Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population / 中华耳鼻咽喉头颈外科杂志

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

Analysis of the efficacy of endoscopic transnasal surgery for sinonasal and skull base adenoid cystic carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the efficacy of endoscopic transnasal surgery for sinonasal and skull base adenoid cystic carcinoma (ACC), and to analyze the prognostic factors. Methods: Data of 82 patients (43 females and 39 males, at a median age of 49 years old) with sinonasal and skull base ACC who were admitted to XuanWu Hospital, Capital Medical University between June 2007 and June 2021 were analyzed retrospectively. The patients were staged according to American Joint Committee on Cancer (AJCC) 8th edition. The disease overall survival(OS) and disease-free survival(DFS) rates were calculated by Kaplan-Meier analysis. Cox regression model was used for multivariate prognostic analysis. Results: There were 4 patients with stage Ⅱ, 14 patients with stage Ⅲ, and 64 patients with stage Ⅳ. The treatment strategies included purely endoscopic surgery (n=42), endoscopic surgery plus radiotherapy (n=32) and endoscopic surgery plus radiochemotherapy (n=8). Followed up for 8 to 177 months, the 5-year OS and DFS rates was 63.0% and 51.6%, respectively. The 10-year OS and DFS rates was 51.2% and 31.8%, respectively. The multivariate Cox regression analysis showed that late T stage and internal carotid artery (ICA) involvement were the independent prognostic factors for survival in sinonasal and skull base ACC (all P<0.05). The OS of patients who received surgery or surgery plus radiotherapy was significantly higher than that of patients who received surgery plus radiochemotherapy (all P<0.05). Conclusions: Endoscopic transonasal surgery or combing with radiotherapy is an effective procedure for the treatment of sinonasal and skull base ACC. Late T stage and ICA involvement indicate poor prognosis.

Application of island flap and its combined flap on repairing nasal alae defects / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.

Application of membrane induced by antibiotic loaded bone cement in skin grafting for tendon exposed wound healing / 中国骨伤

OBJECTIVE@#To evaluate the effects of membrane induced by antibiotic-loaded bone cement in skin grafting for tendon exposed wound healing.@*METHODS@#A total of 10 traumatic patients with tendon exposed wound were admitted to our department between February 2016 and December 2018, including 6 males and 4 females, with a mean age of 34.6 years old (ranged, 19 to 43 years old), and treatment duration ranged from 2 to 6 months. There were 7 cases of traffic accidents, 3 cases of mechanical belt injuries, including 8 cases of lower leg and foot wounds and 2 cases of hand back wounds. These tendons exposed wound were covered by antibiotic-loaded bone cement at the earlier stageto induce the formation of the biomembrane, and then skin grafting were performed on the induced membrane. The survival, appearance, texture, sensation of the skin grafting and healing condition of the wounds were studied.@*RESULTS@#Among the 10 patients, skin graft survived well in 8 patients. Partial skin graft necrosis occurred in 2 patients and cured by dressing.@*CONCLUSION@#Using antibiotic bone cement to seal the wound to form induction membrane followed by skin grafting can effectively repair the tendon exposed wound, which has the characteristics of simple operation and less trauma.

