• 文章类型: Journal Article
    背景:勃起功能障碍可导致自我戒断和生活质量下降。对药物治疗和其他保守治疗无反应的患者应进行阴茎假体植入。可塑阴茎假体是第一个开发的假体,但后来开发了充气阴茎假体,以提供更自然的勃起。没有荟萃分析在安全性和有效性方面比较充气和可塑阴茎假体。这项研究旨在评估患者和伴侣的满意度,易用性,机械故障,阴茎假体植入患者的感染率。
    方法:本荟萃分析遵循系统评价和荟萃分析(PRISMA)方案的首选报告项目。五项符合条件的研究来自Pubmed,Scopus,ScienceDirect,和SemanticScholar数据库。
    结果:在这项研究中,患者和伴侣的满意度显著提高(OR3.39,95%CI1.66-6.93,p=0.0008)(OR2.32,95%CI1.75-3.08,p<0.00001).可充气阴茎假体的机械故障也显着较高(OR5.60,95%CI2.02-15.53,p=0.0009)。充气或可塑阴茎假体在易用性和感染率方面没有显着差异。
    结论:这项研究得出结论,充气阴茎假体在患者和伴侣满意度方面更好,但是在这种类型的假体中,机械故障发生得更频繁。
    BACKGROUND: Erectile dysfunction can cause self-withdrawal and decreased quality of life. Patients who do not respond to pharmacological therapy and other conservative treatments are urged to undergo penile prosthesis implantation. Malleable penile prosthesis was the first prosthesis developed, but then inflatable penile prosthesis was developed to give a more natural erection. There is no meta-analysis comparing inflatable and malleable penile prostheses in terms of safety and efficacy. This study is conducted to evaluate patient and partner satisfaction, ease of use, mechanical failure, and infection rate in patients who underwent penile prosthesis implantation.
    METHODS: This meta-analysis followed Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols. Five eligible studies were included from Pubmed, Scopus, ScienceDirect, and SemanticScholar databases.
    RESULTS: In this study, patient and partner satisfaction are significantly better (OR 3.39, 95% CI 1.66-6.93, p = 0.0008) (OR 2.32, 95% CI 1.75-3.08, p < 0.00001). Mechanical failure is also significantly higher in inflatable penile prostheses (OR 5.60, 95% CI 2.02-15.53, p = 0.0009). There is no significant difference in terms of ease of use and infection rate in inflatable or malleable penile prostheses.
    CONCLUSIONS: This study concluded that inflatable penile prosthesis is better in terms of patient and partner satisfaction, but mechanical failures occur more frequently in this type of prosthesis.
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  • 文章类型: Journal Article
    在观察性研究中,血清25-羟基维生素D水平与勃起功能障碍(ED)相关。然而,它们之间是否存在因果关系仍然不确定。
    进行两个样本的孟德尔随机化(MR)分析,以调查血清25-羟基维生素D水平与ED风险之间的因果关系。
    来自496,949名欧洲血统的人的血清25-羟基维生素D水平的全基因组关联研究(GWAS)数据,包括6,896,093个单核苷酸多态性(SNP),被视为MR分析的暴露。其他GWAS数据涉及6,175例欧洲ED病例和217,630例对照中的9,310,196个SNP被用作结果数据。MR-Egger,逆方差加权(IVW)方法,加权中位数,简单模式,并采用加权模式来评估因果效应,其中IVW是主要的MR分析方法。通过异质性测试证实了MR分析结果的稳定性,水平多效性测试,和留一法。
    有103个SNP用作工具变量(p<5×10-8)。MR分析结果表明,血清25(OH)D浓度对ED风险没有因果关系(IVW;OR=0.9516,95%CI=0.7994至1.1328,p=0.5772)。统计模型中没有异质性和多效性。
    目前的MR研究不支持基因预测的血清25-羟基维生素D浓度与欧洲血统个体ED风险的因果关系。
    UNASSIGNED: Serum 25-hydroxyvitamin D level is associated with erectile dysfunction (ED) in observational studies. However, whether there is a causal association between them remains uncertain.
    UNASSIGNED: Conduct a two-sample Mendelian randomization (MR) analysis to investigate the causal effect between serum 25-hydroxyvitamin D level and ED risk.
