Objective:To investigate the risk factors of urethrovesical anastomotic leakage after laparoscopic radical prostatectomy.Methods:The clinical data of 292 patients who underwent laparoscopic radical prostatectomy in the Tenth People's Hospital Affiliated to Tongji University from January to December 2021 were retrospectively analyzed. According to whether there was anastomotic leakage, the patients were divided into leakage group (27 cases) and non-leakage group (265 cases). There were no significant differences in age [(71.5±6.5) years vs. (70.2±6.4) years], body mass index [(24.5±3.6) kg/m 2 vs. (24.2±3.0) kg/m 2], prostate volume[40(27.3, 63.2)ml vs. 38(28.1, 56.2)ml], Gleason score, clinical stage, and risk classification between the leakage group and the non-leakage group ( P>0.05), but the total prostate-specific antigen in the leakage group was significantly higher than that in the non-leakage group[20.0 (9.6, 79.0) ng/ml vs. 13.7 (8.5, 25.0) ng/ml, P=0.049]. Propensity score matching (PSM) was used to match the above indicators between the leakage group and the non-leakage group as 1∶1, so that the baseline of the two groups was balanced. The perioperative indicators of the matched two groups of patients were compared and analyzed. Statistically significant indicators were selected and included in univariate and multivariate logistic regression to analyze the risk factors of anastomotic leakage after radical prostatectomy. Finally, the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated. The accuracy of each factor in predicting urine leakage was obtained. Results:After PSM, 24 cases were successfully matched. The leakage group had shorter membranous urethral length (MUL) [(15.5±2.2)mm vs. (17.5±1.5)mm, P<0.001], thinner membranous urethral wall thickness (UWT) [(9.5±1.9)mm vs. (10.6±1.5)mm, P=0.024], longer anastomotic time of urethrovesical neck[(21.6±4.1)min vs. (16.9±2.9)min, P<0.001] and higher failure rate of water injection test [16.7% (4/24) vs. 4.2% (1/24), P=0.045] than the non-leakage group. There was no significant difference in other indicators between the two groups. The results of multivariate logistic regression analysis showed that short MUL ( OR=0.544, 95% CI 0.335-0.884, P=0.014), narrow UWT ( OR=0.538, 95% CI 0.313-0.924, P=0.025) and long anastomotic time of urethrovesical neck ( OR=1.519, 95% CI 1.122-2.110, P=0.009) were independent risk factors for anastomotic urine leakage. ROC curve analysis showed that the AUC of MUL, UWT, and anastomotic time were 0.789 (95% CI 0.651-0.927), 0.715 (95% CI 0.562-0.868), and 0.842 (95% CI 0.731-0.953), respectively. Conclusions:Narrow and short membranous urethra and long anastomosis time in patients with laparoscopic radical prostatectomy may be independent risk factors for postoperative anastomotic leakage, which may predict the occurrence of anastomotic leakage.

目的 了解前列腺癌患者经济负担(financial toxicity,FT)现状及影响因素,为降低前列腺癌患者FT水平提供依据.方法 采用便利抽样法,选取2020年1月—2021年8月入住上海市某三级甲等医院的281例前列腺癌患者为调查对象,采用一般资料调查表、癌症患者报告结局的经济毒性量表、医学应对方式问卷和一般自我效能感量表进行横断面调查.采用多元线性回归分析FT的影响因素.结果 前列腺癌患者的经济负担得分为22.0(17.0,24.0)分.多元线性回归分析显示,疾病诊断是否影响其退休年龄、家庭人均月收入(元)、最近3个月以来治疗费用、医学应对方式屈服维度得分及自我效能感水平是影响其FT的主要因素(P<0.001),解释总变异的45.6％.结论 前列腺癌患者FT处于中下水平,临床医务人员可通过实施有效的干预措施帮助其重返工作,评估患者经济状况选择个体化的治疗方案,鼓励其寻求更多的社会支持,引导其采取积极的应对方式和提升其自我效能水平以降低FT水平,提升其生活质量.

