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1.
Artigo em Inglês | MEDLINE | ID: mdl-32365023

RESUMO

We present an image projection network (IPN), which is a novel end-to-end architecture and can achieve 3D-to-2D image segmentation in optical coherence tomography angiography (OCTA) images. Our key insight is to build a projection learning module (PLM) which uses a unidirectional pooling layer to conduct effective features selection and dimension reduction concurrently. By combining multiple PLMs, the proposed network can input 3D OCTA data, and output 2D segmentation results such as retinal vessel segmentation. It provides a new idea for the quantification of retinal indicators: without retinal layer segmentation and without projection maps. We tested the performance of our network for two crucial retinal image segmentation issues: retinal vessel (RV) segmentation and foveal avascular zone (FAZ) segmentation. The experimental results on 316 OCTA volumes demonstrate that the IPN is an effective implementation of 3D-to-2D segmentation networks, and the uses of multi-modality information and volumetric information make IPN perform better than the baseline methods.

2.
J Neuroradiol ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32035971

RESUMO

BACKGROUND AND PURPOSE: The aim of the study was to evaluate whether leukoaraiosis (LA) severity is associated with earlier neurological outcome in acute stroke patients undergoing mechanical thrombectomy. MATERIALS AND METHODS: In this retrospective multicenter study, we evaluated 273 acute stroke patients treated with mechanical thrombectomy. LA severity was graded as 0-2 (absent-to-moderate) versus 3-4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of early neurological improvement and early neurological deterioration. Early neurological improvement was defined as a decrease of≥4 points on the NIHSS, or an NIHSS score of zero 24hours after baseline assessment. Early neurological deterioration was defined as an increase of≥4 points on the NIHSS 24hours after baseline assessment. RESULTS: There was a significantly lower early neurological improvement rate (17.1% versus 39.2%; P=0.006) and non-significantly higher early neurological deterioration rate (29.3% versus 17.7%; P=0.084) in patients with severe LA (sLA) compared with patients with absent-to-moderate LA. In multivariable analysis, sLA was inversely associated with early neurological improvement (OR, 0.31; 95% CI, 0.13-0.78; P=0.012). There was no significant association of sLA with early neurological deterioration. However, in patients without symptomatic intracranial hemorrhage, sLA was an independent predictor of early neurological deterioration (OR, 2.65; 95% CI, 1.09-6.45; P=0.032). CONCLUSIONS: sLA is a significant negative predictor of early neurological improvement and is an independent predictor of early neurological deterioration in patients without symptomatic intracranial hemorrhage.

3.
Sensors (Basel) ; 19(18)2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31514321

RESUMO

It is significant to identify rock-mineral microscopic images in geological engineering. The task of microscopic mineral image identification, which is often conducted in the lab, is tedious and time-consuming. Deep learning and convolutional neural networks (CNNs) provide a method to analyze mineral microscopic images efficiently and smartly. In this research, the transfer learning model of mineral microscopic images is established based on Inception-v3 architecture. The four mineral image features, including K-feldspar (Kf), perthite (Pe), plagioclase (Pl), and quartz (Qz or Q), are extracted using Inception-v3. Based on the features, the machine learning methods, logistic regression (LR), support vector machine (SVM), random forest (RF), k-nearest neighbors (KNN), multilayer perceptron (MLP), and gaussian naive Bayes (GNB), are adopted to establish the identification models. The results are evaluated using 10-fold cross-validation. LR, SVM, and MLP have a significant performance among all the models, with accuracy of about 90.0%. The evaluation result shows LR, SVM, and MLP are the outstanding single models in high-dimensional feature analysis. The three models are also selected as the base models in model stacking. The LR model is also set as the meta classifier in the final prediction. The stacking model can achieve 90.9% accuracy, which is higher than all the single models. The result also shows that model stacking effectively improves model performance.

