ABSTRACT
[Abstract] Objective To define the age-specific normal reference values of prostate specific antigen (PSA) and related parameters in Chinese middle-aged and elderly men.Methods From April 2007 to November 2011,serum PSAs of over 22 055 men aged more than 40 years old in our medical examination center were statistically analyzed.The men was divided into five groups by a 10-year-old interval.Total PSA (tPSA),free PSA (fPSA) and prostate ultrasound results were recorded.The free-total PSA ratio (f/t),PSA density (PSAD) and PSA velocity (PSAV) were calculated.By convention,the 95th percentile (P95)was used as the upper limit value,and the 5th percentile (P5) as the lower limit value.Results The tPSAs were positively correlated with age (r=0.349,P＜0.001).f/t was negatively correlated with age (r=-0.154,P＜0.01).Although f/t was significantly different (P＜0.001) among each age group,P5 of all groups were 0.18.PSAD was significantly different (P＜0.001) between men over and under 70 years,with P95 as 0.09 and 0.15,respectively.PSAD had a positive correlation with age (r =0.263,P＜0.01).The significant difference of PSAV raised between men over and under 60 years,with P95 as 0.21 and 0.58,respectively.PSAV was positively correlated with age (r=0.130,P＜0.01).Conclusions PSA,PSAD and PSAV are positively correlated with age,while f/t is negatively correlated with age.The normal range of f/tis 0.18-1.00 for Chinese men over 40 years old.PSAD's normal ranges are ＜0.09 and ＜0.15 in Chinese men over and under 70 years,respectively.The normal range of PSAV are ＜0.21 and ＜0.58 for Chinese men over and under 60 years,respectively.
ABSTRACT
Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device (PLFT) in benign prostate hyperplasia ( BPH ) patients with high risk factors 24 months after treatment.MethodsSixty-two BPH cases with high risk factors of aged ≥ 80or complicating severe conditions of no less than one organ or system,were treated with PLFT under urethral local anesthesia.The average pre-treatment prostate volume,international prostate symptom score (IPSS),quality of life score (QOL) and maximal urinary flow (Qmax) were 62.03 ml,23.19,4.58 and 4.33 ml/s,respectively.The changes of prostate volume,IPSS,QOL and Qmax at 3 months,12 months and 24 months after treatment were analyzed.ResultsAll patients tolerated well of PLFT performed in common therapy room except lightly bleeding,minor infection and temporary incontinence.There was no severe surgical adverse event.After 3 months,the prostate volume reduced to 43.85 ml,IPSS decreased to 11.63,QOL decreased to 2.44,Qmax rose up to 11.44 ml/s； The average values were 45.10 ml,12.23,2.61 and 10.91ml/s at 12 months after treatment.The corresponding values were 45.80 ml,12.37,2.66 and 10.82 ml/s,respectively at 24 months after treatment.Compared with pre-treatment,all the parameters showed significant improvement ( P ＜ 0.01 ).ConclusionsPLFT is one of the effective and safe treatment options for BPH patients with high risk factors.It can be safely used on day-surgery patients.The best effect appears at 3 months after treatment.
ABSTRACT
ObjectiveTo evaluate the value of intraoperative frozen section examination (IFS) in the diagnosis and surgical procedures selection for renal occupying lesions. MethodsFrom January 2006 to December 2010,IFS was used in 114 men and 81 women with renal occupying lesions.The mean age was 52 years (range 17 -78).In 104,89,and 2 patients,lesions were in the right,left and bilateral kidneys,respectively.All patients underwent physical examination,129 were asymptomatic at presentation while clinical symptoms were observed in 66.The largest dimension of the tumors were 4 cm or less in 128 patients,4- 7 cm in 49,and larger than 7 cm in 18,respectively.The outcomes between IFS and postoperative routine paraffin section examination were compared.In cases with renal tumors nephrectomy or partial nephrectomy was performed.The results of IFS were compared between the 2 groups. ResultsThe sensitivity and specificity of IFS for renal malignant lesions was 96.6％ and 100％,respectively.The total accuracy rate of IFS for renal occupying lesions was 97.4％.By subgroup analysis,the accuracy rate of clear cell carcinoma,papillary cell carcinoma,chromophobe cell carcinoma,sarcomatoid cancer,nephroblastoma,benign tumor and urothelial cancer was 94.3％,25.0％,16.7％,0,0,97.6％ and 100.0％,respectively.Partial nephrectomy and nephrectomy were performed in 57 and 123 patients with renal tumors,respectively.The surgical procedures selection was significantly associated with the lesion size (4 cm or less for 80.7％ vs 62.6％,P =0.015) and the malignant lesion diagnosed by IFS (31.6％ vs 93.5％,P＜0.001). Conclusion The accuracy of frozen section analysis for renal malignant lesions during surgery is reliable and significantly high,and the results can exert an important impact on surgical procedures selection.
