Objective To evaluate the diagnostic value of prostate health index(PHI)and prostate health index density(PHID)in identifying intermediate-to high-risk prostate cancer(PCa).Methods Clinical data of 160 treatment-na?ve patients with highly suspected PCa,who underwent initial prostate biopsy in our hospital during Jul.2022 and Feb.2024,were retrospectively analyzed.Data included age,body mass index(BMI),prostate volume(PV),total prostate-specific antigen(tPSA),free PSA(fPSA),[-2]proPSA(p2PSA),PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiver operating characteristic(ROC)curve and multivariate logistic regression analysis were employed to assess the diagnostic performance of PHI and PHID in predicting PCa and identifying intermediate-to high-risk PCa.Results There were statistically significant differences in tPSA,p2PSA,PHI and PHID between the negative and positive groups,as well as among the low-,medium-and high-risk groups(P＜0.01).Both PHI and PHID demonstrated good diagnostic performance in predicting PCa(AUC=0.820 8 and 0.875 7,respectively;all P＜0.001),and in identifying intermediate-to high-risk PCa(AUC=0.838 0 and 0.878 3,respectively;all P＜0.001).Compared to the baseline model,the incorporation of PHI and PHID individually into the multivariate model significantly improved the screening performance for PCa(AUC=0.910 and 0.898,respectively;all P＜0.001).Conclusion PHI and PHID exhibit high diagnostic efficacy in screening PCa,particularly in identifying intermediate-to high-risk disease.

Objective To explore the differences between community-based population-wide early screening combined with two-way referral model and the traditional opportunistic screening model for early diagnosis of early-stage prostate cancer.Methods From August 2022 to April 2024,12815high-risk elderly males within the Fifth People's Hospital of Shanghai,Fudan University healthcare al-liance underwent population-wide prostate-specific antigen(PSA)screening across five community health centers.Among them,1005 cases with PSA＞4.0ng/ml were identified and referred via a two-way referral model to the Fifth People's Hospital of Shanghai,Fudan University for further evaluation.Prostate biopsies were performed on 445 eligible patients who consented(mean age was 65.6±6.8 years),and clinical data were collected as the community-based population-wide early screening combined with two-way referral mod-el group(Group A).During the same period,4600high-risk elderly males with lower urinary tract symptoms underwent opportunistic PSA screening at the Fifth People's Hospital of Shanghai,Fudan University identifying 700 cases with abnormal PSA levels.Biopsies were performed on 270 eligible patients who consented(mean age was 64.8±6.4 years),and clinical data were collected as the traditional op-portunistic screening model group(Group B).Baseline characteristics,positive rate of prostate cancer,clinical stages,and pathological grades were compared between the two groups.Results There were no statistically significant differences in age,PSA levels,family his-tory,body mass index(BMI),marital status and education level between the groups.There were 160 positive cases in Group A,the pos-itive rate was 35.9％,while there were 90 positive cases in Group B,the positive rate was 33.3％,with no significant statistical differ-ence(P=0.652).In Group A,100 cases(62.5％of diagnosed cases)were classified as clinical stage ≤T2N0M0,compared to 35 ca-ses(38.9％)in Group B,showing a significant statistical difference(P=0.023).Group A had 105 cases(65.6％of diagnosed cases)with International Society of Urological Pathology(ISUP)grade ≤3,while Group B had 30 cases(33.3％),showing a significant statis-tical difference(P=0.002).Conclusion Community-based population-wide early screening combined with two-way referral model showed no difference in the positive rate of prostate cancer compared to traditional opportunistic screening but exhibited advantages in diag-nosing early-stage prostate cancer.Wider adoption of this model may improve the current status of delayed staging and poor prognosis a-mong prostate cancer patients in China.

Objective To evaluate the diagnostic value of prostate health index(PHI)and prostate health index density(PHID)in identifying intermediate-to high-risk prostate cancer(PCa).Methods Clinical data of 160 treatment-na?ve patients with highly suspected PCa,who underwent initial prostate biopsy in our hospital during Jul.2022 and Feb.2024,were retrospectively analyzed.Data included age,body mass index(BMI),prostate volume(PV),total prostate-specific antigen(tPSA),free PSA(fPSA),[-2]proPSA(p2PSA),PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiver operating characteristic(ROC)curve and multivariate logistic regression analysis were employed to assess the diagnostic performance of PHI and PHID in predicting PCa and identifying intermediate-to high-risk PCa.Results There were statistically significant differences in tPSA,p2PSA,PHI and PHID between the negative and positive groups,as well as among the low-,medium-and high-risk groups(P＜0.01).Both PHI and PHID demonstrated good diagnostic performance in predicting PCa(AUC=0.820 8 and 0.875 7,respectively;all P＜0.001),and in identifying intermediate-to high-risk PCa(AUC=0.838 0 and 0.878 3,respectively;all P＜0.001).Compared to the baseline model,the incorporation of PHI and PHID individually into the multivariate model significantly improved the screening performance for PCa(AUC=0.910 and 0.898,respectively;all P＜0.001).Conclusion PHI and PHID exhibit high diagnostic efficacy in screening PCa,particularly in identifying intermediate-to high-risk disease.

