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Colorectal cancer (CRC) is the most common gastrointestinal malignancy worldwide. The poor specificity and sensitivity of the fecal occult blood test has prompted the development of CRC-related genetic markers for CRC screening and treatment. Gene expression profiles in stool specimens are effective, sensitive and clinically applicable. Herein, a novel advantage of using cells shed from the colon is presented for cost-effective CRC screening. Molecular panels were generated through a series of leave-one-out cross-validation and discriminant analyses. A logistic regression model following reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry was used to validate a specific panel for CRC prediction. The panel, consisting of ubiquitin-conjugating enzyme E2 N (UBE2N), inosine monophosphate dehydrogenase 1 (IMPDH1), dynein cytoplasmic 1 light intermediate chain 1 (DYNC1LI1) and phospholipase A and acyltransferase 2 (HRASLS2), accurately recognized patients with CRC and could thus be further investigated as a potential prognostic and predictive biomarker for CRC. UBE2N, IMPDH1 and DYNC1LI1 expression levels were upregulated and HRASLS2 expression was downregulated in CRC tissues. The predictive power of the panel was 96.6% [95% confidence interval (CI), 88.1-99.6%] sensitivity and 89.7% (95% CI, 72.6-97.8%) specificity at a predicted cut-off value at 0.540, suggesting that this four-gene panel testing of stool specimens can faithfully mirror the state of the colon. On the whole, the present study demonstrates that screening for CRC or cancer detection in stool specimens collected non-invasively does not require the inclusion of an excessive number of genes, and colonic defects can be identified via the detection of an aberrant protein in the mucosa or submucosa.
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Prostate cancer is a common clinical disease in men. It is known that prostate cancer ranks 3rd in the incidence of malignant tumors of the male genitourinary system in China, which is able to evaluate the riskiness of life expectancy of male patients. Therefore, we investigated the expression of CD133, recombinant human kallikrein 3 (Klk3), grainy head like 2 (grhl2) in prostate cancer, and correlation with tumor characteristics in the present study. A total of 167 prostate cancer patients who underwent surgical treatment in our hospital from February 2017 to April 2021 were selected. Their cancer and adjacent tissues were resected, and CD133 was detected by double staining using immunohistochemistry, Klk3 and grhl2 were detected by RT-PCR analysis, and CD133, Klk3 were analyzed by Pearson's method in different clinical stages, Gleason grade Correlation of grhl2 with tumor characteristics. The expression of CD133, KLK3, and GRHL2 in cancer tissue was increased compared with adjacent tissue (P < 0.05). The expression of CD133, KLK3, and GRHL2 increased with the aggravation of the clinical stage and Gleason grade (P < 0.05). CD133, KLK3, and GRHL2 showed a positive correlation in prostate cancer. The Pearson method found a positive correlation between CD133, KLK3, GRHL2 and clinical stage, Gleason grade, and lymph node metastasis. In general, high CD133, Klk3, and grhl2 expression was observed in prostate cancer and increased with the disease. They presented a positive correlation in prostate cancer presence, and these three gene products correlated with tumor characteristics.
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Antígeno AC133 , Proteínas de Unión al ADN , Calicreínas , Antígeno Prostático Específico , Neoplasias de la Próstata , Factores de Transcripción , Antígeno AC133/genética , China , Proteínas de Unión al ADN/genética , Humanos , Inmunohistoquímica , Calicreínas/genética , Masculino , Clasificación del Tumor , Antígeno Prostático Específico/genética , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patología , Factores de Transcripción/genéticaRESUMEN
Stem cell-based therapy has been evaluated in many different clinical trials for various diseases. This capability was applied in various neurodegenerative diseases, such as multiple sclerosis, which is characterized by demyelination, axonal injury, and neuronal loss. Dental pulp stem cells (DPSCs) are mesenchymal stem cells from the oral cavity that have been studied with potential application for the regeneration of different tissues. Heat shock protein 27 (HSP27) regulates neurogenesis in the process of neural differentiation of placenta multipotent stem cells. Here, we hypothesize that HSP27 expression is also critical for the neural differentiation of DPSCs. An evaluation of the possible role of HSP27 in the differentiation of DPSCs was performed using gene knockdown and neural immunofluorescent staining. We found that HSP27 played a role in the differentiation of DPSCs and that knockdown of HSP27 in DPSCs rendered cells to oligodendrocyte progenitors; i.e., small hairpin specific for HSP27 DPSCs exhibited NG2-positive immunoreactivity and gave rise to oligodendrocytes or type-2 astrocytes. This neural differentiation of DPSCs may have clinical significance in the treatment of patients with neurodegenerative diseases. In conclusion, our data provide an example of the oligodendrocyte differentiation of a DPSC model, which may be applied in human regenerative medicine.
