BACKGROUND: At present, biopsy is essential for the diagnosis of prostate cancer (PCa) before radical prostatectomy (RP). However, with the development of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and multiparametric magnetic resonance imaging (mpMRI), it might be feasible to avoid biopsy before RP. Herein, we aimed to explore the feasibility of avoiding biopsy before RP in patients highly suspected of having PCa after assessment of PSMA PET/CT and mpMRI. METHODS: Between December 2017 and April 2022, 56 patients with maximum standardized uptake value (SUVmax) of ≥4 and Prostate Imaging Reporting and Data System (PI-RADS) ≥4 lesions who received RP without preoperative biopsy were enrolled from two tertiary hospitals. The consistency between clinical and pathological diagnoses was evaluated. Preoperative characteristics were compared among patients with different pathological types, T stages, International Society of Urological Pathology (ISUP) grades, and European Association of Urology (EAU) risk groups. RESULTS: Fifty-five (98%) patients were confirmed with PCa by pathology, including 49 (89%) with clinically significant prostate cancer (csPCa, defined as ISUP grade ≥2 malignancy). One patient was diagnosed with high-grade prostatic intraepithelial neoplasia (HGPIN). CsPCa patients, compared with clinically insignificant prostate cancer (cisPCa) and HGPIN patients, were associated with a higher level of prostate-specific antigen (22.9 ng/mL vs . 10.0 ng/mL, P = 0.032), a lower median prostate volume (32.2 mL vs . 65.0 mL, P = 0.001), and a higher median SUVmax (13.3 vs . 5.6, P <0.001). CONCLUSIONS It might be feasible to avoid biopsy before RP for patients with a high probability of PCa based on PSMA PET/CT and mpMRI. However, the diagnostic efficacy of csPCa with PI-RADS ≥4 and SUVmax of ≥4 is inadequate for performing a procedure such as RP. Further prospective multicenter studies with larger sample sizes are necessary to confirm our perspectives and establish predictive models with PSMA PET/CT and mpMRI.
Humans ; Male ; Prostatectomy/methods* ; Prostatic Neoplasms/diagnosis* ; Middle Aged ; Aged ; Positron Emission Tomography Computed Tomography/methods* ; Biopsy ; Multiparametric Magnetic Resonance Imaging ; Prostate-Specific Antigen/metabolism*

Emodin is a hydroxyanthraquinone compound that is widely distributed and has multiple pharmacological activities, including anti-diarrheal, anti-inflammatory, and liver-protective effects. Research indicates that emodin may be one of the main components responsible for inducing hepatotoxicity. However, studies on the mechanisms of liver injury are relatively limited, particularly those related to bile acids(BAs) metabolism. This study aims to systematically investigate the effects of different dosages of emodin on BAs metabolism, providing a basis for the safe clinical use of traditional Chinese medicine(TCM)containing emodin. First, this study evaluated the safety of repeated administration of different dosages of emodin over a 5-week period, with a particular focus on its impact on the liver. Next, the composition and content of BAs in serum and liver were analyzed. Subsequently, qRT-PCR was used to detect the mRNA expression of nuclear receptors and transporters related to BAs metabolism. The results showed that 1 g·kg~(-1) emodin induced hepatic damage, with bile duct hyperplasia as the primary pathological manifestation. It significantly increased the levels of various BAs in the serum and primary BAs(including taurine-conjugated and free BAs) in the liver. Additionally, it downregulated the mRNA expression of farnesoid X receptor(FXR), retinoid X receptor(RXR), and sodium taurocholate cotransporting polypeptide(NTCP), and upregulated the mRNA expression of cholesterol 7α-hydroxylase(CYP7A1) in the liver. Although 0.01 g·kg~(-1) and 0.03 g·kg~(-1) emodin did not induce obvious liver injury, they significantly increased the level of taurine-conjugated BAs in the liver, suggesting a potential interference with BAs homeostasis. In conclusion, 1 g·kg~(-1) emodin may promote the production of primary BAs in the liver by affecting the FXR-RXR-CYP7A1 pathway, inhibit NTCP expression, and reduce BA reabsorption in the liver, resulting in BA accumulation in the peripheral blood. This disruption of BA homeostasis leads to liver injury. Even doses of emodin close to the clinical dose can also have a certain effect on the homeostasis of BAs. Therefore, when using traditional Chinese medicine or formulas containing emodin in clinical practice, it is necessary to regularly monitor liver function indicators and closely monitor the risk of drug-induced liver injury.
Emodin/administration & dosage* ; Bile Acids and Salts/metabolism* ; Animals ; Male ; Liver/injuries* ; Chemical and Drug Induced Liver Injury/genetics* ; Drugs, Chinese Herbal/adverse effects* ; Humans ; Rats, Sprague-Dawley ; Mice ; Rats

