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Ethnicity might be associated with treatment outcomes in advanced prostate cancer. This study aimed to evaluate the efficacy and safety of androgen deprivation therapy (ADT) combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer (mCSPC). The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial was conducted at 260 sites in 23 countries. This subgroup analysis included patients enrolled in 62 participating centers in China, Japan, and Korea. Radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and PSA changes from baseline were compared between groups in the East Asian population. The intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups, respectively. The 24-month radiographic PFS rates were 76.1% and 52.3% in the apalutamide and placebo groups, respectively (apalutamide vs placebo: hazard ratio [HR] = 0.506; 95% confidence interval [CI], 0.302-0.849; P = 0.009). Median time to PSA progression was more favorable with apalutamide than placebo (HR = 0.210; 95% CI, 0.124-0.357; P < 0.001). Median maximum percentages of PSA decline from baseline were 99.0% and 73.9% in the apalutamide and placebo groups, respectively. The most common adverse event (AE) was rash in the apalutamide group, with a higher rate than that in the placebo group (37.3% vs 9.1%). The most common grade 3 or 4 AEs were rash (12 [10.9%]) and hypertension (12 [10.9%]) for apalutamide. The efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.

Background Heterogeneous nuclear ribonucleoprotein K (hnRNPK) is a nucleic acid-binding protein that regulates diverse biological events. Pathologically, hnRNPK proteins are frequently overexpressed and clinically correlated with poor prognosis to various types of human cancers, therefore pursued as attractive therapeutic targets for selective patients. However, both the transcriptional regulation and degradation of hnRNPK in prostate cancer are remain poorly understood. Methods qRT-PCR was used to detect the expression of hnRNPK and miRNA; Immunoblots and immunohistochemical assays were used to determine the levels of hnRNPK and other proteins. Flow cytometry was used to investigate cell cycle stage. MTS and clonogenic assays were used to investigate cell proliferation. Immunoprecipitation was used to analyze the interaction between SPOP and hnRNPK. A prostate carcinoma xenograft mouse model was used to detect the in vivo effects of hnRNPK and miRNA. Results In the present study, we observed that hnRNPK emerged as an important player in carcinogenesis process of PrCa. miR-206 and miR-613 suppressed hnRNPK expression by targeting the 3’-UTR of hnRNPK in PrCa cell lines, where hnRNP K is overexpressed. In biological effects studies, proliferation and colony formation of PrCa cells in vitro, and tumor growth in vivo, were also dramatically suppressed upon reintroduction of miR-206/ miR-613. We have further provided clear evidence that Cullin 3 SPOP as a novel upstream E3 ubiquitin ligase complex that governs hnRNPK proteins stability and oncogenic functions through promoting the degradation of HnRNP K in a poly-ubiquitinaion dependent proteolysis in the prostate cancer setting. Moreover, prostate cancer-associated SPOP mutants fail to interact with and promote the destruction of hnRNPK proteins. Conclusion Our finding reveal new post-transcriptional and post-translational modifications mechanism of hnRNPK regulation via miR-206/ miR-613 and SPOP, respectively. More important, given the critical oncogenic role of hnRNPK and high frequency of SPOP mutation in prostate cancer, our results provide a molecular rationale for the clinical investigation of novel strategies to combat prostate cancer based on SPOP genetic status.

Table S1. miR-1-3p expression in multivariable analysis of both the TCGA database and Tongji cohort. (DOCX 18 kb)

OK-432, a Streptococcus-derived anticancer immunotherapeutic agent, has been applied in clinic for many years and achieved great progress in various cancers. In the present study, we investigated its anticancer effect on bladder cancer through tumor associated macrophages (TAMs). MTS assay validated OK-432 could inhibit proliferation in both T24 and EJ bladder cell lines. OK-432 also induced apoptosis of bladder cancer cells in vitro. Consequently, we demonstrated that OK-432 could suppress the bladder cancer cells migration and invasion by altering the EMT-related factors. Furthermore, using SD rat model, we revealed that OK-432 inhibited tumor growth, suppressed PCNA expression and inhibited metastasis in vivo. Taken together, these findings strongly suggest that OK-432 inhibits cell proliferation and metastasis through inducing macrophages to secret cytokines in bladder cancer.

