[Low-concentration hydrogen peroxide solution for continuous bladder irrigation after transurethral resection of the prostate].

OBJECTIVE: To evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution (HPS) for continuous bladder irrigation after transurethral resection of the prostate (TURP). METHODS: We retrospectively analyzed the clinical data about 148 cases of benign prostatic hyperplasia (BPH) treated by TURP from January 2013 to January 2016. Seventy-six of the patients received postoperative continuous bladder irrigation with 0.15% HPS (group A) and the other 72 with normal saline (group B). We compared the two groups of patients in their postoperative hemoglobin (Hb) levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay. RESULTS: There were no statistically significant differences between the two groups of patients preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Hb (P > 0.05). At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B (ï¼»3.38 ± 2.56ï¼½ vs ï¼»7.29 ± 6.58ï¼½ g/L, P < 0.01). The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation (ï¼»32.57 ± 5.99ï¼½ vs ï¼»46.10 ± 8.79ï¼½ h, P < 0.01), lower rate of catheter blockage (3.3% vs 11.8%, P < 0.01), shorter time of catheterization (ï¼»3.74 ± 0.79ï¼½ vs ï¼»4.79 ± 0.93ï¼½ d, P < 0.01), and fewer days of postoperative hospital stay (ï¼»4.22 ± 0.81ï¼½ vs ï¼»4.67 ± 0.88ï¼½ d, P < 0.01). CONCLUSIONS: Low-concentration HPS for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.

Photoselective vaporization of the prostate with GreenLight 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis of randomized controlled trials.

The aim of this study is to assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) with GreenLight 120-W laser versus transurethral resection of the prostate (TURP) for treating patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). We performed a literature search of The Cochrane Library and the electronic databases, including Embase, Medline, and Web of Science. Manual searches were conducted of the conference proceedings, including European Association of Urology and American Urological Association (2007 to 2012). Outcomes reviewed included clinical baseline characteristics, perioperative data, complications, and postoperative functional results, such as postvoid residual (PVR), international prostate symptom score (IPSS), quality of life (QoL), and maximum flow rate (Qmax). Six randomized controlled trials (RCTs) were enrolled. Three hundred and forty-seven patients undergone 120-W PVP, and 350 patients were treated with TURP in the RCTs. There were no significant differences for clinical characteristics in these trials. In perioperative data, catheterization time and length of hospital stay were shorter in the PVP group. However, the operation time was shorter in the TURP group. Capsular perforation, blood transfusion, clot retention, and macroscopic hematuria were markedly less likely in PVP-treated subjects. The other complications between PVP and TURP did not demonstrate a statistic difference. There were no significant differences in QoL, PVR, IPSS, and Qmax in the 1, 3, 6, 12, and 24 months of postoperative follow-up. There was no significant difference at postoperation follow-up of functional outcomes including IPSS, PVR, Qmax, and QoL between the TURP-treated subjects and PVP-treated subjects. Owing to a shorter catheterization time, reduced hospital duration and less complication, PVP could be used as an alternative and a promising minimal invasive surgical procedure for the treatment of BPH.

Oncolytic virus carrying shRNA targeting SATB1 inhibits prostate cancer growth and metastasis.

Recent studies suggest that SATB1 is a promising therapeutic target for prostate cancer. To develop novel SATB1-based therapeutic agents for prostate cancer, in this study, we aimed to construct ZD55-SATB1, an oncolytic adenovirus ZD55 carrying shRNA targeting SATB1, and investigate its effects on the inhibition of prostate cancer growth and metastasis. ZD55-SATB1 was constructed and used to infect human prostate cancer cell lines DU145 and LNCaP. The inhibitory effect of ZD55-SATB1 on SATB1 expression was evaluated by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis. The cytotoxicity of ZD55-SATB1 was detected by MTT assay. Cell invasion was detected by Matrigel invasion assay. The in vivo antitumor activities of ZD55-SATB1 were evaluated in xenograft mouse model. We found that ZD55-SATB1 selectively replicated and significantly reduced SATB1 expression in DU145 and LNCaP cells. ZD55-SATB1 effectively inhibited the viability and invasion of DU145 and LNCaP cells in vitro and inhibited prostate cancer growth and metastasis in xenograft nude mice. In conclusion, replicative oncolytic adenovirus armed with SATB1 shRNA exhibits effective antitumor effect in human prostate cancer. Our study provides the basis for the development of ZD55-SATB1 for the treatment of prostate cancer.