ABSTRACT
Objective To evaluate the value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating the differential glomerular filtration rate (GFR) for chronic obstructed kidneys, and to compare the correlations between the two morphologic indices of renal parenchyma and the GFR for chronic obstructed kidneys. Methods Seventy-one patients who had a diagnosis of unilateral chronic upper urinary tract obstruction were included in this analysis. (1) The renal parenchymal volume was mea-sured by non-contrast spiral CT. Both kidneys were scanned by non-contrast spiral CT. The renal parenchymal area of each section was marked manually. Renal parenchymal volume was calculated as the sum of renal parenchymal area multiplied by the width of each section. The volume percentage of obstructed kidney (%CTvol) was also calculated. (2) Renal parenchymal thickness was measured on the first and last non-contrast CT image levels from the anterior, posterior and lateral locations of the kidney that clearly contained the collecting system. The mean of these measurements was defined as the renal parenchymal thickness. The differential renal parenchymal thickness of the obstructed kidney (%CTt) was defined as the percentage of the obstructed renal parenchymal thickness to the total renal parenchymal thickness for both kidneys. GFR was determined with 99Tcm-DTPA dynamic imaging system by Gates method. The differential GFR for obstructed kidney (%GFR) was the GFR percentage of obstructed kidney to the total GFR for both kidneys. The Pearson relation test was carried out between the %CTvol, %CTt and the %GFR respectively. Results %CTvol and %CTt correlated well with %GFR in chronic obstructed kidneys among the 71 test group patients. Pearson correlation coefficient r was 0.80 (t=11.20, P＜0.05) and 0.66 (t=7.24, P＜0.05), respectively. The linear correlation equation respectively was %GFR=0.05+0.80×%CTvol (F=125.48, P＜0.05) and %GFR=0.12+0.66×%CTt (F=52.36, P＜0.05). Conclusions Renal parenchymal volume and thickness by non-contrast spiral CT might be used as clinical practical parameters to evaluate the differential GFR for chronic obstructed kidneys. Renal parenchymal volume is more accurate than renal parenchymal thickness.
ABSTRACT
Objective To evaluate the efficacy in treatment with transurethral electrocision for prostatic cyst.Methods A total clinical documents of 15 cases prostatic cyst treated with transurethral electrocision were analyzed retrospectively.All the cases were diagnosed confirmly by ultrasonography and CT,all the cysts closed to the prostatic urethra or intrude urinary bladder and all the patients underwent transurethral electrocision.Results All operations were performed successfully with operative time of 18-60 (36 ± 13) min.No blood transfusion during and after the operation and postoperative hospital stay was (5.2 ± 2.6) d.All the patients had been followed up for 6-24 months,the clinic symptom disappeared and no complications happened.Three months after the operation,IPSS decreased from (27.2 ±5.6) scores to (7.5 ± 1.6) scores and QOL decreased from (4.5 ± 1.1 ) scores to ( 1.6 ± 0.6) scores (P＜ 0.01 ),respectively.Qmax increased from (6.8 ±2.3) ml/s to (22.4 ±4.8) ml/s (P ＜0.01).Conclusion Transurethral electrocision is an effective therapeutic measure of prostatic cyst close to the prostatic urethra or intrude urinary bladder without so many complications.
ABSTRACT
Objective To study the clinical,histopathological,immunohistochemical features and the diagnosis and treatment of paraganglioma of urinary bladder. Methods Two cases of paraganglioma of urinary bladder were treated. The first case was a male with painless haematuria. The abdominal ultrasonography and CT scan showed a 2.5 cm× 2.0 cm mass in the right anterior wall of the bladder, and urine vanillylmandelic acid elevated to 17. 9- 31. 3 μmol/24 h (normal range 10- 35 μmol/24 h). The second case was a female who presented with 8 years history of headache and palpitation after voiding. Abdominal ultrasonography and CT scan showed a 2. 6 cm× 1.5 cm mass in the left wall of the bladder, and her urine vanillylmandelic acid was 35.3-43.3 μmol/24 h. Results One patient underwent transurethral resection (TURBT) and the other underwent partial cystectomy.The two cases were diagnosed as bladder paraganglioma by pathological examination. Immunohistochemically, the tumor cells were positive for CgA, Syn, NSE and S-100. No evidence of recurrence was detected during follow-up at 3 months and 3 years. Conclusions Paraganglioma of urinary bladder should be considered as a low grade malignancy. Partial cystectomy should be recommended. The diagnosis depends on clinical symptoms, pathological and immunohistochemical results.
