[Efficacy of European Organization for Research and Treatment of Cancer (EORTC) risk tables for the prediction of recurrence and progression of non-muscle invasive bladder cancer after intravesical pirarubicin instillation].

OBJECTIVE: To analyze the influence of intravesical Pirarubicin (THP) instillation on the prediction results of European Organization for Research and Treatment of Cancer (EORTC) risk tables and to discuss the efficacy of EORTC risk tables in clinical application. METHODS: We retrospectively reviewed the clinical data of 389 patients with non-muscle invasive bladder cancer after TURBT treated with intravesical pirarubicin instillation. According to the EORTC Scoring System, all the cases were divided into low risk group, intermediate risk group and high risk group. The 1-year and 5-year recurrence and progression rates of each group were calculated and compared with the prediction results of the EORTC risk tables. RESULTS: The 1-year recurrence and progression rates of the low risk group were 8.0% and 0, those of the intermediate risk group were 31.0% and 2.8%, and those of the high risk group were 52.5% and 18.6%, respectively. The 5-year recurrence and progression rates of low risk group were 16.0% and 5.3%, those of the intermediate risk group were 42.6% and 10.7%, and those of the high risk group were 63.9% and 41.9%, respectively. The prediction results of progression rate were similar to that of the EORTC risk tables while the overall recurrence rate was lower. CONCLUSIONS: The EORTC risk tables can be effectively used to predict the recurrence rate and progression rate of non-muscle invasive bladder cancer. However, the EORTC risk tables have a tendency to overestimate the recurrence rate. Intravesical pirarubicin instillation is helpful to reduce the recurrence rate, yet has no obvious influence on the tumor progression.

[Safety of solifenacin and tolterodine in the treatment of overactive bladder: a meta-analysis].

OBJECTIVE: To evaluate the safety of solifenacin and tolterodine in the treatment of overactive bladder (OAB). METHODS: Studies on the solifenacin, tolterodine and OAB were searched and those fulfilling the inclusion criteria were selected. RevMan 5.0 software was used to perform meta-analysis. Three studies were included with an overall sample size of 1013 cases. The experimental group of solifenacin contained 517 cases while the control group had 496 cases. RESULTS: The incidence rates of overall adverse event, dry mouth, constipation and blurred vision of the experimental group (solifenacin 5 mg once per day) was 26.69% (138/517), 10.64% (55/517), 5.42% (28/517) and 6.55% (26/397) while those of the control group (tolterodine 2 mg twice per day) 33.27% (165/496), 16.73% (83/496), 2.22% (11/496) and 4.20% (16/381) respectively. There was no statistically significant difference in overall adverse event (RR = 0.76, 95%CI: 0.52 - 1.12, P = 0.170) and blurred vision (RR = 1.59, 95%CI: 0.88 - 2.90, P = 0.130) between two groups. However, the incidence rate of key antimuscarinic adverse events such as dry mouth (RR = 0.63, 95%CI: 0.46 - 0.87, P = 0.005) and constipation (RR = 2.38, 95%CI: 1.21 - 4.66, P = 0.010) showed statistically significant difference. CONCLUSIONS: Dry mouth is the most common adverse event of solifenacin (5 mg once per day) and tolterodine (2 mg twice per day). Solifenacin has a lower incidence rate of dry mouth and a higher rate of constipation than tolterodine. A clinical physician should consider the incidence of adverse events during treating OAB, especially for those patients prone to constipation.

[Role of bulbocavernosus reflex to stimulation of prostatic urethra in pathologic mechanism of primary premature ejaculation].

