Objective To evaluate the effects of exog en ous adenovirus-mediated gene transfer of human tumor suppressor gene PTEN (phos phatase and tensin homology deleted on chromosome 10) on cell prolifiration and invasive ability of human prostate cancer cell lines LNCaP and DU-145. Methods mRNA and protein expressions of PTEN in human prostate c ancer LNCaP and DU-145 cells infected with AdPTEN were detected by RT-PCR and Western blot.MTT assay was used to assess the effect of PTEN on cell proliferati on.The change of cell cycle and apoptosis were measured by flow cytometry and th e invasion abilities in vitro detected by Boyden chamber.Ad-X-TRE-?gal v irus was used as control. Results RT-PCR and Western bl ot analysis showed that LNCaP and DU-145 cells express high level of PTEN after its infected with Ad-PTEN. The growth of LNCaP and DU-145 cells treated with Ad-PTEN was significantly more inhibited than that with a control adenovirus.Ad -PTEN-infected LNCaP and DU-145 cells showed a significant increase in G 0～ G 1 phase and PTEN-induced apoptosis in comparison with the control.The invasiv e ability of prostate cancer cell lines was inhibited by expression of PTEN effe ctively. Conclusions Adenoviral-mediated expression of human tumor suppressor gene PTEN has inhibitory affect on proliferation and inva sive ability of human prostate cancer cell lines LNCaP and DU-145.This study pr ovides an idea for the further development of Ad-PTEN as a potential therapeuti c vector in the gene therapy of prostate cancer.

Objective　To evaluate the status of urological laparoendoscopic single-site surgery (LESS) technique in China.　Methods　We had conducted a systematic review of literatures of urological laparoendoscopic single-site surgery published from Chinese institutions using WanFang,CNKI,VIP,CBM,GoogleScholar and MEDLINE databases.All relevant articles were selected with consensus and analyzed according to the inclusion and exclusion criteria.　Results　Overall,205 articles from 66 different centers all over China published between January 2009 and June 2012 were included in the analysis. Of which,there were 26 articles of science citation index papers and 179 articles from Chinese academic journals.The included literature was mainly composed of case series reports ( 133 articles,64.9％ ),comparison studies (13 articles,6.3％ ),reviews or comments (20 papers,9.8％ ),nursing related papers (28 pieces,13.7％ ),animal surgery studies (6 articles,2.9％ ),and training (5 articles,2.4％ ).A total of 1790 clinical cases were reported during the study period,56.9％ of these were procedures done in the upper urinary tract,only 5.8％ were in the lower urinary tract,and 37.3％ were genital or other procedures.Procedures of tumor-related and reconstruction required accounted for 18.8％ and 18.7％,respectively.Pure single-port technique was applied on 58.3％ of cases.In cases of a single-port platform used,45.6％ used the commercially available devices and 54.4％ used homemade devices.Transperitoneal accesses were adopted in 59.5％ of cases and the other 40.5％ were performed through extraperitoneal approaches.The umbilicus was used as the site of access in 58.5％ of cases.A total of 25 indications were reported,including adrenalectomy,nephrectomy and ureterolithotomy,etc. in the upper urinary tract,radical cystectomy,radical prostatectomy and transvesical enucleation of the prostate,etc.in the lower urinary tract,and varicocelectomy,orchidopexy and others. The three most often done procedures were varicocelectomy (601　cases,33.6％ ),renal cyst decortication (408 cases,22.8％ ) and adrenalectomy ( 179 cases,10.0％ ).The overall conversion rate was 5.5％,and complications were encountered in 3.4％ of cases.　Conclusions Laparoendoscopic single-site surgery has been widely adopted by Chinese urologists and largely covered the spectrum of conventional urologic laparoscopic procedures,with most of these being non-reconstructive operations for the treatment of benign diseases.In large,we are still under the initial stage of LESS application in urology.And more work on creative innovation and well-designed studies are needed to further evaluate its role in the urological minimally invasive surgery.

Laparoscopic partial nephrectomy is gaining more and more popularity in treating patients with early renal carcinoma in recent years.Compared with radical nephrectomy,laparoscopic partial nephrectomy is a mini-invasive,safe method with satisfactory postoperative survival rate.However, there were still limited laboratory and clinical data about laparoscopic partial nephrectomy,and the experimental data of traditional laparoscopic surgery and open surgery were still used.Based on the existing data and the authors' experience,this article proposes three hypotheses for the problems puzzling urologic surgeons;the authors hope to verify the hypotheses through basic or clinical research.

Lower urinary tract symptoms (LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving multiple organs.There has been an increasing emphasis on the integrated management of non-neurogenic male lower urinary tract symptoms.Instead of focusing on the enlarged prostate,the current treatment has paid more attention on the entire urinary tract as well as multiple organ factors.Therefore,we provided a literature review and summarized the key points during the management of male LUTS as 3B,namely beyond prostate,beyond surgery and beyond urology.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays an important role in lipid reg-ulation through interaction with low-density lipoprotein cholesterol receptors , and several types of PCSK 9 inhibi-tors are gradually becoming research hotspots due to their lipid lowering effect .Among them PCSK9 monoclonal antibodies are the closest to clinical application , and a number of phase Ⅲclinical trials in PCSK9 monoclonal antibodies have been completed in recent years .We systemically reviewed the current clinical research on PC-SK9 monoclonal antibodies in this paper , in order to understand their efficacy and long-term safety in reducing the risk of cardiovascular diseases .

