Research progress of stem cells and gene therapy for erectile dysfunction / 中国医师杂志

Erectile dysfunction (ED) is a highly prevalent health problem with considerable impact on the quality of men and their partners.There are many drawbacks in the existing ED treatment.Stem cells have the function of self-renewal and differentiation into various cell types.Gene therapy mainly focuses on the regulation of various transmitters and enzymes in nitricoxide synthase/cyclic guanosine monophosphate (NOS/c GMP) pathway,growth factors,peptides and channel proteins,which make them have broad application prospects in the field of ED treatment.In recent years,stem cell and gene therapy of ED have achieved initial results.This article aims to review the latest research progress in this field.

Impact of transrectal real-time tissue elastography guiding biopsy combined with peak strain index for diagnosing prostate cancer / 中华泌尿外科杂志

Objective To evaluate the value of transrectal real-time tissue elastography (RTE) targeted prostate biopsy in the peripheral zone combined with peak strain index.Methods One hundred and forty-one patients with suspicious prostate lesions in the peripheral zone were evaluated from February 2011 to February 2014.All the patients underwent RTE with a mean age of 71.6 years,PSA of 30 ng/ml,prostate volume of 50.3 ml and measured peak strain index (PSI).The diagnostic value of PSI was assessed by receiver operating characteristic (ROC) curve.Two-core RTE combined with PSI targeted prostate biopsy was taken and subsequently a 10-core systematic biopsy was taken.The value of RTE was evaluated.The data of targeted biopsy and systematic biopsy in prostate were both reviewed and statistically compared.Results Cancer was detected in 72 of 141 patients (PSI,mean 24.79),and 69 patients had benign prostate disease (PSI,mean 3.02).PSI value of prostate cancer was significantly higher than that of the benign lesions (P ＜ 0.05).Prostate cancer could be predicted with the highest sensitivity (87.5％) and specificity (88.6％) using the cutoff value of PSI ≥ 5.97 with an area under the curve of 0.95.RTE targeted biopsy combined with PSI could detect 95.6％ of moderate or high risk prostate cancer.One hundred and fifty-nine suspicious areas detected by RTE in 141 patients were biopsied with 2 cores for each area.The positive incidence of prostate cancer in RTE-targeted biopsy cores was 44％ and in systematic biopsy was 30.2％ (P ＜ 0.05).Among the 72 prostate cancer patients,63 cases (87.5％) were detected by RTE-targeted biopsy,62 cases (86.1％) by systematic biopsy (P ＞ 0.05).Conclusions RTE combined PSI can improve the detection rate of prostate cancer in the peripheral zone and likewise guide targeted biopsy combined with svstematic biopsy to detect more moderate or high risk prostate cancer.

The inhibitory effect of eupatorium japonicum thunb and foeniculum vulgare extract on prostatic hyperpla-sia in rats / 医学研究生学报

Objective Benign prostatic hyperplasia ( BPH) is one of common diseases in aged males , and searching for new therapeutic drugs to BPH has been a research hotspot in recent years .This article was to study the inhibitory effect of eupatorium ja-ponicum thunb and foeniculum vulgare extract ( EFE) on benign prostatic hyperplasia in rats and its possible mechanism . Methods 48 male rats were randomly divided into 6 groups:normal control group without any treatment , model group of BPH treated with subcu-taneous injection of testosterone propionate , positive control group of BPH treated with dutasteride , high, middle and low dosage groups according to different EFE dosage (156 mg/kg, 234 mg/kg and 312 mg/kg).45 days after the treatment, the rats were sacrificed for measurement of the prostate glandular wet weight , the index of prostate gland ( PI ) , the morphological changes of prostate gland by light microscopy and the content of sex hormone . Results The prostate wet weight and PI decreased after EFE treatment for 45 days compared with the BPH model group(P<0.01 ).The hyperplastic glandular epithelium papilla waned and even disappeared in three EFE groups under the light microscope , and the epithelial cells became cubical or flat .High dosage EFE group (312 mg/kg) has simi-lar efficacy to dutasteride group .EFE significantly reduced serum testosterone content , dihydrotestosterone content and T/E2 ratio( P<0.05 ). Conclusion EFE can significantly inhibit prostatic hyperplasia in rats , and its mechanism is related to the decrease of the contents of serum testosterone and dihydrotestosterone as well as T/E2 ratio.

