髂内动脉钙化对肾移植受者移植物功能延迟恢复和近期预后的影响

目的 分析髂内动脉钙化与肾移植受者移植物功能延迟恢复（DGF）及近期预后的相关性。方法 回顾性分析222例肾移植受者的临床资料。依据肾功能恢复情况分为DGF组（50例）和移植物功能正常恢复（IGF）组（172例）,根据是否合并髂内动脉重度钙化将DGF组和IGF组分为DGF高危组（22例）、DGF低危组（28例）、IGF高危组（41例）以及IGF低危组（131例）。比较两组供受者临床资料,总结肾移植术后DGF及髂内动脉钙化发生情况,分析肾移植术后发生DGF的危险因素、髂内动脉钙化与临床指标的相关性以及DGF合并髂内动脉重度钙化受者近期预后。结果 本研究中DGF发生率为22.5%(50/222)。肾移植受者中28.4%(63/222)合并髂内动脉重度钙化,DGF组中44%(22/50)合并髂内动脉重度钙化,高于IGF组中的23.8%(41/172)(P<0.05)。单因素分析结果显示供者终末血清肌酐（Scr）高、男性供者,受者甘油三酯水平高和髂内动脉重度钙化是肾移植术后发生DGF的危险因素（均为P<0.05）。多因素logistic回归分析显示供者Scr≥143μmol/L及受...     

TSP-1在肾透明细胞癌与外周血中的表达及临床意义

目的 检测并分析凝血酶敏感蛋白-1(thrombospondin-1,TSP-1)在肾透明细胞癌患者肾癌、癌旁组织、正常肾组织及外周血中的表达及临床意义.方法 收集47例肾透明细胞癌患者的标本包括:47例肾癌组织、41例癌旁组织、38例正常肾组织、35例患者外周血标本,制备组织抽提液及外周血清.运用ELISA法检测三种组织及血清中TSP-1的表达,并结合临床资料分析其临床意义.结果 TSP-1在肾癌组织、癌旁组织、正常肾组织三者间的表达水平分别为36.44±4.80ng/mL、42.55±4.12ng/mL、46.55±1.55ng/mL,依次递增,三种组织间的表达水平,两两比较均有统计学差异(P均＜0.01).TSP-1在肾癌组织中的表达,随着肾癌TNM分期与Fuhrman分级的提高而均降低,且都呈负相关(r=-0.84,P＜0.01;r=-0.70,P＜0.01).结论 TSP-1在肾透明细胞癌组织中低表达,可能在抑制肿瘤血管形成过程中起重要作用;TSP-1在肾透明细胞癌组织中的表达与肾癌的TNM分期和Fuhrman分级关系密切,可作为评判肾透明细胞癌发展及恶性程度的指标.     

快速序贯器官衰竭评分对经皮肾镜取石术后脓毒症休克的预测价值

目的:探讨快速序贯器官衰竭评分(qSOFA)对经皮肾镜取石术(PCNL)后脓毒症休克的预测价值。方法:回顾性分析2018年5月至2019年10月苏州大学附属第一医院收治的309例肾结石行PCNL患者的临床资料。男192例,女117例;年龄(51.4±12.8)岁;伴高血压病82例,糖尿病23例;78例既往有泌尿系手术史...     

