ABSTRACT
INTRODUCTION: Benign prostatic hyperplasia (BPH) is a condition commonly seen among men aged over 40, significantly affecting their quality of life and typically accompanied by lower urinary tract symptoms (LUTS). Acupuncture presents a potentially effective treatment option; however, the exact effects remain uncertain. Therefore, we design this multicentre randomised trial to evaluate the efficacy and safety of electroacupuncture (EA) for relieving LUTS in men with BPH. METHODS AND ANALYSIS: A two-arm, sham-controlled, subject-blinded and assessor-blinded trial will be conducted in 11 hospitals in China to compare EA with sham electroacupuncture (SA) in treating moderate to severe LUTS of BPH among men aged 40-80. A total of 306 eligible male patients will be recruited and assigned at a 1:1 ratio to receive either EA or SA for 24 sessions over a succession of 8 weeks, with 24 weeks of follow-up. The primary outcome will be the proportions of participants with at least 30% reduction in the International Prostate Symptom Score total score from baseline at weeks 8 and 20. All statistical analyses will be conducted in accordance with the intention-to-treat principle, and a two-tailed p value less than 0.05 will be considered statistically significant. ETHICS AND DISSEMINATION: The trial has been approved by the institutional review board of Guang'anmen Hospital (2022-203-KY), as well as other recruitment centres. Each participant will receive the detailed information of the trial, and sign the written informed consent. The results of the trial are expected to be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05585450.
Subject(s)
Electroacupuncture , Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Quality of Life , Humans , Male , Electroacupuncture/methods , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/therapy , Lower Urinary Tract Symptoms/therapy , Lower Urinary Tract Symptoms/etiology , Middle Aged , Aged , Randomized Controlled Trials as Topic , Treatment Outcome , Adult , Aged, 80 and over , China , Multicenter Studies as TopicABSTRACT
OBJECTIVE: This study aimed to systematically investigate the relationship between immune-inflammatory indexes with lower urinary tract symptoms (LUTSs). DESIGN: Cross-sectional study. SETTING: National Health and Nutrition Examination Survey (NHANES) (2005-2008). PARTICIPANTS: A total of 2709 men with complete information for immune-inflammatory indexes and LUTSs were included from NHANES 2005-2008. OUTCOMES AND ANALYSES: Automated haematology analysing devices are used to measure blood cell counts, and LUTSs were presented by standard questionnaires. Non-linear and logistic regression analyses were used to estimate their association after adjustment for confounders. RESULTS: Multivariate logistic regression showed that pan-immune-inflammation value (OR (95% CI)=1.60 (1.14 to 2.23)), systemic inflammation response index (SIRI) (OR (95% CI)=1.82 (1.21 to 2.73)), neutrophil/lymphocyte ratio (NLR) (OR (95% CI)=1.81 (1.31 to 2.49)), derived NLR (dNLR) (OR (95% CI)=1.91 (1.35 to 2.70)) and C reactive protein (CRP) (OR (95% CI)=1.71 (1.05 to 2.79)) was positively associated with LUTS. Additionally, composite immune-inflammation markers exhibited a stronger association with LUTS than any single index, with the ORs for high SIRI+high CRP, high NLR+high CRP and high dNLR+high CRP being 2.26, 2.44 and 2.16, respectively (all p<0.05). Furthermore, subgroup analyses revealed that age, smoking status and hypertension have different effects on the relationship between immune-inflammatory markers and LUTS. CONCLUSIONS: This study indicated that high levels of immune-inflammatory markers were associated with an increased risk of clinical LUTS. The combination of CRP with SIRI, NLR and dNLR, respectively, showed a stronger positive correlation with clinical LUTS compared with any single index.
Subject(s)
C-Reactive Protein , Lower Urinary Tract Symptoms , Male , Humans , Nutrition Surveys , Cross-Sectional Studies , C-Reactive Protein/metabolism , Biomarkers , Inflammation , Lower Urinary Tract Symptoms/epidemiologyABSTRACT
Benign prostatic hyperplasia (BPH) occurs when there is an imbalance between the proliferation and death of prostate cells, which is regulated tightly by estrogen signaling. However, the role of G protein-coupled estrogen receptor (GPER) in prostate cell survival remains ambiguous. In this study, we observed that prostates with epithelial hyperplasia showed increased yes-associated protein 1 (YAP) expression and decreased levels of estrogen and GPER. Blocking YAP through genetic or drug interventions led to reduced proliferation and increased apoptosis in the prostate epithelial cells. Interestingly, GPER agonists produced similar effects. GPER activation enhanced the phosphorylation and degradation of YAP, which was crucial for suppressing cell proliferation and survival. The Gαs/cAMP/PKA/LATS pathway, downstream of GPER, transmitted signals that facilitated YAP inhibition. This study investigated the interaction between GPER and YAP in the prostate epithelial cells and its contribution to BPH development. It lays the groundwork for future research on developing BPH treatments.
