Feasibility and safety of transurethral plasmakinetic enucleation of prostate with suprapubic bladder puncture and gland fixation / 中华泌尿外科杂志

Objective:To investigate the feasibility and safety of suprapubic bladder puncture and gland fixation in transurethral enucleation of the prostate.Methods:The clinical data of 15 patients with benign prostatic hyperplasia admitted to the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2020 were retrospectively analyzed. The age was (70.27±5.35) years old, preoperative serum prostate-specific antigen (PSA) level was (3.03±1.37) ng/ml, preoperative total prostate weight was 80.3(70.49, 96.78)g, preoperative postvoid residual urine volume(PVR)was 80 (55, 108)ml, and the maximum urine flow rate (Q max) was (6.13±2.25) ml/s. The international prostate symptom score(IPSS) was 25(22, 27), quality of life (QOL)score was 5(5, 6), international erectile function index-5 (IIEF-5) score was (15.38±5.10). All 15 patients underwent conventional transurethral plasma enucleation of prostate by using the three-lobe method, and the enucleated gland was pushed into the bladder completely. Then a laparoscopic pneumoperitoneum needle was used to perform suprappubic cystipuncture, and ureteral grasping forceps were inserted through the outer sheath. The forceps were used to fix the enencied gland. A rapid harvesting electric resection was performed in the broad space of the bladder, and the Ellick was rinsed to remove the tissue fragments. Surgical indicators and complications were recorded. The improvement of subjective score (IPSS, QOL, IIEF-5) and objective index (Q max, PVR) was compared between preoperative and postoperative. Results:All the 15 operations were completed successfully and there were no complications such as blood transfusion, capsule perforation, transurethral resection syndrome, bladder injury, bladder puncture site laceration and bleeding. The weight of resected prostate tissue was 44(40, 60)g, with blood loss (79.20±18.93)ml.The time of enucleation operation was (54.13±10.88)min, with harvest cutting time (14.67±2.50)min, evisceration efficiency (0.89±0.08)g/min, harvesting efficiency (3.26±0.36)g/min, bladder irrigation time (2.47±0.52) d. The time of indwelling catheter was (3.73±0.80)d.The postoperative hospital stay was (4.40±0.91) d. Temporary urinary incontinence occurred in 1 case after operation. All patients were followed up for 6 months after operation. The IPSS score was 3(2, 3), QOL score was 0(0, 1), IIEF-5 score was (20.12±2.30), Q maxwas (21.80±2.14) ml/s and PVR was 10(5, 15)ml, which were all significantly different compared with those before surgery ( P<0.05). The symptoms of the patients were significantly improved. Conclusions:Transurethral plasma enucleation of prostate combined with suprapubic bladder puncture and fixed gland is effective in the treatment of benign prostatic hyperplasia. The subjective symptoms and objective examination of patients have been significantly improved, and no adverse operation-related complications have occurred. It is a suitable method for enucleation of prostate in units which are not equipped with transurethral tissue planer.

Emerging SARS-CoV-2 mutation hotspots associated with clinical outcomes

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the influence of mutations in the SARS-CoV-2 gene on clinical outcomes and related factors is critical for treatment and prevention. Here, we analyzed 209,551 high-coverage complete virus sequences and 321 RNA-seq samples to mine the mutations associated with clinical outcome in the SARS-CoV-2 genome. Several important hotspot variants were found to be associated with severe clinical outcomes. Q57H variant in ORF3a protein were found to be associated with higher mortality rate, and was high proportion in severe cases (39.36%) and 501Y.V2 strains (100%) but poorly proportional to asymptomatic cases (10.04%). T265I could change nsp2 structure and mitochondrial permeability, and evidently higher in severe cases (20.12%) and 501Y.V2 strains (100%) but lower in asymptomatic cases (1.43%). Additionally, R203K and G204R could decrease the flexibility and immunogenic property of N protein with high frequency among severe cases, VUI 202012/01 and 484K.V2 strains. Interestingly, the SARS-CoV-2 genome was more susceptible to mutation because of the high frequency of nt14408 mutation (which located in RNA polymerase) and the high expression levels of ADAR and APOBEC in severe clinical outcomes. In conclusion, several important mutation hotspots in the SARS-CoV-2 genome associated with clinical outcomes was found in our study, and that might correlate with different SARS-CoV-2 mortality rates.

