雷公藤多甙对慢性非细菌性前列腺炎大鼠ICAM-1、TNF-α表达的影响

目的研究TNF-α，ICAM-1在慢性非细菌性前列腺炎中的表达，并观察雷公藤多甙（TWP）对大鼠慢性非细菌性前列腺炎的作用及初步探讨其机理。方法将30只动物随机分为正常对照组、慢性非细菌性前列腺炎模型组和慢性非细菌性前列腺炎＋雷公藤多甙治疗组，每组10只。采用免疫组化法检测ICAM-1、TNF-α在各组大鼠前列腺中的表达。结果（1）所建大鼠模型的病理及病理生理学改变基本符合慢性非细菌性前列腺炎的特点：（2）慢性非细菌性前列腺炎模型组ICAM-1、TNF-α表达强度显著高于正常对照组（P〈0．01）：（3）慢性非细菌性前列腺炎＋雷公藤多甙治疗组ICAM-1、TNF-α蛋白表达与模型组相比有显著差异（P〈0．01）：（4）慢性非细菌性前列腺炎模型组大鼠前列腺TNF-α与ICAM-1蛋白表达比较呈显著正相关（r=0．83，P〈0．01）。结论ICAM-1、TNF-α可能参与了慢性非细菌性前列腺炎发病过程，雷公藤多甙可能是临床治疗慢性非细菌性前列腺炎的一种新的选择。     

大鼠慢性非细菌性前列腺炎模型的建立

目的建立大鼠慢性非细菌性前列腺炎模型。方法参考Robinette[1]的方法选取1周岁SD大鼠经去势后用苯甲酸雌二醇0.25mg/kg皮下注射,观察实验大鼠前列腺组织的病理学表现。结果建模30d后,大鼠前列腺出现不同程度的慢性炎症改变和炎症细胞的浸润。结论运用诱导去势大鼠成功建立了慢性非细菌性前列腺炎模型,为以后进一步研究前列腺炎的发病机理以及临床用药提供了较好的途径。     

前列康泰方对慢性前列腺炎前列腺组织TNF-α、IL-1βmRNA表达的影响

目的 观察慢性细菌性和非细菌性前列腺炎大鼠前列腺组织中TNF-α、IL-1β mRNA的表达及前列康泰方对它们的影响.方法 利用大鼠前列腺两侧叶注入预先稀释好的浓度为10(7)～10(9)个/ml大肠杆菌混悬液0.2ml来建立慢性细菌性前列腺炎病理模型;在大鼠前列腺侧叶注入25%消痔灵注射液0.2ml来建立慢性非细菌性前列腺炎病理模型.采用逆转录-聚合酶链反应(RT-PCR)的方法测定大鼠前列腺组织中TNF-α、IL-1β mRNA表达的变化,观察前列康泰方对它们的影响.结果 与正常对照组比较,慢性细菌性和非细菌性前列腺炎模型组大鼠前列腺组织中TNF-α、IL-1β mRNA的表达均增强;与模型组比较,前列康泰方组大鼠前列腺组织中TNF-α、IL-1β mRNA的表达均降低.结论 前列康泰方对慢性前列腺炎前列腺组织中细胞因子及其受体有一定的调控作用,这可能是该方治疗慢性前列腺炎的作用机制之一.     

维生素D受体及其配体(BXL-35)在SD大鼠慢性非细菌性前列腺炎中的作用研究

目的了解维生素D受体(VDR)在SD大鼠慢性非细菌性前列腺炎中的表达并研究VDR配体(BXL-35)对SD大鼠慢性非细菌性前列腺炎的治疗作用,探讨其可能的机制。方法60只10月龄雄性SD大鼠,随机分正常对照组、慢性非细菌性前列腺炎模型组以及BXL-35治疗慢性非细菌性前列腺炎组。采用RT-PCR对各组SD大鼠前列腺组织中VDRmRNA表达水平进行半定量分析:用免疫组织化学技术检测各组TNF-á,IFN-γ,NF-kB, IkBá的表达水平来判断BXL-35治疗SD大鼠慢性非细菌性前列腺炎的作用。结果(1)前列腺炎模型组VDRmRNA表达水平明显低于正常对照组和BXL-35治疗组(P<0.01);(2)BXL-35治疗组前列腺组织的炎症反应减轻,与前列腺炎模型组比较,其TNF-á,IFN-γ,NF-kB,表达水平明显下降(P<0.01)而IkBá则增高(P<0.01)。结论VDR可能参与了慢性非细菌性前列腺炎的发病机制,其配体能有效抑制前列腺炎症。     

