Objective To investigate the efficacy and safety of salvage radical prostatectomy for men with recurrent prostate cancer (PCa) after radiotherapy.Method Ten pathologically confirmed PCa patients who relapsed after radiotherapy from Jan.2008 to Dec.2013 were retrospectively reviewed.The mean age was (64.7 ±3.7) years,with range from 56 to 72 year.Local recurrence was confirmed by retransrectal biopsy.All patients had increased PSA and/or lower urinary tract symptoms.Pelvis MRI and bone scan were performed to detect lymph node involvement and bone metastasis.All patients received radical prostatectomy with standard pelvic lymphadenectomy.Seven received open surgery (open group),three patients underwent laparoscopic surgery (laparoscopic group).Postoperative complication and PSA level were compared.Results Salvage radical prostatectomies with lymph node dissection were performed in all patients without major complications.The mean operation time of open group versus laparoscopic group were (225 ± 57)min vs.(210 ± 80)min and the mean blood loss was (275 ± 49)ml vs.(260 ± 93) ml,both of which were with no significant difference (P ＞ 0.05).The average length of stay was (14 ± 4) vs.(8 ± 2) day with significant difference (P ＜ 0.05).No rectal injury was observed.Two (20％) patients were with positive margin,and three (30％) patients had postoperative complications,including one case of deep vein thrombosis,one case of incision infection and and one case of anastomotic leakage.After a mean of 20.6 months'follow-up,two patients (25％) reached biochemical recurrence.Conclusion Both open and laparoscopic salvage radical prostatectomies after radiotherapy failure were feasible.Largescaled prospective studies were needed to verify the long-term effectiveness.

Objective To evaluate the anestheisa efficacy of periprostatic nerve block in transrectal ultrasound (TRUS) guided biopsy of the prostate.Methods A total of 223 patients received prostate biopsy in our hospital from July 2010 to December 2013 were retrospectively studied,and were divided randomly into two groups.One hundred and sixteen cases in nerve block group accepted local anesthesia of prostate capsule and periprostatic nerve block after local perineal skin anesthetia,and 107 cases in local anesthesia group only accepted local perineal skin anesthetia and local anesthesia of prostate capsule.Patients in the 2 groups underwent prostate biopsy successfully.The visual analogue scale (VAS) and complications were recorded.Results The age,serum PSA level before biopsy,prostate volume and the number of puncture needles had no significant differences between the 2 groups (P＞0.05).The average VAS score was 2.3± 1.1,and 4.9±2.3 in the 2 groups.The VAS had significant difference between the 2 groups (P＜0.05).The incidences of hematuria,hemospermia and urinary retention were 37.1％ (43/116),3.4％ (4/116) and 1.7％ (2/116) in nerve block group,and 39.3％ (42/107),4.7％ (5/107) and 1.9％ (2/107) in local anesthesia group.The difference was not significant (P＞0.05).Conclusion Periprostatic nerve block for TRUS guided biopsy of the prostate could be safe with good analgesic effect.

Objective To explore the safty and feasibility of transrectal ultrasound guided transperineal seminal vesicle biopsy in the evaluation of clinical staging of prostate cancer.Methods Retrospectively study 57 suspected prostate cancer patients with seminal abnormality during 2010.7-2015.1,age ranged from 50 to 78 years,average 65 ±7 years,serum total prostate specific antigen (tPSA) 3.2-131.1 μg/L, average (23.7 ± 11.3) μg/L.Twenty-two cases had palpable prostate nodules through rectal examination.All the 57 patients underwent ultrasound and template guided transperineal prostate and seminal vesicle puncture biopsies.Results Forty-four cases out of 57 found prostate cancer cells in biopsies, and 32 cases had seminal vesicle invasion (positive group) while the other 12 were negative.Twenty cases had been performed prostatectomy in the positive group and their post-operative pathological examination all showed prostate cancer with seminal vesicle invasion.Eleven cases in the negative group had been performed prostatectomy ,and 2 cases showed seminal vesicle invasion.The clinical stages of all cases in the positive group were considered as T3b both pre-operatively and post-operatively.In the negative group however, 11 cases were considered as T2 stage pre-operatively,while 2 cases were increased to T3b stage post-operatively.The sensitivity of puncturing seminal vesicle was 91％ (20/22) ,specificity was 100.0％ (9/9).Positive predictive value was 100.0％ (20/20),while negative predictive value was 82％ (9/11).All the 57 cases did not present fever after puncture biopsies, while 23 cases presented hematuria (40％) ,20 cases presented hemospermia (35％) and 1 case presented urinary retention (2％).Conclusions Transrectal ultrasound-guided transperinealseminal vesicle puncture is safe and reliable, it helps to improve the accuracy of pre-operative staging.

