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1.
Eur J Pharmacol ; 960: 176121, 2023 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-37866743

RESUMEN

Osteoporosis, a systemic bone disease defined by decreased bone mass and deterioration of bone microarchitecture, is becoming a global concern. Nodakenin (NK) is a furanocoumarin-like compound isolated from the traditional Chinese medicine Radix Angelicae biseratae (RAB). NK has been reported to have various pharmacological activities, but osteoporosis has not been reported to be affected by NK. In this study, we used network pharmacology, molecular docking and molecular dynamics simulation techniques to identify potential targets and pathways of NK in osteoporosis. We found that NK treatment significantly promoted osteogenic differentiation of BMSCs while activating the PI3K/AKT/mTOR signalling pathway by measuring alkaline phosphatase activity and the expression of various osteogenic markers. In contrast, LY294002, an inhibitor of PI3K, reversed these changes and inhibited the osteogenic differentiation-enabling effect of NK. Meanwhile, prevent the Akt and NFκB signalling pathways by down-regulating c-Src and TRAF6 thereby effectively inhibiting RANKL-induced osteoclastogenesis. In addition, oral administration of NK to mice significantly elevated bone mass and ameliorated ovariectomized (OVX)-mediated bone microarchitectural disorders. In conclusion, these data suggest that NK attenuates OVX-induced bone loss by enhancing osteogenesis and inhibiting osteoclastogenesis.


Asunto(s)
Osteogénesis , Osteoporosis , Femenino , Ratones , Animales , Humanos , Proteínas Proto-Oncogénicas c-akt/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Simulación del Acoplamiento Molecular , Osteoporosis/tratamiento farmacológico , Osteoporosis/etiología , Osteoporosis/metabolismo , Ovariectomía/efectos adversos , Osteoclastos , Diferenciación Celular , Ligando RANK/farmacología
2.
Artículo en Inglés | MEDLINE | ID: mdl-37464818

RESUMEN

The birth of a child is a critical and potentially traumatic experience for women, entailing multiple physiological and psychosocial changes. The psychological effects of childbirth pain can have both immediate and long-term effects on the mother's health and her bond with her child. Many studies investigated the different ranges of synthetic drugs available for pain control in labour, inclusive of neuraxial analgesics, inhaled analgesics, and various opioids. The inadequate efficacy and unfavourable side effects of these synthetic drugs prevent appropriate pharmacotherapy, resulting in a quest for natural therapies for reducing labour pain. Herbal therapies (aromatherapy) using several essential oils obtained from various natural plants are another alternative that calms and manages the mind and body through aromatic compounds that have neurological and physiological effects. The review discussed the safety profile of various synthetic drugs with their dosage information and also deliberated on the mechanism and safety profile of various natural plants that are used in aromatherapy. The review also briefly highlighted the other non-pharmacological miscellaneous techniques such as TENS, hypnosis, immersion in water, acupuncture, massage, and different other tactics that aim to assist women in coping with pain in labour.

3.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 52(2): 156-161, 2023 Apr 25.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-37283099

RESUMEN

OBJECTIVES: To investigate the effect of progressive pre-disconnection of urethral mucosal flap during transurethral plasmakinetic enucleation of prostate (TUPEP) on early recovery of urinary continence. METHODS: Clinical data of patients with benign prostatic hyperplasia (BPH) admitted in Zhujiang Hospital of Southern Medical University during February and May 2022 were collected. All the patients underwent TUPEP, and the progressive pre-disconnection of urethral mucosal flap was performed in the procedure. The total operation time, enucleation time, postoperative bladder irrigation time and catheter indwelling time were recorded. Urinary continence was evaluated 24 h, 1 week, and 1, 3, 6 months after the removal of urinary catheter. RESULTS: All surgeries were successfully completed at one time with less intraoperative bleeding, and there were no complications such as rectal injury, bladder injury or perforation of prostate capsule. The total operation time was (62.2±6.5) min, the enucleation time was (42.8±5.2) min, the postoperative hemoglobin decrease by (9.5±4.5) g/L, the postoperative bladder irrigation time was (7.9±1.4) h, and the postoperative catheter indwelling time was 10.0 (9.2, 11.4) h. Only 2 patients (3.6%) had transient urinary incontinence within 24 h after catheter removal. No urinary incontinence occurred at 1 week, and 1, 3, 6 months after operation, and no safety pad was needed. The Qmax at 1 month after operation was 22.3 (20.6, 24.4) mL/s, international prostate symptom scores were 8.0 (7.0, 9.0), 5.0 (4.0, 6.0) and 4.0 (3.0, 4.0) at 1, 3 and 6 months after surgery, and quality of life scores at 1, 3 and 6 months after surgery were 3.0 (2.0, 3.0), 2.0 (1.0, 2.0) and 1.0 (1.0, 2.0), all of these indicators were better than those before surgery (all P<0.01). CONCLUSIONS: In the treatment of BPH, the application of progressive pre-disconnection of urethral mucosal flap in TUPEP can completely remove the hyperplastic glands and promote early recovery of postoperative urinary continence with less perioperative bleeding and decreased surgical complications.


