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1.
Zhongguo Zhen Jiu ; 43(6): 727-32, 2023 Jun 12.
Artículo en Chino | MEDLINE | ID: mdl-37313570

RESUMEN

This paper reviews the researches on acupuncture preconditioning before surgery in recent years and explores its application value from three aspects, i.e. relieving preoperative anxiety, preventing from postoperative cognitive dysfunction, and preventing from postoperative gastrointestinal dysfunction. As a relatively safe non-drug treatment, acupuncture has the underlying advantages in participating into multidisciplinary coordination in the enhanced recovery after surgery (ERAS). By building up higher-quality medical evidences and revealing the effect mechanism of acupuncture from multi-dimenisonal aspects, it is expected that acupuncture technology can be coordinated with ERAS to optimize the clinical path in the perioperative period, and boost the development of the perioperative medicine ultimately.


Asunto(s)
Terapia por Acupuntura , Recuperación Mejorada Después de la Cirugía , Humanos , Ansiedad , Trastornos de Ansiedad , Periodo Perioperatorio
2.
Neurol Genet ; 9(2): e200061, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37090939

RESUMEN

Background and Objectives: There are no therapies for preventing cerebral demyelination in X-linked adrenoleukodystrophy (ALD). Higher plasma vitamin D levels have been linked to lower risk of inflammatory brain lesions. We assessed the safety and pharmacokinetics of oral vitamin D dosing regimens in boys and young men with ALD. Methods: In this open-label, multicenter, phase 1 study, we recruited boys and young men with ALD without brain lesions to a 12-month study of daily oral vitamin D3 supplementation. Our primary outcome was attainment of plasma 25-hydroxyvitamin D levels in target range (40-80 ng/mL) at 6 and 12 months. Secondary outcomes included safety and glutathione levels in the brain, measured with magnetic resonance spectroscopy, and blood, measured via mass spectrometry. Participants were initially assigned to a fixed dosing regimen starting at 2,000 IU daily, regardless of weight. After a midstudy safety assessment, we modified the dosing regimen, so all subsequent participants were assigned to a weight-stratified dosing regimen starting as low as 1,000 IU daily. Results: Between October 2016 and June 2019, we enrolled 21 participants (n = 12, fixed-dose regimen; n = 9, weight-stratified regimen) with a median age of 6.7 years (range: 1.9-22 years) and median weight of 20 kg (range: 11.7-85.5 kg). The number of participants achieving target vitamin D levels was similar in both groups at 6 months (fixed dose: 92%; weight stratified: 78%) and 12 months (fixed dose: 67%; weight stratified: 67%). Among the 12 participants in the fixed-dose regimen, half had asymptomatic elevations in either urine calcium:creatinine or plasma 25-hydroxyvitamin D; no laboratory deviations occurred with the weight-stratified regimen. Glutathione levels in the brain, but not the blood, increased significantly between baseline and 12 months. Discussion: Our vitamin D dosing regimens were well tolerated and achieved target 25-hydroxyvitamin D levels in most participants. Brain glutathione levels warrant further study as a biomarker for vitamin D and ALD. Classification of Evidence: This study provides Class IV evidence that fixed or weight-stratified vitamin D supplementation achieved target levels of 25-hydroxyvitamin D in boys and young men with X-ALD without brain lesions.

3.
Int Urol Nephrol ; 54(11): 2977-2981, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-35596886

RESUMEN

PURPOSE: Holmium laser enucleation of the prostate (HoLEP) is reported to be widely used in the surgical treatment of benign prostatic hyperplasia (BPH), which consists of two procedures: enucleation and morcellation. This study is to examine the efficiency and safety of two different morcellator systems within a cohort of men undergoing HoLEP for BPH. METHODS: A total of 210 consecutive patients undergoing HoLEP and morcellation procedures were enrolled. Individuals were randomly divided into 2 separated groups: the first group (105 patients) was performed with a nephroscope using a mechanical Versacut morcellator and the second (105 patients) was performed with the new morcellation system, nephroscopes and Piranha morcellator. Perioperative characteristics were studied and analyzed. RESULTS: The morcellation time and the morcellation rate was similar when the prostate volume (PV) ≤ 60 mL while the morcellation time was significantly shorter and the morcellation rate was higher in the Piranha group with PV > 60 mL. No significant difference was observed according to the bladder irrigation time, indwelling catheter time, and discharge time. CONCLUSION: Piranha morcellator presents a higher efficiency for the prostate over 60 mL.