OBJECTIVE To establish a method for determining the content of 11 antioxidants and their degradation products in recombinant Exendin-4-FC fusion protein injection by HPLC. METHODS The protein was precipitated with saturated ammonium sulfate. After centrifugation, the supernatant was transferred to a C18 solid phase extraction cartridge activated by methanol. Then the cartridge was eluted with 4 mL of methanol and 5 mL of ethyl acetate respectively, and the eluent was diluted with methanol-ethyl acetate(2∶3) mixed solvent and passed through a 0.22 µm PTFE hydrophobic filter. It was analyzed by HPLC and quantified by external standard method. Chromatographic conditions: Kinetex® XB-C18 100Å (100 mm×4.6 mm, 2.6 µm)column, the detection wavelength was 230 nm, the column oven was 30 ℃, the injection volume was 5 µL and the flow rate was 0.4 mL·min–1, mobile phase was 0.1% formic acid-methanol(A)-0.1% formic acid aqueous solution(B), the running time was 45 min. RESULTS The 11 target substances showed a good linear relationship in the range of 2.5−35 μg·mL–1 with R2 ≥0.99. At three different concentration(25, 10, 5 μg·mL–1) of spiked samples, the average recovery rates of 11 antioxidants ranged from 88.1% to 106.5%, with RSDs in the range of 0.10%–9.05%. The RSDs of 6 repeatable samples was 2.01%–4.77%, which of 12 intermediate precision samples was 2.58%–9.75%. The positive/inverted samples of three batches of recombinant Exendin-4-FC fusion protein injection were detected at 0 month, 3 months and 6 months(25 ℃), and the results showed that there was no antioxidant and its degradation leaching in all batches of samples at different detection points. CONCLUSION The method has good specificity, high accuracy and precision, good solution stability, high durability and can be used for the content detection of antioxidants in drugs.

This study sought to clone Chinese Banna minipig inbred-line (BMI) alpha1,3-galactosyltransferase (alpha1,3-GT) gene and construct its recombinant eukaryotic expression vector. Total RNA was isolated from BMI liver. Full length cDNA of alpha1,3-GT gene was amplified by RT-PCR and cloned into pMD18-T vector to sequence. Subsequently, alpha1,3-GT gene was inserted into pEGFP-N1 to construct eukaryotic expression vector pEGFP-N1-GT. Then the reconstructed plasmid pEGFP-N1-GT was transiently transfected into human lung cancer cell line A549. The expression of alpha1,3-GT mRNA in transfected cells was detected by RT-PCR. FITC-BS-IB4 lectin was used in the direct immunofluorescence method, which was performed to observe the alpha-Gal synthesis function of BMI alpha1,3-GT in transfected cells. The results showed that full length of BMI alpha1,3-GT cDNA was 1116 bp. BMI alpha1,3-GT cDNA sequence was highly homogenous with those of mouse and bovine, and was exactly the same as the complete sequence of those of swine, pEGFP-N1-GT was confirmed by enzyme digestion and PCR. The expression of alpha1,3-GT mRNA was detected in A549 cells transfected by pEGFP-N1-GT. The expression of alpha-Gal was observed on the membrane of A549 cells transfected by pEGFP-N1-GT. Successful cloning of BMI alpha1,3-GT cDNA and construction of its eukaryotic expression vector have established a foundation for further research and application of BMI alpha1,3-GT in the fields of xenotransplantation and immunological therapy of cancer.
Animals ; Animals, Inbred Strains ; Base Sequence ; China ; Cloning, Molecular ; Galactosyltransferases ; genetics ; metabolism ; Genetic Vectors ; genetics ; Molecular Sequence Data ; Recombinant Proteins ; genetics ; metabolism ; Sequence Analysis, DNA ; Swine ; Swine, Miniature ; genetics ; Transfection