目的 探讨前列腺癌患者经济毒性在自我效能与生活质量间的中介效应.方法 采取便利抽样法,选择2021年1-9月上海市某三级甲等医院诊治的404例前列腺癌患者,采用一般资料调查表、一般自我效能感量表、患者报告结局的经济毒性综合评分量表和癌症患者生存质量量表对其进行问卷调查.结果 前列腺癌患者生活质量总分为95.0(80.0,107.0)分;自我效能、经济毒性与生活质量呈正相关(r=0.543,0.641,均P<0.01);经济毒性在自我效能与生活质量间起到部分中介作用,占总效应的69.1％.结论 自我效能可通过经济毒性影响前列腺癌患者的生活质量,临床护理人员在重视提高患者自我效能的同时应重视患者的经济毒性状况,采取针对性的干预措施,提高其生活质量.

雄激素剥夺治疗(androgen-deprivation therapy,ADT)是转移性和局部晚期前列腺癌(PCa)的标准治疗.晚期PCa虽对内分泌治疗敏感,但其个体之间存在高度异质性.目前已可通过血液指标、病理指标、基因检测,以及相关分子标志物等对ADT的敏感性进行大致预测.根据PCa患者对ADT敏感性差别,临床上可以选择持续或间隙ADT.对PCa患者进行基因多态性检测,可能是未来准确预测内分泌治疗敏感性的主要方向,可为制订适期的内分泌治疗时间窗,以及内分泌联合新型药物的治疗策略提供重要依据.

Objective:To investigate the effectiveness of surgical treatment for patients with T 4 stage prostate cancer. Methods:The clinical data and prognosis of 18 patients with T 4 stage prostate cancer treated in Shanghai Tenth People's Hospital from July 2013 to December 2019 were retrospectively analyzed. The average age of these 18 patients was 68.3 (53-81)years. 10 patients were castration resistant prostate cancer (CRPC) and 8 patients were hormone-sensitive prostate cancer (HSPC). 10 CRPC patients were treated with surgical treatment due to bladder clot packing and/or lower urinary tract obstruction. 8 HSPC patients had severe hematuria, severe dysuria and local symptoms. The KPS scores of all patients were ≥80 points with an average score of 84 (80-90). The average QOL score of 18 patients was 28 (21-32). 2 cases in 18 patients underwent total pelvic resection for rectal invasion (one CRPC and one HSPC). 7 cases underwent radical cystoprostatectomy for ureteral invasion (5 cases of CRPC, 2 cases of HSPC), 9 cases underwent bladder preservation surgery for bladder neck invasion (4 cases of CRPC, 5 cases of HSPC), of which 4 cases of enlarged lymph node dissection were all HSPC patients. Results:All cases of T 4 stage prostate cancer patients operation were successfully completed, the average operation time was 256 (219-310)min and the median intraoperative blood loss was about 300 (250-350)ml. Four of them (3 cases of CRPC and 1 case of HSPC) received blood transfusion after operation. The average postoperative hospital stay was 21(11-37) days. All 18 cases were followed up and the median follow-up time was 23.8 months. There was no perioperative death, and no bladder-preserving patients had true urinary incontinence or bladder outlet stenosis.2 CRPC cases died 8 and 15 months after surgery respectively, 7 patients were PSA relapse treated with docetaxel or abiterone therapy, and 1 HSPC patient with rectal invasion was followed up for 58 months after total pelvic resection, the PSA level was still 0.003ng/ml, no distant metastasis was found. 8 cases of hormone-sensitive patients were treated with endocrine therapy, and PSA was less than 0.2 ng/ml. The average QOL of 18 patients 3 months after operation was 37 points (25-45), which was significantly higher than that before operation. The average maximum urine flow rate of patients with bladder preservation was 23(19-25)ml/s. Conclusions:For T 4 stage prostate cancer, surgical treatment is feasible and safe for doctors with extensive surgical experience. For CRPC patients, the surgery can significantly improve short-term symptoms and quality of life, and long-term benefits need to be further evaluated with a large sample. For HSPC patients, it can not only improve clinical symptoms and QOL of patients, but also provide long-term benefits.

