This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretat...This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.展开更多
Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan ...Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.展开更多
Background: Lumboperitoneal (LP) shunts have been used to manage benign intracranial hypertension (BIH) for an extended period. While they may swiftly and effectively alleviate symptoms, their application is accompani...Background: Lumboperitoneal (LP) shunts have been used to manage benign intracranial hypertension (BIH) for an extended period. While they may swiftly and effectively alleviate symptoms, their application is accompanied by potential complications. Objectives: This research aimed to retrospectively analyze the difficulties and complications related to LP shunt implantation. Methods: We conducted a retrospective analysis of the records of 47 patients who had LP shunt placement for the treatment of BIH at our hospital throughout the research period. A thorough history and physical examination were conducted in every case. All patients were asked about age, gender, body mass index, neurological history, and oral contraceptive usage. Post-operative complications, clinical and ophthalmological follow-up occurred at 1, 3, and 6 months post-op. Results: Patients were mostly women (93.6%). The mean age of the patients was 35, and 80.9 percent had BMIs exceeding 25. Many female patients (40.9%) used oral contraceptives. Nearly all patients (93.6%) reported decreased vision, and 87.2% suffered headaches. The most common issue was shunt obstruction (51%), followed by low tension headaches (63.8%). The peritoneal side (10.6%) had higher shunt slippage than the thecal (2.1%). Superficial infections and radiculopathy affected 10.6% of patients, whereas CNS infections, arachnoiditis, and shunt failure affected just 2.1%. Five patients (10.6%) had Chiari malformation, and 60% had syringomyelia. Conclusion: Using LP shunts to treat BIH seems to be a method devoid of major risks despite the high revision rates. At the same time, more severe complications such as CNS infections, arachnoiditis, and shunt failure were less common.展开更多
BACKGROUND Current United States Food and Drug Administration(FDA)guidelines established since 2005 recommend the usage of silicone stents over metal stents due to the risk of complications associated with the older g...BACKGROUND Current United States Food and Drug Administration(FDA)guidelines established since 2005 recommend the usage of silicone stents over metal stents due to the risk of complications associated with the older generation of uncovered stents.Yet,with the advancement of technology,novel innovations of self-expanding metal stents(SEMS)have revolutionized the treatment of benign airway stenosis(BAS),where the insertion of SEMS is known to be easier than silicone stents.AIM To compare the efficacy and safety of covered SEMS against uncovered SEMS,and thereafter propose more direct trials comparing covered SEMS against silicone stents for consideration of revision of current FDA guidelines.METHODS A comprehensive literature review of MEDLINE and EMBASE was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Of 3002 articles,64 publications met the eligibility criteria with a total of 900 patients(468 covered SEMS,432 uncovered SEMS).The collected data were analyzed using Statistical Package for the Social Sciences version 11.5.RESULTS Covered SEMS showed a higher success rate of insertion(98.6%vs 88.2%)and lower complication rates of infection(1.3%vs 13.2%),restenosis(1.5%vs 10.6%),stent fracture(2.6%vs 7.4%),bleeding(0%vs 5.8%),and pneumothorax(0%vs 2.8%)compared to uncovered SEMS.However,covered SEMS compared to uncovered SEMS showed higher complication rates of stent migration(12.4%vs 6.9%)and granulation tissue formation(26.5%vs 20.1%).CONCLUSION Our study suggests that covered SEMS are an effective,safe,and viable option in the treatment of BAS.Thus,further consideration regarding the utilization of covered SEMS over other forms of stent types is appropriate.展开更多
AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective co...AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.展开更多
Objective This study aimed to evaluate the effectiveness of acupuncture for benign prostatic hyperplasia(BPH).Methods We searched PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,Chinese National ...Objective This study aimed to evaluate the effectiveness of acupuncture for benign prostatic hyperplasia(BPH).Methods We searched PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,Chinese National Knowledge Infrastructure,Wanfang Data,and China Science and Technology Journal Database from their inceptions to February 1,2022.The language was restricted to English and Chinese.Two researchers independently screened the literature,extracted data,and evaluated the risk bias of the included study according to the Cochrane Handbook 5.1.0.A meta-analysis was performed using Review Manager version 5.3.Results Twenty-two studies with 1,765 participants were selected to be incorporated in the meta-analysis.The experimental groups(EGs)showed greater benefit on therapeutic effects(relative risk[RR]:1.23,95%CI:1.16,1.3;P<0.00001),International Prostate Score Scale(mean difference[MD]:-2.06,95%CI:-3.17,-0.96;P=0.0002),maximum urinary flow rate(MD:1.7,95%CI:0.89,2.52;P<0.0001),postvoid residual urine volume(MD:-8.25,95%CI:-12.14,-4.36;P<0.0001),quality of life(MD:-0.55,95%CI:-0.8,-0.29;p<0.0001)compared with the control groups,whereas for prostate volume(MD:-0.87,95%CI:-2.66,0.92;P=0.34)was not significantly improved in the EGs.Nevertheless,no statistical variation in the reduction of adverse reactions was observed.Conclusion Acupuncture therapy,a wildly applied complementary–alternative treatment,may help in the management of BPH.展开更多
Objective:Robot-assisted simple prostatectomy(RASP)is increasingly used as a surgical treatment option for large benign prostatic hyperplasia(BPH)(>80 mL).However,there is no sufficient expert consensus or guidelin...Objective:Robot-assisted simple prostatectomy(RASP)is increasingly used as a surgical treatment option for large benign prostatic hyperplasia(BPH)(>80 mL).However,there is no sufficient expert consensus or guidelines to guide clinical practice.We aimed to obtain expert opinions for RASP for large BPH.Methods:A systematic review of the literature was performed in April 2024 using the PubMed,Embase,and Web of Science databases.Search terms were combined to construct the following search strings:(robotic)AND(simple OR benign)AND(prostatectomy).Search results were filtered by language(English only),species(human),and publication type(original article).This study used a two-phase modified Delphi approach.Results:In this expert consensus,some frequently used RASP techniques,including robot-assisted retropubic prostatectomy,robot-assisted transvesical prostatectomy,and robot-assisted urethra-sparing prostatectomy,are described.RASP offers a short learning curve for surgeons with experience in robotic surgery.Severe complications are rare in patients who undergo RASP.Conclusion:RASP technique can be recommended as a safe and effective minimally invasive treatment for symptomatic BPH patients with large prostate glands.展开更多
Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between Octob...Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between October 2022 and October 2024 were selected for high-frequency ultrasound diagnosis.The diagnostic efficacy of high-frequency ultrasound was evaluated by comparing it with the results of surgical pathology.Results:High-frequency ultrasound detected 50 benign nodules,primarily breast fibroadenomas,and 35 malignant nodules,mainly breast ductal carcinoma in situ.Based on surgical pathology results,the diagnostic accuracy of high-frequency ultrasound was 96.47%,specificity was 97.96%,and sensitivity was 94.44%.In high-frequency ultrasound diagnosis,the proportion of grade III and IV blood flow in malignant nodules was higher than that in benign nodules,while the proportion of regular shape and clear margins was lower.The proportion of microcalcifications and posterior echo attenuation was higher in malignant nodules,and the resistance index(RI)and peak blood flow velocity were lower than those in benign nodules(P<0.05).Conclusion:High-frequency ultrasound can effectively differentiate benign and malignant breast micronodules,determine specific nodule types,and exhibits high diagnostic accuracy and sensitivity.Additionally,benign and malignant nodules can be differentiated based on the grading of blood flow signals,sonographic features,and blood flow velocity,providing reasonable guidance for subsequent treatment plans.展开更多
BACKGROUND Benign recurrent intrahepatic cholestasis(BRIC)is a rare autosomal recessive liver disease,causing episodic cholestasis with intense pruritus.This case report highlights the effectiveness of early plasmaphe...BACKGROUND Benign recurrent intrahepatic cholestasis(BRIC)is a rare autosomal recessive liver disease,causing episodic cholestasis with intense pruritus.This case report highlights the effectiveness of early plasmapheresis as a therapeutic option for BRIC type 2,offering rapid symptom relief and early termination of cholestatic episodes.It contributes to the limited evidence supporting plasmapheresis as a treatment for BRIC flares resistant to conventional therapies.CASE SUMMARY A 43-year-old male with BRIC type 2 presented with fatigue,jaundice,and severe pruritus,triggered by a recent mild severe acute respiratory syndrome coronavirus 2 infection.Laboratory results confirmed cholestasis with elevated bilirubin and alkaline phosphatase.First-line pharmacological treatments,including cholestyramine and rifampicin,failed.Endoscopic nasobiliary drainage was ineffective,prompting initiation of plasmapheresis.This intervention rapidly relieved pruritus,with complete biochemical normalisation after 11 sessions.Two years later,a similar episode occurred,and early reinitiation of plasmapheresis led to symptom resolution within two sessions and biochemical recovery within two weeks.The patient tolerated the procedure well,with no adverse effects observed.Follow-up showed no signs of cholestasis recurrence.CONCLUSION Plasmapheresis is a safe and effective option for therapy-refractory BRIC type 2,particularly when initiated early in cholestasis.展开更多
Benign prostatic hyperplasia(BPH)represents a prevalent etiology of lower urinary tract symptoms(LUTS)in the male population,clinically defined by a nonmalignant proliferation of prostatic tissue.While BPH exhibits a ...Benign prostatic hyperplasia(BPH)represents a prevalent etiology of lower urinary tract symptoms(LUTS)in the male population,clinically defined by a nonmalignant proliferation of prostatic tissue.While BPH exhibits a high prevalence among older male populations globally,the precise underlying mechanisms contributing to its development remain incompletely elucidated.Mitochondria,essential organelles within eukaryotic cells,are critical for cellular bioenergetics,the regulation of reactive oxygen species(ROS)generation,and the modulation of cell death pathways.The maintenance of mitochondrial homeostasis involves a complex interplay of processes.By synthesizing previous literature,this review discusses mitochondrial homeostasis in prostate glands and the role of mitochondrial dysfunction in the context of BPH.Furthermore,the review delved into each dimension of mitochondrial dysfunction in the specific etiology of BPH,highlighting its impact on cell survival,apoptosis,ferroptosis,oxidative stress and androgen receptor(AR).Overall,this review aims to unveil the crosstalk between mitochondrial dysfunction and BPH and identify intrinsic mechanisms.展开更多
Benign esophageal stricture is characterized by the narrowing of the digestivetract lumen due to multiple factors. Endoscopic treatment is the first treatmentchoice and includes endoscopic dilatation, drug injection, ...Benign esophageal stricture is characterized by the narrowing of the digestivetract lumen due to multiple factors. Endoscopic treatment is the first treatmentchoice and includes endoscopic dilatation, drug injection, stenosis incision, stentimplantation, stem cell flap transplantation, etc. However, there are currently nospecific clinical standards or guidelines to quantify a series of specific parametersin the treatment of benign esophageal stricture, such as the frequency of drugadministration, dosage, dilation inner diameter, and number of treatments. Thisleads to operator bias in clinical practice and inconsistent treatment outcomesamong patients. Therefore, this article reviews the current advances and existingchallenges in the endoscopic treatment of benign esophageal stricture, with theaim of exploring the possibility of achieving precision and standardization in theendoscopic treatment of this disease.展开更多
