One and five-year efficacy of tension-free vaginal tape (TVT) abbrevo and TVT-obturator in the treatment of stress urinary incontinence: a retrospective study.

BACKGROUND: Surgical interventions are more effective than nonsurgical approaches in providing a cure for stress urinary incontinence (SUI). In this study, we aimed to assess the benefits of tension-free vaginal tape (TVT) abbrevo by comparing its efficacy and complications to those of TVT obturator. METHODS AND RESULTS: 49 and 47 patients at The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between January 2013 and December 2016 were included in the TVT-O and TVT-A groups, respectively. We evaluate the success rate and perioperative complications associated with TVT-O and TVT-A. A questionnaire that utilized the Patient Global Impression of Improvement (PGI-I) Scale was employed to assess the impact of surgery. Patients were followed up at 1 year, and 5 years after surgery. There were no statistically significant differences found in the efficacy of the TVT-A group and TVT-O group during both the one-year (p = 0.4) and five-year (p = 0.32) follow-up periods. In the period of one-year follow-up, 95.9% (n = 47) of patients in the TVT-O group and 95.8% (n = 45) of patients in the TVT-A group demonstrated improvement. During the period of five-year follow-up, 87.8% (n = 43) of patients in the TVT-O group and 93.6% (n = 44) of patients in the TVT-A group demonstrated improvement. CONCLUSIONS: Based on our findings, TVT-A and TVT-O procedures exhibited similarly high success rates and low frequencies of complications.

Aspirin Exposure and Mortality Risk among Prostate Cancer Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Prostate cancer (PCa) is the ninth most common cause of cancer death globally. Many studies have investigated aspirin exposure and mortality risk among PCa patients, returning inconsistent results. We conducted a comprehensive meta-analysis to explore the association between aspirin exposure and mortality risk among PCa patients and to investigate potential dose/duration/frequency-response relationships. METHODS AND RESULTS: Studies published from 1980 to 2018 of PubMed and EMBASE databases were searched. We included 14 studies with 110,000 participants. Multivariate-adjusted odds ratios (ORs) were pooled using random-effect models. Potential dose/duration/frequency-response relationships were evaluated for aspirin exposure and prostate cancer-specific mortality (PCSM) risk. We did not detect an association between the highest aspirin exposure and mortality risk (PCSM of prediagnostic aspirin exposure, OR: 0.96, 95% confidence interval [CI]: 0.87-1. 07, I2= 0%; PCSM of postdiagnostic aspirin exposure, OR:0.92, 95% CI: 0.77-1.10, I2 = 56.9%; all-cause mortality [ACM] of prediagnostic aspirin exposure, OR: 0.96, 95% CI: 0.88-1.04, I2 = 9.4%; ACM of postdiagnostic aspirin exposure, OR: 0.95, 95% CI: 0.73-1.23, I2 = 88.9%). There was no significant dose/frequency-response association observed for aspirin exposure and PCSM risk. On duration-response analysis, we found that short-term postdiagnostic aspirin exposure (shorter than 2.5 years) increased the risk of PCSM. CONCLUSIONS: Our meta-analysis suggests that there is no association between aspirin exposure and PCSM risk. Nor is there an association between the highest aspirin exposure and ACM risk among PCa patients. More studies are needed for a further dose/duration/frequency-response meta-analysis.

Neutrophil-lymphocyte ratio is associated with all-cause mortality among critically ill patients with acute kidney injury.

