Imaging characteristics of hypervascular focal nodular hyperplasialike lesions in patients with chronic alcoholic liver disease

BACKGROUND Focal nodular hyperplasia(FNH)-like lesions are hyperplastic formations in patients with micronodular cirrhosis and a history of alcohol abuse.Although pathologically similar to hepatocellular carcinoma(HCC)lesions,they are benign.As such,it is important to develop methods to distinguish between FNH-like lesions and HCC.AIM To evaluate diagnostically differential radiological findings between FNH-like lesions and HCC.METHODS We studied pathologically confirmed FNH-like lesions in 13 patients with alco-holic cirrhosis[10 men and 3 women;mean age:54.5±12.5(33-72)years]who were negative for hepatitis-B surface antigen and hepatitis-C virus antibody and underwent dynamic computed tomography(CT)and magnetic resonance imaging(MRI),including superparamagnetic iron oxide(SPIO)and/or gadoxetic acid-enhanced MRI.Seven patients also underwent angiography-assisted CT.RESULTS The evaluated lesion features included arterial enhancement pattern,washout appearance(low density compared with that of surrounding liver parenchyma),signal intensity on T1-weighted image(T1WI)and T2-weighted image(T2WI),central scar presence,chemical shift on in-and out-of-phase images,and uptake pattern on gadoxetic acid-enhanced MRI hepatobiliary phase and SPIO-enhanced MRI.Eleven patients had multiple small lesions(<1.5 cm).Radiological features of FNH-like lesions included hypervascularity despite small lesions,lack of“corona-like”enhancement in the late phase on CT during hepatic angiography(CTHA),high-intensity on T1WI,slightly high-or iso-intensity on T2WI,no signal decrease in out-of-phase images,and complete SPIO uptake or incomplete/partial uptake of gadoxetic acid.Pathologically,similar to HCC,FNH-like lesions showed many unpaired arteries and sinusoidal capillarization.CONCLUSION Overall,the present study showed that FNH-like lesions have unique radiological findings useful for differential diagnosis.Specifically,SPIO-and/or gadoxetic acid-enhanced MRI and CTHA features might facilitate differential diagnosis of FNH-like lesions and HCC.

Echinacoside attenuates glandular fibrosis in benign prostatic hyperplasia via inhibiting MKK6/MK2 signaling pathway

Background:Lower urinary tract symptoms commonly occur in the elderly population and seriously constrain the quality of life.Glandular fibrosis is an important pathobiological process in benign prostatic hyperplasia and is also a main inducing factor for benign prostatic hyperplasia-associated lower urinary tract symptoms.Cistanches species is an important herbal medicine resource and is traditionally used in ameliorating renal and prostatic defects.Methods:This study was to investigate the potential protective function of echinacoside(a bioactive compound from Cistanches)against prostatic fibrosis in mice and human benign prostatic hyperplasia epithelial-1 cell models.Results:It was found that echinacoside attenuated testosterone-induced prostatic hyperplasia and collagen deposition in mice,relieved prostate local inflammation and oxidative damage,and ameliorated prostatic epithelial-mesenchymal transition.Additionally,echinacoside inhibited the activation of the MKK6/MK2 signaling pathway both in vivo and in vitro.Conclusion:This study added new evidence for the anti-fibrotic function of echinacoside on the prostate and provided new insights for understanding its possible pharmacological mechanisms.

Alleviatory effect of isoquercetin on benign prostatic hyperplasia via IGF-1/PI3K/Akt/mTOR pathway

We evaluated the effect of isoquercetin(quercetin-O-3-glucoside-quercetin,IQ)as a functional component of Abeliophyllum disistichum Nakai ethanol extract(ADLE)on prostate cell proliferation and apoptosis and its effects on the IGF-1/PI3K/Akt/mTOR pathway in benign prostatic hyperplasia(BPH).Metabolites in ADLE were analyzed using UHPLC-qTOF-MS and HPLC.IQ was orally administered(1 or 10 mg/kg)to a testosterone propionate-induced BPH rat model,and its effects on the prostate weight were evaluated.The effect of IQ on androgen receptor(AR)signaling was analyzed in LNCaP cells.Whether IGF-1 and IQ affect the IGF-1/PI3K/Akt/mTOR pathway in BPH-1 cells was also examined.The metabolites in ADLE were identified and quantified,which confirmed that ADLE contained abundant IQ(20.88 mg/g).IQ significantly reduced the prostate size in a concentration-dependent manner in a BPH rat model,and significantly decreased the expression of AR signaling factors in the rat prostate tissue and LNCaP cells in a concentration-dependent manner.IQ also inhibited the PI3K/AKT/mTOR pathway activated by IGF-1 treatment in BPH-1 cells.In BPH-1 cells,IQ led to G0/G1 arrest and suppressed the expression of proliferation factors while inducing apoptosis.Thus,IQ shows potential for use as a pharmaceutical and nutraceutical for BPH.

