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Purpose@#We evaluated the therapeutic effects on overactive bladder (OAB) symptoms and sexual function of behavioral therapy with or without mirabegron in sexually active male patients with OAB. Mirabegron, a selective β3 adrenoceptor agonist for the treatment of OAB, has been shown to induce corpus cavernosum relaxation. @*Methods@#In this 4-site, randomized controlled trial, 150 sexually active men with OAB were enrolled between June 2020 and May 2022. Participants were randomly allocated (1:2) into 2 treatment groups: (1) behavioral therapy alone (n = 50) and (2) a combination of mirabegron 50 mg daily and behavioral therapy (n = 100). The evaluation was based on the overactive bladder symptoms score (OABSS), the International Index of Erectile Function, the ejaculatory domain short form, the International Prostate Symptom Score, patient perception of bladder condition, quality of life, and urodynamic parameters. The therapeutic outcomes were assessed at baseline, 4 weeks, and 12 weeks. @*Results@#There were 65 patients (65%) in the combination subgroup and 36 patients in the behavioral therapy who completed all 12 weeks of treatment. Both groups had a statistically significant improvement in OABSS after 12 weeks of treatment. The combination therapy group achieved a statistically significant improvement in all 4 subscores of OABSS, however, the urinary frequency (P = 0.120) and urinary incontinence (P = 0.234) subscores in the behavioral therapy only group did not show a significant change. Additionally, the combination group had a significant improvement in functional bladder capacity, which was not seen in the behavioral therapy group. However, both groups did not have a significant change in erectile or ejaculatory function. @*Conclusions@#Behavioral therapy combined with mirabegron had more significant impact on the improvement of OAB than behavior therapy alone. However, both groups did not have significant changes in erectile or ejaculatory function.
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Interstitial cystitis/bladder pain syndrome (IC/BPS), which is characterized by bladder pain and irritative voiding symptoms, is a frustrating disease without effective treatment. The cause is still largely not understood, although urothelium ischemia/hypoxia, apoptosis, denudation, and infiltration of inflammatory cells are common histopathological findings. The current uncertainty regarding the etiology and pathology of IC/BPS has a negative impact on its timely and successful treatment; therefore, the development of new treatment modalities is urgently needed. Herein, we present advances in our knowledge on this topic and review the potential application of regenerative medicine for the treatment of IC/BPS. This article provides information on the basic characteristics and clinical evidence of stem cells, platelet-rich plasma (PRP), and low-energy shock waves (LESWs) based on a literature review with a search strategy for articles related to IC/BPS, stem cells, PRP, and LESW published in MEDLINE and PubMed. Stem cells, PRP, and LESW, which modulate inflammatory processes and promote tissue repair, have been proven to improve bladder regeneration, relieve bladder pain, inhibit bladder inflammation, and increase bladder capacity in some preclinical studies. However, clinical studies are still in their infancy. Based on the mechanisms of action of stem cells, PRP, and LESW documented in many preclinical studies, the potential applications of regenerative medicine for the treatment of IC/BPS is an emerging frontier of interest. However, solid evidence from clinical studies remains to be obtained.
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Objective: To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder (ACS). Methods: One hundred patients diagnosed with ACS were divided into two groups using the random number method. The two groups both received same active rehabilitation exercises. Besides, 55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia, and 45 cases in the control group were given tuina treatment. Changes in the visual analog scale (VAS) score, Melle score and pressure pain index were observed 1 month and 3 months after treatment. The therapeutic efficacies were also compared. Results: The total effective rate was 96.4％ at the 1-month follow-up and 96.4％ at the 3-month follow-up in the treatment group. The total effective rate was 33.3％ at the 1-month follow-up and 28.9％ at the 3-month follow-up in the control group. There were significant differences between the two groups comparing the total effective rate at the two time points (both P<0.05). The scores of VAS, Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group (all P<0.05); the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group (all P>0.05). Conclusion: Based on the active rehabilitation exercises, one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients. It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.
