RESUMEN
Androgen deprivation therapy is the gold standard regimen for advanced Prostate cancer (PCa) patients, nevertheless, patients eventually develop into castration-resistant prostate cancer (CRPC). Currently only a few chemotherapeutics are available for CRPC. Therefore, it is critical for identifying a new drug. In this study, we will explore a new agent, Saikosaponin-d (SSd), for CRPC therapy based on its mechanism of action. DU145 and CWR22Rv1 cells representing CRPC were employed in this study. A series of cell, biochemical, and molecular biologic assays such as Immunofluorescence, Zymography, Sphere formation, Colony formation, and MTT were used. Finally, we find SSd can significantly inhibit the growth of PCa cells in both dose- and time-dependent and suppress the colony formation during a long-term drug administration, it also can inhibit their migration and invasion abilities, which was accompanied by reverse the epithelial-mesenchymal transition (EMT) and suppress MMP2/9 expression as well as activities. Furthermore, SSd can suppress cancer stem cell (CSC) phenotypes such as self-renewal ability. Mechanistically, SSd blocks Wnt/ß-catenin signaling pathway by decreasing GSK3ß phosphorylation to affect EMT and CSC. These findings demonstrate the mechanism of anti-cancer activity of SSd in targeting EMT and CSC, suggesting SSd can be a potent agent for CRPC therapy.
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Carcinoma/prevención & control , Carcinoma/secundario , Células Madre Neoplásicas/efectos de los fármacos , Ácido Oleanólico/análogos & derivados , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Neoplasias de la Próstata Resistentes a la Castración/patología , Saponinas/administración & dosificación , Antineoplásicos Fitogénicos/administración & dosificación , Apoptosis/efectos de los fármacos , Carcinoma/patología , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Estudios de Factibilidad , Humanos , Masculino , Invasividad Neoplásica , Células Madre Neoplásicas/patología , Ácido Oleanólico/administración & dosificaciónRESUMEN
Considerable controversy exists regarding the associations of dietary patterns with the risk of all-cause, CVD and stroke mortality. Therefore, a meta-analysis was conducted to elucidate the potential associations between dietary patterns and the risk of all-cause, CVD and stroke mortality. The PubMed database was searched for prospective cohort studies on the associations between dietary patterns and the risk of all-cause, CVD and stroke mortality published until February 2014. Random-effects models were used to calculate the summary relative risk estimates (SRRE) based on the highest v. the lowest category of dietary pattern scores. Stratified analyses were conducted based on sex, geographical region, follow-up duration, and adjustment/non-adjustment for energy intake. A total of thirteen prospective cohort studies involving 338 787 participants were included in the meta-analysis. There was evidence of inverse associations between the prudent/healthy dietary pattern and the risk of all-cause (SRRE = 0·76, 95% CI 0·68, 0·86) and CVD (SRRE = 0·81, 95% CI 0·75, 0·87) mortality and an absence of association between this dietary pattern and stroke mortality (SRRE = 0·89, 95% CI 0·77, 1·02). However, no significant associations were observed between the Western/unhealthy dietary pattern and the risk of all-cause (SRRE = 1·07, 95% CI 0·96, 1·20), CVD (SRRE = 0·99, 95% CI 0·91, 1·08) and stroke (SRRE = 0·94, 95% CI 0·81, 1·10) mortality. In conclusion, the findings provide evidence that greater adherence to a prudent/healthy dietary pattern is associated with a lower risk of all-cause and CVD mortality and not significantly associated with stroke mortality and that the Western/unhealthy dietary pattern is not associated with all-cause, CVD and stroke mortality. Further studies are required to confirm these findings.