The incidence rate and histological characteristics of intimal hyperplasia in elastase-induced experimental abdominal aortic aneurysms in mice

Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice.A retrospective study was conducted by including 42 male elastaseinduced mouse AAA models.The IH incidence,aortic diameters with or without IH,and hyperplasia lesional features of mice were analyzed.Among 42 elastase-induced AAA mouse models,10 mice developed mild IH(24%)and severe IH was found in only 2 mice(5%).The outer diameters of the AAA segments in mice with and without IH did not show significant difference.Both mild and severe IH lesions show strong smooth muscle cell positive staining,but endothelial cells were occasionally observed in severe IH lesions.There was obvious macrophage infiltration in the IH lesions of the AAA mouse models,especially in mice with severe IH.However,only a lower numbers of T cells and B cells were found in the IH lesion.Local cell-secreted matrix metalloproteinases(MMP)2 was highly expressed in all IH lesions,but MMP9 was only overexpressed in severe lesions.In conclusion,this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastaseinduced mouse AAA model.This will help researchers better understand this model,and optimize it for use in AAA-related research.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

Megestrol acetate plus metformin for fertility-sparing treatment of atypical endometrial hyperplasia and early-stage endometrial adenocarcinoma: a prospective study

Objective To evaluate the efficacy of medroxyprogesterone acetate(MA)plus metformin as the primary fertility-sparing treatment for atypical endometrial hyperplasia(AEH)and early-stage grade 1 endometrial adenocarcinoma(G1 EAC)and the recurrence rate after treatment.Methods Sixty patients(aged 20-42 years)with AEH and/or grade 1 EAC limited to the endometrium were enrolled prospectively and randomized into two groups(n=30)to receive oral MA treatment at the daily dose of 160 mg(control)or MA plus oral metformin(850 mg,twice a day)for at least 6 months.The treatment could extend to 12 months until a complete response(CR)was achieved,and follow-up hysteroscopy and curettage were performed every 3 months.For all the patients who achieved CR,endometrial expressions of IGFBP-rP1,p-Akt and p-AMPK were detected immunohistochemically.Results A total of 58 patients completed the treatment.After 9 months of treatment,23(76.7%)patients in the combined treatment group and 20(71.4%)in the control group achieved CR;two patients in the control group achieved CR after converting to the combined treatment.The recurrence rate did not differ significantly between the control group and combined treatment group(30.0%vs 22.7%,P>0.05).Ten(35.7%)patients in the control group experienced significant weight gain of 5.7±6.1 kg,while none of the patients receiving the combined treatment exhibited significant body weight changes.Compared with the control group,the patients receiving the combined treatment showed enhanced endometrial expressions of IGFBP-rP1 and p-AMPK with lowered p-Akt expression.Conclusion Metformin combined with MA may provide an effective option for fertility-sparing treatment of AEH and grade 1 stage IA EAC,and the clinical benefits of metformin for controlling MA-induced weight gain and promoting endometrial expressions of IGFBP-rP1 and p-AMPK while inhibiting p-Akt expression warrants further study.

Current Status of Mongolian Medicine Treatment for Breast Hyperplasia

Through literature and clinical research,the current status of Mongolian medicine treatment for breast hyperplasia is discussed,such as oral administration of Mongolian medicine for treatment,oral administration of Mongolian medicine combined with external application for treatment,combination of Mongolian medicine acupuncture therapy and oral administration of Mongolian medicine for treatment,integrated treatment of Mongolian and Western medicine,and combination therapy of Mongolian and traditional Chinese medicine,providing new ideas and choices for clinical research.

