【摘要】目的 对比舒芬太尼、羟考酮TURP麻醉诱导中的应用效果。方法 按照随机数字表法将2024年4月—2025年12月我院115例TURP患者分为S组（57例，舒芬太尼）与Q组（58例，羟考酮），其余诱导麻醉方案一致。观察两组麻醉恢复相关指标、血流动力学、疼痛评分、CRBD发生率及不良反应发生率。结果 两组瑞芬太尼总用量及苏醒、自主呼吸恢复时间对比无差异（P>0.05），Q组术中体动发生率较S组低（P<0.05）。T0 时两组MAP、HR无差异（P>0.05）；T1、T4均升高，但Q组较S组低（P<0.05）；T2、T3无差异（P>0.05）。Q组T5、T6 VAS评分均较S组低（P<0.05），T7无差异（P>0.05）。Q组CRBD发生率较S组低（P<0.05）。两组无不良反应差异（P>0.05）。结论 舒芬太尼与羟考酮用于TURP麻醉诱导均安全可行，对苏醒进程无明显影响，不良反应少。但与之相比，羟考酮在稳定血流动力学、减轻术后早期疼痛及降低术中体动、CRBD发生率方面优势更显著。

目的 研究SOCS6/STAT6通路在前列腺细胞炎性增殖作用中的调控作用。方法 使用人前列腺细胞株RWPE-1建立炎症模型,将细胞分为对照（CON）组和炎症刺激（INF）组,后者通过添加脂多糖（LPS）模拟炎症环境。采用ELISA检测白细胞介素-1β（IL-1β）-1β、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）表达水平,蛋白免疫印迹法检测细胞因子信号抑制物-6（SOCS6）、信号转导和转录激活因子-6（STAT6）及磷酸化STAT6蛋白的表达水平。结果 经过LPS处理后,RWPE-1细胞中的SOCS6蛋白表达水平显著下降（P<0.01）,而磷酸化STAT6表达水平上升（P<0.01）。结论 SOCS6/STAT6通路可能通过调节炎症环境下STAT6的磷酸化水平,参与调节前列腺细胞的炎性增殖作用。

Objective To explore the regulatory role of SOCS6/STAT6 pathway in the inflammatory proliferation of prostate cells．Methods The human prostate cell line RWPE-1 was used to establish an inflammation model．Cells were divided into a control（CON）group and an inflammation-stimulated（INF）group,with the latter subjected to lipopolysaccharide（LPS）treatment to simulate an inflammatory environment．The expression levels of interleukin（IL）-1β、IL-6 and IL-8 were detected by ELISA,and the expression levels of suppressor of cytokine signaling 6（SOCS6）,signal transducer and activator oftranscription-6,（STAT6）,and phosphorylated STAT6 proteins were detected by Western blot．Results The results showed that after LPS treatment,the expression of SOCS6 protein in RWPE-1 cells significantly decreased,while the expression of phosphorylated STAT6 increased．Conclusions The SOCS6/STAT6 pathway may be involved in regulating the inflammatory proliferation of prostate cells by modulating the phosphorylation level of STAT6 under inflammatory conditions．

目的 研究磁共振成像（MRI）、经直肠超声（TRUS）结合血清前列腺特异性抗原（PSA）诊断前列腺癌诊断的应用价值。方法 收集2020年1月—2023年1月前在武穴市第一人民医院检查的疑似前列腺癌患者140例,均给予MRI、TRUS检查,并进行血清PSA水平检测,以患者手术病理结果为金标准,观察单一MRI、TRUS、血清PSA及联合诊断时漏诊、误诊情况,进行一致性分析,计算各项单一诊断及联合诊断的诊断灵敏度、特异度、准确率。结果 经手术病理结果证实为前列腺癌81例,非前列腺癌59例,前列腺癌患者血清PSA水平高于非前列腺癌患者（P<0.05）;单一MRI、TRUS或PSA诊断前列腺癌与手术病理结果的一致性一般（Kappa=0.641、0.624、0.536,均P<0.001）,联合诊断与手术病理结果的一致性较好（Kappa=0.906,P<0.001）;联合诊断的灵敏度、特异度、准确率为高于单一MRI、TRUS、血清PSA及各诊断方式两两联合（P<α,α=0.007）。结论 前列腺癌诊断中单一MRI、TRUS、血清PSA诊断均存在漏诊、误诊风险,联合诊断可弥补单一诊断的不足,提高前列腺癌患者的诊断准确率。