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Objective To investigate the efficacy of scalp acupuncture with strong stimulation plus oral hiccup decoction in treating intractable hiccup. Method One hundred patients with intractable hiccup were allocated, using a random number table, to treatment and control groups, 50 cases each. In addition to oral hiccup decoction in the two groups, the treatment group received scalp acupuncture with strong stimulation at the stomach and chest areas and the control group, electroacupuncture, for two courses of treatment. The times to produce the effect and the symptom frequency scores were compared between the two groups. Result After one course of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 42％, 66％ and 78％, respectively, in the treatment group and 24％, 40％ and 68％, respectively, in the control group. There were statistically significant difference in the cure rate and the cure and marked efficacy rate (P<0.05) but no in the total efficacy rate (P>0.05) between the two groups. After two courses of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 68％, 78％ and 88％, respectively, in the treatment group and 40％, 60％ and 74％, respectively, in the control group. There were statistically significant difference in the cure rate (P<0.05) but no in the cure and marked efficacy rate and the total efficacy rate (P>0.05) between the two groups. After one and two courses of treatment, there was a statistically significant difference in the hiccup frequency score between the treatment and control groups (P<0.05). The time to produce the effect was 2-5 hrs in the treatment group and 5-8 hrs in the control group. Conclusion The total efficacy rate of scalp acupuncture with strong stimulation for intractable hiccup is not significantly different from that of electroacupuncture, but the cure rate of the former was significantly higher than that of the latter. Scalp acupuncture with strong stimulation can produce a quick effect, reduce the frequency of hiccups and relieve symptoms accompanying hiccup.
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Objective:To analyze the effects of essential medicine system on revenue structures at primary med-ical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results:Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medi-cine revenue to pharmaceutical revenue rose from 20 . 45% in 2009 to 97 . 03% in 2013 , though the percentage of pharmaceutical revenue to total revenue dropped by 18 . 43%. The percentage of fiscal subsidy revenue in total reve-nue rose from 25 . 77% in 2009 to 54 . 16% in 2013 , though the percentage of business revenue to total revenue dropped in general. Conclusions:The essential medicine system requires the government’s financial support. Essen-tial medicine lists and primary financial aid policies should be further improved;doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed.
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BACKGROUND/OBJECTIVES: The objectives of this study were to investigate the effects of lycopene on the migration, adhesion, tube formation capacity, and p38 mitogen-activated protein kinase (p38 MAPK) activity of endothelial progenitor cells (EPCs) cultivated with high glucose (HG) and as well as explore the mechanism behind the protective effects of lycopene on peripheral blood EPCs. MATERIALS/METHODS: Mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation. EPCs were identified after induction of cellular differentiation. Third generation EPCs were incubated with HG (33 mmol/L) or 10, 30, and 50 microg/mL of lycopene plus HG. MTT assay and flow cytometry were performed to assess proliferation and apoptosis of EPCs. EPC migration was assessed by MTT assay with a modified boyden chamber. Adhesion assay was performed by replating EPCs on fibronectin-coated dishes, after which adherent cells were counted. In vitro vasculogenesis activity was assayed by Madrigal network formation assay. Western blotting was performed to analyze protein expression of both phosphorylated and non-phosphorylated p38 MAPK. RESULTS: The proliferation, migration, adhesion, and in vitro vasculogenesis capacity of EPCs treated with 10, 30, and 50 microg/mL of lycopene plus HG were all significantly higher comapred to the HG group (P < 0.05). Rates of apoptosis were also significantly lower than that of the HG group. Moreover, lycopene blocked phosphorylation of p38 MAPK in EPCs (P < 0.05). To confirm the causal relationship between MAPK inhibition and the protective effects of lycopene against HG-induced cellular injury, we treated cells with SB203580, a phosphorylation inhibitor. The inhibitor significantly inhibited HG-induced EPC injury. CONCLUSIONS: Lycopene promotes proliferation, migration, adhesion, and in vitro vasculogenesis capacity as well as reduces apoptosis of EPCs. Further, the underlying molecular mechanism of the protective effects of lycopene against HG-induced EPC injury may involve the p38 MAPK signal transduction pathway. Specifically, lycopene was shown to inhibit HG-induced EPC injury by inhibiting p38 MAPKs.
