Clinical efficacy and safety of flexible ureteroscopic lithotripsy using 365 µm holmium laser for nephrolithiasis: a prospective, randomized, controlled trial.

PURPOSE: To compare the clinical efficacy and safety between the FURL with 365 µm and 200 µm holmium laser for treating nephrolithiasis. MATERIALS AND METHODS: A prospective randomized controlled trial was performed including analysis of data from 200 patients with nephrolithiasis. A total of 180 patients were randomized into two groups according to 1:1 ratio. In the 365 µm holmium laser group, kidney stones were disintegrated into less than 2 mm fragments with a 365 µm holmium laser fiber with the settings of 30-45 W under direct visualization; in the control group, the conventional 200 µm holmium laser was used. Descriptive statistics and logistic regression analyses tested the association among operation time, stone-free rate (SFR) and incidence of complications. RESULTS: Operation time in the FURL with 365 µm laser was significantly shortened and no significance was observed in the complication rate. Stone size and location were identified as two major confounding factors for the operation time and SFR. Moreover, the FURL using 365 µm laser showed less operation time for renal stones with the diameter between 1 and 2 cm, stones located in lower calyx and multiple calculi; stones larger than 2 cm and/or located in lower pole inclined to present better SFR using the FURL with 365 µm laser. CONCLUSIONS: The FURL combined with 365 µm holmium laser is safer and highly efficacious for the management of nephrolithiasis when compared to conventional FURL procedures, especially for those located in lower pole and larger than 2 cm.

Prostatic Arterial Embolization Followed by Holmium Laser Enucleation of the Prostate as a Planned Combined Approach for Extremely Enlarged Benign Prostate Hyperplasia.

OBJECTIVE: This study was aimed at reporting the initial experience with prostatic arterial embolization (PAE) followed by holmium laser enucleation of the prostate (HoLEP) as a planned combined approach for extremely enlarged benign prostate hyperplasia (BPH), and retrospectively estimating the efficacy and safety of this novel technique. PATIENTS AND METHODS: Twenty-four BPH patients who underwent PAE and subsequent HoLEP were included. The PAE procedure was performed under local anesthesia at the supine position with polyvinyl alcohol spherical particles and gelatin sponge particles. HoLEP was performed 3 months after PAE by the "en-bloc" enucleation technique. Clinical data before and 6 months after the procedure were analyzed. RESULTS: PAE and HoLEP were technically successful in all 24 patients. The mean prostate volume was 219 ± 38 mL; the mean total operative time and enucleation time for HoLEP were 117.8 ± 21.9 and 83.5 ± 15.4 min, respectively; and the mean resected prostate weight was 118.3 ± 20.7 g. No transurethral resection of the prostate syndrome was observed during and after HoLEP. The estimated blood loss during HoLEP was 72.1 ± 33.7 mL, and no case required transfusion. International Prostate Symptom Score and post void residual volume decreased significantly (24.1 ± 2.84 vs. 13.5 ± 3.39, p < 0.001; 107.1 ± 40.8 vs. 21.8 ± 16.8, p < 0.001, respectively), maximal flow rate increased significantly (6.25 ± 1.42 vs. 17.63 ± 16.56, p < 0.001), and prostatic specific antigen level also decreased after the procedure (9.29 ± 2.28 vs. 4.99 ± 1.35, p < 0.001). CONCLUSIONS: PAE followed by HoLEP as a planned combined approach can be performed safely, feasibly, and efficiently in patients with extremely enlarged BPH.

An ectopic adreocortical adenoma of the renal sinus: a case report and literature review.

