The Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) in the Differentiation of Pseudoprogression and Recurrence of Intracranial Gliomas.

Objective: The objective of this study was to determine the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing postoperative changes in intracranial gliomas. Method: A total of fifty-one patients who had new enhanced lesions after surgical resection followed by standard radiotherapy and chemotherapy were collected retrospectively from October 2014 to June 2021. The patients were divided into a pseudoprogression group (15 cases) and a recurrence group (36 cases) according to the pathological results of the second operation or a follow-up of more than six months. The follow-up data of all patients were complete, and DCE-MRI was performed. The images were processed to obtain the quantitative parameters K trans, Ve, and Kep and the semiquantitative parameter iAUC, which were analysed with relevant statistical software. Results: First, the difference in K trans and iAUC values between the two groups was statistically significant (P < 0.05), and the difference in Ve and Kep values was not statistically significant (P > 0.05). Second, by comparing the area under the curve, threshold, sensitivity and specificity of K trans, and iAUC, it was found that the iAUC threshold value was slightly higher than that of K trans, and the specificity of K trans was equal to that of iAUC, while the area under the curve and sensitivity of K trans were higher than those of iAUC. Third, K trans and iAUC had high accuracy in diagnosing recurrence and pseudoprogression, and K trans had higher accuracy than iAUC. Conclusion: In this study, DCE-MRI has a certain diagnostic value in the early differentiation of recurrence and pseudoprogression, offering a new method for the diagnosis and assessment of gliomas after surgery.

Meta-analysis of Glutamine on Immune Function and Post-Operative Complications of Patients With Colorectal Cancer.

The aim of this meta-analysis was to evaluate the clinical significance of glutamine in the management of patients with colorectal cancer (CRC) after radical operation. Electronic databases, including PubMed, EMBASE, MEDLINE, Cochrane Library, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), VIP medicine information system (VIP), and Wanfang electronic databases were comprehensively searched from inception to 30, July 2021. Prospective randomized trials with glutamine vs. routine nutrition or blank therapy were selected. The immune function related indicators (including IgA, IgG, IgM, CD4+, CD8+, and the ratio of CD4+/CD8+), post-operative complications [including surgical site infection (SSI), anastomotic leakage, and length of hospital stay (LOS)], and corresponding 95% confidence intervals (CIs) were assessed in the pooled analysis. Subsequently, the heterogeneity between studies, sensitivity, publication bias, and meta-regression analysis were performed. Consequently, 31 studies which contained 2,201 patients (1,108 in the glutamine group and 1,093 in the control group) were included. Results of pooled analysis indicated that glutamine significantly improved the humoral immune function indicators [including IgA (SMD = 1.15, 95% CI: 0.72-1.58), IgM (SMD = 0.68, 95% CI: 0.48-0.89), and IgG (SMD = 1.10, 95% CI: 0.70-1.50)], and the T cell immune function indicators [including CD4+ (SMD = 0.76, 95% CI: 0.53-0.99) and the ratio of CD4+/CD8+ (SMD = 0.92, 95% CI: 0.57-1.28)]. Meanwhile, the content of CD8+ was decreased significantly (SMD = -0.50, 95% CI: -0.91 to -0.10) followed by glutamine intervention. Pooled analysis of SSI (RR = 0.48, 95% CI: 0.30-0.75), anastomotic leakage (RR = 0.23, 95% CI: 0.09-0.61), and LOS (SMD = -1.13, 95% CI: -1.68 to -0.58) were decreased significantly in glutamine group compared with control group. Metaregression analysis revealed that the covariate of small-sample effects influenced the robustness and reliability of IgG outcome potentially. Findings of the present work demonstrated that glutamine ought to be applied as an effective immunenutrition therapy in the treatment of patients with CRC after radical surgery. The present meta-analysis has been registered in PROSPERO (no. CRD42021243327). Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO, Identifier: CRD42021243327.

Effect of Phosphodiesterase-5 Inhibitors on the Treatment of Male Infertility: A Systematic Review and Meta-Analysis.