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Enfermedades Cardiovasculares/mortalidad , Dieta , Mortalidad , Accidente Cerebrovascular/mortalidad , Bases de Datos Factuales , Dieta Occidental/efectos adversos , Humanos , Modelos Lineales , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de RiesgoRESUMEN
Long-term ketamine abuse is known to affect the lower urinary tract and produce symptoms of cystitis. However, the pathophysiology and causative mechanism of the changes in bladder function remain unclear. The present study aimed to investigate the existence of ketamine-induced cystitis in a rat model and characterize the underlining mechanisms. Rats were assigned to blank control, normal saline (NS), low-dose ketamine (LK, 5 mg/kg), and high-dose ketamine (HK, 50 mg/kg) groups. The two experimental groups received ketamine hydrochloride daily for 16 weeks. All rats were housed individually for assessment of urinary frequency and urine volume. Urinary biomarkers were measured at different time points. Rat bladders were excised for histopathology, immunohistochemistry, and western blot analysis. Ketamine-treated rats had increased urinary frequency compared to NS-treated rats at Week 16. Urinary nitric oxide and antiproliferative factor levels were increased in ketamine-treated rats within the first 30 h after administration. After long-term ketamine administration, urinary glycoprotein GP51 and potassium levels were decreased in the HK and LK groups compared to the NS group. Ketamine-treated rats showed thickened bladder epithelial layer, increased expression of inducible nitric oxide synthase and occludin, and decreased expression of zonula occludens-1 in the bladder wall. Ketamine, or its urinary metabolites, disrupted the proliferation of bladder epithelial cells, resulting in defected bladder epithelial barrier. Subsequent leakage of urinary potassium causes a stress response in the bladder and provokes cystitis.
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Cistitis/inducido químicamente , Cistitis/metabolismo , Epitelio/efectos de los fármacos , Ketamina/efectos adversos , Trastornos Relacionados con Sustancias/metabolismo , Vejiga Urinaria/efectos de los fármacos , Animales , Biomarcadores/orina , Western Blotting , Relación Dosis-Respuesta a Droga , Técnicas Histológicas , Inmunohistoquímica , Ketamina/administración & dosificación , Ketamina/orina , Ratas , Vejiga Urinaria/citología , OrinaRESUMEN
PURPOSE: We investigated the characteristics and management of patients with intravenous misplacement of a nephrostomy tube. MATERIALS AND METHODS: Between July 2007 and July 2013, 4148 patients with urolithiasis underwent percutaneous nephrolithotomy (PCNL) in our hospital. Intravenous misplacement of a nephrostomy tube occurred in two of these patients. Another patient with intravenous misplacement of a nephrostomy tube, who underwent PCNL in another hospital, was transferred to our hospital. The data of the three patients were retrospectively analyzed. RESULTS: The incidence of intravenous misplacement of a nephrostomy tube following PCNL was 0.5% (2/4148) at our hospital. A solitary kidney was present in one of the three patients. The tip of tube was located into the inferior vena cava (IVC) in two patients and into the renal vein in one patient. All three patients were successfully managed with strict bed rest, intravenous antibiotics and one-step (one patient) or two-step (two patients) tube withdrawal under close monitoring. None of the patients underwent antithrombotic therapy. The original operations were performed successfully under close observation in two patients and changed to another operation in one patient. All patients were discharged uneventfully. CONCLUSIONS: The incidence of intravenous misplacement of a nephrostomy tube following PCNL is 0.5% at our hospital. Intravenous nephrostomy tube misplacement is an uncommon complication of PCNL. A solitary kidney may render patients susceptible to this complication. Most patients may be managed conservatively with strict bed rest, intravenous antibiotics and one-step or two-step tube withdrawal under close monitoring.
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Litotricia/efectos adversos , Nefrostomía Percutánea/efectos adversos , Complicaciones Posoperatorias/diagnóstico , Urolitiasis/cirugía , Adulto , Femenino , Humanos , Litotricia/instrumentación , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea/instrumentación , Complicaciones Posoperatorias/terapia , Venas Renales , Estudios Retrospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos X , Catéteres Urinarios/efectos adversos , Urografía , Vena Cava InferiorRESUMEN
OBJECTIVES: Long-term ketamine abuse can affect the urinary system, resulting in interstitial cystitis-like syndrome. However, its pathogenesis remains unclear. In the present study, a proteomic approach of two-dimensional difference gel electrophoresis followed by matrix-assisted laser desorption/ionization time-of-light mass spectrometry was carried out to investigate the potential disease-associated proteins in a rat model of ketamine-associated cystitis. METHODS: Rats were randomly assigned to control, normal saline, low dose of ketamine (10 mg/kg) and high-dose of ketamine (50 mg/kg) groups with six rats in each group. The two experimental groups were given ketamine hydrochloride i.p. daily, whereas the normal saline group rats were treated with saline. After 16 weeks of treatment, all bladders were excised, and samples from normal saline and high dose of ketamine groups were resolved in two-dimensional difference gel electrophoresis. Differentially expressed spots were excised and identified by matrix-assisted laser desorption/ionization time-of-light mass spectrometry. Phosphoprotein and non-phosphoprotein purification, histopathology, immunohistochemistry, and western blot were carried out in all groups. RESULTS: Histological study showed hyperplastic epithelium and inflammatory cells infiltration in the high dose of ketamine-treated rat bladders. Two-dimensional difference gel electrophoresis revealed 30 altered expressions between the normal saline and high dose of ketamine-treated group. Among these proteins, two upregulated and two downregulated protein spots were all identified as smooth muscle protein-22/transgelin. Immunohistochemical staining and western blot analysis showed that the expression of total transgelin had no significant difference between groups. However, the expression of phosphorylated transgelin in the low-dose and high dose of ketamine groups was increased, whereas the non-phosphorylated transgelin was decreased when compared with the normal saline group. CONCLUSIONS: Long-term ketamine abuse induces phosphorylation of transgelin in the bladder wall, and this might play an important role in the pathogenesis of ketamine-associated cystitis.