Asunto(s)
Characiformes , Terapia por Láser , Láseres de Estado Sólido , Morcelación , Hiperplasia Prostática , Resección Transuretral de la Próstata , Animales , Humanos , Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Masculino , Morcelación/efectos adversos , Morcelación/métodos , Estudios Prospectivos , Próstata/cirugía , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Resultado del Tratamiento
4.
Cells ; 11(10)2022 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-35626687

RESUMEN

Renal cell carcinoma (RCC) is one of the most aggressive urological malignancies and has a poor prognosis, especially in patients with metastasis. Although RCC is traditionally considered to be radioresistant, radiotherapy (RT) is still a common treatment for palliative management of metastatic RCC. Novel approaches are urgently needed to overcome radioresistance of RCC. Black phosphorus quantum dots (BPQDs) have recently received great attention due to their unique physicochemical properties and good biocompatibility. In the present study, we found that BPQDs enhance ionizing radiation (IR)-induced apoptotic cell death of RCC cells. BPQDs treatment significantly increases IR-induced DNA double-strand breaks (DSBs), as indicated by the neutral comet assay and the DSBs biomarkers γH2AX and 53BP1. Mechanistically, BPQDs can interact with purified DNA-protein kinase catalytic subunit (DNA-PKcs) and promote its kinase activity in vitro. BPQDs impair the autophosphorylation of DNA-PKcs at S2056, and this site phosphorylation is essential for efficient DNA DSBs repair and the release of DNA-PKcs from the damage sites. Consistent with this, BPQDs suppress nonhomologous end-joining (NHEJ) repair and lead to sustained high levels of autophosphorylated DNA-PKcs on the damaged sites. Moreover, animal experiments indicate that the combined approach with both BPQDs and IR displays better efficacy than monotreatment. These findings demonstrate that BPQDs have potential applications in radiosensitizing RCC cells.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Puntos Cuánticos , Animales , Carcinoma de Células Renales/radioterapia , ADN/metabolismo , Reparación del ADN , Humanos , Neoplasias Renales/radioterapia , Fósforo , Polinucleótido 5'-Hidroxil-Quinasa/metabolismo , Tolerancia a Radiación
5.
Am J Mens Health ; 16(2): 15579883221090826, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35469495

RESUMEN

The purpose of this study was to promote the holmium laser enucleation of the prostate (HoLEP) technology for large-volume prostates (>80 ml) and compare it with the traditional method, we modified the technique and applied this technology to clinical practice. A retrospective study comprising 118 patients who underwent HoLEP surgery from February 2018 to December 2019 was conducted in our center. Group A consisted of 57 patients with large-volume prostate (>80 ml) who received modified "fenestration and tunnel method" from February 2019 till December 2019, while group B consisted of 61 patients who received the traditional trivalvular operation method from February 2018 to December 2018 for comparison. Control subjects are selected such that they match the cases concerning certain characteristics, and perioperative data, voiding outcomes, and complications were evaluated at 1- and 12-month follow-up. The international prostatic symptomatic score (IPSS), quality of life (QoL), and maximum flow rate (Qmax) at 1 month and 12 months were both significantly improved compared with the preoperative baseline, and no significant differences were found between Groups A and B. The mean enucleation time, operation time, catheter indwelling duration, and hemoglobin decrease during the operation of Group A showed superiority compared with Group B (p<.05). The modified "fenestration and tunnel method" of HoLEP was statistically superior to the traditional trivalvular method in terms of the operation time, enucleation time, catheter indwelling duration, and hemoglobin decrease. For large-volume prostates (>80 ml), modified HoLEP was suggested to be a better treatment option.


Asunto(s)
Láseres de Estado Sólido , Hiperplasia Prostática , Resección Transuretral de la Próstata , Estudios de Seguimiento , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Próstata , Hiperplasia Prostática/cirugía , Calidad de Vida , Estudios Retrospectivos , Resección Transuretral de la Próstata/métodos , Resultado del Tratamiento
6.
Chin J Nat Med ; 20(4): 241-257, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35487595

RESUMEN

Lysine specific demethylase 1 (LSD1), a transcriptional corepressor or coactivator that serves as a demethylase of histone 3 lysine 4 and 9, has become a potential therapeutic target for cancer therapy. LSD1 mediates many cellular signaling pathways and regulates cancer cell proliferation, invasion, migration, and differentiation. Recent research has focused on the exploration of its pharmacological inhibitors. Natural products are a major source of compounds with abundant scaffold diversity and structural complexity, which have made a major contribution to drug discovery, particularly anticancer agents. In this review, we briefly highlight recent advances in natural LSD1 inhibitors over the past decade. We present a comprehensive review on their discovery and identification process, natural plant sources, chemical structures, anticancer effects, and structure-activity relationships, and finally provide our perspective on the development of novel natural LSD1 inhibitors for cancer therapy.