Objective To explore the differences between community-based population-wide early screening combined with two-way referral model and the traditional opportunistic screening model for early diagnosis of early-stage prostate cancer.Methods From August 2022 to April 2024,12815high-risk elderly males within the Fifth People's Hospital of Shanghai,Fudan University healthcare al-liance underwent population-wide prostate-specific antigen(PSA)screening across five community health centers.Among them,1005 cases with PSA＞4.0ng/ml were identified and referred via a two-way referral model to the Fifth People's Hospital of Shanghai,Fudan University for further evaluation.Prostate biopsies were performed on 445 eligible patients who consented(mean age was 65.6±6.8 years),and clinical data were collected as the community-based population-wide early screening combined with two-way referral mod-el group(Group A).During the same period,4600high-risk elderly males with lower urinary tract symptoms underwent opportunistic PSA screening at the Fifth People's Hospital of Shanghai,Fudan University identifying 700 cases with abnormal PSA levels.Biopsies were performed on 270 eligible patients who consented(mean age was 64.8±6.4 years),and clinical data were collected as the traditional op-portunistic screening model group(Group B).Baseline characteristics,positive rate of prostate cancer,clinical stages,and pathological grades were compared between the two groups.Results There were no statistically significant differences in age,PSA levels,family his-tory,body mass index(BMI),marital status and education level between the groups.There were 160 positive cases in Group A,the pos-itive rate was 35.9％,while there were 90 positive cases in Group B,the positive rate was 33.3％,with no significant statistical differ-ence(P=0.652).In Group A,100 cases(62.5％of diagnosed cases)were classified as clinical stage ≤T2N0M0,compared to 35 ca-ses(38.9％)in Group B,showing a significant statistical difference(P=0.023).Group A had 105 cases(65.6％of diagnosed cases)with International Society of Urological Pathology(ISUP)grade ≤3,while Group B had 30 cases(33.3％),showing a significant statis-tical difference(P=0.002).Conclusion Community-based population-wide early screening combined with two-way referral model showed no difference in the positive rate of prostate cancer compared to traditional opportunistic screening but exhibited advantages in diag-nosing early-stage prostate cancer.Wider adoption of this model may improve the current status of delayed staging and poor prognosis a-mong prostate cancer patients in China.

【Objective】 To compare the efficacy and safety of thulium laser enucleation of the prostate (ThULEP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were searched in PubMed, Embase, Cochrane Library, CNKI and Wanfang Database from Jan.1,2010 to May 30,2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. All divergences were resolved by a third researcher. RevMan 5.4 software was used for Meta analysis. 【Results】 A total of 7 studies were included, involving 1 726 patients, 750 in the ThULEP group and 976 in the HoLEP group. Meta analysis showed that, compared with HoLEP group, the ThULEP group had shorter catheter indwelling time [MD=-0.10, 95%CI (-0.17--0.03), P=0.004] , shorter hospital stay [MD=-0.43, 95%CI (-0.60--0.25), P<0.000 01] , lower IPSS score 12 months after surgery [MD=-1.13, 95%CI (-1.95- -0.30), P=0.007] , lower QoL score 12 months after surgery [MD=-1.00, 95%CI (-1.19- -0.81), P<0.001] ,lower transfusion rate [OR=0.11, 95%CI (0.03-0.36), P=0.000 3] and lower incidence of urinary incontinence [OR=0.24, 95%CI (0.09-0.66), P=0.006] . 【Conclusion】 ThULEP may have similar efficacy and safety as HoLEP in the treatment of BPH, and has more advantages in some aspects.

An in vitro blood-brain barrier (BBB) model is critical for enabling rapid screening of the BBB permeability of the drugs targeting on the central nervous system. Though many models have been developed, their reproducibility and renewability remain a challenge. Furthermore, drug transport data from many of the models do not correlate well with the data for in vivo BBB drug transport. Induced-pluripotent stem cell (iPSC) technology provides reproducible cell resources for in vitro BBB modeling. Here, we generated a human in vitro BBB model by differentiating the human iPSC (hiPSC) line GM25256 into brain endothelial-type cells. The model displayed BBB characteristics including tight junction proteins (ZO-1, claudin-5, and occludin) and endothelial markers (von Willebrand factor and Ulex), as well as high trans-endothelial electrical resistance (TEER) (1560 Ω.cm ± 230 Ω.cm) and γ-GTPase activity. Co-culture with primary rat astrocytes significantly increased the TEER of the model (2970 Ω.cm to 4185 Ω.cm). RNAseq analysis confirmed the expression of key BBB-related genes in the hiPSC-derived endothelial cells in comparison with primary human brain microvascular endothelial cells, including P-glycoprotein (Pgp) and breast cancer resistant protein (BCRP). Drug transport assays for nine CNS compounds showed that the permeability of non-Pgp/BCRP and Pgp/BCRP substrates across the model was strongly correlated with rodent in situ brain perfusion data for these compounds (R = 0.982 and R = 0.9973, respectively), demonstrating the functionality of the drug transporters in the model. Thus, this model may be used to rapidly screen CNS compounds, to predict the in vivo BBB permeability of these compounds and to study the biology of the BBB.

