Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer

Background: We aimed to determine the concordance between the radiologic stage (rT), using multiparametric magnetic resonance imaging (mpMRI), and pathologic stage (pT) in patients with high-risk prostate cancer and its influence on nerve-sparing surgery compared to the use of the intraoperative frozen section technique (IFST). Methods: The concordance between rT and pT and the rates of nerve-sparing surgery and positive surgical margin were assessed for patients with high-risk prostate cancer who underwent radical prostatectomy. Results: The concordance between the rT and pT stages was shown in 66.4% (n = 77) of patients with clinical high-risk prostate cancer. The detection of patients with extraprostatic disease (≥pT3) by preoperative mpMRI showed a sensitivity, negative predictive value and accuracy of 65.1%, 51.7% and 67.5%. In addition to the suspicion of extraprostatic disease in mpMRI (≥rT3), 84.5% (n = 56) of patients with ≥rT3 underwent primary nerve-sparing surgery with IFST, resulting in 94.7% (n = 54) of men with at least unilateral nerve-sparing surgery after secondary resection with a positive surgical margin rate related to an IFST of 1.8% (n = 1). Conclusion: Patients with rT3 should not be immediately excluded from nerve-sparing surgery, as by using IFST some of these patients can safely undergo nerve-sparing surgery.     

Biomedical Membrane of Fish Collagen/Gellan Gum Containing Bone Graft Materials

The development of a guided bone regeneration (GBR) membrane with non-mammalian fish collagen has the advantage of low risk for transmission of infectious diseases in tissue regeneration. In this work, a fish collagen/gellan gum and bone graft material (FC/GG-BGM) composite GBR membrane were fabricated through solution blending and casting procedures in a vacuum. The membranes were characterized using Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy observation (SEM), and atomic force microscope (AFM) analyses. FT-IR results suggested that ionic interactions were formed between FC and GG both in composite powder and membranes. In vivo experiments showed that these FC/GG-BGM composite membranes could generate osteoblast minerals and promote loose bone calcification, thus accelerating bone regeneration. At 2 weeks, the defected site of rats treated with FC/GG-BGM membrane (0.377 ± 0.012 mm³) showed higher regeneration than that of rats treated with the bovine collagen membrane (0.290 ± 0.015 mm³) and control rats without membrane (0.160 ± 0.008 mm³). Compared with bovine collagen membrane, the FC/GG-BGM composite membrane displays better bone regeneration ability. Therefore, FC/GG-BGM composite membrane is suitable as a GBR membrane for bone regeneration.     

中医药治疗糖尿病血瘀证研究进展

从辨证论治(脾肝肾论治、气阴亏虚论治)、中医药研究(单味药及提取物研究、复方研究等综述糖尿病血瘀证的中医药研究进展)。指出:糖尿病血瘀证的诊断,目前尚无统一标准,有必要确定一个较为统一诊断标准和疗效评定标准,建议采取循证医学原则进行大样本临床研究、选取公认、敏感的多个指标进行评定,重视中药通过改善糖尿病血瘀证对糖尿病慢性并发症的防治作用的研究。     

具有中医特色的保健食品研发优势分析

随着中医药的消费在全球不断升温,具有中医特色的保健食品在人们日常养生保健中发挥着越来越重要的作用,市场占有率也逐年升高。为了更好地继承和发扬中医药理论,合理发展具有中医特色的保健食品,文章从文献、理论、功能、安全性、资源及市场6个方面具体分析其优势。     

The development of dentist practice profiles and management

Rationale and objectives With the current large computerized payment systems and increase in the number of claims, unusual dental practice patterns to cover up fraud are becoming widespread and sophisticated. Clustering the characteristic of dental practice patterns is an essential task for improving the quality of care and cost containment. This study aims at providing an easy, efficient and practical alternative approach to developing patterns of dental practice profiles. This will help the third‐party payer to recognize and describe novel or unusual patterns of dental practice and thus adopt various strategies in order to prevent fraudulent claims and overcharges. Methodology Knowledge discovery (or data mining) was used to cluster the dentists' profiles by carrying out clustering techniques based on the features of service rates. It is a hybrid of the knowledge discovery, statistical and artificial neural network methodologies that extracts knowledge from the dental claim database. Results The results of clustering highlight characteristics related to dentists' practice patterns, and the detailed managerial guidance is illustrated to support the third‐party payer in the management of various patterns of dentist practice. Conclusion This study integrates the development of dentists' practice patterns with the knowledge discovery process. These findings will help the third‐party payer to discriminate the patterns of practice, and also shed more light on the suspicious claims and practice patterns among dentists.     

