[Comparison of efficacy and safety of transurethral thulium laser vapoenucleation of prostate and transurethral thulium laser enucleation of prostate in the treatment of benign prostatic hyperplasia].

Objective: To compare early outcomes between transurethral thulium laser vapoenucleation of prostate and transurethral thulium laser enucleation of prostate for the treatment of benign prostatic hyperplasia (BPH). Methods: Retrospective analysis was conducted on the clinical data of 1 638 BPH patients admitted to the Department of Urology of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021. There were 916 patients underwent transurethral thulium laser vapoenucleation of prostate (ThuVEP group) and 722 patients underwent transurethral thulium laser enucleation of prostate (ThuLEP group). The operation time, eliminated tissue weight, surgical complications, duration of post-operative catheter implantation were compared between the two groups. The improvement of International Prostate Symptom Score (IPSS), Quality of Life Index (QoL), maximum uroflow rate (Qmax) and post-void residual urine volume (PVR) at 1 month after operation was compared between the two groups. Results: There were no significant differences in age, preoperative and 1-month postoperative prostate volume, IPSS score, QoL score, Qmax, and PVR between the ThuVEP and ThuLEP group (all P>0.05). There were no significant differences in perioperative indicators such as operation time, cutting or enucleation time, tissue crushing time, tissue weight, hemoglobin change, catheter indwelling time, and postoperative hospital stay between ThuVEP group and ThuLEP group (all P>0.05). The incidence of minor gross hematuria after extubation in the ThuVEP group was 7.8% (56/916), which was lower than 9.4% (65/722) in the ThuLEP group (P=0.026); the incidence of temporary incontinence at 1 month after surgery was 5.2% (38/916) in ThuVEP group, lower than 11.9% (86/722) in ThuLEP group (P<0.001). A total of 3 patients (0.4%) in ThuLEP group required operative intervention for severe post-operation bleeding, but none of ThuVEP group suffered from this kind of surgical complications. Conclusions: ThuVEP has similar efficacy with ThuLEP for the treatment of BPH. ThuVEP can significantly reduce the incidence of post-operation temporary urine incontinence, and has much superiority in stanching bleeding.

[Bushen Huoxue Fang improves recurrent miscarriage in mice by down-regulating the JAK2/STAT3 pathway].

OBJECTIVE: To investigate the efficacy of Bushen Huoxue Fang (BSHXF, a traditional Chinese medicine formula) for improving recurrent spontaneous abortion (RSA) in mice and the role of tyrosine kinase (JAK2) and transcriptional activator (STAT3) signaling pathway in its therapeutic mechanism. METHODS: Female CBA/J mice were caged with male DBA/2 mice to establish RSA mouse models, which were randomly divided into model group, dydrogesterone group and BSHXF group, with the female mice caged with male BALB/c mice as the control group (n=6). From the first day of pregnancy, the mice were subjected to daily intragastric administration of BSHXF, dydrogesterone, or distilled water (in control and model groups) for 12 days. After the treatments, serum levels of antithrombin III (AT-III), activated protein C (APC), tissue plasminogen activator (t-PA), progesterone, human chorionic gonadotropin (HCG), and estradiol (E2) were detected in each group using ELISA. HE staining was used to observe the morphological changes of the endometrium of the mice. Western blotting was performed to determine the expressions of p-JAK2, p-Stat3 and Bcl-2 in the placenta of the mice. RESULTS: Compared with the control mice, the mouse models of RSA showed a significantly increased embryo loss rate with decreased serum levels of AT-III, T-PA, progesterone, APC and HCG, increased placental expressions of p-JAK2, p-STAT3 and Bax, and decreased expression of Bcl-2 (P < 0.05). Treatments with BSHXF and dydrogesterone both increased serum levels of AT-III, t-PA and HCG in the mouse models; Serum APC level was significantly reduced in BSHXF group and serum progesterone level was significantly increased in dydrogesterone group (P < 0.05). CONCLUSION: BSHXF can improve the prethrombotic state and inhibit cell apoptosis by downregulating the JAK2/STAT3 pathway to increase the pregnancy rate in mouse models of RSA.