Objective:Thulium fiber laser enucleation of the prostate(ThuFLEP)and robot-assisted simple prostatectomy(RASP)are two options for treating large benign prostatic hyperplasia.The most appropriate technique remains a m...Objective:Thulium fiber laser enucleation of the prostate(ThuFLEP)and robot-assisted simple prostatectomy(RASP)are two options for treating large benign prostatic hyperplasia.The most appropriate technique remains a matter of debate.We evaluated the efficacy and safety of ThuFLEP compared to RASP.Methods:Between January 2020 and December 2023,all patients who underwent either RASP or ThuFLEP for a prostate volume>80 mL were retrospectively included.The surgical procedure choice was left to the surgeon’s and patient’s discretion.Preoperative patient evaluation included the assessment of functional parameters.The groups were compared.Results:A total of 234 patients were included:106(45%)underwent RASP and 128(55%)underwent ThuFLEP.The mean operative time was shorter in the ThuFLEP group compared to the RASP group(106.4 with standard deviation[SD]46.1 min vs.123.2[SD 32.8]min,p=0.012).The mean lengths of catheterization and stay were significantly longer in the RASP group(5.0[SD 3.9]days vs.1.7[SD 2.0]days,p=0.009[catheterization]and 4.9[SD 3.0]days vs.1.9[SD 1.8]days,p=0.009[stay]).The overall complication rate was significantly higher in the ThuFLEP group(12%vs.2.8%in the RASP group,p=0.022).However,we did not observe significant differences in major complications(Clavien-Dindo≥3)between the two groups(four[3.1%]in the ThuFLEP group vs.one[0.94%]in the RASP group,p=0.073).At 3 months,the rate of stress urinary incontinence was 4.7%after ThuFLEP and 1.9%after RASP(p=0.2).Finally,the quality of life score and maximum urinary flow were comparable between the ThuFLEP and RASP groups,but the International Prostate Symptom Score at 3 months postoperatively was lower in the RASP group(p=0.012).Conclusion:Both ThuFLEP and RASP are safe techniques with comparable functional outcomes for large benign prostatic hyperplasia.ThuFLEP allows a reduction in catheterization and hospitalization durations but presents more complications compared to RASP.展开更多
Background:Benign prostatic hyperplasia(BPH)is the most common disease in elderly men.There is increasing evidence that periodontitis increases the risk of BPH,but the specific mechanism remains unclear.This study aim...Background:Benign prostatic hyperplasia(BPH)is the most common disease in elderly men.There is increasing evidence that periodontitis increases the risk of BPH,but the specific mechanism remains unclear.This study aimed to explore the role and mechanism of the key periodontal pathogen Porphyromonas gingivalis(P.gingivalis)in the development of BPH.Methods:The subgingival plaque(Sp)and prostatic fluid(Pf)of patients with BPH concurrent periodontitis were extracted and cultured for 16S r DNA sequencing.Ligature-induced periodontitis,testosterone-induced BPH and the composite models in rats were established.The P.gingivalis and its toxic factor P.gingivalis lipopolysaccharide(P.gLPS)were injected into the ventral lobe of prostate in rats to simulate its colonization of prostate.P.g-LPS was used to construct the prostate cell infection model for mechanism exploration.Results:P.gingivalis,Streptococcus oralis,Capnocytophaga ochracea and other oral pathogens were simultaneously detected in the Sp and Pf of patients with BPH concurrent periodontitis,and the average relative abundance of P.gingivalis was found to be the highest.P.gingivalis was detected in both Sp and Pf in 62.5%of patients.Simultaneous periodontitis and BPH synergistically aggravated prostate histological changes.P.gingivalis and P.gLPS infection could induce obvious hyperplasia of the prostate epithelium and stroma(epithelial thickness was 2.97-fold and 3.08-fold that of control group,respectively),and increase of collagen fibrosis(3.81-fold and 5.02-fold that of control group,respectively).P.gingivalis infection promoted prostate cell proliferation,inhibited apoptosis,and upregulated the expression of inflammatory cytokines interleukin-6(IL-6;4.47-fold),interleukin-6 receptor-α(IL-6Rα;5.74-fold)and glycoprotein 130(gp130;4.47-fold)in prostatic tissue.P.g-LPS could significantly inhibit cell apoptosis,promote mitosis and proliferation of cells.P.g-LPS activates the Akt pathway through IL-6/IL-6Rα/gp130 complex,which destroys the imbalance between proliferation and apoptosis of prostate cells,induces BPH.Conclusion:P.gingivalis was abundant in the Pf of patients with BPH concurrent periodontitis.P.gingivalis infection can promote BPH,which may affect the progression of BPH via inflammation and the Akt signaling pathway.展开更多
Background:Fibrosis constitutes a significant pathophysiological mechanism in the clinical progression of benign prostatic hyperplasia(BPH)and represents a contributing factor to the ineffectiveness of prevailing phar...Background:Fibrosis constitutes a significant pathophysiological mechanism in the clinical progression of benign prostatic hyperplasia(BPH)and represents a contributing factor to the ineffectiveness of prevailing pharmacological treatments.Emerging evidence suggests a close association between microbial presence and the development of fibrosis.Nonetheless,the potential involvement of microbes within prostatic tissue in the pathogenesis of BPH and prostatic fibrosis,along with the underlying mechanisms,remains unexplored.Methods:Utilizing immunohistochemistry and microbial sequencing,we analyzed the microbes of prostate tissues from BPH patients with different degrees of prostate fibrosis and found that Salmonellaenterica(S.enterica)was enriched in the high degree of prostate fibrosis.We developed prostate cell and animal models infected with the lipopolysaccharide of S.enterica(S.e-LPS)to assess its impact on prostate fibrosis.To elucidate the underlying functional mechanisms,we employed molecular biology techniques,including RNA degradation assays,N6-methyladenosine(m6A)dot blotting,RNA immunoprecipitation,and m6A immunoprecipitation.Results:Microbial diversity differed between low-and high-fibrosis groups,with S.enterica showing the highest mean abundance among the 4 species that differed significantly.S.e-LPS was detected in S.enterica-rich prostate tissue and was found to significantly promote cell proliferation,cell contractility,lipid peroxidation,and the induction of ferroptosis.Animal experiments demonstrated that S.e-LPS infection led to pronounced hyperplasia of the prostatic epithelium,with epithelial thickness increasing to 1.57 times that of the sham group,and collagen fibrosis increasing to 2.84 times that of the sham group,thereby exacerbating prostatic tissue fibrosis in rats.Invitro experiments further revealed that S.e-LPS promoted prostate cell fibrosis by inducing ferroptosis.Mechanistically,it was determined that S.e-LPS regulates ferroptosis via AlkB homolog 5(ALKBH5)-mediated m6A modification,which affects the stability of glutathione peroxidase 4(GPX4)mRNA,thereby affecting prostatic fibrosis.Conclusion:The findings of this study suggest that S.enterica promotes prostatic fibrosis through ALKBH5-m6A-GPX4-mediated ferroptosis.This research offers novel insights for the development of new therapeutic targets and personalized strategies for the prevention and treatment of BPH from the perspectives of microbes and epigenetics.展开更多
