OBJECTIVE:To investigate the expression of the Pim-1 gene in the LNCaP cells of the animal model of orthotopically implanted prostate cancer by surgical castration simulating androgen-deprivation therapy.METHODS:We equally allocated 32 male BALBc-nu mice into 4 groups, androgen-dependent prostate cancer (ADPC), androgen-deprivation therapy (ADT) , castration-resistant prostate cancer (CRPC) and blank control, and established the models of orthotopically implanted tumor using human prostate cancer LNCaP cells. We detected and ,compared the expressions of Pim-1, PSA, and androgen receptor (AR) in the tumor tissues of different groups by RT-PCR. qRT-PCR, ELSIA and immunohistochemistry.RESULTS:The relative gray scales in the ADPC and CRPC groups were 0.59 ± 0.01 and 1.14 ± 0.02, with statistically significant differences from 0.62 ± 0.03 in the ADT group (P < 0.05), and the Δ Ct values of Pim-1 were 6.15 ± 0.34 and 4.56 ± 0.23 in the former two groups, also with significant differences from 5.11 ± 0.21 in the latter (P < 0.05). The results of 2-ΔΔ Ct relative quantification analysis showed that the amplification products of Pim-1 in the ADT and CRPC groups increased 2.05 and 3.01 times respectively that of the ADPC group. The concentration of PSA was significantly higher in the ADPC ([480 ± 25] pg/ml) and CRPC ([870 ± 23] pg/ml) than in the ADT ([170 ± 32] pg/ml) and blank control groups (0 µg/L) (P < 0.01). The mean optical densities of Pim-1 and AR proteins were 0.017 ± 0.002 and 0.032 ± 0.009 in the ADPC group and 0.024 ± 0.002 and 0.040 ± 0.011 in the CRPC group, both with significant differences from those in the ADT group (0.018 ± 0.001 and 0.019 ± 0.006) (P < 0.01).CONCLUSION:Pim-1 is highly expressed in nude mice with prostate cancer receiving androgen-deprivation therapy and plays an important role in the progression and metastasis of prostate cancer.

BACKGROUND:DNA damage, caused by numerous carcinogens, contributes to the increased risk of different types of cancer. The base excision repair (BER) pathway including the apurinic/apyrimidic endonuclease (APE1, also known as APEX1) gene plays an important role in preventing the accumulation of DNA damage and maintaining genomic stability. The aim of the present study is to determine whether polymorphisms of APE1 are associated with the risk of prostate cancer (PCa) in the Chinese Han population.METHODS:This study consisted of 198 patients with PCa and 156 healthy controls. The polymorphisms of APE1, Asp148Glu (rs1130409) and -141T/G (rs1760944) were determined by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method.RESULTS:The genotypic distributions of the two polymorphisms in controls were in Hardy-Weinberg equilibrium (p = 0.92 and p = 0.83, respectively). Logistic regression analysis indicated that the -141GG genotype was significantly associated with a decreased risk of PCa compared with the -141TT genotype (p = 0.03; OR 0.49; 95% CI 0.26 - 0.92). The G allele was also significantly associated with a reduced risk of PCa compared with the T allele (p = 0.02; OR 0.71; 95% CI 0.52 - 0.96). However, no association between Asp148Glu polymorphism and the risk of PCa was found.CONCLUSIONS:The -141GG genotype and G allele of the APE1 gene are associated with a decreased risk of PCa in the Chinese Han population.

Objective To investigate regulation mechanism on apoptosis and proliferation by recombinant lentivirus-mediated nucleosome-binding protein 1 (NSBP1) gene silencing of the prostate cancer DU145 cell.Methods The lentivirus-shRNA-NSBP1 transfect DU145 cell,cell growth activity is assayed by MTT,cell apoptosis detected by Flow Cytometry and cell cycle detected cyclinB1 and BCL-2 protein expression after knockdown NSBP1 protein by Western blot method.Results We confirm the proliferation of the tumor cells was significantly inhibited 22.6% in 96 h after NSBP1 protein expression were lower,simultaneously cyclinB1 and BCL-2 protein is also reduced.Conclusions NSBP1-RNAi-lentivirus recombinant lentivirus can effectively inhibit the proliferation of DU145 cells,NSBP1 by regulating cyclinB1 and BCL-2 protein affect the growth of tumor cells.

