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OBJECTIVES@#To evaluate the feasibility and safety of bipolar-plasmakinetic transurethral enucleation and resection of the prostate (B-TUERP) in day surgery.@*METHODS@#From January 2021 to August 2022, 34 patients with benign prostatic hyperplasia (BPH) underwent B-TUERP in day surgery in the First Affiliated Hospital of Anhui Medical University. Patients completed the screening and anesthesia evaluation before admission and received the standard surgery which implements "anatomical enucleation of the prostate" and "absolute bleeding control" on the same day of admission, and by the same doctor. Bladder irrigation was stopped, catheter was removed and the discharge evaluation was performed on the first day after operation. The baseline data, perioperative conditions, time of recovery, treatment outcomes, hospitalization costs, and postoperative complications were analyzed.@*RESULTS@#All operations were successfully conducted. The average age of the patients was (62.2±7.8) years, average prostate volume was (50.2±29.3) mL. The average operation time was (36.5±19.1) min, the average hemoglobin and blood sodium were decreased by (16.2±7.1) g/L and (2.2±2.0) mmol/L, respectively. The average postoperative length of hospital stay, and total length of hospital stay were (17.7±2.2) and (20.8±2.1) h, respectively, and the average hospitalization cost was (13 558±2320) CNY. All patients were discharged on the day after surgery except for one patient who was transferred to a general ward. Three patients received indwelling catheterization after catheter removal. The 3-month follow-up results showed a substantial improvement in the International Prostate Symptom Score, quality of life score and maximum urinary flow rate (all P<0.01). Three patients experienced temporary urinary incontinence, 1 patient experienced urinary tract infection, 4 patients were diagnosed with urethral stricture and 2 patients experienced bladder neck contracture. No complications above Clavien grade Ⅱ occurred.@*CONCLUSIONS@#The preliminary results showed that B-TUERP ambulatory surgery is a safe, feasible, economical and effective treatment for appropriately selected patients with BPH.
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Male , Humans , Middle Aged , Aged , Prostate/surgery , Prostatic Hyperplasia/surgery , Ambulatory Surgical Procedures , Quality of Life , Feasibility Studies , Retrospective Studies , Treatment OutcomeABSTRACT
【Objective】 To evaluate the efficacy and safety of 450 nm semiconductor blue laser combined with triamcinolone acetonide injection in the treatment of bladder neck contracture (BNC). 【Methods】 A 61-year-old male patient with BNC and urethral stricture was treated with 450 nm semiconductor blue laser vaporization combined with triamcinolone acetonide injection. The surgery was performed with a small-caliber laser resectoscope of F22. The follow-up results 3 months after surgery were reported. 【Results】 The operation was successful, the operation time was 30 minutes, and the patient was discharged the next day after operation. Follow-up 3 months after operation showed the maximum urinary flow rate (Qmax) was 22.1 mL/s, the International Prostate Symptom Score (IPSS) was 2, the Quality of Life Scale (QoL) was 0, and no recurrence was observed. 【Conclusion】 It is safe and feasible to use 450 nm semiconductor blue laser combined with triamcinolone acetonide injection to treat bladder neck contracture through a small-caliber laser resectoscope of F22, especially for patients with urethral stricture. The short-term efficacy is satisfactory.
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【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.
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Laparoscopic renal pedicle lymphatic disconnection is the most effective method for treating chyluria that has failed to respond to conservative management. Chylous hemothorax is a rare clinical occurrence resulting from the anatomic abnormality. This paper reported a case, who was admitted with painless gross hematuria for 1 month and was diagnosed with left chylous hematuria. Laparoscopic left renal pedicle lymphatic disconnection was performed, and bilateral chylous hemothorax occurred after the operation. After conservative treatment such as bilateral closed thoracic drainage and blood transfusion support, the patient recovered well. After 2 months of follow-up, there was no obvious effusion in the bilateral thoracic cavity, and the chylous test of urine fluid was negative.
