Triptorelin relieves lower urinary tract symptoms in Chinese advanced prostate cancer patients: a multicenter, non-interventional, prospective study.

BACKGROUND: Although triptorelin is increasingly used in China for biochemical castration, its effects on primary prostate cancer symptoms remain unclear. This study aimed to assess the prevalence of lower urinary tract symptoms (LUTS) in Chinese prostate cancer patients and the effectiveness of triptorelin on LUTS. METHODS: In this 48-week multicenter, non-interventional, prospective study, we enrolled patients with locally advanced or metastatic prostate cancer. Patients received triptorelin (15 mg) intramuscularly at baseline and at weeks 12, 24, and 36 with symptom assessment using the International Prostate Symptoms Score (IPSS). The primary endpoints were the prevalence of LUTS at baseline per IPSS categories and the percentage of patients with moderate to severe LUTS (IPSS > 7) at baseline, having at least a 3-point reduction of IPSS score at week 48. RESULTS: A total of 398 patients were included; 211 (53.0%) and 160 (40.2%) among them had severe and moderate LUTS, respectively. Of the patients with IPSS scores available at baseline and at week 48 (n = 213), 81.2% achieved a reduction in IPSS of at least 3 points. Of the patients with moderate to severe LUTS at baseline and IPSS scores available at baseline and at week 48 (n = 194), 86.6% achieved a total IPSS reduction of at least 3 points. CONCLUSIONS: The vast majority of Chinese patients with locally advanced or metastatic prostate cancer scheduled to receive triptorelin as part of their standard treatment have severe or moderate LUTS. Triptorelin therapy resulted in sustained improvement of LUTS in these patients.

Relationship between preoperative renal cortical thickness and glomerular filtration rate before and after minimally invasive surgery in patients with unilateral upper urinary tract obstruction / 中国内镜杂志

Objective To investigate the relationship between preoperative renal cortical thickness and glomerular filtration rate (GFR) before and after minimally invasive surgery in patients with unilateral upper urinary tract obstruction. Methods 63 patients with upper urinary tract obstruction from July 2015 to June 2016 were enrolled in the study, including 34 males and 29 females, age ranged from 22 to 73 years old (52.21 ± 11.56). Their operation methods included 24 cases of ureteroscopic lithotripsy and lithotomy, 21 cases with one-stage percutaneous nephrostomy + two-stage percutaneous nephrolithotomy (PCNL), 18 cases of PCNL. The abdominal enhanced CT and single photon emission computed tomography (SPECT) were measured to RCT and GFR. Then all cases were divided into group A (moderate renal impairment, 15.0 ml/min ≤ GFR < 30 ml/min), group B (severe renal damage, 7.5 ml/min ≤ GFR <15.0 ml/min) and group C (extremely severe renal injury, GFR < 7.5 ml/min) according to preoperative renal GFR, and changes of GFR before and after surgery were compared among three groups. Simple linear correlation analysis was used to analyze the correlation between preoperative RCT and other indexes in group A and B. Results 9 patients were not measured RCT because of serious hydronephrosis, 54 patients included 20 cases of RCT >10 mm, 23 cases of 5 ～ 7 mm and 11 cases of <5 mm, and the average value was (10.75 ± 4.91) mm. The preoperative RCT in group A was significantly higher than that in group B (P < 0.05). GFR at 1 and 9 months after operation in three groups were significantly higher than that before operation in the same group (P < 0.05). GFR at 1 and 9 months after operation in group A were significantly higher than that the other two groups, and GFR at 9 months after operation in group B was significantly higher than that in group C (P < 0.05), but there were no significant differences in GFR at 1 month after operation between group B and C (P > 0.05). GFR recovery value at 1 month after operation in group B was significantly lower than that in other two groups (P < 0.05), but there were no significant differences in GFR at 9 months after operation among three groups (P > 0.05). Preoperative RCT was positively correlated with preoperative GFR (r = 0.613), GFR at 1 month after operation (r = 0.697) and the recovery value (r = 0.552), GFR at 9 months after operation ((r = 0.589) and recovery values (r = 0.488), and the differences were statistically significant (P < 0.05). Conclusion Removal of upper urinary tract obstruction could recover the renal function to varying degrees, even for patients with extremely severe renal injury, who could retrieve their kidney. Preoperative RCT could be helpful in judging the renal function during operation, especially for the postoperative recovery of renal function.

