Clinical significance of transrectal ultrasound measurement of prostate volume in predicting prostate cancer by free prostate specific antigen density / 现代泌尿外科杂志

【Objective】 To explore the application value of free prostate specific antigen density(fPSAD) based on rectal ultrasound in the prediction of prostate biopsy results. 【Methods】 Data of 578 patients undergoing transrectal ultrasound guided prostate biopsy during Jan.2014 and Jul.2021 were retrospectively analyzed, including prostate specific antigen(PSA) level, free prostate specific antigen(fPSA) level, fPSA/total prostate specific antigen(tPSA), prostate specific antigen density(PSAD), combined prostate specific antigen density(cPSAD), fPSAD, prostate volume and other clinical parameters. 【Results】 There were 253 cases of prostate cancer and 325 cases of prostatic hyperplasia. The positive puncture rate was 43.8%. The critical value of fPSAD was 0.05, the corresponding area under receiver operating characteristic (ROC) curve was 0.830, and the Yoeden index was 0.539. The sensitivity, specificity, diagnosis accordance rate and Kappa value of fPSAD to predict prostate cancer were 0.76, 0.77, 76.7% and 0.529, respectively. Compared with PSA, fPSA/tPSA and PSAD, PSA had the highest sensitivity (92.5%), fPSAD had the highest specificity (77.2%), and fPSAD had the highest diagnostic accordance rate (76.7%). 【Conclusion】 When transrectal prostate volume measurement is used to predict prostate cancer, fPSAD has relatively high specificity and diagnosis accordance rate, which is obviously better than using PSA, fPSA/tPSA ratio and PSAD alone in the differential diagnosis and prediction of prostate cancer and prostatic hyperplasia.

Restriction landmark genomic scanning for screening aberrant CpG methylations in prostate cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To screen methylations of CpG islands in prostate cancer using restriction landmark genomic scanning (RLGS).</p><p><b>METHODS</b>The DNA was extracted from homogeneous cells captured by laser capture microdissection in 20 prostate cancer and 18 benign prostatic hyperplasia (BPH) tissues for scanning the CpG islands using RLGS. The methylation status of each CpG island was compared between the cancer and BPH samples to screen the genes involved in prostate cancer development. The screened genes were uploaded to DAVID database for GO analysis, and the genes with the most significant methylation were analyzed by pyrosequencing.</p><p><b>RESULTS AND CONCLUSION</b>Among all the tested CpG islands, 10245 (37.2%) in prostate cancer and 8658 (30.3%) in BPH samples were found to be abnormally methylated, and >60% of the methylated CpG islands were in the promoter region. Compared with BPH samples, the prostate cancer samples showed differential methyation in 735 CpG islands, including 458 hepermethyated and 256 hypomethelated ones. Seven genes (DPYS, P16, APC, GSTP1, TMEM122, RARB, and ARHGAP20) in prostate cancer were identified to have distinct methylations. Bioinformatics analysis suggested that these genes were associated with several biomolecular and biological processes, and among them DPYS gene was involved in 13 GO anotated biologic functions, development of 50 diseases and 47 protein interactions. Pyrosequencing of 7 sites of the CPG island in DPYS gene showed a methylation frequency of 32.7%, suggesting the importance of DPYS gene in the carcinogenesis and progression of prostate cancer.</p>

Comparison of the effect of three-dimensional versus two-dimensional retroperitoneal laparoscopic ureter lithotomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the surgical effect of three-dimensional (3D) versus 2D laparoscopic surgery in ureter lithotomy.</p><p><b>METHODS</b>From January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to undergo ureter lithotomy under 3D laparoscopy (25 cases) and 2D laparoscopy (20 cases). The time used for each surgical process (including the exposure, D-J tube discharge, suture and other surgical procedures) was recorded and compared between the two groups.</p><p><b>RESULTS</b>The operation was completed smoothly in all the 45 patients. In this cohort, the wound drainage tube was removed in a mean of 3.0mnplus;0.8 days after the operation, the catheter was removed after a week, and the double J tube was removed at 1 month. Follow-up intravenous pyelography at 3 months after the operation reveal ureteral stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was significantly shorter in the 3D group than in the 2D group (P<0.05). 3D laparoscopic surgery allowed more precise operation by providing a good sense of depth as in an open surgery to reduce the operation time.</p><p><b>CONCLUSIONS</b>As a minimally invasive surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in ureter lithotomy.</p>