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Cistitis/inducido químicamente , Cistitis/metabolismo , Ketamina/farmacología , Proteínas de Microfilamentos/metabolismo , Proteínas Musculares/metabolismo , Vejiga Urinaria/efectos de los fármacos , Vejiga Urinaria/metabolismo , Anestésicos Disociativos/farmacología , Animales , Electroforesis en Gel Bidimensional , Masculino , Proteínas de Microfilamentos/aislamiento & purificación , Proteínas Musculares/aislamiento & purificación , Fosfoproteínas/aislamiento & purificación , Fosfoproteínas/metabolismo , Fosforilación/efectos de los fármacos , Fosforilación/inmunología , Proteómica/métodos , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Vejiga Urinaria/inmunología , Urotelio/efectos de los fármacos , Urotelio/inmunología , Urotelio/metabolismoRESUMEN
Small-incision lenticule extraction (SMILE) is a safe and effective surgical procedure for refractive correction. However, the nomogram from the VisuMax femtosecond laser system often overestimates the achieved lenticule thickness (LT), leading to inaccurate estimation of residual central corneal thickness in some patients. In order to improve the accuracy of predicting achieved LT, we used machine learning models to make predictions of LT and analyze the influencing factors of LT estimation in this study. We collected nine variables of 302 eyes and their LT results as input variables. The input variables included age, sex, mean K reading of anterior corneal surface, lenticule diameter, preoperative CCT, axial length, the eccentricity of the anterior corneal surface (E), diopter of spherical, and diopter of the cylinder. Multiple linear regression and several machine learning algorithms were employed in developing the models for predicting LT. According to the evaluation results, the Random Forest (RF) model achieved the highest performance in predicting the LT with an R2 of 0.95 and found the importance of CCT and E in predicting LT. To validate the effectiveness of the RF model, we selected additional 50 eyes for testing. Results showed that the nomogram overestimated LT by 19.59% on average, while the RF model underestimated LT by -0.15%. In conclusion, this study can provide efficient technical support for the accurate estimation of LT in SMILE.
RESUMEN
OBJECTIVE: To assess the efficacy of dapoxetine on demand for premature ejaculation and provide evidence for clinical decision-making. METHODS: We searched PubMed, Embase, BIOSIS Previews, Cochrane Library, CNKI Database and Wanfang Database for literature on dapoxetine on demand for premature ejaculation. We performed meta-analysis on the identified publications and evaluated its therapeutic efficacy based on the intravaginal ejaculatory latency time (IELT), patient-reported global impression of change (PGI), and composite PRO criteria for clinical benefit (CCCB). RESULTS: Four relevant studies were included involving 6 081 cases of premature ejaculation. Compared with the placebo controls, the patients treated with dapoxetine on demand showed significant improvement in IELT (WMD = 1.39, 95% CI [1.23, 1.55], P < 0.000 01), PGI (OR = 2.59, 95% CI [2.21, 3.04], P < 0. 000 01), and CCCB (OR = 2.59, 95% CI [1.98, 3.39], P < 0.000 01). There were significant differences between the 60 mg and 30 mg dapoxetine groups in IELT (WMD = 0.46, 95% CI [0.19, 0.74], P = 0.001 0) and PGI (OR = 1.32, 95% CI [1.06, 1.64], P = 0.01), but not in CCCB (OR = 1.39, 95% CI [0.90, 2.15], P = 0.13). CONCLUSION: Dapoxetine on demand can prolong IELT and improve PGI and CCCB, either at the dose of 60 mg or 30 mg, and has an even better efficacy in prolonging IELT and improving PGI at 60 mg.
