The sphingosine-1-phosphate/RhoA/Rho associated kinases/myosin light chain pathway in detrusor of female rats is down-regulated in response to ovariectomy / 中华医学杂志(英文版)

BACKGROUND@#Dysuria is one of the main symptoms of genitourinary syndrome of menopause, which causes serious disruption to the normal life of peri-menopausal women. Studies have shown that it is related to decrease of detrusor contractile function, but the exact mechanism is still poorly understood. Previous results have suggested that the sphingosine-1-phosphate (S1P) pathway can regulate detrusor contraction, and this pathway is affected by estrogen in various tissues. However, how estrogen affects this pathway in the detrusor has not been investigated. In this study, we detected changes of the S1P/RhoA/Rho associated kinases (ROCK)/myosin light chain (MLC) pathway in the detrusor of ovariectomized rats in order to explore the underlying mechanism of dysuria during peri-menopause.@*METHODS@#Thirty-six female Sprague-Dawley rats were randomly divided into SHAM (sham operation), OVX (ovariectomy), and E groups (ovariectomy + estrogen), with 12 rats in each group. We obtained bladder detrusor tissues from each group and examined the mRNA and protein levels of the major components of the S1P/RhoA/ROCK/MLC pathway using quantitative real-time polymerase chain reaction and Western blotting, respectively. We also quantified the content of S1P in the detrusor using an enzyme linked immunosorbent assay. Finally, we compared results between the groups with one-way analysis of variance.@*RESULTS@#The components of the S1P pathway and the RhoA/ROCK/MLC pathway of the OVX group were significantly decreased, as compared with SHAM group. The percent decreases of the components in the S1P pathway were as follows: sphingosine kinase 1 (mRNA: 39%, protein: 45%) (both P  0.05). The percent decreases of the components in the RhoA/ROCK/MLC pathway were as follows: ROCK2 (protein: 41%, mRNA: 36%) (both P  0.05). In addition, all of the above-mentioned decreases could be reversed after estrogen supplementation (E group vs. SHAM group) (all P > 0.05).@*CONCLUSION@#In this study, we confirmed that ovariectomy is closely associated with the down-regulation of the S1P/RhoA/ROCK/MLC pathway in the rat detrusor, which may be one mechanism of dysuria caused by decreased contractile function of the female detrusor during peri-menopause.

Anatomic measurement regarding the effect of proximal interphalangeal joint motion on the tension of the zone Ⅰ extensor tendon / 中国组织工程研究

BACKGROUND: Many conservative and surgical techniques for mallet finger have been described. Most of them have reached an agreement, but the fixation of the proximal interphalangeal joint has not reached a consensus. OBJECTIVE: To discuss the effect of proximal interphalangeal joint motion on the tension of the zone I extensor tendon and to search the fixation position of proximal interphalangeal joint at the minimum tension of the zone I extensor tendon through measuring extensor tendon so as to provide reference for selecting optimal fixation position in the treatment of mallet finger. METHODS: The maximal passive flexion angles of the distal interphalangeal joint of the index, middle, ring and little fingers were measured in 20 cadaver hands when the proximal interphalangeal joint flexed at 0°, 20°, 40°, 60°, 80° and 100°. An incision was made over the back of the distal interphalangeal joint to expose the zone I extensor tendon. The extensor tendon was incised laterally at the level of the distal interphalangeal joint with the distal interphalangeal joint fixed in extension position to make a mallet finger. A Kirschner wire was used to pierce through and perpendicular to the distal phalangeal basement as a sign. Paralleling to this sign, the zone I extensor tendon was marked and its relative distance to the sign was measured as the sliding distance of the extensor. The widest gap between the tendon edges and the tendon sliding distance were recorded, while the proximal interphalangeal joint was in extension and 20°, 40°, 60°, 80° and 100° flexion positions. RESULTS AND CONCLUSION: (1) The maximal passive flexion angle of the distal interphalangeal joint increased with the proximal interphalangeal joint flexion increased. (2) The gap between the extensor tendon edges in zone I reduced when the angle of proximal interphalangeal joint increased. The proximal extensor tendon gliding distance increased, while the proximal interphalangeal joint flexion increased. The gap between the extensor tendon edges in zone I was (1.322 8±1.0788 9) mm when the proximal interphalangeal joint was in extension position. The proximal extensor tendon glided distally, when the proximal interphalangeal joint flexed to 100° with an average sliding distance of (1.540 5±0.690 70) mm. (3) The zone I extensor tendon has the maximal tension while the proximal interphalangeal joint is in extension position. The tension in the zone I extensor tendon reduced when the angle of proximal interphalangeal joint increased. The tension in the zone I extensor tendon was minimal when the proximal interphalangeal joint flexed to 100°.

