Background and Aims:Patients with end-stage liver disease(ESLD)frequently experience persistent pruritus,which significantly impairs their quality of life.Although relief of pruritus after liver transplantation is often attributed to the normalization of bilirubin levels,the role of skin microbiota in developing pruritus remains unclear.This study aimed to investigate the dynamic changes in skin microbiota during the perioperative period of liver transplantation in ESLD patients and to explore their association with pruritic symptoms.Methods:Fifteen ESLD patients treated in the Third Xiangya Hospital between 2022 and 2023 were enrolled and skin swabs were collected from the anterior tibial region at three time points:before liver transplantation and on postoperative days 7 and 30.Skin samples from 15 age-matched healthy controls were collected at the same anatomical site.Microbial composition was analyzed using 16S rRNA sequencing.Meanwhile,pruritus severity was assessed using a visual analogue scale(VAS),and multiple serological indicators were measured to evaluate correlations between microbiota changes,pruritus severity,and liver function parameters.Results:Compared with healthy controls,ESLD patients exhibited significantly altered β-diversity in skin microbiota and an increased relative abundance of Staphylococcus(LDA>4),which was strongly correlated with VAS scores for pruritus(r=0.93,Padj=3.08×10?1?).On postoperative day 7,α-diversity decreased,and Staphylococcus abundance peaked,then gradually normalized by day 30 as pruritus improved.Further analysis revealed that Staphylococcus abundance was positively correlated with alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,total bile acids,and international normalized ratio,and negatively correlated with albumin(all Padj<0.05).Notably,Staphylococcus levels were significantly higher in patients with moderate to severe pruritus(VAS score>5).Conclusion:ESLD patients demonstrate marked dysbiosis of the skin microbiota during the perioperative period of liver transplantation,characterized by an abnormal proliferation of Staphylococcus,which may contribute to the development and exacerbation of pruritus.Targeting the skin microbiome,particularly interventions against Staphylococcus,may offer a novel therapeutic strategy for alleviating pruritus in ESLD patients.

Background and Aims:Patients with end-stage liver disease(ESLD)frequently experience persistent pruritus,which significantly impairs their quality of life.Although relief of pruritus after liver transplantation is often attributed to the normalization of bilirubin levels,the role of skin microbiota in developing pruritus remains unclear.This study aimed to investigate the dynamic changes in skin microbiota during the perioperative period of liver transplantation in ESLD patients and to explore their association with pruritic symptoms.Methods:Fifteen ESLD patients treated in the Third Xiangya Hospital between 2022 and 2023 were enrolled and skin swabs were collected from the anterior tibial region at three time points:before liver transplantation and on postoperative days 7 and 30.Skin samples from 15 age-matched healthy controls were collected at the same anatomical site.Microbial composition was analyzed using 16S rRNA sequencing.Meanwhile,pruritus severity was assessed using a visual analogue scale(VAS),and multiple serological indicators were measured to evaluate correlations between microbiota changes,pruritus severity,and liver function parameters.Results:Compared with healthy controls,ESLD patients exhibited significantly altered β-diversity in skin microbiota and an increased relative abundance of Staphylococcus(LDA>4),which was strongly correlated with VAS scores for pruritus(r=0.93,Padj=3.08×10?1?).On postoperative day 7,α-diversity decreased,and Staphylococcus abundance peaked,then gradually normalized by day 30 as pruritus improved.Further analysis revealed that Staphylococcus abundance was positively correlated with alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,total bile acids,and international normalized ratio,and negatively correlated with albumin(all Padj<0.05).Notably,Staphylococcus levels were significantly higher in patients with moderate to severe pruritus(VAS score>5).Conclusion:ESLD patients demonstrate marked dysbiosis of the skin microbiota during the perioperative period of liver transplantation,characterized by an abnormal proliferation of Staphylococcus,which may contribute to the development and exacerbation of pruritus.Targeting the skin microbiome,particularly interventions against Staphylococcus,may offer a novel therapeutic strategy for alleviating pruritus in ESLD patients.

