Objective: To analyze three different integrated scoring schemes of prostate biopsy and to compare their concordance with the scoring of radical prostatectomy specimens. Methods: A retrospective analysis of 556 patients with radical prostatectomy performed in Nanjing Drum Tower Hospital, Nanjing, China from 2017 to 2020. In these cases, whole organ sections were performed, the pathological data based on biopsy and radical prostatectomy specimens were summarized, and 3 integrated scores of prostate biopsy were calculated, namely the global score, the highest score and score of the largest volume. Results: Among the 556 patients, 104 cases (18.7%) were classified as WHO/ISUP grade group 1, 227 cases (40.8%) as grade group 2 (3+4=7); 143 cases (25.7%) as grade group 3 (4+3=7); 44 cases (7.9%) as grade group 4 (4+4=8) and 38 cases (6.8%) as grade group 5. Among the three comprehensive scoring methods for prostate cancer biopsy, the consistency of global score was the highest (62.4%). In the correlation analysis, the correlation between the scores of radical specimens and the global scores was highest (R=0.730, P<0.01), while the correlations of the scores based on radical specimens with highest scores and scores of the largest volume based on biopsy were insignificant (R=0.719, P<0.01; R=0.631, P<0.01, respectively). Univariate and multivariate analyses showed tPSA group and the three integrated scores of prostate biopsy were statistically correlated with extraglandular invasion, lymph node metastasis, perineural invasion and biochemical recurrence. Elevated global score was an independent prognostic risk factor for extraglandular invasion and biochemical recurrence in patients; increased serum tPSA was an independent prognostic risk factor for extraglandular invasion; increased hjighest score was an independent risk factor for perineural invasion. Conclusions: In this study, among the three different integrated scores, the overall score is most likely corresponded to the radical specimen grade group, but there is difference in various subgroup analyses. Integrated score of prostate biopsy can reflect grade group of radical prostatectomy specimens, thereby providing more clinical information for assisting in optimal patient management and consultation.
Male ; Humans ; Prostate/pathology* ; Retrospective Studies ; Prostatectomy/methods* ; Biopsy ; Prostatic Neoplasms/pathology*

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.
Male ; Humans ; Premature Ejaculation/surgery* ; Intraoperative Neurophysiological Monitoring/methods* ; Prospective Studies ; Neurosurgical Procedures/methods* ; Penis/surgery* ; Retrospective Studies

Traditional ophthalmic pharmaceutical preparations are mostly eye drops or eye ointments, which have the disadvantages of low efficiency and poor patient compliance in application.Drug-loaded contact lenses can overcome these shortcomings and have attracted much attention.Improving drug loading capacity and enhancing sustained-release performance of drug-loaded contact lenses are the main focus of research and development.In recent years, drug-loaded contact lenses made of molecularly imprinted hydrogel can significantly improve drug loading capacity and sustained-release performance, and have been widely studied.The application status of molecularly imprinted hydrogel drug-loaded contact lenses in the delivery of ophthalmic drugs, as well as the effects of various factors on drug loading capacity and sustained-release performance were reviewed in this article.

OBJECTIVE: To explore the effect of Mimics assisted virtual reduction and personalized additional fixation with proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fracture of lateral wall. METHODS: From January 2015 to June 2018, 11 cases of intertrochanteric fracture with unstable lateral wall injury were analyzed retrospectively, including 3 males and 8 females, aged 64 to 81 years old. There were 3 cases of A3.1, 6 cases of A3.2 and 2 cases of A3.3 according to AO classification. All patients underwent CT scanning, according to the CT scanning data, three-dimensional reconstruction of fracture was performed by Mimics soft. Virtual reduction was performed first, and PFNA was implanted after satisfactory reduction. According to the relationship between the fracture characteristics of the lateral wall and the position of the lag screw tail in the lateral wall, 4 cases were treated with PFNA and titanium cable or steel wire, and 7 cases were treated with PFNA and reconstruction locking plate.The quality of reduction and healing were evaluated by follow up, and Harris score of hip joint was performed in the last reexamination. RESULTS: All patients were followed up for 12 to 18 months. No postoperative infection of incision and loosening of internal fixation occurred. The time of fracture healing was 12 to 20 weeks. At the final follow up, Harris score of hip joint was excellent in 6 cases, good in 3 cases and fair in 2 cases. CONCLUSION The treatment of intertrochanteric fracture of femur with Mimics assisted virtual reduction and PFNA is helpful to preoperative planning and improve the surgical effect.
Aged ; Aged, 80 and over ; Bone Nails ; Female ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Software ; Treatment Outcome

