In the present study, we evaluated the safety and efficacy of immediate surgical bipolar plasmakinetic transurethral resection of the prostate (PK-TURP) for patients with benign prostatic hyperplasia (BPH) with acute urinary retention (AUR). We conducted a retrospective analysis of clinical data of BPH patients who received PK-TURP. A total of 1126 BPH patients were divided into AUR (n = 348) and non-AUR groups (n = 778). After the urethral catheters were removed, the urine white blood cell (WBC) count in the AUR group significantly increased compared with the non-AUR group (P < 0.01). However, there was no significant difference in international prostate symptom score, painful urination, and maximal urinary flow rate. The duration of hospitalization of the AUR group was longer than that of the non-AUR group (P < 0.001). A total of 87.1% (303/348) patients in the AUR group and 84.1% (654/778) patients in the non-AUR group completed all of the postoperative follow-up visits. The incidence of urinary tract infection in the AUR group within 3 months after surgery was significantly higher than that in the non-AUR group (P < 0.01). The incidence of temporary urinary incontinence in the AUR group did not exhibit significant difference. During 3-12 months after surgery, there were no significant differences in major complications between the two groups. Multivariate regression analyses showed that age, postvoid residual, maximal urinary flow rate, diabetes, and hypertension, but not the presence of AUR, were independent predictors of IPSS post-PK-TURP. In conclusion, immediate PK-TURP surgery on patients accompanied by AUR was safe and effective.

OBJECTIVETo investigate the clinical features, diagnosis and surgical treatment of giant prostatic hyperplasia

METHODSWe retrospectively analyzed the clinical data of 1 case of GPH, and reviewed the relevant literature published at (GPH). home and abroad.

RESULTSThe patient was 77 years of age. The main clinical features were increased nocturnal urine and gross hematuria. The maximum urinary flow rate was 10 ml/s, the total PSA was 37 pIg/L and the prostate volume was 11 x 10 x 8 cm. Suprapubic prostatectomy was performed successfully, and the removed prostate weighed 450 g. Pathologic examination showed the case to be benign prostatic hyperplasia. The patient was discharged 21 days after surgery, without any obvious complications. We identified 83 cases with the prostate weighing over 200 g in the domestic literature, and 14 cases with the prostate volume exceeding 500 g in the foreign literature, mostly treated by suprapubic prostatectomy and only a few by retropubic prostatectomy.

CONCLUSIONGPH, as a rare entity whose nomenclature is not yet agreed-on, can be diagnosed according to its clinical manifestations and the results of transrectal ultrasonography and prostate CT. Surgical methods most frequently adopted for its treatment include transurethral prostatectomy, transvesical suprapubic prostatectomy, retropubic prostatectomy, and laparoscopic prostatectomy.

Aged ; Humans ; Male ; Prostate ; pathology ; Prostatectomy ; Prostatic Hyperplasia ; diagnosis ; pathology ; surgery ; Retrospective Studies

Objective To evaluate the prognostic significance of carbonic anhydrase IX (CA IX) expression in patients with clear cell renal cell carcinoma (ccRCC). Methods CA IX expression in a cohort of 120 patients with ccRCC was evaluated by P-V immunohistochemistry with a rabbit CA IX polyclonal antibody. Twenty-five normal kidney tissues were used as a control. The relationship between CA IX expression and prognosis was analyzed by univariate and multiple-factor analysis (Cox regression model). The primary end point was cancer specific survival. Results One hundred and twelve (93.3%) patients were followed up with the median follow-up time of 45 months (range, 6 to 94 months). Seventy-five patients survived without evidence of tumor recurrence, 3 patients survived with tumor recurrence, and 34 patients died, 28 of the 34 died of cancer. CA IX expression was negative in all normal renal tissue. High CA IX expression was observed in 89 (74.2%) patients, among which 82 patients were followed up, and the disease free survival was 75.6% (62/82). Two (2.4%) patients survived with tumor recurrence, and 18 (22.0%) patients died, of which 13 (15.9%) died of cancer. Tumor recurrence and (or) metastasis occurred in 9 (11.0%) patients, with a median survival of 92 months in this high expression group. Low CA IX expression was observed in 31 (25.8%) patients, among which 30 patients were followed up, and the disease free survival was 43.3% (13/30). One (3.3%) patient survived with tumor recurrence, and 16 (53.3%) patients died, of which 15 (50.0%) died of cancer. Tumor recurrence and (or) metastasis occurred in 8 (26.7%) patients with a median survival of 53 months in this low expression group. Cancer specific survival between CA IX high expression group and low expression group was significantly different (P=0.000, χ2=15.950), and tumor relapse and (or) metastasis rates were significantly different (P=0.040, χ2=4.200). The 1, 3, 5 and 7 year cancer specific survival rates were 95.2%, 83.9%, 81.2% and 78.2% respectively in the high CA IX expression group, and 89.5%, 63.9%, 46.8% and 40.1% respectively in the low expression group. Multivariate analysis with Cox regression model showed that CA IX expression was a prognostic factor (RR=0.186). Conclusions High CA IX expression is negatively correlated with postoperative mortality, relapse and (or) metastasis in ccRCC. CA IX expression could be used as a prognostic biomarker in ccRCC.

