Prostate-derived IL-1β upregulates expression of NMDA receptor in the paraventricular nucleus and shortens ejaculation latency in rats with experimental autoimmune prostatitis / 亚洲男科学杂志(英文版)

Experimental autoimmune prostatitis (EAP)-induced persistent inflammatory immune response can significantly upregulate the expression of N-methyl-D-aspartic acid (NMDA) receptors in the paraventricular nucleus (PVN). However, the mechanism has not yet been elucidated. Herein, we screened out the target prostate-derived inflammation cytokines (PDICs) by comparing the inflammatory cytokine levels in peripheral blood and cerebrospinal fluid (CSF) between EAP rats and their controls. After identifying the target PDIC, qualified males in initial copulatory behavior testing (CBT) were subjected to implanting tubes onto bilateral PVN. Next, they were randomly divided into four subgroups (EAP-1, EAP-2, Control-1, and Control-2). After 1-week recovery, EAP-1 rats were microinjected with the target PDIC inhibitor, Control-1 rats were microinjected with the target PDIC, while the EAP-2 and Control-2 subgroups were only treated with the same amount of artificial CSF (aCSF). Results showed that only interleukin-1β(IL-1β) had significantly increased mRNA-expression in the prostate of EAP rats compared to the controls (P < 0.001) and significantly higher protein concentrations in both the serum (P = 0.001) and CSF (P < 0.001) of the EAP groups compared to the Control groups. Therefore, IL-1β was identified as the target PDIC which crosses the blood-brain barrier, thereby influencing the central nervous system. Moreover, the EAP-1 subgroup displayed a gradually prolonged ejaculation latency (EL) in the last three CBTs (all P < 0.01) and a significantly lower expression of NMDA NR1 subunit in the PVN (P = 0.043) compared to the respective control groups after a 10-day central administration of IL-1β inhibitors. However, the Control-1 subgroup showed a gradually shortened EL (P < 0.01) and a significantly higher NR1 expression (P = 0.004) after homochronous IL-1β administration. Therefore, we identified IL-1β as the primary PDIC which shortens EL in EAP rats. However, further studies should be conducted to elucidate the specific molecular mechanisms through which IL-1β upregulates NMDA expression.

Role of microRNAs in erectile dysfunction: An update / 中华男科学杂志

MicroRNAs (miRNAs) are short non-coding RNAs consisting of approximately 19－23 nucleotides and involved in many pathological and physiological processes by regulating post-transcriptional gene expressions. ED is one of the common male sexual dysfunctions seriously affecting the patient's quality of life, for which there is currently a lack of effective treatments clinically. More and more experiments have demonstrated that miRNAs are involved in the pathological process of different types of ED. This article presents an overview of the progress in the studies of the pathogenic role of miRNAs in ED.

Mu-opioid receptors in the paraventricular nucleus regulate ejaculatory behaviors via the sympathetic nerve system in male rats / 中华男科学杂志

Objective@#To explore the effects of the mu-opioid receptor (MOR) in the paraventricular nucleus (PVN) on the ejaculatory behaviors of male rats and its potential mechanisms.@*METHODS@#Male SD rats with normal ejaculation ability were mated with female ones in hormone-induced estrus. After bilateral PVN microinjection of D-Ala-2-Me-Phe-4-Gly-ol enkephalin (DAGO) or D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP) with an inserted catheter, the male animals were observed for mount latency (ML), mount frequency (MF), intromission latency (IL), intromission frequency (IF), ejaculation latency (EL), ejaculation frequency (EF), post-ejaculation interval (PEI), and intromission ratio (IR). The lumbar sympathetic nerve activity (LSNA) of the rats was recorded using the PowerLab data acquisition hardware device, and the levels of norepinephrine (NE) in the peripheral plasma were measured by ELISA following microinjection of saline or different doses of DAGO or CTAP.@*RESULTS@#Neither CTAP nor DGAO significantly affected the ML of the male rats (P > 0.05). DGAO remarkably increased IF (P < 0.01) and MF (P < 0.01), prolonged IL (P < 0.01), EL (P < 0.01) and PEI (P < 0.01), and reduced EF (P <0.01) and IR (P < 0.05). On the contrary, CTAP markedly decreased IF (P < 0.01) and MF (P < 0.01), shortened IL (P < 0.01), EL (P < 0.01) and PFI (P < 0.01), and elevated EF (P < 0.01) and IR (P < 0.01). Additionally, DAGO decreased LSNA in a dose-dependent manner and reduced the NE level in the peripheral plasma. CTAP, however, not only offset the effects of DAGO on LSNA, but also significantly increased LSNA.@*CONCLUSIONS@#MOR in PVN inhibits ejaculatory behaviors in male rats by weakening LSNA, which has provided some theoretical evidence for the use of highly selective opioids in the treatment of premature ejaculation.