Long noncoding RNA GHET1 promotes the development of bladder cancer.

In spite of the advances in the diagnosis and treatment of bladder cancer, the prognosis of bladder cancer remains relatively poor. As a result, it is vital to identify novel diagnostic and prognostic marker of bladder cancer. A growing volume of literature has implicated the vital role of long noncoding RNA in the development of cancer. GHET1, a recently identified lncRNA, was initially characterized in gastric cancer. However, its role in bladder cancer remains largely unknown. In this study, we demonstrated that GHET1 was upregulated in bladder cancer tissues compared to adjacent normal tissues and its over-expression correlates with tumor size, advanced tumor and lymph node status, and poor survival. GHET1 knockdown suppressed the proliferation and invasion of bladder cancer cells in vitro. In the meantime, inhibition of GHET1 reversed the epithelial-mesenchymal-transition in bladder cancer cell line. Taken together, our study suggests that the potential use of GHET1 as a prognostic marker and therapeutic target of bladder cancer.

[FISH analysis of meiotic segregation results of the spermatozoa from male pericentric inversion carriers].

OBJECTIVE: To analyze the meiotic segregation results of the spermatozoa from male pericentric inversion carriers by fluorescence in-situ hybridization (FISH). METHODS: Using chemical depolymerization and multicolor FISH, we analyzed the meiotic segregation results of the spermatozoa from 4 male pericentric inversion carriers. RESULTS: Of the 4 males studied, 46,XY,inv(9) (p11q12) was found in 2, 46,XY,inv(9) (p11q13) in 1 and 46,XY,inv(6) (p22q24) in the other; the lengths of the inverted segments represented 16.0, 16.0, 21.0 and 76.0% of the size of the whole chromosome involved; and the frequencies of recombinant sperm were 0.2, 0.4, 0.3 and 43.9%, del(p)/dup(q) accounting for 22.4% and del(q)/dup(p) 21.5%, respectively. CONCLUSION: Males with pericentric inversion may produce spermatozoa with recombinant chromosomes and the rate of recombination varies principally according to the size proportion to the whole chromosome involved. The results of FISH analysis of chromosomal unbalanced spermatozoa can provide accurate personalized information on the genetic risk of fertility.

[Effects of sildenafil on bladder compliance and endothelin-1 in rabbit model of partial bladder outlet obstruction].

OBJECTIVE: To explore the effects of sildenafil on bladder compliance and endothelin-1 in the rabbit model of partial bladder outlet obstruction. METHODS: A total of 24 adult male New Zealand white rabbits were randomly divided into group A, group B, group C and group D (n = 6 each). The rabbit model of partial bladder outlet obstruction was established in groups C and D while groups A and B underwent a sham operation. Daily sildenafil (10 mg/kg) was dosed to groups B and C by lavage. Daily normal saline was dosed similarly to groups A and D. Bladder urodynamic examinations were conducted in each group at Week 16. Then bladder was isolated and weighed from each group. And ET-1 in bladder tissue was measured by ELISA. RESULTS: Pressure thresholds for voiding (PT) in A-D groups were (10.6 ± 2.0), (11.6 ± 2.7), (14.0 ± 4.2) and (20.4 ± 6.1) cm H2O respectively. Compared with groups A, B and C, PT in group D was significantly higher (all P < 0.01). Bladder compliance in 4 groups were (2.75 ± 0.51), (2.78 ± 0.46), (4.98 ± 2.15) and (1.22 ± 0.25) ml/cm H2O respectively. Compared with groups A, B and C, bladder compliance was significantly lower in group D (all P < 0.01). Bladder compliance in group C was higher than that in groups A and B (both P < 0.01). The weights of bladder specimens in 4 groups were (5.0 ± 0.4), (4.6 ± 0.4), (8.2 ± 1.3) and (17.9 ± 2.3) g respectively. Compared with groups A and B, the weights of groups C and D were significantly heavier (all P < 0.01). And the weight of group D was much greater than that of group C (P < 0.01). The contents of ET-1 in bladder tissue of 4 groups were (72 ± 19), (69 ± 18), (76 ± 21) and (106 ± 29) pg/g respectively. Compared with groups A, B and C, ET-1 in bladder tissue was significantly higher in group D (all P < 0.05). CONCLUSIONS: Daily sildenafil can effectively alleviate the damage of rabbit bladder compliance from partial bladder outlet obstruction and protect bladder functions. Its mechanism may be related with the down-regulation of ET-1 in bladder tissue of partial bladder outlet obstruction.

