1.Study on the effect of apoptosis stimulation protein 2 on traumatic proliferative vitreoretinopathy in rabbits
Xiaoli CHEN ; Yuze MAO ; Wenhui CAI ; Haiwei WANG ; Yankun YUE
International Eye Science 2026;26(1):16-20
AIM:To investigate the effect of apoptosis stimulation protein 2(ASPP2)on the development of traumatic proliferative vitreoretinopathy(PVR)in a rabbit model.METHODS:A total of 30 New Zealand white rabbits were selected, and the right eyes of all rabbits were inflicted with a scleral penetrating wound of approximately 6 mm. Then rabbits were randomly and evenly divided into experimental and control group. The experimental group received an intravitreal injection of 0.1 mL of ARPE-19 cell suspension transfected with lentivirus-ASPP2, while the control group received an intravitreal injection of 0.1 mL of ARPE-19 cell suspension transfected with negative control lentivirus. At 1, 2, 3, and 4 wk after PVR modeling, a handheld tonometer was used to measure the intraocular pressure. Moreover, fundus photography and ocular ultrasound examination were performed to detect the retinal proliferation. At 4 wk after modeling, hematoxylin-eosin staining was used to observe the morphological retinal changes, and Western blot was used to determine the protein expressions of ASPP2 and the epithelial-mesenchymal transition(EMT)marker Vimentin in the rabbit retinas.RESULTS:At 1, 2, 3, and 4 wk after modeling, there were no significant changes in intraocular pressure within the experimental and control group of rabbit eyes, either before or after PVR modeling, the success rate of PVR modeling in the experimental group was lower than that in the control group(P<0.05), and the retinal proliferation and structural disorder was less severe in the experimental group. At 4 wk after modeling, the retinal protein expression level of ASPP2 in the experimental group was significantly higher than that in the control group(t=3.193, P=0.033), while the Vimentin protein expression level was significantly lower in the experimental group(t=-3.599, P=0.023).CONCLUSION:ASPP2 may be involved in regulating the process of EMT in retinal pigment epithelial cells, thereby delaying the development and progression of traumatic PVR in rabbit eyes.
2.Recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus: report of 1 case and review of literature
Chen CHEN ; Ruixue LI ; Yankun YU ; Weixia NONG ; Xin PAN
Journal of Leukemia & Lymphoma 2025;34(9):548-552
Objective:To improve the understanding of recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus.Methods:The clinical data of 1 patient with recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus admitted to the First Affiliated Hospital of Shihezi University in January 2024 was collected. Its disease characteristics, effectiveness and safety of treatment scheme were analyzed, and literatures were reviewed.Results:The 42-year-old female patient was diagnosed as Langerhans cell histiocytosis in June 2021. After treated with cytarabine, the symptoms improved and the patient achieved sustained remission. In January 2024, the patient was admitted to the hospital due to pain in the middle part of the front chest. The PET-CT results indicated disease progression, which was manifested by new bone destruction, enlarged lymph nodes, and increased nocturnal urination, with urine volume of 3-5 L within 24 h. Based on the clinical manifestations such as cranial bone lesions, periorbital soft tissue lesions, and enlarged lymph nodes at onset, multiple systems and multiple foci involvement was considered. The diagnosis of combined diabetes insipidus was confirmed through the water deprivation and pressure test. After MACOP-B regimen (doxorubicin liposome, cyclophosphamide, vincristine, bleomycin, prednisone), the patient's bone pain was completely relieved, and no serious complications occurred.Conclusions:Recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus is rare; MACOP-B regimen is safe and effective in treatment of the disease.