Changing trends in the causes and management of male urethral stricture disease in China: an observational descriptive study from 13 centres.

OBJECTIVE: To determine whether there have been any changes in the causes and management of urethral strictures in China. PATIENTS AND METHODS: The data from 4,764 men with urethral stricture disease who underwent treatment at 13 medical centres in China between 2005 and 2010 were retrospectively collected. The databases were analysed for the possible causes, site and treatment techniques for the urethral stricture, as well as for changes in the causes and management of urethral strictures. RESULTS: The most common cause of urethral strictures was trauma, which occurred in 2,466 patients (51.76%). The second most common cause was iatrogenic injures, which occurred in 1,643 patients (34.49%). The most common techniques to treat urethral strictures were endourological surgery (1,740, 36.52%), anastomotic urethroplasty (1,498, 31.44%) and substitution urethroplasty (1,039, 21.81%). A comparison between the first 3 years and the last 3 years showed that the constituent ratio of endourological surgery decreased from 54% to 32.75%, whereas the constituent ratios of anastomotic urethroplasty and substitution urethroplasty increased from 26.73% and 19.18% to 39.93% and 27.32%, respectively (P < 0.05). CONCLUSIONS: During recent years, there has been an increase in the incidence of urethral strictures caused by trauma and iatrogenic injury. Endourological urethral surgery rates decreased significantly, and open urethroplasty rates increased significantly during the last 3 years.

Subcapsular renal hematoma after ureteroscopy with holmium:yttrium-aluminum-garnet laser lithotripsy.

Subcapsular renal hematoma (SRH) after ureteroscopic lithotripsy (URSL) using holmium:yttrium-aluminum-garnet (Ho:YAG) laser to treat ureteric stones is a rare complication. We aimed to review our unit's experience of post-URSL subcapsular renal hematoma. From 2006 to 2012, 2059 URSLs using F9.5 rigid ureteroscope were performed in our unit. Patients with post-URSL symptomatic renal hematoma were reviewed. Perioperative information on patients' renal function, stone characteristics, and degree of renal hydronephrosis were reviewed. Operative data, postoperative information such as clinical manifestation, changes in blood parameters, CT findings, and subsequent treatment were documented. Of the 2059 patients treated with URSL and Ho:YAG laser, three patients were diagnosed as subcapsular renal hematoma after surgery; the age is 57, 61, and 63 years old, respectively. Preoperative imaging examination showed that two patients and one patient had obstructing middle and proximal ureteral stones ranging in size from 0.8 to 1.6 cm, and three patients had thin renal cortices. The double-J ureteral stents were inserted in all cases regularly. All three subcapsular renal hematoma patients had the loin pain of the operation side and fever, and one patient had significant hemoglobin drop (from 111 to 61 g/L) who need to transfusion. Two patients presented within 24 h of URSL, and one patient presented on day 10. One patient was treated conservatively for 3 weeks and recovered with bed rest, antibiotics, hemostasis, and analgesia with no intervention or drain. The other two patients underwent ultrasonography-guided drainage of the hematoma. Two-month follow-up CT scans or ultrasonography confirmed the resolution of the hematoma in all three cases. Renal subcapsular hematoma after URSL is a rare and one of serious complications. Subcapsular renal hematoma should be considered when patients have the symptoms of significant loin pain after URSL for obstructing ureteral stones with thin renal cortices. The treatment of post-URSL renal subcapsular hematomas needs to be customized for each patient.

[Extracorporeal shock wave: An effective and safe therapy for the pain symptom of type IIIB prostatitis].