Glans-preserving surgery for superficial penile squamous cell carcinoma ≥2 cm in diameter / 中华男科学杂志

Objective@#To explore the feasibility of glans-preserving surgery (GPS) in the treatment of superficial penile squamous cell carcinoma (PSCC) with the lesion diameter of ≥2 cm.@*METHODS@#We retrospectively analyzed the clinical data on 69 cases of superficial PSCC (≤T1aN0) treated by GPS (n = 36) or radical surgery (total or partial penectomy, n = 33) from July 2007 to July 2017.@*RESULTS@#The mean tumor diameter and depth of invasion were 3.16 (2.0－6.0) cm and 0.89 (0.5－2.0) cm in the GPS group and 3.56 (2.0－6.0) cm and 1.89 (0.6－4.0) cm respectively in the radical surgery group. The patients were followed up for 10－102 (mean 42) months, during which, 5 patients in the GPS group developed local recurrence at 40 days and 2, 4, 7 and 9 months postoperatively, again underwent gansectomy, partial penectomy or GPS, and experienced no more recurrence during the follow-up of 54, 34, 39, 66 and 70 months. No local recurrence was observed in the radical surgery group, and none of the 69 patients experienced lymph node metastasis or died during the follow-up.@*CONCLUSIONS@#GPS is safe and efficient for the treatment of superficial PSCC with the lesion diameter of ≥2 cm.

Biomarkers for predicting the outcome of microdissection testicular sperm extraction for non-obstructive azoospermia patients: A systematic review / 中华男科学杂志

Infertility is a common medical condition which affects nearly 15% of the world population. Non-obstructive azoospermia (NOA) is a most challenging problem inducing male infertility and does not respond to the existing medication. Surgery is the primary method for obtaining sperm from NOA patients, but the outcome of testicular sperm extraction is unpredictable preoperatively. Recently, with the development of detection techniques for male infertility, some new biomarkers have come into notice, which may be of some value in predicting the outcome of microdissection testicular sperm extraction (MTSE) and evaluating male infertility. This article presents an overview of the known biomarkers contributive to the prediction of the outcome of MTSE for NOA patients.

Adipose-derived stem cells for the treatment of penile erectile dysfunction: An update / 中华男科学杂志

Adipose-derived stem cells (ADSCs) are pluripotent stem cells isolated from the adipose tissue and have the potential for self-renewal and multi-directional differentiation into neurogenic cells, smooth muscle cells, endothelial cells, and so on. Erectile dysfunction (ED) is a common male sexual dysfunction that has a negative impact on the lives of the patients and their partners. Current treatments of ED include surgery and medication, with oral 5-phosphodiesterase inhibitors as the first-line drugs. However, a small number of the patients are not sensitive to these therapies and cannot be improved or cured pathologically. So far, animal experiments and preclinical trials have confirmed the safety and efficacy of ADSCs, which act on ED though paracrine mechanisms. This review summarizes the advances in the recent 5 years in the studies of ADSCs for the treatment of ED.