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A total of 4 patients with renal cancer were admitted to our hospital from October 2006 to September 2015 in a familial renal cancer family. Among the 4 patients, 1 patient showed unilateral multiple clear cell carcinoma, 1 patient showed bilateral multiple clear cell carcinoma, and 2 patients showed bilateral multiple chromophobe cell carcinoma. No mutation of VHL or FLCN gene was found in all patients by genetic analysis.
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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the common diseases in uroloandrology, which recurs easily after treatment. In recent years, the safety and efficacy of extracorporeal shock wave therapy (ESWT) for CP/CPPS has been widely demonstrated. Studies have shown satisfactory short-term (≤12 weeks) outcomes of ESWT, but lack long-term (>12 weeks) follow-up data. In addition, inconsistent indications and unexplained therapeutic mechanisms have limited the further clinical promotion of ESWT. This article summarizes the latest progress and potential mechanism of ESWT in the treatment of CP/CPPS in order to provide new insights for the standardized application of ESWT.
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Neurogenic bladder caused by herpes zoster is not common.An 86 years old male patient with 6 months of dysuria and urinary retention caused by herpes zoster underwent sacral neuromodulation (SNM) operation. The symptoms of dysuria and fecal incontinence were improved significantly after operation.
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Objective:To investigate the characters and emergency treatment strategy of upper urinary tract stone obstruction complicated with urosepsis.Methods:Clinical data of 28 cases of urosepsis, caused by upper urinary tract stone obstruction and arranged for emergency admission in our hospital during January 2018 to December 2019, were retrospectively analyzed. There were 6 males and 22 females. The median age was 54(32-93)years old. All patients had fever with the temperature ranged from 38.5 to 41.0 ℃. The median course of disease was 3 (ranging 1-14) days. The systolic blood pressure ranged from 76 to 138 mmHg at admission. Hypotension group was defined as the systolic blood pressure<90 mmHg after admission. Normotensive group was defined as the systolic blood pressure≥90 mmHg. There were 12 cases in hypotension group, including 3 males and 9 females. The median age was 57 (ranging 32-93) years old. The stones located at left side in 7 cases and right side in 5 cases. The stones located at the upper ureter in 5 cases, middle ureter in 2 cases, lower ureter in 4 cases and renal calculi in one case. The median length of the stone was 10 (ranging 6-20) mm. Six cases suffered with diabetes mellitus. One case suffered with neuron system disease. 3 cases have history of recent extracorporeal shock wave lithotripsy(ESWL). There were 16 cases in normotensive group, including 3 males and 13 females with the median age of 53 (ranging 33-76) years old. The stones located at left side in 5 cases, right side in 9 cases and bilateral in 2 cases. The stones located at the upper ureter in 10 cases, middle ureter in 4 cases, lower ureter in 2 cases. The length of the stone was 10 (ranging 8-14) mm. There were 3 cases with neurological diseases and 3 cases with recent ESWL history. There was significant difference between hypotension group and normotensive group in ration of diabetes mellitus ( P=0.024). Blood routine examination, C-reactive protein (CRP), procalcitonin(PCT), blood and urine bacterial culture were performed in both groups. The patients were treated with empiric antibiotics after the evaluation based on the sequential organ failure assessment (SOFA). Patients with hypotension were given blood volume expansion, and vasoactive drugs were added when the blood pressure was still low. After the blood pressure was stable, the collection system decompression was performed. The difference of infection indicators and therapeutic methods between the two groups was compared. Results:There was no significant difference in median WBC [16.34 (2.55-41.65) × 10 9/L vs. 13.97(6.23-26.65) × 10 9/L, P=0.577], median CRP [143.0(74.2-200.0) ng/ml vs.110.0 (22.7-200.0) ng/ml, P=0.771] between hypotension group and normotensive group. The difference of PCT [95.5 (26.5-200.0) ng / ml vs. 57.6 (1.0-200.0) ng / ml, P=0.040] and PLT [65.5(14.0-170.0)×10 9/L vs. 73.0(17.0-412.0)×10 9/L, P=0.030] between hypotension group and normotensive group was statistically significant. The median SOFA scores of hypotension group and normotensive group were significantly different [8.5(3.0-13.0) vs. 5.0(2.0-8.0), P=0.001]. Ureteral stent placement was performed in 23 cases, and nephrostomy was performed in 5 cases. There was no significant difference in surgical drainage between the two groups ( P=0.887). Eight patients in hypotension group were admitted to ICU. There was no significant difference in the duration of antibiotic use between hypotension group and normotensive group [8 (3-12) d vs. 5 (3-7) d, P=0.453]. Sepsis was cured in both groups after decompression, fluid resuscitation and antibiotic treatment. Conclusions:In severe cases of upper urinary tract stone obstruction complicated with urogenic sepsis, septic shock may occur. The condition is urgent, severe and dangerous. Patients with hypotension had higher PCT and SOFA scores, and lower PLT. It is very important to carry out the collection system decompression drainage in time, liquid resuscitation, early effective antibiotic use.
