Preliminary investigation of intestinal microflora in patients with hepatic cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To examine the differential levels of fecal Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, and Clostridium difficile between patients with hepatic cirrhosis and healthy controls. Fecal samples were collected from 29 patients with hepatic cirrhosis treated in the Department of Digestive Diseases at Zunyi Hospital between March and December of 2010.</p><p><b>METHODS</b>Fecal samples were collected from 13 healthy college students for use as controls. All samples were assessed by pH measurement, bacterial culture for turbidity, fluorescence in situ hybridization, and laser scanning confocal microscopy. The t-test and rank correlation test were used to determine statistical significance of intergroup differences in each tested parameter.</p><p><b>RESULTS</b>The feces of patients with hepatic cirrhosis had higher pH than that of healthy controls (6.79+/-0.64 vs. 6.18+/-0.74, P less than 0.05). The bacterial turbidity was not significantly different between the feces of hepatic cirrhosis patients and healthy controls (1.15+/-0.59 vs. 1.39+/-1.01, P more than 0.05). The numbers of Bifidobacterium, Bacteroides, Eubacterium rectale-Clostridium, Escherichia coli, Enterococcus, and Clostridium difficile in feces of patients with hepatic cirrhosis were significantly lower than those of the controls (all P less than 0.01). No significant correlation was found between the number or ratio of bacteria species and the severity of hepatic cirrhosis (Child-Pugh scores; P more than 0.05).</p><p><b>CONCLUSION</b>The total quantity of intestinal bacteria in patients with hepatic cirrhosis is not significantly different from that in healthy patients. However, the profile of intestinal bacteria is different, which may explain the increased pH of fecal samples from patients with hepatic cirrhosis, but the differential profile is not correlated to cirrhosis pathogenesis.</p>

Expression and significance of macrophage migration inhibitory factor in bladder urothelial cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the expression and clinical significance of macrophage migration inhibitory factor (MIF) in patients with bladder urothelial cell carcinoma.</p><p><b>METHODS</b>Immunohistochemical staining for MIF was performed on tissue sections of 110 patients with bladder urothelial cell carcinoma and 10 normal controls, and the correlations between MIF and clinicopathological characteristics and prognosis were also analyzed.</p><p><b>RESULTS</b>Normal bladder urothelium from control subjects showed negative or weak staining of MIF. Of the cancer specimens, 72/110 (65.5%) showed a moderate to strong staining of MIF. The expression of MIF protein was found predominantly in the tumor cell cytoplasm and inversely correlated with tumor stage. 27 cases also showed a positive intranuclear staining of MIF, which was inversely correlated with tumor grade, stage and tumor size. Kaplan-Meier analysis showed that the expression of MIF in the cell nuclei was associated with disease-free survival for the cancer patients, but multivariate analysis showed that MIF was not an independent prognostic factors.</p><p><b>CONCLUSIONS</b>The expression of MIF in non-muscle invasive bladder cancer tissues was more frequently than that in muscle-invasive disease, the positive staining of MIF in cell nuclei might be a favorable biomarker for patients with bladder urothelial cell carcinoma.</p>

Establishment of a rat model of erectile dysfunction after radical prostatectomy by crush injury or resection of the cavernous nerve / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rat model mimicking erectile dysfunction following radical prostatectomy by crush injury or reaction of the cavernous nerve (CN).</p><p><b>METHODS</b>Thirty rats were randomized into CN crush group, CN resection group and sham-operated group. Four weeks after surgery, the rat models were evaluated by apomorphine test and ICP/MAP measurement. Fluorogold (FG) retrograde tracer was used to assess the CN injury. The penile tissues were then harvested for immunohistochemical detection of the nNOS-positive fibers to evaluate the CN injury.</p><p><b>RESULTS</b>The rats in CN crush group and CN resection group exhibited erectile dysfunction in apomorphine test or in response to electrical stimulation of the ganglion stellatum (MPG). In the sham-operated group, the rats showed normal erectile function with increased ICP/MAP following electrical stimulation (P<0.05). Immunohistochemistry revealed reduced nNOS-positive fibers in both CN crush group and CN resection group as compared with those in the sham-operated group (P<0.05), showing no significant difference between the former two groups (P>0.05). The FG-positive MPG cells in CN crush group and CN resection group were significantly less than that in the sham-operated group (P<0.05), and the positive cells were even less in CN resection group (P<0.05).</p><p><b>CONCLUSION</b>The rat CN is structurally similar to human CN, and crush injury and resection of the CN are both reliable methods for establishing rat models of erectile dysfunction following radical prostatectomy.</p>

