450 nm半导体蓝激光对子宫内膜组织汽化切割效应的离体动物实验研究

目的使用450 nm半导体蓝激光手术系统在不同条件下对离体新鲜猪子宫内膜组织进行汽化切割及内镜下模拟手术实验,初步评估蓝激光在妇科手术应用中的安全性、有效性和可行性。方法取产后和未孕新鲜猪离体子宫各8个,使用450 nm纤芯光纤,步进机移动速度为1.0 mm/s、2.0 mm/s,光纤头距离组织0.5~1.0 mm,调试蓝激光功率为5~30 W等条件下对猪子宫内膜组织进行汽化切割,对汽化切割后的标本行拍照记录后,置入4%多聚甲醛内固定48小时,使用游标卡尺测量凝固范围、汽化宽度、汽化深度,将标本行HE染色。使用产后子宫8个,对比等离子电切设备,在体外内镜辅助下进行模拟手术操作,将术后的标本行HE染色。结果激光在不同的功率(5~25 W)下作用于子宫内膜组织,随着激光功率的增大,组织的汽化深度、汽化宽度也逐渐增大;使用双极等离子电切设备与蓝激光在内镜下行汽化切割实验的比较,结果发现蓝激光汽化切割创面更平整,无明显碳化层,热损伤范围局限可控,凝固层、汽化深度及宽度稳定。相较于等离子电切设备,蓝激光产生的热损伤范围相对较小。结论初步研究表明,蓝激光进行猪子宫内膜相关手术是安全、有效且可行的,并且有望成为可选择的一种新型的妇科激光手术设备。

Treatment and surveillance for non-muscle-invasive bladder cancer:a clinical practice guideline(2021 edition)

Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.

Influence and Correction of Wavefront Primary Aberrations for Radio Telescopes using Aberration Theory

Dual-reflector antennas are widely used in astronomical observations and satellite communication.Structural deformations of the reflectors for radio telescopes are inevitable in outside working conditions due to exterior environment loads,which will cause distortion in the surface of the primary reflector and displacement of the subreflector,then lead to gain degradation and misalignment.In this paper,the influence and correction of misalignment in a dual-reflector antenna have been studied.From the perspective of wavefront aberration,a method is proposed to correct the wavefront primary aberration by adjusting the subreflector position.The characteristics of wavefront errors caused by structural deformation of the reflector have been analyzed,and relationships between the position motions of the subreflector and the Seidel wavefront aberrations are derived.The adjustment quantities of the subreflector are also derived.The results show the appropriate positional change of the subreflector in the lateral and axial directions can effectively correct the effects of the tilt and defocus in the primary aberrations caused by antenna structural deformations.

良性前列腺增生经尿道前列腺等离子电切术临床路径释义

良性前列腺增生是引发中老年男性排尿功能障碍最为常见的一种良性疾病,也是导致下尿路症状的主要原因。经尿道前列腺等离子电切术效果好、安全可靠,已在临床中广泛应用。为进一步规范该手术的临床应用,国家卫生健康委员会于2019年首次发布了《良性前列腺增生经尿道前列腺等离子电切术临床路径》。鉴于临床路径的篇幅有限,本文以该路径为蓝本,遵照循证医学的思路与方法进行释义,旨在提供更为详尽的证据补充,以帮助医护人员和管理人员能更好地理解、把握和正确运用本临床路径。

膀胱肿瘤经尿道等离子电切术临床路径释义

膀胱癌是全球第十大最常被诊断出的癌症,在男性中更常见。经尿道膀胱肿瘤电切术既是膀胱肿瘤的重要诊断方法,也是非肌层浸润性膀胱癌的主要治疗手段。相较于传统单极电切,等离子双极电切具有手术效果好、并发症较少的优势,临床应用渐趋广泛。为规范常见病的诊疗,国家卫健委持续发布相关的临床路径,但临床路径的内容有限,对其进行释义可以更好的推广使用。本释义以最新发布的《膀胱肿瘤经尿道等离子电切术临床路径(2019年版)》为蓝本,采用循证医学的方法,对路径中涉及的给药方案进行了详细解读,以期为医护及管理人员能够更好地理解、把握和正确运用临床路径提供参考。

Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia(2021 Edition)

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline “2018 Standard Edition”. However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons’ surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy;the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons’ skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.

