[Correlation analysis between prostate imaging report and data system score and pathological results of prostate cancer].

Objective: To explore the correlation between prostate imaging report and data system (PI-RADS) score and international society of uological pathology (ISUP) grade of prostate cancer (PCa) and the role of PI-RADS score in predicting the pathological features of clinically significant PCa (csPCa), positive surgical margin and pathological upgrade. Methods: The pathologically positive patients with multi-parameter magnetic resonance image (mpMRI) were included in this study. The patients with prostate specific antigen (PSA)<100 µg/L were divided into two groups: biopsy group (n=523) and RP group (n=215). The correlation between PI-RADS score and ISUP grade and the accuracy of predicting csPCa in the two groups were evaluated. In the RP group, the correlation between PI-RADS score and postoperative pathological grade or degradation and positive incisal margin was further discussed. The patients with PSA≥100 µg/L (171cases in biopsy group and 6 cases in RP group) were not included in the statistical analysis, and the results were simply described. Results: The age, prostate volume, and PSA level of biopsy group and RP group was (72±8) years vs (68±7) years, 48.3 (32-57) cm(3) vs 47.2 (32-54) cm(3), and 26.3(10.2-34.2)µg/L vs 21.7 (9.24-23.95)µg/L, respectively. The PI-RADS scores ≤ 3,4, and 5 in the biopsy group were 109,97, and 317 respectively, and those in the RP group were 61,55, and 99 respectively. There were significant differences in the composition of ISUP grades of different PI-RADS scores between the two groups (P<0.001), and there was a positive correlation between the two groups (r=0.493 in the biopsy group, r=0.671 in the RP group, both P<0.001). Using PI-RADS score to predict csPCa, biopsy group (AUC=0.764, P<0.001, 95%CI:0.710-0.819) and RP group (AUC=0.807, P<0.001, 95%CI:0.735-0.879) had certain accuracy. The PI-RADS score combined with PSA could improve the accuracy of csPCa prediction in the biopsy group (AUC=0.795,P<0.001, 95% CI:0.746-0.843) and the RP group (AUC=0.852, P<0.001, 95%CI:0.789-0.915). Compared with the pathological results of biopsy in the RP group, 52.6% of the patients showed upgrade and degrade of ISUP, and there was insignificant difference in the composition of PI-RADS scores between upgraded and degraded patients (P>0.05). However, 41.7%(27/65) of the patients with ISUP grade 1 biopsies had pathological upgrades that the patients with PI-RADS ≤ 3 accounted for 33.3%, while the patients with PI-RADS>3 accounted for 66.7%, and there was significant difference between the two groups (P<0.05). After RP, 43.3% of the patients had positive surgical margins, and the patients with PI-RADS score ≤ 3, 4 and 5 were 13 (14%), 24 (25.8%) and 56 (60.2%), respectively, while the PI-RADS scores of patients with negative surgical margin were 48 (39.3%), 31(25.4%) and 43(35.2%), respectively. There was significant difference between the two groups (P<0.001). The higher the PI-RADS score, the greater the possibility of the positive surgical margin. For the patients with PSA ≥ 100 µg/L, 98.8% (169/171) patients in the biopsy group had a PI-RADS score 5. The pathological results of all patients were csPCa, of which 85.4% (146/171) had ISUP grade ≥ 4. Among them, 6 cases underwent RP, 5 cases had ISUP grade ≥ 4, all surgical margin were positive, 5 cases had seminal vesicle invasion, 3 cases had capsule invasion and 3 cases had positive pelvic lymph nodes. Conclusion: ThePI-RADS score is correlated with the ISUP grade of PCa. Combined with PSA can accurately predict csPCa. At the same time, the higher PI-RADS score, the more likely the patients with positive incisal margin after RP and Gleason score of 3+3=6 at the time of puncture will be upgraded pathologically.

[Effect of multimodal analgesia using periprostatic nerve block anesthesia combined with flurbiprofen in transperineal template-guided prostate biopsy].

