RESUMO
BACKGROUND: Class III radical hysterectomy (RH III)_plus pelvic lymphadenectomy is the standard surgery for early stage cervical cancer (CC) patients, the 5 year survival rate is about 90%, but pelvic floor disorders especially bladder dysfunction are common due to damaged vessels and nerve fibers following surgery. Transcutaneous electrical stimulation (TENS) treatment has been used to treat bladder disorders for many years, but its effect on cervical cancer patients, the best treatment time point and stimulated protocol, had never been assessed. The aim of this study is to investigate the efficacy of TENS treatment on lower urinary tract symptoms (LUTS) after RH III in CC patients. METHODS/DESIGN: The study will be conducted as a clinical, multicentre, randomised controlled trial with balanced randomisation (1:1). The planned sample size is 208 participants (at 1:1 ratio, 104 subjects in each group). At 5-7 days after RH III, patients are screened according to operative and pathological findings. Enrolled participants are randomised into an intervention group (TENS plus conventional clinical care) or control group (conventional clinical care), with stratification by menopausal status (menopause vs. non-menopause) and surgical modality (laparoscopic RH or abdominal RH). Participants in both groups will be followed up at 14 days, 21 days, 28 days, 3 months, 6 months, 12 months, 18 months and 24 months after surgery. The primary endpoint is improvement rate of urination function which is defined as recovery (residual urine ≤50 ml) or improvement (residual urine 50-100 ml). Secondary endpoints include urodynamic parameter, urinary incontinence, anorectal function, pelvic function, quality of life (QOL), disease-free survival and adverse events. Primary endpoint analyses will be carried out by Cochran-Mantel-Haenszel tests taking into center effect. DISCUSSION: To our knowledge this is the first trial to investigate the effect of TENS treatment on bladder function recovery after RH III among CC patients. This study will provide new information on TENS efficacy for bladder function recovery. Once confirmed, it may help to provide a new, non-invisive treatment for those postoperative CC patients with poor pelvic function, which would help improve their quality of life. TRIAL REGISTRATION: The study is registered to Clinical Trials.gov ( NCT02492542 ) on June 25, 2015.
Assuntos
Protocolos Clínicos , Histerectomia/efeitos adversos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/terapia , Estimulação Elétrica Nervosa Transcutânea , Neoplasias do Colo do Útero/complicações , Adolescente , Adulto , Feminino , Humanos , Histerectomia/métodos , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Estimulação Elétrica Nervosa Transcutânea/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/cirurgia , Adulto JovemRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Ginsenoside Rg1 (Rg1), one of the major bioactive ingredients of Panax ginseng C. A. Mey, has neuroprotective effects in animal models of depression, but the mechanism underlying these effects is still largely unknown AIM OF THE STUDY: Gap junction intercellular communication (GJIC) dysfunction is a potentially novel pathogenic mechanism for depression. Thus, we investigated that whether antidepressant-like effects of Rg1 were related to GJIC. MATERIALS AND METHODS: Primary rat prefrontal cortical and hippocampal astrocytes cultures were treated with 50µM CORT for 24h to induce gap junction damage. Rg1 (0.1, 1, or 10µM) or fluoxetine (1µM) was added 1h prior to CORT treatment. A scrape loading and dye transfer assay was performed to identify the functional capacity of gap junctions. Western blot was used to detect the expression and phosphorylation of connexin43 (Cx43), the major component of gap junctions. RESULTS: Treatment of primary astrocytes with CORT for 24h inhibited GJIC, decreased total Cx43 expression, and increased the phosphorylation of Cx43 at serine368 in a dose-dependent manner. Pre-treatment with 1µM and 10µM Rg1 significantly improved GJIC in CORT-treated astrocytes from the prefrontal cortex and hippocampus, respectively, and this was accompanied by upregulation of Cx43 expression and downregulation of Cx43 phosphorylation. CONCLUSION: These findings provide the first evidence indicating that Rg1 can alleviate CORT-induced gap junction dysfunction, which may have clinical significance in the treatment of depression.
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Astrócitos/efeitos dos fármacos , Junções Comunicantes/efeitos dos fármacos , Ginsenosídeos/farmacologia , Animais , Astrócitos/metabolismo , Comunicação Celular/efeitos dos fármacos , Células Cultivadas , Conexina 43/metabolismo , Corticosterona , Regulação para Baixo , Junções Comunicantes/fisiologia , Hipocampo/citologia , Fosforilação/efeitos dos fármacos , Córtex Pré-Frontal/citologia , RatosRESUMO
The (anaphylactoid) hypersensibility mechanism of â³imprinting templatesâ³ characteristics of traditional Chinese medicine (TCM) injection supramolecules was clarified to lay the foundation to build safety evaluation method. Based on the previous publication on special impact of Chinese medicine theories on supramolcular chemistry, combined with the natural origination of (anaphylactoid) hypersensitized special rules as well as the sensitization phenomenon of cordate houttuynia injection, the impact of the structure characteristics of â³imprinting templatesâ³ in TCM injection supramolecules on its (anaphylactoid) hypersensibility was clarified. In Chinese medicine injections, the supramolecular structures can independently be generated, showing overall apparent (anaphylactoid) hypersensibility nature, and their structure characteristics were dependent on the strength. In addition, (anaphylactoid) hypersensitive critical supramolecular structure was present. When it was administrated by â³injectionâ³, it's structure was not easy to be destroyed, often showing apparent immunogenicity, whereas if it was administrated by â³oralâ³, the structure would be destroyed by the gastrointestinal tract, showing weaker or no apparent immunogenicity. Therefore, there are differences in (anaphylactoid) hypersensibility between â³injectionâ³ and â³oralâ³ administration of TCM. TCM injections would produce the supramolecules between â³molecular societyâ³ by independent reaction of supramolecular â³imprinting templateâ³ (chemical determinants), showing apparent immune process of recognition, copying, and storage. Single molecule is a special example for this. The screening of anaphylactoid (sensitinogen) includes the single ingredients and their forming supramolecules for TCM injection. This is the unique feature for safety evaluation of Chinese medicine injection.
