[Silencing ERp29 promotes the invasiveness of human PCa cells in vitro: Molecular mechanisms].

OBJECTIVE: To analyz the correlation of the expression of ERp29 with the clinicopathological characteristics of PCa and investigate the effect of small interfering RNA (siRNA) silencing the ERp29 gene on the biological behavior of PCa LNCaP cells. METHODS: The expression of the ERp29 gene in the BPH and PCa tissues was detected by immunohistochemistry and that of the ERp29 protein in the PCa and adjacent normal tissues of 6 PCa patients determined by Western blot. Human LNCaP cells were transfected with siRNA using LipofectamineTM 2000, and the expressions of ERp29 mRNA and protein in the LNCaP cells detected by quantitative real-time PCR (qRT-PCR) and Western blot, respectively. The proliferation of the LNCaP cells was measured by MTT assay, their in vitro migration and invasiveness evaluated by the Transwell method, and the expressions of E-cadherin and Vimentin determined by qRT-PCR. RESULTS: The expression of ERp29 was significantly lower in the PCa than in the adjacent normal tissue (73.9% vs 91.9%， P < 0.05), with a significant correlation between the down-regulated ERp29 expression and metastasis (M) staging (P < 0.05). After transfection with siRNA, the LNCaP cells showed dramatically increased proliferation, migration and invasiveness (P < 0.05), and the expression of E-cadherin was markedly down-regulated while that of Vimentin up-regulated as compared with those in the normal control group (P < 0.05). CONCLUSIONS: The ERp29 gene may be a novel repressor of tumor metastasis. Silencing ERp29 can promote the invasiveness of human PCa cells in vitro by down-regulating the expression of E-cadherin and increasing epithelial-mesenchymal transition.

[RNA interference of RelB enhances the radiosensitivity of prostate cancer cell line RM-1 in mice].

OBJECTIVE: To investigate the effect of RNA interference of the RelB gene on the radiosensitivity of the mouse prostate cancer cell line RM-1 and its mechanism. METHODS: We constructed RelB siRNA-expressing lentiviral vectors targeting the RelB gene with the molecular biological technique, and determined the expressions of RelB mRNA and protein on radiation after transfection with siRelB mediated by liposome using RT-PCR and Western blot, respectively. We also detected the apoptosis of RM-1 cells by FCM assay and their radiosensitivity by clonogenic assay. RESULTS: The expressions of RelB mRNA and protein were significantly lower in the RM-1 cells than in the control and negative interference groups after transfection with RelB siRNA (P < 0.05), while the apoptosis of RM-1 cells remarkably higher in the siRelB-RM-1 than in the control group after radiation treatment (P < 0.05). The activity of MnSOD was markedly decreased (P < 0.05), and the radiosensitization rate of the RM-1 cells in the RelB-RM-1 group was 5.13 after radiation treatment. CONCLUSION: RNA interference of the RelB gene could enhance the radiosensitivity of the mouse prostate cancer cell line RM-1, which might be associated with its inhibition of Mn-SOD expression and induction of cell apoptosis.

Down-regulation of EZH2 by RNA interference inhibits proliferation and invasion of ACHN cells via the Wnt/ß- catenin pathway.

Although enhancer of zeste homolog 2 (EZH2) has been reported as an independent prognostic factor in renal cell carcinoma (RCC), little is known about the exact mechanism of EZH2 in promoting the genesis of RCC. However, several studies have shown that dysregulation of the Wnt/ß-catenin signaling pathway plays a crucial role. Therefore, we determined whether EZH2 could affect ACHN human RCC cell proliferation and invasion via the Wnt/ß-catenin pathway. In the present study, we investigated the effects of short interfering RNA (siRNA)-mediated EZH2 gene silencing on Wnt/ß-catenin signaling in ACHN cells. EZH2-siRNA markedly inhibited the proliferation and invasion capabilities of ACHN, while also reducing the expression of EZH2, Wnt3a and ß-catenin. In contrast, cellular expression of GSK-3ß (glycogen synthase kinase-3ß), an inhibitor of the Wnt/ß-catenin pathway, was conspicuously higher after transfection of EZH2 siRNA. These preliminary findings suggest EZH2 may promote proliferation and invasion of ACHN cells via action on the Wnt/ß-catenin signaling pathway.

[Surgical strategy for ectopic kidneys: analysis of 35 cases].