3.Total knee arthroplasty assisted by 3D printing for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture
Senlei LI ; Wei HAN ; Long CHEN ; Ning SHENG ; Jianyang LI ; Yankun LI ; Li SUN
Chinese Journal of Orthopaedic Trauma 2025;27(6):507-511
Objective:To evaluate the clinical outcomes of total knee arthroplasty (TKA) assisted by 3D printing in the treatment of traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture.Methods:A retrospective study was conducted to analyze the clinical data of the 18 patients who had been treated for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture at Department of Orthopaedics, The People's Hospital of Guizhou Province from March 2015 to June 2017. The cohort included 7 males and 11 females, with a mean age of (64.0±7.7) years. The left knee was affected in 12 cases and the right in 6 ones. The injury was caused by a traffic accident in 12 cases, by a fall from heights in 4 cases, and by a heavy object in 2 cases. The time from fracture to TKA was (5.9±2.8) years. All patients underwent TKA assisted by 3D printing after admission. Knee range of motion (ROM), Hospital for Special Surgery (HSS) knee score, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared between preoperation and postoperative 6 months. Complications during the follow-up period were also recorded.Results:All the 18 patients completed a 6-month follow-up. At 6 months after operation, the knee ROM increased significantly from preoperative 85.1°±2.9° to 125.3°±1.3°, the HSS knee score increased significantly from preoperative (39.6±1.4) points to (75.8±1.8) points, and the WOMAC score decreased significantly from preoperative (49.3±1.0) points to (8.3±0.7) points in the 18 patients ( P<0.05). One patient experienced poor wound healing 1 week after operation, and 3 patients developed low-lying patella postoperatively. No such complications as prosthesis loosening, infection, or joint stiffness were reported during the follow-up period. Conclusion:For patients with traumatic osteoarthritis secondary to severe deformity following old tibial plateau fracture, TKA assisted by 3D printing can significantly improve their knee ROM and restore their limb function, but lead to no serious complications.
4.Risk assessment of human Spirometra mansoni infections and cross-sectional study on knowledge, attitude and practice towards sparganosis in endemic areas of Henan Province
Yalan ZHANG ; Tiantian JIANG ; Xiaohui MA ; Yan DENG ; Weiqi CHEN ; Yankun ZHU ; Zhenqiang TANG ; Xi-meng LIN ; Hongwei ZHANG
Chinese Journal of Schistosomiasis Control 2025;37(2):190-195
Objective To assess the risk of human Spirometra mansoni infections and investigate the knowledge, attitude and practice (KAP) towards sparganosis mansoni among residents in Henan Province, so as to provide insights into formulation of the sparganosis mansoni control measures. Methods Qinling Village in Fugou County of Zhoukou City, Bali Village in Yancheng District of Luohe City, Duzhai Village in Puyang County of Puyang City and Doushan Village in Luoshan County of Xinyang City were sampled as survey sites in Henan Province from July to August 2023, and more than 40 frogs were sampled from ponds or streams in each survey site for detection of Sparganum mansoni infections. At least 150 residents were sampled using a cluster sampling method from each survey site, and the sero-prevalence of anti-S. mansoni IgG antibody was estimated. In addition, a questionnaire survey was conducted on the KAP towards sparganosis mansoni among participants, and the proportion of eligible KAP, rate of correct KAP and KAP scores were calculated. Results A total 229 frogs were collected from 4 survey sites in 2023, and the overall prevalence of S. mansoni infection was 4.37% (10/229) in frogs, with 7.75% (10/129) prevalence in wild frogs and 0 in farm-bred frogs. A questionnaire survey was performed among 649 residents sampled from 4 survey sites, and 649 serum samples were collected. The seroprevalence of anti-S.mansoni IgG antibody was 0.15% (1/649) and the overall proportion of eligible KAP was 23.73% (154/649) among participants. There were age- (χ2 = 30.905, P = 0.000), educational level- (χ2 = 41.011, P = 0.000), and occupation-specific proportions of eligible KAP among participants (χ2 = 10.721, P = 0.005), and the proportion of eligible KAP decreased with age (χ2 trend = 22.717, P = 0.000) and increased with education levels (χ2 trend = 40.025, P = 0.000). The rates of correct KAP towards sparganosis mansoni were 40.81% (2 119/5 192), 96.66% (1 882/1 947) and 63.81% (3 727/5 841) (χ2 = 1 913.731, P = 0.000) among residents, respectively. The rates of correct KAP towards sparganosis mansoni varied significantly among survey sites (χ2 = 136.872, 42.347 and 255.157; all P values= 0.000, with the highest rate of correct knowledge (51.94%, 748/1 440) and practices (75.86%, 1 229/1 620) in Yancheng District of Luohe City and the highest rate of correct attitudes in Puyang County of Puyang City (99.11%, 446/450) (all P values< 0.05). Conclusions There is still a high transmission risk of sparganosis mansoni in Henan Province, and the KAP towards sparganosis mansoni is required to be improved among residents.
