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BACKGROUND: This systematic review and network meta-analysis aimed to assess the comparative effectiveness and safety profiles of current combination therapies based on androgen deprivation therapy (ADT) for the heterogeneous population of individuals with metastatic castration-sensitive prostate cancer (mCSPC). METHODS: We retrieved pertinent literature from PubMed, EMBASE, the Cochrane Library, ClinicalTrials.gov, and international conference databases. The study was registered in the Prospective Register of Systematic Reviews (CRD42023453853) for transparency. RESULTS: Our analysis included 20 RCTs involving 14,995 patients, evaluating 15 ADT-based combinations, including systemic therapies, radiotherapy and surgery. In the overall population, the darolutamide triplet (DARO + docetaxel + ADT) demonstrated comparable overall survival (OS) benefits to prostatectomy/radical local therapy (RLT) plus ADT (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.43-1.57). Additionally, the enzalutamide (ENZ) triplet (ENZ + DOC + ADT) appeared to confer the best progression-free survival (HR, 0.34; 95% CI: 0.27-0.43). Subgroup analysis based on metastatic burden indicated that RLT plus ADT had the best OS performance in patients with low burden, while the DARO triplet was associated with the best OS in patients with high burden. Regarding adverse events (AEs), the addition of certain androgen receptor pathway inhibitor (ARPI) agents to ADT led to an increased incidence of severe AEs, while the addition of DOC to the ARPI doublet did not appear to elevate the exposure-adjusted incidence rates. CONCLUSIONS: Our findings suggest that combined treatments result in better survival outcomes than does ADT alone. In the current landscape of systemic therapy, the significance of local therapy should not be underestimated, and therapeutic decisions should be tailored with meticulous consideration of clinical heterogeneity among patients.
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BACKGROUND: Erectile dysfunction (ED) is a common issue among males, and the use of platelet-rich plasma (PRP) therapy for treating ED has gained increasing attention, but there is still no conclusive evidence regarding its efficacy. AIM: To evaluate the efficacy of PRP therapy for ED. METHODS: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases up to November 2023 to identify randomized controlled trials (RCTs) on PRP therapy for ED. We used Review Manager version 5.4 for data analysis and management. RESULT: After applying inclusion and exclusion criteria for screening, a total of 4 studies involving 413 patients were finally included in our meta-analysis. According to our analysis, the PRP group showed significant advantages over the placebo group in terms of MCID at the first month (p = 0.03) and sixth months (p = 0.008), while there was no significant difference between the two groups at the third month (p = 0.19). Additionally, in terms of IIEF, PRP showed significantly better efficacy than placebo at the first, third, and sixth months (p < 0.00001). CONCLUSIONS: PRP shows more effectiveness in treating ED compared to placebo, offering hope as a potential alternative treatment for ED.
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Disfunção Erétil , Plasma Rico em Plaquetas , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Disfunção Erétil/terapia , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: This pooled analysis aims to demonstrate the clinical efficacy and safety of combined desmopressin and anticholinergic therapy in the treatment of pediatric nocturnal enuresis (NE). METHODS: A systematic search was conducted through PubMed, MEDLINE, EMBASE, ResearchGate, and Cochrane Library to identify all randomized controlled trials (RCTs) comparing monotherapy with desmopressin versus combined therapy with desmopressin and anticholinergic agents for the treatment of NE. Data analysis was performed using RevMan version 5.4.1. RESULTS: This study included 8 RCTs involving a total of 659 patients. The frequencies of complete response (CR), partial response (PR), and nonresponse (NR) were computed for both short-term treatment (1 month) and long-term treatment (3 months). Additionally, alterations in the mean number of NE episodes, adverse events, and relapse were assessed. Our analysis indicates that, in comparison to the monotherapy group, the combination therapy group plays a pivotal role in augmenting the CR odds and diminishing the NR ratios in both short-term and long-term treatments (1 month CR ratio [risk ratio (RR): 1.84; 95% confidence interval (CI): 1.22-2.76; p = 0.003, I2 = 72%]; 3 months CR ratio [RR: 1.48; 95% CI: 1.25-1.76; p < 0.00001, I2 = 0%]; 1 month NR ratio [RR: 0.67; 95% CI: 0.55-0.82; p = 0.0001, I2 = 0%]; 3 months CR ratio [RR: 0.37; 95% CI: 0.19-0.73; p = 0.004, I2 = 0%]). Furthermore, in both short-term and long-term treatment, the combined therapy group exhibits a greater magnitude of change in the average number of NE episodes compared to patients receiving monotherapy (1 month, mean difference [MD] = -2.97; 95% CI: -4.23 to -1.71, p < 0.0001; 3 months, MD = -4.30; 95% CI: -7.18 to -1.43, p = 0.003). Moreover, the combination therapy group exhibits a significant reduction in the recurrence rate (RR: 0.36; 95% CI: 0.15-0.86; p = 0.02). There is no significant difference in the incidence of adverse events between the two groups (RR: 1.16; 95% CI: 0.58-2.31; p = 0.67). CONCLUSION: Combining desmopressin with anticholinergic medications is more effective for NE than desmopressin alone, with lower recurrence and minimal adverse effects.
