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【Objective】 To investigate the expressions of P53 and Ki-67 in prostate cancer (PCa)and to explore their correlation with the clinicopathological characteristics. 【Methods】 The expressions of P53 and Ki-67 in 90 PCa patients were detected with immunohistochemistry. Patients’ age, preoperative prostate-specific antigen (PSA) level, postoperative Gleason score, pathological stage, and invasion of neurovascular cancer embolus of all patients were recorded. The relationship of P53 expression with the above indexes was evaluated. 【Results】 The positive rates of P53 and Ki-67 were 27.8% (25/90) and 46.7% (42/90), respectively. The positive rate of P53 in pT2 and pT3-T4 stage groups were 19.7% (13/66) and 50.0% (12/24) (P=0.005), and the positive rate of Ki-67 were 36.4% (24/66) and 75.0% (18/24) (P=0.001), respectively. The positive rate of Ki-67 in Gleason score ≤6, ≤7 and ≥8 groups were 30.4%, 53.8% and 66.7%, respectively, with statistical difference. Positive expression of P53 was related to Ki-67 expression, but not to patients’ age, preoperative PSA level, postoperative Gleason score and nerve and invasion of neurovascular cancer embolus. 【Conclusion】 P53 expression is related to tumor stage and Ki-67, while Ki-67 expression is associated with tumor stage ang grade.
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Objective:To assess the efficacy of Tamsulosin monotherapy for overactive bladder(OAB)symptoms in benign prostatic hyperplasia(BPH)patients with the prostate volume(PV)<40 ml, and to analyze related factors affecting the efficacy.Methods:300 BPH patients with OAB were enrolled, with an average age of(66.9±7.7)years and the PV<40 ml.Smoking, drinking and other living habits were investigated.Data on the Overactive Bladder Symptom Score(OABSS), International Prostate Symptom Score(IPSS)and Quality of Life Scale(QOLS)were collected before and after 4 weeks of treatment with Tamsulosin 0.2 mg QN.The maximum urine flow rate(Qmax)and bladder residual urine volume(PVR)were measured before and after treatment.OBASS was used as the main assessment parameter to analyze the correlation of efficacy with age, lifestyle, pre-treatment symptom scores, PV, Qmax and PVR.Results:257 patients completed the study, and 169 patients were treated effectively, with an overall effectiveness rate of 65.8%.The effectiveness rates of the mild, moderate and severe OAB groups were 83.6%, 62.4% and 38.5%, respectively, with statistical significance( χ2=13.037, P=0.001).3 patients showed adverse drug reactions, including 2 patients with mild dizziness and 1 patient with nausea.The baseline OABSS score, the proportion of smoking patients and the proportion of drinking patients in the effectively treated OAB group were significantly lower than those in the ineffectively treated group.Multivariate analysis showed that baseline OABSS score( OR=0.735, P<0.001)and smoking( OR=2.111, P=0.029)were correlated with tamsulosin's efficacy in treating BPH patients with OAB with PV<40 ml. Conclusions:The effectiveness rate of Tamsulosin for the treatment of BPH patients with mild OAB with PV<40 ml is high.The baseline OABSS score and smoking are factors affecting the efficacy of Tamsulosin on OAB symptoms in these patients.
