Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common and serious disease with unclear pathogenesis and recurrent symptoms. Hedyotis diffusa Willd (HDW) has been recognized for its potential in managing various chronic inflammatory diseases. This research aimed to interrogate the mechanism of HDW in treating CP/CPPS. Complete Freund Adjuvant (CFA) and LPS were utilized to establish the rat and cell models of CP/CPPS. Results showed that HDW decreased levels of inflammation-related factors in CP rat prostate tissue and LPS-elicited RWPE-1 cell injury model. Moreover, HDW administration impaired oxidative stress in the prostate and RWPE-1 cells. In addition, HDW treatment activated the NRF2/ARE signaling in rat prostate tissue and cell models. Interestingly, NRF2/ARE pathway inhibitor ML385 reversed the inhibition effects of cell apoptosis, inflammation, and oxidative stress triggered by HDW. In summary, HDW alleviated inflammation and oxidative stress by activating NRF2/ARE signaling in CP/CPPS rat model and human prostate epithelial cell injury model.

目的 观察围术期予以癃清片联合盐酸坦洛新缓释片治疗对前列腺增生症患者术后排尿功能的影响.方法 将2020年4月至2021年10月该院泌尿外科收治的120例前列腺增生症患者分为手术组、坦洛新组、癃清片组和联合用药组,每组30例.4组患者均行经尿道等离子电切(TPKRP)术.手术组单纯行TP-KRP术,坦洛新组围术期口服盐酸坦洛新缓释片治疗,癃清片组围术期口服癃清片治疗,联合用药组围术期口服癃清片联合盐酸坦洛新缓释片治疗.对比4组患者治疗前后生活质量评分(QOL)、国际前列腺症状评分(IPSS)、中医症状评分、最大尿流率、膀胱最大容量、残余尿量、最大逼尿肌压等.结果 与癃清片组、坦洛新组、手术组比较,联合用药组患者QOL、IPSS降低更明显,最大尿流率提高更明显,术后膀胱残余尿量、最大逼尿肌压力下降更明显,差异均有统计学意义(P＜0.05);联合用药组患者中医症状评分明显低于癃清片组,差异有统计学意义(P＜0.05).4组患者治疗前后膀胱最大容量比较,差异均无统计学意义(P＞0.05).结论 围术期给予癃清片联合盐酸坦洛新缓释片治疗可促进患者术后排尿功能恢复,改善患者生活质量.

Objective:To detect the levels of FAP-α and CSN6 in bladder urothelial carcinoma and analyze the clinical significance of FAP-α and CSN6 in bladder urothelial carcinoma.Methods:From January 2015 to May 2017, 74 patients with bladder urothelial carcinoma in our hospital were selected as the study subjects, at the same time, 61 patients without bladder urothelial carcinoma excluded by cystoscopy but with other urinary system diseases, treated by operation and retained normal bladder tissues in our hospital were taken as control group. The levels of FAP-α and CSN6 were detected by immunohistochemistry; the expressions of FAP-α and CSN6 in bladder urothelial carcinoma and their correlation with general clinical data were analyzed; all patients were followed-up for 3 years to analyze the effects of FAP-α and CSN expressions on the prognosis of bladder urothelial carcinoma; and Cox was used to analyze the risk factors for poor prognosis of bladder urothelial carcinoma.Results:Compared with those in normal bladder tissue, FAP-α and CSN6 proteins in bladder urothelial carcinoma tissue had higher positive expression rates ( P<0.05); the expressions of FAP-α and CSN6 proteins in bladder urothelial carcinoma were related to pathological grade and clinical stage ( P<0.05); the three-year recurrence rate of FAP-α positive group (52.9%) was higher than that of negative group (26.1%); and the three-year 36 recurrence rate of CSN6 positive group (55.1%) was higher than that of negative group (24.0%); in addition, multivariate Cox analysis showed that pathological grade, clinical stage and positive expressions of FAP-α and CSN6 were the risk factors for poor prognosis of bladder urothelial carcinoma ( P<0.05). Conclusions:FAP-α and CSN6 may be involved in the pathogenesis of bladder urothelial carcinoma and may be potential therapeutic targets for bladder urothelial carcinoma.

