Prostate cancer antigen 3 moderately improves diagnostic accuracy in Chinese patients undergoing first prostate biopsy.

Prostate cancer antigen 3 (PCA3) is a biomarker for diagnosing prostate cancer (PCa) identified in the Caucasian population. We evaluated the effectiveness of urinary PCA3 in predicting the biopsy result in 500 men undergoing initial prostate biopsy. The predictive power of the PCA3 score was evaluated by the area under receiver operating characteristic (ROC) curve (AUC) and by decision curve analysis. PCA3 score sufficed to discriminate positive from negative prostate biopsy results but was not correlated with the aggressiveness of PCa. The ROC analysis showed a higher AUC for the PCA3 score than %fPSA (0.750 vs 0.622, P = 0.046) in patients with a PSA of 4.0-10.0 ng ml-1 , but the PCA3-based model is not significantly better than the base model. Decision curve analysis indicates the PCA3-based model was superior to the base model with a higher net benefit for almost all threshold probabilities, especially the threshold probabilities of 25%-40% in patients with a PSA of 4.0-10.0 ng ml-1 . However, the AUC of the PCA3 score (0.712) is not superior to %fPSA (0.698) or PSAD (0.773) in patients with a PSA >10.0 ng ml-1 . Our results confirmed that the RT-PCR-based PCA3 test moderately improved diagnostic accuracy in Chinese patients undergoing first prostate biopsy with a PSA of 4.0-10.0 ng ml-1 .

[Surgical treatment of azoospermia caused by iatrogenic injury to bilateral vas deferens].

OBJECTIVE: To investigate the treatment of azoospermia induced by iatrogenic injury to the bilateral vas deferens. METHODS: We retrospectively analyzed 11 cases of azoospermia caused by iatrogenic injury to bilateral vas deferens. The patients were aged 20－33 years, all diagnosed with azoospermia preoperatively and none with a history of pelvic operation. Seven of them had received bilateral inguinal hernia repair and the other 4 undergone bilateral orchidopexy in the childhood. RESULTS: Intraoperative exploration of the bilateral inguinal region was performed in all the patients. Bilateral vas deference atresia was found in the inguinal canal in 6 cases, which was treated by microscopic vasovasostomy following removal of the atresic segment. Vas deferens residual was observed in or near the deep inguinal ring in the other 5 cases, with the distal vas deferens inaccessible, which was treated by bilateral vasovasostomy in 3 cases and unilateral vasovasostomy in 2 (for longer defect segment than could be anastomosed) following combined laparoscopic exploration of the abdominal cavity. The patients were followed up for 3－12 months postoperatively, during which sperm were detected in 7 cases, with sperm concentration ranging from 0.4×106/ml to 35×106/ml and grade a+b sperm from 15% to 46%. CONCLUSIONS: For the diagnosis of azoospermia, especially in patients with no history of pelvic operation, special attention should be paid to iatrogenic injury to the vas deferens. For the treatment of the disease, non-tension vasovasostomy is essential and, when necessary, the vas deferens can be reconstructed by changing its anatomical path and shortening its length.

Testicular metastasis from gastric carcinoma: A case report.

Gastric cancer (GC) is the most prevalent malignancy in the world, especially in China. GC has been postulated to spread via several different routes, including through hematogenous channels, lymphatic vessels, the seeding of peritoneal surfaces, direct extension through the gastric wall, and retrograde extension through the vas deferens or lymphatics. Testicular metastasis is rare. We show here a 53-year-old patient with GC who underwent a radical total gastrectomy approximately 22 mo ago after he presented with a sensation of heaviness and swelling of the right hemiscrotum. The diagnosis of metastatic adenocarcinoma was made after a right-side orchiectomy. We report the first case of testicular metastasis from gastric adenocarcinoma in mainland China and summarize the clinicopathologic features of the disease based on previously published papers.

A novel urinary long non-coding RNA transcript improves diagnostic accuracy in patients undergoing prostate biopsy.