ABSTRACT
Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.
ABSTRACT
Objective To assess the clinical value of measuring the concentration of serum osteoprotegerin (OPG) in detecting the bone metastases in patients with prostate cancer. Methods The concentration of serum OPG in 40 patients was determined by ELISA. The data of ECT bone scan and Gleason score was collected simultaneously. The correlations between serum OPG and bone metastases, Gleason score were tested. Results The concentration of serum OPG in patients with bone metastases by ECT scan was( 16 237. 19 ±5144. 26) ng/L,which was significantly higher than the concentration in patients without bone metastases , which was (12 123.32 ±4136. 50)ng/L. There was no significant correlation between serum OPG and Gleason score. Conclusions The serum OPG has an important clinical value in prediction of prostate cancer with bone metastases. There is no significant correlation between serum OPG and the Gleason score.
ABSTRACT
Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device(PLFT) in high risk patients with benign prostate hyperplasia (BPH). Methods Sixty-six high risk patients diagnosed with BPH, including aged ≥80 in 32 pa-tients, hypertension in 31 patients, diabetes in 5 patients, heart failure in 8 patients, chronic obstruc-tive pulmonary disease in 8 patients, cerebral infarction in 11 patients, fracture, amputation or joint stiffness unsuitable for lithotomy position in 3 patients, abnormal blood coagulation in 4 patients, pan-creatitis in 2 patients, cardiac arrhythmia in 6 patients and malignant tumor in 3 patients, were treated with PLFT using individual power at urethral local anesthesia, resulting in coagulation necrosis in 15%-30% of prostate tissue around urethra. Meanwhile, real-time monitoring the temperature of prostate and the tissue around it was used. All patients were evaluated by comparing volume of pros-tate, maximal urinary flow (Q_max), international prostate symptom score (IPSS) and quality of life questionnaire (QOL) in pre-treatment and three months after respectively. Results All of patients well tolerated PLFT. There was bleeding lightly, infection lightly and temporary incontinence. There was no severe surgical complication. After three months, the volume of prostate reduced from 62. 2 ml to 44.5 ml; IPSS decreased from 23. 4 to 11.7; QOL decreased from 4.5 to 2.4; Q_max rised from 4, 2 ml/s to 11.2 ml/s. All differences reached significance. Conclusion PLFT is one of effective and safe treatments for patients with BPH especial BPH complicating with severe conditions.
ABSTRACT
Objective To discuss the diagnosis and treatment of primary adrenal lymphoma. Methods The clinical data of 7 adrenal primary lymphoma cases were retrospectively analyzed. Five cases were male,2 were female. Age ranged from 33 to 62 years,mean 48 years. Two cases presented with unilateral and 5 cases with bilateral masses. Two cases were found by regular health examination. Two cases had fever and weakness, with body weight loss for 3-4 months. One case had enlarged testis for 1 month. Two cases had lumbar pain accompanied by enlarged spleen. Abdominal ultra-sonography and CT showed adrenal neoplasms. All 7 cases had elevated serum lactate dehydrogenase (367-568 U/L, normal range 100-245 U/L) and β2 microglobulin (5.9-6.3 mg/L, normal range 2.4 mg/L). The CT showed irregular,inhomogeneous adrenal mass which was mildly enhanced. Results Four of the 7 patients were misdiagnosed before operation. Two patients were diagnosed as adrenal lymphoma by biopsy. One patient was diagnosed by testicular biopsy. One was T cell non-Hodgkin's lymphoma. Six cases were diagnosed as diffuse large B cell non-Hodgkin's lymphoma by pathology. Immunohistochemieally,the tumor cells were positive for CD3,CD45-RO, L26 and CD79a. Four patients had their adrenal mass removed and received chemotherapy afterwards. As follow-up of 2 years, 1 patient had no evidence of recurrence. Three patients died after 2,6,20 months after opera-tion. Three cases took chemotherapy and radiation therapy after diagnosed. They died 19,32, 38 months during follow up. Conclusions Because adrenal mass as the primary representation of prima-ry adrenal lymphoma has no characteristic clinical appearance, diagnosis could not be made preopera-tively. The principal treatment consists of adrenalectomy and adjuvant combination chemotherapy.