Photoselective Vaporesection of the Prostate with an End-firing Lithium Triborate Crystal Laser / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Photoselective vaporization of the prostate is a technique that is widely used for the treatment of benign prostatic hyperplasia (BPH) and has pronounced advantages compared to the traditional transurethral resection of the prostate. Following the recent introduction of end-firing lithium triborate lasers, we have created a new technique called photoselective vaporesection of the prostate (PVRP). This study described our initial experience using the PVRP technique for the treatment of BPH.</p><p><b>METHODS</b>This prospective study included a total of 35 patients with BPH who underwent PVRP from August 2013 to July 2014. The chief clinical parameters were obtained and evaluated during the perioperative period and follow-up, including the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate, and prostate volume. All variables were evaluated for statistically significant differences compared to baseline values using the analysis of variance.</p><p><b>RESULTS</b>The mean subgroup IPSS and QoL scores significantly improved during follow-up; the respective decreases in IPSS storage score, IPSS voiding score, IPSS nocturia score, and QoL score were 75.3%, 83.6%, 51.4%, and 71.7%, respectively (all P < 0.001 compared with baseline). Three patients were diagnosed with prostate cancer based on postoperative pathological examinations. There were no serious perioperative complications.</p><p><b>CONCLUSION</b>The PVRP technique demonstrates satisfactory short-term clinical outcomes and perioperative safety in the treatment of BPH.</p>

Evaluation of the Prostate Imaging Reporting and Data System for Magnetic Resonance Imaging Diagnosis of Prostate Cancer in Patients with Prostate-specific Antigen <20 ng/ml / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The European Society of Urogenital Radiology has built the Prostate Imaging Reporting and Data System (PI-RADS) for standardizing the diagnosis of prostate cancer (PCa). This study evaluated the PI-RADS diagnosis method in patients with prostate-specific antigen (PSA) <20 ng/ml.</p><p><b>METHODS</b>A total of 133 patients with PSA <20 ng/ml were prospectively recruited. T2-weighted (T2WI) and diffusion-weighted (DWI) magnetic resonance images of the prostate were acquired before a 12-core transrectal prostate biopsy. Each patient's peripheral zone was divided into six regions on the images; each region corresponded to two of the 12 biopsy cores. T2WI, DWI, and T2WI + DWI scores were computed according to PI-RADS. The diagnostic accuracy of the PI-RADS score was evaluated using histopathology of prostate biopsies as the reference standard.</p><p><b>RESULTS</b>PCa was histologically diagnosed in 169 (21.2%) regions. Increased PI-RADS score correlated positively with increased cancer detection rate. The cancer detection rate for scores 1 to 5 was 2.8%, 15.0%, 34.6%, 52.6%, and 88.9%, respectively, using T2WI and 12.0%, 20.2%, 48.0%, 85.7%, and 93.3%, respectively, using DWI. For T2WI + DWI, the cancer detection rate was 1.5% (score 2), 13.5% (scores 3-4), 41.3% (scores 5-6), 75.9% (scores 7-8), and 92.3% (scores 9-10). The area under the curve for cancer detection was 0.700 (T2WI), 0.735 (DWI) and 0.749 (T2WI + DWI). The sensitivity and specificity were 53.8% and 89.2%, respectively, when using scores 5-6 as the cutoff value for T2WI + DWI.</p><p><b>CONCLUSIONS</b>The PI-RADS score correlates with the PCa detection rate in patients with PSA <20 ng/ml. The summed score of T2WI + DWI has the highest accuracy in detection of PCa. However, the sensitivity should be further improved.</p>