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Nephroureterectomy is the golden standard for surgical treatment of upper urinary tract urothelial carcinoma. With the development of surgical robotics, the number of robot-assisted laparoscopic nephroureterectomy has increased rapidly worldwide. With the advantages of 3D imaging, high-definition camera and flexible joints, this procedure reduces the complexity of approaches in nephroureterectomy such as dissection of distal and intramural ureter as well as suture of the bladder wound, with comparable oncological outcome to open surgery. The present article reviewed the research progress in preoperative preparation, intraoperative technique, perioperative parameters and prognosis of robot-assisted laparoscopic nephroureterectomy.
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Objective:To explore the therapeutic effect of low-intensity extracorporeal shock wave (Li-ESW) in model rats with chronic prostatitis and its optimal parameters.Methods:From April to August 2019, 90 healthy male SD rats aged 8 weeks were randomly divided into control group (group C, n=15), model group (group M, n=15) and shock wave treatment group (group T, n=60), which were treated with Li-ESW after being modeled successfully. The rats in group T were supine and treated with focused Li-ESW, and the probe was placed above the anatomical position of the prostate. Treatment scheme was 3 Hz of frequency, 500 pulses, and once a week for 4 weeks. Group T was divided into group T1(0.09 mJ/mm 2), T2(0.20 mJ/mm 2), T3(0.30 mJ/mm 2) and T4(0.40 mJ/mm 2) according to energy flux density, with 15 rats in each group. Before the establishment of the model, the rats in each group were tested with von Frey fiber of 2 g, 4 g and 6 g at the scrotum respectively, and the positive reaction was recorded. There was no significant difference between the three groups ( P>0.05). After one week, the rat model with CP was established by injecting 3% carrageenan into the bilateral lobes of the prostate under anesthesia. And one week after the modeling was completed, the rats in each group underwent von Frey test again to measure pain and evaluate the modeling effects. Group T was then treated once a week for a 4-week period. During the treatment, von Frey test was performed before each treatment to evaluate the treatment effect of the previous week. After the von Frey test for one, two and four weeks of treatment, 5 rats were sacrificed in each group, and the bilateral lobes of the prostate were dissected under aseptic conditions for paraffin inclusion and HE staining. Result:The positive reaction in group M and each group T was significantly more than those in group C ( P<0.001) one week after the modeling was completed, and there was no significant difference between group M and group T. The number of positive reactions in group T2 was lower than that in group M at each time point after treatment ( P<0.05), and it is also less in group T1, T3 and T4 were than that in group M after 3 weeks, 3 and 4 weeks and 2 weeks respectively( P<0.05). In group T2, the number of positive reactions began to decrease after 1 week of treatment, and reached the lowest after 4 weeks, with significant difference in pain measurement results at different time points ( P<0.05). The results of pathological examination showed that there were more inflammatory cells in prostatic stroma and disordered arrangement of epithelial cells in group M than that in group C. The pathological scores of group M, T1, T2, T3 and T4 were 8, 7, 4, 6, 9 after 1 week treatment, 8, 5, 3, 4, 7 points after 2 weeks treatment, and 7, 3, 2, 4, 7 points after 4 weeks treatment, respectively. Conclusions:Low-intensity extracorporeal shock wave treatment had a significant effect on the improvement of symptoms in model rats with chronic prostatitis. Under the scheme of frequency 3 Hz, 500 pulses, once a week for 4 weeks, the optimal parameters is 0.20 mJ/mm 2.
