Erectile dysfunction (ED) is a highly prevalent health problem with considerable impact on the quality of men and their partners.There are many drawbacks in the existing ED treatment.Stem cells have the function of self-renewal and differentiation into various cell types.Gene therapy mainly focuses on the regulation of various transmitters and enzymes in nitricoxide synthase/cyclic guanosine monophosphate (NOS/c GMP) pathway,growth factors,peptides and channel proteins,which make them have broad application prospects in the field of ED treatment.In recent years,stem cell and gene therapy of ED have achieved initial results.This article aims to review the latest research progress in this field.

Ankylosing spondylitis (AS) is a type of autoimmune disease that predominantly affects the spine and sacroiliac joints. However, the pathogenesis of AS remains unclear. Some evidence indicates that infection with bacteria, especially Gram-negative bacteria, may have an important role in the onset and progression of AS. Recently, many studies have demonstrated that mesenchymal stem cells (MSCs) dysfunction may contribute to the pathogenesis of many rheumatic diseases. We previously demonstrated that MSCs from AS patients exhibited markedly enhanced osteogenic differentiation capacity in vitro under non-inflammatory conditions. However, the properties of MSCs from AS patients in an inflammatory environment have never been explored. Lipopolysaccharide (LPS), a proinflammatory substance derived from the outer membrane of Gram-negative bacteria, can alter the status and function of MSCs. However, whether MSCs from AS patients exhibit abnormal responses to LPS stimulation has not been reported. Autophagy is a lysosome-mediated catabolic process that participates in many physiological and pathological processes. The link between autophagy and AS remains largely unknown. The level of autophagy in ASMSCs after LPS stimulation remains to be addressed. In this study, we demonstrated that although the basal level of autophagy did not differ between MSCs from healthy donors (HDMSCs) and ASMSCs, LPS-induced autophagy was weaker in ASMSCs than in HDMSCs. Specifically, increased TRAF4 expression in ASMSCs impaired LPS-induced autophagy, potentially by inhibiting the phosphorylation of Beclin-1. These data may provide further insight into ASMSC dysfunction and the precise mechanism underlying the pathogenesis of AS.
Autoimmune Diseases ; Autophagy* ; Bacteria ; Gram-Negative Bacteria ; Humans ; In Vitro Techniques ; Membranes ; Mesenchymal Stromal Cells* ; Pathologic Processes ; Phosphorylation ; Rheumatic Diseases ; Sacroiliac Joint ; Spine ; Spondylitis, Ankylosing* ; Tissue Donors ; TNF Receptor-Associated Factor 4*

Objective To evaluate the value of transrectal real-time tissue elastography (RTE) targeted prostate biopsy in the peripheral zone combined with peak strain index.Methods One hundred and forty-one patients with suspicious prostate lesions in the peripheral zone were evaluated from February 2011 to February 2014.All the patients underwent RTE with a mean age of 71.6 years,PSA of 30 ng/ml,prostate volume of 50.3 ml and measured peak strain index (PSI).The diagnostic value of PSI was assessed by receiver operating characteristic (ROC) curve.Two-core RTE combined with PSI targeted prostate biopsy was taken and subsequently a 10-core systematic biopsy was taken.The value of RTE was evaluated.The data of targeted biopsy and systematic biopsy in prostate were both reviewed and statistically compared.Results Cancer was detected in 72 of 141 patients (PSI,mean 24.79),and 69 patients had benign prostate disease (PSI,mean 3.02).PSI value of prostate cancer was significantly higher than that of the benign lesions (P ＜ 0.05).Prostate cancer could be predicted with the highest sensitivity (87.5％) and specificity (88.6％) using the cutoff value of PSI ≥ 5.97 with an area under the curve of 0.95.RTE targeted biopsy combined with PSI could detect 95.6％ of moderate or high risk prostate cancer.One hundred and fifty-nine suspicious areas detected by RTE in 141 patients were biopsied with 2 cores for each area.The positive incidence of prostate cancer in RTE-targeted biopsy cores was 44％ and in systematic biopsy was 30.2％ (P ＜ 0.05).Among the 72 prostate cancer patients,63 cases (87.5％) were detected by RTE-targeted biopsy,62 cases (86.1％) by systematic biopsy (P ＞ 0.05).Conclusions RTE combined PSI can improve the detection rate of prostate cancer in the peripheral zone and likewise guide targeted biopsy combined with svstematic biopsy to detect more moderate or high risk prostate cancer.