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Pulpa Dental , Proteínas de Choque Térmico HSP27 , Diferenciación Celular/fisiología , Proliferación Celular/fisiología , Células Cultivadas , Proteínas de Choque Térmico HSP27/genética , Proteínas de Choque Térmico HSP27/metabolismo , Humanos , Oligodendroglía , Células MadreRESUMEN
Little is known about genes that induce stem cells differentiation into astrocytes. We previously described that heat shock protein 27 (HSP27) downregulation is directly related to neural differentiation under chemical induction in placenta-derived multipotent stem cells (PDMCs). Using this neural differentiation cell model, we cross-compared transcriptomic and proteomic data and selected 26 candidate genes with the same expression trends in both omics analyses. Those genes were further compared with a transcriptomic database derived from Alzheimer's disease (AD). Eighteen out of 26 candidates showed opposite expression trends between our data and the AD database. The mRNA and protein expression levels of those candidates showed downregulation of HSP27, S100 calcium-binding protein A16 (S100A16) and two other genes in our neural differentiation cell model. Silencing these four genes with various combinations showed that co-silencing HSP27 and S100A16 has stronger effects than other combinations for astrocyte differentiation. The induced astrocyte showed typical astrocytic star-shape and developed with ramified, stringy and filamentous processes as well as differentiated endfoot structures. Also, some of them connected with each other and formed continuous network. Immunofluorescence quantification of various neural markers indicated that HSP27 and S100A16 downregulation mainly drive PDMCs differentiation into astrocytes. Immunofluorescence and confocal microscopic images showed the classical star-like shape morphology and co-expression of crucial astrocyte markers in induced astrocytes, while electrophysiology and Ca2+ influx examination further confirmed their functional characteristics. In conclusion, co-silencing of S100A16 and HSP27 without chemical induction leads to PDMCs differentiation into functional astrocytes.
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Astrocitos , Proteínas de Choque Térmico HSP27 , Células Madre Multipotentes , Astrocitos/metabolismo , Proteínas de Unión al Calcio/metabolismo , Proteínas de Unión al Calcio/farmacología , Femenino , Proteínas de Choque Térmico HSP27/genética , Proteínas de Choque Térmico HSP27/metabolismo , Proteínas de Choque Térmico HSP27/farmacología , Humanos , Células Madre Multipotentes/citología , Células Madre Multipotentes/metabolismo , Placenta/citología , Placenta/metabolismo , Embarazo , Proteómica , Proteínas S100/genética , Proteínas S100/metabolismoRESUMEN
The COVID-19 pandemic has raised awareness about various environmental issues, including PM2.5 pollution. Here, PM2.5 pollution during the COVID-19 lockdown was traced and analyzed to clarify the sources and factors influencing PM2.5 in Guangzhou, with an emphasis on heavy pollution. The lockdown led to large reductions in industrial and traffic emissions, which significantly reduced PM2.5 concentrations in Guangzhou. Interestingly, the trend of PM2.5 concentrations was not consistent with traffic and industrial emissions, as minimum concentrations were observed in the fourth period (3/01-3/31, 22.45 µg/m3) of the lockdown. However, the concentrations of other gaseous pollutants, e.g., SO2, NO2 and CO, were correlated with industrial and traffic emissions, and the lowest values were noticed in the second period (1/24-2/03) of the lockdown. Meteorological correlation analysis revealed that the decreased PM2.5 concentrations during COVID-19 can be mainly attributed to decreased industrial and traffic emissions rather than meteorological conditions. When meteorological factors were included in the PM2.5 composition and backward trajectory analyses, we found that long-distance transportation and secondary pollution offset the reduction of primary emissions in the second and third stages of the pandemic. Notably, industrial PM2.5 emissions from western, southern and southeastern Guangzhou play an important role in the formation of heavy pollution events. Our results not only verify the importance of controlling traffic and industrial emissions, but also provide targets for further improvements in PM2.5 pollution.
