Home Medicine Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
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Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates

  • Tao Wu and Yanchun Xing EMAIL logo
Published/Copyright: October 2, 2024
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Open Medicine
From the journal Open Medicine Volume 19 Issue 1

Abstract

Objectives

We conducted a systematic review to compare the diagnostic utility of ultrasound-guided transperineal (TP) and transrectal (TR) prostate biopsy methods for prostate cancer detection.

Methods

We searched PubMed, Embase, Web of Science, and Cochrane databases up to October 30, 2023, for relevant studies, screening the literature and assessing bias independently.

Results

Eleven trials were analyzed using relative risk and 95% confidence intervals, with no evidence of publication bias. Diagnostic rates showed no significant difference between TP and TR biopsies (mean difference [MD]: 1.03, 95% confidence interval [CI]: 0.91–1.14, P = 0.56). Prostate volume analysis also showed no significant difference (MD: –0.07, 95% CI: –0.73 to 0.59, P < 0.0001, combined effect size P = 0.83). Similarly, PSA levels were comparable between TP and TR biopsies (MD: 0.93, 95% CI: –0.44 to 2.30, P < 0.0001, combined effect size P = 0.18).

Conclusion

Both biopsy methods exhibit similar diagnostic accuracy; however, TP has a lower risk of biopsy

Keywords: prostate cancer; ultrasonic guidance; prostatic needle biopsy; meta-analysis; systematic evaluation

1 Introduction

Prostate cancer (PCa) represents one of the most prevalent malignancies afflicting the male genitourinary system. As reported by Van Poppel et al., projections of cancer mortality within the European Union indicate that PCa occupies the third position in terms of mortality rates among all malignant tumors, with an anticipated 766,200 male fatalities [1]. Howrey et al. have demonstrated that the incidence of PCa is the highest among male malignant tumors in the United States, with mortality rates second only to lung cancer [2]. In China, Fu et al. identified approximately 72,000 new cases of PCa in 2015, yielding a crude incidence rate of 10.23 per 100,000 individuals. The incidence rates of PCa in China and globally stand at 6.59 and 6.47 per 100,000, respectively, placing it sixth among male malignant tumors [3].

PCa is a globally prevalent malignancy; yet, the optimal methods for its detection and diagnosis remain subjects of debate. Prostate-specific antigen (PSA) screening is commonly employed, despite the traditional biopsy threshold’s association with a positive predictive value of only 20–30%, leading to numerous unnecessary biopsies [4,5]. Kayano et al. have identified transrectal ultrasound (TRUS)-guided prostate biopsy as a pivotal diagnostic tool for PCa [6]. Nonetheless, conventional prostate biopsy procedures are not without limitations, including the risk of serious complications and a considerable false-negative rate [7]. This underscores the critical need to establish the most efficacious and secure means of diagnosing PCa.

Despite its widespread recognition as the standard method for detecting PCa and its decades-long global use, systematic transrectal (TR) prostate biopsy has been found by Xue et al. to significantly underreport the initial incidence of PCa, with a rate of malignant detection as high as 49% [8]. Furthermore, this procedure is associated with potentially serious complications, such as rectal bleeding, fever, hematuria, and acute urinary retention [9,10,11]. Recognizing the heightened risk of false negatives and complications with TR biopsy, Ding et al. have proposed the use of ultrasound-guided transperineal (TP) examination as a strategy to enhance both the detection rate and safety of prostate biopsy [12].

Despite the proliferation of studies that compare the detection rates and reliability of ultrasound-guided TP and TR prostate biopsy methods, controversy persists regarding the efficacy of both techniques. Consequently, a meta-analysis is warranted to furnish a higher level of evidence and to elucidate definitive conclusions regarding the two biopsy modalities. Prior meta-analyses have aggregated observational studies and randomized controlled trials (RCTs) without accounting for the nuances in study design and quality assessment methods, thereby introducing heterogeneity in the results. To achieve more precise and uniform conclusions, we have conducted a meticulous evaluation of study quality and have separately pooled observational and randomized controlled studies. Moreover, we have systematically reviewed all relevant studies to appraise the consistency of the two biopsy methods.

2 Methods

2.1 Inclusion criteria

The study design is an RCT or cohort/case–control study. The study subjects are patients undergoing prostate biopsy. The methods of intervention are ultrasound-guided perineal puncture and TR approach. Additional considerations are as follows: the number of biopsy samples and the catheterization method were maintained constant across all intervention groups. Outcomes are PCa diagnosis rate, prostate volume, and PSA level.

2.2 Exclusion criteria

The literature has no available information or incomplete data. The literature is not original research. Patients with a prior history of PCa, acute prostatitis, or a proven urinary tract infection are excluded.

2.3 Literature search

We conducted a comprehensive search of the PubMed, Embase, Web of Science, and Cochrane databases to identify RCTs, cohort studies, or case–control studies that assessed the diagnostic efficacy of ultrasound-guided TP and TR prostate biopsy in the detection of PCa. Our literature review was conducted up to October 30, 2023, adhering to stringent inclusion and exclusion criteria to ensure the selection of relevant studies.

To enhance the recall and precision of our search, we employed a fuzzy search strategy that included the references of the included studies, aiming to capture all pertinent RCTs, cohort studies, or case–control studies that met our inclusion criteria. Our search strategy was formulated as follows: Search ((((((transperineal) OR (transrectal)) AND (prostate biopsy)) AND (detection)) OR (detection)) AND (prostate cancer)) OR (prostatic neoplasms).

2.4 Literature screening and data extraction

The authors compressed the data for the included studies and used pre-determined statistical tables. Any differences are settled by discussion. Important aspects of the study included: the first author’s last name, year of publication, patient age, study design, study population, number of patients in both groups, patients’ PSA levels and prostate volume, biopsy method, and covariates analyzed.