[Effects and mechanisms of phosphodiesterase type 5 inhibitors on rats with overactive bladder].

OBJECTIVE: To investigate the effects and the possible mechanistic pathway of phosphodiesterase type 5 (PDE5) inhibitors on rats with overactive bladder. METHODS: A total of 24 adult male spontaneously hypertensive rats (SHRs) were randomly divided into 3 groups: daily lavage group, discontinuous lavage group and blank group (n = 8 each). Daily vardenafil (10 mg×kg(-1)×d(-1)), discontinuous vardenafil (10 mg×kg(-1)×d(-1)) and daily normal saline were administered respectively to 3 groups by lavage. And 8 adult male SD rats were included into the control group. Bladder urodynamic examinations were conducted in each group 2 weeks later. Then bladder detrusor muscle strips isolated from each group were further divided into two parts. One part was first pre-contracted and then the relaxant effects of sodium nitroprusside and Y-27632 were observed. For another part, enzyme-linked immunosorbent assay was used to measure cyclic guanosine monophosphate (cGMP). RESULTS: As compared with the control group, the values of bladder inter contraction interval (ICI) and bladder capacity (BC) were significantly lower [(409 ± 36) s vs (568 ± 60) s, (284 ± 25) µl vs (395 ± 42) µl, P < 0.01] while the bladder non voiding contraction (NVC) was significantly higher in the blank group [(2.03 ± 0.49) number/min vs(1.07 ± 0.30) number/min, P < 0.01]. Compared with the blank group, the values of ICI and BC were elevated. NVC decreased obviously in the discontinues and daily lavage groups [(486 ± 53) s and (564 ± 44) s; (337 ± 37) µl and (392 ± 30) µl; (1.82 ± 0.32) number/min and (0.52 ± 0.23) number/min, P < 0.05]. The effects were more significant in the daily lavage group (P < 0.01). The maximal relaxant effect of sodium nitroprusside was obviously enhanced in the discontinues and daily lavage groups [(50.6 ± 2.1)% and (67.9 ± 4.1)% vs(25.3 ± 5.0)%, P < 0.01]. However the sensitivity of Y-27632 decreased significantly [(35.8 ± 2.5)% and (20.2 ± 2.3)% vs (71.6 ± 2.8)%, P < 0.01], while the level of cGMP was significantly higher in the bladder detrusor muscle [(20.6 ± 4.1) fmol/mg and (29.4 ± 4.3) fmol/mg vs (12.9 ± 2.1) fmol/mg, P < 0.01]. The effects of the daily lavage group were more pronounced (P < 0.01). CONCLUSION: The phenomenon of bladder overactivity is observed in the SHRs. The PDE5 inhibitors are effective in treating overactive bladder. And the effect of daily supplement is much better. In addition, the mechanism may operate through the cGMP-dependent protein kinase G-RhoA/Rho kinase signaling pathway.

[Inhibition of SRC-1 expression in prostate cancer cells by RNAi and its significance].

OBJECTIVE: To investigate the inhibition of the expression of steroid receptor coactivator-1 (SRC-1) in the LNCap cell line through RNA interference (RNAi) and the effect of the silenced SRC-1 gene on LNCap cells. METHODS: The experiment included four groups: siRNA transfection, siRNA negative control, bland vehicle (with Lipofectamine 2000 but no siRNA), and blank control (with neither Lipofectamine 2000 nor siRNA). LNCap cells were transfected with designed siRNA using the liposomes method, the expressions of SRC-1 determined by Q-PCR and Western blot, and the proliferation of the LNCap cells detected by the CCK-8 method. RESULTS: The expression of SRC-1 mRNA in the transfected LNCap cells was decreased by 35% at 24 hours and 77% at 48 hours, with statistically significant differences from the blank control group (P < 0.05). The SRC-1 protein expression of the transfected group was 0.359 +/- 0.034 at 24 hours and 0.257 +/- 0.065 at 48 hours, markedly decreased as compared with that of the negative control (0.782 +/- 0.078 and 0.766 +/- 0.043) , bland vehicle (0.840 +/- 0.013 and 0.786 +/- 0.051), and blank control group (0.816 +/- 0.065 and 0.805 +/- 0.107) (P < 0.05). The LNCap cell growth inhibition rates were 25%, 52%, 55% and 60% at 24, 48, 72 and 96 hours, respectively. CONCLUSION: The expression of SRC-1 is correlated with the growth of LNCap cells; its high expression in androgen-independent prostate cancer cells may be involved in the progression to androgen-independence. Inhibiting the expression of SRC-1 may be an option for the treatment of androgen-dependent prostate cancer.