1 参加人员 讨论嘉宾: 上海交通大学医学院附属仁济医院泌尿外科董柏君医师海军军医大学附属第一医院泌尿外科 李晶医师中山大学肿瘤防治中心泌尿外科 李永红医师复旦大学附属华东医院泌尿外科 孙忠全医师上海市第十人民医院泌尿外科 杨斌医师暨南大学附属第一医院病理科 陆元志医师南方医科大学珠江医院肿瘤科 曹漫明医师中山大学肿瘤防治中心放疗科 何立儒医师中山大学肿瘤防治中心内科 史艳侠医师记录人:上海交通大学医学院附属仁济医院泌尿外科杜新星医师.

Background Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive treatment for ischemic stroke. Astrocytes regulation has been suggested as one mechanism for rTMS effectiveness. But how rTMS regulates astrocytes remains largely undetermined. There were neurotoxic and neuroprotective phenotypes of astrocytes (also denoted as classically and alternatively activated astrocytes or A1 and A2 astrocytes) pertaining to pro- or anti-inflammatory gene expression. Pro-inflammatory or neurotoxic polarized astrocytes were induced during cerebral ischemic stroke. The present study aimed to investigate the effects of rTMS on astrocytic polarization during cerebral ischemic/reperfusion injury. Methods Three rTMS protocols were applied to primary astrocytes under normal and oxygen-glucose deprivation/reoxygenation (OGD/R) conditions. Cell survival, proliferation, and phenotypic changes were assessed after 2-day treatment. Astrocytes culture medium (ACM) from control, OGD/R, and OGD/R + rTMS groups were mixed with neuronal medium to culture neurons for 48 h and 7 days, in order to explore the influence on neuronal survival and synaptic plasticity. In vivo, rats were subjected to middle cerebral artery occlusion (MCAO), and received posterior orbital intravenous injection of ACM collected from different groups at reperfusion, and at 3 days post reperfusion. The apoptosis in the ischemic penumbra, infarct volumes, and the modified Neurological Severity Score (mNSS) were evaluated at 1 week after reperfusion, and cognitive functions were evaluated using the Morris Water Maze (MWM) tests. Finally, the 10 Hz rTMS was directly applied to MCAO rats to verify the rTMS effects on astrocytic polarization. Results Among these three frequencies, the 10 Hz protocol exerted the greatest potential to modulate astrocytic polarization after OGD/R injury. Classically activated and A1 markers were significantly inhibited by rTMS treatment. In OGD/R model, the concentration of pro-inflammatory mediator TNF-α decreased from 57.7 to 23.0 рg/mL, while anti-inflammatory mediator IL-10 increased from 99.0 to 555.1 рg/mL in the ACM after rTMS treatment. The ACM collected from rTMS-treated astrocytes significantly alleviated neuronal apoptosis induced by OGD/R injury, and promoted neuronal plasticity. In MCAO rat model, the ACM collected from rTMS treatment decreased neuronal apoptosis and infarct volumes, and improved cognitive functions. The neurotoxic astrocytes were simultaneously inhibited after rTMS treatment. Conclusion Inhibition of neurotoxic astrocytic polarization is a potential mechanism for the effectiveness of high-frequency rTMS in cerebral ischemic stroke.

患者男性 ,初诊年龄49岁,2017年5月因下尿路症状于当地医院就诊 ,查总前列腺特异抗原(total prostate specific antigen ,tPSA )为23 ng/mL ,肿瘤标志物CEA、CA724、CA199、CA242、CA125均显著升高 ;盆腔多参数磁共振成像(magnetic resonance imaging ,M RI)示:前列腺癌 ,膀胱颈部侵犯、精囊侵犯、盆壁侵犯 ,盆腔多发淋巴结转移、骨盆骨转移(图1 );前列腺穿刺活检病理示:前列腺腺泡腺癌 ,G lea-son评分=5+4 ,合并印戒细胞癌和黏液腺癌;全身骨扫描示:第4腰椎、左侧髂骨、双侧耻骨、双侧坐骨共6处骨转移;胸部CT 及腹部B超未见明显异常.遂进行内分泌治疗(戈舍瑞林+比卡鲁胺方案)联合多西他赛化疗(6周期).