NSE在慢性非细菌性前列腺炎大鼠模型前列腺组织中的表达及意义

目的：研究慢性非细菌性前列腺炎（chronic abacterial prostatitis,CAP）大鼠前列腺组织中神经元特异性烯醇化酶（NSE）的表达,探讨前列腺神经内分泌细胞因子对CAP的作用及其机制。方法：将40只2月龄SD大鼠随机分为正常对照组、CAP模型组,每组20只。观察大鼠前列腺病理形态学改变,用免疫组化法和ELISA法检测NSE在大鼠前列腺中的表达情况。结果：①CAP模型组的病理形态学呈明显炎症表现;②CAP模型组NSE表达强度显著高于正常对照组。结论：NSE可能参与CAP发病过程,神经内分泌细胞功能的改变可能在慢性前列腺炎发生、发展过程中起重要作用。     

雷公藤多甙对大鼠慢性非细菌性前列腺炎NF-κB及iNOS表达影响的实验研究

目的探讨雷公藤多甙对慢性非细菌性前列腺炎大鼠前列腺组织NF-κB和iNOS表达的影响。方法将30只动物随机分为3组:正常对照组、慢性非细菌性前列腺炎模型组(简称前列腺炎模型组)和慢性非细菌性前列腺炎 雷公藤多甙治疗组(科称雷公藤治疗组),每组10只,分别检测前列腺组织中白细胞总数和卵磷脂小体密度变化以及NF-κB和iNOS在各组大鼠前列腺中的表达情况。结果(1)雷公藤治疗组与正常对照组相比,前列腺炎模型组前列腺内白细胞数明显增多(P<0.01),卵磷脂小体密度降低(P<0.05),NF-κB和iNOS表达强度显著高于正常组(P<0.01);(2)雷公藤治疗组与前列腺炎模型组相比,雷公藤治疗组前列腺内白细胞数明显减少(P<0.01),卵磷脂小体密度增加(P<0.05),NF-κB和iNOS蛋白表达与前列腺炎模型组表达有显著差异(P<0.01)。结论NF-κB和iNOS可能参与了慢性非细菌性前列腺炎发病过程,雷公藤多甙可以使慢性非细菌性前列腺炎的炎症明显好转。     

中药清浊汤对慢性非细菌性前列腺炎大鼠前列腺组织形态及COX-2、NF-κB表达的影响

目的探讨中药清浊汤对慢性非细菌性前列腺炎大鼠前列腺组织形态及COX-2、NF-κB的影响,明确清浊汤治疗慢性非细菌性前列腺炎的作用机制,为其治疗该病提供理论支持。方法选取健康的雄性SD大鼠80只,60只造模采取多点皮下注射大鼠前列腺蛋白提纯液和弗氏完全佐剂法建立慢性非细菌性前列腺炎模型,余20只为空白组。造模成功的60只大鼠按随机数字表随机分为模型组、阳性药物组、清浊汤组各20只。阳性药物组、清浊汤组连续给药30d后处死,采集标本通过光镜观察各组大鼠前列腺组织形态学改变,免疫组化法并结合图形图像分析系统检测前列腺组织COX-2、NF-κB表达的变化。结果清浊汤能明显减轻慢性非细菌性前列腺炎模型大鼠前列腺组织的炎症反应。模型组大鼠COX-2水平为0.4030±0.0136,明显高于正常组水平0.0878±0.0382(P0.01);NF-κB水平为0.5330±0.0137,明显高于正常组水平0.0698±0.0117(P0.01);与模型组大鼠前列腺组织COX-2、NF-κB比较,治疗各组水平为0.1570±0.0221及0.2001±0.0312均有所降低(P0.05);与阳性药物组前列腺组织COX-2水平0.3711±0.0457、NF-κB水平0.4003±0.0879比较,清浊汤组下降更显著(P0.01)。结论清浊汤可改善慢性非细菌性前列腺炎模型大鼠前列腺组织内环境,降低COX-2、NF-κB水平表达可能为其作用机制。     