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Contaminantes Atmosféricos , Contaminación del Aire , COVID-19 , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , China/epidemiología , Control de Enfermedades Transmisibles , Monitoreo del Ambiente , Humanos , Pandemias , Material Particulado/análisis , SARS-CoV-2RESUMEN
Various pain conditions may be associated with depressed mood. However, the effect of inflammatory or neuropathic pain on depression-like behavior and its associated time frame has not been well established in rat models. This frontward study investigated the differences in pain behavior, depression-like behavior, and serotonin transporter (SERT) distribution in the brain between rats subjected to spared nerve injury (SNI)-induced neuropathic pain or complete Freund's adjuvant (CFA)-induced inflammatory pain. A dynamic plantar aesthesiometer and an acetone spray test were used to evaluate mechanical and cold allodynia responses, and depression-like behavior was examined using a forced swimming test and sucrose preference test. We also investigated SERT expression by using positron emission tomography. We found that the inflammation-induced pain was less severe than neuropathic pain from days 3 to 28 after induced pain; however, the CFA-injected rats exhibited more noticeable depression-like behavior and had significantly reduced SERT expression in the brain regions (thalamus and striatum) at an early stage (on days 14, 21, and 28 in two groups of CFA-injected rats versus day 28 in SNI rats). We speculated that not only the pain response after initial injury but also the subsequent neuroinflammation may have been the crucial factors influencing depression-like behavior in rats.
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BACKGROUND: Alzheimer's disease (AD) is a prevalent progressive neurodegenerative human disease whose cause remains unclear. Numerous initially highly hopeful anti-AD drugs based on the amyloid-ß (Aß) hypothesis of AD have failed recent late-phase tests. Natural aging (AG) is a high-risk factor for AD. Here, we aim to gain insights in AD that may lead to its novel therapeutic treatment through conducting meta-analyses of gene expression microarray data from AG and AD-affected brain. METHODS: Five sets of gene expression microarray data from different regions of AD (hereafter, ALZ when referring to data)-affected brain, and one set from AG, were analyzed by means of the application of the methods of differentially expressed genes and differentially co-expressed gene pairs for the identification of putatively disrupted biological pathways and associated abnormal molecular contents. RESULTS: Brain-region specificity among ALZ cases and AG-ALZ differences in gene expression and in KEGG pathway disruption were identified. Strong heterogeneity in AD signatures among the five brain regions was observed: HC/PC/SFG showed clear and pronounced AD signatures, MTG moderately so, and EC showed essentially none. There were stark differences between ALZ and AG. OXPHOS and Proteasome were the most disrupted pathways in HC/PC/SFG, while AG showed no OXPHOS disruption and relatively weak Proteasome disruption in AG. Metabolic related pathways including TCA cycle and Pyruvate metabolism were disrupted in ALZ but not in AG. Three pathogenic infection related pathways were disrupted in ALZ. Many cancer and signaling related pathways were shown to be disrupted AG but far less so in ALZ, and not at all in HC. We identified 54 "ALZ-only" differentially expressed genes, all down-regulated and which, when used to augment the gene list of the KEGG AD pathway, made it significantly more AD-specific.
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To sustain gene delivery and elongate transgene expression, plasmid DNA and cationic nonviral vectors can be deposited through layer-by-layer (LbL) assembly to form polyelectrolyte multilayers (PEMs). Although these macromolecules can be released for transfection purposes, their entanglement only allows partial delivery. Therefore, how to efficiently deliver immobilized genes from PEMs remains a challenge. In this study, we attempt to facilitate their delivery through the pretreatment of the external electrical field. Multilayers of polyethylenimine (PEI) and DNA were deposited onto conductive polypyrrole (PPy), which were placed in an aqueous environment to examine their release after electric field pretreatment. Only the electric field perpendicular to the substrate with constant voltage efficiently promoted the release of PEI and DNA from PEMs, and the higher potential resulted in the more releases which were enhanced with treatment time. The roughness of PEMs also increased after electric field treatment because the electrical field not only caused electrophoresis of polyelectrolytes and but also allowed electrochemical reaction on the PPy electrode. Finally, the released DNA and PEI were used for transfection. Polyplexes were successfully formed after electric field treatment, and the transfection efficiency was also improved, suggesting that this electric field pretreatment effectively assists gene delivery from PEMs and should be beneficial to regenerative medicine application.