OBJECTIVE: Primary premature ejaculation (PPE) is a prevalent sexual dysfunction among men while its precise pathologic mechanism has remained poorly understood. In current study the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of prostatic urethra and primary premature ejaculation was studied. METHODS: Forty-two patients with PPE and 20 normal potent male volunteers were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra to record the sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR and latencies of BCR. Also the sensitivity of glans penis to electrical stimulation was detected by two surface electrodes. RESULTS: The mean sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR and sensory thresholds of glans penis were (18.2 +/- 2.7) mA (0.2 ms in duration, 1 Hz), (34.8 +/- 4.2) mA (0.2 ms, 1 Hz), (71.2 +/- 5.8) ms and (14.2 +/- 1.9) mA (0.04 ms in duration, 3 Hz) in normal potent men respectively and were (12.4 +/- 3.7) mA (0.2 ms, 1 Hz), (23.8 +/- 5.6) mA (0.2 ms, 1 Hz), (70.5 +/- 6.3) ms and (11.9 +/- 2.3) mA (0.04 ms, 3 Hz) in patients with PPE respectively. Statistically significant differences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra, the thresholds to evoke stable BCR and the sensory thresholds of glans penis between two groups (all P < 0.01). No statistically differences were seen regarding the latencies of BCR between two groups (P > 0.05). CONCLUSION: Patients with PPE have hyperexcitable BCR to stimulation of prostatic urethra. It is probably one of the important etiological factors. Moreover the findings may provide new therapeutic modalities of PPE.

[Relationship of transforming growth factor beta1 and basic fibroblast growth factor to detrusor underactivity following bladder outlet obstruction: experiment with rats].

OBJECTIVE: To investigate the relationship of transforming growth factor beta1 (TGFbeta1) and basic fibroblast growth factor (bFGF) to detrusor underactivity following bladder outlet obstruction (BOO). METHODS: Female Wistar rats underwent ligation of the urethra to establish BOO models and were divided into BOO model 2-week group (11 rats) and BOO model 6-week group (10 rats). 8 rats underwent sham operation as control group. The detrusor urine was taken out and stimulated by carbachol to measure the detrusor contraction force (DCF). RT-PCR method was employed to measure the mRNA expression of TGFbeta1 and bFGF in the detrusor urine. Urine TGFbeta1 and bFGF were determined by ELISA. RESULTS: The maximum DCF levels of the BOO 2-week group under the 1 x 10(-4) mmol/L and 1 x 10(-3) mmol/L carbachol concentrations were 0.96 g +/- 0.11 g and 1.98 g +/- 0.21 g respectively, both significantly higher than those of the sham operation group (0.85 g +/- 0.18 g and 1.82 g +/- 0.19 g respectively, both P < 0.05). The maximum DCF levels of the BOO 6-week group under the 1 x 10(-5), 1 x 10(-4), 1 x 10(-3) and 1 x 10 (-2) mmol/L carbachol concentrations were 0.19 g +/- 0.02 g, 0.65 g +/- 0.06 g, 1.12 g +/- 0.08 g, and 1.40 g +/- 0.19 g respectively, all significantly lower than those of the BOO 2-week group (0.24 g +/- 0.03 g, 0.96 g +/- 0.11 g, 1.98 g +/- 0.21 g, and 2.16 g +/- 0.21 g respectively, all P < 0.05) and those of the sham operation group (0.23 g +/- 0.04 g, 0.85 g +/- 0.18 g, 1.82 g +/- 0.19 g, and 2.12 g +/- 0.26 g respectively, all P < 0.05). The mRNA expression of TGFbeta1 of the BOO 6-week group, BOO 2-week group, and sham operation group was 0.72 +/- 0.21, 0.34 +/- 0.10, and 0.32 +/- 0.01 respectively, there was a significant difference between the BOO 6-week group and the BOO 2-week group (P < 0.01). The mRNA expression level of bFGF of the BOO 6-week group was 0.38 +/- 0.13, significantly higher than those of the BOO 2-week group and sham operation group (0.21 +/- 0.07 and 0.10 +/- 0.05 respectively, both P <0.05). DCF was negatively correlated with the mNRA expression of TGFbeta1 and the mNRA expression bFGF in detrusor (both P < 0.05). The urine TGFbeta1 of the BOO 6-week group was (606 +/- 216) microg/mol Cr, significantly higher than that of the BOO 2-week group [(131 +/- 49) microg/mol Cr] and that of the sham operation group [(107 +/- 22) microg/mol Cr, both P <0.05]. CONCLUSION: With the progression of BOO, there is a sustained rise of bFGF mRNA expression in detrusor; however, the TGFbeta1 mRNA expression only increases during the decompensation stage. Urine TGFbeta1 level is very high 6 weeks after BOO, which may help predict the contraction function of bladder after BOO.

