LncRNA THOR promotes human renal cell carcinoma cell growth.

BACKGROUND: Recent studies have characterized a novel but extremely conserved long non-coding RNA (LncRNA) THOR. THOR directly associates with insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) to promote mRNA stabilization of key pro-cancerous genes. RESULTS: Here, we show that THOR is expressed in human renal cell carcinoma (RCC) tissues and established/primary human RCC cells. It was not detected in normal renal tissues nor in HK-2 and primary human renal epithelial cells. THOR silencing (by targeted siRNAs) or CRISPR/Cas9 knockout inhibited RCC cell growth, viability and proliferation in vitro. Reversely, forced over-expression of THOR promoted RCC cell survival and proliferation. IGF2BP1-regulated genes, including IGF2, GLI1 and Myc, were downregulated by THOR silencing or knockout, but they were upregulated after THOR over-expression. In vivo, THOR-knockout 786-O tumors grew significantly slower than the control tumors in nude mice. CONCLUSION: THOR expression promotes RCC cell growth in vitro and in vivo. THOR could be a novel and important therapeutic target for human RCC.

[Establishment of a penile transplantation model in beagle dogs].

OBJECTIVE: To investigate the feasibility of establishing a model of allograft penile transplantation in adult beagle dogs and explore the conditions for constructing a stable animal model of penis transplant. METHODS: Following the principles of similarity, repeatability, feasibility, applicability, and controllability in the construction of experimental animal models, we compared the major anatomic features of the penis of 20 adult beagle dogs with those of 10 adult men. Using microsurgical techniques, we performed cross-transplantation of the penis in the 20 (10 pairs) beagle dogs and observed the survival rate of the transplanted penises by FK506+MMF+MP immune induction. We compared the relevant indexes with those of the 10 cases of microsurgical replantation of the amputated penis. RESULTS: High similarities but no statistically significant differences were observed in penile anatomic features between the 20 beagle dogs and 10 men. All the 10 cases of cross-transplantation of the penis were successfully completed in the 20 beagle dogs, of which the transplanted glans survived with normal micturition in 12 but developed necrosis in the other 8; the success rate of one-time venous anastomosis was 95.0% (38/40) and that of one-time arterial anastomosis was 87.5% (35/40), with an average vascular anastomosis time of (71.0±9.0) minutes, a mean operation time of (133.0±10.3) minutes, and a mean blood loss of (135.8±41.4) ml. In the 10 cases of penile replantation, the success rate of one-time venous anastomosis was 100% (20/20) and that of one-time arterial anastomosis was 90.0% (18/20), with an average vascular anastomosis time of (65.0±7.9) minutes, a mean operation time of (117.4±10.0) minutes, and a mean blood loss of (85.0±10.8) ml. In the 12 cases of replantation of the amputated penis, the success rate of one-time venous anastomosis was 100% (24/24) and that of one-time arterial anastomosis was 95.8% (23/24), with an average vascular anastomosis time of (79.0±17.6) minutes, a mean operation time of (125.0±20.6) minutes, and a mean blood loss of (140.0±44.3) ml. No statistically significant differences were found in the relevant indexes among the three groups. CONCLUSIONS: The anatomic structure of the corpus cavernosum penis of beagle dogs is highly similar to that of men, almost the same in cross-section anatomy. Microsurgical replantation and allograft transplantation of the penis were both successfully performed in beagle dogs, which showed similar operative indexes to those of human penile replantation. The construction of the allograft penile transplantation model in adult beagle dogs is feasible clinically, with the advantages of operability and repeatability.

[Ejaculatory duct dilation combined with seminal vesicle clysis for refractory hematospermia: A report of 32 cases].

OBJECTIVE: To evaluate the effect of ejaculatory duct dilation combined with seminal vesicle clysis in the treatment of refractory hematospermia. METHODS: Using ureteroscopy, we treated 32 patients with refractory hematospermia by transurethral dilation of the ejaculatory duct combined with clysis of the seminal vesicle with diluent gentamicin. RESULTS: The operation was successfully accomplished in 31 cases, with the mean operation time of 32 (26－47) minutes. The patients were followed up for 6－39 (mean 23.6) months. No complications, such as urinary incontinence and retrograde ejaculation, were found after operation. Hematospermia completely disappeared in 27 cases, was relieved in 1, and recurred in 3 after 3 months postoperatively. Those with erectile dysfunction or mental anxiety symptoms showed significantly decreased scores of IIEF-Erectile Function (IIEF-EF) and Self-Rating Anxiety Scale (SAS). CONCLUSIONS: Ejaculatory duct dilation combined with seminal vesicle clysis under the ureteroscope, with its the advantages of high effectiveness and safety, minimal invasiveness, few complications, and easy operation, deserves general clinical application in the treatment of refractory hematospermia.

