目的 探讨良性前列腺增生(BPH)并急性尿潴留(AUR)后血清肌酐、前列腺特异抗原(PSA)及其膀胱尿道功能的相关性及其临床意义。方法 对随机选择的36例已留置尿管48h以上的BPH并AUR患者进行尿流动力学检查,且同日行血清肌酐、PSA检测并分为两组:DI(逼尿肌不稳定)组(22例)和无DI组(14例),分析血清肌酐、PSA与膀胱功能各因素的相关性。结果 36例患者中逼尿肌收缩力很弱(VW)占10例,其游离PSA(fPSA)均<1.0 ng/mL,DI组中血清肌酐与膀胱顺应性、总PSA(tPSA)有相关性(r分别为0.406、-0.340,P值分别<0.01、0.05);DI幅度与膀胱顺应性、逼尿肌收缩力、tPSA有相关性(r分别为-0.309、0.677、0.304,P值分别<0.05、0.01、0.05);DI组与无DI组的fPSA与逼尿肌收缩力均有相关性(r分别为0.375、0.464,P值均<0.05)。DI组血清肌酐与fPSA、DI幅度、逼尿肌收缩力无相关性(r分别为-0.282、-0.301、-0.184,P值均>0.05);无DI组tPSA与血清肌酐、膀胱顺应性、逼尿肌收缩力无相关性(r分别为0.278、0.348、0.365,P值均>0.05)。结论 BPH并AUR患者的血清fPSA越低(<1.0 ng/mL),间接反映逼尿肌收缩力受损越严重,DI影响tPSA及肌酐水平。

目的 研究前列腺癌细胞中miR-221的表达情况及其对癌细胞增殖的影响。方法 运用实时荧光定量PCR(qRT-PCR)检测miR-221在前列腺正常细胞株与前列腺癌细胞株中表达的差异情况,利用细胞转染构建miR-221过表达LNCaP和DU145细胞株,再通过CCK8细胞增殖实验检测细胞增殖情况的变化。结果 qRT-PCR检测细胞株发现miR-221在PC3、LNCaP和DU145三种前列腺癌细胞株中表达量均比前列腺正常细胞株PrEC低 (F=254.197,P<0.001),其中两两比较差异也均有统计学意义。细胞转染技术构建的miR-221过表达LNCaP和DU145细胞株,经qRT-PCR结果显示,miR-221在LNCaP和DU145细胞株中的表达水平明显升高(LNCaP,倍数变化=2.24,t=3.46,P<0.01;Du145,倍数变化=2.24,t=4.29,P<0.01)。细胞增殖实验结果显示,过表达了miR-221的LNCaP(P<0.001)和DU145(P<0.001)细胞生长速度慢于对照组。结论 实验证明miR-221表达过度能减慢前列腺癌细胞的增殖,miR-221有可能成为前列腺肿瘤治疗的生物学标志物。

Objective To investigate miR-221 expression in prostate cancer cells and its influence on prostate cancer cell proliferation. Methods miR-221 expressions in prostate normal cell lines and cancer cell lines were measured by qRT-PCR. Overexpression of the miR-221 in LNCaP and DU145 cell lines used by cell transfection. Effects of the depletion on cell proliferation were assessed in vitro with CCK8. Results qRT-PCR showed miR-221 was lower expressed in PC3, LNCaP and DU145 than in PrEC(F=254.197, P<0.001), in which pairwise comparison also had significant differences. qRT-PCR showed miR-221 expression rose significantly in LNCaP and DU145 cell lines whose miR-221 was overexpression with cell transfection(LNCaP, Fold Change=2.24,t=3.46,P<0.001;Du145, Fold Change=2.24,t=4.29,P<0.001). Cell proliferation assay showed that growth of LNCaP(P<0.001) and DU145(P<0.001) cells whose miR-221 was overexpression was slower than the control group. Conclusion This study demonstrates miR-221 overexpression can inhibited the proliferation of prostate cancer cells for the first time, it also suggests that miR-221 has the potential to serve as a biomarker for PCa therapy.