OBJECTIVETo investigate the possible roles of adenosine and the cytokines TNF-alpha and IL-10 in the pathogenesis of acute bacterial prostatitis (ABP) in rats.

METHODSForty-eight male Wistar rats were randomly divided into groups A (ABP), B (ABP + theophylline intervention), C (sham) and D (blank control). ABP models were established by injecting Escherichia coli 0157 into the prostate, and those in group B were treated by intraperitoneal injection of theophylline immediately after modeling. At 4 and 14 days, the prostate tissues of the rats were collected for detection of the expressions of TNF-alpha and IL-10 by immunohistochemistry and the concentration of adenosine by high-performance liquid chromatography.

RESULTSAt 4 and 14 days, the concentrations of adenosine were significantly higher in group A ([48.38 +/- 17.27] and [26.54 +/- 11.22] microg/g) than in C ([0.45 +/- 0.25] and [0.46 +/- 0.29] microg/g) and D ([0.41 +/- 0.23] and [0.43 +/- 0.27] microg/g) (P < 0.05), and so were the expressions of TNF-alpha in A (0.23 +/- 0.08 and 0.21 +/- 0.03) than in C (0.07 +/- 0.03 and 0.07 +/- 0.01) and D (0.07 +/- 0.06 and 0.07 +/- 0.06) (P < 0.05), and those of IL-10 in A (0.13 +/- 0.03 and 0.25 +/- 0.01) than in C (0.07 +/- 0.03 and 0.07 +/- 0.03) and D (0.07 +/- 0.01 and 0.07 +/- 0.02) (P < 0.05). Compared with group A, the rats in group B showed significant increases at 4 and 14 days in the severity of inflammation, concentration of adenosine ([86.64 +/- 32.87] and [51.17 +/- 22.96] microg/g, P < 0.05) and expression of TNF-alpha (0.37 +/- 0.08 and 0.32 +/- 0.06, P < 0.05), but exhibited no remarkable difference in the expression of IL-10 (0.12 +/- 0.06 and 0.15 +/- 0.06, P > 0.05).

CONCLUSIONAdenosine may affect the progression of inflammation by regulating the expressions of the cytokines TNF-alpha and IL-10 in ABP rats through the adenosine receptor signaling pathway.

Adenosine ; physiology ; Animals ; Escherichia coli O157 ; Interleukin-10 ; metabolism ; Male ; Prostate ; drug effects ; metabolism ; Prostatitis ; metabolism ; microbiology ; Random Allocation ; Rats ; Rats, Wistar ; Theophylline ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo observe the effect of the inducible nitric oxide synthase (iNOS) gene on androgen-independent prostate cancer DU145 cells in vitro.

METHODSThe iNOS gene was transfected into androgen-independent prostate cancer DU145 cells. The positive cells were selected as the transfected group for amplification, and an empty vector (EV) group and a control group were also set. The mRNA transcription of iNOS was analyzed by RT-PCR. The morphological changes of the cells were observed, the effect of iNOS transfection on the cell growth determined using the MTB method, and the apoptosis of DU145 cells detected by flow cytometry, followed by analysis of the effect of NOS inhibitors on the transfected cells.

RESULTSDU145 cells transfected with iNOS secreted significantly more nitric oxide ([272.50 +/- 15.82] micromol/L) than those of the EV and control groups ([122.00 +/- 18.93] micromol/L and [121.00 +/- 6.98] micromol/L) (P < 0.05). The rate of cell apoptosis was markedly enhanced in the transfected group as compared with the EV and control groups ([42.78 +/- 2.01]% vs [30.65 +/- 1.46]% and [28.96 +/- 1.50]%, P < 0.05). MTP test indicated a slower growth of the DU145 cells in the former than in the latter two (P < 0.05). NOS inhibitors enhanced their growth, but with no significance (P > 0.05).

CONCLUSIONDU145 cells transfected with iNOS could secrete high-concentration nitric oxide, induce cell apoptosis, and suppress cell proliferation, which may provide a potentially effective gene therapy for advanced androgen-independent prostate cancer.

Androgens ; pharmacology ; Apoptosis ; genetics ; Cell Cycle ; genetics ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Humans ; Male ; Nitric Oxide Synthase Type II ; genetics ; Prostatic Neoplasms ; genetics ; pathology ; Transfection

OBJECTIVETo investigate the expressions of vinculin (VCL) and the androgen receptor (AR) in benign prostatic hyperplasia (BPH) and prostate cancer (PCa) and analyze their relationship with the clinical stage and pathological grade of PCa and the level of PSA.

METHODSWe detected the expressions of VCL and AR in 18 cases of BPH and 38 cases of PCa by immunohistochemistry, analyzed the differences of VCL and AR expressions in BPH and PCa in different clinical stages and pathological grades of PCa, compared the primary levels of PSA, and studied their correlations.

