遂宁地区180例良性前列腺增生病理诊断分析

目的:探讨良性前列腺增生的病理特点,为临床有效治疗提供依据。方法:回顾性分析180例良性前列腺增生患者病理标本,分析其不同结节类型并归纳各类型病理表现及临床特点。结果:180例良性前列腺增生标本分为纤维肌腺瘤样型84例(46.7%)、腺瘤样型40例(22.2%)、纤维肌型27例(15.0%)、肌型19例(10.6%)、纤维血管型10例(5.6%)。结论:拥有扎实的理论基础并熟练掌握良性前列腺增生病理特征,可以为临床治疗提供准确的诊断依据,使良性前列腺增生的治疗更加趋向合理化。     

膀胱癌合并前列腺增生手术处理回顾（附31例分析）

膀胱癌合并前列腺增生，是一次手术同时处理两种病变还是分次手术颇有争议。1988年来，我们同期处理膀胱癌和前列腺增生13例，与前期单纯处理膀胱癌18例比较，报告如下。临床资料一、一般资料：共收治男性膀胱癌179例，合并前列腺增生31例，占17．26％。年龄55～87岁。均有不同程度排尿困难和血尿，病程5个月～12年。经膀联镜及活检确诊膀肤癌。同时经肛检、B超和尿流率测定并经手术证实前列腺增生：I”增生3例，皿117例，皿”11例。尿流率测定20例，异常19例，最大尿流率7～18ml／s，平均12．3ml／s。单纯膀跳癌手术组18例，年龄56～87岁…     

经膀胱前列腺切除术（附247例分析）

我院自1979～1992年共收治前列腺增生病人336例，手术治疗247例，占73．51％，现报告如下。资料与方法手术治疗247例，年龄56～89岁，平均年龄66岁。前列腺肛门指检：前列腺鸡蛋大小者定为肝的142例，占5749％；前列腺鸭蛋大小者定为肝的83例，占33．6％；前列腺鹅蛋大小者定为     

射频前列腺热疗仪治疗后一过性排尿困难的分析及护理

我院自1992年11月起应用STAR-Ⅱ射频前列腺热疗仪治疗良性前列腺增生44例，发现术后出现一过性排尿困难加重(尿频、尿潴留)39例，占88．6％，需留置导尿14例．占31．8％。本分析其原因及总结护理体会。     

改良Madigan前列腺切除术28例临床观察

我院1996－04～1997－06对28例良性前列腺增生症患者行改良Madigan前列腺切除术，疗效满意，现报道如下．1资料与方法1．1临床资料本组28例，年龄60－82岁，平均68．4岁。有尿频及排尿困难病史9个月~12年，其中尿潴留18例。残余尿量80～620ml，最大尿流率均＜10ml/s．经CT、B超及肛诊诊断为前列腺Ⅰ度增生5例，Ⅱ度增生16例，Ⅲ度增生7例．B超测前列腺左右径平均5．4cm，前后任平均46cm，6例中叶突入膀脱，最大突入2．8cm。其中伴有呼吸道疾患6例，泌尿系感染11例，心血管疾病12例．轻度肾功不全心例，术前引流尿液，改善肾功能后再手术治…     

微创一期处理前列腺增生并发膀胱多发结石

目的：探讨微创一期处理前列腺增生并发膀胱多发结石的疗效。方法：回顾分析我院56例患者气压弹道膀胱多发结石碎石＋前列腺电切同期处理膀胱多发结石合并前列腺增生的临床资料。结果：无死亡及中转开放手术病例,56例膀胱多发结石均碎石、并成功取石。5例患者术中或术后需输血,3例出现电切综合征,4例术后出现尿路感染,2例出现尿失禁。除1例出现尿道外口狭窄外,其余患者术后排尿通畅满意,国际前列腺症状评分由术前（23．5＋4．8）分降为（9．3＋1-4）分P〈0．01,残余尿手术前后分别为（47．5±9．2）ml,（16．3＋7．6）ml（P〈0．01）,结石清除率100％;术后随访5～27个月,平均16．2月,无膀胱结石复发。结论：腔内处理泌尿系结石合并前列腺增生创伤小、安全高效,并发症少,是治疗前列腺增生并泌尿系结石理想方法。     

