A clinical prediction model based on 68Ga-PSMA-11 PET/CT and mpMRI parameters to determine the diagnostic accuracy of targeted biopsy alone in prostate cancer population / 现代泌尿外科杂志

【Objective】 To develop a clinical prediction model based on 68Ga-prostate-specific membrane antigen-11 (68Ga-PSMA-11), positron emission tomography/computed tomography (PET/CT) and multiparametric magnetic resonance imaging (mpMRI) parameters to stratify prostate cancer patients undergoing targeted biopsy, so as to avoid unnecessary systematic biopsy. 【Methods】 A total of 96 clinically significant prostate cancer (csPCa) patients who underwent 68Ga-PSMA-11 PET/CT and mpMRI prior to prostate targeted biopsy with systematic biopsy during Jan.2020 and Feb.2023 in Nanjing Drum Tower Hospital were retrospectively analyzed.By univariate and multivariate logistic regression analyses, maximum standard uptake value (SUVmax) in 68Ga-PSMA-11 PET/CT and minimum apparent diffusion coefficien (ADCmin) in mpMRI, as well as clinical parameters were evaluated to identify the independent predictors correlative with the effective diagnosis of targeted biopsy, and a clinical prediction model was constructed. 【Results】 Multivariate logistic regression analysis showed that SUVmax (OR=0.878, 95%CI: 0.804-0.959, P=0.004) and ADCmin (OR=1.005, 95%CI:1.001-1.010, P=0.027) were independent predictors of the effective diagnosis of targeted biopsy alone.The sensitivity, specificity, accuracy and area under the receiver operator characteristic curve (AUC) of the model were 0.80, 0.80, 0.83 and 0.84, respectively. 【Conclusion】 The clinical prediction model based on 68Ga-PSMA-11 PET/CT and mpMRI parameters is helpful to improve the effective diagnosis of targeted biopsy alone, and has practical value to stratify patients with csPCa so as to safely avoid systematic biopsy and effectively balance the benefits and risks.

Meta-analysis of the efficacy of invisible orthodontic appliances for maxillary molar distalization in adult patients / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.@*Methods@#Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.@*Results@#This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05).@*Conclusion@#Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.

Apego Adulto y Soltería: Validación de una Escala / Adult Attachment and Singleness: Validation of a Scale

Resumen El apego es un vínculo afectivo que caracteriza y moldea las relaciones interpersonales cercanas. Los estilos de apego son el conjunto de conocimientos, expectativas e inseguridades que se sostienen sobre el sí mismo y los demás. El objetivo de la presente investigación fue elaborar una escala que evalúe el apego adulto no solo en el contexto romántico, sino con otros significativos, lo que permitirá el estudio de las personas sin pareja. Se realizaron tres estudios: en el estudio uno se realizó un análisis factorial exploratorio (n=400); en el estudio dos un análisis factorial confirmatorio (n=700). Se obtuvo una escala compuesta por 16 reactivos distribuidos en cuatro factores: preocupado, temeroso, evitante y seguro. La varianza explicada fue del 38.09%, con un índice de fiabilidad con un rango de 0.46 a 0.82 en los distintos factores. En el estudio tres se analizó la validez concurrente (n=201). En los tres estudios se encontraron diferencias entre las personas con pareja y sin pareja, puntuando más alto en seguridad las primeras y más alto en apego ansioso aquellas sin pareja. Se obtuvo una escala válida, confiable, culturalmente relevante que evalúa el apego adulto no solo en el ámbito romántico, sino con otros significativos.

Abstract The attachment is an affective bond that characterizes and shapes close interpersonal relationships. Attachment styles are the set of knowledge, expectations and insecurities about oneself and others. The aim of this research was to develop a scale with adequate psychometric properties, that allows to assess adult attachment not only in a romantic context, but with significant others in general. It will allow the study of groups such as single people. To address that aim, three studies were conducted in which men and women form Mexico City participated voluntarily. In study one an exploratory factor analysis was performed (n=400), in study two a confirmatory factor analysis was performed (n=700). As a result of these studies, it was obtained a scale compounded by 16 items distributed in four factors: preoccupied, fearful, dismissing, and secure. The explained variance was 38.09%, with a reliability index of 0.46 to 0.82 in the different factors. In study three concurrent validity was analyzed (n=201). Differences between people with a partner and single were found in the three studies, scoring higher in security the first and single people scoring higher in preoccupied attachment. It was obtained a valid, reliable, and culturally relevant scale to assess adult attachment not only in the romantic ambit, but also in relation to significant others like family and friends.

