Short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy for oligometastatic prostate cancer: a propensity score matching study / 中华医学杂志(英文版)

BACKGROUND@#The role of local treatment in oligometastatic prostate cancer (PCa) is gaining interest with the oligometastases hypothesis proposed and the improvement of various surgical methods and techniques. This study aimed to compare the short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy (RALP) for oligometastatic prostate cancer (OPC) vs. localized PCa using propensity score matching.@*METHODS@#Totally 508 consecutive patients underwent RALP as a first-line treatment. The patients were divided into two groups according to oligometastatic state: the OPC group (n = 41) or the localized PCa group (n = 467). Oligometastatic disease was defined as the presence of two or fewer suspicious lesions. The association between the oligometastatic state and therapeutic outcomes of RALP was evaluated, including biochemical recurrence (BCR) and overall survival (OS). A Cox proportional hazards model was used to assess the possible risk factors for BCR.@*RESULTS@#Totally 41 pairs of patients were matched. The median operative time, the median blood loss, the overall positive surgical margin rate, the median post-operative hospital stays, and the post-operative urinary continence recovery rate between the two groups showed no statistical significance. The 4-year BCR survival rates of the OPC group and localized PCa group were 56.7% and 60.8%, respectively, without a significant difference (P = 0.804). The 5-year OS rates were 96.3% and 100%, respectively (P = 0.326). Additionally, the results of Cox regression showed that oligometastatic state was not an independent risk factor for BCR (P = 0.682).@*CONCLUSIONS@#Our findings supported the safety and effectiveness of RALP in OPC. Additionally, oligometastatic state and sites did not have an adverse effect on BCR independently.

Midterm outcome comparison between patients with bicuspid or tricuspid aortic stenosis undergoing transcatheter aortic valve replacement / 中华心血管病杂志

Objective: To compare the prognosis of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) stenosis. Methods: This was a retrospective study. Patients with symptomatic severe aortic stenosis, who underwent TAVR with follow-up time more than one year in Guangdong Provincial People's Hospital from April 2016 to August 2018, were included. According to aortic CT angiography, the patients were divided into BAV group and TAV group. The primary endpoint was the composite event of all-cause death and stroke, and the secondary endpoints were TAVR-related complications. Incidence of clinical endpoints and parameters derived from echocardiography were compared between the groups, and Kaplan-Meier survival analysis was used to compare the composite event between the two groups. Results: A total of 49 patients were included. The age was (73.6±6.3) years, and 25(51.0%) were male. There were 32 patients in BAV group and 17 in TAV group, the follow-up time was 466 (390, 664) days. The incidence of composite endpoint of death and stroke at one year were comparable in BAV and TAV groups (6.3% (2/32) vs. 5.9% (1/17), P=1.00). Kaplan-Meier curves also showed a similar risk of the composite endpoint(HR=1.03，95%CI 0.09-11.24，Log-rank P=0.98) between two groups. The incidence of all-cause death, stroke, myocardial infarction, severe bleeding, major vascular complications, new-onset atrial fibrillation or atrial flutter, and permanent pacemaker implantation were all similar between the two groups(all P>0.05), and there was no acute kidney injury (stage 2 or 3) in both groups. Echocardiographic parameters at one year were similar between the two groups (all P>0.05). Conclusions: The midterm prognosis of TAVR in patients with BAV and TAV stenosis is similar. Clinical trials of large sample size with long-term follow-up are warranted to verify our findings.

MAGI-2 downregulation: a potential predictor of tumor progression and early recurrence in Han Chinese patients with prostate cancer / 亚洲男科学杂志(英文版)