BACKGROUND: Long non-coding RNA (LncRNA) PCA3 has been a well-established urine biomarker for the detection of prostate cancer (PCa). Our previous study showed a novel LncRNA FR0348383 is up-regulated in over 70% of PCa compared with matched benign tissues. The aim of this study was to evaluate the diagnostic value of urinary FR0348383 for men undergoing prostate biopsy due to elevated PSA (PSA > 4.0 ng/ml) and/or abnormal digital rectal examination (DRE). METHODS: Post-DRE first-catch urine specimens prior to prostate biopsies were prospectively collected. After the whole transcriptome amplification, quantitative real time polymerase chain reaction was applied to quantify urine FR0348383 and PSA levels. The FR0348383 score was calculated as the ratio of PSA and FR0348383 mRNA (PSA mRNA/FR0348383 mRNA × 1000). The diagnostic value of FR0348383 score was evaluated by logistic regression and decision curve analysis. RESULTS: 213 cases with urine samples containing sufficient mRNA were included, 94 cases had serum PSA level 4.0-10.0 ng/ml. PCa was identified in 72 cases. An increasing FR0348383 score was correlated with an increasing probability of a positive biopsy (P < 0.001). Multivariable logistic analysis indicated FR0348383 score (P < 0.001), PSA (P = 0.004), age (P = 0.007), prostate volume (P < 0.001) were independent predictors of PCa. ROC analysis demonstrated FR0348383 score outperformed PSA, %free PSA, and PSA Density in the prediction of PCa in the subgroup of patients with grey area PSA (AUC: 0.815 vs. 0.562 vs. 0.599 vs. 0.645). When using a probability threshold of 30% in the grey zone cohort, The FR0348383 score would save 52.0% of avoidable biopsies without missing any high grade cancers. CONCLUSIONS: FR0348383 transcript in post-DRE urine may be a novel biomarker for detection of PCa with great diagnostic value, especially in the grey zone cohort. The application of FR0348383 score in clinical practice might avoid unnecessary prostate biopsies and increase the specificity of PCa diagnosis.

Environmental and psycho-social factors related to prostate cancer risk in the Chinese population: a case-control study.

OBJECTIVE: To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population. METHODS: 250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk. RESULTS: Green vegetables and green tea were associated with a decreased risk of PCa (OR=0.39, 95% CI: 0.28-0.53; OR=0.59, 95% CI: 0.40-0.87, respectively). Family history of PCa (OR=7.16, 95% CI: 2.01-25.49), history of prostate diseases (OR=2.28, 95% CI: 1.53-3.41), alcohol consumption (OR=1.97, 95% CI: 1.33-2.90), red meat consumption (OR=1.74, 95% CI: 1.20-2.52), barbecued (OR=2.29, 95% CI: 1.11-4.73) or fried (OR=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (OR=1.61, 95% CI: 1.00-2.59), marital separation (OR=1.94, 95% CI: 1.29-2.91), self-contained suffering (OR=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (OR=1.73, 95% CI: 1.18-2.54) were related to PCa. CONCLUSION: Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.

Histone methyltransferase SETDB1 is required for prostate cancer cell proliferation, migration and invasion.

SETDB1 has been established as an oncogene in a number of human carcinomas. The present study was to evaluate the expression of SETDB1 in prostate cancer (PCa) tissues and cells and to preliminarily investigate the role of SETDB1 in prostate tumorigenesis in vitro. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) were used to detect the expression of SETDB1 in PCa tissues, adjacent normal tissues, benign prostatic hyperplasia (BPH) tissues, PCa cell lines and normal prostate epithelial cells. The results suggested that SETDB1 was upregulated in human PCa tissues compared with normal tissues at the mRNA and protein levels. The role of SETDB1 in proliferation was analyzed with cell counting kit-8, colony-forming efficiency and flow cytometry assays. The results indicated that downregulation of SETDB1 by siRNA inhibited PCa cell growth, and induced G0/G1 cell cycle arrest. The PCa cell migration and invasion decreased by silcencing SETDB1 which were assessed by using in vitro scratch and transwell invasion assay respectively. Our data suggested that SETDB1 is overexpressed in human PCa. Silencing SETDB1 inhibited PCa cell proliferation, migration and invasion.

Diamondization of chemically functionalized graphene and graphene-BN bilayers.

In this article, based on first-principles calculations, we systematically study functionalization induced diamondization of graphene bilayer and graphene-BN hybrid bilayer. With single-side functionalization, the diamondized structures are magnetic semiconductors. Interestingly, if both sides of the bilayer are functionalized, diamondization becomes spontaneous without a barrier. On the other hand, when the bottom layer of the bilayer graphene is replaced by a single hexagonal BN layer, the diamondized structure becomes a nonmagnetic metal. The tunable electronic and magnetic properties pave new avenues to construct graphene-based electronics and spintronics devices.