OBJECTIVE: To investigate the effect and safety of extracorporeal shock wave (ESW) in the treatment of pain symptom of type III B prostatitis. METHODS: We treated 50 cases of type III B prostatitis by ESW once a week for 4 weeks. Then we evaluated the clinical effect and safety of the therapy based on the NIH-CPSI scores, visual analogue scale (VAS) scores, IIEF-5 scores, prostate volume and morphous, state of urination, color of urine, results of routine semen analysis, and changes of cytokines (IL-6, TNF-α and IL-1ß) in expressed prostatic secretion (EPS). RESULTS: All the patients successfully accomplished the treatment. Compared with the baseline, decreases were observed after 4 weeks of cytokine treatment in the pain scores (14. 61 ± 1. 82 vs 9. 36 ± 1. 47, P <0. 01), urination symptom scores (4. 59 ± 1. 01 vs.4. 66 ± 0. 89, P >0. 05) , quality of life scores (6. 51 ± 1. 03 vs 4. 56 ± 1. 02, P <0. 01), NIH-CPSI (25. 43 ± 1. 72 vs 18. 28 ± 2. 32, P <0. 01 ), and VAS (6. 59 ± 1. 10 vs 3. 02 ± 1. 07, P < 0. 01). The concentration of IL-6 in the EPS was significantly increased ([55.82 ± 6. 28] vs [86.59 ± 4. 55] ng/ml, P <0. 01) , while the level of TNF-α ([3.89 ± 0. 12] vs [3. 19 ± 0.22] ng/ml, P<0.01) and that of IL-1ß ([3.21 ± 1.01] vs [1.48 ± 0.95] ng/ml, P< 0. 01) remarkably reduced after treatment. However, there were no statistically significant differences in IIEF-5 scores (18. 58 ± 2. 03 vs 18. 51 1. 89, P >0. 05) or various sperm parameters before and after treatment (P >0. 05). And no significant changes were observed in the prostate volume, morphous or internal echoes. CONCLUSION: The ESW therapy is effective and safe for the pain symptom of type III B prostatitis.

Increased chemosensitivity via targeting testicular nuclear receptor 4 (TR4)-Oct4-interleukin 1 receptor antagonist (IL1Ra) axis in prostate cancer CD133+ stem/progenitor cells to battle prostate cancer.

Prostate cancer (PCa) stem/progenitor cells are known to have higher chemoresistance than non-stem/progenitor cells, but the underlying molecular mechanism remains unclear. We found the expression of testicular nuclear receptor 4 (TR4) is significantly higher in PCa CD133(+) stem/progenitor cells compared with CD133(-) non-stem/progenitor cells. Knockdown of TR4 levels in the established PCa stem/progenitor cells and the CD133(+) population of the C4-2 PCa cell line with lentiviral TR4 siRNA led to increased drug sensitivity to the two commonly used chemotherapeutic drugs, docetaxel and etoposide, judging from significantly reduced IC50 values and increased apoptosis in the TR4 knockdown cells. Mechanism dissection studies found that suppression of TR4 in these stem/progenitor cells led to down-regulation of Oct4 expression, which, in turn, down-regulated the IL-1 receptor antagonist (IL1Ra) expression. Neutralization experiments via adding these molecules into the TR4 knockdown PCa stem/progenitor cells reversed the chemoresistance, suggesting that the TR4-Oct4-IL1Ra axis may play a critical role in the development of chemoresistance in the PCa stem/progenitor cells. Together, these studies suggest that targeting TR4 may alter chemoresistance of PCa stem/progenitor cells, and this finding provides the possibility of targeting TR4 as a new and better approach to overcome the chemoresistance problem in PCa therapeutics.

[Inhibition of stromal interaction molecule 1 and the expression of apoptosis-related proteins in prostate cancer PC-3 cells].

OBJECTIVE: To explore the effects of stromal interaction molecule 1 (STIM1) on the expression of apoptosis-related proteins in prostate cancer PC-3 cells. METHODS: We transfected the lentivirus vector STIM1-pGCSIL-GFP carrying STIM shRNA into human hormone-independent prostate cancer PC-3 cells, and 3 days later observed the transfection efficiency by fluorescence microscopy. At 7 days after transfection, we determined the expression of STIM1 in the PC-3 cells by RT-PCR and Western blot and those of apoptosis-related proteins Bcl-2, Bax, survivin and activated Caspase-3 by Western blot. RESULTS: At 3 days, inverted microscopy revealed a transfection efficiency of > 80%. At 7 days, the STIM1 expression was significantly inhibited at both mRNA and protein levels. The Bcl-2/Bax rate was remarkably decreased as compared with that of the control group (0. 31 vs 1.24 ) , and the survivin expression was markedly reduced, 0. 14 times that of the relative expression in the control. However, the Caspase-3 cleavage was significantly activated, 1.52 times that of the control (P <0.05). CONCLUSION: STIM1 can be regarded as an oncogene in prostate cancer PC-3 cells. Inhibition of its expression can induce PC-3 cell apoptosis by reducing the Bcl-2/Bax rate, decreasing the survivin expression, and activating the Caspase-3 pathway.

