Objective To evaluate the prevention and treatment of rectal complications following 125I brachytherapy for prostate cancer. Methods A total of 90 patients with locally advanced prostate cancer was treated by transrectal ultrasound guided prostate 125I brachytherapy combined with maximal androgen blockage from November 2001 to June 2006. The patients were followed every 1～3 months postoperatively, and rectal complications was analyzed and treated. Results Eighty-nine patients were followed for 1～55 months (mean, 22 months). The incidences of rectal complications at grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 11.2% (10/89), 6.7% (6/89), 0%, and 2.2% (2/89), respectively. Symptomatic therapy was conducted in 16 patients with grade Ⅰ or Ⅱ complications, which were symptomatically relieved 6 months later. The grade Ⅳ complications occurred in 2 patients, one of whom underwent repeated examinations and treatment for proctitis, and the other of whom was complicated with severe diabetes and received a laparocolostomy with cystostomy. Conclusions The optimal medical treatment for radiation proctitis is follow-up checkups and observations. To reduce the incidence of urethrorectal fistula, excessive examinations and treatment should be avoided. Accompanying diabetes should be treated promptly and actively.

0. 05) and the specificity is higher than that of the SEA-ELISA (P

Objective To investigate the clinical value of 125I particle implantation brachytherapy combined with intermittent hormonal therapy for treating clinical moderate and high risk non-metastatic prostate cancer.Methods A prospective study was proceeded and 100 cases with moderate and high risk (cT≥T2b,Gleason score ≥ 7,pre-biopsy PSA ≥ 10 ng/ml)non-metastatic prostate cancer were included.The selected patients were divided into two group.In the study group,patients were treated with 125I particle implantation combined with intermittent hormonal therapy.In the control group,patients were treated with only intermittent hormonal therapy.Hormonal therapy was maximal androgen blockage for two groups,including bicalutamide 50 mg oral every day and Leuprorelin 3.75 mg subcutaneous injection every 28 days.There were 50 cases in each group and clinical trial agreements were signed.During follow-up,PSA were tested every month.Chest X-ray and whole-body hone scanning were checked every 6 months.Hormonal therapy was stopped when patient's PSA level fell to 0.2 ng/ml,and keep stabilized for 3 months.When PSA level elevated for 3 times continuously and over 1 ng/ml,hormonal therapy was initiated again.The IPSS scores were documented before treatment and every 3 months after treatment.Adverse reactions of urinary tract and rectum were assessed every 3 months after 125I particle implantation in study group.The ratio of the first time to stop hormonal therapy,the time duration of first hormonal therapy and stable phase,re-hormonal therapy free survival rate,bone metastasis free survival rate,castration resistance prostate cancer(CRPC) free survival rate,cancer-specific free survival rate and overall survival rate were compared.Results The 100 cases in this study were followed up for 24-40 months,with an average time of 31.6 months.In study group,the PSA level in all cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 4 to 12 months,with an average time of 6.3 months.21 (42％) cases had a PSA elevation again to restart hormonal therapy.In control group,the PSA level in 47 cases descended to the level of stopping hormonal therapy.The time duration of hormone therapy ranged from 5 to 15 months,with an average time of 7.2 months.34 (68％) cases had a PSA elevation again to restart hormonal therapy.There was no significant difference in percentage of cases of stopping hormone therapy and in time duration of hormonal therapy for the first cycle.Instead,there were significant differences in stable phase after first cycle hormonal therapy between two groups (27.2 months vs.17.7 months;P ＜ 0.001).When analyzed by Kaplan-Meier survival curve,there was no significant difference in cancer-specific survival rate and overall survival rate.There were significant differences in Re-hormonal therapy free survival (P =0.002),bone metastasis free survival (P =0.04) and CRPC free survival(P =0.005).Conclusions Compared with intermittent hormonal therapy alone,125I particle implantation brachytherapy combined with intermittent hormonal therapy could prolong the hormonal sensitive time in moderate and high risk nonmetastatic prostate cancer patients and control the progress of the prostate cancer.

Moyamoya disease may cause subarachnoid hemorrhage because of its feature of spontaneous occlusion of the circle of Willis with vascular network abnormal hyperplasia on the base of the brain.This article reviews the disease characteristics of moyamoya disease-related subarachnoid hemorrhage,the correlations between bleeding mechanisms,disease progression and bleeding,as well as its therapeutic measures.

Objective To detect the sperm apoptosis rate and level of reactive oxygen species (ROS) in seminal plasma and explore their correlation among infertile males. Methods Ninety-two inferitile males were divided into varicocele (VC) group (n=32), leukocytospermia group(n=30) and the other cause group (n=30), and another 24 in vitro fertilization sperm samples were sereved as controls. The routine sperm parameters including seminal pH, sperm viability and sperm density were examined by computer assisted sperm analysis, the sperm apoptosis rate was asseseed using Annexin V/PI staining, and the ROS level in seminal plasma was detected by TBA method. The differences in seminal parameters between three infertile groups and control group were compared, and the correlation of sperm apoptosis rate with level of ROS in seminal plasma was explored in each group. Results The sperm viability of three infertile groups was significantly lower than that of control group (P<0.01). The sperm apoptosis rates and levels of ROS in seminal plasma in VC group and leukocytospermia group were significantly higher than those in control group (P < 0.05 or P < 0.01). The sperm apoptosis rate was positively correlated with the level of ROS in seminal plasma in leukocytospermia group(r=0. 573, P < 0.05). Conclusion The increased sperm apoptosis rate and level of seminal plasma ROS may be related to the infertility of patients with VC and leukocytospermia. The increased level of seminal plasma ROS may be one of the causes of increased sperm apoptosis rate in patients with leukocytospermia.

