Horseshoe kidney with retrocaval ureter: one case report / 中华医学杂志(英文版)

Horseshoe kidney and retrocaval ureter are uncommon congenital anomalies of the genitourinary system that are easily diagnosed by typical imaging features. Both anomalies presenting in one patient is a rare disease characterized by isthmus of horseshoe kidney between the abdominal aorta and inferior vena cava. The clinical diagnosis and treatment of horseshoe kidney with retrocaval ureter remain a challenge. Here, we reported a case of a 44-year-old man with the two anomalies who was preoperatively diagnosed by unenhanced computed tomography scanning immediately after retrograde pyelography. The literatures on such combined anomalies are reviewed and the diagnostic evaluation and surgical management of this rare entity are discussed.

Influence of the interruption of arteria iliaca interna distal end on penile vascularity and erectile function in male renal transplant recipients / 中华男科学杂志

<p><b>OBJECTIVE</b>It is controversial whether unilateral interruption of the arteria iliaca interna distal end affects penile hemodynamics and erectile function. The purpose of this study was to prospectively evaluate this influence by detecting the blood flow of the penile artery before and after renal transplantation.</p><p><b>METHODS</b>Thirty-three patients with chronic renal failure (CRF) on maintenance hemodialysis (MHD) received renal transplantation, the grafts revascularized by end-to-end anastomosis to the right internal iliac artery. Six months before and after the surgery, we obtained the IIEF scores of the patients, recorded their penile blood flow on color Doppler ultrasonography and the levels of serum creatinine, hemoglobin and serum cholesterol, and analyzed post-transplantation immunosuppressive medication.</p><p><b>RESULTS</b>The patients ranged in age from 21 to 55 years, of whom 36% had erectile dysfunction (ED) during MHD, and 33% after renal transplantation. A total of 67% of the renal transplant recipients (RTR) complained of unchanged and 15% deteriorated ED, while 18% admitted improved erectile function. The patients showed a significantly stronger sexual desire after the transplantation than before it (6.2 +/- 1.6 vs 8.9 +/- 0.9, P < 0.01). There was a significant decrease in peak systolic velocity (PSV) in the cavernous arteries after transplantation as compared with pre-transplantation (P < 0.01). Penile arterial blood flow insufficiency was found in none of the RTRs.</p><p><b>CONCLUSION</b>Unilateral interruption of the internal iliac artery decreases penile arterial blood flow, but not to such a degree as to result in ED. Unilateral interruption of the arteria iliaca interna distal end does not affect the erectile function of RTRs.</p>

Rapamycin enhances the susceptibility of both androgen-dependent and -independent prostate carcinoma cells to docetaxel / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Docetaxel (DOC) therapy is well tolerated and shows high response rates in patients with hormone refractory prostate cancer (HRPC). There are many reports on the effect of rapamycin (RPM) on the treatment of carcinogenesis. The goal of this study was to test whether RPM could enhance the susceptibility of both androgen-dependent and -independent prostate carcinoma cells to DOC.</p><p><b>METHODS</b>Prostate cancer (PC) cell lines (LNCap, PC3 and AILNCap) were cultured and treated with RPM and DOC alone or in combination. The effects of therapeutic agents on cells were determined by the WST-1 assay. Apoptosis induction was confirmed by flow cytometric analysis. The apopcyto caspase colorimetric assay kit was applied to measure the activities of caspases 3 and 9. The antitumor effects of RPM and DOC against PC cells were also assessed in nude mice using four randomized groups: control, RPM, DOC and combination drug therapy by measuring tumor size. All the animals tolerated both RPM and DOC without significant weight loss.</p><p><b>RESULTS</b>RPM and DOC caused dosage-dependent growth suppression of PC cells. RPM could increase the susceptibility of PC cells to DOC significantly, and combined treatment with RPM and DOC caused synergistic growth suppression in all examined PC cell lines by isobolographic analysis. Both RPM and DOC significantly induced apoptosis in a dosage-dependent manner. RPM (10 nmol/L), DOC (1 nmol/L), and combined treatment induced apoptosis rate were 8%, 17% and 38%, respectively (the control was 2%). RPM could promote the apoptosis induced by DOC in PC cell lines. Both RPM and DOC significantly increased the caspase activity in a dosage-dependent manner. The relative activities of caspase 9 in control, RPM, DOC and RPM + DOC groups were 0.22 +/- 0.02, 0.36 +/- 0.06, 0.47 +/- 0.05 and 0.84 +/- 0.08, respectively. The relative activities of caspase 3 were 0.21 +/- 0.02, 0.24 +/- 0.05, 0.42 +/- 0.06 and 0.81 +/- 0.09, respectively. Either RPM or DOC alone significantly inhibited the growth of PC cells in nude mice compared to the control. The combination of RPM and DOC produced a significant reduction in tumor volume when compared to RPM or DOC alone. After 5-week treatment, the tumor sizes of LNCap in control, RPM, DOC and RPM + DOC groups were (570 +/- 56) mm(3), (412 +/- 41) mm(3), (425 +/- 46) mm(3) and (221 +/- 26) mm(3), respectively.</p><p><b>CONCLUSIONS</b>RPM could significantly increase the susceptibility of both androgen-dependent and -independent PC cells to DOC; the synergy of RPM and DOC was demonstrated. RPM enhanced the DOC-induced upregulation of caspase activity, resulting in an increasing number of cells in sub-G1 phases. The synergy of the combined treatment might be observed in both androgen-dependent and -independent PC cell lines.</p>

Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Renal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs).</p><p><b>METHODS</b>A cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months.</p><p><b>RESULTS</b>Complaints of ED were reported by 75.5% of the 809 RTRs (age range 19 - 75 years, mean age (45 +/- 10) years), whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%, respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P = 0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%, 75.2%, 87.5% and 92.2% in patients with age below 30 years, 31 - 40 years, 41 - 50 years, 51 - 60 years and over 60 years, respectively (P = 0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P = 0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P = 0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P = 0.000). Patients, whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P = 0.000, 0.001, 0.000, 0.000, respectively). After Logistic regression analysis, only five factors, age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life and CsA-based immunosuppressive regimens sustained their significance.</p><p><b>CONCLUSIONS</b>Renal transplant has varying effects on erectile function. ED is highly prevalent among RTRs and its influential factors are multiple. Age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life, CsA-based immunosuppressive regimens are the main influential factors of ED in male RTRs.</p>

Evaluation of sexual function in men with symptomatic benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the degree of sexual dysfunction in an unselected population of men with benign prostatic hyperplasia (BPH) accompanied by lower urinary tract symptoms (LUTS), and to assess the correlation between sexual dysfunction and urinary symptoms and age.</p><p><b>METHODS</b>A total of 88 men with symptomatic BPH were investigated using the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), Brief Sexual Function Inventory (BSFI), and the measurement of urinary flow rate, the total prostatic volume and serum testosterone. Regression analysis was used to determine the correlation among the variables.</p><p><b>RESULTS</b>The mean age of the patients was (67.90 +/- 7.59) years, the mean IPSS score was (18.4 +/- 7. 79), and the mean IIEF-5 was (8.50 +/- 8.98). There were 76 cases of erectile dysfunction (86.36%). Among the BSFI scores, the mean sexual drive score was (1.92 +/- 2.21), the mean erectile function score was (4.18 +/- 4.96), the mean ejaculation score was (2.55 +/- 3.57), the mean problem assessment score was (10.44 +/- 3.57), and the mean overall satisfaction score was (1.90 +/- 1.37). Among the 88 cases, 65 (72.86%) had poor sexual drive, 70 (79.55%) erectile dysfunction, and 60 (68.18%) poor ejaculation. There was statistically significant correlation between age and sexual symptom scores for erection (gamma = -0.552, P = 0.000), IIEF-5 scores (gamma = - 0.567, P = 0.000), and IPSS (gamma = 0.213, P = 0.047) as well as between IPSS and sexual symptom scores for erection and overall satisfaction (gamma = -0.332, P = 0.002 and gamma = -0.302, P = 0.005). IIEF-5 scores were significantly correlated with sexual symptom scores for each of the three categories (sexual drive, erection and ejaculation) (P < 0.05). Serum testosterone did not correlate to age, IIEF-5 scores and sexual function (P > 0.05), nor did peak urinary flow rate and total prostatic volume to IPSS, IIEF-5 scores and sexual function (P > 0.05).</p><p><b>CONCLUSION</b>Results of this study suggest that age and LUTS are risk factors of sexual function, and sexual dysfunction is closely related to the severity of LUTS.</p>