前列康泰方对慢性细菌性前列腺炎的实验研究

目的探讨中药前列康泰方对慢性前列腺炎的治疗作用和机制。方法利用大鼠前列腺侧叶注入大肠杆菌混悬液来建立慢性细菌性前列腺炎(CBP)病理模型,经前列康泰方治疗35d后,观察大鼠前列腺组织病理学改变、测定血浆TXB2、6-K-PGF1α的水平。结果前列康泰方能改善慢性细菌性前列腺炎大鼠前列腺组织病理学改变;可降低血浆TXB2含量,升高6-K-PGF1α含量,使TXB2/6-K-PGF1α(简称T/K)比值下降。结论前列康泰方对慢性细菌性前列腺炎有明显的治疗作用。     

戊聚硫钠对慢性非细菌性前列腺炎大鼠动物模型治疗的研究

目的:探讨戊聚硫钠(PPS)对慢性非细菌性前列腺炎(CNP)大鼠的治疗作用。方法:选取6月龄健康成年雄性SD大鼠80只,体重315~450 g,去势后用苯甲酸雌二醇0.25 mg/(kg.d)皮下注射,每日1次,连续注射30 d建模。成功建立CNP大鼠动物模型后,随机等分为安慰剂组和PPS治疗组,每组40只,分别用PPS、生理盐水灌胃治疗,连续8周后,处死动物,前列腺组织,HE染色,观察其病理变化。结果:建模后各组大鼠前列腺出现不同程度的慢性炎症改变和炎症细胞的浸润。PPS治疗组大鼠前列腺炎症较治疗前明显好转,而安慰剂组炎症未见好转。结论:PPS对大鼠CNP有一定治疗作用,其作用机制可能与PPS可修复大鼠前列腺受损的GAG层,抑制炎症的发生相关。     

体外射频治疗慢性非细菌性前列腺炎和前列腺痛48例报告

应用体外射频熟疗法（ＥＲＦＨ）治疗慢性非细菌性前列腺炎和前列腺痛４８例，治疗后２～３月随访，总有效率为８７．５％（４２／４８）。本文对治疗机理，治疗经验进行了讨论，认为ＥＲＦＨ是治疗慢性非细菌性前列腺炎和前列腺痛的一种有效方法。     

慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中的细菌16SrRNA基因检测

目的:探讨细菌在慢性非细菌性前列腺炎病因中的作用,评估细菌16S核糖体核糖核酸(16SrRNA)基因在前列腺液标本和前列腺组织标本中检出的差异.方法:应用PCR方法检测38例慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中细菌16SrRNA基因,同时对照检测尿道拭子和直肠拭子以及穿刺枪头拭子的细菌16SrRNA基因.结果:细菌16SrRNA基因的检出率在前列腺液中和前列腺组织中分别为 78.9%和81.5%(P＞ 0.05).细菌基因信号在前列腺液标本中和尿道拭子中各有30例( 78.9%)和4例( 10.5%)呈阳性(P＜ 0.01);在前列腺组织中和直肠拭子中各有31例( 81.5%)和6例( 15.8%)呈阳性(P＜ 0.01),无一例穿刺枪头拭子阳性.结论:慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中均有细菌16SrRNA基因的检出,其病因可能与细菌感染有关. 细菌16SrRNA基因的检出在前列腺液标本和前列腺组织标本中差异无统计学意义.     

A search for infectious agents in chronic abacterial prostatitis using ultrasound guided biopsy

A series of 60 patients with a diagnosis of chronic abacterial prostatitis, as defined by the Stamey procedure, was studied by transrectal prostatic ultrasound and subsequent transperineal biopsy of the abnormal areas of the prostate in order to ascertain the role of micro-organisms in this condition. Histological assessment revealed a chronic inflammatory infiltrate, generally of low grade, in 53 patients (88%). Organisms were isolated from the prostatic tissue of only 9 patients (15%) and were considered to be contaminants from the perineal skin, since treatment with an appropriate antimicrobial agent failed to alter symptoms or affect the leucocyte count in the urine or prostatic fluid. Chronic abacterial prostatitis may be a non-organismal inflammatory process.     

Evaluation of 42 patients with chronic abacterial prostatitis: Are there any underlying correctable pathologies?

