Objective To evaluate the clinical application of CT virtual cystoscopy (CTVC). Me-thods Thirteen patients who had clinical indication were studied. Iodine contrast was intravenously injected after the bladder was voided. Thin-slice spiral CT scanning of the bladder area was started when the bladder became filled with contrast media. By using 3D navigator smooth software, CTVC images were obtained. The findings in all cases were compared with the cystoscopy and surgical results. Results Nine patients with CTVC were proved vesical tumor,3 patients with CTVC were proved benign prostatic hyperplasia, and they were confirmed by cystoscopy,1 patient with cystitis glandularis could not be diagnosed with CTVC.By CTVC, the diagnostic accordance rate was 92.3%,the coincidence rate was 100.0% in vesical tumor. Conclusions CTVC is highly sensitive in displaying the vesical lesions.Being a new and non-invasive technique, CTVC is very helpful in the diagnosis of introvesical diseases. It has fine value in the clinical practice.

Objective To observe the mRNA expressions of endothelin-1(ET-1) and endothelin A/B receptors (ETA/B) in tissue of benign prostatic hyperplasia treated by daily low-dose sildenafil.Methods A total of 32 patients with benign prostatic hyperplasia were randomly divided into two groups:treatment(25 mg sildenafi for 12 weeks,n=16) and control (no drug,n=16) groups.Immunohistochemical staining,ELISA and RT-PCR were used to detect the expression levels of ET-1 protein and ET A/B mRNA,respectively.Results The expressions of ET-1 protein and ET A/B mRNA in prostatic tissue were significantly lower in treatment group than in control group[(53.31±18.56) ng/kg vs.(83.34±31.38) ng/kg,0.356±0.056 vs.0.624±0.083,0.721±0.083 vs.0.933±0.905,t=-3.295,10.715,6.937,all P＜0.001].Conclusions Daily low-dose sildenafil can reduce the expressions of ET-1 and ET A/B receptors mRNA in benign prostatic hyperplasia.

Objective To study the relationship between chromosomal abnormality and Y chromosome microdeletions and male infertility. Methods Lymphocytes were cultured from peripheral blood of 1975 male infertility patients and stained with Giemsa. The chromosomes were analyzed under microscope. Y chromosome specific sequence tags (STS) were selected, then the Y chromosome microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in azoospermia and oligozoospermia patients. Results There were 305 cases of detected chromosomal abnormalities (15.44%) in the 1975 cases. There were 101 cases (5.11 %) with autosome abnormalities which clinically manifested as oligozoospermia and teratospermia. There were 204 cases (10. 33%) of sexual chromosome abnormalities and the patients were mainly characterized with Klinefelter's syndrome. Y chromosome microdeletions were detected in 109 (14.97 %) of the 728 cases of azoospermia or oligozoospermia. The most common microdeletion of Y chromosome was AZFc (62.39%) and these patients were characterized with azoospermia and oligozoospermia. Five patients (4. 59%) who suffered Y chromosome microdeletion in AZFa region and AZFb region were characterized with azoospermia. Fifteen cases (13.76%) with microdeletion in AZFb region and AZFc region were mainly characterized with azoospermia. There were 6 cases (5. 50 % ) of microdeletion in AZFa, AZFb and AZFc regions,these patients were all characterized with azoospermia. Conclusions Both Chromosome abnormalities and Y chromosome microdeletions are important causes for male infertility.

ObjectiveTo investigate the finasteride application during the off-cycle of intermittent androgen blockade (IAB) in patients with advanced prostate cancer treated with IAB.MethodsEighty-seven patients with advanced prostate cancer were divided into two groups: forty-nine patients received IAB (group A), and thirty-eight patients underwent IAB and finasteride during the off-cycle of IAB (group B). The time of treatment cycle and the time to disease progression were compared between the two groups. ResultsThe patients in group A completed 89 treatment cycles and the mean cycle length was (12.8±5.4) months [treatment time and non-treatment time were (6.6±3.5) months and (7.1±4.8) months, respectively]. The patients in group B completed 85 cycles and the mean cycle length was (15.3±5.9) months [treatment time and non-treatment time were (6.9±3.2) months and (9.2v±3.9) months, respectively]. There was a significant difference between group A and B in the mean cycle length and the non-treatment time (P=0.0428,P=0.03).The 3-year progression rate was ( 34.8±3.5 )% in group A and ( 28.4±2.7)% in groups B ( P=0.035). ConclusionsThe application of finasteride during the off-cycle of IAB in patients with advanced prostate cancer treated with intermittent androgen blockade (IAB) can delay progression of advanced prostate cancer.

