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Erectile dysfunction (ED) is a common andrological disorder, and traditional oral drugs often fail to achieve satisfactory therapeutic effects. As a new field of biomedicine, stem cell therapy (SCT) has seen a significantly increasing number of researches on its treatment of ED in recent years. Preclinical animal models for the study of ED mainly include the models of diabetes mellitus-, aging-, cavernous nerve injury-, and Peyronie's disease-related ED. Previous studies indicated that SCT improved erectile function through paracrine and was more effective when combined with other therapies than used alone in restoring ED-induced pathological changes. Although clinical trials on SCT have partially proved its safety and effectiveness for the treatment of ED, they were still in the early stages and with relatively small sample sizes. This article summarizes the latest advances in the treatment of ED by SCT.

To investigate the effect of Linshu Decoction (LSD) combined with levofloxacin in the treatment of lower urinary tract symptoms in patients with type ⅢA prostatitis.We randomly divided 124 type ⅢA prostatitis patients with lower urinary tract symptoms into an experimental and a control group, the former treated orally with LSD (1 dose bid) combined with levofloxacin tablets (0.1 g bid), and the latter with levofloxacin tablets only (0.1g bid). Before and after 4 weeks of medication, we obtained the NIH-CPSI, Traditional Chinese Medicine symptoms (TCM) scores, white blood cell (WBC) count in EPS and the results of uroflowmetry from the patients and compared them between the two groups.Finally 115 of the patients were included in this study. After 4 weeks of treatment, the patients of the experimental group, compared with the controls, showed significantly decreased NIH-CPSI (14.57 ± 3.87 vs 20.12 ± 3.45, P0.05), TCM scores (6.35 ± 1.27 vs 10.72 ± 1.72, P0.05) and WBC count in EPS (［7.35 ± 4.52］ vs ［9.87 ± 5.87］ n/HP, P0.05). In comparison with baseline, the maximum urinary flow rate (Qmax) and average urinary flow rate (Qave) were increased in both of the two groups after medication, with statistically significant difference only in the experimental group (P0.05).Linshu Decoction combined with levofloxacin is more effective than levofloxacin alone in the treatment of lower urinary tract symptoms in patients with type ⅢA prostatitis.

To explore the effects of the mu-opioid receptor (MOR) in the paraventricular nucleus (PVN) on the ejaculatory behaviors of male rats and its potential mechanisms.Male SD rats with normal ejaculation ability were mated with female ones in hormone-induced estrus. After bilateral PVN microinjection of D-Ala-2-Me-Phe-4-Gly-ol enkephalin (DAGO) or D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP) with an inserted catheter, the male animals were observed for mount latency (ML), mount frequency (MF), intromission latency (IL), intromission frequency (IF), ejaculation latency (EL), ejaculation frequency (EF), post-ejaculation interval (PEI), and intromission ratio (IR). The lumbar sympathetic nerve activity (LSNA) of the rats was recorded using the PowerLab data acquisition hardware device, and the levels of norepinephrine (NE) in the peripheral plasma were measured by ELISA following microinjection of saline or different doses of DAGO or CTAP.Neither CTAP nor DGAO significantly affected the ML of the male rats (P0.05). DGAO remarkably increased IF (P0.01) and MF (P0.01), prolonged IL (P0.01), EL (P0.01) and PEI (P0.01), and reduced EF (P0.01) and IR (P0.05). On the contrary, CTAP markedly decreased IF (P0.01) and MF (P0.01), shortened IL (P0.01), EL (P0.01) and PFI (P0.01), and elevated EF (P0.01) and IR (P0.01). Additionally, DAGO decreased LSNA in a dose-dependent manner and reduced the NE level in the peripheral plasma. CTAP, however, not only offset the effects of DAGO on LSNA, but also significantly increased LSNA.MOR in PVN inhibits ejaculatory behaviors in male rats by weakening LSNA, which has provided some theoretical evidence for the use of highly selective opioids in the treatment of premature ejaculation.

The novel coronavirus (COVID-19) pneumonia has been classified as a category B and dealt with as a category A infectious disease by the National Health Commission of China, and also as a public health emergency of international concern by the World Health Organization. During the epidemic, unnecessary visits to hospitals may increase the risk of infection among patients and clinicians. Therefore, it is particularly important to provide some scientific medical guidance for patients with male diseases, which is also a current imperative for andrology management. And it also deserves the attention of clinical researchers whether COVID-19 pneumonia and its clinical treatments currently used may affect the male reproductive system.

