We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance imaging. Men with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers (Queen Mary Hospital and Princess Margaret Hospital, Hong Kong, China) between January 2017 and June 2022 were included. Ultrasound-magnetic resonance imaging fusion biopsies were performed after prostate health index testing. Those who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were analyzed. Out of the 747 patients, 47.3% had Prostate Imaging Reporting and Data System score 3 lesions only. The detection rate of clinically significant prostate cancer in this group was 15.0%. The cancer detection rates of clinically significant prostate cancer had statistically significant differences: 5.3% in prostate health index <25.0, 7.4% in prostate health index 25.0-34.9, 17.9% in prostate health index 35.0-54.9, and 52.6% in prostate health index ≥55.0 (P < 0.01). Among the patients, 26.9% could have avoided a biopsy with a prostate health index <25.0, at the expense of a 5.3% risk of missing clinically significant prostate cancer. Prostate health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 lesions. Biopsies could be avoided in patients with low prostate health index, with a small risk of missing clinically significant prostate cancer.

OBJECTIVE: To explore the synergistic immunomodulatory mechanism of interferon alpha-1b, interleukin-2 and thalidomide (ITI) regimen on patients with acute myeloid leukemia (AML). METHODS: Sixty eight untreated de novo or relapsed or refractory or maintenance therapy patients with AML admitted in the Affiliated Cancer Hospital of Zhengzhou University and the other 11 medical units from March 2016 to May 2019 were treated with ITI regimen. Peripheral blood specimen per patient was collected into EDTA-K3 anticoagulation vacuum tube before the administration of ITI and 3 months after the treatment; peripheral blood lymphocyte subsets and perforin and Granzyme B expression were analyzed by using flow cytometry; the levels of VEGF, IFN-γ, TNF-α and IL-6 in the plasma were detected by using a cytometric bead array. Thirty-five healthy subjects from the hospital physical examination centre were selected as normal controls. RESULTS: The ratio of CD4 CONCLUSION The ITI regimen can raise the ratio of CD4
CD8-Positive T-Lymphocytes ; Humans ; Interferon-alpha ; Interleukin-2 ; Leukemia, Myeloid, Acute/drug therapy* ; Perforin ; Thalidomide

A total of 105 undergraduate students of the class 2014 majoring in clinical medicine in Sun Yat-Sen University received probation teaching in our department from October 2017 to May 2018,according to the syllabus of dermatology and venereology of clinical medicine.Senior teachers in our department were responsible for probation teaching,with the help of the independent wards in our department and probation teaching at the outpatient service.The teachers recorded the whole teaching process and evaluated the students' memory after probation.Through the teaching in wards and at the outpatient service,the students mastered the requirements in the syllabus of dermatology and venereology and achieved good results.

Objective To investigate the relationship between body mass index(BMI)and risk levels of thyroid nodules in a multi-center healthy population. Methods A total of 6070 subjects were enrolled from five medical physical examination centers in China from January 2015 to December 2017. All the participants'general information and parameters were recorded. Thyroid nodules were detected by color Doppler ultrasonography. All ultrasound doctors received uniform training before study. Results Among all the subjects,5773(95.1%;with 4274 nodules identified in 2833 subjects)were from northern China and 297(4.9%,with 183 nodules identified in 158 subjects)from central China(χ=1.923,P=0.092). The nodules were single in 1479 of 2991 subjects(49.4%)and multiple in 1512 subjects(50.6%). Nodules larger than 1 cm accounted for 13.3% and nodules smaller than 1 cm accounted for 86.7%. Compared with the non-thyroid nodule group,the thyroid nodule group had significantly more women(χ=156.36,P=0.000),older age(t=-18.768,P=0.000),and higher fasting blood glucose(FBG) level(t=-3.808,P=0.000). Among all the nodules,the prevalence rates of benign,very-low-risk,low-risk,moderate risk,and high risk were 4.5%,6.6%,85.0%,0.1%,and 3.7%,respectively,according to the ATA guidelines. Notably,there were 4291 nodules at moderate or lower risks and 166 nodules at high risk. Compared with the former,patients with high-risk nodules had significantly lower BMI(χ=25.161,P=0.000)and high FBG(t=3.357,P=0.000). Multivariate non-conditional Logistic regression showed low BMI(OR=2.900,95%CI:1.461-5.783,P=0.002)and high FBG level(OR=0.803,95%CI:0.675-0.955,P=0.013)were independent risk factors for high-risk nodules. Compared with subjects with normal weight or obese populations,subjects with low BMI had significantly higher detection rate of high-risk nodules(χ=25.16,P=0.000). In ≥55 year-old group,significantly more high-risk nodules were detected in low BMI group(χ=44.868,P=0.000). Conclusion Low weight is associated with high-risk thyroid nodules among people ≥55 years old.
Body Mass Index ; China ; Female ; Humans ; Middle Aged ; Obesity ; Risk Factors ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