5.Total knee arthroplasty assisted by 3D printing for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture
Senlei LI ; Wei HAN ; Long CHEN ; Ning SHENG ; Jianyang LI ; Yankun LI ; Li SUN
Chinese Journal of Orthopaedic Trauma 2025;27(6):507-511
Objective:To evaluate the clinical outcomes of total knee arthroplasty (TKA) assisted by 3D printing in the treatment of traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture.Methods:A retrospective study was conducted to analyze the clinical data of the 18 patients who had been treated for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture at Department of Orthopaedics, The People's Hospital of Guizhou Province from March 2015 to June 2017. The cohort included 7 males and 11 females, with a mean age of (64.0±7.7) years. The left knee was affected in 12 cases and the right in 6 ones. The injury was caused by a traffic accident in 12 cases, by a fall from heights in 4 cases, and by a heavy object in 2 cases. The time from fracture to TKA was (5.9±2.8) years. All patients underwent TKA assisted by 3D printing after admission. Knee range of motion (ROM), Hospital for Special Surgery (HSS) knee score, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared between preoperation and postoperative 6 months. Complications during the follow-up period were also recorded.Results:All the 18 patients completed a 6-month follow-up. At 6 months after operation, the knee ROM increased significantly from preoperative 85.1°±2.9° to 125.3°±1.3°, the HSS knee score increased significantly from preoperative (39.6±1.4) points to (75.8±1.8) points, and the WOMAC score decreased significantly from preoperative (49.3±1.0) points to (8.3±0.7) points in the 18 patients ( P<0.05). One patient experienced poor wound healing 1 week after operation, and 3 patients developed low-lying patella postoperatively. No such complications as prosthesis loosening, infection, or joint stiffness were reported during the follow-up period. Conclusion:For patients with traumatic osteoarthritis secondary to severe deformity following old tibial plateau fracture, TKA assisted by 3D printing can significantly improve their knee ROM and restore their limb function, but lead to no serious complications.
6.Effects of Runmu Xiaoyao Powder (润目逍遥散) for Dry Eyes Mice with Liver-Meridian Constraint-Heat Syndrome on miR-146a-5p and IRAK1/TRAF6/NF-κB Signalling Pathway in Cornea and Lacrimal Gland Tissue
Tingting LIU ; Yankun CHEN ; Pei LIU ; Pengfei JIANG ; Kang TAN ; Chunwei YAN ; Qinghua PENG
Journal of Traditional Chinese Medicine 2024;65(18):1915-1924
ObjectiveTo explore the possible mechanism of the treatment of dry eye with liver-meridian constraint-heat syndrome by Runmu Xiaoyao Powder (润目逍遥散) by miR-146a-5p and interleukin-1 receptor-associated kinase 1/tumour necrosis factor receptor associated factor 6/nuclear factor-κB (IRAK1/TRAF6/NF-κB) signalling pathway. MethodsEighty C57BL/6J mice were randomly divided into normal group, model group, agonist group, inhibitor group, sodium hyaluronate group, and Runmu Xiaoyao Powder high-, medium-, and low-dose groups, with 10 mice in each group. Except for the normal group, the mice of dry eye with liver-meridian constraint-heat syndrome were modeled by using benzalkonium chloride solution eye drops combined with chronic pain stimulation. Beginning on the 30th day of modelling, mice in Runmu Xiaoyao Powder high-, medium-, and low-dose groups were given 29, 14.5, and 7.25 g/kg of Runmu Xiaoyao Powder respectively twice daily by gavage; mice in sodium hyaluronate group were given 5 μl of sodium hyaluronate drops twice daily; mice in the agonist group were given 2 nmol of agomir-146a-5p drops in each eye at a time, and those in the inhibitor group were given 5 nmol of antagomir-146a-5p drops in each eye, with every other day, 3 times per week; mice in the normal and model groups were gavaged with deionised water at 1 ml/(100 g·d). The intervention was continued for 14 days in each group, and mice in each group were examined for tear secretion, tear film rupture time, corneal fluorescein staining, and irritability scores on the day following the last intervention; HE staining was used to observe the pathological conditions of the cornea and lacrimal glands in each group; corneal and lacrimal gland inflammatory factors, such as interleukin 1β (IL-1β), tumour necrosis factor α (TNF-α), miR-146a-5p expression, were examined; matrix metalloproteinase 3 (MMP-3) and matrix metalloproteinase 9 (MMP-9) expression