Peripheral zone PSA density: a predominant variable to improve prostate cancer detection efficiency in men with PSA higher than 4 ng ml / 亚洲男科学杂志(英文版)

To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0-10.0 ng ml

Discrepancy of blood pressure between the brachial artery and radial artery / 世界急诊医学杂志（英文）

@#BACKGROUND: In this study, we attempted to find the relations between blood pressure (BP) measured on the brachial artery (bBP) and BP assessed on the radial artery (rBP) in the right arm. METHODS: Three hundred and fifteen patients were enrolled in this study. Those who had peripheral vascular disease, wounds of arm skin or subcutaneous tissue infection were excluded. After a 15-minute equilibration and stabilization period after inducation of anesthesia, three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff, respectively. Order for each BP was randomized. RESULTS: The bBP was significantly lower than the rBP (P<0.05). The difference between the two values varied from 13 to 18 mmHg in systolic BP (SBP), diastolic BP (DBP) and mean blood pressure (MAP) respectively. And the rBP was positively correlated with the bBP (r=0.872, 0.754, 0.765; P<0.001, <0.001, <0.001; SBP, DBP, MAP, respectively). CONCLUSION: The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.

Effects of opioid analgesics on sperm motility in vitro / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the effects of short-term exposure to opioid analgesics on human sperm motility.</p><p><b>METHODS</b>Twenty normal semen samples were collected, each divided into 19 groups, one as the control and the others treated in vitro with six opioid analgesics at three different concentrations, respectively, and sperm motility was assessed by computer-assisted sperm analysis at 15 min, 2 h and 4 h.</p><p><b>RESULTS</b>Compared with the control group, fentanyl, alfentanil and sufentanil at 1 x 10(-5), 2 x 10(-3) and 0.05 mg/ml significantly decreased the percentage of grade a + b sperm at 15 min, 2 h and 4 h (P<0.05), and so did butorphanol at 2 x 10(-3) and 0.05 mg/ml (P<0.05) and dezocine at 0.05 and 0.5 mg/ml (P<0.05), but neither showed any remarkable effect at 1 x 10(-5) mg/ml at the three time points (P>0.05). Pentazocine effected no significant difference at 3 x 10(-5) and 0. 05 mg/ml (P>0.05) but a gradual increase in the percentage of grade a + b sperm at 0.5 mg/ml at the three time points (P<0.05). Butorphanol totally inhibited sperm motility at 0.05 mg/ml at 15 min and at 2 x 10(-3) mg/ml at 2 h, and so did dezocine at 0.05 and 0.5 mg/ml, but such inhibitory effect was not observed with fentanil, alfentanil and sulfentanil at 0.05 mg/ml. As for the sperm motility decreasing effect at 0.05 mg/ml at 15 min, sufentanil, butorphanol and dezocine exhibited significant differences (P<0.05) while fentanyl displayed none from alfentanil (P>0.05).</p><p><b>CONCLUSION</b>Given the same length of time of treatment, butorphanol and dezocine totally inhibit sperm motility at a high concentration, but make no significant change at a low concentration. While fentanyl, alfentanil and sufentanil can significantly decrease sperm motility at the same low concentration, and partially inhibit it at all concentrations. On the contrary, a high concentration of pentazocine can promote human sperm motility.</p>

Effects of remifentanil combined with naloxone on human sperm motility / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the effects of remifentanil combined with naloxone on human sperm motility in vitro and to investigate its possible mechanism.</p><p><b>METHODS</b>Twenty normal semen samples were collected, each divided into 13 aliquots, one as the control and the others treated in vitro with different concentrations of remifentanil or remifentanil + naloxone for 35 min. The percentage of progressive mobile sperm was assessed by computer-assisted sperm analysis at 5, 10, 15, 20 and 35 min.</p><p><b>RESULTS</b>Compared with the control group, remifentanil at 0.1, 1, 10 and 100 microg/L significantly decreased sperm motility at 5 and 10 min in a dose-dependent manner, with no significant difference at 15 and 30 min; sperm motility showed no significant difference on 5 -35 min exposure to naloxone at 0.004 -0.04 mg/L, nor on 5, 10, 15 and 20 min exposure at 0.4 -4 mg/L, but was significantly increased at 35 min. Compared with the corresponding concentrations of remifentanil alone, remifentanil + naloxone remarkably increased sperm motility at 0.1 + 0.004, 1 + 0.04, 10 + 0.4, and 100 + 4 mg/L at 5 and 10 min, with no obvious difference at 15 and 30 min.</p><p><b>CONCLUSION</b>The onset and offset of the effect of remifentanil on sperm motility are rapid and its inhibitory effect can be antagonized by naloxone, which may be related with the micro-opioid receptor.</p>