ACADEMIC PROCRASTINATION AMONG UNIVERSITY STUDENTS: A SIGNIFICANT ISSUE FOR CONSIDERATION

In our daily lives, we have to perform multiple tasks in different areas. This leads people to two paths: carrying out the task as soon as possible or postponing it; the latter being part of the tendency to delay the start or completion of a task. This act also known as procrastination. procrastination is the characteristic or behavioural propensity to put off or delay completing a task or making decisions. Procrastination behavior is very common and a serious problem in the era we live in. Academic procrastination appears to be common in academic environments as students frequently put off their obligations without good reason and submit their work right up until the deadline. All levels of kids are impacted, and it may lead to major problems including declining grades and decreased wellbeing. The notion of academic procrastination, reasons why it occurs, negative effects of academic procrastination and several methods for dealing with it are all discussed in this article. It is suggested that some programs should be devised and executed to teach task-oriented coping strategies to students. For this one should reflect on the reasons why you procrastinate, your habits and thoughts that lead to procrastinating

Correlation between different retinal layers with visual acuity in diabetic retinopathy patients with clinically significant macular edema

Purpose: To study the corelation between outer retinal layer thickness (ORL), outer photoreceptor segment thickness (PROS), and central macular thickness (CMT) with best?corrected visual acuity (BCVA) in patients having clinically significant macular edema (CSME) and compare these parameters with normal patients. Methods: This was a prospective, nonrandomized, observational, comparative study done during the period of January to May 2019. The study included 60 eyes of 36 patients. The patient population was segregated into two Groups: Group ? (30 normal eyes of 15 normal patients) and Group ?? (30 eyes of 21 diabetic patients) with CSME. The comparison between ORL, PROS, and CMT was made between both the groups, and the correlation between ORL thickness, PROS thickness, and CMT with BCVA in Group ?? was studied. Results: The mean age in Group I was 52.6+10.66 years, and 53.42+8.15 years in Group II. The male/ female ratio was 1.1:1 in Group I and 4:3 in Group II. The mean CMT was greater in Group ?? (330.13 ± 37.01) than in Group ? (222.20 ± 12.30). The mean ORL thickness was greater in Group ? (97.73 ± 6.92) than in Group ?? (80.63 ± 9.03). The PROS thickness was statistically significant in Group ? (35.05 ± 3.4) than in Group ?? (28.57 ± 3.53). There was a strong correlation between BCVA and ORL thickness (r = ?0.580, P < 0.001) and more strong correlation between BCVA and PROS thickness in Group ?? (r = ?0.611, P < 0.000). There was a moderate correlation between BCVA and CMT (r = 0.410, P < 0.025), and all results were statistically significant. Conclusion: Both ORL and PROS thickness were greater in healthy normal eyes than in eyes with CSME. BCVA was strongly correlated with PROS and ORL thickness and moderately associated with CMT.

Changes of intestinal wall barrier function and its correlation with susceptibility to infection in patients with cirrhotic portal hypertension / 中华肝脏病杂志