Objective To study the application value of magnetic resonance imaging（MRI）,transrectal ultrasound（TRUS）combined with serum prostate-specific antigen（PSA）in the diagnosis of prostate cancer．Methods A total of 140 patients with suspected prostate cancer who were examined at Wuxue First People's Hospital from January 2020 to January 2023 were enrolled．MRI and TRUS examinations were performed,and serum PSA levels were tested．The surgical pathology results of the patients were used as the gold standard．The missed diagnosis and misdiagnosis in single MRI,TRUS,serum PSA and combined diagnosis were observed,consistency was analyzed,and the diagnostic sensitivity,specificity,and accuracy of each single diagnosis and combined diagnosis were calculated．Results There were 81 cases of prostate cancer and 59 cases of non-prostate cancer confirmed by surgical pathology results．The serum PSA level of prostate cancer patients was higher than that of non-prostate cancer patients（P<0.05）．The difference between the diagnosis of prostate cancer by single MRI,TRUS or PSA and the results of surgical pathology was with general consistency（Kappa=0.641,0.624,0.536,all P<0.001）,and the consistency of combined diagnosis and surgical pathology results was good（Kappa=0.906,P<0.001）．The sensitivity,specificity,and accuracy of combined diagnosis were higher than single MRI,TRUS,serum PSA and the combination of two diagnostic methods（P<α,α=0.007）．Conclusions In the diagnosis of prostate cancer,single MRI,TRUS and serum PSA diagnosis all have risks of missed diagnosis and misdiagnosis．Combined diagnosis can make up for the shortcomings of single diagnosis and improve the diagnostic accuracy of prostate cancer．

目的 调查良性前列腺增生（BPH）患者对前列腺手术的接受意愿,并分析其影响因素。方法 采用问卷调查法,于2021年3月—2022年10月选取中山大学附属第一院惠亚医院收治的133例BPH患者为研究对象。由调查者床边发放问卷,并当场收回。结果 调查共发放问卷133份,回收有效问卷130份,有效率为97.74%。单因素分析结果显示,经济负担、医保报销、BPH程度、住院陪护、了解BPH对自身的危害等因素与患者接受手术意愿相关（P<0.05）。Logistic多因素回归分析显示,患者的经济负担、医保报销及已存在BPH并发症是影响患者接受手术意愿的因素（P<0.05）。结论 本区域BPH患者由于经济、医保及已存在BPH并发症的问题,直接影响了接受前列腺手术的意愿,不仅影响患者的生理健康,也影响生活质量及家庭和睦关系,应加大疾病认知宣传力度,组建患者互助团体,促进居民对BPH疾病及手术的了解,提高该类患者的生活质量。

Objective To investigate the willingness of patients with benign prostatic hyperplasia（BPH）to accept prostate surgery and analyze its influencing factors．Methods A questionnaire survey method was used to select 133 patients with BPH admitted to a hospital from March 2021 to October 2022．The questionnaires were distributed and collects by the investigator at the bedside．Results A total of 133 questionnaires were distributed during the survey and 130 valid questionnaires were collected,with an effective rate of 97.74%．The results of single factor analysis showed that factors such as financial burden,medical insurance reimbursement,degree of BPH,hospitalization accompaniment,and understanding of the harm of prostate hyperplasia were significantly related to patients’ willingness to receive surgery,with statistical significance（P<0.05）．Logistic multifactor regression analysis showed that the patient’s financial burden,medical insurance reimbursement,and existing BPH complications were factors that affected the patient’s willingness to receive surgery．Conclusion sBPH patients in local region have financial burden,medical insurance and existing complications of BPH,which directly affect their willingness to undergo prostate surgery．Those factors not only affect the patients’ physical health but also affect the quality of theirlife and harmonious thier family relationships． Awareness of the disease should be increased to promote publicity,and patient mutual aid groups should be started to improve residents’ understanding of BPH disease and surgery and improve the quality of patients’life．

