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Prostate cancer is the most common male malignant tumor in the world, and its death toll is second only to lung cancer. Androgen deprivation therapy (ADT) is a major treatment for prostate cancer besides radical surgery. ADT treatment will lead to the inevitable progression of prostate cancer patients to castration-resistant prostate cancer (CRPC). The current research results have confirmed that the transformation from androgen deprivation prostate cancer (ADPC) to CRP is related to the reactivation of the androgen receptor signal pathway. In this review, the research progress on the mechanism of the androgen receptor signaling pathway in CRPC was reviewed in order to provide a scientific basis and new ideas for the diagnosis and treatment of CRP.
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Objective To investigate the diagnostic value of blue light imaging-bright (BLI-bright) and linked color imaging (LCI) for early esophageal cancer (EEC).Methods:Data of 63 consecutive patients with EEC who underwent gastroscopy under BLI-bright, LCI and white-light imaging (WLI) and endoscopic submucosal dissection (ESD) from May 2018 to August 2020 at Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine were analyzed retrospectively in the cohort study. Subjective visibility analysis was performed by 6 endoscopists who were divided into 2 groups (expert group and trainee group) with 3 endoscopists in each group. The main observation index was the visibility score (ranking score, RS). The objective color difference (Δ E) between lesions of EEC and surrounding mucosa under 3 modes were analyzed by using the L *a *b * color space. Results:The overall RS of 6 endoscopists under WLI mode (2.57±0.81) was significantly lower than that under LCI (3.25±0.67) ( t=9.71, P<0.001) and BLI-bright (3.18±0.67) ( t=9.31, P<0.001). In the expert group, the RS of WLI (2.71±0.80) was significantly lower than that of LCI (3.33±0.66) ( t=7.16, P<0.001) and BLI-bright (3.42±0.62) ( t=8.09, P<0.001). In the trainee group, the RS of WLI (2.40±0.90) was also significantly lower than that of LCI (3.15±0.83) ( t=9.62, P<0.001) and BLI-bright (2.89±0.92) ( t=5.69, P<0.001), and the RS of LCI was higher than that of BLI-bright ( t=4.07, P<0.001). The Δ E between lesions of EEC and surrounding mucosa under WLI (11.52±3.40) was significantly lower than that under LCI (16.64±4.70) ( t=7.10, P<0.001) and BLI-bright (15.72±3.84) ( t=7.88, P<0.001). Conclusion:BLI-bright and LCI can effectively improve EEC visibility and color difference between EEC and surrounding mucosa. Furthermore, LCI is more conducive to the detection of EEC for the trainees.
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Objective:To evaluate the clinical application of LASEREO endoscopic system in early gastric cancer (EGC).Methods:A total of 68 patients diagnosed with EGC were retrospectively analyzed between August 2017 to December 2020 in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine. There were 50 males and 18 females finally enrolled with a median age of 64 years. EGCs were analyzed from subjective and objective aspect, as well as from magnification and non-magnification status. Six endoscopists evaluated the visibility of the EGC (RSC) and calculated the color difference (ΔEC) between EGC and the surrounding mucosa in white light imaging (WLI), blue light imaging-bright (BLI-Bri) and linked color imaging (LCI) modes. In the case of magnification (×80), the visibility of the microstructures and microvessels (RSV) was analyzed and the color difference (ΔEV) between microvessels and non-vessels areas were calculated in WLI, BLI and LCI modes. The visibility was evaluated using visibility ranking scale(RS) and the color difference (ΔE) was calculated using L*a*b* color space.Results:In WLI, BLI-Bri, and LCI modes, the mean (±SD) RSC were 2.56±0.68, 2.63±0.59 and 3.17±0.50, and the mean(±SD) ΔEC were 15.71±5.58, 12.04±3.73, and 22.84±8.46, respectively, which in LCI were higher than those in WLI and BLI-Bri modes ( P<0.001).Regarding the data evaluated by senior endoscopists, the RSC was higher in BLI-Bri than that in WLI mode (2.98±0.58 vs. 2.79±0.73, P<0.001), but as to those evaluated by junior endoscopists, there were no significant differences between the WLI and BLI-Bri modes(2.29±0.72 vs. 2.23±0.72,P =0.218).In magnifying endoscopy with WLI, BLI, and LCI modes, the mean(±SD) RSV were 2.95±0.28, 3.46±0.40, and 3.38±0.33, and the mean (±SD) ΔEV were 21.68±7.52, 44.29±10.94, and 45.38±14.29, respectively.The RSV and ΔEV in LCI and BLI were higher than that in WLI mode ( P<0.001). Conclusions:LCI improves the visibility of EGC by increasing ΔEC, especially in junior endoscopists. Both BLI and LCI improve the visibility of microstructures and microvessels under magnification.