Comparison of application value of LTH and LAVH in hysterectomy / 中国内镜杂志

Objective To investigate the effect of total laparoscopic hysterectomy (LTH) and laparoscopic assisted vaginal hysterectomy (LAVH) for hysterectomy. Methods From February 2015 to February 2017, 182 patients with total hysterectomy were enrolled, among them, LTH was performed in 97 patients, and LAVH was performed in 85 patients, the operation time, intraoperative blood loss, the length of scar, postoperative anal exhaust time and so on were observed in the two groups, C reactive protein (CRP), interleukin -2 (IL-2) and IL-6 were detected before and after operation in two groups. Results In group LTH, the amount of bleeding and the length of scar were (104.33 ± 40.20) ml and (2.03 ± 0.84) cm respectively, which were significantly lower than those in group LAVH (P < 0.05); There was no significant difference between LTH group and LAVH group in postoperative anal exhaust time, hospital stay, postoperative analgesia and hospitalization costs (P > 0.05); The CRP and IL-6 in the LTH group postoperative were (26.43 ± 6.11) mg/L and (40.04 ± 11.03) ng/ml, significantly lower than those in LAVH group (P < 0.05), while IL-2 was (44.20 ± 12.29) ng/ml, was significantly higher than that of the control group (P < 0.05); The incidence of postoperative complications in LTH group was 6.19%, which was significantly lower than that of LAVH group (P < 0.05). Conclusion LTH is a safe and reliable method for hysterectomy, has the advantages of less complications, less influence on immune function and so on, is worthy of clinical application.

Endoscopic Approach to Remove Intra-extracranial Tumors in Various Skull Base Regions: 10-year Experience of a Single Center / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base. Herein, we described a pure endoscopic transnasal or transoral approach (ETA) for the removal of intra-extracranial tumors in various skull base regions.</p><p><b>METHODS</b>Retrospectively, clinical data, major surgical complications, pre- and postoperative images, and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.</p><p><b>RESULTS</b>Gross total tumor removal was achieved in 80/85 cases (94.1%) in this study. All 37 cases with tumors in anterior skull base and all 14 cases with tumors in jugular foramen received total tumor removal. Thirteen and three cases with tumors in clivus received total and subtotal tumor removal, respectively. Total and subtotal tumor removal was performed for 16 cases and 2 cases in lateral skull base, respectively. The complications in this study included: cerebrospinal fluid leakage (n = 3), meningitis (n = 3), and new cranial nerve deficits (n = 3; recovered in 3 months after surgery). In the follow-up period of 40-151 months (median: 77 months), seven patients (8.8%) out of the 80 cases of total tumor removal experienced recurrence.</p><p><b>CONCLUSIONS</b>Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases. Surgical procedure for radical removal of tumors is feasible and safe.</p>

Early experience of resection of meningiomas in anterior skull base with intra-extracranial extension via a pure endoscopic endonasal approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The early experience of treating anterior skull base meningiomas with intra-extracranial extension via pure endoscopic endonasal approach (EEA) was presented, the safety, feasibility and preliminary treatment outcomes were investigated.</p><p><b>METHODS</b>Eight patients with intra-extradural meningiomas who were admitted from October 2006 to October 2010 were operated on via EEA in one stage in Xuanwu hospital. In this study, the operative technique was described, the degree of resection, complications and the early clinical outcomes were discussed.</p><p><b>RESULTS</b>The complete resection of meningiomas with intra-extracranial extension was achieved in all patients using EEA in one stage. Preoperative visual symptoms were improved or resolved in all cases who presented with preoperative visual complaints. No patient in our series experienced a new neurological deficit after surgery or recurrence and death related meningiomas in the follow-up period (33-75 months). One patient experienced postoperative cerebrospinal fluid leak, delayed meningitis and secondary hydrocephalus which responded to therapy. After treatment, the patient was cure.</p><p><b>CONCLUSION</b>Our limited experience indicates that EEA is feasible and safe for the complete resection of anterior skull base meningiomas with intra- and extracranial extension in one stage in selected cases.</p>