目的 观察桂附地黄丸治疗肾阳虚型特发性少弱精子症的临床疗效.方法 选取2020年1月至2021年1月该院90例肾阳虚型特发性少弱精子症患者,分为观察组和对照组,每组45例.观察组口服桂附地黄丸治疗,对照组口服维生素E治疗,治疗时间均为8周.比较两组治疗前后精液常规指标、促卵泡生长激素(FSH)、黄体生成素(LH)及睾酮(T)变化,以及中医证候评分变化和临床疗效.结果 治疗后观察组精子计数、a+b级精子计数、精子总活动率较治疗前提高,且均优于对照组,差异有统计学意义(P<0.05).治疗后观察组患者T(23.66±4.11)nmol/mL高于对照组T(15.14±3.89)nmol/mL,差异有统计学意义(P<0.05).治疗后观察组患者中医证候评分明显优于对照组(P<0.05).结论 桂附地黄丸可提高肾阳虚型特发性少弱精子症患者精子活力,改善患者的临床症状.

肺孤立性纤维瘤(pulmonary fibroma tumor, SFT)1931年由Klemper首先报道，属于纤维母细胞/肌纤维母细胞来源的罕见软组织肿瘤，可能来源于CD34阳性树突状间叶细胞[1]。SFT属于中间性肿瘤，约10.0%~30.0%为恶性，临床上好发于成年人[2]。原发于肺内的SFT通常是良性、低度恶性肿瘤。其影像学表现为生长缓慢、边界清晰，可有分叶，孤立的结节或肿块，增强扫描其强化方式多样。值得注意的是位于肺部的SFT，在疾病的早期偶尔表现为磨玻璃样结节出现。由于其发生非常罕见，尚未见关于描述肺SFT的特征性影像学表现。本文对我院收治的25例SFT患者进行分析，报道如下。

目的 观察癃清片联合伐地那非治疗 ⅢB型慢性前列腺炎伴勃起功能障碍的疗效.方法 选取2018年3月至2019年5月该院收治的86例 ⅢB型慢性前列腺炎伴勃起功能障碍患者,按照随机数字表法分为观察组和对照组,每组43例.观察组给予癃清片联合伐地那非治疗,对照组给予伐地那非治疗,疗程均为8周.观察两组患者治疗前后美国国立卫生研究院慢性前列腺炎症状积分指数(NIH-CPSI)积分 、前列腺液卵磷脂小体计数 、勃起功能国际指数问卷(IIEF5)评分 、勃起硬度评分(EHS)、阴茎血流动力学指标[舒张末期流速(EDV)、收缩期峰值流速(PSV)、阻力指数(RI)]变化,评估其临床疗效.结果 治疗8周后,两组患者NIH-CPSI积分均较治疗前下降,IIEF5评分及EHS较治疗前明显上升(P<0.05);观察组治疗后前列腺液卵磷脂小体计数(+++)及(++++)百分比较治疗前明显升高(P<0.05),对照组治疗前后前列腺液卵磷脂小体计数百分比无明显改变(P>0.05);观察组患者阴茎血流EDV和RI均较治疗前升高,且观察组明显高于对照组(P<0.05),两组PSV均较治疗前降低,且观察组明显低于对照组(P<0.05);观察组临床总有效率明显高于对照组(95.35％vs.83.72％,P<0.05).结论 癃清片联合伐地那非能够明显减轻 ⅢB型慢性前列腺炎患者前列腺炎症状,并改善勃起功能.

目的:观察癃清片治疗精液不液化症的临床疗效.方法:80例随机分为两组各40例.治疗组口服癃清片,对照组口服维生素E,均治疗8周,比较两组治疗前后的精液质量及液化时间、精浆PSA含量变化.结果:总有效率治疗组高于对照组(P＜0.05),治疗组精液液化时间改善程度优于对照纽(P＜0.01),治疗组精浆PSA含量较治疗前明显增加(P＜0.05),且较对照组高(P＜0.05).结论:癃清片治疗精液不液化症可缩短精液液化时间,提高精液质量,其作用机制可能同提高精浆PSA含量有关.