Traditional cell therapy technology relies on the maximum expansion of primary stem cells in vitro, through multiple passages and potential differentiation protocols, in order to generate the abundance of cells needed prior to transplantation in vivo. Implantation of in vitro over-expanded and pre-differentiated cells typically results in poor cell survival and reduced regeneration capacity for tissue repair in vivo. We hypothesized that implantation of primary stem cells, after a short time culture in vitro (passage number ≤p3), in combination with controlled release of relevant growth factors would improve in vivo cell viability, engraftment and tissue regeneration. The goal of this study was to determine whether the release of myogenic growth factors from a heparin-hyaluronic acid gel (hp-HA gel) could enhance in vivo cell survival, in-growth and myogenic differentiation of human urine-derived stem cells (USC) with a corresponding enhancement in graft vascularization, innervation and regenerative properties. Human USC were obtained from healthy adult donors (n = 6), expanded and then mixed with a hp-HA gel containing sets of growth factors known to enhance myogenesis (IGF1, HGF, PDGF-BB), neurogenesis (NGF, FGF) and angiogenesis (VEGF), or a cocktail with a combination of growth factors. Primary cultured USC (p3) mixed with the hp-HA gel and the various combinations of growth factors, were subcutaneously injected into athymic mice. In vivo cell survival, engraftment and functional differentiation within the host tissue were assessed. The implanted grafts containing USC and the growth factor cocktail showed the greatest number of surviving cells as well as increased numbers of cells that expressed myogenic and endothelial cell markers as compared to other groups 4 weeks after implantation. Moreover, the graft with USC and the growth factor cocktail showed increased numbers of blood vessels and infiltrating neurons. Thus, growth factors released in a controlled manner from an hp-HA gel containing USC efficiently improved in vivo cell survival and supported vascularization and myogenic differentiation within the grafts. This study provides evidence for the use of primary USC and growth factors in a hydrogel as a novel mode of cell therapy for the promotion of myogenic differentiation for the treatment of injured muscle tissue. STATEMENT OF SIGNIFICANCE: Cell therapies are a promising treatment option for neuromuscular dysfunction disorders. However, major limitations in cell retention and engraftment after implantation remain a hindrance to the use of stem cell therapy for the treatment of muscle injuries or diseased tissues. Implanted long-term in vitro cultured cells tend to demonstrate low rates of survival and tissue engraftment, lessened paracrine effects, and poor homing and differentiation. Human USC are an easily obtainable stem cell source that possess stem cell characteristics such as a robust proliferative potential, paracrine effects on neighboring cells, and multi-potential differentiation. In this study, we demonstrated that a combination of primary human USC with a cocktail of growth factors combined in a hyaluronic gel was optimal for cell survival and engraftment, including myogenic differentiation potential of USC, angiogenesis and host nerve fiber recruitment in vivo. The present study also demonstrated that the use of primary urine derived stem cells at early passages, without in vitro pre-differentiation, implanted in a hyaluronic-heparin hydrogel containing a cocktail of growth factors, provided an alternative safe site-specific delivery method for cell therapy.

1 参加人员 讨论嘉宾: 上海海军军医大学长海医院泌尿外科 李晶医师 上海交通大学医学院附属仁济医院泌尿科 董柏君医师 浙江省人民医院泌尿外科 董海鹰医师 复旦大学附属华东医院泌尿外科 孙忠全医师 上海市第十人民医院泌尿外科 杨斌医师 暨南大学附属第一医院病理科 陆元志医师 中山大学肿瘤防治中心放疗科 何立儒医师 南京市第一医院核医学科 王峰医师 病例汇报及记录人: 上海海军军医大学长海医院泌尿外科 李晶医师 2 病例介绍 患者男性,63岁,2017年12月因尿频、尿急于当地医院体检时查总前列腺特异抗原(total prostate specific antigen ,tPSA )为5 .01 ng/mL ,游离前列腺特异抗原(free prostate specific antigen ,fPSA )为0.763 ng/mL ,fPSA/tPSA=0 .152;泌尿系B超示:前列腺增生伴回声不均.遂来上海海军军医大学长海医院行盆腔多参数磁共振成像(magnetic reso-nance imaging ,M RI)示:前列腺右侧外周带结节,考虑前列腺癌,突破包膜,伴盆腔淋巴结转移;前列腺穿刺活检病理结果"穿刺15针,12针阳性,前列腺腺癌[Gleason=10(5+5)分]";骨扫描示:全身多发骨转移征象(T1、T2、L4 椎体;右侧股骨上端;右侧耻骨).

