【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

【Objective】 To identify the risk factors of patients of bone metastatic prostate cancer with high tumor load progressed to castration resistant prostate cancer (CRPC), establish a nomogram prediction model and evaluate its consistency and accuracy. 【Methods】 A total of 164 patients diagnosed by puncture and imaging during 2012 and 2022 were included.The general characteristics were analyzed with IBM SPSS software; the variables were screened with Cox regression; the multivariate risk factors with P<0.05 were included in the nomogram prediction model.The consistency and prediction accuracy of the model were evaluated with C-index, receiver operating characteristic (ROC) curve and calibration chart. 【Results】 In univariate analysis, initial prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), Gleason score, T stage, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were correlated with CRPC (P<0.05).Multivariate analysis showed that initial PSA, Gleason score, T stage, ALP and LDH were independent risk factors of CRPC (P<0.05).Based on the above five risk factors, a nomogram prediction model was constructed.The C-index was 0.801, the area under ROC curve (AUC) of 1-year progression-free survival (PFS) was 0.701 (0.608-0.794), and the AUC of 2-year PFS was 0.857 (0.767-0.947).The calibration chart showed that the prediction probability of the model was in good agreement with the actual probability. 【Conclusion】 Initial PSA, Gleason score, T stage, ALP and LDH are independent risk factors of CRPC.The predictive model may be an effective tool for the initial diagnosis of high tumor load bone metastatic prostate cancer, but more data are needed for internal and external validation.

Objective To evaluate the risk of arthralgia due to dipeptidyl peptidase-4 (DPP-4) inhibitors.Methods The documents involving arthralgia due to DPP-4 inhibitors ending in February 2016 were searched from correlative data base and online library.DPP-4 inhibitors was used in the test group while placebo was used in the control group.The relevant data were collected from enrolled documents and the quality of RCTs was assessed.The software Review Manager 5.3 was used for Meta-analysis and the results were expressed in RR and 95％ CI.Results A total of 22 RCTs were enrolled into the Meta-analysis and 9 927 patients [6 760 cases in the test group (T) and 3 167 cases in the control group(T)] were treated 12 to 206 weeks.The number of patients who were enrolled into the study on sitagliptin,saxagliptin,vildagliptin,linagliptin,and alogliptin were 954 (T:545,C:409),4 246 (T:2 923,C:1323),899 (T:528,C:371),2 624 (T:1 893,C:731),and 1 204 (T:871,C:333),respectively.The results of quality evaluation to all literatures showed 13 for Grade A and 8 for Grade B.The results of Meta analysis showed that the risk of arthralgia induced by saxagliptin and vildagliptin was higher than that by placebo (RR =1.35,95％ CI:1.01-1.81,P =0.04 and RR =2.80,95％ CI:1.29-6.08,P ＜ 0.01).The results of subgroup analysis showed that the risk of arthralgia induced by saxagliptin 2.5 mg/d added to metformin or TZDs,saxagliptin 10 mg/d monotherapy or added to metformin,and vildagliptin 50 mg/d was higher than that by placebo (RR =1.74,95％ CI:1.06-2.88,P =0.03;RR =1.97,95％CI:1.01-3.82,P =0.05;RR =1.86,95％CI:1.06-3.28,P =0.03;RR =2.55,95％CI:1.15-5.64,P =0.02).The risk of arthralgiadue induced by itagliptin,linagliptin,and alogliptin were similar with that by placebo(all P ＞ 0.05).Conclusions Saxagliptin and vildagliptin may increase the risk of arthralgia.The patients with type 2 diabetes and joint disease should choose sitagliptin,linagliptin or alogliptin when they were using DPP-4 inhibitors.

Objective To evaluate the risk of arthralgia due to dipeptidyl peptidase-4 (DPP-4) inhibitors.Methods The documents involving arthralgia due to DPP-4 inhibitors ending in February 2016 were searched from correlative data base and online library.DPP-4 inhibitors was used in the test group while placebo was used in the control group.The relevant data were collected from enrolled documents and the quality of RCTs was assessed.The software Review Manager 5.3 was used for Meta-analysis and the results were expressed in RR and 95％ CI.Results A total of 22 RCTs were enrolled into the Meta-analysis and 9 927 patients [6 760 cases in the test group (T) and 3 167 cases in the control group(T)] were treated 12 to 206 weeks.The number of patients who were enrolled into the study on sitagliptin,saxagliptin,vildagliptin,linagliptin,and alogliptin were 954 (T:545,C:409),4 246 (T:2 923,C:1323),899 (T:528,C:371),2 624 (T:1 893,C:731),and 1 204 (T:871,C:333),respectively.The results of quality evaluation to all literatures showed 13 for Grade A and 8 for Grade B.The results of Meta analysis showed that the risk of arthralgia induced by saxagliptin and vildagliptin was higher than that by placebo (RR =1.35,95％ CI:1.01-1.81,P =0.04 and RR =2.80,95％ CI:1.29-6.08,P ＜ 0.01).The results of subgroup analysis showed that the risk of arthralgia induced by saxagliptin 2.5 mg/d added to metformin or TZDs,saxagliptin 10 mg/d monotherapy or added to metformin,and vildagliptin 50 mg/d was higher than that by placebo (RR =1.74,95％ CI:1.06-2.88,P =0.03;RR =1.97,95％CI:1.01-3.82,P =0.05;RR =1.86,95％CI:1.06-3.28,P =0.03;RR =2.55,95％CI:1.15-5.64,P =0.02).The risk of arthralgiadue induced by itagliptin,linagliptin,and alogliptin were similar with that by placebo(all P ＞ 0.05).Conclusions Saxagliptin and vildagliptin may increase the risk of arthralgia.The patients with type 2 diabetes and joint disease should choose sitagliptin,linagliptin or alogliptin when they were using DPP-4 inhibitors.

ObjectiveTo observe the effect of rapamycin on the proliferation and cell cycle of prostate cancer cell lines PC3,and to investigate the mechanism that it inhibits the growth and metastasis of prostate cancer cells.MethodsPC3 cells were cultured in vitro,and treated with different concentrations (10,25ng/ml) of cycle raparnycine.MTT was used to measure the change of proliferation of PC3 cells.Flow cytometry was used to measure the changes of cell cycle and apoptosis of PC3 cells.Nude mice were used to detect the effect of rapamycin on metastasis.ResultsThe proliferation of PC3 cells was significantly inhibited by rapamycin,and a time- and concentration-dependent relationship was shown,the inhibited rate was(42.23 ± 0.78 ) ％ after 36 h in the group of 25 ng/ml ( P ＜ 0.05 ).Flow cytometry analysis showed rapamycin significantly inhibited the cell cycle,prompted the apoptosis,and increased the number of cells in G0/G1 phase at 36 h with a rate of cell staying at Go/G1 [ (92.17 ± 0.69 ) ％ ] ( P ＜ 0.05 ).The weight of tumors in nude mice in the control group was significantly greater than that in RPM group[ (3.41± 0.28)g vs ( 1.19 ± 0.23 )g] ( P＜ 0.05 ),and metastatic sites of the lung and liver in the control group were significantly mote than the RPM group [ 100％ (7/7) vs 14.29％ ( 1/7 ) ] ( P ＜ 0.05 ).Conclusions Rapamycin significantly inhibits the proliferation and metastasis of osteosarcoma.The rapamycin-based regimen is valuable for clinical application.