[Primary cutaneous T-cell lymphoma of the penis complicated by Fournier gangrene: a case report].

OBJECTIVE: To explore the clinical presentation, pathologic characteristics, diagnosis and treatment of cutaneous T-cell lymphoma of the penis. METHODS: A 49-year-old man presented with painful swelling and inflammation of the foreskin, failed to respond to antibiotic treatment and dorsal incision, and was instead complicated by Fournier gangrene. Then he underwent debridement and pathological examination. RESULTS: Pathological results indicated cutaneous T-cell lymphoma of the penis. Immunohistochemistry showed CD3 and CD45 RO to be positive, but CD30, CD79a, CD20 and HMB negative. The patient was treated by interferon alpha and ultraviolet B for 2 weeks, followed by total removal of the external genitalia because of necrosis of the corpus spongiosum, which involved the scrotum and right testis on pathological examination. CONCLUSION: Cutaneous T-cell lymphoma of the penis is a rare condition and easily mis diagnosed in the early phase. Definitive diagnosis depends on pathological study.

[Distribution and differentiation of marrow mesenchymal cells in tumor tissue: experimental with rabbits].

OBJECTIVE: To study the distribution of bone marrow mesenchymal stem cells (MSCs) in tumor tissue and the possibility of MSCs differentiating into myofibroblast under the induction of local tumor microenvironment. METHODS: MSC were isolated from 24 New Zealand rabbits, and cultured. Then vx-2 tumor tissue was transplanted under the bladder mucosa of each animal. Then the rabbits were randomly divided into 2 equal groups: control group and test group. One week after the transplantation, the autologous F2 passage MSCs marked by diamino-phenyl-indole (DAPI) were transplanted into the tumor tissue of the test group and DMEM medium was infused into the tumor tissue of the control group. Ultrasonography was performed 1, 2, 3, and 4 week(s) after the vx-2 tumor mass was transplanted. The maximum bladder tumor diameters of each animal were recorded and the mean value of each group was calculated. One animal in each group with its tumor diameter closest to the average value of the very group was put to death in the third week and all the left animals were killed in the fourth week to observe the tumor development. Another rabbit underwent same treatment as that in the test group was put to death to observe the distribution of MSCs in the tumor tissue one week after self-MSC transplantation. Immunofluorescence was used to trace the MSCs in the tumor tissue. Double labeling immunofluorescence for alpha-smooth muscle actin (alpha-SMA) and vimentin was performed to identify whether MSCs could differentiate into myofibroblasts. RESULTS: Ultrasonography showed no tumor mass one week after the vx-2 tumor mass transplantation. In the second week, the mean maximum tumor diameter of the control group was 0.70 +/- 0.14 cm, not significantly different from that of the test group (0.78 +/- 0.14 cm, t = 1.308, P = 0.204), however, the mean maximum tumor diameter in the third and fourth weeks of the control group were 1.8 +/- 0.4 cm and 2.3 +/- 0.6 cm respectively, both significantly shorter than those of the test group (2.2 +/- 0.3 cm and 3.8 +/- 0.9 cm respectively, both P < 0.05). Microscopy showed that MSCs were distributed uniformly in the tumor tissue one week after transplantation while most of the MSCs were distributed in the tumor stroma three weeks after transplantation. Double labeling immunofluorescence showed an increase of alpha-SMA and vimentin expression three weeks after MSC engraftment. CONCLUSION: MSCs are initially distributed uniformly in the tumor tissue and then distributed mainly in the tumor stroma. Furthermore, MSCs accelerate tumor development and can differentiate into myofibroblasts under the induction of tumor microenvironment.

