Glans preservation contributes to postoperative restoration of male sexual function: a multicenter clinical study of glans preserving surgery.

PURPOSE: We evaluated whether glans preserving surgery would be more helpful for patients to regain satisfactory sexual competency postoperatively than conventional partial amputation. MATERIALS AND METHODS: From 2004 to 2012 at 4 centers a total of 135 men treated with glans preserving surgery and 36 treated with partial amputation were selected for evaluation from a total of 273 consecutive patients with penile cancer. Subjective evaluation for patient sexual performance was investigated using the IIEF-15. Objective evaluation was done using the audiovisual sexual stimulation test with the RigiScan® Plus. The degree of satisfaction with penile appearance, and patient confidence and partner acceptability for intercourse were evaluated by 5-point scales. RESULTS: Patients treated with glans preserving surgery had better performance in 4 IIEF-15 domains (erectile function, orgasmic function, intercourse satisfaction and overall satisfaction) and 1 RigiScan parameter (tip rigidity) (each p <0.01). They also had significantly higher appearance satisfaction (64.4% vs 13.9%) and intercourse confidence (55.6% vs 5.6%) than men who underwent partial amputation. Sexual partners in the glans preserving group also showed significantly higher appearance satisfaction (51.1% vs 5.6%) and intercourse acceptability (37.8% vs 16.7%) than in the partial amputation group. CONCLUSIONS: Glans preserving surgery effectively preserves the functional anatomy and cosmetic appearance of the glans penis. Glans preservation contributes to minimizing postoperative erectile dysfunction and negative psychological impediments, and promotes return to satisfactory sexual performance. Patients treated with glans preservation have more advantages in obtaining sexual acceptance from their partners than those who undergo amputation.

MTHFR C677T polymorphisms are associated with aberrant methylation of the IGF-2 gene in transitional cell carcinoma of the bladder.

The purpose of this study was to determine the relationship between methylation status of the insulin-like growth factor 2 (IGF-2) gene and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphisms in bladder transitional cell carcinoma tissues in a Chinese population. The polymorphisms of the folate metabolism enzyme gene MTHFR were studied by restrictive fragment length polymorphism (RFLP). PCR-based methods of DNA methylation analysis were used to detect the CpG island methylation status of the IGF-2 gene. The association between the methylation status of the IGF-2 gene and clinical characteristics, as well as MTHFR C677T polymorphisms, was analyzed. Aberrant hypomethylation of the IGF-2 gene was found in 68.3% bladder cancer tissues and 12.4% normal bladder tissues, respectively, while hypomethylation was not detected in almost all normal bladder tissues. The hypomethylation rate of the IGF-2 gene in cancer tissues was significantly higher in patients with lymph node metastasis than in those without lymph node metastasis (46.3% vs 17.2%, P = 0.018). No association was found between aberrant DNA methylation and selected factors including sex, age, tobacco smoking, alcohol consumption and green tea consumption. After adjusting for potential confounding variables the variant allele of MTHFR C677T was found to be associated with hypomethylation of the IGF-2 gene. Compared with wildtype CC, the odds ratio was 4.33 (95% CI=1.06-10.59) for CT and 4.95 (95% CI=1.18-12.74) for TT. MTHFR 677 CC and CT genotypes might be one of the reasons that cause abnormal hypomethylation of the IGF-2 gene, and the aberrant CpG island hypomethylation of the IGF-2 gene may contribute to the genesis and progression of bladder transitional cell carcinoma.

The role of aberrant promoter hypermethylation of DACT1 in bladder urothelial carcinoma.

The purpose of this study was to determine the relationship between hypermethylation of DACT1 gene promoter and lower mRNA expression in bladder urothelial carcinoma tissue. The methylation status of 29 urothelial carcinoma samples and 29 normal tissue samples were examined by methylation-specific polymerase chain reaction (MSP). The DACT1 mRNA transcript levels and DACT1 protein levels in all samples were then evaluated to define the relationship between the methylation status of the DACT1 promoter and its expression at the transcriptional and translational levels. Decreased expression of DACT1 was detected in 89.66% of urothelial carcinomas (26/29; P < 0.005). Promoter hypermethylation was found in 58.62% (17/29) urothelial carcinomas and 25% (7/29) normal tissues, respectively (P < 0.05). DACT1 expression was lower in tissues where the DACT1 gene promoter was hypermethylated than in unmethylated tissues (0.25±0.17 vs 0.69±0.30, P < 0.05). DACT1 gene hypermethylation was closely related to tumor size, grade and stage (P < 0.05). Our results indicate that silencing and downregulation of DACT1 mRNA may be implicated in carcinogenesis and the progression of bladder urothelial carcinoma, and may be a potential prognostic factor.

Lateral lymph node dissection with radical surgery versus single radical surgery for rectal cancer: a meta-analysis.