Correlation of androgen receptor CAG repeats with the risks of benign prostatic hyperplasia and prostate cancer: a meta-analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the association of the androgenic receptor (AR) CAG repeats with the risks of benign prostatic hyperplasia (BPH) and prostate cancer (PCa).</p><p><b>METHODS</b>We searched the major databases at home and abroad for the literature addressing the correlation of the AR gene CAG repeats with BPH and PCa. Based on the results of heterogeneity tests, we used the M-H fixed effect model and random effect model to pool the odds ratio (OR) effect size. We evaluated publication bias by Begg and Egger bias analysis, investigated the association of CAG repeats with the risks of BPH and PCa by systematic review, and stratified their relationship according to the races of the patients.</p><p><b>RESULTS</b>Based on the selection criteria, 4 of the 29 identified studies were included, with 485 cases of BPH, 767 cases of PCa, and 709 controls. There was no heterogeneity between the BPH and control groups, and no correlation between short CAG repeats and BPH after pooling the odds ratio (OR) effect size. Heterogeneity was found among the BPH, PCa and control groups. Random effects model suggested an association of short CAG repeats with the risk of PCa (OR(PCa/control) = 1.45, OR(PCa/BPH) = 1.86, OR(PCa/(BPH + control)) = 1.66), while subgroup analysis with racial stratification indicated inter-ethnic differences between the two. Begg and Egger bias analysis showed no significant publication bias.</p><p><b>CONCLUSION</b>Shorter CAG repeats are positively correlated with the risk of PCa but not with that of BPH.</p>

Association of TET2, LMTK2 and FAM84B gene expression with prostate cancer risk in Chinese patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the association between the common variations of TET2 (rs7679673, A), MTK2 (rs6465657, T) and FAM84B (rs12543663, C) genes and prostate cancer (Pca) risk in Chinese population in Beijing, and to understand the relationship between genotypes and phenotypes including clinical characteristics and life style, etc. in patients with prostate cancer.</p><p><b>METHODS</b>Based on a case-control study, 124 patients with prostate cancer and 138 age-matched control subjects were recruited. Information of clinical phenotype and life style, etc. in the prostate cancer patients was collected. We compared the differences of allele and genotype frequencies of TET2 (rs7679673, A), LMTK2 (rs6465657, T) and FAM84B (rs12543663, C) gene expressions between the two groups for the allele and genotype frequencies, and explored the relationship between different genotypes and clinical features such as patient age, BMI, Gleason score, PSA level and tumor stage, by Chi-square test in patients with PCa. Multifactor dimensionality reduction was used to detect the gene-gene interactions.</p><p><b>RESULTS</b>The FAM84B (rs12543663, C) C carriers frequency had significant difference between the case group and the control group (χ(2) = 3.980 P = 0.046; OR = 1.883; 95%CI = 1.006-3.526). The allele and genotype frequencies of TET2 gene (rs7679673, A) and LMTK2 gene (rs6465657, T) were not significantly different between the case group and the control group (P > 0.05). Analysis of the genotypes and clinical phenotypes showed that the genetic type of FAM84B C carriers [CX (CC + CA)] were significantly associated with cancer stage (χ(2) = 9.585; P = 0.002; OR = 3.740; 95%CI = 1.580 - 8.853). Association between three loci and 12 kind of relevant outcomes was found in TET2 A carriers and the smoking and drinking patients (all P < 0.05). Significant correlation was also found between LMTK2 (rs6465657, T) TX carriers and surgery (χ(2) = 8.612; P = 0.003; OR = 0.174; 95%CI 0.049 - 0.620). No significant correlation was seen with other covariates (P > 0.05). Dendrogram analysis among the three loci showed that the best model consisted of the three sites (P = 0.0270), cross validation consistency: 10/10, and testing balanced accuracy: 0.5120. There may be gene-gene interaction among TET2 (rs7679673, A), LMTK2 (rs6465657, T), and FAM84B (rs12543663, C).</p><p><b>CONCLUSIONS</b>There may be obvious association of FAM84B (rs12543663, C) gene with prostate cancer risk and the stages, and the synergistic effects of TET2 (rs7679673, A), LMTK2 (rs6465657, T) and FAM84B (rs12543663, C) genes may have an association with prostate cancer risk in Chinese population.</p>