Membrane-associated guanylate kinase (MAGUK) family protein MAGUK invert 2 (MAGI-2) has been demonstrated to be involved in the tumorigenic mechanism of prostate cancer. The objective of this study was to investigate the expression of MAGI-2 at mRNA and protein levels. The prognostic value of MAGI-2 in Han Chinese patients with prostate cancer was also investigated. The expression data of MAGI-2 were assessed through database retrieval, analysis of sequencing data from our group, and tissue immunohistochemistry using digital scoring system (H-score). The clinical, pathological, and follow-up data were collected. The expression of MAGI-2 in prostate tumor tissues and prostate normal tissues was evaluated and compared. MAGI-2 expression was associated with clinical parameters including tumor stage, lymph node status, Gleason score, PSA level, and biochemical recurrence of prostate cancer. The relative expression of MAGI-2 mRNA was lower in the tumor tissue in The Cancer Genome Atlas (TCGA) database and sequencing data (P < 0.001). There was no difference in MAGI-2 protein expression between tumor and normal tissues in tissue microarray (TMA) results. MAGI-2 expression was associated with pathological tumor stage (P = 0.02), Gleason score (P = 0.05), and preoperation prostate-specific antigen (PSA; P = 0.04). A positive correlation was identified between MAGI-2 and phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expressions through the analysis of TCGA and TMA data (P < 0.0001). Patients with higher MAGI-2 expression had longer biochemical recurrence-free survival in the univariate analysis (P = 0.005), which indicates an optimal prognostic value of MAGI-2 in Han Chinese patients with prostate cancer. In conclusion, MAGI-2 expression gradually decreases with tumor progression, and can be used as a predictor of tumor recurrence in Chinese patients.

Surgical treatment of azoospermia caused by iatrogenic injury to bilateral vas deferens / 中华男科学杂志

<p><b>Objective</b>To investigate the treatment of azoospermia induced by iatrogenic injury to the bilateral vas deferens.</p><p><b>METHODS</b>We retrospectively analyzed 11 cases of azoospermia caused by iatrogenic injury to bilateral vas deferens. The patients were aged 20－33 years, all diagnosed with azoospermia preoperatively and none with a history of pelvic operation. Seven of them had received bilateral inguinal hernia repair and the other 4 undergone bilateral orchidopexy in the childhood.</p><p><b>RESULTS</b>Intraoperative exploration of the bilateral inguinal region was performed in all the patients. Bilateral vas deference atresia was found in the inguinal canal in 6 cases, which was treated by microscopic vasovasostomy following removal of the atresic segment. Vas deferens residual was observed in or near the deep inguinal ring in the other 5 cases, with the distal vas deferens inaccessible, which was treated by bilateral vasovasostomy in 3 cases and unilateral vasovasostomy in 2 (for longer defect segment than could be anastomosed) following combined laparoscopic exploration of the abdominal cavity. The patients were followed up for 3－12 months postoperatively, during which sperm were detected in 7 cases, with sperm concentration ranging from 0.4×10⁶/ml to 35×10⁶/ml and grade a+b sperm from 15% to 46%.</p><p><b>CONCLUSIONS</b>For the diagnosis of azoospermia, especially in patients with no history of pelvic operation, special attention should be paid to iatrogenic injury to the vas deferens. For the treatment of the disease, non-tension vasovasostomy is essential and, when necessary, the vas deferens can be reconstructed by changing its anatomical path and shortening its length.</p>

Calyceal diverticulum mimicking simple parapelvic cyst: a case report / 中国医学科学杂志(英文版)

Calyceal diverticulum is a cystic intrarenal cavity lined by nonsecretory transitional epithelium that communicates with the collecting system via a narrow isthmus or infundibulum. It is a rare anatomic anomaly with an incidence of 0.2% to 0.6% in the patients undergoing renal imaging.1 Single imaging modality usually cannot differentiate calyceal diverticulum from other cystic renal diseases.2 Here, we report a 60-year-old male who was reliably diagnosed with calyceal diverticulum by retrograde urography combined with non-enhanced computed tomography (CT) and magnetic resonance urography (MRU).

