Diagnosis and treatment of prostatic malignant mesenchymal tumors: Analysis of 20 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis, treatment, and prognosis of prostatic malignant mesenchymal tumors (PMMT).</p><p><b>METHODS</b>We retrospectively analyzed the clinical and follow-up data about 20 cases of PMMT and reviewed the literature relevant to the diagnosis, treatment, and prognosis of the disease.</p><p><b>RESULTS</b>Based on the results of pathology and immunohistochemistry, the 20 PMMT cases included leiomyosarcoma (n = 7), rhabdomyosarcoma (n = 5), prostatic stromal sarcoma (n = 3), chondrosarcoma (n = 1), and undifferentiated PMMT (n = 4). Twelve of the patients were treated by radical prostatectomy (3 concurrently by sigmoid colostomy and 1 by cystostomy), 2 by pelvic tumor resection following arterial embolization, 1 by total pelvic exenteration, 1 by colostomy with pelvic lymph node biopsy, and 4 by conservative therapy because of metastasis to the lung, pelvis and bone. Of the 20 patients, 9 died of systemic metastasis within 3 months after treatment, 3 died at 6, 7, and 14 months, respectively, 3 survived with tumor for 5, 11, and 12 months, respectively, 2 survived without tumor for 12 and 24 months so far, all subjected to periodic chemotherapy postoperatively, and 3 lost to follow-up.</p><p><b>CONCLUSION</b>PMMT is a tumor of high malignancy and rapid progression, for which transrectal ultrasound-guided biopsy remains the main diagnostic method. The clinical stage of the tumor is an important factor influencing its prognosis and the survival rate of the patients can be improved by early diagnosis and combined therapy dominated by radical prostatectomy.</p>

Research and analysis of pre-deployment training curriculums for PLA peacekeeping medical units / 第二军医大学学报

Objective To know about the pre-deployment training curriculum of PLA peacekeeping medical units. Methods Methods including questionnaire survey, spot investigation and seminars were used to collect the information of pre-deployment training curriculum from 260 peacekeepers (from 5 military area commands) and 14 international students from Second Military Medical University; their attitudes toward the curriculums were also collected. Microsoft Excel software, SPSS18.0 and Likert statistical method were used to process the collected data. Results The 9 most popular courses included related knowledge, laws and regulations, and principles of battlefield wound first-aid, etc; the most recognized courses included oral English, related knowledge, and laws and regulations; and courses like water and electricity support had a comparatively lower recognition level. Conclusion More efforts should be made on constructing modularized courses, practicing individualying training, intensifying language training and developing novel teaching mode pre-deployment training curriculums for PLA peacekeeping medical unit.

Hand-assisted-drawing-needle running suture with a curved needle: an effective technique to create a W-ileal neobladder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An important milestone in the area of urinary diversion was the advent of a series of orthotopic bladder substitution (OBS). However, reconstruction of OBS by the traditional hand suture method (THSM) is a time-consuming process. Stapling techniques are considered to be inferior to hand-sewn methods. We report our experience and functional results in patients with W-ileal neobladder by a hand-assisted-drawing-needle running suture (HADNRS).</p><p><b>METHODS</b>Between April 1993 and December 2011, 347 patients (338 men and 9 women) aged 28 - 77 years (median age: 59 years) underwent radical cystectomy, followed by the creation of a modified W-ileal neobladder by HADNRS with a curved needle. A total of 347 (20 patients in 2003) were evaluated by urodynamic tests.</p><p><b>RESULTS</b>The operative time ranged from 110 to 310 minutes (mean 148 minutes), and the mean time of reconstruction by HADNRS, excluding ureterointestinal and ileouretral anastomosis, was (20.2 ± 4.3) minutes. Histopathological analysis of removed specimens showed that 317 patients had transitional cell bladder carcinoma. Of these 317 patients, 19 also had squamous carcinoma and 13 had adenocarcinoma. Glandularis and prostate cancer occurred in 16 and 14 patients, respectively. Three patients (0.8%) had neobladder abdominal fistula. No other early complications or injury to the surgeon's hands occurred due to HADNRS. Of the 20 cases with urodynamic examinations in 2003, two suffered from daytime incontinence and six had nocturnal incontinence. The maximum capacity of the neobladder was (492.9 ± 177.8) ml, and the maximum pressure within the reservoir at the end of filling was (32.1 ± 8.6) cmH2O.</p><p><b>CONCLUSION</b>Reconstruction of W-ileal neobladder by HADNRS is effective and economical.</p>

