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 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 investigate the application value of Clavien-Dindo classification (CDC) and comprehensive complication index (CCI) in evaluating early postoperative complications for radical gastric cancer surgery.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 484 patients who underwent radical gastric cancer surgery in Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2016 to December 2018 were collected. There were 1 086 males and 398 females, aged (60±17)years. The early complica-tions of patients were classified by the CDC and the CCI was calculated. Measurement data with normal distribution were represented as Mean± SD. Count data are expressed as absolute numbers. Univariate analysis was performed using the chi-square test. Multivariate analysis was conducted using Logistic regression analysis. Correlation analysis between CDC, CCI and duration of postopera-tive hospital stay, total hospital expenses was performed using the Spearman rank correlation. Multiple linear regression analysis was conducted to compare the correlation analysis between CDC, CCI and duration of postoperative hospital stay, total hospital expenses. Results:(1) Distribution of early postoperative complications by CDC and CCI. Among the 1 484 patients, 432 patients developed early postoperative complications, of which 322 cases had a single complication, and 110 cases had multiple complications. Among the 432 patients with complications, the numbers of patients with grades Ⅰ, Ⅱ, Ⅲa, Ⅲb, Ⅳ, and Ⅴ of CDC were 231, 137, 45, 13, 3, and 3 cases, respectively. The CCI in the 432 patients with complications was 17.2±11.7, with peak values of 8.7 and 20.9. (2) Analysis of factors influencing early postoperative complications in patients undergoing radical gastric cancer surgery. Results of multivariate analysis showed that female, age ≥70 years, and preoperative serum albumin <35 g/L were independent risk factors for early postoperative complications in patients undergoing radical gastric cancer surgery ( odds ratios=1.391, 1.535, 1.521, 95% confidence intervals as 1.083-1.786, 1.187-1.985, 1.055-2.192, P<0.05). (3) Correlation analysis between CDC, CCI and duration of postoperative hospital stay, total hospital expenses. Among the 432 patients with post-operative complications, both CDC and CCI were positively correlated with duration of postoperative hospital stay ( r=0.574, 0.576, P<0.05), and both were positively correlated with total hospital expenses ( r=0.413, 0.438, P<0.05). Among the 110 patients with multiple postoperative complications, both CDC and CCI were positively correlated with duration of postoperative hospital stay ( r=0.514, 0.537, P<0.05), and both were positively correlated with total hospital expenses ( r=0.427, 0.474, P<0.05). (4) Regression analysis between CDC, CCI, and duration of postoperative hospital stay, total hospital expenses. Multiple linear regression analysis of duration of postoperative hospital stay showed that CDC ≥grade 3, age ≥70 years, preoperative C-reactive protein ≥10 g/L, and American Society of Anesthesiology (ASA) classification ≥grade 3 were associated with prolonged duration of postopera-tive hospital stay. The higher CCI indicated longer duration of postoperative hospital stay. The standard b value of CCI was higher than that of CDC ≥grade 3 (0.467 versus 0.212). The regression analysis of total hospital expenses showed that CDC ≥grade 3, age ≥70 years, preoperative serum albumin <35 g/L, ASA classification ≥grade 3, and pathological stage Ⅲ-Ⅳ increased total hospital expenses, while gender of female reduced the expenses. The higher CCI indicated higher hospital expenses. The standard b value of CCI was higher than that of CDC ≥grade 3 (0.449 versus 0.061). Conclusions:Both the CDC and CCI can effectively reflect the severity of postoperative complica-tions following radical gastric cancer surgery. Compared to the CDC, the CCI can better predict post-operative hospital stay and total hospital expenses.