in cornea, IRAK1, TRAF6, nuclear factor κB p65 (NF-κB p65) protein and mRNA expression in cornea and lacrimal gland, and phosphorylated nuclear factor κB p65 (p-NF-κB p65) protein expression were detected. ResultsCompared with the normal group, mice in the model group showed reduced tear secretion, shorter tear film rupture time, higher irritability score (P<0.05), and pathological examination showed staining in the centre of the cornea, obvious corneal damage, increased volume of lacrimal gland follicular cells, disordered arrangement, a large number of inflammatory cell infiltration, and increased neovascularisation; corneal and lacrimal gland tissues showed elevated expression of IL-1β and TNF-α, decreased expression of miR -146a-5p, elevated expression of IRAK1, TRAF6, NF-κB p65, p-NF-κB p65 protein and IRAK1, TRAF6, NF-κB p65 mRNA, and elevated expression of MMP-3, MMP-9 protein in the cornea (P<0.05). Compared with the model group, all of the above indexes were significantly improved in high-dose group of Runmu Xiaoyao Powder, while some indexes were improved in the sodium hyaluronate group and the middle- and low-dose Runmu Xiaoyao Powder groups (P<0.05). Compared with the model group, corneal and lacrimal IRAK1 and TRAF6 mRNA and IRAK1, TRAF6 and p-NF-κB p65 protein expression decreased in the agonist group; compared with the inhibitor group, IRAK1, TRAF6, NF-κB p65 mRNA and protein expression in the cornea and lacrimal gland in the Runmu Xiaoyao Powder groups decreased (P<0.05). ConclusionRunmu Xiaoyao Powder can negatively regulate the IRAK1/TRAF6/NF-κB signalling pathway in the cornea and lacrimal gland of mice with dry eye of liver-meridian constraint-heat syndrome by up-regulation of miR-146a-5p, so as to inhibit inflammatory response and reduce the damage of the ocular surface tissues, and the high doses group showed the best effect.
7.Effect of glycopyrronium bromide on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic inguinal hernia repair surgery
Run FENG ; Yankun FENG ; Peipei CHEN ; Li ZHANG ; Zhijun CHEN
China Journal of Endoscopy 2024;30(10):9-15
Objective To explore the effect of preoperative administration of glycopyrronium bromide on postoperative cognitive dysfunction(POCD)in elderly patients undergoing laparoscopic inguinal hernia repair surgery.Methods 74 elderly patients underwent laparoscopic inguinal hernia repair surgery under general anesthesia with a laryngeal mask were randomly divided into control group(group C,25 cases),low-dose glycopyrronium bromide group(0.2 mg,group L,24 cases),medium-dose glycopyrronium bromide group(0.4 mg,group M,25 cases).Blood was collected from patients 1 d before surgery and 3 d after surgery,and serum levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),brain function related factors[5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDMF)]were measured by enzyme linked immunosorbent assay(ELISA).The Montreal Cognitive Assessment Scale(MoCA)was used to assess the cognitive function of the patients.Airway secretion scores,the incidence of arrhythmia,dry mouth and dysuria were recorded.Results There was no significant difference in the incidence of POCD among the three groups of patients(P>0.05);At 3 d postoperatively,5-HT and BDNF levels in group L were higher than those in group C,the BDNF level in group L was higher than that in group M,there were statistically significant(P<0.05);At 3 days after surgery,the levels of serum IL-1β,IL-6 and TNF-α in group C were significantly higher than those at 1 day before surgery(P<0.05),the levels of serum IL-6 and TNF-α in group M were significantly higher than those at 1 day before surgery(P<0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α in group L compared with those at 1 day before surgery(P>0.05),there were no significant differences in the levels of serum IL-1β,IL-6 and TNF-α among the three groups at 3 days after surgery(P>0.05);Postoperative airway secretion was significantly reduced in group L and group M compared with group C(P<0.05),and there was no significant difference between group L and group M(P>0.05).The incidence of adverse reactions(dry mouth and dysuria)in group M was significantly higher than that in group L and group C(P<0.05).Conclusion Low-dose(0.2 mg)glycopyrronium bromide is more appropriately recommended as a preoperative medication for elderly patients undergoing laparoscopic inguinal hernia repair surgery,and increased dosage is associated with an increase in adverse reactions and POCD.