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Enurese Noturna , Criança , Humanos , Antagonistas Colinérgicos/efeitos adversos , Terapia Combinada , Desamino Arginina Vasopressina/efeitos adversos , Quimioterapia Combinada , Enurese Noturna/tratamento farmacológico , Resposta Patológica CompletaRESUMO
Chlamydomonas reinhardtii polysaccharides (CRPs) are bioactive compounds derived from C. reinhardtii, yet their potential in cancer therapy remains largely unexplored. This study optimized the ultrasound-assisted extraction conditions using response surface methodology and proceeded with the isolation and purification of these polysaccharides. The optimal extraction conditions were identified as a sodium hydroxide concentration of 1.5%, ultrasonic power of 200 W, a solid-to-liquid ratio of 1:25 g/mL, an ultrasonic treatment time of 10 min, and a water bath duration of 2.5 h, yielding an actual extraction rate of 5.71 ± 0.001%, which closely aligns with the predicted value of 5.639%. Infrared analysis revealed that CRP-1 and CRP-2 are α-pyranose structures containing furoic acid, while CRP-3 and CRP-4 are ß-pyranose structures containing furoic acid. Experimental results demonstrated that all four purified polysaccharides inhibited the proliferation of cervical (HeLa) hepatoma (HepG-2) and colon (HCT-116) cancer cells, with CRP-4 showing the most significant inhibitory effect on colon cancer and cervical cancer, achieving inhibition rates of 60.58 ± 0.88% and 40.44 ± 1.44%, respectively, and significantly reducing the migration of HeLa cells. DAPI staining confirmed that the four purified polysaccharides inhibit cell proliferation and migration by inducing apoptosis in HeLa cells. CRP-1 has the most significant inhibitory effect on the proliferation of liver cancer cells. This study not only elucidates the potential application of C. reinhardtii polysaccharides in cancer therapy but also provides a scientific basis for their further development and utilization.
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Antineoplásicos , Proliferação de Células , Chlamydomonas reinhardtii , Polissacarídeos , Polissacarídeos/farmacologia , Polissacarídeos/isolamento & purificação , Polissacarídeos/química , Humanos , Antineoplásicos/farmacologia , Antineoplásicos/isolamento & purificação , Antineoplásicos/química , Proliferação de Células/efeitos dos fármacos , Células HeLa , Células Hep G2 , Células HCT116 , Animais , Linhagem Celular TumoralRESUMO
Berry curvature plays a crucial role in exotic electronic states of quantum materials, such as the intrinsic anomalous Hall effect. As Berry curvature is highly sensitive to subtle changes of electronic band structures, it can be finely tuned via external stimulus. Here, we demonstrate in SrRuO3 thin films that both the magnitude and sign of anomalous Hall resistivity can be effectively controlled with epitaxial strain. Our first-principles calculations reveal that epitaxial strain induces an additional crystal field splitting and changes the order of Ru d orbital energies, which alters the Berry curvature and leads to the sign and magnitude change of anomalous Hall conductivity. Furthermore, we show that the rotation of the Ru magnetic moment in real space of a tensile-strained sample can result in an exotic nonmonotonic change of anomalous Hall resistivity with the sweeping of magnetic field, resembling the topological Hall effect observed in noncoplanar spin systems. These findings not only deepen our understanding of anomalous Hall effect in SrRuO3 systems but also provide an effective tuning knob to manipulate Berry curvature and related physical properties in a wide range of quantum materials.
