ObjectiveTo evaluate the application of prostate-specific membrane antigen （PSMA）PET/CT in prostate biopsy screening， and propose effective strategies for prostate biopsy decision making based on PSMA PET/CT detection. MethodsA retrospective analysis was conducted on PSMA PET/CT imaging and clinical pathological data from 155 patients with suspected prostate cancer between January 2020 and December 2023. PRIMARY score was used as the standardized evaluation method for PSMA PET/CT in the diagnosis of prostate cancer. And compared the positive prostate biopsy rates， missed diagnosis rates and biopsy reduction rates were compared regarding different PRIMARY scores. Receiver operating characteristic （ROC） curves were used to analyze prostate-specific antigen （PSA） and its derived parameters and identify the most suitable supplementary screening indicators for combined use with the PRIMARY score. ResultsAmong patients with PRIMARY scores of 1 to 5， the proportions of patients diagnosed with prostate cancer were 15.8% （3/19）， 17.1% （7/41）， 50% （12/24）， 95.2% （20/21） and 98% （49/50）， respectively. Using PRIMARY score of 3-5 as the biopsy screening strategy resulted in a positive prostate biopsy rate of 85.3% and biopsy reduction rate of 38.7%， but a missed diagnosis rate of 11%. PSA density > 0.15 ng/（mL·cm³） was selected as a supplementary screening criterion to detect prostate cancer from patients with PRIMARY scores of 1-2. The combined application of the above two screening criteria reduced the missed diagnosis rate to 2.2%. ConclusionThis study proposes a novel biopsy screening strategy for suspected prostate cancer patients using PSMA PET/CT， that is， a PRIMARY score of 3-5 or a PRIMARY score of 1-2 but PSA density>0.15 ng/（mL·cm³）， which can effectively avoid unnecessary biopsies and significantly reduce the missed diagnosis rate.

OBJECTIVE: To summarize the effectiveness of orthopedic surgery for patients with moderate and severe hallux valgus and analyze its related influencing factors. METHODS: A clinical data of 247 patients (287 feet) with moderate and severe hallux valgus, who were admitted between January 2013 and October 2024 and met the selection criteria, was retrospectively analyzed. There were 39 males and 208 females, with a median age of 57 years (range, 19-89 years). There were 207 cases of single-foot involvement and 40 cases of double-foot involvement; 159 feet were moderate hallux valgus and 128 feet were severe hallux valgus. The disease duration ranged from 3 months to 25 years, with a median of 5 years and 8 months. The hallux valgus angle (HVA), the intermetatarsal angle (IMA), proximal articular set angle (PASA), and the American Orthopaedic Foot and Ankle Society (AOFAS) scores were measured before operation and at 6 months after operation, and the differences (change values) between pre- and post-operation were calculated. All patients were grouped according to the degree of preoperative hallux valgus deformity and age, and the patients with severe hallux valgus according to different surgical procedures, and the change values of HVA, IMA, and AOFAS scores were compared between groups. All patients were grouped according to postoperative HVA, then the postoperative AOFAS scores were compared between groups. RESULTS: All patients successfully completed the operations and were followed up 6 months to 11 years and 3 months, with an average of 4 years and 6 months. The HVA, IMA, PASA, and AOFAS scores at 6 months after operation showed significant improvement compared to preoperative levels, and the differences were significant ( P<0.05). The patients with severe hallux valgus had the higher change values of HVA, IMA, and AOFAS scores than the patients with moderate hallux valgus ( P<0.05). The elderly patients had the highest change values of HVA and AOFAS scores than the young and middle-aged patients ( P<0.05). The patients with postoperative HVA ranging from 0° to 5° had the highest AOFAS scores than the other patients at 6 months after operation ( P<0.05). Among different surgical procedures for severe hallux valgus, the metatarsophalangeal joint fusion had the highest change value of HVA, the Scarf osteotomy had the highest performance in correcting the IMA, and the first metatarsal base osteotomy had the highest improvement in the postoperative AOFAS score, and the differences were significant ( P<0.05). CONCLUSION Elderly patients show the better improvement in HVA and foot function after operation. The first metatarsal base osteotomy show the better improvement in foot function than other surgical procedures. A certain HVA is allowed to remain after hallux valgus correction, and the postoperative AOFAS score is higher when the corrected HVA is in the range of 0°-5°.
Humans ; Hallux Valgus/diagnostic imaging* ; Middle Aged ; Male ; Female ; Aged ; Retrospective Studies ; Adult ; Aged, 80 and over ; Treatment Outcome ; Osteotomy/methods* ; Severity of Illness Index ; Orthopedic Procedures/methods* ; Metatarsophalangeal Joint/surgery* ; Young Adult ; Metatarsal Bones/surgery*