Forty-two young men with abacterial prostatitis underwent physical examination, semen analyses, rectal US (TRUS) and magnetic resonance imaging (MRI) of the pelvis. Findings on TRUS showed no distinct differences like capsular irregularity, dilatation of the seminal vesicles and calcified foci in the prostate. In MRI pathologic conditions were noted as transitional zone cysts, prostatic utricle cysts and abscesses of the seminal vesicles. MRI had been found superior to TRUS in imaging the prostate and to predict associated pathologic conditions. It is also concluded that some additional factors as a cause of prostatitis must be determined in patients with chronic abacterial prostatitis.     

alpha-BLOCKERS FOR THE TREATMENT OF CHRONIC PROSTATITIS IN COMBINATION WITH ANTIBIOTICS

Purpose

This study was undertaken to evaluate the immediate and long-term effects of the combination of alpha-blockers and antibiotics in the treatment of chronic prostatitis.

Materials and Methods

The patients eligible for study were assigned to 3 groups: group 1-nonprostatodynia, abacterial prostatitis (134), group 2-prostatodynia (72) and group 3-chronic bacterial prostatitis (64). alpha-Blockers were administered to all patients of groups 1 and 2 with demonstrable high maximal urethral closure pressure and typical clinical complaints irrespective of the presence of inflammatory findings in expressed prostatic secretion. alpha-Blockers were given to 50% of patients with bacterial prostatitis. Antibiotics were administered to all patients with positive expressed prostatic secretion cultures, and in half of those with abacterial prostatitis and inflammatory expressed prostatic secretion. Mean followup was 22 months (range 6 months to 3 years). The sign 1-tailed test was used for statistical analysis of data.

Results

The recurrence rate of bacterial prostatitis was significantly reduced by alpha-blockade (expressed prostatic secretion culture negative) and symptom relief was achieved for many months. For abacterial prostatitis statistical analysis revealed a lower symptom recurrence rate in patients receiving only alpha-blockers in comparison with those treated with a combination of alpha-blockers and antibiotics.

Conclusions

The use of alpha-blockers is justified, not only for prostatodynia, but also for abacterial and bacterial prostatitis. In the letter case alpha-blockade not only caused enhanced clinical improvement but also reduced the recurrences as defined by expressed prostatic secretion positive segmental cultures.     

Retrograde transurethral balloon dilation of prostate: Innovative management of abacterial chronic prostatitis and prostatodynia

Retrograde transurethral balloon dilatation (RTBD) of the prostate recently has been suggested as alternative therapy for patients with benign prostatic hyperplasia (BPH). Seven patients with documented functional urinary outlet obstruction at the level of the bladder neck or prostatic urethra underwent RTBD of prostate. Each patient had a classic diagnosis of abacterial chronic prostatitis or prostatodynia based on history, physical examination, and localization cultures. Prior to RTBD of prostate, patients underwent cystoscopy, voiding cystourethrogram, urodynamic and uroflow studies. RTBD of prostate was done as an outpatient procedure requiring intravenous sedation or general anesthesia. Dilation was performed with a 25-mm urethroplasty balloon catheter inflated at 3.5 atm of pressure for twenty minutes. Improvement in voiding symptomatology was noted in all patients and graded numerically (0-10 scale), with ten indicating normal voiding. Follow-up to date ranges from one to five months. This technique may have promise as a treatment option in patients with abacterial chronic prostatitis and prostatodynia.     

The role of Chlamydia trachomatis in chronic abacterial prostatitis: a study using ultrasound guided biopsy

We studied 50 patients with chronic abacterial prostatitis as defined by the Stamey procedure via transrectal prostatic ultrasound and subsequent transperineal biopsy of the abnormal areas of the prostate to ascertain the role of Chlamydia trachomatis organisms (chlamydiae) in this condition. Chlamydiae were detected by an immunofluorescence technique in the urethra of 1 patient (2 per cent) but they were not recovered in McCoy cell culture from the prostatic tissue of any patient nor were they detected in the tissue by immunofluorescence. In addition, serum antibody to Chlamydia trachomatis was not found even in moderate titer. The approach in this study has overcome the problem of urethral contamination in the assessment of prostatic specimens from patients with chronic abacterial prostatitis. There is no evidence that chlamydiae are directly implicated in the disease, although the possibility of an earlier active role cannot be excluded.     