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Objective:To determine the predictive value of preoperative monocyte-to-lymphocyte ratio(MLR) for prognosis in elderly patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy(RNU).Methods:A retrospective study was performed on 168 elderly patients who underwent RNU in Beijing Hospital between March 2004 to February 2019.Males accounted for 44.6% (75 patients) and females 55.4%(93 patients) of the patients. Median age at the time of surgery was 73(69-78) years, and 110 (65.5%) patients suffered from hydronephrosis. There were 147 cases(87.5%)with single tumor, and 21 cases(12.5%)with multiple tumors, including 75(46.6%) cases in renal pelvis or pelvi-ureteric junction, and 93(53.4%)cases in ureter. Open RNU was performed in 106(63.1%) patients, and laparoscopic method in 62(32.9%) patients. The optimal cutoff value of MLR was set as 0.22 by using the median.χ 2 test, which was used to detect the association between MLR(≤0.22 vs.>0.22) and clinicopathological variables. Survival analyses were performed using the Kaplan-Meier method and were compared using the log-rank test. Additional subgroup analyses(low grade vs. high grade) were performed according to pathological grade. Univariate and multivariate analysis by Cox’s proportional hazards model was used to determine the significance of MLR in respect to OS and PFS. Results:The follow-up period ranged from 19.2 to 86.9 months (median 51.9 months). Next, the cohort was divided into 2 groups , including 77 patients with low MLR(≤0.22) and 91 patients with high MLR(>0.22). High MLR was significantly more frequent in male patients(31.2% vs.56.0%), as well as those undergoing laparoscopic surgery (54.5% vs.70.3%)(All P<0.05). Based on a Cox univariate proportional hazards analysis, male gender( HR=1.793, 95% CI 1.003-3.205, P=0.049), presence of lymph node metastasis( HR=6.809, 95% CI 2.124-17.454, P=0.001) and high MLR( HR=2.287, 95% CI 1.259-4.154, P=0.007)were associated with poor OS. Male gender( HR=1.758, 95% CI 1.066-2.902, P=0.027), presence of lymph node metastasis( HR=6.524, 95% CI 2.542-16.748, P<0.001), lymphovascular invasion(LVI) ( HR=2.348, 95% CI 1.139-4.838, P=0.021), high MLR( HR=2.801, 95% CI 1.657-4.735, P<0.001)and PLR( HR=1.663, 95% CI 1.003-2.757, P=0.049) were significantly associated with subsequent PFS. By multivariate analysis, tumor site( HR=2.050, 95% CI 1.079-3.892, P=0.028), lymph node metastasis ( HR=6.641, 95% CI 1.852-23.811, P=0.004) and MLR( HR=2.089, 95% CI 1.062-4.113, P=0.033) were the independent risk factors for OS in elderly patients with UTUC. Tumor side( HR=2.024, 95% CI 1.033-3.965, P=0.040), multifocality ( HR=2.992, 95% CI 1.161-7.713, P=0.023), lymph node metastasis ( HR=6.454, 95% CI 2.026-20.564, P=0.002) and MLR( HR=2.866, 95% CI 1.554-5.284, P=0.001) were associated with PFS.The multivariate analysis of the significant risk factors established a postoperative risk stratification model for OS and PFS. The results showed significant differences among the 3 subgroups of patients with low(0 risk factor), intermediate(1 risk factor), or high risk(2-3 risk factors)(All P<0.05). Conclusion:MLR was an independent risk factor for OS and PFS in elderly patients with UTUC and patients with elevated MLR have worsen prognosis.