[1,1'-Bis(diphenyl-phosphan-yl)cobalto-cenium]carbonyl-chloridohydrido(triphenyl-phosphane)ruthenium(II) hexa-fluoridophosphate dichloro-methane disolvate.

In the title compound, [CoRu(C(17)H(14)P)(2)ClH(C(18)H(15)P)(CO)]PF(6)·2CH(2)Cl(2), the Ru(II) atom is coordinated by three P atoms from a chelating 1,1'-bis-(diphenyl-phosphan-yl)cobaltocenium ligand and a triphenyl-phosphine ligand, one CO ligand, one Cl atom and one H atom in a distorted octa-hedral geometry. In the cobaltocenium unit, the two cyclo-penta-dienyl rings are almost parallel, making a dihedral angle of 1.2 (3)°. The F atoms of the hexa-fluoridophosphate anion are disordered over two sets of sites, with an occupancy ratio of 0.849 (11):0.151 (11). Intra-molecular C-H⋯Cl hydrogen bonds occur in the complex cation. The complex cations, hexa-fluoridophosphate anions and dichloro-methane solvent mol-ecules are linked by inter-molecular C-H⋯F hydrogen bonds.

Communication: Coalescence of carbon atoms on Cu (111) surface: Emergence of a stable bridging-metal structure motif.

By combining first principles transition state location and molecular dynamics simulation, we unambiguously identify a carbon atom approaching induced bridging-metal structure formation on Cu (111) surface, which strongly modify the carbon atom coalescence dynamics. The emergence of such a new structural motif turns out to be a result of the subtle balance between Cu-C and Cu-Cu interactions. Based on this picture, a simple theoretical model is proposed, which describes a variety of surface chemistries very well.

Single-molecule chemistry of metal phthalocyanine on noble metal surfaces.

To develop new functional materials and nanoscale electronics, researchers would like to accurately describe and precisely control the quantum state of a single molecule on a surface. Scanning tunneling microscopy (STM), combined with first-principles simulations, provides a powerful technique for acquiring this level of understanding. Traditionally, metal phthalocyanine (MPc) molecules, composed of a metal atom surrounded by a ligand ring, have been used as dyes and pigments. Recently, MPc molecules have shown great promise as components of light-emitting diodes, field-effect transistors, photovoltaic cells, and single-molecule devices. In this Account, we describe recent research on the characterization and control of adsorption and electronic states of a single MPc molecule on noble metal surfaces. In general, the electronic and magnetic properties of a MPc molecule largely depend on the type of metal ion within the phthalocyanine ligand and the type of surface on which the molecule is adsorbed. However, with the STM technique, we can use on-site molecular "surgery" to manipulate the structure and the properties of the molecule. For example, STM can induce a dehydrogenation reaction of the MPc, which allows us to control the Kondo effect, which describes the spin polarization of the molecule and its interaction with the complex environment. A specially designed STM tip can allow researchers to detect certain molecule-surface hybrid states that are not accessible by other techniques. By matching the local orbital symmetry of the STM tip and the molecule, we can generate the negative differential resistance effect in the formed molecular junction. This orbital symmetry based mechanism is extremely robust and does not critically depend on the geometry of the STM tip. In summary, this simple model system, a MPc molecule absorbed on a noble metal surface, demonstrates the power of STM for quantum characterization and manipulation of single molecules, highlighting the potential of this technique in a variety of applications.

[1,1'-Bis(dicyclo-hexyl-phosphino)cobalto-cenium-κP,P']chlorido(η-cyclo-penta-dien-yl)ruthenium(II) hexa-fluorido-phosphate.

In the title structure, [CoRu(C(5)H(5))(C(17)H(26)P)(2)Cl]PF(6), the Ru(II) atom is bonded to a cyclo-penta-dienyl ring, a Cl atom and two P atoms of the chelating 1,1'-bis-(dicyclo-hexyl-phosphino)cobaltocenium (di-cypc) ligand, leading to a three-legged piano-stool coordination. Part of the PF(6) (-) counter-anion is disordered over two positions, with a site-occupancy ratio of 0.898 (7):0.102 (7). The components are linked by C-H⋯F and C-H⋯Cl hydrogen bonds.