Objective To assess the safety and effica cy of local lidocaine anesthesia for pain control during transrectal ultrasound-g uided 10-core biopsy of the prostate. Methods Transrect al ultrasound-guided prostate biopsy was performed for 150 consecutive men beca use of an abnormal digital rectal examination and(or) abnormal transrectal ult rasound scan and(or) elevated prostate specific antigen.100 paients were rando mly assigned to receive an injection of 2% lidocaine (group 1,50 cases)or norm al saline(group 2,50 cases)into the lateral and apical periprostatic region,3 ml in each point,the other 50 patients(group 3) served as controls.Immediate ly after biopsy the pain score was recorded independently by a nurse using 10-p oint visual analog scale(VAS). Results The pain score range was 0 to 7.5 in the group 1,0 to 9.1 in the group 2 and 0 to 7.4 in the co ntrol group,the mean pain scores being 2.0 in the group 1,4.0 in the group 2 a nd 3.7 in the control group.The diffrence between group 1 and group 2、3 was sig nificant( P

Objective To highlight diagnosis and treatment of primary fibroepithelial polyp of ureter. Methods 7 cases of primary fibroepithelial polyp of ureter treated from May of 1990 to July of 2002 were analyzed retrospectively.Among them ,18～56 age of year,and right side in 5 cases,left in 2 cases.The foci are in upper,middle and lower part 2,3,2 cases respectively.The diagnosis was all ascertained on pathological studies. Results Hematuria and flank pain are the usual presentation.Preoperative image will reveal the lesion but the diagnosis of fibroepithelial polyp cannot be made by radiographic means alone.Surgical intervention was undertaken in all 7 cases.The initial case has undergone unnecessary nephroureterectomy as misdiagnosis of carcinoma of ureter.Surgical exploration and polypectomy was performed in 4 cases and polypectomy with holimlaser under ureteroscopy in 2 cases.The therapeutic results were satisfactory without relapse in 3 months～11 years follow up. Conclusions The diagnosis may be established with intravenous urogram and retrograde pyelography and surgical exploration may be performed when necessary.With the advent of ureteroscopy, a new minimally invasive approach to fibroepithelial polyp of ureter was introduced.

0.05 ). Conclusions Lateral and apical periprostatic anesthesia can significantly diminish the pain and discomfort in those undergoing transrectal prostate biopsy without increasing the incidence of complications.We recommend that this procedure be routinely applied to all patients undergoing transrectal prostate biopsy.

Objective To present the diagnosis and treatment of functional bladder outlet obstruction and to assess the results of transurethral bladder neck incision and alpha-blockers with regard to symptoms and urodynamic findings. Methods From October 1995 to October 2002,39 male patients (age range from 24 to 48 years,with a mean of 37 years) who had dysuria and underwent urodynamic examination,cystourethrography and urethral exploration were diagnosed with functional bladder outlet obstruction.The mean IPSS was 22.5.The mean maximum urinary flow rate was 10.2 ml/s and the mean residual volume was 124 ml.All the patients were treated with transurethral incision of bladder neck and alpha blockers. Results The mean operative duration was 15 min;mean blood loss was 50 ml;mean postoperative hospital stay was 3.5 d.During 1-year follow-up,most of the patients were satisfied with the treatment results.Subjective assessment showed a statistically significant reduction of the voiding complaints.The mean IPSS was 10.1 .The mean maximum urinary flow rate was 22.1 ml/s (range,12.7 to 42.1 ml/s) and the mean residual volume was 49 ml (range,0 to 84 ml). Conclusions Urodynamic examination,voiding cystourethrography and urethral exploration with dilator facilitate the diagnosis of functional bladder outlet obstruction.Treatments with transurethral incision of the bladder neck and alpha-blockers are effective and safe for functional bladder outlet obstruction.

Objective To evaluate the clinical features,diagnosis and treatment of metastatic adrenal carcinoma. Methods The data of 11 cases of metastatic adrenal carcinoma who were admitted from December 1993 to March 2003 were reviewed,including 4 cases of lung carcinoma,5 cases of hepatocellular carcinoma,1 case of bile duct carcinoma and 1 case of renal cell carcinoma.The main clinical manifestations were waist pain in 3,fatigue and weight loss in 3,hematuria in 1 and no symptom in 4.All the 11 cases underwent B-ultrasonography and CT scan,of whom 2 underwent positron emission tomography (PET).All patients were treated by surgical operation,including 9 cases by total adrenalectomy,1 case by palliative adrenalectomy and 1 bilateral metastatic case by left-adrenalectomy alone. Results In 5 cases by total adrenalectomy the survival time was 6 to 63 months with a mean of 34 months.Two cases were followed up for 2 to 16 months and 2 cases were lost with follow-up.One case by palliative adrenalectomy survived for 3 months.One bilateral metastatic case by left-adrenalectomy survived for 4 months. Conclusions Ultrasonography and CT are important in the diagnosis of metastatic adrenal carcinoma,and PET is of greater value in clinical practice.Complete adrenalectomy may be the best treatment choice to prolong the survival time.