Objective To evaluate the treatment of traumatic posterior urethral atresia in boys via a modified transperineal approach. Methods The transperineal approach was adepted in 11 cases with transecting the central perineal teadon, excising the ligaments of arcuate pubis and the traumatic scar, so that end-to-end anastomosis of urethra could be achieved with good exposure. Results 10 cases were cured after the first operation, where as one patient needed the procedure for 3 times. Conclusions The modified transperineal approach provide a good exposure for the anastomosis of urethra in boys.

Objective: To investigate the clinical effect of total cystectomy and W-shaped orthotopic ileal neobladder for bladder cancer. Methods: Total cystectomy and W-shaped orthotopic ileal neobladder were performed on 29 male patients and 3 female patients. Atfer the cystectomy, 35-40 cm terminal ileal segment was isolated to make W-shaped orthotopic ileal neobladder. Bilateral uretero-ileal anastomoses were constructed by nipple technique, urethral stump was sutured to the lowest portion of the ileal pouch. Results: All surgeries were completed successfully. Patients were able to void by increasing the abdominal pressure, daytime continence rate was 87.5% and nighttime continence rate was 78.1%. The mean neobladder capacity was 410.6 mL and the mean postvoid residual urine was22.7 mL at 6 months. After the surgery, ileal neobladder leakage occurred in 3 (9.4%) patients, mild ileus occurred in 2 (6.3%) patients, ileo-urethral anastomosis stricture developed in 1(3.1%) patient, and dysuria occurred in 3 (9.4%) patients because of the mucus.HTe complications were treated properly and satisfactory results were obtained. Erection was preserved in 5 of the 9 male patients with normal erectile function, and normal sexual function was preserved in 1 female patient who underwent uterus-sparing cystectomy. HTe mean follow-up was 15 months.One patient died of distant metastasis and pneumonia, while other patients survived without tumor. Conclusion: Total cystectomy and W-shaped orthotopic ileal neobladder have the advantages of voiding through the native urethra, satisfactory continence, low complication rates of upper urinary tract damage and electrolyte imbalance. W-shaped orthotopic ileal neobladder may be considered as the ifrst option of urinary diversion atfer cystectomy. Postoperative management should focus on complications and follow-up.

Objective To evaluate surgical results an d choice of various procedures for hypospadias repair in boys.323 cases of hypospa dias were treated from 1995-2002,and of these,205 boys whose average age was 5.1 years had underwent different surgical procedure for hypospadias. M ethods 205 boys with hypospadias were retrospectively analysed.MAGPA (5 cases),Mathieu(7),Onlay island flap(9) were given to boys of hypospadias wit hout chordee.Duckett procedure (127),Modified Denis-Browne (16),Bladder mucosa graft technique (16),Duckett plus Duplay techniques(25) were adopted for hypospa dias with chordee. Results There were 19 cases with uret hra fistula and 1 case with external orifice stricture of urethra.The success ra te for all cases was 90.2%,and morbidity of all complications was 9.8%.The compl ication for Duckett techniques was 7.8%(10/127),Modified Denis-Browne 12.5%(2/1 6),Mathieu 28.6%(2/7),Duplay plus Duckett 16.0%(4/25),Bladder mucosa graft techn ique 6.3%(1/16) and Onlay 11.2%(1/9). Conclusions It is suggested that a complete mastery of applications for different surgical approac h and a proper selection of various surgical methods according to individual pat ient’s condition can reduce complication of operation.

Objective:To construct a p53-fused dual luciferase reporter and to test whether this reporter can mimic wild-type p53 activities in a high-throughput screen.Methods:A restriction endonuclease site was added to each terminus and the stop codon of the wild-type full-length p53 open reading frame (ORF) was removed by PCR. A restriction endonuclease site was added to each terminus and the start codon of the ifrelfy luciferase ORF was removed by PCR. The two modified ORFs were inserted upstream of the IRES-induced renilla luciferase ORF in a CMV-derived vector. hTe p53 fusion protein was expressed in cells to test its MDM2-mediated degradation, subcellular localization, and induction of p53-responsive promoter.
Results:hTe p53-fused dual luciferase reporter was successfully constructed. Atfer transfection into the host cells, the reporter expressing the p53 fusion protein that was degraded by oncoprotein MDM2, was mainly located inside the nucleus, and induced the p53-responsive promoter, respectively.
Conclusion:hTe p53-fused dual luciferase reporter (p53FL/IRES/RL) can identify modulators of P53 protein level in a high-throughput screen of genetic or chemical libraries.

