Small-cell carcinoma of the prostate: A report of 2 cases and review of the literature / 中华男科学杂志

Objective@#To investigate the clinicopathological characteristics and improve the clinical treatment of prostatic small-cell carcinoma (PSCC).@*METHODS@#We reported 2 cases of PSCC derived from prostate cancer after treated by androgen blockade and prostate electrotomy and reviewed the relevant literature.@*RESULTS@#Two patients with PSA elevation were diagnosed with prostate cancer by prostatic puncture biopsy and treated by maximum androgen blockade, which reduced their total PSA to the normal level. Later, due to difficult urination, they both underwent prostate electrotomy, followed by chemotherapy or radiotherapy for PSCC confirmed by postoperative pathology. Nevertheless, they died at 8 to 9 months after the discovery of PSCC.@*CONCLUSIONS@#PSCC can derive from prostate cancer after treatment, which may be attributed to the pathological mutation induced by long-term endocrine therapy. PSCC is more malignant than prostate cancer, and its prognosis is poor.

Inhibitory effect of polyphyllin Ⅰ on the proliferation of prostate cancer PC3 cells via ERK1/2/P65/DNMT1 and its molecular mechanism / 中华男科学杂志

<p><b>Objective</b>To explore the inhibitory effect of polyphyllin Ⅰ (PPⅠ) on the proliferation of castration-resistant prostate cancer PC3 cells and its molecular mechanism.</p><p><b>METHODS</b>We cultured human prostate cancer PC3 cells in vitro and treated them with PPⅠ at the concentrations of 0 (blank group), 0.4, 0.8, 1.2, 1.6, 2.0, and 2.4 μmol/L for 24, 48, and 72 hours, respectively. Then we detected the proliferation of the cells by MTT assay, measured their apoptosis by flow cytometry, and determined the expressions of p-ERK1/2, ERK1/2, NF-κB/p65 and DNMT1 proteins as well as the level of NF-κB/p65 in the cells additionally treated with the ERK1/2 inhibitor SP600125 by Western blot.</p><p><b>RESULTS</b>Compared with the blank control group, the PPⅠ-treated PC3 cells showed a concentration- and time-dependent reduction of the survival rate (1.00 ± 0.00 vs 0.85 ± 0.05, P < 0.01) at 0.4 μmol/L after 48 hours of intervention, concentration-dependent early apoptosis at 0.8 μmol/L (4.83 ± 0.95 vs 13.83 ± 2.97, P < 0.01), time-dependent increase of the expressions of p-ERK1/2 (1.00 ± 0.00 vs 1.73 ± 0.17, P < 0.01) and ERK1/2 (1.00 ± 0.00 vs 1.36 ± 0.12, P < 0.01) at 2 hours, and concentration-dependent decrease of the expressions of NF-κB/p65 and DNMT1 at 1.2 μmol/L (1.00 ± 0.00 vs 0.78 ± 0.10 and 0.63 ± 0.06, P < 0.01) and 1.6 μmol/L (1.00 ± 0.00 vs 0.67 ± 0.11 and 0.52 ± 0.09, P<0.01). Inhibition of ERK1/2 phosphorylation with PD98059 markedly reversed PPⅠ-induced decrease of the NF-κB/p65 expression as compared with that in the PPⅠ group (0.86 ± 0.18 vs 0.43 ± 0.09, P < 0.05).</p><p><b>CONCLUSIONS</b>PPⅠ induces the early apoptosis and suppresses the proliferation of PC3 cells, probably by activating the ERK1/2 pathway and inhibiting the expressions of the NF-κB/p65 and DNMT1 proteins.</p>

Staging Based Strategies and Practice for Prostate Cancer / 中国中西医结合杂志

Authors raised that staging based strategies and practice of integrative medicine (IM) by combining syndrome typing and disease identification, and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years' clinical practice and researches. Radical operation as prior (as evil eliminating) and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients. Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients. For example, a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions. In this way, these patients' quality of life (QOL) were improved and time to castration resistant prostate cancer (CRPC) was delayed, even some patients were clinically cured. There are lack of effective medicines and methods for CRPC patients. Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals. Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer, especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients. Besides, it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.