Changes of etiology and management of male urethral stricture in China: a multicentre evaluation / 中华泌尿外科杂志

ObjectiveTo investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years,and to investigate whether there were any changes in etiology and management of urethral stricture with time change.MethodsThe database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected.The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture,and for the changes in etiology and management with time change.ResultsThere were 3455 operations for urethral stricture during the study period.The main causes of urethral strictures were traumas in 1833 patients (53.05％),among which pelvic fractures were in 1327 (38.41％) and perineal trauma in 506 (14.65％).The second cause was iatrogenic causes in 1181 patients (34.18％ ),among which transurethral operations or examinations were in 602 (17.42％),hypospadias surgery in 291 (8.42％) and urethral catheterization in 164 (4.75％ ).Less common causes were urethritis in 201 patients (5.82％),lichen sclerosus in 149 (4.31％),undefined in 91 (2.63％).The treatments of urethral strictures were endourological surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc.The ratios of using various techniques in total number of patients were obviously different by time.The most application technique for treatment of urethral stricture was endourological surgery ( 709 ) during 2004 -2006 and occupied 52.67％ in total number of patients.It was gradually decreased during 2007 -2009 (726) and only occupied 34.42％ (P ＜0.01 ).Open urethroplasty gradually increased during 2007 -2009 ( 1243,58.94％ ) compared with the first three years (563,41.83％ ) (P ＜ 0.01 ). Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes.The main treatments of urethral strictures were endourological surgery and open urethroplasty.Endourological surgery was significantly decreased in total number of patients,while open urethroplasty were significantly increased during the late three years.

Correlation between quantitative parameter in power Doppler ultrasonography and angiogenesis of prostate nodules / 中国医学影像技术

Objective To explore the relationship between the quantitative parameter in transrectal power Doppler ultrasonography (PDUS) and angiogenesis of prostate nodules in pathology. Methods PDUS and the analytic software of color flow were used, and peak vascularization indexs (PVIs) of 94 prostate nodules in 73 patients were recorded. The biopsy specimen was stained with CD34 antibody, and the microvessel density (MVD) was calculated. The correlation between PVI and MVD was statistically analyzed. Results PVI and MVD of the malignant nodules, in both transition zone (TZ) and peripheral zone (PZ), were significantly higher than those of the benign nodules, respectively (P＜0.05). There was positive correlation between PVI and MVD of the malignant nodules (rTZ=0.76;rPZ=0.79), but no correlation between PVI and MVD was found in TZ of benign nodules (r=0.18), while there was correlation between PVI and MVD in PZ (r=0.44). In TZ, the sensitivity and speciality of differentiation malignant nodules from benign nodules were 78.57% and 80.77%, respectively, and in PZ they were 62.07% and 91.00%, respectively. Conclusion As a quantitative parameter in PDUS, PVI can indirectly reflect the angiogenesis of prostate cancerous nodules, providing a new method for differentiation malignant nodules from benign nodules.

Transrectal real-time elastography in normal prostate and benign prostatic hyperplasia / 中国医学影像技术

Objective To observe the characteristics of normal prostate gland and benign prostatic hyperplasia (BPH) on transrectal real-time elastography (TRTE). Methods A total of 77 BPH patients and 17 normal subjects underwent TRTE. The elastographic images were analyzed with the five-point subjective elastic scale. The strain ratio of transition zone, peripheral zone, and transition zone to peripheral zone were respectively measured to compare the stiffness of each zone. Results The elasticity scores of both BPH group and normal prostate group were 1 and 2 in scoring system. There was no significant difference of elasticity scores between BPH group and normal prostate group (P=0.2252), as well as in strain ratio of transition zone (P=0.9793), peripheral zone (P=0.8986), and transition zone to peripheral zone (P=0.5233). Conclusion The stiffness of normal prostate gland and BPH could be offered by TRTE.

Clinical analysis of postoperative delirium after endoscopic surgery in patients with benign prostatic hyperplasia / 中华老年医学杂志

Objective To prevent the occurrence of postoperative delirium after endoscopic surgery in patients with benign prostatic hyperplasia (BPH). Methods A total of 370 BPH patients receiving endoscopic surgery in our hospital were involved in this study. The clinical parameters including age, other systemic diseases, operation method, operation time and postoperative pain were investigated as predictive risk factors. Then the data were dealt by χ~2 test, single factor analysis or multivariate logistic regression analysis. Results Postoperative delirium occurred in 19 cases (5. 1%). Univariate analysis demonstrated that many factors were significantly correlated with the postoperative delirium in elderly patients, such as age (χ~2 = 7. 37, P<0. 05), other systemic diseases (χ~2=10.26, P<0.05), operation time (χ~2 = 19. 87, P<0.05) and postoperative pain (χ~2= 4.99, P<0. 05). The multivariate logistic regression analysis showed that age (OR = 5. 38, P< 0.05), other systemic diseases (OR = 4. 97, P<0. 05) and operation time (OR = 6. 53, P<0. 05) were important factors for postoperative delirium. Conclusions Paying more attention to the advanced age, giving sufficient preoperative preparation and reducing operation time may help to prevent postoperative delirium.