Stromal tumor of the seminal vesicle: a case report and literature review / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical manifestations, pathological features, diagnosis and treatment of stromal tumor in the seminal vesicle.</p><p><b>METHODS</b>We retrospectively analyzed 1 case of stromal tumor of the seminal vesicle, reviewed relevant domestic and international literature, and summarized the clinical manifestations, pathological features, diagnosis and treatment of the tumor.</p><p><b>RESULTS</b>The patient was a 50 years old male, who underwent excision of the tumor together with the seminal vesicle. Pathology showed it to be stromal tumor of the seminal vesicle. Ultrasonography and CT found no recurrence 10 months after surgery.</p><p><b>CONCLUSION</b>Stromal tumor of the seminal vesicle is rare and easy to be misdiagnosed. Digital rectal examination, and ultrasonography, CT and MRI of the urinary system are useful for its diagnosis. The currently accepted treatment is surgical removal of the tumor, and the prognosis is good.</p>

Incidental prostate cancer in radical cystoprostatectomy specimens / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the rates of prostate cancer (PCa) in radical cystoprostatectomy (RCP) specimens for bladder cancer in mainland China. To determine the follow-up outcome of patients with two concurrent cancers and identify whether prostate-specific antigen (PSA) is a useful tool for the detection of PCa prior to surgery.</p><p><b>METHODS</b>From January 2002 to January 2007, 264 male patients with bladder cancer underwent RCP at our center. All patients underwent digital rectal examination (DRE) and B ultrasound. Serum PSA levels were tested in 168 patients. None of the patients had any evidence of PCa before RCP. Entire prostates were embedded and sectioned at 5 mm intervals.</p><p><b>RESULTS</b>Incidental PCa was observed in 37 of 264 (14.0%) RCP specimens. Of these, 12 (32.4%) were clinically significant according to an accepted definition. The PSA levels were not significantly different between patients with PCa and those without PCa, nor between patients with significant PCa and those with insignificant PCa. Thirty-four patients with incidental PCa were followed up. During a mean follow-up period of 26 months, two patients with PSA > 4 ng/mL underwent castration. None of the patients died of PCa.</p><p><b>CONCLUSION</b>The incidence of PCa in RCP specimens in mainland China is lower than that in most developed countries. PSA cannot identify asymptomatic PCa prior to RCP. In line with published reports, incidental PCa does not impact the prognosis of bladder cancer patients undergoing RCP.</p>

Predictive factors for conversion of transurethral resection of the prostate to open prostatectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the factors for the conversion of transurethral resection of the prostate (TURP) to open prostatectomy and to provide clinical evidence for surgical options.</p><p><b>METHODS</b>From January 1997 to March 2005, we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics, clinical history, laboratory data, ultrasound results, and intraoperative complications of the patients. In addition, multivariate logistic regression was used to determine those variables predicting the conversion of TURP.</p><p><b>RESULTS</b>Thirty-nine (3.59%) of the TURP cases required conversion, mostly because of uncontrollable hemorrhage (71.79%). Multivariate analyses showed that a prostate volume > 85.2 ml (OR = 2.568, P < 0.01), intraoperative slit of capsula prostatic (OR = 1.916, P < 0.01) and a second midstream bladder specimen (VB2) white blood cell count of the urine > 13.5/HP (OR = 1.486, P < 0.01) predicted the conversion to open prostatectomy.</p><p><b>CONCLUSION</b>Benign prostatic hyperplasia (BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatic undergoing TURP are more likely to be converted. And uncontrollable hemorrhage, huge prostate and poor endoscopic vision are the major reasons for the conversion.</p>

A multi-center clinical trial of Qianlieantong tablets for chronic prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis.</p><p><b>METHODS</b>A multi-center, self-controlled open clinical trial was conducted. A total of 280 subjects with chronic prostatitis were enrolled and treated by Qianlieantong Tablets, 3 times a day, 5 tablets each time. Before and after 2 and 4 weeks after the administration, NIH-CPSI scores and white blood cell counts in the prostate secretion were recorded.</p><p><b>RESULTS</b>Of the 273 subjects evaluated, the rates of excellence, effectiveness and ineffectiveness were 35.2% (n = 96), 47.6% (n = 130) and 17.2% (n = 47), respectively, with a total effectiveness rate of 82.8%. After 4 weeks'medication, the scores of the subjects on NIH-CPSI pain, voiding and quality of life and white blood cell counts in prostate secretion were significantly decreased compared with pre-treatment (P < 0.01). No adverse events or laboratory abnormality related to the medication were observed.</p><p><b>CONCLUSION</b>Qianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.</p>

