ObjectiveTo explore the molecular mechanism through which modified Guizhi Fulingwan （MGZFLW） promotes apoptosis and inhibits prostate cancer through the miR-34a-5p/δ-like protein 1 （DLL1）/Notch signaling pathway based on the traditional Chinese medicine theory of Yang transforming Qi while Yin constituting form. MethodsThe optimal intervention conditions of MGZFLW-containing serum and docetaxel （DXT） were screened by the cell counting kit-8 （CCK-8） method. Human prostate cancer cells （PC-3） were allocated into blank， MGZFLW （10%）， and DXT （30 nmol·L^-1） groups. The effects of MGZFLW-containing serum on the migration and proliferation of PC-3 cells were evaluated by cell scratch and colony formation assays， and the apoptosis of PC-3 cells was detected by terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling （TUNEL） assay. The cells were transfected with miR-34a-5p mimics and miR-34a-5p inhibitor. The mRNA levels of miR-34a-5p， DLL1， Notch1 and its downstream effector factors Notch1 intracellular domain （NICD1）， Hes family basic helix-loop-helix transcription factor 1 （Hes1）， and hairy/enhancer-of-split related with YRPW motif 1 （Hey1） were determined by Real-time PCR. The protein levels of DLL1， Notch1， NICD1， Hes1， and Hey1 were determined by a WES fully automatic protein system. The effect of miR-34a-5p on the DLL1-mediated Notch pathway was evaluated based on the results. Further， after MGZFLW-containing serum intervention， the expression of DLL1 and Notch1 was detected by the immunofluorescence （IF） assay， and the mRNA and protein levels of miR-34a-5p/DLL1/Notch pathway-related molecules were quantified by Real-time PCR and the WES fully automatic protein system， respectively， to explore the regulatory effect of MGZFLW-containing serum on the miR-34a-5p/DLL1/Notch pathway. ResultsMGZFLW-containing serum inhibited the viability， migration， and proliferation and promote the apoptosis of PC-3 cells （P<0.01）. The overexpression of miR-34a-5p down-regulated the mRNA and protein levels of key molecules in the DLL1/Notch signaling pathway and promoted cell apoptosis （P<0.01）， while inhibition of miR-34a-5p had the opposite effects. MGZFLW-containing serum reversed the activation of the DLL1/Notch pathway and the inhibition of apoptosis caused by miR-34a-5p inhibition， up-regulated the expression of miR-34a-5p， and down-regulated the expression of related molecules in this pathway （P<0.01）. ConclusionMGZFLW can up-regulate the expression of miR-34a-5p to inhibit the DLL1/Notch signaling pathway and promote the apoptosis of prostate cancer cells， thereby inhibiting prostate cancer. This study provides experimental evidence for clarifying the molecular mechanism of the anti-prostate cancer effect of this formula.

Objective: To analyze the risk factors leading to infection after prostate biopsy，establish a nomogram prediction model and verify it. Methods: Clinical data of 523 patients who underwent ultrasound-guided prostate biopsy at our hospital during Jan.2023 and Jul.2024 were retrospectively analyzed.Patients were divided into an infection group and a non-infection group.Independent risk factors for infection after prostate biopsy were identified with univariate and multivariate binary logistic regression analyses，and a nomogram prediction model was constructed，which was validated with receiver operating characteristic (ROC) curve，calibration curve，and decision curve analysis (DCA). Results: Infection occurred in 54 cases (10.3%).Univariate and multivariate logistic regression analyses showed that age >65 years (OR=3.535，P=0.003)，diabetes (OR=5.693，P<0.001)，hypoproteinemia (OR=8.936，P<0.001)，preoperative urinary tract infection (OR=6.153，P<0.001)，puncture needles >12 (OR=4.347，P<0.001)，and transrectal puncture (OR=3.701，P<0.001) were independent risk factors for infection.Based on the multivariate logistic analysis results，a risk prediction nomogram model was constructed，with an area under the ROC curve (AUC) of 0.894.The calibration curve and DCA both indicated that the model had high predictive accuracy and clinical decision-making efficiency. Conclusion: Age >65 years，diabetes，hypoproteinemia，preoperative urinary tract infection，puncture needles >12，and transrectal puncture are independent risk factors for infection after prostate biopsy.The nomogram prediction model based on these factors helps identify high-risk patients，thereby enabling individualized treatment plans to reduce the incidence of infection.