4.
J Sex Med ; 15(9): 1246-1259, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30224017

RESUMO

INTRODUCTION: Erectile dysfunction (ED), which is common in patients with diabetes mellitus (DM), seriously affects quality of life. Previous studies on the treatment of DM-induced ED (DMED) involve autophagy, but the specific effect and mechanism of treatment are not yet clear. AIM: To investigate the effect and mechanism of rapamycin, an autophagy inducer, in ameliorating DMED. METHODS: 45 male Sprague-Dawley rats (7 weeks old) were used in the experiment. 8 rats were randomly selected as the control group; the other rats were treated with streptozotocin to induce type 1 DM. After 10 weeks, an apomorphine test was used to confirm DMED. Rats with DMED were intraperitoneally injected with rapamycin or vehicle for 3 weeks. Rats in the control group were injected with saline. Erectile function in rats was measured by electrically stimulating the cavernous nerve. The penises were then harvested for histologic examinations, ribonucleic acid (RNA), and protein levels of related factors by immunohistochemistry, immunofluorescence, real-time polymerase chain reaction, enzyme-linked immunosorbent assay, and Western blot. MAIN OUTCOME MEASURE: Erectile function was evaluated by maximum intracavernous pressure and mean arterial pressure. Penile tissues were used to perform histologic examinations and to determine the RNA and protein levels. RESULTS: Erectile function, which was impaired in rats with DMED, was significantly ameliorated in the DMED + rapamycin group. The nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway was inhibited in the DMED group, and rapamycin significantly reduced this inhibition. The DMED group showed increased autophagy and apoptosis level compared with the non-diabetic group, and rapamycin increased the autophagy level and decreased the apoptosis level in the penis. Penile fibrosis was more severe in the DMED group than in the control group and was partially but significantly improved in the DMED + rapamycin group compared with the DMED group. The adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin kinase (mTOR) and PI3K/AKT/mTOR pathways were activated, and the mTOR (regulatory associated protein of mTOR, complex 1 [raptor])/p70 ribosomal protein S6 kinase (p70S6K) pathway was inhibited in the DMED group. Compared with DMED group, rapamycin led to lower AMPK/mTOR and AKT/mTOR pathways expression, a higher degree of mTOR (raptor)/p70S6K pathway inhibition, and no change in the mTORC2-related pathway. CLINICAL IMPLICATIONS: Rapamycin was effective in restoring erectile function in type 1 DMED models. STRENGTH AND LIMITATIONS: This study suggested for the first time that rapamycin, an autophagy inducer, is effective in restoring erectile function in rats with diabetes. However, the rat model might not represent the human condition. CONCLUSION: Rapamycin improved erectile function in rats with DMED, likely by promoting autophagy, inhibiting apoptosis and fibrotic activity, and ameliorating endothelial function. These findings provide evidence of a potential treatment option for DMED. Lin H, Wang T, Ruan Y, et al. Rapamycin supplementation may ameliorate erectile function in rats with streptozotocin-induced type 1 diabetes by inducing autophagy and inhibiting apoptosis, endothelial dysfunction, and corporal fibrosis. J Sex Med 2018;15:1246-1259.


Assuntos
Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/complicações , Disfunção Erétil/tratamento farmacológico , Sirolimo/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Diabetes Mellitus Experimental/fisiopatologia , Modelos Animais de Doenças , Disfunção Erétil/complicações , Disfunção Erétil/fisiopatologia , Injeções Intraperitoneais , Masculino , Ereção Peniana/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Sirolimo/administração & dosagem , Sirolimo/farmacologia , Estreptozocina
5.
Chin Med J (Engl) ; 131(12): 1465-1471, 2018 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-29893364