Objective: To investigate the changes of intestinal wall barrier function and its correlation with infection occurrence in patients with cirrhotic portal hypertension. Methods: 263 patients with cirrhotic portal hypertension were split into: the clinically evident portal hypertension (CEPH) combined with infection group (n = 74); CEPH group (n = 104); and Non-CEPH group (n = 85). Among them, 20 CEPH patients and 12 non-CEPH patients in non-infection status were subjected to sigmoidoscopy. Immunohistochemical staining was used to detect the expression of trigger receptor-1 (TREM-1), CD68, CD14, the inducible nitric oxide synthase molecule, and Escherichia coli (E.coli) in the medullary cells of the colon mucosa. An enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1), soluble leukocyte differentiation antigen-14 subtype (sCD14-ST) and intestinal wall permeability index enteric fatty acid binding protein (I-FABP). Fisher's exact probability method, one-way ANOVA, Kruskal-Wallis-H test, Bonferroni method, and Spearman correlation analysis were used for statistical analysis. Results: The serum sTREM-1 and I-FABP levels were higher in CEPH patients than those of non-CEPH patients in the non-infectious state (P < 0.05), but the difference in blood sCD14-ST levels was not statistically significant (P > 0.05). Serum levels of sTREM-1, sCD14-ST, and I-FABP in infected patients were higher than those in patients without a concurrent infection (P < 0.05). Serum sCD14-ST levels were positively correlated with serum sTREM-1, C-reactive protein (CRP), and procalcitonin (PCT), and sTREM-1 levels were also positively correlated with CRP and PCT (r > 0.5, P < 0.001). The rates of CD68, inducible nitric oxide synthase, CD14-positive cells, and E.coli-positive glands were higher in the intestinal mucosa of the CEPH group than those of the control group (P < 0.05). Spearman's correlation analysis showed that the rate of E.coli-positive glands in CEPH patients was positively correlated with the expression of molecular markers CD68 and CD14 in the lamina propria macrophages. Conclusion: Patients with cirrhotic portal hypertension have increased intestinal permeability and inflammatory cells, accompanied by bacterial translocation. Serum sCD14-ST and sTREM-1 can be used as indicators to predict and evaluate the occurrence of infection in patients with cirrhotic portal hypertension.

Risk factors and predictive effectiveness of PI-RADS after targeted combined system puncture for CsPCa patients with 3 points / 现代泌尿外科杂志

【Objective】 To investigate the risk factors and predictive effectiveness of prostate imaging reporting and data system (PI-RADS) score for patients with clinically significant prostate cancer (CsPCa) whose PI-RADS score was 3, so as to provide evidence for the diagnosis and treatment. 【Methods】 The clinical and multi-parameter magnetic resonance imaging (mpMRI) data of 153 CsPCa patients treated during Jan.2017 and Dec.2021 whose PI-RADS score was 3 were retrospectively analyzed. With PI-RADS score of 3 as the independent risk factor for CsPCa, the other relevant independent risk factors in predicting CsPCa were evaluated. 【Results】 Univariate and multivariate analyses showed that prostate-specific antigen (PSA) density and apparent dispersion coefficient (ADC) were independent risk factors for the diagnosis of CsPCa (P<0.05). Analysis of receiver operating characteristic (ROC) curve showed that combined PSA density and ADC were more effective than PSA density and ADC alone (P<0.05). 【Conclusion】 The combination of PSA density and ADC can guide clinicians to identify high-risk CsPCa patients from patients with PI-RADS score of 3 points.

Establishment of a machine learning model for the diagnosis of clinically significant prostate cancer based on transrectal contrast-enhanced ultrasound parameters and clinical data / 中华超声影像学杂志

Objective:To establish a machine learning model for the diagnosis of clinically significant prostate cancer based on transrectal contrast-enhanced ultrasound parameters and clinically relevant data.Methods:A retrospective analysis was performed on 151 patients in Chongqing University Cancer Hospital who underwent transrectal contrast-enhanced ultrasonography and transrectal ultrasound-guided needle biopsy from November 2018 to September 2021. The time intensity curve was drawn using VueBox software and 12 parameters such as rise time, peak time, average transit time, peak intensity, and rising slope were quantitatively analyzed. Age, total prostate-specific antigen, free prostate-specific antigen, free prostate-specific antigen ratio, volume, prostate-specific antigen density, and transrectal contrast-enhanced ultrasonography parameters, a total of 18 characteristic parameters, were analyzed and screened through relevant attribute values and information gain attribute values. The screening features were trained and tested by the machine learning single algorithm and integrated algorithm, and then the model was evaluated by the F1 value and the area under the ROC curve(AUC).Results:Using the related attribute value and the information gain attribute value, 12 variables and 5 variables were screened out respectively to establish a machine learning model. The model established by the ensemble algorithm was better than the single algorithm. For the two variable selection methods, the AUC (0.810 vs 0.789) and F1 values (0.748 vs 0.742) of the Bagging ensemble algorithm model, which basic algorithm was decision tree, were the highest, followed by Logistic regression and support vector machine(SVM) in order of AUC and F1 values.Conclusions:Based on transrectal contrast-enhanced ultrasound parameters and clinical data, the Bagging ensemble model based on decision tree has the best performance in diagnosing clinically significant prostate cancer.