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Dexmedetomidine, an α-2 adrenergic receptor agonist, provides analgesia, sedation, anxiolysis, sympatholysis and anesthetic-sparing effect, without inducing significant respiratory depression. Due to these properties, its clinical use is no longer limited to serving as a sedative agent in the intensive care unit. Proper airway management and the avoidance of cardiac and respiratory complications are common goals of everyday anesthesia practice. Ensuring airway safety is pivotal during the anesthesia stages of induction, maintenance and recovery. In this review, we focus on the advantages of dexmedetomidine in awake fiberoptic intubation (AFOI), diagnostic examinations and surgeries of patients with obstructed airways, and reducing emergence delirium effectively without causing further adverse events. With increasing implementation in different anesthetic scenarios, dexmedetomidine provides a favorable option to enhance patient safety and comfort.
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Agonistas de Receptores Adrenérgicos alfa 2/farmacología , Obstrucción de las Vías Aéreas/cirugía , Dexmedetomidina/farmacología , Delirio/prevención & control , Dexmedetomidina/efectos adversos , Dexmedetomidina/farmacocinética , Tecnología de Fibra Óptica , Humanos , Seguridad del Paciente , Atención PerioperativaRESUMEN
OBJECTIVE: To compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery. DESIGN: A randomized controlled study. SETTING: Single-center university teaching hospital. PARTICIPANTS: The study comprised 80 patients who were 18 years or older requiring lung isolation for surgery. INTERVENTIONS: After institutional review board approval, patients were randomized prior to surgery to either DLT or VDLT usage. Attending anesthesiologists placed the Mallinckrodt DLT or Vivasight (ET View Ltd, Misgav, Israel) VDLT with conventional laryngoscopy or video laryngoscopy then verified correct tube position through the view provided with either VDLT external monitor or FOB. MEASUREMENTS AND MAIN RESULTS: Data collected included: sex, body mass index, successful intubation and endobronchial placement, intubation time, confirmation time of tube position, FOB use, quality of view, dislodgement of tube, and ability to forewarn dislodgement of endobronchial cuff and complications. FOB use for verification of final position of the tube (VDLT 13.2% [5/38] v DLT 100% [42/42], p < 0.0001), need for FOB to correct the dislodgement (VDLT 7.7% [1/13] v DLT 100% [14/14], p < 0.0001), dislodgement during positioning (VDLT 61.5% [8/13] v DLT 64.3% [9/14], p = ns), dislodgement during surgery (VDLT 38.5% [5/13] v DLT 21.4% [3/14], p = ns), and ability to forewarn dislodgement of endobronchial cuff (VDLT 18.4% [7/38] v DLT 4.8% [2/42], p = 0.078). CONCLUSION: This study demonstrated a reduction of 86.8% in FOB use, which was a similar reduction found in other published studies.