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Globally, microplastic pollution of soil ecosystems poses a major risk. The early studies found that the impact of microplastics on different plants could vary depending on the type of microplastic, the mass concentration or the plant species. This study investigated the effect of 3 mass concentrations (0.1%, 1%, and 2.5%) and 3 types of microplastics (PE MPs, PLA MPs, and PVC MPs) on adzuki bean biomass, root traits, Chlorophyll content and antioxidant enzymes. According to our findings, all microplastics had an impact on biomass, but PLA MPs had the strongest inhibitory effect. The high mass concentration of microplastics had a significant influence on chlorophyll content. Adzuki beans exhibited varying degrees of damage upon exposure to microplastics, but they were able to withstand the oxidative stress brought on by PE MPs by increasing the activity of antioxidant enzymes (SOD and POD). Comparing the adverse effects of PE MPs on adzuki beans to those of PLA MPs and PVC MPs, principal component analysis and membership function value analysis revealed that the former had fewer impacts. Disparities in the observed effects may be attributed to variations in the properties of microplastics. Subsequent investigations into the mechanisms underlying microplastic toxicity need a more comprehensive exploration.
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Clorofila , Microplásticos , Poluentes do Solo , Vigna , Vigna/efeitos dos fármacos , Microplásticos/toxicidade , Clorofila/metabolismo , Poluentes do Solo/toxicidade , Biomassa , Raízes de Plantas/efeitos dos fármacos , Superóxido Dismutase/metabolismo , Estresse Oxidativo/efeitos dos fármacos , AntioxidantesRESUMO
In this study, environmentally friendly, low cost, and easy to synthesize InSn and VSn co-doped SnSe materials was designed and prepared via vacuum melting and spark plasma sintering technology, which avoids the shortcomings of high-performance Pb, Ge, and Na-doped SnSe samples. InSn and VSn, doping achieved appropriate bandgap (Eg) and energy band degeneracy (NV) from the valence and conduction band, obtaining the highest electrical conductivity of 4726 S m-1 at 773 K. The impurity state controls the carrier transport process below 573 K, while Eg and NV control the process above 573 K. InSn and VSn doping induces quality fluctuation and local strain, which decreases the lattice thermal conductivity. Owing to the higher power factor and low lattice thermal conductivity, the ZT value of the Sn0.985In0.01Se sample was 1.3 at 773 K. Dual regulation of the valence and conduction band provides a new idea for adjusting the transport behavior of semiconductors.
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BACKGROUND: The therapeutic role of extracorporeal shockwave therapy (ESWT) for Peyronie's disease (PD) has been controversial in a long term. We aimed to further evaluate the therapeutic effect of ESWT for PD on the basis of available high-quality studies. METHODS: The PubMed, CENTRAL and Embase databases were searched for articles published from January 1st, 2000 to December 31, 2022. Only randomized controlled trials (RCTs) using ESWT to treat PD were included. Meta-analysis and forest plots were carried out using Review Manager 5.4.1 software, and outcomes were reviewed by 2 authors independently. Using the Risk of Bias assessment form (ROB-2) by Cochrane Collaboration for quality assessment. PRISMA 2020 guidelines were used in this article to achieve the quantitative and qualitative synthesis of data. RESULTS: A total of four RCTs were included. 151 patients in the ESWT group and 150 patients in the control group. The meta-analysis results showed that ESWT could significantly reduce plaque size (OR 2.59, 95%CI 1.15 to 5.85, P = 0.02) and relieve pain (MD -1.55, 95%CI -2.46 to -0.64, P = 0.0008); but it has no significant effect on reducing the penile curvature (OR 1.93, 95%CI 0.87-4.26, P = 0.11) and improving sexual function (MD 2.6, 95%CI -1.63 to 6.83, P = 0.23), there is also no significant difference in complication rates between groups (OR 2.94, 95%CI 0.66 to 13.03, P = 0.16). The risk of bias of results is low. The limitations of this study are that the number of included studies is too small, some experimental outcomes are missing, and the expression of outcomes is not unified. CONCLUSIONS: For PD, ESWT can be considered as a safe short-term treatment, which can reduce plaque size and relieve pain, but cannot improve penile curvature and sexual function. Its long-term efficacy remains to be discussed. REGISTRATION NUMBER: PROSPERO (ID: CRD42023436744).