Late-onset hypogonadism among old and middle-aged males in a rural community of Zhejiang Province / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiology of late-onset hypogonadism (LOH) in old and middle-aged males in the rural area of Southern China.</p><p><b>METHODS</b>Using the age-stratified sampling method, we conducted a questionnaire investigation on androgen deficiency in aging males (ADAM), aging male symptoms (AMS) and IIEF-5 among 996 males aged 40 -80 years in a rural community of Jiashan county, Zhejiang Province from April to October 2012. We also determined the concentrations of serum total testosterone (TT), serum sex hormone binding globulin (SHBG) and serum albumin (ALB), detected the levels of free testosterone (cFT) and bio-available testosterone (Bio-T) by Vermeulen formula, and measured the volumes of the prostate and testis by ultrasonography.</p><p><b>RESULTS</b>The mean age of the males was 56.22 +/- 8.82 years. The positive rates of LOH were 62.86% and 23.05% based on ADAM and AMS, respectively, and the incidence of erectile dysfunction (ED) was 68.83%. There were significant differences among different age groups in the levels of luteinizing hormone (LH), SHBG, cFT and Bio-T, but not in TT concentration.</p><p><b>CONCLUSION</b>Ours was the first survey on the epidemiology of LOH among old and middle-aged males in the rural area of China. The incidence of LOH in the rural community of Zhejiang Province was lower than that in the urban areas reported in other studies, but the positive rate of ED showed no significant difference.</p>

Transurethral seminal vesiculoscopy for refractory or recurrent hemospermia: clinical analysis of 162 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.</p><p><b>METHODS</b>We retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.</p><p><b>RESULTS</b>Wine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.</p><p><b>CONCLUSION</b>Transurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.</p>

Polymorphism of AR gene CAG copy number and late-onset hypogonadism in males / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the association of the androgen receptor (AR) gene CAG-STR with late-onset hypogonadism (LOH), and explore the pathogenesis of LOH.</p><p><b>METHODS</b>Our investigation involved 1 000 men aged 40-70 years. We randomly selected 127 normal old and middle-aged males and 19 cases of LOH. We detected their levels of Triglyceride (TG), fasting blood glucose (FBG), serum total testosterone (tT) and free testosterone (fT), measured their body mass index (BMI), height, waist circumference (WC) and blood pressure, and examined the length of CAG repeats of the AR gene in the peripheral blood by PCR.</p><p><b>RESULTS</b>The numbers of CAG repeats ranged from 15 to 32, with a mean value 23.05 +/- 2.95. The mean BMI and FBG were significantly lower (P < 0.01), but TG, tT and fT remarkably higher in the normal than in the LOH men (P < 0.01), while the mean length of (CAG) n repeat polymorphism showed no statistically significant difference between the two groups (22.54 +/- 3.06 vs 23.23 +/- 2.24, P = 0.946). The frequencies of long alleles (n > or = 22) were significantly higher in the LOH than in the normal men (73.68% vs 48.82%, P < 0.05). The numbers of CAG repeats had no significant correlation with tT (r = 0.04, P > 0.05) and fT (r = 0.025, P > 0.05).</p><p><b>CONCLUSION</b>The AR gene CAG length showed polymorphism in LOH men. The long alleles (CAG)n (n > or = 22) repeat polymorphism in the AR gene may be a genetic factor for LOH, but it has to be confirmed by further investigation.</p>

Lower urinary tract symptoms and prostatic growth pattern among old and middle-aged males in Shanghai community / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of lower urinary tract symptoms (LUTS) and the age-related growth pattern of the prostate among 40 -70 year-old males in Shanghai community.</p><p><b>METHODS</b>Using cluster and stratified random sampling and IPSS, we investigated the prevalence of LUTS among 1000 males aged 40 -70 years in the general population of Shanghai from November 2009 to June 2010. We measured the transverse, anteroposterior and vertical diameters of the prostate and its transition zone in each volunteer by transrectal ultrasonography and established the equation for the age-related growth pattern of the prostate.</p><p><b>RESULTS</b>In the 40 to 49-, 50 to 59- and 60 to 70-year groups, the incidence rates of moderate and severe LUTS (IPSS > or = 8) were 10.0%, 15.0% and 28.7%, respectively. The length, width, height and volume of the prostate and its transition zone were positively corrected with age (P < 0.05). The prostatic growth pattern equations based on the parameters of the transverse, anteroposterior and vertical diameters were Y = 1.6 x 10(-5)X3-0.002 1X2 + 0.074 6X + 0.677 2, Y = -2.4 x 10(-5)X3 + 0.003 3X2-0.1312X + 1.269, and Y = 1.6 x 10(-5)X3-0.001 8X2 + 0.073X- 0.690 9, respectively. The transverse and anteroposterior diameters of the prostate grew at a relatively similar rate, while the transverse diameter grew obviously faster than the vertical diameter before 60 years old, but the latter significantly increased and even exceeded the former after 60 years old.</p><p><b>CONCLUSION</b>The prevalence of LUTS among old and middle-aged males in Shanghai community is similar to that recently reported at home and abroad. The transverse and anteroposterior diameters of the prostate grow at a relatively similar rate, but the vertical diameter increases faster after 60 years old.</p>