目的 探讨癃清片治疗ⅢB型慢性前列腺炎伴少弱精症患者的临床效果.方法 选择60例ⅢB型慢性前列腺炎伴少弱精症患者,随机分为观察组与对照组,每组30例.观察组患者给予口服癃清片治疗,对照组患者给予口服维生素E丸治疗,均治疗8周.比较两组患者治疗前后精液常规、卵磷脂小体计数及慢性前列腺炎症状评分指数(CPSI).结果 治疗后,观察组较治疗前a+b级精子活力占比提高,精子液化时间缩短,CPSI评分降低(+++)及(++++)卵磷脂小体计数占比升高(均P<0.05),且均优于对照组(P<0.05).观察组治疗总有效率高于对照组(P<0.05).结论 癃清片可缩短ⅢB慢性前列腺炎伴少弱精症患者精液液化时间,提高患者精子活力,增加卵磷脂小体数量,改善患者临床症状.

目的:观察热淋清联合左氧氟沙星治疗尿路感染的疗效.方法:从门诊筛选出120例尿路感染患者随机分为实验组和对照组,对照组单纯使用应用左氧氟沙星,试验组应用左氧氟沙星加热淋清颗粒,观察两组治疗效果,比较两组有效率及1月内复发率.结果:对照组有效率为83.33％,实验组有效率为96.67％,两组有效率间差异有显著性(x2=4.53,P＜0.05);对照组复发率为4.00％.实验组复发率为0,两组有效率间差异有显著性(x2=4.90,P＜0.05).结论:热淋清联合左氧氟沙星治疗尿路感染是一种有效的方法.

Objective:To objectively evaluate the efficacy and safety of Thulium laser enucleation of the prostate(TmLEP)vs transurethral resection of prostate(TURP)in treating benign prostate hyperplasia(BPH).Methods Such online databases as Cochrane Library、Pub Med、EMbase、VIP、Wanfang and CNKI were searched by randomized control trial(RCT)and prospective case controlled trial(CCT)about TmLEP vs TURP for the treatment of BPH.After study selection,assessment and data extraction conducted,meta-analyses were performed by using the RevMan 5.1 software.Results Five studies involving 554 patients were included.The results of meta-analyses showed that:a)safety indicator:compared with the TURP,TmLEP had less intraoperative bleeding(WMD-7.07,CI(-8.99,-5.16) P0.00001),less decrease of serum sodium salt(WMD-3.07,95%CI(-4.36,-1.78)P0.00001),less blood transfusion percentage(RR 0.10,CI(0.02,0.42) P=0.002),shorter catheterization time(WMD-0.92,95%CI(-1.11,-0.73)P0.00001)and shorter hospital stay(WMD-1.82,95%CI(-3.36,-0.28)P=0.02),but there was no significant difference in operation time and postoperative complications(P0.05);b)efficacy indicator:compared with the TURP,the maximum urine rate of flow(Qmax) was higher after 1 months(WMD-1.37,95%CI(-2.20,-0.53)P=0.01),the post-voiding residual urine(PVR)was less after 6、12 months.Other efficacy indicators had no significant difference between the two groups(P0.05).Conclusion TmLEP and TURP have similar therapeutic effects in the management of benign prostatic hyperplasia.TmLEP causes less intraoperative bleeding,less decrease of serum sodium salt,less blood transfusion percentage,shorter catheterization time and shorter hospital stay.