The clinical study of 120 cases total cystectomy and W shape orthotopic ileal neobladder / 中华外科杂志

<p><b>OBJECTIVE</b>To study advantages or disadvantages of total cystectomy and W shape orthotopic ileal neobladder.</p><p><b>METHODS</b>Radical cystectomy and ileal new bladder was performed antegradly and retrogradly for 120 male patients. For the construction of the reservoir, the 40 cm ileal segment was isolated along its antimesenteric border and then arranged into a W shape. The incised ileum was sutured blanketly to create urine bag. The ureters were replanted at the two corners of the W shape by way of creating nipple.</p><p><b>RESULTS</b>The first 50 cases took 210-300 min with a mean of 270 min. The later 70 cases took 110-205 min with a mean of 143 min. Ninety-one of 120 cases had been followed up for 2-88 months with a mean of 30 months. Eighty-five cases had achieved excellent daytime continence, whereas 71 cases had nighttime continence. There were 9 cases of hydroureter and 2 cases of moderate hydronephrosis. Renal function of 2 cases were slightly abnormal. Hypokalemia occurred in 6 cases, and there was no metabolic-disorder. On voiding cystography, only 1 case showed reflux in right ureter. Only 2 case suffered from cancer recurrence of urethral and no patient suffered from cancer recurrence of neobladder. Twenty patients were evaluated by urodynamic examine. The urine flow curve showed continual shape in 12 cases, while intermittent shape in 8 cases. Voiding cystourethrography showed the neobladder outlet presented funnel shape and open well in continual group, while lack of funnel shape or bladder neck opened badly in intermittent group.</p><p><b>CONCLUSION</b>The modified total cystectomy and ileal new bladder are effective and reliable treatment for patients.</p>

Distribution features of Gleason score and its relationship with clinical stages in 346 prostate cancer patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the distribution features of Gleason score and evaluate the relationship between Gleason score and clinical stages in patients with prostate cancer.</p><p><b>METHODS</b>Surveys were made of the inpatients with prostate cancer diagnosed by pathology from January 1992 to June 2005 in our hospital. Gleason score and clinical stages were determined on the basis of pathological examination and clinical data of the prostate cancer patients. The patients were divided into three groups (1992-1999, 2000-2002 and 2003-2005). The Chi-square test was used to evaluate the distribution and differences of Gleason score among the three groups. Spearman rank correlation was applied to the evaluation of the relationship between Gleason score and clinical stages.</p><p><b>RESULTS</b>We found a statistically significant shift in the distribution of Gleason score (chi2 = 17.703, P < 0.01), and a slight increase in the mean Gleason score. The proportion of moderately differentiated tumor increased (chi2 = 10.736, P < 0.01). There was little change in the proportion of Gleason score 7, 8, 9 and 10 (chi2 = 4.038, P > 0.05). Gleason score had a significant positive correlation with clinical stages in the 346 cases of prostate cancer (r = 0.452, P < 0.01). Significant difference was observed between Gleason score 2-6 and 7 or 8-10 (chi2 = 8.786, P < 0.01, chi2 = 22.956, P < 0.01), but not between the latter 2 groups (chi2 = 0.787, P > 0.05) in prediction of organ-confined disease.</p><p><b>CONCLUSIONS</b>Gleason score 7 shows the similar value to Gleason score 8-10 in predicting the progression of the disease. Gleason score was significantly correlated with clinical stages, which suggests that Gleason score is also an important indicator for the prognosis of prostate cancer.</p>

