Impact of immune inflammation on the proliferation and apoptosis of benign prostatic hyperplasia cells / 中华男科学杂志

Objective@#To investigate the impact of macrophage-induced immune inflammation on the proliferation and apoptosis of BPH cells and its possible mechanism.@*METHODS@#Macrophages were stimulated with phorbol myristate acetate, co-cultured with BPH-1 cells, and then treated with the androgen receptor (AR) inhibitor or anti-CD40L antibody. The immunohistochemical biomarkers of the T lymphocytes (CD4 and CD8), B lymphocyte (CD20) and macrophages (CD68), AR, CD40/CD40L, and inflammatory factors IL-1, IL-6 and TNF-α were measured before and after treatment. The proliferation and apoptosis of the cells were observed by MTT assay, colony-forming assay and flow cytometry, and the expressions of cell apoptosis- and MAPK signaling pathway-related proteins were determined by qRT-PCR and Western blot.@*RESULTS@#Significantly increased proliferation and decreased apoptosis of the cells, up-regulated expressions of Bcl-2, IL-1, IL-6, TNF-α, AR, CD40 and CD40L, and down-regulated expression of Bax were observed in the BPH-1 cells co-cultured with macrophages (the M-BPH-1 group) compared with those in the blank control (B-BPH-1) group (P < 0.01). In comparison with the BPH-1 cells treated with normal saline, those treated with either low-dose CD40L (L-CD40L) or high-dose CD40L (H-CD40L) showed markedly inhibited proliferation, increased apoptosis, up-regulated expression of Bax, and down-regulated expressions of Bcl-2, IL-1, IL-6 and TNF-α (P < 0.01), and those in the low- and high-dose AR (L-AR and H-AR) inhibitor groups exhibited remarkably reduced proliferation, increased apoptosis, down-regulated expressions of Bcl-2, IL-1, IL-6 and TNF-α, and up-regulated expression of Bax (P < 0.01). The phosphorylation levels of JNK, ERK and P38 were significantly elevated in the M-BPH-1 group, but declined in the H-CD40L and the H-AR inhibitor groups compared with those in the B-BPH-1 group, all in a concentration-dependent manner (P < 0.01).@*CONCLUSIONS@#Macrophage-induced immune inflammation regulates AR and CD40/CD40L expressions and promotes the proliferation and inhibits the apoptosis of BPH-1 cells by activating the MAPK signaling pathway. /.

Significance of atypical small acinar proliferation and high-grade prostatic intraepithelial neoplasia in prostate biopsy in China / 中华男科学杂志

Objective@#To assess the rates of atypical small acinar proliferation (ASAP) and high-grade prostatic intraepithelial neoplasia (HGPIN) detected in prostate biopsy in China and the risk of PCa found in subsequent repeat biopsy.@*METHODS@#A total of 2,456 patients underwent TRUS-guided prostate biopsy with the samples of ASAP and/or HGPIN tissues in our hospital at least twice between July 2014 and June 2019. We analyzed the findings of digital rectal examination, prostate volumes, PSA levels, and the results of prostate biopsies.@*RESULTS@#Initial prostate biopsies revealed 737 cases of PCa (30.0%), 215 cases of ASAP (8.8%), 98 cases of HGPIN (4.0%), and 18 cases of ASAP+HGPIN (0.7%). Totally, 313 of the patients met the inclusion criteria and included in this study. Of the 215 cases of ASAP confirmed in the first biopsy, 72 and 25 were diagnosed with PCa in the second and third biopsies, respectively, 83 with Gleason score (GS) 6, 14 with GS7, 57 with T1c and 40 with T2a tumors. Of the 98 cases of HGPIN confirmed in the first biopsy, 1 was diagnosed with PCa in the second and another 1 in the third biopsy, both with GS6 and T1c tumors. Of the 18 cases of ASAP+HGPIN confirmed in the first biopsy, 7 and 3 were diagnosed with PCa in the second and third biopsies, respectively, 7 with GS6, 3 with GS7, 6 with T1c and 4 with T2a tumors.@*CONCLUSIONS@#ASAP is a significant risk factor for PCa and repeat prostate biopsy should be performed for patients diagnosed with ASAP in the first biopsy. Whether repeat biopsy is necessary for those diagnosed with HGPIN depends on other related clinical parameters./.