2.5 Quality evaluation

The authors evaluated the quality of observational studies using the Newcastle–Ottawa Scale (NOS). Studies scoring below 7 were deemed of low quality and were consequently excluded from the analysis. Among the RCTs, only one study by Udeh et al. was excluded due to a high loss bias, as a quarter of the patients lost follow-up [13]. Differences in authors’ opinions were resolved through consensus. In the absence of consensus, a third of the experts were invited to provide input to resolve the issue.

2.6 Statistical analysis

Our meta-analysis employed ReviewManager software (version 5.4) to process all statistical data. We evaluated the degree of difference between TR and TP methods within 95% confidence intervals (CIs) using a combined odds ratio (OR). The heterogeneity hypothesis was validated through the calculation of the chi-square test and the I 2 statistic.

In this meta-analysis, we utilized both the fixed effects model (Mantel–Haenszel method) and the random effects model (DerSimonian–Laird method) for analysis. If significant heterogeneity (I 2 > 50%) was detected, we employed the random effects model. In the absence of significant heterogeneity, the fixed effects model was utilized. Moreover, if substantial heterogeneity was identified between studies, we conducted an exploration of the potential sources of heterogeneity.

Sensitivity analyses were performed by sequentially excluding individual studies to assess the robustness of our findings. A P-value of <0.05 was considered indicative of statistically significant differences.

3 Results

3.1 Literature screening results and basic characteristics

The research screening process is depicted in Figure 1. Initially, 960 duplicate literature entries were identified and excluded, and the remaining articles were selected based on their titles and abstracts. Two independent reviewers were chosen for this task. Subsequently, 680 articles were deemed unsuitable due to their clear non-compliance with the inclusion criteria, 210 were found to be duplicates, and 50 did not fulfill the inclusion requirements. This left 20 articles that either met the inclusion criteria or could not be assessed solely based on the title and abstract. Full-text versions of the remaining 20 articles were obtained, and the same two reviewers independently assessed whether each article should be included. Any discrepancies were resolved through discussion. After this process, 2 articles were excluded, 6 did not meet the inclusion criteria, and 1 could not be included due to the unavailability of data and the inability to contact the authors. Ultimately, 11 articles met the inclusion criteria and were included in this systematic review.

Figure 1 Literature screening process and results.
Figure 1

Literature screening process and results.

3.2 Comparison of included literature

Table 1 illustrates the variability in study populations and sample sizes across different studies. Among these, the studies by Lu et al. [15] and Di Franco et al. [18] featured relatively substantial populations and sample sizes, while the study by Pepe et al. [23] had a smaller sample size of only 200 cases. The PSA levels also exhibited variations between the TP and TR groups. For instance, Lu et al. [15] reported a PSA level of 22.0 ng/mL in the TP group and 23.2 ng/mL in the TR group. Similarly, Song et al. [16] found that the PSA level in the TP group was 7.49 ng/mL, compared to 7.18 ng/mL in the TR group. These discrepancies could be attributed to differences in disease distribution or biopsy strategies. Prostate volume also displayed variations between the TP and TR groups. Lu et al. [15] reported a prostate volume of 57.0 mL in the TP group and 54.4 mL in the TR group. Abdollah et al. [17] reported a prostate volume of 65.4 mL in the TP group and 62.3 mL in the TR group. These variations could be due to differences in disease distribution or biopsy strategies. Regarding biopsy methods, some studies employed different techniques. Abdollah et al. [17] used the ultrasound-guided saturation prostate rebiopsy technique. Di Franco et al. [18], Shida et al. [19], and Pepe et al. [23] utilized the mpMRI/TRUS fusion-targeted biopsy technique. These different biopsy techniques could have influenced the study results. In terms of covariates, most studies considered factors such as age, PSA, prostate volume, DRE, and the results of previous biopsies. These factors were used to adjust the findings to mitigate potential bias and the impact of confounding factors. Regarding NOS scores, the studies ranged between 7 and 9, indicating a relatively high quality of the studies. Table 2 presents a comparative study of ultrasound-guided TP and TR prostate biopsy. The table lists the year of each study, patient age, study population, sample size, PSA level, prostate volume, and biopsy method. Guo et al. [14] conducted a study in 2015 with sample sizes of 173 (TP) and 166 (TR), PSA levels of 8.81 and 10.48, respectively, and prostate volumes of 47.2 and 45.9, respectively. They employed a 12-core systematic biopsy method. The 2019 study by Jiang et al. involved a larger sample size of 2,962 men, with 1,216 undergoing TR biopsies and 1,746 undergoing TP biopsies. PSA levels and prostate volume also differed between the two groups. In the 2014 study by Cerruto et al., with a sample size of 54 (TP) and 54 (TR), PSA levels and prostate volume also varied between the two groups. They used a 14-core systematic biopsy method. The basic characteristics are shown in Tables 1 and 2.

Table 1

Comparisons of the observational characteristics of ultrasound-guided transperineal and transrectal prostate biopsy