[Expressions of somatomedins in anoxic prostate epithelial cells].

OBJECTIVE: To observe the changes in the expressions of somatomedins in the prostate epithelial cells in anoxic condition. METHODS: We cultured prostate epithelial cell line RWPE-1 in vitro. At 4, 8, 12, 24, 48 hours after seeding of the cells, we determined the gene and protein expressions of the epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor-beta (TGF-beta), insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) in the prostate epithelial cells by RT-PCR and ELISA, respectively. RESULTS: With the increase of time, the expressions of the EGF, bFGF, TGF-beta, IGF-1 and VEGF genes were obviously up-regulated, more significantly in the anoxic than in the normoxic prostate epithelial cells. Take FGF mRNA, its expression level was 0.14 +/- 0.01 in the anoxic and 0. 12 +/- 0.01 in the normoxic prostate epithelial cells at 8 hours (P = 0.01), but increased to 0.29 +/- 0.01 and 0.14 +/- 0.01, respectively, at 48 hours (P < 0.001). The expression of the TGF-beta protein was also more significantly increased in the anoxic than in the normoxic prostate epithelial cells, 0.32 +/- 0.01 versus 0.26 +/- 0.01 at 4 hours (P = 0.017) and 1.56 +/- 0.13 versus 0.87 +/- 0.06 at 48 hours (P < 0.001). The other 4 somatomedins showed no significant differences in their protein expressions between anoxic and normoxic conditions. CONCLUSION: Anoxia can up-regulate the gene expressions of somatomedins and increase the secretion of TGF-beta in prostate epithelial cells.

[Combination of transrectal 125I seeds implantation brachytherapy and intermittent hormonal therapy for locally advanced prostate cancer].

OBJECTIVE: To evaluate the clinical efficacy of transrectal 125 I seeds implantation brachytherapy (BT) combined with intermittent hormonal therapy (IHT) in the treatment of locally advanced prostate cancer. METHODS: We treated 27 patients with locally advanced prostate cancer by transrectal 125I seeds implantation BT combined with IHT, and dynamically observed the changes in the PSA level, prostate volume, maximum urinary flow rate (Qmax) and International Prostate Symptoms Score (IPSS). RESULTS: All the implantation procedures were completed smoothly, lasting 20 to 35 minutes, with 40 to 58 seeds implanted. At 6 months after implantation, the PSA level was < 0.2 microg/L in all the patients (< 0.1 microg/L in 19 cases), the prostate volume was significantly reduced (P < 0.05), and Qmax and IPSS remarkably improved (P < 0.05). At 3 years after implantation, 19 cases were in the first cycle and the other 8 in the third cycle of IHT, of which 2 progressed to androgen-independent prostate cancer, and another 2 developed early bone metastasis. The rates of 3-year biochemically and clinically progression-free survival were 70.3% and 85.2%, respectively, and the rate of therapeutic effectiveness was 92.6%. No severe complications occurred in any of the cases. CONCLUSION: Transrectal 125I seeds implantation BT combined with IHT is a safe and minimally invasive procedure for locally advanced prostate cancer, which can effectively retard its clinical progression with no such complications as severe urethral, rectal or erectile dysfunction.

Polymorphic variation of CYP11B2 predicts postoperative resolution of hypertension in patients undergoing adrenalectomy for aldosterone-producing adenomas.