目的 探讨尿液前列腺特异性抗原（u-PSA）预测老年良性前列腺增生（BPH）发生急性尿潴留（AUR）的价值。方法 选取东莞市中医院100例老年BPH患者（2020年1月—2021年4月）进行回顾性研究,均口服盐酸坦索罗辛+非那雄胺片治疗,随访1年,记录AUR发生情况,据此分为AUR组、非AUR组。比较2组一般资料,Logistic回归模型分析老年BPH发生AUR的危险因素,受试者工作特征（ROC）分析前列腺体积（PV）、u-PSA对老年BPH发生AUR的预测价值。结果 100例老年BPH患者AUR发生率为26%;AUR组u-PSA水平高于非AUR组,PV大于非AUR组（P<0.05）;Logistic回归模型分析,u-PSA水平及PV增高是老年BPH患者发生AUR的独立危险因素（P<0.05）;ROC曲线分析,u-PSA预测AUR的AUC=0.897,高于AUC_PV（P<0.05）。结论 u-PSA可作为老年BPH继发AUR的量化评估指标,有利于临床早期筛查、诊断,采取针对性干预措施,改善预后。

Objective To investigate the value of urinary prostate-specific antigen（u-PSA）in predicting acute urinary retention（AUR）in elderly patients with benign prostatic hyperplasia（BPH）．Methods A total of 100 elderly patients with BPH in our hospital（from January 2020 to April 2021）were selected for a retrospective study,all of whom were treated with oral tamsulosin hydrochloride + finasteride tablets,followed up for 1 year,and the occurrence of AUR was recorded．The patients were divided into AUR group and non-AUR group．The general data of the two groups were compared．Logistic regression model was used to analyze the risk factors of AUR in elderly BPH patients,and receiver operating characteristic（ROC）was used to analyze the predictive value of prostate volume（PV）and u-PSA for AUR occurrence．Results The incidence of AUR in 100 elderly patients with BPH was 26%;the level of u-PSA in the AUR group was higher than that in the non-AUR group,and the PV was greater than that in the non-AUR group（P<0.05）．Increased PV was an independent risk factor for AUR in elderly patients with BPH（P<0.05）．ROC curve analysis showed that the AUC of u-PSA for predicting AUR was 0.897,which was higher than that of PV（P<0.05）．Conclusions u-PSA can be used as a quantitative evaluation index for AUR secondary to BPH in the elderly,which is conducive to early clinical screening and diagnosing,and taking targeted intervention measures to improve prognosis.

目的 探讨经尿道前列腺双极等离子电切术(bipolar plasmakinetic resection of prostate,BPRP)与经尿道前列腺钬激光剜除术(holmium laser enucleation of prostate,HoLEP)治疗大体积良性前列腺增生症的临床效果。方法 选择2018年1月—2021年1月本院收治的大体积良性前列腺增生症患者82例,以随机数字表法分为观察组(41例,HoLEP)、对照组(41例,BPRP),比较两组患者手术指标、前列腺症状、生活质量及术后并发症情况。结果 手术指标相比,观察组手术时间(P=0.020)、膀胱冲洗时间(P=0.027)、留置导尿管时间(P=0.007)、术后住院时间(P=0.033)均短于对照组;前列腺症状评分相比,观察组与对照组术前评分无差异(P=0.655),观察组术后半年评分低于对照组(P=0.001);生活质量评分相比,观察组与对照组术前评分无差异(P=0.492),观察组术后半年评分低于对照组(P=0.001);术后并发症发生率对比,观察组总发生率9.76%低于对照组31.71%(P=0.014)。结论 在大体积良性前列腺增生症患者治疗时,HoLEP与BPRP 2种术式均安全有效,但前者手术时间更短,患者预后更快,患者术后恢复时间更短,值得推广。