Kidney-tonifying Chinese medicine for male infertility: A systematic review of randomized controlled trials / 中华男科学杂志

<p><b>OBJECTIVE</b>To systematically evaluate the efficacy and safety of kidney-tonifying traditional Chinese medicine in the treatment of male infertility.</p><p><b>METHODS</b>Based on the principles and methods of Cochrane systematic reviews, we searched CNKI, VIP, and Wanfang databases from inception to December 2012 for randomized controlled clinical trials addressing the treatment of male infertility with kidney-tonifying traditional Chinese medicine. According to the inclusion and exclusion criteria and retrieval strategies, we extracted the data, evaluated the quality of the included literature, and conducted meta-analysis using the RevMan 5. 2 software.</p><p><b>RESULTS</b>Twenty trials involving 2,272 patients were included, and the sample size of each study was from 60 to 270 cases. All the studies were graded as of poor quality, with Jadad scores of no more than 3 points. The results of meta-analysis showed that the total effectiveness rate of traditional Chinese medicine versus Western medicine on male infertility was RR = 1.71, 95% CI 1.19-2.47, and that of Chinese-Western combined therapy versus Western medicine was RR = 1.15, 95% CI 1.01-1.30. Both traditional Chinese medicine and Chinese-Western combined therapy showed a significantly better total effectiveness than Western medicine alone in improving the pregnancy rate without serious adverse reactions.</p><p><b>CONCLUSION</b>Due to the poor methodological quality and high heterogeneity of the included studies, the evidence for the efficacy and safety of kidney-tonifying traditional Chinese drugs in the treatment of male infertility is of but limited value, and further validation is needed by more high-quality studies.</p>

Short-course kidney-invigorating therapy improves near-term semen quality in asthenozoospermic men with kidney deficiency / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of short-course kidney-invigorating therapy on near-term semen quality in asthenozoospermic men with kidney deficiency.</p><p><b>METHODS</b>Based on the differential types in traditional Chinese medicine, 121 asthenozoospermia patients received at our clinic of andrology were divided into groups A (kidney-yin deficiency), B (kidney-yang deficiency) and C (spleen and kidney deficiency), and treated with Yougui Decoction plus Wuziyanzong Pills, Jinkuishenqi Pills plus Wuziyanzong Pills, and Shizi Decoction plus Liujunzi Decoction, respectively, all given once daily for 4 weeks. Sperm parameters of the patients were analyzed with the computer-assisted sperm analysis system before and after treatment and compared among the three groups.</p><p><b>RESULTS</b>The baseline sperm concentrations in groups A, B and C ([70.4 +/- 38.6], [73.5 +/- 40.2] and [56.0 +/-34.4] x 10(6)/ml) showed no significant differences from those after medication ([74.4 +/- 32.6], [67.0 +/- 30.8] and [58.6 +/- 24.6] x 10(6)/ml) (P > 0.05). The percentages of grade a sperm in the three groups were (12.9 +/- 5.3)%, (13.7 +/- 7.7)% and (12.9 +/- 6.4)% respectively after treatment, significantly higher than (9.9 +/- 6.7)%, (9.3 +/- 5.4)% and (9.0 +/- 6.8)% before treatment (P < 0.05), and so were the percentages of grade a + b sperm ([37.4 +/- 10.2 ]%, [35.7 +/- 13.7]% and [35.9 +/- 12.3]% after treatment versus [29.6 +/- 13.2]%, [27.5 +/- 10.4]% and [28.3 +/- 12.1]% before treatment, P < 0.05). All the three groups showed significantly increased sperm motility after treatment ([53.8 +/- 10.5]%, [52.6 +/- 15.2]% and [51.1 +/- 13.1]%) as compared with the baseline levels ([44.3 +/- 14.0]%, [43.5 +/- 15.0]% and [42.4 +/- 14.9]%) (P < 0.05). The cure rate and total effectiveness rate were significantly higher in group B than in A (P < 0.05), but had no significant differences between either A and C or B and C (P > 0.05).</p><p><b>CONCLUSION</b>Short-course kidney-invigorating therapy can significantly improve near-term semen quality in asthenozoospermic men with kidney asthenia, especially in those with kidney-yang deficiency, and it has no obvious adverse effects.</p>

