Stage I testis teratoma in adults: treatment options and recurrence factors / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical outcomes of stage I testis teratoma, including pure teratoma, and to provide information on the treatment options for this disease.</p><p><b>METHODS</b>We retrospectively analyzed 27 cases of orchiectomy for stage I testis teratoma, excluding epidermoid cyst, and investigated its recurrence associated with treatment methods and clinicopathological factors.</p><p><b>RESULTS</b>Four of the 27 cases relapsed, all in the orchiectomy group and confined to the retroperitoneal region, 3 with and the other 1 without risk factors, but with no death. No recurrence was found in those treated by orchiectomy followed by chemotherapy with bleomycin, etoposide and platinum (BEP). The total rate of recurrence was 15.8%. No severe side effects were observed in the 9 patients undergoing adjuvant BEP chemotherapy.</p><p><b>CONCLUSION</b>Risk factors may increase the recurrence rate of stage I testis teratoma, while postoperative adjuvant chemotherapy can reduce it, including that of pure teratoma, though surveillance policy remains the most popular option after orchiectomy.</p>

Immune response of recombinant IFN-α-2b-BCG treatment in mice bladder cancer / 中华泌尿外科杂志

Objective To study local and systemic immune response in an animal model treated with recombinant hIFN-α-2b-BCG instillation. Methods The MB49 orthotopic bladder cancer model in C57BL/6 mice was established and treated separately with rBCG, wild BCG, wild BCG combined with IFN-α-2b and PBS as the control. The changes of lymphocyte subgroups in peripheral blood were analyzed with FCM, and mTNF-α and mIL-12 in peripheral blood of mice were detected with ELISA.Immunohistochemistry was carried out to detect the local immune reaction, T cell subsets and FAS, in bladder cancer after being treated with rBCG or wBCG. Results The content of CD4+ T lymphocyte was up-regulated in the rBCG group. The CD4+/CD8+ ratio of 2. 63 was up-regulated than pretreatment, significantly different than that of wBCG group(P＜0.05). ELISA assay showed that BCG significantly up-regulated the level of mTNF-α and mIL-12 in serum of orthotopie murine bladder cancer mice. The mTNF-α 806 pg/ml, mIL-12 860 pg/ml in rBCG group, was not significantly higher than those in wBCG group and combination group. The immunocompetent cell numbers with CD3, CD4,CD8 phenotype increased significantly in the tumor tissue of BCG treated group than the control(P＜0.05). The results of CD4+ in rBCG group and the combination group, and CD8+ in rBCG group were significantly higher than that of the wBCG(P＜0.05). The expression of Fas in tumor tissues treated with intravesical BCG was increased(P＜0. 05). Conclusions The recombinant IFN-α-2b-BCG can retrieve the disproportion of systemic lymphocyte subgroups, and increases Th1-type factors and local Fas expression in orthotopic murine bladder cancer. The recombinant IFN-α-2b-BCG is effective in regulating local and systemic immune reaction in orthotopic murine bladder cancer model.

Effect of recombinant hIFN-alpha-2b-BCG on mouse bladder tumor MB49 cells in vitro / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the antitumor effect of recombinant IFN-alpha-2b-BCG on mouse bladder cancer MB49 cells in vitro, and to explore its antitumor mechanisms.</p><p><b>METHODS</b>MB49 cells were co-cultured with recombinant BCG or wild BCG, and than were examined by light and transmission electron microscopy. The cell growth was assessed by MTT assay, and apoptosis rate and MHC-I of the MB49 cells was detected by flow cytometry using AO and Hoechst33258 fluorescence immunostaining.</p><p><b>RESULTS</b>The hIFN-alpha-2b-BCG-treated tumor cells showed slow growth, detachment of some cells, and various degree of degeneration. Light microscopy revealed organelle disorganization, chromatin aggregation, nuclear pyknosis, and cytolysis in some cells. Cellular membrane bulged and some bubbles were seen under fluorescence microscope using AO staining. Hoechst33258 assay also depicted frequent apoptosis in the tumor cells. The MTT assay showed that rBCG more actively than the wild BCG inhibited the proliferation of MB49 cells. The apoptosis rate of the recombinant BCG group was 19.7% and 46.6% at the time point of 24 h and 48 h, respectively, significantly higher than 10.8% and 20.9%, respectively, in the wild BCG group. The results of flow cytometry indicated that both types of BCG enhanced the expression of MHC-I in the MB49 cells, but more effective in the recombinant BCG group.</p><p><b>CONCLUSION</b>The recombinant hIFN-alpha-2b-BCG has more strong immuno-modulatory properties, anti-tumor effect on MB49 cells and induces apparent cytotoxicity in the bladder cancer cells in vitro.</p>