前列腺增生术后再次尿潴留原因探讨

目的分析前列腺增生术后再次尿潴留的原因。方法选取本院2012年9月～2013年4月收治的62例前列腺增生术后再次尿潴留患者作为研究对象,对其出现术后再次尿潴留的原因进行探讨。结果在62例前列腺增生术后再次尿潴留患者中,32例尿道狭窄,占51．6％;17例膀胱颈缩窄,占27．4％;6例膀胱功能异常,占9．7％;5例腺体残留,占8％;2例腺体残留复发,占3．3％。结论前列腺增生术后再次尿潴留主要受到患者尿道狭窄、膀胱颈缩窄、良性前列腺增生复发以及膀胱功能障碍等因素影响,术中,适宜采用手术治疗与药物治疗相结合的方法进行治疗,进而有效防止发生前列腺增生术后再次尿潴留,缓解患者痛苦。     

GST-pi与p53蛋白表达在肠癌和增生性病变中的关系

目的：探讨胎盘型谷胱甘肽转移酶（GST—pi）与p53蛋白在肠癌和增生性病变中表达及其关系。方法应用S—P免疫组化法检测36例肠腺癌，16例肠腺瘤伴非典型增生，20例肠腺瘤，10例肠息肉组织中GST—pi与p53蛋白表达的关系。结果GST—pi与P53蛋白在肠腺癌中阳性表达率分别为88．8％和86．1％，与其他组相比有显著差异（P〈0．01），腺瘤伴非典型增生组的表达率为81．25％和68．75％。结论在肠道增生性病变中既有GST—pi与p53蛋白的表达，并随着细胞增生程度的增高、非典型增生到肠癌其表达率亦明显增高，说明肠道病变中细胞的异型性与GST—pi、p53蛋白表达呈正相关，可作为检测肠癌和肠道的癌前期病变的一个标志物。     

经尿道前列腺电切术后排尿困难的护理观察

前列腺增生 (ＢＰＨ)是老年男性常见病 ,耻骨上经膀胱前列腺切除术是治疗前列腺增生的常用术式。 1999年 4月～2 0 0 2年 4月 ,我院开展ＴＵＲＰ深受广大老年男性患者的喜欢。为了探讨ＴＵＲＰ术后拔除尿管后的危险因素 ,为预防、治疗护理提供依据。我们调查了 16 0例前列腺增生ＴＵＲＰ术后 1～ 2年的患者 ,现报告如下。1　资料与方法1 1　一般资料　我院前列腺增生症ＴＵＲＰ术后 1～ 2年的患者共 16 0例 ,年龄为 5 5～ 95岁。询问患者术后是否出现了排尿困难。即在术后至随访的这段时间内出现了因排尿困难的症状而需要进一步的外科处理 ,…     

经尿道激光切除前列腺和女性后尿道增生18例

我院从1991年5月～1991年10月用Nd:YAG激光(掺钕钒铝石榴石激光)手术刀经尿道切除增生的前列腺及女性后尿道增生共18例效果满意。1 临床资料 18例中年龄45～76岁,60岁以上占17例,其中前列腺增生13例,女性后尿道增生5例,病程2～15年。术前均有排尿困难,保留尿管者5例,其中女性2例。肛门指诊、B超和膀胱镜检查,前列腺Ⅲ°增生5例,Ⅱ°增生8例。女性后尿道增生,膀胱镜检查颈部隆起,后唇抬高呈水坝样改变显著。本组病例术前残余尿80ml～400ml,夜尿5～10次,18例中并发泌尿系感染5例,伴有冠     

氟他胺对大鼠及小鼠前列腺肥大的抑制作用(英文)

观察氟他胺（Ｆｌｕ）抗前列腺肥大的作用方法：以两种动物模型：阉割大鼠每只每日ｓｃ睾酮０．５ｍｇ引起前列腺肥大和小鼠前列腺中植入同系 １６ ｄ龄胎鼠的尿生殖窦组织, ｉｇ Ｆｌｕ　１０, ２５,和５０ ｍｇ·ｋｇ－１ ３０ ｄ或 ｓｃ雌二醇（Ｅｓｔ）,两模型分别持续３０ ｄ和 １４ｄ．结果：１） Ｆｌｕ能显著抑制大鼠各叶前列腺体积和重量,使其降至对照组的１０％至５０％,并呈良好的剂量效应关系．腺体上皮萎缩,腺腔直径缩小,其效应比Ｅｓｔ强．２）Ｆｌｕ治疗组前列腺体积和重量均减小,但只有体积项呈剂量效应关系此模型中,Ｅｓｔ的作用较Ｆｌｕ强．结论： Ｆｌｕ具有抑制前列腺肥大的作用。     