[Establishment of a new model of neurogenic bladder dysfunction caused by lumbar intervertebral diskhernia and its urodynamic evaluation].

OBJECTIVE: To establish a new rat model of neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia, and to confirm the model by urodynamic examination. METHODS: Twenty male Wistar rats were divided into two groups at random:experimental group (n = 15) and pseudo-operation group (n = 5). The rats underwent laparotomy to disclose the intervertebral disk of L(6)-S(1), and a 1.50 mm x 4.50 mm blunt screw with flat end was inserted into the intervertebral disk of L(6)-S(1) of the rats in the experimental group so as to establish the model of lumbar intervertebral disk hernia. Computed radiography (CR) was performed 3 days after the operation to conform the successful insertion of the screw. Combined behavioral score (CBS) was used 1 d, 3 d, 1 week, 2 weeks, and 4 weeks after the operation. Four weeks after the laparotomy a vesical fistula above the pubis was made in all of the rats, and then urodynamic examination was performed three days after this operation. RESULTS: CR after operation confirmed that the blunt screw had been inserted into the lumbar disk of L(6). The CBS scores of the 2 groups at different time points all decreased along with time, and basically remained unchanged 1 week after. The CBS scores of the experiment group were significantly higher than those of the pseudo-operation group (all P < 0.05). The spontaneous vesical contraction rate in the filling period of the experimental group was (4.37 +/- 2.13) times/min, significantly higher than that of the pseudo-operation group [(0.06 +/- 0.13) times/min, t = 4.425, P = 0.000], the maximum bladder capacity of the experimental group was (1.20 +/- 0.34) ml, significantly greater than that of the pseudo-operation group [(0.60 +/- 0.14) ml, t = 5.141, P = 0.002], and bladder compliance of the experimental group was (0.024 +/- 0.012) ml/cm H(2)O, significantly lower than that of the pseudo-operation group [(0.096 +/- 0.088) ml/cm H(2)O, t = 2.891, P = 0.011], and the leak point pressure of the experimental group was (75 +/- 27) cm H(2)O, not significantly different from that of the pseudo-operation group [(62 +/- 23) cm H(2)O]. The urodynamic examination on the conscious rats confirmed the successful establishment of the neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia. CONCLUSION: A new model of neurogenic bladder dysfunction caused by lumbar intervertebral disk hernia has been established by insertion of a blunt screw into the lumbar intervertebral disk of L(6). The model is confirmed by urodynamic examination.

[Diagnosis and treatment of interstitial cystitis: report of 16 misdiagnosed cases].

OBJECTIVE: To investigate the diagnoses and treatment of interstitial cystitis (IC). METHODS: The clinical data of 16 IC patients were analyzed respectively. The patients with urinary frequency, urgency, suprapubic pain and chronic pelvic pain. They were misdiagnosed as chronic cystitis, pelvic inflammation, endometriosis, cystophthisis and urethral syndrome, and were diagnosed finally by the means of pathology or cystoscopy. Among the 16 patients, 4 cases had the operation of ileal reservoir, Two cases had sigmoid-cysto-plasty, and 10 cases had drug treatment. The methods of IC diagnosis and treatment were discussed with the review of literature. RESULTS: The pelvic ache disappeared completely in 4 cases after the operation of ileal reservoir; Two cases after cystoplasty felt lightly discomfortable in perineum occasionally, and their bladder capacity was above 350 ml, no recurrence after operation having been found after follow-up for 24 months and 33 months; Ten cases treated with non-operative treatment improved obviously, with the O'Leary-Sant IC symptom index and IC problem index decreased from 15.4 +/- 4.1, 9.4 +/- 2.7 to 4.1 +/- 2.1 and 5.1 +/- 3.9, respectively. CONCLUSIONS: Sufficient attention should be paid to the diagnosis and differential diagnosis of IC; Early diagnosis and therapeutic alliance with manifold measures can relieve the patients' symptom and improve the quality of life.

