目的 比较泌尿外科手术领域达芬奇手术系统与传统腹腔镜围术期指标.方法 选择火箭军总医院泌尿外科2014-03至2018-01达芬奇机器人辅助下40例手术患者(达芬奇组),另选择同期40例经普通腹腔镜手术患者(腹腔镜组),对两组术中及术后相关指标进行对比分析.结果 达芬奇组术中出血量为(341.35±52.01)ml,明显少于腹腔镜组的(367.78±50.04)ml,差异有统计学意义(P<0.05);达芬奇组术后排气时间为(40.71±8.59)h,下床活动时间为(42.97±11.80)h,均早于腹腔镜组,差异均有统计学意义(P<0.05);两组手术时间、手术费用对比,差异无统计学意义;但达芬奇组住院时间明显少于腹腔镜组,差异有统计学意义(P<0.05).结论 达芬奇机器人辅助系统下的手术能提高手术的精确性,减少术中出血,缩短术后恢复时间和住院时间.

Objectives:To investigate the clinical efficacy of tamsulosin combined with Ningbitai capsule in the treatment of type-Ⅲ prostatitis.Methods:160 patients with type-Ⅲ prostatitis were randomly divided into treatment gronp and control group,with 80 cases in each group.The treatment group and control group were given imported tamsulosin capsule and domestic tamsulosin capsule 0.2 mg/qd respectively,for 4 weeks.CP symptom score (NIH-CPSI),pain score (PS),voiding symptom score (USS),international prostate symptom score (IPSS),quality of life score (QLS) and adverse events of the two groups were compared.Results:The treatment group had obviously higher efficacy and lithagogue rate than theses of control group,and the differences were statistically significant (P ＜ 0.05).There were significant differences in NIH-CPSI value between pre-treatment and pro-treatment in both groups.NIH-CPSI,PS,USS,IPSS and QLS all had statistically significant difference (P ＜ 0.05).Conclusion:Under the combination of Ningbitai capsule,the efficacy and safety of imported tamsulosin are much better than these of domestic tamsulosin in the treatment of type-Ⅲ prostatitis.

ObjectiveTo investigate the factors influencing the postoperative resolution of varicocele-associated scrotal pain.METHODSUsing the keywords "varicocele", "testicular pain", "scrotal pain", "painful varicocele", "ligation", and "varicocelectomy", we searched the PubMed, Embase, Cochrane Collaboration's Database, CNKI, Wanfang, and VIP Database up to October 2016 for the studies relating to surgical treatment of varicocele-associated scrotal pain. We assessed the quality of the cohort studies included using the Newcastle-Ottawa Scale and that of the randomized controlled trials included with the Cochrane Collaboration's tool. We conducted a meta-analysis using the RevMan software.RESULTSFinally 14 studies were included in this meta-analysis, of which, 2 involved the history of disease, 8 involved the nature of pain, 2 involved the intensity of pain, 9 involved the grade of varicocele, 3 involved the side of varicocele, 9 involved surgical approaches, 3 involved surgical techniques, and 4 involved postoperative recurrence. The pain resolution rate was significantly higher after subinguinal ligation than after high or inguinal ligation (RR = 0.82, 95% CI: 0.76－0.89, P <0.01; RR = 0.92, 95% CI: 0.86－0.99, P = 0.02), and so was it after microsurgery than after laparoscopic varicocelectomy (RR = 0.77, 95% CI: 0.60－0.99, P = 0.04).CONCLUSIONSSubinguinal varicocelectomy and microsurgery are more effective options than laparoscopic and high or trans-inguinal ligation of the spermatic vein for resolution of varicocele-associated scrotal pain, while the history of disease, the nature and intensity of pain, the grade and side of varicocele, or postoperative recurrence cannot be regarded as the influencing factors.