氟他胺对大鼠及小鼠前列腺肥大的抑制作用

观察氟他胺抗前列腺肥大的作用。方法;以两种动物模型：阉割大鼠每只每日ｓｃ睾酮０．５ｍｇ引起前列腺肥大和小鼠前列腺中植入同系１６ｄ龄胎鼠的尿生殖窦组织,ｉｇ Ｆｌｕ １０,２５,和５０ｍｇ．ｋｇ＾０－１３０ｄ或ｓｃ雌二醇,两模型分别持续３０ｄ和１４ｄ,。     

前列康片治疗前列腺增生症100例

本文报道应用花粉制剂前列康片治疗老年男性泌尿系常见病前列腺增生症100例,与30例空白对照组比较,有显著性差异。症状有效率93％,残余尿有效率73.2％,用药后51例B超测定前列腺体积有明显缩小(P<0.05-0.01),总有效率95％。长期服用无明显副作用,随疗程延长,疗效相应增高。花粉制剂治疗前列腺增生症的机理可能与其抗雄性激素作用及改善尿道粘膜及其周围组织水肿有关。     

Active principle of swine prostate extract: II. Effect of a peptide isolated from swine prostate extract on rat prostate.

Previously, we purified a substance from swine prostate extract (PE) that had been reported to have therapeutic effect on benign prostatic hypertrophy. The purified substance (PPE) suppressed 3H-testosterone uptake into the prostate in castrated rats. The present study was carried out to examine the effect of PPE on the weight of accessory sexual organs including the prostate and biochemical parameters in the prostate of normal and/or castrated and testosterone-treated rats. 1) In normal rats, the p.o. administration of PPE daily for a total of 30 days did not affect the prostate weight, but reduced the citric acid content in the prostate. The treatment had little or no influence tissue O2 uptake, aconitase activity or isocitrate dehydrogenase activity in the prostate. 2) In castrated and testosterone-treated rats, the p.o. treatment with PPE for 15 or 30 days reduced the weight of the prostate as well as the total citric acid, DNA and RNA contents in prostatic tissue. However, these biochemical parameters per tissue weight were not obviously affected except for the citric acid content. These findings suggest that PPE is one of the active principals of PE for the therapeutic efficiency on benign prostatic hypertrophy, probably due to its suppressive effect on excessive uptake of androgen by the prostate.     

Dutasteride for the treatment of prostate-related conditions

INTRODUCTION: A variety of pharmaceuticals have been developed directed at mitigating the symptoms associated with benign prostatic hypertrophy (BPH) and have also been evaluated for their potential role in prevention and treatment of prostate cancer. One such agent is dutasteride , a non-selective inhibitor of 5α-reductase, an enzyme responsible for conversion of testosterone to a more potent androgen dihydrotestosterone (DHT). AREAS COVERED: This review will cover the safety profile of dutasteride when it is used in the treatment of prostate-related conditions, specifically looking at the pivotal clinical trials on this drug. EXPERT OPINION: Dutasteride has proved to be a safe and efficacious treatment for symptoms related to BPH. The primary safety concern relates to the increased incidence of high-grade prostate cancer seen in men treated with dutasteride in the setting of prostate cancer prevention. Dutasteride has a role as an adjunct in the treatment of prostate cancer; however, this is an area still under active investigation. It is not recommended for use in prostate cancer prevention given the increased risk of high-grade cancers.     

Biochemical and pharmacogenetic dissection of human steroid 5 alpha-reductase type II

Human prostatic steroid 5alpha-reductase, encoded by the SRD5A2 gene on chromosome band 2p23, catalyses the irreversible conversion of testosterone to dihydrotestosterone (DHT), the most active androgen in the prostate, with NADPH as its cofactor. This enzyme has never been purified but a number of competitive inhibitors have been developed for this enzyme since increased steroid 5alpha-reductase activity may cause benign prostatic hypertrophy and prostate cancer. We report here the detailed biochemical and pharmacogenetic dissection of the human enzyme by analysing 10 missense substitutions and three double mutants which are all naturally found in humans. Nine of these 13 mutants reduce activity (measured as Vmax) by 20% or more, three increase steroid 5alpha-reductase by more than 15% and one results in essentially unaltered kinetic properties suggesting that it is a truly neutral ('polymorphic') amino acid substitution. Substantial pharmacogenetic variation among the mutants was also observed when three competitive inhibitors, finasteride, GG745 (dutasteride) and PNU157706, were investigated. Our studies not only define the substrate and cofactor binding sites of human steroid 5alpha-reductase, but also have significant consequences for the pharmacological usage of steroid 5alpha-reductase inhibitors in human patients treated for prostatic conditions.     