Objective: To evaluate the effect of multimodal analgesia using periprostatic nerve block anesthesia (PNB) combined with flurbiprofen in patients undergoing transperineal template-guided prostate biopsy (TTPB). Methods: Totally 166 patients (aged (68.2±9.1) years, range: 47 to 81 years) who received TTPB from October 2017 to June 2018 at Department of Urology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University were enrolled prospectively. All the patients were randomly divided into 2 groups. The observation group (n=79) was given flurbiprofen axetil 1 mg/kg intravenously for half an hour before operation and lidocaine was used for PNB before the biopsy. The control group (n=87) was given normal saline combined with PNB. A visual analog scale (VAS) and visual numeric scale (VNS) were used to assess the patients' pain and quantify their satisfaction at two time points: VAS-1 and VNS-1: during biopsy procedure, VAS-2 and VNS-2: 30 min after the procedure. The date were compared by t test, χ(2) test, Fisher exact test and two-way repeated measures anova analysis between the 2 groups. Results: The age, total prostate volume, serum prostate-specific antigen and the number of cores were comparable among the 2 groups (P>0.05). The VAS-1 scores of the control group and the observation group were 2.8±1.7, 1.9±1.2, respectively, and the VNS-1 were 3.1±0.7, 3.4±0.3, respectively. The VAS-1 were significantly lower in observation group than in control group (F=3.904, P=0.000). Conversely, the VNS-1 were higher in observation group (F=3.526, P=0.000). At 30-minute postoperative, the VAS-2 and VNS-2 were 0.7±0.4 and 3.7±0.2 in the control group, respectively. The VAS-2 and VNS-2 were 0.6±0.5 and 3.8±0.1 in the observation group, respectively. There were no significant differences in the pain scores or the satisfaction scores between the 2 groups (F=1.429, 2.825; P=0.136, 0.083). The incidence of overall complications was 26.4% (23/87) in the control group and 25.3% (20/79) in the observation group, with no statistical difference between the 2 groups (χ(2)=0.027, P=0.869). And the complications had no statistically significant difference among the 2 groups including hematuria, urinary retention, infection, hematospermia, vascular and neurological reactions, nausea, vomiting, dizziness, headache, and respiratory depression (P>0.05). Conclusion: The multimodal analgesia induced by PNB and flurbiprofen could effectively relieve the pain for patients who received TTPB.

[Effect of prostate volume on the peripheral nerve block anesthesia in prostate biopsy].

OBJECTIVE: To evaluate the anesthetic efficacy of periprostatic nerve block in transrectal ultrasound(TRUS) guided biopsy on different prostate volume. METHODS: A total of 568 patients received prostate biopsy in Department of Urology, Subei People's Hospital from May 2013 to September 2015 were retrospectively studied. All patients were divided into local anesthesia group and nerve block group according to different way of anesthesia. Then each group was divided into four subgroups(20-40 ml, >40-60 ml, >60-100 ml and >100 ml subgroups) according to different prostate volume range. After being anaesthetized successfully, patients in two groups underwent prostate biopsy, visual analogue scale(VAS) scores, visual numeric scale(VNS)scores and complications were recorded and analyzed. At inter-group and intra-group in local anesthesia group and nerve block group, Mann-Whitney U test of non-parametric analysis and single factor variance analysis were used to compare the VAS scores and the VNS scores respectively, and chi-square test was used to compare the rates of complication. RESULTS: The VAS scores of four subgroups: local anesthesia group: 1.9±0.9, 2.8±1.5, 3.8±2.3 and 5.3±2.5; nerve block group: 1.5±0.7, 2.0±0.8, 2.9±1.7 and 4.2±2.0. The VNS scores: local anesthesia group: 3.4±0.6, 2.9±0.6, 2.7±0.5 and 1.6±0.7; nerve block group: 3.7±0.5, 3.3±0.4, 3.0±0.8 and 2.0±0.7. The VAS scores and the VNS scores had significant differences (Z=-3.637-98.253, all P<0.05) at inter-group or intra-group level. For the complication rates of operation, hematuria, blood, urinary retention were significant differences (F=1.347-15.402, all P<0.05) at intra-group level. But there were no significant differences at inter-group level(P>0.05). CONCLUSION: Compared with local anesthesia, ultrasound guided prostate peripheral nerve block anesthesia has great analgesic effect and high safety, but for patients with a large prostate volumethe analgesic effect is inefficiency.