Objective To discuss the clinical effects of transurethral seminal vesiculoscopy in refractory hemospermia caused by seminal vesicle diseases.Methods The clinical data of 50 patients suffered from refractory hemospermia caused by seminal vesicle gland diseases were retrospectively analyzed from February 2012 to February 2014.Patients' age varied from 25 to 54 years old,mean (39.2 ± 9.2) years.The course of disease was (7.44 ± 2.6) months.There were 24 seminal vesiculitis,10 seminal ducts obstruction disease,and 16 seminal vesicle calculi disease.According to patients' priority,the patients were divided into surgical treatment group and conservative treatment group.In surgical group,there were 38 patients with age of (38.9 ± 8.8) years old,and the course of disease was (7.5 ± 2.5) months.There were 18 seminal vesiculitis,8 seminal ducts obstruction,and 12 seminal vesicle calculi.Whereas in conservative treatment group,there were 12 patients,with age of (40.2 ± 10.5) years old,and the course of disease was (7.3 ±2.9) months.Among them,there were 6 seminal vesiculitis,2 seminal ducts obstruction,and 4 seminal vesicle calculi.There was no significant difference between the two groups in patients age,course of disease and constitution of disease.The clinical data derived from the two treatment groups including the white blood cell counts (WBC) and red blood cell counts (RBC) in the seminal fluid,hematospermia rate,quality of life score,cure rate and improvement rate before and after the treatment were analysed.Results 1,3,6 months and 1 year after treatment,all observation indexes in the two groups had been ameliorated and had significant difference compared with those before treatment including WBC and RBC in the seminal fluid,hematospermia rate and quality of life score.No operative complications occurred in conservative treatment group.While a patient in surgical treatment group suffered from infection and recovered after levofloxacin treatment for a day.Six months after two kinds of treatment,in surgical treatment group,the cure rate was 55.2％,and the improvement rate was 36.8％.In the meanwhile,in conservative treatment group,the cure rate and the improvement rate were both 25.0％.A year after two different treatment,in surgical treatment group,the cure rate was 60.5％,the improvement rate was 34.2％.However,in conservative treatment group,the cure rate and improvement rate were both 8.3％.The effective rate of surgical group was much higher than that of conservative treatment group and the difference were significant.Conclusions Both transurethral seminal vesiculoscopy and conservative treatment have certain effects in relieving hemospermia.The transurethral seminal vesiculoscopy has obvious advantages over conservative treatment in improving the clinical effects of hemospermia after long duration.It could be used as a good supplement when medication fail.

To investigate effects of verapamil on primary cultured human urethral scar fibroblasts (USFs) and to provide basis for protecting the formation of urethra scar.
 Methods: The cell proliferation was evaluated with the cell counting kit (CCK)-8 method after USFs were incubated various verapamil concentrations (50, 100, 150, 200, or 250 μmol/L) or solvent for 12, 24, or 48 h. The protein level of matrix metalloproteinase (MMP) was evaluated with ELISA after cells were incubated with verapamil (100 μmol/L) or solvent (control cells) for 24 h.
 Results: The proliferation of USFs was obviously suppressed after verapamil treatment, which was in a dose-dependent and time-dependent manner. Meanwhile, the protein levels of MMP-2 and MMP-9 in the verapamil treatment group increased obviously compared with those of the control groups (P<0.05).
 Conclusion: Calcium channel blockers may prevent the excessive formation of urethra scar by inhibiting the proliferation of urethral scar fibroblasts and enhancing the activity of MMP.
Calcium Channel Blockers ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix ; prevention & control ; Fibroblasts ; drug effects ; Humans ; Matrix Metalloproteinase 2 ; drug effects ; Matrix Metalloproteinase 9 ; drug effects ; Matrix Metalloproteinase Inhibitors ; pharmacology ; Up-Regulation ; drug effects ; Urethra ; cytology ; pathology ; Verapamil ; pharmacology