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Objective:To evaluate the clinical efficacy and safety of transurethral columnar balloon dilation of prostate (TUCBDP) in treatment of patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was performed on 25 cases of BPH treated by TUCBDP in the First Affiliated Hospital of Anhui Medical University from June 2016 to July 2018. The median age was 80(57-94) years, and the median volume of prostate was 75 (30-176) ml. The median preoperative maximum urine flow rate (Q max) was 6 (2-9) ml/s, the median quality of life score (QOL)was 4(3-5) points. The median preoperative international prostate symptom score (IPSS) and residual urine volume (RUV) was 25(18-34) and 85 (30-510) ml respectively.The median preoperative international index of erectile function questionnaire-5 (IIEF-5) score was 11(5-21)points and the median preoperative premature ejaculation diagnostic tool (PEDT) score was 10(6-17)points.The standard procedure of TUCBDP includes injecting 5ml of normal saline into the inner capsule, touching the inner capsule at the apex of prostate, fixing the catheter and then injecting water into the outer capsule to make the pressure reach 2.5 kPa. When the pressure of the outer capsule was maintained at 3 kPa for 5 minutes, the prostate was split. The peroperative IPSS, QOL, Q max and RUV was compared. The IIEF-5 and PEDT score before and after surgery were compared in patients with normal sexual activity to evaluate whether there were reverse ejaculation and semen reduction. Results:One case of BPH failed to rupture and the other two cases was split at 6 o’clock. The three cases were converted to plasma resection. The rest 22 cases were operated successfully with the median operation time of 17(11-23)min, the hemoglobin loss of 19(15-22)g/L. The continuous bladder flushing time was 1(1-2)d, the indwelling catheter time was 10(7-11)d and the hospital stay time was 11(7-12)d. Twenty of 25 cases were followed-up for 12 months. IPSS was 8 (4-14) points, Q max was 17(9-25)ml/s, and RUV was 10 (0-150) ml; there were significant differences between the peroperative and postoperative (all P<0.001). The median QOL was 1(1-2) point, decreased than peroperative( P<0.05). No adverse ejaculation and semen reduction were found in the post-operative patients with normal sexual life. The post-operative IIEF-5 and PEDT score was 16 (7-24) points and 8 (6-14) points respectively, which was not significantly different while compared with pre-operative IIEF-5 and PEDT score. Conclusions:TUCBDP was proved to be effective and safe for treating high-risk BPH patients with the advantages of short operation time, less bleeding, significant improvement of residual urine and dysuria.
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Prostatitis is one of the common diseases of uro-andrology. There are still many deficiencies in the existing classification methods of prostatitis. In traditional classification criteria, the etiology of "nonbacterial prostatitis" is not clear, and it is easily confused with "prostate pain" . NIH classification relies on the Meares-Stamey 4-glass test, which is complex and with a high false-positive rate, thus limiting its clinical application. In addition, the WBC count in prostate fluid could not reflect the actual condition of the disease. The concept of type Ⅲ prostatitis, or chronic prostatitis/chronic pelvic pain syndrome, does not regard the pelvic floor and lower urinary tract as a functional entirety. Renaming type Ⅲ prostatitis into prostate-pelvic syndrome, exploring and establishing the symptom-based criteria of diagnosis and efficacy assessment, would better reflect the intrinsic nature of the disease, and meet the therapeutic goals to relieve symptoms and improve quality of life in type Ⅲ prostatitis patients.