Objective To investigate the differentiation of CD4+T helper cell in expressed prostatic secretions(EPS)in type Ⅲ prostatitis. Methods Seventy-six patients were studied,aged from 18 to 47(average 31.8).All patients presented with typical clinical symptoms for over 3 months.Cases were classified as type Ⅲ A(47 cases),type Ⅲ B(29 cases)and control group(16 cases)according to NIH classification system.Type Ⅲ A was also divided into group Ⅲ A1 with 26 cases(mild inflammation)and group Ⅲ A2 with 21 cases(severe inflammation).Th1 cytokine IFN-γ,Th2 cytokines IL-4 in EPS were detected by double antibody sandwich ELISA,and IFN-γ/IL-4 was determined.Results Compared with group control,IFN-γ in group Ⅲ A and Ⅲ B were significantly up regulated (134.78±43.67 pg/ml,109.82±30.09 pg/ml,P＜0.05),while IFN-γ level in group Ⅲ A was higher than in group Ⅲ B(P＜0.05).IL-4 in groupⅢ A was not changed(51.99±20.59 pg/ml,P＞0.05).IL-4 in group ⅢB was higher(76.40±17.99 pg/ml,P＜0.05).IFN-γ/IL-4 in group ⅢA was elevated significantly(2.94±1.12,P＜0.05),while IFN-γ/IL-4 in group ⅢB was not changed(1.49±0.48,P＞0.05).IFN-γ/IL-4 in group Ⅲ A2 was higher than in groupⅢA1 significantly(3.67±0.82vs 2.34±0.97,P＜0.05). Conclusions Th1 eell differentiation took the dominance in type Ⅲ A prostatitis.Th1/Th2 equilibrium was shifted to Th1.It is probably one of the pathogenies that Th1 dominant differentiation leads to local inflammation in prostate of type Ⅲ A prostatitis.

Objective To investigate the quality of life in man after treatment of advanced prostate cancer by surgical castration. Methods A total of 69 patients with advanced prostate cancer treated by sur-gical castration completed the European organization for research and treatment of cancer quality of life questionnaire (QLQ-C30) and QLQ-prostate specific 25-item (PR25) module third at a 12-month interval.The assessment points were preoporative,6 months postoperative and 12 months postoperative. Results Although there were improvement on pain relief (P ＜ 0.01 ) and symptom of urinary (P ＜ 0.01 ) and global health (P ＜ 0.01 ), the physical functioning (P ＜ 0.05 ), role functioning (P ＜ 0.01 ), emotional functioning (P ＜ 0.01 ), cognitive functioning (P ＜ 0.05 ), social functioning (P ＜ 0.05 or ＜ 0.01 ) were found significantly reduced , and insomnia (P ＜ 0.05) and fatigue (P ＜ 0.01 ) aggravated, treatment related symptoms (P ＜0.01 )appeared predominantly, especially deprivation of sexual functioning. Conclusion The surgical cas-tration when treating advanced prostate cancer did appear to impair the physical and psychological of patients, especially the sexual functioning.