Study Year Age Study design Study population Patients PSA level (ng/mL) Prostate volume (mL) Biopsy methods Covariates NOS score
TP TR TP TR TP TR
Lu et al. [15] 2023 70.1 Cohort study Compared TR or TP acceptance between June 2017 and September 2021 245 207 22.0 23.2 57.0 54.4 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 9
Song et al. [16] 2022 65.20 Cohort study 10,901 cases between May 2003 and December-December 2017 561 561 7.49 7.18 44.30 43.29 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 8
Abdollah et al. [17] 2010 63.3 Cohort study Patients who underwent a rebiopsy between 2005.9 and 2008.6 140 140 9.7 10 65.4 62.3 Ultrasound-guided saturate prostate rebiopsy Age, PSA, PV, DRE, histologic findings on previous biopsy, the number of previous negative biopsy sets 7
Di Franco CA et al. [18] 2017 68 Cohort study 219 men who underwent prostate biopsies between 2004 and 2014 111 108 6.9 7.8 55 43 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 8
Shida et al. [19] 2016 67 Cohort study 1,019 patients underwent the first prostate biopsy and 298 repeated prostate biopsies 66 113 6.7 9.1 37 46 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 9
Lo et al. [20] 2019 69 Cohort study Retrospective study of 100 TPUSPBs and 100 TRUSPBs. 35 25 9.5 12.0 56.8 46.2 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 8
Miano et al. [21] 2014 64.6 Cohort study From January 2015 to January 2016, there were 200 men 278 255 8.6 8.6 38.9 42.4 TP OR TR Age, PSA, PV, DRE, histologic findings on previous biopsy 7
Pepe et al. [23] 2016 61 Cohort study Patients persistently suspicious of PCa between 2015.1 and 2016.1 200 86 / / / mpMRI/TRUS fusion-targeted biopsy Self-control 8

Note: TR is ultrasound-guided perineal prostate biopsy; TP is ultrasound-guided transrectal prostate biopsy.

Table 2

Comparisons of randomized controlled trials of ultrasound-guided transperineal and transrectal prostate biopsy

Study Year Age Study population Patients PSA level Prostate volume Biopsy methods
TP TR TP TR TP TR
Guo et al. [14] 2015 67 Patients between 2012.6 and 2014.8 with a PSA >4.0 ng/mL 173 166 8.81 10.48 47.2 45.9 Systematic 12-core biopsy
Jiang et al. [22] 2019 68 in TP group, 71 in TR group 2,962 men who underwent transrectal (=1,216) or transperineal (=1,746) system 12-core prostate biopsy 1,216 1,746 40.31 38.02 59.64 51.64 TP OR TR
Cerruto et al. [24] 2014 66.5 in TP group, 67.3 in TR group Consecutive patients with a PSA >4 ng/mL 54 54 15.95 12.36 56.29 61.49 Systematic 14-core initial prostatic biopsy

Note: TR is ultrasound-guided perineal prostate biopsy; TP is ultrasound-guided transrectal prostate biopsy.

3.3 Comparison of PCa diagnosis rate

Eleven eligible trials were identified that examined PCa diagnosis rates, and no publication bias was detected through funnel plot analysis. Analysis using the fixed-effect model revealed that the diagnosis rate for PCa by TP biopsy was comparable to that by TR biopsy, with no statistically significant difference (P < 0.005). The mean difference (MD) was 1.03, with a 95% CI of 0.91–1.14, and a P-value of 0.56. The heterogeneity of the literature had no significant impact on sensitivity. Furthermore, by examining the original literature, it was observed that there was no significant difference in sample size or experimental duration among these 11 studies. This finding is illustrated in Figure 2.

Figure 2 Prostate cancer diagnosis rate comparison.
Figure 2

Prostate cancer diagnosis rate comparison.

3.4 Prostate volume comparison

We examined the prostate volume of patients diagnosed with PCa through ultrasound-guided TP and TR prostate biopsy. No significant publication bias was identified using funnel plot analysis. The comprehensive results from the random effects model indicated that the prostate volume in the TP group was similar to that in the TR group, with no statistically significant difference (P < 0.05). The MD was –0.07, with a 95% CI of –0.73 to 0.59, and a P-value of less than 0.0001. The forest plot revealed a combined effect size P-value of 0.83, suggesting no distinction in prostate volume between patients diagnosed with PCa via TP and TR biopsies. This is illustrated in Figure 3.

Figure 3 Prostate volume comparison.
Figure 3

Prostate volume comparison.

3.5 PSA level comparison

We investigated PSA levels in patients diagnosed with PCa through ultrasound-guided TP and TR prostate biopsy. Analysis using the funnel plot method revealed no significant publication bias. The results obtained from the random effects model demonstrated that the PSA levels in the TP group were comparable to those in the TR group, with no statistically significant difference (P < 0.05). The MD was 0.93, with a 95% CI ranging from –0.44 to 2.30, and a P-value of less than 0.0001. The forest plot indicated a combined effect size P-value of 0.18, suggesting no variance in PSA levels between patients diagnosed with PCa via TP and TR biopsies (see Figure 4).

Figure 4 PSA level comparison.
Figure 4

PSA level comparison.

4 Discussion

The two primary techniques for prostate biopsy are TR and TP biopsy. The detection rates for PCa and overall complication rates are generally comparable for both methods, although it is worth noting that TR biopsy is more widely practiced globally. This is due to the fact that TR prostate biopsy offers the advantages of shorter procedure times, relatively simpler procedures, and the absence of the need for complex anesthesia. The American Urological Association and the European Association of Urology recommend TR biopsy as the most commonly used method, with TP biopsy serving as an effective alternative [25]. Research conducted by Udeh et al. revealed that TP biopsy did not demonstrate a significant advantage in detecting cancer during prostate biopsy, but it did exhibit a higher detection rate of core cancer in biopsy [13]. TP and TR biopsies showed similarities in PCa detection rates, suggesting that both methods have good results in diagnosing PCa. The diagnostic accuracy of TP biopsy is no less than TR biopsy, eliminating concerns about the effectiveness of TP biopsy. TP biopsy is especially suitable for patients who are concerned about the risk of infection associated with TR biopsy, as it can significantly reduce the risk of infection and rectal bleeding. Especially in a modern medical environment focused on patient safety and comfort, TP biopsy has emerged as a viable alternative to TR biopsy.