Analysis of important abnormal physical examination results for employees of third class a children's specialized hospital / 现代医院

Objective To analyze the important abnormal results of physical examination of the staff in our hospital in recent 2 years,and to provide evidence for the health management of the staff in our hospital.Methods The physical examina-tion data of hospital staff in recent 2 years were retrospectively analyzed,and the important abnormal results were statistically ana-lyzed.Results A total of 3 584 employees participated in physical examination,including753 males and 2831 females.There were 92 cases with significant abnormal results,and the total detection rate was 2.57%.The detection rate of significant abnor-mal results was slightly lower in males(17cases,2.26%)than in females(75cases,2.65%),and the age of females[(48.89±19.53)years]was lower than that of males[(55.68±17.43)years].The age group with the most significant detec-tion rate of important abnormal results was 50-59 years old(3.07%),and the diseases detected by important abnormal results were as follows:There were 26 thyroid tumors,19 lung tumors,13 breast tumors,12 space occupying cases(3 liver,4 kidney,2 adrenal glands,1 adnexa,1 pancreas,1 mediastinum),9 vascular lesions,6 abnormal tumor markers,5 cervical lesions,1 tuberculosis,and 1 subdural hematoma.Among them,thyroid tumors,breast tumors,lung tumors and cervical lesions were the main cases in women,and vascular diseases,lung tumors,space-occupying lesions(liver and kidney)and thyroid tumors were the main cases in men.Conclusion Physical examination is of great significance in detecting important abnormal diseases.We should attach great importance to physical examination,detect serious diseases as early as possible,and strengthen health man-agement accordingly.

Oral acetaminophen or high-dose ibuprofen as rescue treatment for very preterm infants with patent ductus arteriosus / 中国新生儿科杂志

Objective:To study the efficacy and safety of oral acetaminophen or high-dose ibuprofen as rescue treatment after failure of conservative management in very preterm infants (VPIs) with haemodynamically significant patent ductus arteriosus (hsPDA).Methods:From May 2020 to November 2022, VPIs with hsPDA (gestational age<32 weeks and age 4~6 d) admitted to NICU of our hospital were prospectively enrolled. The rescue treatment was initiated if hsPDA still exist after 3~4 d of conservative management. The infants were randomly assigned into acetaminophen group (oral acetaminophen 15 mg/kg, once every 6 h for 3 d) and high-dose ibuprofen group (oral ibuprofen 20 mg/kg for the first dose, 10 mg/kg each dose after 24 h and 48 h). Before and after rescue treatment, the following were recorded: echocardiography, complete blood count, biochemistry, B-type natriuretic peptide (BNP), fecal occult blood test (FOBT) and transcranial Doppler ultrasound. Urine output and complications were also examined. SPSS 20.0 was used for statistical analysis.Results:A total of 36 cases were in the acetaminophen group and 37 in the high-dose ibuprofen group. The two groups showed similar efficacy as rescue treatment [80.6% (29/36) vs. 78.4% (29/37), P>0.05]. No significant differences existed in the incidences of upper gastrointestinal bleeding, positive FOBT, oliguria, stage Ⅱ-Ⅲ necrotizing enterocolitis and stage Ⅲ-Ⅳ intraventricular hemorrhage between the two groups ( P>0.05). After rescue treatment, the serum cystatin C in high-dose ibuprofen group was higher [(1.72±0.29) mg/L vs. (1.58±0.26) mg/L] and 24-hours urine output was lower [(3.1±1.0) ml/(kg·h) vs. (3.7±0.7) ml/(kg·h)] than the acetaminophen group (all P<0.05). No significant differences existed in serum creatinine, platelet count, BNP, alanine aminotransferase and total serum bilirubin between the two groups ( P>0.05). Conclusions:After failure of early conservative management in VPIs with hsPDA, when initiated within 7-10 d after birth, rescue treatment with oral acetaminophen or high-dose ibuprofen has a similar efficacy of 80%, and both drugs are safe. Oral high-dose ibuprofen may have a greater effect on renal function than acetaminophen.

Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI / 中华肿瘤杂志

Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.

Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI / 中华肿瘤杂志

Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.