Asunto(s)
Hiperplasia Prostática , Resección Transuretral de la Próstata , Incontinencia Urinaria , Masculino , Humanos , Próstata , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Calidad de Vida , Vejiga Urinaria , Incontinencia Urinaria/etiología , Incontinencia Urinaria/prevención & control , Incontinencia Urinaria/cirugía , Resultado del Tratamiento
4.
Infect Drug Resist ; 16: 937-947, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36814826

RESUMEN

Purpose: Vitamin D, an essential nutrient and a pleiotropic steroid hormone, has been reported to be associated with the risk and severity in patients infected with Coronavirus Disease-2019 (COVID-19). The role of vitamin D in predicting clinical outcome for COVID-19 patients is unknown. Here, we aimed to determine the prognostic value of plasma 25(OH)D level in COVID-19 patients. Patients and Methods: A total of 158 patients infected with novel COVID-19 Omicron variants in Shanghai were recruited in this study and were categorized into three groups by the tertile levels of plasma 25(OH)D. Plasma 25(OH)D level was determined along with routine blood tests related to liver and renal functions in newly diagnosed COVID-19 patients at admission. The nucleic acid negative conversion time of throat swab samples was evaluated as the primary clinical outcome. The prognostic value of clinical characteristics and plasma 25(OH)D level was assessed using the Kaplan-Meier plot and Cox proportional hazards regression tests. Results: Higher level of plasma 25(OH)D level in COVID-19 patients was independently associated with shorter nucleic acid negative conversion time from COVID-19 infection (multivariate adjusted HR: 0.54, 95%CI: 0.35-0.82, P=0.004, tertile 2 vs 1; multivariate adjusted HR: 0.60, 95%CI: 0.39-0.90, P=0.014, tertile 3 vs 1). Conclusion: Plasma 25(OH)D level may serve as an independent prognostic factor in COVID-19 patient. Our findings indicate the protective roles of vitamin D supplementation in the regiment of patients with COVID-19.

5.
Zhonghua Nan Ke Xue ; 29(10): 904-909, 2023 Oct.
Artículo en Chino | MEDLINE | ID: mdl-38639660

RESUMEN

OBJECTIVE: To explore the application prospect and clinical efficacy of transurethral plasmakinetic enucleation of the Giant prostatic hyperplasia. METHODS: The clinical data of 5 patients with Giant prostatic hyperplasia treated by transurethral plasmakinetic enucleation in our department from december 2021 to january 2023 were retrospectively analyzed. RESULTS: All 5 patients successfully completed the operation, aged 69-80 years (73.2±4.32),PSA level was 8.07~42.90ng/ml (22.81±13.97), prostate volume was 321.05-534.26g (388.34±84.26), enucleation time was 120-240 min (174±61.48), Gland processing time 40-120 min(63±32.71). There were 1 case of perforation of prostate capsule and severe hematuria,3 cases of blood transfusion. 2 cases of transient urinary incontinence were improved after 2 weeks and 4 months postoperative respectively. International Prostate Symptom Score (IPSS),and quality of life score (QoL) and Maximum urine flow rate(Qmax) were significantly improved compared with preoperative parameters. CONCLUSION: It is safe and effective to treat GPH with plasma enucleation through urethra with skilled plasma enucleation technique.


Asunto(s)
Hiperplasia Prostática , Resección Transuretral de la Próstata , Humanos , Masculino , Próstata/cirugía , Hiperplasia Prostática/cirugía , Hiperplasia Prostática/diagnóstico , Calidad de Vida , Estudios Retrospectivos , Resección Transuretral de la Próstata/métodos , Resultado del Tratamiento , Anciano , Anciano de 80 o más Años
6.
Mil Med Res ; 9(1): 14, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35361280

RESUMEN

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline "2018 Standard Edition". However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons' surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy; the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons' skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.