Benign prostatic hyperplasia(BPH)is a common condition affecting the quality of life and health status of elderly men.Its incidence increases with age and is often accompanied by symptoms such as urinary frequency,urg...Benign prostatic hyperplasia(BPH)is a common condition affecting the quality of life and health status of elderly men.Its incidence increases with age and is often accompanied by symptoms such as urinary frequency,urgency,nocturia,difficulty voiding,and even urinary retention.While conventional Western medicine can alleviate symptoms,it frequently carries risks of side effects and disease recurrence.Traditional Chinese Medicine approaches this condition based on the characteristic patterns observed in the elderly population:predominantly deficiency and blood stasis,with chronic conditions leading to blood stasis.The Yiqi Huoxue method—aimed at tonifying Qi and activating blood circulation—has been shown to improve urinary symptoms,enhance quality of life,and promote overall health in elderly BPH patients.This article explores the application of the Yiqi Huoxue therapeutic principle in managing benign prostatic hyperplasia.展开更多
Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and ...Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.展开更多
In 2013,the World Health Organization defined perivascular epithelioid cell tumor(PEComa)as“a mesenchymal tumor which shows a local association with vessel walls and usually expresses melanocyte and smooth muscle mar...In 2013,the World Health Organization defined perivascular epithelioid cell tumor(PEComa)as“a mesenchymal tumor which shows a local association with vessel walls and usually expresses melanocyte and smooth muscle markers.”This generic definition seems to better fit the PEComa family,which includes angiomyolipoma,clear cell sugar tumor of the lung,lymphangioleiomyomatosis,and a group of histologically and immunophenotypically similar tumors that include primary extrapulmonary sugar tumor and clear cell myomelanocytic tumor.Clear cell tumors with this immunophenotypic pattern have also had their malignant variants described.When localizing to the liver,preoperative radiological diagnosis has proven to be very difficult,and most patients have been diagnosed with hepatocellular carcinoma,focal nodular hyperplasia,hemangioma,or hepatic adenoma based on imaging findings.Examples of a malignant variant of the liver have been described.Finally,reports of malignant variants of these lesions have increased in recent years.Therefore,we support the use of the Folpe criteria,which in 2005 established the criteria for categorizing a PEComa as benign,malignant,or of uncertain malignant potential.Although they are not considered ideal,they currently seem to be the best approach and could be used for the categorization of liver tumors.展开更多
Panax ginseng(C.A.Mey.)has been traditionally employed in Korea and China to alleviate fatigue and digestive disorders.In particular,Korean red ginseng(KRG),derived from streamed and dried P.ginseng,is known for its a...Panax ginseng(C.A.Mey.)has been traditionally employed in Korea and China to alleviate fatigue and digestive disorders.In particular,Korean red ginseng(KRG),derived from streamed and dried P.ginseng,is known for its anti-aging and anti-inflammatory properties.However,its effects on benign prostatic hyperplasia(BPH),a representative aging-related disease,and the underlying mechanisms remain unclear.This study aims to elucidate the therapeutic effects of KRG on BPH,with a particular focus on mitochondrial dynamics,including fission and fusion processes.The effects of KRG on cell proliferation,apoptosis,and mitochondrial dynamics and morphology were evaluated in a rat model of testosterone propionate(TP)-induced BPH and TP-treated LNCaP cells,with mdivi-1 as a control.The results revealed that KRG treatment reduced the levels of androgen receptors(AR)and prostate-specific antigens in the BPH group.KRG inhibited cell proliferation by downregulating cyclin D and proliferating cell nuclear antigen(PCNA)levels,and it promoted apoptosis by increasing the ratio of B-cell lymphoma protein 2(Bcl-2)-associated X protein(Bax)to Bcl-2 expression.Notably,KRG treatment enhanced the phosphorylation of dynamin-related protein 1(DRP-1,serine 637)compared with that in the BPH group,which inhibited mitochondrial fission and led to mitochondrial elongation.This modulation of mitochondrial dynamics was associated with decreased cell proliferation and increased apoptosis.By dysregulating AR signaling and inhibiting mitochondrial fission through enhanced DRP-1(ser637)phosphorylation,KRG effectively reduced cell proliferation and induced apoptosis.These findings suggest that KRG’s regulation of mitochondrial dynamics offers a promising clinical approach for the treatment of BPH.展开更多
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 effec...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.展开更多
This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy(TUEB)for benignprostatic hyperplasia.The study involved 494 consecutive patients who underwent TUEB for benig...This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy(TUEB)for benignprostatic hyperplasia.The study involved 494 consecutive patients who underwent TUEB for benign prostatic hyperplasia fromAugust 2018 to March 2022 by one surgeon(SJJ,Seoul National University Bundang Hospital,Seongnam,Korea).The patientswere followed up at 1 week,1 month,3 months,and 6 months postoperatively.To evaluate the learning curve of TUEB,perioperativeparameters including the enucleation ratio(enucleated tissue weight/transitional zone volume),TUEB efficiency(enucleatedtissue weight/operation time),and enucleation efficiency(enucleated tissue weight/enucleation time)were analyzed.Functionaloutcomes and postoperative complications were also assessed,including the International Prostate Symptom Score(IPSS),IPSSquality-of-life(QoL)score,and uroflowmetry outcomes.The patients’median age was 72(interquartile range[IQR]:66–78)years,and the estimated prostate volume and transitional zone volume were 63.0(IQR:46.0–90.6)ml and 37.1(IQR:24.0–60.0)ml,respectively.The enucleation ratio,TUEB efficiency,and enucleation efficiency were 0.60(IQR:0.46–0.54)g ml−1,0.33(IQR:0.22–0.46)g min−1,and 0.50(IQR:0.35–0.72)g min−1,respectively,plateauing after 70 cases.The functional outcomes,including total IPSS,IPSS QoL score,and uroflowmetry outcomes,significantly improved at 6 months after TUEB(all P<0.05),but without significant differences over the learning curve.Sixty-five(13.2%)patients developed complications after TUEB,21.5%of whom experienced major complications(Clavien–Dindo grade≥3).The rate of major complications declined as the number ofTUEB cases increased(P=0.013).Our results suggest that the efficiency of TUEB stabilized within 70 procedures.展开更多
文摘This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.