Systematic biopsy combined with cognitive fusion targeted biopsy increases the detec-tion rate of clinically significant prostate cancer / 中国肿瘤临床

Objective:To investigate the ability of separate and combined biopsy methods to distinguish clinically significant prostate cancer(csPCa)from clinically insignificant prostate cancer(incsPCa),we assessed diagnostic positive rates for patients undergoing transperineal pro-state systematic biopsy(SB),cognitive fusion targeted biopsy(CF-TB),and combined biopsy(CB)(i.e.SB combined with CF-TB)under intra-venous anesthesia.Methods:We analyzed clinical data from 151 patients with prostate-specific antigen(PSA)≤50 ng/mL undergoing their first prostate biopsy in Cancer Hospital of Huanxing Chaoyang District Beijing and National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from January 2019 to November 2021.The 3.0 Tesla standard prostate multi-parametric magnetic resonance imaging(mpMRI)examinations found 161 lesions with prostate ima-ging reporting and data system(PI-RADS)scores≥3.With patients under intravenous anesthesia and indwelling catheter,2-4 needle CF-TB biopsies were performed using transperineal ultrasound guidance,followed by 12 needle SB.Patients who underwent SB,CF-TB,and CB were each analyzed by stratification for their respective csPCa and incsPCa detection rates,age,PSA,CF-TB needle count,PI-RADS score,and digital rectal examination results.Results:The median PSA value for all patients was 11.50(0.52-49.37 ng/mL).In total,161 lesions with PI-RADS score≥3 points were found.All 151 patients received 12 needles of SB,while 47,52,and 52 patients received 2,3,and 4 needles of CF-TB,respectively.The respective positivity rates of SB,CF-TB and CB in diagnosing csPCa were 54.3%(82/151),53.0%(80/151)and 58.9%(89/151).Statistical results indicate that the difference in positivity rate between CB and SB is significant(P=0.016)as is the difference between CB and CF-TB positivity rates(P=0.004).The respective positivity rates of SB,CF-TB,and CB in diagnosing incsPCa were 7.9%(12/151)、9.3%(14/151),and 11.3%(17/151).The positivity rate of CB was not significantly different than that of SB or CF-TB(all P>0.05).Stratification plane analysis with age,PSA value,number of CF-TB needles,PI-RADS score,and digital rectal examination results showed that the 2-needle CF-TB scheme was inferior to CB in diagnosing csPCa(P=0.031).There was no significant difference in the csPCa positivity rates of 3-needle and 4-needle CF-TB relative to CB.Conclusions:CB achieves a higher csPCa diagnosis rate without increasing de-tection of incsPCa under transperineal ultrasound guidance.CF-TB with 3-needles per lesion was highly effective in diagnosing csPCa.

Diagnostic efficacy of prostate imaging reporting and data system version 2.1 based on multiparametric MRI in detection of clinically significant prostate cancer / 中华放射学杂志

Objective:To evaluate the diagnostic performance of the prostate imaging reporting and data system version 2.1 (PI-RADS v2.1) based on multiparametric MRI (mpMRI) in the detection of clinically significant prostate cancer (csPCa).Methods:A total of 561 patients who underwent prostate mpMRI in the First Affiliated Hospital of Guangxi Medical University from June 2015 to December 2020 due to elevated prostate specific antigen were collected ambispectively. The patients were divided into csPCa group (276 cases) and non-csPCa group (285 cases) according to pathological findings. Prostate were scored according to the PI-RADS v2.1 scoring standard by a junior and a senior radiologist. The prostate volume was measured and the prostate specific antigen density (PSAD) was calculated. The diffusion-weighted imaging and dynamic contrast-enhanced MRI images were processed to measure the quantitative parameters of the index lesion, including apparent diffusion coefficient (ADC), volume transfer constant (K trans) and rate constant (K ep) values. The Mann-Whitney U test was used to compare the difference in parameters between the two groups. The predictors of csPCa were screened by logistic regression analysis. Predictive model of multi-parameter was established. The receiver operator characteristic curves were used to evaluate the efficacy of PI-RADS v2.1 and the model in diagnosing csPCa, and the comparisons of area under the curve (AUC) were conducted by DeLong test. Results:Compared with non-csPCa group, the patients in csPCa group had higher PI-RADS score of senior physician, PSAD, K trans and K ep value, lower ADC value ( Z=-16.69, -12.49, -3.43, -4.67, 13.91, all P<0.001). The PI-RADS scores of senior physician (OR=3.064, 95%CI 2.428-3.866, P<0.001), PSAD (OR=1.554, 95%CI 1.170-2.064, P=0.002) and ADC value (OR=0.095, 95%CI 0.032-0.288, P<0.001) were the predictors of csPCa. The AUC of junior, senior physician PI-RADS and combined prediction model were 0.861 (95%CI 0.830-0.892), 0.895 (95%CI 0.868-0.922) and 0.923 (95%CI 0.898-0.944). The pairwise difference was statistically significant (the PI-RADS score between the junior and senior physicians Z=3.24, P=0.001, the difference between the PI-RADS score of junior physician and prediction model Z=5.54, P<0.001, the difference between the PI-RADS score of senior physician and prediction model Z=4.20, P<0.001). Conclusion:Based on mpMRI, the application of PI-RADS v2.1 by junior and senior radiologists has the high diagnostic efficacy for csPCa, and the multi-parameter model has the best diagnostic efficacy for csPCa.