Protective effect of preserving bladder neck integrity on erectile function in patients undergoing plasmakinetic vaporization for benign prostatic hyperplasia / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical value of preserving the integrity of the bladder neck in plasmakinetic vaporization of the prostate (PKVP) in protecting the erectile function and improving the quality of life of patients with benign prostatic hyperplasia (BPH) below 60 years of age.</p><p><b>METHODS</b>Thirty-two patients with BPH, with a mean age of 55.4 years (range 50-60 years), were enrolled the study to undergo PKVP with Gyrus bipolar systems, in which the transverse fiber muscle area of the bladder neck were carefully preserved. The erectile function and the quality of life of the patients were evaluated with the International Index of Erectile Function (IIEF)-5 and Quality of Life (QoL) before and after the operation. Retrograde ejaculation was also observed after the operation.</p><p><b>RESULTS</b>In the 6-month follow-up, only 1 (3.13%) patient was found to have erectile dysfunction. Five patients (15.6%) reported retrograde ejaculation 3 months after the surgery, and only 3 patients (9.4%) had retrograde ejaculation at 6 months.</p><p><b>CONCLUSIONS</b>Preserving the bladder neck in PKVP may protect the erectile function with BPH below 60 years of age.</p>

Clinical efficacy of transperitoneal verus retroperitoneal laparoscopic partial nephrectomy for renal tumors with R. E. N. A. L score over 7 / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the safety, feasibility and efficacy of transperitoneal and retroperitoneal laparoscopic partial nephrectomy (LPN) in the treatment of renal tumors with R. E. N. A. L score more than 7.</p><p><b>METHODS</b>The clinical data were collected from 62 patients undergoing transperitoneal LPN (32 cases) and retroperitoneal LPN (30 cases) for a complex renal mass (R.E.N.A.L. score≥7) between January 2012 and March 2014. The surgical and early postoperative outcomes and complications were analyzed to evaluate the efficacy of the treatments. The mean operative time, estimated blood loss, warm ischemia time, surgical complications, blood transfusion rate, tolerating regular diet time, postoperative hospital stay and surgical margin were compared between the two groups.</p><p><b>RESULTS</b>The operations were completed successfully in all cases except for 1 case in transperitoneal group and 3 in retroperitoneal group that required conversion to open surgery. No significant differences were found in age, body mass index, ASA score, Charlson comorbidity index, tumor size or R.E.N.A.L. nephrometry score (P>0.05), nor in estimated blood loss, warm ischemia time, intraoperative complication, blood transfusion rate or surgical margin between the two groups (P>0.05, respectively). The transperitoneal LPN group had a shorter mean operative time than retroperitoneal LPN group (210.4∓59.2 vs 252∓58.3 min, P<0.05) but showed longer tolerating regular diet time (47∓10 h vs 23∓6 h, P<0.05) and postoperative hospital stay time (8.4∓1.9 days vs 6.5∓1.6 days, P<0.05).</p><p><b>CONCLUSION</b>Both transperitoneal LPN and retroperitoneal LPN are safe, feasible and effective for surgical management of complex localized tumors, but the transperitoneal procedure offers larger operative space with better exposure; the retroperitoneal procedure better promotes postoperative recovery of the patients.</p>

Effect of CO(2) pneumoperitoneum on renal function in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effects of different CO(2) pneumoperitoneum conditions on renal function in rats and provide experimental evidence for improving renal graft function after transplantation.</p><p><b>METHODS</b>SD rats were randomized into 10 groups (n=12) and subject to CO(2) pneumoperitoneum at different pressures (0.67, 1.33 and 2.0 kPa) for 60 or 120 min. Serum urea nitrogen (BUN), creatinine (Cr) and N-acetyl-β-D-glocosaminidase (NAG) levels were detected after pneumoperitoneum.</p><p><b>RESULTS</b>As the pressure and time of pneumoperitoneum increased, the renal function deteriorated gradually, showing significant differences between the groups (P<0.05).</p><p><b>CONCLUSION</b>Increased pressure and prolonged duration of CO(2) pneumoperitoneum causes impairment of the renal function, suggesting the necessity of reducing the operative time and lowering the pressure of pneumoperitoneum when harvesting renal graft in living donors.</p>

Effect of repeat transurethral resection for superficial bladder cancer / 中国医师进修杂志

Objective To investigate the effect of repeat transurethral resection for superficial bladder cancer. Methods One hundred and twenty patients who were newly diagnosed superficial bladder cancer were divided randomly in to two groups by mechanical sampling method,60 patients underwent second of prostate TUPKVP 4 weeks after initial transurethral and received adjuvant MMC intravesically (experiment group) and the other 60 patients received adjuvant MMC following the initial TUPKVP(control group). The two groups were followed up by cystoscopy at 3-month intervals,and then compared the recurrences between the two groups. Carcinoma in situ or muscle invasive disease were excluded from the study. Results Mean following up time was 6-24 (12.0 ±6.5) months, within the following up period,recurrence was observed in 13 (21.7%, 13/60) patients in experiment group and in 38 (63.3%,38/60)patients in control group, there was signiticantly statistical difference between the two groups (P＜ 0.01). Of all the recurrences, the recurrence rate of high grade tumor was 26.2% (11/42) in experiment group and 70.0% (35/50) in control group,the recurrence rate in experiment group was obviously less than that in control group (P ＜ 0.01). Conclusions Repeat transurethral resection can lower the recurrence of superficial bladder cancer (especially for the high grade tumor) which with initial resection, it can improve the classification of malignant rumor, and find the residual tumor, so it has value in clinical treatment.