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Objective To analyze effects of androgen deprivation therapy on lipid metabolism and nutritional status in patients with prostate cancer.Methods The clinical data of 255 elderly patients (≥ 65 years old) with prostate cancer who received endocrine therapy and complete follow-up data from January 2010 to December 2018 were analyzed retrospectively.The median age of the 255 patients was 76 years (65-92).The average PSA of patients was (58.15 ± 9.62) ng/ml,where 101 patients had PSA ＜ 10 ng/ml,62 patients had PSA 10-20 ng/ml,and 92 patients had PSA ＞ 20 ng/ml.All patients were diagnosed pathologically by prostate biopsy.As for Gleason score,Gleason score≤6,Gleason score =7 and Gleason score ≥ 8 had 62,103 and 90 patients,respectively.Endocrine therapy included maximum androgen blockade (197 cases) and drug castration (58 cases),and continued for at least 1 year.Among them,123 cases had complete blood lipid index data,and the subgroup analysis was based on the age of 80 years old,including 98 cases aged 65 to 80 years old and 25 cases over 80 years old.A total of 186 cases had complete data of total protein and albumin,of which 147 cases were 65 years old and 80 years old and 39 cases were more than 80 years old.Before treatment,cholesterol was (4.08 ±0.87) mmoL/L,including (4.14 ±0.86) mmol/L in the 65-80 years old group,(3.82 ± 0.88) mmol/L in ＞ 80 years old group;triglyceride was (1.23 ± 0.56) mmol/L,65-80 age group was (1.26 ± 0.56) mmol/L and ＞ 80 years old group was (1.11 ± 0.57) mmol/L;High density lipoprotein cholesterol was(1.09 ± 0.24)mmol/L,65-80 age group was (1.10 ±0.25) mmol/L and ＞ 80 years group was (1.04 ± 0.21) mmol/L.Low density lipoprotein cholesterol was (2.50 ± 0.78) mmol/L,65 ～ 80 age group was (2.55 ± 0.77) mmol/L and (2.34 ± 0.83) mmol/L in ＞80 years old group.The total protein before endocrine therapy was (63.81 ± 5.93) g/L,including (63.95 ± 5.79) g/L in the 65-80 years old group,(63.30 ± 6.49) g/L in ＞ 80 years old group.In terms of pre-treatment albumin (39.68 ± 3.50) g/L,including (39.82 ± 3.60) g/L in the 65-80 years old group and (39.21 ± 3.12) g/L in ＞ 80 years old group.The differences of various indexes before and after treatment were analyzed.Results The results of blood lipid data analysis of 123 cases showed that,there were increased significant differences(P ＜ 0.01) in cholesterol (4.80 ± 1.82)mmol/L,triglyceride (1.59 ± 1.17) mmol/L,high density lipoprotein cholesterol (1.21 ± 0.25) mmol/L and low density lipoprotein cholesterol (3.07 ± 1.53) mmol/L after endocrine therapy compared with baseline.In the subgroup analysis,the levels of cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol in 65-80-year-old group after treatment were (4.92 ± 1.95) mmol/L,(1.64 ± 1.25) mmol/L,(1.20 ± 0.25) mmol/L,and (3.15 ± 1.66) mmol/L,respectively,which were significantly higher than those before treatment (P ＜0.01).In the group over 80 years old,the blood lipid index after treatment was higher than that before treatment,including cholesterol (4.35 ± 1.08) mmol/L,triglyceride (1.39 ± 0.73) mmoL/L,high density lipoprotein cholesterol (1.27 ± 0.26) mmol/L and low density lipoprotein cholesterol (2.76 ± 0.93) mmol/L.The levels of cholesterol,triglyceride and high density lipoprotein cholesterol were significantly higher than those before treatment (P ＜ 0.05),but there was no significant difference in low density lipoprotein cholesterol between before and after treatment (P ＞ 0.05).The results of data analysis of 186 cases of total protein and albumin showed that,the total protein after treatment was (62.81 ±7.34) g/L,which was not significantly different from that before treatment (P ＞ 0.05).The total protein in 65-80 years old group after treatment was (62.36 ± 7.36) g/L,which decrease and have statistical significantly different from that before treatment (P ＜ 0.05);The total protein in ＞ 80 years old group after treatment was (64.49 ± 7.12) g/L,it was higher than that before treatment,but the difference was not statistically significant (P ＞ 0.05).The level of albumin after endocrine therapy was (38.34 ± 4.48) g/L,which was significantly different from that before treatment (P ＜ 0.01).The levels of albumin in 65-85 years old group and ＞ 80 years old group after treatment were (38.32 ± 4.54) g/L and (38.44 ± 4.30) g/L respectively,but only in the group of 65 to 80 years old,there were significant differences compared with those before treatment (P ＜ 0.05).Conclusion Endocrine therapy can not only significantly increase total cholesterol,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol in elderly patients with prostate cancer,but also significantly reduce albumin after treatment.