Objective:To present our initial experience with robot-assisted laparoscopic prostatectomy (RALP) for complicated cases.Methods:Clinical and pathological data from 4 complicated prostate cancer cases,who underwent RALP from October to November in 2015,were analyzed retrospectively.All the cases were conducted transurethral plasmakinetic enucleation of prostate and hormonal therapy before RALP.Results:All surgeries were done successfully.The age,baseline prostatic special antigen,clinical tumor stage,operation time and estimated blood loss were 58-70 years,6.04-70.15 ng/mL,T2bT3b,210-360 min and 50-250 mL,respectively.No blood transfusion was needed.All surgical margin were negative.Conclusion:Although previous transurethral surgeries and hormonal therapies may increase the difficulty for operations,RALP is still appropriate for the complicated cases of prostate cancer.

OBJECTIVE: To detect the expression of Raf kinase inhibitor protein (RKIP) and epithelial cadherin (E-cadherin) in human prostate cancer tissues, and their correlation. METHODS: We discussed the relationship between RKIP and E-cadherin and the clinical stage and pathological classification of prostate cancer by immunofluorescence histochemistry staining in the test of expression of RKIP in 26 prostate cancer tissues and 14 BPH tissues, and analyzed the correlation between them. RESULTS: The expression of RKIP and E-cadherin in prostate cancer tissues was obviously lower than that in the benign prostatic hypertrophy tissues. The expression of RKIP and E-cadherin in the dys-good differentiation group (Gleason 8-10) was significantly lower than that in the good differentiation group(GleasonCONCLUSION RKIP and E-cadherin are metastasis suppressor factors, whose decreased expression can increase the invasive capability of prostate cancer and suppress its differentiation. RKIP can suppress the metastasis of prostate cancer by increasing the E-cadherin expression in prostate cancer.
Adenocarcinoma ; metabolism ; pathology ; Aged ; Aged, 80 and over ; Cadherins ; genetics ; metabolism ; Fluorescent Antibody Technique ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Phosphatidylethanolamine Binding Protein ; genetics ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology

OBJECTIVE: To explore the expression of perforin and granzyme-B in peripheral blood lymphocyte (PBL) in patients with prostate cancer (PCa) and the clinical significance. METHODS: The expressions of perforin and granzyme-B in PBL were detected by fluorescence quantitative reverse transcription polymerase chain reaction. The results of perforin and granzyme-B expression were compared among patients with PCa (n=60), patients with BPH (benign prostatic hyperplasia, n=40) and healthy controls (n=20). RESULTS: Th e expressions of perforin and granzyme-B in patients with PCa were significantly lower than that in patients with BPH or that in the healthy controls (P<0.05), respectively. Furthermore, in PCa patients with low pathological grade, the expressions of perforin and granzyme-B in PBL was statistically higher than that in patients with high pathological grade (P<0.05). The expressions of perforin and granzyme-B in PCa patients at high clinical stage was statistically lower than that in PCa patients at low clinical stage (P<0.05). CONCLUSION The results of this study suggest that development and progression of PCa might be associated with poor immune status of patients.
Case-Control Studies ; Granzymes ; metabolism ; Humans ; Lymphocytes ; enzymology ; Male ; Perforin ; metabolism ; Prostatic Hyperplasia ; Prostatic Neoplasms ; immunology