OBJECTIVES: The surgical cure rate of patients with aldosterone-producing adenoma varies widely, and causes of persistent hypertension are not completely established. The objective of this study was to assess the blood pressure outcome in patients after retroperitoneoscopic adrenalectomy, and to analyze the CYP11B2 344 C/T polymorphism and any factors associated with the outcome. METHODS: Between 2002 and 2009, 82 patients with unilateral aldosterone-producing adenoma underwent retroperitoneoscopic adrenalectomy. Clinical and biochemical data were reviewed retrospectively. Patients were investigated to assess the association of the CYP11B2 344 C/T polymorphism with resistant hypertension after surgery. RESULTS: Adrenalectomy cured hypertension in 44 patients (53.7%), and 27 patients (32.9%) had persistent hypertension that was much easier to control after surgery, whereas 11 patients (13.4%) had continued hypertension and poor blood pressure control. Multivariate regression analysis showed that the main determinants of postoperative cure were duration of hypertension less than 5 years (OR 4.515, 95% CI 1.978-10.293), number of antihypertensive medications ≤2 (OR 2.639, 95% CI 1.154-6.035), preoperative response to spironolactone (OR 3.105, 95% CI 1.381-6.985) and the TT genotype of the CYP11B2 gene (344 C/T; OR 2.765, 95% CI 1.261-6.064). CONCLUSIONS: The 344 C/T polymorphism of the CYP11B2 gene predicts resolution of hypertension in patients undergoing adrnelactomy for aldosterone-producing adenoma. Duration of hypertension, number of antihypertensive medications, and preoperative response to spironolactone also represents predictive factors that need to be considered for the identification of patients with continued postoperative hypertension requiring long-term monitoring and treatment.

[Analysis and prevention of postoperative complications of tubularized incised plate urethroplasty for hypospadia].

OBJECTIVE: To explore the reasons and preventions of complications of tubularized incised plate urethroplasty technique for hypospadia repair. METHODS: In the study, 54 patients of 247 hypospadia patients were analyzed who had complications, using SPSS 13.0 statistics to compare their complications with anatomy reasons including positions of the meatus, development of urethral mucous membrane and glans penis and degrees of ventral curvature. RESULTS: (1) Postoperative complications were relative to the position of meatus. The closer urinary meatus was to the coronary sulcus, the higher complication rate would be(χ(2)=26.309, P<0.01).( 2) The complication rate of normal glans penis was lower than that of the small glans penis (χ(2)=23.709, P<0.01). (3) The well developed urethral mucous membrane had a lower complication rate(χ(2)=12.086, P<0.01). (4) When the angle of ventral curvature was larger than 30°, a higher complication rate occurred(χ(2)=10.233, P<0.01). CONCLUSION: Tubularized incised plate urethroplasty procedure for single-stage urethroplasty is the first choice for patients with big glans penis, normal development of urethral plate and slight curvature so as to achieve high curing rates and good shape of penis.

[Can antibiotic treatment exclude inflammation in the differential diagnosis of elevated PSA?].

Considering that antibiotic treatment may elevated the level of prostate-specific antigen (PSA) and hence limit the specificity of PSA test for prostate cancer, urologists use empiric antibiotic treatment for men with increased PSA levels. But it is controversial whether antibiotic treatment can exclude inflammation in the differential diagnosis of PSA elevation. Some researchers have found that antibiotic treatment can decrease inflammation-induced PSA elevation and help to reduce unnecessary biopsies, while others have reported that antibiotic treatment has no significant effect on the PSA level, and the lowered level of PSA following antibiotic treatment does not mean the decreased risk of prostate cancer. Further researches are needed to confirm the value of antibiotic treatment before biopsy.

Diagnosis of male posterior urethral stricture: comparison of 64-MDCT urethrography vs. standard urethrography.

BACKGROUND: There are no reports regarding voiding/retrograde urethrography with 64-row multidetector CT (64-MDCT).To compare the clinical relevance of conventional voiding/retrograde urethrography and 64-MDCT urethrography for the evaluation of male posterior urethral stricture. METHODS: From January to October 2009, 21 men were referred to our institution for the management of posterior urethral stricture. The patients were evaluated with conventional voiding and retrograde urethrography and 64-MDCT urethrography. The patients were examined by open operative intervention which was required in all patients. The radiologic data were compared using the operative findings. RESULTS: 64 MDCT urethrography provided extra clinical data in ten patients. It was superior to conventional urethrography for judging the urethral stricture length in three patients, characterizing the site of urethra-rectal fistula in four patients, and accurately delineating the proximal urethra in six patients. CONCLUSIONS: 64-MDCT urethrography is a promising tool as an alternative to traditional radiographic methods for defining male urethral strictures. It has the advantage of examining patients only in one position, without distortion, and by generating three-dimensional images; it can accurately measure the stricture length, aid in the diagnosis of some associated pathological conditions, such as urethrorectal fistula, and does not expose the physician to radiation.