As one common malignant tumor in male reproductive-urinary system, the incidence of prostate cancer is increasing rapidly. Recent study revealed the participation of FOX transcription factor family in tumor occurrence and progression. FOXJ1, one member of FOX family, plays an important role in tumor pathogenesis and advancement, although its expression and functional role in prostate cancer has not been illustrated. Both tumor and adjacent tissues were collected from prostate cancer patients. Real-time PCR and Western blot were used to test the FOXJ1 expressions, and to analyze their correlation with pathological feature of cancer. DU145 cells were in vitro cultured and were transfected with FOXJ1-overexpressing vectors. MTT assay detected the effect of FOXJ1 on tumor cell proliferation. Western blot quantified MMP-2 and MMP-9 expressions, while Transwell invasion assay determined the impact of FOXJ1 on tumor invasion. Both mRNA and protein levels of FOXJ1 in prostate tumor tissues were significantly depressed compared to adjacent tissues (P<0.05). FOXJ1 expression level was negatively correlated with TNM stage, tumor volume and lymphatic metastasis (P<0.05). The transfection of DU145 cells by FOXJ1-overexpressed vectors inhibited proliferation or invasion abilities, and reduced MMP-2 and MMP-9 expressions (P<0.05 compared to control group). FOXJ1 was down-regulated in prostate cancer tissues, and was closely correlated with pathological features of tumor. FOXJ1 regulated proliferation of prostate cancer cells, and functioned as molecular targets for tumor diagnosis and prognostic prediction via modulating MMP-2 and MMP-9 mediated tumor invasion.

目的 利用Meta分析观察麒麟丸治疗男性少弱精子症的疗效.方法 检索Cochrane图书馆、Pubmed数据库、中国生物医学文献数据库、CNKI数据库、VIP数据库以及万方数据库从建库到201 5年8月,纳入麒麟丸治疗少弱精子症的随机对照治疗(RCT),并进行方法学质量评价,采用RevMan5.3软件进行统计分析,并发表偏倚评估和敏感性分析.结果 7篇RCT文献纳入本项研究,累计病例1250例.Meta分析结果显示:麒麟丸在提高(a+b)级精子率[WMD=5.16,95％CI (-5.09,15.40),P=0.3 2]、精子活动率[WMD=-4.76,95％CI(-10.68,1.16),P=0.11]、显效率[RR=0.61,95％CI (0.23,1.65),P=0.33]、有效率[RR=1.13,95％CI (0.71,1.78),P=0.30]和总有效率[RR=1.29,95％CI (0.95,1.76),P=0.10]方面并无明显优势,但在改善a级精子率[WMD=4.50,95％CI (0.70,8.30),P=0.02]、精子密度[WMD=7.03,95％CI (6.31,7.75),P＜0.01]和痊愈率(妊娠率)[RR=1.78,95％CI (1.03,3.07),p=o.04]方面明显优于对照组.结论 麒麟丸可有效提高a级精子率和精子密度并可改善痊愈率(妊娠率),是治疗男性少弱精子症的有效药物,但仍需进一步的大样本、高质量、多中心的随机对照双盲临床试验进行远期观察.

PURPOSE:Prostate cancer (PC) is the most common malignant disease in males and the second leading cause of cancer related deaths in men in developed countries. The purpose of this study was to investigate whether microRNA (miR)-150 is a factor influencing survival in prostate cancer patients.METHODS:miR-150 mRNA and protein expression levels in prostatic cancer cell lines and healthy tissues were determined by quantitative (q) RT-PCR and Western blotting. Additionally, the protein expression of miR-150 was detected by immunohistochemistry.RESULTS:High miR-150 expression was positively correlated with tumor recurrence or metastasis (p=0.010). In addition, PC patients with high miR-150 expression had significantly poorer overall survival/OR (hazard ratio/HR, 1.87; 95% confidence interval/CI, 1.19-2.94; p=0.006) and poorer disease-free survival/DFS (HR, 1.90; 95% CI, 1.21- 2.98; p=0.005) than those with low miR-150 expression. The cumulative 5-year OS was only 35.19% (95% CI, 26.18- 44.20) in the high miR-150 expression group, whereas it was 55.93% (95% CI, 43.26-68.60) in the low miR-150 expression group (p<0.05). Multivariate Cox regression analysis demonstrated that the expression of miR-150, tumor size, and number of tumor lesions were independent prognostic predictors for OS in PC patients.CONCLUSION:miR-150 was overexpressed in PC at both the mRNA and protein levels, and high expression of miR-150 could serve as a novel and reliable prognostic biomarker for PC patients.