RESUMO

Background: Currently available evaluation criteria for penile tumescence and rigidity have been fraught with controversy. In this study, we sought to establish normative Chinese evaluation criteria for penile tumescence and rigidity by utilizing audiovisual sexual stimulation and RigiScan™ test (AVSS-Rigiscan test) with the administration of phosphodiesterase-5 inhibitor. Methods: A total of 1169 patients (aged 18-67 years) complained of erectile dysfunction (ED) underwent AVSS-RigiScan test with the administration of phosphodiesterase-5 inhibitor. A total of 1078 patients whose final etiological diagnosis was accurate by means of history, endocrine, vascular, and neurological diagnosis, International Index of Erectile Function 5 questionnaire, and erection hardness score were included in the research. Logistic regression model and receiver operating characteristic curve analysis were performed to determine the cutoff value of the RigiScan™ data. Then, the multivariable logistic analysis was used in the selected variables. Results: A normal result is defined as one erection with basal rigidity over 60% sustained for at least 8.75 min, average event rigidity of tip at least 43.5% and base at least 50.5%, average maximum rigidity of tip at least 62.5% and base at least 67.5%, △tumescence (increase of tumescence or maximum-minimum tumescence) of tip at least 1.75 cm and base at least 1.95 cm, total tumescence time at least 29.75 min, and times of total tumescence at least once. Most importantly, basal rigidity over 60% sustained for at least 8.75 min, average event rigidity of tip at least 43.5%, and base at least 50.5% would be the new normative Chinese evaluation criteria for penile tumescence and rigidity. By multivariable logistic regression analysis, six significant RigiScan™ parameters including times of total tumescence, duration of erectile episodes over 60%, average event rigidity of tip, △tumescence of tip, average event rigidity of base, and △tumescence of base contribute to the risk model of ED. In logistic regression equation, predict value P < 0.303 was considered as psychogenic ED. The sensitivity and specificity of the AVSS-RigiScan test with the administration of phosphodiesterase-5 inhibitor in discriminating psychogenic from organic ED was 87.7% and 93.4%, respectively. Conclusions: This study suggests that AVSS-RigiScan test with oral phosphodiesterase-5 inhibitors can objectively assess penile tumescence and rigidity and seems to be a better modality in differentiating psychogenic from organic ED. However, due to the limited sample size, bias cannot be totally excluded.


Assuntos
Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/metabolismo , Adolescente , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inibidores da Fosfodiesterase 5/uso terapêutico , Adulto Jovem
6.
Ageing Res Rev ; 42: 28-39, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29247713

RESUMO

In the central nervous system, the primary immune cells, the microglia, prevent pathogenic invasion as the first line of defense. Microglial energy consumption is dependent on their degree of activity. Microglia express transporters for the three primary energy substrates (glucose, fatty acids, glutamine) and regulate diabetic encephalopathy via microglia-neuron interactions. Microglia may play a sentry role for rapid protection or even ablation of impaired neurons. Neurons exhibit hyperactivity in response to hyperglycemia, hyperlipidemia, and neurotoxic factors and release potential microglial activators. Microglial activation is also regulated by proinflammatory factors, caspase-3 activity, P2X7 receptor, interferon regulatory factor-8, and glucocorticoids. Modulation of microglia in diabetic encephalopathy may involve CX3CL1, p38 MAPK, purinergic, and CD200/CD200R signaling pathways, and pattern recognition receptors. The microglia-neuron interactions play an important role in diabetic encephalopathy, and modulation of microglial activation may be a therapeutic target for diabetic encephalopathy.


Assuntos
Encefalopatias/metabolismo , Diabetes Mellitus/metabolismo , Microglia/metabolismo , Neurônios/metabolismo , Transdução de Sinais/fisiologia , Animais , Encefalopatias/epidemiologia , Encefalopatias/imunologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/imunologia , Humanos , Microglia/imunologia , Neurônios/imunologia
7.
Asian J Androl ; 20(1): 30-36, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28361811

RESUMO

We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (TESE) in patients with nonobstructive azoospermia (NOA). All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis: follicle-stimulating hormone (FSH), testicular volume, and testicular histopathological findings which included three patterns: hypospermatogenesis (HS), maturation arrest (MA), and Sertoli-cell-only syndrome (SCOS). If there was a threshold effect, only the area under the summary receiver operating characteristic curve (AUSROC) was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the diagnostic odds ratio (DOR) were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.


Assuntos
Azoospermia/patologia , Azoospermia/terapia , Hormônio Foliculoestimulante/sangue , Recuperação Espermática , Espermatozoides , Testículo/citologia , Testículo/patologia , Adulto , Humanos , Masculino , Microdissecção , Oligospermia/patologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Síndrome de Células de Sertoli/patologia , Maturação do Esperma , Níveis Máximos Permitidos
8.
J Mater Chem B ; 6(45): 7451-7461, 2018 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-32254747

RESUMO

New self-assembled layer-by-layer nanoparticles, based on hypoglycemic, mucoadhesive, epithelium-penetrating and pH-sensitive functional materials, have been synthesized. The confirmed hypoglycemic and negatively charged polygalacturonic acid, the well-known cell penetrating and positively charged chitosan, and the negatively charged, pH-sensitive polymer alginate were the components of these nanoparticles. The electrical attraction between the negatively charged PGLA and alginate and the positively charged chitosan motivated the assembly and supported the pH-sensitivity of the nanoparticles. The LBL4 and LBL4-Alg nanoparticles were characterized in vitro and in vivo. The pH-sensitivity of LBL4-Alg nanoparticles was greater, with the turning point near pH = 5. Moreover, according to the pharmacological and pharmacokinetic studies, the significant hypoglycemic effect was observed only 1 h after gavage with LBL4 and LBL4-Alg nanoparticles. Insulin was continually released for at least 6 h. These results show that the new self-assembled LBL4-Alg nanoparticles with pH-sensitivity have great potential for oral insulin delivery.

