The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis.

BACKGROUND: This review and meta-analysis aimed to systematically evaluate the clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C (MMC) in patients with nonmuscular invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). METHODS: The Embase, PubMed, CNKI, CBM, WANGFANG, VIP, Cochrane Library, and Clinicaltrial.com databases were searched for articles published before April 2022. The experimental group was treated with intravesical instillation of MMC assisted by equipment, including radiofrequency-induced thermochemotherapy, conductive thermochemical therapy, electromotive drug administration, or locoregional hyperthermia. The control group was treated with simple MMC perfusion. The outcomes of interest in the meta-analysis were recurrence, progression, side-effects, gross haematuria, and bladder irritation. RESULTS: A total of 15 studies that enrolled 1,190 patients were included in the meta-analysis. Compared to that of the control group, device-assisted intravesical instillation of MMC significantly reduced both tumour recurrence (odds ratio [OR] = 0.32, 95% confidence interval [CI] [0.24, 0.42], P <0.00001) and progression (OR = 0.29, 95% CI [0.12, 0.67], P = 0.004). There were no significant differences between the two groups in terms of safety (OR = 1.21, 95% CI [0.66,2.21], P = 0.54), bladder irritation (OR = 1.06, 95% CI [0.72,1.55], P = 0.78), or gross haematuria (OR = 1.11, 95% CI [0.64,1.94], P = 0.72). CONCLUSIONS: Equipment-assisted intravesical instillation of MMC significantly reduced the recurrence and progression of patients with NMIBC who underwent TURBT and improved their quality of life. Given the significant heterogeneity in research quality and sample size among earlier studies, more prospective, multicentre, large sample randomized controlled trials are needed to supplement and verify this in the future.

Clinical analysis of transurethral holmium laser enucleation in the treatment of benign prostatic hyperplasia with prostatic inflammation: A prospective research study.

Objective: To investigate the clinical efficacy of holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with prostatic inflammation (PI). Methods: We prospectively collected and followed up data on patients with BPH who underwent HoLEP at the Affiliated Hospital of Weifang Medical University between July 2021 and July 2022. According to the postoperative pathological results, the patients were divided into two groups: BPH without PI group (BPH group) and BPH with PI group. Statistical analysis was performed on clinical data, including age and body mass index (BMI), prostate volume (PV), postoperative residual urine volume (PVR), preoperative serum total prostate-specific antigen (tPSA), serum-free prostate-specific antigen (fPSA), preoperative and postoperative maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) before and 3 months after surgery, quality of life index (QoL) before and 3 months after surgery, and postoperative complications. Results: A total of 41 patients were included in this study, including 16 in the BPH group and 25 in the BPH with PI group. There were no significant differences in preoperative age, BMI, PV, PVR, tPSA, fPSA, and f/tPSA between the BPH and BPH with PI groups (P > 0.05). The preoperative mean Qmax of the BPH and BPH with PI groups were 9.44 ± 2.449 and 7.52 ± 2.946 [mean ± standard deviation (SD)] ml/s, mean IPSS were 17.75 ± 5.335 and 24.24 ± 5.861 (mean ± SD), and mean QoL were 4.13 ± 0.806 and 4.48 ± 0.8 (mean ± SD), respectively. The postoperative mean Qmax of the BPH and BPH with PI groups were 20.38 ± 4.787 and 14.32 ± 3.827 (mean ± SD) ml/s, mean IPSS were 2.69 ± 1.25 and 5.84 ± 3.579 (mean ± SD), and mean QoL were 0.13 ± 0.342 and 0.92 ± 0.759 (mean ± SD), respectively. In both groups, Qmax significantly increased (P < 0.05) and IPSS and QoL significantly decreased after HoLEP (P < 0.05). Before and after surgery, the Qmax in the BPH with PI group was lower than that in the BPH group, and the IPSS and QoL levels in the BPH with PI group were higher than those in the BPH group (P < 0.05). Compared with the BPH group, the increase in Qmax in the BPH with PI group was smaller and the decrease in IPSS was larger (P < 0.05), but the variation in QoL was not statistically significant (P > 0.05). Conclusion: Improvements in Qmax, IPSS, and QoL in BPH patients with PI after HoLEP surgery were lower than those in BPH patients alone. PI may be a predictor of a worse response to surgical treatment. However, more multicenter randomized controlled trials with larger samples and long-term follow-up are needed to verify this.

[Local injection of BTX-A prevents iatrogenic anterior urethral stricture in rabbits].