Surgery for jugular foramen schwannomas via a pure endoscopic transoral approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To report a new approach, endoscopic transoral approach for the resection of jugular foramen schwannoma.</p><p><b>METHODS</b>Nine patients with jugular foramen schwannoma (three males and six females, ranging in age from 15 to 61 years old) were treated by direct surgery via a pure endoscopic transoral approach to the jugular foramen. Eight patients complained of hypoglossal nerve palsy with hemiatrophy of the tongue; six cases complained of vagus nerve palsy. Three cases complained of glossopharyngeal nerve palsy, one case complained of facial nerve palsy and hearing loss.</p><p><b>RESULTS</b>The nerves in this area were preserved and radical intracapsular removal of the tumor was performed via endoscopic transoral approach in the nine cases. Tumor removal, as assessed by intraoperative endoscopic inspection, postoperative magnetic resonance imaging and clinical evaluation, revealed all tumors were completely removed. One patient suffered from temporary swallowing difficulties and temporary right vagus palsy 1 day after surgery. There were no others intraoperative and postoperative complications. All patients were followed up for 4 - 29 months, no recurrences were occurred in all these patients and the muscle bulk, motor and the pre-postoperative swallowing function, the vagus palsy, the facial nerve palsy and hearing loss had improved in these patients.</p><p><b>CONCLUSION</b>The endoscopic transoral approach and intracapsular removal of the tumor provided for successful minimally invasive surgery in the jugular foramen schwannomas.</p>

Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic transsphenoidal approach to pituitary adenomas invading cavernous sinus.</p><p><b>METHODS</b>The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.</p><p><b>RESULTS</b>Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared. Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.</p><p><b>CONCLUSION</b>These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.</p>

Diagnosis and treatment of penile verrucous carcinoma: a report of 4 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of penile verrucous carcinoma.</p><p><b>METHODS</b>The clinical and pathological data of 4 patients with penile verrucous carcinoma were analyzed.</p><p><b>RESULTS</b>The patients ranged in age from 42 to 76 years (average 52). All the tumors showed exophytic papillary lesions, the biggest being 2.1 to 5.8 cm in diameter. The lesions were confined to the glans penis in two cases and invaded the shafts in the other 2 (1 accompanied by syphilis). One patient, whose tumor was small (1.4 cm in diameter) and confined to the glans penis, underwent glandectomy. One with a larger tumor confined to the glans penis and the other 2 with the shafts involved underwent partial penectomy, including the one accompanied by syphilis, who underwent the operation after treated by Benzathine benzylpenicillin. Histopathological examination of the specimens showed that the tumor cells were mostly well-differentiated and the surgical margins were tumor free in all the 4 cases. HE stain was performed in all the specimens. Microscopic examination revealed papillomatosis and hyperkeratosis of the epithelium, with bulbous projections into the lamina propria consisting of well-differentiated squamous epithelial cells. Marked invasion of the stroma by lymphocytes was noted. Follow-up ranged from 3 to 7 years (average 4.6), revealing no recurrence. The result of the rapid plasma regain (RPR) test was negative but that of the Treponema pallidum passive-particle-agglutination (TPPA) test remained positive in the blood of the patient accompanied by syphilis after treatment.</p><p><b>CONCLUSION</b>Verrucous carcinoma of the penis is characterized by low malignant potential and locally aggressive nature. It seldom develops metastasis to regional lymphonodes or distant areas. Glandectomy or partial penectomy can be chosen for its treatment, with favorable prognosis.</p>

Glucocorticoid receptor subunit expression in adenoid tissue of children with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The expression of glucocorticoid receptor (GR) expression in obstructive sleep apnea hypopnea syndrome (OSAHS) in children is currently unknown. The aim of this study was to determine the GR-alpha and GR-beta status in the adenoidal tissues in children with OSAHS.</p><p><b>METHODS</b>Thirty-four pediatric patients (aged 3-14 years, median 7.8 years) had sleep study with polysomnography before adenoidectomy. According to the criteria of apnea hypopnea index (AHI) > or = 5 /h or/and apnea index (AI) > or = 1/h, they were divided into OSAHS and non-OSAHS sub groups. The study was based on fluorescent quantitative PCR (FQ-RT-PCR) for the mRNA expression of GR-alpha and GR-beta in the adenoidal tissues in children.</p><p><b>RESULTS</b>GR isoforms mRNA encoding for expression of both GR-alpha and GR-beta were detected in the adenoids of all children. GR-alpha mRNA level [(9.40 +/- 3.06) x 10(5) cDNA copies/microg total RNA] in the adenoidal tissues in OSAHS was lower than those in the non-OSAHS [(1.60 +/- 0.26) x 10(6) cDNA copies/microg total RNA] (F = 40.285, P < 0.001), whereas no differences found for GR-beta [(1.57 +/- 0.35) x 10(4) cDNA copies/microg total RNA, (1.52 +/- 0.18) x 10(4) cDNA copies/microg total RNA]. GR-alpha/GR-beta ratio was 62.3 +/- 20. 3 in OSAHS and 107.4 +/- 24.4 in non-OSAHS. AHI or AI was not related to the mRNA levels of GR-alpha and GR-beta in OSAHS or non-OSAHS.</p><p><b>CONCLUSIONS</b>GR-alpha and GR-beta were detectable in the adenoidal tissues in children. These data indicated that the relationship between the expressions of GR and the clinical significance in OSAHS need further and profound investigation.</p>

