This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To compare the clinical efficacy and safety of transarterial chemoembolization(TACE)plus apatinib(Apa)and camrelizumab(Cam)and TACE plus Apa in treating CNLC stage Ⅲ hepatocellular carcinoma(HCC).Methods A total of 54 patients in Affiliated Yancheng No.1 People's Hospital,School of Medicine,Nanjing University with CNLC stage Ⅲ HCC were enrolled in this study.The patients were divided into triple treatment group(n=25,receiving TACE plus Apa and Cam)and dual treatment group(n=29,receiving TACE plus Apa).The overall survival(OS)and progression-free survival(PFS)were compared between the two groups.Univariate analysis and multivariate analysis were used to determine the independent influencing factors for OS and PFS.The target immunotherapy-related adverse reactions(TRAE)were analyzed.Results The median OS and PFS in the triple treatment group were 23.2 months and 10.9 months respectively,which were higher than 15.2 months and 5.8 months respectively in the dual treatment group(both P＜0.001).Multivariate analysis indicated that the therapeutic regimen and the type of portal vein tumor thrombosis(PVTT)were the independent factors affecting OS,while only the therapeutic regimen was the independent factor affecting PFS.The incidence of≥grade Ⅲ TRAE in the triple treatment group and the dual treatment group was 20％(5/25)and 17.2％(5/29)respectively,the difference between the two groups was not statistically significant(P＞0.05).Conclusion For the treatment of patients with CNLC stage Ⅲ HCC,TACE plus Apa and Cam is superior to TACE plus Apa in OS and PFS,and the type of PVTT and the therapeutic regimen are the independent prognostic factors associated with patient's survival.

Objective To investigate the clinical characteristics of patients with chronic abacterial pros-tafitis(CAP),the CAP related factors were analyzed,and a risk prediction model for CAP were constructed and validated.Methods The clinical dataes of 252 suspected CAP patients admitted to the hospital from June 2022 to December 2024 were collected,the patients were divided into modeling set(ni=177)and validation set(n=75)by 7∶3 ratio.Based on the modeling set dataes,the Lasso was used to screen CAP related predictive factors,a logistic multiple factor model was used to analyze the independent influence factors of CAP and a risk prediction model was constructed.The validation set patient dataes were used to plot ROC and DCA and validate the predic-tion model.Results There were 86 cases of CAP in the modeling set,accounting for 48.59％;32 cases of CAP in the validation set,accounting for 42.67％.The Logistic multiple regression analysis showed that BMI,waist to hip ratio,abnormal elevation of IL-8,COX-2,and PGE2 in prostate fluid were independent influence factors of CAP(P＜0.05),a Nomogram column chart based on this was established.The ROC analysis showed that the sensitivity of the model for detecting CAP in the modeling and validation sets were 0.814 and 0.802,respectively,and the specificity were 0.673 and 0.703,respectively.The DCA analysis showed that the net benefit thresholds for model-ing and validation sets by column charts are 0.1～0.9 and 0.2～1.0,respectively.Conclusions The occurrence of CAP is related to the patient's BMI,waist to hip ratio,the levels of IL-8,COX-2,and PGE2 in prostate fluid.The predictive model established based on this is highly accurate and it can help for CAP screening.