OBJECTIVE: To investigate the preventive effect of local injection of botulinum toxin type A (BTX-A) against iatrogenic anterior urethral stricture (IAUS) in New Zealand male rabbits. METHODS: Sixteen adult New Zealand male rabbits were randomly divided into an experimental and a control group of equal number. The model of IAUS was established in the rabbits by incision of the ventral urethra of the penile segment and electrocoagulation of the urethral mucosa. The rabbits of the experimental group were injected with 10 U of BTX-A solution and those of the control group with 1.0 ml of normal saline into the electrocoagulated submucosa of the urethra. At 30 days after modeling, retrograde urethrography was performed and the scarred urethral tissue harvested for HE and Masson staining. RESULTS: No systemic symptoms of botulinum toxin poisoning were observed in either group of the rabbits. Retrograde urethrography showed statistically significant differences between the control and experimental groups in the diameter of the urethra (ï¼»0.15 ± 0.08ï¼½ vs ï¼»0.50 ± 0.23ï¼½ cm, P < 0.05) and the stenosis ratio (3.68 ± 1.22 vs 1.29 ± 0.15, P < 0.05). Urethrography revealed obvious hyperplasia and contracture of urethral scar with high bulge and narrow urethral cavity, while HE and Masson staining exhibited absence or discontinuity of the urethral epithelium, submucosal fibrosis with infiltration of a large number of fibroblasts, and hyperplasia and thickening of collagen fibers (blue) in the control group. All the changes above were slight and the urethral epithelium was continuous in the experimental group. CONCLUSIONS: Local injection of BTX-A reduced the incidence of iatrogenic anterior urethral stricture after iatrogenic acute heat injury in New Zealand male rabbits.

Laparoscopic Versus Open Radical Nephrectomy for Renal Cell Carcinoma: a Systematic Review and Meta-Analysis.

BACKGROUND: The aim of this study is to summarize and quantify the current evidence on the therapeutic efficacy of laparoscopic radical nephrectomy (LRN) compared with open radical nephrectomy (ORN) in patients with renal cell carcinoma (RCC) in a meta-analysis. METHODS: Data were collected by searching Pubmed, Embase, Web of Science, and ScienceDirect for reports published up to September 26, 2016. Studies that reported data on comparisons of therapeutic efficacy of LRN and ORN were included. The fixed-effects model was used in this meta-analysis if there was no evidence of heterogeneity; otherwise, the random-effects model was used. RESULTS: Thirty-seven articles were included in the meta-analysis. The meta-analysis showed that the overall mortality was significantly lower in the LRN group than that in the ORN group (odds ratio [OR] =0.77, 95% confidence interval [CI]: 0.62-0.95). However, there was no statistically significant difference in cancer-specific mortality (OR=0.77, 95% CI: 0.55-1.07), local tumor recurrence (OR=0.86, 95% CI: 0.65-1.14), and intraoperative complications (OR=1.27, 95% CI: 0.83-1.94). The risk of postoperative complications was significantly lower in the LRN group (OR=0.71, 95% CI: 0.65-0.78). In addition, LRN has been shown to offer superior perioperative results to ORN, including shorter hospital stay days, time to start oral intake, and convalescence time, and less estimated blood loss, blood transfusion rate, and anesthetic consumption. CONCLUSION: LRN was associated with better surgical outcomes as assessed by overall mortality and postoperative complications compared with ORN. LRN has also been shown to offer superior perioperative results to ORN.

[Y chromosome microdeletion in azoospermia and severe oligozoospermia patients with or without varicocele:A comparative study].

Objective: To compare the incidences of Y chromosome microdeletion between patients with azoospermia or severe oligozoospermia with varicocele( VC) and those without VC and investigate the etiopathogenisis of their infertility. Methods: We included 137 VC patients in group A(70 with azoospermia as group A1 and 67 with severe oligozoospermia as group A2),135 non-VC patients in group B(69 with azoospermia as group B1 and 66 with severe oligozoospermia as group B2),and 30 normal fertile men as controls in group C. We detected Y chromosome microdeletion in different groups using multiplex PCR. Results: Y chromosome microdeletion was detected in 23(16. 8%) of the patients in group A, another 23(17. 0%) in group B,and 0 in group C. The rates of Y chromosome microdeletion were 22. 9% in group A1,10. 4% in group A2,20. 3% in group B1,and 13. 6% in group B2,and the microdeletion rate in the patients with severe oligozoospermia( groups A1 and B1) was 23. 3%(31 /133). No statistically significant difference was found between groups A and B( P > 0. 05). Conclusion: There are no significant differences in the rate of Y chromosome microdeletion between varicocele and non-varicocele patients with azoospermia or severe oligozoospermia, and Y chromosome microdeletion is one of the causes of azoospermia and severe oligozoospermia with varicocele.