Genome-wide association study identifies TNFSF13 as a susceptibility gene for IgA in a South Chinese population in smokers.

IgA is an important factor in our immune system. There are many diseases associated with it, such as IgA nephropathy, IgA deficiency, and so on. In order to describe the relationship between the genes and the IgA level, we performed a genome-wide association study of serum IgA with 1,999 healthy Chinese men in the first stage and replicated on an independent Chinese sample with 1,496 subjects in the second stage. Association between each SNP with IgA was estimated by multivariate linear regression analysis conditioned on age and smoke. Haplotype analysis for the block around the top SNP was performed. In the first stage, one genomic locus was identified to be significantly associated with IgA. The loci is TNFSF13 (17p13.1; rs3803800; P = 6.26 × 10(-8)). In smoke-specific analysis, rs3803800 was approximately significantly associated with IgA levels in smokers (P = 3.96 × 10(-7)), while no association was observed in nonsmokers (P = 2.28 × 10(-1)). In addition, we performed the haplotype analysis on chromosome 17 with the SNPs around rs3803800. Although the total P value for the haplotype did not acquire significant difference, three haplotypes (TGAG, CACG, and CACA) reached significant (P < 0.05). In conclusion, TNFSF13 could be a susceptible gene which was discovered having relationship with serum IgA level, and smoke might be a factor infecting the IgA level.

Clinical effect of combined finasteride and metformin treatment for benign prostatic hyperplasia plus diabetes mellitus / 中华老年医学杂志

Objective To evaluate the safety and efficiency of combined finasteride and metformin on benign prostatic hyperplasia (BPH) with type 2 diabetes mellitus(T2DM).Methods Totally 106 patients with BPH plus T2DM received finasteride and metformin treatment for over 12months.Before and after treatment,the side effects and following parameters were measured:prostatic volume (PV),prostate-specific antigen(PSA),international prostate symptom score (IPSS),quality of life (QOL),the maximum flow rate of urinary (Qmax),residual urine(RU),body mass index (BMI),cholesterol (TG).Results There were obvious changes in the following:PV decreased from (56.40±18.75)ml to(42.40± 19.68) ml,PSA decreased from(3.65± 1.08) μg/L to (1.76±0.66)μg/L,IPSS decreased from(22.58±9.45)to(16.67±7.56),QOL decreased from(4.22± ±0.87) to (2.36 ± 0.74),Qmax increased from(8.32±2.42)ml/s to(15.48±3.61)ml/s,RU decreased form(68.36±19.25)ml to(36.42±13.91)ml,BMI decreased from(28.52±3.73)kg/m2 to (19.76± 1.88)kg/m2,TG decreased from (2.52 ± 0.43) mmol/L to (1.38 ± 0.52) mmol/L.The changes of PV,PSA,IPSS,QOL,Qmax,RU,BMI and TG were statistically significant (all P＜0.05).Conclusions Long term combined finasteride and metformin treatment for BPH plus T2DM is effective and safe.And the two drugs may be improve the efficacy each other.

The clinical application of finasteride in peri-operation of transurethral plasmakinetic enucleation of prostate / 中华老年医学杂志

ObjectiveTo investigate the effect of finasteride on hemorrhage in peri-operation of transurethral plasmakinetic enucleation of prostate (TUPKEP).Methods150 patients with benign prostatic hyperplasia (BPH) were randomly divided into 3 groups:control group without finasteride (n= 50),treatment groupl 1 with finasteride 5 mg daily for 7 days(n= 50) and treatment group 2 with finasteride 10 mg daily for 7 days(n= 50) before and after operation.All patients received TUPKEP and the data were recorded,including total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time after operation,amount of washing fluid after operation,and rebleeding rate within 3 months after operation.ResultsThe 150 patients successfully received TUPKEP.The total blood loss,amount of washing fluid during operation,operation time,blood loss per gram tissue,amount of washing fluid after operation,washing time after operation and rebleeding rate within 3 months after operation in treatment group 1 and 2 significantly reduced as compared with control group (P＜0.05).The blood loss per minute were (1.77±0.89) ml/min,(1.71±0.82) ml/min and (1.70±0.81) ml/min in 3 groups,respectively,and there were no significant differences among groups (P＞ 0.05).There were no significant differences between treatment group 1 and 2 in the total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time and amount of washing fluid after operation (P＞0.05).The rebleeding rate within 3 months after operation in treatment group 1 (8/35) and treatment group 2 (3/26) decreased as compared with control group (17/39) (x2= 3.544 and 7.523,P=0.016 and 0.025)and it was lower in treatment group 2 than in treatment group 1 (x2 = 1.293,P = 0.044).Conclusions The application of finasteride in peri-operation of TUPKEP can reduce hemorrhage.