    UNASSIGNED: Genome-wide association study (GWAS) data of serum 25-hydroxyvitamin D levels comprising 6,896,093 single nucleotide polymorphisms (SNP) from 496,949 people of European ancestry were regarded as exposure for the MR analysis. Additional GWAS data involving 9,310,196 SNPs of 6,175 European ED cases and 217,630 controls were used as outcome data. The MR-Egger, inverse variance weighted (IVW) method, weighted median, simple mode, and weighted mode were employed to evaluate causal effects, among which IVW was the primary MR analysis method. The stability of the MR analysis results was confirmed by a heterogeneity test, a horizontal pleiotropy test, and the leave-one-out method.
    UNASSIGNED: There were 103 SNPs utilized as instrumental variables (p < 5 × 10-8). The results of MR analysis showed no causal effects of serum 25(OH) D concentration on ED risks (IVW; OR = 0.9516, 95% CI = 0.7994 to 1.1328, p = 0.5772). There was no heterogeneity and pleiotropy in the statistical models.
    UNASSIGNED: The present MR study did not support a causal association for genetically predicted serum 25-hydroxyvitamin D concentration in the risk of ED in individuals of European descent.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    阴茎癌是一种罕见的恶性肿瘤,预后不良。单剂免疫检查点抑制剂(ICIs)的研究已经证明了疗效,但是应答率很低。将ICIs与化疗和靶向治疗相结合的研究正在进行中。多达50%的阴茎癌病例与人乳头瘤病毒(HPV)有关。HPV靶向治疗,如HPV靶向疫苗和T细胞受体疗法,是一个积极调查的领域。阴茎癌细胞还表达细胞表面抗原,这些抗原可能被新兴类别的抗体-药物缀合物靶向。
    Penile cancer is a rare malignancy with a poor prognosis. Studies with single-agent immune checkpoint inhibitors (ICIs) have demonstrated efficacy, but response rates are low. Studies combining ICIs with both chemotherapy and targeted therapy are ongoing. Up to 50% of penile cancer cases are associated with human papillomavirus (HPV). HPV-targeting therapies, such as HPV-targeting vaccines and T-cell receptor therapies, are an area of active investigation. Penile cancer cells also express cell surface antigens that may be targeted by the emerging class of antibody-drug conjugates.
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  • 文章类型: Journal Article
    本文综述了阴茎鳞状细胞癌(PSCC),一种罕见的泌尿生殖系统癌症,患病率一直在增加。它讨论了新兴的疗法,专注于免疫疗法,疫苗治疗,和基于细胞的治疗,特别是在与人乳头瘤病毒相关的PSCC的背景下。讨论了影响这些疗法的因素。这些包括免疫微环境,程序性细胞死亡配体-1表达,和肿瘤免疫细胞浸润。本文还重点介绍了免疫检查点抑制剂和相关的临床试验。这篇综述支持个性化药物在治疗PSCC中的应用。它强调需要合作研究和数据共享,以制定具体的治疗计划并取得更好的结果。
    This article reviews penile squamous cell carcinoma (PSCC), a rare genitourinary cancer that has been increasing in prevalence. It discusses emerging therapies, focusing on immunotherapy, vaccine therapy, and cell-based treatments, especially in the context of human papillomavirus-related PSCC. Factors influencing these therapies are discussed. These include the immune microenvironment, programmed cell death ligand-1 expression, and tumor immune cell infiltration. This article also highlights immune checkpoint inhibitors and related clinical trials. This review supports the use of personalized medicine in treating PSCC. It stresses the need for collaborative studies and data sharing to create specific treatment plans and achieve better outcomes.
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  • 文章类型: Journal Article
    阴茎癌(PC),虽然罕见,在诊断和治疗方面都提出了重大挑战。阴茎鳞状细胞癌(PSCC)是PC最常见的组织学亚型,约占病例的95%。有限的治疗选择,全身治疗已成为晚期PSCC管理的关键组成部分.临床研究的最新进展揭示了新治疗策略的有效性。通过阐明这些治疗的作用机制和临床证据,我们致力于为受这种复杂疾病影响的患者提供优化治疗策略和提高护理质量的见解.