Association of prostate cancer with PDLIM5, SLC22A3 and NKX3-1 in Chinese men / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the association of prostate cancer (PCa) with PDLIM5 (rs17021918, T), SLC22A3 (rs9364554, C) and NKX3-1 (rs1512268, A) in Chinese men.</p><p><b>METHODS</b>We included 124 PCa patients and 138 normal controls in this study, compared the alleles and genotypes of PDLIM5 (rs17021918, T) , SLC22A3 (rs9364554, C) and NKX3-1 (rs1512268, A) of the two groups, and explored the association of each of the genes with the age, body mass index (BMI), Gleason score, PSA level and tumor stage of the patients. We analyzed the gene-gene interaction using the multifactor dimensionality reduction method (MDR).</p><p><b>RESULTS</b>There were no statistically significant differences in the frequency distribution of the risk alleles and genotypes of PDLIM5, SLC22A3 and NKX3-1 between the case and control groups (P > 0.05), nor were the three gene loci significantly associated with the age, Gleason score, PSA level and pathological grade of the PCa patients (CP < 0.05). MDR analysis showed no interaction between PDLIM5 and NKX3-1, but tree-diagram analysis revealed a possible synergistic action of the two polymorphism loci.</p><p><b>CONCLUSION</b>PCa might not be associated with PDLIM5 (rs17021918,T), SLC22A3 (rs9364554,C) and NKX3-1 (rs1512268,A) in Chinese men. However, PDLIM5 and NKX3-1 might have a synergistic action on the risk PCa.</p>

Laparoendoscopic single-site radical prostatectomy: technique and initial outcomes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a challenging urological procedure and needs to be further evaluated. This study was undertaken to illustrate the safety and initial results of pure LESS-RP with conventional available instruments.</p><p><b>METHODS</b>A prospective clinical database was established in September 2010 to assess the outcome following the introduction of LESS-RP at our institution. By June 2012, six procedures had been performed. The mean patient age was 74.7 (74.0 - 76.0) years. The mean body mass index (BMI) was 23.8 (19.5 - 32.2) kg/m(2). The LESS-RP was preformed through an extra-peritoneal approach using single port access with QudaPort, 0° lens 5 mm flexible tip video-laparoscope and available conventional laparoscopic instruments. Parameters assessed were operative time, estimated blood loss, intra-operative complications, drainage time, postoperative pain score (visual analogue pain scale (VAPS), 0 - 10), pathological results, and postoperative prostate specific antigen (PSA) levels.</p><p><b>RESULTS</b>LESS-RP was completed for all six cases without additional trocar placement or conversion to standard laparoscopic or open radical prostatectomy. The mean operative times were 252.5 (190.0 - 305.0) minutes, estimated blood loss was 300 (100 - 500 ml). There was no documentable intraoperative complication. The mean wound-drainage time was 5.2 (2.0 - 7.0) days, and the first postoperative day VAPS was 0.8 (0 - 3.0). Final pathological staging was pT2aN0M0 in four cases and pT2cN0M0 in two cases. Surgical margins were negative for all cases. The one-month post-operative PSA was less than 0.02 ng/ml in each case. All patients were continent without pad usage at 1 year postoperatively.</p><p><b>CONCLUSION</b>The technique of pure LESS-RP is feasible and early outcomes are acceptable.</p>

Two single nucleotide polymorphisms on chromosome 3 and the risk of prostate cancer in Chinese men / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the correlation of the common variant single nucleotide polymorphisms (SNP) on chromosome 3 with the incidence and related risk factors of prostate cancer (PCa) in Chinese men.</p><p><b>METHODS</b>Using the case-control meth- od, we included 124 PCa patients in the PCa group and 111 age- and gender-matched cancer-free healthy subjects as normal controls. We detected the distribution of allele and genotype frequencies of the SNP rs10934853 and rs2660753 with the polymerase chain reaction-high resolution melting curve (PCR-HRM) combined with gene sequencing, analyzed the cumulative effect of the risk genotypes of these two independent variants, and determined the correlation between different genotypes of these two SNPs and clinically related risk factors in the PCa patients.</p><p><b>RESULTS</b>As for the genotypes of rs10934853, there were 28 cases of AA (22.8%), 46 cases of CC (37.4%), and 49 cases of AC (39.8%) in the PCa patients, as compared with 24 (22.0%), 34 (31.2%) and 51 (46.8%) in the healthy controls. As regards the genotypes of rs2660753, there were 13 cases of AA (11.0%), 59 cases of GG (50.0%) and 46 cases of AG (39.0%) in the PCa patients, in comparison with 9 (8.8%), 47 (45.6%) and 47 (45.6%) in the controls. No significant differences were found in the distribution of the genotype and allele frequencies of rs10934853 and rs2660753 between the two groups (P = 0.520 & 0.582). Analysis on the cumulative effect of the risk genotypes of rs10934853 and rs2660753 showed a slightly higher risk of PCa (OR = 1.831 & 1.968) in the two groups with risk genotypes than in the one with wild types (P > 0.05). Different genotypes of rs10934853 and rs2660753 were not correlated with clinically related risk factors of the PCa patients (P > 0.05).</p><p><b>CONCLUSION</b>SNP rs10934853 and rs2660753 on chromosome 3 are not obviously correlated with PCa in Chinese patients, and may not be a genetic risk factor of PCa.</p>