[Analysis of the relationship between expression of caveolin-1 and prognosis in bladder transitional cell carcinoma].

OBJECTIVE: To analyze the relationship between expressions of caveolin-1 and prognosis in bladder transitional cell carcinoma (BTCC). METHODS: The expression of caveolin-1 was detected in 85 cases of BTCC. 64 cases of primary BTCC were followed-up after operation. The tumor-free survival time in recurrent BTCC patients was observed. RESULTS: The positive expression rates of caveolin-1 in primary and recurrent BTCC were 32.8% and 61.9%, respectively, with a significant difference (P < 0.05). There was a significant difference (P < 0.05) between the tumor-free survival times in the groups with positive and negative expressions of caveolin-1. The half-, 1-, 2- and 3-year tumor-free survival rates in the group with positive expression of caveolin-1 were 90.4%, 80.9%, 66.3% and 56.1%, respectively. The half-, 1-, 2-, and 3-year tumor-free survival rates in the group with negative expression of caveolin-1 were 97.7%, 95.4%, 81.4% and 79.0%, respectively. The tumor-free survival rate in the group with positive expression of caveolin-1 was significantly lower than that in the group with negative expression of caveolin-1 (P < 0.05). CONCLUSION: Positive expression of caveolin-1 in BTCC can be regarded as a high risk factor of recurrence of BTCC. Positive expression of caveolin-1 in BTCC is correlated with the prognosis of BTCC, and BTCC patients with positive expression of caveolin-1 should be followed-up after operation.

[Effect of tadalafil therapy upon penile cavernous tissues in spontaneously hypertensive rats].

UNLABELLED: OBJECTIVE; To observe the plasma concentration change of endothelin-1 (ET-1) and the histomorphological changes in penile cavernous body after administrating a continuous low dose of tadalafil into spontaneously hypertensive rats (SHR). METHODS: Forty SHR rats were randomly divided into four groups of blank group, placebo group, continuous low-dose group and intermittent dose group with 10 rats in each. The animals were administrated with different doses of tadalafil via an intragastric route. To observe the plasma concentration change of ET-1 and cellular morphological changes of penile cavernous tissue in SHR after four weeks, the immunohistochemical method of SABC was employed to detect the expression of alpha-smooth muscle actin (alpha-SMA) in penile corpora cavernous of different groups. RESULTS: The plasma levels of ET-1 were lower in continuous low dose group (12.0 +/- 1.6) and intermittent dose group (14.3 +/- 1.7) as compared with the blank (18.0 +/- 1.9) and placebo groups (17.6 +/- 2.2) (all P < 0.01). And there was significant difference between the continuous low dose and intermittent dose groups (P < 0.05). The A-value level of absorbance in alpha-SMA were significantly different with the blank (0.53 +/- 0.03) and placebo groups (0.52 +/- 0.05) (P > 0.05) and it was lower in the continuous low dose group (0.29 +/- 0.03) than the intermittent dose group (0.38 +/- 0.03) (P < 0.05). It can be observed microscopically that in blank group and placebo group: endothelial cell and vascular smooth muscle cells of penile cavernous tissue in SHR had a disorderly distribution. The disrupted continuity and integrity of endothelial cell were also found. And they improved in continuous low dose group and intermittent dose group, especially the former; it can be viewed under TEM that the endothelial cells of penile cavernous tissue in SHR had mostly reverted to normal condition in the continuous low dose group and its ultra-structure indicated that the tissue morphology improved. CONCLUSION: A continuous low dose of tadalafil can improve the function and structure of vascular endothelium in penile cavernous body. Thus it provides rationales for a continuous low dose of PDE5 inhibitor in the treatment of erectile dysfunction.