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Objective To investigate the clinical significance of second transurethral resection of bladder tumor and analyze the related risk factors of recurrence and progression of bladder tumor.Methods A retrospective analysis of 171 patients including 134 males and 37 females.95 patients were enrolled in single TURBT group.The patients were (64.4 ± 10.7) years old.Their mean body mass index (BMI) was (23.5 ± 3.0) kg/m2 and mean tumor diameter was (24.7 ± 8.8) mm.67 cases were diagnosed with Ta stage and 28 cases were diagnosed with T1 stage.There were 44 cases diagnosed with low grade tumor and 51 cases with high grade tumor.76 patients were enrolled in second TURBT group.The patients were (66.0 ± 9.2) years old.Their mean BMI was (23.7 ± 3.0) kg/m2 and mean tumor diameter was (25.3 ± 9.3)mm.44 cases were diagnosed with Ta stage and 32 cases were diagnosed with T1 stage.There were 41 cases diagnosed with low grade tumor and 35 cases with high grade tumor.There was no significant difference between the two groups(P ＞ 0.05).General anesthesia was used for the operation,and the patient was in lithotomy position.For the first TURBT,the standard transurethral resection method was used to resect the tumor and the surrounding mucosa 1-2 cm far from tumor.The tumor size,location and number were recorded.The second resection was performed 2 to 12 weeks after the operation,and the basal part of the original tumor,the inflammatory edema mucosa around the original tumor and other suspicious tumor sites were sequentially removed.Both groups received immediate intravesical instillation chemotherapy with epirubicin or gemcitabine within 24 hours after surgery.The perfusion protocol was started once a week for 8 times;then once a month upto 1 year after surgery.Univariate and multivariate analysis were used to analyze the related factors of bladder tumor residual after first TURBT and the related risk factors of postoperative recurrence and progression.The time of second TURBT was analyzed.The Kaplan-meier method was used to draw the survival curve and analyze the effect of secondary resection on the survival of patients with bladder tumor.Results 17 cases of residual tumor were found in the second TURBT group,including 9 cases with Ta stage and 8 cases with T1 stage.Among them,5 cases in Ta stage were upgraded to T1 stage,and the remaining 12 cases keep the same pathological stage.There was no significant difference in the residual rate between Ta and T1 (11.8％ vs.10.5％,P ＞ 0.05).Multivariate analysis showed that the number of tumors (OR 4.255,95％ CI 1.186-16.124,P =0.034),tumor size (OR 7.800,95％ CI 1.852-32.841,P =0.005),and pathological grade (OR 3.764,95％ CI 0.947-14.968,P =0.006) were risk factors for residual tumor.Univariate analysis showed that secondary TURBT,BMI,tumor size,clinical stage,and pathological grade were the influencing factors of bladder tumor recurrence and progression (P ＜ 0.05).Multivariate analysis showed that single TURBT (OR 0.25,95％ CI 0.135-0.561,P =0.000),tumor diameter ≥ 30 mm (OR 3.548,95 ％ CI 1.899-6.629,P =0.000),high grade tumor (OR 2.62,95％ CI 1.026-4.990,P =0.043) are independent risk factors for tumor recurrence.Single TURBT (OR 0.114,95％ CI 0.033-0.391,P =0.001),tumor diameter ≥ 30 mm (OR 4.026,95％ CI 1.628-9.956,P =0.003),clinical stage T1 (OR 5.623,95％ CI 1.818-17.385,P =0.003) are independent risk factors for tumor progression.The recurrence-free survival time of the first and second resection intervals ≤6 weeks and ＞ 6 weeks was 22.6 months and 17.8 months,respectively (P ＜ 0.05),and the progression-free survival time was 23.4 months and 22.3,respectively (P ＞ 0.05).The follow-up period was 3 to 31 months with an average of 16.7 months.The recurrence-free survival time of the single TURBT group and the second TURBT group was 19.4 months and 23.8 months,respectively (P ＜ 0.05).Tumor progression occurred in 25 patients with 22 in the single TURBT group and 3 in the second TURBT group.The progression-free survival time was 22.1 months and 24.7 months,respectively (P ＜ 0.05).Conclusions Second transurethral resection of bladder tumor can reduce postoperative residual tumor,postpone postoperative recurrence and progression,and improve prognosis of the patients.