To explore the feasibility of glans-preserving surgery (GPS) in the treatment of superficial penile squamous cell carcinoma (PSCC) with the lesion diameter of ≥2 cm.We retrospectively analyzed the clinical data on 69 cases of superficial PSCC (≤T1aN0) treated by GPS (n = 36) or radical surgery (total or partial penectomy, n = 33) from July 2007 to July 2017.The mean tumor diameter and depth of invasion were 3.16 (2.0－6.0) cm and 0.89 (0.5－2.0) cm in the GPS group and 3.56 (2.0－6.0) cm and 1.89 (0.6－4.0) cm respectively in the radical surgery group. The patients were followed up for 10－102 (mean 42) months, during which, 5 patients in the GPS group developed local recurrence at 40 days and 2, 4, 7 and 9 months postoperatively, again underwent gansectomy, partial penectomy or GPS, and experienced no more recurrence during the follow-up of 54, 34, 39, 66 and 70 months. No local recurrence was observed in the radical surgery group, and none of the 69 patients experienced lymph node metastasis or died during the follow-up.GPS is safe and efficient for the treatment of superficial PSCC with the lesion diameter of ≥2 cm.

The sexual behavior of the male can be described as a series of behavioral transitions eventually leading to ejaculation and sexual satisfaction. The ejaculation itself is extensively regulated by different ejaculation generators. The "spinal ejaculation generator" receives genito-sensory signals through afferent fibers and then informs the brainstem and forebrain via ascending fiber projections. Conversely, the supraspinal areas restrict ejaculations to the optimal moments and circumstances through descending afferent fibers. The messages ascending from the spinal cord reach the interconnected thalami, hypothalami, limbic system and cerebral cortex and are integrated with olfactory information. These brain areas are all related to ejaculation, but the exact facilitatory and inhibitory mechanisms involved have not yet been elucidated hitherto. Both the medial preoptic nucleus and brainstem areas play an important role in the "downward" mechanisms underlying the spinal "release" of an ejaculation. The medial preoptic nucleus is also precisely related to the "sexual rewarding" coming with an ejaculation. Meanwhile, the roles of several neurotransmitters are discussed considering their remarkable effects on ejaculation. This review focuses on the ejaculation-related circuits and neurotransmitters for the purpose of gaining a deeper insight into the mechanisms of ejaculation and providing some theoretical evidence for the study and treatment of ejaculation-related diseases.

Table S1. Demographics and imaging features of tumors. (DOCX 20 kb)

Previous studies have indicated that miR-200c is a promising cancer biomarker. However, different studies have presented conflicting results. Therefore, the aim of the present study was to perform a meta-analysis of miR-200c based on 34 relevant studies. The Materials and methods sections of papers were carefully identified using the databases PubMed, Web of Science and Embase for publications up to December 4, 2015. Pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were systematically calculated to investigate the association between the expression of miR-200c and cancer prognosis. The results demonstrated that elevated expression levels of miR-200c indicated significantly worse overall survival rates (HR=1.37, 95% CI: 1.01, 1.85), and a high level of miR-200c was considered an indicator of an unfavorable prognosis in patients from Europe and America (HR=1.85, 95% CI: 1.27, 2.69). Furthermore, overexpression of miR-200c was significantly associated with progression of the disease in the subgroups of tissue and blood samples (HR=0.68 and 2.45, respectively), and inferior overall survival rates for the blood subgroup were revealed (HR=2.21, 95% CI: 1.04, 4.72). In addition, miR-200c was of prognostic value in several disease subgroups. Taken together, high expression levels of miR-200c are of significant prognostic value in various human malignancies.

Infertility is a common medical condition which affects nearly 15% of the world population. Non-obstructive azoospermia (NOA) is a most challenging problem inducing male infertility and does not respond to the existing medication. Surgery is the primary method for obtaining sperm from NOA patients, but the outcome of testicular sperm extraction is unpredictable preoperatively. Recently, with the development of detection techniques for male infertility, some new biomarkers have come into notice, which may be of some value in predicting the outcome of microdissection testicular sperm extraction (MTSE) and evaluating male infertility. This article presents an overview of the known biomarkers contributive to the prediction of the outcome of MTSE for NOA patients.男性不育影响着全世界约15%的人群。非梗阻性无精子症是男性不育最棘手的问题，尚无有效药物治疗，主要依靠取精手术来获得精子，其取精结果成功与否术前无法判断。近年来随着男性不育检测技术的不断发展，陆续出现了激素、非激素类蛋白、核酸等层面的新的生物学标志物，这些生物学标志物对于男性不育都有一定的评估价值，对于显微取精结果也有一定的预测能力。本文就现有的与非梗阻性无精子症显微取精结果方面有关的生物学标志物做一综述。.