Objective To investigate the current status of prevalence, prevention and management of chronic obstructive pulmonary disease(COPD) in rural area in China. Methods A cross-sectional survey of COPD was conducted in Beijing city, Shanghai city, Guangdong province, Liaoning province,Tianjin city, Chongqing province and Shanxi province. A population-based cluster sample was randomly selected from each rural area. In the selected community,all residents at least 40 years old were recruited,and interviewed with a modified standardized questionnaire from the international burden of obstructive lung diseases (BOLD) study. All participants were tested with spirometry. Those with airflow limitation were performed on post-bronchedilator spirometry. The post-bronchedilator a ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 70% was defined as the diagnostic criteria of COPD. Results (1) Data of 9434 participants was valid for analysis, with a valid response rate of 83. 6% ;the prevalence of COPD in rural was 8. 8% (830/9434), 12. 8% in male and 5.4% in female. (2)The percentage of smoking and the exposure to biomass smoke in rural was 43. 0% (4059/9434) and 83. 1% (7835/9434) respectively; cigarettes cessation rate was 17.5% ; only 12. 4% ( 502/4059 ) of smokers had received advice to quit smoking. (3) Among COPD patients, only 30. 0% (249/830) had ever been diagnosed as COPD, bronchitis, emphysema, or asthma, 2. 4% (20/830) had ever received spirometric tests, and 74. 5% were current smokers; only 7.9% (50/634)COPD patients in stage two or over had received regular drug treatment. Conclusion There was high prevalence and poor prevention and management for COPD in rural areas. Therefore, an enforced prevention and management for COPD are urgent.

Objective To evaluate the erectile function following transperineal template-guided prostate saturation biopsy (TFPSB).Methods From June 2013 to October 2015,patients underwent prostate biopsy.All patients were indicated for biopsy according to the criteria of "Guidance on diagnosis and treatment of urology in China".Exclusion criteria include medical history of PCa,severe urinary tract infection,severe cardiovascular and cerebrovascular diseases or abnormal blood coagulation.All patients were divided into observation group (TT'PSB) or control group (traditional trans-perineal template-guided prostate biopsy,TTPB) according to patients' condition,pubic anatomy,PSA abnormality,rectal examination,imaging examination and pain tolerance,etc.Patients were evaluated for pre-biopsy erectile function with the international index of erectile function (IIEF-5).All pathology confirmed prostate cancer patients were excluded.Concomitant systemic diseases and medications that would interfere with erectile function were recorded.Patients who withdrew from the trial or used the drugs such 5-phosphodiesterase inhibitors for sexual activity improvement were excluded.Ninety-seven patients in observation group and 84 patients in control group underwent further evaluation with the IIEF-5 questionnaire at 1,3 and 6 months post-biopsy.Results The average age of the observation group and the control group were (64.1 ± 7.9) years and (61.8 ±8.9) years,PSA were (7.2 ± 3.7) ng/ml and (6.7 ± 3.4) ng/ml,prostate volume were (47.8 ±21.5)ml and (49.2 ±22.2) ml,and the BMI were (21.4 ±3.1) kg/m2 and (20.6 ±3.4) kg/m2,respectively.There was no significant difference between the two groups (P ＞ 0.05) in term of above patients' characteristics.The pre-biopsy IIEF-5 score of the observation group and the control group were 19.1 ±4.5 and 19.7 ±4.3,which had no significant difference (t =-0.890,P=0.375).One month after biopsy,the IIEF-5 of two groups were 17.4 ±4.8 and 18.2 ±4.5 respectively and both group had statistically significant difference when compared with pre-biopsy (both P ＜ 0.05),however,there was no statistical significance at 3 and 6 months after biopsy.Besides,no significant difference of the IIEF-5 score was detected between two groups in 1,3 and 6 months.Conclusions Although TTPSB may resulted in temporary (1 month) post-biopsy erection dysfunction,the erectile function recovered to pre-biopsy level at 3-6 months post-biopsy.TTPSB did not increase the risk of ED compared with traditional TTPB.