ABSTRACT
【Objective】 To explore the application value of transrectal contrast-enhanced ultrasound (CEUS) microangiography, elastography and conventional ultrasound-guided prostate cancer puncture biopsy in the diagnosis of prostate diseases, so as to provide reference for the early diagnosis of prostate cancer. 【Methods】 A total of 156 patients suspected of prostate cancer treated in our hospital during Jan.2021 and Dec.2022 were selected.The patients were divided into group A (n=52, conventional ultrasound), group B (n=49, elastography) and group C (n=55, CEUS microangiography) according to the puncture methods.The positive rate of puncture and diagnostic value of the three methods were analyzed. 【Results】 The positive rate of puncture was 24.18% in group B and 25.71% in group C, which was significantly higher than that in group A (13.15%, P<0.05).The diagnostic accuracy of prostate cancer was 93.88% in group B and 94.55% in group C, higher than that in group A (75.00%, P=0.002).In group B, the Emax and Emean of malignant lesions were (65.56±14.43) kPa and (59.59±11.02) kPa, respectively, which were higher than those of benign lesions (P<0.001).The difference in blood flow grade detected by CEUS microangiography was statistically significant between benign and malignant lesions, and grade 3 blood flow accounted for 95.65% of malignant lesions.The area under the receiver operating characteristic (ROC) curve (AUC) of Emean in elastography in the diagnosis of prostate cancer was 0.810 (95%CI: 0.690-0.930, P<0.05).The AUC of CEUS microangiography in the diagnosis of prostate cancer was 0.965 (95%CI: 0.913-1.000, P<0.05). 【Conclusion】 Compared with conventional ultrasound-guided prostate cancer puncture biopsy, CEUS microangiography and elastography guided prostate cancer puncture biopsy have better application value in the diagnosis of prostate diseases, which can provide semi-quantitative/quantitative parameter basis for the diagnosis of prostate diseases.
ABSTRACT
Prostatitis is a very common disease, with the growth of age, in addition to wrinkles, weight in the longer, the male prostate may also become longer, so there is prostatic hyperplasia (BPH), when its gradual proliferation compression bladder outlet and urethra, will cause dysuria and other symptoms. Simply put, prostatitis causes hyperplasia of the prostate, and prostatitis increases the risk of prostate cancer (Pca). Prostate disease afflicts many men. Therefore, accurate diagnosis of prostate disease is very important for athletic patients to seek medical treatment in time. Multiparametric magnetic resonance imaging (mp-MRI) is a non-invasive imaging technique with superior diagnostic performance compared to other imaging modalities, such as ultrasound and computed tomography. It is widely used in the diagnosis of prostate disease. Advances in science and technology, high-field magnets and new magnetic coil designs (including intra-rectal coils and multichannel surface coils), as well as more advanced software and computational algorithms, allow more sophisticated functional imaging to be incorporated into clinical imaging. The diagnosis of prostate disease has also become faster and more accurate, bringing good news to athletic patients. (AU)
Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Prostatic Diseases/diagnostic imaging , Magnetic Resonance Imaging , Athletes , Prostatitis , Prostatic NeoplasmsABSTRACT
Objective@#To investigate the prevalence and related risk factors of prostate diseases in traffic policemen.@*Methods@#A total of 848 traffic policemen who took part in the physical examination among August and September in 2016 were selected as research subjects, and a questionnaire survey was conducted to collect their information including smoking, alcohol drinking, biological and physiological indicators, as well as prostate disease etc. The relationship between the prevalence of prostate diseases and related risk factors was analyzed by Non-conditional Logistic Regression.@*Results@#The total prostate disease prevalence rate was 40.2% in the study subjects, and there is statistical significance (P<0.05) of differences between prostate disease group and non disease group in age, work age, smoking, drinking and field work. Single factor analysis showed that age, work age, smoking, and field work are independent risk factors of prostate disease (P<0.05) . Multivariate Logistic regression analysis showed that increasing age (OR 1.03) , smoking (OR 1.92) and field work time (OR 1.47) significantly increased the risk of prostate disease in male police after age, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids and other indicators were adjusted.@*Conclusion@#age, smoking and field work time are risk factors of prostate diseases in the traffic police. There is great significance in publicizing the harmful effects of smoking and reducing the duration of field work.