[Superiority of modified method in urine drainage for hypospadias repair: a 20 years' experience with 864 cases].

OBJECTIVE: To explore an ideal urine drainage method and new urethral secretions of hypospadias repair. METHODS: The authors retrospectively analyzed 864 cases of hypospadias undergoing hypospadias repair and different post-operative urine drainages. The patients were divided into 5 groups based on the methods of urine drainage. RESULTS: The rates of such complications as cystospasm, infection of incisional wound and urinary fistula were as follows: modified method group: 2.86%, 3.33%, 1.90%; 3-tube method group: 10.77%, 11.54%, 8.46%; He's method group: 20.89%, 15.04%, 9.75%; traditional method group: 36.25%, 41.25%, 37.50%; 1-tube method group: 56.47%, 58.82%, 48.23%. The modified method was significantly better than all the other four methods (P < 0.05). CONCLUSION: As an ideal drainage method of urine and new urethral secretions of hypospadias repair, the modified method boosts the success ratio of hypospadias repair.

[Effect of ischemia on the structure of bladder in rabbits with partial bladder outlet obstruction].

OBJECTIVE: To compare the structures and functions of rabbit bladder after partial bladder outlet obstruction versus without ischemia so as to explore the effects of ischemia on bladder pathogenesis in rabbits with partial bladder outlet obstruction. METHODS: A total of 64 mature male rabbits were divided into 4 groups (n = 16 each). Four of each group underwent operation to establish an ischemic animal model (ischemia group), another 4 underwent operation to establish a partial bladder outlet obstruction animal model (obstruct group), the other 4 underwent operation to establish an ischemic and partial bladder outlet obstruction animal model (combination group) and the remaining 4 underwent a sham operation as control. The rabbits in 4 groups were evaluated at Week 1, 2, 4 and 8 post-operation respectively. The weight of bladder, the thickness of mucosal, submucosa, muscular layer and placenta percreta and the activities of sarco/endoplasmic reticulum Ca(2+) ATPase citrate synthase of cystic smooth muscle were detected respectively. MASSON staining was used to observe the smooth muscle and collagen in stroma of bladder and S-100 staining for observing the neurons in bladder. RESULTS: In obstruct and combination groups, the weights of bladder at week 1 were (5.10 ± 0.29) g and (4.80 ± 0.37) g respectively. They were both significantly higher than control group [(1.93 ± 0.17) g, all P < 0.05]. The weights of bladder in obstruct and combination groups peaked at Week 4 and they were (18.48 ± 2.03) g and (12.35 ± 0.39) g respectively. The weight of bladder in obstruct group was significantly heavier than combination group in the same terms. And they were both significantly heavier than control and ischemia groups (all P < 0.05). Muscular tissue vicariously thickened during the first 4 weeks, and collagen and stroma increased at Week 4 in obstruct group. Muscular tissue, collagen and stroma all increased initially. But at Week 2 only collagen and stroma increased in combination group. Compare with control group, the other groups all have deletion of neurons, especially in combination group. The activities of sarco/endoplasmic reticulum Ca(2+) ATPase and citrate synthase of cystic smooth muscle of obstruct group peaked at Week 4. In combination group, the activities of sarco/endoplasmic reticulum Ca(2+) ATPase and citrate synthase of cystic smooth muscle were decreased over 2 - 8 weeks. In the same terms, the activities of sarco/endoplasmic reticulum Ca(2+) ATPase and citrate synthase of cystic smooth muscle in control group were significantly higher than those in obstruct and combination groups (all P < 0.05). CONCLUSION: Ischemia can reduce the tolerance of bladder and aggravate the impairment of bladder to partial outlet obstruction.

[Progress in the treatment of penile defect].