ABSTRACT
Objective To discuss the effect and treatment methods of ureteral obstruction caused by primary or metastatic pelvic malignancy. Methods Clinical data of 51 cases with ureteral obstruction caused By pelvic malignancy were reviewed retrospectively. The treatment included traditional open operation in 17 cases in which 3 cases with uretero-uwtero, 9 cases with uretero-bladder anastomotic stoma and 5 cases with cutaneous ureterostomy, retrograde stenting in 19 cases (11 cases with unilateral ureter, 8 cases with bilateral ureter), pereutaneous nephrostomy in 15 cases. Results The median follow-up time was 21 months (range 6 to 72 months ). Three months after operation, uhrasonograph or intravenous urography(IVU)showed that 39 (76.5%) cases had nomal renal function, 12 (23.5%) cases had hydronephrosis relief and renal function improvement. No stricture in the uretero-uretero or uretero-bladder anastomotic stoma was recorded. Conclusions Appropriate treatment is dependent upon the accurate identification of the underlying pathological process and it can relieve ureteral obstruction and increase the quality of life for ureteral obstruction caused by pelvic malignancy.
ABSTRACT
Objective To investigate the stimulate angiogenesis effect of bone marrow stem cell mobilization on coronary collateral development in the hearts of experimental myocardial infarction rats.Methods Left anterior descending coronary arteries were ligated to produce acute myocardial infarction(AMI)model in Wistar rats.Bone marrow stem cells were mobilized and home to the site of myocardial infarction by ginsenoside Rgl and Simvastatin.Hearts were harvested in the 24th hour,1st and 4th week after AMI modeling for histopathological examination.Immu nohistochemisty were used to detect infiltration of CD+34 cells and the expression of VⅢ factor in the part of ischemia.And infarct area were measured.Results Infarct area in mobilized group was obviously less than in AMI group.There were a great number of monocytes infiltrating with CD34 expression by immunohistochemisty in myocardial infracted zone in mobilized rats.Capillary density in mobilized group was greater than those of AMI and sham-operated groups.Conclusion In the AMI model of rat,bone marrow stem cells can be mobilized by ginsenoside Rgl and Simvastatin.The capillary density can be increased by mobilizing bone marrow stem cells.Ginsenoside Rgl and Simvastatin can improve the acute ischemic cardiac function by enhancing angiogenesis.
ABSTRACT
Objective To investigate the relationship between the ADAM gene expression and unknown reason infertile patients. Methods With RT-PCR mehtod, we checked from normal group semen 30 cases and infertile group semen 30 cases in order to know the ADAM1,2,3,32 mRNA expression. Results there are the ADAM1,2,3,32 gene expression in all 30 cases of normal group whereas in 30 cases infertile patients there exists 1 case ADAM1,2,32 lacking expression, 1 case ADAM2,32 lacking expression, 1 case ADAM1 and 1 case ADAM3 lacking expression. Conclusions The lacking of ADAM1,2,3,32 may be one of the most reasons which cause the infertility.