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Objective To explore the potential value of applying three-dimensional visualization technology in the robot-assisted laparoscopic nephron sparing partial nephrectomy.Methods From January to December 2018,98 patients with renal carcinoma undergoing robot-assisted laparoscopic nephron sparing surgery were retrospectively analyzed.Forty-one patients in the experimental group accomplished kidney CT examination and three-dimensional reconstruction before surgery,and fifty-seven patients in the control group only completed kidney CT examination.There were 20 males and 21 females in the experimental group with the age of (51.39 ± 14.80) years and body mass index (BMI) of (23.54 ± 3.08) kg/m2.The median tumor diameter was 3.40 cm (range 1.90-8.30 cm) and the mean R.E.N.A.L.score was (5.83 ± 1.51) in the experimental group including 11 cases of transperitoneal,17 cases of retroperitoneal and 13 cases of combined transperitoneal and retroperitoneal access.There were 35 males and 22 females in the control group with the age of (52.84 ± 12.28) years and BMI of (24.01 ±3.30)kg/m2.The median tumor diameter was 3.35 cm (range 1.40-7.0 cm) and the mean R.E.N.A.L.score was (6.17 ± 1.77) in the control group including 15 cases of transperitoneal,31 cases of retroperitoneal and 11 cases of combined transperitoneal and retroperitoneal access.There was no statistical difference between two groups in term of age,gender,BMI score,R.E.N.A.L.score,tumor size,tumor location and operative approach.Results Ninety-eight cases of operation were successfully completed without causing vascular and ureteral injury.The warm ischemia time in the experimental group was significantly shorter than that of the control group [median 15.0 (7.0-26.0) min vs.20.0 (10.0-28.0) min,P--0.02],while no statistical difference was observed in term of operation time [median 130.0 (65.0-340.0) min vs.139.0 (67.0-250.0) min,P =0.22].There was no significant difference between the two groups in the decrease of hemoglobin within 24 hours after operation [median 20.0 (4.0-39.0) g/L vs.15.5 (2.0-40.0) g/L,P =0.56] and the average length of hospital stay after operation [median 6.0(4.0-14.0) d vs.6.0(5.0-14.0) d,P =0.86].The trend of creatinine declining was not statistically significant between the two groups at both 24 hours [median:2.0 (-10.0-28.0) μmol/L vs.7.5 (-17.0-51.0) μ mol/L,P =0.24] and 6 months after operation [median:2.0 (-12.0-57.0) μ mol/L vs.4.5 (-3.0-24.0) μmol/L,P =0.39].Conclusions Preoperative three-dimensional reconstruction is helpful to shorten the warm ischemia time,but it did not show short-term and long-term protection for renal function.
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Objective To explore the effect of applying humanistic care concept in patients that were performed radical cystectomy and urinary diversion.Methods Eighty-eight patients undergoing radical cystectomy and urinary diversion in our hospital from January 2011 to May 2016 were selected.All patients were randomly divided into experiment group and control group.Of them,control group was given routine nursing care.Experiment group was administered humanistic care pattern-based nursing measures.Self-evaluation on social function was conducted in both groups 1,3 and 6 months after surgery,and the results were compared between two groups.All evaluation indexes were expressed as differences in all scales at various stages.Results Willingness score of ostomy self-nursing and score of ostomy nursing skill in experiment group upon discharge to 1 month after discharge,1 to 3 months after discharge,and 3 to 6 months after discharge,respectively,which were better than those in control group.Differences were of statistical significance(P<0.05).Anxiety score and depression score in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Evaluation score of self-nursing ability in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Score of quality of life in experiment group at those three periods were better than those in control group.All differences were of statistical significance(P <0.05).Judging from the point of view of incidence of complications 6 months after surgery,10 and 23 cases in experiment and control groups developed complications,respectively(P <0.05).Conclusions Applying humanistic care concept in clinical nursing contributes to effectively improving the postoperative recovery of social function in patients and enhancing their quality of life.It shows high application value in clinical practice.