We included 11 trials that compared TP versus TR biopsy for the diagnosis of PCa and found no evidence of publication bias. When analyzed using a fixed-effect model, there was no significant difference in the detection rates between TP and TR biopsies (P < 0.005). The MD was 1.03, with a 95% CI of 0.91–1.14 and a P-value of 0.56. Our findings align with those of Xue, who concluded that there was no significant difference in the detection rate of PCa between TP and TR methods [8]. TR and TP biopsy techniques utilize different procedures, but both are capable of sampling prostate tissue for pathological testing to diagnose PCa. Whether employing TR or TP biopsies, the objective is to obtain a prostate tissue sample for pathological analysis to ascertain the presence, type, and extent of PCa. Therefore, in theory, the diagnostic efficacy of the two methods should be comparable. While there are procedural differences between TR and TP biopsies, both are performed under the guidance of a medical professional. Both procedures require attention to aseptic technique, patient comfort, and other relevant considerations to ensure the accuracy and reliability of the biopsy results.

To further elucidate the differences between the two biopsy methods, we conducted statistical analyses of serum PSA levels and prostate volume. The meta-analysis revealed that, when employing the random effects model, the prostate volume in both TP and TR biopsy groups was similar, with no statistically significant difference (P < 0.05). The MD was –0.07, with a 95% CI of –0.73 to 0.59, and a P-value of less than 0.0001. This indicates that there was no difference in prostate volume between patients diagnosed with PCa who underwent TP or TR biopsy. Additionally, we examined PSA levels in patients diagnosed with PCa via ultrasound-guided TP and TR biopsy and found no publication bias. The comprehensive results from the random effects model again showed that the prostate volume in the TP group was comparable to that in the TR group, with no statistically significant difference (P < 0.05). The MD was 0.93, with a 95% CI ranging from –0.44 to 2.30, and a P-value of less than 0.0001. The combined effect size P-value was 0.18, suggesting no variance in PSA levels between TP and TR biopsy patients diagnosed with PCa. Prostate volume is a critical factor that influences biopsy outcomes. The impact of prostate volume on different biopsy techniques has not been conclusively established.

The meta-analysis revealed statistically significant differences in prostate volume between the two groups. This suggests that prostate volume may indeed affect the selection of biopsy protocols. For larger prostates, a more comprehensive and precise biopsy protocol may be necessary to prevent missed or erroneous diagnoses. For smaller prostates, a simpler and more expedient biopsy option could be considered. We speculate that prostate volume may be associated with the positive rate of PCa detection across different biopsy protocols. Larger prostates may facilitate the detection of PCa with various biopsy techniques, while smaller prostates might necessitate more detailed biopsy protocols to achieve the same level of detection. These hypotheses require further corroboration through additional clinical studies. Our meta-analysis indicates that prostate volume may impact the choice of biopsy protocol. We speculate that prostate volume may be related to the positive rate of PCa detection with different biopsy protocols. These insights have significant implications for guiding clinicians in selecting the most appropriate biopsy techniques and warrant further clinical validation.

Our study enjoys a higher degree of confidence in assessing the diagnostic accuracy of both TP and TR prostate biopsy methods due to the thoroughness of our online database search, the acquisition of all potentially relevant publications, and the strict adherence to the PRISMA guidelines. To enhance the accuracy and reliability of our findings, we employed stringent inclusion criteria. During the screening process, we included only RCTs and high-quality observational studies with a low risk of bias, as indicated by NOS scores exceeding 6. A retrospective study showed that TR ultrasound-guided prostate biopsy (TRUS), the gold standard for performing prostate biopsies, has a higher incidence of post-biopsy sepsis compared to TP [26]. In this study, the incidence of sepsis after TR needle biopsy was 0.36%, compared to 0.48% for TP. Urinary tract infections occur in both methods but at a lower rate. The most common complication was acute urinary retention, which occurred in 28 cases after TP. Another study noted the detection rate and safety of TR and TP needle biopsies for PCa [27]. This retrospective analysis showed no statistically significant difference in PCa detection rates between the two groups. However, the total complication rate of the TP group was lower than that of the TR group, the interval from puncture to radical operation and the operative time of radical operation were shorter than those of the TR group, and the intraoperative blood loss and intraoperative prostate tissue adhesion rate were lower than those of the TR group. TP and TR biopsies were comparable in tumor detection rates, but TP biopsies appeared to have lower complication rates, especially in terms of reducing bleeding and acute urinary retention. However, the results of these studies are not entirely consistent, so the specific circumstances of the patient and the experience of the doctor should be considered when choosing a biopsy method.

We take into account several limitations when interpreting the results. Only three RCTs were included in this study, which may limit the broad applicability and accuracy of the study. This study was observational and could not fully address potential confounders, such as free PSA, benign prostatic hyperplasia, or other unreported factors that could have influenced the conclusions. There are language limitations and screening methods in this study, which may lead to the omission of some unpublished relevant studies, thus affecting the reliability of the results. Therefore, further large (RCTS are warranted.

5 Conclusion

In conclusion, our updated systematic review and meta-analysis of nine studies revealed no substantial difference in overall PCa detection rates between TP and TR ultrasound-guided prostate biopsy approaches. The findings do not support the notion of inferior diagnostic accuracy of TP biopsy when compared to standard TR biopsy. TP biopsy may thus be considered a suitable alternative, particularly for patients who are apprehensive about infection risks associated with TR biopsy. Further adequately powered randomized controlled trials are necessary to comprehensively assess the comparative effectiveness and potential benefits of the two biopsy techniques.

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Acknowledgments

Not applicable.

  1. Funding information: Not applicable.

  2. Author contributions: Tao Wu and Yanchun Xing designed the study and performed the experiments, Tao Wu collected the data, Yanchun Xing analyzed the data, and Tao Wu and Yanchun Xing prepared the manuscript. All authors read and approved the final manuscript.