Adipose-derived stem cells (ADSCs) are pluripotent stem cells isolated from the adipose tissue and have the potential for self-renewal and multi-directional differentiation into neurogenic cells, smooth muscle cells, endothelial cells, and so on. Erectile dysfunction (ED) is a common male sexual dysfunction that has a negative impact on the lives of the patients and their partners. Current treatments of ED include surgery and medication, with oral 5-phosphodiesterase inhibitors as the first-line drugs. However, a small number of the patients are not sensitive to these therapies and cannot be improved or cured pathologically. So far, animal experiments and preclinical trials have confirmed the safety and efficacy of ADSCs, which act on ED though paracrine mechanisms. This review summarizes the advances in the recent 5 years in the studies of ADSCs for the treatment of ED.脂肪源性干细胞（ADSCs）是从脂肪组织中分离得到的一种多能干细胞，具有自我更新和多向分化潜能，可向神经细胞、平滑肌细胞及内皮细胞等多种细胞类型分化。而勃起功能障碍（ED）是一种常见的男性性功能障碍疾病，对患者及其伴侣的生活造成了很大的负面影响。目前治疗ED的方法有手术及药物等，其中5-磷酸二酯酶抑制剂作为临床治疗ED的一线用药，仍对少部分患者不敏感，而且存在无法改善或者治愈ED的病理基础。迄今为止的动物试验及临床前期研究已经证实了ADSCs治疗ED的安全性及有效性，其可通过旁分泌作用达到治疗ED的作用。本文就近5年来ADSCs治疗ED的研究进展进行综述。.

To assess the effect of corporoplasty with autologous tunica vaginalis graft in the treatment of Peyronie's disease.Ten patients with Peyronie's disease underwent plaque excision and corporoplasty with autologous tunica vaginalis graft. We obtained and compared IIEF-5 scores of the patients before and at 1 and 5 years after operation.After surgery, penile curvature was obviously relieved and all the patients achieved normal penile erection and satisfactory sexual intercourse without erection-related pain or recurrent erectile dysfunction. The mean IIEF-5 score was significantly improved at 1 year (22.40±1.08) and 5 years postoperatively (23.00±1.14) as compared with the baseline, (19.20±2.28) (P0.05 or 0.01).Corporoplasty with autologous tunica vaginalis graft is a safe, simple and effective option for the treatment of Peyronie's disease, though its definite efficiency is to be further supported by large-sample clinical studies.目的： 探讨自体睾丸鞘膜移植治疗阴茎硬结症的手术效果。 方法： 10例阴茎硬结症患者，采用自体睾丸鞘膜移植阴茎成形术进行治疗,并在术前以及术后1年和5年接受IIEF-5问卷评分。 结果： 10例患者术后阴茎均能恢复正常勃起形态，阴茎勃起疼痛症状消失，阴茎弯曲明显减轻，无复发性ED，能进行满意的性生活，IIEF-5评分在术后1年和5年分别为(22.40±1.08)、(22.80±1.14)分，均显著高于术前［(19.20±2.28)分，P均0.05］。 结论： 自体睾丸鞘膜移植术治疗阴茎阴茎硬结症造成的勃起畸形是一种安全、简便、经济、有效的手术方式，然而需要进一步大样本的研究来证实。.

Objectives To evaluate whether there is a relation between expression of vascular endothelial growth factor (VEGF) and any of the paraneoplastic syndromes (PNS) in clear cell renal cell carcinoma (ccRCC) patients. Materials and methods A total of 667 patients with ccRCC and at least one PNS were included. Thorough history taking, physical examinations, and laboratory tests were used to diagnose PNS. Immunohistochemistry was performed for VEGF evaluation. Results There were 10 different PNS identified in the population. Sixty patients had a single paraneoplastic presentation. In all patients, presence of cachexia ( n = 267, P n = 40, P = 0.0014), and hypercalcemia ( n = 48, P = 0.0006) was correlated to VEGF expression. Correlation was neither acquired in Stauffer's syndrome, pyrexia, elevated erythrocyte sedimentation rate (ESR), anemia, thrombocytosis, hypertension, neuromyopathy nor obtained within patients with single PNS. Conclusions Relations between PNS and VEGF expression in renal cell carcinoma (RCC) has not been studied yet. The results we gained hereby can help us further understand the mechanistic of PNS in RCC.

To investigate the factors influencing the prognosis of penis-sparing surgery (PSS) for early-stage penile cancer.We retrospectively studied the clinical data about 45 cases of early-stage penile cancer treated by PSS from January 2007 to December 2014. We calculated the rate of local recurrence-free survival by the Kaplan-Meier method, and conducted univariate and multivariate COX regression analyses on the relevant factors including the patient's age, marital status, tumor location, tumor size, postoperative sexual life, histological grade, and TNM stage.One-year and three-year local recurrence-free survival rates were 95.5% and 52.2%, respectively. Multivariate analysis demonstrated that the histological grade (P = 0.039) and postoperative sexual life (P = 0.049) were independent factors for the prognosis of PSS. Logistic regression showed the patients age to be significantly associated with histological grade (P = 0.014).Histological grade and postoperative sexual life are important independent prognostic factors of PSS for early-stage penile cancer, and the patients age is associated with the prognosis of PSS through its influence on the tumor grade.