Acupuncture for chronic prostatitis: a meta-analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the effect of acupuncture on chronic prostatitis.</p><p><b>METHODS</b>We retrieved all the case-control studies on acupuncture for chronic prostatitis before August 2007 in MEDLINE and CNKI databases, screened the eligible literature according to the selection and exclusion criteria, and performed meta-analyses of the included studies with the software Revman 4. 2.</p><p><b>RESULTS</b>Thirteen eligible reports were identified in this study, including 861 cases and 738 controls. The effectiveness and cure rates were significantly higher in the acupuncture therapy group than in the control, with pooled RR as 1.20 (95% CI, 1.14, 1.25; P < 0.01) and 1.85 (95% CI, 1.63, 2.11; P < 0.01), respectively.</p><p><b>CONCLUSION</b>Acupuncture therapy exhibited a definite effect in the treatment of chronic prostatitis.</p>

Retroperitoneal laparoscopy combined with urethral resection for treatment of renal pelvic carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study is to explore the operation method and efficacy through retroperitoneal laparoscopy combined with urethral resection for treatment of renal pelvic carcinoma.</p><p><b>METHODS</b>Total nephroureterectomy with excision of bladder cuff by retroperitoneal laparoscopy plus urethral resection was performed in 18 patients with pathologically confirmed pelvic transitional cell carcinoma (II-III, T1N0M0-T2N0M0). The operation was performed using Olympus celioscope (30 degrees or 0 degree) under general anesthesia. First, a 10 mm incision was made at the intersection of midaxillary line and superior border 2 cm from crista iliaca, then a self-made hyponome filled with 250-300 ml water was put through the small incision in order to open the retroperitoneal space, followed by getting the hyponome out and perfusing CO2 into the retroperitoneal space to make a pneumoretroperitoneum. Finally, the celioscope was put into the retroperitoneal space to operate. During the operation, electric coagulation was used to stop bleeding and the bladder was not irrigated.</p><p><b>RESULTS</b>The operation was successfully performed in 18 patients without any complication. The operative time ranged from 150 to 190 min with a mean of 160 min. The hospital stay after operation was 7 to 10 days. There was no tumor recurrence or metastasis or implantation in all these patients after follow-up of 1-19 months.</p><p><b>CONCLUSION</b>Compared with regular operation mode, retroperitoneal laparoscopy plus urethral resection for treatment of renal pelvic carcinoma is a minimally invasive treatment with less bleeding and quick recovery.</p>

The concentration of HO-2 and CO in rat penile tissue of different ages / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare the distribution of heme oxygenase-2 and concentration of carbon monoxide in rat penile tissue of 8, 16 and 24 months and investigate the relationship between the system of HO-2/CO and aging.</p><p><b>METHODS</b>Using SABC immunohistochemistry staining, image analysis system and the method of carboxyhemoglobin standard curve, the distribution of heme oxygenase-2 and concentration of carbon monoxide in different month rat penile tissues were investigated.</p><p><b>RESULTS</b>The penile arteries were surrounded by HO-2 positive cells, which were also seen in the trabecular meshwork of smooth muscle. Compared with other part of penile, the penile arteries adventitia and the endothelial cells of cavernous exhibited darker staining. With the increasing of rat's living month the staining of penile tissues turned faint and the concentration of carbon monoxide in tissue decreased( P < 0.05 ). The imaging analysis system showed that the older the rat was the less HO-2 positive compositions contained (P < 0.05).</p><p><b>CONCLUSION</b>With aging the decreasing concentration of HO-2 leads to the downfgt-regulation in rat penile tissue.</p>