OBJECTIVE: To explore the optimal vertical traction weight, clinical efficacy, and safety of bidirectional cervical traction in the treatment of cervical kyphosis. METHODS: A total of 130 patients with neck pain and cervical kyphosis confirmed by cervical DR who visited the hospital from April 2023 to April 2024 were enrolled. They were divided into 4 groups according to the vertical traction weight accounting for 5%, 10%, 15%, and 20% of their body weight, respectively. The 5% body weight traction group included 33 cases (13 males and 20 females) with an average age of (34.00±10.58) years old;the 10% body weight traction group included 35 cases (17 males and 18 females) with an average age of (32.23±8.39) years old;the 15% body weight traction group included 32 cases (14 males and 18 females) with an average age of (33.88±10.09) years old;the 20% body weight traction group included 30 cases (11 males and 19 females) with an average age of (36.20±9.13) years old. Each group received treatment for 2 weeks. The visual analogue scale (VAS) score, neck disability index (NDI), and C₂-C₇ Cobb angle on cervical lateral X-ray films before and after treatment were recorded to evaluate the clinical efficacy of the 4 groups. RESULTS: When the traction weight was 10% and 15% of body weight, the pain VAS and NDI were significantly improved, and the C₂-C₇ Cobb angle increased, with statistically significant differences (P<0.05), and no adverse reactions occurred. However, in the 5% body weight group, the above indicators showed no significant changes, with no statistically significant differences (P>0.05). In the 20% body weight group, some patients could not tolerate the treatment, and adverse reactions such as dizziness, nausea, and aggravated neck pain occurred. CONCLUSION The optimal vertical traction weight of bidirectional cervical traction for cervical kyphosis is 10%-15% of body weight, which can effectively improve neck pain and cervical function, increase the C₂-C₇ Cobb angle of the cervical spine, with high safety, and is worthy of promotion and application.
Humans ; Male ; Female ; Traction/methods* ; Kyphosis/physiopathology* ; Adult ; Cervical Vertebrae/physiopathology* ; Middle Aged ; Neck Pain ; Young Adult

Liraglutide (Lira), a glucagon-like peptide-1 (GLP-1) receptor agonist approved for diabetes and obesity, has shown significant potential in treating metabolic dysfunction-associated steatotic liver disease (MASLD). However, its systematic molecular regulation and mechanisms remain underexplored. In this study, a mouse model of MASLD was developed using a high-fat diet (HFD), followed by Lira administration. Proteomics and glycoproteomics were analyzed using label-free liquid chromatography-tandem mass spectrometry (LC-MS/MS), while potential molecular target analysis was conducted via quantitative real-time polymerase chain reaction (qPCR) and Western blotting. Our results revealed that Lira treatment significantly reduced liver weight and serum markers, including alanine aminotransferase (ALT) and others, with glycosylation changes playing a more significant role than overall protein expression. The glycoproteome identified 255 independent glycosylation sites, emphasizing the impact of Lira on amino acid, carbohydrate metabolism, and ferroptosis. Simultaneously, proteomic analysis highlighted its effects on lipid metabolism and fibrosis pathways. 21 signature molecules, including 7 proteins and 14 N-glycosylation sites (N-glycosites), were identified as potential targets. A Lira hydrogel formulation (Lira@fibrin (Fib) Gel) was developed to extend drug dosing intervals, offering enhanced therapeutic efficacy in managing chronic metabolic diseases. Our study demonstrated the importance of glycosylation regulation in the therapeutic effects of Lira on MASLD, identifying potential molecular targets and advancing its clinical application for MASLD treatment.