9.
Sci Rep ; 7(1): 13464, 2017 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-29044143

RESUMO

Metabolic syndrome (MetS) is a risk factor for erectile dysfunction (ED), but the underlying mechanisms are unclear. The aims of this study were to determine the underlying mechanisms of metabolic syndrome-related ED (MED). Sprague Dawley (SD) rats were fed a high-fat diet for 6 months, and metabolic parameters were then assessed. An apomorphine test was conducted to confirm MED. Only rats with MED were administered an intracavernosal injection of either epidermal growth factor (EGF) or vehicle for 4 weeks. Erectile responses were evaluated by determining the mean arterial blood pressure (MAP) and intracavernosal pressure (ICP). Levels of protein expression were examined by western blotting and immunohistochemistry. Body weight, fasting blood glucose, plasma insulin and plasma total cholesterol were increased in the MetS rats compared with those in control rats (each p < 0.05). The  maximum ICP/MAP, total ICP/MAP and concentration of cyclic guanosine mono-phosphate (cGMP) were significantly decreased in MED rats (each p < 0.05). The expression levels of p110α, p-Akt1 (Tyr308)/Akt1 and p-eNOS (Ser1177)/eNOS were reduced in MED rats (each p < 0.05). Activation of the PI3K/Akt/eNOS signaling cascade (intracavernosal injection of EGF) reversed these changes (each p < 0.05). The present study demonstrates that downregulation of the PI3K/Akt/eNOS signaling pathway is involved in MED.


Assuntos
Disfunção Erétil/etiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Animais , Biomarcadores , GMP Cíclico/metabolismo , Dieta Hiperlipídica , Modelos Animais de Doenças , Ativação Enzimática , Fator de Crescimento Epidérmico/metabolismo , Fator de Crescimento Epidérmico/farmacologia , Imunofluorescência , Imuno-Histoquímica , Masculino , Ereção Peniana , Fosforilação , Ratos , Transdução de Sinais
10.
Neurosci Lett ; 644: 94-99, 2017 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-28223160

RESUMO

Parkinson's disease (PD) is a progressive age-related debilitating motor disorder and the second most common neurodegenerative disease after Alzheimer's disease. In this study, we aimed to investigate the expression of 24 candidate miRNAs in PD and to assess their diagnostic value in patients with PD. We collected serum samples from 109 patients with PD and 40 age- and sex-matched healthy volunteers (control group). RNAs encapsulated in exosome-like microvesicles in serum were extracted and reverse transcribed. Serum miRNAs were analyzed by quantitative reverse transcription polymerase chain reaction (qRT-PCR), and the ability of the miRNAs to accurately discriminate PD was analyzed by receiver operating characteristic curves. Based on our analysis, we further validated the downregulation of miR-19b and the upregulation of miR-195 and miR-24 in patients with PD. When compared with the control group, the area under the curve (AUC) values for miR-19b, miR-24, and miR-195 were 0.753, 0.908, and 0.697, respectively. Therefore, analysis of the expression levels of miR-19b, miR-24, and miR-195 in serum may be useful for the diagnosis of PD.


Assuntos
Biomarcadores/sangue , MicroRNAs/sangue , Doença de Parkinson/sangue , Idoso , Área Sob a Curva , Micropartículas Derivadas de Células , Exossomos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade
11.
Sci Rep ; 7: 40421, 2017 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-28079154

