Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: a comparative histopathologic study from a single academic center

Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5%) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margin site was the apex/distal third in all groups (62% retropubic prostatectomies, 79% laparoscopic prostatectomies, 60% robotic-assisted prostatectomies). Total linear length of positive surgical margin sites was significantly correlated with preoperative prostate-specific antigen, preoperative prostate-specific antigen density, pT stage, and tumor volume (P ≤ .001). We found no significant differences among the 3 groups with respect to total linear length, number of foci, laterality, or location of positive surgical margin. The rate of biochemical recurrence was also comparable in the 3 groups. On univariate analyses, biochemical recurrence was significantly associated with preoperative prostate-specific antigen values, preoperative prostate-specific antigen density, Gleason score, number of positive surgical margins, and total linear length of positive surgical margin (P ≤ .02). Only preoperative prostate-specific antigen density and number of positive surgical margin foci were statistically significant (P ≤ .03) independent predictors of biochemical recurrence. We found no significant difference in positive surgical margin characteristics or biochemical recurrence among the 3 radical prostatectomy modalities. Preoperative prostate-specific antigen density and number of positive surgical margin foci were the only independent predictors of biochemical recurrence.     

Effect of cypermethrin, carbendazim and their combination on male albino rat serum

Alpha-cypermethrin and carbendazim are synthetic; α-cypermethrin belongs to a class of synthetic pyrethroids and carbendazim belongs to the class of carbamate fungicides. The current study was carried out to evaluate the low-dose exposure of individual and mixed forms of cypermethrin and carbendazim. α-cypermethrin was used at 0.06, 0.12, 0.30 and 0.60 mg/kg body weight (bw), carbendazim was at 0.48, 0.96, 2.4 and 4.8 mg/kg bw and combined doses (cypermethrin: 0.06, 0.12, 0.30 and 0.60 mg/kg.bwt + carbendazim: 0.48, 0.96, 2.4 and 4.8 mg/kg.bwt) for 12 h and 24 h. The biochemical parameters and serum markey enzymes were analysed. The biochemical parameters include serum total protein, glucose, cholesterol, urea, uric acid, calcium, phosphorous, albumin and creatinine and serum marker enzymes such as alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT) and amylase were ascertained. Results indicated simultaneous changes in serum marker enzyme activity (ALT, AST, ALP, GGT and amylase) and biochemical markers (*P < 0.05, **P < 0.01 and ***P < 0.001). The experimental results indicate that even low-dose use of the synthetic pyrethroid carbamate and their combined form results in consequential negative effects on cell function.     

水肿胎儿血液生化指标分析

目的检测水肿胎儿（包括Bart′s、染色体异常、病毒感染、同种免疫性及其他原因所致水肿胎儿）血液生化指标并与相同孕周胎儿血液生化指标比较,分析各种原因所致水肿胎儿血液生化指标变化,探讨水肿胎儿病因与病理,为胎儿疾病诊断与治疗提供线索和依据。方法应用Bayer1650全自动生化分析仪对66例孕19～35周水肿单活胎儿脐静脉穿刺所取脐血进行：碱性磷酸酶（ALP）、谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TB）、直接胆红素（DB）、间接胆红素（IB）、总蛋白（TP）、白蛋白（ALB）、球蛋白（GLB）、r-谷氨酰基转酞酶（r-GT）、羟丁氨酸脱氢酶（HBDH）、乳酸脱轻酶（LDH）、肌酸磷酸激酶（CK）、肌酸磷酸激酶同工酶-1（CK-MB）等项生化指标检测,同时进行染色体,TORCH,胎儿血红蛋白和血常规等检查;并按染色体、TORCH、Bart′s、不明原因的水肿胎儿分为四类和按孕周分组统计与同孕周正常胎儿比较。结果除外Bart′s水肿胎其余原因（包括染色体、TORCH、和其他原因）所致水肿胎的心、肝酶及蛋白等水平均与与同孕周正常胎儿的水平有显著差异。结论胎儿在水肿的病理状态时存在血液生化指标异常,可能是水肿的原因或是后果,可作为水肿胎儿诊断与评估及治疗效果观察的参考指标。     