[Treatment of the paraplegic patient with erectile dysfunction by implantation of China-made three-piece inflatable penile prosthesis].

OBJECTIVE: To evaluate the effect of the treatment on paraplegic patients with erectile dysfunction (ED) by implantation of China-made three-piece inflatable penile prosthesis. METHODS: Eighteen paraplegic patients with ED refractory to non-operative treatment were implanted with three-piece inflatable penile prosthesis through an incision at the border of penis and scrotum. The rate of maintained coitus and the satisfactory coitus of spouse were obtained by inquiring and letter visiting. RESULTS: Operations were successfully performed upon all 18 patients. Follow-ups after operations ranged from 3 months to 36 months, mean follow-up being 18 months. Fluid exudation from penile prosthesis and localized infection occurred in one patient and mechanic complication occurred in two. Maintained coitus rate was 17/18. Ejaculation reflection occurred in three patients. CONCLUSIONS: Treatment of paraplegic patient with ED refractory to non-operative treatment by implantation of China-made three-piece inflatable penile prosthesis has good concealment and rehabilitative effect, with similar mechanical troubles to imported products. With excellent covertness, implantation of three-piece inflatable penile prosthesis is well accepted by ED patients.

Clinical characteristics of bladder urothelial tumors in male patients--the influences of benign prostatic hyperplasia/benign prostatic enlargement.

OBJECTIVES: To investigate the clinical characteristics of bladder urothelial tumors in male patients. PATIENTS AND METHODS: The clinical characteristics of 356 patients with newly diagnosed bladder urothelial tumors from July 2005 to January 2010 were analyzed. Characteristics of different age groups were compared. Furthermore, tumor characteristics were analyzed to define the relationship, if any, with benign prostatic hyperplasia/benign prostatic enlargement. RESULTS: For bladder urothelial tumors, the percentage of carcinoma increased significantly with increasing age (P < 0.001), and differences were found among 3 age groups in the distribution of high grade carcinoma (P = 0.012). Especially in non-muscle-invasive carcinoma, the percentage of high grade carcinoma increased significantly with increasing age (P = 0.006), with significant differences between the ≤50 years group and the 51-69 years group and ≥70 years group (P = 0.031, P = 0.002). Interestingly, compared with non-benign prostatic hyperplasia/benign prostatic enlargement patients, benign prostatic hyperplasia/benign prostatic enlargement patients were more frequently diagnosed with poorly differentiated tumors, and logistic regression confirmed associations between benign prostatic hyperplasia/benign prostatic enlargement and unfavorable carcinoma, controlling for age (P = 0.009). CONCLUSIONS: Age is an unfavorable influence on the clinical characteristics of bladder urothelial tumors in men, and it was observed that the percentage of unfavorable tumors increased with age. Interestingly, noticeable changes of tumor differentiation appeared at the age of 50 years, and it was indicated that the natural history of carcinoma appeared to differ according to benign prostatic hyperplasia/benign prostatic enlargement statuses. There was a tendency for the men, who were diagnosed with benign prostatic hyperplasia/benign prostatic enlargement, to present with unfavorable carcinoma.

Influence of clinical characteristics and tumor size on symptoms of bladder leiomyoma: a pooled analysis of 61 cases.