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Objective:To evaluate the efficacy of linked color imaging (LCI) for the colorectal polyp detection, especially detection of adenoma.Methods:A retrospective analysis was conducted on the patients who underwent LCI or white light imaging(WLI) mode of LASEREO colonoscopy from May 2018 to March 2019.The differences of the detection rates in the global polyps, adenomatous polyps, flat polyps, small polyps (≤5 mm) and right-sided polyps under two modes were compared. Color differences between the adenomatous polyps and surrounding mucosa (ΔE) were examined under two modes, based on L *a *b * color space by the Commission Internationale de L′Eclairage in 1976. Results:The global polyp detection rate, especially adenoma detection rate, in LCI group was higher than that in WLI group(45.53% VS 32.83%, P=0.038; 53.65% VS 39.62%, P=0.009). The color difference(ΔE) between adenomatous polyps and surrounding mucosa in LCI group was significantly higher than that in WLI group(27.24±8.67 VS 15.28±6.68, P<0.001). In addition, the detection rates of flat polyps, small polyps and right-sided polyps in LCI group were higher than those in WLI group (61.98% VS 47.17%, P=0.005; 60.94% VS 42.77%, P=0.001; 45.83% VS 32.70%, P=0.012). Conclusion:LCI can effectively improve the colorectal polyp detection rate, especially adenoma detection rate, which is worthy of clinical application.
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BACKGROUND:Extensive studies have shown that transcutaneous electrical nerve stimulation (TENS) plays a positive role in relieving the pain caused by a variety of diseases. However, its exact effect to manage pain in patients with knee osteoarthritis is stil controversial. TENS is classified into h-TENS and l-TENS, but currently its respective role in relieving the pain caused by knee osteoarthritis is not clear yet. OBJECTIVE: To compare the efficacy of h-TENS and l-TENS on pain relieving among patients with knee osteoarthritis. METHODS: A computer-based search was performed on PubMed, Embase and Cochrane database for randomized controled trials on TENS for the treatment of knee pain in patients with knee osteoarthritis which were reported before February 2014. Methodology quality of the trials was criticaly assessed and relative data were extracted. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 10 randomized controled trials involving 519 cases were included. The results of meta-analysis showed that the h-TENS group had significant effects on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.56, 95%CI(-0.98,-0.15),P=0.008]; the l-TENS group had no significant effect on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.13, 95%CI(-1.63, 1.38),P=0.87]; the h-TENS group had significant effect on pain relief in knee osteoarthritis patients in comparison to the l-TENS group [MD=-0.85, 95%CI(-1.32, -0.37), P=0.000 5]. These findings indicate that h-TENS performs something positive to reduce pain in knee osteoarthritis patients that l-TENS cannot do. Owing to the limitations of this study, further work is needed to determine the role of TENS in pain management among patients with knee osteoarthritis.
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BACKGROUND:Osteoarthritis and osteoporosis are two aging-related degenerative diseases. There are a lot of studies on their correlation, but no consensus has been reached yet. OBJECTIVE: To examine the cross-sectional association between phalangeal bone mineral density and radiographic knee osteoarthritis. METHODS:A total of 2 855 participants were included in this study. Phalangeal bone mineral density and anteroposterior films of the bilateral knees were detected. A multivariable logistic analysis model was applied to test the relationship between phalangeal bone mineral density and radiographic knee osteoarthritis after adjusting a number of potential confounding factors. RESULTS AND CONCLUSION:A positive association was observed between phalangeal bone mineral density and radiographic knee osteoarthritis in the model that was adjusted for sex, age, bone mass index, smoking status, alcohol drinking status, total energy intake, mean calcium intake, as wel as vitamin and Ca supplementation. This association existed in the total sample and the female subgroup, but not in the male. These findings suggest a positive relationship between phalangeal bone mineral density and radiographic knee osteoarthritis in the female subgroup, which means that bone mineral density is a protective factor to knee osteoarthritis.