RESUMO

A meta-analysis was performed to evaluate the efficacy of local anesthesia in alleviating pain during prostate biopsy. We searched relevant articles in PubMed and Embase. The included studies should be randomized controlled trials (RCT) using local anesthesia to alleviate pain during biopsy, which was recorded by a pain scale. Analgesic efficacy of different local anesthesia techniques were analyzed, including intrarectal local anesthesia (IRLA), periprostatic nerve block (PNB), pelvic plexus block (PPB) and intraprostatic local anesthesia (IPLA). We included 46 RCTs. PNB significantly reduced pain score compared with placebo (-1.27 [95% confidence interval [95% CI] -1.72, -0.82]) or no injection (-1.01 [95% CI -1.2, -0.82]). IRLA with prilocaine-lidocaine cream could also reduced pain (-0.45 [95% CI -0.76, -0.15]), while the IRLA with lidocaine gel was not effective (-0.1 [95% CI -0.24, 0.04]). PNB lateral to the neurovascular bundle had better analgesic effect than at prostate apex (P = 0.02). Combination use of PPB and IRLA considerably alleviated pain of patients compared with the combination of PNB and IRLA (-1.32 [95% CI -1.59, -1.06]). In conclusion, local anesthesia could alleviate patients' pain during the prostate biopsy. PNB was not so effective as PPB.


Assuntos
Anestesia Local , Biópsia Guiada por Imagem , Próstata/diagnóstico por imagem , Próstata/patologia , Reto/diagnóstico por imagem , Anestésicos Locais/farmacologia , Biópsia , Humanos , Plexo Hipogástrico/efeitos dos fármacos , Masculino , Bloqueio Nervoso , Placebos , Próstata/efeitos dos fármacos , Próstata/inervação , Análise de Regressão
12.
World J Surg Oncol ; 15(1): 33, 2017 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-28125986

RESUMO

BACKGROUND: Small cell carcinoma of the bladder (SCCB) is a kind of rare and highly aggressive tumor that is present in an advanced stage and has a propensity for early metastasis. The main presenting symptom of SCCB is hematuria. Surgery, chemotherapy, and radiotherapy, either alone or as a part of combined therapy, have been used as the treatment. The aim of this study is to present our experience with 9 SCCB patients who were treated with different modalities and to share the findings upon reviewing the literatures for patients with SCCB reported in 56 literatures in Chinese. METHODS: We retrospectively evaluated 9 patients with SCCB from February 1980 to January 2014 in Tongji Hospital, Huazhong University of Science and Technology. The general characteristics, clinical manifestations, the pathological and immunohistochemical characteristics, treatment options, and prognostication in those eligible manuscripts were analyzed. In order to gain a better understanding of the clinical features of SCCB, another 119 cases reported in 56 articles were reviewed together (from January 1979 to March 2014). And a retrospective analysis was performed. RESULTS: All the 9 cases in Tongji Hospital were successfully operated, and the tissue samples were sent for pathological examination. All the tumor tissues contained small cell carcinoma components. 4 cases coexisted with other histologic types of bladder cancers, and 2 out of the 9 cases had three different cell components. All the patients had muscle invasion, and 4 cases showed lymph nodes metastasis, 3 cases showed invasion of neighboring structures (seminal vesicle or uterus), and 1 case was highly suspected of liver metastasis. Immunohistochemistry results showed that PCK, Syn, NSE, and CD56 were all positive, but LCA was negative. After operations, 3 patients underwent chemotherapy and only 1 patient received postoperative radiotherapy. Patients were followed up, ranging from 3 to 84 months and the median survival time was 33 months. The leading cause of death was tumor recurrence or metastasis, while 2 patients are still alive. According to the published literature, the pathological stage, immunohistochemical markers, and survival curves of all the 128 cases were also retrospectively analyzed. CONCLUSIONS: SCCB is different from transitional cell carcinoma (TCC) of the bladder. It has its unique cytology, immunohistochemistry, and ultrastructural features. Its diagnosis relies on pathological examination and immunohistochemistry. The current main treatment for SCCB is surgery combined with chemotherapy. Since the disease develops early metastasis easily, the overall prognosis of this cancer is poor. Further research need to clarify the molecular pathogenesis so that novel therapies can be developed for this rare cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Pequenas/patologia , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Carcinoma de Células Pequenas/metabolismo , Carcinoma de Células Pequenas/terapia , China , Terapia Combinada , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/terapia
13.
J Int Med Res ; 44(5): 985-993, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27688686