Objective To evaluate the application value of combined detection of PCA3 and PSA mRNA in peripheral blood of patients with prostate cancer(PCa) for evaluation of mien)metastasis. Methods PCA3 and PSA mRNA were detected by duplex real time quantitative RT-PCR in a total of 49 PCa and 71 benign protatic hyperplasia (BPH) patients' peripheral blood. The diagnostic value was analyzed by receiver operative characteristic(ROC) curve. Results The levels of PCA3 mRNA in PCa patients were significantly higher than those in BPH patients [2 362( <30-7 421 ) copies/ml vs <30 copies/M, Z = -6. 66, P < 0. 01 ], and the same to PSA mRNA [3 425 ( 908-36 639 ) copies/ml vs < 200 copies/ml, Z = - 6. 40, P<0. 01 ]. The positive rate of PCA3 and PSA mRNA in peripheral blood was positively correlated with clinical stage[clinical stage B: 30.0% (3/10), C: 60.0% (9/15) and 86.7% (13/15), D: 91.7% (22/24) and 91.7% (22/24) ,Chi-square = 13. 534 and 16. 541, P <0. 01, respectively]. Meanwhile, the positive rate of PCA3 mRNA and PSA mRNA was also increased with the increase of Gleason score[ Gleason score of 2 to 4 : 20.0% (1/5) and 40. 0% (2/5) ;5 to 7 : 66.7% (12/18) and 72. 2% ( 13/18 ) ;8 to 10 : 84. 6% (22/26) and 92.3% ( 24/26 ) ;Chi-square = 8. 895 and 8. 015, P < 0. 05, respectively ]. ROC analysis showed that the sensitivities for PCA3 and PSA mRNA were 69. 4% (34/49) and 81.7% (40/49) and the specificities was 90. 1% (64/71) and 77.5% (55/71), respectively, when the cut-off value was 846 copies/ml for PCA3 mRNA and 280 copies/ml for PSA mRNA. Meanwhile, the sensitivity can reach to 85.7% (42/49) when the detection of PCA3 and PSA mRNA were combined. However, the specificity was decreased to 76. 1% (54/71). For the diagnosis of PCa micrometastasis, the sensitivity and specificity for PCA3 mRNA was 90.9% (20/22) and 84.7% (11/13), respectively. Conclusions PCA3 and PSA mRNA in peripheral blood are useful markers for PCa diagnosis. Simultaneous detection for PCA3 and PSA mRNA is more helpful for PCa diagnosis. Meanwhile, detection of PCA3 mRNA is a useful marker for diagnosing PCa micrometastasis.

ObjectiveTo investigate the relationship of lymphotoxin β receptor (LTβR) and classical nuclear factor-κB (NF-κB) activation pathway in the pathogenesis and progress of cystitis and bladder cancer.MethodsThe LTβR and P65 mRNA expression were detected by Real-time quantitative PCR in 108 cases of fresh bladder tissue specimens (75 cases of bladder cancer,10 cases of inflammation and 23 normal bladder mucosa cases grouped by the tissue classification ),and protein expression were analyzed by immunohistochemistry assay in 118 cases of paraffin-embedded biopsy specimens (73 cases of bladder cancer,30 cases of cysitis and 15 normal bladder mucosa cases).The correlation analysis between the expressions of LTβR and P65 with clinical pathological data was then performed.Differences between LTβR and P65 mRNA and protein expression level were compared in different groups of bladder tissues using Kruskal-Wallis H test and the Chi-square test.Results( 1 )The mRNA expressions of LTβR and NF-κB/P65were higher in bladder cancer than those in normal group ( LTβR:29.4 ( 14.2 - 46.7 ) × 10 - 3/1.2 ( 0.3 -7.0) ×10-3,Z=-5.508; P65:9.7 (2.7 -21.1) ×10-3/1.0(0.8 ～1.8) ×10-3,Z=-5.030,P＜0.05 ).There were significantly differences between bladder cancer with different histological grades ( LTβR:18.2(2.1-31.3) × 10-3/ 28.4(16.6-36.2) × 10-3/47.9(34.3 -70.5) ×10-3,x2K-W=20.378;P65:4.9(1.3 - 12.0) × 10-3/7.4(3.0-21.9) × 10-3/17.0(10.0 ～28.3)× 10-3 ,x2K-W2 =15.219,P all ＜0.05) and lymph node metastasis (LTβR:27.2(9.7-40.1) ×10-3/39.4(26.7 -52.6) ×10-3,Z=-2.552; P65:7.4(2.3-15.6) ×10-3/13.4(6.7-23.3) ×10-3,Z=-2.026,P＜0.05).(2)The positive rates of LTβR and phosphorylated P65 ( p-P65 ) protein in cancer were higber than those of normal group (LTβR:69.8％/13.3％,x2 =16.600 ; p-P65:56.2％/6.7％,x2 =12.220,P ＜ 0.05 ).Upregulation of LTβR and p-P65 were associated with the histological grade (LTβR:56.3％/70.0％/90.4％,x2 =7.055; p-P65:40.6％ /60.0％/76.2％,x2 =6.679,P ＜0.05) and with lymph node metastasis (LTβR:58.3％/92.0％,x2 =8.849; p-P65:52.1％/64.0％,x2 =5.088,P ＜0.05).(3)There was a positive correlation between LTβR and P65 expression ( mRNA:r =0.654,P ＜ 0.05,protein:r =0.399,P ＜ 0.05 )in the bladder cancer and cystitis (r =0.521,P＜0.05).ConclusionsThe activation of LTβR and P65 was associated with progression and metastasis of bladder cancer.The activation of classical NF-κB pathway by LTβR may be achieved by P65.