Objective:To evaluate the clinical and pathological characteristics and treatments of bladder carcinosarcoma.Methods:4 cases were reported of bladder carcinosarcoma from the secondary hospitals of Tianjin medical university from 1995 to 2010,combining the literature on the diagnosis,pathological characteristics,treatment.Results:4 patients,2 males and 2 females.Age of 63 to 80 years,complained intermittent painless gross hematuria full admission.Cystoscopy prompted cauliflower mass were invasive growth.2 cases partial cystectomy,2 patients had bilateral ureteral bladder full Shaver and skin fistulization.Seen in these patients was basically the same as bladder cancer.Pathology are composed of two components of carcinoma and sarcoma,immunohistochemistry had its specific performance.Different chemotherapy were given after operations.10 months later 2 patients died due to systemic metastasis,and 2 patients were followed up for 10 months and 6 months,whom were still alive and need further observation.Conclusions:Carcinosarcoma of the urinary bladder is a rare sarcomaof bladder.There is no characteristic clinical manifestations.And diagnosis mainly depends on the pathological and immunohistochemical examination,treatment by radical cystectomy better,but its high degree of malignancy and poor prognosis,diagnosis and treatment need further observation.

Objective:To evaluate the clinical and pathological characteristics and treatment of ductal adenocarcinoma of the prostate.Method:Twenty cases report of prostate ductal adenocarcinoma from the major hospitals in Tianjin in 1995-2010,and to combine the literature on the diagnosis and treatment of the line to further explore.Result:Age 64-82 years,mean 74.5 years,of which 13 patients with different degrees of dysuria main reason for hospital admission,9 patients with PSA higher than normal,17 cases of B-ultrasound and MRI abnormalities tips,20 cases were diagnosed after a puncture or biopsy.It requires line of different surgical condition and medication.Immunohistochemistry of prostate ductal adenocarcinoma than specific performance.Follow-up 12-60 months,14 patients died.Conclusion:Ductal adenocarcinoma of the prostate is a clinically rare subtype of prostate cancer and difficult to be found in early stage.The diagnosis depends on histopathologic and immunohistochemical studies.Radical prostatectomy is recommended for this disease.

Objective To investigate the clinical features,diagnosis and treatment of prostate sarcoma. Methods 19 cases of prostate sarcoma had been treated in our hospital from Oct 1995 to Sep 2010,aged from 16 to 48 years (mean,36 years).They were hospitalized due to different degrees of difficulty in urination,6 cases with bladder irritation,3 cases with gross hematuria,3 cases with blood clots in urination,3 cases with difficult defecation,2 cases with urinary tract infection,and 1 case with low back pain.Digital rectal examination showed prostate volume increased significantly in 16 cases,of which 6 cases prominent into bladder,and 3 cases touched hard nodules and tenderness.B ultrasound examination showed prostate neoplasms with internal echo uneven.Pelvic MRI in 12 cases indicated irregular soft tissue density in prostate with unclear edge,a high-low mixed signal inside,and mass protruding outward,among which 7 cases with significantly enlarged prostates and unclear bladder boundaries,6 cases with unclear boundaries with rectum,and 1 case with solid and cystic change. Pelvic CT in 10 cases showed irregular prostate tumors,among which 5 cases with tumor violation of bilateral seminal vesicle,2 cases with tumor invasion of unilateral seminal vesicle,and 3 cases with lymph node enlargement.Chest X-ray in 2 cases showed widespread metastatic lung. Results Different treatments were used according to different conditions:6 cases with full cystoprostatectomy,8 cases with radical prostatectomy,1 case with skin routine ureter fistulization and rectal fistulization,1 case with bladder fistulization,1 case with chemotherapy after prostate biopsy,and 2 cases with prostate biopsy alone. Pathological diagnosis showed 6 cases of leiomyosarcoma,6 cases of rhabdomyosarcoma,2 cases of malignant mesenchymal tumor,1 case of phyllodes sarcoma,1 case of granulocytic sarcoma,1 case of phyllodes sarcoma,1 case of malignant fibrous tissue sarcoma,and 1 case of poorly differentiated muscle induced sarcoma. Immunohistochemical examination in 19 cases of paraffin specimens stained with SP showed vimentin was positive,smooth muscle actin and myoglobin in leiomyosarcoma and rhabdomyosarcoma were positive respectively,and desmin in two kinds of afore-mentioned sarcoma expressed in different level.CD117 and S-100 were weakly positive in 1 patient with undifferentiated component and 1 patient with liposarcoma of the malignant mesenchymoma.Peroxidase was positive in granulocytic sarcoma,p63 was positive in lobulated sarcoma,and CD34 was positive in malignant fibrous histiocytoma.14 patients were given chemotherapy,among which 6 cases were combined with radiotherapy.19 cases were followed up for 4 -30 months (mean 13 months).4 patients survived for 24 -30 months without recurrence,while 15 cases died within 18 months after diagnosis. Conclusions The prostate sarcoma is a clinically rare malignant tumor with high degree of malignancy and unspecific clinical manifestations.The diagnosis relies on biopsy and immunohistochemistry,and early diagnosis and radical surgical excision are helpful for increasing survival rate.