大鼠性别及血清保存条件对生化检测结果的影响研究

目的 研究大鼠不同性别、血清样本放置条件及时间对生化检验结果的影响.方法 80只大鼠编号后一次性取静脉血,放置30min后离心,每只鼠血清分成8份.首次(1h)检测后,所有血清至于-80℃冰箱保存,一份于1、2、4、7、11、23、40d时间点重复解冻、检测后复存于-80℃冰箱;其余七份分别于以上时间点单次解冻、检测后丢弃;检测项目均为谷草转氨酶(AST)、谷丙转氨酶(ALT)、尿素(UREA)、肌酐(CREA)、胆固醇(CHO)、甘油三酯(TG)、血糖(GLU)、总蛋白(TP)、白蛋白(ALB).结果 雄性、雌性大鼠血清样本-80℃冰箱保存至40d 9个生化指标均与1h差异无统计学意义;雌性大鼠血清样本保存-80℃在1d、2d、4d、7d4个时间点重复解冻,部分生化指标逐步显示差异有统计学意义,且随解冻次数及保存时间的增加,差异具有统计学意义的生化指标项数增加,第4次(7d)解冻后ALT、TP指标结果与1h测定结果比较差异具有统计学意义(均P＜0.05);第5次(11d)解冻ALT、TG、TP指标结果与1h测定结果比较差异具有统计学意义(均P＜0.05);第6次(23d)解冻ALT、CREA、TG、TP指标结果与1h测定结果比较差异具有统计学意义(均P＜0.05);第7次(40d)解冻ALT、AST、UREA、CREA、TG、GLU、TP、ALB指标结果与1h测定结果比较差异具有统计学意义(均P＜0.05).其余指标与1h测定结果比较无显著差异(P＞0.05).雄性大鼠血清样本保存-80℃重复解冻1～5次9个生化指标均与1h测定结果比较差异无统计学意义,第6次(23d)解冻TP指标测定结果比较差异具有统计学意义(P＜0.05);第7次(40d)解冻TG、TP指标测定结果比较差异具有统计学意义(均P＜0.05),其余指标与1h测定结果比较差异无统计学意义(P＞0.05).结论 不同性别大鼠血清-80℃条件下保存40d以内单次解冻后测定以及在大鼠血清解冻3次以内对生化指标测定值无影响;但重复解冻4次以上部分生化指标有显著差异,且不同性别大鼠血清指标差异情况不同,血清样本放置条件及时间及解冻次数会对大鼠生化检测指标造成影响.     

A pathological reassessment of organ-confined, Gleason score 6 prostatic adenocarcinomas that progress after radical prostatectomy

Prior studies of radical prostatectomies have reported a small percentage of men with biochemical progression after radical prostatectomy showing organ-confined, Gleason Score 6. One might predict that this should virtually never occur. We identified 2551 (1983-2005) radical prostatectomies coded by the urologists at our institution as pathologically organ-confined, Gleason score 6 cancer with more than 1 year of follow-up. We re-examined histopathogically the serially sectioned and completely embedded radical prostatectomy specimens of 38 men who developed biochemical recurrence defined as a single prostate-specific antigen level of 0.2 ng/mL or greater. In 27 (71%) of 38 of cases, pathology re-review showed higher grade or stage than coded by the urologists. These included 10 cases of organ-confined with Gleason pattern 4 as either the primary or secondary pattern; 9 cases of organ-confined, Gleason score 6 with tertiary pattern 4 (in 4 cases, tertiary pattern 4 was described in the initial pathology report); 5 cases of Gleason score 7 plus extraprostatic extension; 1 case of Gleason score 6 with focal extraprostatic extension; and 2 cases with positive margins due to intraprostatic incision (listed in the initial pathology report). The remaining 11 cases were true organ-confined, Gleason score 6 tumors, but none of the patients developed systemic disease. Most prior reports of organ-confined, Gleason score 6 with progression are undergraded (upgrading with revision of Gleason system), understaged (difficulty recognizing focal extraprostatic extension), or suffer from situations with ambiguous staging (intraprostatic incision) or grading (tertiary pattern 4 or 2 + 4 = 6). Even for the rare true organ-confined, Gleason score 6 (no pattern 4) tumor with supposed biochemical progression, some may be false-positive progression based on low post-radical prostatectomy prostate-specific antigen levels and minute tumors that seem highly improbable to progress. With accurate pathologic evaluation, men with organ-confined, Gleason score 6 (no pattern 4) prostate cancer can be told that their risk of progression is very rare (0.4%).     

