Objective To evaluate the safety and clinical efficacy of finasteride in treating patients with benign prostatic hyperplasia (BPH) during a 14-year period in a hospital.Methods Forty-one patients with BPH receiving finasteride 5 mg daily for the treatment from December 1994 to Febrary 2009 were included in the study. The base line and the end of study data of nocturia, prostate volume, serum creatine, complete blood count and serum prostatic specific antigen (PSA) were recorded. The acute urinary retention, surgical treatment and drug adverse reaction (prostate cancer or breast cancer) during the observation periods were recorded as well.ResultsAll the 41 cases took finasteride regularly for long-term medical therapy of BPH. At the end of this study, the average age of patients was (87.9±5.4) years old and the average duration of treatment was (141.1±27.1) months. The numbers of nocturia were 1.8±1.5 and 3.2±1.3 pre- and post- treatment, respectively (t= -4.52,P<0. 05). Before and at the end of the study, the prostate volumes were (44.9±26.6) ml and (42.8±31.3) ml, respectively(t=0. 33,P>0.05). Stratified study showed that, compared with the baseline data, the prostate volume was increased by 17.3 ％ in patients with prostate volume <25 ml(t= -0. 88 ,P>0. 05) ; the prostate volume was decreased by 17.2％ in patients with prostate volume of 25-40 ml(t=2.59,P<0.05); the prostate volumes were (63.3±28. 9) ml and (62.6±36.5) ml pre- and post-treatment in patients with prostate volume > 40 ml, and there was no significant change(t= 0.07, P>0. 05). Before and after the treatment, the serum creatine levels were (96.8±18. 6) mol/L and (86.45±32. 3) mol/L, respectively(t= 1.79, P>0. 05) ; the white blood cell counts were (6.4±1.5) × 109 L and (6.0±1.7) ×109 L, respectively (t= 1.13,P>0. 05) ; and the PSA levels were (1.2±2.0) μg/L and (1.4±1.7) μg/L, respectively (t=-0. 49,P>0. 05). Three cases (7.3％) occurred acute urinary retention. There was no prostate cancer and breast cancer case, and no new adverse event occurred during long-time use of finasteride. Conclusions This retrospective study has demonstrated that the clinical progress of BPH can be controlled effectively by long-term administration of finasteride.

g this model, trainees could improve their basic techniques, such as resection and vaporization technique.

Objective To study the effect of down-rdgulation of EF-1 alpha gene in prostate cancer cell line DU-145 on cancer cell migration and invasion by using RNA interference technique. Methods The prostate cancer cell line DU-145 was divided into three groups: the control group (untransfected with siRNA), randomly control group (randomly transfected with siRNA) and experimental group (transfected with EF-1 alpha siRNA). Localization of EF-1 alpha and its relationship with F-actin in cytoplasm were analyzed by immunofluorescence technique. Cancer cell migration and invasion capability of DU145 cells were studied by transwell technique in these three groups. Results EF-1 alpha expression in DU145 cell line was down-regulated by using RNA interference technique. EF-1 alpha was localized in cytoplasm and co-located with F-actin. The down-regualtion of EF-1 alpha did not change the F-actin distribution in cytoplasm. The cell migration and invasion study showed that after seeding 20×104 DU145 cells into the upper chamber of transwall for 12 hours, the cells collected in the lower chambers were (10.6±1.0)×104 in control group, (11.2±0.8)×104 in randomly control group and (3.9±0.6)×104 in experimental group. Compared with controls, the cancer cell migration and invasion capability was significantly inhibited to only 37.1% (t= 13.9, P<0.05) after the specific down-regulation of EF-1 alpha expression in DU145 cells. Conclusions The down-regulation of EF-1 alpha expression has negative impacts on prostate cancer cell migration and invasion. EF-1 alpha plays important roles in prostate cancer local invasion.

Objective To study the elongation factor 1α(EF-1α) gene functions in prostate cancer cell line DU145 in the aspects of cell proliferation and clone formation by using the RNA interference technique. Methods DU145 cell lines were divided into control group, transfection control group transfected with scramble siRNA and experimental group transfected with EF-1α siRNA. After transfecting EF-1α siRNA into DU145 cell line, the down-regulation of EF-la expression in DU145 cell line was confirmed by Western blotting and immunofluorescence staining. Then, the cell proliferation and clone formation assays were carried on in these 3 groups of DU145 cells. Results Compared with controls, the specific down-regulation of EF-1α expression was achieved in experimental group only. Compared with control group, after the down-regualtion of EF-1α in DU145 cell line, the cell proliferation rate decreased from day 4 to day 7 after transfection by 45. 9%, 53. 5% , 35. 3% and 38. 1% , respectively(P<0. 05). The clone formation number in experimental group decreased by 67.0% (P<0. 01). Conclusions The down-regulation of EF-1α has a negative impact on prostate cancer cell proliferation and clone formation. EF-1α might be an appropiate targeting gene in prostate cancer targeting therapy.

