[Transperineal targeted prostate puncture combined with rapid pathological examination in the diagnosis of prostate cancer]

Exploring the clinical value of multiparametric magnetic resonance (Mp-MRI)-cognitive fusion method of targeted transperineal prostate puncture combined with rapid pathological diagnosis. Patients with suspected prostate cancer admitted to our hospital from 2022.01 to 2023.05 were selected as the study subjects, and Mp-MRI was performed and the suspected lesions were scored by the Prostate Imaging Reporting and Data System (PI-RADS). The enrolled patients were randomly divided into the transperineal prostate targeted puncture plus rapid pathology group (experimental group) and the transperineal prostate systematic combined targeted puncture plus conventional pathology group (control group), and the positive puncture rate, pathological findings, and complications were analyzed to compare the differences between the two groups. A total of 100 patients were enrolled, 53 in the experimental group [age 55-89 years, (73.17±7.79) years; tPSA 7.01-100 μg/L, mean 21.34 (12.38, 44.42) μg/L]and 47 in the control group [age 60-87 years, (71.96±7.07) years; tPSA 6.11-98.82 μg/L, mean 18.77 (9.04, 38.09) μg/L], and there was no significant difference between the two groups in the diagnostic positivity rate of overall PCa and clinically significant PCa (P>0.05); there was no significant difference in the highest Gleason score of pathological tissues between the two groups (P>0.05); the number of cases of medically induced sarcoid hematuria in the experimental group were significantly reduced compared with the control group (P<0.05). In terms of biopsy pain score (VAS), patients in the experimental group experienced less pain than those in the control group (P<0.05). The Mp-MRI-cognitive fusion method of transperineal targeted prostate puncture combined with rapid frozen section pathological examination can provide rapid and accurate pathological results, reduce the chance of post-puncture complications, and alleviate the pain caused by puncture sampling, which has high clinical value.

[Design and clinical application of goal-oriented retroperitoneoscopic adrenalectomy]

Objective: To investigate the goal-oriented retroperitoneoscopic adrenalectomy and report the initial experiment. Methods: A total of 102 patients were selected to our clinic experiment, and performed retroperitoneoscopic adrenalectomy with the new method. including adrenal cortex adenoma 76 cases, phaochromocytoma 12 cases, adrenal cyst 6 cases, myelolipoma 4 cases, gangliocytoma 1 case and corticohyperplassia 3 cases. The mean diameter of the tumors was 2.8 cm (0.5-5.8 cm). The operative procedure was briefly described as such, with ultrasound guiding, a needle was punched percutaneously up to the adrenal mass or the renal upper pole from lateral to posterior axillary line just below the inferior border of the 12th rib. labeled the pathway of the needle with methylene blue. Along the way of the needle, a 12 mm port was introduced into the retroperitoneal space with closed method, and the laparoscope with a working tunnel was introduced to make a tunnel along the label up to the adrenal for finally removing it. Additional port should be used when it was needed in the procedure. Results: The procedures of all patients were successful, and 10 patients were performed with only one port, 81 patients with two ports, 11 patients with three ports. The operative duration was 49 (31-115) min, the average blood loss was 38 (0-260) ml. There was no transition to open surgery and no perioperative complications. The length of postoperative hospital stay was 4.1 d (2-7 d). 98 patients were available for follow-up of 16.5 months (1-38 months), no complication was found. Conclusions: The new method of retroperitoneoscopic adrenalectomy is feasible and safe for renal masses, and compared to the conventional method, it may be less trauma to the abdominal wall and retropertoneal tissue, and it was also better on cosmetics.

[Cement augmentation for vertebral osteolytic metastatic lesions: an evaluation on postoperative CT]

Objective: To evaluate the effectiveness of cement augmentation on the osteolytic lesion in patients with vertebral metastasis. Methods: A total of consecutive 132 patients with 268 vertebral metastatic lesions treated with PVP from January 2008 to December 2016 in Zhongda Hospital were enrolled in this study. Retrospective analysis of preoperative, postoperative 3 days, 3 months, 6 months, 12 months and ≥ 18 months imaging data on CT, the local control and progression of the tumor were evaluated by MDA response criteria. The local control rates were compared between the groups with the different rate of cement filling by Chi²-test. Results: Vertebroplasty procedures were performed successfully in all 268 vertebrae under DSA guidance, and the mean volume of PMMA injected in each vertebra was 0.7-8.5(3.9±1.5)ml.The rate of local control at 3 months, 6 months, 12 months and ≥18 months after PVP was respectively 98.9%, 95.1%, 91.8%, and 85.2%, the difference was statistically significant(all P<0.05). The local control rate showed a statistically significant relationship to the groups with the rate of cement filling at 6 months, 12 months and ≥18 months after PVP, but there was no statistical difference at postoperative 3 months. The rate of local control was higher in 68 patients with lung or gastrointestinal cancer than in 17 patients with liver or kidney cancer at 3 months, 6 months and 12 months, the difference was statistically significant (P<0.05). Conclusion: Cement augmentation has a local anti-tumor effect on vertebral osteolytic metastatic lesion, and the anti-tumor effect will decrease as the follow-up time extended.