OBJECTIVE: To explore the surgical strategy for ectopic kidney and evaluate the clinical outcomes. METHODS: From January 2000 to October 2009, 35 cases of ectopic kidney were treated surgically in our hospital. Definite diagnoses were established in all the cases by ultrasound, intravenous urography (IVU), cystoscope, CT, magnetic resonance urography (MRU) and radionuclide imaging before the surgery. In these patients, 26 had ipsilateral ectopic ureteral orifice (including 5 with bilateral duplicated kidneys and ureter), 9 had moderate or severe hydronephrosis (including 3 with ectopic kidney calculi), and 24 had dysplastic kidney (24/35). All the patients underwent operations, including 26 with ectopic nephrectomy, 7 with ectopic ureterovesical reimplantation, and 3 with ectopic renal pelvis incision. RESULTS: The clinical effect was satisfactory in all the cases during the follow up of 7 to 29 months. CONCLUSION: Appropriate surgical approaches according to the concurrent deformities and complications can achieve good clinical results in patients with ectopic kidneys.

Clinical utility of fluorescence in situ hybridization for prediction of residual tumor after transurethral resection of bladder urothelial carcinoma.

OBJECTIVES: To evaluate the use of a multiprobe fluorescence in situ hybridization (FISH) assay for predicting the residual tumor load after transurethral resection (TUR) of bladder urothelial carcinoma (UC). METHODS: Voided urine specimens were collected from 125 consecutive patients with suspected UC who had been admitted for TUR. Of the 125 patients, 89 with UC diagnosed underwent a second procedure (repeated TUR or cystectomy) 4-6 weeks after the initial TUR and were included in the present study. Using the pathologic findings from the second procedure, the patients were divided into those with (n = 38) and those without (n = 51) residual tumor. Urine samples were taken both before and after the initial TUR. The multiprobe FISH assay was performed to detect aneuploidy of chromosomes 3, 7, and 17 and the loss of the 9p21 locus. RESULTS: Before the first TUR, no significant difference was found in the FISH-positive percentage between those with and without residual tumor. After the first TUR, the FISH-positive percentage in those with residual tumor was significantly greater than in those without residual tumor (42.2% vs 17.6%, P = .003). Moreover, before and after the initial TUR, the percentage of conversion from FISH positive to FISH negative in those with residual tumor was significantly lower than in those without residual tumor (28.9% vs 58.9%, P < .001). No patients were observed with a FISH result of conversion from negative to positive in those with and without residual tumor after the initial TUR. CONCLUSIONS: FISH appears to be useful for the prediction of the presence of the residual tumor load after TUR of bladder UC.

Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction.

OBJECTIVE: To prospectively study the effects of hyperbaric oxygen therapy (HBOT) on the recovery of erectile function (EF) after posterior urethral reconstruction. METHODS: Between August 2006 and March 2010, a total of 24 male patients with posterior urethral reconstruction and without erectile dysfunction (ED) before urethral stricture were involved in the study. Twelve of them were assigned to HBOT group that received HBOT, and the others comprised the control group. All 24 participants were asked to assess their EF pre-operatively and 3 months postoperatively by using the International Index of Erectile Function (IIEF). RESULTS: All 24 participants completed the study. The total IIEF scores and scores in two domains of IIEF (erectile function (EF) and overall satisfaction (OS) domain) were significantly lower than the preoperative baseline scores in HBOT group (P < 0.05). Meanwhile, a significant decrease in the total IIEF scores and scores in three domains of IIEF (EF, OS and intercourse satisfaction (IS) domain) was observed in control group (P < 0.05). However, at 3 months postoperatively, the total IIEF scores and scores in three domains of IIEF (EF, OS and IS domain) after HBOT were significantly higher in HBOT group than in control group (P < 0.05). CONCLUSIONS: These preliminary results suggest that HBOT may be effective for improving EF recovery after posterior urethral reconstruction.

[Phloroglucinol: safe and effective for the prevention of bladder spasm after TURP].

OBJECTIVE: To evaluate the efficacy of phloroglucinol in preventing bladder spasm after transurethral resection of the prostate (TURP). METHODS: Using the random sampling method, we assigned 74 cases of TURP into a treatment group (n = 39), given 80 mg phloroglucinol every day for 3 days, and a control group (n = 35), left untreated. Then we observed the frequency, duration and pain of bladder spasm within the 3 days and compared them between the two groups. RESULTS: The mean frequency, duration and pain visual analogue score of bladder spasm were (4.3 +/- 1.2) times, (7.2 +/- 2.1) min and 3.2 +/- 1.6 respectively in the treatment group, as compared with (7.5 +/- 2.4) times, (15.6 +/- 6.8) min and 4.7 +/- 2.3 in the control, with statistically significant differences between the two groups (P < 0.05). And no obvious adverse reactions were found in the treatment group. CONCLUSION: Phloroglucinol is safe and effective for the prevention and treatment of bladder spasm following TURP.