Association between single nucleotide polymorphisms on chromosome 17q and the risk of prostate cancer in a Chinese population / 癌症

In European populations, 7 single nucleotide polymorphisms (SNPs) on chromosome 17q, 3 SNPs on 17q12, and 4 SNPs on 17q24.3 were recently identified to be closely related to the risk of prostate cancer by a genome-wide association study. In Japanese populations, the correlation between 2 SNPs on 17q and the risk of prostate cancer and tumor aggressiveness was also confirmed by a large-scale experiment. However, whether 17q is associated with prostate cancer and its clinical manifestations in Chinese populations is still unknown. Therefore, we conducted a case-control study in a northern Chinese population and tested 2 SNPs, rs4430796 and rs1859962, on 17q in 124 prostate cancer patients and 111 controls using polymerase chain reaction-high resolution melting curve (PCR-HRM) combined with sequencing. We analyzed the association of the 2 SNPs with the risk of prostate cancer as well as patients' lifestyles, onset ages, Gleason scores, PSA levels, and pathologic stages. We found a significant difference in the G allele of SNP rs1859962 (P = 0.035, OR = 1.51, 95% CI = 1.03-2.21) but not in the rs4430796 genotype frequency or allele frequency distribution between prostate cancer patients and the controls (P > 0.05). Neither of the SNPs was significantly associated with the onset age, Gleason score, PSA level, pathologic stage, or other clinical indicators of patients with prostate cancer (P > 0.05). Our results show that polymorphism of the G allele of SNP rs1859962 is associated with the risk of prostate cancer in a Chinese population.

Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: a Chinese survey / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The enlarged prostate leads to obstruction and lower urinary tract symptoms (LUTS), which comprise frequency, urgency, weak stream, straining and nocturia. This study was conducted in a large series of patients to evaluate the relationship between LUTS as stipulated in the International Prostate Symptom Score (IPSS) and the objective parameters related to benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We enrolled 1295 BPH patients from seven centers. The patients were either at first diagnosis of BPH or had discontinued medical treatment for at least 3 months. Those with several other diseases that may be potential risk factors affecting urinary symptoms were excluded from the study. Age, IPSS, prostate volume, peak flow rate, urine volume and post-voiding residual urine volume were measured. The relationship between IPSS and objective parameters were quantified by means of Spearman correlation coefficients. The differences in these parameters between the groups with mild, moderate or severe symptoms were also evaluated.</p><p><b>RESULTS</b>Statistically significant correlations were found between IPSS and objective parameters by means of Spearman correlation coefficients. When the patients were divided into three groups with different severities of symptoms, there were significant differences in peak flow rate, urine volume, prostate volume, residue urine volume and quality of life, whereas average age and prostate-specific antigen levels were similar. However, there was evident overlap of these parameters between the groups. The same results were found when the irritative or obstructive subscore of IPSS was considered.</p><p><b>CONCLUSIONS</b>The correlation between objective parameters of BPH and LUTS is significant. However, it is hard to predict the severity of symptoms by these parameters.</p>

Study on patients with benign prostate hyperplasia treated by the therapeutic regimen of watchful waiting during a twenty-four-month follow-up period / 中华流行病学杂志