Asunto(s)
Hiperplasia Prostática , Resección Transuretral de la Próstata , Estrechez Uretral , Anciano , Humanos , Masculino , Próstata , Hiperplasia Prostática/cirugía , Calidad de Vida , Resección Transuretral de la Próstata/efectos adversos , Resección Transuretral de la Próstata/métodos , Estrechez Uretral/etiología , Estrechez Uretral/cirugía
7.
Artículo en Inglés | MEDLINE | ID: mdl-35047049

RESUMEN

The prevalence and risk factors of intracranial atherosclerotic stenosis (ICAS) located in the anterior circulation (AC) and posterior circulation (PC) has been scarcely noted in the general population. We aimed to determine ICAS prevalence and risk factor profile of AC and PC in a representative population. Data were from the China Hypertension Survey of Beijing. In total, 4800 people aged 35 years or older were enrolled in this subsurvey for ICAS, and 3954 participants were eligible for analysis. ICAS was assessed by transcranial Doppler. The prevalence of ICAS in AC was much greater than that in PC (11.9% vs. 4.2%), and subjects with ICAS in PC were 3.9 years older than those with ICAS in AC. Multivariable logistics regression showed that the odds of hypertension and diabetes increased by 79% (OR: 1.79, 95% CI: 1.40-2.27) and 35% (OR: 1.35, 95% CI: 1.04-1.75) in those with AC vascular lesions and by 3.35 times (OR: 3.35, 95% CI: 2.49-4.50) and 71% (OR: 1.71, 95% CI: 1.19-2.46) in those with PC vascular lesions compared with those without vascular lesions. Most modifiable vascular risk factors for ICAS appeared to exert similar magnitudes of risk for PC to AC lesions.

8.
Mol Pharm ; 18(2): 667-678, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32579365

RESUMEN

Gasdermin D (GSDMD) plays a causal role in NOD-like receptor protein 3 (NLRP3) inflammasome-mediated pyroptosis eruption, which has been regarded as a potential therapeutic target for pyroptosis-related diseases including acute gouty arthritis. In the present study, the synthesized PEI-Chol (cholesterol grafted polyethylenimine) was assembled with GSDMD small interfering RNA (siRNA) to form PEI-Chol/siGSDMD polyplexes, which provided high transfection efficiency for siRNA-mediated GSDMD knockdown. Then we evaluated the effect of GSDMD siRNA-loaded PEI-Chol on inflammatory cascades in bone-marrow-derived macrophages (BMDMs) and acute gouty arthritis animal models under MSU exposure. When accompanied by pyroptosis blockade and decreased release of interleukin-1 beta (IL-1ß), NLRP3 inflammasome activation was also suppressed by GSDMD knockdown in vivo and in vitro. Moreover, in MSU-induced acute gouty arthritis mice, blocking GSDMD with siRNA significantly improved ankle swelling and inflammatory infiltration observed in histopathological analysis. Furthermore, investigation using a mouse air pouch model verified the effect of siGSDMD-loaded PEI-Chol on pyroptosis of recruited macrophages and related signaling pathways in response to MSU. These novel findings exhibited that GSDMD knockdown relieved acute gouty arthritis through inhibiting pyroptosis, providing a possible therapeutic approach for MSU-induced acute gouty arthritis molecular therapy using PEI-Chol as a nucleic acid delivery carrier.


Asunto(s)
Artritis Gotosa/tratamiento farmacológico , Portadores de Fármacos/química , Péptidos y Proteínas de Señalización Intracelular/antagonistas & inhibidores , Proteínas de Unión a Fosfato/antagonistas & inhibidores , Piroptosis/efectos de los fármacos , ARN Interferente Pequeño/administración & dosificación , Animales , Artritis Experimental/inducido químicamente , Artritis Experimental/tratamiento farmacológico , Artritis Experimental/inmunología , Artritis Experimental/patología , Artritis Gotosa/inducido químicamente , Artritis Gotosa/inmunología , Artritis Gotosa/patología , Células Cultivadas , Colesterol , Técnicas de Silenciamiento del Gen/métodos , Humanos , Inflamasomas/efectos de los fármacos , Inflamasomas/inmunología , Inflamasomas/metabolismo , Interleucina-1beta/metabolismo , Péptidos y Proteínas de Señalización Intracelular/genética , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Macrófagos/metabolismo , Masculino , Ratones , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Proteínas de Unión a Fosfato/genética , Proteínas de Unión a Fosfato/metabolismo , Polietileneimina/química , Cultivo Primario de Células , Transducción de Señal/efectos de los fármacos , Transducción de Señal/inmunología , Ácido Úrico/administración & dosificación , Ácido Úrico/toxicidad
9.
Food Funct ; 11(12): 10817-10827, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33237064

RESUMEN

OBJECTIVE: The aim of the present study was to explore whether combined calcium and vitamin D supplementation is beneficial for osteoporosis in postmenopausal women. METHODS: We searched the PubMed, Cochrane library, Web of science and Embase databases and reference lists of eligible articles up to Feb, 2020. Randomized controlled trials (RCTs) evaluating the effect of combined calcium and vitamin D on osteoporosis in postmenopausal women were included in the present study. RESULTS: Combined calcium and vitamin D significantly increased total bone mineral density (BMD) (standard mean differences (SMD) = 0.537; 95% confidence interval (CI): 0.227 to 0.847), lumbar spine BMD (SMD = 0.233; 95% CI: 0.073 to 0.392; P < 0.001), arms BMD (SMD = 0.464; 95% CI: 0.186 to 0.741) and femoral neck BMD (SMD = 0.187; 95% CI: 0.010 to 0.364). It also significantly reduced the incidence of hip fracture (RR = 0.864; 95% CI: 0.763 to 0.979). Subgroup analysis showed that combined calcium and vitamin D significantly increased femoral neck BMD only when the dose of the vitamin D intake was no more than 400 IU d-1 (SMD = 0.335; 95% CI: 0.113 to 0.558), but not for a dose more than 400 IU d-1 (SMD = -0.098; 95% CI: -0.109 to 0.305), and calcium had no effect on the femoral neck BMD. Subgroup analysis also showed only dairy products fortified with calcium and vitamin D had a significant influence on total BMD (SMD = 0.784; 95% CI: 0.322 to 1.247) and lumbar spine BMD (SMD = 0.320; 95% CI: 0.146 to 0.494), but not for combined calcium and vitamin D supplement. CONCLUSION: Dairy products fortified with calcium and vitamin D have a favorable effect on bone mineral density. Combined calcium and vitamin D supplementation could prevent osteoporosis hip fracture in postmenopausal women.


Asunto(s)
Calcio/farmacología , Suplementos Dietéticos , Osteoporosis Posmenopáusica/tratamiento farmacológico , Vitamina D/farmacología , Densidad Ósea/efectos de los fármacos , Conservadores de la Densidad Ósea , Calcio de la Dieta , Productos Lácteos , Bases de Datos Factuales , Femenino , Fracturas Óseas , Humanos , Vértebras Lumbares , Posmenopausia , Ensayos Clínicos Controlados Aleatorios como Asunto
10.
Acta Med Okayama ; 74(2): 175-178, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32341594

RESUMEN

Urolithiasis, a common condition in patients with spinal deformity, poses a challenge to surgical procedures and anesthetic management. A 51-year-old Chinese male presented with bilateral complex renal calculi. He was also affected by severe kyphosis deformity and spinal stiffness due to ankylosing spondylitis. Dr. Li performed the percutaneous nephrolithotomy under local infiltration anesthesia with the patient in a kneeling prone position, achieving satisfactory stone clearance with no severe complications. We found this protocol safe and effective to manage kidney stones in patients with spinal deformity. Local infiltration anesthesia may benefit patients for whom epidural anesthesia and intubation anesthesia are difficult.


Asunto(s)
Anquilosis/complicaciones , Cálculos Renales/cirugía , Cifosis/complicaciones , Nefrolitotomía Percutánea/métodos , Posicionamiento del Paciente , Anestesia Local/métodos , Humanos , Cálculos Renales/complicaciones , Cálculos Renales/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
11.
J Agric Food Chem ; 68(16): 4616-4623, 2020 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-32208625

RESUMEN

Tyrosol is a pharmacologically active phenolic compound widely used in the pharmaceutical and chemical industries. Microbial fermentation has potential value as an environmentally friendly approach to tyrosol production, but suffers from low tyrosol yields and the need for expensive media additives. In this study, Escherichia coli MG1655 was modified by integrating an E. coli codon-optimized version of the Saccharomyces cerevisiae phenylpyruvate decarboxylase gene, named ARO10*, into the lacI locus. The resulting strain (YMGA*) produced 0.14 mM tyrosol from 2% glucose without the need for expensive media supplements. Subsequent deletion of E. coli genes designed to eliminate competing metabolic pathways (feaB, pheA, tyrB) or undesirable gene regulation (tyrR) produced a strain (YMGA*R) that produced 3.11 mM tyrosol. Tyrosol production was then increased to 10.92 mM by increasing the ARO10* copy number to five copies (strain YMG5A*R). Finally, tyrosol production was increased to 28 mM (ca. 3.9 g/L) by optimizing fermentation conditions in a 5 L fermenter. Engineering a productive E. coli strain with high tyrosol titer from glucose using a medium that does not require added amino acids, inducer, or antibiotic provides a solid basis to produce tyrosol through microbial fermentation.