Objective:To analyze the risk of missed diagnosis in patients with PI-RADS score>3 and negative prostate initial biopsy and to explore its risk factors.Methods:The clinical data of 268 patients with negative prostate biopsy in Northern Jiangsu People's Hospital from May 2013 to December 2018 were retrospectively analyzed. The patients were divided into observation group (PI-RADS score>3) and control group (PI-RADS score≤ 3) according to different PI-RADS scores. There were insignificant differences in age [(67.4(60.0, 74.0)years and 65.6(66.5, 72.0)years], prostate volume of initial biopsy [62.4(40.0, 72.0)ml and 60.8(38.0, 77.0)ml], biopsy cores [ 20.6(18.0, 22.0)cores and 20.4(18.0, 22.0)cores] between the observation group (n=124) and the control group(n=144)(all P>0.05). But there were significant differences in PSA [17.5(6.5, 23.0)ng/ml and 11.5(6.3, 12.0)ng/ml], PSAD[0.316(0.128, 0.363)ng/ml 2 and 0.211(0.106, 0.256)ng/ml 2], prostate inflammation of the initial biopsy [70 (56.5%) and 32 (22.2%)] between the observation group and the control group(all P<0.05). According to the follow-up results after the initial biopsy, the two groups of repeated biopsy were compared.Furthermore, Logistic regression was used to conduct univariate and multivariate analysis to explore the risk factors of patients with PI-RADS>3 for positive repeated biopsy. At the same time, the receiver operating characteristic curve (ROC curve) was used to analyze the accuracy of the risk factors. Results:There were significant differences in repeated biopsy rate [ 27.4%(34/124)and 14.6%(21/144)], CsPCa detection rate[ 41.4%(14/34) and 4.8%(1/21)]between the observation group and the control group(all P<0.05). The positive rate of repeated biopsy in the observation group (41.1%) was higher than that in the control group (23.8%), but there was no statistical difference ( P=0.248). The risk of positive repeated biopsies in the observation group was 2.24 times than that in the control group. Univariate analysis found repeated biopsy PSA ( P =0.02, OR=1.438, 95% CI 1.161-1.896), PSA ratio (repeated biopsy PSA/initial biopsy PSA) ( P=0.011, OR=10.087, 95% CI 1.714-59.36) were risk factors for positive of repeated biopsy in patients with PI-RADS score >3. Multivariate analysis also found that repeated biopsy PSA ( P=0.017, OR=1.15, 95% CI 1.076-2.123), PSA ratio ( P=0.032, OR=10.2, 95% CI 0.883-116.168) were risk factors for positive repeated biopsy. ROC curve analysis, the accuracy of repeated biopsy PSA (AUC=0.971, P<0.001, 95% CI 0.926-1.000), PSA ratio (AUC=0.839, P=0.001, 95% CI0.707-0.971) to predict positive of repeated biopsy were high. The cut-off values were 21.3 ng/ml and 1.4, respectively. The accuracy was higher when combines repeated biopsy PSA with PSA ratio (AUC=0.993, P<0.001, 95% CI 0.974-1.000). Conclusions:Patients with negative PI-RADS score > 3 have a higher risk of missed diagnosis of CsPCa than those with PI-RADS score≤3. When PSA>21.3 ng/ml and PSA ratio>1.4 during follow-up, the possibility of missed diagnosis in the initial biopsy is high.