BACKGROUND:Ankylosing spondylitis is an autoimmune disease at high inflammatory state, and its pathogenesis is stil unclear. Besides, there is a lack of entirely satisfactory curative strategies. OBJECTIVE: To explore the immunoregulation capability of bone marrow mesenchymal stem cels from ankylosing spondylitis patients on macrophages and the potential therapeutic use of bone marrow mesenchymal stem cels from healthy donors on ankylosing spondylitis. METHODS: Bone marrow mesenchymal stem cels were extracted from 21 healthy donors and 25 ankylosing spondylitis patients respectively, and passage 4 cels were used in subsequent experiments. A human monocytic cel line was induced to differentiate into macrophages. The phenotypic markers of bone marrow mesenchymal stem cels and macrophages were detected by flow cytometry. Expressions of tumor necrosis factor-α and tumor necrosis factor-α-stimulated gene 6 (TSG-6) proteins in the supernatant of co-culture system were detected by ELISA. Quantitative real-time PCR was applied to detect the mRNA level of cytokines secreted by bone marrow mesenchymal stem cels and macrophages. RESULTS AND CONCLUSION:The typical mesenchymal stem cel surface markers were expressed in both bone marrow mesenchymal stem cels from healthy donors and patients with ankylosing spondylitis, and CD68 was detected positively in induced macrophages. The protein and mRNA levels of tumor necrosis factor-α secreted by macrophages co-cultured with bone marrow mesenchymal stem cels from patients with ankylosing spondylitis were obviously higher than those from healthy donors (P < 0.05). TSG-6 secreted by bone marrow mesenchymal stem cels from patients with ankylosing spondylitis was lower than that by bone marrow mesenchymal stem cels from healthy donors in both RNA transcriptional and protein levels (P < 0.05). Our study demonstrates that bone marrow mesenchymal stem cels from patients with ankylosing spondylitis shows abnormal immunoregulatory function on inhibiting the tumor necrosis factor-α secretion from macrophages, which reveals a mechanism of immune disorder in ankylosing spondylitis. The therapeutic mechanism of bone marrow mesenchymal stem cels from healthy donors may work by secreting enough TSG-6 to inhibit the activation of macrophages in patients with ankylosing spondylitis, and thereby to decrease the secretion of tumor necrosis factor-α. Cite this article:Sun SH, Wang P, Su CY, Xie ZY, Li YX, Li D, Wang S, Su HJ, Wu XH, Deng W, Wu YF, Shen HY. Bone marrow mesenchymal stem cels derived from patients with ankylosing spondylitis show abnormal immunoregulation capability on macrophages. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):13-19.

Objective To investigate the feasibility of hydrogen proton magnetic resonance spectroscopy (1 H-MRS)for detection of Wallerian degeneration of the pyramidal tract after cerebral infarction.Methods Multiple metabolic indices including NAA,Cho, Cr of the bilateral cerebral peduncle were detected by using 1 H-MRS in 1 5 patients with unilateral middle cerebral artery infarction and 1 5 age-matched healthy volunteers,NAA/Cr,Cho/Cr were also calculated.Comparing the difference between cerebral infarction group and the control group ,the ROC curve was analyzed.Results The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients were significantly lower than that of the contralateral,and there were significant differences between the two groups(P <0.05).The values of NAA/Cr in the ipsilateral cerebral peduncle of cerebral infarction patients decreased (P <0.05),as compared with that of the control group.The area under the ROC curve was 0.947,the truncation point was 1.63.The NAA/Cr val-ues of the contralateral cerebral peduncle of cerebral infarction patients had no significant differences compared with the control group (P >0.05),the Cho/Cr values of the ipsilateral and the contralateral cerebral peduncle had no significant difference compared with the control group (P >0.05).Conclusion 1 H-MRS can detect Wallerian degeneration of the pyramidal tract after cerebral infarction.