    Penile cancer (PC), although rare, poses significant challenges in both diagnosis and treatment. Penile squamous cell carcinoma (PSCC) represents the most common histologic subtype of PC, accounting for approximately 95% of cases. With limited therapeutic options available, systemic therapies have emerged as critical components in the management of advanced PSCC. Recent developments in clinical research have revealed the effectiveness of new therapeutic strategies. By elucidating the mechanism of action and clinical evidence supporting these treatments, we strive to offer insights into optimizing treatment strategies and enhancing the quality of care for patients affected by this complex disease.
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  • 文章类型: Journal Article
    具有大腹股沟转移的阴茎癌具有很高的可能性,在多学科护理环境中最好地治疗病理累及的淋巴结。对可疑淋巴结进行横断面成像和细针抽吸细胞学检查,以适当的分期指导决策,以使用基于铂的新辅助化疗,然后进行腹股沟淋巴结清扫。手术切除起着重要的诊断,治疗性的,以及在疾病管理中的指导作用。具有不良病理特征的患者,尤其是那些患有结外疾病的人,可能从辅助放疗中获得额外的益处。
    Penile cancer with bulky inguinal metastasis has a high probability of harboring pathologically involved lymph nodes best managed in a multidisciplinary care setting. Appropriate staging with cross-sectional imaging and fine-needle aspirate cytology of suspicious nodes guide decision-making for the use of platinum-based neoadjuvant chemotherapy followed by inguinal lymph node dissection. Surgical resection plays an important diagnostic, therapeutic, and guiding role in disease management. Patients with adverse pathologic features, especially those with extranodal disease extension, may derive additional benefit from adjuvant radiotherapy.
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  • 文章类型: Journal Article
    阴茎癌是一种罕见的癌症,患者不仅需要应对癌症诊断的焦虑,还要管理治疗对他们自尊的影响,身体形象,和亲密关系。许多人感到尴尬,很难与家人和朋友交谈。由于这个原因,排尿的变化和治疗的其他身体影响,许多人也会退出社交活动。患者需要社会心理支持,需要做更多的工作来解决这种未满足的需求。临床中的整体和多学科方法,有了咨询,可以帮助患者适应新情况。
    Penile cancer is a rare cancer, where patients not only need to deal with the anxiety around a cancer diagnosis, but also manage the consequences of treatment on their self-esteem, body image, and intimate relationships. Many find it embarrassing and difficult to talk to family and friends. Due to this, changes in urination and other physical effects of treatment, many will withdraw from social activities too. Patients need psychosocial support and more needs to be done to address this unmet need. Holistic and multidisciplinary approaches in clinic, with access to counseling, may help patients adjust to their new situation.
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  • 文章类型: Journal Article
    自从世界卫生组织对泌尿生殖系统癌症的新分类和最近的欧洲泌尿外科协会/美国临床肿瘤学协会指南以来,阴茎鳞状细胞癌(SCC-P)的景观发生了重大变化。这些变化强调了将SCC-P根据其与人乳头瘤病毒(HPV)感染的相关性分为2组的必要性。这种转变具有重大影响,考虑到先验知识是从这两组的混合中得出的。鉴于不同的预后,治疗方案,以及在其他身体部位观察到的HPV相关肿瘤的分期系统,现在出现的问题是:SCC-P会出现类似的模式吗?
    The landscape of squamous cell carcinoma of the penis (SCC-P) has undergone a significant transformation since the new World Health Organization classification of genitourinary cancers and recent European Association of Urology/American Association of Clinical Oncology guidelines. These changes emphasize the necessity to categorize SCC-P into 2 groups based on its association with human papillomavirus (HPV) infection. This shift has major implications, considering that prior knowledge was derived from a mix of both groups. Given the distinct prognosis, treatment options, and staging systems observed for HPV-associated tumors in other body areas, the question now arises: will similar patterns emerge for SCC-P?