目的 探讨膀胱尿路上皮癌伴肉瘤样变的病理和诊疗特点.方法 回顾性分析我院1995年至2010年收治的5例膀胱尿路上皮癌伴肉瘤样变的临床资料,并结合文献复习,分析其病理和诊疗特点.结果 5例患者中男4例,女1例,年龄40-63岁,4例因间歇性无痛全程肉眼血尿入院,1例因间歇性无痛终末肉眼血尿入院,膀胱镜均提示菜花样肿物,呈浸润性生长.3例行经尿道膀胱电切术,1例行膀胱部分切除术,1例行膀胱全切加双侧输尿管皮肤造瘘术.术中所见与膀胱癌基本相同.术后病理肿瘤均由癌细胞和似肉瘤构象的肿瘤细胞2种结构组成,病理均诊为膀胱尿路上皮癌伴肉瘤样变,免疫组化有该病较特异性的表现.术后予以不同的化疗等.结论 膀胱尿路上皮癌伴肉瘤样变在膀胱恶性肿瘤中罕见,没有特征性的临床表现,确诊主要依靠病理和免疫组化检查,治疗方法采用根治性膀胱切除术效佳,但其恶性程度高,预后不良,诊断和治疗需要进一步的探索.

Objective:To evaluate the clinical characteristics and treatment of ureteral polyps.Methods:A retrospective analysis 1995-2010 Secondary Hospital of Tianjin Medical University,40 cases of ureteral polyps in patients with information and literature on the diagnosis and treatment with the line for further exploring.Results patients aged 18-76 years,mean 35.5 years old,and many affected side of waist and abdomen due to different levels of pain is not admitted.A total of 48 sides of 40 cases of ureteral polyps in patients forming renal pelvis and ureter in 6 cases,26 cases polypectomy,plus end anastomosis in 15 cases,4 cases of ureteral distal ureteral resection and reimplantation ,4 patients disease section of kidney and ureter resection.Patients were cured after surgery and confirmed by pathology.Conclusions:Ureteral polyps is lack of specific clinical manifestations,whose diagnosis and differential diagnosis depend on biopsy,its basic treatment method is partial ureteral stump anastomosis,and endovascular surgery has a good prospect.

<正>患者,男,29岁。主因"肛内肿物2年余,排尿困难、大便变细半年余"入院。曾因间断便血于外院诊断为直肠肿物行相应治疗,疗效欠佳。入院后直肠指检:直肠前壁可触及黏膜下一质韧肿物,下缘距肛缘约3 cm,未及上缘;肿物表面光滑,活动度差,无触痛,指套无血染。尿动力学检查提示膀胱出口梗阻,前列腺部尿道延长。B超报告前列腺后方低回声结构,大小8.3 cm×5.7 cm×4.9 cm,内

Objective:The aim of this article was to discuss the variety of semen criterion,seminal plasma fructose and PSA levels in the chronic prostatitis(CP) patients with infertility.Methods:A total of 12 CP patients were enrolled and classified into group A and B.22 patients of group A with normal semen liquefaction and 20 patients of group B with semen delayed liquefaction were examined.We also added another 15 cases as the control group.We analysed biochemical criterion of semen,fructose and PSA levels in each group.Results:Sperm density. Sperm motility,a grade motile sperm concentration in group A and group B were significantly lower than group C(.P<0.01).The PSA significantly lower than group C(P<0.01).Seminal plasma fructose in group B was lower than group C(P<0.01).Conclusions:Chronic prostatitis can cause decreased sperm quality and biochemical composition changes,which may affect the process of semen liquefaction and lead male infertility.