O Um e a função do sexo segundo a psicanálise / El Uno y la función del sexo según el psicoanálisis / The One and the function of sex according to psychoanalysis

RESUMO Segundo a ambiguidade constitutiva do Um que Lacan promove a partir da lógica e da matemática nos seminários O saber do psicanalista e ... ou pior, entre 1971 e 1972, o artigo busca fundamentar a teoria da sexuação desenvolvida nesse período e esclarecer que tal conceituação retoma a subversão freudiana do polimorfismo pulsional. Se a pulsão não tem qualquer determinação instintual quanto a seu objeto, constata-se que esse mesmo equívoco se deslinda como impossibilidade de proporção e relação sexual [rapport sexuel] para o ser falante, que se posiciona gramaticalmente na estrutura da linguagem a partir desse impasse. Nesse sentido, a bifididade do Um, entre conjunto e elemento, mesmidade e diferença, particularidade e universalidade, ex-sistência e relatividade, real e simbólico, reescreve a diferença (sexual) conforme a psicanálise. O sexo, portanto, é a própria ausência de qualquer referência que não seja a opacidade de princípio do significante, é a evasão fundamental do ser à verdade.

RESUMEN Basado en la ambigüedad constitutiva del Uno que Lacan promueve desde la lógica y de la matemática en los seminarios O saber do psicanalista e ...ou pior, entre 1971 y 1972, el artículo busca apoyar la teoría de la sexuación desarrollada en ese período y aclarar que tal conceptualización reanuda la subversión freudiana del polimorfismo de la pulsión. Si la pulsión no tiene ninguna determinación instintiva en cuanto a su objeto, parece que este mismo malentendido se revela como la imposibilidad de la proporción y la relación sexual [rapport sexuel] para el ser hablante, que se posiciona gramaticalmente en la estructura del lenguaje desde esta cuestión. Así, la bifidez del Uno, entre conjunto y elemento, igualdad y diferencia, particularidad y universalidad, ex-sistencia y relatividad, real y simbólico, reescribe la diferencia (sexual) según el psicoanálisis. El sexo, por lo tanto, es la ausencia misma de cualquier referencia que no sea la opacidad de principio del significante, es la evasión fundamental del ser de la verdad.

ABSTRACT Based on the constitutive ambiguity of the One that Lacan promotes from logic and mathematics in the seminaries O saber do psicanalista e ...ou pior, between 1971 and 1972, the article seeks to support the theory of sexuation developed in that period and clarify that such conceptualization resumes the Freudian subversion of the drive polymorphism. If the drive does not have any instinctual determination as to its object, it appears that this same misunderstanding is revealed as the impossibility of proportion and sexual relationship [rapport sexuel] for the speaking being, who grammatically positions themselves in the structure of language from this impasse. Thus, the bifidity of the One, between set and element, sameness and difference, particularity and universality, ex-sistence and relativity, real and symbolic, rewrites the (sexual) difference according to psychoanalysis. Sex, therefore, is the very absence of any reference other than the constitutive opacity of the signifier, it is the fundamental evasion of the being from the truth.

