经直肠超声放置前列腺线圈临床试用报告

经直肠超声(TRUS)引导经尿道放置前列腺线圈(Prostatic Coil简称PC)是自80年代以来治疗前腺疾病所致急慢性尿潴留的一种新的技术方法。它适用于不宜手术或不愿立即接受手术的患者,包括严重衰老体弱和具有心肺合并症者。采用这种装置74～80%可以代替永久导尿管或耻骨上造瘘。

Clinical Course Of Patients with Small Cell Lung Cancer As Second Primary Malignancy

Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results： Forty-eight patients （13.5%） were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them （40/43） were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 （39.3%） achieved CR. 12 （42.8%） achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months （5.1-77.7 months）, while that of the rest 19 untreated patients （1 of 20 was lost to follow-up） was only 2.0 months （0.5 34.0 months）. There was no significant difference in the median survival and RR between 165 treated first primary SCLC （13.5 months and 77.6% respectively） and 28 treated secondary primary SCLC （11.3 months and 82.1% respectively） （P〉0.05）. The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter （3.5 months vs. 15 months, P〈0.05）. Conclusion： The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.

Short-chain fatty acids act as antiinflammatory mediators by regulating prostaglandin E_2 and cytokines

AIM： To investigate the effect of short-chain fatty acids （SCFAs） on production of prostaglandin E2 （PGE2）, cytokines and chemokines in human monocytes. METHODS： Human neutrophils and monocytes were isolated from human whole blood by using 1-Step Polymorph and RosetteSep Human Monocyte Enrichment Cocktail, respectively. Human GPR41 and GPR43 mRNA expression was examined by quantitative realtime polymerase chain reaction, The calcium flux assay was used to examine the biological activities of SCFAs in human neutrophils and monocytes. The effect of SCFAs on human monocytes and peripheral blood mononuclear cells （PBMC） was studied by measuring PGE2, cytokines and chemokines in the supernatant. The effect of SCFAs in vivo was examined by intraplantar injection into rat paws. RESULTS： Human GPR43 is highly expressed in human neutrophils and monocytes. SCFAs induce robust calcium flux in human neutrophils, but not in human monocytes. In this study, we show that SCFAs can induce human monocyte release of PGE2 and that this effect can be enhanced in the presence of lipopolysaccharide （LPS）. In addition, we demonstrate that PGE2 production induced by SCFA was inhibited by pertussis toxin, suggesting the involvement of a receptor-mediated mechanism. Furthermore, SCFAs can specifically inhibit constitutive monocyte chemotactic protein-1 （MCP-1） production and LPS-induced interleukin-10 （IL-10） production in human monocytes without affecting the secretion of other cytokines and chemokines examined. Similar activities were observed in human PBMC for the release of PGE2, MCP-1 and IL-10 after 5CFA treatment. In addition, SCFAs inhibit LPS-induced production of tumor necrosis factor-α and interferon-7 in human PBIVlC. Finally, we show that SCFAs and LPS can induce PGE2 production in vivo by intraplantar injection into rat paws （P 〈 0.01）. CONCLUSION： SCFAs can have distinct antiinflammatory activities due to their regulation of PGE2, cytokine and chemokine release from human immune cells.

EFFECTS OF PROSTAGLANDIN E1 ON THE PROGRESSION OF ARISTOLOCHIC ACID NEPHROPATHY

Objective To investigate the effects of prostaglandin E1 (PGE1) on the progression of aristolochic acid nephropathy (AAN). Methods Twenty-four patients diagnosed as AAN with serum creatinine (Scr) between 1.5 mg/dL and 4 mg/dL during September 2001 to August 2003 were randomly divided into 2 groups. All patients had ingested long dan xie gan wan con-taining aristolochic acid (0.219 mg/g) for at least 3 months. Twelve patients were injected with Alprostadil (10 μg/d for 10 days in one month, summing up to 6 months). Except for PGE1, the other therapy was same in both groups. Renal function was assessed using reciprocal serum creatinine levels (1/Scr). Results The level of Scr and serum hemoglobin (Hgb) was similar in both groups prior to therapy. During follow-up, 1/Scr levels in PGE1 group were significantly higher than control group (P < 0.01), and Hgb levels in PGE1 group were sig-nificantly increased compared with control (P < 0.05).Conclusion PGE1 can slow the progression of renal failure and increase Hgb level of AAN patient.

Androgen Receptor Roles in Benign and Malignant Prostate Disease

Androgen deprivation therapy （ADT）, which aims to reduce androgen-androgen receptor （AR） signaling, is the normal method of prostate cancer treatment. Despite its early success in suppressing prostate tumor growth, the therapy eventually fails, leading to recurrent hormone-refractory tumor growth. Recent studies have been carried out with stromal cell-specific or fibroblastspecific AR knockout mice or prostate stromal-specific and epithelial-specific AR knockout transgenic mice prostate cancer models and in vitro and in vivo studies of various human prostate cancer cells with knock-in and knock-out of the AR. These have indicated that the AR in prostatic stroma acts as a proliferation stimulator and survival factor, whereas epithelial AR acts as a survival factor for epithelial luminal cells and stromal smooth muscle cell differentiation, and as a suppressor for epithelial basal intermediate cell proliferation. These two opposite AR pose a major challenge for roles of the stromal and epithelial ADT and should be taken into account when developing new therapies targeting AR in selective cells.

CLINICAL OBSERVATION ON 60 CASES OF BENIGN HYPERPLASIA OF PROSTATE TREATED BY INJECTION OF "CHUAN-SHEN-TONG" INJECTIOINTO HUIYIN (CV1)

Objective: To observe the therapeutic e ffect of injection of "Chuan-Shen-Tong" Injectio (川参通注射液) at Huiyin (会阴 CV 1) on benign hyperplasia of prostate . Methods: 60 cases of benign hyperplasia of prostate patients were evenly randomized into treatment group and control group. Those of treatment group were treated with injection o f "Chuan-Shen-Tong" Injectio (composed of Rhizoma Ligustici Chuanxiong, Rad ix Salviae Miltiorrhizae, etc. for relieving hyperplasis of prostate, 4 mL/acupoin t) into Huiyin (CV 1) and the other 60 cases of control group were treated by oral administration of Hytrin (1 mg/d in the 1 st week and increasing 1 mg/3 d, 4 mg at m ost). After 28 days’ treatment, their therapeutic effects were compared. Result s: After treatment, of each 60 cases in treatment and control groups, 11 (18.3%) and 11 (11.7%) were controlled in their symptoms, 25 (41.7%) and 16 (26.7%) had marked improvement, 18 (30.0%) and 17 (28.3%) had improvement, and 6 (10.0%) an d 20 (33.3%) failed, with the effective rate and the markedly effective rate bei ng 90.0% and 66.7% in the treatment group and 66.7% and 38.3% in the control gro up respectively. The therapeutic effect of treatment group was significantly sup erior to that of control group (P<0.01 and P< 0.05). Conclusion: The therapeutic effect of point-injection of "Chuan-Shen-Tong" for benign hyperplasia of p rostate is better than that of oral administration of Hytrin.