To systematically update and review the efficacy and safety of different dosages of tamsulosin treatments on lower urinary tract symptoms (LUTS)in male benign prostatic hyperplasia (BPH)patients to provide more reliable evidence for the use of tamsulosin.Methods:Relevant paper in PubMed (1 966 - May 201 4),Em-base (1 974 - May 201 4),the Cochrane Library Database (201 4,Issue 5)and China National Knowledge Infra-structure (CNKI)(1 995 -201 4)were reviewed.The assessed outcome measures included international Prostate Symptom Score (IPSS)/Boyarsky symptom score,quality of life (QOL)score,maximum flow rate (MFR/Qmax ) and AEs (adverse events).Two authors independently assessed the study quality and extracted data.All data were analyzed through RevMan 5.2.The meta -analysis included ten randomized controlled trials and the study durations ranged from 4 weeks to 1 2 weeks.Results:The pooled results showed that the change in the tamsulosin group was significantly higher than the placebo group in the aspects of the IPSS /Boyarsky symptom score,Qmax /MFR,QoL score [standardized mean difference (SMD)= -0.34,P <0.00001 ;weighted mean difference (WMD)=1 .1 0, P <0.00001 ;WMD =-0.39,P =0.0007 respectively].According to the AEs pooled results,abnormal ejacula-tion,dizziness,rhinitis (nasal congestion),infection,back pain and asthenia/fatigue were the most commonly re-ported adverse events,and the risk ratio (RR)of 1 .1 2 was significantly different from the placebo group (p <0. 0001 ).Conclusion:The current meta -analysis suggests that tamsulosin is effective in treating LUTS of male BPH patients,but its side effects also need further attention.

目的 利用Meta分析观察复方玄驹胶囊治疗不育症的疗效.方法 检索Cochrane图书馆,Pubmed数据库,中国生物医学文献数据库,CNKI数据库,VIP数据库,万方数据库,纳入复方玄驹胶囊治疗不育症的随机对照治疗(RCT),并进行方法学质量评价,采用RevMan5.3软件进行统计分析,并发表偏倚评估和敏感性分析.结果 9篇RCT文献纳入本项研究,累计病例1199例.Meta分析结果显示:复方玄驹胶囊在改善和提高A级精子率[WMD=1.35,95％CI(-6.36,9.07),P=0.73]、(a+b)级精子率[WMD=6.54,95％CI(-17.03,30.11),P=0.59]、精子密度[WMD=3.80,95％CI(-4.23,11.82),P=0.35]、精子活率[WMD=-68.66,95％CI (-12.13,-5.19),P＜0.01]、显效率[RR=0.79,95％CI (0.51,1.23),P=0.30]和总有效率[RR=0.86,95％CI (0.70,1.05),P=0.13]方面并无优势,而在改善正常形态百分率[WMD=9.00,95％CI (0.59,17.40),P=0.04]方面优于对照组.结论 复方玄驹胶囊可更有效改善精子正常形态百分率,是治疗男性不育症的有效药物,但尚需进一步的大样本、高质量、多中心的随机对照的双盲临床试验.

目的:利用Meta分析观察五子衍宗丸治疗不育症的疗效.方法:检索Cochrane图书馆、Pubmed数据库、中国生物医学文献数据库、CNKI数据库、VIP数据库、万方数据库,纳入五子衍宗丸治疗不育症的随机对照治疗(RCT),并进行方法学质量评价,采用RevMan5.2软件进行统计分析,并发表偏倚评估和敏感性分析.结果:7篇RCT文献纳入本项研究,累计病例652例.Meta分析结果显示:五子衍宗丸在改善和提高精子密度[WMD=-5.62,95％CI(-7.01,-4.23),P＜0.01]、A级精子率[WMD=-5.29,95％CI(-7.76,-2.82),P＜0.01]、A+B级精子率[WMD=-9.50,95％CI(-13.04,-5.95),P＜0.01]、总有效率[RR=0.85,95％CI(0.79,0.92),P＜0.01]和痊愈率[RR=0.50,95％CI(0.26,0.97),P＜0.05]方面并无优势.结论:五子衍宗丸在治疗不育症中疗效不确切,并非治疗不育症的有效办法.

