锁阳抑制良性前列腺增生的作用机制研究

目的研究锁阳对大鼠前列腺增生(BPH)模型的作用及相关机制研究。方法用雌/雄激素诱导大鼠前列腺增生。按体重将去势3周后大鼠随机分为3组:模型组,锁阳组(3 g·kg^-1·d^-1),氟他胺组(30 mg·kg^-1·d^-1),每组10只。另外取10只健康大鼠作为假手术组,模型组和假手术组给等量0. 9%Na Cl,均灌胃给药,每天1次,连续给药45 d。以蛋白免疫印迹检测增殖细胞核抗原(PCNA)蛋白变化;用Cyto Scape3. 5. 1软件构建和分析锁阳"化合物-靶点-前列腺增生"复杂网络。结果给药后,假手术组、模型组、锁阳组的PCNA蛋白表达灰度比值分别是0. 58±0. 11,1. 37±0. 21,0. 94±0. 31,模型组与假手术比较,差异有统计学意义(P <0. 05);锁阳组与模型组比较,差异有统计学意义(P <0. 05)。网络药理学揭示,锁阳直接作用于BPH疾病的靶点有7个,4个新发现的靶点分别为细胞周期素D1(CCND1)、磷脂酰基醇(PIK3CA)、氧化物酶体增殖物激活受体(PPARG)和过氧化物合成酶(PTGS2)。结论锁阳抑制大鼠前列腺增生可能与细胞增殖等通路以及调节细胞周期素D1(CCND1)与磷脂酰基醇(PIK3CA)等蛋白表达相关。     

氟哌噻吨美利曲辛片治疗继发性BPPV老年患者残余头晕症状的疗效观察

目的 探讨氟哌噻吨美利曲辛片对继发性良性阵发性位置性眩晕（bnign proxysmal psitional vrtigo,BPPV）老年患者残余头晕症状的影响。方法 收集2014年1月—2016年9月嘉兴市第一医院神经内科治疗的84例继发性BPPV老年患者（年龄>65周岁）的临床资料,分为氟哌噻吨美利曲辛片治疗组（n=42）和常规治疗组（n=42）。比较2组残余头晕的持续时间及治疗前,治疗后第3天、第1周、第2周的眩晕障碍量表（Dizziness Handicap Inventory,DHI）分数。结果 和常规治疗组相比,氟哌噻吨美利曲辛片治疗组残余头晕症状持续时间明显较短（P=0.002）。复位成功后,与常规治疗组相比,氟哌噻吨美利曲辛片组治疗后第1周和第2周的DHI分数明显降低（P分别为0.040和0.030）。结论 氟哌噻吨美利曲辛片治疗继发性BPPV,可使残余头晕的持续时间明显缩短,治疗1周和2周后DHI评分降低。     

术中体温保护对老年前列腺气化电切手术患者术后早期认知功能及血清脑损伤标志物的影响

目的 探讨术中体温保护对老年患者前列腺气化电切手术（TURP）后早期认知功能障碍（POCD）及脑损伤标志物的影响。方法 选择2017年2月至2017年9月河南科技大学第一附属医院行TURP老年患者60例,采用随机数字表法将其分为常温组（对照组）和体温保护组（观察组）,每组各30例。对照组患者术中给予棉被覆盖非手术区域,静脉输注液和电切冲洗液为室温液,观察组患者给予电热风加温毯覆盖非手术区域,静脉输注液和电切冲洗液为38℃加温液。术前1天（D1）、术后第1天（D2）、术后第3天（D3）采用简易智能精神状态检查量表（MMSE）进行神经精神功能测定,同时检测患者脑损伤标志物（MBP、NSE和S-100β蛋白）水平,比较两组患者术后各时间点POCD发病率,及MBP、NSE和S-100β蛋白水平变化。结果 在术后D2、D3时间点对照组患者POCD发病率分别为26.67%、6.67%,均较观察组POCD发病率6.67%、0高,差异有统计学意义（P<0.05）;在D1时间点,两组患者血清MBP、NSE和S-100β蛋白水平差异无统计学意义（P>0.05）;D2、D3时,观察组患者血清MBP、NSE和S-100β蛋白均较对照组降低,差异有统计学意义（P<0.05）。结论 术中体温保护可有效降低老年患者TURP术后POCD的发病率,降低脑损伤特异性血清标志物MBP、NSE、S-100β蛋白水平,是一种有效的防治POCD的保护措施。     