[Evaluation of 80-W and 120-W GreenLight laser vaporization for benign prostatic hyperplasia in high-risk patients].

OBJECTIVE: To investigate and compare the effectiveness and safety of 80-W GreenLight laser vaporization and GreenLight high-performance system (HPS) 120-W laser vaporization for the treatment of benign prostatic hyperplasia (BPH) in high-risk patients. METHODS: We allocated 290 high-risk patients with BPH to two groups to receive 80-W (n = 220) and HPS 120-W GreenLight laser vaporization (n = 70). We recorded and compared the pre-, intra- and post-operative clinical data of the two groups. RESULTS: The operations were successful in both of the groups. There were statistically significant differences in the prostate volume, IPSS, Qmax and PVR before and after surgery (P < 0.01), but not between the two groups (P > 0.05). The operation time, lasing time and energy consumption were (56.5 +/- 22.6) min, (31.2 +/- 10.3) min and (159.8 +/- 29.0) kJ in the 80-W group, as compared with (45.1 +/- 20.4) min, (24.6 +/- 8.3) min and (134.2 +/- 23.3) kJ in the 120 W group, with significant differences between the two (P < 0.01). CONCLUSION: GreenLight laser vaporization of the prostate is a safe and effective procedure for the treatment of BPH, and the new HPS 120-W laser therapy, with its advantages of easier operation and shorter surgical time, is an even better minimally invasive option for elderly high-risk patients.

[Single trocar laparoscopic surgery: a report of 45 cases].

OBJECTIVE: To report the initial urological applications of single trocar laparoscopic surgery. METHODS: From April to December 2010, a total of 45 urologic patients underwent single trocar laparoscopic surgery. The procedures included high ligations of spermatics vessels (n = 17), unroofing of renal cysts (n = 24) and ureterolithotomy (n = 4). Transperitoneal approach: A 15 mm incision was made in umbilicus and CO(2) pneumoperitoneum created. A 10-mm trocar was inserted into enterocoelia. After the installation of single punch laparoscope (STROZ), the operating instruments were guided through integrated working channel to complete operative procedures. Retroperitoneal approach: A 15 mm incision was made above the diseased-side crista iliaca for around 4 cm. Retroperitoneal cavity was prepared for retroperitoneoscopy with the IUPU (Institute of Urology, Peking University) technique. In the same way, a 10-mm trocar was inserted. And the single punch laparoscope was installed to complete operative procedures. RESULTS: The procedures were successful in 41 cases. But the others (renal cysts, n = 2; ureteral calculus, n = 2) were successfully managed by adding a 5 mm trocar. Operation time: transperitoneal approach, 23 - 70 min; retroperitoneal approach, 45 - 175 min. The intra-operative volume of blood loss was minimal. And the hospital stay was 1 - 5 days. No significant postoperative complication occurred. CONCLUSION: For some relatively simple procedures, a new and more minimally invasive approach of single trocar laparoscopic surgery may be attempted.

[Expressions of transforming growth factor-beta1, desmin and CD34 in the penile corpus cavernosum of rats].