Objective To analyze the changes of the main clinic parameters in patients with benign prostate hyperplasia (BPH) treated by watchful waiting and to find out the risk factors contributing the progress of BPH. Methods According to the inclusion and exclusion criteria, 61 patients diagnosed as BPH were recruited in the group of watchful waiting. Data on IPSS, prostate volume, prostate specific antigen(PSA), maxium flow rate, average flow rate and residual urine volume during follow-up period of 24 months, were recorded. Results At 0, 12, 24 months, the IPSS, prostate volume (ml), PSA(ng/ml),maxium flow rate (ml/s) were 7±4, 4±3, 4±3 ; 33.0±9.0, 33.8±7.6, 30.9±6.8 ; 1.53±1.35,1.43±0.95, 1.22±0.99; 17.1±5.0, 17.2±6.1, 19.2±8.0, respectively. At the end of the 24-months follow-up, all observed parameters had a little improvement except the average prostate volume in this group. Of the 61 patients, 42(62%) progressed slowly or became better when comparing with baseline data of the study. Moreover, the difference between at 24-month and at baseline period, IPSS showed statistical significance (P＜0.0001) in t test. In the study of BPH progression risk factors by logistic regression analysis, prostate volume( P = 0. 0910) and residual urine volume( P = 0. 0780) showed a trend of becoming the risk factors. Conclusion Our study showed that patients treated with watchful waiting had slow progression and majority of these patients did not need to alter their treatment options.Through data analysis, we noticed that the changes of data watchful waiting patients could help us to choose more precise and reasonable treatment option in clinical pratice.[ Key words ] Benign prostate hyperplasia; Prostate volume; Residual urine; Watchful waiting;Follow-up

Transperitoneal laparoscopic adrenalectomy: surgical approach and outcome / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the efficiency and safety of transperitoneal laparoscopic adrenalectomy for the treatment of adrenal tumors and to describe surgical technique and management of intraoperative complications.</p><p><b>METHODS</b>From February 2002 to April 2008, 24 male and 44 female consecutive patients with average age (53.4 +/- 12.1) years old were treated with transperitoneal laparoscopic adrenalectomy because of adrenal tumors. Of the patients, 27 cases had right adrenal tumors, 39 cases had left adrenal tumors and 2 cases had bilateral adrenal tumors. The average tumor size was (2.9 +/- 2.0) cm with the maximal diameter of 10 cm. We evaluated this technique in respect of operating time, estimated blood loss, complications during surgery, postoperative complications, duration of hospital stay and pathological results.</p><p><b>RESULTS</b>All the surgeries had been completed successfully without conversion to open surgery. The average operating time was (157.7 +/- 51.5) min, the average estimated blood loss was (68.1 +/- 54.2) ml. No major complication happened during operation. The average drainage time was (2.6 +/- 1.5) days. The average post-operative hospital stay was (8.7 +/- 4.3) days. Four cases (6.0%) developed surgical field liquefaction and 2 cases (2.9%) experienced delayed closure of the drainage wound.</p><p><b>CONCLUSIONS</b>Transperitoneal laparoscopic adrenalectomy is feasible and safe in the treatment of adrenal tumor with low risk of intra-operative and post-operative complication.</p>

Clinical questionnaires about benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>s To assess the understanding degree of urologists for benign prostatic hyperplasia (BPH) and the clinical characteristics of BPH patients.</p><p><b>METHODS</b>The questionnaires was distributed to urologists and patients in 119 hospitals over the country, respectively. The urologist survey was mainly focused on the questions of BPH progression and therapeutic model. The patient survey was mainly focused on the questions of patient's age, symptom features and the preference to receiving treatment.</p><p><b>RESULTS</b>The evaluations based on 289 completed urologist questionnaires and 4253 completed patient questionnaires showed that 98.6% of urologists agreed that BPH was a progressive disease but there were still some differences in understanding the risk factors for BPH progression. Additionally, 98.1% of patients were diagnosed to be moderate or severe BPH, nocturia was the most frequent symptom. In the treatment for BPH, both the urologists and patients concerned about how to improve the system rapidly.</p><p><b>CONCLUSIONS</b>This study is the first questionnaires specifically to the urologists and BPH patients, the results would reflect the situations of BPH diagnosis and treatment in China and would be helpful to the development of BPH guideline.</p>

Construction and identification of recombinant avian adeno-associated virus expressing GFP reporter gene / 病毒学报

