Transurethral laser versus open simple prostatectomy for large volume prostates: a systematic review and meta-analysis of randomized controlled trials

The benefit of transurethral laser prostatectomy over open simple prostatectomy (OSP) is controversial in aged symptomatic benign prostatic hyperplasia (BPH) patients with large volume prostates, and the aim of this study is to compare the safety and efficiency of these two methods. Meta-analysis was applied using the Review Manager V5.3 software and the retrieved randomized controlled clinical trials (RCTs) comparing transurethral laser prostatectomy with OSP were analyzed for the treatment of large volume prostates from 2000 to 2019 in PubMed, Web of Science, Cochrane, and EMBASE datasets. Five RCTs assessing transurethral laser prostatectomy versus OSP were considered suitable for this meta-analysis, which included a total of 448 patients, with 232 patients undergoing laser and 216 patients undergoing OSP. Compared with OSP, although transurethral laser prostatectomy required a longer operative time (weighted mean difference (WMD) 27.49 mins; 95% confidence interval (CI) 16.54–38.44; P?<?0.00001) and obtained a less resected prostate weight (WMD ??11.72 g; 95% CI ??21.75 to ??1.70; P?=?0.02), patients undergoing laser prostatectomy benefited from significantly less hemoglobin decline (??0.97 g/dL; 95% CI ??1.31 to ??0.64; P?<?0.00001), shorter time of catheterization (WMD ??3.67 days; 95% CI ??5.60 to ??1.75; P?=?0.0002), shorter length of hospital stay (WMD ??4.75 days; 95% CI ??6.57 to ??2.93; P?<?0.00001), and less blood transfusion (odds ratio 0.10; 95% CI 0.03 to 0.35; P?=?0.0003). During postoperative follow-up, no significant difference was observed between the two groups in IPSS, QoL, Q_max, and PVR. Both transurethral laser prostatectomy and OSP are safe and effective for large prostates that require prostate resection. Taking into account of less blood loss, shorter catheterization time and hospital stay, and less blood transfusion, transurethral laser prostatectomy may be a better treatment for patients with large prostates.

     

Protective effect of hydroxysafflor yellow A on MSCs against senescence induced by D-galactose

Objective To examine the protective effects of hydroxysafflor yellow A (HSYA) against the senescence of mesenchymal stem cells (MSCs) induced by D-galactose (D-gal) in vitro, and investigate the potential mechanism involved. Methods Grouping experiment, Normal control (NC) group: conventional culture with complete medium; Senescence group: MSCs were cultured for 48 h with complete medium containing 10 g/L D-gal; HSYA group: on the basis of senescence induction, HSYA with the suitable concentration was used to protect MSCs. The key experimental indices associated with oxidative stress, inflammatory response, cell senescence, proliferation and apoptosis were measured through chemical colorimetry, β-galactosidase staining, EdU incorporation and flow cytometry, respectively. The relative quantity (RQ) of proteins related closely to cell proliferation, apoptosis, and NF-κB signaling were measured by Western blotting. Results As compared with Senescence group, treatment with HSYA (120 mg/L) effectively ameliorated the adverse situation of MSCs. Oxidation stress and inflammation along with D-Gal induction was dramatically alleviated in MSCs; The β-Gal-positive staining indicated that MSC senescence was significantly mitigated; The proliferative capability of MSCs was significantly increased by up-regulating PCNA and inhibiting p16 expression; The anti-apoptotic effect on MSCs was exerted by down-regulating the RQ of cleaved Caspase-3 and Bax; The activity of NF-κB signaling in MSCs was notably suppressed through inhibiting phosphorylation of IKKβ and p65. Conclusion HSYA (120 mg/L) significantly delayed the D-Gal-induced senescence process in MSCs through attenuating inflammatory reaction and oxidative stress, and suppressing the activity of NF-κB signaling.     

用非同位素原位杂交组化在光镜和电镜水平观察前阿黑皮素mRNA在垂体的分布

用地高辛标记反意前阿黑皮素(pro-opiomelanocortin,POMC)cRNA探针原位杂交组化在光镜和电镜水平观察了POMC mRNA在大鼠垂体的分布,并比较了碱性磷酸酶(AKP)显色系统和辣根过氧化酶(HRP)显色系统在光镜水平上的敏感性.结果:POMC mRNA广泛地分布于垂体的中间叶和前叶.中间叶全部细胞均为POMC mRNA阳性.前叶中除前叶的腹侧缘和前叶与中间叶交界处阳性细胞较少外,都有较多的POMC mRNA阳性细胞分布.AKP显色系统比HRP显色系统敏感.在电镜水平,POMC mRNA主要分布于粗面内质网,少数分泌颗粒可能呈阳性反应,胞核未见阳性反应沉淀.文内还就阳性分泌颗粒在调节细胞合成功能方面可能起的作用进行了讨论.     

补肾中药对老年大鼠脑组织中胆碱能M受体分布的影响

采用受体放射配基结合分析、原位杂交和放射自显影术等方法,研究胆碱能M受体、M1受体mRNA在脑组织中的分布,观察补肾中药对胆碱能M受体的含量、功能及分布的影响,探讨补肾中药延缓脑组织衰老的机理.结果显示:老年大鼠大脑皮层、海马、纹状体中M受体明显减少,放射自显影的灰度值降低,胆碱能M1受体mRNA在老年大鼠纹状体部位的表达减少,在其他部位的不明显.补肾中药明显增加老年大鼠胆碱能M受体的数量,对脑内胆碱能M1受体mRNA转录水平降低的部位有改善作用.补肾中药可通过改善胆碱能M1受体的mRNA表达、增加脑内胆碱能M1受体数量来延缓脑组织衰老.     