Association of the deleted DAZ gene copy related to gr/gr and b2/b3 deletions with spermatogenic impairment / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the correlation of the deleted azoospermia (DAZ) gene copy related to gr/gr and b2/b3 deletions in the AZFc region with male spermatogenic impairment.</p><p><b>METHODS</b>This study included 121 infertile men with different de- grees of spermatogenic impairment and 95 healthy donors from the sperm bank. Using PCR, PCR-RFLP, and Y chromosome specific sequence tagged sites (STS) , we analyzed the association of DAZ gene copy deletions related to gr/gr and b2/b3 deletions in the AZFc region with spermatogenic impairment.</p><p><b>RESULTS</b>There were 15 cases of gr/gr deletion (12. 40% ) and 6 cases of b2/b3 deletion (4.96%) in the infertility group as compared with 13 cases of gr/gr deletion (13.68%) and 1 case of b2/b3 deletion (1.05%) in the control. Analysis of the DAZ-specific single nucleotide variant (SNV) loci revealed 11 gr/gr-DAZI/DAZ2 deletions (9.09%), 4 gr/gr-DAZ3/DAZ4 deletions (3.31%), and 6 b2/b3-DAZ1/DAZ2 deletions (4.96%) in the infertile men in comparison with 3 gr/ gr-DAZ1/DAZ2 deletions (3.16%), 10 gr/gr-DAZ3/DAZ4 deletions (10.53%), and 1 b2/b3- DAZ3/DAZ4 deletion (1.05%) in the control.</p><p><b>CONCLUSION</b>Partial deletions of gr/gr and b2/b3 exist in both healthy men and male patients with different degrees of spermatogenic impairment and cannot be considered as a risk factor for spermatogenesis impairment. However, deletions of different DAZ duplicons in gr/gr and b2/b3 deletions have different effects on spermatogenesis. DAZ1/DAZ2 instead of DAZ3/DAZ4 deletions might be associated with spermatogenesis impairment.</p>

Corporoplasty using autologous tunica vaginalis graft for Peyronie's disease / 中华男科学杂志

<p><b>Objective</b>To assess the effect of corporoplasty with autologous tunica vaginalis graft in the treatment of Peyronie's disease.</p><p><b>METHODS</b>Ten patients with Peyronie's disease underwent plaque excision and corporoplasty with autologous tunica vaginalis graft. We obtained and compared IIEF-5 scores of the patients before and at 1 and 5 years after operation.</p><p><b>RESULTS</b>After surgery, penile curvature was obviously relieved and all the patients achieved normal penile erection and satisfactory sexual intercourse without erection-related pain or recurrent erectile dysfunction. The mean IIEF-5 score was significantly improved at 1 year (22.40±1.08) and 5 years postoperatively (23.00±1.14) as compared with the baseline, (19.20±2.28) (P<0.05 or 0.01).</p><p><b>CONCLUSIONS</b>Corporoplasty with autologous tunica vaginalis graft is a safe, simple and effective option for the treatment of Peyronie's disease, though its definite efficiency is to be further supported by large-sample clinical studies.</p>

Prognostic factors of penis-sparing surgery for early-stage penile cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the factors influencing the prognosis of penis-sparing surgery (PSS) for early-stage penile cancer.</p><p><b>METHODS</b>We retrospectively studied the clinical data about 45 cases of early-stage penile cancer treated by PSS from January 2007 to December 2014. We calculated the rate of local recurrence-free survival by the Kaplan-Meier method, and conducted univariate and multivariate COX regression analyses on the relevant factors including the patient's age, marital status, tumor location, tumor size, postoperative sexual life, histological grade, and TNM stage.</p><p><b>RESULTS</b>One-year and three-year local recurrence-free survival rates were 95.5% and 52.2%, respectively. Multivariate analysis demonstrated that the histological grade (P = 0.039) and postoperative sexual life (P = 0.049) were independent factors for the prognosis of PSS. Logistic regression showed the patients age to be significantly associated with histological grade (P = 0.014).</p><p><b>CONCLUSION</b>Histological grade and postoperative sexual life are important independent prognostic factors of PSS for early-stage penile cancer, and the patients age is associated with the prognosis of PSS through its influence on the tumor grade.</p>