Purpose: This study assessed the ability of metabolic parameters from 18Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinicopathological data to predict epidermal growth factor receptor (EGFR) expression/mutation status in patients with lung adenocarcinoma and to develop a prognostic model based on differences in EGFR expression status, to enable individualized targeted molecular therapy. Patients and Methods: Metabolic parameters and clinicopathological data from 200 patients diagnosed with lung adenocarcinoma between July 2009 and November 2016, who underwent 18F-FDG PET/CT and EGFR mutation testing, were retrospectively evaluated. Multivariate logistic regression was applied to significant variables to establish a prediction model for EGFR mutation status. Overall survival for both mutant and wild-type EGFR was analyzed to establish a multifactor Cox regression model. Results: Of the 200 patients, 115 (58%) exhibited EGFR mutations and 85 (42%) were wild-type. Among selected metabolic parameters, metabolic tumor volume (MTV) demonstrated a significant difference between wild-type and mutant EGFR mutation status, with an area under the receiver operating characteristic curve (AUC) of 0.60, which increased to 0.70 after clinical data (smoking status) were combined. Survival analysis of wild-type and mutant EGFR yielded mean survival times of 34.451 (95% CI 28.654-40.249) and 53.714 (95% CI 44.331-63.098) months, respectively. Multivariate Cox regression revealed that mutation type, tumor stage, and thyroid transcription factor-1 (TTF-1) expression status were the main factors influencing patient prognosis. The hazard ratio for mutant EGFR was 0.511 (95% CI 0.303-0.862) times that of wild-type, and the risk of death was lower for mutant EGFR than for wild-type. The risk of death was lower in TTF-1-positive than in TTF-1-negative patients. Conclusion: 18F-FDG PET/CT metabolic parameters combined with clinicopathological data demonstrated moderate diagnostic efficacy in predicting EGFR mutation status and were associated with prognosis in mutant and wild-type EGFR non-small-cell lung cancer (NSCLC), thus providing a reference for individualized targeted molecular therapy.

Objective: This study compared the clinicopathological features and survival of metastatic prostate cancer (mPCa) after stratification by age and non-bone-related metastasis to identify prognostic factors. Methods: Patients with mPCa between 2010 and 2015 were identified from the Surveillance, Epidemiology and End Results database and analyzed. The overall survival (OS) rate was assessed using the Kaplan-Meier curve and log-rank test as well as multivariate Cox regression analysis. Results: Among the 10147 patients with mPCa, 5378 were classified as young (≤70 years), 3140 were classified as middle-aged (70-82 years), and 1629 were classified as elderly (> 82 years). The younger patients with a single site metastasis with non-regional lymph nodes (NRLN) had a better prognosis than those with bone metastasis [hazard ratio (HR), 0.59, 95% confidence interval (CI), 0.47-0.73, P < 0.001], whereas patients with liver metastasis had the worst OS rate (P = 0.001). Moreover, patients in the middle-aged group with NRLN or lung metastasis had a better prognosis than those with bone metastasis (P < 0.05). The OS rate of patient with bone + liver and bone + brain metastasis was poorer (P < 0.001) than those with bone + NRLN metastasis in the younger patients (P < 0.05). The elder patients with bone + lung metastasis had the worst OS (HR, 1.54; 95% CI, 1.25-1.90, P < 0.001), although the death risk of patients with bone + brain and bone + NRLN metastasis not significantly different (P > 0.05). However, the OS of the patients with bone + liver metastasis remained the worst (P < 0.001). Conclusions: Prostate cancer patients with lung metastasis or younger patients (≤70 years old) with bone + lung metastases had better OS than patients with other types of metastasis or old age.