BACKGROUND: Ectopic adrenal tumors are very rare, especially in the renal sinus in adults. An unusual case of ectopic adrenal cortical adenoma in the right renal sinus is reported here. CASE PRESENTATION: This patient was a 37-year-old woman. She was admitted to our hospital for hypertension and bilateral limb weakness. Computed tomography (CT) revealed a mass in right renal sinus. It was initially considered a tumor of the renal pelvis. Further computed tomographic angiography (CTA) showed the mass to be located outside the renal pelvis. After adequate preoperative preparation (blood pressure control and serum potassium supplement), the patient underwent laparoscopic resection of retroperitoneal tumor. During the procedure, a soft tissue tumor 3.4*3.0 cm(2) in size with a golden color was found in the right renal sinus. The final immunohistochemistry examination showed an ectopic adreocortical adenoma. CONCLUSION: Ectopic adrenal tumors are rare in the renal sinus and difficult to diagnose and treat. Large and functional tumors should be treated with complete resection. The procedure is sometimes difficult for tumors located deep in the renal sinus. The decision to perform an open or minimally invasive surgery should be made according to the surgeon's experience.

Co-incubation of human spermatozoa with anti-VDAC antibody reduced sperm motility.

BACKGROUND: Voltage-dependent anion channel (VDAC), a channel protein, exists in the outer mitochondrial membrane of somatic cells and is involved in multiple physiological and pathophysiological processes. Up until now, little has been known about VDAC in male germ cells. In the present study, the relationship between VDAC and human sperm motility was explored. METHODS: Highly motile human spermatozoa were incubated in vitro with anti-VDAC antibody. Total sperm motility, straight line velocity (VSL), curvilinear velocity (VCL), and average path velocity (VAP) were recorded. Intracellular free calcium concentration ([Ca(2+)]i), pH value (pHi), and ATP content were determined. RESULTS: Co-incubation with anti-VDAC antibody reduced VSL, VCL, and VAP of spermatozoa. Co-incubation further reduced [Ca(2+)]i. Anti-VDAC antibody did not significantly alter total sperm motility, pHi and intracellular ATP content. CONCLUSION: The data suggest that co-incubation with anti-VDAC antibody reduces sperm motility through inhibition of Ca(2+) transmembrane flow. In this way, VDAC participates in the modulation of human sperm motility through mediating Ca(2+) transmembrane transport and exchange.

Modified liver mobilization for the treatment of renal cell carcinoma with thrombosis involving the intrahepatic inferior vena cava.

BACKGROUND: We aimed to evaluate the feasibility and clinical significance of using a modified liver-mobilization technique to treat renal cell carcinoma (RCC) combined with intrahepatic inferior vena cava (IVC) thrombosis. METHODS: A total of 11 level III thrombus patients underwent radical nephrectomy with resection of the tumor thrombus from intrahepatic IVC. A father clamp was used in combination with hepatic portal blocking to control the IVC. RESULTS: The intraoperative mortality and postoperative complications were reduced in 11 cases of RCC with intrahepatic IVC thrombosis. The mean blood loss was 800 mL, and mean patient hospital stay was 13 days. Follow-up was conducted for one to four months, with only two cases of recurrence recorded. CONCLUSIONS: The proposed modified liver-mobilization technique could safely and effectively treat RCC and reduce intrahepatic IVC thrombosis.

Downregulation of clusterin expression in human testicular seminoma.

BACKGROUND: Clusterin, a heterodimeric glycoprotein of approximately 80 kDa, exists extensively in human body fluids. The abnormal expression of clusterin is closely related to the occurrence, progression, and prognosis of tumors. Up to now, few studies have focused on clusterin in human testicular cancer. This study describes an extensive exploration of the presence and expression of clusterin in testicular seminoma. METHODS: Tumor tissues and normal testis tissues were collected from 13 patients with testicular seminoma and 16 patients undergoing surgical castration for prostate cancer. Real-time polymerase chain reaction (PCR) was performed to detect the expression difference of clusterin mRNA between testicular seminoma and normal testis. Western blot and immunohistochemical analysis were performed to detect the presence and expression difference of clusterin protein between two groups. RESULTS: Real-time PCR showed the expression of clusterin mRNA in testicular seminoma to be significantly lower than in normal testis (only 13% relative quantification). Western blot analysis indicated marked reductions in the expression of clusterin protein in testicular seminoma. Similar results were observed upon immunohistochemical analysis. CONCLUSION: In testicular seminoma and normal testis, clusterin exists in its heterodimeric secretory isoform. Clusterin expression is significantly lower in testicular seminoma than in normal testis. This is the first comprehensive study of the presence and expression of clusterin in human testicular cancer.