Arthroscopic synovectomy for synovial hyperplasia in chronic knee gouty arthritis:A case report

BACKGROUND Chronic synovitis due to chronic knee gouty arthritis(KGA)resulting in synovial hyperplasia has not been documented in the current literature,and thus the optimal management for this condition remains unclear.This case report discusses a 34-year-old man with a history of chronic KGA who presented with recurrent knee effusion resulting from synovial hyperplasia.CASE SUMMARY A 34-year-old man presented to our outpatient clinic with a 5-year recurrent knee effusion and a history of chronic KGA.Symptoms persisted despite serial aspiration and urate-lowering medication(febuxostat 80 mg once daily)for 2 months.Diagnostic arthroscopy was performed due to the recalcitrant symptoms.Intraoperatively,tophi deposition and excessive thickening of the synovial membrane were observed.Synovial biopsy and partial synovectomy were performed,revealing chronic synovitis with synovial hyperplasia that was consistent with chronic KGA.At follow-up after 6 months,the patient reported no further episode of knee effusion.CONCLUSION Arthroscopic synovectomy for synovial hyperplasia in chronic KGA sufficiently eradicates the symptoms of recurrent knee effusion.

Search trends in the treatment for benign prostatic hyperplasia:A twenty-year analysis

Objective:Minimally invasive treatments for benign prostatic hyperplasia (BPH) have seen an increase in usage in recent years. We aimed to determine what types of events may influence patient search habits related to surgical BPH treatments.Methods:Google Trends was used to determine the frequency of searches for different minimally invasive and prostatic ablative treatments for BPH in the United States. The procedures including transurethral resection of the prostate (TURP), Aquablation therapy (Aquablation), Greenlight laser therapy (Greenlight), transurethral needle ablation, transurethral microwave thermotherapy, Urolift (prostatic urethral lift [PUL]), Rezum, iTind, holmium laser enucleation of the prostate, simple prostatectomy, and prostatic artery embolization were compared.Results:From January 1, 2004 to February 28, 2023, the number of internet search queries have increased for TURP, PUL, Rezum, prostatic artery embolization, and holmium laser enucleation of the prostate. There has been a slight decrease in searches for Greenlight, transurethral needle ablation, transurethral microwave thermotherapy, iTind, simple prostatectomy, and Aquablation.Conclusion:Despite increased searches of alternatives, TURP remains the most searched BPH procedure. Additionally, search habits may be influenced by several factors including government approval, corporate acquisition, and marketing campaigns. It is important for physicians to understand the types of events that may cause patients to inquire about certain treatments for better quality health information and clinical visits.

Giant Brunner's gland hyperplasia of the duodenum successfully resected en bloc by endoscopic mucosal resection: A case report

BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.

A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果观察

目的:探讨A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果。方法:选择2019年8月—2022年12月联勤保障部队第904医院口腔科收治的接受颌面部手术的患者92例,采用随机数字表法分为试验组(n=46)和对照组(n=46)。试验组采用A型肉毒素联合脉冲染料激光(pulsed dye laser,PDL)预防手术切口瘢痕增生,对照组仅采用A型肉毒素。比较2组患者的临床疗效、瘢痕情况、患者满意度及不良反应。采用SPSS 22.0软件包对数据进行统计学分析。结果:试验组临床总有效率为84.78%,显著高于对照组的63.04%(P<0.05)。2组治疗前瘢痕颜色、平整度、弹性程度、瘢痕宽度评分等无统计学差异(P>0.05),2组治疗完成1周后瘢痕颜色、平整度、弹性程度、瘢痕宽度评分均显著低于治疗前,且试验组显著低于对照组(P<0.05)。试验组总体满意度显著高于对照组(P<0.05)。试验组与对照组减张缝合情况、伤口位于瘢痕增生好发部位情况与存在瘢痕张力情况比较,差异无统计学意义(P>0.05)。2组治疗后不良反应发生率无统计学差异(P>0.05)。结论:A型肉毒素联合脉冲染料激光预防颌面部手术切口瘢痕增生的效果较好,安全性高,可在临床上推广使用。

CYP17A1基因突变致先天性肾上腺皮质增生症一例报道并文献复习

17α-羟化酶缺乏症(17-OHD)是先天性肾上腺皮质增生症(CAH)中的一种罕见类型,约占CAH的1%,其患病率为1∶50000。本文报道了1例疑似17-OHD患者,通过外显子测序鉴定了1个类固醇生成酶基因CYP17A1的基因突变,结合临床表现、体格检查、肾上腺和性腺功能检查等,最终将其明确诊断为CAH并给予规范治疗。故结合该病例,本文回顾总结了17-OHD的鉴别和诊断,以期提高临床对该病的认识,促进临床对17-OHD的规范诊治,为17-OHD的诊断和治疗提供更多的参考资料。

