Removal of numerous vesical magnetic beads with a self-made magnetic sheath.

INTRODUCTION: Sexual curiosity and the quest for sexual excitement are the most frequent reasons for patients to introduce foreign bodies into the urethra or the bladder. Imagination and surgical skill are essential for urologists to retrieve such vesical foreign bodies. AIM: The aim of this study was to describe a novel method for retrieving vesical magnetic beads, which were inserted for autoeroticism by a male adolescent, with a self-made "magnetic sheath." METHODS: A 21-year-old young man inserted more than one hundred small magnetic beads into his urethra for sexual excitement, which lately caused symptoms of gross hematuria, frequent urination, and acute lower abdominal pain when walking or urinating. We invented a magnetic sheath by fixing a magnetic bead on the tip of an F9.5 ureteral access sheath to remove the foreign bodies in a minimally invasive way. MAIN OUTCOME MEASURE: The feasibility of using magnetic sheath to remove vesical foreign bodies; and operation duration. RESULTS: Under direct visualization of an F8/9.8 ureteroscope, the magnetic sheath could firmly attach to the magnetic bead inside the bladder and could easily pull out 5 to 15 beads each time. It took about 5 minutes to remove all of the 125 magnetic beads by utilizing our magnetic sheath. CONCLUSIONS: The self-made magnetic sheath can make the task of removal of magnetic foreign bodies easy to urologists, requiring less time and surgical skills. The new equipment provides a new method for urologists to deal with the challenging task of removing metal vesical foreign bodies which were self-inserted for masturbation.

Antibody and complement levels in patients with hypersplenism associated with cirrhotic portal hypertension and therapeutic principles.

BACKGROUND: Hypersplenism associated with cirrhotic portal hypertension is a common condition often resulting from hepatitis B-related cirrhosis. However, the levels of immunoglobulin (Ig) and complement in patients with hypersplenism associated with cirrhotic portal hypertension remain unclear. This study was undertaken to determine the levels of Ig and complement in these patients, the relationship between these levels and Child-Pugh class and their clinical significance. AIM: To investigate the antibody (Ig) and complement levels in patients with hypersplenism associated with cirrhotic portal hypertension and their clinical significance. METHODS: Clinical data of 119 patients with hypersplenism associated with cirrhotic portal hypertension were statistically analyzed and compared with those of 128 control patients. RESULTS: IgA and IgG levels in patients with hypersplenism were significantly higher than controls (P < 0.001). There was no significant difference in IgM between the two groups (P = 0.109). C3 and C4 levels in patients with hypersplenism were significantly lower than controls (P < 0.001). As liver function decreased, IgA and IgG levels increased (P < 0.001), and C3 and C4 levels decreased (P < 0.001). CONCLUSION: Patients with hypersplenism associated with cirrhotic portal hypertension have significantly higher antibody (IgA and IgG) levels and significantly lower complement (C3 and C4) levels, which are both related to liver damage. Clinically, the administration of anti-hepatitis virus agents and protection of liver function should be strengthened.

LncRNA SNHG12 promotes proliferation and epithelial mesenchymal transition in hepatocellular carcinoma through targeting HEG1 via miR-516a-5p.

Hepatocellular carcinoma (HCC) is the most common cancer and its prognosis is poor due to metastasis and recurrence. EMT is associated with metastasis. A deep understanding of regulatory mechanism of EMT is critical. LncRNA is involved in regulation of various biological processes including EMT. This study aimed to investigate the regulatory signal axis among lncRNA SNHG12, miR-516a-5p and the target gene HEG1 during EMT. Cell cycle and apoptosis were analyzed by flow cytometry. Tumorigenesis was analyzed by clone formation assay. Wound healing assay and transwell assay was performed to detect migration and invasion, respectively. Interaction among SNHG12, miR-516a-5p and HEG1 were analyzed by dual luciferase assay and RIP assay. We also detected expression of RNA and protein by QPCR and western blotting. Finally, tumor growth was analyzed by tumorigenesis assay in vivo. Ki-67 and HEG1 level in tumor tissues was analyzed by IHC. SNHG12 and HEG1 were upregulated, miR-516a-5p was downregulated in HCC cell lines. SNHG12 could interact with and inhibit miR-516a-5p. MiR-516a-5p could interact with HEG1 and inhibit HEG1 expression. Knock down SNHG12 inhibited proliferation, migration, invasion, EMT and promoted apoptosis of HCC cells. Such effects were antagonized by inhibiting miR-516a-5p. SNHG12 overexpression lead to opposite results. Similar results were observed in mice. SNHG12 could promote EMT in HCC through targeting and inhibiting miR-516a-5p, which eventually upregulated HEG1 expression, in both cell and mice.