OBJECTIVE: To detect the expressions of transforming growth factor-beta1 (TGF-beta1), Desmin and CD34 in the penile corpus cavernosum of SD rats in different age groups. METHODS: We randomly selected 10 SD rats in each of the 2-, 5- and 20-month age groups, harvested their penile corpus cavernosum tissues under ether anesthesia, and detected the mRNA and protein expressions of TGF-beta1, Desmin and CD34 by RT-PCR and immunohistochemistry. RESULTS: The results of RT-PCR showed the mRNA expressions of TGF-beta1, Desmin and CD34 in the corpus cavernosum tissues, with significant differences between every two groups (P < 0.01). The TGF-beta1 protein was mainly expressed in the trabeculae and around the arteries of the corpus cavernosum for membrane and cytoplasm staining, the Desmin protein mainly in the membrane and cytoplasm for muscle tissue staining; and the CD34 protein mainly in the vascular and sinusoidal endothelia. The mRNA expression of TGF-beta1 was correlated positively (r = 0.944, P < 0.01) while those of Desmin and CD34 negatively with the age of the rats (r = -0.947, P < 0.01; r = -0.934, P < 0.01). And the mRNA expressions of both Desmin and CD34 had a significant correlation with that of TGF-beta1 (r = -0.888, P < 0.01; r = -0.887, P < 0.01). CONCLUSION: With the increase of age, the expression of TGF-beta1 is significantly up-regulated, while those of Desmin and CD34 significantly down-regulated in the corpus cavernosum tissues, and it is negatively correlated with the latter two. TGF-beta1 is an important influencing factor on ED.

[Clinical evaluation on fengweicao granule in treating benign prostatic hyperplasia].

OBJECTIVE: To report the effect of Fengweicao Granule (FWCCG), a Chinese herbal preparation made of herba Pteris multifidae, in treating benign prostatic hyperplasia (BPH). METHODS: One hundred and fifty-five patients were assigned to two groups, the 108 patients in the treated group were administered orally with FWCG twice a day, 5 g every time; the 47 patients in the control group were treated with Proscar 5 mg per day for 3 months. The effects were evaluated by the change of the related indexes before and after treatment, including scoring by international prostatic symptom scale (I-PSS), maximum flowing rate of urine (MFR), residue urine volume (RU) in urinary bladder determined by abdominal B-ultrasonography and volume of prostate. RESULTS: After being treated for 3 months, the I-PSS, MFR and RU improved remarkably in both groups (P <0.05 or P <0.01), but with no significant change in the volume of prostate, neither with significant difference in comparison between the two groups (P >0.05). CONCLUSION: FWCG has a good effect with less adverse reaction in treating BPH.

[Advanced glycation end products and their receptors elevate the activity of endothelin-1 in rat cavernosum].

OBJECTIVE: To investigate the role of advanced glycation end products (AGEs) and their receptors (RAGE) in the pathogenesis of diabetic mellitus erectile dysfunction (DMED) and the effects of AGEs and RAGE on the activity of endothelin-1 (ET-1) in rat cavernosum. METHODS: Forty male Sprague-Dawley rats were taken at random to construct 2 groups of diabetes mellitus (DM) models of equal number, one given free access to water and the other administered aminoguanidine hydrochloride (DM + AG) in water at the dose of 1 g/L. Another 20 male SD rats were equally divided into a normal control and an AG control group. After 8 weeks, the cavernosum tissues were harvested from all groups of rats, part of the isolated penile tissues homogenated to detect the content of AGE-peptide (AGE-P) and the activity of ET-1, and the AGEs and RAGE in the rest of the penile tissues analyzed by immunohisto- chemical assay. RESULTS: Compared with the normal controls, the expressions of AGEs and RAGE, the content of AGE-P and the activity of ET-1 in the cavernosum tissues were significantly high in the DM group (P < 0.05), while the administration of AG to the DM rats reversed the above results. No significant difference was observed between the normal control and AG control groups in any of the data (P > 0.05). CONCLUSION: In DM conditions, the joint effect of AGEs and RAGE may elevate the activity of ET-1 in rat cavernosum and thus promote the development of DMED.

[Construction of the recombinant adenovirus vector bearing dual-survivin shRNA].

OBJECTIVE: To construct a recombinant adenovirus vector bearing dual-survivin short hairpin RNA (shRNA). METHODS: Dual-survivin shRNA was designed and synthesized respectively, both inserted into adenovirus DNA. The recombinant adenovirus vector was confirmed via both sequencing and restriction digestion analysis, and then linearized and transfected into the HEK 293 cell line to generate recombinant adenoviruses. RESULTS: The recombinant adenovirus vector was constructed and the target sequence was obtained. CONCLUSION: The construction of the recombinant adenovirus vector provides a basis for the research of potential gene therapy for prostate cancer.

ATM­JAK­PD­L1 signaling pathway inhibition decreases EMT and metastasis of androgen­independent prostate cancer.