Objective: To investigate the mechanism of action of Wuzi Yanzong pill (WYP) in rats with oligoasthenozoospermia (OAZ) via metabolomics and to provide a possible basis for improving this WYP-based treatment. Methods: A rat model of OAZ was established by treating male Sprague–Dawley rats with glucosides from Tripterygium wilfordii Hook. F. Seventy-two rats were randomly divided into six groups: control, L-carnitine (positive control), model, and low-, medium-, and high-dose WYP groups. Rats in the experimental groups were treated with WYP for 4 weeks. At the end of the treatment period, sperm cell quality (density, motility, and viability) was assessed using a semen analysis system, mitochondrial membrane potential (MMP) was assessed using flow cytometry, and testicular injury was assessed using hematoxylin and eosin staining to validate the therapeutic effect of WYP in OAZ. Further, serum metabolomics-based analysis was performed using high-performance liquid chromatography-mass spectrometry to identify differential metabolic pathways and possible mechanisms of action of WYP in OAZ treatment. Results: A rat model of OAZ was considered successfully-established after comparing the quality of spermatozoa in the model group to that in the control group. WYP-M and WYP-H treatments significantly improved sperm cell density, motility, and viability compared with those in the model group (all P < .05). Compared with the model group, both WYP-M and WYP-H treatments increased MMP values (P = .006 and P = .021 respectively), while there was no significant difference in the L-carnitine group. L-carnitine and WYP administration reversed damage to the testes to varying degrees compared with that in the model group. Further, 44 differential metabolites and four metabolic pathways, especially autophagy pathway, related to OAZ were identified via metabolomics. Conclusions WYP improves sperm cell quality and MMP in OAZ primarily via autophagy regulation. These findings can be employed to improve the efficacy of WYP in humans.

Objective:To investigate the application value of Clavien-Dindo classification (CDC) and comprehensive complication index (CCI) in evaluating early postoperative complications for radical gastric cancer surgery.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 484 patients who underwent radical gastric cancer surgery in Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2016 to December 2018 were collected. There were 1 086 males and 398 females, aged (60±17)years. The early complica-tions of patients were classified by the CDC and the CCI was calculated. Measurement data with normal distribution were represented as Mean± SD. Count data are expressed as absolute numbers. Univariate analysis was performed using the chi-square test. Multivariate analysis was conducted using Logistic regression analysis. Correlation analysis between CDC, CCI and duration of postopera-tive hospital stay, total hospital expenses was performed using the Spearman rank correlation. Multiple linear regression analysis was conducted to compare the correlation analysis between CDC, CCI and duration of postoperative hospital stay, total hospital expenses. Results:(1) Distribution of early postoperative complications by CDC and CCI. Among the 1 484 patients, 432 patients developed early postoperative complications, of which 322 cases had a single complication, and 110 cases had multiple complications. Among the 432 patients with complications, the numbers of patients with grades Ⅰ, Ⅱ, Ⅲa, Ⅲb, Ⅳ, and Ⅴ of CDC were 231, 137, 45, 13, 3, and 3 cases, respectively. The CCI in the 432 patients with complications was 17.2±11.7, with peak values of 8.7 and 20.9. (2) Analysis of factors influencing early postoperative complications in patients undergoing radical gastric cancer surgery. Results of multivariate analysis showed that female, age ≥70 years, and preoperative serum albumin <35 g/L were independent risk factors for early postoperative complications in patients undergoing radical gastric cancer surgery ( odds ratios=1.391, 1.535, 1.521, 95% confidence intervals as 1.083-1.786, 1.187-1.985, 1.055-2.192, P<0.05). (3) Correlation analysis between CDC, CCI and duration of postoperative hospital stay, total hospital expenses. Among the 432 patients with post-operative complications, both CDC and CCI were positively correlated with duration of postoperative hospital stay ( r=0.574, 0.576, P<0.05), and both were positively correlated with total hospital expenses ( r=0.413, 0.438, P<0.05). Among the 110 patients with multiple postoperative complications, both CDC and CCI were positively correlated with duration of postoperative hospital stay ( r=0.514, 0.537, P<0.05), and both were positively correlated with total hospital expenses ( r=0.427, 0.474, P<0.05). (4) Regression analysis between CDC, CCI, and duration of postoperative hospital stay, total hospital expenses. Multiple linear regression analysis of duration of postoperative hospital stay showed that CDC ≥grade 3, age ≥70 years, preoperative C-reactive protein ≥10 g/L, and American Society of Anesthesiology (ASA) classification ≥grade 3 were associated with prolonged duration of postopera-tive hospital stay. The higher CCI indicated longer duration of postoperative hospital stay. The standard b value of CCI was higher than that of CDC ≥grade 3 (0.467 versus 0.212). The regression analysis of total hospital expenses showed that CDC ≥grade 3, age ≥70 years, preoperative serum albumin <35 g/L, ASA classification ≥grade 3, and pathological stage Ⅲ-Ⅳ increased total hospital expenses, while gender of female reduced the expenses. The higher CCI indicated higher hospital expenses. The standard b value of CCI was higher than that of CDC ≥grade 3 (0.449 versus 0.061). Conclusions:Both the CDC and CCI can effectively reflect the severity of postoperative complica-tions following radical gastric cancer surgery. Compared to the CDC, the CCI can better predict post-operative hospital stay and total hospital expenses.