Diagnosis and treatment of cystic renal cell carcinoma.

BACKGROUND: To summarize the diagnosis and treatment of cystic renal cell carcinoma (CRCC). METHODS: A retrospective study was conducted on 13 patients with CRCC at our center from August 2004 to April 2012. The pathologic features, clinical manifestation, imaging characteristics, treatment, and prognosis of CRCC were summarized according to available literature. RESULTS: Of the 13 patients, 11 were diagnosed with CRCC by preoperative B ultrasonography and computed tomography (CT) scan. The remaining two cases were initially misdiagnosed with simple renal cysts. Open radical nephrectomy was performed on two of the 13 cases, laparoscopic radical nephrectomy on seven cases, and open partial nephrectomy on four cases. All diagnoses of CRCC were confirmed by pathological examination. After the operation, all patients had an uneventful recovery. During the follow-up (range, 6-60 months), the serum creatinine concentrations and GFR of the partially removed kidneys remained stable within the normal range. No tumor recurrence or metastasis occurred. CONCLUSIONS: By combining imaging examinations (B ultrasonography and CT scan) with intraoperative pathological examination, most cases of CRCC can be diagnosed and treated promptly and accurately. Nephrectomy is the first-line therapy. Nephron-sparing surgery should be preferred for CRCC. After a successful operation, the prognosis of CRCC is good.

Influence of SLCO1B1 Polymorphisms on the Pharmacokinetics of Mycophenolic Acid in Renal Transplant Recipients.

OBJECTIVE: This study was designed to analyze the correlation between single nucleotide polymorphisms (SNP) related to drug metabolism and pharmacokinetics of mycophenolic acid (MPA) during long-term follow-up. MATERIALS AND METHOD: A retrospective cohort study involving 71 renal transplant recipients was designed. Blood samples were collected to extract total DNAs, followed by target sequencing based on next-generation sequencing technology. The MPA area under the curve (AUC) was calculated according to the formula established in our center. The general linear model and linear regression model were used to analyze the association between SNPs and MPA AUC. RESULTS: A total of 689 SNPs were detected in our study, and 90 tagger SNPs were selected after quality control and linkage disequilibrium analysis. The general linear model analysis showed that 9 SNPs significantly influenced MPA AUC. A forward linear regression was conducted, and the model with the highest identical degree (r2=0.55) included 4 SNPs (SLCO1B1: rs4149036 [P < 0.0001], ABCC2: rs3824610 [P = 0.005], POR: rs4732514 [P = 0.006], ABCC2: rs4148395 [P = 0.007]) and 6 clinical factors (age [P < 0.0001], gender [P < 0.0001], the incident of acute rejection (AR) [P = 0.001], albumin [P < 0.0001], duration after renal transplantation [P = 0.01], lymphocyte numbers [P = 0.026]). The most relevant SNP to MPA AUC in this model was rs4149036. The subgroup analysis showed that rs4149036 had a significant influence on MPA AUC in the older group (P = 0.02), high-albumin group (P = 0.01), male group (P = 0.046), and both within-36-month group (P = 0.029) and after-36-month group (P = 0.041). The systematic review included 4 studies, and 2 of them showed that the mutation in SLCO1B1 resulted in lower MPA AUC, which was contrary to our study. CONCLUSION: A total of 4 SNPs (rs4149036, rs3824610, rs4148395, and rs4732514) were identified to be significantly correlated with MPA AUC. Rs4149036, located in SLCO1B1, was suggested to be the most relevant SNP to MPA AUC, which had a stronger influence on recipients who were elder, male, or with high serum albumin. Furthermore, 6 clinical factors, including age, gender, occurrence of acute rejection, serum albumin, time from kidney transplantation, and blood lymphocyte numbers, were found to affect the concentration of MPA.

A case report of unusual retroperitoneal Castleman's disease in an old woman.