PARP inhibitors for homologous recombination-deficient prostate cancer

Introduction: Prostate adenocarcinoma represents a leading cause of cancer-related mortality. Increased emphasis on understanding the molecular basis of prostate cancer has identified a substantial burden of homologous recombination (HR) pathway mutations, which are enriched in castrate-resistant disease. This discovery has yielded novel therapeutic opportunities.

Areas covered: We will discuss the treatment of castrate-resistant prostate cancer (CRPC), with a focus on the use of poly (ADP-ribose) polymerase (PARP) inhibitors in this space. Evidence for use in HR-deficient patients will be outlined with discussion of the mechanism of action for this drug class, pathways of resistance, and approaches for expanding PARP inhibitor use to non–HR-deficient prostate cancer subgroups.

Expert opinion: PARP inhibition represents an exciting tool for management of HR-inactivated CRPC. With rapid adoption of next-generation sequencing technologies and other molecular techniques, the number of patients in this category is likely to increase. Ongoing and future investigations will be critical for improved understanding of the promise and appropriate treatment sequencing of PARP inhibition and optimal options for HR-proficient and -deficient prostate cancer populations. Questions remain about the clinical significance of monoallelic vs. biallelic HR mutations, the relevance of germline vs. somatic-only mutations, and the importance of mutations in non-canonical HR genes.     

重庆黔江地区230例育龄期妇女乳腺增生状况调查及相关因素分析

目的探讨重庆黔江地区育龄期妇女乳腺增生状况及相关危险因素。方法选取2016年1-12月重庆市黔江中心医院行乳腺增生普查的育龄期妇女行问卷调查、乳房触诊、乳腺B超或乳腺X线钼靶,对难以诊断的情况可采用乳腺组织穿刺病理活检以明确诊断。结果参与本次普查的230例育龄期妇女中,共发现137例患有乳腺疾病的患者,患病率为59.57%。其中患乳腺增生者113例,患病率为49.13%;患乳腺纤维肿瘤者11例,患病率为4.78%;乳腺囊肿7例,患病率3.04%,乳腺炎3例,患病率1.30%,乳头内陷1例,患病率0.43%,乳腺癌者2例,患病率为0.87%。单因素分析结果提示,年龄、流产史、职业、家族史、初潮年龄、情绪状态、避孕方式是乳腺增生发病的相关因素(P<0.05)。多因素分析结果提示,流产史、初潮年龄、家族史、情绪状态是乳腺增生的危险因素(P<0.05)。结论重庆黔江地区育龄期妇女乳腺增生的发病率较高,应加强该地区育龄期妇女有关疾病知识的教育宣讲,加强普查次数,从而降低乳腺疾病对女性的影响,提高其生活质量。     

Modeling Clinical Outcomes in Prostate Cancer: Application and Validation of the Discrete Event Simulation Approach

Objectives

Treatment landscape in prostate cancer has changed dramatically with the emergence of new medicines in the past few years. The traditional survival partition model (SPM) cannot accurately predict long-term clinical outcomes because it is limited by its ability to capture the key consequences associated with this changing treatment paradigm. The objective of this study was to introduce and validate a discrete-event simulation (DES) model for prostate cancer.