Objective To evaluate the efficacy and safety of rocephin versus rpectinomycin for uncom-plicated gonorrhea by Meta-analysis . Methods The studies involving randomized controlled trials (RCTs) on ceftriaxone (rocephin) versus spectinomycin for uncomplicated gonorrhea were collected from the database, such as the Cochrane Library, Pubmed, CBMdisc, CNKI, VIP and Wanfang. After the necessary methodologi-cal quality evaluation of the selected studies, assessment of publication bias and sensitivity analysis, the statistic analysis was conducted by the software RevMan5.2. Results Six eligible reports were identified in this study, including accumulative total 789 cases. The Meta-analysis results showed rocephin in the treatment of uncom-plicated gonorrhea had higher effectiveness and recovery than the spectinomycin group(P<0.05), which could increase the cure rate [OR1.18;95%CI(1.06,3.34),P<0.05] and the total effective rate [OR3.96;95%CI(1.29, 12.18), P<0.05],but there were no significant difference among bacterial eradication rate and incidence of ad-verse reactions. Conclusion The ceftriaxone (rocephin) showed definite curative effect in the treatment of un-complicated gonorrhea.

目的 探讨膀胱副神经节瘤的诊断和治疗.方法 回顾性分析2000年1月至2010年9月间确诊的膀胱副神经节瘤5例患者的临床资料.结果 5例患者均经手术治疗,经尿道膀胱肿瘤电切术2例、膀胱部分切除3例(开放切除1例,腹腔镜下切除2例),术后病理及免疫组化证实膀胱副神经节瘤.随访3个月至2年,无肿瘤复发.结论 膀胱副神经节瘤为潜在恶性肿瘤,诊断需结合临床、病理及免疫组化结果.手术切除是首选治疗方法,术后应密切随访.

Objectives: To compare the therapeutic effect of Qianliexian decoction and cernilton on rats with abacterial chronic prostatitis of qi stagnancy and blood stasis. Method: 40 adult male rats were randomly divided into group A,B,C and D,10 rats in each group. Rats in group A were cut on testes and sutured. Rats in group B, C and D were removed of testes and received hypodermic injection of oestradiol monobenzoate 0. 25mg / kg. After 30- day administration,these rats were given acoustic,electric and photic stimuli for four weeks in order to build the model of abacterial chronic prostatitis of qi stagnancy and blood stasis. Group A was given 10 mL / kg saline lavage for four weeks; group B no drug; group C Qianliexian decoction; group D cernilton. General status,prostate indexes,WBC in EPS,whole blood viscosity of the rats were observed. Results: Compared with group B,due to Qianliexian decoction,group C showed significant lower WBC in EPS,prostate indexes,and blood viscosity( P 0. 05). Cernitol reduced WBC in EPS and prostate indexes,but was ineffective to reduce blood viscosity. Conclusion: Qianlexian dcoction can improve the condition of abacterial chronic prostatitis of qi stagnancy and blood stasis in adult male rats.

Objectives:To evaluate the efficacy and safety of the micro-injury peritomy anastomoses de-vice for redundant prepuce or phimosis.Methods:The randomized controlled trials (RCTs)were collected from database,such as the Cochrane Library,Pubmed,CBMdisc,CNKI,VIP and Wangfang from the founded year to December 2013.After the necessary methodological quality evaluation of the selected studies and assessment of pub-lication bias,the statics analysis was conducted by the software RevMan5.2.Result:Nineteen studies involving 3809 patients were included.In comparison with the conventional technique,the results showed that shorter time of surgery [WMD=-24.25,95%CI (-26.48,-22.02),P<0.0000 1],less capability of intraoprative bleeding [WMD=-7.59,95% CI(-10.14,-5.05),P<0.0000 1],lower postoperative infection [OR=0.10,95%CI(0.06,0.19),P<0.0000 1],fewer number of appearance defect [OR=0.12,95% CI (0.04,0.35),P<0.0000 1],fewer incidence of postoperative hematoma [OR=0.10,95% CI (0.03,0.33),P=0.000 1],but longer time for wound healing [WMD=5.06,95%CI(1.87,8.25),P=0.00 2].Conclusion:The evidence a-vailable indicates that the micro-injury peritomy anastomoses device is an effective and minimally invasive treat-ment for phimosis or redundant prepuce,but due to the limitations of included RCTs,high quality and large sample size clinical RCTs are suggested in future.