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Broncoscopía/instrumentación , Diseño de Equipo/instrumentación , Tecnología de Fibra Óptica/instrumentación , Intubación Intratraqueal/instrumentación , Cirugía Torácica Asistida por Video/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Broncoscopía/métodos , Diseño de Equipo/métodos , Femenino , Tecnología de Fibra Óptica/métodos , Humanos , Intubación Intratraqueal/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cirugía Torácica Asistida por Video/métodos , Adulto JovenRESUMEN
BACKGROUND: Liver fibrosis is the response of liver diseases that puzzles patients. MiRNAs were involved in the regulating processes of liver fibrosis. This study aims to investigate the effects of ARRB1 mediated by miR-29a and miR-652 on liver fibrosis and its possible mechanism. METHODS: Liver fibrosis of mice was induced by intraperitoneal injection of CCl4. Liver function was observed by the levels of alanine transaminase (ALT) and aspartate transaminase (AST). Flow cytometry was used to detect the percent of T helper17 (Th17). ELISA (Enzyme linked immunoassay) was used to detect the levels of Interleukin-17 (IL-17) and Interleukin-22 (IL-22). Real-time PCR was used to detect the expression of IL-17A, IL-22, miR-29a, miR-652 and ß-Arrestin 1 Gene (ARRB1). Western blot was used to detect the protein expression of ARRB1. RESULTS: CCl4 supplementation significantly increased the level of ALT and AST, the percent of Th17, the level of IL-17A, IL-22, miR-29a and miR-652, but decreased ARRB1. Overexpression of miR-29a/miR-652 prominently decreased Th17, IL-17A, IL-22 and ARRB1 in the normal CD4+ T cells. Both miR-29a and miR-652 targeted ARRB1 to regulate its expression. The effects of miR-29a/miR-652 overexpression on CD4+ T cells were reversed by ARRB1 overexpression. In vivo experiments demonstrated the protective role of miR-29a/miR-652 overexpression on liver fibrosis. CONCLUSION: ARRB1 mediated by miR-29a and miR-652 probably involved in the CD4+ T cells differentiation in patients with liver fibrosis, and functioned as a biomarker of fibrosis liver.Key words: liver fibrosis, miR-29a, miR-652, ARRB1, CD4+ T cells.
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Linfocitos T CD4-Positivos/citología , Linfocitos T CD4-Positivos/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Cirrosis Hepática/tratamiento farmacológico , MicroARNs/genética , Animales , Tetracloruro de Carbono , Diferenciación Celular/genética , Células Cultivadas , Cirrosis Hepática/inducido químicamente , Cirrosis Hepática/genética , Masculino , Ratones , Ratones Endogámicos C57BL , MicroARNs/farmacologíaRESUMEN
BACKGROUND: Calculus pyonephrosis is difficult to manage. The aim of this study is to explore the value of a patented suctioning sheath assisted minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of calculus pyonephrosis. METHODS: One hundred and eighty two patients with calculus pyonephrosis were randomizely divided into observation group (n = 91) and control group (n = 91). The control group was treated with MPCNL traditionally using peel-away sheath while the observation group was treated with MPCNL using the patented suctioning sheath. RESULTS: All the patients in the observation group underwent one stage surgical treatment, 14 patients in the control group underwent first-stage surgery with the rest of the group underwent one stage surgery. The complication rate was 12.1% in the observation group, significantly lower than the rate in the control group which was 51.6%; One surgery stone clearance in the observation group was 96.7% while it was 73.6% in the control group; operative time in the observation group was (54.5 ± 14.5) min, compared to (70.2 ± 11.7) min in the control group; the bleeding amount in the observation group was (126.4 ± 47.2) ml, compared to (321.6 ± 82.5) ml in the control group; the hospitalization duration for the observation group was (6.4 ± 2.3) days, compared to (10.6 ± 3.7) days in the control group. Comparison of the above indicators, the observation group was better than the control group with significant difference (p < 0.001 each). CONCLUSIONS: Minimally invasive percutaneous nephrolithotomy with the aid of the patented suctioning sheath in the treatment of calculus pyonephrosis in one surgery is economic, practical, and warrants clinical promotion. TRIAL REGISTRATION: This study was registered with Chinese Clinical Trial Registry on May 18, 2016 (retrospective registration) with a trial registration number of ChiCTR-IOR-16008490 .
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Cálculos Renales/cirugía , Nefrostomía Percutánea/instrumentación , Nefrostomía Percutánea/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Cálculos Renales/complicaciones , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Pionefrosis/etiología , Succión/instrumentación , Adulto JovenRESUMEN
BACKGROUND: Flexible ureteroscopic lithotripsy (URS) is rapidly becoming a first-line therapy for patients with renal and ureteral calculi. Most current medical infusion devices can only monitor infusion flow and pressure, but not renal pelvic pressure (RPP). PATIENTS AND METHODS: We designed a patented intelligent system to facilitate flexible URS that included an irrigation and suctioning platform and a ureteral access sheath (UAS) with a pressure-sensitive tip, enabling regulation of the infusion flow precisely and control of the vacuum suctioning by computerized real-time recording and monitoring of RPP. A stable RPP was ensured by pressure feedback technology. Ninety-three patients with renal or ureteral calculi participated in the study and received flexible URS. Gravel particles were sucked out automatically during the flexible URS. Patients were evaluated on postoperative days 1 and 30 by X-ray of kidneys, ureters, and bladder to assess stone-free status. RESULTS: In 81 of the 93 patients, only one surgery was needed to remove the stone. There were nine cases who failed the first surgery due to difficulty in placing the UAS, but flexible URS was performed in these patients after indwelling a Double-J stent to the ureter with the calculus for 2 weeks. Three cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis. For the 90 patients who underwent flexible URS, the actual RPP was controlled under 20 mmHg with clear operative visualization. The stone-free rates at postoperative days 1 and 30 were 90.0% (81/90) and 95.6% (86/90), respectively. Clavien I complications were noted in 13 cases, while Clavien II complications were noted in two cases. No major complications (Clavien III-V) were noted. CONCLUSIONS: Our patented system is technically feasible, safe, and efficient for treating upper urinary calculi. The advantages include breaking stones effectively and low complication rates because of its automatic control of RPP.