Asunto(s)
Antineoplásicos , Neoplasias , Antineoplásicos/química , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/uso terapéutico , Histona Demetilasas/química , Histona Demetilasas/metabolismo , Humanos , Lisina/uso terapéutico , Neoplasias/tratamiento farmacológico
7.
J Endourol ; 35(10): 1533-1540, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33779288

RESUMEN

Purpose: To compare the efficacy and safety of plasma kinetic enucleation of the prostate (PKEP) with holmium laser enucleation of the prostate (HoLEP) for treatment of benign prostatic hyperplasia (BPH). Methods: A total of 160 patients with indications for the surgical treatment of BPH were randomly assigned to receive either PKEP or HoLEP prospectively. Baseline characteristics, perioperative data, and postoperative outcomes of the patients were recorded. One hundred twenty-six (78.75%) patients (PKEP 64 vs HoLEP 62) completed the 3-year follow-up assessment. Results: Patients in both groups had similar baseline characteristics. Compared with PKEP, HoLEP was associated with shorter operative time as well as take-out time, lower perioperative hemoglobin decrease, and shorter bladder irrigation time, catheterization time, and hospital stay time. PKEP was superior to HoLEP in terms of the noise of the machine and hospitalization expenses. There were no significant differences in enucleating time, resected weight, and serum sodium levels. Both groups achieved satisfactory results and maintained improvement from baseline in terms of maximum urinary flow rate (Qmax), International Prostatic Symptomatic Score, quality of life, and postvoid residual at 3-year follow-up, with no significant differences between the two procedures. Except for re-catheterization rate, postoperative data such as transrectal ultrasound volume, International Index of Erectile Function-5, and follow-up scores of the flexible cystourethroscopy results, as well as the acute and mid-to long-term complications after surgery, were statistically similar. Conclusion: The 3-year follow-up data of this randomized trial confirmed that both PKEP and HoLEP were effective and safe surgical procedures for the transurethral management of BPH. HoLEP presented certain advantages compared to PKEP, such as reduced operative duration, decreased risk of blood loss, and less bladder irrigation, hospital stay time, and re-catheterization rate, whereas PKEP had lower noise and no additional laser cost. Chinese Clinical Trial Registry (ChiCTR-TRC-13004468).


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Resección Transuretral de la Próstata , Estudios de Seguimiento , Holmio , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Calidad de Vida , Resultado del Tratamiento
8.
Mol Psychiatry ; 26(5): 1634-1646, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-32376999

RESUMEN

The gamma aminobutyric acid (GABA) neurotransmission system has been implicated in autism spectrum disorder (ASD). Molecular neuroimaging studies incorporating simultaneous acquisitions of GABA concentrations and GABAA receptor densities can identify objective molecular markers in ASD. We measured both total GABAA receptor densities by using [18F]flumazenil positron emission tomography ([18F]FMZ-PET) and GABA concentrations by using proton magnetic resonance spectroscopy (1H-MRS) in 28 adults with ASD and 29 age-matched typically developing (TD) individuals. Focusing on the bilateral thalami and the left dorsolateral prefrontal cortex (DLPFC) as our regions of interest, we found no differences in GABAA receptor densities between ASD and TD groups. However, 1H-MRS measurements revealed significantly higher GABA/Water (GABA normalized by water signal) in the left DLPFC of individuals with ASD than that of TD controls. Furthermore, a significant gender effect was observed in the thalami, with higher GABA/Water in males than in females. Hypothesizing that thalamic GABA correlates with ASD symptom severity in gender-specific ways, we stratified by diagnosis and investigated the interaction between gender and thalamic GABA/Water in predicting Autism-Spectrum Quotient (AQ) and Ritvo Autism Asperger's Diagnostic Scale-Revised (RAADS-R) total scores. We found that gender is a significant effect modifier of thalamic GABA/Water's relationship with AQ and RAADS-R scores for individuals with ASD, but not for TD controls. When we separated the ASD participants by gender, a negative correlation between thalamic GABA/Water and AQ was observed in male ASD participants. Remarkably, in female ASD participants, a positive correlation between thalamic GABA/Water and AQ was found.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Adulto , Trastorno del Espectro Autista/diagnóstico por imagen , Femenino , Humanos , Masculino , Corteza Prefrontal , Tálamo/diagnóstico por imagen , Ácido gamma-Aminobutírico
9.
Cereb Cortex ; 30(6): 3644-3654, 2020 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-32108220