目的 通过对不同职业人群前列腺疾病患病情况及相关危险因素进行分析,探讨不同职业人群前列腺疾病的患病率及相关危险因素。方法 选择2019年1月—2019年12月在我院健康管理中心进行前列腺超声检查的不同职业人群3 219例,按其职业分为5类:医务人员、国企职工、私企职工、高校教职工和银行职工,分析不同职业人群前列腺疾病患病情况及其相关影响因素。结果 3 219例受检者中,前列腺疾病的患病率为43.96%,前列腺疾病患病率随着年龄的增长而升高(P＜0.001);20～29岁及30～39岁年龄组前列腺钙化患病率均高于其他三种类型前列腺疾病(P＜0.001),而60岁以上年龄组前列腺增生和合并两种及以上前列腺疾病患病率均高于其他两种类型前列腺疾病(P＜0.001);前列腺增生和合并两种及以上前列腺疾病的患病率均随着年龄的增长而递增(P＜0.001);不同职业人群前列腺疾病的患病率不同(P＜0.001),银行职工的前列腺疾病患病率最高,为52.36%;体质量指数升高组、血压升高组和血脂升高组的前列腺钙化患病率均高于其对应的正常组(P＜0.05);体质量指数升高组、血糖升高组、血压升高组和血脂升高组的前列腺增生患病率均高于其对应的正常组(P＜0.001)。结论 不同的职业群体前列腺疾病的患病情况不一样,体质量指数升高、血压升高、血脂升高及血糖升高等相关因素增加患前列腺疾病的风险,应加强前列腺疾病预防保健方面的健康宣传,提倡健康的生活方式,从而降低前列腺疾病的患病率。

Objective To study on epidemic situation of prostate disease and related risk factors in different occupational groups by analyzing the prevalence and related risk factors of prostate disease in different occupational groups. Methods 3 219 cases of five different occupations including medical staffs, state-owned enterprise staffs, private enterprise staffs,college staffs and bank staffs who had underwent prostate ultrasonography in the health management centre department of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2019 were included as study objects to analyze the prevalence of prostate disease and its related factors in different occupational groups. Results The prevalence of prostate disease was 43.96% in 3 219 cases of different occupational groups, and the prevalence of prostate disease increased greatly with age(P＜0.001). The detection rates of prostate calcification in the age group of 20-29 and 30-39 were greatly higher than the other three types of prostate diseases(P＜0.001). The detection rate of BPH and with two or more prostate diseases in the age group over 60 years old was greatly higher than the other two types of prostate diseases(P＜0.001);The detection rates of BPH and with two or more prostate diseases were significantly increased with age (P＜0.001). There was an obvious difference inthe prevalence of prostate diseasesamong different occupational groups(P＜0.001). The prevalence of prostate disease in bank staffs was 52.36%, which was the highest among the five occupations. The prevalence of prostate calcification in the group with high body mass index, high blood pressure and high blood lipid were greatly higher than that of their normal group(P＜0.05). The prevalence of BPH in the group with high body mass index, high blood glucose, high blood pressure and high blood lipid were higher than that of their greatly normal group(P＜0.001). Conclusions The prevalence of prostate diseases is different among different occupational groups. Relative factors such as high body mass index, high blood glucose, high blood pressure and high blood lipid will increase the risk of prostate disease. By strengthening the health promotion of prostate disease prevention and health care, promoting a healthy lifestyle, it may reduce the prevalence of prostate disease.

目的 快速康复外科理念在老年前列腺电切术后的应用分析。方法 选取我院2019年1月—2020年10月行前列腺电切术老年患者88例,以随机数字表法分为两组,参照组给予常规护理,研究组给予快速康复外科理念下护理,比较两组患者术后尿管拔除时间、术后首次进食时间、术后首次下床活动时间,并比较两组住院天数、及入院时和出院前生活质量(以ADL评价)评分,术后并发症发生情况。结果 研究组术后尿管拔除、首次进食、首次下床活动时间、住院天数短于参照组,术后并发症发生率低于参照组,差异有统计学意义(P＜0.05);入院时,两组ADL评分比较,差异无统计学意义(P＞0.05)。出院前,两组ADL评分高于入院时,且研究组高于参照组,差异有统计学意义(P＜0.05)。结论 老年患者行前列腺电切术后,给予快速康复外科理念下的护理服务,有利于缩短术后尿管拔除、进食、下床活动时间,也能够提高患者生活质量,减轻并发症影响,缩短住院天数,提高床位周转率,具有较高的护理价值。