[Effect of PI3K/AKT inhibitor on benign prostate hyperplasia and its mechanism: an experimental study].

OBJECTIVE: To explore the effect of the phosphoinositide 3-kinase/protein kinase B (PI3K/PKB or PI3K/AKT) signaling pathway inhibitor on benign prostate hyperplasia (BPH) and its mechanism. METHODS: Forty-eight SD male adult rats aged 12 weeks were equally randomized to 4 groups: sham operation control, BPH model, 50 mg LY294002 and 100 mg LY294002. The BPH models were made by muscular injection of testosterone propionate at 10 mg/kg/d for 30 days following castration. The LY294002 groups were treated with the PI3K/AKT signaling pathway inhibitor LY294002 at 50 and 100 mg/kg every other day for 30 days. The prostates of the rats were weighed and the structural changes of the prostatic histiocytes observed under the light microscope. The expressions of Ki-67, anti-apoptotic Bcl-2 and apoptotic Bax were detected by immunohistochemistry, and the apoptosis of prostatic cells determined by terminal de-oxynucleotidyl transferase-mediated dUTP nick end labeling. RESULTS: The prostate wet weight and prostatic index were (551 +/- 10.8) mg and 1.61 +/- 0.05 in the sham operation group, (687 +/- 13.8) mg and 2.15 +/- 0.12 in the BPH model group, (623 +/- 23.5) mg and 1.95 +/- 0.11 in the LY294002 50 mg group (P < 0.05 versus the BPH models) and (561 +/- 12.6) mg and 1.71 +/- 0.18 in the LY294002 100 mg group (P < 0.01 versus the BPH models). The expressions of apoptotic Bax and anti-apoptotic Bcl-2 were 16.7% and 16.7% in the sham operation group, 16.7% and 58.3% in the BPH model group, 33.3% and 33.3% in the LY294002 50 mg group (P < 0.05 versus the BPH models), and 50.0% and 25.0% in the LY294002 100 mg group (P < 0.01 versus the BPH models). The proliferative and apoptotic indexes were 14.2 +/- 6.4 and 6.5 +/- 1.8 in the epithelial and 7.6 +/- 2.6 and 2.5 +/- 0.3 in the interstitial tissue of the sham operation group, 50.9 +/- 12.8 and 2.7 +/- 1.4 in the epithelial and 16.5 +/- 5.7 and 1.3 +/- 0.8 in the interstitial tissue of the BPH models, 32.0 +/- 13.8 and 6.2 +/- 2.5 in the epithelial and 12.1 +/- 3.8 and 1.6 +/- 1.1 in the interstitial tissue of the LY294002 50 mg group (P < 0.05 versus the BPH models), and 17.8 +/- 14.7 and 7.4 +/- 3.6 in the epithelial and 9.5 +/- 3.4 and 2.2 +/- 1.3 in the interstitial tissue of the LY294002 100 mg group (P < 0.01 versus the BPH models). CONCLUSION: The increased proliferation and decreased apoptosis of prostatic cells in the BPH animal models might be involved in the development and progression of BPH. The PI3K/AKT signaling pathway plays an important role in the development of BPH, which could be inhibited by blocking the PI3K/AKT signaling pathway.

[Diagnosis and treatment of rare mixed prostatic carcinoma].

OBJECTIVE: To discuss the diagnosis and treatment of rare mixed prostatic carcinoma. METHODS: We retrospectively analyzed the clinical data of 6 cases of mixed prostatic tumor confirmed by surgery or transrectal ultrasound guided prostate biopsy, and reviewed the related literature. RESULTS: Three of the patients (2 with mixed small cell carcinoma and adenocarcinoma and 1 with adenosquamous carcinoma of the prostate) underwent palliative transurethral electrovaporization of the prostate (TUVP) and endocrine therapy, but all died within 7 - 10 months. The other 3 (2 with adenosquamous carcinoma and 1 with carcinosarcoma of the prostate) received cystoprostatectomy, urinary diversion, pelvic lymphadenectomy and radiation therapy, and survived for more than 12 months, with 2 of them still under the follow-up observation. CONCLUSION: Mixed prostatic carcinoma behaves aggressively with poor prognosis, of which the diagnosis relies on meticulous pathological examination and immunohistochemical techniques, and the most effective treatment is radical surgery.