Objective To verify the safety and advantages of total transperitoneal laparoscopic nephroureterectomy (ttLNU) in the treatment of upper urinary tract urothelial carcinoma (UTUC).Methods From Jun.2013 to Jun.2014,there were 13 UTUC patients treated with ttLNU,including 7 males and 6 females.The mean age was 70.4 ± 8.3 yrs,and BMI was 23.3±4.1.Of them,11 cases were diagnosed with renal pelvis carcinoma,6 in the left and 5 in the right.2 cases were diagnosed with left ureteral carcinoma.TNM stages were T1-T3N0M0.Patients were put on lateral position and the position was not changed during the operation.A ttLNU was performed,and the specimen was removed from the middle extended inferior umbilical incision.Results The mean operative time was 188±33 (150-240) min,the intraoperative blood loss was 150.5±60.1 (50-700) ml,and the time of out-of-bed activity was between 1 and 4 d.The mean postoperative drainage time was 6.8±4.6 (3-6) d.The mean postoperative bowel function recovery time was 1.5± 1.0 (2-4) d and postoperative hospital stay was 12.8±7.0 (3-27) d.The ttLNU procedures were successfully performed in all cases without conversion to open surgery.Pathological results showed urothelial carcinoma in all cases,including 8 high grade and 5 low grade.All the surgical margins were negative.The followed up was from 2 to 12 mon,and there was no tumor recurrence and metastasis found.Conclusions Total transperitoneal laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma is characterized by short operative time,low blood loss,decreased trauma and quick recovery.This is a safe and effective treatment option for the treatment of upper urinary tract urothelial carcinoma.

Objective To verify the safety and feasibility of applying laparoendoscopic singlesite radical prostatectomy (LESS-LRP) in the treatment of prostate cancer. Methods From Sept. to Dec. 2010, LESS-LRP was used to treat 2 early stage prostate cancer patients. The LESS-LRP was preformed through extra-peritoneal approach by using standard laparoscopic instruments and a 5 mm flexible laparoscope. This technique were evaluated in respects of operative time, estimated blood loss, intraoperative complications, drainage time, post-operative pain score (VAPS), post-operative hospital stay, pathological results and post-operative PSA levels. Results All procedures of the 2cases were completed with LESS-LRP without conversion to standard laparoscopic or open radical prostatectomy. The operative times for LESS-LRP were 280 and 285 min, estimated blood loss were 400 and 200 ml, respectively. There was no severe intraoperative complication. The drainage times were 2 and 6 d, the VAPS in the first post-operative day were 1 and 0, and post-operative hospital stay were 14 and 7 d. There was no secondary bleeding or wound infection. The 2 prostate cancer cases were all in pathological stage pT2c N0 M0. Surgical margins of the specimens were negative. The first case showed PSA of 0. 033 ng/ml 1 month after the surgery. Conclusion LESS-LRP can be an exploratory option in clinical for the treatment of prostate cancer.

Objective To verify the clinical safety and feasibility of applying laparoendoscopic single-site surgery (LESS) in the treatment of elder patients with urological tumors. Methods From August 2010 to March 2011, LESS technique was used to do prostatectomy in five cases, nephrectomy in 3 cases and adrenalectomy in four cases. Quadport was inserted through a transumbilical incision. Flexible tip 5 mm laparoscope and standard laparoscopic instruments were employed. This technique was evaluated in respects of operative time, estimated blood loss, intraoperative complications, drainage time, post-operative visual analogue pain scale (VAPS), post-operative hospital stay and pathological change. Results All the procedures in this group were completed successfully with LESS. There was no additional trocarand conversion to standard laparoscopic or open surgery. Application of Quadport reduced the clash of instruments. Carefully performing surgery and avoiding blunt dissection to reduce intraoperative bleeding is the cornerstone of success. The operative time and estimated blood loss were (192.0±76.7) min and (174.6±167.2) ml, respectively. There was no severe intraoperative complication and blood transfusion. The VAPS in the first post-operative day was (0.9 ± 1.0) minutes and the drainage time was (3.5±1.7) d while post-operative hospital stays were (7.9±3.4) d. There was no occurrence of secondary bleeding and wound infection. Conclusions LESS is a safe and feasible alternative for the treatment of urological tumors in elderly patients, but needs further clinical investigation.