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Objective:To investigate the effect of maximal androgen blockade(MAB)therapy on serum calcium, phosphorus and other metabolic indices in elderly patients with prostate cancer.Methods:Clinicopathological data of prostate cancer patients treated with MAB in our department from January 2010 to December 2018 were retrospectively analyzed.All patients underwent prostate biopsy for definitive diagnosis.Detailed data on patient's age, body mass index(BMI), previous medical history, treatment plan and peripheral blood indicators before and after endocrine treatment, such as blood calcium, phosphorus, hemoglobin, fasting blood glucose, triglycerides and cholesterol, were collected.Results:Patients had a mean age of(75.5±5.8)years and a mean BMI of(24.6±3.2)kg/m 2.Blood calcium levels exhibited a downward trend after MAB treatment compared pre-treatment[(2.12±0.44)mmol/L vs.(2.17±0.31)mmol/L, t=0.82, P=0.42], but had no significant difference.Serum phosphorus concentrations were higher and the calcium-phosphorus ratio was lower after MAB treatment than before treatment[(1.02±0.26)mmol/L vs.(1.17±0.34)mmol/L, 2.10±0.28 vs.1.88±0.60, t=-4.12 and 3.56, P<0.01]. After MAB treatment, blood fasting glucose[(6.50±1.55)mmol/L vs.(5.34±1.04)mmol/L, t=-7.82, P<0.01], triglycerides[(1.66±1.32)mmol/L vs.(1.22±0.59)mmol/L, t=-3.38, P<0.01]and cholesterol[(4.70±1.08)mmol/L vs.(4.16±0.90)mmol/L, t=-4.72, P<0.01]were elevated, while hemoglobin concentrations[(122.11±20.43)g/L vs.(130.78±23.98)g/L, t=3.98, P<0.01]were decreased compared with pre-treatment levels. Conclusions:MAB therapy can cause varying degrees of metabolic abnormalities in calcium and phosphorus metabolism, hemoglobin concentrations, blood glucose and lipid levels in elderly prostate cancer patients.The above indicators should be closely monitored during treatment, and treatment-related complications should be proactively prevented.
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Objective To investigate the effects of radical prostatectomy on the overall survival (OS)and tumor-specific survival in prostate cancer(PCa)patients aged 75 years and older.Methods Clinical data of patients aged 75 and older with localized PCa from Surveillance,Epidemiology,and End Results(SEER)Database from 2004 to 2016 were retrospectively analyzed.There were 17 899 cases of PCa undergoing radical prostatectomy and 3 648 cases of PCa without surgery in this study.The OS and prostate cancer-specific survival(PSS)were compared between the surgery group and the nonsurgery group.Results For 75-79-year-old patients with high-risk localized PCa,the OS and PSS in the surgery group were better than in the non-surgery group (OR =1.49,95 ％ CI:1.22 ～ 1.82,P ＜ 0.01;OR=1.43,95％CI:1.09～2.04,P＜0.05).For patients aged 75-79 years with low-risk PCa and patients aged 80 years and older with low-,middle-,or high-risk PCa,the OS was worse in the surgery group than in the non-surgery group(OR =0.54,95％CI:0.38～0.76,P＜0.01;OR =0.47,95％CI:0.34～0.66,P＜0.01;OR =0.58,95％CI:0.44～0.78,P＜0.01;OR =0.59,95％CI:0.51 ～0.68,P＜0.01).For patients aged 75-79 years with low-or medium-risk PCa and patients aged 80 years and older with medium-risk PCa,there was no statistical difference in PSS between the surgery and non-surgery groups(P＞0.05).Conclusions Age limits for prostatectomy should be extended as a result of increasing average life expectancy.Patients aged 75-79 years with high-risk PCa can be considered for surgical treatment,while it should not be recommended for patients aged 75-79 years with low-or medium-risk localized PCa or aged more than 80 years.Many factors should be considered in making treatment decisions for prostate cancer.