Objective To assess the feasibility and clinical efficiency of laparoscopic Madigan enucleation of the prostate for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From Nov.2008 to Jan.2010,24 eases of BPH patients with large prostate ( ＞90 g) were treated in our institute by laparoscopic Madigan enucleation.The average patient's age was 65.2 yrs,the average prostate weight were 132.3 ± 21.9 g,preoperative residual urine was 143.2 ± 23.2 ml,average IPSS was 28.6 ± 3.8,average QOL was 5.5 ± 2.4 and average MFR was 5.4 ± 2.3 ml/s.All patients accepted the laparoscopic Madigan enucleation of the prostate.The pre-surgery and three months post-operative IPSS,QOL,and MFR were compared and analyzed.Results All 24 patients successfully completed the surgery.The resected prostate tissue weight was 104.7 ± 23.3 g,blood loss was 112.5 ± 47.8 ml,postoperative hospital stay was 3.5 ± 0.8 d,bladder irrigation time was 1.3 ± 0.9 d,drainage time was 2.3 ± 0.5 d and catheterization time was 3.1 ±0.4 d.Three months after surgery,patient's IPSS was 4.5 ± 1.8,QOL was 19.9 ±3.1,and MFR was 18.5 ±2.9 ml/s.All the parameters significantly improved compared with the pre-surgery data ( P ＜ 0.05 ).Conclusions Laparoscopic Madigan enucleation of the prostate is a safe and effective method in the treatment of BPH with large prostate volume.

Purpose: Laparoscopic Madigan prostatectomy have not been reported yet. We modified the Madigan prostatectomy to make it suitable for laparoscopically enucleating hyperplastic glands larger than 100 g. Patients and Methods: Between May 2007 and Oct 2008, extraperitoneal laparoscopic prostatectomy with maintenance of the intact urethra had been performed on 16 patients with benign prostatic hyperplasia (BPH) and glands than 100 mg. To make it suitable for laparoscopic use, two major modifications had been made: (1) Open the prostate capsule near the bladder neck without sutures along the opening; (2) identify the bladder neck mucosa before recognizing the urethra. All patients were evaluated preoperatively and postoperatively. Data were compared with those from open surgeries. Results: All laparoscopic procedures were successful with the total operative time of 111.8 +/- 28.6 minutes, which had no significant difference compared with open surgeries. Estimated blood loss of laparoscopic procedures (112.5 +/- 47.8 mL) was significantly lower than that of open surgery. The catheterization time and hospital stay time was significantly shorter than open surgery. The improvement of the International Prostate Symptom Score, maximum flow rate, and quality-of-life score were not different between the comparing groups. Conclusions: The laparoscopic Madigan prostatectomy is a safe and feasible approach for large glands (BPH). Furthermore, its advantages include shorter learning curve, reduced blood loss, less retroejaculation rate, shorter catheterization time, and shorter hospital stay.

Objective: To explore whether retroperitoneal laparoscopic dismembered pyeloplasty can replace traditional surgery.Methods:Totally 57 cases with ureteropelvic junction obstruction(UPJO) were enrolled in this study.The related clinical data were compared between 27 patients who underwent retroperitoneal laparoscopic dismembered pyeloplasty and 30 patients who underwent open dismembered pyeloplasty.Results: In the laparoscopic group,blood loss,analgesic treatment time,postoperative ambulation time,postoperative drainage tube retention time,postoperative hospital stay,lumbal paresthesia were better than those in open group(P0.05);operation time was longer than that in open group(P0.05);urinary leakage and incisional infection were equivalent in two groups(P0.05).Conclusion:Retroperitoneal laparoscopic dismembered pyeloplasty associates with minimal trauma,little pain and rapid recovery.It can gradually replace open opration in clinic.

OBJECTIVE:To investigate the clinical presentations and pathologic features of undifferentiated sarcoma of the prostate with cartilage metaplasia, and to clarify its category.METHODS:We analyzed the clinical data of a case of undifferentiated sarcoma of the prostate with cartilage metaplasia treated by surgical resection. The tumor tissue was subjected to routine HE and immunohistochemical staining, its histological structure and immunohistochemical expression were observed under the light microscope, and relevant literature on its manifestations was reviewed.RESULTS:The case was pathologically diagnosed as gray prostate tumor, with chondrosarcomatous and undifferentiated malignant mesenchymal components under the light microscope. Immunohistochemical staining revealed vimentin (+), local CD117 (+/-), SMA (-), Des (-), myoglobin (-), CD34 (-), CK7 (-), and CK8 (-). Tumor metastasis was found 2 months after the operation, and the patient died 4 months later.CONCLUSION:Undifferentiated sarcoma of the prostate with cartilage metaplasia is a very rare and highly malignant aggressive tumor, which can be diagnosed by biopsy and immunohistochemistry.