RESUMO

Objective To perform a meta-analysis of data from available published studies comparing laparoendoscopic single-site surgery varicocelectomy (LESSV) with conventional transperitoneal laparoscopic varicocele ligation. Methods A comprehensive data search was performed in PubMed and Embase to identify randomized controlled trials and comparative studies that compared the two surgical approaches for the treatment of varicoceles. Results Six studies were included in the meta-analysis. LESSV required a significantly longer operative time than conventional laparoscopic varicocelectomy but was associated with significantly less postoperative pain at 6 h and 24 h, a shorter recovery time and greater patient satisfaction with the cosmetic outcome. There was no difference between the two surgical approaches in terms of postoperative semen quality or the incidence of complications. Conclusion These data suggest that LESSV offers a well tolerated and efficient alternative to conventional laparoscopic varicocelectomy, with less pain, a shorter recovery time and better cosmetic satisfaction. Further well-designed studies are required to confirm these findings and update the results of this meta-analysis.


Assuntos
Laparoscopia/métodos , Cordão Espermático/cirurgia , Varicocele/cirurgia , Abdome/cirurgia , Humanos , Masculino , Duração da Cirurgia , Dor Pós-Operatória , Satisfação do Paciente , Análise do Sêmen
15.
Med Sci Monit ; 22: 1959-65, 2016 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-27281233

RESUMO

BACKGROUND This study aimed to evaluate the combined effect of vacuum sealing drainage (VSD) and antibiotic-loaded bone cement on soft tissue defects and infection. MATERIAL AND METHODS This prospective non-blinded study recruited 46 patients with soft tissue defects and infection from January 2010 to May 2014 and randomly divided them into experimental and control groups (n=23). Patients in the experimental group were treated with VSD and antibiotic-loaded bone cement, while the patients in the control group were treated with VSD only. RESULTS In the experimental group, the wound was healed in 23 cases at 4 weeks postoperatively, of which direct suture was performed in 12 cases, and additional free flap transplantation or skin grafting was performed in 6 cases and 5 cases, respectively. No infection reoccurred in 1-year follow-up. In the control group, the wound was healed in 15 cases at 6 weeks postoperatively, of which direct suture was performed in 8 cases, and additional free flap transplantation or skin grafting was performed in 3 cases and 4 cases, respectively. In the other 8 cases the wound was healed at 8 weeks postoperatively. Infection reoccurred in 3 cases during the follow-up. The experimental group had significantly fewer VSD dressing renewals, shorter time needed until the wound was ready for surgery, shorter duration of antibiotic administration, faster wound healing, and shorter hospital stay than the control group (p<0.01). CONCLUSIONS The combination of VSD and antibiotic bone cement might be a better method for treatment of soft tissue defects and infection.


Assuntos
Antibacterianos/administração & dosagem , Cimentos para Ossos , Drenagem/métodos , Tratamento de Ferimentos com Pressão Negativa/métodos , Lesões dos Tecidos Moles/microbiologia , Lesões dos Tecidos Moles/terapia , Adulto , Idoso , Quimioterapia Combinada , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/cirurgia , Pseudomonas aeruginosa/isolamento & purificação , Transplante de Pele/métodos , Lesões dos Tecidos Moles/tratamento farmacológico , Lesões dos Tecidos Moles/cirurgia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/cirurgia , Staphylococcus aureus/isolamento & purificação , Resultado do Tratamento , Vácuo , Cicatrização
16.
PLoS One ; 11(4): e0154341, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27111659

RESUMO

INTRODUCTION: Stem cell therapy is a novel method for the treatment of diabetic erectile dysfunction (ED). Many relative animal studies have been done to evaluate the efficacy of this therapy in rats. AIMS: This meta-analysis was performed to compare the efficacy of different stem cell therapies, to evaluate the influential factors and to determine the optimal stem cell therapeutic strategy for diabetic ED. METHODS: We searched the studies analyzing the efficacy of stem cell therapy for diabetic ED in rats published before September 30, 2015 in PubMed, Web of Science and EBSCO. A random effects meta-analysis was conducted to assess the outcomes of stem cell therapy. Subgroup analysis was also performed by separating these studies based on their different characteristics. Changes in the ratio of intracavernous pressure (ICP) to mean arterial pressure (MAP) and in the structure of the cavernous body were compared. RESULTS: 10 studies with 302 rats were enrolled in this meta-analysis. Pooled analysis of these studies showed a beneficial effect of stem cell therapy in improving erectile function of diabetic rats (SMD 4.03, 95% CI = 3.22 to 4.84, P< 0.001). In the stem cell therapy group, both the smooth muscle and endothelium content were much more than those in control group. There was also significant increase in the expression of endothelial nitric oxide synthase (eNOS) and neuronal nitric oxide synthase (nNOS), the ratio of smooth muscle to collagen, as well as the secretion of vascular endothelial growth factor (VEGF). Besides, apoptotic cells were reduced by stem cell treatment. The subgroup analysis indicated that modified stem cells were more effective than those without modification. CONCLUSIONS: Our results confirmed that stem cell therapy could apparently improve the erectile function of diabetic rats. Some specific modification, especially the gene modification with growth factors, could improve the efficacy of stem cell therapy. Stem cell therapy has potential to be an effective therapeutic strategy for diabetic ED.