Asunto(s)
Escherichia coli/genética , Escherichia coli/metabolismo , Alcohol Feniletílico/análogos & derivados , Fermentación , Dosificación de Gen , Glucosa/metabolismo , Ingeniería Metabólica , Alcohol Feniletílico/metabolismo , Tirosina/metabolismo
12.
Food Funct ; 11(4): 3280-3297, 2020 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-32219282

RESUMEN

BACKGROUND: Previous studies did not draw a consistent conclusion about the effects of vitamin K combined with vitamin D on human skeletal quality. METHOD AND FINDINGS: A comprehensive search on Web of Science, PubMed, Embase and the Cochrane Library (from 1950 to February 2020) and bibliographies of relevant articles was undertaken, with the meta-analysis of eight randomized controlled trials (RCTs) including a total of 971 subjects. Vitamin K combined with vitamin D significantly increased the total bone mineral density (BMD): the pooled effect size was 0.316 [95% CI (confidence interval), 0.031 to 0.601]. A significant decrease in undercarboxylated osteocalcin (-0.945, -1.113 to -0.778) can be observed with the combination of vitamin K and D. Simultaneously, subgroup analysis showed that K2 or vitamin K (not specified) supplement was less than 500 µg d-1, which when combined with vitamin D can significantly increase the total BMD compared with the control group fed a normal diet or the group with no treatment (0.479, 0.101 to 0.858 and 0.570, 0.196 to 0.945). CONCLUSIONS: The combination of vitamin K and D can significantly increase the total BMD and significantly decrease undercarboxylated osteocalcin, and a more favorable effect is expected when vitamin K2 is used.


Asunto(s)
Huesos/efectos de los fármacos , Vitamina D/farmacología , Vitamina K/farmacología , Densidad Ósea/efectos de los fármacos , Bases de Datos Factuales , Suplementos Dietéticos , Humanos , Osteocalcina/farmacología , Ensayos Clínicos Controlados Aleatorios como Asunto , Vitamina K 2/farmacología
13.
Biomed Res Int ; 2020: 8241637, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32104707

RESUMEN

OBJECTIVE: To assess the value of clinically relevant data for predicting the failure of removal of the urinary catheter within 48 hours after TUERP. Materials and Methods. We retrospectively analyzed the medical records of 357 patients who underwent TUERP between January 2015 and July 2018, all of whom stopped bladder irrigation and removed urinary catheter within 48 hours after the operation. According to whether the removal of the catheter was successful, the patients were classified into 2 groups: Group A was successful and group B was a failure. Univariate analysis was performed to determine the association between the failure of removal of the catheter and the patients' preoperative clinical characteristics. Logistic regression analysis and receiver operating characteristic analysis (ROC) were conducted to establish the prediction model. Then the area under the curve (AUC) and the cut-off value were calculated. RESULTS: 357 patients were divided into group A (n = 305, 85.4%) and group B (n = 305, 85.4%) and group B (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (P=0.006), history of acute urinary retention (AUR) (. CONCLUSION: This study demonstrated that IPSS, QoL, drug medication, history of AUR, TPV, and IPP are independent factors associated with the failure of removal of the urethral catheter within 48 hours after TUERP.


Asunto(s)
Remoción de Dispositivos , Próstata/cirugía , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/efectos adversos , Cateterismo Urinario/efectos adversos , Catéteres Urinarios/efectos adversos , Anciano , Humanos , Masculino , Estudios Retrospectivos , Factores de Tiempo
14.
Nutrients ; 10(8)2018 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-30081527

