[Objective] To analyze the clinicopathological characteristics of treatment-naive patients with highly suspected prostate cancer (PCa) with prostate-specific antigen (PSA) level ≥20 ng/mL, to provide reference for promoting early screening of PCa. [Methods] A retrospective analysis was conducted on the clinical data of treatment-naive patients with PSA level ≥20 ng/mL, undergoing prostate biopsy for highly suspected PCa at the Department of Urology, Tianjin Medical University Second Hospital during Jan.2013 and Jun.2023. The correlation between patients' age, body mass index (BMI), PSA, prostate volume (PV), prostate cancer-specific antigen density (PSAD), prostate imaging reporting and data system (PI-RADS) score, and International Society of Urological Pathology (ISUP) grade with highly suspected PCa metastasis and PSA stratification were analyzed. [Results] A total of 1778 suspected patients were enrolled. Pathological findings confirmed PCa in 1465 cases (82.4%), with 487(33.2%) diagnosed as metastatic PCa. Over the past decade, the number of patients undergoing prostate biopsy for highly suspected PCa and being confirmed has been increasing annually, with the proportion of metastatic cases remaining at around 30%. Compared with those with PSA level being 20-50 ng/mL, patients with PSA level >50 ng/mL had older age, lower BMI, higher PSAD, higher PI-RADS, higher ISUP, more diverse pathological types, and a higher incidence of metastasis (P<0.05) with lower proportion of urban residents. Additionally, analysis of metastatic PCa cases showed that 46.8%(228/487) had oligometastasis (≤5 metastatic lesions), including 99.0% bone metastasis, 4.1% extraregional lymph node metastasis, and 4.3% other organ metastasis. [Conclusion] Over the past 10 years, there has been a continuous increase in the number of treatment-naive biopsied cases and newly diagnosed cases of highly suspicious PCa with PSA level ≥20 ng/mL, while the proportion of metastatic cases remains high. Therefore, proactive efforts should be made to promote early screening of high-risk suspected cases.

Objective To analyze the clinical characteristics of lung adenocarcinoma patients with positive EGFR mutations detected in pleural effusion.Methods We retrospectively analyzed the clinical characteristics including gender,age,smoking history,presence of other underlying diseases(such as COPD,cardiovascular disease,and diabetes),site of pleural fluid,feature of pleural fluid,and TNM stage in patients with lung adenocar-cinoma who had been admitted to the first Affiliated Hospital of Bengbu Medical College from 2020.01 to 2022.12 for the first time by the detection of EGFR mutation positive in pleural effusion.The data were statistically analyzed using the SPSS 26.0 software.Results A total of 126 patients were screened for enrollment,including 61 patients(48.41%)with EGFR exon 19 deletion mutation(19del),56 patients(44.44%)with exon 21 L858R mutation(21L858R),and 9 patients(7.14%)with non-classical mutations.Univariate analysis showed that the three muta-tion subtypes were statistically significant in terms of gender,age,smoking history,and presence of COPD(P<0.05 for all comparisons),but not in terms of pleural fluid site,feature of pleural fluid,tumor size,and presence of cardiovascular disease,diabetes mellitus,presence of distant metastases,and mediastinal lymph node metastases(P>0.05 for all comparisons);Multivariate analysis showed that 21 L858R mutation was more likely to be found in male,older age,non-smoking,and presence of COPD than 19del mutation;non-classical mutation was more likely to be found in male than 19del mutation.Conclusions There are significant differences among the three mutation subtypes in sex,age,smoking history,and presence of COPD,but not in pleural fluid location,feature of pleural fluid,tumor size,presence of cardiovascular disease or diabetes mellitus,presence of distant metastases,or medias-tinal lymph node metastases;Among lung adenocarcinoma patients with positive EGFR mutations in pleural fluid,21 L858R mutation mostly occurs in male,older age,non-smokers,and those complicated with COPD,while non-classical mutation mainly develops in male.However,more case studies are needed to confirm the above conclusions.

Adverse reactions commonly associated with apalutamide include hot flashes, fatigue, joint pain, rash, hypertension, and anemia. Apalutamide-induced agranulocytosis is relatively rare. In this paper, we reported a case with metastatic hormone-sensitive prostate cancer who developed agranulocytosis after taking apalutamide for one month. The patient’s neutrophil count returned to normal with appropriate supportive therapy, and no significant decrease in neutrophil count was observed during 10 months of follow-up after discharge.