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Tratamento por Ondas de Choque Extracorpóreas , Induração Peniana , Masculino , Humanos , Induração Peniana/terapia , Pênis , Bases de Dados Factuais , DorRESUMO
PURPOSE: Even though there isn't enough clinical evidence to demonstrate that robot-assisted radical cystectomy (RARC) is preferable to open radical cystectomy (ORC), RARC has become a widely used alternative. We performed the present study of RARC vs ORC with a focus on oncologic, pathological, perioperative, and complication-related outcomes and health-related quality of life (QOL). METHODS: We conducted a literature review up to August 2022. The search included PubMed, EMBASE and Cochrane controlled trials register databases. We classified the studies according to version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The data was assessed by Review Manager 5.4.0. RESULTS: 8 RCTs comparing 1024 patients were analyzed in our study. RARC was related to lower estimated blood loss (weighted mean difference (WMD): -328.2; 95% CI -463.49--192.92; p < 0.00001), lower blood transfusion rates (OR: 0.45; 95% CI 0.32 - 0.65; p < 0.0001) but longer operation time (WMD: 84.21; 95% CI 46.20 -121.72; p < 0.0001). And we found no significant difference in terms of positive surgical margins (P = 0.97), lymph node yield (P = 0.30) and length of stay (P = 0.99). Moreover, no significant difference was found between the two groups in terms of survival outcomes, pathological outcomes, postoperative complication outcomes and health-related QOL. CONCLUSION: Based on the present evidence, we demonstrated that RARC and ORC have similar cancer control results. RARC is related to less blood loss and lower transfusion rate. We found no difference in postoperative complications and health-related QOL between robotic and open approaches. RARC procedures could be used as an alternate treatment for bladder cancer patients. Additional RCTs with long-term follow-up are needed to validate this observation.
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Procedimentos Cirúrgicos Robóticos , Robótica , Neoplasias da Bexiga Urinária , Humanos , Cistectomia/métodos , Qualidade de Vida , Resultado do Tratamento , Procedimentos Cirúrgicos Robóticos/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias da Bexiga Urinária/patologia , Complicações Pós-Operatórias/etiologiaRESUMO
We conducted a meta-analysis to evaluate the efficacy and safety of photo selective vaporisation of the prostate (PVP) with the GreenLight Laser versus transurethral resection of the prostate (TURP) for the treatment of small-volume benign prostatic hyperplasia (BPH). As of July 2022, relevant literature in online databases such as Cochrane Library, PubMed, and Embase was searched, including studies published on or before that date, and there were 9 studies in total, including 5 RCTs and 4 non-RCTs. In total 1525 patients were included to compare the efficacy of PVP and TURP in treating BPH. The Cochrane Collaboration criteria were used to evaluate the risk of bias. The software was used for random effect meta-analysis with RevMan 5.3. Data extraction included: clinical baseline characteristics, perioperative parameters, complication rates, International Prostate Symptom Score (IPSS), prostate specific antigen (PSA), post-void residual urine (PVR), maximum flow rate (Qmax), and quality of life (QoL). The pooled analysis showed that PVP was associated with reduced blood loss, blood transfusion, clot retention, catheterization time, definitive catheter removal, and hospital stay, but was associated with longer operative time and more severe dysuria (all p < 0.05). The results of this meta-analysis show that PVP as a technique for the treatment of benign prostatic hyperplasia with a volume of less than 80 cc has similar efficacy to standard TURP in IPSS, PSA, PVR, Qmax and QoL, and is an effective alternative. It outperformed TURP in terms of blood transfusion, catheterization time and hospital stay, while TURP is superior to PVP in terms of operation time.
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Terapia a Laser , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Retenção Urinária , Masculino , Humanos , Próstata/cirurgia , Hiperplasia Prostática/cirurgia , Hiperplasia Prostática/complicações , Ressecção Transuretral da Próstata/efeitos adversos , Ressecção Transuretral da Próstata/métodos , Qualidade de Vida , Antígeno Prostático Específico , Resultado do Tratamento , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Retenção Urinária/cirurgiaRESUMO
Adjusting the crystal and band structures is of great significance for phonon or carrier transport in functional materials. Lattice contraction was designed to adjust the crystal and energy band structures, which bring about energy valley degeneracy and a band gap decrease in the SnSe system. The Seebeck coefficient of the rapid cooling sample increases significantly due to the energy valley degeneracy. The multichannel effect based on the energy valley degeneracy weakens scattering among the carriers and maintains a high σ along the "â¥" direction. The PF for the rapid cooling sample at 773 K reaches 686 µW m-1 K-2, which is boosted by 66.13% compared with that of the slow cooling sample. Due to the contribution from the high power factor, the ZT value of the rapid cooling sample reaches 0.86, which is an increase of 26% compared with the 0.69 of the slow cooling sample.
