An Initial Study Of The Relationship Between Infection,Psychologic Factor And Chronic Prostatitis

Chronic prostatitis (CP) is one of the most common and perplexed diseases in men younger and older. There are diverse symptoms like urinary frequency, urgency, odynuria and hesitancy. And some patients have pains in lumbosacral and hypogastrium area and still many patients may have insomnia, forgetfulness, anxiety and many such symptoms of autonomic nerve functional disorders. Though chronic prostatitis can't threaten the lives of the patients , their life, especially their emotional health, can be greatly affected; meanwhile large quantities of medical resources are wasted . The etiopathogenisis and pathogenesy of chronic prostatitis are still unknown with a lot of problems yet to be solved..Whether Chlamydia trachomatis and mycoplasma urealytium are the pathogen of prostatitis is still in dispute now . The aetiological organisms of prostatitis syndrome suggested to be important in the medical literature include C. trachomatis, U. urealyticum, M. hominis and T. vaginalis. C. trachomatis may originate in the prostate in an unknown percentage of patients with prostatitis syndrome. Chlamydia trachomatis and mycoplasma urealytium may infect the male urethra of patients through direct sexual contact and then diffuse to prostate along the urethra .In our modern society , the number of the patients of CP with psychological obstacle are increasing with the increase of mental stress .The major symptoms of CP with psychological obstacle are anxiety ,depression ,hypochondria ,fear ,hysteria andsuicide tendency.On the whole , the etiological factors of CP are extremely complicated, and the major factors may be infection .inflammation, and psychological factor. For this reason, it is only one-sided and unreasonable to emphasize only one factor to explain the numerous and complicated clinical symptoms.A STUDY ON BACTERIAL 16SrRNA GENE IN EPS OF MEN WITH CPPSObjectiveThe pathogen of CP is uncertain .We can't detect every pathogenic bacteria with PCR (polymerase chain reaction ) to decide what's the infected pathogen .16S rRNA is the gene order of bacteria chromosome encoding rDNA .Some of the 16SrRNA tracts are owned by all bacterium with a highly conserved region .For this reason ,the 16SrRNA gene is called bacterial fossil .The bacteria can be directly detected according to the level of gene with a polymerase chain reaction (PCR ).On this account ,we design the study to investigate the role of bacteria in the morbidity of chronic prostatitis (CP ). Methods1. Clinical dataThe patients were taken from the outpatient surgery of Qilu Hospital Affiliated to Shandong University ,and 135 cases of chronic prostatitis ,18 cases of infertility.21 cases of control group were from postgraduates of medical school of Shandong University.2. According to diagnostic criteria, some patients are chosen in this study .(1) The following data were obtained from each patient: medical history, clinical status including rectal prostatic examination, selective samples of urine, and EPS (expressed prostatic secretion), according to the 4-glass localization test (Meares and Stamey's localization technique).Two EPS samples from each patient ,onewas sent to the gene room for PCR and the other to the laboratory for bacterial culture and routine examination .(2) Cell lysis and PCR amplification(3) AGE (agarose gel electrophoresis)(4) Result analysisThe amplification products were examined by electrophoresis in a 2% agarose gel and 1 X TBE buffer and documented with the Multilmage-Light-Cabinet. If signal strap of 373bp was obtained and no signal strap in negative contrast, the result was positive, otherwise negative.(5) Antimicrobial treatmentPatients were randomized to receive quinolones like Lelang,Woerde medicines and Chinese formulated products like Ningmitai,Wonglitong. After 3 months treatment, the curative effect was evaluated with NIH-CPSI and compared with that of pretherapy. 3 Statistic analysisThe SPSS Chi-Square test, t test and Logistic regression analysis program were used for statistic analysis .Significance was considered as PO.05. ResultsOf the 135 CPPS patients, positive 16SrRNA signals were detected in 78 samples, negative in 57 samples. The positive 16SrRNA signals were detected in 3 samples of the health control, negative in 18 samples of the group. Of 18 the infertility 6 were positive , negative in 12 .No 16 SrRNA signal was detected in any of the selective sample of urine before prostatic massage. Of 135 CPPS patients, UU was detected in 30 cases, and 11 being positive of bacterial culture. Significant difference was seen in positive rate between CPPS group and health control group .Significant difference of curative effect was seen in improvement between positive 16 SrRNA signal and negative group. ConclusionA molecular method for the detection of bacteria strains based on 16S rRNA sequence analysis was developed by a modification of the previously described PCRprimer. Bacteria can be defined by detecting 16 SrRNA with PCR in clinical practice .This is a method of speed ,sensitivity ,and specificity using highly conserved sequences of bacteria 16 SrRNA. We hope that the results of this study will help physicians to select the proper antimicrobial therapy for the patients of CPPS .In our findings, bacteria 16 SrRNA can be detected in the EPS of most CPPS patients. Our findings indicate that bacteria play an important role in chronic prostatitis .We also hope that the results of this study will encourage further research into the role of bacteria in all categories of prostatitis syndrome.PART 2: A STUDY ON THE RELATIONSHIP OF UU AND CT AND CHRONIC PROSTATITISAbstract ObjectiveTo investigate the situation of infection of Ureaplasma urealyticum(UU) and Chlamydia trachomatis(CT) in chronic prostatitis(CP) patients, and study the causes of chronic prostatitis and improve the methods of treatment.MethodsChlamydia trachomatis (CT) and Ureaplasma Urealyticum (UU) were detected by fluorogenic quantitative PCR in 1708 patients' prostatic fluid with CP.ResultsTotal infectious rate of UU and CT wasl6.51% .The positive rates of CT and UU infection were 5.15% and 23% respectively.ConclusionThe results indicate that UU and CT are important pathogens of CP, because of the high detection rate of UU and CT in CP patients. The highest detection rate washappened in the age group of CP patients from 25 to 35 years old .It may be relate with the prosperity sexual activity of CP. Fluorogenic quantitative PCR is a fast, sensitive clinic technology in diagnosis of CP and popularized worthfully.PART 3: A STUDY ON THE RELATIONSHIP OFPSYCHOLOGIC FACTOR ANDCHRONIC PROSTATITISAbstractObjectiveTo improve the knowledge of psychological hindrance of CP and study the treatment of it.Methods258 patients of CP with psychological hindrance, aged 16 to 65 years (average age 33 years), were divided into the psychotherapy group and the control. 148 cases in the psychotherapy and 110 cases in the control, the control was only treated with antibiotics and Chinese traditional medicines, while the psychotherapy was treated with cognitive therapy besides the medicines used above.ResultsThe symptoms showing in the psychotherapy group were improved obviously compared with that in the control. The cure rate (P<0.05) of psychotherapy was higher than that of the control as well as the effective rate (PO.001).ConclusionChronic prostatitis is a common, often chronic condition in which psychological factors are suspected to play a role. The results indicate depression and psychosocial distress are common among chronic prostatitis patients, calling for careful evaluation and attention to psychological symptoms .It is an effective way to treat CP patientswith psychological hindrance by psychotherapy.