Objective To investigate the clinical characteristics of patients with chronic abacterial pros-tafitis(CAP),the CAP related factors were analyzed,and a risk prediction model for CAP were constructed and validated.Methods The clinical dataes of 252 suspected CAP patients admitted to the hospital from June 2022 to December 2024 were collected,the patients were divided into modeling set(ni=177)and validation set(n=75)by 7∶3 ratio.Based on the modeling set dataes,the Lasso was used to screen CAP related predictive factors,a logistic multiple factor model was used to analyze the independent influence factors of CAP and a risk prediction model was constructed.The validation set patient dataes were used to plot ROC and DCA and validate the predic-tion model.Results There were 86 cases of CAP in the modeling set,accounting for 48.59％;32 cases of CAP in the validation set,accounting for 42.67％.The Logistic multiple regression analysis showed that BMI,waist to hip ratio,abnormal elevation of IL-8,COX-2,and PGE2 in prostate fluid were independent influence factors of CAP(P＜0.05),a Nomogram column chart based on this was established.The ROC analysis showed that the sensitivity of the model for detecting CAP in the modeling and validation sets were 0.814 and 0.802,respectively,and the specificity were 0.673 and 0.703,respectively.The DCA analysis showed that the net benefit thresholds for model-ing and validation sets by column charts are 0.1～0.9 and 0.2～1.0,respectively.Conclusions The occurrence of CAP is related to the patient's BMI,waist to hip ratio,the levels of IL-8,COX-2,and PGE2 in prostate fluid.The predictive model established based on this is highly accurate and it can help for CAP screening.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

Objective To investigate the application value of tenofovir alafenamide fumarate (TAF) in elderly patients with chronic hepatitis B (CHB) and its influence on bones and kidneys. Methods A total of 36 CHB patients, aged ≥60 years, who received TAF antiviral therapy in Qingdao Municipal Hospital, The Affiliated Hospital of Qingdao University, Qingdao Sixth People's Hospital, Chengyang People's Hospital, and Jimo People's Hospital from June 2021 to October 2022 were enrolled in this study, and all patients received TAF (25 mg/d) antiviral therapy. Related data were collected at baseline and weeks 24 and 48 of treatment, including virological indicators, biochemical parameters, urinary protein electrophoresis indices, transient elastography (FibroScan), and bone mineral density. Virological indicators included high-sensitivity HBV DNA quantification; biochemical parameters included total bilirubin, direct bilirubin (DBil), indirect bilirubin (IBil), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bile acid (TBA), glucose, blood urea nitrogen, creatinine, estimated glomerular filtration rate, and cystatin C (Cys C); urinary protein electrophoresis indices included urinary β2 microglobulin (β2-MG), urinary retinol (URBP), and urinary α1 microspherin (α1-MG). The paired t -test was used for comparison of normally distributed continuous data before and after treatment, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment; the chi-square test or the Fisher's exact test was used for comparison of categorical data. Results A total of 36 CHB patients completed 24 weeks of follow-up. The complete virological response rate after 24 weeks of treatment was higher than that at baseline [83.3% (30/36) vs 77.8% (28/36), χ 2 =0.36, P =0.55], and there were significant reductions in DBil ( t =-2.42, P =0.02) and Cys C ( t =-4.34, P < 0.001) from baseline to week 24. A total of 18 CHB patients completed 48 weeks of follow-up. The complete virological response rate after 48 weeks of treatment was higher than that at baseline (94.4% vs 77.8%, χ 2 =2.22, P =0.34), and there were significant increases in IBil ( t =2.43, P =0.03), TBA ( Z =-2.24, P =0.03), and bone mineral density T score of lumbar vertebra ( t =2.92, P = 0.01) and femoral neck ( t =2.42, P =0.03) and a significant reduction in liver stiffness measurement ( t =-2.31, P =0.03). There were no significant changes in β2-MG, URBP, and α1-MG after treatment (all P > 0.05). Conclusion TAF has a good antiviral effect in CHB patients aged ≥60 years and can help more CHB patients achieve complete virological response, without causing damage to the kidney, and it can also improve bone mineral density and liver fibrosis degree.