Objective To explore the molecular mechanism by which FEZF1-AS1 overexpression promotes progression of non-small cell lung cancer(NSCLC)via the miR-130a-5p/CCND1 axis.Methods TCGA database was used to analyze FEZF1-AS1 expression levels in NSCLC.FEZF1-AS1 expression was detected by qRT-PCR in clinical specimens of NSCLC tissues and NSCLC cell lines,and its correlation with clinical features of the patients were analyzed.The binding sites of FEZF1-AS1 with hsa-miR-130a-5p and those of hsa-miR-130a-5p with CCND1 were predicted.CCK8 assay,clone formation assay,scratch assay,and Transwell assay were employed to examine the effects of FEZF1-AS1 knockdown and hsa-miR-130a-5p inhibitor on proliferation,invasion,and migration abilities of lung cancer cell lines.Dual luciferase assay was used to verify the binding of FEZF1-AS1 with hsa-miR-130a-5p and the binding of hsa-miR-130a-5p with CCND1.Western blotting was performed to detect the changes in CCND1 protein expression level in H1299 and H358 cells following FEZF1-AS1 knockdown and treatment with hsa-miR-130a-5p inhibitor.Results FEZF1-AS1 was highly expressed in NSCLC tissues in close correlation with lymph node metastasis and also in H1299 and H358 cell lines(all P<0.05).FEZF1-AS1 knockdown obviously reduced proliferation,migration,and invasion abilities of NSCLC cells(P<0.05).Dual luciferase assay confirmed the binding of hsa-miR-130a-5p with FEZF1-AS1 and CCND1(P<0.05),and hsa-miR-130a-5p inhibitor significantly inhibited proliferation,migration,and invasion of NSCLC cells(P<0.05).FEZF1-AS1 knockdown significantly reduced CCND1 protein expression in NSCLC cells,and this effect was strongly inhibited by treatment with hsa-miR-130a-5p inhibitor(P<0.05).Conclusion FEZF1-AS1 is highly expressed in NSCLC tissue in close correlation with lymph node metastasis to promote cancer progression through the miR-130a-5p/CCND1 axis.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective To explore the molecular mechanism by which FEZF1-AS1 overexpression promotes progression of non-small cell lung cancer(NSCLC)via the miR-130a-5p/CCND1 axis.Methods TCGA database was used to analyze FEZF1-AS1 expression levels in NSCLC.FEZF1-AS1 expression was detected by qRT-PCR in clinical specimens of NSCLC tissues and NSCLC cell lines,and its correlation with clinical features of the patients were analyzed.The binding sites of FEZF1-AS1 with hsa-miR-130a-5p and those of hsa-miR-130a-5p with CCND1 were predicted.CCK8 assay,clone formation assay,scratch assay,and Transwell assay were employed to examine the effects of FEZF1-AS1 knockdown and hsa-miR-130a-5p inhibitor on proliferation,invasion,and migration abilities of lung cancer cell lines.Dual luciferase assay was used to verify the binding of FEZF1-AS1 with hsa-miR-130a-5p and the binding of hsa-miR-130a-5p with CCND1.Western blotting was performed to detect the changes in CCND1 protein expression level in H1299 and H358 cells following FEZF1-AS1 knockdown and treatment with hsa-miR-130a-5p inhibitor.Results FEZF1-AS1 was highly expressed in NSCLC tissues in close correlation with lymph node metastasis and also in H1299 and H358 cell lines(all P<0.05).FEZF1-AS1 knockdown obviously reduced proliferation,migration,and invasion abilities of NSCLC cells(P<0.05).Dual luciferase assay confirmed the binding of hsa-miR-130a-5p with FEZF1-AS1 and CCND1(P<0.05),and hsa-miR-130a-5p inhibitor significantly inhibited proliferation,migration,and invasion of NSCLC cells(P<0.05).FEZF1-AS1 knockdown significantly reduced CCND1 protein expression in NSCLC cells,and this effect was strongly inhibited by treatment with hsa-miR-130a-5p inhibitor(P<0.05).Conclusion FEZF1-AS1 is highly expressed in NSCLC tissue in close correlation with lymph node metastasis to promote cancer progression through the miR-130a-5p/CCND1 axis.