Objective: To evaluate the effect of multimodal analgesia using periprostatic nerve block anesthesia (PNB) combined with flurbiprofen in patients undergoing transperineal template-guided prostate biopsy (TTPB). Methods: Totally 166 patients (aged (68.2±9.1) years, range: 47 to 81 years) who received TTPB from October 2017 to June 2018 at Department of Urology, Northern Jiangsu People′s Hospital Affiliated to Yangzhou University were enrolled prospectively. All the patients were randomly divided into 2 groups. The observation group (n=79) was given flurbiprofen axetil 1 mg/kg intravenously for half an hour before operation and lidocaine was used for PNB before the biopsy. The control group (n=87) was given normal saline combined with PNB. A visual analog scale (VAS) and visual numeric scale (VNS) were used to assess the patients′ pain and quantify their satisfaction at two time points: VAS-1 and VNS-1: during biopsy procedure, VAS-2 and VNS-2: 30 min after the procedure. The date were compared by t test, χ² test, Fisher exact test and two-way repeated measures anova analysis between the 2 groups. Results: The age, total prostate volume, serum prostate-specific antigen and the number of cores were comparable among the 2 groups (P>0.05). The VAS-1 scores of the control group and the observation group were 2.8±1.7, 1.9±1.2, respectively, and the VNS-1 were 3.1±0.7, 3.4±0.3, respectively. The VAS-1 were significantly lower in observation group than in control group (F=3.904, P=0.000). Conversely, the VNS-1 were higher in observation group (F=3.526, P=0.000). At 30-minute postoperative, the VAS-2 and VNS-2 were 0.7±0.4 and 3.7±0.2 in the control group, respectively. The VAS-2 and VNS-2 were 0.6±0.5 and 3.8±0.1 in the observation group, respectively. There were no significant differences in the pain scores or the satisfaction scores between the 2 groups (F=1.429, 2.825; P=0.136, 0.083). The incidence of overall complications was 26.4% (23/87) in the control group and 25.3% (20/79) in the observation group, with no statistical difference between the 2 groups (χ²=0.027, P=0.869). And the complications had no statistically significant difference among the 2 groups including hematuria, urinary retention, infection, hematospermia, vascular and neurological reactions, nausea, vomiting, dizziness, headache, and respiratory depression (P>0.05). Conclusion The multimodal analgesia induced by PNB and flurbiprofen could effectively relieve the pain for patients who received TTPB.

Objective:To investigate the effect of local anesthesia in patients with a PI-RADS score of 5 and ECOG score ≥2 for prostate puncture.Methods:Retrospective analysis of case data of 33 patients admitted to the Subei People's Hospital for prostate puncture from April 2020 to April 2022. Age (82.5±3.6) years. There were 18 cases with hypertensive disease, 8 cases with diabetes mellitus, and 6 cases with both diabetes mellitus and hypertensive disease. Body mass index (25.2±3.5) kg/m 2. prostate-specific antigen (PSA)(131.5±69.7) ng/ml. prostate volume (38.5±21.4) ml. all patients had a PI-RADS score of 5 on multiparametric magnetic resonance (mpMRI) and an Eastern Cooperative Oncology Group (ECOG) score ≥2. All 33 cases in this group underwent trans-perineal targeted prostate puncture using local anesthesia at the tip of the prostate. The visual analog score (VAS) and visual numeric score (VNS) were applied by the same surgeon to assess the patient's pain level and satisfaction at the time of puncture (VAS-1 and VNS-1) and 30 min after puncture (VAS-2 and VNS-2), and to record the duration of the procedure and the occurrence of postoperative complications. Results:In this group of 33 cases, the VAS-1 score was (1.9±0.3) and the VAS-2 score was (0.1±0.2); the VNS-1 score was (2.9±0.2) and the VNS-2 score was (3.9±0.1). Postoperative pathological results indicated that one of the 33 patients had a negative puncture result (pathology report indicating interstitial inflammation), while the rest of the patients had a positive puncture pathology report (puncture pathology report indicating prostate cancer), with a positive rate of 97%. One case of postoperative carnal haematuria occurred, which gradually improved after the patient was advised to drink water and take alpha-blockers. No perineal hematoma occurred, and all patients did not suffer complications such as urinary tract infection, urinary retention, azoospermia, vagal reaction, and infectious shock.Conclusion:In patients with a PI-RADS score of 5 and ECOG score ≥2, the use of single-hole local anesthesia for performing trans-perineal targeted puncture biopsy has the advantages of good paroxysmal pain and high safety.