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Objective To establish PKD2 gene recombinant lentivirus and to investigate its restorative effects on polycystin-2 and Wnt/β-catenin signaling pathways in Pkd2-null cell lines.Methods From August 2016 to February 2017,PKD2 gene was cleaved from the pcDNA3.1-TM-PKD2 plasmid and was inserted into the pLV-sfGFP 2A Puro by restriction enzymes Xba Ⅰ and Xho Ⅰ.The recombinant pLV-sfGFP-PKD2 plasmid was sequenced to verify a correct construction.Then we obtained recombinant lentiviruses by co-transfecting 293T cells with recombinant plasmid and packaging plasmids.B3/D3 (Pkd2 +/-) and B2/E8 (Pkd2-/-) cell lines were used to evaluate the effectiveness of lentivirus,they were divided into experimental group,control group,blank group and treated with pLV-sfGFP-PKD2 virus,pLV-sfGFP virus or culture media,respectively.The expression of PC2 was detected by Western blotting and immunofluorescence staining.Finally the cell proliferation was evaluated by detecting of proliferating cell nuclear antigen.The changes of Wnt/β-catenin signaling pathway were evaluated by real-time quantitative PCR.Results Enzyme digestion analysis and DNA sequencing showed that the recombinant plasmid pLV-sfGFP-PKD2 was constructed successfully.After infected with pLV-sfGFP-PKD2 virus,the expression of PC2 in the experimental group B2 and E8 cells(0.668 ±0.013,0.763 ±0.021) was restored to the normal level,compared with control group B3 and D3 cells,respectively (0.687 ± 0.015,P =0.164;0.776 ± 0.008,P =0.409).The proliferative activity in experimental group B2 cells(0.573 ±0.010) was significantly lower than that in control group B2 cells (0.848 ±0.031,P ＜0.01),and was returned to the level of blank group B3 cells (0.585 ±0.017,P =0.369).Reexpression of PKD2 in experimental group B2 cells also reduced the expression of Wnt7a,β-catenin,back to blank group B3 cells' level(0.037 ±0.005 vs.0.037 ±0.004,P=0.969;0.554 ±0.008 vs.0.571 ±0.013,P =0.64).Conclusions The recombinant pLV-sfGFP-PKD2 lentivirus has been constructed successfully.The lentivirus could rectify the absence of PC2 in PKD2-null cell lines,by which the hyperactivated Wnt/β-catenin signaling pathway and the abnormal cell proliferation caused by PC2 deficiency could be also restored to normal levels.
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Objective To investigate the clinical features, diagnosis, treatment and prognosis of primary testicular diffuse large B-cell lymphoma.Methods 8 patients with primary testicular diffuse large B-cell lymphoma were reviewed from April, 2012 to April, 2015.The mean age was 58 years old, ranging 43-68 years old.Color Doppler echocardiography examination showed that there were round or oval regular tumors in the scrotum, which the diameter ranged from 3.5 to 8.0 cm, mean 5.5 cm.There was no abnormal changes among abdomen and pelvic cavity in CT scan and tumor markers examination.The radical orchiectomy were performed in all patients.After opening the tunica vaginalis, a hard texture tumor could be found, which has the vague border line with normal tissue.All patients were diagnosed according to the combination of morpbologic and immunohistochemical examination after operating.Results All patients accepted operation successfully.The mean operation time was 34 minutes, ranging 25-40 minutes.8 cases were diagnosed as primary testicular diffuse large B-cell lymphoma after operating.Immunohistochemical analysis showed that CD20, BCL-6 were positive.CD3, CD10, CK were negative.All patients received adjuvant chemotherapy with RCHOP(cytoxan 750 mg/m2, adriamycin 50mg/m2, leurocnstine 1.4 mg/m2, prednisone 60 mg/m2 ,rituximab 375 mg/m2) regimen over 6 cycles, which was conducted once every three weeks, one week post-operatively.The follow up duration ranged from 6 to 36 months, mean 17 months.All patients survived at the end of this study with no sign of recurrence and metastasis.Conclusions The patients with primary testicular diffuse large B-cell lymphoma are rare.The radical orchiectomy is recommended.And RCHOP chemotherapy should be considered one week post-operatively.The short term outcome of the treatment is satisfactory.But the long term outcome should be further studied.
