Malignant ureteral obstruction: experience and comparative analysis of metallic versus ordinary polymer ureteral stents.

BACKGROUND: To study the outcome and experience of using metallic stents in treating patients with malignant ureteral obstruction (MUO). METHODS: Seventy-six patients with MUO were assigned to the metallic stent group (MSG) or the ordinary polymer stent group (OPSG) according to the different materials. The success rate of the operation, duration of operation, patency rate serum creatinine values ,postoperative complications and QOL scores were compared between the two groups. RESULTS: In the OPSG and MSG, the success rates of the operation were 95.5% and 96.9%, respectively, and the durations of the operation were 20.6 ± 2.2 min and 50.9 ± 10.3 min (P < 0.01), respectively. There was no significant difference between the groups in serum creatinine values at 3 days after the operation (P > 0.05); however, the creatinine values at 3 days after the operation decreased significantly compared with those before the operation (P < 0.01). In the OPSG, there was no significant difference in creatinine values between 3 days and 6 months after operation, while the creatinine values 1 year after operation were increased significantly compared to those at 3 days after the operation (P < 0.05). In the MSG, there was no significant difference among creatinine values at different intervals (P > 0.05). The total rate of post-procedural complication was lower in the MSG than that in the OPSG(P < 0.05). There was no significant difference in the QOL score between the two groups before the operation (P > 0.05); however, the QOL scores at 6 months and 1 year after the operation were higher in the MSG than that in the OPSG(P < 0.05). In the MSG, there was no significant difference in the QOL score between preoperation and 6 months after surgery. Similarly, there was also no difference in the QOL score between 6 months after surgery and 1 year after surgery(P > 0.05). On the contrary, the differences of QOL score in the OPSG group were much significant between disparate time intervals (P < 0.05). CONCLUSIONS: For patients with MUO who require long-term retention of the stent, metallic stents with longer indwelling time are superior to ordinary polymeric stents.

Protective roles of hepatic gamma-aminobutyric acid signaling in acute ethanol exposure-induced liver injury.

Alcoholic liver disease (ALD) is a consequence of heavy and prolonged alcohol consumptions. We previously demonstrated a hepatic gamma-aminobutyric acid (GABA) signaling system that protects the liver from toxic injury. The present study was designed to investigate the role of the hepatic GABA signaling system in the process of acute ethanol exposure-induced liver injury. Our results showed that the expression of GABA synthesizing enzyme glutamic acid decarboxylase and type A GABA receptor (GABAA R) subunits was upregulated in ethanol-treated mice compared with saline-treated controls. Remarkably, pretreatment of mice with GABA (1.5 mg kg-1 body weight, intraperitoneal injection [i.p.]) or with the GABAA R agonist muscimol (1.2 mg kg-1 body weight, i.p.) protected the liver against ethanol toxicity and improved liver function, whereas pretreatment of mice with the GABAA R antagonist bicuculline (2.0 mg kg-1 body weight, i.p.) worsened the liver function. Further analyses suggest that GABAA R-mediated signaling protects the liver from ethanol injury by, at least partially, inhibiting the IRE1α-ASK1-JNK pro-apoptotic pathway in hepatocytes in the process of ethanol-induced endoplasmic reticulum stress response.

Roles of autophagy-related genes Beclin-1 and LC3 in the development and progression of prostate cancer and benign prostatic hyperplasia.

Prostate cancer (PCa) is common in Western populations and the second leading cause of cancer-related mortality among males in North America, with an increasing morbidity in China and other Asian countries. The aim of this study was to evaluate the protein expression of autophagy-related genes Beclin-1 and LC3 in patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and elucidate their association with p53 and Bcl-2. The total protein of 34 PCa and 50 BPH samples was extracted and the expression of Beclin-1 and LC3 was analyzed by western blotting assay. Subsequently, a total of 96 paraffin-embedded BPH tissue samples was subdivided into 2 groups, one group in which patients had received 5α-reductase inhibitor, due to its effect of androgen ablation, and the control group, in which patients had not received the 5α-reductase inhibitor. The samples were randomly collected and examined using immunohistochemical (IHC) analysis. The western blot analysis demonstrated that Beclin-l and LC3 expression was higher in BPH tissues compared to PCa tissues (P<0.001). There was no statistically significant difference between PCas of different Gleason scores (P>0.05). The result of IHC revealed that Beclin-l and LC3 expression in the group of patients who had received the 5α-reductase inhibitor was significantly higher compared to that in the control group; however, the expression of Bcl-2 and p53 was lower (P<0.05). Beclin-1 expression exhibited a negative correlation with Bcl-2 (r=-0.402, P<0.001), whereas LC3 expression exhibited a positive correlation with Beclin-1 (r=0.345, P=0.001) and a negative correlation with Bcl-2 (r=-0.216, P=0.035). It was suggested that autophagy-related genes Beclin-l and LC3 may be involved in the development and progression of PCa. In addition, the expression of these genes was higher in patients with BPH who had received a 5α-reductase inhibitor, due to androgen reduction. As a result, the induced autophagy may reduce the risk of PCa.