8.Epidemiological features of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2021
Yalan ZHANG ; Tiantian JIANG ; Dan WANG ; Yan DENG ; Weiqi CHEN ; Yankun ZHU ; Hongwei ZHANG
Chinese Journal of Schistosomiasis Control 2023;35(2):177-179
Objective To analyze the epidemiological characteristics of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2011, so as to provide insights into for echinococcosis control and surveillance. Methods The data pertaining to reported echinococcosis cases in Henan Province from 2010 to 2021 were retrieved from the National Notifiable Disease Report System, and a descriptive epidemiological analysis was performed using the software SPSS 22.0. Results A total of 150 echinococcosis cases were reported in Henan Province from 2010 to 2021, including 88 confirmed cases (58.67%) and 62 clinically diagnosed cases (41.33%), 77 cases reported by Henan Province (51.33%) and 73 cases reported by other provinces (48.67%). Echinococcosis cases were reported in each month, with 8 to 21 cases reported in each month, and the number of reported echinococcosis cases appeared no remarkable temporal changes. The echinococcosis cases were reported across 18 cities of Henan Province, with the highest number of cases reported in Zhoukou (17.33%) and Nanyang cities (17.33%) and the lowest number reported in Sanmenxia City (0.67%). The reported echinococcosis cases had a male to female ratio of 1.17:1, and the cases were found at each age group, with the the highest number of cases seen at ages of 20 to 59 years (73.33%). Farmer was the predominant occupation (63.33%), followed by housekeepers and the unemployed (12.67%). Of all reported echinococcosis cases, there were 25 local cases (16.67%) and 125 imported cases (83.33%), 144 cases reported by medical institutions (96.00%) and 6 cases reported by centers for disease control and prevention (4.00%). Conclusions Although imported echinococcosis cases were the predominant source of echinococcosis cases reported in the National Notifiable Disease Report System in Henan Province from 2010 to 2021, there were still sporadic local cases, and the emergence of local sources of infection cannot be excluded. Further expanded field surveys and surveillance of echinococcosis are required.
9.Resting-state regional homogeneity changes across three mood states of bipolar disorder
Yankun WU ; Chao CHEN ; Qian LI ; Ke LI ; Yawei ZENG ; Yun'ai SU ; Tianmei SI
Chinese Journal of Psychiatry 2022;55(1):38-46
Objective:To investigate resting-state regional homogeneity in patients with bipolar disorder in different mood states and the potential trait imaging markers of bipolar disorder.Methods:This is a cross-sectional study involving 169 patients who met the diagnosis criteria of bipolar disorder in DSM-Ⅳ-TR (including 68 patients with bipolar depression, 29 patients with bipolar (hypo)mania, 72 patients with bipolar euthymia) and 113 controls matched by age and gender. The severity of depression, mania, and the positive and negative affects were assessed by the Hamilton Depression Scale (HAMD 17), Young Mania Rating Scale (YMRS), and Positive and Negative Affect Schedule (PANAS). Resting-state fMRI data were obtained. After fMRI data processing, 64 patients with bipolar depression, 28 patients with bipolar (hypo)mania, 66 patients with bipolar euthymia, and 112 controls were included in the final analysis. The regional homogeneity (ReHo) values were computed, and analysis of covariance was performed on ReHo values among the four groups. Post hoc analysis was conducted based on the ReHo values extracted from the brain regions with significant differences. The relationship between the ReHo values and clinical scores was examined. Results:Significant ReHo differences were observed in the bilateral posterior cerebellum ( F=11.41 for left, F=10.45 for right), bilateral calcarine cortex ( F=10.60 for left, F=9.59 for right), and right superior temporal gyrus ( F=10.58). Compared to controls, bipolar patients in all mood states demonstrated decreased ReHo in the left posterior cerebellum ( P<0.01 for all) and increased ReHo in the right posterior cerebellum ( P<0.05 for all), bilateral calcarine cortex and right superior temporal gyrus ( P<0.01 for all). The clinical score of negative affects was negatively correlated with the ReHo values in the right calcarine cortex ( r=-0.17, P=0.04, uncorrected). Conclusions:Bipolar disorder is characterized by regional homogeneity changes in the bilateral posterior cerebellum, bilateral calcarine cortex and right superior temporal gyrus across different mood states. The functional abnormalities in the cerebellum, visual network and sensorimotor network could comprise a trait biomarker for bipolar disorder.