2型糖尿病患者生化指标与甲状腺功能指标分析

目的探讨2型糖尿病患者生化指标与甲状腺功能指标的变化,以及2糖尿病患者甲状腺疾病的患病情况。方法随机选取2014年1月至6月我院住院的2型糖尿病患者(T2DM)295例(2型糖尿病组),健康人员80例(对照组),检测其生化指标15项:丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总蛋白(TP)、白蛋白(ALB)、碱性磷酸酶(ALP)、γ-谷氨酰基转移酶(GGT)、葡萄糖(GLU)、肌酸激酶(CK)、总胆固醇(CH)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、钙(Ca)、磷(P)、糖化血红蛋白(Hb A1c),甲状腺功能指标5项:甲状腺素(T4)、三碘甲腺原氨酸(T3)、游离T4(FT4)、游离T3(FT3)、促甲状腺激素(TSH),并对2型糖尿病组结合临床资料进行分析。结果2型糖尿病组中生化类指标TP、ALB、GLU、CH、TG、Ca、P、HDL、LDL、Hb A1c及甲状腺功能指标T3、FT3与对照组相比均有统计学意义(P<0.05);2型糖尿病组中患有甲状腺结节的患者比例最高,为44.7%;将2型糖尿病患者分为甲状腺结节组,其它甲状腺疾病组,甲状腺正常组,将甲状腺结节组和甲状腺正常组进行比较,年龄差异具有统计学意义(P<0.01),甲状腺结节组为53±12岁,甲状腺正常组为46±13岁,性别无差异(P>0.05),糖尿病病程差异具有统计学意义(P<0.01),甲状腺结节组为9±6年,甲状腺正常组为7±6年,对两组代谢指标进行分析,FT3差异显著(P<0.05),甲状腺结节组为4.48±0.82pmol/L,甲状腺正常组为4.67±0.67pmol/L,其它指标差异均无统计学意义(P>0.05);将2型糖尿病患者按空腹血糖水平分为A、B、C三组,血糖越高,甲状腺结节的比例越高,但差异无统计学意义(P>0.05)。结论 2型糖尿病患者其T3、FT3和一系列生化指标会发生变化,监测这些指标有助于对2型糖尿病进行更为全面的评估,且2型糖尿病患者中,甲状腺结节发病比例较高,且与年龄和病程相关,对于年龄较大和病程较长的患者更要关注甲状腺的检查。     

微RNA-374b与前列腺癌恶性程度及生化复发的分析

目的检测前列腺癌组织及良性前列腺组织中微RNA-374b表达,探讨其与前列腺癌恶性程度及生化复发的关系。方法收集广州医科大学附属广州市第一人民医院、中山大学附属第二医院、广州市红十字会医院2000年至2010年泌尿外科103例前列腺癌手术后的样本和25例前列腺增生手术获取的前列腺良性组织样本。采用原位杂交技术检测微RNA．374b在前列腺癌组织及良性前列腺组织中表达,并对微RNA．374b表达与前列腺癌患者年龄、术前PSA、临床分期、病理分期、Gleason评分、是否生化复发、是否转移及是否死亡的关系进行统计分析。根据微RNA．374b的相对表达量,以中位数（M=4．50）将其分为低表达组及高表达组,运用Kaplan．meier方法及Log．rank检验进行总体生存率和无生化复发生存率分析。结果微RNA．374b在前列腺癌的表达低于良性组织（3．97±1．17比4．70±0．71,P〈0．05）。微RNA．374b的表达量同Gleason评分、病理分期、转移、是否生存及生化复发有关（均P〈0．05）,同年龄、PSA水平及临床分期无关（均P〉0．05）。微RNA．374b低表达组无生化复发生存率低于高表达组（P〈0．05）,高表达组的生化复发时间高于低表达组（P〈0．05）。微RNA．374b表达与总体生存率无关。结论微RNA．374b的低表达与前列腺癌恶性程度有关,有望成为评价前列腺癌恶性程度及生化复发的指标。     