  3. Conflict of interest: The authors state that there are no conflicts of interest to disclose.

  4. Data availability statement: All data generated or analyzed during this study are included in this published article. The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

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Received: 2024-06-11
Revised: 2024-08-19
Accepted: 2024-08-21
Published Online: 2024-10-02

© 2024 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  4. Association of SOX6 gene polymorphisms with Kashin-Beck disease risk in the Chinese Han population
  5. The pyroptosis-related signature predicts prognosis and influences the tumor immune microenvironment in dedifferentiated liposarcoma
  6. METTL3 attenuates ferroptosis sensitivity in lung cancer via modulating TFRC
  7. Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps
  8. Novel lumbar plexus block versus femoral nerve block for analgesia and motor recovery after total knee arthroplasty
  9. Correlation between ABCB1 and OLIG2 polymorphisms and the severity and prognosis of patients with cerebral infarction
  10. Study on the radiotherapy effect and serum neutral granulocyte lymphocyte ratio and inflammatory factor expression of nasopharyngeal carcinoma
  11. Transcriptome analysis of effects of Tecrl deficiency on cardiometabolic and calcium regulation in cardiac tissue
  12. Aflatoxin B1 induces infertility, fetal deformities, and potential therapies
  13. Serum levels of HMW adiponectin and its receptors are associated with cytokine levels and clinical characteristics in chronic obstructive pulmonary disease
  14. METTL3-mediated methylation of CYP2C19 mRNA may aggravate clopidogrel resistance in ischemic stroke patients
  15. Understand how machine learning impact lung cancer research from 2010 to 2021: A bibliometric analysis
  16. Pressure ulcers in German hospitals: Analysis of reimbursement and length of stay
  17. Metformin plus L-carnitine enhances brown/beige adipose tissue activity via Nrf2/HO-1 signaling to reduce lipid accumulation and inflammation in murine obesity
  18. Downregulation of carbonic anhydrase IX expression in mouse xenograft nasopharyngeal carcinoma model via doxorubicin nanobubble combined with ultrasound
  19. Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement
  20. miR-335-3p improves type II diabetes mellitus by IGF-1 regulating macrophage polarization
  21. The analyses of human MCPH1 DNA repair machinery and genetic variations
  22. Activation of Piezo1 increases the sensitivity of breast cancer to hyperthermia therapy
  23. Comprehensive analysis based on the disulfidptosis-related genes identifies hub genes and immune infiltration for pancreatic adenocarcinoma
  24. Changes of serum CA125 and PGE2 before and after high-intensity focused ultrasound combined with GnRH-a in treatment of patients with adenomyosis
  25. The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis
  26. Development and validation of a novel model to predict pulmonary embolism in cardiology suspected patients: A 10-year retrospective analysis
  27. Downregulation of lncRNA XLOC_032768 in diabetic patients predicts the occurrence of diabetic nephropathy
  28. Circ_0051428 targeting miR-885-3p/MMP2 axis enhances the malignancy of cervical cancer
  29. Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
  30. The construction of a novel prognostic prediction model for glioma based on GWAS-identified prognostic-related risk loci
  31. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study
  32. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database
  33. CD36-mediated podocyte lipotoxicity promotes foot process effacement
  34. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis
  35. FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage
  36. Challenges in treating primary immune thrombocytopenia patients undergoing COVID-19 vaccination: A retrospective study
  37. Let-7 family regulates HaCaT cell proliferation and apoptosis via the ΔNp63/PI3K/AKT pathway
  38. Phospholipid transfer protein ameliorates sepsis-induced cardiac dysfunction through NLRP3 inflammasome inhibition
  39. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy
  40. Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction
  41. High SEC61A1 expression predicts poor outcome of acute myeloid leukemia
  42. Comparison of polymerase chain reaction and next-generation sequencing with conventional urine culture for the diagnosis of urinary tract infections: A meta-analysis
  43. Secreted frizzled-related protein 5 protects against renal fibrosis by inhibiting Wnt/β-catenin pathway
  44. Pan-cancer and single-cell analysis of actin cytoskeleton genes related to disulfidptosis
  45. Overexpression of miR-532-5p restrains oxidative stress response of chondrocytes in nontraumatic osteonecrosis of the femoral head by inhibiting ABL1
  46. Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
  47. Clinical analysis of incomplete rupture of the uterus secondary to previous cesarean section
  48. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
  49. No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study
  50. Identification and validation of autophagy-related genes in SSc
  51. Long non-coding RNA SRA1 suppresses radiotherapy resistance in esophageal squamous cell carcinoma by modulating glycolytic reprogramming
  52. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study
  53. The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis
  54. Compilation of a self-management assessment scale for postoperative patients with aortic dissection
  55. Left atrial appendage closure in conjunction with radiofrequency ablation: Effects on left atrial functioning in patients with paroxysmal atrial fibrillation
  56. Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study
  57. Clinical characteristics and assessment of risk factors in patients with influenza A-induced severe pneumonia after the prevalence of SARS-CoV-2
  58. Analgesia nociception index is an indicator of laparoscopic trocar insertion-induced transient nociceptive stimuli
  59. High STAT4 expression correlates with poor prognosis in acute myeloid leukemia and facilitates disease progression by upregulating VEGFA expression
  60. Factors influencing cardiovascular system-related post-COVID-19 sequelae: A single-center cohort study
  61. HOXD10 regulates intestinal permeability and inhibits inflammation of dextran sulfate sodium-induced ulcerative colitis through the inactivation of the Rho/ROCK/MMPs axis
  62. Mesenchymal stem cell-derived exosomal miR-26a induces ferroptosis, suppresses hepatic stellate cell activation, and ameliorates liver fibrosis by modulating SLC7A11
  63. Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke
  64. ANO6 (TMEM16F) inhibits gastrointestinal stromal tumor growth and induces ferroptosis
  65. Prognostic value of EIF5A2 in solid tumors: A meta-analysis and bioinformatics analysis
  66. The role of enhanced expression of Cx43 in patients with ulcerative colitis