To investigate the role of the extracellular signal-regulated protein kinase 1/2 (ERK1/2) pathway in erectile dysfunction (ED) caused by the absence of testosterone (T).We randomly divided 30 eight-week-old healthy male SD rats into groups A (control) , B (castration), and C (castration + androgen replacement). The rats in groups B and C were castrated surgically, and those in C injected with T undecanoate (100 mg/kg) at 1 week after castration, while the others with 0.9% normal saline instead. At 1 month after treatment, we determined the serum T level, intracavernous pressure (ICP), and mean carotid arterial pressure (MAP) of the rats, and detected the expressions of ERK1/2 and endothelial nitric oxide synthase (eNOS) by Western blot.The serum T level was significantly lower in group B ([1.27 ± 0.48] nmol/L) than in A ([17.14 ± 1.07] nmol/L) and C ([16.24 ± 1.90] nmol/L) (P0.05), and so were ICP and MAP (P0.05). The expression of ERK1/2 showed no statistically significant differences among the three groups (P0.05), that of phosphatase ERK1/2 was markedly higher while that of eNOS remarkably lower in group B than in A and C (both P0.05).Androgen replacement may improve the erectile function of castrated rats by regulating the ERK1/2 pathway.

Primers used in this paper and their targets. (DOC 29 kb)

Polymer blending is one of the most effective methods for providing new, desirable biocomposites for tissue-engineering applications. In this study, electrospun poly(L-lactide)/poly(e-caprolactone) (PLLA/PCL) blend fibrous membranes with defect-free morphology and uniform diameter were optimally prepared by a 1 : 1 ratio of PLLA/PCL blend under a solution concentration of 10 wt %, an applied voltage of 20 kV, and a tip-to-collector distance of 15 cm. The fibrous membranes also showed a porous structure and high ductility. Because of the rapid solidification of polymer solution during electrospinning, the crystallinity of electrospun PLLA/PCL blend fibers was much lower than that of the PLLA/PCL blend cast film. To obtain an initial understanding of biocompatibility, adipose-derived stem cells (ADSCs) were used as seed cells to assess the cellular response, including morphology, proliferation, viability, attachment, and multilineage differentiation on the PLLA/PCL blend fibrous scaffold. Because of the good biocompatibility and nontoxic effect on ADSCs, the PLLA/PCL blend electrospun fibrous membrane provided a high-performance scaffold for feasible application in tissue engineering using ADSCs. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2011

BACKGROUND AND OBJECTIVE The mammalian target of rapamycin (mTOR) signaling network regulates cell growth, proliferation, survival and apoptosis. This study was to investigate the effect and the underlying mechanism of rapamycin on prostate cancer PC-3 cells. METHODS PC-3 cells were treated with 1 nmol/L rapamycin. The proliferation of PC-3 was examined by MTT. The cell cycle distribution of PC-3 was measured by FCM. The protein levels of raptor, rictor, Akt, pS6k1-T389, pAkt-s473 in PC-3 were examined by western blot. RESULTS Rapamycin increased the proliferation of PC-3 at 24 h, however, it remarkably inhibited cell proliferation after 36 h (P

Objectives To evaluate the efficacy and safety of abiraterone acetate-prednisone versus placebo-prednisone in Asian metastatic castration-resistant prostate cancer patients who have failed docetaxel-based chemotherapy. Methods In this double-blind, phase 3 study from China, 214 patients were randomized (2:1) to abiraterone acetate 1000 mg once daily plus prednisone 5 mg twice daily and placebo plus prednisone 5 mg twice daily in 28-day treatment cycles. Results Abiraterone acetate–prednisone treatment significantly decreased prostate-specific antigen progression risk by 49%, with longer median time to prostate-specific antigen progression of 5.55 months versus 2.76 months in the placebo-prednisone group (hazard ratio 0.506, P = 0.0001, primary end-point). There was a strong trend for improved overall survival in the abiraterone acetate–prednisone group, with a 40% decrease in the risk of death (hazard ratio 0.604, P = 0.0597); however, median survival was not reached in either group because of the short follow-up period (12.9 months) and limited number of observed death events. The prostate-specific antigen response rate was higher in the abiraterone–prednisone group (49.7%) than in the placebo–prednisone group (14.1%). A total of 37.1% patients in this group had pain progression events compared with 50.7% in the placebo–prednisone group. Abiraterone–prednisone significantly decreased the risk of pain progression by 50% (hazard ratio 0.496, P = 0.0014). The incidence of adverse events was similar between the two groups; the most common adverse events being anemia (25.9% for abiraterone–prednisone vs 22.5% for placebo–prednisone), hypokalemia (25.9% and 11.3%), bone pain (23.8% and 21.1%), hypertension (16.1% and 12.7%) and increased aspartate aminotransferase (14.7% and 15.5%), respectively. Conclusions Abiraterone–prednisone significantly delays disease and pain progression, and prostate-specific antigen, with a favorable benefit–risk ratio in Asian metastatic castration-resistant prostate cancer patients in the post-docetaxel setting.