ABSTRACT
Lower urinary tract diseases (LUTD) include different conditions that affect the urinary bladder, urethra and prostate. The objective of this study was to determine the frequency of different related diseases, to characterize the population affected, and to determine risk factors in dogs. The clinical cases were diagnosed with LUTD through physical examination, and clinical laboratory and imaging studies. Male dogs had a greater predisposition to present a LUTD. Dogs from 3 months to 18 years with a median of 8 years were affected, and the most affected breeds were Poodle, Labrador, German shepherd, Schnauzer, Cocker Spaniel and Chihuahua. The LUTD presented with the following frequencies: bacterial urinary tract infection 34.02%; micturition disorders 22.68%; urolithiasis 20.61%; prostatic disease 14.43%; traumatic problems 8.24%. Sixty-seven per cent of the cases were specific diseases, such as uncomplicated and complicated bacterial urinary tract infections, urinary retention of neurologic origin and silica urolithiasis.(AU)
Doenças do trato urinaÌrio inferior (DTUI) incluem vaÌrias condiçoÌes cliÌnicas que afetam a bexiga, proÌstata e uretra. O objetivo deste estudo foi determinar a frequeÌncia de diferentes doenças relacionadas, caracterizar a populaçaÌo afetada, e determinar os fatores de risco em caÌes. Os casos cliÌnicos com DTUI foram diagnosticados atraveÌs de exame fiÌsico, estudos laboratoriais e de imagem. Os caÌes machos apresentam uma maior predisposiçaÌo para DTUI. Foram afectados cães com idades compreendidas entre os 3 meses a 18 anos, com uma mediana de oito anos, sendo as raças mais predispostas os Poodle, Labrador, Pastor AlemaÌo, Schnauzer, Cocker Spaniel e Chihuahua. A etiologia DTUI apresentou as seguintes frequeÌncias: 34,02% foram originadas em infecção do trato urinário inferior; 22,68% em distúrbios miccionais; 20,61% em urolitíase; 14,43% em doença prostática; 8,24% em problemas traumáticos. Sessenta e sete por cento dos casos de DTUI estavam associados a doenças específicas, tais como infecçoÌes bacterianas do trato urinaÌrio naÌo complicadas e complicadas, retençaÌo urinaÌria neurogeÌnica e urolitíase por siÌlica.(AU)
Subject(s)
Animals , Dogs , Prostatic Diseases/veterinary , Urologic Diseases/veterinary , Urologic Diseases/epidemiology , Dogs , Urolithiasis/veterinaryABSTRACT
Objective To detect the expression of peripheral blood free prostate specific antigen (fSPA),total prostate specific antigen (tSPA),prostate specific antigen density (PSAD) and prostate cancer gene 3 (PCA3) in prostate disease,and the significance of combined detection of fSPA,tSPA and PCA3.Methods 67 patients with prostate cancer,75 patients with prostatic hyperplasia and 70 healthy male were selected as the research objects from Dec.2014 to Jul.2016.The serum level of fSPA and tSPA was detected by chemiluminescence immune staining method.The prostate volume was tested by ultrasonic sound and PSAD value was calculated.The total RNA was extracted by Trizol,and the serum PCA3 mRNA expression was detected by RT-PCR.The specificity and sensitivity of combined detection of fSPA,tSPA and PCA3 were analyzed.Results The serum levels of fSPA,tSPA,PSAD and PCA3 in prostate cancer were significantly higher than those in patients with prostatic hyperplasia and healthy male,and they were higher in patients with hyperplasia of prostate than in healthy male,and the differences had statistical significance (P<0.01).The serum levels of fSPA,tSPA,PSAD and PCA3 were higher in patients with Gleason score ≥7 points and in T3-T4 stage than in patients with Gleason score <7 and in T1-T2 stage,and the difference had statistical significance (P<0.01).The serum levels of fSPA,tSPA,PSAD and PCA3 were positively correlated with Gleason score and TMN pathological stage,and the difference had statistical significance (P<0.01).The AUC value of fSPA,tSPA,PSAD and PCA3 in diagnosis of prostate cancer was 0.53,0.57,0.63 and 0.75,and the AUC value of combined detection was 0.92.The combined detection efficiency was higher than the single index.The specificity of fSPA,tSPA,PSAD and PCA3 was 67.16%,68.66%,73.13% and 85.07%,and the sensitivity was 71.64%,70.15%,74.63% and 82.09% respectively.The specificity of combined detection was 97.01%,the sensitivity was 92.54%,and the difference had statistical significance (P<0.01).Conclusion The serum level of fSPA,tSPA,PSAD and PCA3 is increased in prostate disease,and is negatively correlated with Gleason score and TMN pathological stage.The combined detection of fSPA,tSPA,PSAD and PCA3 can improve the sensitivity and specificity of prostate disease diagnosis,and is of high clinical value.