Objective To investigate the efficacy and safety of tamsulosin for benign prostatic hyperplasia(BPH).Methods 30 cases of patients with BPH were selected,who were given tamsulosin 0.2 mg/d,for 4 weeks.Results The clinical onset times are after medication within 48 hours,the patient′s international prostate symptom score,quality of life score,maximum flow rate,residual urine,were significantly different(P0.05)between before and after treatment.Comparison of blood pressure,alanine aminotransferase,creatinine clearance did not change significantly(P0.05).Conclusion Tamsulosin treatment of lower urinary tract symptoms caused by BPH,is safe and effective with few complications,and especially it also has a high cardiovascular safety.

患者男性,14岁,因"双侧腰部间断疼痛5年"于2009年10月30日入院.疼痛多在受凉或劳累后出现,每年出现2～3次,每次疼痛时间持续2 d,休息后可自行缓解.不伴恶心、呕吐,无肉眼血尿,无发热等不适.既往无肾脏疾病病史,家族中无肿瘤或特殊遗传病史.

Objective:To study the pathology of prostate mucinous adenocarcinoma,and treatment characteristics. Methods:A retrospective analysis of our hospital from January 1995 to March 2011 were treated 2 cases of prostate mucinous adenocarcinoma of the clinical data,combining with review of the literature,analysis of its characteristics. Results:2 patients aged 73 and 84 years,hospitalized with different degrees of difficulty urinating.1 patient was misdiagnosed as benign prostatic hyperplasia after transurethral resection of prostate.Another 1 case of B-rectal examination,CT,MRI and PSA are indications of prostate cancer,diagnosed after biopsy puncture,consider the situation in patients with epidural anesthesia under general transurethral resection of the prostate to improve urinary symptoms.Mucinous adenocarcinoma of prostate was diagnosised by the pathological,and their immunohis-tochemistry had specific performances.Patients were given anti-androgen therapy after the surgery.Conclusions: Mucinous adenocarcinoma of prostate rare in prostate cancer,there is no characteristic clinical manifestations,diagnosis mainly depends on the pathological and immunohistochemical examination,treatment can be radical prostatectomy.

OBJECTIVETo study the clinical manifestations, pathological characteristics and treatment methods of prostate cancer with five different histological features.METHODSWe reported 1 case of prostate cancer with five different histological features and further analyzed the diagnosis, pathology and treatment of the disease by reviewing the relevant literature.RESULTSThe patient was an 84-year-old male, admitted due to difficult urination and dribbling urine for 1 year, hematuria for 8 months and deterioration for 2 weeks. Prostate cancer was indicated by rectal examination, ultrasonography, CT, MRI and PSA, and confirmed by biopsy. Considering the general condition of the patient, we performed electrotransurethral resection under epidural anesthesia to alleviate his urinary symptoms and remove suspected tumor tissues. Postoperative pathology showed the case to be prostate adenocarcinoma, histologically characterized by cribriform carcinoma, acinar carcinoma, diffuse invasive carcinoma, ductal carcinoma, and mucinous adenocarcinoma, with a Gleason score of 9. Bicalutamide and goserelin were administered postoperatively. Systemic metastasis occurred 10 months later, and the patient died 1 year after the operation.CONCLUSIONProstate cancer with five different histological features is extremely rare. Its early diagnosis is difficult and mainly depends on pathological and immunohistochemical examinations, and radical prostatectomy can be considered for its treatment.

患者女,78岁.因右侧腰部绞痛1月余,发热7 d,于2009年12月28日入院.入院前34 a及3 a分别因右侧肾盂肾炎及右肾结石入本院治疗,均好转出院.查体:腹平软,右肾区轻叩痛,右输尿管上段压痛点压痛.

目的观察腹腔镜全膀胱切除回肠原位新膀胱术的手术效果。方法对两例肌层浸润性膀胱移行细胞癌患者施行腹腔镜全膀胱切除回肠原位新膀胱术。结果手术均获成功,手术时间分别为375、360 min,出血量分别为100、300 ml,术后3~4 d排气,术后均于第2天下床活动,术后均未予止痛药。随访4~5个月,新膀胱无明显残尿,排尿功能正常。结论腹腔镜全膀胱切除回肠原位新膀胱术治疗无远处转移的浸润性膀胱癌效果满意。