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Objective To explore the correlation between prostate neuroendocrine cells and chronic prostatitis via substance P (SP) detection.Methods Forty SPF-level SD male rats in two months old were randomized into two groups:the chronic prostatitis model group and the control group,20 in each.The model was induced by castration surgery under aseptic condition and post-castration injection of 17-β estrogen for 1 month duration.The control group was done by injection of 0.9％ NS without castration surgery.Making sure that the chronic prostatitis model was made successfully,then SP quantification in the 2 groups was analyzed via ELISA and immunohistochemical staining.Results The difference of SP in the 2 groups was significant (P =0.009) and SP was expressed highly in the model rats compared with controls.Conclusion The relationship between prostate neuroendocrine cells and chronic prostatitis is notable,maybe they participate in progress of chronic prostatitis.
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Objective To investigate the change of intracellular calcium ion concentration in prostate smooth muscle cells of SD rats with chronic abacterial prostatitis under high potassium solution.Methods SD rats were divided into experiment group and control group.The CP model was set up by castration and estradiol injection.The PSMC was cultured and purified in vitro.Laser confocal scanning microscope was used after the ceils were incubated with Quest Fluo-8TM.The cells were treated with high potassium solution,and the change of fluorescence intensity was observed.Results The pathologic specimens of the experiment group showed typical pathologic characteristics of chronic prostatitis under light microscope,the control group without inflammation performance.Using immunocytochemistry method confirmed that the experiment group and the control group were prostate smooth muscle cells.The change of fluorescence intensity of [Ca2+] i in the experiment group and control group in the high potassium solution was 27.86 ± 9.88 and 7.61 ± 4.31.There were statistically significant differences between the two groups (P ＜ 0.01).Conclusions High potassium solution cause intracellular calcium ion concentration increased.
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Objective To investigate the prevalence and relevant factors of psychological disorders in patients with premature ejaculation (PE). Methods From September 2009 to October 2010,we employed the Self- Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS),Chinese Index of Sexual Function for Premature Ejaculation ( CIPE-5 ),NIH-Chronic Prostatitis Symptom Index (NIH-CPSI),International Index of Erectile Function (IIEF-5) and self-designed questionnaire to investigate the psychological status of 1164 patients with PE.The relevance between scores of SAS,SDS and such parameters as NIH-CPSI score,CIPE-5 score,erectile function,age,disease duration,occupation,education,personality characteristics and other factors were evaluated. Results The SAS and SDS scores of 1,164 cases with PE were 43.87 ± 10.53,44.05 ±9.81,respectively.If the cut-off points were set at SAS ≥ 50 and SDS ≥53,341 (29.3％) of cases had symptoms of anxiety and 217( 18.6％ ) patients had symptoms of depression.The SAS,SDS scores and detection rate of anxiety and depression were correlated with the CIPE-5 score,NIH-CPSI score,erectile function and duration of disease,personality characteristics ( P ＜ 0.05),while they were not correlated with age,occupation,and education. Conclusions Psychological disorders widely exist in patients with PE and may have a close relationship with a variety of factors.