To investigate the correlation of the deleted azoospermia (DAZ) gene copy related to gr/gr and b2/b3 deletions in the AZFc region with male spermatogenic impairment.This study included 121 infertile men with different de- grees of spermatogenic impairment and 95 healthy donors from the sperm bank. Using PCR, PCR-RFLP, and Y chromosome specific sequence tagged sites (STS) , we analyzed the association of DAZ gene copy deletions related to gr/gr and b2/b3 deletions in the AZFc region with spermatogenic impairment.There were 15 cases of gr/gr deletion (12. 40% ) and 6 cases of b2/b3 deletion (4.96%) in the infertility group as compared with 13 cases of gr/gr deletion (13.68%) and 1 case of b2/b3 deletion (1.05%) in the control. Analysis of the DAZ-specific single nucleotide variant (SNV) loci revealed 11 gr/gr-DAZI/DAZ2 deletions (9.09%), 4 gr/gr-DAZ3/DAZ4 deletions (3.31%), and 6 b2/b3-DAZ1/DAZ2 deletions (4.96%) in the infertile men in comparison with 3 gr/ gr-DAZ1/DAZ2 deletions (3.16%), 10 gr/gr-DAZ3/DAZ4 deletions (10.53%), and 1 b2/b3- DAZ3/DAZ4 deletion (1.05%) in the control.Partial deletions of gr/gr and b2/b3 exist in both healthy men and male patients with different degrees of spermatogenic impairment and cannot be considered as a risk factor for spermatogenesis impairment. However, deletions of different DAZ duplicons in gr/gr and b2/b3 deletions have different effects on spermatogenesis. DAZ1/DAZ2 instead of DAZ3/DAZ4 deletions might be associated with spermatogenesis impairment.

To investigate the expressions and action mechanisms of nerve growth factor (NGF) receptors TrkA and p75NTR in the oncogenesis and progression of prostate cancer (PCa).Using immunohistochemistry, we detected the expressions of TrkA and p75NTR in 62 PCa and 35 benign prostatic hyperplasia (BPH) samples, and conducted statistical analysis on the basis of clinical data.Independent-samples t-test showed that, along with poorer tissue differentiation or higher clinical stage of PCa, the expression of TrkA was significantly up-regulated, that of p75NTR remarkably down-regulated, and the expression ratio of TrkA to p75NTR markedly increased. The TrkA/p75NTR ratio was 0.32 in the BPH, 0.52 in the PCa tissue with Gleason score of 6, 1.65 in the PCa tissue with Gleason score of 7, 5.75 in the PCa tissue with Gleason score ≥ 8, 0.89 in the clinical stage of pT2, 1.5 in pT3 a, 3.75 in pT3b, and 7.00 in pTxN1.The abnormally increased expression ratio of TrkA to p75NTR might be one of the essential features of malignant transformation of prostate cells. A higher TrkA/p75NTR expression ratio may be associated with a lower tissue differentiation, a higher clinical stage or Gleason score, and therefore a poorer prognosis.

Comparisons of penile cancer-related factors between delayed and undelayed patients. (DOC 72Â kb)

Comparisons of sociodemographic factors between delayed and undelayed patients. (DOC 106Â kb)

Objective: To investigate any association between renal cell carcinoma (RCC) and paraneoplastic syndromes (PNS). Subjects and Methods: The retrospective analysis included 1,028 patients of Chinese Han nationality with resectable RCC and PNS. The PNS included elevated erythrocyte sedimentation rate (ESR), hypertension, cachexia, anemia, pyrexia, abnormal liver function, hypercalcemia, polycythemia, varicocele and neuromyopathy. Staging was categorized as local (T1–2N0M0) and locally advanced (T3–4NxM0). Results: Among patients with at least one PNS, elevated ESR (p = 0.008), cachexia (p = 0.000), varicocele (p = 0.000) and pyrexia (p = 0.021) were related to advanced stage of RCC. Among patients with only one PNS, hypertension (p = 0.012) and hypercalcemia (p = 0.000) were related to advanced stage. The remaining PNS were not associated with tumor stage. Conclusion: Pyrexia, elevated ESR, cachexia and varicocele were related to advanced RCC. Hypertension and hypercalcemia occurring as single PNS, although also correlated with advanced stage, require further investigation.