  67. Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance
  68. Role of ICAM-1 in triple-negative breast cancer
  69. Cost-effectiveness of ambroxol in the treatment of Gaucher disease type 2
  70. HLA-DRB5 promotes immune thrombocytopenia via activating CD8+ T cells
  71. Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome
  72. Efficacy of tacrolimus monotherapy in primary membranous nephropathy
  73. Mechanisms of Tripterygium wilfordii Hook F on treating rheumatoid arthritis explored by network pharmacology analysis and molecular docking
  74. FBXO45 levels regulated ferroptosis renal tubular epithelial cells in a model of diabetic nephropathy by PLK1
  75. Optimizing anesthesia strategies to NSCLC patients in VATS procedures: Insights from drug requirements and patient recovery patterns
  76. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss
  77. Correlation between fat-soluble vitamin levels and inflammatory factors in paediatric community-acquired pneumonia: A prospective study
  78. CD1d affects the proliferation, migration, and apoptosis of human papillary thyroid carcinoma TPC-1 cells via regulating MAPK/NF-κB signaling pathway
  79. miR-let-7a inhibits sympathetic nerve remodeling after myocardial infarction by downregulating the expression of nerve growth factor
  80. Immune response analysis of solid organ transplantation recipients inoculated with inactivated COVID-19 vaccine: A retrospective analysis
  81. The H2Valdien derivatives regulate the epithelial–mesenchymal transition of hepatoma carcinoma cells through the Hedgehog signaling pathway
  82. Clinical efficacy of dexamethasone combined with isoniazid in the treatment of tuberculous meningitis and its effect on peripheral blood T cell subsets
  83. Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis
  84. Lycopene inhibits pyroptosis of endothelial progenitor cells induced by ox-LDL through the AMPK/mTOR/NLRP3 pathway
  85. Methylation regulation for FUNDC1 stability in childhood leukemia was up-regulated and facilitates metastasis and reduces ferroptosis of leukemia through mitochondrial damage by FBXL2
  86. Correlation of single-fiber electromyography studies and functional status in patients with amyotrophic lateral sclerosis
  87. Risk factors of postoperative airway obstruction complications in children with oral floor mass
  88. Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction
  89. Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022
  90. Evaluating anemia in HIV-infected patients using chest CT
  91. Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court
  92. Causal association of circulating immune cells and lymphoma: A Mendelian randomization study
  93. Assessment of the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals on treating renal fibrosis: A systematic review and meta-analysis
  94. Comprehensive landscape of integrator complex subunits and their association with prognosis and tumor microenvironment in gastric cancer
  95. New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: A drug Mendelian randomization study
  96. Population pharmacokinetics of meropenem in critically ill patients
  97. Comparison of the ability of newly inflammatory markers to predict complicated appendicitis
  98. Comparative morphology of the cruciate ligaments: A radiological study
  99. Immune landscape of hepatocellular carcinoma: The central role of TP53-inducible glycolysis and apoptosis regulator
  100. Serum SIRT3 levels in epilepsy patients and its association with clinical outcomes and severity: A prospective observational study
  101. SHP-1 mediates cigarette smoke extract-induced epithelial–mesenchymal transformation and inflammation in 16HBE cells
  102. Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway
  103. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma
  104. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program
  105. Exploring anesthetic-induced gene expression changes and immune cell dynamics in atrial tissue post-coronary artery bypass graft surgery
  106. Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism
  107. Analysis of the risk factors of the radiation-induced encephalopathy in nasopharyngeal carcinoma: A retrospective cohort study
  108. Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review
  109. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population
  110. Prognostic and diagnostic value of circulating IGFBP2 in pancreatic cancer
  111. Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques
  112. Research trends related to emergence agitation in the post-anaesthesia care unit from 2001 to 2023: A bibliometric analysis
  113. Frequency and clinicopathological correlation of gastrointestinal polyps: A six-year single center experience
  114. ACSL4 mediates inflammatory bowel disease and contributes to LPS-induced intestinal epithelial cell dysfunction by activating ferroptosis and inflammation
  115. Affibody-based molecular probe 99mTc-(HE)3ZHER2:V2 for non-invasive HER2 detection in ovarian and breast cancer xenografts
  116. Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials
  117. The relationship between IFN-γ, IL-10, IL-6 cytokines, and severity of the condition with serum zinc and Fe in children infected with Mycoplasma pneumoniae
  118. Paraquat disrupts the blood–brain barrier by increasing IL-6 expression and oxidative stress through the activation of PI3K/AKT signaling pathway
  119. Sleep quality associate with the increased prevalence of cognitive impairment in coronary artery disease patients: A retrospective case–control study
  120. Dioscin protects against chronic prostatitis through the TLR4/NF-κB pathway
  121. Association of polymorphisms in FBN1, MYH11, and TGF-β signaling-related genes with susceptibility of sporadic thoracic aortic aneurysm and dissection in the Zhejiang Han population
  122. Application value of multi-parameter magnetic resonance image-transrectal ultrasound cognitive fusion in prostate biopsy
  123. Laboratory variables‐based artificial neural network models for predicting fatty liver disease: A retrospective study
  124. Decreased BIRC5-206 promotes epithelial–mesenchymal transition in nasopharyngeal carcinoma through sponging miR-145-5p
  125. Sepsis induces the cardiomyocyte apoptosis and cardiac dysfunction through activation of YAP1/Serpine1/caspase-3 pathway
  126. Assessment of iron metabolism and iron deficiency in incident patients on incident continuous ambulatory peritoneal dialysis
  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
  227. Identification of signatures associated with microsatellite instability and immune characteristics to predict the prognostic risk of colon cancer
  228. Single-cell analysis identified key macrophage subpopulations associated with atherosclerosis
https://doi.org/10.1515/med-2024-1039
Keywords for this article
prostate cancer; ultrasonic guidance; prostatic needle biopsy; meta-analysis; systematic evaluation
Creative Commons
BY 4.0