Assuntos
Hipersensibilidade a Drogas/etiologia , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/síntese química , Hipersensibilidade a Drogas/imunologia , Medicamentos de Ervas Chinesas/administração & dosagem , Humanos , Injeções , Medicina Tradicional Chinesa , Impressão MolecularRESUMO
Orchard and black locust are two typical plants for comprehensive control in the small watershed of land uses in Loess area. The analysis of soil carbon sequestration function changes of growing two plants is important to gain a deep understanding of soil carbon cycle process and its influencing factors of terrestrial ecosystems under the condition of small watershed comprehensive control. The experiment was conducted in the Changwu State Key Agro-Ecological Station, Shanxi, China. SOC, TN, fine root biomass and litter amount were determined at different age apple orchards and black locusts on the slope land of Wangdonggou watershed to study the variation characteristics of soil organic carbon and its influencing factors under two measurements. The results showed that: (1) SOC and TN contents in apple orchards significantly decreased with the increased age, whereas those in black locust showed an increased tendency with the age increased. Compared with the adjacent cropland,the SOC and TN contents in year 3, year 8, year 12 and year 18 apple orchards were decreased 3. 26%, 10. 54%, 18. 08%, 22. 55% and - 8. 08%, - 0. 48%, 4. 97%, 16. 91%, respectively. However,SOC and TN contents increased 5. 31%, 32. 36%, 44. 13% and 2. 49%, 15. 75%, 24. 22%, in year 12, year 18 and year 25 black locusts, respectively. (2) The fine root biomass in year 3, year 8, year 12, and year 18 apple orchards were about 25. 97% 66. 23%, 85. 71% and 96. 10% of the adjacent cropland, respectively; and the litter amounts were all 0 g . m-2. However, compared with adjacent cropland, The fine root biomass in year 12, year 18 and year 25 black locusts were increased 23. 53%, 79. 41%, 157. 35%, respectively; and the litter input rates were 194, 298 , 433 g . (m2 . a) -1, respectively. (3) The difference of organic matter input was the major factor which drove the variability of soil carbon sequestration function of apple orchard and black locust ecosystems.
Assuntos
Sequestro de Carbono , Carbono/análise , Malus , Robinia , Solo/química , Biomassa , China , Ecossistema , Raízes de PlantasRESUMO
By using cylindrical sediment sampler and Peeper' s interstitial water sampler, the intact sediment and interstitial water were collected from different zones of Nansi Lake in Shandong Province in summer and winter. The distribution characteristics of the sediment phosphorus forms and of the phosphate (PO4(3-)-P) in interstitial water were analyzed, and their correlations were discussed. In the sediments of Nansi Lake, phosphorus was richer, and had a significant spatial differentiation, with an overall decreasing trend from north to south, which was related to the seriously polluted Northern Nansi Lake near Jining City. Among the phosphorous forms, inorganic phosphorus (IP) had the highest concentration, accounting for 52.3%-87.2% and 60.6%-88.3% of the total phosphorus (TP) in summer and winter, respectively. The TP concentrations in 5 cm surface sediment of four sub-lakes were all higher in summer than in winter, which could be related to the human activities such as exuberant aquaculture, more chemical fertilizers application around lake, and frequent tourism activities, etc. in summer. In vertical direction, the PO4(3-)-P concentration in interstitial water decreased after an initial increase in summer and winter, and was obviously higher in summer than in winter, suggesting that the phosphorous in sediment had a higher potential to release to the overlying water in summer. The organic phosphorus (OP) and IP in sediment had a significant correlation in summer but less correlation in winter, indicating that the transformation between sediment IP and OP was more active in summer than in winter. The iron and aluminum bound phosphorus (Fe/Al-P) and IP in sediment were significantly positively correlated with the PO4(3-)-P in interstitial water. In summer and winter, the average PO4(3-)-P concentration in interstitial water collected by Peeper' s interstitial water sampler was about 20%-50% higher than that collected by the conventional centrifugal method, suggesting that using Peeper' s interstitial water sampler could be more precise.