Assuntos
Complicações do Diabetes/terapia , Disfunção Erétil/terapia , Transplante de Células-Tronco , Animais , Pressão Arterial , Coleta de Dados , Diabetes Mellitus Experimental/complicações , Modelos Animais de Doenças , Masculino , Ereção Peniana , Pênis/fisiopatologia , Pressão , Ratos , Células-Tronco/citologia
17.
J Sex Med ; 13(5): 778-85, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27017070

RESUMO

INTRODUCTION: For patients with diabetes, erectile dysfunction (ED) is common and greatly affects quality of life. However, these patients often exhibit a poor response to first-line oral phosphodiesterase type 5 inhibitors. AIM: To investigate whether taurine, a sulfur-containing amino acid, affects diabetic ED (DED). METHODS: Type 1 diabetes mellitus was induced in male rats by using streptozotocin. After 12 weeks, an apomorphine test was conducted to confirm DED. Only rats with DED were administered taurine or vehicle for 4 weeks. Age-matched nondiabetic rats were administered saline intraperitoneally for 4 weeks. MAIN OUTCOME MEASURES: Erectile function was evaluated by electrical stimulation of the cavernous nerve. Histologic and molecular alterations of the corpus cavernosum also were analyzed. RESULTS: Erectile function was significantly reduced in the diabetic rats compared with in the nondiabetic rats, and was improved in the diabetic rats treated with taurine. The corpus cavernosum of the rats with DED exhibited severe fibrosis and decreased smooth muscle content. Deposition of extracellular matrix proteins was increased in the diabetic rats, while expression of endothelial nitric oxide synthase/cyclic guanosine monophosphate/nitric oxide pathway-related proteins was reduced. Taurine supplementation ameliorated erectile response as well as histologic and molecular alterations. CONCLUSION: Taurine supplementation improves erectile function in rats with DED probably by potential antifibrotic activity. This finding provides evidence for a potential new therapy for DED.


Assuntos
Diabetes Mellitus Experimental/fisiopatologia , Diabetes Mellitus Tipo 1/fisiopatologia , Ereção Peniana/efeitos dos fármacos , Taurina/farmacologia , Animais , Diabetes Mellitus Experimental/tratamento farmacológico , Masculino , Pênis/metabolismo , Ratos , Ratos Sprague-Dawley , Estreptozocina
18.
Clin Cancer Res ; 22(6): 1531-44, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26527749

RESUMO

PURPOSE: Flightless I (FLII), member of the gelsolin superfamily of actin-remodeling proteins, functions as a transcriptional coregulator. We aim to evaluate a tumor-suppressive function of FLII in regulating androgen receptor (AR) in prostate cancer progression. EXPERIMENTAL DESIGN: We examined FLII protein and mRNA expression in clinical prostate cancer specimens by immunohistochemistry. Kaplan-Meier analysis was conducted to evaluate the difference in disease-overall survival associated with the expression levels of FLII and AR. Prostate cancer cells stably expressing FLII or shRNA knockdown were used for functional analyses. Immunoprecipitation, Luciferase reporter, and immunofluorescence staining assays were performed to examine the functional interaction between FLII and AR. RESULTS: Our analysis of the expression levels of FLII in a clinical gene expression array dataset showed that the expression of FLII was positively correlated with the overall survival of prostate cancer patients exhibiting high levels of AR expression. Examination of protein and mRNA levels of FLII showed a significant decrease of FLII expression in human prostate cancers. AR and FLII formed a complex in a ligand-dependent manner through the ligand-binding domain (LBD) of AR. Subsequently, we observed a competitive binding to AR between FLII and the ligand. FLII inhibited AR transactivation and decreased AR nuclear localization. Furthermore, FLII contributed to castration-sensitive and castration-resistant prostate cancer cell growth through AR-dependent signaling, and reintroduction of FLII in prostate cancer cells sensitized the cells to bicalutamide and enzalutamide treatment. CONCLUSIONS: FLII plays a tumor-suppressive role and serves as a crucial determinant of resistance of prostate cancer to endocrine therapies.