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Bencilaminas/uso terapéutico , Naftalenos/uso terapéutico , Eyaculación Prematura/tratamiento farmacológico , Eyaculación , Humanos , Masculino , Resultado del TratamientoRESUMEN
OBJECTIVE: To summarize the experience in the application of circumcision anastomat in the treatment of phimosis and redundant prepuce in children. METHODS: A total of 551 children with phimosis or redundant prepuce were treated by circumcision from 2008 to 2010, 342 with circumcision anastomat and the other 209 by traditional circumcision. Their clinical data were retrospectively analyzed. RESULTS: Compared with traditional circumcision, circumcision with the anastomat showed the advantages of less operation time (P < 0.05), fewer complications, no need for dressing, and better cosmetic appearance, but it also exhibited the disadvantages of longer healing time (P < 0.05) and more obvious postoperative pain (P < 0.05). CONCLUSION: Circumcision with the anastomat and traditional circumcision for the treatment of phimosis and redundant prepuce in children each have their own advantages and disadvantages, but the former is more advantageous and more feasible clinically.
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Anastomosis Quirúrgica , Circuncisión Masculina/instrumentación , Fimosis/cirugía , Adolescente , Niño , Circuncisión Masculina/métodos , Humanos , Masculino , Resultado del TratamientoRESUMEN
OBJECTIVES: To study the impact of asymptomatic prostatitis on semen parameters. METHOD: Based on the count of WBC in EPS, we assigned 152 patients with asymptomatic (type IV) prostatitis to Groups A (WBC + to + +) and B (WBC + + + to + + + +), and included 68 normal healthy men controls in Group C. All the patients were examined for the volume, pH value and liquefaction time of the semen, sperm concentration, sperm survival rate, grade a sperm percentage, morphologically normal sperm percentage, WBC count, and accompanying inflammatory cytokines. RESULTS: The semen liquefaction time, grade a sperm percentage and morphologically normal sperm percentage were (24.5 +/- 5.2) min, 20.0 +/- 4.1 and 10.5 +/- 4.8 in Group A, (30.4 +/- 5.0) min, 10.0 +/- 3.8 and 7.5 +/- 4.2 in Group B, and (18.5 +/- 5.3) min, 32.3 +/- 4.5 and 17.8 +/- 3.6 in Group C, with statistically significant differences between A and B (P < 0.01). The pH value, semen volume, sperm survival rate and sperm concentration were 7.6 +/- 0.3, (3.0 +/- 1.1) ml, 56.0 +/- 6.0 and (65.9 +/- 11.3) x 10(6)/ml in Group A, 7.7 +/- 0.3, (2.8 +/- 1.2) ml, 52.3 +/- 6.3 and (62.5 +/- 10.3) x 10(6)/ml in Group B, and 7.5 +/- 0.2, (2.9 +/- 1.2) ml, 62.1.0 +/- 5.3 and (87.7 +/- 10.1) x 10(6)/ml in Group C, with no significant differences among the three groups (P > 0.05). The contents of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) in the semen were (58.64 +/- 30.82) pg/ml and (50.57 +/- 27.48) pg/ml in Group B, significantly increased as compared with (17.68 +/- 5.65) pg/ml and (23.50 +/- 4.80) pg/ml in Group C (P < 0.01). CONCLUSION: Asymptomatic prostatitis effects significant changes in the major parameters of the patient's semen quality.