Purpose::Intramedullary nailing is the preferred internal fixation technique for the treatment of subtrochanteric fractures because of its biomechanical advantages. However, no definitive conclusion has been reached regarding whether combined cable cerclage is required during intramedullary nailing treatment. This study is performed to compare the clinical effects of intramedullary nailing with cerclage and non-cerclage wiring in the treatment of irreducible spiral subtrochanteric fractures.Methods::Patients with subtrochanteric fractures admitted to our center from January 2013 to December 2021 were retrospectively analyzed. The patients were enrolled in the case-control study according to the inclusion and exclusion criteria and divided into the non-cerclage group and the cerclage group. The patients' clinical data, including the operative time, intraoperative blood loss, hospital stay, reoperation rate, fracture union time, and Harris hip score, were compared between these 2 groups. Categorical variables were compared using Chi-square or Fisher's exact test. Continuous variables with normal distribution were presented as mean ± standard deviation and analyzed with Student's t-test. Nonnormally distributed variables were expressed as median (Q 1, Q 3) and assessed using the Mann-Whitney test. A p < 0.05 was considered significant. Results::In total, 69 patients were included in the study (35 patients in the non-cerclage group and 34 patients in the cerclage group). The baseline data of the 2 groups were comparable. There were no significant difference in the length of hospital stay (z = -0.391, p = 0.696), operative time (z = -1.289, p = 0.197), or intraoperative blood loss (z = -1.321, p = 0.186). However, compared with non-cerclage group, the fracture union time was shorter (z = -5.587, p < 0.001), the rate of nonunion was lower (χ 2= 6.030, p = 0.03), the anatomical reduction rate was higher (χ 2= 5.449, p = 0.03), and the Harris hip score was higher (z =-2.99, p = 0.003) in the cerclage group, all with statistically significant differences. Conclusions::Intramedullary nailing combined with cable cerclage wiring is a safe and reliable technique for the treatment of irreducible subtrochanteric fractures. This technique can improve the reduction effect, increase the stability of fracture fixation, shorten the fracture union time, reduce the occurrence of nonunion, and contribute to the recovery of hip joint function.

Objective To explore the effects of standardized environmental enrichment(EE)on cognitive function and serum brain-derived neurotrophic factor(BDNF)levels in patients with post-stroke dementia.Methods A prospective study was conducted,including 80 patients with post-stroke dementia admitted to Department of Traditional Chinese Medicine Rehabilitation,910th Hospital of the Joint Logistics Support Force of Chinese PLA from January 2021 to May 2023.Patients were randomly divided into control group,cognitive training(COG)group,aerobic exercise training(AE)group and environmental enrichment(EE)group,with 20 cases in each group.All patients received routine treatment,with COG group receiving additional cognitive function training(30 minutes each time),AE group receiving additional aerobic exercise training(30 minutes each time),and EE group receiving both aerobic exercise and cognitive function training(15 minutes of aerobic exercise training and 15 minutes of cognitive training each time).The training was conducted once a day,5 days a week,for a total of 8 weeks.The patients'mini-mental state scale(MMSE),modified Barthel index(MBI),Hamilton depression scale(HAMD),stroke-specific quality of life(SS-QOL)score and serum levels of BDNF were assessed before treatment,at 4 weeks and 8 weeks of treatment,respectively.Results Before treatment,there were no significant differences in general information,MMSE,MBI,HAMD,SS-QOL scores,and serum levels of BDNF among the four groups(P＞0.05).After 4 and 8 weeks of treatment,the above indicators of the four groups were improved compared with those before treatment,with all differences being statistically significant(P＜0.05).Inter-group comparison showed that after 4 and 8 weeks of treatment,MMSE,MBI,SS-QOL scores,and serum BDNF levels in COG,AE and EE groups were significantly higher than those in control group,and HAMD scores were significantly lower than those in control group(P＜0.05).In addition,MMSE,MBI,SS-QOL scores and BDNF levels of group EE were better than those of other 3 groups,while HAMD scores were lower than those of other 3 groups,with all differences being statistically significant(P＜0.05).There was no significant difference in above outcome indicators between COG group and AE group after 4 and 8 weeks of treatment(P＞0.05).Conclusion Standardized enrichment environment can significantly enhance cognitive function,daily living abilities of post-stroke dementia patients,alleviate depression symptoms,and improve the quality of life,which may be related to the increase in serum BDNF levels.