To investigate the concentration of basic fibroblast growth factor (bFGF) in aged rat plasma and penile tissues.Twelve 24-month-old rats and ten 12-week-old rats were selected. We assessed the erectile responses of rats to cavernous nerve electrostimulation. Then the concentrations of bFGF in the rats' plasma and penile tissues were detected by ELISA kit and smooth muscle contents in the rats' cavernous corpus were evaluated by masson trichrome staining.Compared with the young rats, we found that the erectile function of the aged rats were significantly attenuated (The Max ICP/MAP in the aged rats were 0.41±0.05, 0.44±0.04 and 0.51±0.06 at 2.5 volts, 5.0 volts and 7.5 volts respectively while the Max ICP/MAP in the normal controls were 0.70±0.06, 0.75±0.07 and 0.81±0.04 at 2.5 volts, 5 volts and 7.5 volts respectively, P0.05). The concentrations of bFGF [The bFGF levels in plasma and penile tissues in the aged rat were (6.43±0.51) μg/L and (598.6±51.7) pg/mg protein respectively while the bFGF levels in the normal control were (10.53±0.42) μg/L and (985.8±76.8) pg/mg protein] were significantly reduced (P0.05). Furthermore, the smooth muscle contents in the aged rats' penile tissues (0.038±0.005) were dramatically decreased compared with the normal control (0.075±0.006, P0.05).The reduced levels of bFGF may be related to the decreased smooth muscle contents in the penile tissues of the aged rats.

Long non-coding RNAs (lncRNAs) are a group of RNA molecules which are longer than 200 nucleotides. They do not have functional open reading frames and cannot encode proteins. Recent studies have demonstrated that lncRNAs are widely involved in the regulation of gene expression network at epigenetic, transcriptional and post-transcriptional levels, which may affect the growth, proliferation, differentiation, metabolism, apoptosis and other important physiological processes of cells. The abnormal expression of lncRNAs is closely associated with the development, invasion, metastasis and prognosis of tumors. The development of prostate cancer is a multi-factor and multi-step process, in which abnormal gene expression may play an important role. This review focuses on the recent progress in the studies on the role of lncRNAs in prostate cancer, aiming for some new clues to the clinical prevention, diagnosis and treatment of this malignancy.

Purpose To explore the feasibility and efficacy of docetaxel plus prednisone for Chinese population with metastatic castration refractory prostate cancer (mCRPC). Patients and methods A total of 228 patients recruited from 15 centers were randomized to receive 10 cycles of D3P arm (docetaxel: 75 mg/m2, intravenous infusion, every three weeks; Prednisone 10mg orally given daily) or M3P arm (mitoxantrone: 12 mg/m2, intravenous infusion, every three weeks; Prednisone 10mg orally given daily). Primary end point was overall survival, and secondary end points were events progression-free survival (PFS), response rate, response duration. Quality of life (QoL) was also assessed in both treatment groups. Results The median overall survival was 21.88 months in D3P arm and 13.67 months in M3P arm (P = 0.0011, hazard ratio = 0.63, 95% confidence interval, 0.46–0.86). Subgroup analysis was consistent with the results of overall analysis. Events progression-free survival (pain, PSA, tumor and disease) were significantly improved in D3P arm compared with M3P arm. PSA response rate was 35.11% for patients treated by D3P arm and 19.39% for M3P arm (P = 0.0155). Pain response rate was higher in D3P arm (61.11%, P = 0.0011) than in M3P (23.08%) arm. No statistical differences were found between D3P arm and M3P arm for QoL, tumor response rate and response duration of PSA and pain. The tolerability and overall safety of D3P arm were generally comparable to that of M3P arm. Conclusions Compared with M3P arm, D3P arm significantly prolonged overall survival for the Chinese patients with mCRPC and improved the response rate for PSA and pain. Trial Registration clinicaltrials.gov NCT00436839