目的 探讨多参数磁共振成像-经直肠超声(mpMRI-TRUS)认知融合技术引导前列腺穿刺活检的临床应用价值。方法 选取2018 年1月—2020年12月就诊于本院且为前列腺癌疑似患者作为研究对象,分为mpMRI-TRUS组与TRUS组。mpMRI-TRUS组所有病例穿刺活检前均行mpMRI检查,根据MRI结果确定靶向病灶,行mpMRI-TRUS认知融合靶向活检和系统10针活检。TRUS组患者只行系统13针活检,比较两组间前列腺癌的检出率,同时比较mpMRI-TRUS组中靶向活检和系统活检在前列腺癌检出率方面的差异,并对穿刺病理结果进行观察和分析。结果 mpMRI-TRUS组穿刺活检阳性率为43.59%,TRUS组穿刺活检阳性率为33.07%,两组前列腺癌检出率差异无统计学意义。mpMRI-TRUS组中靶向穿刺的单针阳性率、靶向穿刺组织前列腺癌组织占比高于系统穿刺;mpMRI-TRUS组中靶向穿刺阳性率为38.46%,系统穿刺阳性率为42.30%,两者差异无统计学意义。结论 mpMRI-TRUS认知融合技术在前列腺穿刺活检能够以较少的穿刺针数检出前列腺癌,靶向穿刺能提供更多前列腺癌组织,降低前列腺癌穿刺活检的漏诊率。

Objective To explore the clinical application value of multi-parameter magnetic resonance imaging-transrectal ultrasound (mpMRI-TRUS) cognitive fusion technology to guide targeted prostate biopsy. Methods The research objects were patients suspected of prostate cancer from January 2018 to December 2020 and the patients were divided into mpMRI-TRUS group and TRUS group. All cases in the mpMRI-TRUS group underwent mpMRI examination before needle biopsy. The targeted lesions were determined according to the MRI results.And mpMRI-TRUS cognitive fusion targeted biopsy and system 10-needle biopsy were performed. Patients in the TRUS group only underwent a systematic 13-needle biopsy. The detection rate of prostate cancer between the two groups was compared. At the same time, the difference in the detection rate of targeted biopsy and systematic biopsy in the mpMRI-TRUS group was also compared. The pathological results of puncture were observed and analyzed. Results The positive rate of needle biopsy in the mpMRI-TRUS group was 43.59%, and the TRUS group was 33.07%. There was no significant difference in the detection rate of prostate cancer between the two groups. In the mpMRI-TRUS group, the single-needle positive rate and the proportion of prostate cancer tissue were higher than that of system puncture. The positive rate of targeted puncture in the mpMRI-TRUS group was 38.46%, and the system puncture was 42.30%. The difference between the two groups is not statistically significant. Conclusion The mpMRI-TRUS cognitive fusion technology can detect prostate cancer with fewer needles in prostate biopsy. Targeted biopsy puncture can provide more prostate cancer tumor tissues and reduce the missed diagnosis rate of prostate cancer biopsy.

前列腺癌作为最常见的男性泌尿系统恶性肿瘤之一,目前常规治疗手段主要为手术、放化疗、内分泌治疗等,但后期并发症、治疗副作用等问题突出,且多转化为去势抵抗性前列腺癌,预后极差。既往研究已然证实,中医药在前列腺癌的治疗中可有效减少复发、减轻症状,提高患者生活质量。本文旨在总结近几年中医药对前列腺癌的研究,为往后的研究与临床治疗提供一些新的思路。

Prostate cancer(PCa) is one of the most common male urinary system malignancies.At present,conventional treatment methods are mainly surgery, radiotherapy and chemotherapy, endocrine therapy,etc.However, late complications, treatment side effects and other problems are prominent, and prostate cancer tends to develop as castration-resistant prostate cancer (CRPC), and the prognosis is very poor. Previous studies have confirmed that Chinese medicine can effectively reduce recurrence incidence, relieve symptoms and improve the quality of life of patients in the treatment of prostate cancer. This article summarizes the research of traditional Chinese medicine on prostate cancer in recent years, and provides some new ideas for future research and clinical treatment.