Articles in the same Issue

  1. Research Articles
  2. EDNRB inhibits the growth and migration of prostate cancer cells by activating the cGMP-PKG pathway
  3. STK11 (LKB1) mutation suppresses ferroptosis in lung adenocarcinoma by facilitating monounsaturated fatty acid synthesis
  4. Association of SOX6 gene polymorphisms with Kashin-Beck disease risk in the Chinese Han population
  5. The pyroptosis-related signature predicts prognosis and influences the tumor immune microenvironment in dedifferentiated liposarcoma
  6. METTL3 attenuates ferroptosis sensitivity in lung cancer via modulating TFRC
  7. Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps
  8. Novel lumbar plexus block versus femoral nerve block for analgesia and motor recovery after total knee arthroplasty
  9. Correlation between ABCB1 and OLIG2 polymorphisms and the severity and prognosis of patients with cerebral infarction
  10. Study on the radiotherapy effect and serum neutral granulocyte lymphocyte ratio and inflammatory factor expression of nasopharyngeal carcinoma
  11. Transcriptome analysis of effects of Tecrl deficiency on cardiometabolic and calcium regulation in cardiac tissue
  12. Aflatoxin B1 induces infertility, fetal deformities, and potential therapies
  13. Serum levels of HMW adiponectin and its receptors are associated with cytokine levels and clinical characteristics in chronic obstructive pulmonary disease
  14. METTL3-mediated methylation of CYP2C19 mRNA may aggravate clopidogrel resistance in ischemic stroke patients
  15. Understand how machine learning impact lung cancer research from 2010 to 2021: A bibliometric analysis
  16. Pressure ulcers in German hospitals: Analysis of reimbursement and length of stay
  17. Metformin plus L-carnitine enhances brown/beige adipose tissue activity via Nrf2/HO-1 signaling to reduce lipid accumulation and inflammation in murine obesity
  18. Downregulation of carbonic anhydrase IX expression in mouse xenograft nasopharyngeal carcinoma model via doxorubicin nanobubble combined with ultrasound
  19. Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement
  20. miR-335-3p improves type II diabetes mellitus by IGF-1 regulating macrophage polarization
  21. The analyses of human MCPH1 DNA repair machinery and genetic variations
  22. Activation of Piezo1 increases the sensitivity of breast cancer to hyperthermia therapy
  23. Comprehensive analysis based on the disulfidptosis-related genes identifies hub genes and immune infiltration for pancreatic adenocarcinoma
  24. Changes of serum CA125 and PGE2 before and after high-intensity focused ultrasound combined with GnRH-a in treatment of patients with adenomyosis
  25. The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis
  26. Development and validation of a novel model to predict pulmonary embolism in cardiology suspected patients: A 10-year retrospective analysis
  27. Downregulation of lncRNA XLOC_032768 in diabetic patients predicts the occurrence of diabetic nephropathy
  28. Circ_0051428 targeting miR-885-3p/MMP2 axis enhances the malignancy of cervical cancer
  29. Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
  30. The construction of a novel prognostic prediction model for glioma based on GWAS-identified prognostic-related risk loci
  31. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study
  32. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database
  33. CD36-mediated podocyte lipotoxicity promotes foot process effacement
  34. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis
  35. FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage
  36. Challenges in treating primary immune thrombocytopenia patients undergoing COVID-19 vaccination: A retrospective study
  37. Let-7 family regulates HaCaT cell proliferation and apoptosis via the ΔNp63/PI3K/AKT pathway
  38. Phospholipid transfer protein ameliorates sepsis-induced cardiac dysfunction through NLRP3 inflammasome inhibition
  39. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy
  40. Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction
  41. High SEC61A1 expression predicts poor outcome of acute myeloid leukemia
  42. Comparison of polymerase chain reaction and next-generation sequencing with conventional urine culture for the diagnosis of urinary tract infections: A meta-analysis
  43. Secreted frizzled-related protein 5 protects against renal fibrosis by inhibiting Wnt/β-catenin pathway
  44. Pan-cancer and single-cell analysis of actin cytoskeleton genes related to disulfidptosis
  45. Overexpression of miR-532-5p restrains oxidative stress response of chondrocytes in nontraumatic osteonecrosis of the femoral head by inhibiting ABL1
  46. Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
  47. Clinical analysis of incomplete rupture of the uterus secondary to previous cesarean section
  48. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
  49. No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study
  50. Identification and validation of autophagy-related genes in SSc
  51. Long non-coding RNA SRA1 suppresses radiotherapy resistance in esophageal squamous cell carcinoma by modulating glycolytic reprogramming
  52. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study
  53. The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis
  54. Compilation of a self-management assessment scale for postoperative patients with aortic dissection
  55. Left atrial appendage closure in conjunction with radiofrequency ablation: Effects on left atrial functioning in patients with paroxysmal atrial fibrillation
  56. Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study
  57. Clinical characteristics and assessment of risk factors in patients with influenza A-induced severe pneumonia after the prevalence of SARS-CoV-2
  58. Analgesia nociception index is an indicator of laparoscopic trocar insertion-induced transient nociceptive stimuli
  59. High STAT4 expression correlates with poor prognosis in acute myeloid leukemia and facilitates disease progression by upregulating VEGFA expression
  60. Factors influencing cardiovascular system-related post-COVID-19 sequelae: A single-center cohort study
  61. HOXD10 regulates intestinal permeability and inhibits inflammation of dextran sulfate sodium-induced ulcerative colitis through the inactivation of the Rho/ROCK/MMPs axis
  62. Mesenchymal stem cell-derived exosomal miR-26a induces ferroptosis, suppresses hepatic stellate cell activation, and ameliorates liver fibrosis by modulating SLC7A11
  63. Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke
  64. ANO6 (TMEM16F) inhibits gastrointestinal stromal tumor growth and induces ferroptosis
  65. Prognostic value of EIF5A2 in solid tumors: A meta-analysis and bioinformatics analysis
  66. The role of enhanced expression of Cx43 in patients with ulcerative colitis