Oxcarbazepine (OXC) is a common antiepileptic drugs. In this study, one hundred and eighty four epilepsy patients with 196 observations of oxcarbazepine's active metabolite, 10,11-dihydro-10-monohydroxy carbazepine (MHD) were collected prospectively from routine clinical monitoring. Nonlinear mixed effect modeling was employed to develop a population pharmacokinetic model of oxcarbazepine in Chinese patients with epilepsy to investigate the impact of gender, age, weight, co-medications and genetic polymorphisms of UGT2B7 c.802T>C, ABCC2 c.1249G>A, ABCC 23972C>T on pharmacokinetic characteristics of OXC. The population estimate of apparent clearance (CL/F) and apparent volume of distribution (V/F) was 1.84 L·h⁻¹ and 275 L, respectively. Gender and UGT2B7 c.802T>C affected the clearance rate of MHD significantly. The established model was:CL/F=1.84×0.848^UGT2B7×1.17^GENDER. Where the genotype of UGT2B7 c.802T>C was CC, UGT2B7=0, otherwise UGT2B7=1. When the patient was male, GENDER=1, otherwise GENDER=0. The final model was evaluated by normalized predictive distribution error (NPDE) and bootstrap method. The model was stable and reliable, which offers a powerful approach for rational use of OXC in epilepsy patients.

Objective To investigate the protective effects of Coptis chinensis decoction on the metabolic index and renal function of rats with fructose-induced metabolism syndrome (MS).Methods From 56 male Wistar rats,6 were randomly selected as normal control group,the other rats were daily fed with 10％ fructose water for 8 weeks to reproduce the MS model.Twenty-four rats were established successfully as MS model and randomly divided into 4 groups (6 each):model group,Coptis decoction group,tauroursodeoxycholic acid (TUDCA) group and berberine hydrochloride (BH) group.The body weight,visceral fat weight,fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (HOMA-IR),cholesterol (TC),triglyceride (TG),systolic blood pressure (SBP),diastolic blood pressure (DBP),urinary N-acetyl-β-D-glucosidase (NAG),urine microalbumin (m-ALB),blood urea nitrogen (BUN) and serum creatinine (Scr) levels were compared between the groups,and the renal pathological changes were observed by light microscopy and electron microscopy.Results The levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP,DBP and urinary NAG were obviously higher in the four MS model groups than in normal control group (P＜0.05),while the levels of m-ALB,BUN and Scr showed no significant difference (P＞0.05).After the intervention,the levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP and DBP decreased significantly in Coptis decoction group than in model group (P＜0.05).Compared with BH group and TUDCA group,the levels of FINS and HOMA-IR decreased obviously in Coptis decoction group (P＜0.05),while the levels of body weight,TC,TG,SBP,DBP,urinary NAG,BUN and Scr showed no significant difference (P＞0.05).It was observed in model group by light microscopy and electron microscopy that the glomerular swelled obviously,the capillary basement membrane of glomerular and renal tubules thickened,mesangial region and interstitial substances hyperplasia,podocytes swelled markedly and most of fusion,the epithelial cells of renal tubules serious vacuolar degeneration,and a lot of secondary lysosomes formed,autophagy of organelles occurred,and most of endoplasmic reticulum and mitochondria disappeared.The kidney pathological damage reduced obviously after treatment of Coptis decoction,but no significant difference when compared with that in BH group and TUDCA group.Conclusions Coptis decoction may decrease the body weight,reduce the levels of blood lipid and blood pressure,and better improve the insulin resistance when compared with BH and TUDCA.In addition,Coptis decoction can also reduce the renal pathological damage,and has the protective function for kidney.

BACKGROUND: Hand dermatitis is a common chronic relapsing skin disease resulting from a variety of causes, including endogenous predisposition and environmental exposures to irritants and allergens. Lifestyle factors such as smoking have been implicated in hand dermatitis. OBJECTIVE: To evaluate the association between tobacco exposure and hand dermatitis using the 2003~2004 National Health and Nutrition Examination Survey (NHANES) database. METHODS: Data were retrieved and analyzed from 1,301 participants, aged 20~59 years, from the 2003~2004 NHANES questionnaire study who completed health examination and blood tests. Diagnosis of hand dermatitis was based on standardized photographs of the dorsal and palmar views of the hands read by two dermatologists. RESULTS: There were 38 diagnosed cases of active hand dermatitis out of the 1,301 study participants (2.9%). Heavy smokers (>15 g tobacco daily) were 5.11 times more likely to have active hand dermatitis (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.39~18.88; p=0.014). Those with serum cotinine >3 ng/ml were also more likely to have active hand dermatitis, compared with those with serum cotinine ≤3 ng/ml (OR, 2.50; 95% CI, 1.26~4.95; p=0.007). After adjusting for confounding factors such as age, atopic diathesis, occupational groups, and physical activity, the association between tobacco exposure and active hand dermatitis remained significant. CONCLUSION: Smoking has a significant association with the presence of active hand dermatitis. It is important to consider smoking cessation as part of management of hand dermatitis.
Adult* ; Allergens ; Cotinine ; Dermatitis* ; Diagnosis ; Disease Susceptibility ; Eczema ; Environmental Exposure ; Epidemiology ; Hand* ; Hematologic Tests ; Humans ; Irritants ; Life Style ; Motor Activity ; Nutrition Surveys ; Occupational Groups ; Skin Diseases ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco ; United States*

BACKGROUNDLaparoscopic liver resection (LLR) has been considered to be safe and feasible. However, few studies focused on the comparison between the anatomic and nonanatomic LLR. Therefore, the purpose of this study was to compare the perioperative factors and outcomes of the anatomic and nonanatomic LLR, especially the area of liver parenchymal transection and blood loss per unit area.

