Circadian rhythm in prostate cancer: time to take notice of the clock.

The circadian clock is an evolutionary molecular product that is associated with better adaptation to changes in the external environment. Disruption of the circadian rhythm plays a critical role in tumorigenesis of many kinds of cancers, including prostate cancer (PCa). Integrating circadian rhythm into PCa research not only brings a closer understanding of the mechanisms of PCa but also provides new and effective options for the precise treatment of patients with PCa. This review begins with patterns of the circadian clock, highlights the role of the disruption of circadian rhythms in PCa at the epidemiological and molecular levels, and discusses possible new approaches to PCa therapy that target the circadian clock.

[Risk Factors for Wound Healing of Infective Surgical Incision after Radical Cystectomy in Patients of Muscle Invasive Bladder Cancer].

OBJECTIVE: To evaluate the risk factors for wound healing of infective surgical incision in patients of muscle invasive bladder cancer undergoing radical cystectomy. METHODS: This study retrospectively collected clinical data of the patients who received radical cystectomy and experienced incisional infection after operation between January 2009 and December 2016. The patients were divided into early healing group and delayed healing group (the healing time is less or more than 14 d after operation). The risk factors for wound healing and infection were analyzed by single factor and multivariate logistic regression. RESULTS: A total of 171 patients with wound infection after radical cystectomy were included in the study. The average time of wound healing time was (17.9±16.9) d. There were 118 and 53 patients in early healing group and delay healing group respectively. Age, body mass index (BMI), operative incision type, preoperative albumin level, diabetes mellitus, infection wound size, infection wound with sinus, postoperative intestinal fistula and urinary fistula were statistically significant differences between the two groups (P<0.05).Univariate logistic regression analysis indicated that male, older than 65 yr., T4 stage, Type-Ⅲ surgical incision (infective incision), low preoperative albumin level (<30 g/L), hemoglobin level (<90 g/L), diabetes, wound size (>30 mm), intestinal fistula, urinary fistula were risk factors for delayed wound-healing. Multivariate logistic regression analysis revealed that Type-Ⅲ surgical incision and wound size (>30 mm) were independent risk factors for delayed wound healing. CONCLUSION: Type-Ⅲ surgical incision and the size of wound (>30 mm) are independent risk factors for delayed wound healing after radical cystectomy in bladder cancer patients.

[Evaluation of greenlight photoselective vaporization of prostate and plasmakinetic resection of prostate for the treatment of eldly benign prostatic hyperplasia men with high surgical risk: a prospective randomised control trial].

OBJECTIVE: To compare the clinical effects and safety between greenlight photoselective vaporization of prostate (PVP) and plasmakinetic resection of prostate (PRP) in eldly benign prostatic hyperplasia (BPH) men with high surgical risk. METHODS; Fifty three eldly BPH patients, who had the indication of surgical treatment but complicated with at least one internal disease, were randomly divided into PVP group and PRP group. The clinical data of all the patients were collected and compared between the two groups, including pre-operative and post-operative international prostate symptom score (IPSS), postvoid residual urine (PVR), urine flow rate (Qmax), quality of life (QOL) as well as prostate volume (PV), operational time, operative bleeding volume, postoperative recovery, peri-operative complications. RESULTS: The complete follow-up data of 44 patients were achieved: 21 of PVP, 23 of PRP. There were significant differences between two groups in operative bleeding, bladder irrigation time, indwelling catheter time and hospital stay (P < 0.002). The peri-operative bleeding was lower in PVP group, while the bladder irrigation time, indwelling catheter time and hospital stay were shorter in PVP group. The operation time showed no difference (P = 0.12). No significant differences were found 3 months postoperatively between two groups in all the data associated with urination (IPSS, Qmax, PVR, QOL), P > 0.05. Complications (urethrostenosis, retrograde ejaculationwere acceptable in both groups. CONCLUSION: For surgical treatment of eldly men with high surgical risk, both PVP and PRP are safe and effective with the internal disease being sufficient control.