Objective:To investigate the expression of low-molecular-weight PSA(lw-PSA) and lactoferrin in the expressed prostatic secretion(EPS) from both benign prostatic hyperplasia(BPH) and normal prostate.Methods: Forty human EPS samples obtained from 20 BPH patients and 20 normal males were subjected to two-dimensional gel electrophoresis(2-DE).Mass spectrometry was performed to confirm the nature of the secreted proteins in EPS.Results: One uniquely expressed protein in BPH was detected and mass spectrometry determined its nature as lw-PSA(molecular weight 10?10~3,pI 8.5-(9.3)).More importantly,Western blotting analysis also revealed that lw-PSA detected in BPH-EPS,but was undetectable in BPH-free EPS.In addition,up-regulation of Lactoferrin(molecular weight 35?10~3,pI 7-7.5) in BPHEPS,as compared with BPH-free EPS,was also observed.More interestingly,lactoferrin was absent in prostate cancer tissues.Conclusion: Our results indicate lw-PSA may be produced specifically by BPH epithelium and it has a potential to be used as a specific biological marker for the diagnosis of BPH.In addition,benign prostatic epithelium can produce more lactoferrin while prostate cancer tissues go without its lactoferrin secretion.

Objective To evaluate the quantitative determination of urine nuclear matrix protein 22 (NMP-22) and bladder tumor antigen (BTA) in the screening of bladder tumor recurrence. Methods 90 patients who had undergone TURBT were recruited in this study.Standard ELISA test was used to determine the quantity of NMP-22 in urine and urine BTA stat test was also performed.the findings were analyed with reference to the cystoscopic and pathological results. Results In comparison with the results of cystoscopy,urine NMP-22 test might denote 77% (32/43) recurrence of bladder cancer and this positive rate would increase to 93% (40/43) with the combined use of urine NMP-22 and BTA test. Conclusions Examination of NMP-22 in urine is a rapid and effective means of detecting the recurrence of bladder cancer.With the combined use of BTA test,urine NMP-22 determination might be a useful non-invasive method in screening the recurrence of bladder cancer,and the conventional invasive cystoscopy might be avoided.

Objective To detect both the protein and gene expression of matrix metalloproteinase (MMP 2,MMP 9) and its tissue inhibitor (TIMP 2) in tissues of bladder transitional cell carcinoma (BTCC), and to study the correlation with the grading and staging of the neoplasm and with the prognosis. Methods 41 human BTCC ,15 normal bladder tissue were studied by Western Blot and RT PCR analysis followed by computer assisted image analysis in order to detect the A values of their expression. Results In BTCC, the A value of MMP 2, MMP 9 were increased significantly as compared to normal bladder epithelium. There was no statistical significant difference of A value of TIMP 2 between normal bladder tissue and bladder cancer tissue. The ratio of MMP 2/TIMP 2 in bladder cancer showed statistical significantly difference as compared with normal bladder tissue. Conclusions This study demonstrated there was a high expression of MMP 2 and MMP 9 in BTCC,by which collagen Ⅳ inside basement membrane of bladder was damaged.However, the ratio of MMP 2/TIMP 2 has more prognostic value than the expression of MMP 2 and MMP 9 alone.

Objective The aim of this study was to investigate the understanding and application of the Chinese Urological Association (CUA) guidelines of Benign Prostatic Hyperplasia (BPH) (2011 edition) in Chinese urologists.Methods The survey was conducted between September,2012 and November,2012.Questionnaires designed by the CUA were used to investigate the understanding and management of BPH in CUA-registered urologists,who work in clinic for at least 20 hours per week.Data,including general characteristics of the urologists,understanding of BPH,BPH diagnosing in suspected patients,BPH treatment,and follow up,were collected.7500 questionnaires were distributed.A total of 4 897 participants responded (response rate 70.0％).86 questionnaires with incomplete information and 37 duplicate questionnaires were excluded.And 4 774 validate questionnaires were included for the analysis,finally.The mean age of those investigated urologists was (39.9±9.2) years old.Among them,3 802 (81.0％) urologists work in the tertiary hospital,878 (18.7％) urologists work in the secondary hospital and 12 (0.3％) urologists work in the other hospital.The district distribution in those urologists included 455 (9.6％) in northeast china,812 (17.1％) in north china,1 696 (35.6％) in east china,869 (18.2％) in south china,634 (13.3％) in southwest china,295 (6.2％) in northwest china.1 835 (43.8％) urologists have less than ten years working experience.1 505 (35.9％) urologists have 11 to 20 years working experience.The 21 to 20 years working experience was reported in 705 (16.8％) urologist.And the other 149 (3.5％) urologists have working experience more than 31 years.The educational background in this study included doctor degree in 732 (15.8％) urologists,master degree in 1 729 (37.4％) urologists,bachelor degree in 2 067 (44.7％)urologists and college degree in 101 (2.1％) urologists.The position composition included 834 (18.2) directors,1 371 (30.0％) deputy directors,1 605 (35.1％) attendings and 765 (16.7％) residents.The data were analyzed using rank-sum test,2 test,or Fisher's exact test.Results The understanding of BPH clinical progression and progression-associated risk factors in Chinese urologists was poor.Compared to the guidelines,the rate of consistent were only 43.4％ (2 023/4 665) and 10.2％ (477/4 660),respectively.The initial evaluation methods for suspected BPH patients were in low consistency with the guidelines (20.2％,845/4 181) and were inconsistent among different areas [66.5％ (290/436) in northeast china,64.7％ (556/859) in south china,55.6％ (158/284) in northwest china,55.1％ (922/1 672) in east china,54.7％ (435/795) in north china,48.0％ (296/617) in southwest china].The participants showed poor understanding of the primary goal of treatment for BPH (4.9％ consistent,229/4 666) and the criteria about watchful waiting (22.5％ consistent,1 051/4 674).However,the understanding of surgical indications for BPH was good (94.6％ consistent,4 410/4 663).The therapeutic effects of 5α-reductase inhibitor for BPH were acknowledged by 93.4％ (4 388/4 699) participants.The consistent rate with the guidelines of follow-up examinations was low for patients with watchful waiting (7.8％,355/4 531),medication treatment (8.4％,373/4432),and surgery (44.8％,2 105/4 702).Conclusions The understanding of the CUA BPH guidelines is poor in Chinese urologists.Target training in the specific urologists with tailored contents is necessary.