RESUMEN

Hypnosis is the oldest form of Western psychotherapy and a powerful evidence-based treatment for numerous disorders. Hypnotizability is variable between individuals; however, it is a stable trait throughout adulthood, suggesting that neurophysiological factors may underlie hypnotic responsiveness. One brain region of particular interest in functional neuroimaging studies of hypnotizability is the anterior cingulate cortex (ACC). Here, we examined the relationships between the neurochemicals, GABA, and glutamate, in the ACC and hypnotizability in healthy individuals. Participants underwent a magnetic resonance imaging (MRI) session, whereby T1-weighted anatomical and MEGA-PRESS spectroscopy scans were acquired. Voxel placement over the ACC was guided by a quantitative meta-analysis of functional neuroimaging studies of hypnosis. Hypnotizability was assessed using the Hypnotic Induction Profile (HIP), and self-report questionnaires to assess absorption (TAS), dissociation (DES), and negative affect were completed. ACC GABA concentration was positively associated with HIP scores such that the higher the GABA concentration, the more hypnotizable an individual. An exploratory analysis of questionnaire subscales revealed a negative relationship between glutamate and the absorption and imaginative involvement subscale of the DES. These results provide a putative neurobiological basis for individual differences in hypnotizability and can inform our understanding of treatment response to this growing psychotherapeutic tool.


Asunto(s)
Ácido Glutámico/metabolismo , Giro del Cíngulo/metabolismo , Hipnosis , Individualidad , Ácido gamma-Aminobutírico/metabolismo , Adulto , Femenino , Giro del Cíngulo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Masculino , Encuestas y Cuestionarios , Adulto Joven
10.
Oxid Med Cell Longev ; 2018: 1393641, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30140361

RESUMEN

PURPOSE: To investigate the protective effect of epigallocatechin gallate (EGCG), a green tea extract, and its underlying mechanism on bladder dysfunction in a rat model of bladder outlet obstruction (BOO). MATERIALS AND METHODS: Sprague-Dawley rats of BOO were surgically induced and followed by treatment with EGCG (5 mg/kg/day) or saline (control) via intraperitoneal injection. Cystometry was performed on four weeks postoperatively in conscious rats. H&E, Masson trichrome, and TUNEL staining were performed to observe tissue alterations. Oxidative stress markers were measured, and protein expression of Nrf2-ARE pathway was examined by immunohistochemistry and Western blotting. RESULTS: Our data showed that EGCG could increase the peak voiding pressure and bladder compliance and prolong micturition interval of BOO rats compared with control and finally reduce the frequency of urinary. EGCG could ameliorate the increase of collagen fibers and ROS induced by obstruction and increase the activity of SOD, GSH-Px, and CAT. The level of cell apoptosis was decreased in BOO rats treated with EGCG compared with control, and caspase-3 expression was reduced as well. Moreover, EGCG could activate the Nrf2 expression with elevation of its target antioxidant proteins. CONCLUSIONS: EGCG alleviates BOO-induced bladder dysfunction via suppression of oxidative stress and activation of the protein expression of Nrf2-ARE pathway.


Asunto(s)
Anticarcinógenos/uso terapéutico , Catequina/análogos & derivados , Obstrucción del Cuello de la Vejiga Urinaria/tratamiento farmacológico , Vejiga Urinaria/patología , Animales , Anticarcinógenos/farmacología , Catequina/farmacología , Catequina/uso terapéutico , Modelos Animales de Enfermedad , Masculino , Estrés Oxidativo , Ratas , Ratas Sprague-Dawley , Obstrucción del Cuello de la Vejiga Urinaria/patología
11.
Zhonghua Nan Ke Xue ; 24(2): 133-137, 2018 Feb.
Artículo en Chino | MEDLINE | ID: mdl-30156072