BACKGROUND: Inflammation plays a critical role in the development of acute kidney injury (AKI). Neutrophil-lymphocyte ratio (NLR) is a biomarker of systemic inflammation used to predict the prognostic outcome of several diseases. We conducted a retrospective cohort study to investigate if NLR can be used as a biomarker to predict the mortality of AKI. METHODS AND RESULTS: Records of critically ill patients with AKI were extracted from the Medical Information Mart for Intensive Care Database III version 1.3 (MIMIC-III v1.3). The primary outcome was 30-day mortality and the two secondary outcomes were in hospital and 90-day mortality. We used the Cox proportional hazards models to assess the association between different categories of NLR and outcomes. This analysis included data for 13,678 eligible subjects, with a total of 2,588 30-day, 2,224 in-hospital and 3,545 90-day deaths during the follow-up period. For 30-day mortality, an increased risk of mortality was associated with a higher level of NLR. The HR (95% confidence interval [CI]) of upper tertile (NLR > 12.14) was 1.37 (1.17-1.60) in a multivariate model when compared with that of the lower tertile (NLR < 5.55). In the quintile analysis, we confirmed the upward trend with HR (95% CI) of the fifth quintile (NLR > 17.4) of 1.35 (1.08, 1.69) in a multivariate model compared to the first quintile (NLR < 3.82). A similar tendency was observed for 90-day mortality. In the analysis of in-hospital mortality, the HR of fifth quintile (NLR > 17.4) showed a slight decrease. CONCLUSIONS: Our analysis indicates that a higher level of NLR is associated with increased risk of 30-day and 90-day mortality in AKI patients. The similar upward trend is not detected in analysis of in-hospital mortality.

Carbohydrate intake and the risk of prostate cancer.

BACKGROUND: Prostate cancer (PCa) is one of the leading cause cancer among men worldwide. Many epidemiologic studies have reported an association between carbohydrate intake and PCa. However, the evidence from epidemiologic studies is inconsistent. We conducted a comprehensive meta-analysis to explore the associations between carbohydrate intake and PCa risk and to investigate potential dose-response relationships. METHODS: We searched PubMed and EMBASE for studies published from 1980 to 2018. 21 studies were included with 98,739 participants and 11,573 cases. Multivariate-adjusted odds ratios (ORs) were pooled using random-effect models. Potential dose-response relationships were evaluated for PCa risk. RESULTS: We did not detect an association about higher carbohydrate intake and PCa risk (OR:1.11, 95% confidence interval [CI]: 0.98-1. 26, I2 = 62.7%), nor association was detected about higher carbohydrate intake with advanced PCa risk (OR:0.95, 95% CI: 0.78-1.16, I2 = 14.1%) or non-advanced Pca risk (OR:1.01, 95% CI: 0.79-1.29, I2 = 64.4%). There was not a significant dose-response association observed for carbohydrate intake with PCa risk and advanced PCa risk. CONCLUSIONS: Our meta-analysis shows no association between carbohydrate intake and prostate cancer risk. Nor is association detected about carbohydrate intake with advanced or non-advanced Pca risk. More studies are needed for a further dose-response meta-analysis.

Triptorelin relieves lower urinary tract symptoms in Chinese advanced prostate cancer patients: a multicenter, non-interventional, prospective study.

BACKGROUND: Although triptorelin is increasingly used in China for biochemical castration, its effects on primary prostate cancer symptoms remain unclear. This study aimed to assess the prevalence of lower urinary tract symptoms (LUTS) in Chinese prostate cancer patients and the effectiveness of triptorelin on LUTS. METHODS: In this 48-week multicenter, non-interventional, prospective study, we enrolled patients with locally advanced or metastatic prostate cancer. Patients received triptorelin (15 mg) intramuscularly at baseline and at weeks 12, 24, and 36 with symptom assessment using the International Prostate Symptoms Score (IPSS). The primary endpoints were the prevalence of LUTS at baseline per IPSS categories and the percentage of patients with moderate to severe LUTS (IPSS > 7) at baseline, having at least a 3-point reduction of IPSS score at week 48. RESULTS: A total of 398 patients were included; 211 (53.0%) and 160 (40.2%) among them had severe and moderate LUTS, respectively. Of the patients with IPSS scores available at baseline and at week 48 (n = 213), 81.2% achieved a reduction in IPSS of at least 3 points. Of the patients with moderate to severe LUTS at baseline and IPSS scores available at baseline and at week 48 (n = 194), 86.6% achieved a total IPSS reduction of at least 3 points. CONCLUSIONS: The vast majority of Chinese patients with locally advanced or metastatic prostate cancer scheduled to receive triptorelin as part of their standard treatment have severe or moderate LUTS. Triptorelin therapy resulted in sustained improvement of LUTS in these patients.