Objective To study the expressions of DD3 mRNA and PSA mRNA in the prostate tissues and its diagnostic value in prostate cancer (PCa). Methods DD3 mRNA and PSA mRNA were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction ( FQ-RT-PCR) based on Taqman technique in the tissues of 21 cases of PCa and 39 cases of BPH. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of DD3 mRNA, PSA mRNA and DD3 mRNA/PSA mRNA. Results The expressions of DD3 mRNA and PSA mRNA, and DD3 mRNA/ PSA mRNA were significantly higher in PCa tissues than those in BPH tissues ( P 0.05 for all). The AUC-ROC of DD3 mRNA,PSA mRNA and DD3 mRNA/PSA mRNA were 0. 937 (95% CI,0. 879 -0. 995) , 0.755(95% CI,0.629 -0.880) and 0.839 (95%CI,0.738 -0.940),respectively. The sensitivity for DD3 mRNA,PSA mRNA and DD3 mRNA/PSA mRNA was 90. 5% ,81. 0% and 81. 0% , respectively, and the specificity was 85.0% ,62.0% and 66.7% at cutoff value of 1.4?105 copies/mg tissue,3.0?107 copies/ mg tissue and 5. 0?10-3,respectively. The sensitivity and specificity of simultaneous detection for DD3 mRNA and PSA mRNA were 100% and 85.0%. Conclusions Both DD3 mRNA and PSA mRNA expressions were significantly higher in PCa tissues than those in BPH tissues; and the quantitative detection of DD3 mRNA is more helpful for the diagnosis. The simultaneous detection of DD3 mRNA and PSA mRNA can improve the sensitivity in the diagnosis of PCa.

Objective:To analyze the value of serum ceruloplasmin (CP) levels in predicting the outcome of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).Methods:The clinical data of 1 751 patients with HBV-ACLF treated in the Third Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2018 were retrospectively analyzed. According to 30-day outcomes, 1 220 survival patients were classified into group A; 465 fatal patients and 46 patients receiving liver transplantation were classified into group B (total 531 cases). Risk factors associated with 30-day survival were estimated using Cox proportional hazards regression. ROC curve analysis was performed to evaluate the predictive value of CP on the 30-day outcome of patients with HBV-ACLF.Results:Multivariate analysis indicated that CP, albumin and alpha fetoprotein were independent protective factors for 30-day survival of HBV-ACLF patients ( P<0.05 or <0.01), while age, white blood cell count, AST, total bilirubin, INR, serum creatinine, HBV DNA, hepatorenal syndrome and hepatic encephalopathy were independent risk factors ( P<0.01). The area under the ROC curve (AUC) of CP was 0.570 (95% CI 0.540-0.599, P<0.01); while AUC of MELD score was 0.783 (95% CI 0.759-0.807, P<0.01) and MELD-Na score was 0.774 (95% CI 0.750-0.798, P<0.01). Compared with MELD score and MELD-Na score, the value of CP in predicting the 30-day prognosis of HBV-ACLF patients was lower ( P<0.01). The cut-off value of CP for predicting 30-day outcome of HBV-ACLF patients was 0.173 g/L, with the sensitivity of 69.4%, and the specificity of 41.6%. According to the cut-off value, the patients were divided into low CP level group (level of CP<0.173 g/L) and high CP level group (level of CP≥0.173 g/L); the 30-day cumulative survival rate of low CP level group was lower than that of high CP level group ( χ2=17.75, P<0.01). Conclusions:Serum CP level can predict the 30-day outcome of HBV-ACLF patients to a certain extent.