Intermittent tri-weekly docetaxel plus bicalutamide in patients with castration-resistant prostate cancer： a single-arm prospective study using a historical control for comparison

Whether continuous docetaxel （DTX） chemotherapy offers an advantage over intermittent therapy for castration-resistant prostate cancer （CRPC） is unknown. In this study, we evaluated the efficacy, toxicity and quality of life （QoL） of intermittent tri-weekly DTX with bicalutamide in CRPC. Forty-two patients （group A） with CRPC were enrolled. The patients received intravenous DTX （75 mg m^-2） once tri-weekly with oral bicalutamide （50 mg） once daily. Patients had a DTX holiday when the prostate-specific antigen （PSA） level declined ≥ 50%. DTX was restarted in patients with a PSA increase ≥ 25%. Sixty patients （group B） who had matching characteristics and had continuously received DTX without bicalutamide for 10-12 cycles were also enrolled. There were no statistically significant differences in progression-free survival （8 months vs. 9 months, P=0.866） or overall survival （19 months vs. 21 months, P=0.753） between groups A and B; however, the proportions of patients in group A with all grades of neutropenia （33% vs. 58%, P=0.013） and nausea/vomiting （11% vs. 29%, P=0.024） were significantly less compared to group B. A significant improvement in the global health and fatigue scores was recorded for group A post-chemotherapy compared to pre-chemotherapy （P〈0.05）. The fatigue, nausea/ vomiting and appetite loss scores in group B were increased post-chemotherapy compared to pre-chemotherapy （P〈0.05）. In conclusion, intermittent tri-weekly DTX plus bicalutamide is well tolerated and has the potential to achieve comparable disease control with an improvement in QoL for oatients with CRPC.

Relationships among androgen receptor CAG repeat polymorphism, sex hormones and penile length in Han adult men from China： a cross-sectional study

This study aimed to investigate the correlations among androgen receptor （AR） CAG repeat polymorphism, sex hormones and penile length in healthy Chinese young adult men. Two hundred and fifty-three healthy men （aged 22.8 ± 3.1years） were enrolled. The individuals were grouped as CAG short （CAGs） if they harbored repeat length of 〈20 or as CAG long （CAGL） if their CAG repeat length was 〉20. Body height/weight, penile length and other parameters were examined and recorded by the specified physicians; CAG repeat polymorphism was determined by the polymerase chain reaction （PCR） method; and the serum levels of the sex hormones were detected by radioimmunoassay. Student＇s t-test or linear regression analysis was used to assess the associations among AR CAG repeat polymorphism, sex hormones and penile length. This investigation showed that the serum total testosterone （T） level was positively associated with the AR CAG repeat length （P = 0.01）; whereas, no significant correlation of T or AR CAG repeat polymorphism with the penile length was found （P = 0.593）. Interestingly, an inverse association was observed between serum prolactin （PRL） levels and penile length by linear regression analyses （β = -0.024, P = 0.039, 95% confidence interval （CI）： -0.047, 0）. Collectively, this study provides the first evidence that serum PRL, but not T or AR CAG repeat polymorphism, is correlated with penile length in the Han adult population from northwestern China.

Festosterone regulates keratin 33B expression in rat penis growth through androgen receptor signaling

Androgen therapy is the mainstay of treatment for the hypogonadotropic hypogonadal micropenis because it obviously enhances penis growth in prepubescent microphallic patients. However, the molecular mechanisms of androgen treatment leading to penis growth are still largely unknown. To clarify this well-known phenomenon, we successfully generated a castrated male Sprague Dawley rat model at puberty followed by testosterone administration. Interestingly, compared with the control group, testosterone treatment stimulated a dose-dependent increase of penis weight, length, and width in castrated rats accompanied with a dramatic recovery of the pathological changes of the penis. Mechanistically, testosterone administration substantially increased the expression of androgen receptor （AR） protein. Increased AR protein in the penis could subsequently initiate transcription of its target genes, including keratin 33B （Krt33b）. Importantly, we demonstrated that KRT33B is generally expressed in the rat penis and that most KRT33B expression is cytoplasmic. Furthermore, AR could directly modulate its expression by binding to a putative androgen response element sequence of the Krt33b promoter. Overall, this study reveals a novel mechanism facilitating penis growth after testosterone treatment in precastrated prepubescent animals, in which androgen enhances the expression of AR protein as well as its target genes, such as Krt33b.

Global,regional,and national burden of kidney,bladder,and prostate cancers and their attributable risk factors,1990–2019

Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.

