ABSTRACT
Objective:To investigate the protective effect and mechanism of Icaritin Ⅱ (ICAⅡ) on bladder in radiation cystitis model.Methods:A total of 18 10-week-old male SD rats were selected from July 2021 to March 2022 and divided into control group, model group and treatment group by random number table method, with 6 cases in each group. Model group and treatment group were given a single dose of 20 Gy X-ray irradiation in the pelvic area. 24 h after irradiation, the treatment group was given ICAⅡ 4.5 mg/(kg·d) gavage, while the control group and model group were given the same volume of solvent (10% anhydrous ethanol, 20% isopropyl alcohol, 30% polyethylene glycol and 40% deionized water) gavage for 4 consecutive weeks. Drug eluting for 1 week. The bladder volume and leakage point pressure of the three groups of rats were measured by multi-conducting physiological apparatus, and the bladder function was evaluated. HE staining, Masson staining, ELISA, TUNEL staining and western blotting were performed on the bladder samples of the three groups of rats. The pathological changes (thickness of bladder mucosa, ratio of smooth muscle to collagen fiber), oxidative stress level (superoxide dismutase SOD, malondialdehyde), apoptosis rate, protein levels of inflammatory factors (IL-6, NF-kB) and anti-oxidative stress signaling pathway factors (Nrf2, HO-1) of the three groups of rats were compared.Results:After 4 weeks of modeling, in the model group, the bladder volume [(1.01±0.12)ml vs. (1.58±0.21)ml, P=0.001], the bladder leakage point pressure [(38.79±4.12) cmH 2O (1 cmH2O=0.098 kPa)vs.(60.59±3.81) cmH 2O, P=0.001], the ratio of smooth muscle of bladder wall to collagen fiber [1.78±0.17 vs.3.15±0.57, P=0.001], SOD[(6.31±0.73) U/mg vs.(14.67±1.04) U/mg, P=0.001] were lower than the control group, and the differences were statistically significant. In the model group, the thickness of bladder mucosa [(47.33±1.78)μm vs.(20.83±2.33)μm, =, P=0.001], malondialdehyde [(1.01±0.13) nmol/mg vs.(0.49±0.03) nmol/mg, P=0.001], IL-6 (0.87±0.11 vs. 0.33±0.10, P=0.001), NF-kB (0.71±0.14 vs. 0.29±0.07, P=0.001), apoptosis rate [(11.60±3.04)% vs. (3.91±1.40)%, P=0.007] was higher than the control group, and the differences were statistically significant. In the treatment group, the bladder volume [(1.27±0.13)ml, P=0.030], bladder leakage point pressure [(47.83±2.50)cmH 2O, P=0.004], smooth muscle to collagen fiber ratio (2.78±0.68, P=0.015), SOD[(10.48±0.85) U/mg, Compared with model group, bladder mucosa thickness [(31.94±3.20)μm, P=0.001], malondialdehyde [(0.64±0.09) nmol/mg, P=0.001], IL-6 (0.69±0.11, P=0.035), NF-kB (0.45±0.06, P=0.002) and apoptosis rate [(6.05±0.60)%, P=0.030] were lower than those in model group. The protein expression level of Nrf2 in model group (0.73±0.08 vs. 0.58±0.11, P=0.023) was higher than that in control group, but there was no significant difference in the protein expression level of downstream antioxidant factor HO-1 (0.50±0.14 vs. 0.35±0.06, P=0.060). Nrf2 protein expression level (0.88±0.03, P=0.027) and HO-1 expression level (0.68±0.07, P=0.026) in treatment group were higher than those in model group. Conclusion:ICAⅡ can reduce radiation cystitis injury, and its mechanism may be related to anti-oxidative stress and reducing inflammation.
ABSTRACT
In this study, the vaporization ratio of the 2-mum laser in the prostatic tissue with benign prostatic hyperplasia was examined in vitro, to explore a technique to estimate the clearance rate of prostatic tissue during the transurethral vaporesection of the prostate. A total of 9 fresh prostatic tissue specimens were obtained by open surgery and the wet weight of the prostatic tissue were measured immediately after the sample collection. Under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, each prostate gland was completely vaporesected into fragments with a diameter of less than 1.0 cm in vitro. After the vaporesection, the whole fragments of prostatic tissue were collected and measured. Then the lost weight of prostatic tissue, the weight of the collected prostatic tissue and the ratio of the lost weight of prostatic tissue to the wet weight of the prostate glandular organ specimen were calculated. The correlation between the weight of collected prostatic tissue and the weight of the whole glandular organ was analyzed. All the experimental procedures were carried out by one operator. Wet weight of the prostatic gland specimen and the weight of the harvested prostatic tissues after the procedure were recorded. With respect to the wet weight of prostate gland specimen, the percentage of the weight of collected prostatic tissue was (34.45+/-1.51) %, and the percentage of the lost weight of prostatic tissue was (65.55+/-1.51)%. Satisfactory linear relationship was observed between the weight of collected prostatic tissue and the wet weight of prostate gland specimen [y=3.245x-6.475 (t=15.097, P=0.000)]. It is concluded that under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, the vaporization ratio of prostatic tissue can be calculated on the basis of the weight of collected prostatic tissue, and thereby the clearance of prostatic tissue during the formal operation by 2-mum laser could be quantitatively determined.
ABSTRACT
Objective To evaluate the efficacy of the RevoLix 70 Watt 2 micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia(BPH,＞80 g).Methods Forty-five patients with obstructive BPH were treated with 2 micron continuous wave laser vaporesection.The age ranged from 57 to 88 years with a mean of 69 years.Nine patients had acute urinary retention.Mean prostatic volume was(96±1 3)ml(ranged from 80 to 128 m1).Eight cases were given suprapubic puncture.All cases were successfully anesthetized by using epidural anesthesia.At the beginning of the operation,the distal resection border close to the verumontanum was marked and laser incisions were performed at 5 and 7 o'clock lithotomy position.Firstly,median lobe was vaporeseeted closely along capsule from bladder neck to verumontanum.Secondly,prostate at 12 o'clock was vaporesected until the capsule was reached,and both lateral lobes were dissected downward.Thirdly,the apical position was enucleated by sheath,and then prostate was vaporesected from the tissue in 12 o'clock position to the tissue at 6.It was important to follow the 2 principles:inner to extra,up to down.Transfusion rate,resection time,time of indwelling catheter,improvement in urinary flow rate(Qmax),international prostate symptom score(IPSS)and quality of life(QOL)were measured.Results AIl cases were successfully operated.except one whose left lateral lobe was left due to heavy fluctuation of heart rate and blood pressure in operation.The mean operation time was (104±12)min.Transfusions were not necessary in any patients.The catheter was indwelled for 3 to 5 d postoperatively.One case had urethral stricture 3 weeks after operation,and urinated free after 22 times urethral sounding disj unctively.All cases were followed up for 3-1 2 months.All patients were satisfied with voiding outcome,none had incontinence.Mean Qmax increased from(3.3±0.5)ml/spreoperatively to(16.5±1.5)ml/s postoperatively.IPSS decreased from 28.6±5.5 to 8.3±2.3 and QOL score decreased from 4.5±0.4 to 2.7±0.2.respectively(P＜0.01).No hemorrhage occurred after the operation.Conclusion RevoLix 2 micron continuous wave laser vaporesection for treatment of large volume BPH is a safe and effective relief therapy,and that in combination with enucleation could improve the efficiency of vaporesection.