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In this study, the exopolysaccharides of Chlorella sp. (CEP) were isolated to obtain the purified fraction CEP4. Characterization results showed that CEP4 was a sulfated heteropolysaccharide. The main monosaccharide components of CEP4 are glucosamine hydrochloride (40.8%) and glucuronic acid (21.0%). The impact of CEP4 on the immune activity of RAW264.7 macrophage cytokines was detected, and the results showed that CEP4 induced the production of nitric oxide (NO), TNF-α, and IL-6 in a dose-dependent pattern within a range of 6 µg/mL. A total of 4824 differentially expressed genes (DEGs) were obtained from the results of RNA-seq. Gene enrichment analysis showed that immune-related genes such as NFKB1, IL-6, and IL-1ß were significantly upregulated, while the genes RIPK1 and TLR4 were significantly downregulated. KEGG pathway enrichment analysis showed that DEGs were significantly enriched in immune-related biological processes, including toll-like receptor (TLR) signaling pathway, cytosolic DNA-sensing pathway, and C-type lectin receptor signaling pathway. Protein-protein interaction (PPI) network analysis showed that HSP90AB1, Rbx1, ISG15, Psmb6, Psmb3, Psmb8, PSMA7, Polr2f, Rpsa, and NEDD8 were the hub genes with an essential role in the immune activity of CEP4. The preliminary results of the present study revealed the potential mechanism of CEP4 in the immune regulation of RAW264.7 macrophages, suggesting that CEP4 is a promising immunoregulatory agent.
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Anti-Inflamatórios/farmacologia , Chlorella/metabolismo , Perfilação da Expressão Gênica , Macrófagos/efeitos dos fármacos , Polissacarídeos/farmacologia , Transcriptoma , Animais , Anti-Inflamatórios/isolamento & purificação , Regulação da Expressão Gênica , Redes Reguladoras de Genes , Mediadores da Inflamação/metabolismo , Macrófagos/imunologia , Macrófagos/metabolismo , Camundongos , Polissacarídeos/isolamento & purificação , Mapas de Interação de Proteínas , Células RAW 264.7 , Transdução de SinaisRESUMO
Auxin is a key plant growth regulator for diverse developmental processes in plants. Indole-3-acetic acid (IAA) is a primary plant auxin that regulates the formation of various organs. Plants also produce phenylacetic acid (PAA), another natural auxin, which occurs more abundantly than IAA in various plant species. Although it has been demonstrated that the two auxins have distinct transport characteristics, the metabolic pathways and physiological roles of PAA in plants remain unsolved. In this study, we investigated the role of Arabidopsis UDP-glucosyltransferase UGT84B1 in IAA and PAA metabolism. We demonstrated that UGT84B1, which converts IAA to IAA-glucoside (IAA-Glc), can also catalyze the conversion of PAA to PAA-glucoside (PAA-Glc), with a higher catalytic activity in vitro. Furthermore, we showed a significant increase in both the IAA and PAA levels in the ugt84b1 null mutants. However, no obvious developmental phenotypes were observed in the ugt84b1 mutants under laboratory growth conditions. Moreover, the overexpression of UGT84B1 resulted in auxin-deficient root phenotypes and changes in the IAA and PAA levels. Our results indicate that UGT84B1 plays an important role in IAA and PAA homeostasis in Arabidopsis.