RESUMEN

Previous studies have not drawn a consistent conclusion about effect of multivitamin and multimineral supplementation (MVMS) on blood pressure. A comprehensive search of PubMed, Embase and Cochrane Library (up to May 2018) and references of relevant articles was undertaken. The present meta-analysis included 12 randomized controlled trials (RCTs), of which eight RCTs in 2011 subjects evaluated the effect of MVMS on blood pressure and four RCTs in 21,196 subjects evaluated the effect of MVMS on the risk of hypertension. MVMS had a lowering effect on systolic blood pressure (SBP) and diastolic blood pressure (DBP): the weighted mean difference (WMD) was -1.31 mmHg (95% CI, -2.48 to -0.14 mmHg) and -0.71 mmHg (95% CI, -1.43 to 0.00 mmHg), respectively. Subgroup analysis indicated that the lowering effect of MVMS on blood pressure was only significant in 134 subjects with chronic disease but not in 1580 healthy subjects, and the WMD for systolic blood pressure (SBP) and DBP in subjects with chronic disease was -6.29 mmHg (95% CI, -11.09 to -1.50 mmHg) and -2.32 mmHg (95% CI, -4.50 to -0.13 mmHg), respectively. The effect size of MVMS on SBP in 58 hypertensive subjects (WMD, -7.98 mmHg; 95% CI, -14.95 to -1.02 mmHg) was more than six times of that in 1656 normotensive subjects (WMD, -1.25 mmHg; 95% CI, -2.48 to -0.02 mmHg). However, no significant effect on DBP was observed in both hypertensive and normotensive subgroups. There was no significant effect of MVMS on risk of hypertension in 22,852 subjects with a normal blood pressure at baseline. In conclusion, although MVMS had a significant lowering effect on blood pressure in normotensive subjects, the lowering effect was too small to effectively prevent future hypertension. MVMS may be an effective method for blood pressure control in subjects with chronic disease including hypertension, but the sample size of subjects with hypertension or other chronic disease was too small, and more well-designed RCTs are needed to confirm this result.


Asunto(s)
Presión Sanguínea , Suplementos Dietéticos , Hipertensión/terapia , Minerales/administración & dosificación , Vitaminas/administración & dosificación , Adulto , Suplementos Dietéticos/efectos adversos , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Minerales/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Resultado del Tratamiento , Vitaminas/efectos adversos , Adulto Joven
15.
World J Urol ; 36(7): 1117-1126, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29459994

RESUMEN

PURPOSE: Bipolar endoscopic enucleation of the prostate (BEEP) was recommended by the 2016 EAU guidelines as the first choice of surgical treatment in men with a substantially enlarged prostate and moderate-to-severe lower urinary tract symptoms. The main aim of this study was to compare a modified diode laser enucleation of the prostate (DiLEP) to BEEP. METHODS: A total of 114 patients with prostate (20-160 mL) were randomized 1:1 into either DiLEP or BEEP in a dual-centre, non-inferiority-design randomized-controlled trial. The primary outcomes included Qmax and IPSS at 12 months. Non-inferiority was evaluated by comparing the two-sided 95% CI for the mean differences of Qmax and IPSS. Secondary endpoints included other perioperative parameters, postoperative micturition variables, and complication rate. RESULTS: A total of 111 patients (97%) had completed the intent-to-treat analysis, The results showed that DiLEP was comparable to BEEP regarding Qmax (28.0 ± 7.0 vs. 28.1 ± 7.2 mL/s) and IPSS (3.0 ± 2.2 vs. 2.9 ± 2.6) at 12 months, the non-inferiority was met for both Qmax and IPSS. There were also no significant difference between two groups regarding tissue removal rate (71.8 vs. 73.8%), hemoglobin decrease (0.33 ± 0.66 vs. 0.36 ± 0.75 g/dL), sodium decrease (1.0 ± 2.7 vs. 0.3 ± 2.9 mmol/L), and Clavien III complications (5.3 vs. 1.8%) at 12 months. CONCLUSIONS: This DiLEP is an anatomical endoscopic enucleation technique for the treatment of benign prostatic hyperplasia, it is non-inferior to BEEP regarding Qmax and IPSS at 12 months postoperatively.


Asunto(s)
Terapia por Láser/métodos , Síntomas del Sistema Urinario Inferior/cirugía , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Anciano , Estudios de Seguimiento , Humanos , Análisis de Intención de Tratar , Láseres de Semiconductores , Tiempo de Internación , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Hiperplasia Prostática/complicaciones , Calidad de Vida , Factores de Tiempo , Resultado del Tratamiento
16.
J Tradit Chin Med ; 38(3): 427-432, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32185976