Heme oxygenase-1 gene transfer protects rat kidney transplant from ischemia/reperfusion injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the protective effect of Heme oxygenase-1 (HO-1) gene transfer on rat renal autograft against ischemia/reperfusion injury.</p><p><b>METHODS</b>HO-1 recombinant adenovirus vectors were constructed and transduced into rat renal autograft by renal arterial perfusion. The renal autografts were transplanted orthotopically after store at 4 degrees C for 24 h, followed by contralateral native nephrectomy 5 d after transplantation. There were 25 rats in the control group. 5 h and 3 d after transplantation, reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry were used to detect the expression of HO-1 gene; enzyme-labeled immunosorbent (ELISA) was used to measure HO-1 protein content in the homogenate of renal autograft.</p><p><b>RESULTS</b>The intensity of HO-1mRNA expression at 3 h and 3 d after transplantation were 0.65 +/- 0.11, 0.86 +/- 0.17 in the experimental group and 0.09 +/- 0.01, 0.15 +/- 0.02 in the control group respectively. The differences between the two groups were significant (t = 14.38, 11.73, P < 0.05). HO-1 protein content at 3 h and 3 d after transplantation were significantly increased in the experimental group, as compared with the control group [(297 +/- 61) ng/g and (468 +/- 51) ng/g versus (98 +/- 30) ng/g and (155 +/- 31) ng/g; t = 8.27, 14.83, P < 0.05]. HO-1 transduced autografts had less renal ischemic injury and lower serum creatinine level compared with control animals (P < 0.05).</p><p><b>CONCLUSION</b>Adenoviral vector can successfully transduce rat kidneys with the HO-1cDNA, which can protect rat renal autografts from ischemia/reperfusion injury.</p>

Androgen and prostatic stroma / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the effect of androgen on the proliferation, differentiation and regression of canine prostatic stromal cells in vivo and human stromal cells in vitro.</p><p><b>METHODS</b>Twenty-two dogs, including 15 normal prostate dogs and 7 prostatic hyperplasia dogs, had their serum concentration of testosterone and estrodiol determined by radioimmunoassay before and after castration. The expression of androgen receptor (AR) and estrogen receptor (ER) in the prostate were analysed by immunohistochemistry and semi-quantitative RT-PCR before and after castration. Light microscopy, transmission electron microscopy and TUNEL assay were carried out successively before and after castration to evaluate the prostatic histomorphology. In vitro serum-free cell cultures from human prostatic stroma were established and exposed to dihydrotestosterone (DHT). The proliferation of the cell culture was detected by MTT assay. The expression of TGFbgr, bFGF, AR, and smooth muscle cell (SMC) specific proteins (myosin and/or smoothelin) were detected using immunohistochemistry and RT-PCR. The differentiation from fibroblasts to smooth muscle cells was deduced by measuring the expression of SMC specific proteins.</p><p><b>RESULTS</b>Before castration, the serum concentrations of testosterone and estrodiol were not statistically different between normal and hyperplasia groups. Following castration, the serum concentration of testosterone decreased rapidly in 2 days, and the concentration of estrodiol had no significant change compared with the pre-castration data. In the prostate, AR was presented in both the epithelial and stromal cells and the AR mRNA level was higher in hyperplasia than in normal prostate tissues (P<0.05). While ER predominantly existed in the prostate stromal cells and the ER mRNA had no difference between the hyperplasia and the normal group. Within the early phase of castration (<d7), the expression of AR was increased rapidly. Then it gradually dropped to a lower level than that of the pre-castration by the end of d90. The expression of ER remained unchanged in the whole course. The prostatic stromal cells, including SMCs and fibroblasts, diminished and underwent serial pathological changes of atrophy and apoptosis after castration. The atrophic cells were filled with huge intracellular lipofuscin. The expression of SMC myosin declined after castration, coincident with the increase in TGFbgr mRNA level and decline in bFGF mRNA level. In vitro, DHT caused a weak increase in the proliferation and expression of SMC-specific proteins (P<0.05). However, DHT and bFGF together stimulated the proliferation of stromal cells significantly more than either agent alone (P<0.01). The combination of DHT and TGFbgr greatly enhanced the expression of SMC-specific proteins (P<0.01) more strongly than either alone (P<0.01).</p><p><b>CONCLUSION</b>The whole prostate gland is an androgen-sensitive organ with both the epithelium and stroma under the control of androgen. Androgen may direct the proliferation, differentiation and regression of stromal cells by regulating the expression of TGFbgr, bFGF, AR and smooth muscle cell specific proteins.</p>