ABSTRACT
Objective To discuss the value of three-dimensional (3D) transrectal ultrasound (3DTRUS)in diagnosing prostatic diseases.In this study ,73 patients were examed.Methods 73 patients underwent three-dimensional reconstruction of prostatic ultrasonic echo were performe.At sametime we did 2DTRUS in these 73 patients.We compare these two groups` ultrasonic echo characteristics.Results 3DTRUS can provide more detailed three-dimensional makeup of prostatic lesions when compared with 2DTRUS.Overall informative value 3DTRUS in detection of prostatic lesions was 94.5%,2DTRUS is 83.6%.3DTRUS produced a significantly higher detection rate (P
ABSTRACT
Objective To evaluate the value of endorectal coil(E-coil) in the diagnosis of prostate diseases.Methods The comparative study was done with E-coil and body coil in 15 patients including 9 cases of prostate carcinoma,4 cases of benign prostatic hyperplasia and 2 normal individuals.The conventional spin-echo sequence(SE T 1WI,FSE T 2WI)were done in all cases.The axial images obtained with two types were compared according to the subjective viewing and scoring.Results Overall imaging quality on E-coil was significantly superior to that on body coil.The average scores were 2.97?0.61 points with body coil vs 3.4?0.60 points with E-coil on T 2WI (?
ABSTRACT
The purpose or this study was to evaluate the clinical usefulness of serum prostate specific antigen (PSA) in prostate disease with Tandem-E method. The advantages of this immunoenzymatic assay (Tandem-E) are that no radioactive material must be handled by laboratory personnel, no radioactive waste products must be disposed of in a meticulous manner and it is markedly less expensive to establish a laboratory capable of performing the immunoenzymatic as apposed to the immunoradiometric assay. And the performance characteristics of the Tandem-E PSA were similar to those of the Tandem-R PSA assay. Serum PSA was measured in 30 healthy men without prostate disease as control and 90 prostate disease patients (Chronic prostatitis: 20, Benign prostate hyperplasia(BPH) 40 and Prostate cancer: 30) with Tandem-E & Tandem-R methods. Chronic prostatitis patients were divided into two subgroups(group I: 10 patients with bacterial prostatitis, group II 10 patients with nonbacterial prostatitis), and BPH patients were divided into three subgroups(group A(10): Prostate volume: 51cm 3). Mean(+/-SD) serum PSA(Tandem-E) in control group was 1.88+/-0.85 ng/ml. In chronic prostatic, BPH and prostate cancer group, they were 2.10+/-1.22, 6.64+/-2.85 and 51.21+/-34.05 ng/ml. There was no significant difference between chronic prostatitis and control group(p>0.05), but not in BPH group(p<0.05). The benign prostatic hyperplastic tissue elevated the serum PSA level according to the prostate volume(group A: 4.24+/-1.64, group B: 6.68+/-1.58, group C: 8.79+/-2.27). Mean(+/-SD) serum PSA(Tandem-E) in prostate cancer group was significantly elevated than that of control and BPH group(p<0.05) There was a direct correlation between the serum PSA concentration and clinical stage in prostate cancer group, but PSA is not sufficiently reliable to determine the clinical stage in individual basis. However, if combined with prostate volume, PSA(Tandem-E) may become a vital part of any early detection program. In this study, the results of Tandem-E PSA assay were similar to those of Tandem-R PSA assay in control and prostate disease patients.