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective:Based on multi-parametric prostate magnetic resonance imaging (mpMRI) and related clinical indicators, a nomogram model for patients with PI-RADS ≥3 and PSA 4-20ng/ml was developed and validated, and the predictive value of the model in diagnosing clinically significant prostate cancer was evaluated.Methods:The clinical and pathological data of 865 patients who underwent ultrasound-guided transperineal prostate biopsy for the first time at the Department of Urology, Second Hospital of Tianjin Medical University from January 2020 to August 2023, with PI-RADS scores ≥3 and PSA levels between 4-20 ng/ml were retrospectively analyzed. These 865 patients were included in Cohort A, and from them, 437 patients with PHI were selected in Cohort B. In Cohort A, the median age was 68(64, 73); the median f/tPSA was 14.36 (10.63, 19.74); the median PSAD was 0.17(0.11, 0.25); 375 cases (43.35%) with PV≤50 ml and 490 cases (56.65%) with PV>50 ml; PSA fluctuation <-50% 84 cases (9.71%), -50%--20% in 206 cases (23.82%), and >-20% in 575 cases (66.47%); PI-RADS v2.1 3 scores 546 cases (63.12%), 4 in 230 cases (23.59%), and 5 in 89 cases (10.29%); localization of suspicious lesions on mpMRI in the peripheral zone in 619 cases (71.56%), transitional zone in 181 cases (20.92%), others in 42 cases (4.86%), and both peripheral and transitional zones in 23 cases (2.66%). In Cohort B, the median PSAD was 0.17 (0.12, 0.25); the median D-dimer was 310.00 (230.00, 411.48); the median PHI was 49.75 (35.90, 73.27); with 198 cases (45.31%) with PV≤50 ml and 239 cases (54.69%) with PV>50 ml; PSA fluctuation<-50% was in 40 cases (9.15%), -50%--20% in 107 cases (24.49%), and>-20% in 290 cases (66.39%); PI-RADS v2.1 scores 3 was in 289 cases (66.13%), 4 in 103 cases (23.57%), and 5 in 45 cases (10.30%).Patients in cohorts A and B were randomly assigned to the training set and validation set using R language with " 123" as the random number seed, at a ratio of 7∶3.There was no statistically significant difference between the clinical data of the training and validation sets for both groups ( P>0.05).Univariate and multivariate logistic regression analyses were used to identify independent risk factors for CsPCa, and a nomogram model was constructed using R. The diagnostic performance of the prediction model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis(DCA).External validation of the model was conducted in the validation set. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and missed diagnosis rate analyses were performed on nomogram models A and B, as well as PSAD and PHI, under different thresholds. Results:Cohort A training set has 608 cases, and the validation set has 257 cases.The results of multivariate backward regression analysis in the training set show that age( OR=1.06, P=0.001), f/tPSA( OR=0.96, P=0.008), prostate volume (PV)>50ml( OR=0.36, P<0.01), prostate-specific antigen density(PSAD)( OR=145.19, P<0.01), PSA fluctuation(-50%--20%: OR=1.97, P=0.234; >-20%: OR=6.81, P<0.01), PI-RADS v2.1 score(4: OR=10.65, P<0.01; 5: OR=21.20, P<0.01), and localization of suspicious lesions on mpMRI(TZ: OR=0.57, P=0.074; Others: OR=0.26, P=0.022) were all risk factors for CsPCa. Nomogram A was developed based on these risk factors and had an area under the ROC curve (AUC) of 0.905 (95% CI 0.881-0.928) for the training set and 0.893 (95% CI 0.854-0.931) for the validation set. Cohort B training set developed based on age( OR=1.05, P=0.053), PV>50ml( OR=0.18, P<0.01), PSAD( OR=54.14, P=0.021), PSA fluctuation(-50%--20%: OR=4.78, P=0.100; >-20%: OR=20.37, P=0.001), PHI( OR=1.02, P=0.002), D-Dimer( OR=1.00, P=0.031), and PI-RADS scores(4: OR=11.35, P<0.01; 5: OR=57.61, P<0.01) as risk factors for CsPCa. Nomogram B had an AUC of 0.933(95% CI 0.906-0.959) for the training set and 0.908 (95% CI 0.859-0.958) for the validation set.The two nomogram models mentioned above both have excellent discrimination, and the calibration curves also indicated that the calibration of the two models were good.Moreover, both nomogram A and nomogram B demonstrate good clinical net benefits in the DCA curves of the training and validation sets, especially when applying nomogram B to predict CsPCa, with an accuracy rate of up to 85.82%. Conclusions:The two nomogram models developed in study, based on mpMRI and related clinical indicators, both have excellent predictive value for the diagnosis of clinically significant prostate cancer prior to prostate biopsy in patients with PI-RADS≥3 and PSA 4-20ng/ml.

