Focus on Upper Urinary Tract Stones Combined with Parenchymal Infiltrative Renal Pelvis Cancer.

INTRODUCTION: Upper urinary tract stones combined with parenchymal infiltrative renal pelvic cancer are challenging to detect on imaging and to evaluate the differential diagnosis. CASE PRESENTATION: The symptoms and diagnoses in three cases of parenchymal infiltrative renal pelvic cancer and upper urinary tract stones that occurred between June 2019 and June 2022 were reviewed. Primary symptoms of lumbar discomfort and hematuria were evident in all 3 patients. Preoperative computed tomography (CT) abdominal imaging revealed that all three cases had hydronephrosis along with renal stones, while the other two cases only had localized hypoenhancement of the renal parenchyma, which was only thought to be limited inflammatory changes in the renal cortex as a result of the combination of renal pelvis infection. After percutaneous nephrolithotomy or ureteroscopic lithotripsy, a combined renal pelvis tumor was discovered in all of these instances. Radical tumor surgery was later performed. One patient who had several tumor metastases passed away 6 months after surgery. A case with multiple metastases was discovered 15 months after surgery and survived with the help of the current chemotherapy. A case with a bladder tumor recurrence was discovered 16 months after surgery and had transurethral bladder tumor electrosurgery and routine bladder perfusion chemotherapy. CONCLUSION: Upper urinary tract stones and parenchymal infiltrative pyel carcinoma have atypical imaging, easily confused with infectious diseases. CT or computed tomography urography (CTU) must be considered by urologists. Patients who have a CT with local renal parenchyma density should be suspected of having parenchymal invasive renal pelvis carcinoma; a needle biopsy ought to be performed; and repeat biopsies may be performed if necessary. High-risk individuals need multiple, sufficient biopsies as needed and a comprehensive intraoperative assessment of the renal pelvic mucosa.

[Construction and Denitrification Performance of A2/O Based on Partial Nitrification Coupled with an ANAMMOX System].

To resolve the issue of existing municipal wastewater treatment plants (WWTPs) in China with an insufficient influent carbon source, a bench-scale A2/O process based on partial nitrification coupled with ANAMMOX was constructed by controlling aeration partition ratio, dissolved oxygen (DO) concentration, and sludge retention time (SRT). In this study, the nitrogen removal performance, nitrogen removal pathway, and microbial community structure of the system under different conditions were investigated. The results showed that the system had excellent nitrogen removal efficiency at low-C/N influent (C/N=5). The A2/O reactor had experienced the co-culture stage (Phase 1), screening stage (Phase 2-3), and enrichment stage (Phase 4) successively during the 140-day experiment, and the nitrogen removal pathway changed from nitrification and denitrification to partial nitrification coupled ANAMMOX in the end. The optimal removal efficiencies of 97.69% for NH4+-N and 87.83% for TN were obtained in the enrichment stage (Phase 4), and the effluent concentration of NH4+-N and TN were 1.20 mg·L-1 and 7.03 mg·L-1, respectively. Illumina MiSeq sequencing results showed that the enrichment of AOB including Nitrosomonas and Nitrosospira and the elimination of NOB including Nitrospira, Nitrococcus, and Nitrobacter were the main causes of achieving partial nitrification in the system. The enrichment of AnAOB including Candidatus Kuenenia and Candidatus Jettenia was the key point for the occurrence of ANAMMOX in the system, and thus, played an important role in the achievement of advanced nitrogen removal.

[International focuses in the studies of chronic pelvic pain syndrome: A social network analysis].

OBJECTIVE: To analyze the internationally published literature relevant to chronic pelvic pain syndrome (CPPS) using bibliometrics and social network analysis, and investigate the current status and focuses of CPPS studies. METHODS: We identified 692 publications on CPPS by searching PubMed up to December 2015, extracted their subject headings, calculated the frequencies of the headings, and constructed a co-occurrence network of the high-frequency (≥10) subject headings. Then we studied the features and structure of the co-occurrence network by analyzing its attributes and topological structure. RESULTS: The density of the constructed co-occurrence network was 0.111, with an average distance of 2.886 and a clustering coefficient of 0.685. Its low density, long average distance and high clustering coefficient indicated that it was a sparse network, with a slow speed of information spreading among nodes but a strong potential coherence, which suggested that the current topics in the study of CPPS were scattered and weakly correlated, with a high possibility of being integrated. Based on the topological structure of the co-occurrence network, the topics in the study of CPPS were divided into six aspects: diagnosis and classification, drug therapy, treatment, etiology, microbiology, psychology, and epidemiology, the more important of which were diagnosis and classification, drug therapy, treatment and etiology. CONCLUSIONS: A system has been formed in the studies of CPPS, focusing on the diagnosis, drug therapy, and etiology of the disease. However, the research topics are relatively scattered and frequently repeated. Therefore, more attention should be paid to the macrocosmic guidance and rational coordination of the researches on CPPS.