Aberrant expression of long noncoding RNA in prostate cancer / 中华男科学杂志

Prostate cancer (PCa) is one of the most common malignant tumors as well as a frequent cause of cancer-related mortality in men worldwide. The test of serum markers has dramatically improved the early diagnosis of PCa, but its underlying molecular mechanisms are not yet completely identified. Long noncoding RNA (IncRNA) is emerging as a new player in the PCa paradigm demonstrating its potential roles in both oncogenic and tumor suppressive pathways. LncRNA is frequently aberrantly expressed in the majority of PCa cases. This review highlights recent findings of the aberrant expression of lncRNA in PCa and discusses its novel roles in the diagnosis, prediction, prognosis, metastasis, and potential clinical treatment of PCa.

Expression ratio of the nerve growth factor receptor TrkA to p75NTR correlates with the clinical stage and pathological grade of prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expressions and action mechanisms of nerve growth factor (NGF) receptors TrkA and p75NTR in the oncogenesis and progression of prostate cancer (PCa).</p><p><b>METHODS</b>Using immunohistochemistry, we detected the expressions of TrkA and p75NTR in 62 PCa and 35 benign prostatic hyperplasia (BPH) samples, and conducted statistical analysis on the basis of clinical data.</p><p><b>RESULTS</b>Independent-samples t-test showed that, along with poorer tissue differentiation or higher clinical stage of PCa, the expression of TrkA was significantly up-regulated, that of p75NTR remarkably down-regulated, and the expression ratio of TrkA to p75NTR markedly increased. The TrkA/p75NTR ratio was 0.32 in the BPH, 0.52 in the PCa tissue with Gleason score of 6, 1.65 in the PCa tissue with Gleason score of 7, 5.75 in the PCa tissue with Gleason score ≥ 8, 0.89 in the clinical stage of pT2, 1.5 in pT3 a, 3.75 in pT3b, and 7.00 in pTxN1.</p><p><b>CONCLUSION</b>The abnormally increased expression ratio of TrkA to p75NTR might be one of the essential features of malignant transformation of prostate cells. A higher TrkA/p75NTR expression ratio may be associated with a lower tissue differentiation, a higher clinical stage or Gleason score, and therefore a poorer prognosis.</p>

Impact of autosomal dominant polycystic kidney disease on the outcomes of intracytoplasmic sperm injection in infertile males / 中华男科学杂志

<p><b>OBJECTIVE</b>To summarize the features and treatment of male infertility induced by autosomal dominant polycystic kidney disease (ADPKD), and compare the outcomes of intracytoplasmic sperm injection (ICSI) for infertile men with ADPKD and those with congenital bilateral absence of vas deferens (CBAVD).</p><p><b>METHODS</b>We retrospectively analyzed 21 cases of ADPKD-induced infertility, 15 treated by ICSI (group A), and another 164 cases of strictly matched CBAVD-induced infertility (group B). We compared the two groups in the couples' age, the number of ICSI oocytes, and the rates of fertilization, transferrable embryos, good embryos, embryos implanted, clinical pregnancy, biochemical pregnancy, early abortion, singleton and twins in the first cycle.</p><p><b>RESULTS</b>After 28 cycles of ICSI, 10 of the 15 ADPKD-induced infertility patients achieved clinical pregnancy, including 7 cases of live birth, 1 case of spontaneous abortion, and 2 cases of pregnancy maintenance. No significant differences were observed between groups A and B in the couples' age, the wives' BMI, or the numbers of ICSI oocytes and embryos transplanted (P >0.05), nor in the rates of ICSI fertilization (72.64% vs 76.17%), transferrable embryos (51.28% vs 63.24%), quality embryos (38.46% vs 49.83%), embryo implantation (17.64% vs 38.50%), abortion (0 vs 9.23%), singleton (50% vs 81.54%) and twins (50% vs 18.46%). However, the rates of clinical pregnancy (13.33% vs 42.68%, P = 0.023 <0.05) and biochemical pregnancy (13.33% vs 39.63%, P = 0.032 <0.05) were significantly lower in group A than in B.</p><p><b>CONCLUSION</b>ICSI is effective in the treatment of male infertility induced by either ADPKD or CBAVD, but the ADPKD cases have a lower success rate than the CBAVD cases in an individual cycle. The affected couples should be informed of the necessity of prenatal genetic diagnosis before embryo implantation and the inevitable vertical transmission of genetic problems to the offspring.</p>

