ABSTRACT
【Objective】 To investigate the preoperative epidemiological factors affecting the surgical outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and to evaluate the clinical predictive value. 【Methods】 Patients undergoing TURP at our hospital during Dec.2018 and Sep.2021 whose pathological examination suggestive of BPH were involved. Before operation, the clinical data, International Prostate Symptom Score (IPSS), quality of life (QoL) score, overactive bladder (OAB) score, prostate-specific antigen (PSA), and urological ultrasound results were collected. After operation, all patients were followed up with telephone call or face-to-face interview, and the IPSS, QoL score and OAB score were examined. Patients were divided into effective and ineffective groups according to the efficacy rubrics. The epidemiological factors affecting the efficacy of TURP were identified with univariate analysis, the independent influencing factors were screened with binary logistic regression, and the diagnostic value of each independent influencing factor was evaluated using receiver operating characteristic (ROC) curve. 【Results】 OAB score (OR=0.749, 95%CI: 0.627-0.895, P=0.001), IPSS-V/S (OR=4.919, 95%CI: 1.617-14.963, P=0.005), history of urinary retention (OR=7.513, 95%CI: 2.289-24.656, P=0.001), and history of urinary incontinence (OR=2.656, 95%CI: 1.015-6.950, P=0.047) were independent influencing factors for poor postoperative outcomes. ROC curve revealed that the area under the ROC curve (AUC) showed that AUC of OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were 0.784 (95%CI: 0.718-0.841), 0.686 (95%CI: 0.614-0.751), 0.713 (95%CI: 0.643-0.777), and 0.723 (95%CI: 0.654-0.786), respectively. ROC curve of the regression model showed that the AUC was 0.888 (95%CI: 0.834-0.930), and the sensitivity and specificity were 93.53% and 67.35%, respectively. 【Conclusion】 Preoperative OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were independent epidemiological factors of poor outcomes after TURP in BPH patients. The diagnostic efficacy ranked from the highest to the lowest as regression model >OAB score>history of urinary incontinence >history of urinary retention>IPSS-V/S.
ABSTRACT
Objective To investigate the effect of sorafenib in ameliorating renal fibrosis and its possible mechanisms.Methods Rats were subjected to unilateral ureteral obstruction (UUO ) and intragastrically administered sorafenib.NRK-52E cells were treated with transforming growth factor-β1 (TGF-β1)and sorafenib. HE staining was used to visualize renal fibrosis.α-SMA and E-cadherin expressions in kidney tissue and NRK-52E cells were performed using immunofluorescence.The cell cycle of NRK-52E cells was determined by flow cytometry analysis.Smad3 and p-Smad3 protein expressions in NRK-52E cells were detected by Western blot analysis. Results HE staining showed that kidney interstitial fibrosis,tubular atrophy,and inflammatory cell infiltration in the sorafenib-treated UUO groups were significantly decreased compared with the vehicle-treated UUO group (P<0.05).Compared with those in UUO and TGF-β-stimulated NRK-52E groups,the expression of a-SMA decreased but E-cadherin expression increased in the UUO kidneys and NRK-52E cells of the sorafenib-treated groups (P<0.05).After 24 h stimulation with TGF-β1 5 ng/mL,the number of cell cycles arrested in G0/G1 phase was significantly increased and the number of cells that entered G2 ,S phase decreased (P<0 .0 5 ).Compared with that in TGF-β-stimulated NRK-52E groups, p-Smad3 decreased in the sorafenib-treated groups (P<0.05). Conclusion Our results suggest that sorafenib may be useful for the treatment of renal fibrosis through suppressing TGF-β/Smad3 signaling.
ABSTRACT
Objective To evaluate the quality of life (QOL ) of chronic hepatitis B (CHB) patients and to explore its related factors .Methods SF‐36 questionnaire was used to evaluate the QOL of 626 CHB patients visited or hospitalized in China‐Japan Friendship Hospital from July 2014 to June 2015 .And the residents around the hospital were included as control group .Sociological characteristics ,clinical data , health related behaviors and nutritional status were collected .Logistic regression analysis was used to analyze the factors related to quality of life . Results Six hundred and twenty‐six participants were enrolled in each group ,including 424 males and 202 females .The average age of CHB group and control group were 44 .2 ± 13 .9 and 44 .2 ± 13 .9 ,respectively .The average QOL score of the CHB patients was 72 .25 ± 16 .06 ,and 8 dimensions and 2 domains of CHB group were lower than those of control group (both P < 0 .05 ) . In multivariate analysis , factors independently associated with higher physical component summary (PCS) score were younger age (18—45 years old:OR=0 .27 ,95% CI:0 .13—0 .54 ;45—60 years old :OR= 0 .47 ,95% CI:0 .23—0 .95) ,high‐quality sleep (OR= 0 .20 ,95% CI:0 .12—0 .33) ,frequent exercise (OR=0 .37 ,95% CI:0 .19—0 .73) or occasional exercise (OR=0 .49 ,95% CI:0 .30—0 .77) ,and mild hepatitis symptoms (mild:OR=0 .19 ,95% CI:0 .05 -0 .76 ;moderate :OR=0 .20 ,95% CI:0 .06—0 .68 ) , while disease duration was associated with lower PCS score ;factor independently associated with higher mental component summary (MCS) score was high quality sleep (OR=0 .25 , 95% CI:0 .16—0 .41) ,while longer duration (OR= 14 .04 ,95% CI:1 .81—109 .38) and lower weight (OR=2 .72 ,95% CI:1 .48—4 .98) were associated with reduced MCS score ( all P<0 .05) .Conclusions The QOL of CHB patients is damaged universally .More attention should be paid to the health related life behavior and nutritional status of CHB patients in the future management .