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Prostatitis/fisiopatología , Análisis de Semen , Adulto , Estudios de Casos y Controles , Citocinas/análisis , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Semen , Recuento de Espermatozoides , Adulto JovenRESUMEN
Macrophagecapping protein (CapG) is a newly characterized oncogene involved in several types of cancer. However, the expression patterns and biological mechanisms of CapG in clear cell renal cell carcinoma (ccRCC) are unclear. The present study aimed to investigate the roles of CapG in the prognosis, proliferation and metastasis of ccRCC. In the present study, the expression of CapG was analyzed by western blotting in 24 paired ccRCC and adjacent normal tissue samples. Another 152 tissue samples from 152 patients with ccRCC were examined by immunohistochemistry. Compared with normal tissue, CapG expression was significantly increased in ccRCC tissue, and high CapG expression was associated with advanced tumor stage, histological grade, lymph node metastasis, and poor overall survival. Moreover, CapG was an independent predictor of survival. Lentivirusmediated CapG knockdown significantly inhibited 786O cell proliferation, migration, and invasion, induced cell cycle arrest at the G2/M phase, and increased apoptosis in vitro. Microarray analysis indicated that RAC, CDC42 and ERK/MAPK signaling were disrupted by CapG knockdown in 786O cells. In conclusion, the present findings indicate that CapG plays an oncogenic role in ccRCC and may represent a potential therapeutic target for this disease.
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Carcinoma de Células Renales/metabolismo , Neoplasias Renales/metabolismo , Proteínas de Microfilamentos/metabolismo , Proteínas Nucleares/metabolismo , Proteínas Oncogénicas/metabolismo , Carcinoma de Células Renales/genética , Carcinoma de Células Renales/mortalidad , Carcinoma de Células Renales/patología , Línea Celular Tumoral , Movimiento Celular , Puntos de Control de la Fase G2 del Ciclo Celular , Técnicas de Silenciamiento del Gen , Humanos , Neoplasias Renales/genética , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Puntos de Control de la Fase M del Ciclo Celular , Sistema de Señalización de MAP Quinasas , Proteínas de Microfilamentos/genética , Proteínas Nucleares/genética , Proteínas Oncogénicas/genéticaRESUMEN
OBJECTIVE: The ratio of psychological to organic ED changes with aging. This study aimed to analyze the results of nocturnal electrobioimpedance volumetric assessment (NEVA) for ED patients of different age groups and their significance in the diagnosis of ED. METHODS: A total of 83 ED patients were divided into 4 age groups (< or = 29 yr, 30 -39 yr, 40 -49 yr and > or = 50 yr) and detected for nocturnal penile tumescence (NPT) by NEVA. RESULTS: Thirty-four of the cases were diagnosed as organic ED, and the other 49 as psychological ED. With the increase of age, the former was increased from 30.3% in the < or = 29 yr group to 60.0% in the > or = 50 yr group, while the latter decreased from 69.7% to 40.0%. CONCLUSION: The percentage of organic ED tends to grow with the increase of age, while that of psychological ED is just the opposite.
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Envejecimiento , Disfunción Eréctil/diagnóstico , Disfunción Eréctil/fisiopatología , Erección Peniana , Adulto , Impedancia Eléctrica , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To explore the effects of low-dose oral tadalafil on self-esteem, confidence and sexual relationship in ED patients. METHODS: We treated 17 ED patients with oral tadalafil at the low dose of 5 mg once daily for 12 weeks, and used the paired t test to compare their scores on The Self-Esteem and Relationship Questionnaire (SEAR) and IIEF-5 and the results of nocturnal penile tumescence (NPT) obtained by nocturnal electrobioimpedance volumetric assessment (NEVA) before and after the medication. RESULTS: The scores on SEAR and IIEF-5 were significantly increased (P < 0.01) and NPT markedly improved (P < 0.05) after tadalafil treatment as compared with the baseline. CONCLUSION: Low-dose oral tadalafil once daily can significantly improve the self-esteem, confidence, sexual relationship satisfaction and NPT of ED patients.
