Cognitive magnetic resonance imaging-ultrasound fusion transperineal targeted biopsy combined with randomized biopsy in detection of prostate cancer

BACKGROUND Prostate cancer(PCa)is one of the most common cancers among men.Various strategies for targeted biopsy based on multiparametric magnetic resonance imaging(mp-MRI)have emerged,which may improve the accuracy of detecting clinically significant PCa in recent years.AIM To investigate the diagnostic efficiency of a template for cognitive MRIultrasound fusion transperineal targeted plus randomized biopsy in detecting PCa.METHODS Data from patients with an increasing prostate-specific antigen(PSA)level but less than 20 ng/mL and at least one lesion suspicious for PCa on MRI from December 2015 to June 2018 were retrospectively analyzed.All patients underwent cognitive fusion transperineal template-guided targeted biopsy followed by randomized biopsy outside the targeted area.A total of 127 patients with complete data were included in the final analysis.A multivariable logistic regression analysis was conducted,and a two-sided P<0.05 was considered statistically significant.RESULTS PCa was detected in 66 of 127 patients,and 56 cases presented clinically significant PCa.Cognitive fusion targeted biopsy alone detected 59/127 cases of PCa,specifically 52/59 cases with clinically significant PCa and 7/59 cases with clinically insignificant PCa.A randomized biopsy detected seven cases of PCa negative on targeted biopsy,and four cases had clinically significant PCa.PSA density(OR:1.008,95%CI:1.003-1.012,P=0.001;OR:1.006,95%CI:1.002-1.010,P=0.004)and Prostate Imaging-Reporting and Data System(PI-RADS)scores(both P<0.001)were independently associated with the results of cognitive fusion targeted biopsy combined with randomized biopsy and targeted biopsy alone.CONCLUSION This single-centered study proposed a feasible template for cognitive MRIultrasound fusion transperineal targeted plus randomized biopsy.Patients with higher PSAD and PI-RADS scores were more likely to be diagnosed with PCa.

Oncological impact of different distal ureter managements during radical nephroureterectomy for primary upper urinary tract urothelial carcinoma

BACKGROUND The current standard surgical treatment for non-metastatic upper urinary tract urothelial carcinoma(UTUC)is radical nephroureterectomy(RNU)with bladder cuff excision(BCE).Typically,BCE techniques are classified in one of the following three categories:An open technique described as intrasvesical incision of the bladder cuff,a transurethral incision of the bladder cuff(TUBC),and an extravesical incision of the bladder cuff(EVBC)method.Even though each of these management techniques are widely used,there is no consensus about which surgical intervention is superior,with the best oncologic outcomes.AIM To investigate the oncological outcomes of three BCE methods during RNU for primary UTUC patients.METHODS We retrospectively analyzed the data of 248 primary UTUC patients,who underwent RNU with BCE between January 2004 to December 2018.Patients were analyzed according to each BCE method.Data extracted included patient demographics,perioperative parameters,and oncological outcomes.Statistical analyses were performed using chi-square and log-rank tests.The Cox proportional hazards regression model was utilized to identify independent predictors.P<0.05 was considered statistically significant.RESULTS Of the 248 participants,39.9%(n=99)underwent intrasvesical incision of the bladder cuff,38.7%(n=96)EVBC,and 21.4%(n=53)TUBC.At a median followup of 44.2 mo,bladder recurrence developed in 17.2%,12.5%,and 13.2%of the cases,respectively.Cancer-specific deaths occurred in 11.1%,5.2%,and 7.5%of patients,respectively.Kaplan-Meier survival curves with a log-rank test highlighted no significant differences in intravesical recurrence-free survival,cancer-specific survival,and overall survival among these approaches with P values of 0.987,0.825,and 0.497,respectively.Multivariate analysis showed that the lower ureter location appears to have inferior intravesical recurrence-free survival(P=0.042).However,cancer-specific survival and overall survival were independently influenced by tumor stage(hazard ratio[HR]=8.439;95%con
dence interval:2.424-29.377;P=0.001)and lymph node status(HR=14.343;95%CI:5.176-39.745;P<0.001).CONCLUSION All three techniques had comparable outcomes;although,EVBC and TUBC are minimally invasive.While based upon rather limited data,these findings will support urologists in blending experience with evidence to inform patient choices.However,larger,rigorously designed,multicenter studies with long term outcomes are still required.