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Humanos , Apoptose , Western Blotting , Centrifugação com Gradiente de Concentração , Ficoll , Citometria de Fluxo , Glucose , Proteínas Quinases p38 Ativadas por Mitógeno , Fosforilação , Proteínas Quinases , Transdução de Sinais , Células-TroncoRESUMO
BACKGROUND/OBJECTIVES: The objectives of this study were to investigate the effects of lycopene on the migration, adhesion, tube formation capacity, and p38 mitogen-activated protein kinase (p38 MAPK) activity of endothelial progenitor cells (EPCs) cultivated with high glucose (HG) and as well as explore the mechanism behind the protective effects of lycopene on peripheral blood EPCs. MATERIALS/METHODS: Mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation. EPCs were identified after induction of cellular differentiation. Third generation EPCs were incubated with HG (33 mmol/L) or 10, 30, and 50 microg/mL of lycopene plus HG. MTT assay and flow cytometry were performed to assess proliferation and apoptosis of EPCs. EPC migration was assessed by MTT assay with a modified boyden chamber. Adhesion assay was performed by replating EPCs on fibronectin-coated dishes, after which adherent cells were counted. In vitro vasculogenesis activity was assayed by Madrigal network formation assay. Western blotting was performed to analyze protein expression of both phosphorylated and non-phosphorylated p38 MAPK. RESULTS: The proliferation, migration, adhesion, and in vitro vasculogenesis capacity of EPCs treated with 10, 30, and 50 microg/mL of lycopene plus HG were all significantly higher comapred to the HG group (P < 0.05). Rates of apoptosis were also significantly lower than that of the HG group. Moreover, lycopene blocked phosphorylation of p38 MAPK in EPCs (P < 0.05). To confirm the causal relationship between MAPK inhibition and the protective effects of lycopene against HG-induced cellular injury, we treated cells with SB203580, a phosphorylation inhibitor. The inhibitor significantly inhibited HG-induced EPC injury. CONCLUSIONS: Lycopene promotes proliferation, migration, adhesion, and in vitro vasculogenesis capacity as well as reduces apoptosis of EPCs. Further, the underlying molecular mechanism of the protective effects of lycopene against HG-induced EPC injury may involve the p38 MAPK signal transduction pathway. Specifically, lycopene was shown to inhibit HG-induced EPC injury by inhibiting p38 MAPKs.
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Humanos , Apoptose , Western Blotting , Centrifugação com Gradiente de Concentração , Ficoll , Citometria de Fluxo , Glucose , Proteínas Quinases p38 Ativadas por Mitógeno , Fosforilação , Proteínas Quinases , Transdução de Sinais , Células-TroncoRESUMO
<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture on force-displacement value (FDV) of muscle state and electrophysiology of the muscle in rabbits with lumbar nerve root compression.</p><p><b>METHODS</b>Thirty New Zealand white rabbits were randomly divided into a control, a model, an electro-acupuncture acupoints (EAA), a medication, and an electro-acupuncture un-acupoints (EAU) group. All rabbits except those in the control group were subject to modeling (surgical lumbar nerve root compression). The control group was sham-operated without nerve root compression. The EAA group received electro-acupuncture at bilateral Shenshu (BL23) and Dachangshu (BL25) that were located 1.5 cun lateral to the posterior midline on the lower border of the spinous process of the 2nd and 4th lumbar vertebra, respectively. The EA was 15 mm deep and the frequency was 2 Hz. Each session lasted for 20 min per day for a total of 14 times. The medication group was treated with Loxoprofen sodium by gastrogavage at 4 mg/kg per day for 14 days. The EAU group received electro-acupuncture identical to the EAA group with regard to the treatment frequency and duration except a different acupoint at the tip of rabbit tail. Muscle states were determined by measuring FDVs of the bilateral biceps femoris using the Myotonometer® fast muscle state detector. Meanwhile, the prolonged and non-prolonged insertion potentials were measured by electromyography before and after modeling and after treatment. Latency, amplitude (Amp) of evoked potential, motor nerve conduction velocity (MNCV) were also determined after treatment.</p><p><b>RESULTS</b>(1) After modeling, FDVs of right side activation (RSA, P=0.003) and right side relaxation (RSR) in the model group (P=0.000) were significantly decreased in comparison to the control group. The number of rabbits with non-prolonged insertion potentials in the model group was also significantly decreased (P=0.015) in comparison to the control group. (2) After treatment, FDVs of RSR were significantly increased in the EAA (P=0.000) and medication groups (P=0.018) in comparison to the model group. The increase in FDVs of RSR in the EAA group was significantly higher than that in EAU (P=0.000) and medication groups (P=0.002). MNCV in the model group was reduced compared with the control group (P=0.000). The reduction in MNCV after modeling was reversed in the EAA group (P=0.000) and medication group (P=0.008) after treatment and the increases were significant in both treatment groups in comparison to the model group. The EAA group had a greater MNCV recovery than the medication group (P=0.022).</p><p><b>CONCLUSION</b>Electro-acupuncture could improve the rehabilitation and regeneration of FDVs and the electrophysiology index of the muscle with nerve control impairment.</p>