Ausencia de diferencias relacionadas con el sexo en los valores de los cambios mínimos significativos para composición corporal por DXA en sujetos adultos / Absence of sex-related differences in the values of minimum significant changes for body composition by DXA in adult subjects

Para la evaluación longitudinal de la composición corporal por DXA se deben calcular los cambios mínimos significativos (CMS). No está claro si hay diferencias de género para los CMS de adultos. Con consentimiento informado se realizaron 2 escaneos DXA de cuerpo completo consecutivos, con reposicionamiento entre ellos, en 40 varones y 40 mujeres (rango de edad de 22 a 85 años), con un equipo GE Lunar Prodigy Advance®, siguiendo las pautas de la International Society for Clinical Densitometry (ISCD). Todos los escaneos fueron obtenidos por la misma técnica experta. Los CMS se calcularon de acuerdo con el método propuesto por la ISCD. Los resultados se analizaron con GraphPad® para Windows 6.0, con una significancia fijada en p < 0,05. No hubo diferencias de género para la edad (p = 0,846) o el índice de masa corporal (p = 0,802). La altura, la masa corporal, la masa magra y el contenido mineral óseo (CMO) fueron mayores en los varones (todos p < 0,0001), mientras que la masa grasa fue mayor en las mujeres (p = 0,0036). No hubo diferencias significativas entre géneros para los coeficientes de variación de masa grasa (p = 0,0698), masa magra (p = 0,1483) o CMO (p = 0,5254). Los CMS (para IC de 95%) para la masa grasa fueron 1,780 kg (varones), 1,671 kg (mujeres) y 1,727 kg (ambos sexos); para masa magra, 1,658 kg (varones), 1,644 kg (mujeres) y 1,651 (ambos sexos); y para CMO, 112,2 g (varones), 109,4 (mujeres) y 110,8 g (ambos sexos). Los resultados sugieren que los CMS para la composición corporal de su-jetos adultos pueden calcularse a partir de una muestra de cualquier género o una que incluya sujetos de ambos sexos. (AU)

Lack of gender-related differences in least significant changes for DXA body composition analysis in adult subjectsFor longitudinal assessment of body composition by DXA, least significant changes (LSCs) should be calculated. It is unclear if there are gender differences for adult LSCs. With informed consent, 2 consecutive total-body DXA scans, with repositioning between them, were performed on 40 males and 40 females (age range 22 to 85 years) with a GE Lunar Prodigy Advance scanner, following the guidelines of the International Society for Clinical Densitometry (ISCD). All scans were obtained by the same skilled technologist. The LSCs were calculated according to the method proposed by the ISCD. Results were analyzed with GraphPad for Windows 6.0, with significance set at p < 0.05. There were no gender differences for age (p = 0.846) or body mass index (p = 0.802). Height, body mass, lean mass, and bone mineral content (BMC) were higher in males (all p < 0.0001), whereas fat mass was higher in females (p = 0.0036). There was no significant difference between genders for the coefficients of variation of fat mass (p = 0.0698), lean mass (p = 0.1483), or BMC (p = 0.5254). The LSCs (for a 95% CI) for fat mass were 1.780 kg (men), 1.671 kg (women), and 1.727 kg (both genders); for lean mass, 1.658 kg (men), 1.644 kg (women) and 1,651 (both genders); and for BMC, 112.2 g (men), 109.4 (women), and 110.8 g (both genders). These results suggest that LSCs for body composition of adult subjects can be calculated from either a sample of each gender or one that includes subjects of both genders. (AU)

Quality of life among geriatric population: A cross-sectional study to assess the quality of life among geriatric population covered under urban health training center of a tertiary care hospital in Kancheepuram, Tamilnadu

Introduction: To assess the quality of life among geriatric population covered under urban health training center of a tertiary care hospital in Kancheepuram and to find out if there are any associated factors affecting them. Methods: This cross-sectional study was conducted at Saveetha Medical College, Chennai, India. It comprised geriatric population of males and females aged above 60 and 58 respectively. A pre tested semi structured questionnaire was used for collecting socio demographic data, whereas a WHO standard questionnaire was used to assess the QOL. Analysis was done using SPSS software. Objectives: To assess the quality of life among the geriatric age group and to assess the factors affecting the quality of life among the geriatric population. Results: Out of the 228 geriatrics interviewed, females (68.66) were found to have a better QOL when compared to males (67.85). The p values obtained from the chi square tests were found to be significant for age (0.056), marital status (0.004), family type (0.002), co morbid factors (0.001), alcoholics (0.00). Conclusion: From the study we could infer that co morbidity, marital status, type of family have a significant association with QOL.