A clinical study of prostat combined with an antibiotic for chronic nonbacterial prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Prostate in combination with an antibiotic for the treatment of chronic nonbacterial prostatitis.</p><p><b>METHODS</b>A double-blind, parallel contrasted, multi-central method was applied in the study. After the Stamey test and expressed prostate secretion (EPS) examination, 160 patients with prostatitis were recruited and randomized into a trial group (80 cases with 1 case missing) and a control group (80 cases). In the trial group, the patients used the levofloxacin and Prostate during the first 4 weeks and Prostate only during the following 4 weeks. In the control group, the patients used the levofloxacin and placebo during the first 4 weeks, and placebo only during the following 4 weeks. Before and 4 and 8 weeks after the treatment, the patients were visited and evaluated by the national institute health-chronic prostatitis symptom index (NIH-CPSI), EPS, and asked about the side.</p><p><b>RESULTS</b>After 4-week and 8-week treatment, the pain index dropped by 3.34 +/- 2.45 and 4.06 +/- 3.03 in the trial group, and effects. 2.28 +/- 2.42 and 3.30 +/- 3.29 in the control; the voiding index dropped by 2.22 +/- 1.79 and 2.77 +/- 2.04 in the trial group, and 1.24 +/- 1.67 and 1.83 +/- 2.25 in the control respectively. There was significant difference between pre-treatment and post-treatment in both the two groups (P < 0.01), while the difference was not significant between 4-week and 8-week post-treatment (P > 0.05). And there was significant difference between the two groups in the pain index and voiding index (P < 0.01), but not in the white blood cell count and lipid in the EPS (P > 0.05). No serious side effects were recorded, and the tolerance to Prostate and placebo showed no significant difference.</p><p><b>CONCLUSION</b>Prostate in combination with an antibiotic can effectively relieve the pain and voiding symptoms and improve the life quality of the patients with nonbacterial prostatitis and well deserves to be recommended in clinical practice.</p>

Sexual-nerve-Sparing radical cystectomy: experience with 32 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of sexual-nerve-sparing radical cystectomy.</p><p><b>METHODS</b>Thirty-two male patients were treated with sexual-nerve-sparing radical cystectomy in our hospital in the past 5 years. The age of the patients ranged from 38 to 72 years, with the course of the disease ranging from 2 days to 20 years. All of them were potent preoperatively. Radical cystectomy was performed antegradely and retrogradely with the neurovascular bundle spared.</p><p><b>RESULTS</b>The patients were followed up for 6 to 54 months, 3 achieved sexual activity of Grade I, 6 Grade II and 23 Grade III after the operation. The recovery time of erectile function ranged from 2 to 14 months, averaging at 4. 5 months.</p><p><b>CONCLUSION</b>Whenever condition suits, sexual-nerve-sparing radical cystectomy is to be strongly recommended.</p>

Penile squamous carcinoma in circumcised patients: a report 17 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of penile carcinoma in circumcised men.</p><p><b>METHODS</b>We reviewed 17 cases of penile carcinoma detected 1 month to 16 years after circumcision performed in our hospital from January, 1997 to December, 2004.</p><p><b>RESULTS</b>Of the total number, 11 cases were diagnosed as penile carcinoma 1 - 12 months and the others 3 - 16 years after the circumcision. Sixteen of them were treated by partial penectomy, anti 1 first by extensive circumcision and later by partial and total penectomy successively after recurrence. Cloquet nodes biopsy showed 16 cases to be pathologically well-differentiated and I case moderately differentiated penile squamous carcinoma. One died of extensive metastasis, but the other 16 remained disease-free survivals.</p><p><b>CONCLUSION</b>Circumcised adult men, especially those over 40 years of age, are likely to develop penile carcinoma. Patients with inflammation, plaque or ulcer in the prepuce should be checked by pathological biopsy and followed up closely. For Stage-I penile squamous carcinoma, partial penectomy is shown to be an effective therapeutic option, and Cloquet's nodes biopsy is necessary for all patients.</p>

Diagnosis and treatment of priapism due to neoplasma of penis / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the clinician's ability for emergency treatment of priapism.</p><p><b>METHODS</b>Both cases received 2 mg to 8 mg of metaraminol injection at the root of cavernous body, and perfusion of heparinized saline at glans and root of cavernous body of the penis by contrecoup, but they had not good response to the above therapy. At last surgery was performed.</p><p><b>RESULTS</b>Total penectomy was performed for both cases. One case was diagnosed of penile sarcoma, and another was metastatic transitional cell carcinoma.</p><p><b>CONCLUSION</b>Priapism due to neoplasma is infrequent, it should not be misdiagnosed in case of emergency.</p>

Clinical application of alpha1 adrenoceptor antagonist Naftopidil to the treatment of chronic non-bacterial prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the efficacy and safety of alpha1 adrenoceptor antagonist Naftopidil in the treatment of chronic non-bacterial prostatitis.</p><p><b>METHODS</b>An opened, self-controlled, multicentral clinical trial was conducted. One hundred and six cases of patients who had been diagnosed as chronic non-bacterial prostatitis (NBP) were treated with Naftopidil (25 mg once a day) for 4 weeks. The efficacy was evaluated by the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and the WBC in the examination of prostatic secretion (EPS) after the treatment.</p><p><b>RESULTS</b>After 4 weeks therapy, 105 cases were evaluable. After treatment, NIH-CPSI total score were averagely decreased 12.0 points (P <0.001), symptom score 7.9 points (P <0.001) and QOL score 4.1 points (P <0.001). There was a statistically significant difference in WBC count ([(15.2 +/- 15.1)/HP vs (9.5 +/- 12.0)/HP, P < 0.01] and max flow rate(MFR) [(19.2 +/- 4.8) ml/s vs (22.7 +/- 4.9) ml/s, P < 0.01]. The total effective rate were 84.8% in the whole group. The clinical adverse rate was 3.81%, including 3 cases of mild dizziness and 1 case of mild inappetence.</p><p><b>CONCLUSION</b>alpha1 adrenoceptor antagonist Naftopidil is effective and safe for the treatment of chronic non-bacterial prostatitis.</p>