Background: C-reactive protein (CRP), considered as a prototypical inflammatory cytokine, has been proposed to be involved in tumor progression through inflammation. Recent studies have indicated CRP as a progostic predictor for urological cancers, but the results remain controversial. Materials and Methods: A systematic search of Medline, Scopus and the Cochrane Library was performed to identify eligible studies published between Jan 1, 2001 and Sep 1, 2013. Outcomes of interest were collected from studies comparing overall survival (OS), cancer-specific survival (CSS) and relapse-free survival (RFS) in patients with elevated CRP levels and those having lower levels. Studies were pooled, and combined hazard ratio (HR) of CRP with its 95% confidence interval (CI) for survival were used for the effect size estimate. Results: A total of 43 studies (7,490 patients) were included in this meta-analysis (25 for RCC, 10 for UC, and 8 for PC). Our pooled results showed that elevated serum CRP level was associated with poor OS (HR: 1.26, 95%CI: 1.22-1.30) and RFS (HR: 1.38 95%CI: 1.29-1.47), respectively. For CSS the pooled HR (HR: 1.33, 95%CI: 1.28-1.39) for higher CRP expression could strongly predict poorer survival in urological cancers. Simultaneously, elevated serum CRP was also significantly associated with poor prognosis in the subgroup analysis. Conclusions: Our pooled results demonstrate that a high serum level of CRP as an inflammation biomarker denotes a poor prognosis of patients with urological cancers. Further large prospective studies should be performed to confirm whether CRP, as a biomarker of inflammation, has a prognostic role in urological cancer progression.

To assess the influence of photoselective vaporization of the prostate (PVP) on the erectile function of the patient with benign prostatic hyperplasia (BPH).Using IIEF-5, we conducted a questionnaire investigation among 210 BPH patients before and after treated by PVP (n = 80) and transurethral resection of the prostate (TURP, n = 130). We also reviewed the clinical data and compared the pre- and post-operative penile erectile function between the two groups of patients.Follow-up was completed in 76 cases of PVP and 123 of TURP. The baseline data showed no statistically significant differences between the two groups in age, prostate volume, IPSS, QOL, Qmax, post void urine residual volume and IIEF-5 scores (P0.05). Compared with the IEFF-5 score at the baseline (21.88 +/- 2.46), those at 3, 6 and 12 months after PVP were 16.72 +/- 3.17, 19.34 +/- 2.46 and 19.29 +/- 2. 18, respectively, significantly decreased at 3 months (P = 0.042), but with no remarkable difference at 6 and 12 months (P0.05). Nor were there significant differences in the IIEF-5 score between the PVP and TURP groups at any time points (P0.05). At 6 months after surgery, the incidence rates of erectile dysfunction were 11.7% and 13.7% in the TURP and PVP groups, respectively (P0.05).PVP may reduce erectile function in some cases in the early stage after surgery, but this adverse effect does not last long and is basically similar to that of TURP.

Immediate intravesical instillation of chemotherapeutic agents after transurethral resection (TUR) of nonmuscle invasive transitional cell bladder cancer has recently been suggested and has been proven to decrease the tumor recurrence rate significantly. This study is to evaluate the efficacy and safety of immediate intravesical instillation combined with regular instillations of Pirarubicin (THP(®)) as prophylaxis compared to regular instillations only after TUR operation.This was a prospective, randomized, multi-center, clinical study. Patients diagnosed with non-muscle invasive bladder cancer (Ta and T1) pathologically and suitable for TUR were enrolled randomly into two groups. In the study group, the patients received intravesical instillation within 24-hour post TURBT, followed by regular intravesical therapy using 30 mg/50 ml of THP(®) once a week for 8 weeks, and then once a month to 1 year postoperatively Among the patients. In the control group, patients received regular instillation only.A total of 403 patients were enrolled into this study from 26 institutions in China. Among the potients, 210 were enrolled into the study group and 193 were enrolled into the control group. At the median follow-up of 18 months, the recurrence rate was 7.8% in the study group, significantly lower than that in the control group (14.3%; P = 0.042). Subgroup analysis showed that the recurrence rate in low and intermediate-risk patients was significantly lower in the study group (6.8%) than in the control group (14.0%; P = 0.047), although no significant differences were found in high-risk patients.One immediate dose of THP(®) 30 mg after TURBT followed by regular intravesical therapy appears well tolerated and more effective than regular intravesical therapy for preventing tumor recurrence, especially in low and intermediate-risk patients.

Curcumin possesses chemopreventive properties against several types of cancer, but the molecular mechanisms by which it induces apoptosis of cancer cells and inhibits cancer cell proliferation are not clearly understood. To evaluate the antitumor activity of curcumin for prostate cancer, we used an androgen dependent LNCaP prostate cancer cell line and an androgen independent PC-3 prostate cancer cell line as experimental models. We treated these cells with curcumin and then evaluated the effects of curcumin on cell cycle profiling and apoptosis, as well as the activation of NF-kaapaB and c-jun in these cells. The results showed that the ratios of apoptosis in LNCaP and PC-3 cells were significantly elevated in a dose dependent manner after exposure to curcumin. In addition, curcumin induces the G2/M cell cycle arrest of LNCaP and PC-3 cells in a dose dependent manner. Mechanistically, we found that curcumin upregulated the protein level of NF-kappaB inhibitor IkappaBalpha and downregulated protein levels of c-Jun and AR. These data suggest that curcumin is a promising agent for the treatment of both androgen-dependent and androgen-independent prostate cancer.