OBJECTIVES: To assess the value of lateral lymph node dissection( LLND) in the radical surgery of rectal cancer. METHODS: The published Chinese and English literature was retrieved. A total of 15 papers fitted the selection criteria, including 4,858 patients. Among them 2,401 were in the LLND group and 2,457 in the non- LLND (NLLND) group. Evaluation parameters included 5-year survival rate recurrence rate, peri-operative outcomes, postoperative urinary and sexual functions. RESULTS: The operating time was significantly shorter in the NLLND group than that in the LLND group (weighted mean difference (WMD)=109 min, 95 confidence interval(CI):90-129, P <0.001). Intra-operative blood loss was greater in the LLND group, but the difference was not significant (WMD=429 mL, 95 CI:325-854, P = 0.05).The frequency of peri-operative morbidity(OR, 1.57 95 CI:1.06-2.33, P = 0.02) was also significantly higher in the LLND group. There were no significant differences in 5-year survival rate and recurrence rate between the two groups. Data from individual studies(three)showed that the frequency of male urinary dysfunction (OR=5.12, 95CI 2.15-12.19, P=0.0002) and sexual dysfunction (P < 0.05) were greatly lower in the NLLND group. CONCLUSION: Meta analysis showed that LLND did not have specific advantage in decreasing postoperative recurrence and prolonging survival time. Furthermore it was associated with prolonged operation time, increased blood loss and elevated incidence of peri-operative complications and urinary and sexual dysfunction.

Construction and identification of recombinant lentiviral vector containing HIV-1 Tat gene and its expression in 293T cells.

OBJECTIVE: To construct a lentiviral vector expressing HIV-1 Tat and identify its expression in 293T cells. METHODS: The gene fragment of HIV-1 Tat101 was subcloned to lentiviral transfer vector pHAGE-CMV-MCS-IZsGreen, which was named pHAGE-Tat. Then the constructed pHAGE-Tat was used to co-transfect the packing 293T cells, together with the packaging plasmids pMD2.G and psPAX2. The packaged viral particles designated LV-Tat were used to infect the 293T cells and the viral titer was calculated. The expression of HIV-1 Tat in 293T cells was confirmed using RT-PCR and western blot. RESULTS: The recombinant lentiviral vector was successfully constructed and could express HIV-1 Tat in 293T cells. The virus titer was 5.73×10(6) ifu/ml. CONCLUSION: The successfully constructed recombinant lentiviral vector makes a strong foundation for further exploring the possible role of HIV-1 Tat in the development of prostate cancer.

CYP17 T27C polymorphism and prostate cancer risk: a meta-analysis based on 31 studies.

OBJECTIVE: The cytochrome P450 17α-hydroxylase (CYP17) plays a vital role in androgen biosynthesis. A T-to-C polymorphism in the 5' promoter region of CYP17 has been implicated as a risk factor for prostate cancer, but the results of individual studies are inconclusive or controversial. To derive a more precise estimation of the relationship, we performed an updated meta-analysis from 31 studies based on 27 publications. METHODS: A comprehensive search was conducted to examine all the eligible studies of CYP17 polymorphism and prostate cancer risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. RESULTS: Overall, individuals with CC/CT genotype were not associated with prostate cancer risk (CC vs. TT: OR = 1.03, 95% CI = 0.86-1.24, P = 0.72, P heterogeneity < 0.0001; CT vs. TT: OR = 0.99, 95% CI = 0.87-1.12, P = 0.88, P heterogeneity = 0.0006). In the stratified analysis by ethnicity, there was a significantly increased risk of prostate cancer among individuals of African descent under the recessive model (OR = 1.56, 95% CI = 1.01-2.39, P = 0.04, P heterogeneity = 0.65). CONCLUSION: This meta-analysis suggested that CYP17 polymorphism might be associated with prostate cancer risk among individuals of African descent.

TGFbeta1 T29C polymorphism and cancer risk: a meta-analysis based on 40 case-control studies.

Transforming growth factor-beta1 (TGFbeta1) plays a significant role in regulating cellular proliferation and apoptosis. The TGFbeta1 T29C polymorphism reportedly affects cancer risk, but pertinent studies offer conflicting results. We therefore performed a meta-analysis based on 40 studies from 32 publications, assessing the strength of the association using odds ratios with 95% confidence intervals. Overall, no evidence has indicated that individuals carrying CC or CT genotypes had significantly increased cancer risks, compared with TT genotype carriers [CC vs. TT: odds ratio (OR)=1.10, 95% confidence interval (95% CI)=1.00-1.21, P=0.06; CT vs. TT: OR=1.07, 95% CI=0.99-1.16, P=0.09). However, stratified analysis by cancer type and ethnicity indicated a significantly increased risk of prostate cancer (CT vs. TT: OR=1.28, 95% CI=1.01-1.61, P=0.04) and cancer in those of Asian descent (CC vs. TT: OR=1.26, 95% CI=1.03-1.53, P=0.02; CT vs. TT: OR=1.20, 95% CI=1.01-1.43, P=0.04). This association was also observed in the dominant model for prostate cancer. Although not all bias could be eliminated, this meta-analysis suggested that TGFbeta1 29C was a low-penetrant risk factor for prostate cancer and cancer in Asians. A larger single study is still required to evaluate any association with other types of cancer or in other populations.