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BACKGROUND:Reconstruction of the anterior cruciate ligament has become the gold-standard treatment for an anterior cruciate ligament rupture. Despite the popularity of the procedure, there remains a considerable amount of controversies over whether an autograft or anal ograft should be used for primary anterior cruciate ligament reconstruction. OBJECTIVE:To compare the clinical outcomes of al ograft and autograft in primary anterior cruciate ligament reconstruction. METHODS:Randomized control ed trials concerning autograft versus non-irradiated al ograft for anterior cruciate ligament reconstruction were identified from the PubMed/Medline database conducted up to July 12, 2014. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 6 randomized control ed trials consisting of 858 cases were included, 441 cases in autograft group and 417 cases in non-irradiated al ograft. The results of the meta-analysis indicate no significant difference between autografts and non-irradiated al ografts in overal IKDC [relative risk (RR)=1.02, 95%confidence interval (CI) (0.99 to 1.06), P=0.21], degree of laxity [mean difference (MD)=-0.13, 95%CI (-0.29 to-0.02), P=0.09], Lachman test [RR=1.04, 95%CI (0.95 to 1.13), P=0.37], pivot shift test [RR=1.00, 95%CI (0.95 to 1.05), P=0.96], one-leg hop test [RR=1.01, 95%CI (0.96 to 1.06), P=0.77], Lysholm score [MD=-0.64, 95%CI (-1.45 to 0.17), P=0.12], Tegner score [MD=0.16, 95%CI (-0.16 to 0.47), P=0.34] and rate of postoperative complications [RR=1.42, 95%CI (0.67 to 3.04), P=0.36]. Therefore, in the meta-analysis, there is no significant difference between autograft and non-irradiated al ograft in clinical outcomes. However due to the limitations of our study, further work is needed to determine this conclusion.
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BACKGROUND:Ultrasonic therapy is one of several physical therapy modalities suggested for the management of pain and loss of function due to osteoarthritis. However, its effectiveness stil remains controversial in the previous studies. OBJECTIVE:To analyze the effect of ultrasonic therapy for the treatment of relieving knee osteoarthritis pain. METHODS:A retrieval of Pubmed, Ovid/Medline, Ovid/EMBASE, and Cochranee database was performed. The relevant literatures were manual y retrieved. The retrieval deadline was set on March 31, 2014. Randomized control ed trials on ultrasonic therapy of knee osteoarthritis were col ected. RESULTS AND CONCLUSION:A total of eight studies of meta-analysis were accumulated. Among them, six studies adopted visual analog scale and Western Ontario and McMaster Universities Arthritis Index, one study adopted visual analog scale only, and one study adopted Western Ontario and McMaster Universities Arthritis Index. Then the Western Ontario and McMaster Universities Arthritis Index scores were transformed into visual analog scale scores for data analysis. There was a statistical difference between the groups in the visual analog scale pain score (standardized standard deviation:-0.51;95%confidence interval:-0.68,-0.33;P=0.05). Ultrasonic therapy is an effective method for knee osteoarthritis pain.
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BACKGROUND:Symptomatic treatment is the main management strategy for patients with knee osteoarthritis at early metaphase. Some previous studies have demonstrated that neuromuscular electrical stimulation can al eviate pain in knee osteoarthritis patients. To date, this effectiveness, however, stil remains controversial. OBJECTIVE:To assess the efficacy of neuromuscular electrical stimulation on pain in patients with knee osteoarthritis. METHODRandomized control ed trials concerning the efficacy of neuromuscular electrical stimulation in the treatment of knee osteoarthritis were identified from the Medline database conducted up to July 3, 2014. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 5 randomized control ed trials consisting of 239 participants were included. The results of the meta-analysis indicate neuromuscular electrical stimulation has no significant impact on measure of pain in knee osteoarthritis patients in comparison to the blank control group [mean difference=-0.40, 95%confidence interval (-1.34-0.54), P=0.40]. Owing to the sample limitations of our study, it is hard for us to draw a conclusion that the application of neuromuscular electrical stimulation in managing pain in patients with knee osteoarthritis is of little significance. Further work based on large-sample and high-quality randomized control ed trials is needed to determine the role of neuromuscular electrical stimulation in pain in this population.