Castration-resistant prostate cancer (CRPC), also known as androgen-independent prostate cancer, frequently develops local and distant metastases, the underlying mechanisms of which remain undetermined. In the present study, surgical specimens obtained from patients with clinical prostate cancer were investigated, and it was revealed that the expression levels of ataxia telangiectasia mutated kinase (ATM) were significantly enhanced in prostate cancer tissues isolated from patients with CRPC compared with from patients with hormone­dependent prostate cancer. CRPC C4­2 and CWR22Rv1 cells lines were subsequently selected to establish prostate cancer models, and ATM knockout cells were established via lentivirus infection. The results of the present study demonstrated that the migration and epithelial­mesenchymal transition (EMT) of ATM knockout cells were significantly decreased, which suggested that ATM is closely associated with CRPC cell migration and EMT. To further investigate the mechanisms underlying this process, programmed cell death 1 ligand 1 (PD­L1) expression was investigated in ATM knockout cells. In addition, inhibitors of Janus kinase (JAK) and signal transducer and activator of transcription 3 (STAT3; Stattic) were added to C4­2­Sc and CWR22Rv1­Sc cells, and the results demonstrated that PD­L1 expression was significantly decreased following the addition of JAK inhibitor 1; however, no significant change was observed following the addition of Stattic. Furthermore, a PD­L1 antibody and JAK inhibitor 1 were added to C4­2­Sc and CWR22Rv1­Sc cells, and it was revealed that cell migration ability was significantly decreased and the expression of EMT­associated markers was effectively reversed. The results of the present study suggested that via inhibition of the ATM­JAK­PD­L1 signaling pathway, EMT, metastasis and progression of CRPC may be effectively suppressed, which may represent a novel therapeutic approach for targeted therapy for patients with CRPC.

Combined inhibition of JAK1,2/Stat3­PD­L1 signaling pathway suppresses the immune escape of castration­resistant prostate cancer to NK cells in hypoxia.

Castration­resistant prostate cancer (CRPC) is difficult to treat in current clinical practice. Hypoxia is an important feature of the CRPC microenvironment and is closely associated with the progress of CRPC invasion. However, no research has been performed on the immune escape of CRPC from NK cells. The present study focused on this subject. Firstly, when the CRPC cell lines C4­2 and CWR22Rv1 were induced by hypoxia, the expression of the UL16 binding protein (ULBP) ligand family of natural killer (NK) group 2D (NKG2D; ULBP­1, ULBP­2 and ULBP­3) and MHC class I chain­related proteins A and B (MICA/MICB) decreased. NKG2D is the main activating receptor of NK cells. Tumor cells were then co­cultured with NK cells to conduct NK cell­mediated cytotoxicity experiments, which revealed the decreased immune cytolytic activity of NK cells on hypoxia­induced CRPC cells. In exploring the mechanism behind this observation, an increase in programmed death­ligand 1 (PD­L1) expression in CRPC cells induced by hypoxia was observed, while the addition of PD­L1 antibody effectively reversed the expression of NKG2D ligand and enhanced the cytotoxic effect of NK cells on CRPC cells. In the process of exploring the upstream regulatory factors of PD­L1, inhibition of the Janus kinase (JAK)1,2/signal transducer and activator of transcription 3 (Stat3) signaling pathway decreased the expression of PD­L1 in CRPC cells. Finally, it was observed that combined inhibition of JAK1,2/PD­L1 or Stat3/PD­L1 was more effective than inhibition of a single pathway in enhancing the immune cytolytic activity of NK cells. Taking these results together, it is thought that combined inhibition of the JAK1,2/PD­L1 and Stat3/PD­L1 signaling pathways may enhance the immune cytolytic activity of NK cells toward hypoxia­induced CRPC cells, which is expected to provide novel ideas and targets for the immunotherapy of CRPC.

[Extraperitoneal laparoscopic radical prostatectomy for prostate cancer: a report of 65 cases].