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Cálculos Renales/cirugía , Nefrostomía Percutánea/instrumentación , Stents , Cálculos Ureterales/cirugía , Ureteroscopios , Adulto , Anciano , Diseño de Equipo , Femenino , Humanos , Pelvis Renal , Litotricia , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea/métodos , Presión , Estudios Retrospectivos , Succión , Resultado del Tratamiento , Uréter , Ureteroscopía , Adulto JovenRESUMEN
OBJECTIVE: To investigate the application of intelligent pressure control devices (medical irrigation and suctioning platform with pressure feedback function, and suctioning ureteral access sheath with pressure-measuring function) in flexible ureteroscopy for monitoring and control of renal pelvic pressure. MATERIALS AND METHODS: Nine pigs with a total of 18 kidneys were randomly divided into 3 groups according to varied renal perfusion flow rates: group A, 50 mL/min; group B, 100 mL/min; and group C, 150 mL/min. A ureteral catheter connected to an invasive blood pressure monitor was retrogradely placed to the upper renal calyx to measure upper calyceal pressure; the suctioning sheath was connected to a 3-channel tubing and was connected to an invasive blood pressure monitor; and the platform and renal pelvic outlet pressure was measured. Perfusion flow, intraluminal pressure control, and warning values were preset on the platform. A flexible ureteroscope was inserted into the upper, mid, and lower renal calyces, and to the front end of the sheath, respectively, each location was irrigated for 5 minutes, and pressure was measured every second. RESULTS: No statistical significance was found between monitor renal pelvic outlet pressure and platform renal pelvic outlet pressure for each group, or between platform renal pelvic outlet pressure and upper renal caliceal pressure for each group at different locations when varied irrigation flow rates were used, or among groups for platform renal pelvic outlet pressure at various irrigation flow rates. CONCLUSION: The intelligent devices used in the flexible ureteroscopy can reliably and stably monitor and control the renal pelvic pressure within a safety range.
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Pelvis Renal , Ureteroscopios , Ureteroscopía/métodos , Animales , Presión , Distribución Aleatoria , Succión , PorcinosRESUMEN
INTRODUCTION: In order to better control renal pelvic pressure (RPP), reduce surgical complications and increase operative efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL), we designed an MPCNL with intelligent monitoring and control of RPP and sought to explore its clinical efficacy and characteristics. SUBJECT AND METHODS: This study included 60 patients with renal staghorn calculi. A 5F ureteral catheter was connected to an invasive blood pressure monitor for monitoring and control of RPP. A 12F renoscope was inserted through a percutaneous tract for lithotripsy using a laser, with the help of an intelligent system to monitor RPP continuously, which includes an irrigation and suctioning platform and an integrated intraluminal pressure sensory PCNL suctioning sheath. Before the lithotripsy, intraluminal pressure control value and perfusion flow were set on the platform. RESULTS: RPP was maintained at a range of -12 to 2 mm Hg. The mean operative time was 120 min. The mean intraoperative bleeding amount was 100 ml. Fifty-two of the 60 patients the stones were cleared by one surgery. CONCLUSIONS: In our suctioning MPCNL with the intelligent control of RPP, the intraoperative RPP could be accurately controlled within the preset safety range. The stone clearance rate was high.
