Exploration on the reformation of epidemiology teaching mode for postgraduates / 中华流行病学杂志

Objective: To explore the suitable teaching mode of epidemiology for postgraduates, so as to provide techniques for improving and enhancing the teaching quality. Methods: The course was divided into three stages according to the teaching progress, which was, traditional teaching, traditional teaching and case discussion, online learning and case discussion. The test scores in three stages were compared respectively, and the students' willingness to teaching methods was investigated by questionnaire. Results: The scores of 214 students showed an upward trend in three stages, and the differences were statistically significant (P<0.001). Most students paid more attention to the knowledge systematization and important knowledge. Most students proposed that the teaching time between theoretical knowledge and case discussion should be evenly distributed. More students chose Chinese literature related to their major as teaching cases. Most students believed that case discussion improved the skills of self-study and communication. Conclusion: The epidemiology course for postgraduate should integrate the traditional teaching and case discussion, with online learning as a supplementary, and take effective methods to evaluate, so as to improve the teaching quality of postgraduate.

Establishment of a rat model of low calcium diet related hyperoxaluria / 中国医学科学院学报

<p><b>OBJECTIVE</b>To establish a rat model of low calcium diet related hyperoxaluria and explore its features.</p><p><b>METHODS</b>By means of randomized blocks design, totally 24 SD male rats were divided into low calcium diet group, medium calcium diet group, and high calcium diet group. Each group was sequentially fed on different calcium diets for 3 days. The urinary volume within 24 hours was recorded, the consistency of urinary oxalate by high-efficiency liquid chromatography, and the consistency of urine creatinine by automatic biochemical analyzer. The consistency was corrected to the output of urinary oxalate of rats in 24 hours, and the results were evaluated by repeated measurement of variance analysis and multivariate analysis of variance.</p><p><b>RESULTS</b>The output of urinary oxalate of rats in 24 hours varied with time (F=7.893, P0.05). The output of urinary oxalate of rats in 24 hours varied with group division (F=3.565, P<0.05). The output of urinary oxalate in 24 hours in three groups on the third day was significantly higher than that on the first day (P<0.05).</p><p><b>CONCLUSION</b>By controlling the calcium intake, we successfully established the model of low calcium diet related hyperoxaluria in rat.</p>

Prognostic value of Her-2/neu and clinicopathologic factors for evaluating progression and disease-specific death in Chinese men with prostate cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Her-2/neu gene overexpression has been found in several malignancies, and is associated with poor prognosis; while its role in the tumorigenesis and progression of prostate cancer (PCa) is still controversial. This study aimed to evaluate the prognostic value of Her-2/neu protein expression and clinicopathologic factors in antiandrogen-treated Chinese men with PCa for disease progression and PCa-specific death.</p><p><b>METHODS</b>Her-2/neu protein expression was determined using immunohistochemistry (IHC) in specimens collected from 124 prostate biopsies and transurethral resection of prostate (TURP) from seven prostate cancer patients.</p><p><b>RESULTS</b>Her-2/neu protein expression was 0, 1+, 2+, and 3+ in 40 (30.5%), 8 (6.1%), 67 (51.1%), and 16 (12.2%) cases, respectively. Her-2/neu protein expression showed significant correlation as judged by Gleason score (P = 0.049), clinical tumor-node-metastases (cTNM) stage (P = 0.018) and disease progression (P = 0.001), but did not correlate with prostate-specific antigen (PSA) (P = 0.126) or PCa-specific death (P = 0.585). PSA (P = 0.001), Gleason score (P = 0.017), cTNM (P = 0.000) and Her-2/neu protein expression (P = 0.001) had prognostic value for evaluating the progression of PCa in univariate analysis. In Kaplan-Meier plots, both Gleason score (P = 0.035) and cTNM (P = 0.013) correlated with PCa-specific death. In multivariate analysis, only cTNM was significant for both disease progression (P = 0.001) and PCa-specific death (P = 0.031).</p><p><b>CONCLUSIONS</b>Her-2/neu protein expression is significantly correlated with Gleason score, cTNM and disease progression, although it is not an independent predictor of disease progression and PCa-specific death. cTNM staging serves as an independent prognostic factor for disease progression and PCa-specific death.</p>