Laparoscopic radical prostatectomy for incidental prostate cancer after TURP / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the management of incidental prostate cancer after TURP by laparoscopic radical prostatectomy (LRP).</p><p><b>METHODS</b>Between April 2005 and December 2011, we treated 4 cases of incidental prostate cancer with p504s (+) by LRP, 1 at 3 mon, while the other 3 at 1.5 mon after TURP.</p><p><b>RESULTS</b>The operations were successfully performed in all the 4 cases, all by extraperitoneal approach. Postoperative pathology showed prostate cancer in 2 of the cases with Gleason scores of 6-7, high-level epithelial neoplasia in 1, and no malignancy in the other. Postoperative observation and 1-79 mon follow-up visit revealed good urinary function but no obvious urinary incontinence, metastasis and erectile dysfunction.</p><p><b>CONCLUSION</b>With practiced laparoscopic skills, laparoscopic radical prostatectomy may achieve satisfactory results in the treatment of incidental prostate cancer after TURP.</p>

Effects of perioperative treatment by integrated traditional Chinese and Western medicine on postoperative parameters of TURP / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical effects of perioperative treatment by integrated traditional Chinese and Western medicine on postoperative parameters of TURP.</p><p><b>METHODS</b>From Jun. 2002 to Oct. 2006, 238 cases of TURP were performed in our hospital, of whom, 179 (Group A) were treated by integrated traditional Chinese and Western medicine, and the other 59 (Group B) by Western medicine. The postoperative parameters of the 2 groups were recorded and compared.</p><p><b>RESULTS</b>Postoperative catheter indwelling, hospital stay, Q(max) 4 w after TURP and incidence of bacteriuria (> 5 d) showed no significant difference (P > 0.05), while the incidence rates of overactive bladder and urgent urinary incontinence, hematuria time, dysuria time, IPSS score and QOL score 4 w after TURP were statistically different between the 2 groups (P < 0.05).</p><p><b>CONCLUSION</b>For TURP patients, perioperative treatment by integrated traditional Chinese and Western medicine can reduce postoperative complications, increase the success rate of surgery and improve QOL score.</p>

NF-kappa B and prostatic adenocarcinoma / 中华男科学杂志

Nuclear factor of kappa B (NF-kappa B) is a multipolar nuclear transcription factor, and adjusts many gene expressions concerned with immunization, apoptosis, inflammation, neoplasia and metastasis. Recently, NF-kappa B has become a kind of hot spot in the studies of neoplasia, infiltration, metastasis and drug resistance. NF-kappa B can serve as an ideal target molecular approach to the promising gene therapy. This article reviews recent advances in studies on the structure and function of NF-kappa B, and the relationship between NF-kappa B and prostatic adenocarcinoma infiltration, metastasis and tactics of gene therapy.

Tumor infiltrating dendritic cells and Mucin1 gene expression in benign prostatic hyperplasia and prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the expression of Mucin1 gene and tumor infiltrating dendritic cells(TIDC) in the tissues of benign prostatic hyperplasia (BPH) and prostate cancer.</p><p><b>METHODS</b>Mucin1 and TIDC were detected in 20 specimens of BPH and 30 specimens of prostate cancer by immunohistochemistry SP method.</p><p><b>RESULTS</b>MUC1 expressed in both prostate cancer and BPH. The staining patterns were significantly associated with tumor pathological grade (P < 0.001). The number of TIDC was negatively correlated with tumor pathological grade, the higher the grade, the smaller the number of TIDC (P < 0.001).</p><p><b>CONCLUSIONS</b>The expression pattern of MUC1 and the number of TIDC could be considered as useful markers to evaluate the malignant degree and prognosis of prostate cancer. The decrease of TIDC plays an important role in tumor immune evasion and immune tolerance. Highly expressed MUC1 could lead to the failure of hormonal treatment for prostate cancer, and contribute much to tumor infiltration and metastasis.</p>