[A clinical analysis of benign prostatic hyperplasia with chronic prostatitis].

OBJECTIVE: To study the incidence of benign prostatic hyperplasia (BPH) complicated by chronic prostatitis. METHODS: We performed routine examinations and bacterial culture of the expressed prostate secretion (EPS) for 213 cases of BPH, detected mycoplasma, chlamydia and serum PSA, and compared the results of IPSS of those complicated with chronic prostatitis before and after a 4-week anti-inflammatory treatment. RESULTS: Of the total cases, 69 (32.4%) were complicated by chronic prostatitis, 27 (12.7%) EPS positive and 15 (7.0%) mycoplasma and chlamydia positive. Among the 69 cases of chronic prostatitis, 7 were found with an elevated level of PSA (> 4 microg/L), and 43 with the mean IPSS score decreased from (12.2 +/- 2.6) before anti-inflammatory treatment to (10.5 +/- 2.3) after it (P < 0.01). CONCLUSION: EPS examination should be performed for patients with BPH, which is highly significant for the diagnosis of prostatitis, choice of medical or surgical treatment, improvement of therapeutic effect and reduction of complications.

[Expression of Ki-67, Bcl-2,Bax and caspase-3 in benign prostatic hyperplasia combined with prostatitis and their significances].

OBJECTIVE: To detect the expression of Ki-67, Bcl-2, Bax and caspase-3 in simple benign prostatic hyperplasia (BPH) and BPH combined with prostatitis,and to evaluate the effect of inflammation on the development and progression of BPH. METHODS: All specimens were obtained from patients undergoing surgical resection of the prostate. The paraffin section of the specimens was stained with hemotoxyline and eosin, and observed under light microscope to examine the inflammation hispathological changes. Sixteen patients with simple BPH (Group A) and 42 patients with BPH combined with prostatitis (Group B) were included. Immunohistochemical analysis and Western blot were used to examine the expression of Ki-67, Bcl-2, Bax and caspase-3. RESULTS: The expression of Ki-67 and Bcl-2 was significantly higher in Group B than that in Group A (P<0.05), and caspase-3 expression was significantly lower (P<0.05). There was no difference in Bax expression between the 2 groups (P>0.05). CONCLUSION: Prostatitis can up-regulate Ki-67, Bcl-2 expression, and down-regulate the expression of caspase-3 in BPH. Prostatitis appeared to play an important role in the development of BPH by affecting the proliferation and apoptosis of the prostatic cells.

[Urethroplasty with tunica vaginalis flap for treating hypospadias with hydrocele: a report of 9 cases].

OBJECTIVE: To explore the treatment of hypospadias with hydrocele. METHODS: Nine patients with hypospadias complicated by hydrocele underwent urethroplasty with tunica vaginalis flap. RESULTS: Satisfactory results were achieved in 7 cases, all with a normal anatomic position of urethral meatus, perfect urination and no infection. Local infection and meatal stricture occurred in 1 case, which was restored to normal by urethral sounding. Scrotal urinary fistula developed in another. CONCLUSION: With minimum surgical trauma, conveniently available material and fast tissue repair, urethroplasty with tunica vaginalis flap is a desirable method for the treatment of hypospadias with hydrocele.

Chronic inflammation in benign prostatic hyperplasia: implications for therapy.

Benign prostatic hyperplasia (BPH) is a common age related proliferative abnormality of the human prostate. Histological features demonstrate that the typical nodules of BPH are composed of stromal and epithelial cells that are proportionally different between nodules. BPH nodules frequently occur concurrently with chronic inflammatory infiltrates, mainly composed of chronically activated T cells and macrophages. Recent studies suggest that these inflammatory cells, immunity responses and their precursors play important roles in the pathogenesis of BPH. Clinical evidences also indicate that chronic inflammation correlates with clinical progression of BPH. Therefore, we hypothesize that BPH is an inflammatory disease. Reducing inflammation may play a crucial role in the treatment of BPH and finally lead to a better clinical outcome. If our hypotheses can be further supported with clinical trials it may change the approach of the medical management for BPH.

[A multi-center clinical trial of Qianlieantong tablets for chronic prostatitis].