目的 比较腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)后发生尿失禁(postprostatectomy incontinence,PPI)与没有发生PPI的患者在尿动力学上的差异,为临床诊疗提供尿动力学依据。方法 对87例LRP术后的患者按术后是否并发PPI分成两组,行尿动力学检查后进行比较分析。结果 PPI组患者术中保留一侧或双侧神经血管束的比例少于非PPI组,且最大尿道闭合压(maximum urethral closure pressure,MUCP)、最大膀胱容量(maximum cystometric capacity,MCC)、排尿时膀胱开口压力和最大逼尿肌压均较非PPI组低。而腹压漏尿点压试验阳性与临床上是否漏尿并不完全相符。多变量回归分析表明,术中保留神经血管束、MUCP和MCC是PPI的相关因素。结论 PPI与LRP术中保留神经血管束、MUCP和MCC独立相关。尿动力学检查能为更精准有效指导临床治疗提供依据。

Objective To compare the urodynamic parameters in men with and without postprostatectomy incontinence(PPI) after laparoscopic radical prostatectomy(LRP). Methods 87 patients of prostatic carcinoma after LRP were divided into two groups according to have PPI or not. After urodynamic study, the data were collected to find the difference. Results Overall, the proportion of preservation of unilateral or bilateral neurovascular bundles(NVBs) during LRP was lower in PPI group than that in non-PPI group. Besides, the patients in PPI group had lower maximum urethral closure pressure (P=0.04), maximum cystometric capacity (P=0.04), detrusor pressure during opening (P=0.02)and maximum detrusor pressure (P<0.001), as compared with those in non-PPI group. In the multivariate logistic regression, the preservation of unilateral or bilateral NVBs, MUCP and MCC were identified as the related factor with PPI. Conclusion PPI is significantly associated with the preservation of unilateral or bilateral NVBs, MUCP and MCC. Urodynamic test can be used to make the treatment for PPI. It will be more accurate and effective in clinical practice.

目的 观察自拟方前列清化汤治疗慢性前列腺炎的临床疗效。方法 2010年8月—2014年8月对90例慢性前列腺炎患者随机分为两组,治疗组50例采用自拟方前列清化汤水煎口服,并复渣药水睡前熏洗会阴,对照组40例采用西药左氧氟沙星、吲哚美辛治疗,对比观察疗效。结果 治疗组治愈13例,有效14例,好转16例,无效7例,总有效率86%;对照组治愈8例,有效8例,好转9例,无效15例,总有效率62.50%;两组总有效率比较,P＜0.05,治疗组优于对照组。结论 前列清化汤治疗慢性前列腺炎的疗效确切,值得临床观察及推广应用。

目的 分析经直肠彩超引导下不同前列腺穿刺方式的阳性率及其相关因素,探讨安全的穿刺方案。方法 回顾性分析接受经直肠彩超引导下前列腺穿刺的701例患者临床资料,所有患者均接受系统性13点穿刺活检,并假设13点穿刺中减少前列腺中线3个穿刺点为10点穿刺术式,加之标准的6点穿刺术式。比较上述穿刺术式的阳性率,分析T-PSA、前列腺体积、PSA体积密度(PSAD)、有无前列腺结节对穿刺阳性率的影响。结果 随前列腺穿刺针数的增加,活检阳性率增高。同一穿刺方式,不同T-PSA组间、不同前列腺体积组、不同PSAD组阳性率有差异。T-PSA>100 ng/mL时,三种穿刺方式的阳性率无差异;T-PSA<100 ng/mL时,6点穿刺法阳性率较低,而10点穿刺、13点穿刺阳性率无差异。前列腺体积>80 mL时,不同穿刺法阳性率有差异。PSAD<0.5 ng/mL²时,10点、13点穿刺阳性率无差异。结论 前列腺穿刺活检阳性率随穿刺针数增多而增加,可根据PSA水平、前列腺体积、PSAD选择个体化穿刺方案。

