5/13 and 16.53% (20/121); 89.29% (25/28) vs. 53.19% (25/47), 7/13 and 18.18% (22/121); 89.29% (25/28) vs. 57.45% (27/47), 7/13 and 23.14% (28/121); 92.86% (26/28) vs. 55.32% (26/47), 7/13 and 23.97% (29/121); 85.71% (24/28) vs. 48.94% (23/47), 6/13 and 16.53% (20/121); 89.29% (25/28) vs. 53.19% (25/47), 7/13 and 23.14% (28/121); 89.29% (25/28) vs. 44.68% (21/47), 6/13 and 17.36% (21/121); 96.43% (27/28) vs. 51.06% (24/47), 7/13 and 22.31% (27/121); 67.86% (19/28) vs. 46.81% (22/47), 6/13 and 20.66% (25/121); 89.29% (25/28) vs. 42.55% (20/47), 6/13 and 18.18% (22/121); 92.86% (26/28) vs. 53.19% (25/47), 7/13 and 20.66% (25/121); 89.29% (25/28) vs. 48.94% (23/47), 6/13 and 16.53% (20/121), the incidences in group B and group C were significantly higher than those in group D, and there were statistical differences ( P<0.05); there were no statistical differences in the incidences between group B and group C ( P>0.05). Multifactor Logistic regression analysis result showed that maximum body temperature of 24 h after admission ≥ 37 ℃, time from onset to operation ≥12 h, hematoma in the thalamus, intraoperative hemostasis and unsatisfactory on postoperative blood pressure control were the independent risk factors of hematoma enlargement or rebleeding in the short term after decompressive craniectomy in patients with cerebral hemorrhage ( OR = 3.271, 25.739, 4.255, 3.995 and 13.749; 95% CI 1.072 to 9.977, 7.711 to 85.919, 1.297 to 13.954, 1.252 to 12.747 and 3.961 to 47.732; P<0.05 or <0.01). Conclusions:After decompressive craniectomy, some patients with cerebral hemorrhage may have hematoma enlargement or rebleeding in the short term. The admission body temperature, hematoma site, intraoperative hemostasis, postoperative blood pressure control and operation timing are influencing factors, and the corresponding intervention may help to prevent the occurrence of hematoma enlargement or rebleeding in a short term.
10.Clinical factors of positive surgical margin after robot-assisted laparoscopic radical prostatectomy in patients with high-risk prostate cancer
Weijun FU ; Yong SONG ; Jian ZHAO ; Jinpeng SHAO ; Ziyan AN ; Qiwei ZHOU ; Shengkun SUN ; Wenzheng CHEN ; Jie ZHU ; Dan SHEN ; Qingshan DU ; Fan ZHANG ; Kan LIU ; Xu ZHANG
Chinese Journal of Urology 2022;43(7):518-522
Objective:To investigate the relationship between the positive surgical margin and clinical factors such as neoadjuvant hormonal therapy after robot-assisted laparoscopic radical prostatectomy (RARP) in high-risk patients with prostate cancer.Methods:The clinical data of 164 patients with high-risk prostate cancer being performed RARP by one surgeon were analyzed retrospectively in our hospital from January 2016 to January 2022. The mean patient’s age was (65.3±6.2) years old, mean body mass index (BMI) was (25.6±3.0) kg/m 2, the median value of total prostate specific antigen (tPSA) before operation was 18.6(11.3, 31.3)ng/ml, the median value of Gleason score before operation was 7 (7, 8), the median value of prostate volume was 29.3 (22.4, 40.2) ml, and the clinical stage was T 2aN 0M 0-T 4N 0M 0. 80 patients with prostate cancer were treated with neoadjuvant endocrine therapy. All of them were treated with complete androgen blockade with a median course of 3 months. Univariate analysis was used to analyze the correlation between age, BMI, prostate volume, neoadjuvant hormonal therapy, preoperative tPSA, clinical stage, Gleason score before operation and positive surgical margin. Then multivariate logistic regression was used to further analyze the independent risk factor of positive surgical margin after RARP. Results:The postoperative pathological diagnosis included pT 2 stage in 111 cases (67.7%), pT 3a stage in 15 cases (9.1%), pT 3b stage in 25 cases (15.2%), pT 4 stage in 13 cases (7.9%). No lymph node metastasis was noticed in all patients. The Gleason scores included 6 in 11 cases (6.7%), 3+ 4 in 26 cases (15.9%), 4+ 3 in 36 cases (22.0%), 8 in 17 cases (10.4%), 9-10 in 24 cases (14.6%), un-evaluation due to endocrine therapy in 50 (30.5%). The positive surgical margin of high-risk patients with prostate cancer was 44.5% (73/164). Univariate analysis showed that the neoadjuvant hormonal therapy, tPSA and clinical stage were correlated with positive surgical margin ( P<0.05). Multivariate logistic regression analysis showed that non-neoadjuvant hormonal therapy, preoperative tPSA>20ng/ml and clinical stage>T 2b were independent risk factors for positive surgical margin of high-risk patients with prostate cancer. Stratified analysis showed that when the preoperative tPSA was 10-20 ng/ml(21.1% vs.55.9%, P=0.014), the clinical stage was T 2c(29.6% vs.49.1%, P=0.040), the Gleason score before operation was 7(19.4% vs.54.1%, P=0.003), the positive surgical margin of high-risk patients in the neoadjuvant hormonal therapy group was significantly lower than that in the non-neoadjuvant hormonal therapy group ( P<0.05). Conclusions:Non-neoadjuvant hormonal therapy, preoperative tPSA>20 ng/ml and clinical stage>T 2b were independent risk factors for positive surgical margin of RARP in the high-risk patients with prostate cancer. For high-risk patients with preoperative tPSA of 10-20 ng/ml, clinical stage of T 2c and Gleason score before operation of 7, neoadjuvant hormonal therapy has important clinical significance in reducing the positive surgical margin of RARP.


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