RESUMEN

OBJECTIVE: To investigate the effect of Sini decoction on rats with myocardial fibrosis induced by banding the abdominal aorta, and explore the mechanism underlying its actions on angiotensin ¢ò(Ang ¢ò), transforming growth factor-¦Â1 (TGF-¦Â1) and connective tissue growth factor (CTGF). METHODS: Forty-eight male Sprague-Dawley rats were randomly divided into sham operation, model, Captopril, and Sini decoction groups. The models were established by the partial banding of the abdominal aorta according to Doering's method. Eight weeks later, heart weight indexes were calculated; hemodynamic changes of the hearts were tested; changes in myocardial tissue morphology were observed by Masson staining; and myocardial collagen volume fraction was calculated. Enzyme-linked immunosorbent assay was used to measure the concentration of Ang ¢ò in serum. The expression of TGF-ß1 and CTGF were determined by immunohistochemistry and Western blotting. RESULTS: Compared with the sham operation group, the heart weight index, collagen volume fraction of the myocardium, serum levels of Ang ¢ò and the expression of myocardial TGF-ß1 and CTGF in the model group were significantly increased (P < 0.05). Compared with the model group, the heart weight index, collagen volume fraction of the myocardium, serum levels of Ang ¢ò and the expression of myocardial TGF-ß1 and CTGF in all treatment groups were significantly reduced (P < 0.05). CONCLUSION: Sini decoction reduced Ang ¢ò level and inhibited the expression of myocardial TGF-ß1 and CTGF, which may explain the mechanism of its protective effect on myocardium with fibrosis.

17.
Oncotarget ; 8(13): 21177-21186, 2017 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-28416753

RESUMEN

Renal cell carcinoma (RCC) management has undergone a major transformation over the past decade; immune checkpoint inhibitors are currently undergoing clinical trials and show promising results. However, the effectiveness of immune checkpoint inhibitors in patients with metastatic RCC (mRCC) is still limited. Lycorine, an alkaloid extracted from plants of the Amaryllidaceae family, is touted as a potential anti-cancer drug because of its demonstrative growth inhibition capacity (induction of cell cycle arrest and inhibition of vasculogenic mimicry formation). Moreover, T cell checkpoint blockade therapy with antibodies targeting cytotoxic T-lymphocyte associated protein 4 (CTLA-4) has improved outcomes in cancer patients. However, the anti-tumor efficacy of combined lycorine and anti-CTLA-4 therapy remains unknown. Thus, we investigated a combination therapy of lycorine hydrochloride and anti-CTLA-4 using a murine RCC model. As a means of in vitro confirmation, we found that lycorine hydrochloride inhibited the viability of various RCC cell lines. Furthermore, luciferase-expressing Renca cells were implanted in the left kidney and the lung of BALB/c mice to develop a RCC metastatic mouse model. Lycorine hydrochloride and anti-CTLA-4 synergistically decreased tumor weight, lung metastasis, and luciferin-staining in tumor images. Importantly, the observed anti-tumor effects of this combination were dependent on significantly suppressing regulatory T cells while upregulating effector T cells; a decrease in regulatory T cells by 31.43% but an increase in effector T cells by 31.59% were observed in the combination group compared with those in the control group). We suggest that a combination of lycorine hydrochloride and anti-CTLA-4 is a viable therapeutic option for RCC patients.


Asunto(s)
Alcaloides de Amaryllidaceae/farmacología , Anticuerpos Monoclonales/farmacología , Antineoplásicos/farmacología , Antígeno CTLA-4/antagonistas & inhibidores , Carcinoma de Células Renales/terapia , Inhibidores de Crecimiento/farmacología , Fenantridinas/farmacología , Extractos Vegetales/farmacología , Alcaloides de Amaryllidaceae/uso terapéutico , Animales , Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Carcinoma de Células Renales/tratamiento farmacológico , Puntos de Control del Ciclo Celular/efectos de los fármacos , Línea Celular Tumoral , Terapia Combinada , Sinergismo Farmacológico , Femenino , Inhibidores de Crecimiento/uso terapéutico , Humanos , Factores Inmunológicos/farmacología , Factores Inmunológicos/uso terapéutico , Inmunoterapia/métodos , Ratones , Ratones Endogámicos BALB C , Neoplasias Experimentales , Fenantridinas/uso terapéutico , Extractos Vegetales/uso terapéutico , Subgrupos de Linfocitos T/efectos de los fármacos , Subgrupos de Linfocitos T/inmunología , Resultado del Tratamiento
18.
Asian J Androl ; 19(6): 655-658, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27924790