10.Microfocal prostate cancer: a clinicopathological analysis of 206 cases
Ling NIE ; Xueqin CHEN ; Yankun SONG ; Mengni ZHANG ; Miao XU ; Jing GONG ; Qiao ZHOU ; Ni CHEN
Chinese Journal of Pathology 2022;51(7):634-639
Objective:To investigate the clinical and pathological features and prognosis of patients with microfocal prostate adenocarcinoma.Methods:Clinical and pathological data of the patients diagnosed with microfocal adenocarcinoma on prostate biopsy at the West China Hospital from 2013 to 2019 were collected. Microfocal adenocarcinoma was defined as follows: Gleason score of 3+3=6, total number of the cores ≥10, number of the positive cores ≤2, and proportion of the tumor in each positive core<50%. Clinicopathological parameters, treatment plans and follow-up data were collected. Pathological information of the biopsy and radical resection specimens was used to analyze the correlation between pathological parameters in the biopsy report and adverse pathological features of radical resection specimens, including increased Gleason score, capsule invasion, positive surgical margin and perineural invasion.Results:A total of 206 cases of microfocal adenocarcinoma were diagnosed on prostate biopsies from 2013 to 2019, accounting for 6.7% of all adenocarcinoma cases. There were 139 cases of 1 positive core and 67 cases of 2 positive cores. Patients with microfocal adenocarcinoma were younger than those with non-microfocal adenocarcinoma (69 years versus 71 years, P<0.001). Compared with patients with non-microfocal adenocarcinoma, the pre-biopsy total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) levels in patients with microfocal adenocarcinoma were both lower (11.2 μg/L 2 versus 23.7 μg/L 2; 1.4 μg/L 2 versus 3.0 μg/L 2, P<0.001), the fPSA/tPSA level was higher (12.9% versus 10.7%, P<0.05), the prostate volume was larger (38.9 mL versus 34.3 mL, P<0.05), and the PSA density was lower (0.3 μg/L 2 versus 0.8 μg/L 2, P<0.001). 130 patients underwent radical prostatectomy, 30 patients chose active monitoring, 31 patients chose endocrine or radiation therapy, and 15 patients were lost to follow-up. Three patients in the active surveillance group underwent radical prostatectomy for disease progression after 21-39 months observation. Biochemical relapses occurred in two patients in the radical prostatectomy group. The remaining patients have no disease progression or recurrence at present. Compared with radical prostatectomy specimens, Gleason score in the biopsy material was increased in 64/115 patients (55.7%). Among resection excision specimens, 14 cases (12.2%) had extraprostatic extension (EPE), 35 cases (30.4%) had perineural invasion, and 16 cases (13.9%) had a positive margin. Univariate and multivariate analyses showed that low fPSA/tPSA ratio and 2 positive cores were independent risk factors for Gleason score increase in the radical prostatectomy specimens. A low fPSA/tPSA ratio was an independent risk factor for perineural invasion. Low fPSA/tPSA ratio and low prostate volume were associated with a positive margin in radical prostatectomy specimens. Conclusions:In this study, patients diagnosed with microfocal adenocarcinoma on prostate biopsy account for a high proportion of the patients with increased Gleason score in the radical prostatectomy specimens, and there is a certain proportion of adverse pathological features in the radical specimens. Therefore, for the patients with only a small amount of low-grade adenocarcinoma found in biopsy, PSA levels and PSA density should be taken into consideration in treatment selection.

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