目的 探讨标准化术前访视在前列腺等离子电切术中的应用价值。方法 回顾性分析我科在2012年1月—2014年9月期间实施的120例择期经尿道前列腺等离子电切手术资料。根据术前接受的护理方式,患者被分为对照组(n=48)和观察组(n=72)两组。对照组患者接受传统的术前访视,观察组患者则接受标准化术前访视。结果 两组患者术前焦虑评分及等级分布有差异(P<0.05),观察组情况好于对照组。对照组手术知识问卷平均得分为(67.9±12.5)分,观察组平均得分为(81.6±10.8)分,两组间比较,差异有统计学意义(t=4.258, P=0.045)。对照组手术相关护理满意度平均评分为(70.8±13.5)分,观察组平均评分为(83.5±9.8)分,观察组得分高于对照组(t=5.002, P=0.038)。结论 标准化术前访视可缓解患者的术前焦虑情绪,提高患者对手术知识的了解,提升患者对手术护理的满意度。

目的 探讨群组管理对老年前列腺术后患者下肢活动依从性的效果。方法 将60例患者分为干预组和对照组,对照组按常规护理,干预组实施1周的群组管理活动。结果 干预后干预组患者对预防DVT发生的知晓度、进行下肢主动活动的依从性高于对照组,双下肢皮肤温度、颜色、胀痛等改变显著小于对照组,比较差异均有统计学意义(P＜ 0. 01)。结论 群组管理是一种有效的管理模式,可增强患者的自我效能,提高患者下肢活动的依从性,达到预防DVT发生的作用。

Objective To explore the influence of group management on compliance of lower extremities of elderly patients who underwent prostatectomy. Methods 60 patients were divided into the intervention group and the control group. While the control group was accepted normal nursing, the intervention group was accepted one-week group management. Results The intervention group performed better than the control group in awareness on the prevention of DVT and compliance of activities of lower extremities, and experienced less changes than the control group in skin temperatures, colors and ache of both lower extremities. These changes had statistical significant (P＜0.01). Conclusion Group management is an effective management mode, and improves parents' self-efficacy and compliance of lower extremities, is helping prevent DVT.

目的 探讨OAB与CP/CPPS的症状及诊断的重叠情况,为临床诊疗提供参考。方法 151例中青年男性患者入选为研究对象,按OAB及CP/CPPS的定义及诊断标准将其分为OAB组、CP/CPPS组及OAB+CP/CPPS组,并对OAB+CP/CPPS组进行诊断性治疗对研究对象进行明确诊断;根据年龄分为:18~25岁组、26~35岁组和36~49岁组,比较各年龄组患者OAB及CP/CPPS的重叠情况;对各组患者的临床症状进行分析比较,了解其重叠情况。结果 在151例研究对象中,可诊断为OAB、CP/CPPS、OAB+CP/CPPS的分别有62例(41.06%)、32例(21.19%)、57例(37.75%),因此OAB与CP/CPPS的诊断重叠率为37.75%,明显大于CP/CPPS患者的诊断率;各年龄组间诊断重叠率无差异(P>0.05);症状的重叠方面,OAB+CP/CPPS组有尿急、尿频、夜尿症、急迫性尿失禁、尿不尽感、排尿困难、泌尿生殖系疼痛和或不适症状的分别为57例(100.00%)、50例(87.72%)、21例(36.84%)、2例(3.51%)、12例(21.05%)、2例(3.51%)、57例(100.00%),其中,尿急、尿频及泌尿生殖系疼痛或不适症状的重叠率最高;OAB+CP/CPPS组经诊断性治疗后诊断为OAB患者约61.40%,而CP/CPPS患者为38.60%。结论 OAB与CP/CPPS两者间有相当高的重叠率且远高于CP/CPPS的诊断率,在OAB与CP/CPPS两者诊断重叠的患者中为OAB的可能性更大。