Effects of simvastatin on the proliferation and apoptosis of prostatic epithelial RWPE-1 cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of simvastatin on the proliferation and apoptosis of prostatic epithelial RWPE-1 cells.</p><p><b>METHODS</b>RWPE-1 cells cultured in vitro were treated with simvastatin at 0, 10, 20, and 40 μmol/L for 24, 48, and 72 hours followed by determination of their proliferation by MTT assay, and their apoptosis by flow cytometry. The mRNA and protein expressions of Bcl-2, Bax, and Cx43 were detected by fluorescence quantitative RT-PCR and Western blot, respectively.</p><p><b>RESULTS</b>After 72 hours of treatment with simvastatin at 10, 20, and 40 μmol/L, the inhibition rates of the RWPE-1 cells were (21.07 ± 6.41)%, (34.87 ± 9.65)%, and (47.18 ± 10.88)%, respectively, significantly higher than (1.21 ± 0.54)% in the control group (P < 0.05) and in a dose-dependent manner (P < 0.05); the cell apoptosis rates were (0.066 ± 0.016)%, (0.126 ± 0.023)%, and (0.192 ± 0.025)%, respectively, remarkably higher than (0.015 ± 0.005)% in the control (P < 0.05) and also in a dose-dependent manner (P < 0.05); the mRNA and protein expressions of Bcl-2 were decreasing while those of Bax and Cx43 increasing with the increased concentration of simvastatin (P < 0.05). The expression of Cx43 was correlated negatively with that of Bcl-2 but positively with that of Bax.</p><p><b>CONCLUSION</b>Simvastatin inhibits the proliferation of prostate epithelial cells and induce their apoptosis by acting on the gap junctional intercellular communication.</p>

Qilin Pills combined with clomiphene for idiopathic oligoasthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Qilin Pills combined with clomiphene on idiopathic oligoasthenospermia.</p><p><b>METHODS</b>We randomly assigned 300 patients with idiopathic oligoasthenospermia to a trial (n = 156) and a control group (n = 144) to be treated with Qilin Pills (6 g, tid) combined with clomiphene (50 mg, qd) and clomiphene alone (50 mg, qd), respectively, both for a course of 12 weeks. Before and after 4, 8, and 12 weeks of medication, we determined sperm concentration, the percentages of grade a and grade a + b sperm, sperm motility, and the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T), followed by evaluation of the clinical efficacy of Qilin Pills with the pregnancy rate in the patients' spouses as the secondaty therapeutic indexes.</p><p><b>RESULTS</b>Compared with the baseline, both groups of patients showed remarkably improved semen parameters and hormone levels after treatment (all P < 0.01). After 4, 8, and 12 weeks of medication, statistically significant differences were observed between the trial and control groups in sperm concentration ([17.06 ± 2.24] vs [15.07 ± 2.48], [22.10 ± 2.65] vs [18.11 ± 2.97], and [28.13 ± 3.59] vs [21.21 ± 3.60] x 10(6)/mL, P < 0.01), the percentage of grade a sperm ([15.03 ± 2.39] vs [13.08 ± 2.51], [21.08 ± 3.16] vs [16.04 ± 3.05], and [28.08 ± 4.70] vs [20.14 ± 4.74]%, P < 0.01), the percentage of grade a + b sperm ([30.10 ± 5.07] vs [26.21 ± 3.96], [38.08 ± 5.64] vs [30.07 ± 4.80], and [48.04 ± 6.49] vs [35.28 ± 4.77]%, P < 0.01), sperm motility ([42.04 ± 4.86] vs [40.29 ± 4.19], [52.05 ± 5.58] vs [48.03 ± 4.40], and [65.03 ± 5.13] vs [56.67 ± 4.99]%), the FSH level ([7.75 ± 1.38] vs [7.20 ± 1.17], [10.83 ± 1.23] vs [9.10 ± 1.32], and [14.22 ± 0.84] vs [12.06 ± 1.45] IU/L, P < 0.01), the LH level ([10.05 ± 1.68] vs [9.18 ± 1.54], [13.96 ± 1.68] vs [11.99 ± 1.71], and [19.01 ± 2.42] vs [15.86 ± 2.08] IU/L, P < 0.01) and the T level ([19.19 ± 192] vs [18.34 ± 1.79] [21.06 ± 1.63] vs [20.06 ± 1.56], and [24.63 ± 1.06] vs [22.03 ± 1.49] nmol/L, P < 0.01). The pregnancy rate in the patients' spouses was significantly higher in the trial than in the control group at 4, 8, and 12 weeks (1.92 vs 0.69, 4.81 vs 3.47, and 11.54 vs 8.33%, P < 0.01). There were no statistically significant differences in drug tolerance between the two groups (P > 0.05). No obvious adverse reactions were observed.</p><p><b>CONCLUSION</b>Qilin Pills combined with clomiphene can evidently improve the seminal quality and hormone level of oligoasthenospermia patients with no obvious adverse events. However, its long-term efficacy and tolerance deserve further clinical investigation.</p>