RESUMEN

OBJECTIVE: To compare the safety and effectiveness of shovel-shaped electrode transurethral plasmakinetic enucleation of the prostate (PKEP) with those of plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH). METHODS: We retrospectively analyzed the clinical data about 78 BPH patients received in Shanghai Ninth People's Hospital from June 2016 to January 2017, 39 treated by shovel-shaped electrode PKEP and the other 39 by PKRP. We observed the patients for 6 months postoperatively and compared the effects and safety of the two surgical strategies. RESULTS: No statistically significant difference was observed between the PKEP and PKRP groups in the operation time (ï¼»69.3 ± 8.8ï¼½ vs ï¼»72.2 ± 7.9ï¼½ min, P = 0.126), but the former, as compared with the latter, showed a markedly less postoperative loss of hemoglobin (ï¼»3.9 ± 2.8ï¼½ vs ï¼»13.9 ± 5.2ï¼½ g/L, P <0.001) and shorter bladder irrigation time (ï¼»12.5 ± 1.2ï¼½ vs ï¼»43.4 ± 2.8ï¼½ h, P <0.001), catheterization time (ï¼»64.0 ± 4.5ï¼½ vs ï¼»84.8 ± 3.0ï¼½ h, P <0.001) and hospital stay (ï¼»3.1 ± 0.3ï¼½ vs ï¼»5.5 ± 0.4ï¼½ d, P <0.001). There were no statistically significant differences between the PKEP and PKRP groups in the postoperative maximum urinary flow rate (Qmax) (ï¼»21.62 ± 1.07ï¼½ vs ï¼»21.03 ± 0.96ï¼½ ml/s, P = 0.12), International Prostate Symptoms Score (IPSS) (5.85 ± 0.90 vs 6.03 ± 0.81, P = 0.279), quality of life score (QoL) (2.0 ± 0.73 vs 2.28 ± 0.72, P = 0.09), postvoid residual urine volume (PVR) (ï¼»19.59 ± 6.01ï¼½ vs ï¼»20.21 ± 5.16ï¼½ ml, P = 0.629), or the incidence rates of urinary incontinence (2.56% ï¼»1/39ï¼½ vs 7.69% ï¼»3/39ï¼½, P >0.05) and other postoperative complications. CONCLUSIONS: Both PKEP and PKRP are effective methods for the treatment of BPH, but PKEP is worthier of clinical recommendation for a better safety profile, more thorough removal of the prostate tissue, less blood loss, shorter hospital stay, and better improved quality of life of the patient.


Asunto(s)
Electrodos , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , China , Electrodos/efectos adversos , Diseño de Equipo , Humanos , Masculino , Calidad de Vida , Estudios Retrospectivos , Resección Transuretral de la Próstata/instrumentación , Resultado del Tratamiento
12.
Zhongguo Gu Shang ; 31(1): 47-55, 2018 Jan 25.
Artículo en Chino | MEDLINE | ID: mdl-29533037

RESUMEN

OBJECTIVE: To systematically evaluate the clinical effect of high frequency repeated transcranial magnetic stimulation(HF rTMS)therapy on dyskinesia in patients with incomplete spinal cord injury. METHODS: Randomized controlled trials(RCTs) about HF rTMS therapy on patients with motor incomplete spinal cord injury were searched electronically in PubMed, Google scholar, Cochrane library, Clinical trial, Medline, Web of science, CNKI, VIP, and Wanfang database before October 2016. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as extracted the data and assessed the methodological quality. The observed outcomes included ASIA motor score, ASIA lower extremities motor score(LEMS), Modified Ashworth score (MAS), Ten-meter walking test (10MWT) and Walking index for SCI II(WISCI II), and the outcomes were analyzed using RevMan5.2 software provided by the Cochrane information management system. RESULTS: Five RCTs involved 103 patients were included, and 61 patients(experimental group) accepted real rTMS and physical rehabilitation care for SCI, 51 patients(control group) accepted only physical rehabilitation care. There were significant differences in ASIA motor score, LEMS and 10MWT between two groups after HF rTMS therapy (statistics were Z=2.96, P=0.003; Z=3.04, P=0.002; Z=2.16, P=0.03; respectively). When stimulating the leg motor cortex, there was significant difference in MAS between two groups(Z=2.79, P=0.005), and when stimulating the vertex, there was no significant difference(Z=0.09, P=0.93). There was no significant difference in WISCI IIscore after HF rTMS therapy between two groups(Z=0.90, P=0.37). CONCLUSIONS: HF rTMS can raise motor score in patients with incomplete spinal cord injury, improve the spasticity of the lower extremities, and increase the motor ability.