Testis-sparing surgery for benign testicular tumor / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of testis-sparing surgery (TSS) in the treatment of testicular tumor.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 8 cases of benign testicular tumor treated by TSS in our hospital from October 2005 to March 2012.</p><p><b>RESULTS</b>The 8 patients, aged 18-67 (mean 45) years, were preoperatively diagnosed with benign testicular tumor and all underwent partial testis resection. Rapid intraoperative pathology showed the incisal margins to be negative. Postoperative pathological examination confirmed Sertoli cell tumor in 3 cases, adenomatoid tumor in another 3, and mature teratoma in the other 2. The patients were followed up for 6 months to 7 years (mean 4 years), which revealed no relapse and metastasis, nor significant differences from the baseline in the testosterone level, IIEF score, and routine semen parameters.</p><p><b>CONCLUSION</b>Testis-sparing surgery is one of the effective options for the management of benign testicular tumor, which can maximally preserve the testis tissue and protect the patient's sexual function.</p>

Surgical treatment of penile Paget's disease: a report of 10 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and surgical treatment of penile Paget's disease.</p><p><b>METHODS</b>We retrospectively analyzed the treatment and follow-up data of 10 cases of penile Paget's disease surgically treated in Jiangsu Provincial Government Hospital and Jiangsu Provincial People's Hospital from 2008 to 2012.</p><p><b>RESULTS</b>All the 10 patients received expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free skin flaps from the thigh. All surgeries were successful and the postoperative course was uneventful with complete graft survival and no lymph node metastasis. IIEF scores obtained before and 1 -2 months after surgery showed no statistically significant differences in the penile erectile function (P = 0.229), sexual orgasm (P = 0.761), and sexual satisfaction (P = 0.801) of the patients.</p><p><b>CONCLUSION</b>When penile skin lesions suggest the possibility of Paget's disease, biopsy should be performed and surgery should follow as soon as possible. The ideal surgical option is expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free flaps according to the patient's specific conditions.</p>

Composition and morphology of stones in enlarged prostatic utricle / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the composition and morphology of the stones in the enlarged prostatic utricle (EPU).</p><p><b>METHODS</b>We took out 36 EPU stones from 11 patients by transurethral fenestration between 1992 and 2011, and analyzed the stones by scanning electron microscopy, x-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIS).</p><p><b>RESULTS</b>Under the scanning electron microscope, all the EPU stones were constituted of many intensive minicrystals and amorphous matrix. XRD and FTIS revealed that all were hydroxyapatite crystal.</p><p><b>CONCLUSION</b>EPU stones belong to the category of prostatic pseudo-calculi, whose formation is ascribed not to the abnormal change of urine composition, but to the continuous secretion, absorption and concentration of EPU liquid and ablated epithelial cells from the EPU.</p>

Relationship between aberrant expression of miRNAs and prostate cancer / 中华男科学杂志

MicroRNAs (miRNAs) are a kind of small non-coding single-stranded RNA molecules that negatively regulate gene expressions by binding to imperfect complementary sites in the 3 untranslated region of targeted mRNAs at the post-transcriptional level. The aberrant expression of some miRNAs has been discovered to be involved in the pathogenesis of various cancers, including prostate cancer. By analyzing miRNA expressions in prostate cancer tissues, serum and cell lines, and then investigating their mechanisms, we expect to provide some new theoretic bases for the clinical diagnosis and treatment of prostate cancer.