文摘Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.
文摘Background: Lumboperitoneal (LP) shunts have been used to manage benign intracranial hypertension (BIH) for an extended period. While they may swiftly and effectively alleviate symptoms, their application is accompanied by potential complications. Objectives: This research aimed to retrospectively analyze the difficulties and complications related to LP shunt implantation. Methods: We conducted a retrospective analysis of the records of 47 patients who had LP shunt placement for the treatment of BIH at our hospital throughout the research period. A thorough history and physical examination were conducted in every case. All patients were asked about age, gender, body mass index, neurological history, and oral contraceptive usage. Post-operative complications, clinical and ophthalmological follow-up occurred at 1, 3, and 6 months post-op. Results: Patients were mostly women (93.6%). The mean age of the patients was 35, and 80.9 percent had BMIs exceeding 25. Many female patients (40.9%) used oral contraceptives. Nearly all patients (93.6%) reported decreased vision, and 87.2% suffered headaches. The most common issue was shunt obstruction (51%), followed by low tension headaches (63.8%). The peritoneal side (10.6%) had higher shunt slippage than the thecal (2.1%). Superficial infections and radiculopathy affected 10.6% of patients, whereas CNS infections, arachnoiditis, and shunt failure affected just 2.1%. Five patients (10.6%) had Chiari malformation, and 60% had syringomyelia. Conclusion: Using LP shunts to treat BIH seems to be a method devoid of major risks despite the high revision rates. At the same time, more severe complications such as CNS infections, arachnoiditis, and shunt failure were less common.
文摘BACKGROUND Current United States Food and Drug Administration(FDA)guidelines established since 2005 recommend the usage of silicone stents over metal stents due to the risk of complications associated with the older generation of uncovered stents.Yet,with the advancement of technology,novel innovations of self-expanding metal stents(SEMS)have revolutionized the treatment of benign airway stenosis(BAS),where the insertion of SEMS is known to be easier than silicone stents.AIM To compare the efficacy and safety of covered SEMS against uncovered SEMS,and thereafter propose more direct trials comparing covered SEMS against silicone stents for consideration of revision of current FDA guidelines.METHODS A comprehensive literature review of MEDLINE and EMBASE was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Of 3002 articles,64 publications met the eligibility criteria with a total of 900 patients(468 covered SEMS,432 uncovered SEMS).The collected data were analyzed using Statistical Package for the Social Sciences version 11.5.RESULTS Covered SEMS showed a higher success rate of insertion(98.6%vs 88.2%)and lower complication rates of infection(1.3%vs 13.2%),restenosis(1.5%vs 10.6%),stent fracture(2.6%vs 7.4%),bleeding(0%vs 5.8%),and pneumothorax(0%vs 2.8%)compared to uncovered SEMS.However,covered SEMS compared to uncovered SEMS showed higher complication rates of stent migration(12.4%vs 6.9%)and granulation tissue formation(26.5%vs 20.1%).CONCLUSION Our study suggests that covered SEMS are an effective,safe,and viable option in the treatment of BAS.Thus,further consideration regarding the utilization of covered SEMS over other forms of stent types is appropriate.
基金Supported by Natural Science Foundation of Hubei Province(No.2023BCB147,No.2023AFB1026).
文摘AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.
基金supported by Institute level project of the Second Affiliated Hospital of Xi’an Medical University(X2Y-R13)。
文摘Objective This study aimed to evaluate the effectiveness of acupuncture for benign prostatic hyperplasia(BPH).Methods We searched PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,Chinese National Knowledge Infrastructure,Wanfang Data,and China Science and Technology Journal Database from their inceptions to February 1,2022.The language was restricted to English and Chinese.Two researchers independently screened the literature,extracted data,and evaluated the risk bias of the included study according to the Cochrane Handbook 5.1.0.A meta-analysis was performed using Review Manager version 5.3.Results Twenty-two studies with 1,765 participants were selected to be incorporated in the meta-analysis.The experimental groups(EGs)showed greater benefit on therapeutic effects(relative risk[RR]:1.23,95%CI:1.16,1.3;P<0.00001),International Prostate Score Scale(mean difference[MD]:-2.06,95%CI:-3.17,-0.96;P=0.0002),maximum urinary flow rate(MD:1.7,95%CI:0.89,2.52;P<0.0001),postvoid residual urine volume(MD:-8.25,95%CI:-12.14,-4.36;P<0.0001),quality of life(MD:-0.55,95%CI:-0.8,-0.29;p<0.0001)compared with the control groups,whereas for prostate volume(MD:-0.87,95%CI:-2.66,0.92;P=0.34)was not significantly improved in the EGs.Nevertheless,no statistical variation in the reduction of adverse reactions was observed.Conclusion Acupuncture therapy,a wildly applied complementary–alternative treatment,may help in the management of BPH.
基金funded by National Natural Science Foundation of China(82072846 to Xu B).
文摘Objective:Robot-assisted simple prostatectomy(RASP)is increasingly used as a surgical treatment option for large benign prostatic hyperplasia(BPH)(>80 mL).However,there is no sufficient expert consensus or guidelines to guide clinical practice.We aimed to obtain expert opinions for RASP for large BPH.Methods:A systematic review of the literature was performed in April 2024 using the PubMed,Embase,and Web of Science databases.Search terms were combined to construct the following search strings:(robotic)AND(simple OR benign)AND(prostatectomy).Search results were filtered by language(English only),species(human),and publication type(original article).This study used a two-phase modified Delphi approach.Results:In this expert consensus,some frequently used RASP techniques,including robot-assisted retropubic prostatectomy,robot-assisted transvesical prostatectomy,and robot-assisted urethra-sparing prostatectomy,are described.RASP offers a short learning curve for surgeons with experience in robotic surgery.Severe complications are rare in patients who undergo RASP.Conclusion:RASP technique can be recommended as a safe and effective minimally invasive treatment for symptomatic BPH patients with large prostate glands.