Transrectal Doppler and contrast-enhanced ultrasonography to siscriminate benign and xancerous nodules in prostate / 中华泌尿外科杂志

Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.

Progress of transrectal ultrasonography in the diagnosis of prostate cancer / 中国介入影像与治疗学

Transrectal ultrasonography is one of the early diagnostic approaches of prostate cancer.In this article,the recent study progression of conventional transrectal ultrasonography with combination of new techniques,such as contrast-enhanced ultrasonography,elastography,image fusion,and so on,in diagnosis of prostate cancer was summarized on the basis of a review of the literatures.

CCND1 gene A870G polymorphism and genetic susceptibility to prostate cancer / 中华泌尿外科杂志

Objective To investigate the possible association between the CCND1 A870G polymorphism and susceptibility to prostate cancer(PCa)in a Chinese population.Methods The CCND1 A870G genotypes were determined by TaqMan assays in 245 PCa cases and age-matched 245 controis.Odds ratios(OR)for PCa and 95%confidence intervals(CI)from unconditional logistic regression models were used to evaluate relative risks.Age,a potential PCa risk factor,was included in the logistic regression models as a covariate in the multivariate analyses on genotype and PCa risk.Results The frequencies for G and A alleles were 0.476,0.524 in PCa cases,and 0.408 and 0.592 in controls,respectively.The G allele was marginally significantly associated with the presence of PCa (P=0.054)and had an increased risk for PCa(OR=1.31,95%CI=1.00-1.72)as compared to theA allele.Compared to AA homozygote,AG heterozygote had a 1.43-fold increased risk(95%CI=0.89-2.31,P=0.142),whereas GG homozygote had a significantly higher 2.02-fold increased risk (95%CI=1.07-3.80,P=0.029)of PCa(Armitage's trend test,P=0.029).The G allele(AG or GG genotype)was more frequently found in PCa patients with metastasis than those without metastasis(P=0.014).Conclusion The G allele of CCND1 A870G is associated with the presence of PCa and GG homozygote is potentially one of the genetic risk factors for PCa in Chinese population.The G allele may be associated with the progression of PCa metastasis.

Expression of DNA methyltransferase 1 in transitional cell carcinoma of bladder by real-time PCR / 中华泌尿外科杂志

Objective To investigate the expression of DNA methyltransferase 1 (DNMT1)mRNA in tissue of human transitional cell carcinoma of bladder(TCCB)and its clinical significance.Methods DNMT1 mRNA expression in 35 tumor tissues and 10 normal bladder tissues was measured by real-time PCR.Results Higher expression of DNMT1 transcripts was detected in tumor(3.25±0.74)than in normal tissues(1.53±0.44,P＜0.001).The expression level of DNMT1 mRNA in stage Tis-T1,T2-T4 was 3.14±0.67,3.31±0.84;in grade Ⅰ,Ⅱ,Ⅲ was 3.13±0.59,3.25±0.64,3.43±0.55;in patients older tham 40 years and younger than 40 years was 3.34±0.50.3.01±0.27;in male and female group was 3.31±0.42,3.01±0.20;in primary and recurrence group was 3.21±0.63,3.45±0.33.mRNA levels did not correlate with grade.stage and recurrence (P＞0.05).Higher levels of expression were associated with advanced age(P＜0.05).Male group had significant higher levels of expression than female group(P＜0.05).Conclusions Over-expres-sion of DNMT1 may play an important role in TCCB.DNMT1 can be an important therapeutic target in TCCB.