OBJECTIVE: To evaluate the clinical efficacy of the intratympanic methylprednisolone perfusion for patients of intractable Meniere's disease (MD). METHOD: Ten cases (10 ears), collected from Janu 2008 to Janu 2010, of intractable MD were studied retrospectively. The micro-catheter was placed into the tympanum of the affected ear, then methylprednisolone was imported into the tympanum once a day for 10 days. The average followed-up duration was (15. 4 +/- 5. 4) months after the perfusion. The treatment effect of vertigo, hearing loss and activity capacity was evaluated with Diagnostic Criteria for MD set by the Guiyang Meeting in 2006. The efficacy of tinnitus was analyzed by comparing the score of tinnitus handicap inventory (THI) before and after treatment. RESULT: The vertigo was absolutely controlled in 7 patients (grade A), partially controlled in 2 patients (grade B) and no efficiency in 1 patient (grade C). The 2 patients in grade B had a vertigo again in 9 months and 11 months after intratympanic perfusion, respectively, while the frequency, severity and duration of their vertigo softened obviously. Puretone threshold average (PTA) at the affected frequencies was decreased to within the level of 20 dB in one patient and was improved more than 30 dB in another one (grade A), improved 15 dB to 30 dB in 4 patients (grade B), and improved less than 15 dB in the other 4 patients. The average score of THI was 48.80 +/- 7.25 and 41.9 +/- 7.78 before and after perfusion respectively. The ability capacity of all the 10 patients after treatment was as normal (grade A), i. e. All of them could lead an independent life. There was no irreversible tympanic perforation in the operated ear and there was no other complications left. CONCLUSION Intratympanic methylprednisolone perfusion through the micro-catheter is a safe and effective method for the intractable Meniere's disease.
Ear, Middle ; Female ; Humans ; Male ; Meniere Disease ; drug therapy ; Methylprednisolone ; administration & dosage ; therapeutic use ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To diagnose the mycotic otitis media correctly and to explore the most adequate treatment for the disease. METHOD: Thirty-six inpatients (39 ears) with mycotic otitis media in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2007 were analyzed retrospectively. Morphous of the fungi, the methods and efficacies of the treatment were analyzed respectively. RESULT: According to the fungal cultures, 27 ears were induced by mold fungus and 12 ears were induced by budding fungus. Among these 36 patients (39 ears), myringoplasty accompanied local antifungal cream were applied in one ear, mastoidectomy with canal wall down and/or tympanoplasty accompanied with oral antifungal medication were administrated in 35 ears, only oral antifungal drugs were used in 3 ears (the control ears of the bilateral mycotic otitis media, which was not treated by surgery). All of the patients were followed up for 3 to 36 months, otorrhea occurred in the patients who refused to oral antifungal medication for 3 weeks after the myringoplasty, then dry again by local antifungal cream, but otorrhea recurred 3 times within 2 years. Thirty-five patients (38 ears) acquired dry ear after surgery and/or oral antifungal drugs, but 2 of the 38 ears recurred separately at the fourth and sixth month after their surgeries, then dry again by irrigation with hydrogen peroxide and by administrating local antifungal cream for 3 weeks. CONCLUSION Otologists should elevate suspicion of mycotic otitis media when they meet patients with continuous otorrhea and patients who did not respond to the antibacterial treatment. The diagnosis based on microbiological findings, such as direct microscopy or fungal cultures should be done as soon as possible. If the otomycosis is decided, we suggest that topical treatment should be selected firstly, although most patients in present study were treated by surgery accompanied with oral antifungal medications. If there is obvious bone erosion, surgery is necessary to excise the pathological tissues, minificate the mastoid cavity and close the middle cavity in order to improve the hearing and prevent the infection from the outer ear.
Adult ; Aged ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Mycoses ; diagnosis ; therapy ; Otitis Media ; diagnosis ; microbiology ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media. METHOD: The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant. RESULT: Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty. CONCLUSION In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.
Adolescent ; Adult ; Auditory Threshold ; Bone Conduction ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; physiopathology ; surgery ; Postoperative Period ; Tympanoplasty ; Young Adult