Human tissue kallikrein 1 ameliorates erectile function via modulation of macroautophagy in aged transgenic rats.

Previously, we have demonstrated that human tissue kallikrein 1 (hKLK1) improves age-related erectile dysfunction (ED). Autophagy has been implicated in age-related diseases, including ED. However, the molecular mechanisms underlying hKLK1-mediated amelioration of age-related ED via regulation of autophagy remains unknown. To explore the potential mechanism, male wild-type Sprague-Dawley rats (WTR) and transgenic rats harboring human KLK1 (TGR) were bred till 4 or 18 months of age and divided into three groups: young WTR (yWTR) as the control group, aged WTR (aWTR) group, and aged TGR (aTGR) group. The erectile function of each rat was evaluated using cavernous nerve electrostimulation. The ratio of intracavernous pressure/mean arterial pressure (ICP/MAP) and total ICP were also measured. Western blotting, immunohistochemistry, and transmission electron microscopy were performed to detect the levels of autophagy. The expression levels of related signaling pathways were determined by western blotting and immunohistochemistry. We found that hKLK1 improved the impaired erectile function of aged rats. Compared to the yWTR and aTGR groups, the aWTR group showed reduced smooth muscle/collagen ratio, fewer autophagosomes, and lower expression of Beclin 1 and LC3-II, which indicate impaired smooth muscle function and low level of autophagy in the smooth muscle cells. Moreover, the PI3K/Akt/mTOR signaling pathway, which is considered to be a negative regulator of autophagy, was upregulated in the aWTR group. hKLK1 may partially restore erectile function in aged transgenic rats by upregulating protective autophagy via the PI3K/Akt/mTOR pathway. These observations indicate that hKLK1 is a potential gene therapy candidate for age-related ED.

Diagnostic dilemma: treatment outcomes of tuberculosis patients with inconsistent rifampicin susceptibility.

OBJECTIVE: A retrospective clinical trial to evaluate treatment outcomes in adults with smear-positive tuberculosis (TB) and discordant rifampicin (RMP) resistance results. DESIGN: A total of 2156 smear-positive TB patients underwent both conventional and Genechip drug susceptibility testing (DST) for RMP resistance. All 49 patients with discordant results treated with either a first-line or second-line regimen were analysed. RESULTS: Of 30 Type I cases (Genechip-resistant, conventional DST-susceptible) receiving the first-line regimen, 4 had a favourable outcome and 5 failed treatment. The 21 remaining Type I cases were treated with the second-line regimen, of whom 18 had a favourable outcome. Second-line regimen thus resulted in significantly more favourable outcomes than first-line treatment (P = 0.032). Among Type II cases (Genechip-susceptible, conventional DST-resistant), 13/19 received the first-line regimen, and 7 had a favourable outcome. The six Type II cases treated with the second-line regimen all had favourable outcomes. CONCLUSION: Patients with discordant RMP DST results who receive second-line regimens may have a better clinical response than those treated with the first-line regimen. Patients infected with fluoroquinolone-resistant Mycobacterium tuberculosis strains were observed to have a significantly higher treatment failure rate.

Tenuifolin, an extract derived from tenuigenin, inhibits amyloid-beta secretion in vitro.

AIM: Previous studies have shown that tenuigenin, a crude extract of Polygala tenuifolia Willd. that is commonly used in traditional Chinese herbal medicine for memory loss, can reduce the secretion of Abeta from cultured cells. However, the mechanism underlying this effect and the active compound derived from tenuigenin is unknown. In this study, a purified component of tenuigenin, tenuifolin, was examined and revealed to be an effective compound in vitro. METHODS: Abeta secretion from three sets of COS-7 cells, each carrying a plasmid expressing a different form of APP was examined following the treatment with tenuifolin. Initially, tenuifolin was determined to have no inherent toxicity to either the transfected or wild type cells at the effective concentrations. Cells were then treated with 0.5-2.0 microg mL(-1) tenuifolin for 12 h and their media were examined via an ELISA for Abeta1-40 and Abeta-42. RESULTS: We found that treatment with 2.0 microg mL(-1) tenuifolin significantly decreased Abeta secretion from COS-7 cells without altering the ratio of Abeta1-40 and Abeta-42. This effect is most probably due to inhibition of the beta-site APP cleaving enzyme as Abeta secretion was not inhibited from cells expressing the C99 fragment. CONCLUSION: Tenuifolin is an effective compound from tenuigenin. We believe that this finding should lead the way for future experiments to determine the exact mechanism for tenuifolin's effect on Abeta secretion.

Folic acid protects SWV/Fnn embryo fibroblasts against arsenic toxicity.

It has been proposed that arsenic exerts its toxic effects, in part, by perturbing cellular methyl metabolism. Based on the hypothesis that folic acid treatment will attenuate the cytotoxic and growth inhibitory effects of arsenic, SWV/Fnn embryo fibroblasts were cultured in media supplemented with various concentrations of folic acid during treatment with sodium arsenite or dimethylarsinic acid (DMA). It was found that folic acid protects SWV/Fnn embryo fibroblasts from sodium arsenite and DMA cytotoxicity in a dose-dependent manner. In contrast, folic acid supplementation has no effect on toxicity resulting from treatment with ethanol or staurosporine, suggesting that folic acid is not generally protective against necrosis and apoptosis. Although folic acid protects against acute arsenic toxicity, this agent shows a modest and delayed ability to attenuate the growth inhibitory effect of arsenic on these cells. These results support a model in which perturbations of methyl metabolism contribute to the acute cytotoxicity of arsenic.

[Preventive and therapeutic effect of Chinese herbs naofeikang on experimental emphysema and pulmonary artery hypertension in hamsters].

OBJECTIVE: To observe preventive and therapeutic effect of Chinese herbs Naofeikang on hypoxic pulmonary artery hypertension of elastase-induced emphysema hamsters and investigate its mechanism. METHODS: Hamsters for 30 days after intratracheally-instilled elastase, were kept in hypoxia environment under normal atmospheric pressure for 15 days, 50 hamsters were divided into prevention group (Prv), treatment group (T), emphysema + hypoxia (EH), and control group(N). Mean pulmonary artery pressure (MPAP) was measured before hamsters were killed. And then right ventricle hypertrophy index (RVHI) was measured, as well as circulating endothelial cells (CEC) and cells recoveries from bronchoalveolar lavage fluid (BALF) were counted. Meanwhile, pulmonary tissue changes were studied under light microscope with morphometric analysis. RESULTS: Compared with EH group, MPAP, CEC, and cells recoveries of BALF of Prv and T groups were significantly decreased (P < 0.05 or P < 0.01); Mean linear intercept and percentage of arterial media area of Prv and T groups had totally a significant difference (P < 0.01) in comparison with EH group. CONCLUSIONS: Chinese herbs Naofeikang could lower pulmonary hypertension, preserve vessel endothelial cells and lessen the inflammatory reaction in pulmonary tissue. Thereby, it could hinder the further development of emphysema and inhibit the remodeling of pulmonary small artery.

[Effect of feishuling on production of tumor necrosis factor alpha from hamster alveolar macrophages].

OBJECTIVE: To observe the effect of the traditional Chinese medicine Feishuling on the production of tumor necrosis factor alpha (TNF-alpha) from hamster alveolar macrophages in vitro and investigate the mechanism of its preventive and therapeutic effect on chronic obstructive pulmonary diseases(COPD). METHOD: Alveolar macrophages were harvested through bronchoalveolar lavage and cultured, Feishuling were added to the culture medium with lipopolysaccharide(LPS) simultaneously or 6 h after LPS. TNF-alpha production in the culture supernatants was tested by ELISA assay and the expression of TNF-alpha mRNA in the cells was measured through in situ hybridization. RESULT: After administration of Feishuling, the content of TNF-alpha in the supernatants and the expression of TNF-alpha mRNA in the cells were decreased more significantly than those in LPS stimulation group(P < 0.01), and there was a dose-effect relationship, but no significant differences were observed as compared with the simple culture medium group(P > 0.05). CONCLUSION: The effect of reducing the production of TNF-alpha from alveolar macrophages and inhibiting the damage mediated by TNF-alpha might be a part of the mechanism of Feishuling to prevent and treat COPD.

[The morphometric analysis of lung on protective effect of Chinese herbs 814 on elastase-induced emphysema in hamsters].

OBJECTIVE: To determine the protective effect of Chinese herbal medicine 814 on elastase-induced emphysema in hamsters. METHODS: Animals were injected intratrachealy with elastase for emphysematous models, prophylactic-therapeutic groups were administrate with 814 through esophagus two weeks before the instillation of elastase untill animals were killed at three different time at first, second, and third month. Pulmonary artery pressure, blood gas analysis, heart index and the ratio of dried weight to wet weight of lungs (WW/DW) were examined. The lung paraffin sections were measured mean linear intercept (MLI), mean alveolar number (MAN), ratio of parenchyma area to total area (PA/TA) by the microscope-computer morphometric analysis system. RESULTS: WW/DW in the prophylactic-therapeutic groups was recovered at the same level with the controls, whereas the emphysematous were significantly increased (P < 0.05); and compared with the emphysematous groups, the prophylactictherapeutic groups significantly decreased in MLI, increased in MAN and PA/TA (P < 0.001 or P < 0.05). CONCLUSIONS: Administration of 814 could partly inhibit the development of emphysema induced by elestase in hamsters.

[Morphometric investigation on hypoxic structural remodeling of intraacinar pulmonary arteries].

OBJECTIVE: To observe the inhibitory effects of Radix Astragali (RA) on hypoxic structural remodeling of intraacinar pulmonary arteries (IAPA) and pulmonary hypertension (PHT). METHOD: 60 rats were divided into H (hypoxia) group (n = 20 rats) H + RA group (n = 20) and normal control (C) group (n = 20). The rats of H group and H + RA group were fed in hypoxic environment under normal atmospheric pressure (10% O2, 10 hours/day). On the 15th and 30th day of hypoxia, right ventricular systolic pressure (RVSP) and right ventricle hypertrophy index (RVHI) were measured and pulmonary vessel changes were studied under light and electron microscope with morphometric analysis. RESULT: Compared with H + RA group on 30th day, RVSP in H was 1.8 time as high as that of H + RA(P < 0.05); RVHI in H was 1.3 time as high as that of H + RA (P < 0.05); the media thickness of IAPA in H was 2.3 time as high as that of H + RA (P < 0.05); the density of adventitial fibroblasts of IAPA was 13.1 +/- 0.3 (H) and 7.6 +/- 0.2 (H + RA) (P < 0.05). CONCLUSION: Preserving the IAPA wall cells and dilating IAPA by RA may play an important role in inhibiting remodeling of IAPA and PTH.

[Effect of herbs 814 on tumor necrosis factor a production from alveolar macrophages in vitro].

OBJECTIVE: To study the influence of herbs 814 on the secretion of tumor necrosis factor alpha (TNF-alpha) from hamster alveolar macrophages (AMs) in vitro and elucidate mechanism of herbs 814's prevention of emphysema. METHODS: AMs of hamster were collected by bronchial alveolar lavage (BAL). The lung lavage cells were adjusted to 5 x 10(5)/ml and seeded in each well of a 24-well tissue culture plates. The herbs 814 was added into these wells before or after lipopolysaccharide (LPS) stimulation and then cultured supernatants were collected. TNF-alpha production in the supernatants was tested by ELISA, TNF-alpha cytotoxicity was assayed using L929 cells which were susceptible to TNF-alpha and a monoclonal antibody (MAb) that neutralizes rhTNF-alpha was utilized to identify the cytotoxicity of cultured TNF-alpha. RESULTS: ELISA showed that TNF-alpha production in the supernatants with 814 added was lower than those either in LPS-stimulated or non LPS-stimulated supernatants and there was a significant decrease in the supernatants of higher concentration (1:5) of herbs 814. Cytotoxicity test showed that TNF-alpha cytotoxic activity in the supernatants into which herbs 814 was added was lower than one in the LPS-stimulated supernatants and there was a significant decrease in the supernatants of higher concentration (1:5) of herbs 814. Meanwhile, MAb significantly reduced cytotoxicity of LPS-stimulated culture supernatants. CONCLUSIONS: Herbs 814 could inhibit the secretion of TNF-alpha and prevent the lung damage mediated by TNF-alpha.