BACKGROUND: The SMARCA4 mutation has been shown to account for at least 10% of non-small cell lung cancer (NSCLC). In the present, conventional radiotherapy and targeted therapy are difficult to improve outcomes due to the highly aggressive and refractory nature of SMARCA4-deficient NSCLC (SMARCA4-DNSCLC) and the absence of sensitive site mutations for targeted drug therapy, and chemotherapy combined with or without immunotherapy is the main treatment. Effective SMARCA4-DNSCLC therapeutic options, however, are still debatable. Our study aimed to investigate the efficacy and prognosis of programmed cell death 1 (PD-1) immune checkpoint inhibitors (ICIs) in combination with chemotherapy and chemotherapy in patients with stage III-IV SMARCA4-DNSCLC. METHODS: 46 patients with stage III-IV SMARCA4-DNSCLC were divided into two groups based on their treatment regimen: the chemotherapy group and the PD-1 ICIs plus chemotherapy group, and their clinical data were retrospectively analyzed. Efficacy assessment and survival analysis were performed in both groups, and the influencing factors for prognosis were explored for patients with SMARCA4-DNSCLC. RESULTS: Male smokers are more likely to develop SMARCA4-DNSCLC. There was no significant difference in the objective response rate (76.5% vs 69.0%, P=0.836) between chemotherapy and the PD-1 ICIs plus chemotherapy or the disease control rate (100.0% vs 89.7%, P=0.286). The one-year overall survival rate in the group with PD-1 ICIs plus chemotherapy was 62.7%, and that of the chemotherapy group was 46.0%. The difference in median progression-free survival (PFS) between the PD-1 ICIs plus chemotherapy group and the chemotherapy group was statistically significant (9.3 mon vs 6.1 mon, P=0.048). The results of Cox regression analysis showed that treatment regimen and smoking history were independent influencing factors of PFS in patients with stage III-IV SMARCA4-DNSCLC, and family history was an individual influencing factor of overall survival in patients with stage III-IV SMARCA4-DNSCLC. CONCLUSIONS Treatment regimen may be a prognostic factor for patients with SMARCA4-DNSCLC, and patients with PD-1 ICIs plus chemotherapy may have a better prognosis.
Humans ; Male ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Immune Checkpoint Inhibitors/therapeutic use* ; Programmed Cell Death 1 Receptor/genetics* ; Retrospective Studies ; Antineoplastic Agents, Immunological/therapeutic use* ; Prognosis ; DNA Helicases/genetics* ; Nuclear Proteins/genetics* ; Transcription Factors/genetics*