To generate recombinant avian adeno-associated virus (rAAAV) for gene transfer studies in avian cells, the recombinant plasmid containing the whole genome of AAAV was digested with restriction enzymes to remove the Rep and Cap genes, resulting in AAAV transfer vector pAITR. GFP-expressing cassette was amplified by PCR and inserted into the AAAV transfer vector. The Rep-Cap gene of AAAV amplified by high fidelity PCR was subcloned into eukaryotic expression vector pcDNA3, resulting in an AAAV helper vector pcDNA-ARC. The Rep and Cap genes amplified by high fidelity PCR were subcloned separately into the co-expression vector pVITRO2-mcs, resulting in another AAAV helper vector pVITRO2-ARC. Using calcium phosphate precipitation method, rAAAV-GFP was generated by co-transfecting AAV-293 cells with a cocktail of pAITR-GFP, pcDNA-ARC or pVITRO2-ARC, and adenovirus helper vector pHelper. The three structural proteins VP1, VP2 and VP3 of correct molecular masses were detected by SDS-PAGE and the GFP reporter gene was detected by PCR in purified rAAAV-GFP virions. Chicken embryonic fibroblast (CEF) cells and CEL cell line were transduced with the recombinant virus, the GFP-positive cells were easily observed under fluorescent microscope, expression of which lasted for at least two weeks. These data demonstrate that an efficient helper virus-free packaging system has been established for generating recombinant AAAV particles for gene transfer studies in avian cells and for development of recombinant vaccines against avian diseases.

Photoselective green-light laser vaporization of the prostate with volume more than 80ml / 中华老年医学杂志

Objective To analyze the safety and effectiveness of photoselective green-light laser vaporization of the prostate(PVP)in treatment of large prostate with volume more than 80 ml. Methods Retrospective analysis was performed in 25 benign prostatic hypertrophy patients undergoing the PVP treatment,whose prostate volume was more than 80 ml.Results Twenty-five patients with prostate mean volume of 151.8(84.0-270.0)ml were treated by PVP and 23 cases were finished successfully.One operation was suspended because of bleeding and the other because of damaging orifice.No blood transfusion was needed and no“transurethral resection(TUR)syndrome”happened.Five cases had acute retention and 2 of them needed second PVP.In a mean of 7.9(3.0- 12.0)months follow-up,maximal urinary flow rate(Qmax),international prostate symptom score (IPSS),quality of life score(QOL),and prostate-specific antigen(PSA)level were improved significantly.The volume of prostate reduced after PVP than before PVP but no significant difference was found.Conclusions PVP is feasible in treating large prostate even the volume is more than 80 ml,although it needs better skill.Catheterization for some time is helpful in reducing the incidence of early postoperative acute urinary retention.

Diagnosis and treatment of prostate cancer with prostate specific antigen 4-10?g/L / 中华老年医学杂志

Objective To investigate the diagnostic and therapeutic characteristics of prostate cancer with prostate specific antigen(PSA)4-10?g/L. Methods The data of prostate biopsies for the patients with PSA 4-10?g/L from May 1998 to February 2004 and the treatment and prognosis of these patients were retrospectively analyzed. Results In the 141 cases, 34 were diagnosed as prostate cancer, including 3 cT1, 21 cT2, 6 cT3 and 4 cT4. Mean Gleason score was 5.8, and the mean Gleason scores of cT1 and cT2 were significantly lower than those of cT3 and cT4. Twenty-four cases of cT1 and cT2 underwent radical prostatectomy. Four cases of cT3 recieved radical prostateetomy after 4 months of neoadjuvant endocrine therapy. Two cases of cT3 and 4 cT4 received castration. Pathological section from radical surgeries showed that 21 cases were organ confined and 7 were locally invasive. The difference of mean Gleason score between these two groups was significant in statistics. After 18 to 69 months (mean 42 months)follow-up, 21 organ confined cases were free survived, 4 locally invasive cases had biochemical recurrence and 1 case had multifocal bone metastasis. No cancer-specific death happened. Two of 4 cT4 cases were still alive and 2 died of the tumor. Conclusions Routine needle biopsy is necessary for the cases with“grave area”PSA of 4～10 ?g/L. Prostate cancers with PSA 4～10/?g/L are not always early diseases. Gleason score is a very important index for determine the stage of pathology after surgery. Radical prostatectomy is an effective treatment for organ confined disease.