Purpose: To investigate the correlation between 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) metabolic parameters and clinicopathological factors in pathological subtypes of invasive lung adenocarcinoma and prognosis. Patients and Methods: Metabolic parameters and clinicopathological factors from 176 consecutive patients with invasive lung adenocarcinoma between August 2008 and August 2016 who underwent 18F-FDG PET/CT examination were retrospectively analyzed. Invasive lung adenocarcinoma was divided into five pathological subtypes:lepidic predominant adenocarcinoma (LPA), acinar predominant adenocarcinoma (APA), papillary predominant adenocarcinoma (PPA), solid predominant adenocarcinoma (SPA), and micropapillary predominant adenocarcinoma (MPA). The differences in metabolic parameters [maximal standard uptake value (SUVmax), mean standard uptake value (SUVmean), total lesion glycolysis (TLG), and metabolic tumor volume (MTV)] and tumor diameter for different pathological subtypes were analyzed. Patients were divided into two groups according to their prognosis: good prognosis group (LPA, APA, PPA) and poor prognosis group (SPA, MPA). Logistic regression was used to filter predictors and construct a predictive model, and areas under the receiver operating curve (AUC) were calculated. Cox regression analysis was performed on prognostic factors. Results: 82 (46.6%) females and 94 (53.4%) males of patients with invasive lung adenocarcinoma were enrolled in this study. Metabolic parameters and tumor diameter of different pathological subtype had statistically significant (P < 0.05). The predictive model constructed using independent predictors (Distant metastasis, Ki-67, and SUVmax) had good classification performance for both groups. The AUC for SUVmax was 0.694 and combined with clinicopathological factors were 0.745. Cox regression analysis revealed that Stage, TTF-1, MTV, and pathological subtype were independent risk factors for patient prognosis. The hazard ratio (HR) of the poor prognosis group was 1.948 (95% CI 1.042-3.641) times the good prognosis group. The mean survival times of good and poor prognosis group were 50.2621 (95% CI 47.818-52.706) and 35.8214 (95% CI 27.483-44.159) months, respectively, while the median survival time was 47.00 (95% CI 45.000-50.000) and 31.50 (95% CI 23.000-49.000) months, respectively. Conclusion: PET/CT metabolic parameters combined with clinicopathological factors had good classification performance for the different pathological subtypes, which may provide a reference for treatment strategies and prognosis evaluation of patients.

Purpose SHP2 has roles in a variety of signal transduction pathways and in many important cellular processes, including proliferation, differentiation, movement regulation, and apoptosis. In addition, SHP2 expression is closely associated with multiple types of malignancies. In this study, we examined the role of SHP2 in epithelial ovarian cancer. Patients and methods SHP2 expression in cancer and normal ovarian tissue specimens was evaluated by immunohistochemical staining and Western blot analyses. The correlation between the SHP2 expression level and clinicopathological features was analyzed. The role of SHP2 in epithelial ovarian cancer was evaluated by assessing SHP2 expression patterns in vitro and in vivo, and activation of the PI3K/AKT pathway was examined. Results SHP2 is expressed at higher levels in ovarian cancer tissues than in normal ovarian tissues and in an ovarian cancer cell line than in a normal ovarian cell line. On the basis of these findings, SHP2 is overexpressed in ovarian cancer both in vitro and in vivo. In addition, SHP2 overexpression is associated with tumor stage and differentiation, enhanced cell proliferation and invasion, and tumorigenesis and metastasis. Conclusion SHP2 overexpression enhances ovarian tumor proliferation and invasion by activating the PI3K-AKT axis, indicating that SHP2 potentially plays a direct role in the pathogenesis of ovarian epithelial cell cancer. These novel findings provide key insights that are applicable to basic cancer research and to the prevention and treatment of cancer.