内皮祖细胞与间充质干细胞治疗血管支架相关疾病

背景:随着干细胞研究的发展,成体干细胞如内皮祖细胞和间充质干细胞在动脉粥样硬化、血管支架植入损伤并发症中的治疗效能逐渐被发现,由于静脉输注成体干细胞治疗疾病存在靶向性差、治疗效率低等问题,近年来对血管支架表面改性以实现内皮祖细胞或间充质干细胞的局部聚集与功能调节一直是研究的焦点。目的:论述内皮祖细胞、间充质干细胞在血管支架相关疾病中的治疗进展,以及基于内皮祖细胞、间充质干细胞的血管支架设计方面的研究现状。方法:在CNKI、万方、PubMed、Web of Science数据库检索建库以来发表的相关文献。中文检索词“内皮损伤,支架植入术,血栓,内膜增生,动脉粥样硬化,内皮修复,内皮祖细胞,间充质干细胞,血管支架”;英文检索词“endothelial injury,stenting,thrombosis,intimal hyperplasia,atherosclerosis,endothelial repair,endothelial regeneration,endothelial progenitor cell,mesenchymal stem cell,vascular stent,vascular scaffold”。根据纳入和排除标准,最终对127篇文献进行综述。结果与结论:内皮祖细胞、间充质干细胞能够通过分化以及旁分泌作用治疗动脉粥样硬化及支架植入损伤并发症,其作用机制主要包括保护内皮细胞、调节炎症细胞与炎症因子表达、调节平滑肌细胞增殖和表型等。间充质干细胞在治疗应用中可能伴有血栓、血管钙化等不良反应,使用细胞外囊泡、联合使用肝素进行表面设计是解决这一问题的可行方案。目前基于内皮祖细胞的支架研究较多,主要从内皮祖细胞的募集、捕获、增殖、分化与活性等方面进行支架表面改性;血管领域基于间充质干细胞捕获的支架研究较少,但间充质干细胞来源外泌体洗脱支架被发现具有极高的治疗效能。此外一些基础疾病如糖尿病可能会对成体干细胞活性造成影响,导致基于干细胞设计的支架失去效能,因而未来在设计相应的支架时,应注意考虑这方面的影响因素。

基于网络药理学与分子对接探究沙库巴曲缬沙坦钠对抑制血管内膜增生治疗动静脉内瘘成熟障碍及狭窄的作用机制

目的利用网络药理学及分子对接方法探讨沙库巴曲缬沙坦钠(sacubitril valsartan sodi-um,LCZ696)抑制血管内膜增生(intimal hyperplasia,IH)治疗动静脉内瘘成熟障碍及狭窄的分子靶点机制。方法通过Chemical Book平台及SwissTarget Prediction数据库获取LCZ696的有效成分及对应靶点;利用GeneCards及在线人类孟德尔遗传数据库收集IH靶点、Protain-Protain Interaction数据库构建蛋白质互作网络、Cytoscape 3.10筛选核心靶点、微生信平台进行基因本体和京都基因与基因组百科全书富集分析,最后用AutoDockTools 1.5.7进行核心靶点与有效成分验证。结果获得有效成分2个、交集靶点80个,核心靶点包括表皮生长因子受体(epidermal growth factor receptor,EGFR)等共18个;富集分析显示作用机制与磷脂酰肌醇3-激酶/蛋白激酶B信号通路等通路相关。分子对接结果表明EGFR和核心靶点所组成的对接体具有强烈的对接活性,最为稳定。结论LCZ696可能通过多靶点与多通路抑制IH治疗动静脉内瘘成熟障碍及狭窄,为LCZ696的进一步研究提供理论依据和潜在研究方向。

酰胺质子转移成像联合扩散加权成像对前列腺癌及前列腺增生的鉴别价值

目的探讨MRI酰胺质子转移成像联合扩散加权成像在前列腺癌及前列腺增生鉴别诊断中的价值。资料与方法回顾性分析2020年2月—2021年8月新乡医学院第一附属医院前列腺癌与前列腺增生患者,分为前列腺癌组52例和前列腺增生组60例,分别测量两组的非对称磁化转移率(MTRasym)、表观扩散系数(ADC),并对比分析其差异,比较各参数单独及联合诊断的效能,并分析两参数的相关性。结果前列腺癌组MTRasym[(3.70±0.94)%]显著高于前列腺增生组[(2.35±0.60)%](t=8.89,P<0.05);前列腺癌组ADC值[(0.93±0.15)×10^(-3) mm^(2)/s]显著低于前列腺增生组[(1.32±0.22)×10^(-3) mm^(2)/s](t=-11.01,P<0.05)。MTRasym、ADC值及两者联合鉴别前列腺癌和前列腺增生的受试者工作特征曲线下面积分别为0.886、0.914、0.966。MTRasym、ADC值的诊断效能差异无统计学意义(P>0.05),两者联合的诊断效能优于MTRasym、ADC值单独的诊断效能(Z=3.125、2.776,P<0.05)。MTRasym值与ADC值呈负相关(r=-0.469,P<0.001)。结论酰胺质子转移与扩散加权成像鉴别前列腺癌和前列腺增生均有较高的效能,两序列联合的诊断效能更高。