PURPOSE: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction, more and more studies show that it has a certain effect on male infertility in recent years. But there was currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality. MATERIALS AND METHODS: We retrieved the electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, etc. Related randomized controlled trials (RCTs) were collected and selected up to May 20, 2020. We have searched literature with terms "male infertility", "phosphodiesterase-5 inhibitors", "PDE5i", "Tadalafil", "Sildenafil", "Vardenafil", "Udenafil", "Avanafil", "semen", and "sperm". Mean value and its standard deviation were used to perform quantitative analysis. All statistical analyses were conducted by RevMan 5.3 and Stata software. RESULTS: There were a total of 1,121 participants in the nine included studies. There was a statistically significant improvement treated with PDE5is compared with sham therapy, which including sperm concentration (mean difference [MD]=1.96, 95% confidence interval [CI]=1.70-2.21, p<0.001; MD=3.22, 95% CI=1.96-4.48, p<0.001), straight progressive motility (%) Grade A (MD=3.71, 95% CI=2.21-5.20, p<0.001), sperm motility (MD=8.09, 95% CI=7.83-8.36, p<0.001), morphologically normal spermatozoa (%) (MD=0.67, 95% CI=0.20-1.15, p=0.005; MD=1.27, 95% CI=0.02-2.52, p=0.05), sperm abnormalities (%) (MD=-0.64, 95% CI=-0.81--0.47, p<0.001), and progressive motile sperm (MD=5.34, 95% CI=3.87-6.81, p<0.001). CONCLUSIONS: In this meta-analysis of nine RCTs, treatment with PDE5is could improve some indicators of male sperm.

Is Acupuncture Another Good Choice for Physicians in the Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Review of the Latest Literature.

This study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A search of PUBMED, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, Chinese Scientific Journal Database (VIP), and other available resources was made for studies (up to February 2019). Searches were limited to studies published in English and Chinese. Only randomized controlled trials (RCTs) related to the efficacy and/or safety of acupuncture for CP/CPPS were included. Two investigators independently evaluated the quality of the studies. A total of 11 studies were included, involving 748 participants. The results revealed that compared with sham acupuncture (MD: -6.53 [95% CI: -8.08 to -4.97]) and medication (MD: -4.72 [95% CI: -7.87 to -1.56]), acupuncture could lower total NIH-CPSI score more effectively. However, there are no significant differences between acupuncture and sham acupuncture in terms of IPSS score. In terms of NIH-CPSI voiding domain subscore, no significant differences were found between acupuncture and medication. Compared with sham acupuncture (OR: 0.12 [95% CI: 0.04 to 0.40) and medication (OR: 3.71 [95% CI: 1.83 to 7.55]), the results showed favorable effects of acupuncture in improving the response rate. Acupuncture plus medication is better than the same medication in improving NIH-CPSI total score and NIH-CPSI pain domain subscore. In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture's effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare.

Effect of phosphodiesterase-5 inhibitors (PDE5is) on the treatment of male infertility: A protocol for systematic review and meta-analysis.

BACKGROUND: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction (ED), but more and more studies show that it has a certain effect on male infertility in recent years. The literatures of PDE5is related to male infertility have shown inconsistent results, and there is currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality in male infertility patients. METHODS: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org, China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry and Cochrane Library were retrieved. Grey literature will be searched in Open Grey. Related Randomized controlled trials (RCTs) were collected and selected before October 20, 2019. We will search English literature and Chinese literature with search terms "male infertility", "phosphodiesterase-5 inhibitors", "PDE5i", "Tadalafil", "Sildenafil", "Vardenafil", "Udenafil", "Avanafil", "semen" and "sperm". Sperm concentration, motility and morphology, sperm DNA fragmentation index, number of per ejaculate, sperm viability and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: Efficacy and safety of PDE5is on male sperm quality in infertile men will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions. REGISTRATION INFORMATION: PROSPERO CRD42019142980.

Shugan Yiyang capsule for the treatment of erectile dysfunction: A protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Erectile dysfunction (ED) is a common disease. It affects the quality of life of both husband and wife and becomes an independent risk factor for cardiovascular events. In China, Shugan Yiyang (SGYY) capsule has been increasingly reported in clinical trials for the treatment of ED and reported inconsistent findings. Therefore, it is necessary to conduct a systematic review to evaluate the efficacy and safety of this drug for the treatment of ED. METHODS: Chinese and English literature of SGYY capsule for ED published before August 31, 2019 will be comprehensive searched in PubMed, Cochrane Library, EMBASE, WANFANG, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journal Database, Chinese biomedical document service system, and Clinicaltrials.gov. All randomized controlled trials that meet the eligibility criteria will be included and other studies will be excluded. Two investigators will conduct literature screening, data extraction and assess risk of bias alone, and the third investigator will handle disagreements. Two outcomes involving the international index of erectile function 5 score and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used to conduct this systematic review. The preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P) statement is followed in this protocol and the the PRISMA statement will be followed in the completed systematic review. CONCLUSION AND DISSEMINATION: The efficacy and safety of SGYY capsule for ED will be evaluated. We will publish the results of this systematic review in peer-reviewed journals to provide new evidence to clinicians.Registration information: PROSPERO CRD42019140903.