To assess the diagnostic value and potentially protective capacity of tumor necrosis factor-alpha (TNF-alpha), interleukin 1beta (IL-1beta) and heat-shock protein 70 (HSP70) in chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).We determined the levels of cytokines TNF-alpha, IL-1beta and HSP70 by ELISA in the seminal plasma of 150 men: 36 with CBP, 43 with CP/CPPS IIIA, 46 with CP/CPPS IIIB, and 25 healthy controls. We analyzed the correlation of the HSP70 expression in the CBP and CP/CPPS patients with the chronic prostatitis symptom index (CPSI).Significantly increased levels of TNF-alpha, IL-1beta and HSP70 were observed in the seminal plasma of the CBP patients as compared with the CP/CPPS patients and healthy controls. The expression of IL-1beta was significantly higher in the patients with CP/CPPS IIIA than in those with CP/CPPS III B and the controls, while the HSP70 level remarkably lower in those with CP/CPPS than in the controls, and its concentration in the seminal plasma of the CBP patients was negatively correlated with CPSI.The levels of HSP70 and IL-1beta in the seminal plasma appear to be most reliable molecular biological markers for the diagnosis of CBP and CP/CPPS, respectively. HSP7O has an important protective role in the regulation of cell functions in CBP patients. CP/CPPS is probably detrimental to the function of T cells and consequently suppresses the expression of HSP70.

To explore the relationship between occupational factors and the incidence of bladder cancer.The present research was based on a hospital-based case-control study. The cases were frequency matched. The non-conditional Logistic regression was used to calculate the odds ratio (OR) of each occupation.The OR of business and administration professionals, male electricians and electronic workers were 3.88 and 7.40; the OR of janitors and helpers was 0.21; the OR of handcrafted and printing clerks was 0.71, but there was no significant difference.Business and administration professionals, male electricians and electronic workers tend to have bladder cancer. The occupation of janitors and helpers has a protective effect on bladder cancer while the occupation of printing clerks shows no statistical significance on bladder cancer.

Bladder urothelial cancer has been diagnosed at an increasing rate among young adults in China while the clinical outcomes remain highly controversial. To optimize the management of young patients with bladder cancer, we examined whether bladder urothelial cancer in young patients behaved differently from that in the elder patients.From 1994 to 2008, a database of bladder urothelial cancer patients at a major tertiary medical center was retrospectively reviewed. The clinical and pathological parameters of patients who were less than 40 years of age and a series of patients older than 40 years of age as the control group during the same period were compared. A survival analysis was performed using the Kaplan-Meier method and log-rank test, and Cox regression was performed to identify clinical parameters that affected the clinic outcomes.Young bladder cancer patients had a lower male-to-female ratio and were less likely to have advanced stages and high-grade cancers at the initial diagnosis. Tumors in young bladder cancer patients tended to be less multifocal at diagnosis. In addition, young patients had a lower recurrence rate and longer recurrence interval than older patients. The Kaplan-Meier curve and Log-rank test showed that young patients had significantly better cancer specific survival than old patients. The univariate and multivariate Cox regression analysis revealed that tumor grade is the sole predictor for tumor recurrence in young patients.Young patients with bladder cancer have favorable pathological features and clinical outcomes than older patients. These findings argue for more conservative management approaches for young patients with bladder cancer.