Objective To discuss the clinical outcomes of surgical treatment on epididymal obstructive azoospermia (EOA) and the factors affecting clinical results. Methods The clinical data of 51 EOA patients who underwent single layer longitudinal 2-suture intussusception vasoepididymostomy (LIVE) were retrospectively analyzed. The months of follow up, mean level of sperm count per ejaculate and percentage of grade A sperm were collected. Patency and pregnancy rates were recorded during followups. Results A total of 51 men were taken scrotal exploration. Sperms were bilaterally or unilaterally present in epididymal fluid in 49 cases, including 1 case had sperm in one side of the epididymal fluid and the contralateral vasal fluid. No sperm was found in epididymis in 2 cases. Bilateral and unilateral LIVE were performed in 48 cases. 44 were followed for more than 6 months and 39 for more than 1 year. Sperm was present in ejaculate in 32 of cases, the overall patency rates were 72.7%. The mean sperm count was (24±23) × 106 per ejaculate. Grade A sperm was present in the ejaculate in 28 cases with a mean levels of (12± 11.2)%. A total of 10 cases achieved pregnancy.Pregnancy was achieved only when the site of anastomosis was at cauda epididymis. Conclusions Loupe-assisted LIVE, with lower cost and simplified surgical procedure, could achieve optimistic patency outcomes and pregnancy results. Data of this paper also suggested that it should be taken into account that pregnant outcome was related to the site of anastomosis.

At present, antibacterial drugs are widely used in the clinical treatment of infectious diseases. It is particularly impor-tant to focus on the safety of antibacterial drugs for the application improvement in the clinical treatment. The paper reviewed and sys-tematically analyzed the relative literatures in order to explain the pathomechanism of drug-induced renal injury caused by antibacterial drugs and propose some preventive measures. The study suggested that attention should be paid to the distribution and characteristics of the adverse drug reaction of antibacterial drugs to ensure the safe and proper administration of the drugs.

Objective To compare the outcomes of TOT and TVT procedure treating female intrinsic sphincter deficiency (ISD).Methods From May 2010 to September 2015,42 stress urinary incontinence (SUI) patients whose abdominal leak point pressure was less than 60 cmH2O were enrolled in this study.Thirty-five patients were followed up.The mean age was (56.8 ±10.5) years,with a range of 30-80 years.The mean history was(10.5 ± 9.1)years,with a range of 4 months to 30 years,with 26 (74.3％) of them being postmenopausal,5 (14.3％) having a history of pelvic surgery,and no pelvic organ prolapsed or hormone replacement.All of them were randomly divided into 2 groups to undergo either TVT operation (13 cases) or TOT operation (22 cases).The baseline characteristics of the two groups including age,length of history,urodynamic parameters and scale scores showed no significant difference.The scales including urinary incontinence severity score (UISS),detrusor instability score (DIS),Quality of Life Scale Evaluation (I-QOL),lower urinary tract symptoms affect score (UDI-6) were used.The outcomes between TVT group and TOT group were compared.Result After procedure,patients in TVT group got a lower UISS score than TOT group(17.2 ± 2.2 vs.17.7 ± 3.1),and their severity of urinary incontinence improved significantly (P ＜ 0.05).Patients from TVT group got a lower DIS score than TOT group (12.6 ± 4.2 vs.14.2 ± 3.5),and their detrusor instability symptoms improved more significantly (P ＜ 0.05).Patients from TVT group got a higher I-QOL score than TOT group(17.5 ± 14.5 vs.16.1 ± 13.0),and their quality of life improved more significantly (P ＜ 0.05).Patients from TVT group got a lower UDI-6 score than TOT group (10.1 ± 3.0 vs.11.2 ± 3.4),and their lower urinary tract symptoms improved more significantly (P ＜ 0.05).Conclusion Urinary incontinence of female ISD patients were improved greater by TVT than TOT procedure.