To summarize the features and treatment of male infertility induced by autosomal dominant polycystic kidney disease (ADPKD), and compare the outcomes of intracytoplasmic sperm injection (ICSI) for infertile men with ADPKD and those with congenital bilateral absence of vas deferens (CBAVD).We retrospectively analyzed 21 cases of ADPKD-induced infertility, 15 treated by ICSI (group A), and another 164 cases of strictly matched CBAVD-induced infertility (group B). We compared the two groups in the couples' age, the number of ICSI oocytes, and the rates of fertilization, transferrable embryos, good embryos, embryos implanted, clinical pregnancy, biochemical pregnancy, early abortion, singleton and twins in the first cycle.After 28 cycles of ICSI, 10 of the 15 ADPKD-induced infertility patients achieved clinical pregnancy, including 7 cases of live birth, 1 case of spontaneous abortion, and 2 cases of pregnancy maintenance. No significant differences were observed between groups A and B in the couples' age, the wives' BMI, or the numbers of ICSI oocytes and embryos transplanted (P0.05), nor in the rates of ICSI fertilization (72.64% vs 76.17%), transferrable embryos (51.28% vs 63.24%), quality embryos (38.46% vs 49.83%), embryo implantation (17.64% vs 38.50%), abortion (0 vs 9.23%), singleton (50% vs 81.54%) and twins (50% vs 18.46%). However, the rates of clinical pregnancy (13.33% vs 42.68%, P = 0.0230.05) and biochemical pregnancy (13.33% vs 39.63%, P = 0.0320.05) were significantly lower in group A than in B.ICSI is effective in the treatment of male infertility induced by either ADPKD or CBAVD, but the ADPKD cases have a lower success rate than the CBAVD cases in an individual cycle. The affected couples should be informed of the necessity of prenatal genetic diagnosis before embryo implantation and the inevitable vertical transmission of genetic problems to the offspring.

To investigate the safety and feasibility of testis-sparing surgery (TSS) in the treatment of testicular tumor.We retrospectively analyzed the clinical data of 8 cases of benign testicular tumor treated by TSS in our hospital from October 2005 to March 2012.The 8 patients, aged 18-67 (mean 45) years, were preoperatively diagnosed with benign testicular tumor and all underwent partial testis resection. Rapid intraoperative pathology showed the incisal margins to be negative. Postoperative pathological examination confirmed Sertoli cell tumor in 3 cases, adenomatoid tumor in another 3, and mature teratoma in the other 2. The patients were followed up for 6 months to 7 years (mean 4 years), which revealed no relapse and metastasis, nor significant differences from the baseline in the testosterone level, IIEF score, and routine semen parameters.Testis-sparing surgery is one of the effective options for the management of benign testicular tumor, which can maximally preserve the testis tissue and protect the patient's sexual function.

To investigate the clinical characteristics and surgical treatment of penile Paget's disease.We retrospectively analyzed the treatment and follow-up data of 10 cases of penile Paget's disease surgically treated in Jiangsu Provincial Government Hospital and Jiangsu Provincial People's Hospital from 2008 to 2012.All the 10 patients received expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free skin flaps from the thigh. All surgeries were successful and the postoperative course was uneventful with complete graft survival and no lymph node metastasis. IIEF scores obtained before and 1 -2 months after surgery showed no statistically significant differences in the penile erectile function (P = 0.229), sexual orgasm (P = 0.761), and sexual satisfaction (P = 0.801) of the patients.When penile skin lesions suggest the possibility of Paget's disease, biopsy should be performed and surgery should follow as soon as possible. The ideal surgical option is expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free flaps according to the patient's specific conditions.

To investigate the clinical effect and application value of the modified method of prepuce-degloving repair (PDR) in the treatment of urethrocutaneous fistula (UCF) following hypospadias surgery.We retrospectively analyzed 87 cases of UCF caused by hypospadias repair from May 2001 to December 2011, of which 61 were treated by simple closure or Y-V plasty of the fistula (group A), and the other 26 by modified PDR (group B). We compared the success rate of surgery and long-term recurrence between the two groups.The total success rates of repair were 78.7 and 96.2% in groups A and B, respectively. Thirteen cases in group A did not respond to surgery, of which 6 failed to be cured by the second operation but later were treated successfully by modified PDR. In comparison, there was only 1 case of failure in group B, which was cured by a second PDR.Modified PDR can significantly improve the success rate and reduce the recurrence rate of UCF after hypospadias surgery, which deserves wide clinical application.

MicroRNAs are a kind of small non-coding single-stranded RNA molecules that negatively regulate the gene expression by binding to imperfect complementary sites in the 3' untranslated region of targeted mRNAs at the post-transcriptional level. Aberrant expressions of some miRNAs like miR-221/222, miR-146a and miR-125b have been found to be significantly associated with androgen-independent progression of prostate cancer. By analyzing the aberrant expressions and regulation mechanisms of miRNAs in cell lines, tissues and peripheral blood samples, we hope to provide a new theoretic base for the clinical diagnosis and treatment of androgen-independent prostate cancer.