Down-regulation of kallikrein in prostate cancer / 中华泌尿外科杂志

Objective To study the expression of kallikrein 7 (KLK7) in different prostate tissues and its clinical significance. Methods KLK7 mRNA levels in normal prostate epithelia (5 cases), benign prostat(ic) hyperplasia (BPH) epithelia (13 cases), prostate cancer and prostate cancer cell lines (8 cases) were analyzed by using semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Western blot was used to analyze the protein levels of human kallikrein 7 (hK7) in benign prostate epithelia and prostate cancer cell lines, hK7 expressions were examined in 20 normal prostate tissue specimens, 50 BPH specimens and 103 prostate cancer specimens by immunohistochemical staining.Results The mRNA levels of KLK7 in normal prostate, BPH and prostate cancer were 0.59, 0.52 and 0.02 respectively, mRNA levels of KLK7 were significantly different among the three groups (F=13.03, P＜0.01). mRNA levels of KLK7 were decreased in prostate cancers compared with that in benign hyperplastic prostate epithelial cells (P＜0.01) and in normal prostate epithelial cells (P＜0.01). No significant difference of KLK7 mRNA levels was found between normal prostate and BPH. The protein levels of KLK7 in normal prostate, BPH, DU145, LNCaP, PC3,22RV1 and BPH1 was 0.22, O. 40, 0.01, 0.05, 0, 0.03 and 0.14 respectively, hK7 protein level was down-regulated in prostate cancer cell lines compared to benign prostate epithelial cells. The expression of bK7 was observed in benign prostate epithelial cells, whereas little or no staining was observed in prostate cancer cells in immunohistochemical study, hK7 protein was detected in 13 of 20 (65%)normal prostate specimens, 38 of 50 (76%) BPH specimens and 18 of 103 (17.5%) prostate cancer specimens. The difference between the normal prostate and prostate cancer was significant (Z=-4.43, P＜0.01). The difference between BPH and prostate cancer was significant (Z=-7.77,P＜0.01) as well. However, no significant difference of hK7 protein level was found between normal prostate and BPH (Z=-1. 52, P＞0.05). Conclusions KLK7 expression level is down regulated in prostate cancer. KLK7 may play an important role in prostate cancer progression.

Intravesical instillation in pure line LEW rats and nude mice / 华中科技大学学报（医学）（英德文版）

In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomical microscopy. A trochar was prepared according to the outline and angle of the urethra. Ink was poured into female rats and nude mice bladder though urethra. Filling and staining of bladder were observed and evaluated under anatomical microscopy. Status and urethral injury of rats and mice were observed. The results showed that urethra anatomic structure of rats and nude mice was different from that of human urethra. When bladder was filled with ink and became blue, liquid was not seen to leak out. The success rate of intubation was high (100%). Living activities of animals weren't influenced by intravesical instillation. It was concluded that bladder irrigation might be a kind of valid and utilizable method in pure line rat and nude mouse empirical study. The model may be a more effective tool for study of bladder tumor.

Intravesical Instillation in Pure Line LEW Rats and Nude Mice / 华中科技大学学报（医学）（英德文版）

In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomical microscopy. A trochar was prepared according to the outline and angle of the urethra. Ink was poured into female rats and nude mice bladder though urethra. Filling and staining of bladder were observed and evaluated under anatomical microscopy. Status and urethral injury of rats and mice were observed. The results showed that urethra anatomic structure of rats and nude mice was different from that of human urethra. When bladder was filled with ink and became blue, liquid was not seen to leak out. The success rate of intubation was high (100%). Living activities of animals weren't influenced by intravesical instillation. It was concluded that bladder irrigation might be a kind of valid and utilizable method in pure line rat and nude mouse empirical study. The model may be a more effective tool for study of bladder tumor.

Applicationof Network Resource Platform in Urology Teaching / 中华医学教育探索杂志

The article introduces the network resource in urology surgery both at home and abroad and analyses the existing problems in carrying out online teaching uronology and puts forward some countermeasures.