Vitamin D deficiency is a common health issue around the world. We therefore evaluated the associations of semen quality with both serum and seminal plasma vitamin D levels and studied the mechanisms underlying these by incubating spermatozoa with 1,25(OH)₂D In vitro. Two hundred and twenty-two men were included in our study. Vitamin D was detected using an electrochemiluminescence method. Spermatozoa used for In vitro experiments were isolated by density gradient centrifugation. Positive relationships of serum 25(OH)D with semen volume and seminal plasma fructose were identified. Seminal plasma 25(OH)D level showed no relationship with serum 25(OH)D level, while it was inversely associated with sperm concentration and positively correlated with semen volume and sperm kinetic values. In vitro, sperm kinetic parameters increased after incubation with 1,25(OH)₂D, especially upon incubation for 30 min with it at a concentration of 0.1 nmol l^-1. Under these incubation conditions, the upward migration of spermatozoa increased remarkably with increasing adenosine triphosphate (ATP) concentration. The concentration of cyclic adenosine monophosphate (cAMP) and the activity of protein kinase A (PKA) were both elevated, and the PKA inhibitor, N-[2-(p-Bromocinnamylamino)ethyl]-5-isoquinolinesulfonamide dihydrochloride (H89) reversed the increase of ATP production. The concentrations of cytoplasmic calcium ions and nicotinamide adenine dinucleotide (NADH) were both enhanced, while mitochondrial calcium uniporter (MCU) inhibitor, Ruthenium 360 (Ru360) did not reverse the increase of ATP production. Therefore, seminal plasma vitamin D may be involved in regulating sperm motility, and 1,25(OH)₂D may enhance sperm motility by promoting the synthesis of ATP both through the cAMP/PKA pathway and the increase in intracellular calcium ions.
Adenosine Triphosphate/metabolism* ; Adult ; Calcium/metabolism* ; Cyclic AMP/metabolism* ; Cyclic AMP-Dependent Protein Kinases/metabolism* ; Humans ; Male ; Semen/metabolism* ; Semen Analysis ; Signal Transduction/physiology* ; Sperm Motility/physiology* ; Spermatozoa/metabolism* ; Vitamin D/pharmacology* ; Vitamin D Deficiency/blood* ; Wit and Humor as Topic ; Young Adult

Objective To evaluate the effect of epidural block on postoperative long-term quality of life in patients undergoing radical operation for lung cancer under general anesthesia. Methods A total of 348 patients with primary non-small cell lung cancer of both sexes, aged 18-80 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, with body mass index of 18-30 kg∕m2, with International Associa-tion for the Study of Lung Cancer staging criteria stage 1-2, scheduled for elective radical operation for lung cancer under general anesthesia, were divided into 2 groups ( n＝174 each) using a random number table method: general anesthesia plus patient-controlled intravenous analgesia ( PCIA) group ( group G) and general anesthesia plus epidural anesthesia plus patient-controlled epidural analgesia group ( group GE). Anesthesia was induced by target-controlled infusion of propofol and fentanyl and intravenous injection of rocuronium. The patients were tracheally intubated and mechanically ventilated to maintain the end-tidal pressure of carbon dioxide at 30-40 mmHg. Anesthesia was maintained by target-controlled infusion of propofol and intravenous injection of remifentanil. An increment of fentanyl was given immediately after chest opening and closing, and cisatracurium besylate was injected intravenously. In group GE, 0. 375%ropivacaine was epidurally injected in a initial dose of 5-8 ml followed by continuous epidural infusion at 5 ml∕h, and infusion was stopped before closing the chest. Bispectral index value was maintained at 40-60 during operation. PCIA was performed at the end of operation with fentanyl, flurbiprofen, ramosetron or palonosetron hydrochloride, and the PCA pump was set up with a 0. 5 ml bolus dose, a 15-min lockout in-terval and background infusion at a rate of 2 ml∕h in group G. Patient-controlled epidural analgesia was per-formed with 0. 15%-0. 18% ropivacaine 250 ml, and the PCA pump was set up to deliver 2-3 ml bolus dose with a 20-min lockout interval and background infusion at 4-5 ml∕h in group GE. Postoperative analge-sia was performed until 48 h after operation in both groups. Patients were followed up by telephone at half a year and 1 and 2 yr after operation. The 12-item short-form scale was used to evaluate the quality of life. Physical component summary (PCS-12) and mental component summary (MCS-12) scores were calculated. Results PCS-12 and MCS-12 scores were significantly lower at 2 yr after operation than at half a year in both groups (P＜0. 05). Compared with group G, PCS-12 and MCS-12 scores were significantly increased at 2 yr after operation in group GE (P＜0. 05). Conclusion Compared with general anesthesia alone, epi-dural block provides better effect on postoperative long-term quality of life in patients undergoing radical op-eration for lung cancer under general anesthesia.