The diagnosis and treatment of the Mullerian duct cyst: 48 cases report / 中华外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment methods of Mullerian duct cyst.</p><p><b>METHODS</b>The records of 48 patients with Mullerian duct cyst were reviewed and the diagnosis and treatment methods were compared. From January 1993 to December 1997, eight patients visited the clinic, most of whom complained of the chronic prostatitis symptom. They all underwent the transrectal ultrasonography (TRUS). Seven patients were treated by transperineal TRUS-guided aspiration therapy. One patient with the large Mullerian duct cyst was extirpated by open operation. From January 2002 to December 2007, we treated forty patients. Most of them visited us complained of the obstructive azoospermia. All patients were diagnosed by the TRUS and twelve patients underwent MRI examine. Thirty-nine patients with smaller Mullerian duct cyst were treated by transurethral cyst incision therapy. One patient with large Mullerian duct cyst was extirpated by laparoscopic operation.</p><p><b>RESULTS</b>One of the eight patients, recurrence was detected at the half-year's follow-up and cured by transurethral cyst incision. All the 40 patients underwent TRUS at three months postoperative follow-up, no cysts recurrence. At the six months postoperative follow-up, ten of thirty-nine patients obstructive azoospermia patients had made their wives pregnant successfully. Nine patients of the other twenty-nine patients had sperms in semen. One 19 years old patient's symptom disappeared.</p><p><b>CONCLUSIONS</b>The patient with Mullerian duct cyst often complained of chronic prostatitis symptom and the obstructive azoospermia. TURS was the preferred examine method in the diagnosis of the Mullerian duct cyst. And MRI could offer more exact informations. Transurethral cyst incision was effective methods for Mullerian duct cyst. Laparoscopic Mullerian duct cyst resection was a good choice for the large cysts.</p>

Value of 3D 1H-MRS with body coil at 3T in the differential diagnosis of the prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the value of three dimensional proton magnetic resonance spectroscopy (3D 1H-MRS) with body coil at 3T in the differential diagnosis of prostate cancer.</p><p><b>METHODS</b>Forty patients suspected of prostate cancer underwent MRI and MRS examinations, and then transrectal ultrasound guided prostate biopsy for pathological diagnosis. The MRI and MRS features of benign prostate hyperplasia, prostate cancer and prostatic intraepithelial neoplasia (PIN) were analyzed in comparison with the pathological reports, and the receiver operating characteristic curve was drawn for the diagnosis of cancer from peripheral zones.</p><p><b>RESULTS</b>The examinations were accomplished for all the patients. The mean ratios of (Cho + Cre)/Cit in the interstitial and glandular hyperplasia tissues, the cancer tissue of the central and peripheral glands, the healthy peripheral gland and PIN were 0.75 +/- 0.23, 0.59 +/- 0.14, 1.79 +/- 0.90, 1.18 +/- 0.95, 0.46 +/- 0.18, and 0.97 +/- 0.10, respectively, with statistically significant differences between the cancer and normal prostate tissues (P < 0.01). The optimum threshold for the diagnosis of prostate cancer in the peripheral zone was 0.68 with a sensitivity of 88.6% and a specificity of 88.7%.</p><p><b>CONCLUSION</b>The 3D 1H-MRS with body coil at 3T has a high sensitivity and specificity in the differential diagnosis of prostate cancer, and can provide valuable information for the diagnosis of PIN.</p>