Effects of working memory load on uncertain decision-making: evidence from the Iowa Gambling Task.

The Iowa Gambling Task (IGT) simulates uncertain gains and losses in real life situations and thus is a good measure of uncertain decision-making. The role of working memory (WM) in IGT performance still remains unclear. The present study aimed to examine the effect of WM on IGT performance. Three groups of participants matched on gender ratio were randomly assigned to no WM load, low WM load, and high WM load conditions. Initially the three groups did not show significant difference in WM capacity. They finished a modified version of IGT and then their implicit learning effect and explicit cognition on IGT were assessed. Results indicated a linear increasing trend of IGT performance among high WM load, low WM load and no WM load groups; participants in the no WM load and low WM load groups revealed implicit learning effect, while participants in the high WM load group did not; all participants showed explicit cognition on IGT to the same level. These results suggested that participants in the high WM load group showed good explicit cognition to IGT but showed poor performance. This pattern is similar to frontal patients. Further studies should be conducted to explore this issue.

The association between NQO1 Pro187Ser polymorphism and bladder cancer susceptibility: a meta-analysis of 15 studies.

NAD(P)H: quinone oxidoreductase 1 (NQO1), an obligate two-electron reductase, plays an important role in reducing reactive quinones to less reactive and less toxic hydroquinones. Genetic variations in NQO1 gene that impede its enzyme function may be considered as putative risk factor for cancer. Numerous studies have been performed to investigate the association between NQO1 Pro187Ser polymorphism and bladder cancer risk; nevertheless, the results remain controversial. METHODS: We indentified eligible publications from PubMed, Embase and CBM databases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to access the strength of the associations. False-positive report probability (FPRP) analysis was also performed for all statistically significant findings. RESULTS: We collected a total of 15 studies including 4298 cases and 4275 controls in the final meta-analysis. Overall, the NQO1 187Ser carriers were associated with an increased bladder cancer risk (homozygous: OR = 1.43, 95% CI = 1.08-1.90; recessive: OR = 1.33, 95% CI = 1.03-1.72; dominant: OR = 1.19, 95% CI = 1.04-1.37, and allele comparing: OR = 1.18, 95% CI = 1.06-1.33). Stratification analyses showed a statistically significant association among Asians (homozygous: OR = 1.82, 95% CI = 1.39-2.38; recessive: OR = 1.52, 95% CI = 1.20-1.93, dominant: OR = 1.40, 95% CI = 1.05-1.88, and allele comparing: OR = 1.35, 95% CI = 1.15-1.58), never smokers (homozygous: OR = 2.30, 95% CI = 1.14-4.65; heterozygous: OR = 2.26, 95% CI = 1.43-3.56; dominant model: OR = 1.59, 95% CI = 1.14-2.21, and allele comparing: OR = 1.72, 95% CI = 1.27-2.33), hospital-based studies (homozygous: OR = 1.46, 95% CI = 1.09-1.94; recessive: OR = 1.32, 95% CI = 1.02-1.69; dominant: OR = 1.28, 95% CI = 1.05-1.56, and allele comparing: OR = 1.24, 95% CI = 1.07-1.43), studies with genotyping performed by PCR-RFLP under all genetic models, and studies with minor allele frequency >0.30 (homozygous: OR = 1.69, 95% CI = 1.25-2.27; recessive: OR = 1.46, 95% CI = 1.10-1.95, and allele comparing: OR = 1.25, 95% CI = 1.04-1.51), respectively. CONCLUSIONS: Despite some limitations, our meta-analysis provides sufficient evidence that NQO1 Pro187Ser polymorphism may contribute to bladder cancer risk. These findings need further validation in well-designed prospective studies with larger sample size and different ethnicities, especially for Asians.

[Clinical application of the disposable circumcision suture device in male circumcision].