超声引导下经直肠前列腺穿刺活检术的临床应用

目的 探讨经直肠超声引导前列腺穿刺活检术诊断前列腺癌的临床价值.方法 对69例直肠指诊阳性或PSA＞4ng/ml及前列腺B超有异常低回声结节病例,在行前列腺系统十点穿刺活检术同时对可疑回声区随机增加穿刺点.结果 共检出前列腺癌21例,占30.43%,前列腺良性增生并前列腺炎40例,占59.97%,前列腺炎5例,占5.80%,前列腺囊肿1例,占1.45%,前列腺不典型增生2例,占2.90%,随机增加穿刺活检检出7例,占10.15%,复检穿刺出前列腺癌3例,占4.35%.结论 前列腺穿刺活检为前列腺癌早期诊断的重要手段,经直肠超声引导定位准确,可随机增加穿刺点,能够提高前列腺癌检出率,无严重并发症.     

Leuprorelin. A review of its pharmacology and therapeutic use in prostatic disorders.

Leuprorelin (leuprolide acetate) is a synthetic analogue of gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH)] which initially stimulates luteinising hormone (LH) and hence testicular androgen release; continuous administration then results in profound suppression of these hormones. Testosterone levels associated with castration are attained within 3 to 4 weeks. A biodegradable subcutaneous or intramuscular depot formulation of leuprorelin 3.75 or 7.5 mg, which releases the drug at a constant rate over 28 days, is available and may be preferred over daily subcutaneous injections. The progression of previously untreated advanced prostatic cancer is delayed in 70 to 90% of men receiving leuprorelin, with median survival of approximately 2 years. The efficacy of leuprorelin is equivalent to that of estrogen therapy, but the tolerability of the GnRH analogue is far better. In contrast to most other studies of GnRH agonists, a slight survival advantage has been reported for combined treatment with leuprorelin and the antiandrogen flutamide. Small noncomparative trials reveal that leuprorelin also causes regression of benign hyperplastic prostate tissue with corresponding relief of obstructive, but not irritative, symptoms although continuous treatment is necessary to maintain remission. Impotence and flushing occur in most leuprorelin recipients but, unlike diethylstilbestrol (stilboestrol), cardiovascular toxicity and gynaecomastia are not significant problems. Symptom flare, usually manifested as bone pain in prostate cancer patients and exacerbation of obstructive symptoms in those with benign prostatic hypertrophy, can occur in 4 to 29% at the beginning of treatment. Leuprorelin treatment is therefore an established effective palliative measure in men with previously untreated advanced prostatic cancer, and may have a role in those with benign hypertrophy who are unfit for surgery.     

伴原发不孕症的子宫腺肉瘤临床病理分析

目的：探讨伴原发性不孕症的子宫腺肉瘤临床病理特点及误诊分析。方法观察分析2例伴原发不孕症的子宫腺肉瘤临床表现、病理特点。结果患者年龄分别为29岁和31岁，主要表现为不规则子宫出血及宫腔占位；组织学特征为良性子宫内膜腺体伴肉瘤性间质，其中1例合并有高级别子宫内膜间质肉瘤，另1例伴肉瘤成分过度生长。2例均采用全子宫＋双侧附件＋盆腔淋巴结清扫治疗，术后在随访中。结论子宫腺肉瘤常发生于中老年妇女，伴原发性不孕症的病例尚未见报道。作者认为，不孕症的原因除与宫腔占位有关外，下丘脑-垂体-卵巢轴的协调功能紊乱与不孕症和腺肉瘤的发生相关。     

铁蛋白轻链在前列腺癌中的表达及意义

目的：研究 FLC 在前列腺癌与前列腺增生中的表达及临床意义。方法采用免疫组织化学方法,对前列腺癌和前列腺增生患者病理切片进行组化检测;采用蛋白质印迹法对收集的前列腺癌和前列腺增生患者术后标本进行蛋白定量。结果 FLC 蛋白在前列腺癌和前列腺增生中过表达率分别是63．3％和20％,差异有统计学意义（P ＜0．05）;FLC 蛋白在年龄、术前 PSA、前列腺体积、Gleason 评分、临床分期、淋巴结转移各分组中差异无统计学意义（P ＞0．05）;在远处转移各分组中 FLC 蛋白表达水平差异有统计学意义（P ＜0．05）。前列腺癌组与前列腺增生组 FLC 蛋白表达水平分别为（1．52±0．27）和（0．41±0．21）,差异有统计学意义（P ＜0．05）。结论 FLC 蛋白在前列腺癌中高表达,可以作为前列腺癌新的诊断手段;FLC 蛋白在前列腺癌的发展过程中起重要作用。