A novel set of surgical instruments facilitate the procedure of laparoscopic pyeloplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Open pyeloplasty has been historically described as the gold standard for the surgical treatment of ureteropelvic junction obstruction (UPJO), even if new techniques have recently gained a prominent role in this field. Laparoscopic pyeloplasty (LP) is not widely prevelant because of the technically challenging nature and it represents the gold standard for UPJO only in expert hands. To overcome some difficulties and technical challenges encountered during pure laparoscopic pyeloplasty, we designed a set of new instruments and assessed them using porcine model.</p><p><b>METHODS</b>According to the ideas from the surgeons, our medical engineer designed three new instruments, including the right angle laparoscopy scissors, the petal-shape ureter dilator and the guide tube. Four experienced laparoscopic experts were involved in a no survival porcine study to assess the help of these new instruments. Four experiments were conducted on live pigs that weighed 22 to 25 kg at the same time. After general anesthesia was administered, transperitoneal ureteroureterostomy was performed using standard laparoscopic instruments, including placing the double J stent anterograde. Then, the opposite lateral was done by the same surgeon plus these new devices for side-by-side comparative analysis. All experts were interviewed to assess these new instruments by the questionnaire based on the visual analog scale (VAS) from 1 (none) to 10 (very much).</p><p><b>RESULTS</b>The procedures were all technically successful. The right angle laparoscopy scissors and the guide tube were accepted by all participants and the Help Score were 6.75 and 4.25 respectively, at the same time the New Difficulty Score 1.25 and 1.75. However, the petal-shape ureter dilator got 1.5 Help Score and 6.5 New Difficulty Score. These surgeons made a negative comment and one of surgeons recommended the stone basket was more suitable.</p><p><b>CONCLUSION</b>The right angle laparoscopy scissors and the guide tube may be helpful to minimize some difficulties in pure laparoscopic pyeloplasty.</p>

Ultrasonic endoscopy in retroperitoneal laparoscopic nephron-sparing surgery for endogenous renal tumor i an initial experieiice / 第二军医大学学报

Objective To assess the feasibility of using ultra sonic endoscopy in retroperitoneal laparoscopic nephron-sparing surgery for treatment of endogenous renal tumor, and to summarize our clinical experience. Methods A female patient, aged 28 years old, was found to have a mass (diameter1.4cm×1.0cm, clinical stage T1aN0M0)in the right upper part of the kidney. Retroperitoneal laparoscopic nephron? Sparing surgery was performed. The tumor could not be accurately located during the operation due to the smooth renal surface; then ultrasonic endoscopy was used to locate the tumor; and color Doppler mode was used to observe the blood supply of the tumor and its relation with surrounding tissues. The nephron-sparing surgery was performed following the guidance of ultrasonic endoscopy positioning; the integrity of tumor resection and surgical margin were also observed. Results The involvement of the tumor an dits blood supply were clearly displayed by ultrasonic endoscopy. Nonoticeable signals of blood flow were seen around the tumor after blocking the renal artery, and the tumor was totally and thoughly removed with a negative margin of 0.5-1.0cm.There was no transfer to opening surgery. The procedure of ultrasonic endoscopy last ed for 5 min. Post operative pathological results in dicated angiomyolipoma with negative margins. Conclusion Our initial clinical practice suggests that ultrasonic endoscopy is safe and benificial for retroperitoneal laparoscopic nephron-sparing surgery in treatment of endogenous renal tumors, especially for observing the tumor location, tumor blood supply, and the integrity of resection.