OBJECTIVE: To investigate the safety and efficiency of the disposable circumcision suture device (DCSD) in the surgical treatment of phimosis and redundant prepuce. METHODS: We randomly assigned 249 outpatients with phimosis or redundant prepuce to be treated with DCSD (n = 129) and by conventional circumcision (CC, n = 120), respectively. Then we compared the safety and efficiency of the two strategies. RESULTS: Comparisons between DCSD and CC showed that the operation time was (4.02 +/- 0.69) vs (30.8 +/- 4.05) min, blood loss was (1.07 +/- 1.29) vs (8.72 +/- 2.15) ml, intraoperative pain score was 0.81 +/- 0.81 vs 2.42 +/- 1.15, 24-hour postoperative pain score was 1.84 +/- 1.02 vs 4.99 +/- 1.36, postoperative complication rate was 13. 95% (18/129) vs 9.17% (11/120), wound healing time was (13.99 +/- 9.06) vs (17.48 +/- 3.49) d, satisfaction with the penile appearance was 98.4% (127/129) vs 95% (109/120), and treatment cost was (2215.62 +/- 17.67) vs (576.47 + 15.58) Y RMB. DCSD exhibited obvious superiority over CC for shorter operation time, less blood loss, milder intraoperative pain, sooner wound healing, and better penile appearance, but it also had a higher rate of postoperative complications (P > 0.05) and involved more treatment cost than the latter (P < 0.05). CONCLUSION: The disposable circumcision suture device affords ideal clinical effects and therefore deserves clinical popularization.

Neural correlates of uncertain decision making: ERP evidence from the Iowa Gambling Task.

In our daily life, it is very common to make decisions in uncertain situations. The Iowa Gambling Task (IGT) has been widely used in laboratory studies because of its good simulation of uncertainty in real life activities. The present study aimed to examine the neural correlates of uncertain decision making with the IGT. Twenty-six university students completed this study. An adapted IGT was administered to them, and the EEG data were recorded. The adapted IGT we used allowed us to analyze the choice evaluation, response selection, and feedback evaluation stages of uncertain decision making within the same paradigm. In the choice evaluation stage, the advantageous decks evoked larger P3 amplitude in the left hemisphere, while the disadvantageous decks evoked larger P3 in the right hemisphere. In the response selection stage, the response of "pass" (the card was not turned over; the participants neither won nor lost money) evoked larger negativity preceding the response compared to that of "play" (the card was turned over; the participant either won or lost money). In the feedback evaluation stage, feedback-related negativity (FRN) was only sensitive to the valence (win/loss) but not the magnitude (large/small) of the outcome, and P3 was sensitive to both the valence and the magnitude of the outcome. These results were consistent with the notion that a positive somatic state was represented in the left hemisphere and a negative somatic state was represented in the right hemisphere. There were also anticipatory ERP effects that guided the participants' responses and provided evidence for the somatic marker hypothesis with more precise timing.

[Role of NF-κB in the anti-tumor effect of thymoquinone on bladder cancer].