BACKGROUND: Bladder leiomyoma is an uncommon type of bladder neoplasms. Most publications are reports of isolated cases. The influence of tumor size on patients' early symptoms was seldom analyzed. We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients'symptoms in Chinese population. METHODS: We reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department, collected 53 cases from Chinese National Knowledge Infrastructure (CNKI), Wangfang data base, and Chinese Biological Medicine Disk, and performed a pooled analysis. The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups. The association between tumor size and the occurrence of symptoms was evaluated. Furthermore, Logistic regression model was constructed to discriminate variables. RESULTS: Women comprised the majority of the patients (49/61, 80.3%). The mean age and tumor size were (42.3 ± 14.0) years and (45.0 ± 25.7) mm, respectively. Among all the symptoms, irritative symptoms occurred most frequently (37.7%, 23/61), followed by obstructive urinary symptoms (31.1%, 19/61), hematuria (24.6%, 15/61), and abdominal bulge or pain (14.8%, 9/61). In our study, patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs. 3/25, P = 0.021). The histological, as well as anatomical, location of tumor, did not show significant differences between symptomatic and asymptomatic patients (P = 0.306 and 0.700). Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P = 0.048) and irritative symptoms (P = 0.037). Logistic regression confirmed the association between tumor size and the occurrence of symptoms, which was related with age. CONCLUSIONS: Bladder leiomyoma occurs mainly in women and most frequently with irritative symptoms. The occurrence of symptoms is related to tumor size rather than the location. In this setting, patients with endovesical tumors smaller than 30 mm in the greatest diameter tended to be asymptomatic, which were usually treated with transurethral resection of bladder tumor.

Clinical characteristics of bladder urothelial tumors in female patients.

OBJECTIVE: The aim of this study was to investigate the influence of age and menopause on the clinical characteristics of bladder urothelial tumors in female patients. METHODS: We retrospectively reviewed the clinical and pathological data of 215 consecutive female patients with bladder urothelial tumors who were treated at our department from January 2000 to July 2008. To investigate the relationship with age, the clinical characteristics of the patients were first classified into three groups: 50 years or younger, 51 to 69 years, and 70 years or older. Then, the women were classified into two groups: premenopausal and postmenopausal. The tumor characteristics of the two groups were analyzed to define the relationship, if any, with menopause. Furthermore, logistic regression model was constructed to discriminate variables (age and menopause). RESULTS: The percentage of women with bladder urothelial carcinoma increased with increasing age, and a significant difference was observed among the three age groups (P = 0.003). Painless macroscopic hematuria occurred more frequently in the group of women 50 years or older at the first presentation (P = 0.003). On the other hand, compared with premenopausal women, postmenopausal women were more frequently diagnosed with bladder urothelial carcinoma and had a higher frequency of infiltrating carcinoma (P < 0.001 and P = 0.011, respectively). Logistic regression confirmed associations between menopause and tumor characteristics, controlling for age. CONCLUSIONS: Our study provided evidence that the natural history of bladder urothelial tumors seemed to differ according to menopause. It was observed that the percentage of bladder urothelial carcinomas increased with menopause. Moreover, there was a tendency for postmenopausal women to present with unfavorable infiltrating carcinoma more frequently.

Distribution and differentiation of mesenchymal stem cells in tumor tissue.

BACKGROUND: Tumor has an ability to become enriched in mesenchymal stem cells (MSCs) and of guiding MSCs to migrate to tumor tissue. But there are lack of relevant reports on the distribution and differentiation of MSCs in tumor tissue and the effect on tumor growth after MSCs engrafted in tumor tissue. In this study, we observed the distribution of bone marrow MSCs in tumor tissue and the possibility of MSCs differentiating into myofibroblast under the induction of local tumor microenvironment. METHODS: Twenty-four New Zealand rabbits were randomly classified into the control group and the test group. MSCs were isolated and cultured for each animal. vx-2 tumor tissue was transplanted under the bladder mucosa of each animal. One week after the transplantation, the self F2 passage MSCs marked by 4', 6-diamidino-2-phenylindole were transplanted into tumor tissue in the test group while only Dulbecco's modified Eagle's medium-low glucose was infused into the control group. Ultrasonography was performed for each animal 1, 2, 3 and 4 week (s) after the vx-2 tumor mass was transplanted. The maximum bladder tumor diameter of each animal was recorded and the mean value of each group was calculated. One animal from each group was sacrificed in the third week and the remaining animals in the fourth week to observe the tumor development. Another animal treated the same as the test group was sacrificed to observe the distribution of MSCs in tumor tissue one week after self MSCs transplantation. Immunofluorescence was used to trace MSCs in tumor tissue. The double labeling immunofluorescence for alpha-smooth muscle actin (alpha-SMA) and vimentin was performed to identify whether the MSCs can differentiate into myofibroblast. RESULTS: The ultrasonography showed no tumor mass one week after the vx-2 tumor mass transplantation. The mean maximum tumor diameter of the control group and test group was (0.70 +/- 0.14) cm and (0.78 +/- 0.14) cm, respectively, and there was no significant difference (t = 1.308, P = 0.204). The tumor growth rate of the test group increased gradually in the third and fourth weeks, and the difference of the mean maximum tumor diameter between the two groups also increased gradually and was statistically significant (P < 0.05). MSCs distributed uniformly in tumor tissue one week after transplantation while most were distributed in the tumor stroma three weeks after transplantation. The double labeling immunofluorescence showed that the expression of alpha-SMA as well as Vimentin increased significantly three weeks after mesenchymal stem cells engrafted into tumor, indicating that MSCs had differentiated into myofibroblasts under the induction of the tumor microenvironment. CONCLUSION: MSCs can accelerate the tumor development and can differentiate into myofibroblast under the induction of tumor microenvironment.