Castleman's disease (CD) is an uncommon disorder of the lymphoid hyperplasia. It is especially rare in the retroperitoneum or perirenal area. We report the case of a 62-year-old woman who had an abdominal mass localized above the right kidney in the region of the right adrenal gland found by computed tomography scan. The patient subsequently underwent an exploratory laparotomy. Pathological examination revealed retroperitoneal localized CD (LCD) of the hyaline vascular type. Diversity of disease sites and nonspecificity of clinical manifestations lead to diagnostic difficulties. Therefore, diagnosis is mainly achieved via lymph node biopsy or pathological examination. Like in the reported case, LCD usually has a good prognosis after complete resection of the lesion.

Identification of the circRNA-miRNA-mRNA Regulatory Network in Bladder Cancer by Bioinformatics Analysis.

In recent years, increasing evidence shows that circular RNA (circRNA) disorder is closely related to tumorigenesis and cancer progression. However, the regulatory functions of most circRNAs in bladder cancer (BCa) remain unclear. This study was aimed at exploring the molecular regulatory mechanism of circRNAs in BCa. We obtained four datasets of circRNA, microRNA (miRNA), and messenger (mRNA) expression profiles from the Gene Expression Omnibus and The Cancer Genome Atlas microarray databases and identified 434, 367, and 4799/4841 differentially expressed circRNAs, miRNAs, and mRNAs, respectively. With these differentially expressed RNAs, we established a circRNA-miRNA-mRNA targeted interaction network. A total of 18, 24, and 51 central circRNAs, miRNAs, and mRNAs were identified, respectively. Among them, the top 10 mRNAs that had high connectivity with other circRNAs and miRNAs were regarded as hub genes. We detected the expression levels of these 10 mRNAs in 16 pairs of BCa tissues and adjacent normal tissues through quantitative real-time polymerase chain reaction. The differentially expressed mRNAs and central mRNAs were enriched in the processes and pathways that are associated with the growth, differentiation, proliferation, and apoptosis of tumor cells. The outstanding genes (CDCA4, GATA6, LATS2, RHOB, ZBTB4, and ZFPM2) also interacted with numerous drugs, indicating their potency as biomarkers and drug targets. The findings of this study provide a deep understanding of the circRNA-related competitive endogenous RNA regulatory mechanism in BCa pathogenesis.

[Clinical value of prostate specific antigen screening in early detection of prostate cancer].

OBJECTIVE: To evaluate the clinical significance of prostate-specific antigen (PSA) screening in early detection of prostate cancer in Chinese men. METHODS: PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were > or = 50 years old. Prostate biopsy was recommended for those with a serum PSA level > or = 4.0 ng/ml. The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period. RESULTS: Of the 8562 asymptomatic men, 719 had PSA levels > or = 4.0 ng/ml and biopsy was performed in 295 of them. Fifty-eight prostate cancers were detected. The biopsy rate was 41.0% and positive detection rate was 19.7%. The overall age distribution in the screening group and the clinical groups was not significantly different (P = 0.176). However, 41.4% (24/58) of the patients in screening group were > 75 years old, and significantly more than that in the clinical group (25.6%, P = 0.0491). The proportion of the patients with PSA levels > or = 20 ng/ml in the screening group was significantly less than that in the patients of the clinical group (44.8% vs. 75.6%, P = 0.0002). Whether in the patients whose age was > 75 years old (P < 0.05) or < or = 75 years old (P = 0.0002), the patients in the screening group had significantly lower Gleason scores < 7 (60.3% vs. 34.1%, P = 0.002), more T1 or T2 tumor (87.9% vs. 26.8%, P < 0.0001) and more chance to receive radical prostatectomy (50.0% vs. 18.3%, P < 0.0001) than the patients in the clinical group did. However, the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups (P > 0.05). CONCLUSION: Prostate-specific antigen (PSA) screening is useful for early detection of prostate cancer in Chinese men aged > or = 50 years. The patients detected by PSA screening usually show a lower PSA level, Gleason scores and early clinical stage disease, and have more chance for radical prostatectomy than the clinically diagnosed patients.

Diagnostic accuracy of the UBC® Rapid Test for bladder cancer: A meta-analysis.