ABSTRACT
<p><b>OBJECTIVE</b>To elucidate the regulation of epidermal growth factor receptor (EGFR) expression by transforming growth factor (TGFalpha) and epidermal growth factor (EGF) in human prostate androgen-unresponsive cancer cells.</p><p><b>METHODS</b>EGFR mRNA expression and its protein level were measured by means of RT-PCR and Western blot respectively in human prostate cancer androgen-unresponsive cell lines, ARCaP and PC3, all treated with exogenous TGFalpha.</p><p><b>RESULTS</b>In the TGFalpha group, the levels of EGFR mRNA were 5.01 0.45 and 9.05 0.63 in PC3 and ARCaP respectively, significantly higher than in the control group (P < 0.05). The level of EGFR protein in PC3 treated with TGFalpha was 2.28 0.53, higher than in the control group (P < 0.05); however, the level of EGFR protein in ARCaP treated with TGFalpha was only 1.24 0.22, not different from the control (P > 0.05).</p><p><b>CONCLUSION</b>TGFalpha/EGF-EGFR pathway serves as a key growth regulator in prostate cancer. TGFalpha, but not EGF, preferentially maintains an autocrine loop in human androgen-unresponsive prostate cancer.</p>
Subject(s)
Humans , Male , Blotting, Western , Cell Line, Tumor , Prostatic Neoplasms , Metabolism , Pathology , RNA, Messenger , Genetics , ErbB Receptors , Genetics , Reverse Transcriptase Polymerase Chain Reaction , Transforming Growth Factor alpha , PharmacologyABSTRACT
Objective To investigate the effectiveness of malononitrilamide 715 (FK778) in combination with tacrolimus in prevention of acute renal allograft rejection in Vervet monkeys. Methods Eleven groups ( n ≥4/group) were involved in this study. FK778 and tacrolimus were administered orally for 60 days according to protocol. Proliferation assay was used to evaluate the effect of FK778 plus tacrolimus on monkey lymphocytes, after activation with T or B cell specific mitogens. Results Naive controls rejected renal graft with a median survival time (MST) of 8.0 days in group 1. When recipient monkeys were treated with tacrolimus 1.0 mg?kg -1 ?d -1 in group 2 or FK778 2.5 mg?kg -1 ?d -1 in group 3, the MST was 16.0 days ( P = 0.001 ) and 11.0 days ( P = 0.266 ), respectively. Combination therapy of these two agents at the same doses immediately after transplantation resulted in a MST of 25.0 days ( P = 0.016 ) in group 4. When tacrolimus was initiated immediately after transplantation and FK778 treatment was delayed until day 7 after surgery in group 5, recipient survivals were significantly prolonged to 38.0 days ( P = 0.02 ). These results were repeatable when FK778 5.0 mg?kg -1 ?d -1 ( 9.0 days, P = 0.544 in group 6) was combined with tacrolimus 1.0 mg?kg -1 ?d -1 immediately after transplantation ( 8.0 days, P = 0.339 ) in group 7, or when FK778 was delayed 7 days ( 60.0 days, P = 0.002 ) in group 8. Furthermore, it was also repeatable when FK778 10 mg?kg -1 ?d -1 was combined with tacrolimus 1.0 mg?kg -1 ?d -1 with a 7 day delay. Proliferation assay in the combination groups revealed that 88.8 % (8/9) produced additive to synergistic effects in B cells, while 66.6 % (6/9) produced moderate antagonistic effects in T cells. Conclusion A significant prolongation of renal allograft survival was produced when FK778 administration was delayed by 7 days combined with tacrolimus in Vervet monkeys. And the combination of FK778 with tacrolimus in vitro produces synergistic inhibition on B cells proliferation, but not on T cells.
ABSTRACT
Objective To elucidate the regulation of e pidermal growth factor receptor (EGFR) expression by transforming growth factor (TGF)? and epidermal growth factor (EGF) in human prostate cancer cells. Methods EGFR mRNA expression and its protein level were measur ed by means of RT-PCR and Western blot respectively in three human prostate can cer cell lines,the androgen-responsive (LNCaP) and the nonresponsive (ARCaP and PC3), all being treated with exogenous EGF or TGF?. Results TGF? enhanced EGFR mRNA two-to tenfold in all three cell lines, whereas EGF increased EGFR mRNA two-to sixfold.In all the three cell lines, TGF? induc ed total EGFR protein levels were higher than EGF. Conclusions These data indicate that TGF?/EGF-EGFR path-way serves as a key growth regulator in prostate cancer.TGF?, but not EGF, would preferentially maintain an autocrine loop in human androgen-nonresponsive prostate cancer.
ABSTRACT
Objective To improve the diagnosis and treatment of upper urinary tract hematuria. Methods A total of 121 patients with hematuria who had undergone B-utrasonography,KUB plus IVU,CT and cystoscopy were suspected of hematuria from upper urinary tract.For these cases ureterorenoscopy was performed to establish the diagnosis and to conduct specific therapies. Results The diagnostic accordance rate was 92%(111/121).Among these cases,ureteral small stones in middle and lower segments were found in 45 cases;renal pelvis and ureteral tumors in 32 cases;renal hemorrhagic diseases in 19 cases and ureteral polyps in 15 cases.19 cases who had renal hemorrhagic diseases and 10 who had no definite lesions received specific therapies were followed up for 6 to 8 months.The long-term successful rate was 79%(23/29). Conclusions The application of ureterorenoscopy for the management of upper urinary tract hematuria is quite effective and worthy of widespread application.