Objective To explore symptoms and diagnosis of overlap between OAB and CP/CPPS, providing reference for clinical treatment. Methods 151 cases of young men were enrolled in the study. According to the definition and diagnostic criteria of OAB and CP/CPPS, we divided the study subjects into OAB group, CP/CPPS group and OAB+CP/CPPS group. And OAB+CP/CPPS group would get a two-week diagnostic treatment to study a clear diagnosis. We also divided the subjects into 18-25 age group, 26-35 year-old age group and 36-49 group according to the age, comparing the overlap of OAB and CP/CPPS in different age groups. The symptoms of the subjects in each group were analyzed to compare and study the overlap. Results Among these 151 cases, 62 cases (41.06%) can be diagnosed as OAB, 32 cases (21.19%) as CP/CPPS, 57 cases (37.75%) as OAB+CP/CPPS. Therefore, OAB and CP/CPPS diagnostic overlap was 37.75%, significantly higher than the diagnosis of CP/CPPS patients; no significant difference (P>0.05) among all age groups diagnostic overlap rate; overlapping terms of symptoms, OAB + CP/CPPS group urgency, urinary frequency, nocturia, urgency incontinence, urine not the flu, difficulty urinating, or genitourinary pain and discomfort were 57 cases (100.00%), 50 cases (87.72%), 21 cases (36.84%), 2 cases (3.51%), 12 cases (21.05%), 2 cases (3.51%), 57 patients (100.00%), which overlap ratio urgency, frequency, and genitourinary pain or discomfort was high; OAB+CP/CPPS group after diagnosis diagnostic treatment of OAB patients was about 61.40%, while CP/CPPS patients was 38.60%. Conclusion There is high overlap rate between OAB and CP/CPPS, which is much higher than the diagnostic rate of CP/CPPS. It is likely to have an OAB when a patient is diagnosed as OAB or CP/CPPS at the same time.

       目的   研究SOCS6/STAT6通路在前列腺细胞炎性增殖作用中的调控作用。方法  使用人前列腺细胞株RWPE-1建立炎症模型，将细胞分为对照（CON）组和炎症刺激（INF）组，后者通过添加脂多糖（LPS）模拟炎症环境。采用ELISA检测白细胞介素-1β（IL-1β）-1β、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）表达水平，蛋白免疫印迹法检测细胞因子信号抑制物-6（SOCS6）、信号转导和转录激活因子-6（STAT6）及磷酸化STAT6蛋白的表达水平。结果  经过LPS处理后，RWPE-1细胞中的SOCS6蛋白表达水平显著下降（P＜0.01），而磷酸化STAT6表达水平上升（P＜0.01）。结论  SOCS6/STAT6通路可能通过调节炎症环境下STAT6的磷酸化水平，参与调节前列腺细胞的炎性增殖作用。

       Objective   To explore the  regulatory  role of  SOCS6/STAT6  pathway in the inflammatory  proliferation of 

prostate cells．Methods  The human prostate cell line RWPE-1 was used to establish an inflammation model．Cells were divided into a control（CON）group and an inflammation-stimulated（INF）group，with the latter subjected to lipopolysaccharide（LPS）treatment to simulate an inflammatory environment．The expression levels of interleukin（IL）-1β、IL-6 and  IL-8 were detected by ELISA，and the expression levels of suppressor of cytokine signaling 6（SOCS6），signal transducer and activator oftranscription-6，（STAT6），and phosphorylated STAT6 proteins were detected by Western blot．Results  The  results showed that after LPS treatment，the expression of SOCS6 protein in RWPE-1 cells significantly decreased，while the expression of phosphorylated STAT6 increased．Conclusions  The SOCS6/STAT6 pathway may be involved in  regulating the inflammatory proliferation of prostate cells by modulating the phosphorylation level of STAT6 under inflammatory conditions．