Role of Urine ErbB3 Protein in Early Diagnosis of Clear Cell Renal Cell Carcinoma / 中山大学学报(医学科学版)

[Objective]To explore the diagnostic value of urine ErbB3 protein in clear cell renal cell carcinoma.[Methods]We collected 31 urine samples of clear cell renal cell carcinoma patients who received operations in the Urology Department of the First Affiliated Hospital of Sun Yat-Sen University from April 2,2016 to August 31,2016.Meanwhile we collected 50 urine samples of normal people as control.We tested the expression of urine ErbB3 protein in experimen-tal group and control group,and analyzed the differences between the two groups.Then we established the ROC curve of which diagnosing clear cell renal carcinoma by urine ErbB3 protein. Also,we analyzed the relation between ErbB3 pro-tein in urine and the patients'BMI,preoperative creatinine,tumor diameter and underlying diseases such as hyperten-sion and hyperglycemia.[Results]①The expression of urine ErbB3 protein in clear cell renal cell carcinoma group was significantly lower than normal group(P<0.001). ② When diagnosing clear cell renal carcinoma by ErbB3 protein,the AUC of ROC was 0.802(P<0.001). When setting the cutoff as 13.98 pg/mL,the max Youden index was 0.525,the sensitivity was 0.645 and the specificity was 0.880. The Kappa value of diagnostic test was 0.542(P<0.001). ③ There was no correlation between the ErbB3 content and patients'BMI,tumor diameter or preoperative creatinine by correlation analysis. Also,there was no correlation between the urine ErbB3 protein content and blood pressure or blood glucose.[Conclusion]The urine ErbB3 protein of clear cell renal cell carcinoma was significantly lower than normal people,and it is meaningful for applying urine ErbB3 protein to early diagnosis of clear cell renal cell carcinoma.

Genetic characterization and protein stability analysis of a Chinese family with Von Hippel-Lindau disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Von Hippel-Lindau disease (VHL), a heritable autosomal dominant disease characterized by neoplasia in multiple organ systems, has rarely been reported in Asia. We genetically investigated a unique Chinese family with VHL disease and performed an analysis of the VHL protein stability.</p><p><b>METHODS</b>Genomic deoxyribonucleic acid (DNA) extracted from peripheral blood was amplified by polymerase chain reaction (PCR) to three exons of the VHL gene in 9 members of the Chinese family with VHL disease. PCR products were directly sequenced. We estimated the effects of VHL gene mutation on the stability of pVHL, which is indicated by the free energy difference between the wild-type and the mutant protein (ΔΔG).</p><p><b>RESULTS</b>The Chinese family was classified as VHL type 1. Three family members, including two patients and a carrier, had a T to G heterozygotic missense mutation at nucleotide 515 of the VHL gene exon 1. This missense mutation resulted in the transition from leucine to arginine in amino acid 101 of the VHL protein. There was low stability of the VHL protein (the ΔΔG was 12.71 kcal/mol) caused by this missense mutation.</p><p><b>CONCLUSIONS</b>We first reported a family with this VHL gene mutation in Asia. This missense mutation is predicted to significantly reduce the stability of the VHL protein and contribute to the development of the renal cell carcinoma (RCC) phenotype displayed by this family. The genetic characterization and protein stability analysis of families with VHL disease are important for early diagnosis and prevention of the disease being passed on to their offspring.</p>

Microsurgical denervation of the spermatic cord for treatment of idiopathic chronic orchialgia / 中华医学杂志(英文版)

A patient referred to our hospital, diagnosed with left idiopathic chronic orchialgia, was evaluated with a thorough medical and psychiatric history, physical examination, scrotal ultrasound and magnetic resonance imaging. Conservative management failed. The patient had temporary pain relief after undergoing outpatient cord block three times. Microsurgical denervation of the left spermatic cord was operated in March, 2011. A pain questionnaire was used to determine efficacy before and after operation, and complete pain relief was noted at one week after operation. The follow up period was 12 months, at the end of which the pain score was still zero. No complications, including testicular atrophy and hydrocele, occurred. Microsurgical denervation of the spermatic cord can be a minimally invasive, safe and effective management option for treatment of idiopathic chronic orchialgia.