Objective To assess the clinical relevance of polymorphisms at position-251 in the promoter region of IL-8 gene and the incidence of sepsis in patients with severe trauma.Methods A total of 296 patients with severe trauma were included in the prospective cohort study.Incidence of sepsis was decided on the basis of the clinical manifestations and blood culture results.Muhiple organ dysfunction score (MODS) was performed using Marshall' s standard.IL-8/-251 gene polymorphisms were genotyped using restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP).IL-8 plasma level was determined using ELISA method.Results Genotype frequency at IL-8/-251 locus in trauma patients was in accord with Hardy-Weinberg equilibrium (P ＞ 0.05).Sepsis incidence in trauma patients with TT,TA,and AA genotypes at IL-8/-251 locus was 58.1％,49.6％,and 25.0％ respectively.Multiple regression analysis showed inverse correlation between sepsis incidence and quantity of A alleles [OR =0.637,95％ CI (0.421,0.963),P ＜ 0.05].Carriers of AA genotype presented lower MODS score than those of other two genotypes (P ＜ 0.05).IL-8 plasma level presented significant difference among carriers of the three genotypes (P ＜ 0.01) and A alleles were associated with the down-regulation of IL-8 (P ＜ 0.01).Conclusion IL-8/-251T/A polymorphisms are implicated in the development of posttraumatic sepsis and AA genotype is protective against posttraumatic sepsis.

Objective To investigate the effect of tuftsin and its inhibitor on pancreas microcirculation in acute pancreatitis(AP). Methods Sprague Dawley (SD) rats were randomly divided into five groups. Murine AP model was produced by retrograde injection of 4% sodium taurocholate into pancreatic duct, tuftsin or its inhibitor was injected at a dosage of 75 ?g/kg. At the time of 0,3, 6, 12 h, pancreas was harvested for pathology of microthrombus. esults Microthrombus in control group was not different with that in tuftsin group; At the time of 3、6 and 12 h microthrombus in other 3 groups significantly increased than control group and tuftsin group; With time, microthrombus in AP group、AP+ tuftsin group and AP+inhibitor group increased steadily and statistically significant; Tuftsin inhibitor significantly decreased microthrombus at the time of 6、12 h.Conclusions In acute pancreatitis tuftsin deteriorated pancreas microcirculation, which could be partially reversed by the administration of tuftsin inhibitor.

Objective To make clear the incidence, clinical characteristics and possible regional difference of gallbladder cancer in China.Methods A total of 430 cases of gallbladder cancer from 28 hospitals between 1986-1996 were reviewed, according to a standard protocol called "the clinical epidemiological list of gallbladder cancer".Results The incidence of gallbladder cancer was higher in the females than in the males. There was significant difference in the incidence between the north and south of China, and between the mountain area and flatlands. Gallbladder cancer accounted for 1.6% of bile tract disease in the same period. Gallstones were found in about 50% of the cases of gallbladder cancer. The clinical symptoms included abdominal pain, ictus, etc. The major pathohistologic type was adenocarcinoma, and 58% of tumors were localized in the whole gallbladder. Metastasis occurred mainly along the biliary tract or directly to the bed of gallbladder and liver. Ultrasonography and CT were useful to diagnosis. The positive imaging diagnostic rate was higher in the first 5 years (1986-1990) than in the last 5 years (1991-1996, P<0.05). The rate of operative resection was 100% for stage Ⅰ and Ⅱ disease, 75% for stage Ⅲ and Ⅳ, and significantly lower for stage Ⅴ (P<0.05). The 3-year survival rate in patients with stage Ⅰ or Ⅱ disease was significantly higher than that in those with terminal cancer (P<0.05). Conclusions There is specific populational, time and regional difference in the distribution of gallbladder cancer. Ultrasonography and CT are the most important diagnostic methods. Early diagnosis and early radical resection are the key to increasing the 5-year survival rate.