Objective To reveal the characteristics of Tibetan human body composition in Gannan.Methods The body composition of 410 Tibetan adults(221 males and 189 females)in Gannan was measured by bioelectrical impedance method.The data were processed by SPSS 20.0 statistical software.Results Related analysis results showed that the total body muscle mass,estimated fat level and trunk muscle mass of the male decreased with age,while the percent body water,visceral fat level and percent trunk fat increased with age.The stature and left lower limb muscle mass of the female decreased with age,while body weight,percent body fat,body mass index,visceral fat level,percent right upper limb fat,right upper limb muscle mass,percent left upper limb,left upper limb muscle mass,percent right lower limb fat,percent left lower limb fat,left lower limb muscle mass and percent trunk fat increased with age.Analysis of single factor variance showed that there were statistically significant differences in the four indexes of male percent body water,visceral fat level,percent trunk fat and trunk muscle mass,while there were no statistically significant differences in the other 14 indexes among age groups.Females weight,stature,percent body fat,total body muscle mass,estimated fat level,body mass index,visceral fat level,percent right upper limb fat,right upper limb muscle mass,percent left upper limb fat,left upper limb muscle mass,percent right lower limb fat,percent left lower limb fat,left lower limb muscle mass,percent trunk fat,trunk muscle mass 16 index values were statistically significant differences between age groups,the remaining two index values were not statistically significant differences between age groups.The results of u test showed that the body weight,total body muscle mass,estimated fat level,percent body water,limb muscle mass and trunk muscle mass of males were higher than those of females,and percent body fat,limb fat rate,visceral fat rate and trunk fat rate of females were higher than those of males.According to the body mass index,Gannan Tibetan male and female were overweight;according to the percent body fat,Gannan Tibetan males were non-obesity and females were obesity.Conclusion The body mass index and overall fat content of Tibetan males and females in Gannan are relatively high among the 13 ethnic groups.

Objective To analyze the characteristics of adult body composition and obesity status of three ethnic groups:Ewenki,Daur and Mongolian Buryat.Methods The bioelectrical impedance analysis(BIA)was used to measure 18 body composition components in three adults ethnic groups:245(male 124,female 121)Ewenki,207(male 90,female 117)Daur,and 181(male 74,female 107)Mongolian Buryat.The data were processed using Excel 2016 and SPSS 24.0 statistical software.Results The result of correlation analysis showed that visceral fat level was significantly and positively correlated with age(P＜0.01).Stature,total body muscle mass,estimated bone mass and trunk muscle mass were all significantly and negatively correlated with age(P＜0.01)in males and females of the three ethnic groups.The percent body fat,percent left upper limb fat and percent trunk fat were positively correlated with age in Ewenki males(P＜0.05 or P＜0.01)and the percent body fat,body mass index(BMI),percent limb fat and percent trunk fat were positively correlated with age in Ewenki females(P＜0.05 or P＜0.01).Body weight,BMI,percent left upper limb fat,left upper limb muscle mass,bilateral lower limb fat and muscle mass were all negatively correlated with age in Daur males(P＜0.05 or P＜0.01).Body weight,upper limb muscle mass and left lower limb muscle mass were negatively correlated with age(P＜0.05 or P＜0.01)in Mongolian Buryat males and percent trunk fat was positively correlated with age(P＜0.05)in Mongolian Buryat females.Comparison between ethnic groups showed that most of the body composition index values of the Ewenki and Mongolian Buryat divisions were closest to each other,and the body fat content was higher than that of the Daur.BMI,percent body fat and visceral fat level were all manifested in the Mongolian Buryat Department＞Ewenki＞Daur.Cluster analysis showed that Ewenki,Daur and Mongolian Buryat were closer to the northern groups and further from the southern groups.Conclusion The Ewenki is most similar to the Mongolian Buryat in body composition characteristics all three ethnic groups has a more serious obesity problem.

Objective To explore the common features of Chinese ethnic groups.Methods Eight body indexes of 62 ethnic groups in China were analyzed.Results The cluster analysis showed that 52 males and 59 females ethnic groups were grouped into the mixed group dominated by the northern ethnic group and the mixed group dominated by the southern ethnic group.Eight Han ethnic groups were grouped into each group,but no Han group was aggregated.The result of body index classification showed that the main body types of Chinese male population were long trunk,middle chest,wide shoulder,wide pelvis and middle leg.Middle body,wide chest,wide shoulder,wide pelvis and middle leg were the main body types of Chinese female population.This showed that the characteristics of Chinese ethnic groups had obvious consistency.The consistency of Chinese group features was related to its close origin.It should be said that Han nationality played an important role in the process of communication and integration of various ethnic groups in China.In the history of the Han nationality,there had been many large-scale population migration.The southern movement of the northern ethnic minorities into the northern Han and the southward movement of the northern Han into the south promoted the formation of the Southern Han,which made the southern Han and the northern Han had similar body features,and also promoted the southern ethnic minorities into the southern Han.In addition,the Han nationality who moved into minority areas also gradually integrated into minority areas.Conclusion There are obvious commonalities in Chinese ethnic groups.