Clinical significance of CUL4A in human prostate cancer.

Aberrant expression of the Cullin 4A (CUL4A) is found in many tumor types, but the functions and mechanism of CUL4A in prostate cancer (PCa) development and progression remain largely unknown. The aim of this study was to investigate the possible role of CUL4A in prostate tumorigenesis. Immunohistochemistry was used to examine CUL4A expression in human PCa tissues and BPH tissues. Cell proliferation was assessed by MTT, and migration and invasion were analyzed by Transwell and Matrigel assays after CUL4A knockdown in PCa in vitro. The results showed that CUL4A protein was overexpressed in 86.21 % of PCa tissues. CUL4A knockdown with siRNA in PCa cells decreased cell proliferation, migration, and invasion. Mechanistically, CUL4A could modulate the expression of P53 in PCa cells. Our results indicate that CUL4A overexpression play an oncogenic role in the pathogenesis of PCa, and CUL4A may be a potential therapeutic target for PCa.

[Correlation between di-2-ethylhexyl phthalate and idiopathic oligoasthenospermia].

OBJECTIVE: To investigate the relationship between the level of di-2-ethylhexyl phthalate (DEHP) and idiopathic oligoasthenospermia by measuring the content of DEHP in the semen samples of different subjects. METHODS: We obtained semen samples from 100 infertile men with idiopathic oligoasthenospermia, 50 working all the year round in the plastic greenhouse (group A) and the other 50 constantly dining from plastic meal boxes (group B). We also enrolled 50 normal male volunteers as controls (group C). We conducted semen analyses using a computer-assisted sperm analyzer, measured the DEHP concentration by reversed-phase high-pressure liquid chromatography, and subjected the data to statistic processing by t-test and correlation analysis. RESULTS: The mean concentrations of DEHP in the seminal plasma were (0.72 +/- 0.48), (0.71 +/- 0.49) and (0.21 +/- 0.18) mg/L in groups A, B and C, respectively, significantly higher in A and B than in C (both P < 0.05). The DEHP concentration was negatively correlated with sperm motility (P < 0.05). CONCLUSION: The DEHP level in the seminal plasma is higher in infertile men frequently exposed to plastic products than in normal males and excessive DEHP may be one of the important factors of idiopathic male infertility.

[Screening of Y chromosome microdeletions in infertile males with varicocele].

OBJECTIVE: To investigate the relationship between Y chromosome microdeletions and human spermatogenesis in infertile men with varicocele (VC). METHODS: We divided 174 infertile VC patients into groups A (with azoospermia, n = 47) , B (with severe oligozoospermia, n=57) and C (with mild oligozoospermia, n=70), and enlisted 28 fertile males and 26 fertile females as normal controls. We collected DNA from the peripheral blood, amplified 6 sequence tagged sites in AZFa, AZFb and AZFc using multiplex PCR technique. Then we separated and scanned the amplified products by agarose gel electrophoresis to identify microdeletions and their types in comparison with the controls. RESULTS: Y chromosome microdeletions were observed in 12.64% of the patients (22/174), 11 cases in group A and the other 11 in group B, but none in group C and the normal controls. The differences were statistically significant (P<0.05). In group A, 6 of the microdeletion cases were in the AZFc region, 1 in the AZFa region, 2 in the AZFb region and 2 in both AZFb and AZFc regions, while in group B, 8 cases were in the AZFc region, 2 in the AZFb region and 1 in both AZFb and AZFc regions. CONCLUSION: Infertility is correlated to Y chromosome microdeletions in VC patients. Y chromosome microdeletion screening should be performed for infertile VC patients, especially for those with azoospermia or severe oligozoospermia.

[Verapamil and hypothermia protect spermatogenesis of torsioned testes in rats].