A proteomic study of the serum proteins in BPH and HGPIN patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate two-dimensional gel electrophoresis (2DGE) and mass spectrometry in the studies of the serum proteins expressed in patients with BPH and those with high-grade prostatic intraepithelial neoplasm (HGPIN).</p><p><b>METHODS</b>We extracted serum proteins from BPH and HGPIN patients by 2DGE and cut the differentially expressed interesting protein spots from the gel. Then we digested the proteins, obtained the peptide mass fingerprint by mass spectrometry and identified the proteins through database retrieval.</p><p><b>RESULTS</b>We successfully achieved the 2DGE maps of the serum proteins from the BPH and HGPIN patients, obtained 1 421-1 532 protein spots from the 2D map of HGPIN and 1 466-1 778 from that of BPH. Based on peptide mass fingerprinting, 9 of the protein spots were identified. Serum amyloid A was found to be expressed in the HGPIN group, but weakly or not at all in the BPH.</p><p><b>CONCLUSION</b>Proteomics can be applied to the study of the serum proteins in BPH and HGPIN patients. It can afford experimental evidence for the early diagnosis and development HGPIN, promote the search of functional and specific proteins of prostate diseases and shed new light on the network mechanisms of the problems.</p>

Efficacy and safety of long-acting gonadotropin-releasing hormone analogue in the treatment for metastatic prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gonadotropin-releasing hormone analogue (GnRHa) triptorelin 11.25 mg 3-month sustained release formulations in the treatment of metastatic prostate cancer.</p><p><b>METHODS</b>From January 2004 to March 2006, a randomized, parallel-controlled, multicenter clinical trial was conducted. One hundred and twenty-seven patients with documented metastatic prostate cancer were randomized to receive one injection of the 11.25 mg formulation triptorelin (n = 65) or three injections at 28-day intervals of the 3.75 mg formulation (n = 62). Changes from baseline of TPSA, prostate volume, testosterone, LH, FSH, PRL and estradiol were assessed over 3 months. Changes of the metastatic lesions were also observed and evaluated. The occurrences of adverse events were evaluated as well.</p><p><b>RESULTS</b>After 3 months treatment, total PSA level decreased significantly from baseline both in 11.25 mg group and 3.75 mg group. At 30, 60 and 90 days, TPSA (median level) declined from 164.55 microg/L into 11.34, 4.12, 3.89 microg/L in 11.25 mg group, and from 101.38 microg/L into 6.88, 2.41, 2.57 microg/L in control group respectively. The patients ratio with over 90% decreasing from TPSA baseline were 78.6% and 75.5% respectively in two groups (P = 0.700). Prostate volume were also decreased significantly in both groups, median volume declined from 48.0 mm(3) into 21.5 mm(3) in 11.25 mg group and from 45.0 mm(3) into 21.0 mm(3) in 3.75 mg group. No significant differences were found between the two groups in changes of TPSA (P = 0.601) and prostate volume (P > 0.05). Both formulations were able to induce castration levels, 0.31 microg/L in 11.25 mg group and 0.26 microg/L in 3.75 mg group (P > 0.05). 13.8% and 17.7% of adverse events were recorded respectively in two groups, and no differences were found (P = 0.547).</p><p><b>CONCLUSION</b>As a new long-acting sustained release formulation, triptorelin 11.25 mg is comparable to triptorelin 3.75 mg formulation in the aspect of efficacy and safety for the treatments of metastatic prostate cancer.</p>

Clinical questionnaires about benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>s To assess the understanding degree of urologists for benign prostatic hyperplasia (BPH) and the clinical characteristics of BPH patients.</p><p><b>METHODS</b>The questionnaires was distributed to urologists and patients in 119 hospitals over the country, respectively. The urologist survey was mainly focused on the questions of BPH progression and therapeutic model. The patient survey was mainly focused on the questions of patient's age, symptom features and the preference to receiving treatment.</p><p><b>RESULTS</b>The evaluations based on 289 completed urologist questionnaires and 4253 completed patient questionnaires showed that 98.6% of urologists agreed that BPH was a progressive disease but there were still some differences in understanding the risk factors for BPH progression. Additionally, 98.1% of patients were diagnosed to be moderate or severe BPH, nocturia was the most frequent symptom. In the treatment for BPH, both the urologists and patients concerned about how to improve the system rapidly.</p><p><b>CONCLUSIONS</b>This study is the first questionnaires specifically to the urologists and BPH patients, the results would reflect the situations of BPH diagnosis and treatment in China and would be helpful to the development of BPH guideline.</p>