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Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Glucosiltransferases/metabolismo , Ácidos Indolacéticos/metabolismo , Fenilacetatos/metabolismo , Arabidopsis/genética , Proteínas de Arabidopsis/genética , Sistemas CRISPR-Cas , Escherichia coli/genética , Escherichia coli/metabolismo , Regulação da Expressão Gênica de Plantas , Glucosiltransferases/genética , Mutação , Plantas Geneticamente ModificadasRESUMO
The amount of sulfur dioxide residue is currently employed by Chinese Pharmacopoeia (CP) as an index to screen sulfur-fumigated herbs, but it is unclear if this index can objectively reflect the quality of sulfur-fumigated herbs. In the present study, sulfur-containing derivatives were confirmed in sulfur-fumigated Moutan Cortex (MC) by UPLC-QTOF-MS/MS analysis, and the contents of sulfur-containing derivatives and sulfur dioxide residues were statistically analyzed both in self-made and commercially available sulfur-fumigated and non-fumigated MC as well as the samples thereof before and after eight-month storage. The amount of sulfur dioxide was significantly decreased, but that of the newly-generated sulfur-containing markers was not, after eight-month storage of the sulfur-fumigated MC samples, indicating that the amount of sulfur dioxide residue may not be positively correlated with the quality of sulfur-fumigated MC. Therefore, sulfur dioxide residue index alone may not objectively reflect the sulfur-fumigation extent (quality change extent) of MC, more specific method using characteristic sulfur-containing derivatives as chemical markers should be developed to supplement the sulfur dioxide residue determination in the quality control of sulfur-fumigated MC.
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Medicamentos de Ervas Chinesas/química , Fumigação , Paeonia/química , Controle de Qualidade , Enxofre/química , Cromatografia Líquida de Alta Pressão , Dióxido de Enxofre , Espectrometria de Massas em TandemRESUMO
BACKGROUND: The generalized tonic-clonic seizure (GTCS) is the most usual variety of epileptic seizure. It is mainly characterized by strong body muscle rigidity, loss of consciousness, a disorder of plant neurofunction, and significant damage to cognitive function. The effect of antiepileptic drugs on cognition should also be considered. At present, there is no effective treatment for patients with epilepsy, but traditional Chinese medicine has shown a significant effect on chronic disease with fewer harmful side effects and should, therefore, be considered for the therapy means of epilepsy with cognitive dysfunction. AIM: To investigate the clinical efficacy of Baijin pills for treating GTCS patients with cognitive impairment. METHODS: This prospective study enrolled patients diagnosed with GTCS between January 2020 and December 2023 and separate them into two groups (experimental and control) using random number table method. The control group was treated with sodium valproate, and the experimental group was Baijin pills and sodium valproate for three months. The frequency and duration of each seizure, the Montreal Cognitive Assessment Scale (MoCA), and the Quality of Life Rating Scale (QOLIE-31) were recorded before and after treatment. RESULTS: There were 85 patients included (42 in the control group and 43 in the experimental group). After treatment, the seizure frequency in the experimental group was significantly reduced (P < 0.05), and seizure duration was shortened (P < 0.01). The total MoCA score in the experimental group significantly increased compared to before treatment (P < 0.01), and the sub-item scores, except naming and abstract generalization ability, significantly increased (P < 0.05), whereas the total MoCA score in the control group significantly decreased after treatment (P < 0.05). The QOLIE-31 score of the experimental group increased significantly after treatment compared to before treatment (P < 0.01). CONCLUSION: Baijin pills have a good clinical effect on epilepsy with cognitive dysfunction.
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Adenoid cystic carcinoma (ACC), a rare malignancy, typically originates in salivary glands and is rarely found in other locations. In this case report, we describe a 54-year-old male patient who was presented to the Urology Department of Yantai Yuhuangding hospital with right-sided waist pain. The patient underwent percutaneous ultrasound-guided biopsies of lesions in the kidney and lung, which were histologically confirmed as primary adenoid cystic carcinoma of the lung and metastatic renal adenoid cystic carcinoma, respectively. Given the presence of multiple metastases, the patient received systemic palliative chemotherapy, which was well-tolerated and effectively controlled the tumor. At the last follow-up, there was no evidence of tumor progression in the patient.