Apalutamide for metastatic castration-sensitive prostate cancer:final analysis of the Asian subpopulation in the TITAN trial

The final analysis of the phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen(TITAN)trial showed improvement in overall survival(OS)and other efficacy endpoints with apalutamide plus androgen deprivation therapy(ADT)versus ADT alone in patients with metastatic castration-sensitive prostate cancer(mCSPC).As ethnicity and regional differences may affect treatment outcomes in advanced prostate cancer,a post hoc final analysis was conducted to assess the efficacy and safety of apalutamide in the Asian subpopulation.Event-driven endpoints were OS,and time from randomization to initiation of castration resistance,prostate-specific antigen(PSA)progression,and second progression-free survival(PFS2)on first subsequent therapy or death.Efficacy endpoints were assessed using the Kaplan–Meier method and Cox proportional-hazards models without formal statistical testing and adjustment for multiplicity.Participating Asian patients received once-daily apalutamide 240 mg(n=111)or placebo(n=110)plus ADT.After a median follow-up of 42.5 months and despite crossover of 47 placebo recipients to open-label apalutamide,apalutamide reduced the risk of death by 32%(hazard ratio[HR]:0.68;95%confidence interval[CI]:0.42–1.13),risk of castration resistance by 69%(HR:0.31;95%CI:0.21–0.46),PSA progression by 79%(HR:0.21;95%CI:0.13–0.35)and PFS2 by 24%(HR:0.76;95%CI:0.44–1.29)relative to placebo.The outcomes were comparable between subgroups with low-and high-volume disease at baseline.No new safety issues were identified.Apalutamide provides valuable clinical benefits to Asian patients with mCSPC,with an efficacy and safety profile consistent with that in the overall patient population.

2018年中国发布临床实践指南利益冲突与经济学证据的调查分析

目的评价2018年中国发布的临床实践指南中有关利益冲突和经济学证据的情况,并与2017年进行比较,以期了解指南制定变化情况,为完善我国临床实践指南的制定/修订提供参考。方法计算机检索中国知网、万方数据库及中国生物医学文献数据库,检索2018年我国发布的临床实践指南,检索时间为2018年1月1日至2018年12月31日。由2名研究者独立筛选文献、提取纳入指南的利益冲突声明与是否关注经济学证据等相关信息后,使用Microsoft Excel 2019软件进行统计分析。结果共纳入临床实践指南92部,其中23部指南(25.00%)声明了利益冲突,25部(27.17%)报告了资金来源,22部(23.91%)报道了经济学证据,且该报道的指南中有一半都有国家重大或重点专项支持(50.00%)。而2017年中国发布的53部临床实践指南中,有26.42%声明利益冲突,18.87%报告资金来源,11.32%提及经济学证据。结论相较于2017年,2018年我国加大了对临床实践指南制定资金投入的力度,在指南经济学证据方面的关注也有所提高,但是对于指南中利益冲突的声明报告和确切的经济学证据仍然很低。因此,进一步推进和完善我国临床实践指南对利益冲突的声明与经济学证据的关注,使我国临床实践指南制定更加客观、透明和独立是必要的。

Tetrandrine suppresses proliferation, induces apoptosis, and inhibits migration and invasion in human prostate cancer cells

Tetrandrine （TET）, a traditional Chinese medicine, exerts remarkable anticancer activity on various cancer cells. However, little is known about the effect of TET on human prostate cancer cells, and the mechanism of function of TET on prostate cancer has not yet been elucidated. To investigate the effects of TET on the suppression of proliferation, induction of apoptosis, and inhibition of migration and invasion in human prostate cancer cell lines, DU145 and PC-3. Inhibition of growth was determined by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide assay and clone formation assay, and flow cytometry analysis was performed to detect the induction of apoptosis. Activation of poly （ADP-ribose） polymerase, caspase-3, Akt, phospho-Akt, Bcl-2, and Bax was analyzed by Western blotting. Wound healing assay and transwell migration assay were used to evaluate the effect of TET on migration and invasion of cancer cells. TET inhibited the growth of DU145 and PC-3 cells in a dose- and time-dependent manner. Cell cloning was inhibited in the presence of TET in DU145 and PC-3 cells. TET suppressed the migration of DU145 and PC-3 cells. Transwell invasion assay showed that TET significantly weakened invasion capacity of DU 145 and PC-3 cells. TET exhibited strong inhibitory effect on proliferation, migration, and invasion of prostate cancer cells. In addition, TET induced apoptosis in a dose-dependent manner by activating the caspase cascade and inhibiting phosphoinositide 3-kinase-Akt signal pathway. The accumulating evidence suggests that TET could be a potential therapeutic candidate against prostate cancer in a clinical setting.

Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml^-1

Percent free prostatic-specific antigen （%fPSA） has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml^-1, however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml^-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer （PCa） and high-grade PCa （HGPCa） was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA〉4.0 ng ml^-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA （%fPSA ＋ PSA） was determined by the area under the receivers operating characteristic curve （AUC）. %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1, respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1.

Andrographolide sensitizes prostate cancer cells to TRAIL-induced apoptosis

Tumor necrosis factor-related apoptosis-inducing ligand （TRAIL） is a promising agent for anticancer therapy. The identification of small molecules that can establish the sensitivity of prostate cancer （PCa） cells to TRAIL-induced apoptosis is crucial for the targeted treatment of PCa. PC3, DU145, JAC-1, TsuPrl, and LNCaP cells were treated with Andrographolide （Andro） and TRAIL, and the apoptosis was measured using the Annexin V/PI double staining method. Real time-polymerase chain reaction （PCR） and Western blot analysis were performed to measure the expression levels of target molecules. RNA interference technique was used to down-regulate the expression of the target protein. We established a nude mouse xenograft model of PCa, which was used to measure the caspase-3 activity in the tumor cells using flow cytometry. In this research study, our results demonstrated that Andro preferentially increased the sensitivity of PCa cells to TRAIL-induced apoptosis at subtoxic concentrations, and the regulation mechanism was related to the up-regulation of DR4. In addition, it also increased the p53 expression and led to the generation of reactive oxygen species （ROS） in the cells. Further research revealed that the DR4 inhibition, p53 expression, and ROS generation can significantly reduce the apoptosis induced by the combination of TRAIL and Andro in PCa cells. In conclusion, Andro increases the sensitivity of PCa cells to TRAIL-induced apoptosis through the generation of ROS and up-regulation of p53 and then promotes PCa cell apoptosis associated with the activation of DR4.

Apalutamide for patients with metastatic castrationsensitive prostate cancer in East Asia:a subgroup analysis of the TITAN trial

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.

PSA time to nadir as a prognostic factor of first-line docetaxel treatment in castration-resistant prostate cancer： evidence from patients in Northwestern China

Docetaxel-based chemotherapy remains the first-line treatment for patients with metastatic castration-resistant prostate cancer （mCRPC） in China; however, the prognostic factors associated with effects in these patients are still controversial. In this study, we retrospectively reviewed the data from 71 eligible Chinese patients who received docetaxel chemotherapy from 2009 to 2016 in our hospital and experienced a reduction of prostate-specific antigen （PSA） level 〉50% during the treatment and investigated the potential role of time to nadir （TTN） of PSA. TTN was defined as the time from start of chemotherapy to the nadir of PSA level during the treatment. Multivariable Cox regression models and Kaplan-Meier analysis were used to predict overall survival （OS）. In these patients, the median of TTN was 17 weeks. Patients with TTN ≥17 weeks had a longer response time to chemotherapy compared to TTN 〈17 weeks （42.83 vs 21.50 weeks, P 〈 0.001）. The time to PSA progression in patients with TTN ：〉17 weeks was 11.44 weeks compared to 5.63 weeks when TTN was 〈17 weeks. We found several factors to be associated with OS, including TTN （hazard ratio [HR]. 3.937, 95% confidence interval [CI]： 1.502-10.309, P = 0.005）, PSA level at the diagnosis of cancer （HR： 4,337, 95% CI： 1.616-11.645, P= 0.004）, duration of initial androgen deprivation therapy （HR： 2.982, 95% CI： 1.104-8.045, P= 0.031）, neutrophil-to-lymphocyte ratio （HR： 3.963, 95% CI： 1.380-11.384, P = 0.011）, and total PSA response （Class 1 [〈0 response] compared to Class 2 [0-50% response], HR： 3.978, 95% CI： 1.278-12.387, P = 0.017）. In conclusion, TTN of PSA remains an important prognostic marker in predicting therapeutic outcome in Chinese population who receive chemotherapy for mCRPC and have 〉50% PSA remission.