Clinical characteristics and surgical treatment for localized Castleman's disease / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and treatment of localized Castleman's disease (CD), and review the literatures to improve the diagnosis and management of this disease.</p><p><b>METHODS</b>The clinical symptoms, histopathology, CT, MRI findings and results of surgery in 20 patients with localized CD were evaluated retrospectively.</p><p><b>RESULTS</b>The average age of the patients was 37.7 years. The lesions were located in the retroperitoneal space (9 cases), mediastinum (7 cases), pelvic cavity (1 case), neck (1 case), upper arm (1 case), and axillary (1 case). All patients underwent surgical resection, including 9 cases for retroperitoneal resection (6 cases had open operation and 3 cases laparoscopic resection) and 7 cases for mediastinal resection (open operation in 5 cases and thoracoscopic resection in 2 cases). The Castleman's disease was confirmed by histopathology. There were hyaline vascular type of CD in 17 cases, plasma cell type of CD in 1 case, and mixed cellularity type of CD in 2 cases. The duration of follow-up ranged from 12 to 165 months for 16 cases. Among them 15 patients were alive without recurrence, and 1 case had recurrence in the primary site at 47 months after the operation.</p><p><b>CONCLUSIONS</b>Patients with Castleman's disease have no typical clinical symptoms and have normal laboratory results. The majority of patients are of hyaline vascular type of the disease. Imaging examination is helpful to diagnosis, and the final diagnosis depends on pathologic examination. Complete surgical resection of the tumor is the best treatment for localized Castleman's disease.</p>

Shorter recurrence-free survival time, higher risk of multiple recurrences: a retrospective study of non-muscle invasive bladder cancer after transurethral resection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Multiple recurrences are common in non-muscle invasive bladder cancer, but the risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help to select an optimal therapeutic strategy and to improve prognosis. This study was conducted to identify the risk factors for multiple recurrences of non-muscle invasive bladder cancer.</p><p><b>METHODS</b>We reviewed the clinical data of all patients with non-muscle invasive bladder cancer in our hospital between January 2003 and February 2010. Patients with at least one recurrence were included. Multivariate analysis was performed for theorized risk factors (age, gender, tumor stage, grade, size, location, number of lesions, adjuvant intra-vesical chemotherapy after transurethral resection, and recurrence-free survival after each resection) to clarify risk factors for multiple recurrences of non-muscle invasive bladder cancer.</p><p><b>RESULTS</b>Of the 278 patients with non-muscle invasive bladder cancer, 84 were with at least one recurrence and a total of 222 recurrences among them were followed up for 6 - 70 months (mean, 36.1 months). Recurrence-free survival after initial resection predicted the overall frequency of bladder cancer recurrence (risk ratio (RR) = 37.83, 95% confidence interval (CI) = 3.45 - 396.13, P = 0.001) and second recurrence (RR = 6.15, 95%CI = 1.28 - 29.57, P = 0.023). Similarly, recurrence-free survival after a second resection was the only significant risk factor for third recurrence (RR = 31.08, 95%CI = 2.53 - 381.47, P = 0.007). Moreover, recurrence-free survival after initial resection was the only significant factor to predict later progression to muscle invasive bladder cancer (RR = 8.62, 95%CI = 1.47 - 58.34, P = 0.001).</p><p><b>CONCLUSIONS</b>Recurrence-free survival after resection is an independent predictor of multiple recurrences of non-muscle invasive bladder cancer. The shorter the period between resection and recurrence is, the higher the risk of multiple recurrences.</p>

Transrectal ultrasonography in the etiological diagnosis of male obstructive azoospermia: analysis of 695 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the role of transrectal ultrasonography (TRUS) in the etiological diagnosis of male obstructive azoospermia.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data and TRUS findings of 695 patients with obstructive azoospermia from January 2007 to May 2009.</p><p><b>RESULTS</b>Concerning the etiology of obstructive azoospermia, the main TRUS findings included ejaculatory duct abnormality (29.2%), seminal vesicle abnormality (25.4%) and prostate midline cyst (18.5%). TRUS revealed 203 cases of ejaculatory duct dilation, 177 cases of seminal vesicle abnormality (including 108 with absence or agenesis and 51 with dilation of the seminal vesicle), and 128 cases of prostate midline cyst (including 75 with ejaculatory duct cyst and 39 with Müllerian cyst). Calcification of the verumontanum or ejaculatory duct was suspected to be the causes of obstructive azoospermia in 34 cases. However, no significant etiological abnormality was found in 153 cases. Obvious etiology was shown by TRUS in 78.0% of the patients.</p><p><b>CONCLUSION</b>TRUS can clearly display the structural abnormality of the ejaculatory duct and seminal vesicle, and provide important information on the etiology of male obstructive azoospermia.</p>