The prostate has secretory dysfunction for category IIIA and IIIB prostatitis.

PURPOSE: We investigated whether the prostate has secretory dysfunction for category IIIA and IIIB prostatitis. MATERIALS AND METHODS: Normal human prostatic secretions are remarkably rich in citrate, which is considered the most useful marker for determining prostate secretory function. It is certain that the prostate has secretory dysfunction for category I and II prostatitis, while it is not clear for category IIIA and IIIB prostatitis. To clarify this question expressed prostatic secretion citrate and pH were determined in 21, 25 and 25 outpatients with category II, IIIA and IIIB prostatitis, respectively, and in 21 normal controls without any prostatic disease. Outpatients with category II disease served as positive controls, while normal controls served as negative controls. No outpatients with category IIIA and IIIB prostatitis underwent treatment. RESULTS: Mean +/- SD expressed prostatic secretion citrate was 3.32 +/- 0.79, 3.41 +/- 0.88, 4.37 +/- 0.77 and 8.55 +/- 1.20 mg/ml in groups II, IIIA, IIIB and normal controls, respectively. Compared to normal controls expressed prostatic secretion citrate was significantly decreased in category II, IIIA and IIIB cases. Furthermore, there was no overlap of expressed prostatic secretion citrate values between category IIIA and IIIB cases, and the normal control group. CONCLUSIONS: The prostate has secretory dysfunction for category IIIA and IIIB prostatitis, which suggests that the prostate may be involved in category IIIA and IIIB prostatitis.

[Toxic effects of HSV-TK and CD-TK suicidal gene systems on prostate carcinoma cells].

BACKGROUND & OBJECTIVE: Suicidal gene therapy is one of promising gene therapies. In order to assess the value of suicidal gene therapy on human prostate carcinoma, the authors studied the toxic effects of HSV-TK gene and CD-TK fusion gene systems on prostate carcinoma cell line PC-3m. METHODS: HSV-TK gene and CD-TK fusion gene were separately transfected into PC-3m cells through retrovirus vectors. Reverse transcription-polymerase chain reaction (RT-PCR) was used to demonstrate successful transfection and transcription of suicidal genes. The toxic effects of GCV, 5-FC, and both of them on transfected PC-3m cells were explored by MTT assay; non-transfected PC-3m cells were used as control. RESULTS: Significantly cytotoxic activity of GCV was observed and 50% inhibitory concentration(IC(50)) was 8.34 microg/ml,the bystander effect of GCV was modest,while the bystander effect of 5-Fc was significant,it began to show when the percent of tansfected PC-3m cells in mixed cells was 5%. Simultaneous treatment with two prodrugs on CD-TK expressing cells resulted in additive or synergistic toxicity,coefficient of drug interaction(CDI) was under 1. CONCLUSION: CD-TK fusion suicidal gene system has significant toxic effect on PC-3m cells in vitro, which was superior to HSV-TK alone gene system.