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Carbolinas/administración & dosificación , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/psicología , Encuestas y Cuestionarios , Adulto , Carbolinas/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Autoimagen , Tadalafilo , Vasodilatadores/administración & dosificación , Vasodilatadores/uso terapéuticoRESUMEN
OBJECTIVE: To investigate the expression of programmed cell death 5 (PDCD5) in tissues of normal human prostate (NP), benign prostatic hyperplasia (BPH), and prostate cancer (PCa) in order to assess the clinical role of PDCD5 in PCa. METHODS: PDCD5 expression was determined by EnVision immunohistochemical staining in formalin-fixed and paraffin-embedded specimens obtained from 12 subjects with NP, 22 with BPH, and 22 with PCa. In addition, PCa cases were classified as low/middle-risk (Gleason sum < or = 7) and high-risk (Gleason sum >7) on the basis of Gleason grade. Positive expression rates and intensity of PDCD5 protein were observed under light microscope and analyzed with computer imaging technique. Expression of PDCD5 was compared among different prostatic tissues. RESULTS: The expression of PDCD5 was significantly lower in tissue of PCa than in tissues of NP and BPH (P<0.01). However, there was no significant difference in PDCD5 expression between tissues of NP and BPH. In addition, the expression of PDCD5 was further downregulated with the increase of Gleason sum in PCa. CONCLUSIONS: By downregulating apoptosis, low PDCD5 expression may play an important role in the occurrence and development of PCa. PDCD5 is supposed to have a potential clinical value to be a new predictor of progression and target of gene therapy in PCa.
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Proteínas Reguladoras de la Apoptosis/fisiología , Proteínas de Neoplasias/fisiología , Neoplasias de la Próstata/etiología , Anciano , Apoptosis , Proteínas Reguladoras de la Apoptosis/análisis , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Proteínas de Neoplasias/análisis , Próstata/química , Neoplasias de la Próstata/química , Neoplasias de la Próstata/patología , Proteínas Proto-Oncogénicas c-bcl-2/análisisRESUMEN
OBJECTIVE: To compare suprapubic puncture and transurethral catheterization for pressure-flow determination during voiding in BPH patients. METHODS: Both suprapubic puncture and transurethral catheterization were used for pressure-flow determinations during voiding in 23 BPH patients at the mean age of 69.3 years (range 57-77 years) and the related parameters were compared by t-test. RESULTS: Compared with transurethral catheterization, suprapubic puncture increased Qmax by 1.19 mn/s (P <0.05) and MMC by 66.61 ml (P <0.01) , and reduced the pressure of detrusor at Qmax (Pdet, Qmax) by 10.57 cmH2O (P < 0.05), URA by 11.39 cmH2O (P < 0.01) and AG by 12.94 (P < 0.01). Either according to the Schäfer diagram or with AG > 40 as the diagnostic standard, there were 16 (69.6%) cases of bladder outlet obstruction (BOO) in the suprapubic puncture group and 20 (87.0%) in the transurethral catheterization group. CONCLUSION: In pressure-flow determination during voiding, suprapubic puncture and transurethral catheterization each have its own advantages and disadvantages, but the former is preferred for BPH patients. As for other patients, it all depends on specific conditions.
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Hiperplasia Prostática/fisiopatología , Hiperplasia Prostática/cirugía , Micción/fisiología , Anciano , Cistostomía , Humanos , Masculino , Persona de Mediana Edad , Cateterismo Urinario , UrodinámicaRESUMEN
BACKGROUND: The aim of this study was to review our experience in managing renal or adrenal tumors with level III or IV inferior vena cava thrombus by using deep hypothermic circulatory arrest (DHCA), and to evaluate survival outcomes. METHODS: Between September 2004 and March 2016, we treated 33 patients with renal or adrenal malignancy tumor and thrombus extending into the inferior vena cava. Patients were identified according to radiographic records and operative findings. Clinicopathological and operative characteristics were recorded, and comparisons of clinical and operative characteristics through DHCA were performed. A Cox regression model was used to determine predictors of perioperative mortality. RESULTS: Twenty-one out of 33 patients with level III (n = 15), level IV (n = 5), or level II (n = 1) renal or adrenal tumors were treated surgically through cardiopulmonary bypass (CPB) with DHCA, and 12 patients with level II or III tumors were treated surgically through normothermic CPB. Three complications were observed, and one death occurred perioperatively, owing to multiple organ failure. The overall perioperative mortality was 4.7%. There were significant differences in the clinicopathological characteristics, operative duration, estimated blood loss, transfusions and hospital stay depending on use of DHCA. Multivariate analysis indicated that the operative duration (OR, 3.78; P < 0.001), estimated blood loss (OR, 1.08; P = 0.02), and transfusion (OR, 2.13; P = 0.038) during/after surgery were positively associated with higher mortality and morbidity. DHCA failed to reach statistical significance (P = 0.378). CONCLUSIONS: Use of CPB and DHCA to treat renal or adrenal tumors allows for complete tumor resection, especially at the T4 stage. Although it can cause physical damage, this technique does not increase operative risk and is a relatively safe approach.