Impact of asymptomatic prostatitis on semen quality / 中华男科学杂志

<p><b>OBJECTIVES</b>To study the impact of asymptomatic prostatitis on semen parameters.</p><p><b>METHOD</b>Based on the count of WBC in EPS, we assigned 152 patients with asymptomatic (type IV) prostatitis to Groups A (WBC + to + +) and B (WBC + + + to + + + +), and included 68 normal healthy men controls in Group C. All the patients were examined for the volume, pH value and liquefaction time of the semen, sperm concentration, sperm survival rate, grade a sperm percentage, morphologically normal sperm percentage, WBC count, and accompanying inflammatory cytokines.</p><p><b>RESULTS</b>The semen liquefaction time, grade a sperm percentage and morphologically normal sperm percentage were (24.5 +/- 5.2) min, 20.0 +/- 4.1 and 10.5 +/- 4.8 in Group A, (30.4 +/- 5.0) min, 10.0 +/- 3.8 and 7.5 +/- 4.2 in Group B, and (18.5 +/- 5.3) min, 32.3 +/- 4.5 and 17.8 +/- 3.6 in Group C, with statistically significant differences between A and B (P < 0.01). The pH value, semen volume, sperm survival rate and sperm concentration were 7.6 +/- 0.3, (3.0 +/- 1.1) ml, 56.0 +/- 6.0 and (65.9 +/- 11.3) x 10(6)/ml in Group A, 7.7 +/- 0.3, (2.8 +/- 1.2) ml, 52.3 +/- 6.3 and (62.5 +/- 10.3) x 10(6)/ml in Group B, and 7.5 +/- 0.2, (2.9 +/- 1.2) ml, 62.1.0 +/- 5.3 and (87.7 +/- 10.1) x 10(6)/ml in Group C, with no significant differences among the three groups (P > 0.05). The contents of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) in the semen were (58.64 +/- 30.82) pg/ml and (50.57 +/- 27.48) pg/ml in Group B, significantly increased as compared with (17.68 +/- 5.65) pg/ml and (23.50 +/- 4.80) pg/ml in Group C (P < 0.01).</p><p><b>CONCLUSION</b>Asymptomatic prostatitis effects significant changes in the major parameters of the patient's semen quality.</p>

Clinical analysis of renal cell carcinoma: report of 271 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of renal cell carcinoma.</p><p><b>METHOD</b>From January 1993 to December 2000 the data of 271 cases of renal cell carcinoma were reviewed.</p><p><b>RESULTS</b>Ultrasonography and CT scanning were still the main diagnostic methods. Surgical operation was performed on 234 patients. Radical nephrectomy was performed on 197 patients (72.6%); Nephron sparing surgery was performed on 19 patients; Metastatic tumor resection was performed on 6 patients and other procedures for 12. The pathological results showed that 137 cases (61.4%) were clear cell carcinoma, 18 cases (8. 1%) of granular cell carcinoma, 32 cases (14. 3%) being combination of the above two varieties, 23 cases (10.3%) of renal papillary adenocarcinoma, 13 cases being renal cell of other types. And 210 cases (77.5%) had been successfully followed up. The 1, 3, 5 and 10 year survival rates were 95.3% (182/191), 88.7% (107/122), 74.7% (56/75) and 32.1% (10/31) respectively.</p><p><b>CONCLUSIONS</b>Ultrasonography is the first select examination method of detecting of renal cell carcinoma, and CT scanning is the most valuable diagnostic mean. Early diagnosis and prompt radical nephrectomy or nephron sparing nephrectomy are the critical points for achieving long-term survivals of patients with renal cell carcinoma.</p>

Comparison of different drugs on the treatment of benign prostate hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the differences of the efficacy and different therapeutic drugs on the treatment of benign prostatic hyperplasia (BPH) in order to ensure the optimal indication for different BPH patients.</p><p><b>METHODS</b>A randomized, parallel-controlled, multicenter clinical trial was conducted. From September 2002 to December 2003 906 BPH patients were enrolled into 7 therapeutic groups, including selective-adrenoceptor antagonist (terazosin, doxazosin tamsulosin and naftopidil), 5 alpha-reductase inhibitor (finasteride and epristeride) and natural product (cernilton). International Prostate Symptom Score (IPSS) and Quality of Life (QOL), uroflowmetry, total prostatic volume (TPV) and transitional zone volume and residual urine were used as efficacy criteria.</p><p><b>RESULTS</b>According to the baseline, the IPSS and Qmax were significantly correlated to the prostatic volume and transitional zone volume (P < 0.01). At average follow-up of 6 months, significant improvements in IPSS, QOL, Qmax and residual urine volume were observed in each therapeutic group, and no difference in IPSS improvement was found among the groups. Prostatic volume and transitional zone volume were significant decreased in 5alpha-reductase inhibitor groups (P < 0.05). In patients with baseline TPV greater than 35.5 cm3, the improvement of Qmax was more significant than that in patients with TPV less than 35.5 cm3 in finasteride group (P < 0.01) (5.7 ml/s and 2.2 ml/s respectively), and more significant symptomatic improvements were also found in cernilton, doxazosin and naftopidil group. In each group, the improvement of symptom were more significant in patients with IPSS higher than 20 points (P < 0.01).</p><p><b>CONCLUSIONS</b>Each drug observed in this study can improve the subjective and objective symptoms significantly for BPH patients, especially for patients with higher IPSS baseline. When using 5alpha-reductase inhibitor, prostatic volume can be decreased significantly and more obviously subjective and objective improvement can be found in the patients with TPV greater than 35.5 cm3.</p>