慢性非细菌性前列腺炎患者前列腺组织中细菌16SrRNA基因和大肠杆菌tufA mRNA基因的检测

目的 探讨细菌感染与慢性非细菌性前列腺炎的相关性。方法 应用PCR方法检测慢性非细菌性前列腺炎患者前列腺组织中的细菌16SrRNA基因，同时用RT-PCR方法检测其中的大肠杆菌tufAmRNA基因。结果 38例慢性非细菌性前列腺炎患者前列腺组织中31例（81．5％）呈细菌16SrRNA基因阳性；在31例细菌16SrRNA基因阳性的患者前列腺组织中，有6例（19．4％）检出大肠杆菌tufAmRNA基因。结论 慢性非细菌性前列腺炎患者的前列腺组织中不仅有细菌的存在，而且部分被证实是活力细菌。细菌在慢性非细菌性前列腺炎的病因中可能起一定的作用。     

Questionnaire survey of Japanese urologists concerning the diagnosis and treatment of chronic prostatitis and chronic pelvic pain syndrome

OBJECTIVES: We performed a questionnaire survey to investigate various issues in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome by Japanese urologists and to clarify the circumstances surrounding prostatitis in Japan. METHODS: Japanese urologists (n = 1869) were surveyed by mail using a 17-item questionnaire to determine current diagnostic and treatment practices for prostatitis/chronic pelvic pain syndrome. RESULTS: Only 1.5% (11/739) of urologists diagnosed chronic prostatitis/chronic pelvic pain syndrome using the 4-glass test, while most did so using the 2-glass test (voided bladder [VB]2 and VB3, or VB2 and expressed prostatic secretion [EPS]). Approximately half (55.2%; 412/746) did not perform urine cultures to differentiate chronic bacterial prostatitis from chronic abacterial prostatitis/chronic pelvic pain syndrome. Approximately half (46%; 343/746) did not count the number of leukocytes in VB2 or VB3/EPS to differentiate chronic abacterial prostatitis from chronic pelvic pain syndrome. Although many urologists (63.8%; 459/720) thought that chronic abacterial prostatitis/chronic pelvic pain syndrome was not an infectious disease, many chose antimicrobial agents as the primary treatment. More than half (52.2%; 384/735) of all urologists felt pessimistic about dealing with chronic prostatitis/chronic pelvic pain syndrome compared to treating benign prostatic hypertrophy or prostate cancer, because of the high number of complaints by patients and their own lack of confidence in diagnosing and treating the condition. CONCLUSION: There is much confusion and frustration among Japanese urologists about chronic prostatitis/chronic pelvic pain syndrome. Further studies are needed to elucidate its etiology and pathogenesis, and to establish guidelines for its diagnosis and treatment.     

Eosinophilic prostatitis and prostatic specific antigen.

Eosinophilic prostatitis is a rare form of abacterial prostatitis with uncertain aetiology. Its clinical presentation, like other types of abacterial prostatitis, commonly mimics carcinoma of the prostate. Transrectal ultrasound may be helpful in the diagnosis of prostatitis but histological confirmation is necessary. Prostatic specific antigen has been widely used in the diagnosis and follow-up of patients with prostatic carcinoma. High levels of this antigen (greater than 30 micrograms/l) have been claimed to be highly specific for prostate cancer, although lesser elevations may also occur in patients with large benign prostate glands and in bacterial prostatitis. We report 3 patients with histologically proven eosinophilic prostatitis and high levels of prostatic specific antigen. This diagnosis may closely mimic carcinoma of the prostate and must be excluded by histological examination of biopsy material before treatment for presumed prostate carcinoma is initiated.     

坦洛新联合前列安栓治疗Ⅲ型前列腺炎临床观察

目的 观察坦洛新联合前列安栓治疗Ⅲ型前列腺炎的临床疗效.方法 Ⅲ型前列腺炎患者90例,随机分为治疗组(n=45)和对照组(n=45),治疗组应用坦洛新和前列安栓,对照组应用特拉唑嗪和前列安栓,观察2组治疗前后的慢性前列腺炎症状积分指数(NIH-CPSI评分)和疗效变化,并进行统计学分析.结果 治疗组:临床痊愈12例,显效14例,有效16例,无效3例,总有效率93.3%;对照组:临床痊愈5例,显效9例,有效17例,无效12例,总有效率72.1%.治疗组优于对照组(P<0.05):治疗组在改善患者尿路症状、生活质量及总NIH-CPSI方面优于对照组(P<0.05);两者在改善疼痛症状上无明显差异(P>0.1).结论 坦洛新联用前列安栓是治疗Ⅲ型前列腺炎有效的药物组合.