前列腺癌是男性常见的恶性肿瘤之一,具有较高的发病率和致死率.前列腺特异性抗原(PSA)在前列腺癌筛查中意义重大.随着前列腺癌诊疗研究的深入,各类生物标志物不断被发现,在前列腺癌诊疗全过程发挥着重要作用.使用血液或尿液样本的前列腺健康指数(PHI)、4K评分、PCA3、精选MDx、外泌体智能积分等指标可以有效辅助前列腺的筛查和诊断.血液循环肿瘤细胞(CTC)、循环肿瘤DNA(ctDNA)可用于前列腺癌的风险分层和治疗药物选择、治疗反应监测,以及临床试验替代终点.使用前列腺癌组织样本的基因组前列腺积分、Prolaris积分等可用于前列腺癌的风险分层.文章就基于血液、尿液和其他类型样本的各类前列腺癌生物标志物的临床应用进行综述.

Background: The kidney is an important organ for maintaining homeostasis. Kidney-specific senescence plays an important role in aging; however, the mechanism underlying this process is still unclear. We conducted an analysis of renal function impairment in a group of healthy volunteers with a wide range of ages. The aims of this study were to investigate the age profile of kidney-specific aging, the characteristics of symbiotic microorganisms in urine and the aging mechanism related to these microorganisms.Methods: A total of 3342 adults aged 20–104 years were included in the study. Serum creatinine, urea nitrogen and glomerular filtration rate were evaluated by blood biochemical analysis to determine the typical age range of abrupt renal function change. Sequencing of the 16S rDNA of urinary microbiota was performed on members of the cohort in the age range of transition to declining renal function, and comparative analysis was performed.Findings: A decline in renal functional beginning at 50–65 years of age was evident. Urinary microbiota 16S rDNA sequencing was performed on 74 subjects from a distribution based on quartiles of renal function. Analysis of the sequencing results revealed significant differences between the flora in males and females, and significant changes in urinary flora with renal aging. Correlation analysis combined with clinical indicators revealed that the dominant microbiota in female subjects in the quartile of poorest renal function was closely associated with altered electrolyte metabolism, inflammatory activation and positive balance of energy metabolism during renal aging. In particular, our analysis suggests that Streptococcus plays an important role.Interpretation: The age at which early impairment of renal function occurs was confirmed and a multidimensional analysis revealed that changes in urinary commensal bacteria, especially Streptococcus, are closely associated with renal aging. This work provides a better understanding of the importance of microbiological studies in chronic kidney disease and reveals potential indicators for early detection of chronic kidney disease.Funding Information: This work is supported by the National Key Research and Development Project of China (2018YFC2000500/03) and Natural Science Foundation of Shanghai (21ZR1409200). Dr. C Zhao is supported by outstanding talent from Fudan University (2015).Declaration of Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethics Approval Statement: All participants agreed to take part in this study and signed an informed consent form. This study was approved by the ethics committee of Shanghai Medical College of Fudan University (ethics committee approval letter No. 2020-C017).

目的 研究社区居家养老老年人抑郁状况及其与认知障碍的关系.方法 本研究于2020年4月9日-6月15日间,选取842例上海某社区健康体检老年人为研究对象,用老年抑郁量表(GDS)评估其抑郁状态,用简易智力状态检查量表(MMSE)评估其认知功能.结果 分析发现,抑郁组的MMSE得分下降(P=0.005),表明抑郁与认知功能障碍之间存在相关性.进一步分析MMSE量表中各个分项的情况,发现对认知功能影响较大的三个方项分别是延迟回忆、视空间知觉和书写能力,抑郁组和正常组在MMSE量表中上述三个方面的得分差异率分别为30％、21％和16％.结论 在社区居家养老老年人健康体检中常规设置心理健康量表检查,有利于早期发现认知功能障碍患者,可为必要的早期健康教育和指导提供依据.

目的 探讨远程康复会诊系统对脑卒中患者肢体功能及生活能力恢复的影响.方法 选取符合入组条件的脑卒中病例120例,分为A组和B组各60例,A组通过远程康复会诊系统,在6个社区卫生中心进行规范化指导和康复治疗;B组在远程康复会诊中心的中心医院进行康复治疗.治疗疗程均为8周,在治疗前、后对患者进行Fugl-meyer运动功能评分和ADL评分;分析评估治疗的结果,评估远程康复会诊系统在实际应用过程中的作用.结果 治疗前、后两组内进行比较,Fugl-meyer运动功能评分和ADL评分比较差异均有统计学意义(P＜0.05).治疗后两组间比较:Fugl-meyer运动功能评分和ADL评分差异均无统计学意义(P＞0.05).结论 远程康复会诊系统对脑卒中患者肢体功能及日常生活能力能恢复起到良好的康复指导效果,能起到节约医疗资源,方便患者,促进社区康复网络化建设的良好效果.