Prostate cancer is the most prevalent male urogenital malignancy.Androgen deprivation therapy is the principal method for initial treatment for the patients,but the majority of them will eventually develop progressive disease,a status called castration-resistant prostate carcinoma.Lots of susceptibility genes,tumor suppressor genes and oncogenes,and their variations rdevant to the occurrence and development of prostate cancer have been revealed by the studies of molecular oncology.These findings on the molecular basis of prostate carcinogenesis will further improve the strategies on prevention,diagnosis and clinical management for prostate carcinoma.

Influences of environment on medical equipment lie in many fields and exist independent of human consciousness.In order to lengthen the service life of medical equipment and produce the best possible results,human beings use scientific methods to utilize and change the natural situation.Bad influence from natural conditions to medical equipment is expatiated from such aspects as influence from thunder,rain,snow,electricity,warmth,humidity,mist,magnetism,etc.The management and the protection of the medical equipment under the natural situations are discussed.

Objective To explore the relationship between condition of hypoxia and prognosis in patient with renal clear cell carcinoma (RCCC).Methods The expression of hypoxia-inducible factor-lo( HIF-1 α) protein in cancer tissue of 89 RCCC cases was examined by streptavidin-biotin complex immunohistochemistry.Clinical and pathological data and prognosis of 89 cases were analyzed retrospectively.There were 66 males and 23 females,with an average age of 57 years.The patients were divided into two groups,the chronic pulmonary disease (CPD) group ( 19 cases) and non CPD (NCPD) group (70 cases),with 46cases in clinical stage I,15 cases in stage Ⅱ,26 cases in stage Ⅲ,and 2 cases in stage Ⅳ.The relationship between survival time and clinicopathological variables including the presence of CPD,the positive rate of HIF-1α protein,smoking history and hemoglobin level were evaluated by the Kaplan-Meier method.And the Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time.Results The 89 cases were followed up for a median time of 19 months (6 to 84 months).Twenty cases died,and 69 cases survived.Between the CPD group and NCPD group,clinical stage,hemoglobin level and the degree of expression of HIF-1 α were significantly different (P ＜ 0.05 ).The median survival time was 44 and 71 months in CPD group and NCPD group,respectively,and the difference was significant ( P ＜ 0.05 ).The median survival time was 43 and 70 months in Hb≤ 110 g/L group and Hb ＞ 110 g/L group,respectively,and the difference was significant ( P ＜ 0.05).The stronger the degree of expression of HIF-lα was,the shorter the overall survival was.And the difference was significant ( P ＜0.05 ).Associated with CPD,hemoglobin level,the expression of H1F-1α were independent factors affecting overall survival of the patients (P ＜0.05 ).CPD and HIF-1 α expression were positively related to disease-free survival time,and hemoglobin level was negatively related to disease-free survival time.Conclusions Systemic hypoxia caused by CPD may aggravate the hypoxie state in the organization of the patients with RCCC.The condition of hypoxia and prognosis in patient with RCCC is negatively correlated.

Objective To investigate the effect of aurora kinase inhibitor VX-680 on cell apoptosis and Bcl-2 expressions in human bladder cancer T24 cells. Methods T24 cells were cultured and treated with VX-680 at various concentrations and time points in vitro. VX-680-induced apoptosis of T24 cells was calculated by flow cytometry. The morphological change of treated cells was observed by microscopy;Bcl-2 mRNA and protein expression in T24 cells was detected by RT-PCR and Western blot assay , respectively. Results The apoptosis rate of VX-680-induced T24 cells increased in a dose-and time-dependent manner. The increase of apoptosis rate and decrease of Bcl-2 mRNA and protein expression in VX-680-induced T24 cells were in a dose-dependent manner. Conclusion VX-680 can significantly induce the apoptosis of T24 cells by down-regulating Bcl-2expression in a dose-dependent manner.