Asunto(s)
Discinesias/rehabilitación , Traumatismos de la Médula Espinal/rehabilitación , Estimulación Magnética Transcraneal , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
13.
Artículo en Inglés | MEDLINE | ID: mdl-28941767

RESUMEN

Multiple lines of research have reported thalamic abnormalities in individuals with autism spectrum disorder (ASD) that are associated with social communication impairments (SCI), restricted and repetitive behaviors (RRB), or sensory processing abnormalities (SPA). Thus, the thalamus may represent a common neurobiological structure that is shared across symptom domains in ASD. Same-sex monozygotic (MZ) and dizygotic (DZ) twin pairs with and without ASD underwent cognitive/behavioral evaluation and magnetic resonance imaging to assess the thalamus. Neurometabolites were measured with 1H magnetic resonance spectroscopy (MRS) utilizing a multi-voxel PRESS sequence and were referenced to creatine+phosphocreatine (tCr). N-acetyl aspartate (NAA), a marker of neuronal integrity, was reduced in twins with ASD (n=47) compared to typically-developing (TD) controls (n=33), and this finding was confirmed in a sub-sample of co-twins discordant for ASD (n=11). NAA in the thalamus was correlated to a similar extent with SCI, RRB, and SPA, such that reduced neuronal integrity was associated with greater symptom severity. Glutamate+glutamine (Glx) was also reduced in affected versus unaffected co-twins. Additionally, NAA and Glx appeared to be primarily genetically-mediated, based on comparisons between MZ and DZ twin pairs. Thus, thalamic abnormalities may be influenced by genetic susceptibility for ASD but are likely not domain-specific.


Asunto(s)
Trastorno del Espectro Autista/diagnóstico por imagen , Trastorno del Espectro Autista/metabolismo , Espectroscopía de Protones por Resonancia Magnética , Tálamo/diagnóstico por imagen , Tálamo/metabolismo , Adolescente , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Trastorno del Espectro Autista/genética , Niño , Estudios de Cohortes , Enfermedades en Gemelos , Femenino , Lateralidad Funcional , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Índice de Severidad de la Enfermedad , Gemelos Dicigóticos , Gemelos Monocigóticos
14.
J Endourol ; 32(2): 139-143, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29239228

RESUMEN

PURPOSE: To evaluate the long-term and flexible cystourethroscopy results of holmium laser enucleation of the prostate (HoLEP) and to compare them with those of plasmakinetic resection of the prostate (PKRP). METHODS: In the long-term follow-up, variables, including the international prostatic symptomatic score, quality of life scores, maximum flow rate (Qmax), and international index of erectile function (IIEF), and the adverse events, including the need for retreatment, were specifically assessed. One hundred twenty-two HoLEP and 119 PKRP of the initial 280 patients included in this study were available, with 10 deceased and 29 lost to follow-up. RESULTS: We found that none of the assessable patients required reoperation for recurrent benign prostatic enlargement (BPE) in the HoLEP group, whereas two required reoperation in the PKRP group. There were no significant differences in most variables between the two groups in the long-term results. But in terms of Qmax, transrectal ultrasound prostate volume, prostate specific antigen (PSA) level, IIEF-5 score, and long-term posttrial follow-up of flexible cystourethroscopy, the HoLEP group showed better results. CONCLUSION: The long-term follow-up data of this randomized trial confirm that HoLEP and PKRP are both effective and durable surgical interventions for the treatment of lower urinary tract symptoms due to BPE. Given the clinically relevant advantages associated with HoLEP, the alternation of PSA level, sexual function, and urination can be improved.


Asunto(s)
Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Prostatectomía/métodos , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Anciano , Estudios de Seguimiento , Holmio , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Persona de Mediana Edad , Erección Peniana/fisiología , Antígeno Prostático Específico/análisis , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Reoperación , Micción/fisiología
15.
BMC Urol ; 17(1): 71, 2017 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-28859618