[Detection of bacterial signal of 16S rRNA gene in prostate tissues obtained by perineal approach from patient with chronic pelvic pain syndrome].

OBJECTIVE: To explore the role of bacteria in etiology of chronic pelvic pain syndrome (CPPS), i.e., chronic prostatitis and the correlation between presence of bacterial signal of 16S ribosomal RNA (16S rRNA) gene and the response to antibiotics. METHODS: Samples of prostatic and subcutaneous tissues were obtained by biopsy via perineal approach from 112 CPPS patients, aged 20 - 48. Polymerase chain reaction was conducted to detect the 16S rRNA gene of bacteria. The patients were treated with gatifloxacin 0.4 g once a day for 4 weeks and then 4 weeks later the effects of treatment were assessed by the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). RESULTS: PCR was completed in 94 of the 112 patients, and 18 were excluded because their subcutaneous biopsies were positive for 16S rRNA, showing the possible contamination of their prostatic tissues. The total positive rate of bacterial 16S rRNA gene was 63.8% (60/94). The positive rate of bacterial 16S rRNA gene in the patients with IIIa CPPS and IIIb CPPS were 68.3% and 60.3% respectively. The total gatifloxacin effective rate of positive bacterial signal group after the was 55.0%, significantly higher than that of the negative bacterial signal group (14.7%, P < 0.001). The gatifloxacin effective rate of the 16S rRNA positive IIIa CPPS patients was 75%, significantly higher than that of the 6S rRNA negative IIIa CPPS patients (23.1%, P < 0.001), and the gatifloxacin effective rate of the 16S rRNA positive IIIb CPPS patients was 37.5%, significantly higher than that of the 6S rRNA negative IIIb CPPS patients (9.5%, P < 0.05). CONCLUSION: Bacterial infection is related to CPPS in part of the patients. Bacterial signal detection helps predict the effect of antimicrobial therapy.

[Transurethral unroofing in seminal vesicle cyst].

OBJECTIVE: To investigate the effects of transurethral unroofing in treatment of seminal vesicle cyst. METHODS: Seven patients seminal vesicle cyst 2.1 cm x 3.0 cm x 3.3 cm - 5.5 cm x 6.3 cm x 10.2 cm in size, aged 36 (21 - 65), with the symptoms of hematospermia (4 cases), hematuria (3 cases), epididymitis (2 cases), dysuria (1 case), bladder irritation symptoms (1 case), bloody mucus of urethral orifice after miction (1 case), perineal discomfort (2 case), and infertility (3 cases), underwent transurethral unroofing of seminal vesicle cyst. RESULTS: Operation was performed successful on all 7 patients. The mean operative time was 20 min, the mean estimated operative blood loss was 5 ml, and the mean hospital stay was 3 d. Follow-up was conduced for 28.3 months (8 months-10 years). All patients were free of symptoms after surgery, without recurrence and complications that needed further therapy. Two of the 3 patients with infertility succeeded in fertilization 1 year after surgery, and 1 patient with retrograde ejaculation underwent intracytoplasmic sperm injection and succeeded in fertilization 6 months after operation. CONCLUSION: Transurethral unroofing provides an effective approach to the seminal vesicle cyst with minimal invasion, short hospitalization, and rapid recovery.

Insulin resistance in patients with advanced prostate cancer undergoing intermittent or continuous androgen blockade.

BACKGROUND AND OBJECTIVE: Androgen blockade is the principle strategy in the treatment of advanced prostate cancer. Impaired glucose tolerance often occurs in those patients after androgen blockade. This study was to investigate the correlation of insulin resistance to intermittent androgen blockade (IAB) or continuous androgen blockade, which is also named surgical castration, in patients with advanced prostate cancer. METHODS: A total of 139 patients with advanced prostate cancer were classified into four groups according to the body mass index (BMI) and the treatment method. Group A consisted of 30 patients receiving surgical castration with BMI >or= 24 kg/m(2), group B consisted of 32 patients treated with IAB with BMI >or= kg/m(2), group C consisted of 37 patients undergoing surgical castration with BMI < 24 kg/m(2), group D consisted of 40 patients treated by IAB with BMI < 24 kg/m(2). Fasting plasma glucose (FPG) and fasting serum level of insulin (FINS) were assessed before treatment, six months and 12 months after treatment, respectively. Insulin resistance index (IRI) was also calculated. RESULTS: Six months after treatment, FINS and IRI were all increased in the four groups compared with those before treatment; FINS and IRI were significantly higher in groups B and D than in A and C (FINS: t(A:B)=7.7516, p < 0.01, t(C:D)=4.8078, p < 0.01; IRI: t(A:B) =7.3671, p < 0.01, t(C:D)=5.1005, p < 0.01). Twelve months after treatment, which was the intermittent period of the IAB method, FINS returned to the pretreatment level in group D (q=2.5255, p > 0.05), and dramatically decreased in group B compared to the value six months after treatment (q = 9.0942, p < 0.01); in contrast, FINS and IRI remained unchanged in groups A and C. CONCLUSIONS: Androgen blockade promotes insulin resistance in patients with advanced prostate cancer. Insulin resistance gradually disappears during the intermittent period of IAB.