RESULTSThe positive rate of VCL was significantly higher in PCa than in BPH tissues (P < 0.05), while that of AR showed no significant differences between the two groups (P > 0.05). Both the expressions of VCL and AR were closely related with the clinical stage and pathological grade of PCa (P < 0.05), but not with the PSA level (P > 0.05). There was a positive correlation between the expressions of VCL and AR in PCa tissues (r = 0.489, P < 0.05).

CONCLUSIONVCL is expressed differently in BPH and PCa, which may serve as an indicator for the differential diagnosis of benign and malignant prostate diseases. The expressions of AR and VCL are gradually reduced with the progression of PCa, with a positive correlation between them, and could be used jointly to evaluate the progression and prognosis of PCa.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; Receptors, Androgen ; metabolism ; Vinculin ; metabolism

OBJECTIVETo explore the efficacy of urethral dilatation with the renal sheath dilator under the ureteroscope in the treatment of male patients with urethrostenosis.

METHODSEighteen male patients with urethrostenosis underwent urethral dilatation with the renal sheath dilator. Under the ureteroscope, a zebra-guide wire was inserted through the stenosed urethra into the bladder and the stenosis was gradually dilated with the renal sheath dilator, followed by placing a Foley catheter of proper size for 1-4 weeks. For children, the renal sheath dilator was selected according to their age, while for adults, metal dilators (> or = F20) were used following dilatation with the F18 renal sheath dilator. All the patients were followed up for 6-24 months.

RESULTSThe operation was successfully performed in all the 18 cases, with no urethral false passage, urethral perforation or urethra tearing. Sixteen of the patients were cured, and the other 2 received urethroplasty for stenosis recurrence. The maximum flow rate was increased to 13.6-30.2 (18.1 +/- 3.5) mL/s after the operation.

CONCLUSIONUrethral dilatation with the renal sheath dilator under the ureteroscope is a simple, safe and effective method for the treatment of urethrostenosis.

Adolescent ; Adult ; Child ; Child, Preschool ; Dilatation ; methods ; Fasciotomy ; Humans ; Male ; Middle Aged ; Urethral Stricture ; surgery ; Young Adult

OBJECTIVETo study the causes of orchiectomy in different age groups.

METHODSWe retrospectively reviewed the clinical data about 291 cases of orchiectomy performed between March 1993 and October 2014 and analyzed the causes of surgery and their distribution in different age groups.

RESULTSThe main causes of orchiectomy were testicular torsion (45.8%), cryptorchidism (32.5%) and testicular tumor (16.9%) in the patients aged 0-25 years, testicular tumor (42.4%), cryptorchidism (25.9%) and tuberculosis (10.6%) in those aged 26-50 years. Prostate cancer was the leading cause in those aged 51-75 years (77.6%) or older (84.0%)), and testicular tumor was another cause in the 51-75 years old men (10.2%). Prostate cancer, testicular tumor, cryptorchidism, and testicular torsion were the first four causes of orchiectomy between 1993 and 2009. From 2010 to 2014, however, testicular tumor rose to the top while prostate cancer dropped to the fourth place.

CONCLUSIONThe causes of orchiectomy vary in different age groups. The proportion of castration for prostate cancer patients significantly reduced in the past five years, which might be attributed to the improvement of comprehensive health care service.

Adolescent ; Adult ; Age Factors ; Aged ; Causality ; Child ; Child, Preschool ; Cryptorchidism ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Orchiectomy ; statistics & numerical data ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Spermatic Cord Torsion ; surgery ; Testicular Neoplasms ; surgery ; Tuberculosis, Male Genital ; surgery ; Young Adult

OBJECTIVETo evaluate the effect of the transverse preputial island flap technique (Duckett's procedure) for hypospadias repair.

METHODSA total of 356 patients with hypospadias were treated by Duckett's procedure from March 1995 to December 2010, of whom 324 (91.0%) were younger than 14 years. The length of urethra repair ranged from 1.5 to 10 cm.

RESULTSThe total success rate of Duckett's procedure was 91.0%. Urethra fistula occurred in 30 cases, external orifice stricture in 1, and urethral anastomosis stricture in another. There were no significant differences in the rate of complications among either different age groups or different surgical times (P > 0.05).

CONCLUSIONDuckett's procedure remains the first choice for the one-stage repair of hypospadias, especially applicable to hypospadias with chordee.

Adolescent ; Adult ; Child ; Child, Preschool ; Foreskin ; surgery ; Humans ; Hypospadias ; surgery ; Infant ; Male ; Surgical Flaps ; Young Adult

ObjectiveTo test the effect of human tremor detector in clinic based on the principle of photoelectrical transformation.MethodsFifty-five subjects including normal youth and elderly persons, patients with Parkinson's disease (PD), hyperthyroidism and cerebellor ataxia were tested with human tremor detector. The displacement, frequency spectrograph, velocity and acceleration of both hands in four kinds of postures and action were involved.ResultsThe physiological tremor and pathological tremor in different kinds of patients were significantly different (P<0.05). Especially in PD, both quantitive and qualitative data had a significant difference.ConclusionHuman tremor detector can provide the evidence for early diagnosis of PD.