Perception and social attitude towards child adoption among doctors of a Medical College in Kancheepuram

Background: To assess the perception and social attitude among doctors towards child adoption and to find out if there are any associated factors affecting them. Methods: A cross sectional study was undertaken of sample of 258 volunteers .It comprised of doctors who volunteered for the research. A pre tested semi structured questionnaire was used for collecting socio demographic data and questions pertaining to attitude and perception toward child adoption. Analysis was done using SPSS software. Results: Out of the 258 volunteers interviewed, there was a positive association between age and perception and attitude toward child adoption (Chi square value -0.00). Sex and marital status were also analysed but no association was found (Chi square is 0.108 for sex and 0.916 for marital status). Conclusion: From the study we could infer that age has a significant association with perception and attitude toward child adoption among doctors

Secure Exchange of Medical Images Via Extended Visual Cryptography / Intercambio Seguro de Imágenes Médicas Mediante Criptografía Visual Extendida

ABSTRACT Medical image security is acquiring its importance to preserve the integrity and confidentiality of information (medical data) from malicious users given its importance in timely and successful diagnosis. In this context, several techniques have been developed to protect medical images, such as encryption, data hiding, image tagging, application of Hash algorithms, etc. This paper proposes a technique to cipher medical images by adding the metadata inside a cover image, based on extended visual cryptography as well as the inclusion of a Hash-like function to verify the integrity of the image and the metadata once they are recovered. The method proposed in this work is implemented using medical images with a grayscale resolution of [0,4095] that is a depth of 12 bits/pixel and color images with 24 bits/pixel depth. Experimental results prove the effectiveness of the proposed method in the task of secure exchange of medical images by allowing higher hiding capability, lower distortion in the visual quality of the image with the hidden medical data, as well as a means to verify the integrity of the sent data, compared to state-of-the-art.

RESUMEN La seguridad de imágenes médicas está incrementando su importancia para preservar la integridad y la confidencialidad de la información (datos médicos), frente a usuarios malintencionados dada su importancia en el diagnóstico oportuno y acertado. En este contexto, se han desarrollado varias técnicas para proteger las imágenes médicas, como el cifrado, la ocultación de datos, el etiquetado de imágenes, la aplicación de algoritmos Hash, etc. Este trabajo propone una técnica para cifrar imágenes médicas añadiendo los metadatos dentro de una imagen de cubierta, basada en la criptografía visual extendida, así como la inclusión de una función tipo Hash para comprobar la integridad de la imagen y los metadatos una vez estos sean recuperados. El método propuesto en este trabajo se implementa utilizando imágenes médicas con una resolución en escala de grises de [0,4095] es decir una profundidad de 12 bits/ píxel e imágenes en color con 24 bits/píxel de profundidad. Los resultados experimentales demuestran la eficacia del método propuesto en la tarea de transmisión segura de imágenes médicas permitiendo una mayor capacidad de ocultamiento, una menor distorsión en la calidad visual de la imagen con los datos médicos ocultos, así como un medio para comprobar la integridad de los datos enviados, en comparación con los artículos publicados.

Assessing Knowledge and Behaviour Towards HIV/AIDS among the school students: A cross sectional study

Background: Inadequate knowledge of advance, absence of exact health data, and the prohibitions associated with sex education at homes and schools, indulgence in risky behavior and a lack of access to adequate reproductive health services further lends the adolescents susceptible to AIDS. Aim & Objectives: In the present study, the knowledge and behavior towards HIV/AIDS among students in selected school have been assessed. Material & Methods: Primary data has been taken from selected school with the help of structured questionnaire tools; school is located at Bhaipur Brahman village in Jewar block of Gautam Budh Nagar district, India. Univariate and Bivariate tables as well as chi-square test have been applied to know the association between demographic variables of students and their response. Results: It was found that more than 65 % students were aware about HIV/AIDS. About 31% of students were reported that it cannot be transmit through sharing syringes where equal responses have been observed by male and female students. Conclusions: It was observed that they had inadequate knowledge towards HIV/AIDS especially among age group10-13 years. Most of them have good attitude towards HIV/AIDS infected person.