Idiopathic hyperoxaluria (IH) may be caused by increased endogenous formation or exogenous absorption of oxalic acid. Characterization of the molecular pathogenesis of IH has been hampered by the lack of an ideal animal model. We therefore established a stabile rat IH model in order to analyze variation in gene expression profile in the jejunum and to investigate the association between IH pathogenesis and exogenous absorption of oxalic acid.A rat model of IH was established and three female rats with IH were assigned to the study group, while three normal rats served as controls. Total RNA was isolated from the jejunum of rats in the two groups and mRNA was purified, reversely transcribed, labeled with Cy5 or Cy3 and hybridized to 27K Rat Genome Array. Differences in gene expression profile between the 2 groups were analyzed by bioinformatics methods.Comparative analysis revealed that the expression of 517 genes was up-regulated and that of 203 genes was down-regulated by at least two-fold in the jejunum of rats with idiopathic hyperoxaluria. These genes are related to many functions including cell signal transduction, DNA binding and transcription, ATP binding, ion binding and transport, cell receptors, immunity, cyclins, cytoskeleton structure, and metabolic proteins. Kyoto encyclopedia of genes and genomes (KEGG) signaling pathway analysis revealed that the variations of 239 pathway functional changes are statistically significant (P0.05).cDNA microarray can be used effectively to screen differentially expressed genes in the jejunum of rats with idiopathic hyperoxaluria. These differentially expressed genes may underlie idiopathic hyperoxaluria pathophysiology and provide a platform for further studying molecular pathogenetic mechanisms.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum, pelvis, suprapubic area, or external genitalia and variable degrees of voiding and ejaculatory disturbance. The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis, on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints. In this study, we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (IIIB) CP/CPPS.Men diagnosed with IIIB CP/CPPS were randomized to either ESWT (group 1, n = 40) or the control (group 2, n = 40). Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period, whereas group 2 received only a sham procedure. The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline, mid-treatment, end-point, and 4-week and 12-week follow-up visits.The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P0.01 for all). Decreases in pain domain and quality of life (QOL) scores were also significant. In group 2, no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points. At the end-point of treatment, 71.1% of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0% of group 2 (P0.001); additionally, 28.9% of group 1 exhibited clinically significant improvement compared with 10.8% of group 2 (P0.01). Moreover, a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.ESWT exhibits a potentially therapeutic role in the treatment of CP/CPPS.

To investigate the architectural features and frequency of glomeruloid features in pathological section of prostatic adenocarcinoma and evaluate the association between glomerulations and its clinical data.We studied 196 prostatic adenocarcinoma specimens obtained from needle biopsies or radical prostatectomy and their clinical data, and reviewed related literatures.Three of the 196 cases showed glomeruloid features, the Gleason score of which was 7, 8, and 8, respectively. Of the 3 cases 1 had osseous metastasis and 2 extraprostatic nervus extension. After 5 to 15 months' follow-up, 1 case died and the other 2 still under treatment.Glomeruloid structures in the prostate represented an uncommon but distinctive growth pattern that was specific for malignancy. Glomeruloid structures were usually seen in high-grade adenocarcinoma, often with extraprostatic extension.

To explore the clinical, pathological features and prognosis of patients with chromophobe renal cell carcinoma.From January 1998 to January 2008, clinical data of 29 patients with chromophobe renal cell carcinoma including clinical manifestations, imaging examinations, treatment models, pTNM stages and follow-up results, were summarized to investigate its features and prognosis.All cases had no obvious clinical and preoperative imaging presentation. There were 23 patients underwent radical nephrectomy, and 6 cases underwent nephron sparing surgery. Postoperative pathological findings confirmed the diagnosis of chromophobe renal cell carcinoma. Macroscopically, the cut surface of the tumors were generally beige in color. Histologically, it showed polygonal chromophobe cells and small round eosinophilic cells with eccentric hyaline degeneration. These tumor cells had a clear and sharp membrane, lightly stained abundant cytoplasm with a fine reticular translucent pattern and irregular nuclei. And a perinuclear halo was often seen in these cells. Histochemically, the tumor cells generally show a diffuse and strong reaction for CK-8 with a negative expression of Vimentin. The pTNM stages of the tumor were as follows, pT1N0M0 in 11 cases, pT2N0M0 in 8 cases, pT3aN0M0 in 5 cases, pT1N1M0 in 3 cases, pT2N1M0 in 2 cases. Twenty-six cases of patients were followed up (24 to 144 months, with an average of 90 months), 3 cases died of cardio-cerebrovascular disease, and local recurrence involved in 6 cases with reoperation in 4 cases, as well as distant metastasis in 1 case. Twenty-one cases survived with tumor-free. The statistical results indicated that the survival rates of the patients with chromophobe renal cell carcinoma in five years and ten years were 83.9%, 77.9%, respectively, compared with renal cell carcinoma of the same stage 63.8% and 49.9% at the same periods, and there is no difference in the survival rate of five years (P0.05) but significant difference in that of ten years (P0.01).Chromophobe renal cell carcinoma is a morphologically uncommon subtype of renal cell carcinoma with the good prognosis. Definite diagnosis depends on its typical pathological feature. Radical nephrectomy is the first choice for the treatment of chromophobe renal cell carcinoma.