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Nefrostomía Percutánea/instrumentación , Nefrostomía Percutánea/métodos , Cálculos Coraliformes/terapia , Adulto , Anciano , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Presión , Estudios Retrospectivos , Succión/instrumentaciónRESUMEN
To describe a novel technique of transurethral seminal vesiculoscopy using a pediatric ureteroscope in the diagnosis and management of persistent hematospermia, a retrospective study was carried out for 20 patients with recurrent hematospermia whom we evaluated and treated using a 6-7.5F (6F front end and 7.5F rear end) pediatric ureteroscope from August 2009 to September 2013. For the 20 patients, the age ranges from 25 to 48 years with a mean age of 36 years. The duration of the hematospermia ranges from 6 to 48 months with a mean duration of 18 months. Transurethral seminal vesiculoscopy was successfully performed in the 20 cases and the mean operative time was 35 min (ranges from 25 to 90 min). Among the 20 patients, 11 patients were found to have seminal vesiculitis, five were with seminal vesicle stone, one was with prostatic utricle stone, one was with prostate cyst, and one was with ejaculatory duct obstruction. The mean follow-up period was 7 months (ranged from 6 to 12 months). Hematospermia in 19 cases disappeared after the surgery and only in one patient the hematospermia recurred 6 months after the surgery. The cure rate was 95%. This study indicated that transurethral seminal vesiculoscopy could be performed easily using a semirigid pediatric ureteroscope with few complications and is an effective therapeutic approach for persistent hematospermia.
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BACKGROUND: There are still disagreements on which is a better approach to choose to establish percutaneous tract for percutaneous nephrolitotomy (PCNL), between supracostal and infracostal approaches. The aim of this study is to investigate the safety, efficacy and practicability of minimally invasive PCNL (MPCNL) with the aid of a patented system either through supracostal or through infracostal access. METHODS: A retrospective study was carried out for 83 patients with renal or upper ureteral stones. Under the guidance of B ultrasound or C-arm, these patients were treated by MPCNL through either 12th rib infracostal (Group 1, 43 cases) or supracostal (Group 2, 40 cases) access approach. These 2 groups were compared for total number of percutaneous tracts, average time in establishing a given percutaneous tract, the number of percutaneous tract used for each case, the average stone clearance time, the clearance rate of all stones by one surgery, and the amount of bleeding using a single percutaneous tract. RESULTS: There was a significantly smaller total number of percutaneous tracts needed, a smaller number of cases that needed two percutaneous tracts to clear stones completely, a shorter average time in establishing a percutaneous tract, and a smaller average amount of bleeding in infracostal access group. At the same time, there were a significantly larger number of cases in which stones were cleared completely using a single percutaneous tract and a higher renal stone clearance rate by one surgery. CONCLUSION: There were several advantages of infracostal access. These included accuracy in establishing a percutaneous tract, safety, quickness, convenience and flexibility in moving the patented sheath, and higher renal and upper ureteral stone clearance rate by one surgery.
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Cálculos Renales/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Nefrostomía Percutánea/instrumentación , Irrigación Terapéutica/instrumentación , Cálculos Ureterales/cirugía , Adulto , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Cálculos Renales/diagnóstico , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Nefrostomía Percutánea/métodos , Patentes como Asunto , Costillas/cirugía , Succión/instrumentación , Succión/métodos , Cirugía Asistida por Computador/instrumentación , Integración de Sistemas , Irrigación Terapéutica/métodos , Resultado del Tratamiento , Cálculos Ureterales/diagnósticoRESUMEN
OBJECTIVE: To explore the efficacy and safety of vitamin D (VD) in the treatment of idiopathic oligoasthenozoospermia. METHODS: This study included 86 infertile men with idiopathic oligoasthenozoospermia, who were randomized to a VD and a control group of equal number, the former given oral VD 200 IU/d and calcium 600 mg/d,qd, while the latter administered oral vitamin E 100 mg and vitamin C 100 mg, tid. After 3 months of medication, we compared the semen parameters, adverse reactions, and pregnancy rate between the two groups. RESULTS: After medication, the count of progressively motile sperm per ejaculate was increased from (9.82 ± 3.72) x 10(6) to (21.47 ± 6.52) x 10(6) ( P < 0.05) and the proportion of progressively motile sperm from (18.41 ± 9.82)% to (28.27 ± 4.47)% (P < 0.05) in the VD group. In comparison, the count of progressively motile sperm per ejaculate was elevated from (9.51 ± 6.31) x 10(6) to (12.36 ± 4.43) x 10(6) (P > 0.05) and the proportion of progressively motile sperm from (17.79 ± 5.25)% to (21.35 ± 2.41)% (P > 0.05) in the control group. Pregnancy was achieved in 7 cases (16.3%) in the VD group, but only lease (2.3%) in the control (P < 0.05). No adverse reactions were observed in either of the groups. CONCLUSION: Vitamin D, as a safe option for the treatment of idiopathic oligoasthenozoospermia, can effectively improve the semen quality, especially the progressive sperm motility of the patient.