[Frequency and transcript variant analysis of gene fusions between TMPRSS2 and ETS transcription factor genes in prostate cancer].

OBJECTIVE: To investigate the frequencies and types of fusions between the transmembrane protease serine 2 (TMPRSS2), ETS-related gene (ERG), ETS variant-1 (ETV1), and ETS variant-4 (ETV4) genes in prostate cancer (PCa) and significance thereof. METHODS: Biopsy samples of prostate were obtained under transrectal ultrasound (TRUS) from 32 PCa patients, aged (74 +/- 8) and 34 patients with benign prostate hyperplasia (BPH). Nested RT-PCR and direct DNA sequencing were used to detect the fusion genes of TMPRSS2/ERG, TMPRSS2/ETV1, and TMPRSS2/ETV4. The association between the fusion-positive tumor rate and Gleason grading was analyzed. RESULTS: Of the 32 PCa patients, TMPRSS2/ERG fusion was detected in 17 cases (53.1%), including 5 variant fusion transcripts one of which was newly discovered with the GenBank accession number of EU090248. TMPRSS2/ETV1 fusion was detected in only 2 cases (6.3%), including one newly discovered variant fusion transcripts with the GenBank accession number of EU090249. TMPRSS2/ETV4 fusion was not detected. The positive rates of TMPRSS2/ERG and TMPRSS2/ETV1 fusions showed no statistical association with the Gleason grade (P = 0.169). No fusion between the TMPRSS2 and ETS transcription factor genes was detected in the 34 BPH samples. CONCLUSION: TMPRSS2/ERG and TMPRS22/ETV1 fusion genes with different subtypes exist in the tissues of PCa. TMPRSS2/ERG and TMPRSS2/ETV1 fusion genes may be used as diagnostic tools for PCa.

[Quantitative detection of DD3 mRNA in prostate cancer tissues by real-time fluorescent quantitative reverse transcription polymerase chain reaction].

OBJECTIVE: To analyze the expression of DD3 mRNA in the prostate tissues. METHODS: DD3 mRNA was detected by realtime fluorescent quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) based on the Taqman technique in the tissues of 27 patients with non-prostate cancer( NPCa), 21 prostate cancer( PCa), 39 benign prostatic hyperplasia (BPH) and 15 normal prostate (NP). The ROC curve was used to evaluate the diagnostic value of DD3 mRNA. RESULTS: DD3 mRNA expression was not detected in the NPCa tissues. The median expressions of DD3 mRNA in PCa, BPH and NP tissues were 7. 2 x 10(6), 2. 5 x 10(4) and 1.5 x 10(4) copies/mg tissue, respectively. The DD3 mRNA expression levels were significantly different between nonmalignant and malignant tissues (P < 0.01). No significant differences in DD3 mRNA expression were detected between the NP and BPH tissues and no significant correlation was found between the DD3 mRNA expression and clinical pathological parameters. The AUC-ROC was 0.937 (95% CI: 0.879 - 0.995) at cutoff value 1.4 x 10(5) copies/mg tissue. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio for DD3 were 90.5%, 85.0%, 86.7%, 76.0%, 94.3%, 6.03 and 0.11 respectively. CONCLUSION: The DD3 mRNA expression is confined to prostate tissues and highly upregulated in PCa tissues. It has a potential application value in the early diagnosis of prostate cancer and the follow-up of the patient.

[Etiology, diagnosis and management of spontaneous per renal hemorrhage].