Value of transrectal ultrasonography in the diagnosis of midline prostatic cysts / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the value of transrectal ultrasonography (TRUS) in the diagnosis of midline prostatic cysts.</p><p><b>METHODS</b>We retrospectively analyzed the TRUS manifestations of 87 cases of midline prostatic cysts.</p><p><b>RESULTS</b>Of the total number, 33 cases were diagnosed as Müllerian duct cysts, 21 cases ejaculatory duct cysts and the other 33 cases undifferentiated midline prostatic cysts; 19 cases had dilated seminal vesicles, 19 seminal vesicle agenesis, 9 seminal vesiculitis and 5 dilation of the ejaculatory duct.</p><p><b>CONCLUSION</b>TRUS, convenient, sensitive, safe and non-invasive, is a desirable method for the diagnosis of midline prostatic cysts.</p>

Diagnosis and treatment of primitive neuroectodermal tumor of the penis: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and pathological characteristics, treatment and prognosis of peripheral primitive neuroectodermal tumor (PNET) of the urinary tract and reproductive system.</p><p><b>METHODS</b>The clinical data and pathological characteristics of a PNET patient was analyzed and relevant literature reviewed.</p><p><b>RESULTS</b>The diagnosis was established by pathological and immunohistochemical method. The patient underwent radical surgery, followed by chemotherapy.</p><p><b>CONCLUSION</b>Pathology and immunohistochemistry help the diagnosis of PNET. For the treatment of the tumors in the early stage, surgery is the best choice, and for that in the late stage, it can be followed by chemotherapy. The PNET of the penis is a rare disease and evidence still lacks for the evaluation of its prognosis.</p>

Clinical analysis of renal cell carcinoma: report of 271 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of renal cell carcinoma.</p><p><b>METHOD</b>From January 1993 to December 2000 the data of 271 cases of renal cell carcinoma were reviewed.</p><p><b>RESULTS</b>Ultrasonography and CT scanning were still the main diagnostic methods. Surgical operation was performed on 234 patients. Radical nephrectomy was performed on 197 patients (72.6%); Nephron sparing surgery was performed on 19 patients; Metastatic tumor resection was performed on 6 patients and other procedures for 12. The pathological results showed that 137 cases (61.4%) were clear cell carcinoma, 18 cases (8. 1%) of granular cell carcinoma, 32 cases (14. 3%) being combination of the above two varieties, 23 cases (10.3%) of renal papillary adenocarcinoma, 13 cases being renal cell of other types. And 210 cases (77.5%) had been successfully followed up. The 1, 3, 5 and 10 year survival rates were 95.3% (182/191), 88.7% (107/122), 74.7% (56/75) and 32.1% (10/31) respectively.</p><p><b>CONCLUSIONS</b>Ultrasonography is the first select examination method of detecting of renal cell carcinoma, and CT scanning is the most valuable diagnostic mean. Early diagnosis and prompt radical nephrectomy or nephron sparing nephrectomy are the critical points for achieving long-term survivals of patients with renal cell carcinoma.</p>

A clinical study of sertraline and vardenafil in the treatment of premature ejaculation complicated by erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of sertraline and vardenafil in the treatment of patients with concomitant erectile dysfunction (ED) and premature ejaculation (PE).</p><p><b>METHODS</b>Sixty patients with concomitant ED and PE received at our clinic of andrology were randomly divided into a vardenafil group and a sertraline group. The vardenafil group received flexible doses of vardenafil from 10 mg to 20 mg and the sertraline group 50 mg daily, both for 2 months. The differences in IIEF-5 before and after the treatment were recorded and compared, and the results of ED treatment evaluated. Intravaginal ejaculatory latency time (IELT) was recorded to evaluate the outcome of PE treatment.</p><p><b>RESULTS</b>In the vardenafil group, 24 patients had their ED improved and the efficacy rate was 80%, as compared with 27% in the sertraline group. There was significant difference between the two groups (P < 0.05). Twenty patients had their PE improved in vardenafil group, with an efficacy rate of 67% as compared with 40% in the sertraline group. The difference was significant between the two groups (P < 0.05). In both of the two groups, a significantly higher rate of PE improvement was found in patients with improved ED than in those without. Only mild side effects were recorded, and none withdrew from the treatment.</p><p><b>CONCLUSION</b>To patients with concomitant ED and PE, the key to the treatment is to improve their erectile function, and for this purpose, vardenafil works better than sertraline.</p>