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Objective: To analyze the clinical pathologic characteristics of cases with fluorescence in situ hybridization (FISH) positive of exfoliated urothelial cells, so as to evaluate the clinical utility of FISH in the diagnosis of urothelial carcinoma (UC).Methods: A total of 271 cases of FISH positive in Department of Urology of Peking University First Hospital from Apr.2012 to Sep.2015 were recruited in this study.Retrospective analysis was made on their clinical data.For FISH analysis, labeled probes specific for chromosomes 3, 7, 17, and the p16 (9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.The positive predict values (PPV) of all the techniques were analyzed.Results: Of the 271 patients, 207 cases were UC, 7 cases were non-UC, and 57 cases were benign diseases.The PPV of FISH in detecting UC was 76.4%, while the 95% confidence interval (CI) 71.3% to 81.5%.In the cohort of FISH positive, this value was similar to that of urinary cytology (PPV 86.8%, 95% CI: 78.5%-95.0%).The PPV of FISH was lower than that of cystoscopy and ureteroscopy (PPV 96.1%, 95% CI: 91.7%-100.0%).There were significant differences between this study and the PPV of FISH reported abroad (PPV 53.9%, χ2=33.048, P<0.001).Of all the UC with FISH positive, bladder cancer showed an earlier pathological stage versus renal pelvic carcinoma and ureteral carcinoma, with significance (χ2=5.894, P=0.015, and χ2=13.601, P<0.001, respectively).However, no difference was found in the size, pathological stage and pathological grade of tumors between the urinary cytology positive group and the urinary cytology negative group.The rate of high-grade UC in ureteral carcinoma of FISH positive was 92.3%, much higher than that of ureteral carcinoma reported domestically.Conclusion: The PPV of FISH in detecting UC is higher relatively, with a better clinic value for Chinese patients.The ureteral carcinoma with FISH positive obtains a higher pathological grade, which is of great guiding significance for UC.
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Phytic acid intake of preschool children was measured with modified ion exchange method. Zinc bioavailability was assessed by metabolic balance experiment and phytic acid/zinc molar ratio was calculated.The average intake of phytic acid in the diet was 499mg/day. The average of phytic acid/zinc molar ratio was 6.66. Even the subjects ingested foods rich in phytic acid, the phytic acid/zinc molar ratio (10.6) still remained at the lower limit of the critical value (10-20), that will inhibit zinc bioavailability. Metabolic balance study indicated that zinc bioavailability was not inhibited.Therefore, the phytic acid in present Chinese diet is unlikely a factor of zinc deficiency among children.
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2,3-Diaminonaphthalene was used for the fluorometric determination of selenium in cereals and vegetables. Nitric-perchloric-sulphuric acids mixture was used for digestion. Coefficient of variation and recovery for cereals were 4-10% and 97.1%, and for vegetables were 4-18% and 97.8% respectively. Addition of hydrochloric acid to the final digests could be omitted for ordinary cereals and soybean, but it was necessary for samples from seleni-ferous area and some vegetables with higher selenium content such as mushrooms.
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A modification of Watkinson's method was used for the flaorimetric determination of selenium in blood, hair, urine and animal tissues with 2,3-Di-aminonaphthalene. A mixture of sulphuric, perchloric acid and sodium molybdate was used for digestion. As little as 3 ng selenium in the sample could be estimated out. Coefficients of variation and recoveries for blood, hair, urine and animal tissues were 3.9, 5.5, 3.3 and 5.6%, and 97.0, 95.0, 97.8 and 99.8% respectively. No significant difference in selenium content estimated was found as graded amounts of samples were taken for analysis, indicating no foreign interference in the extracts. Both precision and accuracy of this method are satisfactory.
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It has been demonstrated by animal and human experiments that the growth promoting effect of soybean milk substitute formula 5410 is comparable with that of human milk or cow's milk formula commonly used in infant feeding. It was assumed that such a favorable effect is due in part to the inclusion of 5% of egg yolk powder in the formula. However, such an assumption remains to be confirmed.In the present animal experiment, the 5% egg yolk powder was either removed (diet 5700), or substituted with 5% whole egg powder (diet 5411), 5% whole cow's milk powder (diet 5720), 10% whole cow's milk powder (diet 5721).It was fouad that the growth promoting effect of diet 5411 is the, same as that of 5410, while that of the other, diets are all significantly inferior than that of 5410. The role played by the definite amount of egg yolk in the soybean milk substitute is postulated.