综合护理在烧伤患儿中的应用

目的探讨综合护理在烧伤患儿中的应用。方法随机抽选2020年10月至2023年10月在江阴市人民医院治疗的85例烧伤患儿,按照入院顺序分为两组。对照组(42例)采用常规护理干预,观察组(43例)采用综合护理干预,比较两组护理效果。结果观察组并发症总发生率低于对照组(P<0.05)。与对照组比较,观察组家属总满意率更高(P<0.05)。与对照组相比,观察组睡眠质量、瘢痕增生、瘙痒程度评分更低(P<0.05)。结论综合护理干预用于烧伤患儿的效果较好,能减少并发症,提高睡眠质量,改善瘢痕增生,缓解瘙痒,提升家属对护理的满意度。

玫瑰蜂花粉破壁工艺优化及其醇提物生理活性比较

玫瑰蜂花粉气味芳香、口感清甜,富含多酚等活性物质,是极具营养价值和开发潜力的天然保健品。本研究以玫瑰蜂花粉为研究对象,旨在优化其酶解破壁工艺条件,并比较不同乙醇提取物的生理活性及主要成分含量,以期筛选抗炎和抗良性前列腺增生(Benign prostatic hyperplasia,BPH)活性最佳的玫瑰蜂花粉提取物。结果显示,玫瑰蜂花粉双酶解法破壁最优工艺参数是料液比为1:30、温度55℃、pH6、复合酶体系添加量2.0%(纤维素酶:复合蛋白酶=7:5),反应9 h,可得最佳破壁率为73.13%;90%乙醇提取的活性物质能显著(P<0.01)降低脂多糖诱导的RAW264.7细胞炎症因子释放水平(20μg/mL时,与造模组相比,一氧化氮、白细胞介素-6和肿瘤坏死因子-α分别降低了67.04%、16.74%、21.74%)并对BPH-1细胞活力和增殖有最明显的抑制作用,因此具有最佳的抗炎和抗BPH效果。本研究为明确玫瑰蜂花粉中的活性成分及进一步开发其深加工产品提供了理论依据。

COVID-19对前列腺增生患者逼尿肌收缩功能的影响

目的:采用超声影像尿动力学检查(sonography video urodynamics studies,SVUDS)分析新型冠状病毒肺炎(coronavirus disease-2019,COVID-19)对前列腺增生(benign prostatic hyperplasia,BPH)患者逼尿肌收缩功能的影响。方法:纳入桂林医学院第二附属医院及邵阳市中心医院2023年1—6月诊断为BPH伴或不伴COVID-19感染患者124例进行回顾性研究分析。根据病毒核酸检测阳性或阴性情况分为COVID-19(+)组51例和COVID-19(-)组73例。比较两组患者一般情况、炎症指标及SVUDS参数差异,分析COVID-19(+)组患者炎症指标及无创性SVUDS参数与逼尿肌收缩功能的相关性。结果:COVID-19(+)组患者C反应蛋白(C-reactive protein,CRP)、白介素(interleukin,IL)-6高于COVID-19(-)组患者(P<0.05)。两组患者年龄、IL-1β、前列腺特异性抗原(prostate specific antigen,PSA)、游离前列腺特异性抗原(free prostate-specific antigen,fPSA)、fPSA/PSA、前列腺体积(prostate volume,PV)、前列腺特异性抗原密度(prostate specific antigen density,PSAD)、前列腺突入膀胱距离(intravesical prostatic protrusion,IPP)、最大尿流率(peak flow rate,Qmax)、尿道阻力因子(urethral resistance factor,URA)、膀胱出口梗阻指数(bladder outlet obstruction index,BOOI)、基点(footpoint)、曲率(curvature)差异无统计学意义(P>0.05)。相比COVID-19(-)组,COVID-19(+)组最大逼尿肌压(maximum detrusor pressure,Pdet.max)、最大尿流率逼尿肌压(detrusor pressure at peak flow rate,Pdet.Qmax)、膀胱收缩指数(bladder contractility index,BCI)和最大瓦特因子(maximum Watts factor,WF_(max))降低,膀胱壁厚度(bladder wall thickness,BWT)和残余尿量(post-void residual volume,PVR)增加(P均<0.05)。COVID-19(+)组患者BWT与WF_(max)呈负相关(r=-0.313,P=0.036),PVR与BCI(r=-0.471,P=0.001)和WF_(max)(r=-0.491,P=0.001)均呈负相关。结论:BPH患者若合并COVID-19感染可能进一步加重逼尿肌活动低下,导致残余尿量增加甚至尿潴留,逼尿肌活动低下可能是BPH患者“long-COVID”尿动力学表现之一。