Vascular factors in the pathogenesis of diabetic erectile dysfunction / 中华男科学杂志

Diabetic erectile dysfunction (DED) is a multifactor syndrome, which involves vascular disease, neuropathy, metabolic control, nutrition, endocrine disorders, psychogenic factors, and anti-diabetes drugs. Among all these factors, vascular disease plays a very important role. In the development of diabetic vasculopathy, some vasomotion factors and growth factors undergo conspicuous changes, which may be significantly correlated with the development of diabetic erectile dysfunction.

Erectile function in male kidney transplant recipients and effects of different methods of renal arterial anastomosis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate erectile function in men with renal failure before and after kidney transplantation and the effects of different methods of renal arterial anastomosis.</p><p><b>METHODS</b>Fifty-five married males, aged 22-50 years, who had received kidney transplantation at least one year before and whose serum creatinine was under 200 micromol/L , were selected in the study. The end-to-end revascularization to the internal iliac artery was accomplished in 39 of them, and the end-to-side revascularization to the external iliac artery was conducted in 16. Their erectile function was investigated according to the International Index of Erectile Function-5 (IIEF-5) before kidney transplantation and 3, 6 and 9 months after it. The effects of different methods of renal arterial anastomosis were evaluated and hypophyseal hormones determined in 25 of them.</p><p><b>RESULTS</b>IIEF-5 was higher in the patients 3, 6 and 9 months after transplantation than before it (P < 0.05) and 6 and 9 months after transplantation than 3 months after it (P < 0.05) , so was it in the patients with less than 12 months hemodialysis than those with over 12 months (P < 0.05) and in the patients with end-to-side revascularization to the external iliac artery than those with end-to-end revascularization to the internal iliac artery (P < 0.05). The differences between the level of hypophyseal hormones and that of sex hormones before transplantation were significant (P < 0.05).</p><p><b>CONCLUSION</b>Erectile function and the level of hypophyseal hormones were improved after kidney transplantation, and the patients who received end-to-side revascularization to the external iliac artery experienced better erectile function recovery than those who underwent end-to-end revascularization to the internal iliac artery.</p>

Neurotrophin and erectile dysfunction in diabetes / 中华男科学杂志

Neurotrophins play significant roles in the development, differentiation and regeneration of many neurons. The abnormal changes of neurotrophins are one of the nosogenesis of diabetic peripheral neuropathy. Erectile dysfunction (ED) in diabetes is multifactorial and one of the most important causes is the injury of pelvic splanchnic nerves. Neurotrophins therapy shows exact effects on ED with pelvic splanchnic nerves injured. Recent researches indicates that the same treatment has the similar therapeutic effects on the ED animals with diabetes. Neurotrophins therapy develops a new way for us to cure the ED with diabetes.

Retroperitoneoscopic dismembered pyeloplasty in children / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the technique and the clinical efficacy of Retroperitoneoscopic dismembered pyeloplasty in children.</p><p><b>METHODS</b>Retroperitoneoscopic dismembered pyeloplasty was performed on 17 patients of pediatric ureteropelvic junction (UPJ) obstruction, age ranging from 3 - 10 years. All patients had radiographic evidence of obstruction with signs, symptoms or deterioration of renal function.</p><p><b>RESULTS</b>All of the 17 operations were performed successfully, and no serious complications occurred during and after the operations. Average operating time was 4.3 hours, which decreased with surgeon experience. Average blood loss was 38 ml, mean postoperative stay was 4.6 d. Only one case had postoperative urine leakage. With a mean follow-up of 14 months, all patients were free of obstruction on follow-up radiographic imaging.</p><p><b>CONCLUSIONS</b>Retroperitoneoscopic dismembered pyeloplasty is a safe, effective and minimally invasive procedure for treatment of UPJ obstruction in children, and it can be used as an alternative to open surgery.</p>

Progress of gene therapy for erectile dysfunction / 中华男科学杂志

Gene therapy is currently investigated in animal studies for treating erectile dysfunction (ED), and is affording an conspicuous therapeutic possibility for the treatment of ED, especially in L-arg-NO-cGMP pathway, ion channel, the protection of nerves and endothelia in erectile tissues. However there still exist so many problems for gene therapy to be effectively applied to the clinical treatment of ED. This review aims to examine the experimental efforts in recent years and tries to give a brief introduction to the new approaches in the field of ED researches.