Correlation of cyclooxygenase 2 with upstream mitogen-activated protein kinase, nuclear factor kappa B signal transduction pathway in middle turbinate mucosa of chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression and correlation of cyclooxygenase 2 (COX-2)and key enzymes both of mitogen activated protein kinase (MAPK) and nuclear factor-kappa B( NF-KB) pathways in middle turbinate mucosa of chronic rhinosinusitis (CRS) and to investigate their roles in CRS pathogenesis.</p><p><b>METHODS</b>Twenty-four lateral mucosa of CRS middle turbinates were equally divided into 3 groups according to FESS-97 Haikou criterion (CRS type I stage 2 in group 1, type II stage 2 in group 2, and type III in group 3), and 8 normal mucosa were enrolled as control. Immunohistochemistry and fluorescent real time quantitative polymerase chain reaction (FQ-RT-PCR) were performed to detect the expression of COX-2, ERK, p38MAPK, JNK and NF-kappaB subunits. The correlations between cox-2 and MAPK, NF-kappaB pathway were statistically treated by Pearson test.</p><p><b>RESULTS</b>Positive expressions of COX-2, ERK, p38MAPK and NF-kappaB subunits were detected in CRS groups, which were stronger than those in control group, by immunohistochemistry and FQ-RT-PCR (P < 0.05). Statistic difference was not found among CRS groups (P > 0.05). Negative expression of JNK was detected in all groups. Significantly positive correlation between protein and RNA expression of COX-2,ERK,p38MAPK and NF-kappaB subunits in each CRS group was confirmed by Pearson correlation treatment (P < 0.05). Significantly positive correlation of protein and RNA expression between COX-2 and ERK, p38MAPK in same CRS group was also founded (P < 0.05). The expression of COX-2 and the nucleic expression of NF-kappaB subunits in same CRS group was proved to be positively correlated (P < 0.05).</p><p><b>CONCLUSIONS</b>Upregulated expression of COX-2 is correlated with upstream ERK, p38MAPK and NF-kappaB pathway in CRS. It indicates the involvement of ERK, p38MAPK and NF-kappaB signal transduction pathway in regulation of COX-2 in CRS.</p>

Expression and significance of toll like receptor 4 mRNA and nuclear factor-kappaB p50 mRNA in human normal nasal mucosa after stimulation by lipopolysaccharide / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of Toll like receptor (TLR)4 mRNA and nuclear factor (NF)-kappaB p50 mRNA in human normal nasal mucosal cell before and after stimulation by LPS.</p><p><b>METHODS</b>The tissue was obtained from 15 normal middle turbinates (without rhinosinusitis). Every tissue was cultured in vitro, divided into 2 specimens. LPS was added into 15 specimens as LPS group and not added into other 15 specimens as control group. The pathomorphological characters of nasal mucosal cells were observed under optical microscope after stimulation by LPS. The expression of TLR4 mRNA and NF-kappaB p50 mRNA in normal human nasal mucosal cells were evaluated by in situ hybridization.</p><p><b>RESULTS</b>Normal mucociliary agglutinated and mucosal cells were enlarged after stimulation by LPS; The expression of TLR4 mRNA in LPS group was higher than control group obviously. Their average density of light was 1.283 +/- 0.027 in LPS group while 0.538 +/- 0.038 in control group, and there was statistical significance between the two groups (t = 1.761, P < 0.05). The expression of NF-kappaB p50 mRNA was higher than control group obviously, and expressed in cellular nucleus predominantly. Their average density of light was 1. 668 +/- 0.037 in LPS group while 0. 372 +/- 0.052 in control group, and there was statistical significance between the two groups (t = 2. 624, P < 0. 01).</p><p><b>CONCLUSIONS</b>LPS can activate the NF-kappaB p50 of human nasal mucosal cells through TLR4, and it may play some roles in stimulating and damage effect induced by LPS in nasal mucosal cells.</p>