As the important external genitalia of males, penis has the functions of both urination and copulation. Battle wound, other trauma, and some diseases such as penile cancer can result in total and partial penile defect, which has great impact on the sufferers' mind and life. Therefore, the treatment of penile defect is receiving more and more importance from both the patients and doctors. The ideal treatment is expected to achieve a satisfactory appearance, unobstructed standing urination and successful copulation. Nowadays, the main clinical techniques for the treatment of penile defect include penile replantation, penile lengthening, and penile reconstruction. The progress made in transplantation immunity, tissue matching, immunosuppressive agents, and long-term surviving of animal allograft limb transplantation has prepared a firm ground for human penile allograft. The construction of penile tissues by tissue engineering techniques is still at the experimental stage. It would be a valuable research how to assimilate the constructed and autologous tissues in clinical practice so as to achieve better function and appearance of the penis.

[Changes in prostatic stromal composition and benign prostatic hyperplasia].

OBJECTIVE: To investigate whether there are different stromal compositions in the prostate tissue of patients with benign prostatic hyperplasia (BPH) and evaluate their significance in the course of the disease. METHODS: Forty-three surgical or bioptic prostatic specimens of BPH and 5 autoptic normal prostatic specimens were stained by the Masson method to display the elements of the muscle fiber and collagen. The relationship of the changes in the prostatic stromal composition was analyzed with the degree of bladder outlet obstruction (BOO) , IPSS and medication results. RESULTS: The mean ratio of muscle fiber to collagen in the normal prostate tissue was (3.2 +/- 0.2):1, significantly higher than that of the BPH patients (1: [4.7 +/- 3.1] ) (P < 0.01); that in the BPH patients with BOO was 1: (5.4 +/- 3.7) markedly lower than in those without BOO (1: [2.5 +/- 1.1] ) (P = 0.02); that in the BPH patients with severe prostatic symptoms was 1: (9.1 +/- 2.9), remarkably lower than in those with moderate (1: [5.3 +/- 3.4]) and mild prostatic symptoms (1: [2.8 +/- 1.7]) (P < 0.01); and that in the BPH patients with satisfactory medicinal therapeutic results was 1:(2.3 +/- 1.9), significantly higher than in those with poor therapeutic results (1: [7.6 +/- 4.3]) (P < 0.01). CONCLUSION: The stromal composition in the prostatic tissue of BPH patients undergoes different degrees of changes. More obvious BPH symptoms and poorer therapeutic results are associated with a bigger proportion of collagens and a smaller proportion of muscle fibers in the prostatic tissue. These changes may play an important role in the development and progression of BPH.

[Arteriosclerotic risk factors and benign prostatic hyperplasia].

OBJECTIVE: To evaluate the correlation between arteriosclerotic risk factors and the severity of benign prostatic hyperplasia (BPH). METHODS: A total of 877 patients with diagnosed BPH were selected according to the inclusion criteria. The weight of the prostate was estimated by transrectal ultrasonography, the degree of bladder outlet obstruction determined by urodynamic examination, and the symptoms quantified by the International Prostate Symptom Score (IPSS). Arteriosclerotic risk factors included age, hypertension, dyslipidemia, type 2 diabetes mellitus, and smoking. Comparative studies were made on the data obtained by univariate and multivariate analyses. RESULTS: The severity of BPH was increased with the increase in the severity of the risk factors and the incidence of the disease. The logistic regression analysis showed that type 2 diabetes mellitus was a prominent predictor of the prostate volume, IPSS and degree of bladder outlet obstruction (OR = 3.179, 3.862 and 2.847, P < 0.001), while the level of serum triglyceride was not (P > 0.05). Age, hypertension, high LDL, low HDL and smoking were all prominent predictors of the severity of BPH. CONCLUSION: Arteriosclerotic risk factors are obviously correlated with the development and severity of BPH, among which type 2 diabetes mellitus is the most important.

The prevalence of prostatitis-like symptoms in China.