OBJECTIVE: To explore the effects and mechanism of thymoquinone in the growth inhibition of bladder cancer both in vitro and in vivo. METHODS: After the treatment of thymoquinone, the cellular proliferation of human bladder cancer cell line BIU-87 was detected by the method of methyl thiazolyl tetrazolium (MTT). Flow cytometry (FCM) was used to determine the cellular apoptosis. And the location of nuclear factor (NF)-κB was identified by the method of immunofluorescent histochemistry. Western blotting was employed to detect the cellular expressions of NF-κB, survivin and XIAP. BIU-87 cells were injected subcutaneously into nude mice to establish a xenograft model. After 2 weeks of implantation, the mice were randomized into 2 groups (n = 8): (a) vehicle alone (control), (b) thymoquinone (5 mg/kg daily by intragastric intubation). All treatments lasted for 2 weeks. At Week 7 post-implantation, the mice were sacrificed and their tumor weights and inhibition rates evaluated. Immunohistochemistry was used to detect the positive expressions of Ki-67, NF-κB and XIAP in tumors. RESULTS: The proliferation of bladder cancer cells was inhibited significantly by thymoquinone at 20, 40, 80 µmol/L (81.2% ± 4.6%, 72.5% ± 6.5%, 58.4% ± 8.9% vs 100%, all P < 0.05). Apoptosis rate induced by thymoquinone was more significant than that of the control (7.6% ± 1.6%, 11.2% ± 2.1%, 14.3% ± 2.8%vs 1.6% ± 0.5%, all P < 0.05). Immunofluorescent histochemistry showed that thymoquinone could significantly lower the nuclear expression of NF-κB. The expressions of NF-κB and XIAP were down-regulated in BIU-87 cells after the treatment of thymoquinone. But thymoquinone had no effect on the expression of survivin. The final tumor weight showed significant decrease in the test group versus the control group ((0.41 ± 0.12) vs (0.89 ± 0.23) g, P < 0.05). Furthermore, the positive expressions of Ki-67, NF-κB and XIAP decreased in tumors after the administration of thymoquinone. CONCLUSION: Thymoquinone exerts anti-tumor effects on bladder cancer both in vitro and in vivo through the down-regulations of NF-κB and its regulated molecules such as XIAP.

Efficacy and postoperative complication of tension-free vaginal tape-Secur for female stress urinary incontinence.

BACKGROUND: As the third-generation tension-free tape for female stress urinary incontinence (SUI), tension-free vaginal tape (TVT)-Secur has decreased the common complications associated with TVT and tension-free vaginal tape-transobturator (TVT-O), such as bladder perforation and obstruction of the bladder outlet; but its efficacy and persistence were still controversial. The aim of this study was to prospectively evaluate and compare the postoperative efficacy and complication at different follow-up time. METHODS: Patients with SUI, who underwent TVT-Secur treatment in two hospitals from October 2008 to October 2009, were selected. By analyzing preoperative and intraoperative data and postoperative complications, the therapeutic effect and satisfaction at different follow-up stages were evaluated. RESULTS: A total of 30 female patients participated in this study. Patients were scheduled for follow-up at the 1st month, 3rd month, 6th month and 12th month, while the cure rate was 83.3% (25 patients), 66.7% (20 patients), 63.3% (19 patients) and 60.0% (18 patients) respectively and the overactive bladder (OAB) symptoms appeared in 11 patients (36.7%), 10 patients (33.3%), 6 patients (20%) and 7 patients (23.3%) respectively. CONCLUSION: With the follow-up time becoming longer, TVT-Secur has a high recurrence rate of SUI, the therapeutic effect from the 3rd month to the 12th month is relatively persistent.

Comparison of three mid-urethral tension-free tapes (TVT, TVT-O, and TVT-Secur) in the treatment of female stress urinary incontinence: 1-year follow-up.

INTRODUCTION AND HYPOTHESIS: The purpose of the study was to evaluate and compare the clinical values of tension-free vaginal tape (TVT), tension-free vaginal tape-transobturator (TVT-O), or tension-free vaginal tape-Secur (TVT-Secur) as treatment for female stress urinary incontinence. METHODS: The pre-operative and 1-year post-operative follow-up protocols for patients who were treated with serial mid-urethral tension-free tape procedures in two hospitals from October 2008 to December 2009 were prospectively studied. These patients were randomly allocated to TVT, TVT-O, or TVT-Secur. RESULTS: A total of 102 women participated. At the 1-year follow-up, complications were not statistically different across the three groups except for pain in the thigh, which was more common in the TVT-O group. The overall efficacy and cure rate were similar between the TVT and TVT-O groups, but were significantly lower in the TVT-Secur group. CONCLUSIONS: A comparison of the three procedures shows that TVT-O is easy to operate and is as safe as TVT-Secur, and it has similar long-term efficacy to TVT, though, as one of the third-generation mid-urethral tension-free tapes, TVT-Secur is still being evaluated. Basing on the outcome of our study, it had rare complications but unsatisfactory efficacy, and we suggest that TVT-Secur is not fit for severe cases. However, observation and comparison of these groups in a larger sample size on a longer term are needed.