Bladder cancer is one of the most common cancer types globally. The UBC® Rapid Test is a potential novel diagnostic method for bladder cancer, but studies into its accuracy have produced inconsistent results. Thus, the present meta-analysis was conducted in order to determine the overall accuracy of the UBC® Rapid Test in detecting bladder cancer. A comprehensive literature search was conducted using MEDLINE, Embase, Cochrane Library, Web of Science, Chinese WanFang and the China National Knowledge Infrastructure databases for relevant studies. Quality assessment of diagnostic accuracy studies 2 was used to assess the quality of each included study. The diagnostic accuracy of the UBC® Rapid Test was evaluated by pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the curve (AUC). In addition, Deeks' funnel plot was used to evaluate potential publication bias. Eight studies were included in the quantitative meta-analysis. The results were as follows: Sensitivity 0.59 [95% confidence interval (CI), 0.55-0.62], specificity 0.76 (95% CI, 0.72-0.80), PLR 2.55 (95% CI, 1.75-3.70), NLR 0.56 (95% CI, 0.46-0.67), DOR 4.88 (95% CI, 2.82-8.45) and AUC 0.70 (95% CI, 0.67-0.74). According to the present results, the UBC® rapid test is highly accurate in the diagnosis of bladder cancer, however, further studies with better-designed and larger samples are required in order to support the results of the present study.

Direct-acting antiviral agent efficacy and safety in renal transplant recipients with chronic hepatitis C virus infection: A PRISMA-compliant study.

BACKGROUND: The efficacy and safety of direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV)-infected renal transplant recipients (RTRs) has not been determined. METHODS: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and assessed the quality of eligible studies using the Joanna Briggs Institute scale. DAA efficacy and safety were assessed using standard mean difference (SMD) with 95% confidence intervals (95%CIs). RESULTS: Six studies (360 RTRs) were included. Two hundred thirty six RTRs (98.3%) achieved sustained virological response within 12 weeks; HCV infection was cleared in 239 RTRs after 24-week treatment. Liver function differed significantly pre- and posttreatment (alanine aminotransferase, SMD: 0.96, 95%CIs: 0.65, 1.26; aspartate aminotransferase, SMD: 0.89, 95%CIs: 0.60, 1.18); allograft function pre- and posttreatment was not statistically different (serum creatinine, SMD: -0.13, 95%CIs: -0.38, 0.12; estimated glomerular filtration rate, SMD: 0.20, 95%CIs: -0.11, 0.51). General symptoms (fatigue nausea dizziness or headache) were the most common adverse events (AEs) (39.3%). Severe AEs, that is, anemia, portal vein thrombosis, and streptococcus bacteraemia and pneumonia, were present in 1.1%, 0.6%, and 1.1% of RTRs, respectively. CONCLUSION: Our findings suggest that DAAs are highly efficacious and safe for treating HCV-infected RTRs and without significant AE.

Extraperitoneal Laparoscopic Radical Nephroureterectomy and Lymph Node Dissection in Modified Supine Position.

OBJECTIVE: To explore the feasibility of extraperitoneal laparoscopic radical nephroureterectomy (EL-RNU) and lymph node dissection in a modified supine position for managing urothelial carcinomas in the renal pelvis or in the upper two-thirds of the ureter. PATIENTS AND METHODS: Consecutively from January 2014 to October 2015, 15 patients with high-risk urothelial carcinoma in the renal pelvis or in the upper two-thirds of the ureter underwent EL-RNU and extraperitoneal laparoscopic lymph node dissection (EL-LND). Clinical and pathologic data, histologic nodal status, perioperative complications, and recurrence data were collected. RESULTS: All of the 15 patients were treated with EL-RNU and EL-LND in a modified supine position, and none was converted to open surgery. The mean operation time was 178 ± 18 minutes. The mean estimated blood loss was 140 ± 40 mL. The mean postoperative intestinal function recovery time was 2 days. The mean postoperative hospitalization was 7 ± 1 days. Pathologic studies revealed positive lymph nodes in 3 patients (20%). The mean number of harvested lymph nodes was 12 ± 3. No local recurrence and distant metastasis were found after a median follow-up of 14.4 months (7-23 months). CONCLUSION: EL-RNU and EL-LND in the modified supine position are mini-invasive and feasible for patients with urothelial carcinoma in the renal pelvis or in the upper two-thirds of the ureter. Good exposure and dissection of the abdominal aorta and inferior vena cava and the integrity of the peritoneum are key to the operational success of this approach.