  67. Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance
  68. Role of ICAM-1 in triple-negative breast cancer
  69. Cost-effectiveness of ambroxol in the treatment of Gaucher disease type 2
  70. HLA-DRB5 promotes immune thrombocytopenia via activating CD8+ T cells
  71. Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome
  72. Efficacy of tacrolimus monotherapy in primary membranous nephropathy
  73. Mechanisms of Tripterygium wilfordii Hook F on treating rheumatoid arthritis explored by network pharmacology analysis and molecular docking
  74. FBXO45 levels regulated ferroptosis renal tubular epithelial cells in a model of diabetic nephropathy by PLK1
  75. Optimizing anesthesia strategies to NSCLC patients in VATS procedures: Insights from drug requirements and patient recovery patterns
  76. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss
  77. Correlation between fat-soluble vitamin levels and inflammatory factors in paediatric community-acquired pneumonia: A prospective study
  78. CD1d affects the proliferation, migration, and apoptosis of human papillary thyroid carcinoma TPC-1 cells via regulating MAPK/NF-κB signaling pathway
  79. miR-let-7a inhibits sympathetic nerve remodeling after myocardial infarction by downregulating the expression of nerve growth factor
  80. Immune response analysis of solid organ transplantation recipients inoculated with inactivated COVID-19 vaccine: A retrospective analysis
  81. The H2Valdien derivatives regulate the epithelial–mesenchymal transition of hepatoma carcinoma cells through the Hedgehog signaling pathway
  82. Clinical efficacy of dexamethasone combined with isoniazid in the treatment of tuberculous meningitis and its effect on peripheral blood T cell subsets
  83. Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis
  84. Lycopene inhibits pyroptosis of endothelial progenitor cells induced by ox-LDL through the AMPK/mTOR/NLRP3 pathway
  85. Methylation regulation for FUNDC1 stability in childhood leukemia was up-regulated and facilitates metastasis and reduces ferroptosis of leukemia through mitochondrial damage by FBXL2
  86. Correlation of single-fiber electromyography studies and functional status in patients with amyotrophic lateral sclerosis
  87. Risk factors of postoperative airway obstruction complications in children with oral floor mass
  88. Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction
  89. Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022
  90. Evaluating anemia in HIV-infected patients using chest CT
  91. Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court
  92. Causal association of circulating immune cells and lymphoma: A Mendelian randomization study
  93. Assessment of the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals on treating renal fibrosis: A systematic review and meta-analysis
  94. Comprehensive landscape of integrator complex subunits and their association with prognosis and tumor microenvironment in gastric cancer
  95. New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: A drug Mendelian randomization study
  96. Population pharmacokinetics of meropenem in critically ill patients
  97. Comparison of the ability of newly inflammatory markers to predict complicated appendicitis
  98. Comparative morphology of the cruciate ligaments: A radiological study
  99. Immune landscape of hepatocellular carcinoma: The central role of TP53-inducible glycolysis and apoptosis regulator
  100. Serum SIRT3 levels in epilepsy patients and its association with clinical outcomes and severity: A prospective observational study
  101. SHP-1 mediates cigarette smoke extract-induced epithelial–mesenchymal transformation and inflammation in 16HBE cells
  102. Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway
  103. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma
  104. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program
  105. Exploring anesthetic-induced gene expression changes and immune cell dynamics in atrial tissue post-coronary artery bypass graft surgery
  106. Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism
  107. Analysis of the risk factors of the radiation-induced encephalopathy in nasopharyngeal carcinoma: A retrospective cohort study
  108. Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review
  109. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population
  110. Prognostic and diagnostic value of circulating IGFBP2 in pancreatic cancer
  111. Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques
  112. Research trends related to emergence agitation in the post-anaesthesia care unit from 2001 to 2023: A bibliometric analysis
  113. Frequency and clinicopathological correlation of gastrointestinal polyps: A six-year single center experience
  114. ACSL4 mediates inflammatory bowel disease and contributes to LPS-induced intestinal epithelial cell dysfunction by activating ferroptosis and inflammation
  115. Affibody-based molecular probe 99mTc-(HE)3ZHER2:V2 for non-invasive HER2 detection in ovarian and breast cancer xenografts
  116. Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials
  117. The relationship between IFN-γ, IL-10, IL-6 cytokines, and severity of the condition with serum zinc and Fe in children infected with Mycoplasma pneumoniae
  118. Paraquat disrupts the blood–brain barrier by increasing IL-6 expression and oxidative stress through the activation of PI3K/AKT signaling pathway
  119. Sleep quality associate with the increased prevalence of cognitive impairment in coronary artery disease patients: A retrospective case–control study
  120. Dioscin protects against chronic prostatitis through the TLR4/NF-κB pathway
  121. Association of polymorphisms in FBN1, MYH11, and TGF-β signaling-related genes with susceptibility of sporadic thoracic aortic aneurysm and dissection in the Zhejiang Han population
  122. Application value of multi-parameter magnetic resonance image-transrectal ultrasound cognitive fusion in prostate biopsy
  123. Laboratory variables‐based artificial neural network models for predicting fatty liver disease: A retrospective study
  124. Decreased BIRC5-206 promotes epithelial–mesenchymal transition in nasopharyngeal carcinoma through sponging miR-145-5p
  125. Sepsis induces the cardiomyocyte apoptosis and cardiac dysfunction through activation of YAP1/Serpine1/caspase-3 pathway
  126. Assessment of iron metabolism and iron deficiency in incident patients on incident continuous ambulatory peritoneal dialysis
  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
  227. Identification of signatures associated with microsatellite instability and immune characteristics to predict the prognostic risk of colon cancer
  228. Single-cell analysis identified key macrophage subpopulations associated with atherosclerosis
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