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  • 文章类型: Journal Article
    背景:Peyronie病的特征是阴茎白膜中纤维化斑块的形成。有效的治疗方法有限,保证研究新的有希望的疗法,例如调节纤维化相关基因的microRNAs的应用。
    目的:我们旨在研究在纤维蛋白诱导的Peyronie病大鼠模型中模拟microRNA-29b的治疗潜力。
    方法:本研究分为两个阶段。为了建立最佳的佩罗尼病模型,在第0天和第5天,大鼠在白膜中接受了人纤维蛋白和凝血酶或盐溶液。通过表达和组织病理学分析进行动物模型验证。最新的是一位经验丰富的泌尿病理学家。验证后,我们在研究的第14,21和28天进行了microRNA-29b治疗.该阶段具有对照(生理盐水)和乱序(microRNA乱序)组。在第30天取出阴茎中轴,用于两个研究阶段的组织学检查和分子分析。
    结果:对照组在动物模型验证中显示出典型的白膜组织学结构。在佩罗尼的疾病组中,苏木精和伊红和Masson三色染色方法显示间质炎症过程,伴随致密纤维化斑块以及胶原纤维紊乱.此外,我们发现,在Peyronie病组中,减少的microRNA-29b(p=0.05)与显著增加的COL1A1和转化生长因子β1基因和蛋白(p>0.05)相关。用模拟microRNA-29b刺激处理后,苏木精和伊红和Masson三色染色显示一个离散的和较不致密的纤维化斑块。该结果与COL1A1,COL3A1和转化生长因子β1基因和蛋白质的表达显着降低有关(p<0.05)。
    结论:与对照组相比,纤维蛋白诱导的动物模型显示出明显的组织病理学和分子学变化,这表明我们的模型是合适的。先前的研究结果表明,microRNA-29b的表达增加与病理性纤维化的减少有关。在本研究中,用microRNA-29b处理降低了胶原蛋白和转化生长因子β1的基因和蛋白质表达。这项研究揭示了涉及分子靶标的Peyronie病的治疗潜力。
    结论:MicroRNA-29b应用于大鼠白膜减毒纤维化,作为佩罗尼疾病管理的一种新的潜在策略。
    BACKGROUND: Peyronie\'s disease is characterized by the formation of fibrotic plaques in the penile tunica albuginea. Effective treatments are limited, warranting the investigation of new promising therapies, such as the application of microRNAs that regulate fibrosis-related genes.
    OBJECTIVE: We aimed to investigate the therapeutic potential of mimicking microRNA-29b in a fibrin-induced rat model of Peyronie\'s disease.
    METHODS: The study was designed in two phases. To establish an optimal Peyronie\'s disease model, rats received either human fibrin and thrombin or saline solutions into the tunica albuginea on days 0 and 5. The animal model validation was done through expression and histopathological analyses, the latest by an experienced uropathologist. After validation, we performed microRNA-29b treatment on days 14, 21, and 28 of the study. This phase had control (normal saline) and scramble (microRNA scramble) groups. The mid-penile shaft was removed on day 30 for histological examination and molecular analyses in both study stages.
    RESULTS: The control group displayed typical tunica albuginea histologic architecture in the animal model validation. In Peyronie\'s disease group, the Hematoxylin and eosin and Masson Trichrome staining methods demonstrated an interstitial inflammatory process with concomitant dense fibrotic plaques as well as disarrangement of collagen fibers. Additionally, we found out that reduced microRNA-29b (p = 0.05) was associated with significantly increased COL1A1 and transforming growth factor β1 genes and proteins (p > 0.05) in the Peyronie\'s disease group. After treatment with mimic microRNA-29b stimulation, the Hematoxylin & eosin and Masson Trichrome staining revealed a discrete and less dense fibrotic plaque. This result was associated with significantly decreasing expression of COL1A1, COL3A1, and transforming growth factor β1 genes and proteins (p < 0.05).
    CONCLUSIONS: The fibrin-induced animal model showed significant histopathological and molecular changes compared to the Control group, suggesting that our model was appropriate. Previous findings have shown that increased expression of microRNA-29b was associated with decreased pathological fibrosis. In the present study, treatment with microRNA-29b decreased the gene and protein expression of collagens and transforming growth factor β1. This study reveals the therapeutic potential for Peyronie\'s disease involving molecular targets.
    CONCLUSIONS: MicroRNA-29b application on the rat\'s tunica albuginea attenuated fibrosis, arising as a novel potential strategy for Peyronie\'s disease management.
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