OBJECTIVE: To investigate the etiology, diagnosis, and management of spontaneous perirenal hemorrhage (SPH). METHODS: The clinical data of 35 patients, 10 males and 12 females, aged 35.9 (12-77), with the diagnosis of SPH, without history of trauma, anticoagulant use, dialysis, and renal transplantation, were analyzed. RESULTS: The underlying disease of SPH included angiomyolipoma (18 cases), renal cell carcinoma (7 cases), kidney cyst (2 cases), renal artery aneurysm (3 cases), rupture of renal artery aneurysm accompanied with pregnancy (2 cases), renal pheochromocytoma (3 cases 2 of which accompanied with pregnancy), congenital stricture of pelvic ureter junction (1 case), and liver cancer (1 case). The most common underlying diseases were nephrogenic (96%) with angiomyolipoma ranking first (54%) followed by renal cell carcinoma (21%). The underlying diseases were diagnosed correctly in 23 cases (69%). CT helped in diagnosis of 34 cases. Surgery was performed on most of the cases. CONCLUSION: The most common causes of SPH is renal neoplasms more than 50% of which are benign. Renal artery aneurysm and pheochromocytoma tend to rupture during pregnancy. CT is the first method of choice in diagnosis.

[Quantitative detection of differential display code 3 mRNA in peripheral blood of patients with prostate cancer].

OBJECTIVE: To investigate the expression of DD3 mRNA in the peripheral blood and its value in diagnostic of prostate cancer (Pca). METHODS: Thirty-five untreated Pca patients, aged 72 (53 - 83), 58 Pca patients treated with endocrinotherapy, aged 74 (53 - 86), and 59 patients with benign prostatic hyperplasia, aged 71 (48 - 85), underwent peripheral blood sample collection one week before or after digital examination. RT-PCR was used to examine the level of DD3 mRNA. The level of prostate specific antigen (PSA) was detected too. Ten healthy male frontiers, aged 33 (21 - 38), were used as controls. Receiver operating curve (ROC) was drawn to evaluate the diagnostic performance of DD3 mRNA. RESULTS: The DD3 mRNA level of the untreated Pca patients was 2741 copies/ml, significantly higher than those of the Pca patients treated with endocrinotherapy, patients with benign hyperplasia, and healthy persons (all < 24 copies, all P < 0.001). The DD3 mRNA level of the endocrinotherapy-treated Pca patients was significantly higher than those of the patients with benign hyperplasia, and healthy persons (both P < 0.001). ROC analysis showed that when the critical value was 846 copies/ml the area under curve of ROC (AUC-ROC) was 0.8233 (95% CI: 0.725 - 0.910). and the sensitivity was 74.34%, the specificity was 89.8%. The DD3 mRNA in the peripheral blood increased along with the increase of clinical staging (P < 0.01). CONCLUSION: The level of DD3 mRNA in the peripheral blood is an excellent marker for diagnosis pf Pca, and may help in monitoring of the curative effects of endocrinotherapy.

[Intravesical instillation of pirarubicin (THP) together with polyvinylpyrrolidone (PVP) in the prevention of postoperative recurrence of superficial bladder cancer].

BACKGROUND & OBJECTIVE: Superficial bladder transitional cell carcinoma is aggressive and tends to recurrence after operation. In order to prevent the relapse of bladder neoplasms,this study was designed to explore the effect of intravesical instillation of pirarubicin (THP) together with polyvinylpyrrolidone (PVP) on patients with superficial bladder cancer who had undergone surgical operation. METHODS: A total of 34 cases were enrolled from October 1999 to May 2002. After one week of operation, pirarubicin (20 mg) dissolved in 10 ml normal saline plus 20 ml PVP was instilled into bladder, and was retained for 60 minutes. In the following 7 weeks, intravesical instillation of pirarubicin was administered once a week. Subsequently it was done bi-monthly, finally once a month for 6 months. RESULTS: Follow-up was performed for 5-26 months (mean:17.2 months). Among the 34 cases, recurrence was found in 2 cases (5.8%),bladder irritation in 6 cases (17.6%) and hematuria in 4 cases (11.7%) as well. CONCLUSION: Intravesical instillation of THP/PVP is effective for prevention of postoperative recurrence of superficial bladder cancer with fewer side effects. Further study is needed for wide use in such way.