[Oblique puncture approach via anterolateral to C2: a study of imaging anatomy on corpses]

Objective: To determine the anatomical relation between the carotid artery or laryngopharynx and the needle path via anterolateral oblique approach to C2 vertebral body, and whether the simulated path can direct the actual procedure. Methods: Contrast agent was injected into bilateral carotid arteries of 10 fresh cadavers (20 sides), and then CT scans were performed on each subject. Bilateral simulated puncture paths were simulated on the image of two-dimensional reconstruction CT. The distance between the puncture site and middle line(AC), the angle between the simulated puncture paths and the median sagittal plane (AOB), the distance between the simulated puncture paths and the side wall of hypopharynx, or the carotid artery was measured respectively. Under the guidance of fluoroscopy, oblique puncture via anterolateral to C2 was performed according to the simulated parameters, and then CT was done. The actual needle path was measured on the image of two-dimensional reconstruction CT. The outcomes were compared by using paired t test between groups. Results: Bilateral simulated puncture paths in all 10 cadavers were achieved on the image of CT. The bilateral punctures via anterolateral to C2 were successfully performed under fluoroscopic guidance in 10 cadavers, and the actual needle path could be showed on the image of two-dimensional reconstruction CT. The AC, angle AOB, the distance to carotid artery and side wall of laryngopharyngeal of the left simulated path was(4.7±1.0)cm, (33±8)°, (6.7±2.6)mm, (6.6±2.8)mm, respectively; and those in the right side was(5.2±1.3) cm, (36±8)°, (7.5±2.2) mm, (7.2±2.5) mm, respectively.The AC, angle AOB, the distance to carotid artery and side wall of laryngopharyngeal of the left actual needle was(4.5±1.1) cm, (33±9) °, (6.7±3.0) mm, (7.1±3.9) mm, respectively; and those in the right side was(5.1±1.5) cm, (35±10) °, (7.4±2.1) mm, (7.2±2.6) mm, respectively.And the actual and simulation data of both sides were compared and no significant differences was found by t test (t=0.104-1.882, all P>0.05). Conclusion: The simulated approach via anterolateral to C2 can be achieved on the image of two-dimensional reconstruction CT, it is consistent with the real needle path and can be used to direct the actual practice to improve the accuracy and safety.

Metabolic and muscular responses during and after a 100 km hill walk

AIM

Aim of the study was to assess different metabolic and muscular responses of recreational hikers during and after a hill walk of 100 km duration.

METHODS

Nine subjects (6 males and 3 females) completed the 100 km hill walk within 40 hrs. Physiological and muscular responses, and biomarkers were measured during- and 18 hrs after the exercise.

RESULTS

On average, exercise intensity was moderate with reference to %HRmax (64±7.1), with a declining trend. Energy expenditure ranged from 102.5 kcal/km to 186.2 kcal/km in different sections. Using a visual analog scale, left and right quadriceps, and left and right calf muscles had elevated values of perceived muscular soreness (5±2.4, 5±2.4, 4.6±2.7 and 4.6±2.7, respectively). Ranges of motion at hip and knee joints decreased at 47.4 km (P<0.05). Creatine kinase for male subjects increased 16-fold (from 106.8±95 U/L to 1747.6±1834.2 U/L) at 79.6 km. Creatine kinase-MB and lactate dehydrogenase for males were also elevated at 79.6 km and peaked at 100 km. Following recovery, creatine kinase for male subjects was still slightly higher than resting level (321.1±283.6 U/L vs. 106.8±95 U/L). Ranges of motion at hip and knee joints were higher than pre-walk level (P<0.05).

CONCLUSION

The data suggest that healthy recreational hikers with average physical fitness can complete a 100 km hill walk within 40 hours without showing excessively stressful physiological responses. However, complete recovery would probably require more than 18 hours.

Experimental and molecular dynamics investigation on tribological properties of nanocrystalline diamond films

Nanocrystalline diamond films were deposited on cemented tungsten carbide substrates using hot filament chemical vapor deposition (HFCVD) method, and their tribological properties were investigated by friction experiments and classical molecular dynamics simulations. The friction tests were performed on a ball-on-plate type reciprocating friction tester under various normal loads and sliding velocities conditions; the experimental results suggested that the friction coefficient of diamond films showed increasing tendency with the growing normal load and sliding velocity. Furthermore, classical molecular dynamics simulations were conducted to investigate the changes in atomic scale friction behaviors of diamond films under extremely high normal load and sliding velocity conditions, the atomistic sliding mechanism was also discussed in this study.

The population biology and control of Necator americanus in a village community in south-eastern China

The population dynamic parameters of Necator americanus infections were estimated from longitudinal intensity and prevalence data from a village in south-eastern China. The theoretical predictions of a deterministic model incorporating these parameters were then compared with observed, horizontal, age-prevalence data from an infected population (N = 565), and an estimate of the basic reproduction rate (R0 = 3.7) of N. americanus was obtained. The findings indicate that populations of N. americanus might be easier to control by mass-treatment chemotherapy (eradication requiring only 63% of the population to be treated every year for 4 years) than those of Ascaris lumbricoides and Trichuris trichiura.