Purpose: Ultrasound-guided biopsy is the standard method for diagnosing prostate cancer. However, according to the literature, the positive predictive value of prostate biopsy is very low when PSA < 30 ng/mL. We assessed the association of prostate cancer detection rates with age, prostate volume, and health condition in a referral-based biopsy population when PSA < 30 ng/mL. Materials and methods: We retrospectively reviewed the records of 546 men who underwent prostate biopsy at Shanghai Tenth People's Hospital with a total PSA of 4 to 30 ng/mL. The age, body mass index, biopsy results, and health condition including diabetes mellitus, hypertension, and other chronic diseases were collected. Cancer detection rates with respect to age, body mass index, and health condition were analyzed. Results: A total of 546 patients were included in the analysis. The mean age was 71.1 years, and the median PSA level was 14.7 ng/mL. Prostate cancer was detected from the biopsy in 198 patients (36.26%). A higher prostate cancer detection rate was found in obese patients than in normal patients (81% vs 16.7%). No significant difference was found for age and the odds of being diagnosed with prostate cancer (P = 0.211). However, patients with prostate volume < 50 cc had a higher prostate cancer detection rate than patients with prostate volume > 50 cc (49.1% vs. 13.3%). Our data also indicated that DM and hypertension are risk factors for the development of prostate cancer. Logistic analysis showed that prostate nodules, BMI, PSA, and prostate volume were the significant predictors of a positive biopsy. Conclusion: BMI, prostate volume, DM, and hypertension were associated with an increased prostate cancer detection rate. However, age did not affect the rate of prostate cancer biopsy detection.

Objective: To evaluate the safety and curative effects of ultrasound-guided percutaneous nephrolithotomy (PCNL) for renal calculi in solitary kidneys. Methods: The clinical data of 138 renal calculi with functional or anatomic solitary kidney undergone PCNL in our department from July 2005 to December 2012 were retrospectively analyzed. They comprised of 16 anatomical solitary kidneys and 122 functional solitary kidneys (the GFR of contralateral kidney <10 mL/min). The total renal function was abnormal in 35 cases. There were staghorn calculi in 41 cases, multiple calculi in 85 cases, and single stone in 12 cases. 11 cases had a history of open

Objectives This study was conducted to evaluate the value of sonographic B-lines (previously called "comet tail artifacts") in assessment of pulmonary hypertension in patients with interstitial lung diseases.Methods One hundred thirty-four patients with clinically diagnosed interstitial lung diseases complicated by pulmonary hypertension underwent transthoracic lung sonography and Doppler echocardiography for assessment of the presence of B-lines, the distance between them, and the pulmonary artery (PA) systolic pressure. A correlation analysis and a receiver operating characteristic curve analysis were performed.Results All patients had diffuse bilateral B-lines. The maximum number of B-lines seen in any positive zone (not a summation) was significantly correlated with the severity of PA systolic pressure (r = 0.812; P < .0001), and a linear regression equation could be demonstrated: that is, y = 6.06 x + 17.57, where x and y represent the number of B-lines and PA systolic pressure, respectively. A cutoff of more than 4 B-lines seen in any positive zone had 89.5% sensitivity, 85.0% specificity, and 87.2% accuracy in predicting elevated PA pressure (>30 mm Hg).Conclusions The number of B-lines is useful in assessment of pulmonary hypertension, especially when tricuspid regurgitation and pulmonary valve regurgitation do not exist or cannot be satisfactorily measured by Doppler echocardiography.

Notch signaling plays critical roles during myogenesis by promoting the proliferation and inhibiting the differentiation of myogenic progenitors. However, the mechanism of the temporal regulation of Notch signaling during the myogenic lineage progression remains elusive. In the present study, we show that a constitutively phosphoryl-mimicking mutation of Fas-associated death domain (FADD-D) enhances Notch-1 signaling and compromises Wnt signaling in both cultured myoblasts and regenerating muscles, which results in inhibited myogenic differentiation and muscle regeneration. Inhibition of Notch signaling recovers the regeneration ability in injured FADD-D muscles through rescuing Wnt signaling. Furthermore, we found that protein kinase Ca mediates FADD-D-induced Notch-1 signaling by stabilizing Notch-1. Collectively, these data identify a novel mechanism for the temporal regulation of Notch signaling during myogenic lineage progression and muscle regeneration. (C) 2015 S. Karger AG, Basel