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Neoplasias de las Glándulas Suprarrenales/cirugía , Puente Cardiopulmonar , Paro Circulatorio Inducido por Hipotermia Profunda , Neoplasias Renales/cirugía , Vena Cava Inferior/cirugía , Trombosis de la Vena/cirugía , Neoplasias de las Glándulas Suprarrenales/complicaciones , Adulto , Anciano , Pérdida de Sangre Quirúrgica , Transfusión Sanguínea , Carcinoma de Células Renales , Puente Cardiopulmonar/efectos adversos , Paro Circulatorio Inducido por Hipotermia Profunda/efectos adversos , Femenino , Humanos , Riñón/patología , Neoplasias Renales/complicaciones , Tiempo de Internación , Masculino , Persona de Mediana Edad , Tempo Operativo , Complicaciones Posoperatorias/mortalidad , Estudios Retrospectivos , Trombosis/etiología , Trombosis de la Vena/etiologíaRESUMEN
OBJECTIVE: To investigate the effects of transurethral catheterization on the uroflow rate in the pressure-flow study of patients with benign prostatic hyperplasia (BPH). METHODS: Thirty-nine men with BPH underwent free uroflowmetry and pressure-flow analysis respectively. With an 8 F urethral catheter, the standard pressure-flow variables such as the maximum flow rate, detrusor pressure at the maximum flow rate and so on were recorded. The free maximum flow rate and the maximum flow rate with transurethral catheterization were statistically analyzed. RESULTS: The maximum voided volumes of the free uroflowmetry group and the pressure-flow study group were (209.23 +/- 56. 56) ml and (210.33 +/- 62.02) ml respectively (P > 0.05). The free maximum flow rate was (8.61 +/- 2.80) ml/s, and the maximum flow rate with transurethral catheterization-was (7.39 +/- 3.01) ml/s (P < 0.05). When the patients were divided into seven grades of bladder outlet obstruction (BOO) according to the Schäfer nomogram, the free maximum flow rate and the maximum flow rate with transurethral catheterization with Grade 0-I of BOO were (12.56 +/- 1.57) ml/s and (10.95 +/- 2.51) ml/s, and those of Grade II were (9.35 +/- 0.76) ml/s and (8.41 +/- 1.23) ml/s respectively. For Grades III, IV and V-VI , the two maximum flow rates were (7.88 +/- 1.21) ml/s and (6.37 +/- 0.59) ml/s, (6.54 +/- 1.93) ml/s and (5.55 +/- 2.48) ml/s, and (6.01 +/- 2.10) ml/s and (4.84 +/- 2.89) ml/s, respectively, all with significant difference in between (P < 0.05). CONCLUSION: The 8 F urethral catheter has a significant effect on the maximum uroflow rate in the pressure-flow study and this effect is correlated with the grade of BOO.
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Hiperplasia Prostática/fisiopatología , Hiperplasia Prostática/terapia , Cateterismo Urinario/métodos , Anciano , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Obstrucción del Cuello de la Vejiga Urinaria/fisiopatología , Obstrucción del Cuello de la Vejiga Urinaria/terapia , Micción , UrodinámicaRESUMEN
CKLF-like MARVEL transmembrane domain-containing 5 (CMTM5) has been reported to function as a potential tumor suppressor in several human cancers. However, the involvement of CMTM5 in human renal cell carcinoma (RCC) remains unclear. The current study aimed to detect its expression pattern in RCC tissues and cells, and to determine its anti-proliferative functions in this malignancy. The mRNA and protein expression levels of CMTM5 in RCC tissues and cells were detected by reverse transcription-quantitative polymerase chain reaction, immunohistochemistry and western blotting. Following the transfection with CMTM5 lentivirus or control lenti-EGFP lentivirus into the RCC cell line ACHN, the viability, migration, apoptosis and cell cycle of these cells were detected by Cell Counting kit-8 assay, Transwell assay and flow cytometry, respectively. Compared with the adjacent non-malignant kidney tissue samples, CMTM5 expression was significantly downregulated in RCC tissues (P<0.05). In addition, enforced expression of CMTM5 could efficiently inhibit the cell growth of ACHN cells, which were arrested in G0/G1 phase. Furthermore, the migration and invasion of ACHN cells were also inhibited by restoration of CMTM5 expression. The present data suggest that CMTM5 may function as a tumor suppressor in human RCC by suppressing the viability of RCC cells, implying its potential as a therapeutic target for this malignancy.