Objective:To investigate the clinical effect of esophagofundostomy combined with pericardial devascularization in the treatment of upper gastrointestinal hemorrhage caused by portal hypertension.Methods:The clinical data of 108 patients with portal hypertension admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb 2009 to Feb 2015 were analyzed. Among them 42 patients underwent esophagofundostomy combined with pericardial devascularization as the study group, and 66 patients underwent pericardial devascularization only as the control group. All patients presented with splenomegaly or hypersplenism; the spleen was routinely removed during the operation.Results:The difference of operation time between the study group and the control group was statistically significant [(157±41) min vs. (143±27) min, t=2.81, P<0.05]. The improvement in the esophagogastric varices in the study group within 6 months was significantly better than that in the control group( Z=2.47, P<0.05). In addition, the rebleeding rates of varicose veins within 1, 3 and 5 years in the study group was 2%, 5% and 10%, while that in the control group was 15%, 21% and 26% (χ 2=5.49, 4.27, 4.31, all P<0.05). Conclusions:Esophagofundostomy combined with pericardia devascularization achieves complete devascularization and low rebleeding rate.

Advanced glycation end-products (AGEs) are stable and toxic by-products of non-enzymatic metabolic reaction of proteins,lipids and nucleotides.The elevated serum AGEs level in pregnant women is strongly associated with hyperglycemia,oxidative stress and insulin resistance and may be one of the cause for the onset and development of the gestational diabetes mellitus(GDM).This review mainly focuses on the pathogenesis of AGEs and GDM.

Objective:To study the anatomical correlation between dental arch and the volume of upper airway in patients with obstruc-tive sleep apnea hypoventilation syndrome(OSAHS). Methods: Dental arch architecture and upper airway volume were measured by cone beam CT(CBCT) in the subjects with OSAHS(n=22) and without OSAHS(n=19). The correlation between dental arch and the supper airway volume in OSAHS patients was analyzed. Results:The length of the upper dental arch and the height of palate in OSAHS patients were larger than those of the controls(All, P<0. 05). Cross-sectional area of nasopharynx and retropalatal and the total volume of upper airway were negatively correlated with the palatal height and upper dental arch length(P<0. 05), while positively correlated with upper dental arch of molar regions(P<0. 05). Conclusion:The abnormal shape of upper dental arch is related to the airway vol-ume of nasopharynx and retropalatal region in patients with OSAHS.

The aim of this study was to construct a mammary gland-specific expressional vector pBC1-hLF-Neo for Human Lactoferrin (hLF) gene and then investigate its expression in the mammary gland epithelium cells. The constructed vector contained the 6.2 kb long 5' flank regulation region including promoter, other elements and the 7.1 kb long 3' flank regulation region including transcriptional ending signal of a goat's beta-casein gene. A cassette of Neo gene was also inserted into the vector which gave a total length of 26.736 kb identified by restriction fragment analysis and partial DNA sequencing. The results revealed that the structure of the final constructed vector accords with the designed plasmid map. In order to analyze the bioactivity of the vector, we transfected the lined vector DNA into the dairy goat's mammary gland epithelium cells and C127 cells of a mouse's mammary epithelium by Lipofectamine. After selection with G418 for 8-10 days, G418-risistant clones were obtained. PCR analysis demonstrated that hLF gene cassette had been integrated into the genomic DNA of G418-risistant clones. After proliferation culture, the two kinds of transgenic cells were cultured in serum-free DMEM-F12 medium with prolactin, insulin and hydrocortisone- a medium capable of inducing recombinant hLF expression. RT-PCR, Western blotting and anti-bacteria bioactivity experiments demonstrated that the constructed mammary gland specific vector pBC1-hLF-Neo possessed the desirable bioactivity to efficiently express and could secrete hLF in both mammary gland cells and have the effect of E. coli proliferation inhibition. Paramount to everything, this study laid a firm foundation for preparing the hLF gene transgenic goat fetal-derived fibroblast cells.
Animals ; Base Sequence ; Breast Neoplasms ; metabolism ; pathology ; Caseins ; genetics ; Cell Line, Tumor ; DNA, Complementary ; biosynthesis ; genetics ; Epithelial Cells ; metabolism ; Female ; Genetic Vectors ; genetics ; Goats ; Humans ; Lactoferrin ; biosynthesis ; genetics ; Mammary Glands, Animal ; cytology ; metabolism ; Mice ; Molecular Sequence Data ; Mutagenesis, Insertional ; Promoter Regions, Genetic ; genetics