OBJECTIVE: To report the experience with extraperitoneal laparoscopic radical prostatectomy (EP-LRP) in the treatment of prostate cancer. METHODS: Sixty-five patients with diagnosed localized prostate cancer underwent extraperitoneal laparoscopic radical prostatectomy. RESULTS: The procedures were successful in 64 cases. Mean operating time was 172 min (range 100 to 440 min). Mean blood loss was 340 ml (range 150 to 800 ml). Seven (10.8%) of the 65 patients received transfusion with MAP of 24 units. Rectal injury occurred in 1 patient, 2 developed urethrovesical anastomotic leakage, 6 (9.2%) had positive surgical margins, 58 (89.2%) were fully continent with urination 3 months after the operation. CONCLUSION: EP-LRP, as a safe and feasible procedure for prostate cancer, which avoides violation of the peritoneal cavity, potentially decreases the risk of intraoperative complications and further reduces postoperative morbidity, is well worth popularizing.

Transrectal real-time tissue elastography targeted biopsy coupled with peak strain index improves the detection of clinically important prostate cancer.

The focus of the present study was to evaluate transrectal real-time tissue elastography (RTE)-targeted two-core biopsy coupled with peak strain index for the detection of prostate cancer (PCa) and to compare this method with 10-core systematic biopsy. A total of 141 patients were enrolled for evaluation. The diagnostic value of peak strain index was assessed using a receiver operating characteristic curve. The cancer detection rates of the two approaches and corresponding positive cores and Gleason score were compared. The cancer detection rate per core in the RTE-targeted biopsy (44%) was higher compared with that in systematic biopsy (30%). The peak strain index value of PCa was higher compared with that of the benign lesion. PCa was detected with the highest sensitivity (87.5%) and specificity (85.5%) using the threshold value of a peak strain index of ≥5.97 with an area under the curve value of 0.95. When the Gleason score was ≥7, RTE-targeted biopsy coupled with peak strain index detected 95.6% of PCa cases, but 84.4% were detected using systematic biopsy. Peak strain index as a quantitative parameter may improve the differentiation of PCa from benign lesions in the prostate peripheral zone. Transrectal RTE-targeted biopsy coupled with peak strain index may enhance the detection of clinically significant PCa, particularly when combined with systematic biopsy.

Breviscapine (BVP) inhibits prostate cancer progression through damaging DNA by minichromosome maintenance protein-7 (MCM-7) modulation.

Naturally occurring compounds are reported as effective candidates for prevention and treatment of various cancers. Breviscapine (BVP) is a mixture of flavonoid glycosides, derived from the Chinese herbs. Previous researches have indicated that BVP has comprehensive pharmacological functions. However, little is known about whether BVP has preventive effects on human prostate cancer. Here, we attempted to explore if BVP inhibits human prostate cancer in vitro and in vivo in a comprehensive manner. We found that BVP triggered cytotoxicity in prostate cancer cell lines dose-dependently. BVP-induced DNA damage caused the cell cycle arrest and apoptosis and further induced cell death. High expression of MCM-7 was reduced in BVP-treated cancer cells and tumor tissues, and also the DNA damage response marker of γH2AX is down-regulated by BVP, associated with MCM-7 expression through regulating retinoblastoma protein (Rb) and checkpoint control proteins expression. Additionally, BVP induced apoptotic response in prostate cancer cells and tumors via activating Caspase-3 and PARP. In vivo studies indicated that BVP impeded tumor growth in xenograft animal models. In conclusion, our data indicates that breviscapine (BVP) can be further explored for its potential, which might be used in human prostate cancer therapeutics.

Chemical characterization, anti-benign prostatic hyperplasia effect and subchronic toxicity study of total flavonoid extract of Pteris multifida.

The decoction of Pteris multifida had been applied to attenuate symptoms of benign prostatic hyperplasia in Chinese folk medicine. In this study, the total flavonoid extract of Pteris multifida was processed at first. High performance liquor chromatography and tandem mass spectrometer assay revealed 10 flavonoids as key constituents of this extract. After 60-day administration, the total flavonoid extract (180 mg/kg, i. g.) decreased the prostate index in mice of benign prostatic hyperplasia apparently. Immunohistochemical assay revealed inhibition of vascular endothelial growth factor expression, together with activation of transforming growth factor-beta 1 expression in the prostatic samples after administration of the extract. A 90-day subchronic toxicity test was further undertaken in male Sprague-Dawley rats, and the no-observed-adverse-effect level for the extract was 200 mg/kg body weight/day. These results revealed that the total flavonoid extract of Pteris multifida exhibited positive effect with safety, which might be applied in treatment of benign prostatic hyperplasia.