RESUMEN

BACKGROUND: To evaluate noise hazard during holmium laser enucleation of the prostate (HoLEP), we designed a study to detect such a risk in this procedure. METHODS: This study was conducted over a 12-month period on 223 patients with benign prostatic hyperplasia (BPH), 121 of whom underwent HoLEP while those remaining underwent transurethral resection of the prostate (TURP). A sound level meter was used to detect the exposure of surgeons to noise. The recordings used were in accordance with the standards set by the Occupational Safety and Health Administration (OSHA) and the United States E nvironmental Protection A gency . Moreover, each of the 43 surgeons participating in a BPH discussion conference answered the questionnaire on the influence of noise, and 33 surgeons in our department volunteered for blood pressure monitoring post-surgically. RESULTS: The sound level produced by a high-powered holmium laser emitter during HoLEP was 67.37 ± 0.13 dB, which was significantly higher than the sound heard during TURP (46.41 ± 0.29 dB, P < 0.01). The 65-70 dB noise during HoLEP was proved to be a safe level in accordance with the OSHA standards. However, this level was considerably greater than the stated 55 dB. Moreover, it exceeded the normal communication protective level of 60 dB. In the analysis of responses from the surgeons, the HoLEP group obtained an average score that reflected disturbance caused by the laser emitter and an increase in average systolic pressure relative to that in the TURP group. CONCLUSIONS: The noise level during HoLEP is within hearing conservation levels. However, the noise disturbs intrateam communication and concentration during surgery. Some surgeons may experience discomfort post-surgically, but no significant difference among the groups is indicated. The findings suggest that measures should be taken to address the noise caused by the laser emitter during HoLEP.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido/uso terapéutico , Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Prostatectomía/métodos , Hiperplasia Prostática/cirugía , Urología , Adulto , Humanos , Masculino , Resección Transuretral de la Próstata
16.
Hepatobiliary Pancreat Dis Int ; 16(4): 431-436, 2017 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-28823375

RESUMEN

BACKGROUND: Emodin, a traditional Chinese medicine, has a therapeutic effect on severe acute pancreatitis (SAP), whereas the underlying mechanism is still unclear. Studies showed that the intestinal mucosa impairment, and subsequent release of endotoxin and proinflammatory cytokines such as IL-1ß, which further leads to the dysfunction of multiple organs, is the potentially lethal mechanism of SAP. Caspase-1, an IL-1ß-converting enzyme, plays an important role in this cytokine cascade process. Investigation of the effect of emodin on regulating the caspase-1 expression and the release proinflammatory cytokines will help to reveal mechanism of emodin in treating SAP. METHODS: Eighty Sprague-Dawley rats were randomly divided into four groups (n=20 each group): SAP, sham-operated (SO), emodin-treated (EM) and caspase-1 inhibitor-treated (ICE-I) groups. SAP was induced by retrograde infusion of 3.5% sodium taurocholate into the pancreatic duct. Emodin and caspase-1 inhibitor were given 30 minutes before and 12 hours after SAP induction. Serum levels of IL-1ß, IL-18 and endotoxin, histopathological alteration of pancreas tissues, intestinal mucosa, and the intestinal caspase-1 mRNA and protein expressions were assessed 24 hours after SAP induction. RESULTS: Rats in the SAP group had higher serum levels of IL-1ß and IL-18 (P<0.05), pancreatic and gut pathological scores (P<0.05), and caspase-1 mRNA and protein expressions (P<0.05) compared with the SO group. Compared with the SAP group, rats in the EM and ICE-I groups had lower IL-1ß and IL-18 levels (P<0.05), lower pancreatic and gut pathological scores (P<0.05), and decreased expression of intestine caspase-1 mRNA (P<0.05). Ultrastructural analysis by transmission electron microscopy found that rats in the SAP group had vaguer epithelial junctions, more disappeared intercellular joints, and more damaged intracellular organelles compared with those in the SO group or the EM and ICE-I groups. CONCLUSIONS: Emodin alleviated pancreatic and intestinal mucosa injury in experimental SAP. Its mechanism may partly be mediated by the inhibition of caspase-1 and its downstream inflammatory cytokines, including IL-1ß and IL-18. Our animal data may be applicable in clinical practice.


Asunto(s)
Caspasa 1/metabolismo , Inhibidores de Caspasas/farmacología , Emodina/farmacología , Mucosa Intestinal/efectos de los fármacos , Pancreatitis/tratamiento farmacológico , Enfermedad Aguda , Animales , Caspasa 1/genética , Modelos Animales de Enfermedad , Mediadores de Inflamación/sangre , Interleucina-18/sangre , Interleucina-1beta/sangre , Mucosa Intestinal/enzimología , Mucosa Intestinal/ultraestructura , Masculino , Páncreas/efectos de los fármacos , Páncreas/metabolismo , Páncreas/ultraestructura , Pancreatitis/inducido químicamente , Pancreatitis/enzimología , Pancreatitis/patología , Ratas Sprague-Dawley , Índice de Severidad de la Enfermedad , Transducción de Señal/efectos de los fármacos , Ácido Taurocólico
17.
Zhonghua Nan Ke Xue ; 23(10): 912-916, 2017 Oct.
Artículo en Chino | MEDLINE | ID: mdl-29727542