Study on prevention of catheter associated urinary tract infection by using JUS long-acting antibacterial material / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the effect of reducing the incidence of CAUTI by spraying the long-acting antibacterial material JUS on the surface of catheter and urethral orifice.</p><p><b>METHODS</b>Sixty male patients, aged from 68 to 79, with indwelling catheter after TURP were divided randomly into two groups (control group and treated group), each consisting of 30 patients. For the control group, their urethral orifice was treated conventionally twice a day; while for the treated group, in addition to the conventional treatment of their urethral orifice, the catheter and their urethral orifice were sprayed with the long-acting antibacterial material JUS twice a day.</p><p><b>RESULT</b>The number of cases of urinary tract infection in the treated group during catheterization was evidently less than those of the control group (P < 0.01), so the difference was of remarkable significance.</p><p><b>CONCLUSION</b>The long-acting antibacterial material, after spraying on the wall of catheter and urethral orifice of the patients with indwelling catheter, may form a layer of physically antibacterial molecular film to prevent the formation of a bacterial biological film and effectively reduce the incidence of CAUTI.</p>

Expression of nerve growth factor in cavernous tissue and its effects on the treatment of rats with diabetic erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the content of nerve growth factor (NGF) in penis of rats with diabetic erectile dysfunction (DED) and apply rhNGF to treat the DED rat model to study the pathogenesis mechanism of DED and treatment effects by NGF for DED rat model.</p><p><b>METHODS</b>Fifty adult male SD rats were randomly selected to make up diabetic models. After 8 weeks, the mRNA and protein levels of NGF in rat penis were detected. Then the rest of rats were divided into 5 groups: normal control group, non-treated diabetes group, NGF treatment group, insulin treatment group, NGF plus insulin treatment group. After 8 weeks of treatment, intracavernous pressure (ICP) was measured. The content of neuronal nitric oxide synthase (nNOS) in the erectile tissue was also value- ated by immunohistochemistry staining.</p><p><b>RESULTS</b>Compared with those of normal control group, the mRNA content of NGF and protein in the penis of non-treated diabetic rats is increased significantly. Compared with non-treated diabetic group, ICP was much higher in the treated groups which received NGF or/and insulin therapy, and the changes in nNOS staining of those groups were the same.</p><p><b>CONCLUSION</b>The injury of pelvic splanchnic nerves in advanced stage of diabetes may lead to DED, which may be relevant to the abnormal of NGF level or the NGF receptors. The increased extent of NGF in penis of rat with DED suggests that erectile nerves be severely damaged by diabete and the increase of producing NGF couldn't compensate the needs for reproduction of the nerve fibers. The ability of combination of NGF with its receptor may also be damaged. It is helpful to use exogenous NGF to lessen the partly neuropathy and improve the erectile dysfunction of diabetic rats. The abnormal of NGF may play an important role in the pathogenesis of diabetic ED and its treatment.</p>

Effect of FK506 on the cavernous nerve regeneration after injury / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of FK506 on the cavernous nerve regeneration after injury and to discuss its possible action mechanisms.</p><p><b>METHODS</b>Fifty-four male adult Sprague-Dawley rats were randomized into three groups: Group 1 (sham control), Group 2 (unilateral cavernous nerve ablation), and Group 3 (unilateral cavernous nerve ablation with subsequent injection of FK506). Electrostimulation of the cavernous nerve was performed at 1 and 3 months after surgical injury. The intracavernous pressure was continuously detected and the rats were followed by nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) staining to identify NOS in the penile nerve fibers of the penile shaft.</p><p><b>RESULTS</b>At 1 month, the number of NOS-positive nerve fibers significantly decreased with no statistical difference among the three groups except the sham controls (P > 0.05). At 3 months, electrostimulation revealed greater maximal intracavernous pressure in Group 3 than in Group 2 (P < 0.01). Furthermore, the number of NOS-positive nerve fibers showed a significant increase (P < 0.01), but not in Group 2 (P > 0.05).</p><p><b>CONCLUSION</b>FK506 injection enhances the regeneration of cavernous nerves after injury and the recovery of erectile function in rats.</p>