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Astenozoospermia/tratamiento farmacológico , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico , Administración Oral , Adulto , Femenino , Humanos , Masculino , Embarazo , Índice de Embarazo , Semen/efectos de los fármacos , Semen/fisiología , Análisis de Semen , Motilidad Espermática/efectos de los fármacos , Vitamina E/uso terapéuticoRESUMEN
OBJECTIVES: Although high abundant cystatin c (CysC) in cerebrospinal fluid (CSF) is well known, its ambiguous role associated with pain still remains unclear. This study evaluated the effects of intrathecal CysC content from chronic pain caused by osteoarthritis (OA) and the novel relationship with matrix metalloproteinases 2 and 9 (MMP2 and MMP9) in CSF. METHODS: Samples of CSF were obtained from 8 elderly patients (65 y and above) with OA with lower limb pain for at least 6 months (OA group) and 8 sex-matched and age-matched relatively healthy elderly individuals without any pain problems (control group). The intrathecal CysC, MMP2, and MMP9 were examined by Western blotting. The analysis of CysC cleavage under different conditions was performed through silver staining and using mass-spectroscopy (SELDI-TOF) on 2 groups. RESULTS: Expression of full-length CysC and pro-MMP2 proteins showed statistically significant upregulation (P=0.0004 vs. 0.03), and expression of MMP9 protein showed downregulation (P=0.007) in the OA group. Both MMP9 and MMP2 initiated the mechanism for full-length CysC cleavage only in the presence of CSF. However, MMP9 showed greater ability than MMP2 for CysC cleavage in control and OA groups in sliver staining. Incubation of CSF with the MMP9 inhibitor led to the suppression of CysC cleavage in SELDI-TOF. DISCUSSION: These findings provide the first in vivo evidence on a relationship between CysC and gelatinases (MMP2 and MMP9), and could facilitate further investigation of novel interactions among these proteins within the proteomics field, especially protein-protein interactions involved in pain.
Asunto(s)
Dolor Crónico/líquido cefalorraquídeo , Dolor Crónico/etiología , Cistatina C/líquido cefalorraquídeo , Metaloproteinasa 9 de la Matriz/líquido cefalorraquídeo , Osteoartritis/complicaciones , Transducción de Señal/fisiología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Regulación hacia Arriba/fisiologíaRESUMEN
OBJECTIVE: To determine an efficient method for treating upper ureteral impacted stones, we compared the outcome of minimally invasive percutaneous nephrolithotomy with the aid of our patented system and transurethral ureteroscopy. MATERIALS AND METHODS: A total of 182 patients with complicated impacted upper ureteral stones above the level of L4 were randomly divided into 2 groups. Group 1 included 91 patients who were treated with minimally invasive percutaneous nephrolithotomy with the aid of a patented system. Group 2 included 91 patients who were treated with ureteroscopy. The patients underwent postoperative shock wave lithotripsy, when necessary. The operative time, stone clearance rate, operative complication markers (amount of intraoperative bleeding and postoperative fever rate), and cost of treatment were compared. RESULTS: A significantly shorter operative time, greater rate of stone clearance, lower need for postoperative shock wave lithotripsy, and lower rate of postoperative fever was found in group 1 than in group 2 (P <.05). However, the cost of treatment and amount of intraoperative bleeding were significantly greater. CONCLUSION: We believe minimally invasive percutaneous nephrolithotomy with the aid of the patented system could be the first choice in treating complicated impacted upper ureteral stones above the level of L4.