To investigate the effects of intraprostatic injection of botulinum toxin A (BTX-A) on benign prostate hyperplasia (BPH) in rats.Models of BPH were established in adult male Sprague-Dawley rats by injection of testosterone propionate, and then divided into three BTX-A groups, injected with BTX-A into the ventral prostate at the doses of 5 U, 10 U and 20 U, a negative control group, injected with saline only, and a sham operation group, with 12 in each. The prostates of the animals were harvested at 2 or 4 weeks after the injection, their volumes and weights measured, histological changes examined by HE staining, and glandular and interstitial areas semi-quantified by the image analysis system.Two rats died in the 20 U group within 3 days after BTX-A injection. Compared with the saline group, the 5 U, 10 U and 20 U BTX-A groups showed significant decreases in prostatic volume (P0.01, 0.01 and 0.05), weight, and glandular and interstitial areas as well as atrophic epithelia in the glandular tube at 2 weeks. These changes were lessened at 4 weeks, especially in the 5 U group.Intraprostatic injection of BTX-A induces obvious atrophy and histological changes of the prostate, but meanwhile may potentially result in death at a large dose.

To investigate the urodynamic features in patients of benign prostatic hyperplasia (BPH) with coexisting overactive bladder (OAB).Clinical data of 235 patients with symptomatic BPH who underwent urodynamic examination during January 2009 to May 2010 were retrospectively analyzed. Patients were divided into group of pure BPH, BPH with detrusor overactivity (DO), BPH with coexisting OAB without DO and BPH with coexisting OAB with DO. The difference of age, International Prostate Symptom Score (IPSS), transrectal ultrasound (TRUS)-volume, maximum flow rate, residual urine volume, bladder volume of first sensation, bladder volume of strong sensation, bladder outlet obstruction index (BOOI) and the prevalence of decreased detrusor contractility were compared between these groups. The urodynamic characteristics of DO between group of BPH with DO and group of BPH coexisting OAB and DO were analyzed.A total of 219 cases were included in the final analysis, with mean age of (66 ± 8) years, mean TRUS-volume was (35 ± 24) ml, mean maximum flow rate was (11 ± 6) ml/s. Of the 219 patients, 93 patients (42.5%) had pure BPH, 11 patients (5.0%) had BPH with DO, 52 patients (23.7%) had BPH coexisting OAB without DO, 63 patients (28.8%) had BPH coexisting OAB and DO. Comparing to group of BPH (n = 104), patients with BPH and OAB (n = 115) were older, had higher IPSS, bigger TRUS-volume, less bladder volume of first sensation and strong sensation, higher BOOI and higher prevalence of decreased detrusor contractility. Comparing to group of BPH with coexisting OAB without DO patients, patients of BPH with coexisting OAB and DO had higher IPSS score (19 ± 12 vs 17 ± 10), bigger TRUS-volume [(51 ± 33) ml vs (43 ± 27) ml], higher BOOI (49 ± 18 vs 37 ± 14). Comparing to patients pure BPH, patients of BPH with DO had less bladder volume of first sensation and bladder volume of strong sensation [(82 ± 41) ml vs (118 ± 35) ml;(335 ± 67) ml vs (419 ± 53) ml]. Comparing to group of BPH with DO, patients of BPH with coexisting OAB and DO had higher maximum DO pressure [(45 ± 36) cmH2O vs (39 ± 30) cmH2O (1 cmH2O = 0.098 kPa)] and longer DO time [(7 ± 4) s vs (6 ± 4) s].The urodynamic features in patients with BPH differ greatly and these information should be helpful in making choice of treatment and in predicting treatment outcomes.

To investigate the features of chronic prostatitis with non-neurogenic detrusor sphincter dyssynergia (NNDSD) and the effects of pelvic floor biofeedback in the treatment of the disease.We included in this study 113 male patients, aged 15 - 48 (mean 36) years and diagnosed as having chronic prostatitis for 1 -2 (mean 1.2) years based on such typical symptoms as frequent micturition, urgent micturition, voiding pain, difficult void, etc, that lasted over 3 months, and the scoreor = 1 on the first and second parts of NIH-CPSI. Urethritis, interstitial cystitis, urethral stricture and neurogenic bladder were excluded. All the patients underwent urodynamic examinations for the uroflow curve, Q(max), Pdet. max and MUCP. Biofeedback was carried out for those with non-neurogenic detrusor sphincter dyssynergia, and the effects were evaluated at 10 weeks.Twenty-one (18.6%) of the 113 cases were found to be NNDSD. Biofeedback treatment achieved obvious decreases in Q(max) (8.2 +/- 4.1), Pdet. max (125.1 +/- 75.3), MUP (124.3 +/- 23.3) and MUCP (101.5 +/- 43.6), as compared with 15.1 +/- 7.3, 86.3 +/- 54.2, 65.4 +/- 23.0 and 43.5 +/- 16.7 before the treatment (P0.05). Statistically significant differences were observed between pre- and post-treatment scores on voiding pain (4.0 +/- 2.0 vs 2.2 +/- 1.7), urination (7.9 +/- 2.1 vs 2.2 +/- 1.9), life impact (9.6 +/- 2.7 vs 2.9 +/- 2.6) and total scores (21.7 +/- 4.8 vs 8.4 +/- 4.6) (P0.05).Chronic prostatitis patients with LUTS may have NNDSD, which is urodynamically characterized by low Q(max), high intra-bladder pressure and increased urethral pressure in some patients. Urodynamic examinations may contribute to definite diagnosis and appropriate choice of treatment. Pelvic floor biofeedback has satisfactory short-term effects in the treatment of these patients.