PURPOSE: We studied the prevalence of prostatitis-like symptoms and identified their associated risk factors in a population based Chinese sample. MATERIALS AND METHODS: A volunteer group of 15,000 eligible men residing in Beijing, Anhui, Xi'an, Guangzhou and Gansu cities or provinces were invited randomly to take part in the survey to complete a questionnaire that elicited information regarding sociodemographics, Eysenck personality questionnaire, current stress and health ratings, lifestyle, medical history, expressed prostatic secretion evaluation, score of the National Institutes of Health Chronic Prostatitis Symptom Index and International Index of Erectile Function-5. RESULTS: Information on 12,743 (84.95%) men was collected. Of these men 1,071 (8.4%) reported prostatitis-like symptoms (mean National Institutes of Health Chronic Prostatitis Symptom Index pain score 7.55 +/- 3.22). The percent of chronic prostatitis was 4.5% (571) among the symptoms group according to past urological history and expressed prostatic secretion evaluation. Subjects with prostatitis-like symptoms (mean age 34.56 +/- 13.48 years) had higher mean pain and urinary symptoms scores (7.53 +/- 3.22 and 2.84 +/- 2.72, respectively) compared with subjects without prostatitis-like symptoms (1.18 +/- 2.32 and 0.72 +/- 1.66 for pain and urinary symptoms scores, respectively, mean age 30.7 +/- 10.17) (pain and symptoms scores, p <0.05). The quality of life score was 6.03 +/- 2.88 and 3.83 +/- 2.55 in groups with symptoms or nonsymptoms, respectively (p <0.05). CONCLUSIONS: Prostatitis-like symptoms are a multifactorial problem affecting men of all ages (15 to 60 years) and demographics, and the prevalence is high in China. The syndrome is closely related to alcohol consumption, cigarette smoking, frequent intercourse, as well as fatigue, pressure and too little sleep. These findings suggest that risk factors for this condition are largely modifiable and highlight potential targets for future prevention.

Treatment of chronic prostatitis in Chinese men.

The aim of this study is to assess the status of treatment of chronic prostatitis (CP) in Chinese men. A population-based cross-sectional survey was performed, in which 15 000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI) status, therapeutic efficacy and 28 other items. A total of 12 743 men (84.95%) completed the questionnaire, of whom 1 071 (8.4%) were identified as having prostatitis-like symptoms and 517 (4.5%) were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology. Of the CP patients, 372 (65%) underwent long-term routine treatment 12 times per year. Additionally, 217 (72.8%) patients received antibiotic therapy and 215 (79.3%) men showed therapeutic effects. The treatment cost USD 1 151 (8 059 yuan) per person per year on average. Most CP patients received routine treatment, in most cases with antibiotics. Treatment was costly and most CP patients were not satisfied with its effectiveness. Antibacterial treatment might have been effective primarily in patients with bacterial disease.

[Effectiveness and significance of prostatic ischemia in rabbit].

OBJECTIVE: To evaluate the effect of prostatic ischemia in rabbit and approach the significance of ischemia in the development of benign prostatic hyperplasia. METHODS: Male rabbits underwent surgical prostatic ischemia for durations of 1, 2, 4, 8 and 12 weeks and sham-operated rabbits served as controls. The weight of prostate was examined and a histological examination conducted. Ki67 immunohistochemical stain for the generation of prostatic cells and TUNEL test for the apoptosis of prostatic cells were used. RESULTS: In sham-operated rabbits, the mean (SD) weight of prostate were 0.831(0.127) g, the mean (SD) positive Ki67 staining prostatic epithelial cells 2.1(0.8) in 100 prostatic epithelial cells and stromal cells 2.6(1.1) in 100, mean (SD) positive TUNEL test prostatic epithelial cells 2.0(1.0) in 100 and stromal cells 2.5(0.7) in 100. In operated rabbits, the generation of prostatic stromal cells increased and the apoptosis of prostatic stromal cells decreased over 1 - 12 weeks. The generation of prostatic epithelial cells increased and the apoptosis of prostatic epithelial cells decreased over 2 - 12 weeks, but in the first week, there were no significantly difference between operated and sham-operated rabbits in the generation and apoptosis of prostatic epithelial cells. The weight of prostate in operated animals increased at Weeks 4, 8 and 12, were significantly heavier than sham-operated rabbits, 1 week post-op and 2 weeks post-op rabbits, there were no significantly difference between the latter 3 groups. CONCLUSION: Ischemia can induce the gain of prostatic weight by improving the generation and inhibiting the apoptosis of prostatic cells. And the effect of ischemia to prostate is correlated with ischemic time. Ischemia may play an important role in the development of benign prostatic hyperplasia. The first response to ischemia is the change of prostatic stromal cells.

[Transrectal high-intensity focused ultrasound with the Sonablate 500 for the treatment of prostate cancer].