Preparation of anti-prostate stem cell antigen monoclonal antibody and experimental study on mice xenografts of prostate cancer / 中华泌尿外科杂志

Objective To prepare monoclonal antibody against Prostate Stem Cell Antigen(PSCA) and explore the inhibitory effects of Anti-PSCA mAb in treatments of human prostate cancer xenografts in mice. Methods Balb/c mice were immunized by PC-3 cell line. After fusing and screening, the anti-PSCA McAb’s characterizations were determined. Solid tumors in mice were produced by subcutaneous injection with PC-3 cells in the flanks of the mice.We picked out 10 mice bearing human prostate cancer xenografts.They were divided into a treatment group (n_1=5) and a control group (n_2=5).200 ?g Anti-PSCA mAb was injected into abdominal cavity of each mouse of the treatment group and PBS for them of the control group.Anti-PSCA mAb and PBS were administered once every three days for consecutive three times.The mice survival conditions of two groups were recorded during 5 weeks.The serum PSA, the tumor weights and dimensions of survived mice were measured.The tumor volume inhibition rate was calculated. T-test was performed to compare differences of PSA in serum,tumor weights and volumes between the treatment and control groups.Routine pathological slides of tumor tissue were observed under light microscope to evaluate the range of tumor tissues damaged by Anti-PSCA mAb. Ultrastructure was observed with transmission electron microscope. Results A marine McAb was produced, which raised against PSCA,belonged to IgG1 subclass. The average PSA serum level of the two groups were(3.28?0.55)ng/ml and(7.26?0.43)ng/ml.The weights of tumors of the two groups were(0.95?0.17)g and(3.08?0.18)g.The volumes of them were(164.59?14.08)mm3 and(548.49?19.79)mm3.There are remarkable differences between the treatment group and the control group(P

Dynamic contrast-enhanced MR of the prostatic cancer and benign prostatic hyperplasia: correlation with angiogenesis / 中华放射学杂志

Objective To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnose of prostatic cancer and benign prostatic hyperplasia (BPH), and to determine the correlation between dynamic MRI findings with angiogenesis.Methods Thirty-two cases of prostatic cancer and 40 cases of BPH underwent dynamic contrast-enhanced MRI.All the patients in this study were diagnosed by histopathology.The results of dynamic contrast-enhanced MRI were evaluated by early-phase enhancement parameters and time-signal intensity curves (SI-T curves), and the curves were classified according to their shapes as type Ⅰ, which had steady enhancement; type Ⅱ, plateau of signal intensity; and type Ⅲ, washout of signal intensity.The pathologic specimens of region of interest (ROI) were obtained, and HE staining, immunohistochemical vascular endothelial growth factor (VEGF), and microvessel density (MVD) measurements were performed.The relationships among dynamic contrast-enhanced MRI features, VEGF, and MVD expression were analyzed.Results In the early-phase enhancement parameters of dynamic contrast-enhanced MRI, onset time,maximum signal intensity, and early-phase enhancement rate differed between prostatic cancer and BPH(P

Transurethral electrovaporization for benign prostatic hyperplasia in the elderly over 70 years / 中华老年医学杂志

Objective To summarize and evaluate the transurethral electrovaporization of prostate (TVP), a minimally invasive method for elderly patients with benign prostatic hyperplasia(BPH). Methods After full preparation,TVP was performed on 96 cases of 70 95 year old BPH patients, and all patients were followed up for 3 6 months after operation. Results On the average,the operation time was 48 minutes, blood loss 88 ml, catheterization time was 4 5 days. The patients had satisfactory voiding after removal of the catheter and the average post operative hospital stay was 6 5 days. By 3 6 months of follow up, I PSS score dropped to 9 8 and 6 5; peak urine flow increased to 13 6 15 8 ml/s, residual urine dropped to 28 5 12 0 ml( P

Perioperative care in transurethral electrovaporization of the prostate in the treatment of benign prostatic hyperplasia / 中国微创外科杂志

Objective To summarize the perioperative care experience in patients with benign prostatic hyperplasia (BPH) treated by transurethral electrovaporization of the prostate (TVP). Methods A retrospective analysis of 693 cases of BPH treated by TVP from June 1998 to September 2002 was conducted. Results The operation time ranged (25～130) min (mean, 54 min). Four patients intraoperatively presented with the early symptoms of the transurethral resection syndrome (TURS) and were treated promptly, without deaths during operations. Follow-up checkups for (3～9) months in 422 cases showed that, from the preoperative period to the 3rd postoperative month, the I-PSS declined from (24.8?3.2) points to (11.4?1.9) points ( t=5.48; P

Expression of E-Cadherin 、?-Catenin in human renal cell carcinoma / 中华泌尿外科杂志

Objective To elucidate the functional changes of E-cadherin (ECD) and ?-Catenin in the process of invasion and metastasis in renal cell carcinoma (RCC). Methods The expressions were investigated in 41 RCC by immunohistochemical staining of SP methods. Results Decreased expression of ECD and ?-Catenin correlate with the progression and higher clinical stage and poorer outcomes (P