Objective To compare the efficacy and safety of transurethral plasmakinetic resection of the prostate(TUPKRP)and transurethral resection of prostate(TURP). Methods A total of 36 elderly patients with large volume prostate and high-risk benign prostatic hypertrophy were involved in this study.Among them,16 patients underwent PKRP and 20 patients underwent TURP.The operation time,blood loss,resected prostate weight,continuous bladder irrigation time,catheterization time,international prostate symptom score(IPSS)and Omax 6 months post-operation were compared between PKRP group and TURP group. Results There was no significant difference in all parameters except the blood losss between the 2 groups.The blood loss was less in TUPKRP group than in TURP group[(283±155)ml vs.(465±264)ml,P<0.05],and no blood transfusion needed during operation in TUPKRP group(O case vs.2 cases,P<0.01).However,IPSS and Omax 6 months post-operation improved significantly as compared with preoperation in the 2 groups(PKRP:(27.8±3.5)vs.(6.8±3.4),(4.5±2.7)ml/s us.(15.8±6.2)ml/s;TURP:(29.2±6.1)vs.(7.4±4.2),(5.2±3.6)ml/s vs.(15.2±5.3)ml/s,all P<0.01). Conclusions The effect of TUPKR is similar to TURP,but TUPKR is more safety than TURP for the elderly patients with large volume and high-risk BPH.

Objective To evaluate the efficiency and safety of extraperitoneal laparoscopic radi-cal prostatectomy for the treatment of localized prostate cancer. Methods Fifteen localized prostate cancer patients were treated with extraperitoneal laparoscopic radical prostatectomy. The mean pre-op-erative PSA was 8.1 ng/ml and prostate biopsy pathological Gleason score was 5.7±1.3. The Beijing Hospital Technique characterized by cutting directly into linea alba abdominis was used to establish the extraperitoneal space. Harmonic scrapple was used in dissection and haemostasis during the proce-dure. This technique was evaluated in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, post-operative pain score (NRS), catheterization time, length of hospital stay, pathological results and post-operative PSA. Results All the surgeries had been completed successfully except 1 case converted to open surgery. The average operation time was (316±74)min, the average estimated blood loss was (4084±362)m1. There were 5 cases accepted blood transfusion. No rectal or ureteral injury happened during operation. The NRS at post-operative day 1 and day 2 were 2.3 and 1.4. The average length of hospital stay was (19.5±4.9)d. The cathe-terization time was (14.1±2.9)d. There were 2 cases (13%) with positive surgical margins. No case was found having lymph node metastasis. During the 1-12 month follow up, 10 cases (67%) were continence. PSA in 12 cases was lower than 0.2 ng/ml. Conclusion Extraperitoneal laparoscopic radical prostatectomy is feasible and safe in the treatment of localized prostate cancer.

ObjectiveTo verify the safety and feasibility of retroperitoneal laparoendoscopic singlesite surgery (LESS) adrenalectomy in the treatment of adrenal gland tumors or cyst.MethodsFrom Oct.2009 to Jan.2012,7 patients underwent retroperitoneal LESS adrenalectomy with Quadport technology by one surgeon.The mean patient age was 46 ( 39 - 55 ) years.The mean largest tumor diameter was 2.3 (1.8-3.6) cm.All procedures were performed through retroperitoneal approach by using Quadport,tip flexible laparoscope with 0° lens and conventional laparoscopic instruments.This technique was evaluated in respects of operative time,estimated blood loss,intraoperative complications,drainage time,visual analog pain scale (VAPS) score,post-operative hospital stay and pathological results.ResultsSeven cases of LESS adrenalectomy were completed successfully.There was no additional trocar added,no conversion to conventional laparoscopic or open approach.The mean operative time was 106 (70 - 180) min,and the mean estimated blood loss was 59 (5 -200) ml.The mean first day post-operative VAPS score was 2 (1 -3),drainage time was 2 (2 -3) d.Post-operative hospital stay was 5 (3 -6) d.No perioperative complication was observed.Pathological results showed 1 case of adrenal pheochromocytoma,5 cases of adrenal cortical adenoma and 1 case of adrenal cyst.ConclusionRetroperitoneal LESS adrenalectomy is a safe and feasible option for the treatment of adrenal tumors and cyst.