Cost-Effectiveness of Antibiotic Prophylaxis Strategies for Transrectal Prostate Biopsy in an Era of Increasing Antimicrobial Resistance

Objectives

To determine the optimal antibiotic prophylaxis strategy for transrectal prostate biopsy (TRPB) as a function of the local antibiotic resistance profile.

Orofacial lesions in treated southeast Brazilian leprosy patients: a cross-sectional study

AIM: The aim of the present study was to clinically evaluate the oral mucosa lesions of leprosy patients during and after multi-drug therapy. METHODS: Clinical examination, medical and dental history examination was performed in 100 leprosy patients. RESULTS: The results revealed that 71 patients, 50 men and 21 women, exibited oral lesions. The most frequent lesions were: fissured tongue (18 cases), inflammatory papillary hyperplasia (16 cases), chronic atrophic candidiasis (10 cases), fibroma (10 cases), erythematous candidiasis (eight cases), and traumatic ulceration (seven cases). CONCLUSION: We conclude that leprosy-related lesions are not present in patients undergoing treatment for leprosy, probably due to response to multidrug therapy.     

Predicting PSA response of prostate cancer to radiation therapy with Doppler sonography

OBJECTIVE: We report a prospective investigation of the correlation between pretreatment Doppler vascular density (DVD) of the entire prostate gland and subsequent prostate-specific antigen (PSA) response following external beam radiation therapy, for patients with low- or intermediate-risk prostate cancer. This report updates a previous report (Sehgal et al., Acad Radiol 2003;10:366) with longer patient follow-up and additional quantitative and clinically relevant end points. METHODS: Before radiation therapy, we imaged 12 patients with transrectal Doppler sonography and measured the mean DVD of the prostate for each. For analysis, patients were separated into 3 groups by low, intermediate, and high DVD. The mean DVD for each group was linearly correlated with mean values for time above a PSA threshold of 1.0 ng/ml, post-therapy plateau PSA, and nadir PSA. RESULTS: We previously observed that pretreatment mean DVD had a strong inverse correlation with initial rate of post-therapy decline in PSA. With substantially longer follow-up on the same cohort of patients (median, 52 months), we now observe that pretreatment mean DVD also correlates with post-therapy nadir PSA (R = 0.94) and with time above a PSA threshold of 1.0 ng/mL (R = 0.99). CONCLUSION: The results of the current study are consistent with our earlier suggestion that pretreatment measurement of DVD of the entire prostate gland may be a clinically useful prognostic indicator in early prostate cancer treated with radiation. However, additional data from larger numbers of patients are needed to draw firm conclusions.     

华蟾素注射液辅助治疗前列腺癌的临床研究

目的研究华蟾素注射液辅助治疗前列腺癌的临床疗效。方法收集2015年1月—2017年2月襄阳市中心医院(湖北文理学院附属医院)肿瘤科收治的前列腺癌患者110例,随机分为对照组和治疗组,每组各55例。对照组患者给予相应的放化疗治疗。治疗组在放化疗开始时即静脉滴注华蟾素注射液,10~20 m L稀释于5%葡萄糖注射液250 m L中,连续用药6 d,停药1 d。连续用药3周为1个疗程,共治疗4个疗程。观察两组的临床疗效,比较两组治疗前后血清前列腺特异抗原(PSA)水平和毒副反应。结果治疗后,对照组客观缓解率(ORR)是69.09%,临床获益率(CBR)是85.45%;治疗组ORR是89.09%,CBR是96.36%,两组ORR、CBR比较差异有统计学意义(P0.05)。治疗后,两组患者血清PSA水平均显著降低,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组血清PSA水平显著低于对照组,两组比较差异有统计学意义(P0.05)。治疗组患者白细胞减少、恶心呕吐的发生率明显低于对照组,两组比较差异有统计学意义(P0.05)。结论华蟾素注射液辅助治疗前列腺癌临床疗效确切,能显著降低血清PSA水平,减少患者白细胞降低和恶心呕吐的发生率,具有一定的临床推广应用价值。