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BACKGROUND:Dorsal and volar plate fixation for distal radius fracture is a common fixation in the clinic. It is controversial whether complications after fixation have difference. OBJECTIVE: To compare the difference in complications folowing dorsal and volar plate fixation for distal radius fracture. METHODS:A computer-based search was performed on PubMed database for articles on controled trials of comparison between complications folowing dorsal and volar plate fixation for distal radius fractures published before August 25, 2012. Data were analyzed using STATA 11.0 software. Simultaneously, meta-analysis was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION:A total of 12 studies (952 cases) of meta-analysis were accumulated. Sufficient evidence demonstrated that there was no statistic difference in the overal rate of complications after dorsal and volar plate fixation. However, compared with dorsal approach, neuropathy [relative risk (RR)=2.19, 95% confidence interval (CI) 1.27-3.76,P < 0.05] and carpal tunnel syndrome [RR=4.56, 95%CI(1.02-20.44),P < 0.05] easily occurred after volar fixation, but tendon irritation seldom appeared [RR=0.38, 95%CI (0.17-0.86), P < 0.05]. Results indicated that compared with volar plate fixation, a low incidence of neuropathy and carpal tunnel syndrome, but a high risk of tendon irritation were found after dorsal approach. No significant difference in other complications was detected between volar and dorsal approaches.
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Objective To investigate the effect of silent information regulator 1 (SIRT1)on cigarette smoke extract (CSE)-induced apoptosis of human alveolar epithelial cell (AECs).Methods The expression levels of SIRT1 protein were examined by Western Blotting in A549 cells that were treated with CSE at different concentrations.The impairment models of A549 cells induced by CSE were established.The concentration of CSE was 20.0％ and the treatment time of CSE was 24 hours.A549 cells were pretreated with 20 μmol/L resveratrol(Res)or 5 mmol/L nicotinamide (NAM) for 2 h before CSE treatment.The protein levels of SIRT1,Bax and Bcl2 were further explored by Western blotting.The proportion of apoptotic A549 cells was measured using MTT.Results The expression of SIRT1 was reduced after treatment with CSE in a dose-dependent manner(P＜0.05).Compared with the control group,the group of CSE treatment with 2.5％,5.0％,10.0％,20.0％and 40.0％ CSE for 24h showed that the expression of SIRT1 in A549 cells was decreased by 25.6％(P＜0.05),35.2％(P＜0.05),38.7％ (P＜0.05),57.9％ (P＜0.05)and 64.0％(all P＜0.05)separately; that A549 cell viability was decreased in a dose-dependent manner; and that A549 cell viability was decreased by 10.2％(t=2.035,P＜0.05),18.4％(t=4.269,P＜0.05),27.7％ (t=5.963,P＜0.05),59.0％(t=21.140,P＜0.05)and 88.1％(t=58.827,P＜0.05)separately.CSE plus 20 μmol/L Res pretreatment reversed the expression levels of SIRT1,Bax and Bcl2 in A549 cells (all P＜0.05)and reduced the apoptosis of A549 cells.The effects of CSE on inhibiting SIRT1 pathways were aggravated by NAM (an inhibitor of SIRT1) in the A549 cells (P＜ 0.05).Conclusions SIRT1 plays important role in regulating the apoptosis of human alveolar epithelial A549cell induced by CSE.SIRT1 may inhibit apoptosis by up-regulating Bcl2 expression and downregulating Bax expression,which has a protective effect on A549 cells apoptosis induced by CSE.
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BACKGROUND:Pain after arthroscopic treatment can not only affect the patient’s life quality, and is not conducive to the early reasonable exercise and functional recovery of the patients after treatment. Up to 2012, there are 18 randomized placebo-control ed trials on intra-articular injection of bupivacaine for analgesia after arthroscopic surgery, but the results are different. OBJECTIVE:To examine the efficacy and safety of intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery through randomized placebo-control ed trials. METHODS:The MEDLINE database, Cochrane Central Register and Google Scholar database were retrieved for the randomized control ed trials on intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery up to April 2012. The key words were“bupivacaine, intra-articular, arthroscopic, postoperative pain, placebo”. RESULTS AND CONCLUSION:Eighteen studies (n=934) were included (461 cases in bupivacaine group and 473 cases in the placebo control group). The Meta-analysis results showed the visual analog scale score of the bupivacaine group was lower than that of the placebo control group (weighted mean difference:-1.39, 95%confidence interval:-2.17 to-0.61, Pmean difference:157.72, 95%confidence interval:16.43 to 299.01, P<0.000 01). There was no significant difference in the incidence of side effect between two groups (relative risk:0.64, 95%confidence interval:0.29 to 1.44, P=0.48). On the basis of the currently available literature, the intra-articular of bupivacaine after arthroscopic surgery can significantly relieve pain without increasing the adverse reactions when compared with the placebo control group.