Objectives:To explore the effect of the Chinese medicine Shengjingtang on oligospermia and as-thenospermia through meta -analysis.Methods:The studies involving randomized controlled trials (RCTs)were collected from the database,such as the Cochrane Library,Pubmed,CBMdisc,CNKI,VIP and Wangfang from the founding day to December 2013.After necessary methodological quality evaluation of the selected studies and as-sessment of publication bias and sensitivity analysis,the statics analysis was conducted by the software RevMan5.2. Results:Nine eligible reports were identified in this study,including 738 cases.The Meta -analysis results showed Shengjingtang had higher effectiveness in the treatment of male infertility than the western medicine group (P <0.01),which could significantly increase the total effective ratio [OR =4.62,95%CI (3.19,6.69),P <0.01] and improve sperm density [WMD =14.47,95% CI (12.85,16.10),P <0.01]and sperm motility [WMD =15.92,95% CI (7.89,23.95),P <0.01]and sperm vitality (a +b)[WMD =15.07,95% CI (3.38,26.77) P <0.01].Conclusion:The Chinese medicine Shengjingtang shows definite curative effect in the treatment of oli-gospermia and asthenospermia.

Chronic prostatitis (CP)is attributed to many etiologies,and the corresponding treatment are al-so different.Recent researches suggest that patients with CP are obviously heterogeneous,that is to say,the etiolo-gies and prognoses differ among those CP patients.In view of this,the MAPP Network Group put forward the UOPINT clinical phenotypic approach,which aimed to diagnose and treat different patients on the basis of their het-erogeneity.This paper reviewed the theoretical background,specific content,application and limitation of the UP-OINT clinical phenotypic approach.

人们对前列腺癌早期诊断的标志物及理想的治疗靶点的探寻从未停止过脚步。迄今为止,一批潜在的将用于诊治前列腺癌的候选蛋白逐步浮现。其中一个新发现的重要的生物标志物是前列腺干细胞抗原(PSCA)。PSCA是一种糖化磷脂酰肌醇(GPI)锚定的细胞膜表面糖蛋白,属于Thy-1/Ly-6家族成员之一,在人前列腺癌细胞中高表达,在正常前列腺组织中表达有限。正是这样的组织特异性,使其成为前列腺癌诊断和预后判断的一个潜在的标志物和颇具吸引力的免疫治疗的候选靶点。研究显示,PSCA表达的增加与前列腺癌Gleason评分、肿瘤分期和骨转移均具有相关性。PSCA作为前列腺癌特异的膜抗原,具有严格的表达模式,现其已被作为免疫治疗的靶点而进行深入研究,如利用单克隆抗体、结合细胞毒的抗体、遗传工程T细胞、PSCA疫苗和负载肽段的树突状细胞(DC)等手段进行免疫治疗。本文主要对PSCA在前列腺癌诊断、预后判断、治疗等方面的研究加以综述,同时简要介绍一些PSCA在其他肿瘤中与在前列腺癌中表达情况不同的研究报告。

Objective To investigate the value of the urinary sarcosine in the diagnosis and prognosis of prostate cancer(PCa). Methods A total of 16 PCa patients, with age ranging from 65 to 89(68.4±10.2)years, diagnosed by prostate biopsy in our department from May 2009 to May 2011, were enrolled in this study. Their blood and urinary samples were collected for detection of sarcosine level by isotope dilution-liquid chromatography mass spectrometry (LC/MS). Electrochemiluminescence assay was used for the detection of serum level of prostate specific antigen (PSA). The results were statistically analyzed with their Gleason scores and with bone metastasis. Results There was significant difference in the total PSA(TPSA) level between the PCa patients with bone metastases [n=9, (203.95±169.68)μg/L] and without [n=7, (35.53±35.77)μg/L, P<0.05], while no difference was found in free PSA (fPSA) level between them [(14.41±11.84) vs (3.92±4.15)μg/L, P>0.05]. The urinary sarcosine level was significantly higher in the PCa patients with bone metastasis than those without [(1277.67±432.78) vs (494.71±211.35) μg/L, P=0.018]. There was no significant difference in the serum sarcosine level between different pathological Gleason scores, but urinary sarcosine level was significantly elevated with the increase of Gleason score(P>0.05). Urinary sarcosin level was correlated with Gleason score and bone metastasis(P<0.05). Conclusion Urinary sarcosine might be used as a useful tumor marker for the diagnosis and prognosis of PCa.