成人急性淋巴细胞白血病4种特异性靶抗原的特征研究

本研究针对成人急性淋巴细胞白血病(ALL)抗体免疫治疗的主要4种特异性靶抗原(CD19、CD20、CD22和CD33),深入探究其临床和预后特征,探讨针对这些靶抗原的新型靶向药物应用于成人ALL治疗的临床依据和价值。对220例成人ALL患者采用四色流式细胞仪进行免疫表型分析,采用常规细胞遗传学、荧光原位杂交、实时定量PCR和巢式PCR扩增及DNA测序等技术进行细胞学和分子遗传学、分子生物学指标检测。结果显示,CD19阳性(CD19+)组女性和60岁以上老年患者比例高于CD19阴性(CD19-)组(46.4%vs 23.4%,P=0.006)(14.4%vs.2.1%,P=0.022),CD19+伴CD33表达增高(47.8%vs.12.0%,P<0.01),遗传学高危组患者比例显著增高(55.8%vs.20.8%,P<0.01),Philadelphia染色体阳性(Ph+)发生率高(35.3%vs.7.9%)(P<0.01);CD20+组伴CD13+低于CD20-组(31.6%vs.67.1%,P<0.01),CD20+无显著预后意义;在B-ALL患者中,CD22+比CD22-组12月复发率增高(93.9%vs.57.1%,P<0.05);CD33+组Ph+率显著增高(43.5%vs.19.4%,P<0.01),CD33+与Ph+之间有显著相关性(相关系数=0.261,P<0.01)。结论:本研究对CD19、CD20、CD22和CD33这些特异性靶抗原特征的深入分析,有助于指导临床正确把握抗体免疫治疗的适应症和应用时机,使患者最大程度获益。     

妊娠糖尿病患者血清、脐血及胎盘组织中 Visfatin和 Chemerin的表达与胰岛素抵抗发生机制的研究

目的　探讨妊娠糖尿病（ gestational diabetes mellitus,GDM）患者血清、脐血及胎盘组织中的内脏脂肪组织（Visfatin）、脂肪因子趋化素（ Chemerin）的表达变化及与患者发生胰岛素抵抗的关系。方法　选取阜阳市人民医院 2018年 12月～ 2020年 4月妊娠分娩的 GDM孕妇 100例作为 GDM组、糖耐量正常孕妇 100例作为 NGT组。统计分析两组的一般资料、血糖指标、血脂指标,检测两组研究对象血清、脐血、胎盘组织中的 Visfatin,Chemerin表达水平,分析 Visfatin,Chemerin表达与胰岛素抵抗指数（ HOMA-IR）的相关性;通过重组慢病毒载体构建 Visfatin, Chemerin过表达的 3T3-L1脂肪细胞,分析 Visfatin,Chemerin过表达对 3T3-L1脂肪细胞增殖、葡萄糖消耗量、 Akt及 pAkt蛋白表达的影响。结果　GDM 组的 FPG(5.84±0.52mmol/L),Fins(18.96±3.75μU/ml),HbA1c(6.42%±0.89%), HOMA-IR(2.48±0.66),TC(5.22±0.57mmol/L)和 TG(2.41±0.43mmol/L)测定值均高于 NGT组 (4.61±0.40mmol/L,     

住院糖尿病高危足患者临床特征及预后分析

目的 通过分析糖尿病高危足患者临床资料及预后,为糖尿病足溃疡的预防提供临床依据。方法 对2012年1月1日-2018年12月31日在四川大学华西医院住院的糖尿病高危足患者进行了回顾性分析,按照既往是否有足溃疡或者截肢（趾）史,分为高风险组和低风险组。比较两组患者的临床特征,并随访患者从出院至2021年1月31日,对患者生存及溃疡复发或新发状况进行了评估。结果 最终纳入患者123例,高风险组患者29例,低风险组患者94例。两组患者的糖尿病病程、吸烟史、饮酒史、受教育程度、接受正规治疗比例、定期监测血糖比例、体质量指数、合并糖尿病周围神经病变、胼胝、足畸形、糖尿病肾病、糖尿病视网膜病变、糖尿病心脏自主神经病变、糖尿病胃肠自主神经病变、高血压、冠心病的比例和实验室检查结果差异无统计学意义（P>0.05）。高风险组的女性比例（51.7%vs. 29.8%）、年龄[（69.8±10.3）vs.(64.4±11.3)岁]、合并下肢动脉病变比例（62.1%vs. 34.4%）、合并高尿酸血症比例（27.6%vs. 10.6%）高于低风险组（P<0.05）。在随访（67±20）个月后,有2...     

7.0T磁共振T2*-mapping在实验性自身免疫性脑脊髓炎脊髓病变中的应用

目的 应用超高场强MR T2^*-mapping序列定量评估实验性自身免疫性脑脊髓炎(EAE)动物模型的脊髓病变。方法 6~8周雌性C57BL/6小鼠,MOG_35-55诱导制备EAE模型10只(实验组),同龄健康对照组10只。在造模后第18天,分别对实验组和对照组脊髓行T2^*-mapping序列扫描,经后处理软件分析,比较实验组和对照组脊髓感兴趣区T2^*值的差异。结果 实验组第12天大鼠的体质量开始减轻,第14天神经学评分逐步增加。对照组体质量无明显减轻。MR T2^*加权像显示实验组脊髓内病灶呈不规则点片状稍高信号;对照组脊髓呈均匀等信号。T2^*值实验组[(12.66±1.78) ms]和对照组[(17.80±2.06)ms]差异有统计学意义(P<0.001),实验组各评分T2^*值之间差异无统计学意义(P>0.05)。结论 超高场强MR T2^*-mapping序列能够清晰显示小鼠脊髓病灶,并且可对病灶组织内铁含量进行定量测定,为EAE模型脊髓病变的无创检查提供新方法。