血红蛋白-白蛋白-淋巴细胞-血小板评分与老年良性前列腺增生电切术后全身炎症反应综合征的关系

目的探讨血红蛋白-白蛋白-淋巴细胞-血小板(HALP)评分在预测老年良性前列腺增生电切术后全身炎症反应综合征(SIRS)的有效性和可靠性。方法选取2021年1月至2022年12月滁州市第一人民医院收治的100例老年良性前列腺增生患者,年龄(71.47±5.26)岁,年龄范围为65~82岁。电子病历系统采集患者临床资料,按照患者术后是否出现SIRS分为SIRS组(n=14)和无SIRS组(n=86)。多因素logistic回归分析老年良性前列腺增生电切术后发生SIRS的因素,受试者操作特征(ROC)曲线分析HALP评分与单一指标预测老年良性前列腺增生电切术后发生SIRS的价值。结果SIRS组与无SIRS组术前国际前列腺症状(IPSS)评分、血红蛋白、白蛋白、血小板、HALP评分比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,术前IPSS评分[OR=1.633,95%CI(1.330,2.005)]、血红蛋白[OR=0.708,95%CI(0.617,0.812)]、白蛋白[OR=0.740,95%CI(0.645,0.849)]、血小板[OR=0.949,95%CI(0.929,0.970)]、HALP评分[OR=0.723,95%CI(0.627,0.835)]均为患者术后发生SIRS的独立预测因子(P<0.001);ROC曲线分析显示,HALP评分较血红蛋白、白蛋白、血小板单独检测有更高的预测能力,曲线下面积为0.881,灵敏度为0.923,特异度为0.743,约登指数为0.666,截断值为34.53分。结论HALP评分可帮助预测老年良性前列腺增生患者在电切术后发生SIRS的风险。

免疫表型和血浆代谢物与良性前列腺增生之间的关联:一项中介孟德尔随机化研究

目的采用中介孟德尔随机化(Mendelian randomization,MR)的方法探讨免疫细胞-血浆代谢物-良性前列腺增生(benign prostatic hyperplasia,BPH)之间潜在的因果关系以及血浆代谢的中介作用。方法采用双样本双向MR分析,预测可能影响BPH的免疫表型,同时排除受BPH反向影响的免疫细胞。其次,单向双样本MR分析筛选与BPH相关的血浆代谢物,并探讨其是否受免疫细胞的影响,以相同方法评估血浆代谢物与BPH之间的因果关系。最后,进一步估算血浆代谢物在免疫细胞与BPH之间的中介效应。结果双向MR分析,显示8种免疫细胞表型与BPH之间存在显著关联。IVW分析显示,其中5种免疫细胞表型对BPH具有保护作用,而另外3种表型显著增加了BPH的发病风险。在血液代谢物与BPH的MR分析中,IVW结果表明17种血液代谢物指标与BPH存在因果关系,其中8种代谢物显著提高了BPH的发病风险,而另外9种代谢物显著降低了BPH的发病风险。中介MR分析结果显示DP[CD4(+)CD8(+)]AC-5'-甲基硫腺苷(MTA)磷酸盐比率-BPH[中介比例=-12.086%,95%CI(-22.430%,-1.742%)]和CD19 on IgD(-)CD24(-)-脱氧胆酸葡萄糖醛酸水平-BPH[中介比例=-11.230%,95%CI(-21.873%,-0.588%)]两条免疫细胞表型-血浆代谢物-BPH因果通路在BPH发生中的作用。两种代谢物在免疫细胞与BPH关联中的中介比例均超过10%。结论本研究通过中介MR揭示了两种免疫表型分别通过两种血浆代谢物与BPH之间的潜在关联,为BPH的诊断和治疗提供了新的潜在靶点。