Objective The aim of this study was to investigate the relationship between peripheral plasma stem cell factor (SCF)/c-kit levels and the types of dipper and non-dipper hypertension in hypertensive patients. Methods This cross-sectional study included newly diagnosed hypertensive patients who underwent 24-hour ambulatory blood pressure monitor (ABPM) between January 2009 and 2012 in Jiangning city. Patients were divided into the dipper group and the non-dipper group according to ABPM measurements. The levels of SCF and its receptor c-kit, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in peripheral blood were measured via enzyme-linked immunosorbent assays. The serum levels of glucose and lipid were examined as well. The levels of SCF/c-kit were compared between the dippers and the non-dippers; and their correlation with 24-hour mean systolic blood pressure (MSBP), 24-hour mean diastolic blood pressure (MDBP), TNF-α and IL-6 were investigated using linear regression analyses statistically. Results A total of 247 patients with newly diagnosed hypertension were recruited into the study, including 116 non-dippers and 131 dippers. The levels of peripheral plasma SCF were higher in non-dipper group (907.1±52.7 ng/L vs. 778.7±44.6 ng/L; t=2.837, P<0.01), and the levels of c-kit were higher in non-dipper group too (13.2±1.7 μg/L vs 9.57±1.4 μg/L; t=2.831, P<0.01). Linear regression analysis revealed that SCF/c-kit levels were significantly positively correlated with MSBP, MDBP, plasma TNF-α, and IL-6 levels (all P<0.01). Conclusions Peripheral plasma SCF/c-kit levels are higher in patients with non-dipper hypertension than those with dipper one, and significantly correlate with 24-hour MSBP, 24-hour MDBP, serum TNF-α and IL-6 levels.

OBJECTIVETo analyze the clinical application value of the 7th edition UICC-AJCC TNM pT classification of gastric cancer.

METHODSThe classification of tumor invasion depth of 874 cases of gastric cancer was determined using the 7th edition UICC-AJCC TNM classification and the relationships of prognosis with clinicopathological factors was compared with that obtained using the 6th edition TNM classification.

RESULTSThe 5-year survival rates according to the 6th edition pT1, pT2, pT3, pT4 were 98.4%, 55.8%, 26.0% and 24.5%, respectively, showing a significant difference among the four substages (P<0.001). The 5-year survival rates according to the 7th edition pT1a, pT1b, pT2, pT3, pT4a, and pT4b were 98.6%, 98.2%, 75.8%, 48.9%, 26.0% and 24.5%, respectively, and there were significant differences in survival time among the six substages (P<0.001). According to the 7th edition TNM classification, for the pT2 and pT3 patients groups, the 5-year survival rates of the 7th edition pN0 (without lymphatic metastasis) were 84.8% and 77.9%, respectively, showing no significant difference between the two survival rates (P=0.204). The 5-year survival rates according to the 7th edition pNx (with lymphatic metastasis) were 66.9% and 37.5%, respectively, and there was a significant difference between the two survival times (P<0.001). In multivariate analysis, the 7th edition pT stage, vascular or lymphatic invasion, the 6th edition pT staging and primary tumor site were independent prognostic factors in patients with gastric cancer (P<0.05), and the relationship of the staging of the 7th version of pT was more close with the prognosis of patients with gastric carcinoma than that of the 6th edition of pT staging system.