Significance of p16 gene and p21 gene expression abnormality in the prognosis of bladder carcinoma:a Meta-analysis / 中华泌尿外科杂志

Objective To investigate the correlation of p16 gene and p21 gene expression abnormal- ity with the prognosis of bladder carcinoma.Methods Using the search terms“bladder neoplasm”,“prognosis”,“p16”or“p21”,the literature on the correlation of p16 gene and p21 gene expression abnor- mality with the prognosis of bladder carcinoma were searched from MEDLINE database,PubMed database, CBMdisc and China Academic Periodical database,and were evaluated by Meta-analysis with Dersimonian- Laird model.Results A total of 19 trials involving 1584 patients(positive rate of 40.4%)were identi- fied,including 12 trials of 975 patients(positive rate of 37.4%)on p16 gene expression abnormality and 7 trials of 609 patients(positive rate of 45.4%)on p21 gene expression abnormality.The combined relative hazard(RH)of p16 gene expression abnormality on the prognosis of bladder carcinoma,p21 gene expression abnormality on the prognosis of bladder carcinoma and both p16 gene and p21 gene expression abnormality on the prognosis of bladder carcinoma was 3.70(95% CI,3.42-3.99),3.01(95% CI,2.81-3.21)and 3.18(95% CI,3.01-3.35),respectively.Conclusions Both p16 gene and p21 gene expression abnor- malities are biomarkers for poor prognosis of bladder carcinoma.The detection of these biomarkers may be helpful in making the treatment strategy.

Bladder cancer in patients under 40 years of age:analysis of 92 cases / 中华泌尿外科杂志

Objective To evaluate the clinical features,pathological grades,treatment and prognosis in bladder cancer patients under 40 years.Methods A retrospective review of transitional cell carcinoma of the bladder in patients under 40 years who had been treated from January 1994 to April 2005 were conduc- ted.The patients were divided into 2 groups(group A,20-30 years;group B,31-40 years)based on their age.The differences in pathologic grading,recurrence rate and positive rate of urine cytology were compared between the 2 groups.The statistical analyses were performed using x~2 test.Results The incidence of bladder cancer in patients under 40 years was 4.2%(92/2200).The male/female ratio was 2.7:1.0.At initial visit,86%(68.7% in group A and 91.1% in group B)of the patients presented with gross hematuri- a;and 25.0% in group A and 33.9% in group B concomitantly had frequency and dysuria.The mean disease course in the 2 groups was 3.8 months for male and 6.9 months for female.Solitary tumor occurred in 19 ca- ses(100.0%)in group A and 63(86.3%)in group B;and multiple carcinomas,in 10 cases(13.7%)in group B.All were superficial bladder cancers in group A,while 6(8.2%)were invasive carcinomas in group B.According to WHO pathological grading of bladder cancer,in group A,10 cases(52.6%)had G_1,8 (42.1%)had G_2 and 1(5.3%)had G_3 tumors;in group B,8 cases(11.0%)had G_1,49(67.1%)had G_2 and 16(21.9%)had G_3 tumors(P＜0.01).The positive rate of urine cytology was 53.3% in all 92 ca- ses(25.0% in group A and 60.7% in group B,P＜0.05).The diagnostic rates by B-ultrasound and cysto- scopy were 98.6% and 100.0%,respectively.Of the 92 patients,11(12.0%)were treated by partial cys- tectomy,73(79.3%)by TUR-Bt and 8(8.7%)by cystectomy.The follow-up was 3-115 months(mean, 39 months).The overall recurrence rate was 12.0%,with 5.3%(1/19)in group A and 13.7%(10/73)in group B.Of 10 patients with multiple carcinomas,6(60.0%)developed recurrence;and of 82 with solitary tumors,5(6.1%)developed recurrence,with significant difference between them(P＜0.01).Two of the multiple carcinoma patients developed invasive carcinoma.Conclusions In bladder cancer patients under 40 years,the positive rate of urine cytology,pathological grading and recurrence rate increase with age.Multi- ple tumors,invasive carcinoma and long-term smoking are high risk factors for tumor recurrence.TURBt is the main surgical method for treating bladder cancer patients under 40 years.