Objective Benign prostatic hyperplasia ( BPH) is one of common diseases in aged males , and searching for new therapeutic drugs to BPH has been a research hotspot in recent years .This article was to study the inhibitory effect of eupatorium ja-ponicum thunb and foeniculum vulgare extract ( EFE) on benign prostatic hyperplasia in rats and its possible mechanism . Methods 48 male rats were randomly divided into 6 groups:normal control group without any treatment , model group of BPH treated with subcu-taneous injection of testosterone propionate , positive control group of BPH treated with dutasteride , high, middle and low dosage groups according to different EFE dosage (156 mg/kg, 234 mg/kg and 312 mg/kg).45 days after the treatment, the rats were sacrificed for measurement of the prostate glandular wet weight , the index of prostate gland ( PI ) , the morphological changes of prostate gland by light microscopy and the content of sex hormone . Results The prostate wet weight and PI decreased after EFE treatment for 45 days compared with the BPH model group(P<0.01 ).The hyperplastic glandular epithelium papilla waned and even disappeared in three EFE groups under the light microscope , and the epithelial cells became cubical or flat .High dosage EFE group (312 mg/kg) has simi-lar efficacy to dutasteride group .EFE significantly reduced serum testosterone content , dihydrotestosterone content and T/E2 ratio( P<0.05 ). Conclusion EFE can significantly inhibit prostatic hyperplasia in rats , and its mechanism is related to the decrease of the contents of serum testosterone and dihydrotestosterone as well as T/E2 ratio.

ObjectiveTo investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years,and to investigate whether there were any changes in etiology and management of urethral stricture with time change.MethodsThe database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected.The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture,and for the changes in etiology and management with time change.ResultsThere were 3455 operations for urethral stricture during the study period.The main causes of urethral strictures were traumas in 1833 patients (53.05％),among which pelvic fractures were in 1327 (38.41％) and perineal trauma in 506 (14.65％).The second cause was iatrogenic causes in 1181 patients (34.18％ ),among which transurethral operations or examinations were in 602 (17.42％),hypospadias surgery in 291 (8.42％) and urethral catheterization in 164 (4.75％ ).Less common causes were urethritis in 201 patients (5.82％),lichen sclerosus in 149 (4.31％),undefined in 91 (2.63％).The treatments of urethral strictures were endourological surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc.The ratios of using various techniques in total number of patients were obviously different by time.The most application technique for treatment of urethral stricture was endourological surgery ( 709 ) during 2004 -2006 and occupied 52.67％ in total number of patients.It was gradually decreased during 2007 -2009 (726) and only occupied 34.42％ (P ＜0.01 ).Open urethroplasty gradually increased during 2007 -2009 ( 1243,58.94％ ) compared with the first three years (563,41.83％ ) (P ＜ 0.01 ). Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes.The main treatments of urethral strictures were endourological surgery and open urethroplasty.Endourological surgery was significantly decreased in total number of patients,while open urethroplasty were significantly increased during the late three years.

Objective To observe the characteristics of normal prostate gland and benign prostatic hyperplasia (BPH) on transrectal real-time elastography (TRTE). Methods A total of 77 BPH patients and 17 normal subjects underwent TRTE. The elastographic images were analyzed with the five-point subjective elastic scale. The strain ratio of transition zone, peripheral zone, and transition zone to peripheral zone were respectively measured to compare the stiffness of each zone. Results The elasticity scores of both BPH group and normal prostate group were 1 and 2 in scoring system. There was no significant difference of elasticity scores between BPH group and normal prostate group (P=0.2252), as well as in strain ratio of transition zone (P=0.9793), peripheral zone (P=0.8986), and transition zone to peripheral zone (P=0.5233). Conclusion The stiffness of normal prostate gland and BPH could be offered by TRTE.

Objective To prevent the occurrence of postoperative delirium after endoscopic surgery in patients with benign prostatic hyperplasia (BPH). Methods A total of 370 BPH patients receiving endoscopic surgery in our hospital were involved in this study. The clinical parameters including age, other systemic diseases, operation method, operation time and postoperative pain were investigated as predictive risk factors. Then the data were dealt by χ~2 test, single factor analysis or multivariate logistic regression analysis. Results Postoperative delirium occurred in 19 cases (5. 1%). Univariate analysis demonstrated that many factors were significantly correlated with the postoperative delirium in elderly patients, such as age (χ~2 = 7. 37, P<0. 05), other systemic diseases (χ~2=10.26, P<0.05), operation time (χ~2 = 19. 87, P<0.05) and postoperative pain (χ~2= 4.99, P<0. 05). The multivariate logistic regression analysis showed that age (OR = 5. 38, P< 0.05), other systemic diseases (OR = 4. 97, P<0. 05) and operation time (OR = 6. 53, P<0. 05) were important factors for postoperative delirium. Conclusions Paying more attention to the advanced age, giving sufficient preoperative preparation and reducing operation time may help to prevent postoperative delirium.

Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.