肾移植患者血清中可溶性B7-H3水平的变化及其临床意义

Objective To detect the serum soluble B7-H3 (sB7-H3) in patients before and after renal transplantation, and to investigate the clinical significance. Methods The serum level of sB7-H3 in 34 patients were determined before and 3, 6, 12 months after renal transplantation. Besides, 11 health adults were elected as controls. These 34 patients were divided into two groups according to HLA and/or MICA antibodies using Luminex before operation. After transplantation, all the patients were divided into two groups according to their conditions; group Ⅰ with rejection; group S with stable renal function and no rejection. Results The serum level of sB7-H3 in all 34 patients before operation was significantly higher than health controls [(27. 10 ± 13. 61) μg/L,n = 34 vs (11.61 ±3.77) μg/L,n = 11 ,P ＜0. 01], and significantly higher in patients with antibodies than in those without before operation [(34. 96 ± 17. 37) (μ/L, n = 11 vs (23. 34 ± 9. 75) (μg/L, n = 23, P ＜ 0. 05]. There was no significant difference in the serum level of sB7-H3 between control group and S group after operation (P ＞0. 05). In group Ⅰ, the serum level of sB7-H3 was increased obviously when rejection occurred [(20. 63 ±4. 28) μg/L,n = 12; (18. 95 ±2.98) μg/L,n=6; (28.36 ±19. 83) μg/L,n = 10] , as compared with group S and control group (P＜0. 01), while at the time without rejection, there was no difference among them (P ＞0. 05). Conclusion Monitoring serum sB7-H3 after renal transplantation would be clinically useful in indicating therapeutic effect and outcome of the patients.     

前列腺液中B7-H3分子表达对t-PSA灰区内炎性PSA升高的鉴别诊断价值

目的 探讨前列腺液(EPS)中B7-H3分子对血清t-PSA灰区(4～10 ng/ml)内炎性PSA升高患者的鉴别诊断价值.方法 选择2009年12月至2010年4月收治的全部慢性前列腺炎(CP)患者和t-PSA灰区内行前列腺穿刺活检患者共116例,年龄19～80岁,平均40岁.CP 91例,年龄19～49岁,平均31岁.其中慢性细菌性前列腺炎(II型)11例、慢性炎症性非细菌前列腺炎(IIIA型)26例、慢性非炎症性非细菌前列腺炎(IIIB型)54例.t-PSA灰区内接受经直肠超声引导下前列腺穿刺活检患者25例,年龄62～80岁,平均71岁,t-PSA(7.21±2.60)ng/ml.其中穿刺病理结果阳性5例,Gleason评分6分2例、7分2例、8分1例;阴性20例,其中伴炎症细胞浸润11例.采用经直肠按摩法提取EPS.酶联免疫吸附法检测各组EPS B7-H3水平.健康男性对照11例,年龄24～46岁,平均30岁.既往无泌尿系不适症状及手术史.结果 对照组、II型组、IIIA型组、IIIB型组EPS中B7-H3水平依次为(49.81±11.54)、(19.33±13.90)、(17.67±15.76)、(25.14±13.44)ng/ml,穿刺阳性组、阴性不伴炎症组、阴性伴炎症组分别为(26.30±16.32)、(30.23±18.42)、(10.11±5.42)ng/ml.CP各组EPS B7-H3水平均低于对照组,差异有统计学意义(P＜0.01).II型组和IIIA型组间差异无统计学意义(P＞0.05),但均显著低于IIIB型组,差异有统计学意义(P＜0.05).穿刺阴性伴炎症组EPS中B7-H3水平与II型组、IIIA型组比较差异无统计学意义(P＞0.05),但显著低于穿刺阳性组及阴性不伴炎症组,差异有统计学意义(P＜0.05).EPS B7-H3表达检测在t-PSA灰区内诊断炎性PSA升高患者的ROC曲线下面积为0.883(P=0.001),当EPS B7-H3值≤16.24 ng/ml时,诊断敏感性为78.6%,特异性为81.8%.结论 EPS B7-H3表达检测可能成为t-PSA灰区内鉴别诊断炎性PSA升高的新指标,从而减少不必要的前列腺穿刺活检.