RESUMEN

The aim of this study was to determine whether the lower urinary tract storage symptoms of benign prostatic obstruction (BPO) could be completely resolved after plasmakinetic enucleation of the prostate (PKEP) and the possible predictors of persistent symptoms. Two hundred and sixty-seven cases of BPO performed PKEP from July 2008 to June 2009 were retrospectively analyzed. Five-year postoperative data were collected and compared with the preoperative data. According to the urodynamic results, the patients were divided into involuntary detrusor contraction (IDC) group (n = 95) and no IDC group (n = 172) preoperatively; the patients with IDC were divided into IDC-persistent group (n = 33) and IDC-resolved group (n = 62) after PKEP. The predictors of persistent IDC were analyzed. Compared with the preoperative data, the 5-year postoperative data showed that the IDC rate was lower (P = 0.000), Overactive Bladder Symptom Score (OABSS) was lower (P = 0.000), maximum cystometric capacity (MCC) was larger (P = 0.000), Prostate volume (PV) was smaller (P = 0.000), and prostate-specific antigen (PSA) was lower (P = 0.000). Compared with the no IDC group, the IDC group showed that the age was older (P = 0.016), MCC was smaller (P = 0.004), PSA was higher (P = 0.016), and Chronic Inflammation rate was higher (P = 0.004). Compared with IDC-resolved group after PKEP, IDC-persistent group showed that the age was older (P = 0.019), MCC was smaller (P = 0.000), PSA was higher (P = 0.013), and Chronic Inflammation rate was higher (P = 0.032). The present study shows that the storage symptoms are still needed to be focused on after PKEP. The advanced patient age, MCC, PSA, and chronic inflammation may be the important clinical predictors of persistent IDC.


Asunto(s)
Síntomas del Sistema Urinario Inferior/cirugía , Próstata/cirugía , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Anciano , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/fisiopatología , Masculino , Persona de Mediana Edad , Próstata/fisiopatología , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/fisiopatología , Calidad de Vida , Resultado del Tratamiento , Urodinámica/fisiología
19.
Nan Fang Yi Ke Da Xue Xue Bao ; 36(8): 1100-4, 2016 Aug 20.
Artículo en Chino | MEDLINE | ID: mdl-27578580

RESUMEN

OBJECTIVE: To assess the safety and therapeutic effect of morcellator in transurethral bipolar plasmakinetic anatomical enucleation (TUPKAEP) of benign prostate hyperplasia (BPH). METHODS: The clinical data of 47 patients with BPH receiving TUPKAEP between January and July, 2015 were analyzed. During the operation, morcellator was used to smash the enucleated BPH which was aspirated with subatmospheric pressure in 29 cases, and the tissue was smashed with bipolar electrosurgical loop slicing from top to bottom and aspirated by ellic suction in 18 cases. RESULTS: s The procedures were completed successfully in all the 47 cases. The time used for adenoma dissociation was 2.24∓1.09 with morcellator at the speed of 18.43∓6.01 g/min, and was 17.19∓11.74 min with bipolar electrosurgical loop at the speed of 1.91∓0.65 g/min; the mean total operation time was significantly shorter in morcellator group (28.13∓14.71 vs 43.22∓25.39 min). The 2 groups showed no significant difference in postoperative continuous bladder irrigation time, postoperative indwelling time of urinary catheter or postoperative hospital stay. CONCLUSION: s Morcellator is safe and feasible for application in TUPKAEP and helps to shorten the operation time.


Asunto(s)
Morcelación , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata , Humanos , Tiempo de Internación , Masculino , Tempo Operativo , Irrigación Terapéutica , Resultado del Tratamiento
20.
Zhonghua Nan Ke Xue ; 20(3): 249-52, 2014 Mar.
Artículo en Chino | MEDLINE | ID: mdl-24738463

RESUMEN

OBJECTIVE: To investigate the feasibility and effect of early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH). METHODS: We equally randomized 128 BPH patients treated by PKRP to an experimental group and a control group, urethral catheters removed at 1 -2 days for the former and at 5 -7 days for the latter. We compared the relevant indexes and clinical effects between the two groups. RESULTS: The baseline data were not significantly different between the two groups. Compared with the controls, the experimental group showed a significantly shorter postoperative hospital stay ([6.8 +/- 1.9] d vs [3.7 +/- 1.5] d, P < 0.05) and lower infection rate (25.0% vs 10.9%, P < 0.05). All the patients were followed up for 3 -6 months postoperatively. At 3 months after surgery, both the experimental and the control groups showed remarkable improvement in the International Prostatic Symptoms Scores (4. 9 +/- 2. 2 vs 5. 3 +/- 2. 3), maximum urine flow rate ([21.5+/- 5.6 ] ml/s vs [19.1 +/-4.9 ] ml/s) , and residual urine ( [ 16.8+/- 10.3 ] ml vs [18.9 +/- 12.3 ] ml), but with no significant differences between the two (P > 0.05) , and no significant differences were observed in postoperative complications (P >0.05). CONCLUSION: Early removal of the urethral catheter after PKRP, with its advantages of shorter postoperative hospital stay, lower infection rate, and no influence on the long-term effect, deserves to be recommended as a routine method in the treatment of BPH.


Asunto(s)
Remoción de Dispositivos , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata/métodos , Cateterismo Urinario , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos
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