Effects of physical exercises on semen quality and reproductive outcomes in male infertility: A protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Infertility has troubled the world's 186 million people, and male infertility accounts for more than half. The literature of physical exercise related to semen quality has shown inconsistent results, and there is currently no systematic review to evaluate the effects of exercise on reproductive outcomes in male infertility patients. This study aims to assessing the effects of exercise interventions based on randomized controlled trials (RCTs) on semen quality and reproductive outcomes in male infertility. METHODS: English and Chinese literature about physical exercise treatment for male infertility published before July 31, 2019 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only RCTs of patients with male infertility will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Live-birth rate, pregnancy rate, adverse events (including miscarriage), sperm concentration, progressive motility, sperm morphology, and sperm DNA fragmentation will be evaluated. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: We will assess the efficacy and safety of physical exercise on semen quality and reproductive outcomes in infertile men. The findings will be published in a peer-reviewed journal to provide evidence-based medical evidence for clinical decision making and the patient's lifestyle guidance. REGISTRATION INFORMATION: PROSPERO CRD42019140294.

[Effects of telmisartan on the expression of adiponectin and its receptors in testes of type 1 diabetic rats].

OBJECTIVE: To explore the effects of telmisartan on the expressions of adiponectin and adiponectin receptor and its signal transduction pathway AMP-activated protein kinase (AMPK), Akt/endothelial nitric oxide synthase (Akt/e-NOS/NO) and examine the possible protective mechanisms of telmisartan in testis of type 1 diabetic rats. METHODS: A total of 27 male Sprague-Dawley rats were randomly divided into normal control (NC, n=8) group and diabetic model (n=19) group. Diabetes was induced by an intraperitoneal injection of streptozotocin (STZ). And 16 established diabetic rats were randomly divided into diabetic control (DM, n=8) and diabetic treated with telmisartan (DT, n=8) groups. Group DT received a lavage of telmisartan while groups NC and DM had an equal volume of normal saline by gavage. At the end of 8-week of telmisartan treatment, the animals were sacrificed after harvesting of blood samples. Bilateral testes were extracted and epididymis was minced for preparing sperm suspension. Blood samples were used to detect the related parameters. Some tresticular tissues were fixed in neutral 40% formaldehyde solution and processed for histological analysis. And the remaining testicular tissues were immediately placed into liquid nitrogen and then stored in a -70 °C refrigerator until analyses. The levels of insulin and sex hormone were detected by radioimmunoassay. The levels of adiponectin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were assayed by enzyme-linked immunosorbent assay (ELISA). The mRNA expression of testicular adiponectin and its receptor was assessed by real-time fluorescent quantitative polymerase chain reaction (PCR). The protein expressions of testicular adiponectin, adiponectin receptor, AMPK, P-AMPK, AKT, P-AKT and e-NOS were analyzed by Western blot. RESULTS: There was significant pathological changes in testes in group DM than that in group NC. The levels of P-AKT/AKT, e-NOS and NO were significantly increased in group DM than those in group NC [(1.54 ± 0.27) vs (1.00 ± 0.00), (1.56 ± 0.26) vs (1.00 ± 0.00), (1.75 ± 0.28) vs (1.08 ± 0.02) µmol/g, all P<0.05]. The levels of serum adiponectin,testicular adiponectin and its receptor 1, and the ratio of P-AMPK to AMPK significantly decreased in group DM than that in group NC [(622.46 ± 95.86) vs (2 022.07 ± 51.13)ng/ml, (0.66 ± 0.09) vs (1.00 ± 0.00), (0.68 ± 0.05) vs (1.00 ± 0.00), (0.34 ± 0.11) vs (1.00 ± 0.00), all P<0.05]. There was no significant difference in the expression of adiponectin receptor 2 between group DM and NC [(1.02 ± 0.13) vs (1.00 ± 0.00), P>0.05]. After 8-week telmisartan treatment, the pathological changes of testes became alleviated in diabetic rats. The levels of P-AKT/AKT, e-NOS and NO significantly decreased in group DT than those in group DM [(1.24 ± 0.39) vs (1.54 ± 0.27), (1.16 ± 0.47) vs (1.56 ± 0.26), (1.35 ± 0.30) vs (1.75 ± 0.28) µmol/g, all P<0.05]. The serum and testicular levels of adiponectin and testicular adiponectin receptor 1 significantly increased in group DT than those in group DM [(1 051.55 ± 102.55) vs (622.46 ± 95.86), (0.84 ± 0.09) vs (0.66 ± 0.09), (0.80 ± 0.07) vs (0.68 ± 0.05), all P<0.05]. No significant difference existed in the ratio of P-AMPK to AMPK in testes or the expression of adiponectin receptor 2 between group DM and NC [(0.65 ± 0.52) vs (0.34 ± 0.11), (1.02 ± 0.15) vs (1.02 ± 0.13), all P>0.05]. CONCLUSION: Telmisartan may reduce the injury degree of testes and play protective roles in testicular tissues in diabetic rats by regulating the expressions of adiponectin, adiponectin receptor and the signal pathways mediated by adiponectin receptor.