OBJECTIVE: To observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis. METHODS: 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. RESULTS: 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. CONCLUSION: Qianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.

[Evaluation of 126 radical cystectomy with orthotopic ileal or sigmoidocolic neobladder].

OBJECTIVE: To evaluate the long-term clinical effects of orthotopic ileal or sigmoidocolic neobladder. METHODS: One hundred and twenty six patients with bladder cancer who underwent radical cystectomy and orthotopic ileal or sigmoidocolic neobladder from 1989 to 2001 were followed up, the clinical data was collected and analysed. Hautmann orthotopic ileal neobladder was performed on 84 cases and orthotopic sigmoidocolic neobladder was performed on 42 cases; Lymph node clearing during surgery was performed on 62 cases, chemotherapy and radiotherapy was performed on 64 cases after surgery. The continence and complications were compared between sigmoidocolic group and ileal group, the tumor recurrent rate and the 5-year survival rate were compared between lymphnode clearing group and chemoradical therapy group. RESULTS: Complete follow up was performed in 122 cases. Ureter broaden and urine backflow rate were higher in sigmoidocolic group than in ileal group (P < 0.05), nocturnal continence rate in sigmoidocolic group was higher than in ileal group (P < 0.05); Post-surgical tumor recurrent rate in lymphnode clearing group was lower than in chemoradical therapy group (P < 0.05), the 5-year survival rate in lymphnode clearing group was higher than in chemoradical therapy group (P < 0.05). The overall short-term complication rate was 15.9% (20/126), the overall long-term complication rate was 9.8% (12/122). CONCLUSION: The effects of orthotopic ileal or sigmoidocolic neobladder were satisfactory with low complication rate, lymphnode clearing during the surgery can increase the 5-year survival rate when compared with the chemoradical group.

[Smad4 and TGF-beta1 expression and clinical significance in bladder transitional cell carcinoma].

OBJECTIVE: To determine the expression of Smad4 and TGF-beta1 in bladder transitional cell carcinoma (BTCC), and to understand the mechanism of invasion, angiogenesis, and metastasis of BTCC. METHODS: The expressions of Smad4 and TGF-beta1 in samples of 42 human bladder carcinoma and 12 normal bladder mucosa tissues were determined with standard immunohistochemical analysis. We also analyzed the relationship among the expressions of Smad4 and TGF-beta1 and invasion, angiogenesis, and metastasis of BTCC, and the correlation between Smad4 and TGF-beta1. RESULTS: The positive rate of Smad4 in BTCC was significantly lower than those in normal bladder mucosa tissues (33.3% vs 83.3%, P < 0.01). The expressions of Smad4 in poorly differentiated, invasive, recurrent, or with lymph node metastasis of BTCCs were lower than those in well differentiated, superficial, nonrecurrent, or without lymph node metastasis ones (P <0.05). The positive rate of TGF-beta1 in BTCC was significantly lower than that in normal bladder mucosa tissues (64.3% vs 100%, P <0.01), which was positively correlated to that of Smad4 (P = 0.000). CONCLUSION: The expressions of Smad4 and TGF-beta1 in BTCC decrease with the increase in clinical stage, poor pathological grade, and the recurrence and metastasis of BTCC.

[The efficacy and safety in the treatment of chronic abacterial prostatitis/chronic pelvic pain syndrome after intraprostatic injection of Chuanshentong].

OBJECTIVE: To assess the clinic efficacy and safety in the treatment of chronic abacterial prostatitis/chronic pelvic pain syndrome (CABP/CPPS) after intraprostatic injection of Chuanshentong. METHODS: Five milliliter of solution blending Chuanshentong and lidocaine was transperineally injected into one lobe of prostate, once a day for 6 days, for a total of 98 cases of patients who had been diagnosed as chronic abacterial prostatitis/chronic pelvic pain syndrome. The efficacy was evaluated by the NIH Chronic Prostatitis Symptom Index (CPSI) after a 12 week follow-up. RESULTS: All cases had completed the follow-up. Fifty-three cases (54.08%) were completely cured, accompanied by remarkable effective in 17 cases (17.35%) and improved in 23 cases (23.47%). The total remarkable efficacy was 71.43% and improved 94. 90%. Scores of CPSI decreased significantly compared with pre-treatment (95% confidence interval 12.85 approximately 17.91). CONCLUSION: It is suggested that transperineally intraprostatic injection of Chuanshentong may be a useful method for the treatment of CABP/CPPS.