文摘Objective:To analyze the significance of high-frequency ultrasound in differentiating benign and malignant breast micronodules.Methods:Eighty-five patients with breast micronodules admitted for diagnosis between October 2022 and October 2024 were selected for high-frequency ultrasound diagnosis.The diagnostic efficacy of high-frequency ultrasound was evaluated by comparing it with the results of surgical pathology.Results:High-frequency ultrasound detected 50 benign nodules,primarily breast fibroadenomas,and 35 malignant nodules,mainly breast ductal carcinoma in situ.Based on surgical pathology results,the diagnostic accuracy of high-frequency ultrasound was 96.47%,specificity was 97.96%,and sensitivity was 94.44%.In high-frequency ultrasound diagnosis,the proportion of grade III and IV blood flow in malignant nodules was higher than that in benign nodules,while the proportion of regular shape and clear margins was lower.The proportion of microcalcifications and posterior echo attenuation was higher in malignant nodules,and the resistance index(RI)and peak blood flow velocity were lower than those in benign nodules(P<0.05).Conclusion:High-frequency ultrasound can effectively differentiate benign and malignant breast micronodules,determine specific nodule types,and exhibits high diagnostic accuracy and sensitivity.Additionally,benign and malignant nodules can be differentiated based on the grading of blood flow signals,sonographic features,and blood flow velocity,providing reasonable guidance for subsequent treatment plans.
文摘BACKGROUND Benign recurrent intrahepatic cholestasis(BRIC)is a rare autosomal recessive liver disease,causing episodic cholestasis with intense pruritus.This case report highlights the effectiveness of early plasmapheresis as a therapeutic option for BRIC type 2,offering rapid symptom relief and early termination of cholestatic episodes.It contributes to the limited evidence supporting plasmapheresis as a treatment for BRIC flares resistant to conventional therapies.CASE SUMMARY A 43-year-old male with BRIC type 2 presented with fatigue,jaundice,and severe pruritus,triggered by a recent mild severe acute respiratory syndrome coronavirus 2 infection.Laboratory results confirmed cholestasis with elevated bilirubin and alkaline phosphatase.First-line pharmacological treatments,including cholestyramine and rifampicin,failed.Endoscopic nasobiliary drainage was ineffective,prompting initiation of plasmapheresis.This intervention rapidly relieved pruritus,with complete biochemical normalisation after 11 sessions.Two years later,a similar episode occurred,and early reinitiation of plasmapheresis led to symptom resolution within two sessions and biochemical recovery within two weeks.The patient tolerated the procedure well,with no adverse effects observed.Follow-up showed no signs of cholestasis recurrence.CONCLUSION Plasmapheresis is a safe and effective option for therapy-refractory BRIC type 2,particularly when initiated early in cholestasis.
文摘Benign prostatic hyperplasia(BPH)represents a prevalent etiology of lower urinary tract symptoms(LUTS)in the male population,clinically defined by a nonmalignant proliferation of prostatic tissue.While BPH exhibits a high prevalence among older male populations globally,the precise underlying mechanisms contributing to its development remain incompletely elucidated.Mitochondria,essential organelles within eukaryotic cells,are critical for cellular bioenergetics,the regulation of reactive oxygen species(ROS)generation,and the modulation of cell death pathways.The maintenance of mitochondrial homeostasis involves a complex interplay of processes.By synthesizing previous literature,this review discusses mitochondrial homeostasis in prostate glands and the role of mitochondrial dysfunction in the context of BPH.Furthermore,the review delved into each dimension of mitochondrial dysfunction in the specific etiology of BPH,highlighting its impact on cell survival,apoptosis,ferroptosis,oxidative stress and androgen receptor(AR).Overall,this review aims to unveil the crosstalk between mitochondrial dysfunction and BPH and identify intrinsic mechanisms.
文摘Benign esophageal stricture is characterized by the narrowing of the digestivetract lumen due to multiple factors. Endoscopic treatment is the first treatmentchoice and includes endoscopic dilatation, drug injection, stenosis incision, stentimplantation, stem cell flap transplantation, etc. However, there are currently nospecific clinical standards or guidelines to quantify a series of specific parametersin the treatment of benign esophageal stricture, such as the frequency of drugadministration, dosage, dilation inner diameter, and number of treatments. Thisleads to operator bias in clinical practice and inconsistent treatment outcomesamong patients. Therefore, this article reviews the current advances and existingchallenges in the endoscopic treatment of benign esophageal stricture, with theaim of exploring the possibility of achieving precision and standardization in theendoscopic treatment of this disease.
文摘Objective:Thulium fiber laser enucleation of the prostate(ThuFLEP)and robot-assisted simple prostatectomy(RASP)are two options for treating large benign prostatic hyperplasia.The most appropriate technique remains a matter of debate.We evaluated the efficacy and safety of ThuFLEP compared to RASP.Methods:Between January 2020 and December 2023,all patients who underwent either RASP or ThuFLEP for a prostate volume>80 mL were retrospectively included.The surgical procedure choice was left to the surgeon’s and patient’s discretion.Preoperative patient evaluation included the assessment of functional parameters.The groups were compared.Results:A total of 234 patients were included:106(45%)underwent RASP and 128(55%)underwent ThuFLEP.The mean operative time was shorter in the ThuFLEP group compared to the RASP group(106.4 with standard deviation[SD]46.1 min vs.123.2[SD 32.8]min,p=0.012).The mean lengths of catheterization and stay were significantly longer in the RASP group(5.0[SD 3.9]days vs.1.7[SD 2.0]days,p=0.009[catheterization]and 4.9[SD 3.0]days vs.1.9[SD 1.8]days,p=0.009[stay]).The overall complication rate was significantly higher in the ThuFLEP group(12%vs.2.8%in the RASP group,p=0.022).However,we did not observe significant differences in major complications(Clavien-Dindo≥3)between the two groups(four[3.1%]in the ThuFLEP group vs.one[0.94%]in the RASP group,p=0.073).At 3 months,the rate of stress urinary incontinence was 4.7%after ThuFLEP and 1.9%after RASP(p=0.2).Finally,the quality of life score and maximum urinary flow were comparable between the ThuFLEP and RASP groups,but the International Prostate Symptom Score at 3 months postoperatively was lower in the RASP group(p=0.012).Conclusion:Both ThuFLEP and RASP are safe techniques with comparable functional outcomes for large benign prostatic hyperplasia.ThuFLEP allows a reduction in catheterization and hospitalization durations but presents more complications compared to RASP.