应用核酸分子杂交技术检测心肌炎组织中的肠道病毒RNA

用生物素标记ｐＣＢＩＩＩ／３５和ｐＣＢＩＩＩ／５１肠道病毒属特异性探针，对４５心肌炎和心肮病尸检或心肌活检心脏组织进行原位杂交，结果显示：１２例（２６．６％）存在肠道病毒ＲＮＡ。柯萨基Ｂ３病毒型特异性探针ｐＣＢＩＩＩ／２９进一步杂交表明，１２例经证实存在肠道病毒ＲＮＡ的心肌组织中５例（４１．７％）出现阳性杂交信号。阳性杂信号主要位于单个或多个心肌细胞的胞浆和心肌的间质组织，偶见竽心肌小血管内皮细胞     

Homer 1b/c通过内质网功能调节由谷氨酸诱发的HT22细胞自噬

目的　研究Homer1b/c蛋白在谷氨酸诱发的细胞自噬中的作用及机制。方法　选用小鼠海马细胞系HT22细胞,通过500 ?mol/L谷氨酸处理建立细胞损伤模型。用siRNA慢病毒转染方式下调Homer1b/c表达和10 ?mol/LBAPTA-AM（1,2-双(2-氨基苯氧基)乙烷-N,N,N`,N`-四乙酸四乙酸甲酯,钙离子螯合剂）、10 mmol/L4-PBA（4-苯基丁酸,内质网应激抑制剂）分别抑制细胞内钙离子释放和内质网应激后,使用蛋白质印迹法检测Homer1b/c,自噬蛋白Beclin-1、微管相关蛋白轻链3（LC3）,以及内质网应激标志蛋白CHOP（人内质网应激相关蛋白）、GRP-78(葡萄糖调节蛋白78)的表达水平。每组实验均进行3次,采用独立样本t检验和单因素方差分析进行统计学分析。结果　谷氨酸处理HT22细胞12 h后,Beclin-1表达和LC3-Ⅱ/LC3-Ⅰ比值均升高（P<0.05）,下调Homer1b/c表达可降低Beclin-1表达和LC3-Ⅱ/LC3-Ⅰ比值的升高程度（P<0.05）。抑制细胞内钙离子释放和抑制内质网应激均能降低Beclin-1表达和LC3-Ⅱ/LC3-Ⅰ比值的升高程度（P<0.05）。然而在下调Homer1b/c表达后,抑制细胞内钙离子释放和抑制内质网应激未能进一步降低Beclin-1表达和LC3-Ⅱ/LC3-Ⅰ比值的升高程度（P<0.05）。结论　Homer1b/c能够调节谷氨酸诱导的自噬,其调节作用可能与内质网功能有关。     

Relationship between age and effect of early and long-term captopril treatment in patients with acute myocardial infarction

Objective To analyse the relationship between age and treatment with captopril after acute myocardial infarction (AMI). Methods In a randomized trial, 822 patients with a first AMI received conventional medic al treatment, including intravenous thrombolytic therapy and oral aspirin or metoprolol, and then were randomly allocated to captopril ［dosage fr om the first 6.25 mg to 25 mg/t.i.d, 209 younger patients (≤64 years), 269 elderly patients (65-75 years)］ or conventional treatment only (131 younger p atients, 213 elderly). Survival in the four groups was calculated with the Kapl an-Meier method. Multivariate analysis was performed to understand the degree that multi-variables (including age) affect survival in patients taking captopr il in the hospital or during long term follow-up. Results The survival of patients who took captopril correlated significantly with age ( P&lt;0.001). The survival of the elderly patients on captopril treatment did increase (P&lt;0.0001), but not of the younger ones (P&gt;0.05) during hosp italization. During follow-up, the survival of patients who took captopril cor related insignificantly with age (P&gt;0.05), but both the elderly and the you n ger patients have good survival rates (all P&lt;0.01) and lower cardiac events (all P&lt;0.01) when they took captopril.Conclusions Captopril exerts a weak effect on the younger patients but a beneficial effect o n the elderly patients during hospitalization after AMI. However, there is no d ifference between the younger and the elderly in the prognosis, both having good survival and lower cardiac events when they take captopril long term during fol low-up.     

普罗布考对体外培养的主动脉平滑肌细胞NF—kB活性的影响

目的：观察普罗布考（probucol)对血管平滑肌细胞（VSMCs)核因子kB(NF-kB)活性的调控作用,以探讨probucol在动脉粥样硬化（AS）和经皮腔内冠状动脉成形术后再狭窄（RS）防治中的某些可能的作用机制。方法：采用电泳迁移位移测定法观察probucol对VSMCsNF-kB活性的影响。结果：H2O2或胎牛血清（NCS）处理VSMCs72h后,NF-kB活性均明显增强;而加入100umol/Lprobucol后,NF-kB活性受到部分抑制,抑制率分别为37.1%和14.8%。结论：Probucol抑制NCS、H2O2诱导的VSMCsNF-kB的活性,可能是其临床有效防治RS及AS的作用机制之一。