RTA-408 Protects Kidney from Ischemia-Reperfusion Injury in Mice via Activating Nrf2 and Downstream GSH Biosynthesis Gene.

Acute kidney injury (AKI) induced by ischemia-reperfusion is a critical conundrum in many clinical settings. Here, this study aimed to determine whether and how RTA-408, a novel oleanane triterpenoid, could confer protection against renal ischemia-reperfusion injury (IRI) in male mice. Mice treated with RTA-408 undergoing unilateral ischemia followed by contralateral nephrectomy had improved renal function and histological outcome, as well as decreased apoptosis, ROS production, and oxidative injury marker compared with vehicle-treated mice. Also, we had found that RTA-408 could strengthen the total antioxidant capacity by increasing Nrf2 nuclear translocation and subsequently increased Nrf2 downstream GSH-related antioxidant gene expression and activity. In vitro study demonstrated that GSH biosynthesis enzyme GCLc could be an important target of RTA-408. Furthermore, Nrf2-deficient mice treated with RTA-408 had no significant improvement in renal function, histology, ROS production, and GSH-related gene expression. Thus, by upregulating Nrf2 and its downstream antioxidant genes, RTA-408 presents a novel and potential approach to renal IRI prevention and therapy.

[Detection of Y chromosome microdeletions in patients with severe oligozoospermia and azoospermia].

OBJECTIVE: To explore the clinical significance of azoospermia factor (AZF) region deletion. METHODS: Detection of the Y-link sequence tagged sites in AZF region was conducted by means of 2 multiplex polymerase chain reactions among 80 patients with severe oligozoospermia and 63 patients with azoospermia, totally 143. RESULTS: Twenty-one cases of microdeletion were found among the 143 infertile patients with a prevalence of 14.7%. PCR analysis showed that deletion of the portions of Yq in 12 of the 62 idiopathic infertility patients, 3 being with severe oligozoospermia and 9 with azoospermia, and in 9 out of the 81 patients with non-idiopathic infertility. PCR analysis of 40 normal fertile men did not detect any abnormality. The results of the microdeletion showed that 1 patient had a microdeletion in the AZFa region with sY84 and sY86 (1/21, 4.8%), 2 patients presented a large deletion involving sY127 and sY143 from AZFb, and sY254 and sY255 from AZFc (1/21, 9.5%). Two patients had the deletions located in AZFb region (2/21, 9.5%), and 16 patients had a deletion on the AZFc region involving the DAZ (deleted in azoospermia) gene (16/21, 76.2%) Among the 21 infertile men 4 showed a testicular cytologic picture of maturation arrest, 6 patients had severe hypospermatogenesis, and 11 had Sertoli cell-only syndrome. There were not significant differences in location and extent of deletions between the patients with idiopathic infertility and those with non-idiopathic infertility. CONCLUSION: It is recommended to carry out screening of microdeletion of Y chromosome among the patients with idiopathic and non-idiopathic infertility, especially the candidates for intracytoplasmic sperm injection.

The Potential Role of IL-33 in Renal Transplant Recipients with Chronic Allograft Dysfunction.

BACKGROUND Chronic allograft dysfunction (CAD) is the major factor endangering the long-term allograft survival in kidney transplantation. The mechanisms of CAD remain unclear. MATERIAL AND METHODS A total of 64 renal transplant recipients were enrolled in our study and divided into a stable group and CAD group according to their allograft function. A group of 32 normal controls (healthy volunteers) were also included. An ELISA was used to detect serum interleukin-33 (IL-33), IL-2, IL-4, IL-10, IL-17, and interferon-gamma (IFN-γ). Flow cytometry was performed to measure the percentage of CD3+CD4+ and CD3+CD8+ T cells in the peripheral blood from the three patient groups. The correlations among the study indexes were also analyzed using Pearson's method. RESULTS Levels of serum IL-33 was significantly higher in CAD patients than recipients with stable allograft function. Moreover, serum IL-2, IL-4, and IL-10 also increased statistically in patients with CAD. In addition, significant differences were observed in CD4+ T cells and the ratio of CD4+ and CD8+ T cells between CAD and stable patients. CONCLUSIONS Serum upregulated IL-33 could contribute to the pathogenesis of CAD in kidney transplant recipients.