Effect of aging temperature on the microstructures and mechanical properties of ZG12Cr9Mo1Co1NiVNbNB ferritic heat-resistant steel

The effect of aging on the mechanical properties and microstructures of a new ZG12Cr9 MolColNiVNbNB ferritic heat resistant steel was investigated in this work to satisfy the high steam parameters of the ultra-supercritical power plant.The results show that the main precipitates during aging are Fe（Cr,Mo）23C6,V（Nb）C,and（Fe2Mo） Laves in the steel.The amounts of the precipitated phases increase during aging,and correspondingly,the morphologies of phases are similar to be round.Fe（Cr,Mo）23C6 appears along boundaries and grows with increasing temperature.In addition,it is revealed that the martensitic laths are coarsened and eventually happen to be polygonization.The hardness and strength decrease gradually,whereas the plasticity of the steel increases.What＇s more,the hardness of this steel after creep is similar to that of other 9%-12%Cr ferritic steels.Thus,ZG12Cr9 MolColNiVNbNB can be used in the project.

Synergistic Effects of Gamma Irradiation,Tensile Stress and Moisture on the Radiolysis of Silicone Foam

The present work involves the investigation of the synergistic effects of gamma irradiation,tensile stress and absorbed moisture on the radiolysis behaviors of silicone foams by experiments and theoretical simulations.For both the pristine and dehydrated samples,the permanent tensile set increases with the initial tensile strain.Further analysis uncovers that the dehydrated samples exhibit greater permanent tensile sets,lower further elongation and higher Young’s modulus than the counterparts of the pristine samples with the same initial tensile strain and gamma dose,verifying the vital synergistic effects on crosslinking network and aggregation structures caused by moisture and gamma radiation.The synergistic effects unveiled by reactive molecular dynamics at the atomic scale are due to the moisture-induced neutralization and stabilization of the macromolecular radicals.The steric hindrance of moisture located at the interface of silica and polymer chains also conduces to the observed synergistic effects due to the inhibited crosslinking reactions.

Clinical characteristics and risk factors of infantile hemangioma: a case-control study in Northwest China

Objective To investigate the clinical characteristics and risk factors of infantile hemangioma in Xinjiang Uygur Autonomous Region,China.Methods A total of 941 infants with infantile hemangioma were identified as subjects and matched with 941 infants of the same age without infantile hemangioma.Trained investigators used a standardized questionnaire to collect data from both groups,including demographic,prenatal,and perinatal characteristics.Univariate and multiple logistic regression models were used to screen risk factors.Results This study revealed that female (P < 0.001,OR =3.08,95% CI =2.54-3.74),maternal tea drinking (P< 0.001,OR =1.86,95% CI=1.32-2.61),low birthweight (P< 0.001,OR =3.01,95% CI=2.10-4.30),preterm (P< 0.001,OR =4.07,95% CI=2.73-6.09),gestational diabetes (P < 0.001,OR =2.03,95% CI =1.41-2.94),maternal progesterone use (P <0.001,OR =2.44,95% CI =1.83-3.25) and a history of hemangiomas in first-degree relatives (P <0.001,OR =1.80,95% CI =1.33-2.43) influenced the occurrence of infantile hemangioma.Female (P < 0.001,OR =2.82,95% CI =2.30-3.45),maternal progesterone use (P < 0.001,OR =14.64,95%CI =3.52-60.88) and a history of hemangiomas in first-degree relatives (P< 0.001,OR =0.011,95%CI =0.002-0.065) were independent risk factors for infantile hemangioma.Conclusions Female,maternal tea drinking,low birthweight,preterm,gestational diabetes,maternal progesterone use,and a history of hemangiomas in first-degree relatives may interact with each other leading to the occurrence of infantile hemangioma.