Application of the first rechargeable sacral neuromodulation system for treatment of neurogenic lower urinary tract dysfunction in China: a case report.

Neurogenic lower urinary tract dysfunction (NLUTD) is caused by nervous system lesions and characterized by impaired micturition and urinary incontinence. The goal of treatment is to manage these symptoms, improve quality of life, prevent urinary tract infections, and maintain urinary function. Pelvic floor muscle training and medication are commonly used for treating it. Sacral neuromodulation (SNM) has been used in the treatment of NLUTD for >20 years worldwide, and its effectiveness and safety have been verified. Several countries have begun using a rechargeable SNM system, whereas the current sacral SNM system used in China is non-rechargeable. A 29-year-old man with persistent voiding dysfunction for >20 years presented with progressive symptoms 1 year ago. He was admitted to our hospital in August 2022 for a rechargeable SNM system implantation. The patient underwent a video-urodynamic examination and the Short Form of a Urinary Quality of Life Questionnaire (SF-Qualiveen) before and 1 month after surgery. The video-urodynamic examination showed that the maximum bladder capacity significantly increased after surgery, bladder compliance improved, the phenomenon of uninhibited bladder contraction during filling decreased, and urine leakage was reduced. The SF-Qualiveen score showed the patient's quality of life significantly improved. To our knowledge, this is the first case of a rechargeable SNM system implantation in China, which shows that it is safe and effective. More clinical cases and long-term observation are still needed. In conclusion, a rechargeable SNM system has significance for health and the economy and has a broad clinical application prospect.

Synthesis and synergistic antifungal effects of monoketone derivatives of curcumin against fluconazole-resistant Candida spp.

Twenty-three monoketone derivatives of curcumin were synthesized to investigate the synergy with fluconazole against fluconazole-resistant Candida spp. The minimal inhibitory concentration (MIC80) and the fractional inhibitory concentration index (FICI) of the antifungal synergist fluconazole were measured against fluconazole-resistant C. albicans, C. tropicalis and C. krusei in vitro. Most of these compounds showed good synergistic activities against C. tropicalis. Among them, compound 9 exhibited significant synergistic activities against Candida spp. SARs were also discussed. In particular, a cell growth test exhibited that a combination of 1 µg ml-1 fluconazole and 64 µg ml-1 or 128 µg ml-1 compound 9 showed the most potent fungicidal effect against C. tropicalis. The synergistic effect may be associated with the changes of the intracellular ATP content and cell membrane permeability. Our results provided a basis for future evaluation and development of these compounds as leads for therapeutics for fluconazole-resistant candidiasis.