Age and pathological features of 481 prostate cancer patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the age and pathological features of prostate cancer patients in recent years.</p><p><b>METHODS</b>An analysis was made of the age and pathological features of 481 cases of prostate cancer pathologically diagnosed from January 1998 to April 2004, 39 cases in 1998, 69 in 1999, 73 in 2000, 68 in 2001, 72 in 2002, 121 in 2003, and 39 in the first four months of 2004.</p><p><b>RESULTS</b>The patients ranged in age from 40 to 91 years, averaging 72, 95% between 55 and 84, and 84.2% over 65 years. Pathologically, 14 cases were well, 29 moderately, and 83 poorly differentiated according to the three-grade system (WHO, the Mostofi system), with 355 cases ungraded. Forty cases (8.3%) were microcarcinoma (< 1 cm), and 20 cases (4.2%) incidental carcinoma. Of the total number, 473 cases (98.1%) were pathologically diagnosed as adenocarcinoma, 1 endometrioid adenocarcinoma, 1 squamous cell carcinoma, 1 signet ring cell carcinoma, 1 adenosquamous cell carcinoma, 1 small cell carcinoma, 1 mucinous adenocarcinoma, 1 adenoid cystic carcinoma, and 1 transitional cell carcinoma.</p><p><b>CONCLUSION</b>Prostate cancer commonly develops in men over 65 years, and adenocarcinoma is the most common histological type. The disease has become a major malignant tumor to endanger elderly males.</p>

Diagnosis and treatment of urinary neurofibrosarcoma / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, diagnosis and treatment of urinary neurofibrosarcoma.</p><p><b>METHODS</b>Clinical data of 1 case of urinary neurofibrosarcoma was analyzed retrospectively and related literature reviewed. The 61-year old male patient had undergone TURP for benign prostate hyperplasia ten months before.</p><p><b>RESULTS</b>Total urethral cavernostomy, total cystectomy and ileal cystostomy were performed on the patient and pathological diagnosis pointed to urinary neurofibrosarcoma. Another operation was done for metastatic rectal mass, which revealed abdominal metastasis. With progressing consumptive constitution, the patient died 40 days after the second operation.</p><p><b>CONCLUSION</b>It is difficult to make a definite diagnosis in urinary neurofibrosarcoma, and the effective treatment for this highly malignant disease needs to be further studied.</p>

Inverted urothelial papilloma: report of 151 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features, pathology, diagnosis and treatment of inverted urothelial papilloma.</p><p><b>METHODS</b>A total of 151 cases of urothelial inverted papilloma were analysed retrospectively. Of the cases, 134 were male and 17 were female, with a mean age of 54 years old. Most patients complained of painless gross hematuria. The diagnosis could be established mainly by ultrasonic, intravenous urography, retrograde pyelography, cystoscope and pathology. Among them, 7 cases who had the papilloma at upper urinary tract underwent nephroureterectomy except one. One hundred and forty-four cases had the papilloma at low urinary tract, with 124 treated by transurethral bladder tumor resection (TURBT), among which 11 cases accompanying benign prostatic hyperplasia were treated by transurethral prostatic resection, 3 by transurethral resection of prostatic urethral tumor, 15 by partial cystectomy, 2 by total cystectomy.</p><p><b>RESULTS</b>One hundred and eighteen cases were followed up 1 year to 12.5 years (mean 6.3 years). Intravesical recurrence was found in 5 cases. Of them 2 cases developed malignance in 8 and 30 months postoperatively, and 1 case underwent total cystectomy.</p><p><b>CONCLUSIONS</b>Inverted urothelial papilloma is a benign tumor, which appears male predominant. Most of the lesions are found in the bladder. TURBT is the preferred treatment choice for inverted papilloma of the bladder. Although this disease has a good prognosis, regular follow-up observations are necessary.</p>