To investigate the correlation between parathyroid hormone-related protein (PTHrP), erythropoietin (EPO), and vascular endothelial growth factor (VEGF) expression in clear cell renal cell carcinoma (ccRCC). Immunohistochemical studies on PTHrP, EPO and VEGF were performed in 249 patients with ccRCC. Serum calcium level and haematocrit were analyzed. The expression of the factors and clinicopathological parameters were studied statistically for possible correlations. The incidence for hypercalcaemia and polycythaemia were 15.3 % and 2.0 % respectively. Expression of PTHrP, EPO, and VEGF were respectively related to advanced stage (P

To investigate the composition and morphology of the stones in the enlarged prostatic utricle (EPU).We took out 36 EPU stones from 11 patients by transurethral fenestration between 1992 and 2011, and analyzed the stones by scanning electron microscopy, x-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIS).Under the scanning electron microscope, all the EPU stones were constituted of many intensive minicrystals and amorphous matrix. XRD and FTIS revealed that all were hydroxyapatite crystal.EPU stones belong to the category of prostatic pseudo-calculi, whose formation is ascribed not to the abnormal change of urine composition, but to the continuous secretion, absorption and concentration of EPU liquid and ablated epithelial cells from the EPU.

Extramammary Paget’s disease (EMPD) is considered an intraepithelial adenocarcinoma. Paget’s disease of the penis is the most common disease of EMPD in male patients. The objective of this study was to investigate and improve our knowledge of the clinical features, diagnosis, therapeutic methods and outcome of penile Paget’s disease. Eleven patients from 2007 to 2012 with Paget’s disease of the penis were analyzed retrospectively based on diagnosis, treatment and the results on follow-up. All patients received local expanding resection with intraoperative frozen sections and reconstruction of defects with split-thickness skin graft from autologous thigh tissue. All surgeries were successful, and the postoperative course was uneventful with complete wound healing and graft survival. No lymph node metastasis was obtained. Both the morphology of the penis and its function were well maintained. Chronic skin lesions of the penis should be biopsied as soon as possible, if they are suspected to be due to Paget’s disease. Paget’s disease of the penis should be treated with wide local excision and intraoperative frozen section examination. In addition, reconstruction of defects with split-thickness skin graft from the patient’s thigh is an ideal choice for treatment.

Alterations in P53 and murine double minute 2 (MDM2) genes appear to be important in the development of many human tumors. We investigated the potential prognostic roles of p53 codon 72 and MDM2 309 and 1797 polymorphisms in prostate cancer after radical prostatectomy.Fifty southern Chinese with prostate cancer undergoing radical prostatectomy were included in this study. All polymorphisms were detected by PCR-RFLP. Their prognosis on biochemical recurrence was assessed using Kaplan-Meier analysis and Cox regression model.p53 codon 72 GG genotype was associated with increased biochemical recurrence compared with CG+CC genotypes and poorer PSA-free survival. It was also noted that GG genotype was an independent risk factor for biochemical recurrence after radical prostatectomy on multivariate analysis. No statistical difference was observed in MDM2 polymorphisms and prostate cancer prognosis.Our data revealed that p53 codon 72 GG genotype carriers more frequently show biochemical recurrence than CG+CC genotypes carriers.

To evaluate the clinical significance of prostate-specific antigen (PSA) screening in early detection of prostate cancer in Chinese men.PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all wereor = 50 years old. Prostate biopsy was recommended for those with a serum PSA levelor = 4.0 ng/ml. The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.Of the 8562 asymptomatic men, 719 had PSA levelsor = 4.0 ng/ml and biopsy was performed in 295 of them. Fifty-eight prostate cancers were detected. The biopsy rate was 41.0% and positive detection rate was 19.7%. The overall age distribution in the screening group and the clinical groups was not significantly different (P = 0.176). However, 41.4% (24/58) of the patients in screening group were75 years old, and significantly more than that in the clinical group (25.6%, P = 0.0491). The proportion of the patients with PSA levelsor = 20 ng/ml in the screening group was significantly less than that in the patients of the clinical group (44.8% vs. 75.6%, P = 0.0002). Whether in the patients whose age was75 years old (P0.05) oror = 75 years old (P = 0.0002), the patients in the screening group had significantly lower Gleason scores7 (60.3% vs. 34.1%, P = 0.002), more T1 or T2 tumor (87.9% vs. 26.8%, P0.0001) and more chance to receive radical prostatectomy (50.0% vs. 18.3%, P0.0001) than the patients in the clinical group did. However, the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups (P0.05).Prostate-specific antigen (PSA) screening is useful for early detection of prostate cancer in Chinese men agedor = 50 years. The patients detected by PSA screening usually show a lower PSA level, Gleason scores and early clinical stage disease, and have more chance for radical prostatectomy than the clinically diagnosed patients.