Long-term efficacy and safety of tamsulosin hydrochloride for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: data from China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tamsulosin hydrochloride can significantly improve benign prostatic hyperplasia (BPH) symptoms after the first dose and achieve long-term efficacy in European and American populations; however, the corresponding studies from China are rarely seen. The purpose of this study was to evaluate the long-term efficacy and safety of tamsulosin hydrochloride 0.2 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of BPH in China.</p><p><b>METHODS</b>Chinese patients with LUTS suggestive of BPH were enrolled in a 4-week placebo run-in period and subsequent 60-week open-label study. Tamsulosin hydrochloride 0.2 mg was administered daily during the period of the study. The efficacy and safety parameters were evaluated at the end of treatment period I (0 - 12 weeks) and period II (13 - 60 weeks). The BPH patients were divided into tamsulosin monotherapy group and combination therapy group which received concomitant medication of finasteride 5 mg once daily after the evaluation at the end of treatment period I.</p><p><b>RESULTS</b>A total of 113 patients were recruited to the study. Eighty-two patients received tamsulosin monotherapy and twenty-nine received combination therapy during the treatment period II. Tamsulosin hydrochloride produced a great improvement in mean maximum urinary flow rate (Q(max)) (1.7 ml/s, 3 ml/s) and a significant decrease in mean international prostate symptom score (IPSS) (4.1, 6.4) after 12-week and 60-week treatments, respectively. At the end of treatment period II, there were significant improvement in IPSS, quality of life (QOL) score, Q(max) and average flow rate (Q(ave)) for combination therapy group compared with the treatment period I (all P < 0.05). No serious adverse events (SAE) were recorded during the study.</p><p><b>CONCLUSION</b>Long-term tamsulosin hydrochloride therapy is a safe, effective and well-tolerated method for the treatment for LUTS suggestive of BPH in China.</p>

Differential proteome analysis of conditioned medium of BPH-1 and LNCaP cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although the introduction of serum prostate-specific antigen (PSA) measurements into clinical practice has revolutionized the care of patients with prostate cancer, there are well-recognized limitations of PSA, and there is a critical need to identify additional prostate cancer biomarkers to assist in early detection and prognosis. In this regard, high resolution proteomic technology has the unexceptionable superiority to find those high abundance biomarkers. The purpose of this study was to search new tumor markers by proteomic technology.</p><p><b>METHODS</b>The proteins in conditioned medium (CM) of BPH-1 and LNCaP cells were profiled by two-dimensional electrophoresis and identified by matrix-assisted laser desorption ionization mass spectrometry (MALDI-TOF-MS). The corresponding mRNA levels of some identified proteins were analyzed by RT-PCR.</p><p><b>RESULTS</b>Totally 11 differentially expressed proteins (6 up-regulated including creatine kinase, brain (CKB), triosephosphate isomerase 1 (TPI1), isocitrate dehydrogenase 2 (IDH2) and 5 down-regulated including glutathione S-transferase pi (GST-pi)) in the CM were identified using MALDI-TOF-MS and database search. The expression pattern between mRNA and CM protein levels of CKB, IDH2, TPI1 and GST-pi in BPH-1 and LNCaP was similar.</p><p><b>CONCLUSION</b>We proved a feasible and effective way to search new tumor markers by a proteomics-based strategy and identified 11 potentially useful proteins in CM of BPH-1 and LNCaP cells to distinguish prostate cancer from benign prostatic hypertrophy.</p>

