ABSTRACT
Objective:To investigate the role of vitamin D analogue paricalcitol in activating vitamin D receptor/glutathione peroxidase 4 (VDR/GPX4) pathway in ventilator-induced lung injury (VILI).Methods:Twenty-four male C57BL/6J mice were randomly divided into control group, high tidal volume (HVT) induced VILI model group (HVT group), paricalcitol control group (P group), and paricalcitol pretreatment group (P+HVT group), with 6 mice in each group. The mice were endotracheal intubated and ventilated at 40 mL/kg tidal volume to prepare VILI model, while those in the control group were intubated without ventilation. The mice in the P+HVT group were intraperitoneally injected with paricalcitol 0.2 μg/kg once a day 1 week before modeling, while those in the P group were intraperitoneally injected paricalcitol 0.2 μg/kg once a day for 1 week before the experiment. After ventilation for 4 hours, the mice were sacrificed for lung tissue collection. Lung injury was evaluated by wet/dry (W/D) ratio, hematoxylin-eosin (HE) staining and Masson staining. The expressions of VDR and GPX4 were determined by Western blotting and immunohistochemistry. Malondialdehyde (MDA) and glutathione (GSH) contents were determined by micro method.Results:After HVT for 4 hours, compared with the control group, lung injury score and W/D ratio were significantly higher (lung injury score: 0.430±0.035 vs. 0.097±0.025, lung W/D ratio: 4.860±0.337 vs. 3.653±0.332, both P < 0.05), collagen fiber deposition was significantly increased, the content of MDA in lung tissue was significantly increased (nmol/g: 212.420±8.757 vs. 97.073±5.308, P < 0.05), GSH content and the protein expressions and immunoreactive score (IRS) of VDR and GPX4 were significantly decreased [GSH (μg/g): 44.229±1.690 vs. 70.840±0.781; VDR protein (VDR/GAPDH): 0.518±0.029 vs. 0.762±0.081, GPX4 protein (GPX4/GAPDH): 0.452±0.032 vs. 0.649±0.034; IRS score: VDR was 4.168±0.408 vs. 10.167±0.408, GPX4 was 4.333±1.033 vs. 10.333±0.516; all P < 0.05], which meant that the mice in HVT group showed obvious lung injury. After VDR was activated by paricalcitol, compared with the HVT group, lung injury score and W/D ratio were significantly decreased (lung injury score: 0.220±0.036 vs. 0.430±0.035, lung W/D ratio: 4.015±0.074 vs. 4.860±0.337, both P < 0.05), collagen fiber deposition was reduced, MDA content in lung tissue was decreased (nmol/g: 123.840±8.082 vs. 212.420±8.757, P < 0.05), GSH content and the protein expressions and IRS score of VDR and GPX4 were significantly up-regulated [GSH (μg/g): 63.094±0.992 vs. 44.229±1.690; VDR protein (VDR/GAPDH): 0.713±0.056 vs. 0.518±0.029, GPX4 protein (GPX4/GAPDH): 0.605±0.008 vs. 0.452±0.032; IRS score: VDR was 9.000±0.632 vs. 4.168±0.408, GPX4 was 8.833±0.408 vs. 4.333±1.033; all P < 0.05], which meant that lung injury in P+HVT group was significantly improved. Conclusion:Vitamin D analogue paricalcitol ameliorates pulmonary oxidation-reduction imbalance by activating the VDR/GPX4 pathway, thereby alleviating VILI.