1-Ethyl-3-(2,4,6-trimethyl-phen-yl)imidazolium tetra-fluoro-borate.

The title compound, C(14)H(19)N(2) (+)·BF(4) (-), was obtained by reaction of 1-ethyl-3-(2,4,6-trimethyl-phen-yl)imidazolium tetra-fluoro-borate with sodium tetra-fluoro-borate. The imidazole ring makes a dihedral angle of 78.92 (13)° with the benzene ring.

Transurethral seminal vesiculoscopy in the diagnosis and treatment of persistent or recurrent hemospermia: a single-institution experience.

The diagnosis and treatment of hemospermia presents significant difficulty, especially if it persists or recurs. In this retrospective study, we assessed whether transurethral seminal vesiculoscopy is feasible and effective in the diagnosis and treatment of hemospermia. To address this complex condition, we report our experience in a population of patients treated with transurethral seminal vesiculoscopy. From February 2006 to July 2008, 72 hemospermic patients underwent transurethral seminal vesiculoscopy examination and treatment at our urology center. Transurethral seminal vesiculoscopy was performed by a 7-F or 8-F rigid ureteroscope. The endoscopic procedure was conducted through the normal anatomic route of the seminal tracts. In this series, the mean follow-up period was 21.7 months. Definite diagnosis was made for 93.1% patients, and 94.4% patients were cured or showed a decrease in their symptoms. Postoperative complications were not observed in the study. Our study proves that transurethral seminal vesiculoscopy is effective in the diagnosis and treatment of hemospermia with minimal complication.

[Experimental studies of kidney biopsy by natural orifices: transgastric and transvesical combined approach].

OBJECTIVE: To evaluate the feasibility of kidney biopsy by transgastric and transvesical combined approach in the porcine model. METHODS: Five female pigs (20 to 30 kg) were included in this study. All procedures were performed with pigs under general anesthesia. The transvesical access was established by the ureteroscope. Then monitored by ureteroscopy, the transgastric access was established by a needle knife with cautery. The puncture dilation was performed with balloon through the gastroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath. The kidney biopsy was finished by the scissor from the transvesical access and the grasping forcep from the work channel of gastroscope. RESULTS: Among five cases the procedure were successful in three cases with 380 min, 180 min, 78 min respectively. Establishment of transvesical and transgastric accesses took place without complications. The exposure and biopsy of the kidney were easily achieved during operation. The transgastric and transvesical access were not closed in the end. CONCLUSIONS: This new method is a technically feasible procedure in a porcine model. But the safety and the clinical future of it needs more study.

How graphene is cut upon oxidation?

Our first principles calculations reveal that an oxidative cut of graphene is realized by forming epoxy and then carbonyl pairs. Direct formation of a carbonyl pair to tear graphene up from an edge position is not favorable in energy. This atomic picture is valuable for developing effective means of graphene manipulation. The proposed epoxy pairs may be related to some long puzzling experimental observations on graphene oxide.

[Single-port transumbilical laparoscopic nephrectomy: initial clinical experience of 3 cases].

OBJECTIVE: To evaluate the safety and efficacy of single-port transumbilical laparoscopic nephrectomy. METHODS: From December 2008 to August 2009, we have performed three cases of single-port transumbilical laparoscopic nephrectomy of nonfunctioning renal by Tri-Port system. Among three patients there were two cases of UPJO and one case of upper ureteral obstruction. Involved kidneys were not visualized in IVU and the GFR were not more than 0.90 ml/s. Tri-Port system was inserted transperitoneal through a 2 cm umbilical incision. The flexible grasper, scissors were used in addition to standard laparoscopic equipment. Renal pedicle was divided by Endoscopic Linear Stapling device. Specimens were extracted through the incision. RESULTS: The first and second case were successful, and the operation time were 85 min and 165 min. The bleeding volume were 50 ml and 100 ml. The discharge time after operation was 3 days and 5 days, respectively. The third case was converted to open surgery because of the edema and adhesion of renal pedicle. At 3 weeks of follow-up, the incisions were hidden in the umbilicus with good cosmetic benefit. CONCLUSIONS: This new method is technically feasible, which combined with these advantages of less trauma and more cosmetic benefit. However, more special instruments and long learning curving may be needed for those surgeons, who are going to carry out it.