Prostate cancer cell line PC-3 conditioned medium promotes proliferation and osteogenic differentiation of human bone marrow mesenchymal stem cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of prostate cancer cell line PC-3 conditioned medium (PC- 3-CM) on the proliferation and osteogenic differentiation of human bone marrow human basalis mesenchymal stem cells (hBMSCs).</p><p><b>METHODS</b>hBMSCs were isolated and culture-expanded by density gradient centrifugation from normal volunteers. PC-3 cells were cultured till the time of logarithmic growth and then transferred to a fresh medium, which, after 24 hours of incubation, was collected as PC-3-CM. Passage 3 hBMSCs were cultured in the fresh medium alone (the control group) or that with 50% PC-3-CM (the experimental group), and the effect of PC-3-CM on the proliferation activity of the hBMSCs was detected by WST-8 assay. Based on the types of medium used, the hBMSCs were divided into Groups I (control), II (50% PC-3-CM), III (osteoblast inducer) and IV (osteoblast inducer containing 50% PC-3 CM). The effects of PC-3-CM on the osteoblastic differentiation of the hBMSCs were determined by ALP staining, ALP activity detection, Von Kossa staining, and calcium quantitation.</p><p><b>RESULTS</b>At 1, 3, 5 and 7 days of incubation, the absorbance values of the cells in the experimental group were 0.4370 +/- 0.0285, 0.7980 +/- 0.0213, 1.9090 +/- 0.0612 and 2.3023 +/- 0.0610, and those in the control group were 0.4060 +/- 0.0223, 0.6643 +/- 0.0075, 1.3727 +/- 0.0176 and 1.7947 +/- 0.0115, respectively, with significant differences between the two groups (P < 0.01) except on day 1 (P > 0.05). The positive rate and intensity of ALP staining were gradually increased in the four groups, with the ALP activities of 0.29 +/- 0.03, 1.30 +/- 0.03, 2.13 +/- 0.08, and 3.80 +/- 0.03, respectively (P < 0.01), and so was the intensity of Von Kossa staining, with the calcium depositions of 0.04 +/- 0.01, 0.44 +/- 0.05, 0.98 +/- 0.03, and 1.27 +/- 0.04, respectively (P < 0.01).</p><p><b>CONCLUSION</b>PC-3- CM can promote the proliferation and osteogenic differentiation of human bone marrow mesenchymal stem cells.</p>

Adult male circumcision for military men: history and future / 中华男科学杂志

Adult male circumcision (MC) has been shown to reduce the transmission of HPV, HSV, and HIV significantly during vaginal intercourse. However, the benefits of adult MC for men in military service have been poorly documented. Soldiers in war time have additional challenges in maintaining good penile hygiene, rendering uncircumcised men vulnerable to inflammation and infection; these maladies not only negatively impact these individuals, but also undermine the overall military strength. Adult MC can provide some long-term benefits for these military service men. Many African countries have already taken a special interest in adult MC for their military forces, resulting in increased numbers of these surgeries among this special population of men. In this review, we discuss the history of adult MC in the military along with the current trends and economic significance.

Induction of prostate cancer-specific CTLs with dendritic cells pulsed by different types of tumor antigens / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the effectiveness of freeze-thaw antigens and acid eluted peptide antigens extracted from tumor cell-pulsed dendritic cells (DC) in inducing prostate cancer-specific cytotoxic T lymphocytes (CTL) in vitro.</p><p><b>METHODS</b>Tumor antigens were extracted from the prostate cancer cell line PC-3 with the repeated freeze-thaw and weak acid elution methods. Peripheral blood mononuclear cells were cultured with recombinant human GM-CSF and IL-4 for inducing DCs in vitro. Then the DCs were pulsed with the two kinds of prostate cancer tumor antigens respectively and cultured with T cells for inducing CTLs. The activity of the tumor-specific CTLs were detected by LDH release assay.</p><p><b>RESULTS</b>The protein content in the tumor antigens obtained from PC-3 (2 x 10(7)) by citric acid-phosphate buffer elution and that by the repeated freeze-thaw method were (212.2 +/- 7.9) microg and (963.0 +/- 25.3) microg, respectively. The two kinds of prostate cancer antigens-pulsed DCs had a significant role in inducing the PC-3 cell-specific CTLs, and the CTLs induced by acid-eluted peptide antigen-pulsed DCs exhibited an even more significant tumor-specific cytotoxicity than those induced by repeated freeze-thaw ([60.4 +/- 5.52]% vs. [43.7 +/- 4.11]%, P < 0.01).</p><p><b>CONCLUSION</b>Both the weak acid elution and repeated freeze-thaw methods for extracting prostate cancer antigens can be used for in vitro sensitization of DCs. The DCs pulsed by either of the two kinds of antigens can activate CTLs, and the antigens extracted by weak acid elution are even more effective.</p>