CONCLUSIONThe 7th edition UICC-AJCC classification of pT staging of gastric cancer patients has a better prognostic predictive value than the 6th edition.

Objective To analyze the clinical application value of the 7th edition UICC-AJCC TNM pT classification of gastric cancer.Methods The classification of tumor invasion depth of 874 cases of gastric cancer was determined using the 7th edition UICC-AJCC TNM classification and the relationships of prognosis with clinicopathological factors was compared with that obtained using the 6th edition TNM classification.Results The 5-year survival rates according to the 6th edition pT1 , pT2 , pT3 , pT4 were 98.4%, 55.8%, 26.0% and 24.5%, respectively, showing a significant difference among the four substages (P<0.001).The 5-year survival rates according to the 7th edition pT1a, pT1b, pT2, pT3, pT4a, and pT4b were 98.6%, 98.2%, 75.8%, 48.9%, 26.0% and 24.5%, respectively, and there were significant differences in survival time among the six substages (P<0.001).According to the 7th edition TNM classification, for the pT2 and pT3 patients groups, the 5-year survival rates of the 7th edition pN0 ( without lymphatic metastasis ) were 84.8% and 77.9%, respectively, showing no significant difference between the two survival rates (P=0.204).The 5-year survival rates according to the 7th edition pNx ( with lymphatic metastasis ) were 66.9% and 37.5%, respectively, and there was a significant difference between the two survival times (P<0.001).In multivariate analysis, the 7th edition pT stage, vascular or lymphatic invasion, the 6th edition pT staging and primary tumor site were independent prognostic factors in patients with gastric cancer (P<0.05), and the relationship of the staging of the 7th version of pT was more close with the prognosis of patients with gastric carcinoma than that of the 6th edition of pT staging system.Conclusion The 7th edition UICC-AJCC classification of pT staging of gastric cancer patients has a better prognostic predictive value than the 6th edition.

Objective To analyze the clinical application value of the 7th edition UICC-AJCC TNM pT classification of gastric cancer.Methods The classification of tumor invasion depth of 874 cases of gastric cancer was determined using the 7th edition UICC-AJCC TNM classification and the relationships of prognosis with clinicopathological factors was compared with that obtained using the 6th edition TNM classification.Results The 5-year survival rates according to the 6th edition pT1 , pT2 , pT3 , pT4 were 98.4%, 55.8%, 26.0% and 24.5%, respectively, showing a significant difference among the four substages (P<0.001).The 5-year survival rates according to the 7th edition pT1a, pT1b, pT2, pT3, pT4a, and pT4b were 98.6%, 98.2%, 75.8%, 48.9%, 26.0% and 24.5%, respectively, and there were significant differences in survival time among the six substages (P<0.001).According to the 7th edition TNM classification, for the pT2 and pT3 patients groups, the 5-year survival rates of the 7th edition pN0 ( without lymphatic metastasis ) were 84.8% and 77.9%, respectively, showing no significant difference between the two survival rates (P=0.204).The 5-year survival rates according to the 7th edition pNx ( with lymphatic metastasis ) were 66.9% and 37.5%, respectively, and there was a significant difference between the two survival times (P<0.001).In multivariate analysis, the 7th edition pT stage, vascular or lymphatic invasion, the 6th edition pT staging and primary tumor site were independent prognostic factors in patients with gastric cancer (P<0.05), and the relationship of the staging of the 7th version of pT was more close with the prognosis of patients with gastric carcinoma than that of the 6th edition of pT staging system.Conclusion The 7th edition UICC-AJCC classification of pT staging of gastric cancer patients has a better prognostic predictive value than the 6th edition.