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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.
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Objective:To investigate the effectiveness of enhanced recovery after surgery (ERAS) concept in perioperative period of retroperitoneal laparoscopic radical nephrectomy.Methods:The clinical data of 189 patients who underwent retroperitoneal laparoscopic radical nephrectomy from October 2015 to July 2021 were retrospectively analyzed. According to different perioperative management methods, they were divided into two groups: ERAS group ( n=97) and traditional group ( n=92). Patients of ERAS group were managed by the ERAS concept during the perioperative period, patients of traditional group were managed by the traditional method during the perioperative period. First drinking time after surgery, first exhaust time, 24 h postoperative pain score, first activity time out of bed, indwelling time of urinary catheter, indwelling time of drainage tube, postoperative hospital stay, incision length and complications of pneumonia and venous thrombosis were recorded and compared between the two groups. Measurement data were expressed as mean ± standard deviation ( Mean± SD), and independent sample t-test was used for comparison between groups; count data comparison between groups was by Chi-square test or Fisher exact probability method. Results:There were no significant differences in age, gender, body mass index, tumor side, tumor diameter, maximum diameter of samples, T stage, diabetes and hypertension from between two groups ( P >0.05). In ERAS group, the time of first drinking water after surgery was (3.8±1.4) h, the time of first anal exhaust was (10.2±2.5) h, the 24 h pain score was (2.4±1.0), the time of first activity out of bed after surgery was (18.8±3.6) h, the indwelling time of urinary catheter was (19.8±3.7) h, the indwelling time of drainage tube was (3.4±0.5) d, the surgical incision length was (7.2±0.9) cm, and the postoperative hospital stay was (5.5±0.6) d. In the traditional group, the time of first drinking water after surgery was (21.2±4.2) h, the time of first anal exhaust was (20.1±4.3) h, the 24 h pain score was (5.4±1.0), the time of first activity out of bed after surgery was (32.8±7.8) h, the indwelling time of urinary catheter was (55.7±8.0) h, the indwelling time of drainage tube was (4.2±0.5) d, the surgical incision length was (13.6±1.5) cm, and the postoperative hospital stay was (7.2±1.3) d. There were statistically significant differences in these indexes between the two groups ( P<0.05). Conclusion:The clinical application of the concept of ERAS during the perioperative period can promote the rapid postoperative recovery of patients undergoing retroperitoneal laparoscopic radical nephrectomy, and can effectively reflect the minimally invase advantages of retroperitoneal laparoscopic technology.
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Objective:To study the feasibility of transplantation of normal rat penile corpus cavernosum and major pelvic ganglion (MPG)into the renal subserous region of a Nu /Nu mouse based on allograft technology.Methods:Penile corpus cavernosum and MPG,harvested from Sprague-Dawley (SD)rats under sterile condition,were transplanted underneath the kidney capsule of Nu /Nu mice through the mi-crosurgery instruments and surgery microscope.The histopathologic changes and cellular proliferation in the transplanted penile corpus cavernosum and MPG were then analyzed at the end of 1week and 4 weeks after transplantation.Histological staining and immunohistochemical staining were used to evaluate the main outcome measures.Results:After 1 week,the tissue morphology of the transplanted corpus caverno-sum underneath the kidney capsule of Nu /Nu mice was consistent with normal penile corpus cavernosum, and blood could be observed in the penis cavernous sinus of the graft;after 4 weeks,the mophorlogy of the tranplanted corpus cavernosum near the kidney was consistent with normal penile corpus cavernosum, while fibrosis was noteworthy in the graft away from the kidney,but blood could still be seen in the penis cavernous sinus.After 1 week,the tissue morphology of the transplanted MPG was consistent with normal MPG,multiple islet-like cell clusters could be seen in the transplanted MPG in the renal subserous re-gion,and angiogenesis could be observed near the kidney;after 4 weeks,a network of blood vessels was clearly visible away from the kidney,and islet-like cell clusters were still clearly observed in the trans-planted MPG.In addition,ki67 positive cells were observed in the transplanted penile corpus cavernosum and MPG after 4 weeks of transplantation,which indicated that there was still cell proliferation activity in the grafts.Conclusion:The transplanted corpus cavernosum and MPG underneath the kidney capsule of Nu /Nu mice could survive at least 4 weeks.Moreover,the inner structure of the transplanted corpus ca-vernosum and MPG was close to the normal tissue.The underlining mechanism may be related to the lo-cal microenvironment underneath the kidney capsule of Nu /Nu mice and the neovascularization in the transplanted grafts.
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Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED.