Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation.

BACKGROUND: Although some recent neuroimaging studies have indicated the abnormal brain structure or function in patients with lifelong premature ejaculation (LPE), whether and how the abnormal thalamic function participates in processing sexual behavioral information are still unclear in patients with LPE. AIM: The aim of this study was to assess the changes in the thalamus metabolism and structural integrity in patients with LPE. METHODS: We performed a multimodal magnetic resonance approach in a 3.0 T system, including proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging, and volumetric analysis to detect the differences in thalamic metabolism and structure between 20 patients with LPE and 15 healthy controls. OUTCOMES: We analyzed and correlated the clinical symptoms of the subjects with significant 1H-MRS-based features. Peak areas of N-acetylaspartate, choline, creatine (Cr), and glutamate/glutamine (Glu) were calculated with the LCModel software. RESULTS: Diffusion tensor imaging and volumetric analysis of thalami showed no differences between the 2 groups. On the contrary, 1H-MRS study disclosed that both Glu concentrations and Glu/Cr ratio values in the thalami of patients with LPE were remarkably increased when compared with healthy controls (P < .01 for both variables). In addition, both the intravaginal ejaculatory latency time score and Chinese Index of Sexual Function for Premature Ejaculation-5 score were negatively related to increased Glu concentrations and Glu/Cr ratio values. CLINICAL IMPLICATIONS: Glutamatergic activity changes of thalamus may be an underlying indicator for evaluating sensory conduction efficiency in patients with LPE. STRENGTHS & LIMITATIONS: The present study first found the abnormal thalamic metabolism in patients with LPE and contributed to a better understanding of the LPE etiology. Limitations include a cross-sectional study design with small samples and no examination of other brain areas. CONCLUSION: Our findings show that the increase in glutamatergic activity of thalamus is related to LPE, suggesting that the increased Glu neurotransmission in the thalamus may contribute to the development of premature ejaculation. Xia J-D, Chen F, Zhang Q-J, et al. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2021;18:275-283.

Microwave assisted chitosan-polyethylene glycol hydrogel membrane synthesis of curcumin for open incision wound healing.

Chitosan and polyethylene glycol hydrogel membranes containing curcumin were synthesized using microwave technology at fixed frequency, power and time of 2450 MHz, 500 Watt and 120 s. Polymers were solubilized separately, combined with drug and mixed in two different ratios i.e. F1=80:20 and F2=85:15. The untreated and microwave treated hydrogel membranes were analyzed for degree of swelling, degree of degradation, tensile strength, surface morphology, vibrational and thermal analysis and in vitro drug release. Results indicated that F2(micro) showed a significantly high degree of swelling (96.49±1.21 %), low degradation (9.88±1.68 %), sustained drug release through slow erosion (55.1±3.11 %) via non-Fickian diffusion. The vibrational and thermal analysis revealed rigidification of hydrophilic domains of the polymers by formation of hydrogen bonds between chitosan and PEG moieties (OH/NH) and elasticity of hydrophobic domains (asymmetric and symmetric CH moieties and/or C=O moieties) which not only significantly increased the transition temperature and enthalpy (297.2±3.2 °C and 4.24±1.4 J/g) of the chitosan moiety but also resulted in enhanced tensile strength (18.2±1.3 Mpa). In vivo wound healing study revealed significantly faster wound healing in the F2(micro) treated animal group in comparison to a control animal group where at day 14, a significant re-epithelization (87.26 %) with smaller wound size was observed. Hence microwave assisted chitosan-PEG hydrogel membrane of curcumin is advocated to be a suitable plate form for wound healing applications.

Efficacy and Safety of Serenoa repens Extract Among Patients with Benign Prostatic Hyperplasia in China: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial.

OBJECTIVE: To evaluate the efficacy and safety of Serenoa repens among patients with benign prostatic hyperplasia (lower urinary tract symptoms/benign prostatic hyperplasia [LUTS/BPH]) in China. METHODS: We conducted a double blind, placebo-controlled study of 354 patients with LUTS/BPH from 19 institutions, to evaluate the efficacy and safety of Serenoa repens. Participants were randomly assigned (1:1) into the Serenoa repens extract (320 mg) or placebo groups for 24 weeks. Primary efficacy parameters were changes in International Prostate Symptom Score and peak urinary flow from baseline to each assessment. Secondary efficacy parameters included improvement of storage symptom and voiding symptom scores, prostate volume, urinary frequency, and total prostate-specific antigen level. Other parameters assessed were quality of life score, a four-item male sexual function questionnaire score, and International Index of Erectile Function score across the consecutive double-blind visits. RESULTS: Statistically significant improvement in the peak urinary flow, International Prostate Symptom Score, scores of storage symptoms and voiding symptoms, quality of life score, four-item male sexual function questionnaire score, and International Index of Erectile Function score were observed in the Serenoa repens extract group compared with those in the placebo group (P <.05). Two (1.18%) of 169 patients in the placebo group and 3 (1.89) of 159 patients in the Serenoa repens extract group experienced 1 or more adverse events. CONCLUSION: The Serenoa repens extract was effective, safe, well-tolerated, and clinically and statistically superior to placebo in the target LUTS/BPH population.

An Up-to-date Meta-analysis of Coffee Consumption and Risk of Prostate Cancer.

PURPOSE: Results of the association between coffee consumption (CC) and the risk of prostate cancer (PC) are still controversy. Based on published relevant studies, we conducted an up-to-date meta-analysis to investigatethis issue. MATERIALS AND METHODS: The protocol used in this article is in accordance with the PRISMA checklist. Eligible studies were screened and retrieved by using PUBMED and EMBASE as well as manual review of references up to July 2016. We calculated the pooled relative risk (RR) with 95% confidence interval (CI) with random effect models. The dose-response relationship was assessed by generalized least-squares trend estimation analysis. RESULTS: Totally, we included twenty-eight studies (14 case-control and 14 cohort studies) on CC with 42399 PC patients for the final meta-analysis. No significant association of PC was found for high versus non/lowestCC, with RR = 1.07 (95% CI: 0.96-1.18). In subgroup meta-analysis by study design, there were no significant positive associations between CC and PC in case-control studies (RR = 1.19, 95% CI: 1.05-1.35) or in the cohort studies (RR = 0.97, 95% CI: 0.84-1.12). Additionally, RR with different quality of studies were respectively 1.15 (95% CI: 0.99-1.34) and 1.28 (95% CI: 1.03-1.58) for high and low quality in the case-control studies; while were respectively 1.02 (95% CI: 0.88-1.20) and 0.81 (95% CI: 0.57-1.14) in the cohort studies. When analyzed by geographic area, we found no association between CC and PC, with RR = 1.06 (95% CI: 0.86-1.30) for 10 studies from Europe, 1.06 (95% CI: 0.94-1.20) for 13 studies conducted in America; 1.12 (95% CI: 0.70-1.79) for 4 studiesfrom Asia. However, in subgroup analysis by subtype of the disease, there was a significant negative (beneficial) association in the localized PC (RR = 0.90, 95% CI: 0.84-0.97), but not for the advanced PC (RR = 0.90, 95%CI: 0.70-1.16). Additionally, RR = 0.99 (95% CI: 0.98-0.99) for an increment of one cup per day of coffee intake shows significant association with the localized PC. CONCLUSION: Our results indicate that CC has no harmful effect on PC. On the contrary, it has an effect on reducing the localized PC risk. Further prospective cohort studies of high quality are required to clarify this relationship.

Artesunate Suppresses the Growth of Prostatic Cancer Cells through Inhibiting Androgen Receptor.

Prostatic cancer (PCa) is a leading cause of cancer related death in males and is often regarded as a kind of androgen-sensitive cancer. Artesunate (ART), a semi-synthetic derivative of the Chinese herb Artemisia annua, is such an anti-cancer agent. However, the effects and mechanism of ART on PCa cells remains unclear. The study aims to elaborate the mechanism of the involvement of androgen receptor (AR) in anti-prostatic cancer (PCa) of artesunate (ART). PCa cells 22rvl were used in vivo and in vitro, and the viability and apoptosis were conducted using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay, respectively. Ectopic expressions of AR and DNA methyltransferase (DNMT) were detected in cells in overexpression or interference of AR or DNMT3b. ART dose-dependently suppressed tumor growth, inhibited cell viability, enhanced apoptosis, decreased AR expression, and increased the expression and the catalytic activity of DNMT3b in 22rv1 cells either in transplanted mice or in vitro. Furthermore, AR downregulated DNMT3b expression, and overexpression of AR or interference of DNMT3b could reverse ART-induced cytotoxicity and apoptosis in 22rvl cells, whereas overexpression of DNMT3b could not change the effect profiles of ART on the cells. The results indicated that ART suppressed tumor growth of prostatic cancer cells through AR-DNMT3b pathway, underlying ART will allow for the utilization of this Chinese therapeutic agent for the potential treatment of prostate cancer.

Protective Effects of the Segmental Renal Artery Clamping Technique on Ischemia-Reperfusion Injury in db/db Diabetic Mice.

Renal ischemia-reperfusion (I/R) injury is inevitable in partial nephrectomy and other kidney surgeries, with a higher incidence in patients with renal insufficiency. This study aimed to investigate the protective effects of precise segmental renal artery clamping (SRAC) against renal I/R injury in db/db diabetic mice, compared with conventional renal artery clamping (RAC). Grape seed extract, a powerful free radical scavenger, was administered to diabetic mice for 4 weeks before operation in subgroups (30 mg/kg/d). The unilateral renal pedicle was ligatured, and I/R injury to the contralateral kidney was induced (ischemia for 30 min followed by reperfusion for 24 h). Blood glucose value, creatinine, blood urea nitrogen, and urine microalbumin/urine creatinine ratio increased gradually and showed no preoperative statistical differences among six subgroups. These parameters were significantly lower in the SRAC than in the RAC group 24 h postoperatively. Moreover, the nonischemic area in the SRAC group expressed less KIM-1 and TNF-α mRNA and also revealed minor histopathological damage induced by I/R. These findings suggest that SRAC effectively reduces early renal injury induced by I/R and accelerates the recovery of renal function in diabetic mice. Thus, SRAC may be an ideal technique in partial nephrectomy, especially for patients with diabetic nephropathy and other renal insufficiencies.

A novel surgical management for male infertility secondary to midline prostatic cyst.

BACKGROUND: To summary the procedure and experience of a novel surgical management for male infertility secondary to midline prostatic cyst (MPC). METHODS: From February 2012 to February 2014, 12 patients were diagnosed with PMC by semen analysis, seminal plasma biochemical analysis, transrectal ultrasonography (TRUS), and pelvic magnetic resonance imaging (MRI). All patients underwent the transurethral unroofing of MPC using resectoscope, the dilation of ejaculatory duct, and the irrigation of seminal vesicle using seminal vesiculoscope. All patients were followed up at least 3 months after operation. RESULTS: Preoperative semen analyses of 12 patients showed oligoasthenozoospermia (5/12) or azoospermia (7/12), low semen volume (0-1.9 mL), and low pH level (5.5-7.0). Preoperative seminal plasma biochemical analyses showed reduced semen fructose. TURS and MRI revealed a cyst lesion located in the midline of prostatic. After 3 months follow up, the semen quality of 80% patients (4/5) with oligoasthenozoospermia improved obviously. The spermatozoa were present in the semen in 5 of 7 cases with azoospermia. In one patient, the spermatozoa occurred in the urine after ejaculation. CONCLUSIONS: Surgical management using transurethral resectoscopy and seminal vesiculoscopy is effective, minimally invasive, and safe for male infertility secondary to MPC.

[Prostate cancer after prostatectomy for benign prostatic hyperplasia].

OBJECTIVE: To study the diagnosis and treatment of prostate cancer after prostatectomy for benign prostatic hyperplasia (BPH). METHODS: Twelve cases of prostate cancer after prostatectomy for benign prostatic hyperplasia were reviewed and studied. The mean intervals between prostatectomy for BPH and the diagnosis of prostate cancer was 10 months to 14 years, 5.6 years on average. The main symptoms were dysuria, hematuria and pain. Serum prostate specific antigen (PSA) was elevated in 11 cases. Digital rectal examination (DRE) was abnormal in 8 cases. Three cases were in clinical stage B, 3 in stage C and 6 in stage D. Ten cases received combined androgen blockade therapy. Monotherapy with surgical castration was given to 2 cases. Three patients with urinary tract obstruction received additional treatment of TURP. RESULTS: During the 4 months to 8 years follow-up, 3 patients died, 6 remained stable and 2 deteriorated. CONCLUSION: Surgery for BPH could not prevent the development of prostate cancer. PSA and DRE were the main methods for the diagnosis of this prostate cancer.