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Animais , Coelhos , Eletroacupuntura , Eletromiografia , Fenômenos Eletrofisiológicos , Potenciais Evocados , Fisiologia , Vértebras Lombares , Neurônios Motores , Fisiologia , Músculos , Condução Nervosa , Fisiologia , Radiculopatia , TerapêuticaRESUMO
<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture on the muscle condition and electrophysiology of the muscle in rabbits with lumbar nerve root compression and to explore potential mechanisms.</p><p><b>METHODS</b>Twenty-four New Zealand white rabbits were randomly divided into a normal group, a model group, a medication group and an electroacupuncture group. The rabbit model with lumbar nerve root compression was established in the model group, the medication group and the electroacupuncture group. The model and the treatment were not produced in the normal group. The medication group was treated with oral administration of Loxoprofen tablets at a dose of 30 mg each day for 14 days. The electroacupuncture group was treated with electroacupuncture at "Jiaji" (EX-B 2) of L5 and L6 for 14 days. The hibateral muscle condition before and after making model and after treatment was detected and the electromyogram and the nerve conduction velocity (NCV) were observed.</p><p><b>RESULTS</b>The spontaneous potential and the insertion potential were increased in the model group, the medication group and the electroacupuncture group after making model. The value of the activation and the relaxed condition of the strength-creep (ARCSC) in the right muscle was significantly decreased. The motor nerve conduction velocity (MNCV) and the wave amplitude of evoked potential (WAEP) were significantly decreased in the model group, the medication group and the electroacupuncture group after treatment, but the value of MNCV and WAEP in the electroacupuncture group, and ARCSC in the right muscle in the electroacupuncture group and the medicine group were closed to those level in the normal group, among them, the relaxed condition in the electroacupuncture group was more close to the level in the normal group.</p><p><b>CONCLUSION</b>Electroacupuncture can improve the strength-creep condition of the muscle that damage nerve place controls and the electrophysiology of the muscle can recover the MNCV and the wave amplitude of evoked potential in the compression nerve root.</p>
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Animais , Feminino , Humanos , Masculino , Coelhos , Modelos Animais de Doenças , Eletroacupuntura , Região Lombossacral , Contração Muscular , Músculos , Condução Nervosa , Radiculopatia , Terapêutica , Distribuição AleatóriaRESUMO
<p><b>OBJECTIVE</b>To study the effect of lycopene on red blood cell and the level of blood lipid.</p><p><b>METHODS</b>According to the level of serum total cholesterol and weight, forty-eight adult male SD rats were divided randomly into six groups: normal control (group A), fed by normal feed; hyperlipidemia group (group B): fed by high fat diet; positive control group (group C): fed by high fat diet plus 10 mg * kg(-1) * d(-1) fluvastatin sodium; lycopene groups: fed by high fat diet plus 11 (group D), 22 (group E), 44 mg * kg(-1) * d(-1) (group F) lycopene through gavage, respectively. For all six groups, the level of serum total cholesterol (TC) and total triglyceride (TG) were measured at the end of 0, 1, 3 weeks of the study by taking samples from tail vein. At the end of the experiment, RBC and HGB were measured.</p><p><b>RESULTS</b>After the rats were fed with high-fat feed for a week, models of hyperlipidemia rats were established. At the end of 3 weeks, TC of group A, B, C, D, E and F were (1.31 +/- 0.05), (19.40 +/- 0.54), (4.66 +/- 0.07), (7.18 +/- 0.06), (5.30 +/- 0.28), (4.49 +/- 0.23) mmol/L (F = 4395.72, P = 0.00), respectively;and TG were (0.42 +/- 0.01), (2.29 +/- 0.42), (0.69 +/- 0.03), (1.10 +/- 0.05), (0.63 +/- 0.02), (0.62 +/- 0.04) mmol/L (F = 127.26, P = 0.00), respectively; HGB were (143.13 +/- 6.33), (112.63 +/- 2.56), (124.75 +/- 3.62), (124.63 +/- 7.78), (132.38 +/- 6.41), (142.13 +/- 5.54) g/L (F = 34.14, P = 0.00), respectively; RBC were (6.75 +/- 0.60) x 10(12)/L, (5.08 +/- 0.75) x 10(12)/L, (7.14 +/- 0.82) x 10(12)/L, (5.94 +/- 1.09) x 10(12)/L, (6.18 +/- 0.36) x 10(12)/L and (7.31 +/- 0.58) x 10(12)/L (F = 10.35, P = 0.00), respectively.</p><p><b>CONCLUSION</b>Lycopene have some protective effects on red blood cells of the hyperlipidemic rats by regulating the blood lipid and antioxidant.</p>
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Animais , Masculino , Ratos , Carotenoides , Farmacologia , Colesterol , Sangue , LDL-Colesterol , Sangue , Eritrócitos , Hipercolesterolemia , Sangue , Lipídeos , Sangue , Ratos Sprague-Dawley , Triglicerídeos , SangueRESUMO
