Stevensonmohammad2343

e oligospermia, with no obvious adverse events.Objective To investigate the status quo of the diagnosis and treatment of male urethritis (MU) in urology and andrology. METHODS According to The Guidelines for Clinical Diagnosis and Treatment of Sexually Transmitted Diseases (2017), we designed 27 questions on the prevalence, diagnosis, treatment, and prognosis of MU. Using these questions, we conducted a questionnaire investigation among urological, andrological and other relevant clinicians with different professional titles, followed by an analysis of the compliance of the doctors to the Guidelines. RESULTS Totally, 116 valid questionnaires were collected from 86 urological, 28 andrological and 2 other relevant doctors, including 22 professors, 36 associate professors, 40 attending doctors and 16 resident doctors. MU was found mostly in those aged 20－40 years and more than half of the patients had a history of unclean sex, gonococcal urethritis significantly less prevalent than non-gonococcal, with Ureaplasma urealyticum as the most common pathogen of no azithromycin for non-gonococcal urethritis (P 0.05), and that of non-gonococcal urethritis was 86.36% by professors, 61.11% by associate professors, 62.50% by attending doctors and 37.50% by resident doctors (P less then 0.05). CONCLUSIONS Urological and andrological clinicians do not strictly follow the Guidelines in the diagnosis and treatment of male urethritis. There are significant differences in the dosing of azithromycin and results of treatment of non-gonococcal urethritis among doctors with different professional titles, but not in the other aspects.Objective To investigate the clinical feasibility and effect of nerve-sparing robot-assisted laparoscopic radical cystectomy (NSRA-LSRC). METHODS We retrospectively reviewed the clinical data on 12 cases of NSRA-LSRC performed from March 2016 to May 2018. The patients were aged 45 to 65 years old and all potent before surgery, with a mean IIEF-5 score of >17. The surgical procedure involved excision of the bladder and prostate and dissection of the pelvic lymph nodes, with preservation of the bilateral neurovascular bundles, internal accessory pudendal artery and pubic bladder complex. All the patients were advised to take PDE5I postoperatively and followed up for the sexual function with the IIEF-5 scores. RESULTS Surgical procedures were completed successfully, all with negative surgical margins. Postoperative pathology confirmed invasive high-grade urothelial carcinoma or carcinoma in situ in all the cases, including 11 cases in stage T2N0M0 or below and 1 case in stage T3aN0M0. There were no serious intraoperative or postoperative complications, nor recurrence or metastasis during the follow-up period of 12－36 (20.7 ± 8.0) months. The IIEF-5 scores of the patients at 3, 6 and 12 months after operation were 10.9 ± 6.9, 12.3 ± 6.9 and 14.1 ± 8.0, respectively. At 12 months, satisfactory sexual intercourse was achieved with the help of potency-enhancing medicine in 5 cases (41.7%), penile erection insufficient for sexual intercourse in 3 cases (25%), and no erection in 4 cases (33.3%). CONCLUSIONS Nerve-sparing robot-assisted laparoscopic radical cystectomy can maximally preserve the sexual function of the patients with urinary bladder carcinoma.Objective To assess the value of transrectal shear wave elastography (SWE) in improving the detection of PCa and differentiating benign from malignant prostatic lesion. METHODS We performed transrectal ultrasonography (TRUS) and SWE for 83 PCa-suspected patients and measured the maximum (Emax) and mean elastic modulus (Emean) of the lesions. In addition to conventional "6+X" puncture, we conducted SWE-guided prostate puncture and evaluated SWE in improving the detection rate of PCa based on the pathological results. Then, we obtained the threshold value of the Emax using the ROC curve and analyzed its correlation with the clinicopathological data. RESULTS SWE-guided puncture was completed in all the 83 patients, of whom 31 were pathologically diagnosed with PCa and the other 52 with BPH. Compared with the BPH patients, the men with PCa showed significantly higher values of Emax (［47.13 ± 9.95］ vs ［63.70 ± 14.29］ kPa, P less then 0.05) and Emean (［33.25 ± 4.61］ vs ［43.04 ± 8.57］ kPa, P less then 0.05). The area under the ROC curve of Emax was 0.913, with a sensitivity of 90.1% and a specificity of 80.2%, with 54.15 kPa as the diagnostic threshold. The positive rates of PCa detected by SWE-guided puncture and single-needle puncture were 32.53% and 72.38%, respectively, significantly higher than 28.92% and 17.27% by TRUS-guided puncture and single-needle puncture (P less then 0.05). Compared with TRUS, SWE exhibited a remarkably higher sensitivity (54.84% vs 80.65%, P less then 0.05), specificity (67.31% vs 86.54%, P less then 0.05), accuracy (62.65% vs 84.34%, P less then 0.05), positive predictive value (50.00% vs 78.13%, P less then 0.05) and negative predictive value (71.43% vs 88.26%, P less then 0.05) in the differential diagnosis of benign and malignant prostatic lesions. Emax was positively correlated with the Gleason scores of the PCa patients. CONCLUSIONS SWE can help determine the biopsy target, improve the detection of PCa and differentiate PCa from BPH.Objective To investigate the effects of triptolide (TP) on the activity of TM3 Leydig cells and the AMPK/Akt/mTOR pathway. click here METHODS We treated TM3 Leydig cells with TP at 50, 100 and 200 nmol/L, respectively, and with 0.1% DMSO as the control, and cultured them in a 37℃ thermostat container for 24 hours. Then we measured the damage to the cell membrane and apoptosis of the cells using lactate dehydrogenase (LDH) activity assay and the apoptosis assay kit, and detected the changes in the AMPK/Akt/mTOR pathway-related proteins by Western blot. RESULTS The LDH activity was significantly increased in the 50, 100 and 200 nmol/L TP groups in a dose-dependent manner compared with that in the DMSO control (［163.4±33.6］%, ［346.8±148.8］% and ［422.8±113.9］% vs ［157.5±20.3］%, P less then 0.01), and so was the apoptosis of the cells (［189.9±73.5］%, ［284±103.5］% and ［419.2±155.7］% vs ［6.27±1.41］%, P less then 0.01). The TP-treated cells showed a significantly decreased p-AMPK/AMPK ratio in comparison with the control (P less then 0.