[Investigate the expression of miRNA-203 in papillary thyroid carcinomaand its effect on cell proliferation].

Objective:To investigate the expression of miRNA-203 in papillary thyroid carcinoma（PTC）tissues and its correlation with clinical pathological parameters，explore its effect on cell proliferation of WRO cell. Method:Thirty cases of PTC tissues, paired normal tissues were collected in our hospital during 2013-2016. The expression of miRNA-203 was determined by qRT-PCR，then the relationship of miRNA-203 expression, clinical pathological parameters were analyzed.WRO cells were transfected with miRNA-203 mimics, then cell proliferation, cell cycle and concerned cyclin protein(CyD1,CyB1) were tested by MTT, flow cytometry and western blot. Result:Compared to the paired normal tissues，tumor tissues showed sifnificantly lower expression of miRNA-203. Upregulaion of miRNA-203 in WRO cells effectively reduced cell growth, G2/M arrest. Mechanistically,in the miRNA-203-mimics-treated groups,cell-cycle-related proteins cyclin B1 was up-regulated, while cyclin D1 was down-regulated. Conclusion:miRNA-203 may play an anticarcinogenic effect in PTC. Upregulation of miRNA-203 is highly correlated with cell prolliferation, and maybe miRNA-203 is a potential targert for the treatment of thyroid carcinoma.

Dibenzo[b,h][1,4,7]thiadiazonines: examples of a novel ring system.

Acetanilides 1a-e react with 1,1'-sulfinylbis(benzotriazole)/trimethylchlorosilane at 45-65 degrees C to form 1,2-di(benzotriazol-1-yl)-2-arylimino-1-ethanethiones 3a-e, while heating the same reagents at 110 degrees C results in dibenzo[b,h][1,4,7]thiadiazonines 5a,c,d, and 6. X-ray crystal structures are reported for three representative examples.

[Preparation of novel chiral stationary phases for ligand exchange chromatography and their applications].

Two novel chiral stationary phases for ligand exchange chromatography were prepared by synthesizing 2-(2-hydroxyl-3-octoxy)propyl-(S)-1, 2, 3, 4-tetrahydro-3-isoquinolinecarboxylic acid (C8-(S)-THIQCA) and 2-(2-hydroxyl-3-dodecoxy)propyl-(S)-1, 2, 3, 4-tetrahydro-3-isoquinolinecarboxylic acid (C12-(S)-THIQCA) as chiral selectors, and coating them on ODS bonded stationary phase. Chromatographic resolutions of some DL-amino acids were achieved on the chiral stationary phases by using 1 mmol/L NH4Cl with 0.2 mmol/L Cu(Ac)2 solution as mobile phase and detection at 254 nm. Ability of chiral resolution of the DL-amino acids through the stationary phases was compared and the effect of cupric ion on resolutions of the DL-amino acids was examined. The elution order of D-isomer before L-isomer was observed for all the DL-amino acids resolved, except DL-Val. For DL-Pro, DL-Val and DL-Leu the elution order through the chiral phases was different from that through the chiral ligand exchange phases prepared from L-Pro or L-hydroxyl proline with five membered ring structure.

A case-control study of risk factors of nasopharyngeal carcinoma.

Risk factors and nasopharyngeal carcinoma (NPC) in residents of Guangzhou city were investigated in a case-control study: 104 cases were compared with an equal number of age, sex, and neighborhood-matched controls. The results of multiple conditional regression of logistic model showed that plum vegetable (adjusted OR = 1.81, 95% CI 1.01-3.33), preserved prune (adjusted OR = 2.95, 95% CI 1.04-8.41), no separate kitchen (if >35 years, adjusted OR = 1.98, 95% CI 1.24-3.75), kitchen range without chimney (if >10 years, adjusted OR = 2.72, 95% CI 1.56-4.73) and hereditary factor (adjusted OR = 8.27, 95% CI 1.94-35.54) were significantly associated with an increased risk of NPC. Grape (adjusted OR = 0.31, 95% CI 0.17-0.58) may be a protective factor.