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Objective To investigate the effects of 5-Aza-CdR( methylation transferase inhibitor) on the expression levels of leptin gene in chondrocytes and methylation states of leptin promoter region between osteoarthritis (OA) group and control. Methods The chondrocytes in osteoarthritis group were treated with 5-Aza-CdR with different doses and time-points, and the expression level of leptin was detected by real-time polymerase chain reaction for picking up the optimum dose and time-point. Next, the chondrocytes in 5 osteoarthritis patients and 5 control patients (amputation due to severe trauma) were treated with 5-Aza-CdR. Lastly, leptin mRNA expression levels in the four groups osteoarthritis and control chondrocytes treated with/without 5-Aza-CdR were measured by real-time PCR and the methylation state of promoter region ( - 280- + 79) was detected by epityper quantitative DNA methylation analysis. Results ( 1 ) After treating the chondrocytes in OA groups with 10 μmol/L 5-Aza-CdR for 72 h, the mRNA expression levels of leptin were increased significantly. ( 2 ) The mRNA expression levels of leptin were significantly different among the four groups ( P ＜ 0. 05 ), and the chondrocytes in osteoarthritis groups treated with 5-Aza-CdR showed a marked induction of leptin mRNA expression. (3) Analysis of quantitative methylation data using an unsupervised hierarchical clustering algorithm, showed that methylation patterns of leptin promoter was different between control and osteoarthritis chondrocyte treated with/without 5-Aza-CdR. Conclusion Demethylation of leptin promoter might up-regulate leptin gene expression level and it might contribute to osteoarthritis.
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Objective To evaluate the clinical significance of antiplatelet antibody in patients with systemic lupus erythematosus complicated with thrombocytopenia.Methods Antiplatelet antibody (anti-GP Ⅱb/Ⅲa antibody, anti-GP Ⅰb/Ⅸ antibody, anti-GP Ⅰa/Ⅱ a antibody, anti-GP Ⅳ antibody) were detected by modified antigen capture ELISA. The positive rate of antiplatelet antibody between SLE complicated with thrombocytopenia group and without thrombocytopenia group before therapy were compared,and the positive rate of antiplatelet antibody before therapy and after therapy in SLE complicated with thrombocytopenia were compared,and the relevance between antiplatelet antibody and conditions in SLE complicated with thrombocytopenia were analyzed. Rank test and Chi square test were used for statistical analysis. Results The positive rate of anti-GP Ⅱb/Ⅲa antibody and anti-GP Ⅰb/Ⅸ antibody in SLE complicated with thrombocytopenia group before therapy was 50% and 67% respectively, however,the positive rate in SLE without thrombocytopenia group before therapy was 11% and 28% respectively,there was significant difference between the two groups (P＜0.05) and the positive rate of anti-GP Ⅱb/Ⅲa antibody and anti-GP Ⅰb/Ⅸ antibody in SLE complicated with thrombocytopenia group after therapy was 6% and 28% respectively, which was significantly lower than those before therapy (P＜0.05). In SLE complicated with thrombocytopenia group before therapy, there was significant relevance between anti-GP Ⅱb/Ⅲ a antibody and anti-GP[b/Ⅸ antibody, and there was significant relevance between these two antibodies and SLEDAI score,but no significant relevance between these two antibodies and ANA,dsDNA, ANCA. Neither anti-GPⅣ antibody nor anti-GP Ⅰ a/Ⅱ a antibody was detected in patients of this study. Conclusion The positive rate of antiplatelet antibody (anti-GP Ⅱb/Ⅲ a antibody, anti-GP Ⅰb/Ⅸ antibody) is significantly higher in patients with active systemic lupus erythematosus complicated with thrombocytopenia,and these two antibodies are significantly associated with clinical outcomes.