The inhibitory effects of Radix Astragali on hypoxic pulmonary hypertension of rats.

OBJECTIVE: To observe the inhibitory effects of Radix Astragali (RA) on hypoxic structural remodeling of intraacinar pulmonary arteries (IAPA) and pulmonary hypertension (PHT). METHODS: Sixty rats were divided into three groups: hypoxia group, hypoxia + RA group and normal control group. The rats of hypoxia group and hypoxia + RA group were fed in hypoxic environment under normal atmospheric pressure (10% O2, 10 h/day). On the 15th and 30th day of hypoxia, right ventricular systolic pressure (RVSP) and right ventricle hypertrophy index (RVHI) were measured and pulmonary vessel changes were studied under light and electron microscope and with morphometric analysis. RESULTS: Compared with the result of hypoxia + RA group, RA could relieve IAPA wall cell injuries and dilate the constricted IAPA induced by hypoxia. RA could also inhibit hypertrophic changes in the tunica media and proliferation of adventitial cells of the IAPA and muscularization of nonmuscular arteries. CONCLUSION: By preserving the IAPA wall cells and dilating IAPA, RA may play an important role in inhibiting the remodeling of IAPA and preventing PHT.

[Therapeutic effect of radix Astragali on hypoxia pulmonary hypertension in rats].

Radix Astragali could inhibit the type III collagen deposition, smooth muscle cell proliferation in IAPA, and increase the tolerance of myocardium to hypoxia in rats.

[The inhibitory effects of Radix Astragali on hypoxic pulmonary hypertension of rats].

The inhibitory effects of Radix Astragali (RA) on hypoxic structural remodeling of intra-acinar pulmonary arteries (IAPA) and pulmonary hypertension (PHT) were studied in rats, which were fed in hypoxic environment under normal atmospheric pressure (10% O2 10 hours/day). 60 rats were divided into 3 groups; hypoxia group, hypoxia+RA group and control group. On the 15th and 30th day of hypoxia, right ventricular systolic pressure (RVSP) and right ventricle hypertrophy index (RVHI) were measured and pulmonary vessel changes were studies under light and electronic microscopes and morphometric analysis. Compared with the hypoxia+RA group, RA could prevent IAPA wall cell damage and dilate the constricted IPIA induced by hypoxia. RA could also inhibit hypertrophic changes in the tunica media and proliferation of adventitial cells of the IAPA and muscularization of non-muscular arteries. Therefore, preserving the IAPA wall cells and dilating IAPA by RA may play an important role in inhibiting structural remodeling of IAPA and pulmonary hypertension.

[Experimental studies on inhibitory effects of radix Peucedani on hypoxic pulmonary hypertension in rats].

Light microscopic and morphometric methods along with the measurement of right ventricular systolic pressure (RVSP) and right ventricle hypertrophy index (RBHI) were performed by the authors in studying the inhibitory effects of Radix Peucedani (RP) on structural remodeling of intraacinar pulmonary arteries (IAPA) and pulmonary hypertension (PHT) in hypoxic rats. The results showed that, RP could not only antagonize IAPA contraction caused by hypoxia and lower the resistance of pulmonary circulation, inhibit the cell proliferation and hypertrophy of adventitial cells of pulmonary artery, but also reverse the change in structure and function of pulmonary artery. It suggests that RA plays a key role in inhibiting hypoxic structural remodeling of IAPA and pulmonary hypertension.