Objective To systematic review bladder tumor antigen(BTA) stat in the diagnosis of bladder cancer. Methods MEDLINE, EMBASE, Cochrane Library, CMCC and CNKI were searched for studies about BTA stat in the diagnosis of bladder cancer. The search strategy was made according to the Collaborative Review Group search strategy. Data were extracted by two reviewers using the designed extraction form. The software MetaDiScl. 4 was used to review management and data analysis. Results Seventy-one relevant studies were searched, of which 20 studies were included with 5929 patients involved and 51 studies were excluded. Heterogeneity (except for threshold effect) was found within these studies. A meta-analysis was performed using random effect model. Pooled accuracy indicators like sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio (dOR) were 0. 64(95%CI 0. 62-0. 66), 0. 72(95%CI 0. 70-0. 73) , 2. 33(95% CI 2. 03-2. 68), 0. 48(95%CI 0.42 -0.55) and 5.12(95%CI 3. 88-6. 75), respectively. The sensitivity increased with tumor grades. The sensitivity of primary tumors was higher than the recurrent tumors. Area under curve (AUC) of SROC curve was 0. 7500 and Q* index was 0. 6934. Conclusions The performance of urine BTA stat is moderate in the diagnosis of bladder tumor. It can be an optional non-invasive test and an important adjunct test in preoperative detecting and postoperative monitoring of bladder tumor.

Objective To evaluate the treatment of bilateral hydronephrosis caused by prostate cancer. Methods Twenty-four eases with mean age of 71 years old (ranging from 64--81 years old) were diagnosed with bilateral hydronephrosis caused by prostate cancer and treated with complete androgen deprivation. Surgical castration plus Bicalutamide 50 mg/d was offered to 18 eases and medical castration (Goserelin, 3. 6 mg/month) plus Bicalutamide 50 mg/d was offered to 6 cases. There were 19 cases developed severe lower urinary tract symptoms. Among these 19 cases, 13 cases had accepted Foley catheter and 6 cases accepted suprapubic tube drainage. Results Before and after the treatment, the prostate volume decreased from (70. 3±11.2)ml to (42.6±15.8)ml(P=0. 001). Total PSA decreased from (40. 3±27.2)ng/ml to (9.5±8.3)ng/ml(P=0.02). Of the 24 cases, hydrone phrosis improved in 18 cases, remained unchanged in 3 cases and deteriorated in 3 cases. There were 14 patients developed renal insufficiency. After the treatment, Serum urea nitrogen decreased from (12. 8±6. 5) mmol/L to (6. 3 ± 4. 2) mmol/L (P = 0. 004) and serum ereatinine decreased from (206.8±152.3)μmol/L to (85.3±43.6)μmol/L(P=0.03), respectively. For those 6 cases with hy dronephrosis unchanged or deteriorated during the treatment, 4 cases accepted percutaneous nephros tomy and 2 cases accepted chtaneous ureterostomy. Conclusion The combination of complete androgen deprivation and bladder drainage through Foley catheter or suprapubic tube is an effective option in the treatment of bilateral hydronephrosis caused by prostate cancer.

ObjectiveTo determine whether antibiotic prophylaxis can reduce the risk of postoperative infective complications in men undergoing transrectal prostatic biopsy (TPB) who had sterile preoperative urine.MethodsMEDLINE, EMBASE, Cochrane Collaboration Reviews, Chinese Medical Current Contents (CMCC), and National Knowledge Infrastructure (CNKI) were searched for rando-mized controlled trials that compared the effect of antibiotic prophylaxis with placebo or active controls for men undergoing TPB with preoperative sterile urine. Two reviewers independently extracted the data of patient characteristics and outcomes based on a prospectively developed protocol.ResultsA total of 12 trials (3 placebo controlled, 3 non-treatment controlled, and 6 activly controlled) involving 1 987 patients, met the inclusion criteria. Prophylactic antibiotic use in patients at low risk undergoing TPB significantly decreased bacteriuria and middle degree fever incidence, but could not decrease the incidence of bacteremia. The relative risk for post-TPB bacteriuria, middle degree fever, and bacteremia were 0.32 (95% CI 0.23 to 0.46), 0.37 (95% CI 0.17 to 0.77), and 0.96 (95% CI 0.61 to 1.50), respectively. Effective antibiotic classes included quinolone, co-quinolone and nitroimidazole, and co-trimethoprim and sulfamethoxazole. Treatment protocols of any duration were effective.ConclusionAntibiotic prophylaxis obviously decreases the incidence of bacteriuria and middle degree fever but not bacteremia in men with preoperative sterile urine undergoing TPB. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones and co-quinolone and nitroimidazole. Treatment protocols of any duration are effective with no heterogeneity.