Oral medication of statins retards the progression of benign prostatic hyperplasia and lower urinary tract symptoms / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine whether oral statins can delay the progression of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS).</p><p><b>METHODS</b>We conducted a retrospective cohort study of 50-69-year-old males who came for physical examination in our hospital between January 2003 and December 2008. We designed the inclusion criteria, followed them up for 5 years, and investigated the relationship of oral statins with the clinical progression of BPH and LUTS.</p><p><b>RESULTS</b>Totally, 653 men met the inclusion criteria and were included in this study, of whom 283 were treated with oral statins (group 1) while the other 370 with none (group 2). There were no statistically significant differences between the two groups in age and baseline IPSS, Qmax, and prostate volume (PV) (P > 0.05). During the follow-up, 24 cases in group 1 and 35 cases in group 2 were excluded for obvious dys-uria. A gradual increase was observed in IPSS in both groups 1 and 2 year by year from the baseline to the 5th year of follow-up, but significantly lower in the former group (4.27 +/- 1.16, 4.63 +/- 1.05, 5.27 +/- 0.96, 6.41 +/- 1.04, 7.21 +/- 1.21, and 7.93 +/-1.50) than in the latter (4.24 +/- 1.35, 5.26 +/- 1.23, 6.84 +/- 1.20, 8.75 +/- 1.84, 10.82 +/- 3.01, and 12.98 +/- 4.21) (P < 0.01); a gradual decrease was seen in Qmax, though markedly higher in group 1 ([26.56 +/- 2.09], [24.06 +/- 1.94], [21.33 +/- 1.66], [19.24 +/- 1.54], [17.44 +/- 1.53], and [16.27 +/- 1.37] ml/s) than in group 2 ([26.74 +/- 2.40], [23.62 +/- 2.01], [20.63 +/- 1.69], [17.72 +/- 1.48], [14.82 +/- 1.11], and [11.86 +/- 1.24] ml/s) (P < 0.01); and a gradual increase was found in PV, but remarkably smaller in the former group ([19.82 +/- 4.94], [22.60 +/- 4.99], [25.80 +/- 5.20], [27.92 +/- 5.05], [29.11 +/- 5.24], and [29.97 +/- 5.26] ml) than in the latter ([20.21 +/- 4.78], [24.30 +/- 4.98], [28.50 +/- 5.14], [32.84 +/- 4.77], [36.99 +/- 4.78], and [40.90 +/- 4.78] ml) (P < 0.01). Longer medication of statins was associated with better efficacy.</p><p><b>CONCLUSION</b>Oral statins can significantly delay the clinical progression of BPH and LUTS.</p>

Prophylatic antibiotic use in percutaneous nephrolithotomy: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in patients undergoing percutaneous nephrolithotomy (PCNL) who have sterile preoperative urine.</p><p><b>METHODS</b>MEDLINE, EMBASE, Cochrane Collaboration Reviews, CMCC and CNKI were searched for RCTs comparing antibiotic prophylaxis with placebo (or blank controls) for patients undergoing PCNL with preoperative sterile urine. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by 2 reviewers using the designed extraction form. The software RevMan 4.2 was used to review management and data analysis.</p><p><b>RESULTS</b>A total of 9 trails, 1 placebo controlled, 3 non treatment controlled, and 5 active controlled, involving 1018 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing PCNL significantly decreased fever (RR = 0.71, 95% CI: 0.54-0.92, P = 0.009), bacteriuria (RR = 0.39, 95%CI: 0.23-0.67, P = 0.0006) and bacteremia incidence (RR = 0.43, 95%CI: 0.25-0.73, P = 0.002). Effective antibiotic classes included quinolone which significantly decreased bacteriuria incidence (RR = 0.31, 95%CI: 0.12-0.82, P = 0.010) and nitrofurantoin which significantly decreased fever incidence (RR = 0.38, 95%CI: 0.24-0.61, P = 0.005). Extended course significantly decreased fever incidence (RR = 0.64, 95%CI: 0.47-0.87, P = 0.004) and bacteriuria incidence (RR = 0.35, 95%CI: 0.18-0.71, P = 0.003).</p><p><b>CONCLUSIONS</b>Prophylactic antibiotics can significantly decrease the incidence of postoperative infective complications. A significant decrease in bacteriuria incidence can be achieved with quinolones. Extended course is effective in decreasing fever, and bacteriuria incidence.</p>