A GC polymorphism (rs2910164) which is located in the sequence of miR-146a precursor, results in a change from a G:U pair to a C:U mismatch in its stem region. To explore whether rs2910164 plays any role in prostate cancer (CaP), we analyzed the association between miR-146a polymorphism and risk of CaP and the expression of miR-146a with different genotypes in CaP tissues in southern Chinese Han population.Two hundred fifty-one CaP and 280 control subjects were included in the cancer association study, and 15 CaP tissue samples were used to test the expression of the miRNA precursors by real-time quantitative reverse transcription PCR.We found that subjects carrying CC homozygotes had a 0.65-fold reduced risk (95% CI = 0.43-0.99) than those carrying GG/GC genotypes (P = 0.03), and the C allele displayed a lower prevalence of CaP compared with the G allele (OR = 0.73, 95% CI = 0.57-0.94, P = 0.01). Moreover, hsa-miR-146a quantification showed that homozygous carriers of the C-variant had significantly decreased miRNA levels compared to the carriers of the GG/GC genotype.The natural genetic variation in pre-miR-146a affects the amount of mature miR-146a, contributes to the genetic predisposition to CaP.

To investigate the association of the risk of prostate cancer (PCa) with the polymorphism of the CYP2E1 gene, smoking and drinking, and to explore the joint role of genes and living habits in PCa pathogenesis.We conducted a case-control study on 109 PCa patients and 202 age-matched non-PCa male controls, and detected the polymorphisms of CYP2E1 Rsa I and Pst I sites by PCR-RFLP using DNA from peripheral blood lymphocytes.The history of deep smoking (OR = 2.29, 95% CI: 1.28 - 4.09) or heavy smoking (OR = 1.81, 95% CI: 1.02 - 3.22) was a risk factor. The CYP2E1 C1/C1 genotype significantly increased the risk of PCa (OR = 1.71, 95% CI: 1.04 - 2.82) and apparently interacted with drinking (OR = 2.21, 95% CI: 1.06 - 4.59). Heavy smokers with the C1/C1 genotype showed an increased risk of PCa (OR = 2.80, 95% CI: 1.20 - 6.56), as compared with non-smokers carrying the genotype of C1/C2 or C2/C2.The risk of PCa obviously increases in individuals with both the CYP2E1 C1/C1 genotype and the habit of smoking or drinking, and it has a significant positive correlation with the dose of tobacco exposure.

To study the distribution of FASL-844 polymorphism in southern Chinese males of Han nationality and examine the contribution of the polymorphism to susceptibility of idiopathic azoospermia and oligozoospermia.FASL-844 polymorphism was genotyped by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP) in 184 infertile patients with idiopathic azoospermia or severe oligozoospermia 236 normal fertile male controls.Frequencies of FASL-844 CT and TT genotypes of the patients were significantly different from those of the controls (P = 0.024; P = 0.008). Males with FASL-844 TT genotype had an increased risk of idiopathic azoospermia or severe oligozoospermia compared with those with CC genotype (OR 2.76, 95% CI: 1.20-6.35), and even a higher risk when compared with those with CC and CT genotypes (OR 2.90, 95% CI: 1.28-6.58).FASL-844 polymorphism appears to be a genetic predisposing factor of idiopathic azoospermia or severe oligozoospermia among southern Chinese Han males.

To explore the clinical significance of azoospermia factor (AZF) region deletion.Detection of the Y-link sequence tagged sites in AZF region was conducted by means of 2 multiplex polymerase chain reactions among 80 patients with severe oligozoospermia and 63 patients with azoospermia, totally 143.Twenty-one cases of microdeletion were found among the 143 infertile patients with a prevalence of 14.7%. PCR analysis showed that deletion of the portions of Yq in 12 of the 62 idiopathic infertility patients, 3 being with severe oligozoospermia and 9 with azoospermia, and in 9 out of the 81 patients with non-idiopathic infertility. PCR analysis of 40 normal fertile men did not detect any abnormality. The results of the microdeletion showed that 1 patient had a microdeletion in the AZFa region with sY84 and sY86 (1/21, 4.8%), 2 patients presented a large deletion involving sY127 and sY143 from AZFb, and sY254 and sY255 from AZFc (1/21, 9.5%). Two patients had the deletions located in AZFb region (2/21, 9.5%), and 16 patients had a deletion on the AZFc region involving the DAZ (deleted in azoospermia) gene (16/21, 76.2%) Among the 21 infertile men 4 showed a testicular cytologic picture of maturation arrest, 6 patients had severe hypospermatogenesis, and 11 had Sertoli cell-only syndrome. There were not significant differences in location and extent of deletions between the patients with idiopathic infertility and those with non-idiopathic infertility.It is recommended to carry out screening of microdeletion of Y chromosome among the patients with idiopathic and non-idiopathic infertility, especially the candidates for intracytoplasmic sperm injection.