[Efficacy of interleukin-10 for experimental autoimmune prostatitis].

OBJECTIVE: To study the efficacy of interleukin-10 (IL-10) in the treatment of experimental autoimmune prostatitis (EAP) and its effect on the expressions of tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1 ) in EAP rat models. METHODS: Thirty Wistar rats were equally and randomly divided into a control, an EAP and an IL-10 group. The controls were treated with normal saline, the EAP models were made by injection of purified prostate protein twice with immune adjuvant, and the IL-10 group included the EAP models subjected to IL-10 intervention. The infiltration of the inflammatory cells of the prostate tissue was detected by HE staining, the ultrastructure of the prostate cells and their surrounding cells observed by electron microscopy, and the levels of TNF-alpha and TGF-beta1 in the three groups determined by semi-quantitative RT-PCR assay. RESULTS: The EAP group showed significantly severer inflammation and higher levels of TNF-alpha and TGF-beta1 in the prostate tissue than the controls (P < 0.05). The IL-10 group exhibited significantly lessened inflammatory infiltration of the prostate tissue and decreased levels of TNF-alpha and TGF-beta as compared with the EAP group (P < 0.05). CONCLUSION: IL-10 could relieve inflammatory infiltration of the prostate tissue and inhibit the expressions of TNF-alpha and TGF-beta1 in EAP rats, which is suggestive of its therapeutic efficacy for autoimmune prostatitis.

[Transabdominal ultrasound measurement of intravesical prostatic protrusion helps diagnosis of benign prostatic obstruction].

OBJECTIVE: To evaluate the measurement of intravesical prostatic protrusion (IPP) by transabdominal ultrasonography (TAUS) in the diagnosis of benign prostatic obstruction (BPO). METHODS: We studied the clinical data of 109 BPH patients referred for lower urinary tract symptoms (LUTS) from April 2005 to December 2006. IPP was measured by TAUS, urodynamic parameters such as Qmax and PdetQmax obtained by urodynamic studies and AG values calculated. The patients were divided into an obstruction and a non-obstruction group according to their AG values. RESULTS: IPP was found statistically different between the obstruction and non-obstruction groups (P<0.001) and positively correlated with the AG value (r=0.729, P=0.001). With the cutoff at IPP > or = 10 mm for the diagnosis of BPO, the sensitivity, specificity and accuracy of the diagnosis were 89.9%, 97.5% and 92.7%, respectively. CONCLUSION: The measurement of IPP by TAUS offers a valuable help for the diagnosis of BPO.

[Clinical analysis of postoperative delirium in elderly patients with benign prostatic hyperplasia].

OBJECTIVE: To study the influential factors leading to postoperative delirium in elderly patients with benign prostatic hyperplasia(BPH). METHODS: For 198 elderly postoperative BPH patients in our hospital, the clinical parameters including age, hypoxemia, postoperative pain, and sleep reduction were investigated, and the data were processed by chi2 test. RESULTS: Of the total number of patients, 13 (6.5%) experienced postoperation delirium. Many factors were significantly correlated with the problem in these elderly BPH patients, such as advanced age (> or =70), postoperative pain and sleep reduction (P < 0.05). CONCLUSION: Advanced age, postoperative pain and sleep problem were important factors for delirium, and therefore postoperative analgesia and good sleep may help to prevent postoperative delirium.

[Effect of sildenafil on nocturnal penile tumescence].

OBJECTIVE: To evaluate the efficacy of sildenafil on nocturnal penile tumescence (NPT). METHODS: Thirty-five patients with erectile dysfunction (ED), 28 cases of organic ED and 7 cases of psychogenic ED, were treated with sildenafil 100 mg before bedtime. The NPT of the patients was observed by using NEVA. RESULTS: Erectile function significantly improved in the 28 cases of organic ED (P < 0.05), but not in the 7 cases of psychogenic ED (P > 0.05). CONCLUSION: Sildenafil can improve NPT of organic ED patients without sexual stimulation.