RESUMEN

OBJECTIVE: To investigate the clinical effect of "3+1" bladder function restoration combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with acontractile detrusor (ACD). METHODS: We treated 35 BPH patients with ACD by HoLEP followed by "3+1" bladder function restoration, that is, a 3-phase bladder function training plus simultaneous 1-drug medication after surgery. We recorded and analyzed the detrusor pressure, post-void residual urine volume (PVR), maximum urinary flow rate (Qmax), International Prognostic Scoring System (IPSS) scores, quality of life (QoL), voluntary micturition, satisfaction with the bladder function, hydronephrosis, ureterectasia, renal function, and urinary tract infection of the patients before and after treatment. RESULTS: Compared with the base line, at 6 months treatment, the patients showed significantly increased detrusor pressure (ï¼»35.1±2.7ï¼½vs ï¼»50.2±2.3ï¼½ cmH2O, P<0.05) and Qmax (ï¼»4.2±2.7ï¼½vs ï¼»21.1±4.1ï¼½ ml/s, P<0.05) but decreases in PVR (ï¼»173.0±31.6ï¼½ vs ï¼»30.5±12.9ï¼½ml, IPSS score (27.3±3.2 vs 5.1±1.4, P<0.05) and QoL (4.1±0.8 vs 0.8±0.1, P<0.05), elevated rates of voluntary urination (0% ï¼»0/35ï¼½ vs 100% ï¼»35/35ï¼½, P<0.05), regularurination (0% ï¼»0/35ï¼½ vs 85.71% ï¼»30/35ï¼½, P<0.05), grade Ⅰ satisfaction with bladder function (0% ï¼»0/35ï¼½ vs 85.71% ï¼»30/35ï¼½, P<0.05), reduced rate of overflowing urinary incontinence (28.57% ï¼»10/35ï¼½ vs 5.71% ï¼»2/35ï¼½, P<0.05), and increased percentages of normal renal function (34.29% ï¼»12/35ï¼½ vs 85.71% ï¼»30/35ï¼½, P<0.05) and non-infection of the urinary system (17.14% ï¼»6/35ï¼½ vs 94.29% ï¼»33/35ï¼½, P<0.05). After treatment, urination was markedly improved in 94.29% (33/35) of the patients. CONCLUSIONS: "3+1" bladder function restoration combined with HoLEP produced a desirable effect on BPH with ACD, though its long-term effect remains to be further investigated.


Asunto(s)
Terapia por Láser/métodos , Láseres de Estado Sólido , Hiperplasia Prostática/cirugía , Recuperación de la Función , Resección Transuretral de la Próstata/métodos , Vejiga Urinaria/fisiología , Anciano , Holmio , Humanos , Masculino , Satisfacción Personal , Calidad de Vida , Resultado del Tratamiento , Micción/fisiología
18.
Artículo en Inglés | MEDLINE | ID: mdl-27087823

RESUMEN

The present study aimed to assess the effects and mechanisms of genistin in the rat model of myocardial ischemia reperfusion injury. The rat hearts were exposed to the left anterior descending coronary artery (LAD) ligation for 30 min followed by 1 h of reperfusion. In the rat of myocardial ischemia/reperfusion (MI/R), it was found that genistin pretreatment reduced myocardial infarct size, improved the heart rate, and decreased creatine kinase (CK) and lactate dehydrogenase (LDH) levels in coronary flow. This pretreatment also increased catalase (CAT), superoxide dismutase (SOD) activities but decreased glutathione (GSH), malondialdehyde (MDA) levels. Furthermore, we determined that genistin can ameliorate the impaired mitochondrial morphology and oxidation system; interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) levels were also recovered. Besides, related-proteins of nuclear factor kappa-B (NF-κB) signal pathway activated by P2X7 were investigated to determine the molecular mechanism of genistin and their expressions were measured by western blot. These results presented here demonstrated that genistin enhanced the protective effect on the rats with myocardial ischemia reperfusion injury. Therefore, the cardioprotective effects of genistin may rely on its antioxidant and anti-inflammatory activities via suppression of P2X7/NF-κB pathways.

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