Significance and limitations of f/tPSA in differential diagnosis of prostate cancer with tPSA levels between 4 and 10 ng/ml / 中华外科杂志

<p><b>OBJECTIVE</b>To study significance and limitations of the ratio of free to total prostate specific antigen (f/t PSA) in differential diagnosis between prostate cancer and benign prostatehyperplasia (BPH) with total PSA (tPSA) levels between 4 and 10 ng/ml.</p><p><b>METHODS</b>We analysed retrospectively 180 prostate cancer and BPH patients who were diagnosed and treated in our hospital from October 1998 to October 2002 and had serum tPSA levels between 4 and 10 ng/ml. Of the 180 patients, 36 (20%) were histologically confirmed as prostate cancer and 144 (80%) BPH. The tPSA and free PSA (fPSA) in serum were measured by micropartical enzyme immunoassay. Prostate volume was measured by transabdominal ultrasonography. We chose Student's t-test for comparison between prostate cancer and BPH groups. The correlation between prostate volume and f/t PSA was analyzed using Pearson's correlation coefficient.</p><p><b>RESULTS</b>The mean values of tPSA and f/t PSA were 6.75 ng/ml and 0.17 in patients with prostate cancer, 6.48 ng/ml and 0.25 in patients with BPH. The mean value of tPSA wasn't significantly different between patients with prostate cancer and BPH (P > 0.05). However, the mean value of f/t PSA of patients with prostate cancer was significantly lower than that of patients with BPH (P < 0.01). Furthermore, there were significant and positive correlation between prostate volume and f/t PSA in both groups with prostate cancer and BPH (prostate cancer group's correlation coefficient (r = 0.50, P < 0.01); BPH group (r = 0.24, P < 0.01). There was significant difference in f/t PSA between prostate cancer and BPH patients with prostate volumes more than 40 cm(3) (P < 0.05), but not between these two groups with prostate volumes more than 40 cm(3) (P > 0.05).</p><p><b>CONCLUSION</b>The f/t PSA is significant in differential diagnosis between prostate cancer and BPH with tPSA levels between 4 and 10 ng/ml. But prostate volume has an effect on f/tPSA. The f/tPSA has diagnostic value of differentiation only when the prostate volume is less than 40 cm(3).</p>

Change of nerve growth factor mRNA in human detrusor in bladder outlet obstruction with benign prostatic hyperplasia and their implication / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the change of nerve growth factor (NGF) mRNA in human detrusor in bladder outlet obstruction (BOO) with benign prostatic hyperplasia (BPH) and their implication.</p><p><b>METHODS</b>Eight cases of bladder cancer and 40 patients with BPH were included in this study. All patients were divided into three groups, a control group, an obstructive detrusor stability group and an obstructive detrusor instability group. NGF mRNA in detrusor from all patients was measured using a RT-PCR.</p><p><b>RESULTS</b>The RT-PCR study indicated that NGF mRNA was expressed in detrusor of three groups of patients. There were significant differences among the three groups (P < 0.01). The expression of NGF mRNA in the obstructive instability group was higher than that in the obstructive stability group and in the control group. The NGF mRNA level in the obstructive stability group was higher than that in the control group.</p><p><b>CONCLUSION</b>The expression of NGF mRNA in detrusor was elevated in BOO with BPH. The elevated expression of NGF mRNA might be correlated with detrusor instability (DI) due to BOO.</p>

Attentive problem in the clinic about acute obstructive anuria at upper urinary tract / 中华外科杂志

<p><b>OBJECTIVE</b>To improve the understanding of acute obstructive anuria at upper urinary tract in order to cope properly with corresponding clinical problems.</p><p><b>METHODS</b>The clinical problems of acute obstructive anuria at upper urinary tract in 55 patients was summarized and analysed. Anuria, lumbago, edema and progressive increase of blood creatinine and ureal nitrogen were the main bases of diagnosis. B-typed ultrasonography and plain film of abdomen (KUB) were the first choice in examinations. The treatment principles lied in prompt removal of obstruction as well as effective prevention and treatment of infection to protect renal function to maximum extent.</p><p><b>RESULTS</b>Forty-three cases (78.2%) recovered normal renal function. Ten cases (18.2%) still had azotemia three months after treatment. Two cases gave up treatment.</p><p><b>CONCLUSIONS</b>The reason of tumor for anuria should be paid attention to. The first choice in treatments is ureteral intubation by cystoscope. Diuretic should be used cautiously.</p>