基金supported(in part)by the National Natural Science Foundation of China(82200862,82370778)the Hubei Provincial Natural Science Foundation(2022CFB681,2023AFA061,2019CFB760)+4 种基金the Hubei Province Health and Family Planning Scientific Research Project(WJ2023M058,WJ2019H035)the Key Scientific Research Project of Education Department of Henan Province(22A320038)the Fundamental Research Funds for the Central Universities(2042023kf1019,2042023kf0051,2042022kf0072)the Zhongnan Hospital of Wuhan University,Science Technology and Innovation Seed Fund(CXPY2022074)the Young Top-notch Talent Cultivation Program of Hubei Province(for Prof.Zeng XT).
文摘Background:Benign prostatic hyperplasia(BPH)is the most common disease in elderly men.There is increasing evidence that periodontitis increases the risk of BPH,but the specific mechanism remains unclear.This study aimed to explore the role and mechanism of the key periodontal pathogen Porphyromonas gingivalis(P.gingivalis)in the development of BPH.Methods:The subgingival plaque(Sp)and prostatic fluid(Pf)of patients with BPH concurrent periodontitis were extracted and cultured for 16S r DNA sequencing.Ligature-induced periodontitis,testosterone-induced BPH and the composite models in rats were established.The P.gingivalis and its toxic factor P.gingivalis lipopolysaccharide(P.gLPS)were injected into the ventral lobe of prostate in rats to simulate its colonization of prostate.P.g-LPS was used to construct the prostate cell infection model for mechanism exploration.Results:P.gingivalis,Streptococcus oralis,Capnocytophaga ochracea and other oral pathogens were simultaneously detected in the Sp and Pf of patients with BPH concurrent periodontitis,and the average relative abundance of P.gingivalis was found to be the highest.P.gingivalis was detected in both Sp and Pf in 62.5%of patients.Simultaneous periodontitis and BPH synergistically aggravated prostate histological changes.P.gingivalis and P.gLPS infection could induce obvious hyperplasia of the prostate epithelium and stroma(epithelial thickness was 2.97-fold and 3.08-fold that of control group,respectively),and increase of collagen fibrosis(3.81-fold and 5.02-fold that of control group,respectively).P.gingivalis infection promoted prostate cell proliferation,inhibited apoptosis,and upregulated the expression of inflammatory cytokines interleukin-6(IL-6;4.47-fold),interleukin-6 receptor-α(IL-6Rα;5.74-fold)and glycoprotein 130(gp130;4.47-fold)in prostatic tissue.P.g-LPS could significantly inhibit cell apoptosis,promote mitosis and proliferation of cells.P.g-LPS activates the Akt pathway through IL-6/IL-6Rα/gp130 complex,which destroys the imbalance between proliferation and apoptosis of prostate cells,induces BPH.Conclusion:P.gingivalis was abundant in the Pf of patients with BPH concurrent periodontitis.P.gingivalis infection can promote BPH,which may affect the progression of BPH via inflammation and the Akt signaling pathway.
基金supported by the National Key Research and Development Program of China(2022YFC3600700)the National Natural Science Foundation of China(82370778)+2 种基金the Hubei Provincial Natural Science Foundation of China(2023AFA061)the Fundamental Research Funds for the Central Universities(2042024kf1043)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Zeng XT).
文摘Background:Fibrosis constitutes a significant pathophysiological mechanism in the clinical progression of benign prostatic hyperplasia(BPH)and represents a contributing factor to the ineffectiveness of prevailing pharmacological treatments.Emerging evidence suggests a close association between microbial presence and the development of fibrosis.Nonetheless,the potential involvement of microbes within prostatic tissue in the pathogenesis of BPH and prostatic fibrosis,along with the underlying mechanisms,remains unexplored.Methods:Utilizing immunohistochemistry and microbial sequencing,we analyzed the microbes of prostate tissues from BPH patients with different degrees of prostate fibrosis and found that Salmonellaenterica(S.enterica)was enriched in the high degree of prostate fibrosis.We developed prostate cell and animal models infected with the lipopolysaccharide of S.enterica(S.e-LPS)to assess its impact on prostate fibrosis.To elucidate the underlying functional mechanisms,we employed molecular biology techniques,including RNA degradation assays,N6-methyladenosine(m6A)dot blotting,RNA immunoprecipitation,and m6A immunoprecipitation.Results:Microbial diversity differed between low-and high-fibrosis groups,with S.enterica showing the highest mean abundance among the 4 species that differed significantly.S.e-LPS was detected in S.enterica-rich prostate tissue and was found to significantly promote cell proliferation,cell contractility,lipid peroxidation,and the induction of ferroptosis.Animal experiments demonstrated that S.e-LPS infection led to pronounced hyperplasia of the prostatic epithelium,with epithelial thickness increasing to 1.57 times that of the sham group,and collagen fibrosis increasing to 2.84 times that of the sham group,thereby exacerbating prostatic tissue fibrosis in rats.Invitro experiments further revealed that S.e-LPS promoted prostate cell fibrosis by inducing ferroptosis.Mechanistically,it was determined that S.e-LPS regulates ferroptosis via AlkB homolog 5(ALKBH5)-mediated m6A modification,which affects the stability of glutathione peroxidase 4(GPX4)mRNA,thereby affecting prostatic fibrosis.Conclusion:The findings of this study suggest that S.enterica promotes prostatic fibrosis through ALKBH5-m6A-GPX4-mediated ferroptosis.This research offers novel insights for the development of new therapeutic targets and personalized strategies for the prevention and treatment of BPH from the perspectives of microbes and epigenetics.