Corticoid combined with an antibiotic for chronic nonbacterial prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of corticoid in combination with an antibiotic in the treatment of chronic nonbacterial prostatitis (CNP).</p><p><b>METHODS</b>We used the randomized, double-blind and parallel contrasted method, selected 160 CNP patients via the Stamey test, EPS examination and NIH-CPSI scores, and equally randomized them into an experimental group (with 1 case missing) and a control group. The former received prednisone and levofloxacin for 2 weeks followed by another 2-week administration of levofloxacin only, while the latter were given levofloxacin and placebo in the first 2 weeks and placebo only in the next 2. All the patients were evaluated by NIH-CPSI scores and EPS results and followed up for adverse events after 2 and 4 weeks of treatment.</p><p><b>RESULTS</b>The total NIH-CPSI score, the pain index, voiding index and quality of life (QOL) score in the experimental group were decreased by 9.56 +/- 2.05, 4.59 +/- 1.18, 2.38 +/- 1.24 and 2.59 +/- 2 1.20 after the 2-week treatment, and 11.72 +/- 2.41, 5.51 +/- 1.42, 2.92 +/- 1.17 and 3.33 +/- 1.08 after the 4-week treatment; while those in the control group were reduced by 6.53 +/- 2.70, 3.20 +/- 1.30, 1.40 +/- 1.05 and 1.80 +/- 1.15 after the 2-week treatment, and 8.53 -/+ 2.91, 3.88 +/- 1.44, 2.08 +/- 1.11 and 2.55 +/- 1.33 after the 4-week treatment, with significant differences between the two groups as well as between pre- and post-treatment (P < 0.01), but not between the 2- and 4-week treatment (P > 0.05). Statistically significant differences were also observed in the count of WBCs in EPS between not only pre- and post-treatment, but also the 2- and 4-week treatment (P < 0.01). No serious adverse events were recorded, nor were significant differences in the tolerance to corticoid and placebo.</p><p><b>CONCLUSION</b>Prednisone in combination with an antibiotic can effectively relieve pain and voiding symptoms, improve QOL and reduce WBC in the EPS of CNP patients, and therefore well deserves to be recommended in clinical application. But its long-term efficacy and tolerance are yet to be further studied.</p>

Comparison of the therapeutic efficacy of benzalkonium bromide, pirarubicin, and mitomycin C in prevention of postoperative recurrence of superficial bladder cancer / 肿瘤

Objective: To compare the effectiveness and safety of bladder instillation of bzalkonium bromide (BR), pirarubicin (THP), or mitomycin C (MMC) in prevention of postoperative recurrence of superficial bladder transient cell carcinoma (SBTCC). Methods: One hundred and twenty-seven patients with SBTCC who underwent transurethral resection of bladder tumor (TURBt) or partial cystectomy were randomly divided into 3 groups. BA group (n = 43) received intravesical instillation of 0.1% BB 300 mL and retained for 15 min for one time. THP group (n = 42) received intravesical instillation of 30 mg THP in 50 mL of 0.9% NaCl solution. MMC group (n = 42) received intravesical instillation of 40 mg MMC in 50 mL of 0.9% NaCl solution. THP and MMC were given to patients once a week for 8 weeks and then once a month for one year. All the patients were followed up and received cystoscopy examination. The recurrence rate and side effects were compared between the three groups. Results: All patients were followed up for 24 months. The tumor recurrent rates were 4.7%, 23.8%, and 26.2% in BB, THP, and MMC groups, respectively. The tumor recurrence rate of BB group was significantly lower than that in THP and MMC groups (P 0.05). The pathological grade, clinical staging, primary and recurrent tumors, and different instillation drug therapies had significant effects on the recurence rate (P 0.05). Conclusion: Postoperative intravesical administration of BB is more effective than THP and MMC with well toleration and low cost. No apparent side effects are observed.

Advances in the treatment of chronic prostatitis/chronic pelvic pain syndrome / 中华男科学杂志

So far the etiology of chronic prostatitis (PC) and particularly chronic pelvic pain syndrome (CPPS) remains to be elucidated. According to recent epidemiologic data, CP is the most common urological disease in men below 50 years and occurs in 2.5%-16.0% of the world population. Since the 1990s, researchers of many countries have carried out deeper, more extensive and larger scaled studies than ever before on the etiology, diagnosis and treatment of the disease, with the sponsorship and coordination of such international institutions as the International Prostatitis Collaborative Network (IPCN), the Chronic Prostatitis Collaborative Research Network of the National Institute of Health (NIH-CPCRN) and so on. As prevalent as multiple sclerosis, CPPS is the most common yet most poorly understood "prostatitis syndrome". This article reviews the progress in the studies of the treatment of CPPS, explores the main problems and ventures the prospects for the development in this field.

Progress in the studies of alpha1-adrenoceptor blocker for concurrent benign prostatic hyperplasia and hypertension / 中华男科学杂志

The epidemiological survey shows that primary hypertension is one of the independent risk factors in the development and the progress of BPH, 25 percent of old male patients aged 60 or more suffer from the two diseases at the same time, which grievously affects their quality of life. There is little literature about the appropriate therapeutic regimen of BPH associated hypertension. The article reviews the progress in the studies of alpha1-adrenoceptor blocker for BPH associated hypertension, and explores the main problems facing us and ventures the prospects for the development in this field.