Cancer of the nasopharynx in childhood.

Between 1964 and 1983, 54,304 cases of nasopharyngeal carcinoma (NPC) patients were diagnosed at the Tumor Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou, People's Republic of China. Of the total, 53 (0.1%) cases were younger than 14 years of age, and of these, none were Stage I, four (8%) were Stage II, 36 (68%) were Stage III, and 12 (23%) were Stage IV. Among all cases, 26% had initial symptoms characterized by lesions of the nasopharynx and the majority by cervical mass. Among the children, symptoms involving the cranial nerve were rarely observed. There were significant differences between adults and children on histopathology other than the ratio of carcinoma to sarcoma (4:1 for children; 443:1 for adults). Among the poorly differentiated carcinoma cases, vesicular nucleus carcinoma was observed more frequently in children than adults. The prognosis for children with NPC is poor with a 5-year survival rate of 21% in this series. If NPC is diagnosed early and radiotherapy begun promptly (with doses greater than 5000 cGy), the prognosis may be improved.

Occupational and other non-dietary risk factors for nasopharyngeal carcinoma in Guangzhou, China.

We conducted interviews on 306 histologically confirmed incident cases of nasopharyngeal carcinoma (NPC) occurring in residents of Guangzhou City, China, who were under the age of 50, and an equal number of age-, sex-, and neighborhood-matched controls. We also interviewed 110 mothers of patients under 45 and 139 mothers of controls who were matched to patients under age 45, to obtain information on childhood exposures of study subjects. Occupational exposure to products of combustion (RR = 2.4, p = 0.001) and cotton dust (RR = 0.3, P = 0.01) was independently related to risk of NPC. Use of tobacco products showed a moderate association with NPC; a lifetime exposure of 30+ pack-year equivalents conferred a 2-fold increased risk. A history of chronic ear or nose condition (rhinitis, sinusitis, nasal polyp, otitis media) was another risk factor for NPC (RR = 2.2, p less than 0.0005), and 18 cases compared to 3 controls had a first-degree relative with NPC (RR = 6.0, p = 0.001).

[Nasopharyngeal carcinoma in childhood].

From 1964 to 1983, 54304 cases of nasopharyngeal carcinoma (NPC) had been diagnosed in our hospital, of which 53 (0.10%) were under 14 years old. Among the 53 cases, 4 (7.55%) had Stage II, 36 (67.92%) Stage III, 12 (22.64%) Stage IV and 1 (1.89%) unstaged lesions, 26.42% had presenting symptoms related to nasopharyngeal lesion and 73.58% to cervical mass. Involvement of the cranial nerves was relatively rare. There was a significant difference between the adult and children patients on the ratio of carcinoma to sarcoma (4.08:1 for children, 443:1 for adult). Among the poorly differentiated carcinomas, vesicular nucleus carcinoma was more frequent in children than in adult. The prognosis of childhood NPC was poor with a 5-year survival rate of 20.75% in this series. Early diagnosis and treatment may improve the prognosis.

Diet and nasopharyngeal carcinoma: a case-control study in Guangzhou, China.

We conducted interviews on 306 histologically confirmed incident cases of nasopharyngeal carcinoma (NPC) occurring in residents of Guangzhou City, China, who were under the age of 50 years, and an equal number of age-, sex-, and neighborhood-matched controls. We also interviewed 110 mothers of patients under age 45 years and 139 mothers of controls who were matched to patients under age 45 years, to obtain information on childhood exposures of study subjects. Exposure to salted fish, whether in adulthood or in childhood, was significantly associated with an increased risk of NPC. The association was strongest for exposure during weaning, and exposures at all other periods were no longer related to NPC risk after adjustment for exposure during weaning. Besides salted fish, childhood exposure to 5 other preserved foods (fermented fish sauce, salted shrimp paste, moldy bean curd, and 2 kinds of preserved plum) was significantly related to NPC, and the effects were independent of salted fish exposure. Finally, cases ingested significantly less fresh vegetables and fruits than controls, especially during early childhood, and the differences were not explained by their differing consumption pattern of salted fish and other preserved foods.