Abstract：

Objective To investigate the value of B7-H3 in expressed prostatic secretions (EPS) in differential diagnosis of patients with inflammatory elevation of PSA in t-PSA gray zone (4-10 ng/ml). Methods One hundred and sixteen patients from the ages of 19 to 80 years (mean, 40 years) were stu-died. In the group there were 91 chronic prostatitis (CP) patients (mean age 31 years, 19-49 years), including 11 chronic bacterial prostatitis (type II) patients, 26 inflammatory nonbacterial prostatitis (IIIA) patients and 54 noninflammatory nonbacterial prostatitis (IIIB) patients. Transrectal ultrsound guided prostate biopsy was performed on 25 patients (mean age 71 years, 62-80 years) with t-PSA in gray zone (7.21±2.60 ng/ml). Five had positive results, Gleason score was 6 in two cases, 7 in two cases and 8 in one case. Twenty patients had negative results, of whom 11 patients had inflammatory cell infiltration. EPS was collected by transrectal massage, and Enzyme-linked immunosorbent assays (ELISA) were performed for B7-H3 detection. In addition, 11 normal male controls with a mean age of 30 years (24-46 years) were recruited into the study. Volunteers were excluded if they had a history of genitourinary symptoms or surgery.Results The EPS B7-H3 levels of controls, II, IIIA, IIIB groups were 49.81±11.54, 19.33±13.90, 17.67±15.76, 25.14±13.44 ng/ml, respectively. The levels of EPS B7-H3 in positive biopsy, noninflammatory negative biopsy and inflammatory negative biopsy groups were 26.30±16.32, 30.23±18.42, 10.11±5.42 ng/ml, respectively. The highest levels were found in the control group (P<0.01). Compared to the IIIB, B7-H3 levels in II and IIIA groups were significantly lower (P<0.05). There was no significantly difference between II and IIIA groups (P>0.05). The EPS B7-H3 levels in the inflammatory negative biopsy group were statistically lower than in positive biopsy and noninflammatory biopsy groups (P<0.05). But no significant differences were found among inflammatory negative biopsy, II and IIIA groups (P>0.05). Receiver operating curve (AUC=0.883, P=0.001) utilizing EPS B7-H3 levels≤16.24 ng/ml identified patients with inflammatory elevation of PSA with a sensitivity of 78.6% and a specificity of 81.8% from patients with t-PSA in gray zone. Conclusion The EPS B7-H3 detection provides a new way for differential diagnosis of patients with inflammatory elevation of PSA in t-PSA gray zone resulting in a reduction of unnecessary prostate biopsy.     

肾上腺巨大血管平滑肌脂肪瘤1 例

患者女,40 岁,因“阵发性腰背部酸痛2 月余冶于2014 年3 月18 日入院。既往无高血压等疾病史。     

外周血NLR、PLR和PSA的前列腺癌诊断价值

目的 探讨外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和前列腺特异性抗原(PSA)对前列腺癌的诊断价值.方法 检测119例前列腺癌患者(前列腺癌组)和97例非前列腺癌患者(非前列腺癌组)外周血中性粒细胞、淋巴细胞、血小板和PSA水平,计算NLR和PLR,分析NLR、PLR和PSA对前列腺癌的...     

非那雄胺对PSA及Gleason评分的影响

目的：探讨非那雄胺类药物对前列腺癌患者前列腺特异抗原（PSA）的影响及与病理Gleason评分的关系。方法回顾性分析2012年4月至2013年12月期间经前列腺穿刺确诊为前列腺癌患者的临床资料。结果服用非那雄胺患者较未服用非那雄胺患者血清PSA水平低（P<0.05）。穿刺后病理显示Gleason评分>7分的患者占55.56%,服用非那雄胺患者较未服用非那雄胺患者病理Gleason评分低（P<0.05）。结论非那雄胺能降低患者血清PSA水平,并降低患者病理Gleason评分。     

The value of B7-H3 expression in expressed prostatic secretions in differential diagnosis of patients with inflammatory elevation of PSA in t-PSA gray zone

<正>Objective To investigate the value of BT-H3 in expressed prostatic secretions ( EPS) in differential diagnosis of patients with inflammatory elevation of PSA in t - PSA gray zone ( 4 - 10 ng /ml) . Methods One hundred and sixteen patients from ages of 19 to 80 years ( mean,40 years) were studied. In the group there were