Objective To explore the efficacy of foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in the treatment of concealed penis. Methods Fifty-eight patients diagnosed as concealed penis were included in the study.All of them underwent the foreskin-deglove and shaft-fix procedure.Foreskin was degloved from 5 mm to 10 mm proximal to corona deep to the root,and bilateral tunica albuginea at this level was sutured to suprapubic scarpas' fascia.Z plasty of penis and scrotum skin was applied to cover penile shaft. Results After follow-up for 6 to 12 months,there was no recurrent retraction of the penile shaft,and all the patients were satisfied with the appearance of penis after plastic surgery.Edema of prepuce occurred in 2 patients,and completely regressed in 2 to 3 months.There was no incision scar hyperplasy,and the function of urination and erection were normal. Conclusion Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin can resolve pathologic problems of concealed penis and has favourable aesthetic results with less complications.It is easy to perform and is an ideal procedure in the treatment of concealed penis.

ObjectiveTo develop a stable model of focal cerebral infarction in rat to study the curative effect of neural stem cells transplantation.MethodsThirty-seven rats were selected which were divided into two groups in random, experimental group and control group. The focal infarction model was developed by the ligation of the left middle cerebral artery followed by the ligation of the ipsilateral common carotid artery and the temporary clip occlusion of the contralateral common carotid artery for 1.5 h. The operation adopted minimally invasive craniotomy though temporal bone. The model was evaluated by examining the neurologic deficits, ink perfusion, TTC staining and Magnetic Resonance imaging.ResultsAll the rats were in good condition after the operation, the mortality rate was 6.25% after 4 weeks. Ink perfusion and TTC staining confirmed that the ischemia was confined to the cortex. The areas of infarction measured 83.52 mm3 by Magnetic Resonance imaging after 4 weeks.ConclusionA stable focal cerebral infarction model can be achieved by minimally invasive craniotomy. It is superior for its homogeneity of infarction volume and site, and its low mortality. It can be used for the study of transplantation of neural stem cells.

More than one-third of men may experience erectile dysfunction (ED) after nerve-sparing radical retropubic prostatectomy. A recent study has shown that vardenafil, a phosphodiesterase 5 inhibitor, could significantly improve the key indices of erectile function in men after unilateral or bilateral nerve-sparing radical retropubic prostatectomy. Few adverse events were observed in the study.
Double-Blind Method ; Erectile Dysfunction ; drug therapy ; etiology ; Humans ; Imidazoles ; therapeutic use ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Postoperative Complications ; drug therapy ; Prostatectomy ; Randomized Controlled Trials as Topic ; Spheroids, Cellular ; Sulfones ; therapeutic use ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

Objective To evaluate the expressions of estrogen receptor (ER) α and β in human prostate cancer and adjacent non-cancerous tissues,and to evaluate the correlation between the expression and the clinicopathological features and prognosis.Methods Immunohistochemical staining was used to detect ERα and ERβ in 85 prostate adenocarcinoma tissues,adjacent non-cancerous tissues,and 29 benign prostatic hyperplasia (BPH) tissues.The correlation between the expression and the clinicopathological features was analyzed by Spearman's coefficient.Cox's proportional hazards regression model was used to identify the risk factors for biological recurrence.Results There were significant differences between the expression of ERα in prostate cancer,adjacent non-cancerous tissues,and BPH [epithelial cell 0 (0/85),11.8％ (10/85) and 24.1％ (7/29),P=0.000; and in stromal cell 52.9％ (45/85),67.1％ (57/85),31.0％ (9/29),P =0.003].There were significant differences between the expression of ERβ in these groups [epithelial cell 36.5％ (31/85),61.2％ (52/85),100.0％ (29/29),P =0.000; and in stromal cell 49.4％ (42/85),72.9％ (62/85),79.3％ (23/29),P =0.001].The ERα expression in cancerous stromal cells was positively correlated with the PSA level (r =0.296,P =0.006) and Gleason score (r =0.404,P =0.000).The ERβ expression was negatively correlated with Gleason score in cancerous epithelial cells (r =-0.254,P =0.019) and stromal cells (r =-0.315,P =0.003).Multivariate analysis revealed that negative expression was an independent poor prognostic factor for the biological recurrence free survival after radical prostatectomy (HR =0.107,95.0％ CI 0.019-0.592,P =0.010).Conclusions There were significant differences between the expression of ERα and ERβ in prostate cancer,adjacent non-cancerous tissues,and BPH.ERα in cancerous stromal cells,ERβ in cancerous epithelial and stromal cells were related to the differentiation of prostate adenocarcinoma.ERβ in cancerous epithelial cells can be used as an independent prognostic factor for biological recurrence after radical surgery.

Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrast-enhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope (a3), descending slope (a2), arrival time (AT), time to peak intensity (TTP), basic intensity (BI), peak intensity, amplification (AMP), area under the curve (AUC), mean transit time (MTT) and perfusion index (PI). The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and slow-out was found in renal angiomyolipoma (AML). The perfusion modes in renal malignant tumors and renal AML were fast-in and fast-out in 28 cases and 0 case, fast-in and slow-out in 4 cases and 1 case, slow-in and fast-out in 5 cases and 1 case, and slow-in and slow-out in 1 case and 10 cases, respectively. There were significant differences in the quantitative parameters such as a2, AUC and PI between renal malignant tumors and renal AML obtained by the time-intensity curves (P<0.05). Conclusion Gamma fitting analysis of contrast-enhanced ultrasound system can provide quantitative information of microcirculation of renal tumors, which helps to differentiate benign renal tumors from malignant ones.