Omission factors in detecting early stage prostate cancer by TRUS needle biopsy / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze and reduce the omission factors in detecting early stage prostate cancer by TRUS needle biopsy, and to improve the diagnosis of the disease.</p><p><b>METHODS</b>A total of 80 benign prostatic hyperplasia patients suspected of prostatic carcinoma underwent TRUS sextant biopsies. The pathological results being negative, the patients received transurethral resection of the prostate (TURP).</p><p><b>RESULTS</b>After TURP, 25 cases were pathologically diagnosed as prostate cancer, with an omission rate of 31.25% (25/80). Of the diagnosed cancer patients, 10 were treated by radical perineum prostatectomy, 8 by surgical castration, and 7 by medical castration.</p><p><b>CONCLUSION</b>Some tumors may fail to be detected by TRUS needle biopsy. Serial or multi-core needle biopsies can decrease the omission rate in the diagnosis of organ confined cancer.</p>

Estrogen and bone metabolism in man / 中华男科学杂志

In males, androgen can be aromatized into estrogen by aromatase. Estrogen receptors were shown to be present in male-derived human osteoblasts. For males bone is an important target tissue of estrogen. It was demonstrated that deficiency of estrogen or mutation of estrogen receptor gene in males could lead to osteopenia, even osteoporosis. Estrogens are required for the pubertal growth of bone and play important roles in maintenance of bone mass in males.

Two methods of laparoscopic varicocelectomy for the treatment of spermatic varicocele / 中华男科学杂志

<p><b>OBJECTIVE</b>To introduce two methods of laparoscopic varicocelectomy for the treatment of spermatic varicocele.</p><p><b>METHODS</b>Forty-five cases of spermatic varicocele were treated by video laparoscopic technique with two or three punch.</p><p><b>RESULTS</b>All the 45 operations were performed successfully, and no complications occurred during and after the operations.</p><p><b>CONCLUSIONS</b>Spermatic varicocele is one of the most suitable indications for video laparoscopic surgery. The two-punch technique is more advantageous than the three-punch.</p>

A survey of the level of AIDS knowledge among people concerned in Nanjing City / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate the level of AIDS knowledge among people concerned in Nanjing city in order to provide scientific evidence and constructive suggestions for the government to formulate relevant policies for AIDS control.</p><p><b>METHODS</b>Three sets of questionnaires on AIDS knowledge were designed, the scores calculated, and the results evaluated.</p><p><b>RESULTS</b>Of the 2,500 questionnaires issued to 4 different groups of people, 2,436 were collected back with effective answers, 991 from medical and health-related workers with the mean score of 58, 473 from college students with the mean score of 39.9, 524 from common city residents with the mean score of 42.3, and 448 from those working in high risk environment with the mean score of 47.</p><p><b>CONCLUSIONS</b>The level of AIDS knowledge among people concerned in Nanjing city was far below the requirement of the nation, especially among medical and health-related workers. Efforts must be made to raise the level of AIDS knowledge of people concerned so as to enhance the prevention and treatment of the disease.</p>

Clinical investigation of the treatment of children urethral calculi with pneumatic lithotripsy under ureteroscopy / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of pneumatic lithotripsy on children urethral calculi.</p><p><b>METHODS</b>Twenty-two cases of the male children with urethral calculi were treated with pneumatic lithotripsy under ureteroscopy.</p><p><b>RESULTS</b>All the patients were treated successfully in a single procedure. The time of lithotripsy was (5.5 +/- 2.2) minutes, and no serious complication such as obvious hematuria, infection and urethral stricture occurred.</p><p><b>CONCLUSIONS</b>It is suggested that pneumatic lithotripsy under ureteroscopy is an effective and simple way for the treatment of urethral calculi in children.</p>