Investigation of GR mRNA quantu expression in chronic sinusitis and nasal polyps / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression of the glucocorticoid receptor-alpha/beta (GR-alpha/beta) mRNA in nasal polyp and normal nasal mucosa and investigate the significance of receptor-alpha/beta in GC-insensitive and GC-sensitive patients.</p><p><b>METHODS</b>The expression of GR-alpha/beta mRNA in 40 samples of nasal polyp and 30 normal nasal mucosa was examined by using Fluorescent quantitative PCR.</p><p><b>RESULTS</b>Forty cases were screened from the 80 cases after follow-up, including 26 cases of GC-sensitive and 14 cases of GC-insensitive. the levels of GR-beta mRNA in group of GC-insensitive [(5.72 +/- 0.58) x 10(2) copy/microg] were significantly higher than that of GC-sensitive [(4.82 +/- 0.28) x 10(2) copy/microg, t = -6.65, P < 0.01] and normal nasal mucosa [(4.44 +/- 0.35) x 10(2) copy/microg, t = -9.19, P < 0.01]. There was difference between group of GC-insensitive and other two groups of GC-sensitive and normal nasal mucosa (P < 0.01). The ratio of GR-alpha/GR-beta showed significant difference between the group of GC-sensitive (829.42 +/- 67.36) and that of GC-insensitive (535.70 +/- 89. 00, t = 11.74, P < 0.01).</p><p><b>CONCLUSIONS</b>The high expression of GR-beta mRNA and low expression of GR-alpha mRNA in nasal polyp show the status of "insensitive" in chronic sinusitis and nasal polyp. The GR-beta may play an important role in evaluating the effect of glucocorticoid in chronic sinusitis and nasal polyps.</p>

Relationship of serum prostate-specific antigen and alkaline phosphatase levels with bone metastases in patients with prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the relation of serum prostate-specific antigen (PSA) and alkaline phosphatase (ALP) levels to bone metastases in patients with prostate cancer.</p><p><b>METHODS</b>We made a retrospective study of 96 cases of prostate cancer with (29 cases ) and without (67 cases ) bone metastases and evaluated their initial levels of serum PSA and ALP as well as the radionuclide bone scan findings.</p><p><b>RESULTS</b>The median concentrations of serum PSA and ALP were both in the bone scan-positive patients statistically higher than in those the negative ones (P < 0.01). The percentages of the bone scan-positive patients with PSA > 20 microg/L or ALP > 90 U/L were also higher than those with PSA < 20 microg/L or ALP < 90 U/L (P < 0.01).</p><p><b>CONCLUSION</b>Prostate cancer patients with bone metastases have higher levels of PSA and ALP than those without. Radionuclide bone scan is necessary when the serum PSA level is > 20 microg/L and/or ALP level > 90 U/L.</p>