Objective To evaluate the efficacy and safety of CT-guided 125I radioactive seed implantation combined with gemcitabine and Gio (gemcitabine and S-1, GS scheme) chemotherapy in treating advanced pancreatic carcinoma. Methods Sixty-eight patients with inoperable advanced pancreatic carcinoma were randomly divided into two groups. Patients in group A(n=38) were treated with CT-guided 125I radioactive seed implantation combined with GS chemotherapy scheme, while patients in group B (n=30) received GS chemotherapy scheme only. The short-term effect, the median progression-free survival time, the median survival time and adverse reactions of the two groups were determined , and the results were compared between the two groups. Results The objective response rate (ORR), disease control rate (DCR) and clinical benefit rate (CBR) of the group A were 57.9%, 73.7%and 84.2%respectively, while those of group B were 26.7%, 46.7% and 60.0% respectively. The differences between the two groups were statistically significant (P<0.05). In group A the median progression-free survival time and the median survival time were 8.00 months and 11.84 months respectively, which were strikingly higher than those in group B (5.63 months and 10.40 months respectively), the differences between the two groups were statistically significantly (P<0.05). No significant differences in gastrointestinal reactions, blood toxicity, liver toxicity and other adverse reactions existed between the two groups (P>0.05). Conclusion For advanced pancreatic carcinoma, CT-guided 125I radioactive seed implantation combined with GS program is a safe and effective treatment.

Objective To investigate the value of CT-guided 125I particles implantation combined with gemcitabine plus S-1 (GS) regimen in the treatment of locally advanced pancreatic cancer.Methods 42 patients with unresectable local advanced pancreatic cancer were given with CT-guided 125I seed implantation.3-4 cycles of GS regimen was given based on the tolerance of patient s body within 3-7 d after implantation of particles.Review of blood,CA199,chest X-ray,CT scan + enhanced or MRI were performed at 2nd,4th,6th,12th month after surgery.Results 2nd,4th,6th month after surgery,tumor lesions were significantly reduced,ORRs were 59.5 ％ (25/42),66.7 ％ (28/42) and 73.8 ％ (31/42),respectively,DCRs were 83.3 ％ (35/42),78.6 ％ (33/42) and 76.2 ％ (32/42),respectively.No serious adverse reactions were observed,patient could tolerate these reactions.The 6th,12th,24th month survival rates were 100 ％ (42/42),47.6 ％ (20/42) and 11.9 ％ (5/42),respectively,mPFS was 8.27 months and mOS was 12.00 months.Conclusion CT-guided 125I particles implantation combined with GS regimen is convenient,safe,high efficacy in the treatment of locally advanced pancreatic cancer.

Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia (BPH) in elderly patients with metabolic syndrome (MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group (n=45,40 mg/d),atorvastatin group (n=45,20 mg/d) and control group (n=45).BMI,waist circumference,blood pressure,levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL C),high sensitivity C-reactive protein (hs-CRP),interleukin 6 (IL-6),testosterone,estradiol,prostate specific antigen (PSA) and international prognostic scoring system (IPSS) and prostate volume were detected before and 12 months after treatment.Results Compared with control group,patients receiving simvastatin or atorvastatin for 12 months showed that the levels of serum TC,TG,LDL-C,hs-CRP,IL-6,IPSS were decreased(all P＜0.05),the level of serum HDL-C level were increased (all P＜0.05),and prostate volume was reduced(P＜0.05).The decrease in prostate volume was more in patients receiving simvastatin than receiving atorvastatin [(10.86±5.65) ml vs.(5.91 ± 3.03)ml,P＜0.05].Multiple stepwise regression analysis showed that the reduction of prostate volume was positively related to the decreases of serum TC and IL-6 levels,and to the increase of serum HDL-C level.Conclusions Simvastatin and atorvastatin have the efficacy reducing prostate volume and improving obstruction symptoms of lower urinary tract,and slowing the clinical progression of BPH and simvastatin is more effective than atorvastatin on reducing prostate volume.The efficacies of statins might be through lowering cholesterol level and antiinflammatory effect.