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OBJECTIVE: To identify specific protein markers for renal cell carcinoma detection and diagnosis, as well as develop new potential therapeutic targets of the disease. METHODS: We used two-dimensional difference in-gel electrophoresis (2-D DIGE) technique conjunction with mass spectrometry (MS) for the identification of significant differentially expressed proteins between 15cases of paired clear cell renal cell carcinoma (ccRCC) and adjacent normal renal tissues. The protein spots were considered as differentially expressed if a 1.5-fold altered expression level was observed (Student's t test, P value<0.05). RESULTS: Of the 27 differentially expressed protein spots, 26 proteins were successfully identified. 11 proteins up-regulated in renal cell carcinoma,15 proteins down-regulated. Among them Short/branched chain specific acyl-CoA dehydrogenase, mitochondrial (ACDSB), Aldose 1-epimerase (GALM), Peroxiredoxin-4 (PRDX4), Macrophage-capping protein (CAPG), Beta-defensin 107 (D107A), Microfibril-associated glycoprotein 4 (MFAP4) were first time screening as new differential expressed proteins by protomic study in renal cell carcinoma. CONCLUSIONS: 2-D DIGE is a useful technique for screening and analysis differential expressed proteins in renal cell carcinoma. These new differently expressed proteins may be useful for development new molecular markers for the tumor.
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Carcinoma de Células Renales/metabolismo , Neoplasias Renales/metabolismo , Proteoma/metabolismo , Biomarcadores de Tumor/metabolismo , Proteínas Portadoras , Electroforesis en Gel Bidimensional , Proteínas de la Matriz Extracelular , Glicoproteínas , Humanos , Proteínas de Microfilamentos , Proteínas Nucleares , Peroxirredoxinas , Proteómica , Espectrometría de Masa por Láser de Matriz Asistida de Ionización DesorciónRESUMEN
AIM: To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. METHODS: Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith (AG) number and the Schaer linear nomogram. RESULTS: There were statistically significant differences between the methods in the mean values of maximum flow rate (P < 0.05), detrusor pressure at the maximum flow (P < 0.01), urethral resistance algorithm (P < 0.01), AG number (P < 0.01) and maximum cystic capacity (P < 0.01). Of the men in the study, 10 (43.5%) remained in the same Schaer class with both methods and 18 (78.3%) in the same AG number area. Using the transurethral method, 12 (52.2%) men increased their Schaer class by one and 1 (4.3%) by two. There were also differences between the suprapubic and transurethral methods using the AG number: 4 (17.4%) men moved from a classification of equivocal to obstructed and 1 (4.3%) from unobstructed to equivocal. CONCLUSION: The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.
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Hiperplasia Prostática/fisiopatología , Obstrucción del Cuello de la Vejiga Urinaria/diagnóstico , Anciano , Humanos , Masculino , Persona de Mediana Edad , Presión , Punciones , Cateterismo Urinario , Micción/fisiología , UrodinámicaRESUMEN
OBJECTIVE: To analyze the correlation between serum calcium level and tumor size/ stage in patients with renal cell carcinoma (RCC). METHODS: Totally 173 RCC cases were divided into 3 groups according to their serum calcium level, namely low, normal and high level groups. SPSS10.0 software was used for statistical analysis of the tumor sizes/stages and their association with serum calcium level in the 3 groups. RESULTS AND CONCLUSION: Kruskal-Wallis H test revealed no significant difference in the tumor size between the 3 groups (X(2)=4.768, df=2, P=0.092), but Spearman correlation analysis suggested inverse correlation between serum calcium and tumor size (r=-0.166, P=0.029). Kruskal-Wallis H test also failed to suggest significant difference in the tumor stage between the 3 groups (X(2)=4.277, df=2, P=0.118), but serum calcium was found to be inversely correlated with the tumor stage (r=-0.157, P=0.039 by Spearman correlation analysis).