Expressions of the androgen receptor in normal prostate, benign prostatic hyperplasia and prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the expressions of the androgen receptor (AR) in the normal prostate, benign prostatic hyperplasia and prostate cancer (PCa), and investigate the relationship of AR with prostatic hyperplasia and PCa.</p><p><b>METHODS</b>The expressions of AR were detected in 15 normal prostate, 20 benign prostatic hyperplasia and 40 PCa samples by immunofluorescent staining, real-time PCR and Western blotting.</p><p><b>RESULTS</b>Real-time PCR and Western blotting revealed no statistically significant differences in the expressions of AR between the normal prostate and prostatic hyperplasia groups (P < 0.05), while immunofluorescent staining exhibited an increase of the expression in the BPH tissues. All the three methods showed that the AR expression was significantly higher in the PCa than in the normal prostate and prostatic hyperplasia groups (P < 0.05), in the well differentiated than in the poorly differentiated tumor, and in the early than in the advanced stage (P < 0.05), but the lowest in the hormone-refractory PCa (HRPC) tissue.</p><p><b>CONCLUSION</b>The expression of AR is higher in PCa than in normal prostate and prostatic hyperplasia tissues, and is correlated with the pathological grade and clinical stage of PCa.</p>

Nonsteroidal anti-inflammatory drug NS398 induces RECK expression in the animal model of prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the regulatory effect of the nonsteroidal anti-inflammatory drug NS398 on the expression of the RECK gene in the animal model of prostate cancer.</p><p><b>METHODS</b>Nude mouse models of prostate cancer were divided into an experimental and a control group, the former fed with NS398 at 0.1 mg/g per day for 10, 20 and 30 days, while latter left without medication. All the mice were killed at 30 days, the mRNA expressions of RECK and MMP-9 in the tumor tissues measured by RT-PCR, and the protein level of RECK evaluated by Western blot.</p><p><b>RESULTS</b>Both the mRNA and protein expressions of RECK were increased, while the level of MMP-9 decreased, in an obviously time-dependent manner in the experimental group as compared with the control.</p><p><b>CONCLUSION</b>NS398 obviously inhibits the pathogenesis and metastasis of prostate cancer, which may be attributed to its induction of the expression of the RECK gene and suppression of the expression of MMP-9.</p>

Age-specific PSA reference ranges in Chinese men without prostate cancer / 亚洲男科学杂志(英文版)

This study is to determine age-specific prostate-specific antigen (PSA) distributions in Chinese men without prostate cancer (PC) and to recommend reference ranges for this population after comparison with other studies. From September 2003 to December 2006, 9 374 adult men aged from 18 to 96 years agreed to participate in the study. After all cases of PC were excluded, 8 422 adult men participated in statistical analysis and were divided into five age groups. Simple descriptive statistical analyses were carried out and quartiles and 95th percentiles were calculated for each age group. The age-specific PSA reference ranges are as follows: 40-49 years, 2.15 ng mL(-1); 50-59 years, 3.20 ng mL(-1); 60-69 years, 4.10 ng mL(-1); 70-79 years, 5.37 ng mL(-1). The results indicate that the ethnic differences in PSA levels are obvious. The currently adopted Oesterling's age-specific PSA reference ranges are not appropriate for Chinese men. The reference ranges of this study should be more suitable to Chinese men.

Neoadjuvant hormonal deprivation for patients undergoing radical prostatectomy / 亚洲男科学杂志(英文版)

The purpose of this study is to evaluate the therapeutic effect of radical prostatectomy combined with preoperative neoadjuvant hormonal ablation therapy for prostate cancer (PCa). In this study, a total of 31 patients with local PCa underwent radical prostatectomy; of these, 12 patients underwent preoperative hormonal deprivation with a combination of goserelin and flutamide for a period of 5.6 months. Data regarding clinical characteristics were compared between the neoadjuvant therapy and radical prostatectomy groups. A total of 31 patients received pelvic lymph node clearance, and the rate of positive lymph nodes was 12.9% (4/31). Serum prostate-specific antigen (PSA) was 8.9 +/- 1.2 microg L(-1) after the neoadjuvant therapy and 0.4 +/- 0.3 microg L(-1) one month after the radical prostatectomy. There were significant differences in the positive surgical margins, seminal vesicle invasion and lymph node metastasis between the neoadjuvant therapy group (n = 12) and the radical prostatectomy group (n = 19, P < 0.01). The resulsts indicates that preoperative hormonal deprivation induced by goserelin and flutamide can decrease clinical and pathological staging, but assessment of its influence on long-term prognosis requires further study.