Natural history of benign prostate hyperplasia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.</p><p><b>METHODS</b>One hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.</p><p><b>RESULTS</b>All patients were visited after 6 months, the mean volume of transitional zone was found to have increased by 1.6 ml (P < 0.01), International Prostate Symptom Score was increased by 0.8 (P < 0.01) and Quality of Life was increased by 0.2 (P < 0.01), and there was no statistical change in other data. Among these patients, 17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).</p><p><b>CONCLUSIONS</b>After one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.</p>

Surgical therapy for azoospermia with ejaculatory duct obstruction / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of transurethral resection of ejaculatory ducts (TURED) for azoospermia with ejaculatory duct obstruction (EDO).</p><p><b>METHODS</b>From June 2003 to December 2004, 20 azoospermia with EDO were diagnosed, diagnostic criteria included a history, physical examination, semen analyses, semen fructose measurement, endocrine assessment, testicular biopsy and transrectal ultrasonography (TRUS); All 20 cases were treated by TURED. Fifteen of them were followed up more than 3 months after the treatment. The semen samples of them were analysed at 3-month intervals in post-therapy.</p><p><b>RESULTS</b>Semen analyses in all 20 cases showed the typical characteristics of EDO, low semen volume (0.4-1.6 ml), azoospermia, low pH, absent or low semen fructose. TRUS showed the main etiology factor of EDO was a midline cyst in 11, lateral cystic lesions in 2, the remaining 7 cases had dilated ejaculatory duct with or without dilated seminal vesicles. Among 15 cases followed up more than 3 months after TURED, 10/15 (67%) had an improvement in semen parameters and 3/15 (20%) had pregnancies. Semen analyses had not been done in anther 5 cases.</p><p><b>CONCLUSION</b>Transurethral resection of ejaculatory ducts may be a safe and effective method for the treatment of azoospermia with EDO.</p>

The effect of cell killing and apoptosis by human herpes simplex virus- thymidine kinase/ganciclovir system combined with allitride in BIU87 cells / 中华外科杂志

<p><b>OBJECTIVE</b>To study the killing effect of human herpes simplex virus-thymidine kinase/ganciclovir (HSV-TK/GCV) system combined with allitride and the possible apoptosis mechanism in BIU87 cells.</p><p><b>METHODS</b>The cytotoxicity after combination were estimated by theamine blue tetrazolium bromide (MTT). The morphological changes were observed with inverted microscope and in-situ cell apoptosis detection kit. Changes of apoptosis rate and cell cycle were assessed by flow cytometry. B-cell lymphoma-2 (bcl-2), bax, caspase-3 (cysteine aspartate specific proteinase) mRNA changes were detected by reverse transcriptase polymerase chain reaction, and caspase-3 activity was estimated with colorimetry.</p><p><b>RESULTS</b>For combination group, the cell killing rate was raised to 72.50% to compare with 35.00% of GCV and 37.00% of allitride separately and there was a synergistic effect between these two drugs. The cell apoptosis was induced in all three groups and for the combination group the time of S-phase and G(2)-phase arrest were earlier than other two groups. Both drugs could inhibit the expression of bcl-2 and promote the expression and activity of caspase-3.</p><p><b>CONCLUSIONS</b>The combination of HSV-TK/GCV system with allitride can inhibit the proliferation of BIU87 cells congenerously through apoptosis, which may be correlated with S- and G(2)-phase arrest, down-regulation of bcl-2 and increased caspase-3 expression and its activity.</p>

Effect of nitric oxide donor and alpha1-receptor antagonist on proliferation/apoptosis of hyperplastic prostatic stromal cells in vitro / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of nitric oxide donor and alpha(1)-receptor antagonist on proliferation/apoptosis of hyperplastic prostatic stromal cells in vitro.</p><p><b>METHODS</b>Primary cultured prostatic stromal cells were treated by nitric oxide donor SNP and Terazosin, and the antiproliferative index and apoptosis index were determined by MTT assay and TUNEL respectively.</p><p><b>RESULTS</b>There was a significant dose-effect relationship between SNP and the antiproliferative effects, while Terazosin showed no antiproliferative effects and the combination of SNP and Terazosin showed no strengthen effects. Terazosin significantly induced apoptosis, but SNP showed no effect on induction of apoptosis, while there were much more effects of inducing apoptosis in the combination of Terazosin and SNP than the Terazosin alone.</p><p><b>CONCLUSIONS</b>Terazosin induces apoptosis in cultured BPH stromal SMCs with little effect on the cell proliferation. SNP inhibits the proliferation of the cells without affecting apoptosis. The apoptosis induction effect is enhanced when Terazosin is combined with SNP, but they do not have an additive antiproliferative effect.</p>