[Clinicopathologic features and molecular genetic analysis of multilocular cystic renal cell carcinoma].

OBJECTIVE: To assess the clinicopathological features and molecular genetic changes of multilocular cystic renal cell carcinoma (MCRCC). METHODS: All the data reviewed were from the files of pathology department of Changhai hospital collected from 1990 to 2006. In totally 706 cases of renal cell carcinoma studied, there were 21 MCRCC cases identified. The clinical and pathological features were assessed, immunohistochemical staining was performed, and loss of heterozygosity (LOH) and microsatellite instability (MSI) were assessed using four microsatellite markers on chromosomes 3, 9 and 14. RESULTS: Of the 21 patients, the age ranged from 34 to 72 years (mean 50 years), 19 were male and two female. Tumors were found incidentally in 18 patients during physical examination, three patients had anemia or microhematuria. Among the 21 patients, 10 tumors were in the left kidney and 11 in the right. Eighteen patients were stage T1, two stage T2, and one stage T3 with perinephric tissue involvement. Follow up information was available in 20 patients, all showed no evidence of tumor recurrence or metastasis. Grossly, the tumor size ranged from 0.3 cm to 10.0 cm in the greatest dimension, consisting of multilocular cysts with variable sizes which contained light yellow, colloid or hemorrhagic fluid. The septae varied in thickness (ranged 0.1 cm to 0.5 cm, mean 0.2 cm). Microscopically the cysts were lined by single to multilayered epithelial cells with clear or lightly eosinophilic cytoplasm. There were clusters of clear cells seen in the septae stroma. Sixteen tumors were of Fuhrman grade 1, and five were of Fuhrman grade 2. Immunohistochemically, the clear cells were positive for vimentin, ABC, CAM5.2 and EMA. Six samples were positive for CD10, and 16 were positive for NSE. Among 21 patients, PCR amplification was successful in 11 patients. Microsatellite alterations were found in five patients. LOH was observed in 3 of 11 MCRCC (27%), two were at D3S1560 locus, and one at D14S617 locus. MSI frequency was identified in 2 of 11 MCRCC (18%), locating at D9S168 or D14S617 locus, respectively. CONCLUSIONS: MCRCC is an uncommon tumor of kidney, constituting 2.9% of all RCC enrolled into the study. It has distinctive clinical and pathological characteristics with an excellent outcome. Results indicated that MCRCC is a rare entity with low malignant potential.

Irrigation eliminates smoke formation in laser laparoscopic surgery: ex vivo results.

BACKGROUNDS AND OBJECTIVES: To evaluate the desmoke effects of irrigation on surgical smoke generated during laser laparoscopic surgery using ex vivo model. STUDY DESIGN/MATERIALS AND METHODS: A hand-piece was devised as both an irrigation tube and a laser fiber holder. The laser system used was a diode pumped continuous wave Thulium YAG laser (Lisa laser products OHG, Katlenburg-Lindau, Germany) emitting at 2.01-mum through a quartz fiber with a core diameter of 365 mum. Using a transparent container as experimental model (approximately 3 L in volume), 6 irrigation rates (0, 20, 40, 60, 80, and 100 mL/min) were tested combining with 4 laser power settings (20, 30, 40, and 50 W). To evaluate the desmoke efficiency of irrigation, lasing time with effective visibility under different combination of irrigation rates and laser powers were documented, and corresponding smoke generation rate were calculated (=3 L/lasing time). Analysis of variance was used to compare difference and significance was indicated at P<0.05. RESULTS: Calculated smoke generation rate was increased with laser power whereas decreased with irrigation rate. At 4 tested laser powers, calculated smoke generation rates were high (mean: 91.4 to 306.6 mL/s) when no water presented, but were significantly decreased (mean: 12.6 to 55.0 mL/s, P<0.001) with the lowest water flow rate (20 mL/min) and further decreased with higher rates. The proper range of irrigation rate for future clinical practice would be around 40 mL/min. CONCLUSIONS: Irrigation eliminates smoke formation accompanying laser tissue irradiation. It shows promise for future application in laser laparoscopic surgery.