The role of miRNAs in androgen-independent progression of prostate cancer / 中华男科学杂志

MicroRNAs are a kind of small non-coding single-stranded RNA molecules that negatively regulate the gene expression by binding to imperfect complementary sites in the 3' untranslated region of targeted mRNAs at the post-transcriptional level. Aberrant expressions of some miRNAs like miR-221/222, miR-146a and miR-125b have been found to be significantly associated with androgen-independent progression of prostate cancer. By analyzing the aberrant expressions and regulation mechanisms of miRNAs in cell lines, tissues and peripheral blood samples, we hope to provide a new theoretic base for the clinical diagnosis and treatment of androgen-independent prostate cancer.

Modified prepuce-degloving repair for urethrocutaneous fistula following hypospadias surgery / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect and application value of the modified method of prepuce-degloving repair (PDR) in the treatment of urethrocutaneous fistula (UCF) following hypospadias surgery.</p><p><b>METHODS</b>We retrospectively analyzed 87 cases of UCF caused by hypospadias repair from May 2001 to December 2011, of which 61 were treated by simple closure or Y-V plasty of the fistula (group A), and the other 26 by modified PDR (group B). We compared the success rate of surgery and long-term recurrence between the two groups.</p><p><b>RESULTS</b>The total success rates of repair were 78.7 and 96.2% in groups A and B, respectively. Thirteen cases in group A did not respond to surgery, of which 6 failed to be cured by the second operation but later were treated successfully by modified PDR. In comparison, there was only 1 case of failure in group B, which was cured by a second PDR.</p><p><b>CONCLUSION</b>Modified PDR can significantly improve the success rate and reduce the recurrence rate of UCF after hypospadias surgery, which deserves wide clinical application.</p>

Is there an association between advanced stage of renal cell carcinoma and paraneoplastic syndrome?

To investigate any association between renal cell carcinoma [RCC] and paraneoplastic syndromes [PNS]. The retrospective analysis included 1,028 patients of Chinese Han nationality with resectable RCC and PNS. The PNS included elevated erythrocyte sedimentation rate [ESR], hypertension, cachexia, anemia, pyrexia, abnormal liver function, hypercalcemia, polycythemia, varicocele and neuromyopathy. Staging was categorized as local [T1-2N0M0] and locally advanced [T3-4NxM0]. Among patients with at least one PNS, elevated ESR [p = 0.008], cachexia [p = 0.000], varicocele [p = 0.000] and pyrexia [p = 0.021] were related to advanced stage of RCC. Among patients with only one PNS, hypertension [p = 0.012] and hypercalcemia [p = 0.000] were related to advanced stage. The remaining PNS were not associated with tumor stage. Pyrexia, elevated ESR, cachexia and varicocele were related to advanced RCC. Hypertension and hypercalcemia occurring as single PNS, although also correlated with advanced stage, require further investigation

Glans-preserving surgery for superficial penile cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of glans-preserving surgery in the treatment of superficial penile cancer (SPCa).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 21 cases of SPCa treated by glans-preserving surgery in our hospital from January of 2003 to March of 2010.</p><p><b>RESULTS</b>The study included 21 SPCa patients aged 36 to 57 (mean 46) years, with superficial lesions involving the glans penis, coronary sulcus or shaft skin. The tumors were staged and graded TaG1 in 6 cases, TaG2 in 5, TisG1 in 2, TisG2 in 4, T1G1 in 3, and T1G2 in 1. All the patients underwent glans-preserving surgery to preserve the normal appearance and functional integrity of the glans penis, and all returned to normal sexual activity 1 month after operation, with good sexual function and sexual satisfaction. Postoperative follow-up lasted 2 to 7 (mean 5) years, and 2 cases of recurrence in situ found at 6 and 9 months, respectively, which were successfully managed by a second glans-preserving surgery.</p><p><b>CONCLUSION</b>Glans-preserving surgery is an effective method for superficial penile cancer. With proper selection of the patients, this procedure is technically safe, maximally preserves the penile appearance, and least affects the patients' sexual satisfaction.</p>