[The diagnosis and treatment of acute prostatitis: report of 35 cases].

OBJECTIVE: To study the diagnosis and treatment of acute prostatitis. METHODS: The data of 35 cases of acute prostatitis who were admitted from January 2001 to March 2004 were reviewed. The main clinical manifestations were chills, fever, frequency, urgency and dysuria. All patients were treated with antibiotics and supportive measures. Two patients underwent surgical drainage for prostate abscess. Three patients were indwelled catheter for acute urinary retention. RESULTS: All patients'temperatures returned to normal within 3 to 5 days. Blood and urine routine tests, urine culture and transurethral ultrasound examination results returned to normal 2 weeks later. Q maximal urinary flow rate improved in patients with dysuria. CONCLUSIONS: After diagnosis of acute prostatitis, full-dose of sensitive antibiotics should be given to all patients for some time as early as possible. At the same time, supportive therapy may be important to some patients. Surgical drainage should be used for patients with prostate abscess.

[High intensity focused ultrasound combined with endocrine therapy in treating prostate cancer].

OBJECTIVE: To evaluate the clinical efficacy of high intensity focused ultrasound (HIFU) combined with endocrine therapy in the treatment of patients with prostate cancer. METHODS: Twenty patients with prostate cancer were treated with extracorporeal HIFU device( model FEP-BY01 ) and androgen ablation, of whom 15 received orchiectomy and 5 LHRH-a. Fourteen patients of the total number were given flutamide in addition to castration. RESULTS: The mean follow-up was 13.5 months (ranging 6 to approximately 30). Before and after the treatment, the prostate volume, prostate specific antigen (PSA), international prostate symptom score (IPSS) and maximal flow rate (Qmax) of the patients were (36.4 +/- 16.2) ml and (20.6 +/- 11.8) ml (P < 0.05), (32.2 +/- 10.4) ng/ml and (2.4 +/- 0.8) ng/ml (P < 0.01), 20. 5 +/- 6.5 and 13.6 +/- 7.5 (P < 0.05), (10.6 +/- 6.3) ml/s and (14.2 +/- 4.6) ml/s (P < 0.05), respectively. Mild hematuria and pain were noted in 5 and 8 patients respectively, and 1 patient underwent internal urethrotomy with a cold knife because of urethral stricture. er, with minimal complications. CONCLUSION: HIFU combined with endocrine therapy is effective in the treatment of prostate canc-

[Prostate cancer after prostatectomy for benign prostatic hyperplasia].

OBJECTIVE: To study the diagnosis and treatment of prostate cancer after prostatectomy for benign prostatic hyperplasia (BPH). METHODS: Twelve cases of prostate cancer after prostatectomy for benign prostatic hyperplasia were reviewed and studied. The mean intervals between prostatectomy for BPH and the diagnosis of prostate cancer was 10 months to 14 years, 5.6 years on average. The main symptoms were dysuria, hematuria and pain. Serum prostate specific antigen (PSA) was elevated in 11 cases. Digital rectal examination (DRE) was abnormal in 8 cases. Three cases were in clinical stage B, 3 in stage C and 6 in stage D. Ten cases received combined androgen blockade therapy. Monotherapy with surgical castration was given to 2 cases. Three patients with urinary tract obstruction received additional treatment of TURP. RESULTS: During the 4 months to 8 years follow-up, 3 patients died, 6 remained stable and 2 deteriorated. CONCLUSION: Surgery for BPH could not prevent the development of prostate cancer. PSA and DRE were the main methods for the diagnosis of this prostate cancer.