To study the diagnosis and treatment of acute prostatitis.The data of 35 cases of acute prostatitis who were admitted from January 2001 to March 2004 were reviewed. The main clinical manifestations were chills, fever, frequency, urgency and dysuria. All patients were treated with antibiotics and supportive measures. Two patients underwent surgical drainage for prostate abscess. Three patients were indwelled catheter for acute urinary retention.All patients'temperatures returned to normal within 3 to 5 days. Blood and urine routine tests, urine culture and transurethral ultrasound examination results returned to normal 2 weeks later. Q maximal urinary flow rate improved in patients with dysuria.After diagnosis of acute prostatitis, full-dose of sensitive antibiotics should be given to all patients for some time as early as possible. At the same time, supportive therapy may be important to some patients. Surgical drainage should be used for patients with prostate abscess.

To investigate the clinical characteristics, diagnosis and therapeutic strategies of congenital absence of the vas deferens (CAVD).We summarized the clinical data of 81 cases of CAVD and investigated clinical features, diagnosis and management of the disease.Seventy-nine cases of infertility were diagnosed as CAVD at the clinic, and 2 were diagnosed during surgical exploration. The population consisted of 40 cases of congenital bilateral absence of the vas deferens (CBAVD), 25 cases of congenital unilateral absence of the vas deferens (CUAVD), and 16 cases of segmental agenesis of the vas deferens. Seventy-four spouses received the treatment of assisted reproductive techniques, including intracytoplasmic sperm injection (ICSI) in 12 cases, and 4 of them achieved pregnancy.CAVD frequently presents with infertility. CBAVD may manifest as obstructive azoospermia, and CUAVD and segmental vasal agenesis as oligospermia, asthenospermia, or obstructive azoospermia. CAVD is usually not difficult to diagnose, but may be missed due to careless examination. Assisted reproductive technology (ART) plays a key role in the management of CAVD.

Cytogenetic and molecular studies of azoospermic and oligozoospermic males have suggested the presence of azoospermia factors (AZF) in the Y chromosome. Deletion in AZF regions has been reported to disrupt spermatogenesis and cause infertility. Several candidate genes responsible for spermatogenesis have been identified in this region and some of them are thought to be functional in human spermatogenesis. And we reported clinical and molecular studies of Y chromosome microdeletions in Chinese. This study aimed at assessing the frequency of microdeletions in Chinese men with idiopathic and nonidiopathic infertility problems and dicussing the clinical significance of the AZF region.In this study, we screened 143 infertile men (62 with idiopathic infertilitas and 81 with nonidiopathic infertilitas), in whom karyotype, sperm count, hormonal parameters and fine needle aspiration cytology were evaluated. Genomic DNA was extracted from the peripheral leukocytes. Molecular analysis was performed by two multiplex polymerase chain reactions (PCR) using a set of a sequence tagged sites (STS) from 3 different regions of the Y chromosome: AZFa (sY84, sY86), AZFb (sY127, sY134), AZFc (sY254, sY255).Nineteen point four percent of idiopathic males (12/62, 19.4%) had microdeletions of either the AZFa, AZFb, AZFc or AZFb + c region. Significantly, a high frequency of microdeletions (9/81, 11.1%) was found in nonidiopathic patients with varicocele and cryptorchidism. No deletions were found in healthy fertile men. There were no significant differences in the localization and extent of deletions between idiopathic and nonidiopathic patients.The knowledge of the presence of these deletions in idiopathic and nonidiopathic cases is important to understand the prognosis, better management and counsel these patients accordingly. Furthermore, a more extended screening for Y chromosome microdeletions in idiopathic and nonidiopathic men, particularly candidates for intracytoplasmic sperm injection, is recommended.

To evaluate the clinical efficacy of high intensity focused ultrasound (HIFU) combined with endocrine therapy in the treatment of patients with prostate cancer.Twenty patients with prostate cancer were treated with extracorporeal HIFU device( model FEP-BY01 ) and androgen ablation, of whom 15 received orchiectomy and 5 LHRH-a. Fourteen patients of the total number were given flutamide in addition to castration.The mean follow-up was 13.5 months (ranging 6 to approximately 30). Before and after the treatment, the prostate volume, prostate specific antigen (PSA), international prostate symptom score (IPSS) and maximal flow rate (Qmax) of the patients were (36.4 +/- 16.2) ml and (20.6 +/- 11.8) ml (P0.05), (32.2 +/- 10.4) ng/ml and (2.4 +/- 0.8) ng/ml (P0.01), 20. 5 +/- 6.5 and 13.6 +/- 7.5 (P0.05), (10.6 +/- 6.3) ml/s and (14.2 +/- 4.6) ml/s (P0.05), respectively. Mild hematuria and pain were noted in 5 and 8 patients respectively, and 1 patient underwent internal urethrotomy with a cold knife because of urethral stricture. er, with minimal complications.HIFU combined with endocrine therapy is effective in the treatment of prostate canc