Metformin promotes angiogenesis and functional recovery in aged mice after spinal cord injury by adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway

Treatment with metformin can lead to the recovery of pleiotropic biological activities after spinal cord injury.However,its effect on spinal cord injury in aged mice remains unclear.Considering the essential role of angiogenesis during the regeneration process,we hypothesized that metformin activates the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway in endothelial cells,thereby promoting microvascular regeneration in aged mice after spinal cord injury.In this study,we established young and aged mouse models of contusive spinal cord injury using a modified Allen method.We found that aging hindered the recovery of neurological function and the formation of blood vessels in the spinal cord.Treatment with metformin promoted spinal cord microvascular endothelial cell migration and blood vessel formation in vitro.Furthermore,intraperitoneal injection of metformin in an in vivo model promoted endothelial cell proliferation and increased the density of new blood vessels in the spinal cord,thereby improving neurological function.The role of metformin was reversed by compound C,an adenosine monophosphate-activated protein kinase inhibitor,both in vivo and in vitro,suggesting that the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway likely regulates metformin-mediated angiogenesis after spinal cord injury.These findings suggest that metformin promotes vascular regeneration in the injured spinal cord by activating the adenosine monophosphate-activated protein kinase/endothelial nitric oxide synthase pathway,thereby improving the neurological function of aged mice after spinal cord injury.

Periprostatic fat thickness measured on MRI correlates with lower urinary tract symptoms,erectile function,and benign prostatic hyperplasia progression

This study investigated the correlation between periprostatic fat thickness(PPFT)measured on magnetic resonance imaging and lower urinary tract symptoms,erectile function,and benign prostatic hyperplasia(BPH)progression.A total of 286 treatment-naive men diagnosed with BPH in our department between March 2017 and February 2019 were included.Patients were divided into two groups according to the median value of PPFT:high(PPFT>4.35 mm)PPFT group and low(PPFT<4.35 mm)PPFT group.After the initial evaluation,all patients received a combination drug treatment of tamsulosin and finasteride for 12 months.Of the 286 enrolled patients,244 completed the drug treatment course.Patients with high PPFT had larger prostate volume(PV;P=0.013),higher International Prostate Symptom Score(IPSS;P-0.008),and lower five-item version of the International Index of Erectile Function(IIEF-5)score(P=0.002)than those with low PPFT.Both high and low PPFT groups showed significant improvements in PV,maximum flow rate,IPSS,and quality of life score and a decrease of IIEF-5 score after the combination drug treatment.The decrease of IIEF-5 score was more obvious in the high PPFT group than that in the low PPFT group.In addition,more patients in the high PPFT group underwent prostate surgery than those in the low PPFT group.Moreover,Pearson’s correlation coefficient analysis indicated that PPFT was positively correlated with age,PV,and IPSS and negatively correlated with IIEF-5 score;however,body mass index was only negatively correlated with IIEF-5 score.