OBJECTIVE: To determine the diagnostic value of real-time Rigiscan monitoring and Doppler ultrasonography following intracavernous injection of prostaglandin E1in erectile dysfunction(ED). METHODS: From January 1998 to December 2007, 1 392 ED patients completed the test. PGE(1) was injected into corpus cavernosum penis near the radix penis with injection guns. After 1 or 2 minutes, the Rigiscan Plus device was used for real-time evaluation of penile rigidity. Optimal injected dosage of each patient with positive reaction was determined. Injected dosage of patients with negative reaction was gradually increased from to 60 microg. As the dosage was established, color Doppler ultrasonography was used to assess the morphodynamic features of cavernosal arteries. RESULTS: Altogether 1 039 patients were positive, while 353 patients were negative by Rigiscan. In the 1 039 positive patients,663 were injected with 10 microg PGE(1), 265 patients 20 microg, 97 patients 30 microg,and 14 patients 60 microg while 89(13.4%),39(14.7%),41(42.3%),and 10(71.4%) patients were diagnosed vascular ED. Of the 353 negative patients, 267(75.64%) patients were diagnosed vascular ED. During intracavernous pharmacological testing,the more PGE(1) was used, the more vascular ED patients would be found(P<0.001). CONCLUSION PGE(1) is safe and effective for the erectile responses. The dosage of PGE(1) following intracavernous injection is related to vascular ED. Real-time Rigiscan monitoring combined with color Doppler ultrasonograph can be helpful to diagnose penile vascular diseases.
Adult ; Alprostadil ; administration & dosage ; Erectile Dysfunction ; diagnosis ; diagnostic imaging ; physiopathology ; Humans ; Male ; Penile Erection ; Penis ; blood supply ; diagnostic imaging ; Ultrasonography, Doppler, Color

OBJECTIVE: To analyze the clinical features of benign prostate hyperplasia (BPH) with prostatitis and the role of prostatitis in progression of BPH. METHODS: From July 2003 to Feb. 2009, 466 patients diagnosed BPH were enrolled in this study. Several items including age, history, IPSS, volume of prostate, prostatic special antigen (PSA) and related parameters, Qmax, acute urinary retention (AUR) and the way of treatment were analyzed. RESULTS: A total of 423 patients were diagnosed as BPH with prostatitis (90.77%, PS/BPH group), and 43 were BPH without prostatitis (9.23%, BPH group). Compared with the BPH group, patient's history of the PS/BPH group was longer, IPSS/QOL was increased, the volume of total prostate and transitional zone were larger, maximum flow rate was decreased and risk of AUR was increased, and the proportion of BPH-related surgery was higher.There was no significant difference in patient's age, tPSA, fPSA, f/tPSA, and PSAD between the 2 groups. CONCLUSION Prostatitis may be one etiological factor for BPH. Patients with inflammation were more likely to progress clinically in terms of lower urinary tract symptoms (LUTS), acute urinary retention (AUR), or BPH-related surgery.
Aged ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; complications ; diagnosis ; surgery ; Prostatitis ; complications ; diagnosis ; Retrospective Studies ; Urinary Retention ; etiology

OBJECTIVE: To investigate the timing of reaching maximum improvement of the lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer treated with maximal androgen blockade(MAB), and to provide guidelines for the treatment program. METHODS: We collected the data of 45 advanced prostate cancer patients complicated with lower urinary tract symptoms who were treated by MAB. The international prostate symptom score (IPSS) and maximum urinary flow rate (Qmax) were selected as indicators reflecting the degree of lower urinary tract symptoms and were observed before the MAB, 3, 6, and 9 months after the patients received MAB. We also observed the changes of prostate volume and analyzed the role of MAB in improving LUTS in patients with prostate cancer. RESULTS: The IPSS and Qmax had significant difference between the 3rd month after the patients received MAB and before the MAB (P<0.05). No significant difference was found between the 3rd month and the 6th month after the patients received MAB (P>0.05). The prostate volume had significant difference in the 3rd month and the 6th month (P<0.05), but no significant difference in the 6th month and the 9th month (P>0.05). CONCLUSION MAB for patients with advanced prostate cancer can improve their lower urinary tract symptoms, whose main effect is presented in the 3rd months after the androgen deprivation therapy.
Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Anilides ; therapeutic use ; Flutamide ; therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Prostatic Neoplasms ; complications ; drug therapy ; Tosyl Compounds ; therapeutic use ; Urination Disorders ; drug therapy ; etiology