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Carcinoma Adenoide Cístico , Neoplasias Renais , Neoplasias Pulmonares , Masculino , Humanos , Pessoa de Meia-Idade , Carcinoma Adenoide Cístico/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Rim , HospitaisRESUMO
Circumcision is a common pediatric operation, and distraction technique can be used as an adjunct analgesic method during the perioperative period. The study aims to explore the effect of distraction techniques on reducing pain, fear, and anxiety in children undergoing circumcision. The PubMed, ClinicalTrials.gov, and Embase databases were searched for articles published from January 1, 2000, to December 31, 2023. Only randomized controlled trials (RCTs) were included. Meta-analysis and forest plots were carried out using Review Manager 5.4.1 software, and outcomes were reviewed by two authors independently. We used the Risk of Bias assessment form (ROB2) developed by the Cochrane Collaboration to assess the quality of included studies. PRISMA 2020 guidelines were used in this article to achieve the quantitative and qualitative synthesis of data. A total of seven RCTs were included. The intervention group consisted of 417 patients, while the control group had 245 patients. The meta-analysis and sensitivity analysis results showed that the distraction technique could significantly relieve pain (MD -1.3, 95% confidence interval [CI]: [-1.61 to -0.99], p < .00001), fear (SMD -1.04, 95%CI -1.68 to -0.4, p = .001), and anxiety (SMD -1.07, 95%CI [-1.64 to -0.51], p = .0002). Similarly, therapeutic play significant could significantly relieve fear (MD -0.4, 95%CI [-0.71 to -0.1], p = .01) and anxiety (SMD -1.31, 95%CI [-2.59 to -0.04], p = .04), virtual reality (VR) could significantly relieve anxiety (SMD -0.67, 95%CI [-0.98 to -0.37], p < .0001). Distraction techniques can alleviate perioperative pain, fear, and anxiety in children undergoing circumcision.
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Ansiedade , Dor , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Ansiedade/prevenção & controle , Transtornos de Ansiedade , MedoRESUMO
INTRODUCTION: Peyronie's disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD. METHODS: We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie's Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3. RESULTS: For penile length (MD, 0.81 cm; 95% CI, 0.17-1.45; P = .01), PDQ symptom bother (MD, -1.02; 95% CI, -1.83 to -0.21; P = .01), and PDQ penile pain (MD, -0.93; 95% CI, -1.50 to -0.36; P = .001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies. CONCLUSION: This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.
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Colagenase Microbiana , Induração Peniana , Induração Peniana/tratamento farmacológico , Humanos , Masculino , Colagenase Microbiana/uso terapêutico , Colagenase Microbiana/administração & dosagem , Quimioterapia Combinada , Resultado do Tratamento , Pênis/efeitos dos fármacosRESUMO
Biodegradable mulch residues contribute significantly to the presence of microplastics in soil ecosystems. The environmental impact of microplastics, especially biodegradable microplastics (bio-MPs), on soil and plants is of increasing concern. In this study, the responses of five crop species potted in soil treated with different mass concentrations of bio-MPs were assessed for one month. The shoot and root biomasses of cabbages and strawberries were inhibited by bio-MPs treatment. There was little variation in the growth indicators of identical plants with the addition of different mass concentrations of bio-MPs; however, a significant difference was observed among different plants with the addition of the same concentration of bio-MPs. The detrimental effects of bio-MPs were more pronounced in strawberries and cabbages than in the other plant species. Moreover, bio-MPs can affect the availability of soil nutrients and enzyme activities. Structural equation modeling showed that changes in soil properties may indirectly affect plant growth and nutrient uptake when exposed to bio-MPs. This study provides a theoretical basis for understanding the ecological effects of biodegradable mulch films.
Assuntos
Biodegradação Ambiental , Microplásticos , Poluentes do Solo , Solo , Solo/química , Microplásticos/toxicidade , Desenvolvimento Vegetal/efeitos dos fármacos , Plásticos Biodegradáveis , Plantas/efeitos dos fármacosRESUMO
Prussian blue analogues possess numerous advantages as cathode materials for sodium-ion batteries, including high energy density, low cost, sustainability, and straightforward synthesis processes, making them highly promising for practical applications. However, during the synthesis, crystal defects such as vacancies and the incorporation of crystal water can lead to issues such as diminished capacity and suboptimal cycling stability. In the current study, a Y-tube assisted coprecipitation method was used to synthesize iron-based Prussian blue analogues, and the optimized feed flow rate during synthesis contributed to the successful preparation of the material with a formula of Na1.56Fe[Fe(CN)6]0.90â¡0.10·2.42H2O, representing a low-defect cathode material. This approach cleverly utilizes the Y-tube component to enhance the micro-mixing of materials in the co-precipitation reaction, featuring simplicity, low cost, user-friendly, and the ability to be used in continuous production. Electrochemical performance tests show that the sample retains 69.8% of its capacity after 200 cycles at a current density of 0.5C (1C = 140 mA g-1) and delivers a capacity of 71.9 mA h g-1 at a high rate of 10C. The findings of this research provide important insights for the development of high-performance Prussian blue analogues cathode materials for sodium-ion batteries.