不同年龄、性别新疆锡伯族、哈萨克族成人血清生化指标比较

目的 探讨新疆锡伯族和哈萨克族人群血清生化指标随年龄及性别的变化规律及其差异,为相关疾病的预防提供依据。 方法 随机选择新疆维吾尔自治区某医院正常体检的新疆锡伯族和哈萨克族健康成人511人,其中新疆锡伯族252人,哈萨克族259人。使用美国Beckman生产的CX-7自动生化分析仪对血清生化指标进行检测,采用方差分析、t 检验、相关性分析和 χ2 检验进行统计学分析。结果 新疆锡伯族和哈萨克族血清生化指标男性和女性谷丙转氨酶（GPT）、直接胆红素（DBil）、肌酐（Cre）、尿素(Ure)、尿酸(UA)、血糖(Glu)、总胆红素（TBil）、胱抑素C(Cys-C)均随年龄增长而增加,同性别各年龄组间差异均有统计学意义（Ｐ<0.05）,同年龄段男性高于女性（Ｐ<0.05）;高密度脂蛋白（HDL）随年龄增长逐渐降低,低密度脂蛋白（LDL）、甘油三酯(TG)、总胆固醇(TC)随年龄增长逐渐增高,同性别各年龄段之间差异有统计学意义（Ｐ<0.05）;TG、TC 和 LDL 在50岁以前各年龄组女性低于男性,HDL 女性高于男性（Ｐ<0.05）,50岁以后无差异（Ｐ>0.05）。同性别同年龄段新疆锡伯族和哈萨克族的Glu、TG、TC、LDL和 HDL 差异有统计学意义（Ｐ<0.05）。结论 不同年龄、不同性别新疆锡伯族和哈萨克族血清生化指标有差异;新疆锡伯族Glu、血脂水平与哈萨克族存在差异。     

Cartilage degradation products as markers for evaluation of patients with rheumatic disease

Markers of cartilage degradation hold a great, but so far underutilized potential in the research and clinical management of joint diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). With the rapid pace of development of such markers, they are likely to emerge as promising clinical tools for several uses. These roles may include: improving preclinical and clinical development in arthritis research; differentiation of patients with high and low turnover states at disease diagnosis; selection of optimal therapy and therapy dose for the individual patient; monitoring disease progression; and predicting disease outcome.This review focuses on the cartilage matrix components and the metabolites from this very special tissue that have been proposed as biochemical markers. Special attention is focused on the challenges facing the development of such markers to the standards required for widespread practical use. Examples are provided on the current use of cartilage derived biochemical markers and perspectives for the future use of markers and required clinical documentation are presented.     

Choline PET/CT for prostate cancer: Main clinical applications

Several studies investigated the potential roles of imaging modalities in prostate cancer patients for the evaluation of intra-prostatic disease, stage and restage. However no precise guidelines exist about the use of imaging modalities, in particular about the role of PET/CT hybrid imaging. Considering the results of the literature and our experience, we tried to summarize the main applications of choline positron emission tomography (PET) in prostate cancer patients. The use of choline PET/CT for initial diagnosis and staging is not recommended as a first-line method. Instead the main and important application of choline PET/CT is represented by the restaging of the disease in case of biochemical relapse for the detection of lymph node and distant recurrence. In particular choline PET/CT could play a crucial role as first diagnostic procedure in prostate cancer patients who show a fast growing Prostate Specific Antigen (PSA) kinetics.