siRNA knocks down the expression of AR gene in PC3 cell lines / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the suppression of the expression of androgen receptor (AR) gene in PC3 cells after AR-specific siRNAs transfection, and to search for the siRNA (s) with the greatest suppressing efficiency.</p><p><b>METHODS</b>Five AR-specific siRNAs were selected, RNAi expression vectors were constructed and transfected into PC3 cells, and the AR expression was detected by real time FQ-PCR and Western blot. A nonsense small RNA was set as negative control.</p><p><b>RESULTS</b>Compared with the control group, the AR expression decreased in various degrees in the 5 experimental groups (P < 0.05), and siRNA1, siRNA4 and siRNA5 showed the greatest suppressing efficiency as compared with the other experimental groups, with statistically significant difference (P < 0.05).</p><p><b>CONCLUSION</b>The AR-specific siRNAs could suppress the endogenous expression of target gene. Three siRNAs with great suppressing efficiency were identified and the expression vectors were constructed successfully. It can be applied in the future researches in vivo.</p>

Diagnostic value of urodynamic parameters multianalysis in the evaluation of bladder outlet obstruction resulting from benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To construct a function model that can be used in the diagnosis bladder outlet obstruction (BOO) resulting from benign prostatic hyperplasia, and to develop a diagram allowing the judgement of bladder outlet for patients with different detrusor contractility, especially with impaired one.</p><p><b>METHODS</b>Urodynamic and clinical data of 131 men were analyzed retrospectively. By Logistic analysis, a function model was constructed. Based on the model, a diagram allowing the evaluation of bladder outlet was drawn. The cutoff point for diagnosing BOO with the function model and the curve was confirmed by ROC curve analysis.</p><p><b>RESULTS</b>The function model (BOOI) was obtained by the formula 5.03 x residual fraction + 0.04 x PdetatQmax - 0.20 x Qmax - 0.91 + alpha (alpha = 0 for those with low pressure-low flow on P-FS, alpha = 1.42 for high pressure-low flow, alpha = -7.30 for high pressure-high flow). The cutoff point for BOOI diagnosing BOO was 0.36. When validated, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.7%, 91.7%, 96.0% and 73.3% respectively.</p><p><b>CONCLUSION</b>The BOOI, with an easy calculation mode, could predict the probability of BOO. The sensitivity and specificity of the criterion for the diagnosis of BOO were satisfactory. The curve we drew could help to differentiate the obstructed men with low pressure-low flow and thus benefit them by surgical relief of their obstruction.</p>

Persistent Muellerian duct syndrome with transverse testicular ectopia / 亚洲男科学杂志(英文版)

Persistent Muellerian duct syndrome (PMDS) is a rare form of male pseudohermaphrodism without the feature of ambiguous genitalia. We present a case of PMDS with transverse testicular ectopia (TTE).

Endotoxins in the prostatic secretions of chronic prostatitis patients / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients.</p><p><b>METHODS</b>The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate.</p><p><b>RESULTS</b>Patients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 +/- 32.83 EU/L vs. 4.77 +/- 4.14 EU/L (P <0.05)]. The levels of endotoxins in CP type II, type IIIa and type IIIb were 68.62 +/- 34.78 EU/L, 45.30 +/- 23.33 EU/L and 15.83 +/- 5.31 EU/L, respectively [type II vs. type IIIa (P >0.05), type IIIb vs. normal controls (P <0.05), type II/type IIIa vs. normal controls P >0.05)].</p><p><b>CONCLUSION</b>CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.</p>