FAS and FASLG polymorphisms and susceptibility to idiopathic azoospermia or severe oligozoospermia.

FAS, together with FASLG, triggers germ cell apoptosis, which occurs in various stages of mammalian testicular development. Single nucleotide polymorphisms (SNP) in the promoter regions of these two genes can influence their transcriptional activities and result in abnormal cell apoptosis, thus leading to spermatogenesis impairment. Therefore, it is reasonable to postulate that FAS and FASLG SNP may be associated with idiopathic azoospermia or severe oligozoospermia. To test this hypothesis, the distributions of FAS -1377G/A and -670A/G SNP and FASLG -844C/T SNP were studied in Han Chinese men. These SNP were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 203 infertile men with idiopathic azoospermia or severe oligozoospermia and in 246 proven fertile controls. Frequencies of FASLG -844CC, CT and TT genotypes among infertile men were significantly different from those among controls (P = 0.024). Men with FASLG -844TT genotype had an increased risk of idiopathic azoospermia or severe oligozoospermia compared with those with CC and CT genotype (odds ratio 2.72, 95% confidence interval 1.25-5.93). The results suggest that FASLG -844C/T SNP may be a genetic predisposing factor of idiopathic azoospermia or severe oligozoospermia among Han Chinese men.

[Association of FASL-844 polymorphism with the risk of idiopathic azoospermia and severe oligozoospermia].

OBJECTIVE: To study the distribution of FASL-844 polymorphism in southern Chinese males of Han nationality and examine the contribution of the polymorphism to susceptibility of idiopathic azoospermia and oligozoospermia. METHODS: FASL-844 polymorphism was genotyped by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) in 184 infertile patients with idiopathic azoospermia or severe oligozoospermia 236 normal fertile male controls. RESULTS: Frequencies of FASL-844 CT and TT genotypes of the patients were significantly different from those of the controls (P = 0.024; P = 0.008). Males with FASL-844 TT genotype had an increased risk of idiopathic azoospermia or severe oligozoospermia compared with those with CC genotype (OR 2.76, 95% CI: 1.20-6.35), and even a higher risk when compared with those with CC and CT genotypes (OR 2.90, 95% CI: 1.28-6.58). CONCLUSION: FASL-844 polymorphism appears to be a genetic predisposing factor of idiopathic azoospermia or severe oligozoospermia among southern Chinese Han males.

[Extraperitoneal laparoscopic radical prostatectomy: a report of 2 cases].

OBJECTIVE: To probe into the operation method and clinical result of extraperitoneal laparoscopic radical prostatectomy. METHODS: Two male patients of prostate cancer underwent extraperitoneal laparoscopic radical prostatectomy. The main operation procedures proceeded under the extraperitoneal laparoscope, consisting of dissecting the prostate gland, cutting the bladder shank and the apix of the prostate gland, and then freeing the seminal vesicles followed by removing the prostate anteriorly. The final step was to connect the urethra and bladder neck. RESULTS: The operation time was 10 and 7 hours and blood loss was 1 000 and 500 ml respectively. The intestinal function resumed 24 hours after the operation. The catheter was removed 3 weeks after surgery and no complication was seen. CONCLUSION: Extraperitoneal laparoscopic radical prostatectomy is a good and least invasive method for local prostate cancer.

[The clinical efficacy of Naftopidil tablet in the treatment of benign prostatic hyperplasia].

OBJECTIVES: To evaluate the clinical efficacy and safety of Naftopidil tablet in treating benign prostatic hyperplasia. METHODS: Eighty BPH patients were divided into two groups randomly by double-blind, double-simulated and active control parallel study trials. Forty patients in treatment group were given Naftopidil tablet 25 mg, p.o., qn for 42 days, while 40 patients in control group were given Tamsulosin 0.2 mg, p.o., qn for 42 days. Statistical analysis was given from 77 cases in the groups. Estimation of the efficacy was done by the change of major indexes include international prostate symptom score (IPSS), maximum flowrate (Qmax) and secondary indexes such as quality of life (QOL), residual urine (Ru) and volume of prostate (V). RESULTS: The changes of IPSS, Qmax, QOL had significant difference between two groups before and after treatment(P < 0.05). The change of Ru had no significant difference between two groups before and after treatment (P > 0.05) while there was significant difference between two groups after six-week treatment(P < 0.05). The change of V had no significant difference (P > 0.05). The adverse reactions in both groups were mild, and there was no significant difference between two groups(P > 0.05). CONCLUSIONS: Naftopidil tablet was safe and effective in treating benign prostatic hyperplasia.