ABSTRACT
ObjectiveTo observe the clinical efficacy of Jiawei Xiaochaihutang combined with microwave ablation （MWA） in the treatment of primary hepatocellular carcinoma （HCC） and its influence on tumor microenvironment. MethodA total of 128 patients were randomly divided into control group （64 cases： 2 cases of dropout，2 cases of elimination，and 60 cases of completion） and observation group （64 cases： 3 cases of dropout，2 cases of elimination，and 59 cases of completion）. Both groups were given comprehensive treatment after MWA surgery. Patients in control group took Biejiajian Wan orally （3 g/time，3 times/d）， and those in observation group took Jiawei Xiaochaihutang （1 dose/d）. The treatment lasted for 3 consecutive months. The size of solid tumor before and after treatment was evaluated to record the progression-free survival （PFS）. The alpha-fetoprotein-L13 （AFP-L3），des-γ-carboxy prothrombin （DCP），Golgi protein 73 （GP73），tumor necrosis factor-α （TNF-α），transforming growth factor-β （TGF-β），vascular endothelial growth factor （VEGF） and matrix metalloproteinase-2 （MMP-2） levels，as well as performance status （PS），liver function and syndrome of liver depression and Qi stagnation scores were also detected before and after treatment. In addition， the incidence of side effects of grade Ⅲ and above was compared. ResultThe total effective rate of solid tumor in observation group was 91.53% （54/59），higher than that （76.67%， 46/60） in control group（χ2=4.895，P<0.05）. The PFS in observation group was （7.16±0.95） months， longer than that （6.24±0.89 months） in control group （P<0.01）. The effective rate of traditional Chinese medicine （TCM） syndrome in observation and control groups were 88.14% （52/59）and 70.00% （42/60）， respectively （χ2=5.897，P<0.05）. The observation group （57.63%，34/59） had higher marked effective rate of TCM syndrome than control group （31.67%，19/60） （χ2=8.116，P<0.01）. The AFP-13，DCP，GP73，TNF-α，TGF-β，VEGF and MMP-2 levels and the PS，liver function and syndrome of liver depression and Qi stagnation scores in observation group were lower than those in control group （both P<0.01）. The cumulative incidence of side effects of grade Ⅲ and above in observation and control groups was 16.95% and 33.33%， respectively（χ2=4.261，P<0.05）. ConclusionConsolidation treatment of HCC after MWA surgery with Jiawei Xiaochaihutang relieved symptoms and side effects，improved PS and liver function，regulated tumor microenvironment，inhibited tumor markers and prolonged survival time. The clinical effect was better than that of Biejia decoction pill， and thus it was worthy of clinical use.
ABSTRACT
Objective:To evaluate the efficacy and safety of continuous infusion of low-dose intravenous (Ⅳ) heparin during perioperative period of simultaneous pancreas-kidney (SPK) transplantation for donation after citizen death (DCD) donor to prevent pancreatic thrombosis post-transplantation.Methods:From January 2015 to August 2019, 46 DCD donors undergoing SPK were divided into retrospective cohort groups 1 ( n=27) and 2 ( n=19). Group 1 received aspirin enteric-coated tablets only at Day 1 post-SPK. In Group 2, 5-7 days of continuous infusion of heparin 260 IU per hour at Day 1 post-SPK was followed by a daily intake of aspirin enteric-coated tablets of 100 mg. Incidence of thrombus, recovery of graft function and adverse reactions of anticoagulant therapy were observed. Results:Thrombosis occurred in (5.3%, 1/19 vs 14.8%, 4/27) in heparin and non-heparin groups. Thrombosis and graft loss were significantly lower in heparin group than those in non-heparin group ( P<0.05). Conclusions:Continuous infusion of low-dose heparin vein is effective and safe in preventing thrombosis after SPK transplantation.
ABSTRACT
Objective:To explore the protective effect of hypothermia plus extracorporeal membrane oxygenation(ECMO)on kidney in brain-dead kidney transplant donors.Methods:From July 2017 to July 2018 at Institute of Transplantation Medicine, Hospital No. 923 of PLA, 29 patients with circulatory dysfunction brain death donors fulfilling the organ donation criteria were randomly divided into sub-hypothermia group according to the treatment of extracorporeal membrane oxygenation(body temperature 34.0~35.0℃, 15 cases)and normal temperature group(36.5~37.5℃, 14 cases). Hemodynamic profiles and renal function changes were compared between two groups during ECMO.And renal complications of two groups were followed up.Results:The hemodynamic parameters of two groups remained stable during ECMO period.Heart rate of 5 MO-organs was lower in hypothermia group than that in normal temperature group( P<0.05). Systolic and diastolic pressures before ECMO 3 h-organ acquisition were higher than normal temperature group( P<0.05). No significant difference existed between PaO 2 and normal temperature groups( P>0.05). Donor serum creatinine(SCr)and blood urea nitrogen(BUN)were lower in hypothermia group than in normal temperature group( P<0.05). The postoperative recipient levels of BUN were lower in mild hypothermia group than those in normothermia group( P<0.05)and no significant difference between SCr and normal temperature groups( P>0.05). The postoperative hospital stay was(16.52±3.59)days in mild hypothermia group. And it was lower than that in normal temperature group( P<0.05). Delayed renal function was lower than normal temperature group(3.45% and 21.43%, P<0.05). Conclusions:Mild hypothermia plus ECMO can reduce hemodynamic fluctuations in circulatory unstable donors after brain death, improve renal function and lower the incidence of delayed functional recovery after renal transplantation.