Assuntos
Proteínas dos Microfilamentos/metabolismo , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia , Receptores Androgênicos/metabolismo , Receptores Citoplasmáticos e Nucleares/metabolismo , Transdução de Sinais , Linhagem Celular Tumoral , Progressão da Doença , Expressão Gênica , Perfilação da Expressão Gênica , Humanos , Imuno-Histoquímica , Masculino , Proteínas dos Microfilamentos/genética , Prognóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/mortalidade , Neoplasias de Próstata Resistentes à Castração/genética , Neoplasias de Próstata Resistentes à Castração/metabolismo , Neoplasias de Próstata Resistentes à Castração/patologia , Ligação Proteica , Domínios e Motivos de Interação entre Proteínas , Transporte Proteico , Receptores Androgênicos/química , Receptores Androgênicos/genética , Receptores Citoplasmáticos e Nucleares/genética
19.
Biomed Res Int ; 2015: 514234, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26491675

RESUMO

CX43 plays a critical role in tumor progression. Previous studies imply that AR pathway may be involved in regulation of CX43. This study was focused on determining the relationship between AR pathway and CX43. The result showed that the expression of CX43 in malignant cells was higher than that in normal cells, and in nonmalignant and malignant cells, not only is the expression level of CX43 different, but the localization of CX43 can also be changed. After androgen stimulation and inhibition of AR pathway, expression of CX43 can also be changed. Thus, AR pathway plays an important role in regulation of CX43 expression in prostate cancer cells. AR may be the upstream signal of CX43.


Assuntos
Conexina 43/biossíntese , Regulação Neoplásica da Expressão Gênica , Proteínas de Neoplasias/metabolismo , Neoplasias da Próstata/metabolismo , Receptores Androgênicos/metabolismo , Transdução de Sinais , Linhagem Celular Tumoral , Conexina 43/genética , Feminino , Humanos , Masculino , Proteínas de Neoplasias/genética , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Receptores Androgênicos/genética
20.
PLoS One ; 10(4): e0122497, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25860144

RESUMO

BACKGROUND: Although some trials assessed the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after extracorporeal shock wave lithotripsy (ESWL), the role of the α-blocker in facilitating upper urinary calculi expulsion after ESWL remain controversial. AIMS: To determine the efficacy and safety of the α-blocker in facilitating renal and ureteral stones expulsion after ESWL. METHODS: A literature search was carried out using the PubMed database, EMBASE and the Cochrane Library database to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis. RESULTS: The meta-analysis included 23 RCTs, α-blocker significantly enhanced expulsion rate of upper urinary tract calculi after ESWL (P<0.00001; RR 1.21; 95% CI 1.12-1.31), significantly promoted steinstrasse expulsion (P=0.03; RR 1.25; 95% CI 1.03-1.53), significantly shortened the discharge time of upper urinary tract calculi (P=0.0001; MD -2.12; 95% CI -3.20--1.04), significantly reduced the patient's pain VAS score (P=0.001; RR -1.0; 95% CI -1.61--0.39). Compared with the control group, dizziness (P=0.002; RR 5.48; 95% CI 1.91-15.77), anejaculation (P=0.02; RR 12.17; 95% CI 1.61-91.99) and headache (P=0.04; RR 4.03; 95% CI 1.04-15.72) in the α-blocker group was associated with a higher incidence. CONCLUSIONS: Treatment with α-blocker after ESWL appears to be effective in enhancing expulsion rate of upper urinary tract calculi, shortening the discharge time of upper urinary tract calculi, reducing the patient's pain. The side effects of α-blocker were light and few.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Cálculos Renais/terapia , Litotripsia , Cálculos Ureterais/terapia , Humanos , Litotripsia/métodos , Razão de Chances , Viés de Publicação , Resultado do Tratamento
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