A pilot study of photon therapy for benign prostate hyperplasia (a report of 30 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy and safety of photon therapy for benign prostate hyperplasia (BPH).</p><p><b>METHODS</b>Thirty patients with severe BPH received brachytherapy of prostate photon treatment system irradiation for one month, with the active area of the applicator located in the rectum, and at a dosage of 726-810 cGy. International prostate symptom score (IPSS), quality of life (QOL), volume of prostate gland, maximum flow rate (Qmax), and residual urine were evaluated before and after the treatment.</p><p><b>RESULTS</b>After one-month treatment, 18 cases remarkably improved, 9 slightly improved and 3 had no response. There was significant improvement in IPSS, QOL, volume of prostate gland, Qmax and residual urine (P<0.01, except Qmax P = 0.038).</p><p><b>CONCLUSION</b>Prostate photon treatment system can be used as a safe, effective, micro-invasive, convenient and economical therapy for severe BPH, especially applicable to older and weaker patients.</p>

Rat model of erectile dysfunction caused by cavernous nerve ablation / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To identify the rat cavernous nerve and establish a rat model of erectile dysfunction (ED) caused by injury of the cavernous nerve.</p><p><b>METHODS</b>Twenty rats underwent dissections. Cavernous nerves were identified with the aid of an operating microscope and confirmed by electrical stimulation. Then, 42 experimental rats were randomized into 3 groups, including sham-operated controls and unilateral and bilateral cavernous nerve ablation groups. Three weeks after surgery, rat models were evaluated with the Apomorphine test.</p><p><b>RESULTS</b>The major pelvic ganglion lies on either side of the dorsolateral lobes of the prostate.It includes 2 inflows, one called hypogastric nerve and the other, the pelvic nerve. The largest outflow is termed the cavernous nerve. Stimulus parameters which could induce obvious penile erection were 5 volts, a frequency of 20 Hertz and a duration of 5 milliseconds. Three weeks after surgery, apomorphine could induce penile erection of each rat in the controls with a mean of 2.57 +/- 1.40 erections in 30 minutes, while there were no erections (0.00 +/- 0.00) in either the unilateral or bilateral groups.</p><p><b>CONCLUSIONS</b>The rat large ganglion and its cavernous nerve can be easily identified and it produces an obvious response to electrical stimulation. Rats are low cost animals to purchase, easy to house and very available making an ideal animal for developing an ED model caused by cavernous nerve injury. In addition, our study showed that in the early period of cavernous nerve ablation, unilateral and bilateral treated rats lost erectile capacity.</p>

Identifying difference in mRNA expression of prostate epithelial cells cocultured with and without stromal cells / 中华泌尿外科杂志

Objective To identify the difference in mRNA expression of prostate epithelial cells cocultured with and without stromal cells. Methods Cocultured model and DDRT PCR were used to analyze different mRNA expression of prostate epithelial cells with and without stromal cells.The different expression sequence tags (ESTs) were obtained,then identified by reverse dot hybridization,and sequenced.The obtained cDNA sequence was compared with that in the public database. Results It was found that there was a significant difference of gene expression in prostate epithelial cells.70 differential display cDNA fragments were obtained.After they were sequenced,45 ESTs were found to share high homology to the known genes,whereas the remaining 25 ones were novel. Conclusions There is different gene expression in prostate epithelial cells cocultured with and without stromal cells.These differential genes may play a role in the interaction between epithelial cells and stromal cells.

Antiproliferative Effect of Curcumine on Human Prostatic Hyperplasia Cell Line BPH1 / 中国药房

OBJECTIVE:To investigate the inhibitory effect of Curcumine on the proliferation and gene expression of human prostatic hyperplasia cell line BPH1. METHODS: MTT were used to examine the cell growth of Human prostatic hyperplasia cell line BPH1 after treated with different doses of Curcumine. The expressions of PCNA mRNA and Bcl-2 at transcription were detected by RT-PCR. RESULTS: Curcumine inhibited cell growth time or dose-dependently and down-regulated the expressions of PCNA and Bcl-2 in BPH1 cells dose-dependently within 24 h after being treated by Curcumin.CONCLUSI-ON: The antiproliferative effect of Curcumine on BPH1 might be associated to the downregulation of PCNA and Bcl-2 levels.