ABSTRACT
Accurate methods for identifying pelvic lymph node metastasis (LNM) of prostate cancer (PCa) prior to surgery are still lacking. We aimed to investigate the predictive value of peripheral monocyte count (PMC) for LNM of PCa in this study. Two hundred and ninety-eight patients from three centers were divided into a training set (n = 125) and a validation set (n = 173). In the training set, the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses, and the optimal cutoff value was calculated by the receiver operating characteristic (ROC) curve. The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort. Finally, a nomogram based on the PMC was constructed for predicting LNM. Multivariate analyses of the training cohort demonstrated that clinical T stage, preoperative Gleason score, and PMC were independent risk factors for LNM. The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405 × 109 l
ABSTRACT
BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.
Subject(s)
Female , Humans , China , Gynecologic Surgical Procedures/adverse effects , Pelvic Floor/surgery , Pelvic Organ Prolapse/surgery , Surgical Mesh/adverse effects , Treatment Outcome , VaginaABSTRACT
Autophagy and apoptosis have been regarded as important processes in the development of diabetic erectile dysfunction (DMED). Probucol is considered to have anti-apoptotic effects, but its relationship with autophagy has not been reported. The aim of this study was to investigate the effects and mechanisms of probucol on erectile function. Thirty Sprague-Dawley (SD) male rats (12 weeks old) were fasted for 12 h. Twenty SD rats were injected with a single intraperitoneal injection of 60 mg kg-1 streptozotocin (STZ). Ten rats were given vehicle only and used as a sham group. After 72 h, 20 STZ-treated rats with random blood glucose concentrations consistently greater than 16.7 mmol l-1 were used as successfully established diabetic rats. The diabetic rats were divided randomly into two groups and treated with a daily gavage of probucol at a dose of 0 or 500 mg kg-1 for 12 weeks. After treatment, the intracavernous pressure (ICP) was used to measure erectile function upon electrical stimulation of the cavernous nerve. After euthanasia, penile tissue was examined using immunohistochemistry and Western blot to assess the protein levels of B-cell lymphoma-2 (Bcl-2), BCL2-associated X (Bax), microtubule-associated protein light chain 3-II (LC3-II), mammalian target of rapamycin (mTOR), and sequestosome 1 (P62). Caspase-3 activity was measured to determine apoptosis using a caspase-3 assay kit. After 12 weeks of treatment, the erectile function of the probucol group was significantly better than that of the DM group (P < 0.05). Bax and LC3-II protein expression and caspase-3 activity were significantly lower in the probucol group than those in the DM group (all P < 0.05), while Bcl-2, mTOR, and P62 protein expression levels were significantly higher than those in the DM group (all P < 0.05). We demonstrated that probucol inhibited apoptosis and autophagy in STZ-induced diabetic rats.