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Previous feeding experiments on infants have shown that the growth promoting effect of the milk-substitute 5410 was comparable to that of hu- man milk or a milk powder diet. In order to know more about the biochemical and physiological properties of this mixture, nine male infants were put in serial metabolic studies with respect to the digestion, nitrogen, calcium and phosphorus utilization of this soybean product.The age of the infants were 37-77 days at the beginning of the experiment, and 6-7 months at the end. The infants were fed with the milk-substitute and a milk powder diet in alternative periods each of which lasted 2-4 weeks. In the first and second periods the infants were fed milk powder or milk-substitute alone, while in the third and forth periods the same diets were supplemented with concentrated cod liver oil, and in the fifth period the infants were fed with another soybean product similar to mixture 5410 but with higher protein content.The digestibility of protein and the absorption of nitrogen, calcium and phosphorus of mixture 5410 were significantly lower than those of the milk powder diet. However, the nitrogen retention were the same during these two dietary periods (191 and 196 mg per kilo per day). The calcium and phosphorus retention were signigicantly lower during periods without cod liver oil (24 and 24 mg per kilo per day) but improved markedly after supplementation (58 and 36 mg per kilo per day).On the average, each infant received from the milk-substitute 4.3g of protein per kilo per day. The amount of calcium ingested was 850 mg per day; it seems to be that supplementation with cod liver oil is necessary for adequate calcium retention at this level of intake.Raising the protein content of the milk-substitute by further addition of soybean powder may increase the nitrogen retention, but it tends to lower the absorption and retention of calcium and phosphorus due to increased amount of fecal excretion.
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Metabolic studies were carried out on nine male infants to investigatethe digestibility and utilization of some of the nutrients of the Milk-substitute 5410, there by ascertaining whether those nutrients could satisfy their requirements. From the results of the chemical analyses of the foods and excreta of the infants, statistical treatment of the records on the fre- quency of defecation, the amount and form of the stools, and the growth rate of the infants, it was possible to evaluate the apparent energy utilization of the milk-substitute.The ages of the infants at the beginning of the experiment were 37-77 days, and 6-7 months at the end. The experiment was divided into five periods: in the first and second periods the infants were fed alternately with the milk-substitute and powdered whole milk diet; in the third and fourth periods the diets were the same as the first and second but supplemented with cod liver oil concentrate (sbout 1500 1. U. vitamin A and 500 I. U. vitamin D per day). In the fifth period the protein content of the milk-substitute was raised from 16.6% to 22.6%, supplemented also with cod liver oil. In periods when the infants were fed with the milk substitute alone, the number of defecation was significantly less and loose stools fewer than in the milk diet period. Introduction of cod liver oil tended to reduce the dry weight of the feces. When the milk-substitute with higher protein content was given, the number of defecation increased and occurence of diarrhea was more frequent but not more so than during the cow's milk powder period.From the statistical analyses of the results, it was found that the digestibility of protein and carbohydrate of the milk-substitute was significantly lower than that of cow's milk powder but that of fat was higher. Introduction of cod liver oil increased the digestibility of protein, fat, carbohydrate and crude fibre. There was no significant difference between the availability of energy of the milk-substitute and cow's milk powder, the former being 90.9% while the latter 91.7%.The growth curves of the nine infants showed that the higher the food intake, the higher the growth rate. The caloric intakes of eight infants were 100-120 kcal per kilogram of body weight per day and their growth rates were almost identical. The caloric intake of one infant was consistently below 100 kcal per kilogram of body weight per day and his growth rate was significantly lower. It may be concluded, therefore, that when the Milk-substitute 5410 is given to infants supplying 100-120 kcal per kilogram of body weight per day, would be adequate for normal growth.