基金Hebei Provincial Administration of Traditional Chinese Medicine Scientific Research Project (2025576).
文摘Benign prostatic hyperplasia(BPH)is a common condition affecting the quality of life and health status of elderly men.Its incidence increases with age and is often accompanied by symptoms such as urinary frequency,urgency,nocturia,difficulty voiding,and even urinary retention.While conventional Western medicine can alleviate symptoms,it frequently carries risks of side effects and disease recurrence.Traditional Chinese Medicine approaches this condition based on the characteristic patterns observed in the elderly population:predominantly deficiency and blood stasis,with chronic conditions leading to blood stasis.The Yiqi Huoxue method—aimed at tonifying Qi and activating blood circulation—has been shown to improve urinary symptoms,enhance quality of life,and promote overall health in elderly BPH patients.This article explores the application of the Yiqi Huoxue therapeutic principle in managing benign prostatic hyperplasia.
基金supported(in part)by the National Key Research and Development Program(2022YFC3600700)the Fundamental Research Funds for the Central Universities(2042024YXA008)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Xian-Tao Zeng).
文摘Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
文摘In 2013,the World Health Organization defined perivascular epithelioid cell tumor(PEComa)as“a mesenchymal tumor which shows a local association with vessel walls and usually expresses melanocyte and smooth muscle markers.”This generic definition seems to better fit the PEComa family,which includes angiomyolipoma,clear cell sugar tumor of the lung,lymphangioleiomyomatosis,and a group of histologically and immunophenotypically similar tumors that include primary extrapulmonary sugar tumor and clear cell myomelanocytic tumor.Clear cell tumors with this immunophenotypic pattern have also had their malignant variants described.When localizing to the liver,preoperative radiological diagnosis has proven to be very difficult,and most patients have been diagnosed with hepatocellular carcinoma,focal nodular hyperplasia,hemangioma,or hepatic adenoma based on imaging findings.Examples of a malignant variant of the liver have been described.Finally,reports of malignant variants of these lesions have increased in recent years.Therefore,we support the use of the Folpe criteria,which in 2005 established the criteria for categorizing a PEComa as benign,malignant,or of uncertain malignant potential.Although they are not considered ideal,they currently seem to be the best approach and could be used for the categorization of liver tumors.
基金supported by the 2021 Grant from the Korean Society of Ginseng。
文摘Panax ginseng(C.A.Mey.)has been traditionally employed in Korea and China to alleviate fatigue and digestive disorders.In particular,Korean red ginseng(KRG),derived from streamed and dried P.ginseng,is known for its anti-aging and anti-inflammatory properties.However,its effects on benign prostatic hyperplasia(BPH),a representative aging-related disease,and the underlying mechanisms remain unclear.This study aims to elucidate the therapeutic effects of KRG on BPH,with a particular focus on mitochondrial dynamics,including fission and fusion processes.The effects of KRG on cell proliferation,apoptosis,and mitochondrial dynamics and morphology were evaluated in a rat model of testosterone propionate(TP)-induced BPH and TP-treated LNCaP cells,with mdivi-1 as a control.The results revealed that KRG treatment reduced the levels of androgen receptors(AR)and prostate-specific antigens in the BPH group.KRG inhibited cell proliferation by downregulating cyclin D and proliferating cell nuclear antigen(PCNA)levels,and it promoted apoptosis by increasing the ratio of B-cell lymphoma protein 2(Bcl-2)-associated X protein(Bax)to Bcl-2 expression.Notably,KRG treatment enhanced the phosphorylation of dynamin-related protein 1(DRP-1,serine 637)compared with that in the BPH group,which inhibited mitochondrial fission and led to mitochondrial elongation.This modulation of mitochondrial dynamics was associated with decreased cell proliferation and increased apoptosis.By dysregulating AR signaling and inhibiting mitochondrial fission through enhanced DRP-1(ser637)phosphorylation,KRG effectively reduced cell proliferation and induced apoptosis.These findings suggest that KRG’s regulation of mitochondrial dynamics offers a promising clinical approach for the treatment of BPH.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF)funded by the Ministry of Education,Science and Technology (NRF2020R1A2C1014798 to E-K Kim)。
文摘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.
文摘This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy(TUEB)for benignprostatic hyperplasia.The study involved 494 consecutive patients who underwent TUEB for benign prostatic hyperplasia fromAugust 2018 to March 2022 by one surgeon(SJJ,Seoul National University Bundang Hospital,Seongnam,Korea).The patientswere followed up at 1 week,1 month,3 months,and 6 months postoperatively.To evaluate the learning curve of TUEB,perioperativeparameters including the enucleation ratio(enucleated tissue weight/transitional zone volume),TUEB efficiency(enucleatedtissue weight/operation time),and enucleation efficiency(enucleated tissue weight/enucleation time)were analyzed.Functionaloutcomes and postoperative complications were also assessed,including the International Prostate Symptom Score(IPSS),IPSSquality-of-life(QoL)score,and uroflowmetry outcomes.The patients’median age was 72(interquartile range[IQR]:66–78)years,and the estimated prostate volume and transitional zone volume were 63.0(IQR:46.0–90.6)ml and 37.1(IQR:24.0–60.0)ml,respectively.The enucleation ratio,TUEB efficiency,and enucleation efficiency were 0.60(IQR:0.46–0.54)g ml−1,0.33(IQR:0.22–0.46)g min−1,and 0.50(IQR:0.35–0.72)g min−1,respectively,plateauing after 70 cases.The functional outcomes,including total IPSS,IPSS QoL score,and uroflowmetry outcomes,significantly improved at 6 months after TUEB(all P<0.05),but without significant differences over the learning curve.Sixty-five(13.2%)patients developed complications after TUEB,21.5%of whom experienced major complications(Clavien–Dindo grade≥3).The rate of major complications declined as the number ofTUEB cases increased(P=0.013).Our results suggest that the efficiency of TUEB stabilized within 70 procedures.