ABSTRACT
Objective:To explore the mechanism of modified Guipitang in the treatment of Yin-Fire insomnia with anxiety with the help of network pharmacological analysis technology. Method:Traditional Chinese Medicine Systems Pharmacology (TCMSP) was used to screen the main components and target genes of modified Guipitang. GeneCards and Online Mendelian Inheritance in Man (OMIM) were used to establish the target gene sets of insomnia and anxiety. STRING 11.0 software was used to analyze the interaction between the overlapping genes, and Cytoscape_3.6.1 software analysis and Matthews correlation coefficient (MCC) algorithm were used to screen the core genes. Based on the results of network analysis, 48 SD female rats were randomly divided into blank control group, model group, eszopiclone tablets group (0.2 mg·kg-1·d-1), modified Guipitang low，medium，and high-dose groups (0.31，1.25，5 g·kg-1·d-1). The model of insomnia with anxiety was established by intraperitoneal injection of Para-chlorophenylalanine (PCPA) and these rats were treated with corresponding drugs for 7 days. Then the frequency, time and distance of the activities were observed in the experiment of autonomic activity. Real-time quantitative polymerase chain reaction (PCR) was used to detect the mRNA expressions of proactivated protein kinase 8 (MAPK8), RAC-alpha serine/threonine protein kinase (Akt1), mitogen-activated protein kinase 3 (MAPK3) and interleukin-6 (IL-6) in rat hippocampus. Result:A total of 228 active compounds were screened from TCMSP database and 181 intersecting genes of diseases and drugs were obtained by comparing with GeneCards and OMIM comprehensive database. 9 core genes, including MAPK3, MAPK8, Akt1 and IL-6 were identified by STRING software and MCC algorithm. Animal experiments showed that the number of activity times, time and distance of modified Guipitang in high and medium dose groups were significantly lower than those in the model group. The high and middle dose groups of modified Guipitang could significantly inhibit the mRNA expression of MAPK3, MAPK8, Akt1 and IL-6 in hippocampus（P<0.01）, while the low dose group had no significant effect. Conclusion:The mechanism of modified Guipitang in treating Yin-fire insomnia with anxiety may be related to the regulation of MAPK3, MAPK8, Akt1 and IL-6 genes.
ABSTRACT
Organ shortage is one of the important factors restricting the development of human organ transplantation. The identification and referral of potential donors determine the total scale of organ donation. Whether potential donors can be identified and referred is the most important reason for the difference of organ donation rates in different regions. This paper interprets the chapter of the identification and referral of potential donors in the Guide to the Quality and Safety of Organs for Transplantation (6th edition) issued by European Union in order to provide reference for the staff of organ procurement organization and related medical personnel in China and improve the organ donation rate in China.
ABSTRACT
The application of microsurgery and immunosuppressive agents have led to remarkable progress in uterus allotransplantation for patients with absolute uterine infertility. At present, more than 40 cases of human uterus transplantation have been successfully carried out worldwide, and 12 healthy newborn babies have been delivered using cesarean section. However, selection of transplant donors and recipient, in vitro uterine perfusion, the immunosuppressive therapy and characteristics of graft rejection after uterus allotransplantation are worthy of attention. This article reviews the research progress in uterus allotransplantation.
ABSTRACT
Objective: To intensively study the chemical constituents from the seed cake of Camellia oleifera and its pharmacological activities,in order to provide scientific basic for its further development and utilization. Method: All kinds of column chromatography and spectral methods were employed to isolate and identify the monomeric compounds from its ethyl acetate portion of ethanol extract. The in vitro anti-inflammatory effects were evaluated by LPS-induced inflammatory model in RAW264.7 macrophages. Result: Eight phenolic acids and two flavonoids were isolated from the ethyl acetate soluble portion and identified as p-hydroxybenzoic acid(1),protocatechuic acid(2),gallic acid(3),methyl gallate(4),ethyl gallate(5),isovanillic acid(6),ethyl 3,4-dihydroxylbenzoate(7),2-(3',4'-dihydroxyphenyl)-1,3-benzodioxole-5-aldehyde(8),quercetin(9),rutoside(10). Among them, compounds 4-8 were first isolated from this plant. These compounds had good anti-inflammatory activities against NO production in LPS-stimulated RAW264.7 macrophages in an obvious dose-dependent manner. Among them, compound 8 showed a strongest activity. Conclusion: The above results show that the phenolic acids and flavonoids from seed cake of C. oleifera have good prospects for the development and application of anti-inflammatory drugs.
ABSTRACT
Neuroendocrine prostate cancer (NEPC) is a highly malignant subtype of prostate cancer and it mostly occurs in castration-resistant prostate cancer patients after antiandrogen therapy. The process of cell differentiation to obtain neuroendocrine phenotypes is called neuroendocrine differentiation (NED). It is a proposed mechanism of prostate cancer resistance to androgen-resistance therapy, which is associated with poor prognosis. At present, there is no consensus on the physiological and pathological characteristics of NEPC, and the treatment of this subtype is particularly difficult. This paper reviews the latest findings related to NEPC and NED, and summarizes the most studied targets, hoping to provide new ideas for peer diagnosis, treatment and research of NEPC.