Chronic prostatitis, especially type III A, is a common disease in adult males, for which there are quite a few therapeutic methods. This study aimed to investigate the clinical efficacy of enoxacin in the treatment of III A prostatitis.We selected 198 cases of III A prostatitis with complete treatment and follow-up data from the outpatients, all treated by enoxacin injection for 1 week, followed by oral medication of enoxacin for 2 weeks. Then we evaluated the therapeutic effect based on the NIH-CPSI scores and changes in the indexes of expressed prostatic secretions (EPS).The rate of total effectiveness was 86.4%, cure 8.6% (17/198), remarkable effectiveness 58.1% (115/198), improvement 19.7% (39/198), and ineffectiveness 13.6% (27/198). Only 16 cases (8.1%) complained of transitory gastrointestinal tract discomfort and/or skin itching.Enoxacin has desirable efficacy and few adverse effects on type III A prostatitis.

To investigate the mechanisms of erectile dysfunction induced by hyperlipidemia through studying the changes of contractility and relaxation of corpus cavernosum in hypercholesterolemic rabbit in vitro.New Zealand white rabbits were randomly divided into control and experiment groups. The control group (n = 20) received a regular diet for 8 weeks while the experimental group (n = 20) were fed a 1% cholesterol diet for 8 weeks. The authors conducted isometric tension studies with phenylephrine, endothelium-dependent vasodilators (acetylcholine), endothelium-independent vasodilators (sodium nitroprusside) and rho kinase inhibitor (Fasudil) on isolated strips of corpus cavernosum.The weight and total serum cholesterol significantly improved (P0.01) in experimental group as compared with the non-fed experimental group. The total serum cholesterol significantly improved (P0.01) in experimental group as compared with the control group. The contractility responses to phenylephrine in experiment group in doses (0.5, 1, 5, 10, 50, 100 micromol) were 4.79% +/- 2.00%, 8.84% +/-2.95%, 12.81% +/- 3.77%, 14.63% +/- 5.38%, 25.01% +/- 6.14% and 34.69% +/- 8.53% respectively. The contractility responses to phenylephrine in control group were 1.00% +/- 0.3%, 2.60% +/- 0.72%, 4.28% +/- 1.27%, 5.91% +/- 2.09%, 6.49% +/- 4.02% and 5.64% +/- 11.87% respectively. The contractility responses to phenylephrine significantly improved (P0.01) in experimental group in these doses as compared with the control group. The relaxation responses to acetylcholine in experimental group in doses (1, 10 and 100 micromol) were 36.28% +/- 4.71%, 48.81% +/- 4.36% and 56.27% +/- 11.93% respectively. The relaxation responses in control group were 48.04% +/- 4.78%, 69.12% +/- 5.27% and 78.23% +/- 5.30% respectively. There was significant reduction (P0.01) in experimental group in these doses as compared with the control group. No difference were found among the two groups in the relaxation response to sodium nitroprusside. The relaxation responses to fasudil in experimental group in doses (0.25, 1.25, 2.5 and 12.5 micromol) were 1.56% +/- 0.43%, 5.03% +/- 1.02%, 8.28% +/- 1.35% and 16.77% +/- 3.57% respectively. The relaxation responses in control group were 4.69% +/- 1.23%, 10.39% +/- 2.05%, 15.08% +/- 3.04% and 25.22% +/- 3.72% respectively. There was significant reduction (P0.01) in experimental group in these doses as compared with the control group.The improvement of cavernous smooth muscle contractility and the impairment of cavernous smooth muscle relaxation in response to endothelium-mediated stimuli are the mechanisms of erectile dysfunction induced by hyperlipidemia.