OBJECTIVE: To evaluate the clinical effect of transrectal high-intensity focused ultrasound (HIFU) in the treatment of prostate cancer (PCa). METHODS: A total of 57 PCa patients, 27 localized and 30 advanced, underwent transrectal HIFU with the Sonab- late 500, the localized group treated by transrectal HIFU only, while the advanced group by transrectal HIFU combined with androgen ablation. RESULTS: For the HIFU treatment, the mean operating time, hospital stay and follow-up were 111 mm (ranging from 86 to 153 mm), 3.2 days (ranging from 2 to 18 days) and 18 months (ranging from 6 to 30 months), respectively. The biochemical disease-free rates at 1, 2 and 3 years in the localized group were 86%, 81% and 79%, respectively. While in the advanced group, the serum prostate specific antigen (PSA) was < 4.0 microg/L in 26 cases ( < 0.51 microg/L in 20) and the prostate volume decreased more than 50% in 21 cases after treated for an average of 8 months (ranging from 3 to 24 months). After transrectal HIFU prostate ablation, the prostate volume reduced, serum PSA lowered, Qmax raised and IPSS improved significantly (P < 0.05). No serious complications occurred including severe urethrorectal fistula and incontinence. CONCLUSION: Transrectal HIFU is a safe, effective and minimally invasive therapy for patients with prostate cancer.

[Seminal parameter analysis in noninflammatory chronic prostatitis/chronic pelvic pain syndrome].

OBJECTIVE: To investigate seminal parameters in noninflammatory chronic prostatitis/chronic pelvic pain syndrome (CAP III B). METHODS: A total of 74 consecutive cases of patients who had been diagnosed as CAP III B and 46 cases of controls were included in the study. Severity of symptoms in men with CAP III B was defined according to the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). All of them underwent a 'four glass-test' including leukocyte determination in expressed prostatic secretions (EPS), voided urine after prostatic massage (VB3) and ejaculate semen followed by analysis according to WHO. The analysis included seminal volume, pH, duration of liquefaction, sperm density, vitality, motility(a + b) and morphology. Correlations between the duration or the severity of symptoms and spermiogram results in patients with CAP III B were assessed respectively. RESULTS: The CAP III B group and the control group differed significantly in ejaculate volume, duration of liquefaction and motility, while the remaining parameters did not differ significantly. The duration of chronic pelvic pain showed apparently positive correlationship with liquefaction time, while the symptom duration negatively correlated with sperm motility. The NIH-CPSI score had no significant relationship with seminal volume, duration of liquefaction and sperm motility. CONCLUSION: Our results indicate that CAP III B can have a significant negative impact on sperm volume, liquefaction and motility. Our data also supports the results that the longer the duration of symptoms, the more influences on semen liquefaction and motility might be.

[Effects of antibiotic and anti-inflammatory treatment on serum PSA and free PSA levels in patients with chronic prostatitis IIIA].

OBJECTIVE: To investigate the effect of antibiotics and a nonsteroidal anti-inflammatory agent on the level of total prostate specific antigen (PSA) and free PSA ratio (F-PSAR) in patients with chronic prostatitis IIIA. METHODS: A total of 228 outpatients diagnosed as with chronic prostatitis III A received 4-week antibiotic and anti-inflammatory treatment. The PSA level and F-PSAR were determined before and after the treatment, and the changes analyzed. RESULTS: Significant variations were observed in the median PSA concentrations (3.51 microg/L and 2.75 microg/L) and F-PSAR (0.25% and 0.27%) 4 weeks after the treatment. Sixty-five of the patients (28.5%) presented with serum PSA greater than 4 ng/ml, the mean PSA decreased by 32.9%, from 6.24 microg/L before the treatment to 4.58 microg/L 4 weeks after the treatment (P < 0.05), and the serum PSA was normalized in 18 of the 65 patients (27.7%). The median variation of F-PSAR (0.16% and 0.22%) was greater than that of PSA. The variation indexes obtained 4 weeks after the treatment showed no statistical difference from those observed 8 weeks after the treatment. CONCLUSION: Chronic prostatitis IIIA appears to contribute to increased serum PSA levels in some men. Antibiotic and anti-inflammatory treatment could significantly reduce the PSA level and increase F-PSAR.