Experimental investigation of effects of adenovirus transduced tissue factor pathway inhibitor-2 gene on growth of laryngeal squamous carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the inhibitory effects of adenovirus transduced TFPI-2 gene on the growth of laryngeal squamous carcinoma.</p><p><b>METHODS</b>Recombinant adenoviruses carrying human TFPI-2 gene were amplified and identified. The nude mouse model of laryngeal squamous carcinoma was established by intracutaneous injection of Hep-2 cells. Mice in the treated group were injected with recombinant adenoviruses with Ad-TFPI-2 (adenoviruses-TFPI-2) in peritumor tissue while mice in control group were injected with equivalent null plasmids. After treatment, the tumor weight and volume of tumor in each mouse were measured respectively. The morphological changes of tumor cells were observed using transmission electron microscope and proliferating cell nuclear antigen (PCNA) expression was examined using immunohistochemistry.</p><p><b>RESULTS</b>The Ad-TFPI-2 virus titer was 2.8 x 10(12) PFU/ml after amplification. The average tumor weight and volume in Ad-TFPI-2 treated group were (1.20 +/- 0.34) cm3 and the volume (1.52 +/- 0.39) g, which were significantly lower than the tumor weight (2. 08 +/- 0.52) cm3 and (2.67 +/- 0.47) g in the control group (P < 0. 01). Apoptosis was observed in the tumors of Ad-TFPI-2 treated group. The PCNA index in Ad-TFPI-2 group was (54.9% +/- 12.4%), which was obviously lower than that (75.8% +/- 11.2%)in control group (P < 0.01).</p><p><b>CONCLUSION</b>Peritumor injection of Ad-TFPI-2 can inhibit the growth of laryngeal squamous carcinoma in nude mouse model.</p>

Comparative study of transurethral electrovaporization of prostate versus transurethral resection of prostate on benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVES</b>To compare the efficacy of transurethral electrovaporization of prostate (TUVP) with transurethral resection of prostate (TURP).</p><p><b>METHODS</b>206 patients with symptomatic benign prostatic hyperplasia (BPH) whose prostatic sizes were all less than 60 grams were randomly divided into two groups. 97 cases were treated by TUVP while the other 109 cases were treated by TURP. The patients who underwent either TUVP or TURP were followed up for 12-34 months with an average of 20 months postoperatively.</p><p><b>RESULTS</b>Both groups showed the significant decline in the mean IPSS (international prostatic symptom score) (P < 0.01), the mean PVR (Postovoiding Residual Volume) (P < 0.01), while increase in mean Qmax (Peak uroflow rate) (P < 0.01) in 12 months, 24 months after the operation. There were significant differences in the mean duration of operation or catheterization postoperatively (P < 0.05). The main complications of post-operation in the two groups were stress incontinence, TUR syndrome, urethral stricture, secondary bleeding.</p><p><b>CONCLUSIONS</b>Both TUVP and TURP are effective treatment for the patient with BPH whose prostatic size is less than 60 grams. TUVP spends shorter time of the operation and postoperative catheterization than that of TURP.</p>

Prostaglandin E1 versus sildenafil in the management of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVES</b>To evaluate the outcome of treatment in patients with erectile dysfunction (ED) using sildenafil or intracavernosal injection of prostaglandin E1(PGE1).</p><p><b>METHODS</b>54 patients with ED were randomly classified into two groups and received either oral sildenafil (group A) or intracavernosal injection of PGE1(group B) for 4-9 months with an average of 6 months.</p><p><b>RESULTS</b>The percentages of efficacy in the two groups were 80.0% and 83.3%, respectively. There was no statistical difference between group A and B (P > 0.05). Two of six patients who did not respond to sildenafal in group A achieved erections sufficient for sexual intercourse when the six patients received intracavernous injection of PGE1. None of the four patients who did not respond to intracavernous injection of PEG1 in group B achieved erection sufficient for sexual intercourse when they received oral sildenafil.</p><p><b>CONCLUSIONS</b>Both oral sildenafil and intracavernous injection of PGE1 are effective for patients with ED of various etiologies. The patients who do not respond to sildenafil can receive intracavernous injection therapy. The satisfactory results can probably achieved.</p>