METHODSIn this study, surgical and oncological data of patients underwent pure LLR procedures for malignant liver tumor were prospectively collected. Blood loss per unit area of liver parenchymal transection was measured and considered as an important parameter. All procedures were conducted by a single surgeon.

RESULTSDuring nearly 5 years, 84 patients with malignant liver tumor received a pure LLR procedure were included. Among them, 34 patients received anatomic LLR and 50 received nonanatomic LLR, respectively. Patients of the two groups were similar in terms of demographic features and tumor characteristics, despite the tumor size was significantly larger in the anatomic LLR group than that in the nonanatomic LLR group (4.77 ± 2.57 vs. 2.87 ± 2.10 cm, P = 0.001). Patients who underwent anatomic resection had longer operation time (364.09 ± 131.22 vs. 252.00 ± 135.21 min, P < 0.001) but less blood loss per unit area (7.85 ± 7.17 vs. 14.17 ± 10.43 ml/cm 2 , P = 0.018). Nonanatomic LLR was associated with more blood loss when the area of parenchymal transection was equal to the anatomic LLR. No mortality occurred during the hospital stay and 30 days after the operation. Moreover, there was no difference in the incidence of postoperative complications. The disease-free and overall survival rates showed no significant differences between the anatomic LLR and nonanatomic LLR groups.

CONCLUSIONSBoth anatomic and nonanatomic pure LLR are safe and feasible. Measuring the area of parenchymal transection is a simple and effective method to estimate the outcomes of the liver resection surgery. Blood loss per unit area is an important parameter which is comparable between the anatomic LLR and nonanatomic LLR groups.

Aged ; Blood Loss, Surgical ; Female ; Humans ; Laparoscopy ; methods ; Length of Stay ; Liver ; pathology ; surgery ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Prospective Studies

Rosai-Dorfman disease is a rare, idiopathic, benign, and self-limiting histiocytic proliferative disorder. A 26-year-old man presented with a single massive cutaneous nodule (reaching 30 cm in diameter) on the left shoulder and back for 15 months. The routine hematological and biochemical tests were normal. Magnetic resonance scanning showed the lesion involved the skin, subcutaneous tissue, and subjacent muscle group, accompanied by obvious lymph node enlargement in the left part of the neck, supraclavicular fossa, and axillary fossa. The histopathology of the left cervical lymph node revealed diffuse effacement of the normal nodal architecture, with patchy chronic inflammatory cell infiltrates comprising lymphocytes and sheets of histiocytes. Some histiocytes contained lymphocytes within their pale cytoplasm. Many multinucleated giant cells were found; however, caseating granulomas were not seen. The skin and muscle biopsy specimen obtained from the back revealed infiltrating lymphocytes and histiocytes diffusely distributed in the dermis, subcutaneous tissue, and crevices of the muscle fibers. The phenomenon of emperipolesis and the presence of multinucleated giant cells were also seen. Immunohistochemical staining revealed that the histiocytes were positive for S-100 protein and CD68 but negative for CD1a. Immunophenotyping of the infiltrating lymphocytes indicated positive reactions to CD3, CD45RO, CD5, CD7, CD4, CD8 (partly), CD79a, CD20 (partly), and Ki-67 (<1%). The final diagnosis was Rosai-Dorfman disease. Owing to the extensive and deep involvement of the subcutaneous tissue and muscles, the patient did not undergo surgery to excise the massive skin nodule. The lesion showed no obvious change at the 12-month follow-up.
Adult ; Biopsy ; Cytoplasm ; Dermis ; Diagnosis ; Emperipolesis ; Follow-Up Studies ; Giant Cells ; Granuloma ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Immunophenotyping ; Lymph Nodes ; Lymphocytes ; Muscles ; Neck ; S100 Proteins ; Shoulder* ; Skin ; Subcutaneous Tissue

The capability of the central vestibular system in utilizing cues arising from the inner ear determines the ability of animals to acquire the sense of head orientations in the three-dimensional space and to shape postural movements. During development, neurons in the vestibular nucleus (VN) show significant changes in their electrophysiological properties. An age-dependent enhancement of membrane excitability is accompanied by a progressive increase in firing rate and discharge regularity. The coding of horizontal and vertical linear motions also exhibits developmental refinement in VN neurons. Further, modification of cell surface receptors, such as glutamate receptors, of developing VN neurons are well-orchestrated in the course of maturation, thereby regulating synaptic efficacy and spatial coding capacity of these neurons in local circuits. Taken together, these characteristic features of VN neurons contribute to developmental establishment of space-centered coordinates within the brain.
Animals ; Ear, Inner ; physiology ; Electrophysiological Phenomena ; Movement ; Neurons ; physiology ; Rats ; Receptors, Cell Surface ; physiology ; Vestibular Nuclei ; physiology