ABSTRACT
Transvaginal NOTES surgery,as an emerging minimally invasive surgical technique,is widely used in gynecology disease.However,there are some difficulties in clinical application. This article discusses the indications and contraindications of transvaginal NOTES,the difficulties and countermeasures in the establishment of the access platform,the exposure problems of the surgical visual field,the complications encountered during the operation and their treatment,and infection prevention.
ABSTRACT
Cervical cancer is one of the most common gynecological malignancies during pregnancy.The management of cervical cancer during pregnancy depends on the following factors:tumor stage,histological type,gestational age,state of lymph nodes and desire regarding fertility.The treatment for patients who want to preserve pregnancy needs to be individualized and requires a multidisciplinary team.This article reviews the researches about management of cervical cancer during pregnancy.
ABSTRACT
AIM:To observe the expression of long noncoding RNA TTTY 15 in osteosarcoma tissues and cell lines and to explore its effect on the viability and invasion ability of osteosarcoma cell lines.METHODS:qPCR was used to detect the expression of TTTY15 in 11 cases of osteosarcoma and its adjacent tissues.The mRNA levels of TTTY15 in os-teosarcoma cell lines(143B,Saos2,MG-63,U2OS and HOS)and human osteoblast cell line hFOB1.19 were also tested. TTTY15 was down-regulated after transfected with small interfering RNA in MG-63 cells,the cell line with the highest level of TTTY15.The effect of TTTY15 knockdown on the viability of MG-63 cells was measured by CCK-8 assay.The cell cycle distribution was analyzed by flow cytometry.The effect of TTTY15 knockdown on the cell invasion ability was detected by Transwell assay.The levels of miR-216b-5p and FOXM1 mRNA were detected by qPCR, and the changes of the related proteins were determined by Western blot.RESULTS:Compared with the adjacent tissues,the expression of TTTY15 in-creased in the osteosarcoma tissues(P<0.01).Compared with the human osteoblast cell line,the expression of TTTY15 increased in the osteosarcoma cell lines(P<0.05), and the level of TTTY15 in the MG-63 cells was the highest(P<0.01).After knockdown of TTTY15 expression in the MG-63 cells,the cell viability was decreased(P<0.05),cell cycle progression was inhibited(P<0.01), and the cell invasion ability was decreased(P<0.01).The expression of miR-216b-5p was increased(P<0.01)and the expression of FOXM1 mRNA was decreased(P<0.01).The protein expres-sion of FOXM1,CDK4,cyclin D1,MMP-2 and N-cadherin was decreased,while the protein expression of E-cadherin was increased(P <0.05).CONCLUSION: The expression of TTTY15 is increased in the osteosarcoma tissues and cell lines.The low expression of TTTY15 inhibits the cell viability and invasion ability of osteosarcoma cells.The possible mechanism is that the knockdown of TTTY 15 expression results in the increase in miR-216b-5p expression and the down-regulation of FOXM1 expression.
ABSTRACT
· AIM:To investigate the correlation between retinal thickness (CSRT) in the macular region and glycosylated hemoglobin (HbA1c) of patients with type 2 diabetes mellitus.· METHODS:Totally 39 cases of patients with diabetes (77 eyes) who screened from May 2016 to March 2017 were selected,and were divided into two groups according to the levels of HbA1c,which the 24 cases (47 eyes) in the low HbA1c group (HbA1c＜8％) and 15 cases (30 eyes) in high HbA1c group (HbA1c≥8％).Other 22 cases of normal people (normal control group) and who for healthy physical examination were selected in the same period.Then,the correlation between HbA1c level and CSRT were analyzed by the Spearman correlation analysis.· RESULTS:In the high HbA1c group,HbA1c was (10.45±1.30)％,FBG was 10.67±1.64mmol/L and 2hPG was 15.98± 1.38mmol/L,which was higher than that in the low HbA1c group,and there was significant difference between the two groups (P＜ 0.05).The CSRT in the normal group was lower than the low HbA1c group and the high HbA1c group,and there was significant difference between the groups (P＜ 0.05).According to the analysis of the Spearman method,there was positive correlation between HbA1c and CSRT,macular volume,average macular thickness,FBG and those parameters,2hPG and them (P＜0.01).· CONCLUSION:The HbA1c level is associated with retinal thickening in the macular region of patients with diabetes,which could predict the severity of diabetic retinopathy and provide important guidance for prevention and treatment.