Objective To explore the relationship between serum iron(SI)metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 T2DM patients hospitalized in the Department of Endocrinology,Lanzhou University First Hospital from 2019 to 2021 were included.During the same period,30 healthy individuals from physical examination center were selected as the normal control(NC)group.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1,HbA1c＜7%,n=39),poor glucose control(H2,7%＜HbA1c＜9%,n=63)and very poor glucose control(H3,HbA1c＞9%,n=68).According to the level of blood lipids,T2DM patients were divided into subgroups with normal blood lipids(L1,n=36)and high blood lipids(L2,n=134).Results Compared with NC group,age,SBP,DBP,BMI,serum ferritin(SF),FPG,FIns,HOMA-IR,TyG,TG,LDL-C and SUA increased inT2DM group(P＜0.05),while SI,TF,total iron binding capacity(TIBC),DI,HDL-C and eGFR decreased(P＜0.05).The levels of TF and TIBC in H3 subgroup were lower than those in H1 subgroup(P＜0.05).LDL-C of L2 subgroup was higher than that of L1 subgroup(P＜0.05),while HDL-C was lower than that of L1 subgroup(P＜0.05).Pearson correlation analysis showed that SF was positively correlated with HbA1c,TyG,TG and SUA(P＜0.05),and negatively correlated with HDL-C and eGFR(P＜0.05).TF was positively correlated with HDL-C and eGFR(P＜0.05),but negatively correlated with age,SBP,DBP,TyG and SUA(P＜0.05).Multiple linear regression analysis showed that SF and FPG were influencing factors for HbA1c in T2DM patients.Conclusion SI metabolism is closely related to glucose and lipid metabolism in T2DM patients.

Objective:To summarize the clinical characteristics of drug-resistant epilepsy (DRE) in children and to analyze the efficacy of lamotrigine (LTG) add-on therapy for DRE in children of different seizure type, syndrome and etiological category.Methods:All cases of DRE patients treated with LTG or other antiseizure medication (ASM) adjunctive therapy in the Third Affiliated Hospital of Zhengzhou University from May 2019 to April 2020 were collected.The LTG add-on therapy group was treated with LTG add-on therapy, and the control group was treated with other ASM add-on therapy.The therapeutic effects of the two groups were compared.Results:A total of 134 cases meeting the requirement of research were collected, including 98 cases in the LTG add-on therapy group and 36 cases in the control group.For seizure of focal onset and unknown origin, there was statistical difference in efficacy between the LTG add-on therapy group and the control group ( Z=-2.48、-2.11, P<0.05), but for generalized DRE in children, there was no statistical difference in efficacy between the two groups ( Z=-0.39, P>0.05). There was a significantly statistical difference in curative effect between the LTG add-on therapy group and the control group for childhood DRE which could not be classified as any epileptic syndrome ( Z=-3.99, P<0.01), but there was no statistical difference in efficacy between the two groups for West syndrome and benign epilepsy accompanied by central temporal spikes ( Z=-0.94、-1.22, P>0.05). For childhood intractable epilepsy with unknown etiology, there was statistical difference in efficacy between the LTG add-on therapy group and the control group ( Z=-1.96, P<0.05), and for childhood intractable epilepsy with structural etiology, there was significantly statistical difference in efficacy between the two groups ( Z=-3.07, P<0.01), but there was no statistical difference in the efficacy for childhood intractable epilepsy with genetic etiology between the two groups ( Z=-1.02, P>0.05). Conclusion:The efficacy of LTG add-on therapy is significantly better than others for childhood DRE with seizure of focal onset or unknown origin, childhood DRE unclassified to any syndrome, and childhood DRE with structural etiology and unknown origin, especially with structural etiology.