OBJECTIVE: To investigate the protective effect of verapamil and hypothermia on the spermatogenesis of rats after testicular torsion. METHODS: Sixty healthy pubertal male Sprague-Dawley rats were equally divided into 5 groups: A (testis torsion), B (testis torsion + verapamil), C (testis torsion + hypothermia), D (testis torsion + verapamil + hypothermia) and E (control). After treatment, the left testis was removed for the observation of the histological changes under the microscope and measurement of the percentage of apoptotic cells by flow cytometry. RESULTS: HE staining showed disordered arrangement, reduced layers and decreased number of spermatogenic cells, apoptotic bodies, necrosis and partial invasion of inflammatory cells in all the groups but E, most obvious in Group A. The apoptosis rates of germ cells in Groups A, B, C, D and E were (32.11 +/- 2.20)%, (20.18 +/- 1.50)%, (20.02 +/- 1.90)%, (13.75 +/- 1.40)% and (8.56 +/- 0.90)%, respectively, and the Makler scores in the 5 groups were (14.47 +/- 1.35), (15.45 +/- 0.75), (15.48 +/- 0.75), (16.22 +/- 0.72) and (19.60 +/- 0.56), respectively, both with statistically significant differences (P < 0.01). CONCLUSION: The increased apoptosis of germ cells after testicular torsion-and-reposition may reduce the spermatogenesis of the testis. Either verapamil or local hypothermia can enhance testicular resistance against injuries, and the combination of the two can more efficiently prevent the germ cells from apoptosis.

[Prevalence and related factors of prostatitis-like symptoms in young men].

OBJECTIVE: To investigate the prevalence and related factors of prostatitis-like symptoms among young men. METHODS: The study was a cross-sectional survey of 2500 young men aged 18-30 years in the city of Weifang, and all of them completed a questionnaire on prostatitis. The univariate and multivariate logistic regression procedures were used to investigate the risk factors among the young men with chronic prostatitis-like symptoms. RESULTS: The valid response rate was 85% (n = 2125). Of the 128 subjects (6.02%) identified as having chronic prostatitis-like symptoms, the mean age was 21.8 years, the average pain score was 6.98 +/- 0.29, and the average voiding score was 3.77 +/- 0.25. Of the sampled population, 39 men had prostatitis-like symptoms with an index pain score of 8 or more. Significant risk factors include frequent masturbation, prolonged sitting, long-time fixed posture, cold environment, stress at home and work. CONCLUSION: The study suggested that chronic prostatitis-like symptoms are common among young men, and the urethritis history, frequent masturbation, prolonged sitting, long-time urine holding, cold environment, and stress at home and work might be significant risk factors.

[Effects of vasectomy on prostatic histomorphology and cell apoptosis in rats].

OBJECTIVE: To detect the effects of vasectomy on the growth and apoptosis of prostatic tissue cells. METHODS: Forty-five SD rats were divided at random into three groups of fifteen each. Vasectomy (Vsm) model was established by ligating the bilateral vas deferens of the rats in Group A and testosterone propionate and normal saline were subcutaneously injected in those of Groups B and C, respectively. The area percentage of each part in the prostatic tissue was measured with computer-assisted image analysis system. The apoptotic rate was examined with TUNEL. RESULTS: The ratio of stromal area to epithelial plus lumen area in the prostatic tissues in Groups A, B and C were (29.20 +/- 6.85), (39.77 +/- 7.58) and (48.90 +/- 6.49), respectively, and the differences were significant statistically (P all < 0.05). The apoptosis rates in Groups A, B and C were (6.39 +/- 0.84)%, (2.62 +/- 0.57)% and (4.58 +/- 0.93)%, respectively, significantly higher in Group A than in Groups B and C (P all < 0.05). CONCLUSION: Vasectomy may induce interstitium reduction and cell apoptosis in the prostatic tissues of rats, which may help prevent benign prostatic hyperplasia.

[Apoptosis and expression of caspase-3 protein in germ cells of varicocele rats].

OBJECTIVE: To explore the relationship between the expression of caspase-3 in testicular germ cells of rats with experimental left varicocele (ELV) and apoptosis of germ cells. METHODS: Twenty-four male SD rats were randomly divided into three groups with eight animals each: sham-operation group (SOG), 30-day post-operation group (PG1) and 60-day psot-operation group (PG2). ELV model was established by the partial ligation of the left renal vein. To detect apoptosis of germ cells and expression of caspase-3, TUNEL assay and immunohistochemistry (SABC) were used respectively. RESULTS: The number of caspase-3 positive germ cells per tubular cross section in left and right testes of rats in SOG, PG1, PG2 were 0.1175 +/- 0.0129, 0.2463 +/- 0.0421, 0.2938 +/- 0.0511 and 0.1650 +/- 0.0192, 0.2538 +/- 0.0219, 0.2775 +/- 0.0343, respectively. Compared with SOG, the expression of caspase-3 in bilateral testes of rats in PG1 and PG2 were increased, and the differences were statistically significant(P = 0.0115 and P = 0.0144). CONCLUSION: Expression of caspase-3 protein increased in germ cells of rats with ELV, which may be one of the molecular mechanisms related to excessive testicular germ cell apoptosis.