ABSTRACT
Objective By analyzing the perioperative management in our hospital to explore the clinical effect and safety of single kidney transplantation from deceased juveniles' donors.Methods We retrospectively analyze 86 cases of kidney transplantations from deceased juveniles' donors in our hospital from 2007 December to 2015 August.Results The success rate of the operations was 100％.The postoperative complications occurred as fellows:7 cases of acute rejection (8.14％);10 cases of drug intoxication (11.62％);21 cases of DGF (24.44％),4 cases of leakage of urine (4.65％),7 cases of lung infection (8.14％).Two cases (2.32％) died after the operation because of serious lung infection,and by corresponding treatment 47 cases recovered after 2-4 weeks.The creatinine level in 37 cases without any complications was 131.88 ± 44.20 μmol/L during discharge.Conclusion With strict selection,the organ from a deceased juvenile donor is safe and practicable.
ABSTRACT
Objective To evaluate the efficacy of sirolimus (SRL) after liver transplantation for hepatocellular carcinoma (HCC).Methods The information up to January 2018 was retrieved from Cochrane library,Pubmed,EMbase,CBM,CNKI,VIP.Collected publications were all about casecontrol study of SRL versus calcineurin inhibitors (CNIs) after liver transplantation for HCC.After evaluating the literatures' quality and extracting the data,RevMan 5.3 was used to analyze the data of each study.Results A total of 13 articles including 4181 patients were enrolled.There was no significant difference between SRL and CNIs in 3 and 5 year diseasefree survival (RR=1.13,95％CI:0.97-1.31,P=0.11;RR=1.07,95%CI:0.92-1.24,P=0.37),however,the 1-,3-and 5-year overall survival rate and 1-year disease-free survival rate in SRL were significantly higher than CNIs (RR=1.09,95％CI.:1.03-1.15,P=0.005;RR=1.08,95％CI:1.02-1.14,P =0.006;RR =1.11,95％CI:1.00-1.23,P =0.05;RR=1.14,95％CI:1.05-1.24,P =0.001).Conclusion There was no significant difference between SRL and CNIs in 3-and 5-year disease-free survival,but the 1-,3-and 5-year overall rate and 1-year disease-free survival rate in SRL was significantly higher than in CNIs.
ABSTRACT
<p><b>Background</b>The effectiveness of an anti-incontinence procedure concomitant with prolapse reconstruction for pelvic organ prolapse (POP) in preventing urinary incontinence (UI) after surgery remains controversial. Our study aimed to describe the incidence of pre- and postoperative UI for pelvic reconstructive surgery and evaluate the management of POP associated with UI.</p><p><b>Methods</b>A total of 329 patients who underwent total pelvic reconstruction between June 2009 and February 2015 at a single institution were identified. These patients were divided into two groups (Group A [Prolift reconstruction]: n = 190 and Group B [modified total pelvic reconstruction]: n = 139). Data regarding surgical procedures and patient demographic variables were recorded. Chi-square and Student's t-tests were used for two independent samples.</p><p><b>Results</b>A total of 115 patients presented with UI preoperatively. The average follow-up time was 46.5 months, with 20 patients lost to follow-up (6.1%). The cure rates of stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) were 51% (30/59), 80% (16/20), and 48% (14/29), respectively. The cure rate of UUI after total pelvic reconstruction (80% [16/20]) was higher than that of SUI (50.8% [30/59], χ= 5.219, P = 0.03), and the cure rate of MUI (48%, 14/29) was the lowest. The cure rate of patients with UI symptoms postoperatively was lower than that of those with symptoms preoperatively (9.1% [28/309] vs. 16.2% [50/309], χ= 7.101, P = 0.01). There was no difference in the incidence of UI postoperatively between Groups A and B (P > 0.05). The cure rate of SUI in patients undergoing tension-free vaginal tape-obturator was not higher than that in those who did not undergo the procedure (42.9% [6/14] vs. 53.3% [24/45], χ= 0.469, P = 0.49). There were no differences in the cure rate for POP or UI between these two types of reconstructions (P > 0.05).</p><p><b>Conclusions</b>No correlation between the incidence of UI and POP was identified. The results suggest that UI treatment should be performed after POP surgery for patients with both conditions.</p>
ABSTRACT
Objective@#To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP).@*METHODS@#We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS).@*RESULTS@#Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course.@*CONCLUSIONS@#The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.