Objective:To investigate the risk factors for cerebral injury in survivors of twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser occlusion of chorioangiopagous vessels(FLOC) and to analyze the neurodevelopmental outcomes at 12 months of corrected age.Methods:A total of 136 cases of TTTS receiving FLOC in the Third Affiliated Hospital of Zhengzhou University from May 2018 to August 2021 were retrospectively selected as the FLOC group, and the survivors were followed up. Neurological development at 12 months of corrected age was assessed using the Griffiths mental development scales-Chinese (GDS-C) from five dimensions with locomotor, personal-social, hearing and language, hand-eye coordination and performance subscales. Eighty-eight fetuses of TTTS pregnancies receiving expectant treatment or amniotic fluid reduction were selected as the non-FLOC group. The perinatal mortality and the incidence of cerebral injury in the two groups were compared, as well as the incidence of cerebral injury between patients undergoing Solomon surgery and selective laser surgery in the FLOC group. Generalized estimating equations were used to analyze the risk factors for neonatal cerebral injury after FLOC and the factors influencing general developmental quotient score at the corrected age of 12 months. Chi-square test, t-test, and Mann-Whitney U test were used for statistical analysis. Results:(1) The perinatal mortality rate in the FLOC group was lower than that in the non-FLOC group [14.7% (20/136) vs 26.1% (23/88), χ 2=4.50, P=0.034]. There was no statistical significance in the incidence of neonatal cerebral injury between the two groups [18.7% (23/123) vs 21.8% (17/78), χ 2=0.29, P=0.592], but the incidence of severe cerebral injury in the FLOC group was lower than that in the non-FLOC group [6.5% (8/123) vs 15.4% (12/78), χ 2=4.20, P=0.040]. (2) In the FLOC group, there was no significant difference in the incidence of cerebral injury between donors and recipients, or between Solomon surgery and selective laser surgery [16.4% (10/61) vs 21.0% (13/62), χ 2=0.42; 20.0% (9/45) vs 17.9% (14/78), χ 2=0.08; both P>0.05]. (3) Multivariate analysis showed that neonatal asphyxia ( OR=7.04, 95% CI: 1.45-34.20, P=0.016) and higher preoperative TTTS stage ( OR=2.05, 95% CI: 1.10-3.82, P=0.023) were risk factors for neonatal cerebral injury. (4) Fifty-two cases were successfully followed up at the corrected age of 12 months, and the incidence of developmental delay in at least one dimension was 34.6% (18/52). Developmental delay was mainly manifested in locomotor skills and language, accounting for 26.9% (14/52) and 11.5% (6/52). No significant difference in Z value was found between recipients and donors in each dimension (all P>0.05). Solomon surgery, larger gestational age at operation and low birth weight were related to low general developmental quotient score (95% CI:－11.71 to－0.23，－1.99 to－0.47，0.00-0.01，respectively，all P<0.05). Conclusions:The occurrence of cerebral injury in TTTS survivors after FLOC is related to preoperative TTTS staging and intrapartum neonatal asphyxia. Neurodevelopment of survivors is related to birth weight and gestational age at surgery, and there is a higher incidence of mild developmental delay at corrected age of 12 months.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To explore the relationship between sleep quality and depression among fertile women, and provide a scientific reference for protecting the mental health of fertile women.Methods:The study included 12 518 fertile women who were 15 to 49 years old from the Second Affiliated Hospital of Kunming Medical University and Maternal and Child Health Hospital of Qujing in Yunnan Province from January 2019 to November 2019. Sleep quality was collected by using self-reported questionnaires, and depression was evaluated by using the Edinburgh Postpartum Depression Scale. We used logistic regression to analyze the relationship between sleep quality and depression after controlling for other factors.Results:Among 12 518 fertile women, 3197 had poor sleep quality which accounted for 25.54% (95% CI=24.77%-26.30%). The detection rate of depression was 55.59% (6959/12 518; 95% CI=54.72%-56.46%). The detection rate of depression of the poor sleep quality group [75.40% (2410/3197)] was significantly higher than that of the good sleep quality group [48.80% (4549/9321), P<0.001]. Multivariate logistic regression analysis showed that after controlling for basic demographic characteristics, health status, lifestyle habits and other factors, depression was still associated with poor sleep quality (a OR=3.28, 95% CI=2.99-3.60; P<0.001). Conclusion:The problem of depression and sleep quality on fertile women cannot be ignored, and sleep quality was associated with depression significantly which suggested that it was necessary to keep good life style, improve sleep quality and promote mental health.