Primary stromal cells isolated from human various histological/pathological prostate have different phenotypes and tumor promotion role / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prostate stromal cells are known to regulate epithelial growth as well as support and maintain epithelial function. However, how stromal cells regulate epithelial cells and what differences among various histological/pathological prostate stromal cells in prostate cancer progression still remain unclear. This study aimed to investigate the different phenotypes of human various histological/pathological prostate stromal cells, and their role in tumor promotion.</p><p><b>METHODS</b>The different phenotypes of the human normal prostatic peripheral zonal primary stromal cells (NPPF), transitional zonal primary stromal cells (NPTF), and prostate cancer associated primary stromal cells (CAF) were examined with growth curves and Annexin V-fluorescein isothiocyanate (FITC) assay. The different effects on prostate cancer cell line C4-2B by NPPF, NPTF, and CAF were examined with MTT assay and Annexin V-FITC assay. The gene expression of different histological/pathological prostate stromal cells was profiled by microarray and hierarchical cluster analysis.</p><p><b>RESULTS</b>The growth rate of NPPF, NPTF and CAF gradually increased, followed by decreasing apoptosis. In vitro stromal-C4-2B cell line co-culture models, the proliferation and apoptosis of C4-2B cell line were differently affected by human various histological/pathological prostate stromal cells. CAF showed the most powerful effect to C4-2B cell line, as opposed to a weakest effect of NPTF. Microarray and hierarchical cluster analysis showed that the differentially expressed genes of CAF and NPPF were less than NPPF and NPTF, or CAF and NPTF. This was consistent with clinical observations that prostate cancer mostly derived from the peripheral zone and does not usually occur in the transitional zone.</p><p><b>CONCLUSION</b>NPPF, NPTF and CAF possess extremely different biological characteristics and gene expression, which may play an important role in genesis and development of prostate cancer.</p>

Characterization of stromal cell cultures from the prostatic peripheral zone of men at different ages / 中华男科学杂志

<p><b>OBJECTIVE</b>To characterize age-related cellular phenotype alterations and growth rates of human prostatic stromal cell cultures from the normal prostatic peripheral zone of young donors (PZ-young) and old donors (PZ-old).</p><p><b>METHODS</b>We isolated stromal cells from 10 donors of different ages, assessed the cellular phenotypes by immunocytostaining for prolyl-4-hydroxylase, alpha-smooth muscle actin (alpha-SMA) and desmin, and analysed the ultrastructure by transmission electron microscopy (TEM). The proliferation and apoptosis of the cells were determined by Cell Counting Kit-8 assay and flow cytometry, respectively.</p><p><b>RESULTS</b>All the stromal cells were positive for prolyl-4-hydroxylase regardless of the donors' age, while alpha-SMA and desmin positive cells increased with their age. The positive expressions of alpha-SMA and desmin were (2.56 +/- 1.81)% and (0.89 +/- 0.93)% in PZ-young, and (38.89 +/- 11.22)% and (14.89 +/- 5.97)% in PZ-old (P < 0.01). The alpha-SMA- and/or desmin-positive stromal cells were morphologically large, flat and polygonal. Ultrastructural analysis showed that the cell cultures from PZ-old were richer in rough endoplasmic reticulum and golgi complexes. The stromal cells of PZ-old had a lower growth rate than that of PZ-young (P < 0.01), but there was no significant difference in the apoptosis rate between the two groups.</p><p><b>CONCLUSION</b>Cellular phenotypes of human prostate stromal cell cultures change with the increase of age from predominantly typical fibroblasts to a mixture of fibroblasts and myofibroblasts, which might responsible for the high incidence of prostate cancer in elderly men.</p>

Effects of inhaled anesthetics on human sperm motility in vitro / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the effects of inhaled anesthetics on human sperm motility in vitro.</p><p><b>METHODS</b>Sperm samples were obtained from 20 healthy men by masturbation and prepared by the swim-up technique. The effects of isoflurane and sevoflurane at the clinical concentration (1.4%-5.6%) and high concentration (5.6%-84%) on human sperm motility in vitro were observed at 25 degrees C by the computer-assisted sperm analysis (CASA).</p><p><b>RESULTS</b>The sperm vitality and motility were significantly increased on 0.5-4 h exposure to isoflurane at the clinical concentration and decreased gradually at high concentration (42%-84%). The effect of isoflurane on human sperm motility and vitality at the clinical concentration was reversible when the anesthetic withdrawn. Sevoflurane had no effects on human sperm motility and vitality at either the clinical or high concentration.</p><p><b>CONCLUSION</b>Isoflurane has a reversible increasing effect at the clinical concentration and a significant decreasing effect at the high concentration on the motility and vitality of human sperm, while sevoflurane does not affect human sperm motility and vitality at either concentration.</p>

Effects of isoflurane combined with diltiazem on human sperm motility / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the effects of isoflurane combined with diltiazem on human sperm motility in vitro and to investigate its possible mechanism.</p><p><b>METHODS</b>Ten normal semen samples were collected, each divided into 9 groups, one as the control and the others treated in vitro with different concentrations of diltiazem or diltiazem +4.2% isoflurane for 1 hour. Sperm motility was observed with the computer-assisted sperm analyzer.</p><p><b>RESULTS</b>Compared with the control, diltiazem significantly decreased sperm motility at the concentrations of 0.01 g/L, 0.04 g/L, 0.2 g/L and 1 g/L in a dose-dependent manner, and reduced it to approximately 0% at 1 g/L. When combined with 4.2% isoflurane, diltiazem obviously increased sperm motility at 0.01 g/L, markedly decreased it at 0.2 g/L, and effected no significant difference at 0.04 g/L and 1 g/L as compared with the corresponding concentrations of diltiazem alone.</p><p><b>CONCLUSION</b>The stimulating effect of isoflurane on sperm motility may be associated with the calcium ion channel in sperm. When completely blocked by diltiazem, this effect may turn into an inhibition of sperm motility.</p>