Objective To investigate the safety of transurethral 2-micron laser used to prostatic surgery in advanced aged patients(>65 years). Methods A total of 114 males and 23 females with a median age of 71 years (ranging from 65 to 87 years) receiving transurethral surgery in our department from September 2010 to October 2012 were enrolled in this study. There were 83 males with benign prostatic hyperplasia (BPH) and 31 with non-muscle bladder cancer(BCa), and all 23 females suffered from BCa. There were 121 cases(88.3%) with comorbidity, and 85 cases having over two diseases. Selective transurethral resection by 2-micron laser was performed after judging the function of important organs. Operation time, duration of indwelling urethral catheter, obturator nerve reflex, bladder washing, urination after BPH surgery, and peri-operative complications were analyzed. Results All operation procedures were successfully carried out. The mean operaton time was 30min(ranging from 15 to 55min) for BCa and 65min(ranging from 35 to 130min) for BPH, respectively. Bladder washing was taken, and time for indwelling urethral catheter ranged from 5 to 7d. Post-operative complications occurred in 11 cases(8.03%), and they were all discharged after corresponding treatment. There was no death in the cohort of patients. Conclusion Transurethral resection by 2-micron laser is an approach with satisfactory outcome and minimal invasion, and is of high safety for advanced aged who needs surgical treatment but suffers from comorbidity.

Objective To investigate and compare the clinical effects of 2-micron laser vaporization resection of prostate (2-micron laser) and versus transurethral resection of prostate (TURP) for treatment of benign prostatic hyperplasia(BPH) in this prospective random control study.Methods Sixty patients of BPH were randomly divided into two groups including the 2-micron laser group (n =30) and the TURP group (n =30).The perioperative markers and therapeutic results including duration of surgery,blood lose during surgery,improvement of symptoms after treatment,postoperative bladder washing time,the mean bladder irrigating time,hospital stay time,and recent complications were recorded and analyzed.Results The international prostate symptom score((6.6 ± 1.8) vs.(33.2 ±2.2),(5.7 ± 1.3) vs.(33.4 ±2.3) respectively),maximal urinary flow((20.6 ± 1.5) ml/s vs.(7.8 ± 4.3) m/s,(19.5 ± 1.7) ml/s vs.(8.3 ± 4.5) ml/s respectively),residual urine volume((22.3 ±4.7) ml vs.(57.2 ± 10.5) ml,(26.3 ±7.2) ml vs.(60.2 ± 14.5) ml respectively) were significantly improved in both groups after operation (P =0.005,0.008,0.036,0.001,0.005,0.013 respectively),but the differences between these two groups were not significant (P =0.16,0.49,0.97 respectively).The volume of hemorrhage ((20.9 ± 12.1) ml vs.(55.3 ± 27.8) ml),the mean bladder irrigating time ((1.0 ±0.5) d vs.(3.5 ±0.7) d),cathererization time ((3.2 ± 1.3) d vs.(6.0 ± 1.5) d),hospital stay time ((6.8 ±0.7) d vs.(10.6 ±0.6) d) were significantly less or shorter in the 2-micron laser group than in the TURP group (P =0.009,0.005,0.035,0.03 respectively).There was no significant difference in rates of complications between the two groups (P ＞ 0.05).Conclusion The therapy of 2-micron laser is safer and more efficacious than TURP for BPH patients,with advantages of short surgery duration,little blood loss,and quick recovery.

Objective: To improve the diagnosis and treatment of primary epididymal carcinoma,and to evaluate its clinical features diagnosis treatment and prognosis.Methods: The clinical data of one case of the primary epididymal embryonal carcinoma was analyzed retrospectively and reported,then relevant literature was reviewed.Results: The malignant tumor patient underwent radical orchiectomy and epididymectomy.The final pathological report was testicular and epididymal embryonal carcinoma,the spermatic cord was not invaded.The patient was followed up with poor prognosis in time of 1year post-operation.Conclusions: The histogenesis of primary epididymal malignant tumor is unclear yet.The diagnosis is depends on combination of history,physical examination and pathologic studies.Radical surgery is the main treatment choice.