[Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI].

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.

[A comparative study of the retroperitoneal cavity established by the modified Hasson in urology].

Objective: To examine the safety and complications of two methods of establishing retroperitoneal cavity in urology. Methods: Totally 83 patients undergoing retroperitoneal laparoscopic surgery in Department of Urology, Shanxi Bethune Hospital from January 2020 to June 2021 were analyzed retrospectively. There were 47 males and 36 females, aged (48.3±11.3) years (range: 35 to 71 years). Forty-three cases in Hasson group(the first Trocar channel was selected at the junction of the 12th rib and the posterior axillary line or lumbar triangle), 40 cases in modified Hasson group(the first Trocar channel is selected at 1.5 cm above the iliac crest on the mid-axillary line). The t test, χ² test, and Fisher exact test were used to compare the surgical safety indicators and complications of the two groups of patients. Results: There was no statistical difference between the two groups in gender, age, body mass index, waist length, and height (P>0.05). The comparison of safety indicators, included the time from skin incision to establishment of the retroperitoneal cavity and the amount of bleeding from the cavity were statistical difference between the two groups (P<0.05). Compared to that in Hasson group, the time from skin incision to establishment of the abdominal cavity in modified Hasson group was shorter ((8.56±2.64) minutes vs. (5.32±1.36) minutes, t=6.949, P<0.01), the blood loss of establishment was less ((15.32±6.09) ml vs. (9.85±3.55) ml, t=4.951, P<0.01). In terms of complication indicators, the incidence of Trocar hernia and the number of subcutaneous emphysema in modified Hasson group were lower than that in Hasson group (20.9% (9/43) vs. 2.5% (1/40), P=0.015, 18.6% (8/43) vs. 2.5% (1/40), P=0.030). Conclusions: The modified Hasson group is a safe method of establishing retroperitoneal cavity. The technique is simple and fast. It provides urologists with a more effective and easy-to-implement option with fewer complications.

In vitro neural differentiation of bone marrow stromal cells induced by hepatocyte growth factor and glial cell derived neurotrophic factor.

OBJECTIVE: Bone marrow stromal cells (BMSCs) have great potential for cell-based transplantation therapy in treating neurological disease. However, the best combination of various trophic factors to produce full neural differentiation of BMSCs was still unclear. In our study, we aimed to investigate the neural differentiation capacity of rat BMSCs induced by growth factors including hepatocyte growth factor (HGF) and glial cell-derived neurotrophic factor (GDNF). MATERIALS AND METHODS: Cell counting kit-8 (CCK-8) assay, BrdU cell proliferation assay and flow cytometry were implemented to evaluate whether GDNF and HGF had positive effects on the proliferation of BMSCs. Moreover, the expression of neural specific markers in BMSCs was identified using immunofluorescence and quantitative real-time polymerase chain reaction (RT-PCR) at various time points (1, 7, 14 and 21-day post-induction). RESULTS: CCK-8 and BrdU proliferation analyses demonstrated that only HGF treatment had positive effects on the proliferation of BMSCs on the day 14 and 21 after incubation. RT-PCR and immunofluorescence analyses showed that GDNF and HGF elevated the expression of nestin and NCAM, and the combined application of GDNF and HGF has the most significant effect on day 7 after induction. However, at the day of 14 and 21 post-induction, the expression level of nestin and NCAM in GDNF-treatment group was significantly higher than the other three groups. CONCLUSIONS: HGF, not GDNF plays a positive role in BMSCs proliferation, whereas GDNF and HGF are capable of promoting BMSCs to differentiate into neuron-like cells.