ObjectiveTo evaluate the role of transurethral resection of the prostate (TURP) in the management of prostate carcinoma.MethodsTURP were randomly performed on 19 suspected patients with prostate carcinoma, based on their mean serum PSA level (14.5 ng/ml) and negative result of anal touch,so as to take more biopsy samples and to make histopathologic diagnosis.Meanwhile,another 8 patients with prostate carcinoma underwent palliative TURP so as to resolve bladder outlet obstruction.ResultsOf the 19 suspected patients, 6 (33%) were pathologically diagnosed to have prostate carcinoma.These 6 patients were all alive during a follow-up for 3 months to 6 years.Obstructive symptom was relieved in 4 patients who underwent palliative TURP,but repeat palliative TURP was needed in 2 patients 3 months after initial operations.ConclusionsIn certain circumstances,TURP may play a role in the diagnosis of prostate carcinoma. In addition, it relieves obstructive symptom caused by enlarged prostate. However, the long-term effects are unpredictable.

Objective:To compare the effects of rotational night shifts on the micturition patterns of fe-male nurses.Methods:A total of 58 nurses without lower urinary tract symptoms were recruited,who worked in the Peking University People’s Hospital during January and June in 2014.The nurses aged 20 -43 years were divided into two groups,the night-shift group (n =28)and the non-shift group (n =30).The alcohol or coffee intaking were forbidden.In the night-shift group,nurses had worked on rota-tional shifts for at least 6 months.Their average age was (26.75 ±4.11)years.In the non-shift group, nurses took regular day-time work,whose average age was (27.80 ±5.60)years.A voiding diary was kept for 7 consecutive days at the end of 6 months,starting 2 days before their night duties until 4 days after completion of their night duties.For comparison,the non-shift group with regular shifts completed a 7-day voiding diary.In the 7-day recording voiding diary,the nurses were required to have the normal in-take of liquid about 1 500 -2 000 mL/d.The frequency volume charts of nocturia,the 8-hour interval urine production and frequency were compared between the two groups.Results:Nocturia frequency was increased in the night-shift group [0.5 (0 -2.4)]compared with the non-shift group [0 (0 -2),P =0.02].The volume of nocturia was increased in the night-shift group [125 mL (0 -660 mL)]compared with the non-shift group [0 mL (0 -340 mL),P <0.01].The 8-hour interval indices showed that urine production changed with shift (P <0.01).In the consecutive 7 days,the nocturnal volume of the night-shift group increased on the day after night shift.When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high,and the frequency of noctu-ria also increased significantly (P <0.05).Compared with the 8-hour interval indices,the night-shift group’s voiding volume [(542.35 ±204.66)mL]and voiding frequency (2.24 ±0.69)were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm).During the 8 h interval night time (from 10 pm to 6 am),the volume of nocturia in the night-shift group [(309.74 ±162.74) mL]was more than that in the non-shift group [(199.38 ±153.98)mL,P =0.01];the frequency of nocturia in the night-shift group (1.31 ±0.52)was increased than that in the non-shift group (0.82 ± 0.55,P <0.01).Conclusion:The rotational shifts affect the micturition patterns of nurses who go through the night shift work,which increases the volume and frequency of the nocturia.

Objective:To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diag-nosis and treatment database,and to assess its clinical significance of urodynamic study.Methods:From April 2011 to December 2015,196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study,after excluding pelvic organ prolapse.The preoperative uro-dynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated.Results:In this study,23 cases (11.73%)changed or amended their diagnoses by the urodynamic study,which were inconsistent with the previous clinical diagnoses concluded by the symptoms,physical examinations, and lab tests.A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study.Of them,3 were diagnosed as detrusor overactive and undertook conservative treatment;3 were diagnosed as bladder outlet obstruction plus stress urinary in-continence and were undertaken the transurethral resection of the bladder neck (TURBN)plus tension free vaginal tape (TVT);2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone;1 was diagnosed as bladder outlet obstruction plus stress urinary in-continence and was undertaken TURBN plus tension free vaginal tape obturator (TOT);1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inap-propriate surgical methods.Conclusion:In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences,the preoperative urodynamic study is necessary besides detailed medical history,physical examination,and laboratory tests.With the help of the urodynamic study,the concomitant diseases of patients with stress urinary incontinence may be detected,the individualized treatment regimen can be developed,and more importantly,the inappropriate surgical de-cision can be avoided.