<p><b>OBJECTIVE</b>To compare therapeutic effects of acupuncture at pain points and massage combined with medicine on myofascial pain syndrome (MPS).</p><p><b>METHODS</b>One hundred and fifty cases were randomly divided into an observation group (n=90) and a control group (n=60). The observation group was treated with needle-sticking method combined with single-finger meditation pushing therapy at pain points, and the control group with local application of Votalin Emulgel combined with Tuina. All the patients were treated for 1 course and followed up after 3 months and their therapeutic effects were compared.</p><p><b>RESULTS</b>There were significant differences in cumulative scores of symptoms before and after treatment in the two groups (both P < 0.01), and there were no significant differences in the pain and pressure pain between the two groups (P > 0.05), and there were significant differences in the muscle spasm and joint range of motion between the two groups (P < 0.05); after treatment, the markedly effective rate and the total effective rate in the observation group were 57.8% and 94.4% respectively, and were 31.7% and 73.3% respectively in the control group, with a significant difference between the two groups (both P < 0.05).</p><p><b>CONCLUSION</b>Needle-sticking method combined with single-finger meditation pushing therapy at pain points can effectively alleviate pain and pressure pain in the patients with MPS and it has better therapeutic effect in the markedly effective rate and the total effective rate as well as improvement of muscle spasm and joint range of motion than local application of Votalin Emulgel combined with Tuina.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Pontos de Acupuntura , Terapia por Acupuntura , Seguimentos , Síndromes da Dor Miofascial , Terapêutica , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To explore the mechanism of acupuncture for treatment of lumbar nerve root compression injury.</p><p><b>METHODS</b>Fifty healthy SD rats were randomly divided into 5 groups, a normal group, a model group treated by saline, a medication group treated with Caerulein, an acupuncture group treated with acupuncture at L5, L6 Jiaji (EX-B 2) and a warm needle group treated with acupuncture and moxibustion at L5, L6 Jiaji (EX-B 2). The lumbar nerve root compress injury model was made by placing microsilica gel tablet. After they were treated for 14 days, the compressed nerve root was taken and the ultra-microstructure changes of the injured nerve root were observed by electron microscope and changes of nitric oxide synthase (NOS) and calcitonin gene-related peptide (CGRP) expressions were investigated by ELISA assay.</p><p><b>RESULTS</b>The changes of ultra-microstructure of the nerve root were the most obvious in the model group and the changes in the medication group, the acupuncture group and the warming needle group reduced in order; the NOS activity and CGRP content in the nerve root tissue of the compressed area in the warm needle group were significantly reduced as compared with the model group (P < 0.05), but with no significant difference as compared with those in the normal group (P > 0.05).</p><p><b>CONCLUSION</b>Warm needle treatment can effectively maintain cellular form, and ultra-microstructures of nerve root dorsal root ganglia, and effectively inhibit the release of inflammatory factors NOS and CGRP.</p>
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Animais , Feminino , Humanos , Masculino , Ratos , Peptídeo Relacionado com Gene de Calcitonina , Alergia e Imunologia , Modelos Animais de Doenças , Mediadores da Inflamação , Alergia e Imunologia , Moxibustão , Métodos , Óxido Nítrico Sintase , Alergia e Imunologia , Radiculopatia , Alergia e Imunologia , Terapêutica , Distribuição Aleatória , Ratos Sprague-Dawley , Raízes Nervosas Espinhais , Alergia e ImunologiaRESUMO
<p><b>OBJECTIVE</b>To compare therapeutic effects of electroacupuncture at Houxi (SI 3) and medicine on acute lumbar sprain.</p><p><b>METHODS</b>Three hundred cases of acute lumbar sprain were randomly divided into two groups, a electroacupuncture (EA) group and a medication group, 150 cases in each group. The EA group were treated with EA at Houxi (SI 3), once each day, 3 sessions constituting one course, and the medication group with Mobike, once daily, 7. 5 mg each time. Their therapeutic effects were evaluated after treatment for 7 days and one month respectively.</p><p><b>RESULTS</b>For the short-term therapeutic effect, the effective rate was 97. 3% in the EA group and 89. 2% in the medication group with a very significant difference between the two groups (P<0. 01); for the long-term therapeutic effect, the effective rate was 99. 3% in the EA group and 93. 2% in the medication group with a very significant difference between the two groups (P<0. 01).</p><p><b>CONCLUSION</b>Both the short-term and the long-term therapeutic effects of EA at Houxi (SI 3) on acute lumbar sprain are better than those in the medication group.</p>