Objective:To systematically review the advantages of minimally invasive percutaneous nephrolithotomy(MPCNL).Methods:Randomized controlled trials of minimally invasive and standard percutaneous nephrolithotomy were retrieved and their included references were investigated.Data analysis of literatures meeting the inclusion criteria was performed with the Cochrane Collabora tion's RevMan 5.0 software.Results:Five literatures were finally retrieved after screening and a total of 726 patients were included for Meta-analysis.Results showed that the patients in experimental group had the following features as compared with those in control group: ①remarkable improvement of the calculi clearance rate(95%CI[1.00-1.21],P=0.04);②obvious decrease of the complication incidence(95%CI[0.40-0.79],P=0.000 9).Conclusions:With higher clearance rate,lower complication incidence,MPCNL is safer and more effective than standard percutaneous nephrolithotomy in treating upper urinary tract calculi.As the literatures and samples in this study are limited,high quality trials with lager sample and longer follow-up are recommended in order to provide reliable evidences for clinical application of MPCNL.

Objective:To systematically review and evaluate the efficacy and safety of photoselective vaporization of the prostate for the benign prostate hyperplasia.Methods:Such databases as WANFANG;VIP,CNKI,CNM,PUBMED,EMBASE were searched from their establishment to 2011 for collecting randomized controlled trials(RCTs)about PVP versus TURP for the treatment of BPH,and their references were also searched.After study selection,assessment and data extraction conducted by two reviewers independently,Meta-analyses were performed by RevMan 5.0,software.Results:Six studies involving 569 patients were included in this review.Meta-analyses showed that compared with the TURP,PVP had the advantages of lesser blood loss(WMD-1.06,95% CI(-1.26,-0.86);P0.00001),shorter hospital stay(WMD-2.28,95%CI(-2.61,-1.95);P0.00001) and shorter catheterization time(WMD-40.40,95%CI(-49.03,-31.77),but the operation time is longer than TURP(WMD 14.57,95%CI(1.36,27.79);P=0.03).There was no statistical difference in improving of IPSS,Qmax(WMD 1.65,95%CI(-3.01,6.31);P=0.49;WMD-0.97,95%CI(-5.61,3.67);P=0.68 respectively).Conclusion:PVP and TURP have similar effect in improving Qmax,IPSS,but PVP have advantages of lesser blood loss during operation,shorter hospital stay and catheterization time.

OBJECTIVE:The aim of this meta-analysis was to evaluate the efficacy and safety of total tubeless percutaneous nephrolithotomy (PCNL) versus standard PCNL.METHOD:MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Literature Database were researched. Randomized controlled trials (RCTs) and clinically controlled trials (CCTs) comparing total tubeless PCNL (tubeless and stentless) versus standard PCNL were included in this review. The related studies that met the inclusion criteria were included in the meta-analysis. Two reviewers independently assessed the quality of each included studies and extracted data. RevMan 5.1. was used for meta-analysis.OUTCOME:Five RCTs and four CCTs were included, involving a total of 652 patients. All patients were divided into the total tubeless PCNL group and the standard PCNL group. The pooled results showed that the total tubeless PCNL group significantly reduced the hospital stay [weighted mean difference (WMD) -1.09 (95% confidence intervals, 95% CI -1.33, -0.85)] and analgesic requirement [standardized mean difference (SMD) -0.59 (95% CI -0.96, -0.23)]. There was no statistically significant difference in the operation time [WMD -4.14 (95% CI -8.27, -0.01)], mean hemoglobin decrease [-0.07 (95% CI -0.20, 0.06)], fever [relative risk (RR) 0.53 (95% CI 0.16, 1.69)], transfusion [RR 0.86 (95% CI 0.40, 1.85)], prolonged urinary drainage [RR 0.58 (95% CI 0.08, 4.09)], and ancillary procedure [extracorporeal shockwave lithotripsy, RR 0.84 (95% CI 0.29, 2.41), second-look PCNL RR 1.18 (95% CI 0.49, 2.89)]. According to the study design, the subgroup analyses were performed; most results were consistent with the overall findings, except the one that evaluated the analgesic requirement in the CCT subgroup.CONCLUSION:Total tubeless PCNL is a safe and effective procedure. It significantly reduced the hospital stay, analgesic requirement, and the time to return to normal activity without increasing complications. However, further randomized trials are needed to confirm these findings.