Graphene/ZnO Nanowire/p-GaN Vertical Junction for a High-Performance Nanoscale Light Source.

We report on a high-brightness ultraviolet (UV) nanoscale light source. The light emission diodes are constructed with graphene/ZnO nanowire/p-GaN vertical junctions, which exhibit strong UV electroluminescence (EL) emissions centered at a wavelength of 397 nm at one end of the ZnO nanowire. Compared to the horizontal heterojunction, the vertical junction based on the ZnO nanowire increases the interface area of the heterojunction along with a high-quality interface, thus making the device robust under a large excitation current. In this structure, transparent flexible graphene is used as the top electrode, which can effectively improve performance by increasing the carrier injection area. Moreover, by analyzing the relationship between the integrated light intensity and applied bias, a superlinear dependency with a slope of 3.99 is observed, which means high electrical-to-optical conversion efficiency. Three electron-hole irradiation recombination processes are distinguished according to the EL emission spectra.

Targeting an Autocrine Regulatory Loop in Cancer Stem-like Cells Impairs the Progression and Chemotherapy Resistance of Bladder Cancer.

PURPOSE: Cancer stem-like cells (CSCs) contribute to bladder cancer chemotherapy resistance and progression, but the associated mechanisms have not been elucidated. This study determined whether blocking an autocrine signaling loop in CSCs improves the therapeutic effects of cis-platinum on bladder cancer. EXPERIMENTAL DESIGN: The expression of the epithelial marker OV6 and other markers in human bladder cancer specimens was examined by IHC. The CSC properties of magnetic-activated cell sorting (MACS)-isolated OV6+ and OV6- bladder cancer cells were examined. Molecular mechanisms were assessed through RNA-Seq, cytokine antibody arrays, co-immunoprecipitation (co-IP), chromatin immunoprecipitation (ChIP) and other assays. An orthotopic bladder cancer mouse model was established to evaluate the in vivo effects of a YAP inhibitor (verteporfin) and a PDGFR inhibitor (CP-673451) on the cis-platinum resistance of OV6+ CSCs in bladder cancer. RESULTS: Upregulated OV6 expression positively associated with disease progression and poor prognosis for bladder cancer patients. Compared with OV6- cells, OV6+ bladder cancer cells exhibited strong CSC characteristics, including self-renewal, tumor initiation in NOD/SCID mice, and chemotherapy resistance. YAP, which maintains the stemness of OV6+ CSCs, triggered PDGFB transcription by recruiting TEAD1. Autocrine PDGF-BB signaling through its receptor PDGFR stabilized YAP and facilitated YAP nuclear translocation. Furthermore, blocking the YAP/TEAD1/PDGF-BB/PDGFR loop with verteporfin or CP-673451 inhibited the cis-platinum resistance of OV6+ bladder cancer CSCs in an orthotopic bladder cancer model. CONCLUSIONS: OV6 could be a helpful indicator of disease progression and prognosis for patients with bladder cancer, and targeting the autocrine YAP/TEAD1/PDGF-BB/PDGFR loop might serve as a remedy for cis-platinum resistance in patients with advanced bladder cancer.

[Volumes of total prostate and transitional zone are positively correlated with age in benign prostatic hyperplasia patients].

OBJECTIVE: To investigate the total prostate volume (TPV) and prostate transitional zone volume (TZV) in different age groups of benign prostatic hyperplasia patients, calculate the transitional zone index (TZI), and analyze correlation of age with the above parameters. METHODS: We divided 1,563 BPH patients into 4 age groups (50-59, 60-69, 70-79 and 80-89 y), measured their TPV and TZV by rectal ultrasonography, calculated their TZI and evaluated all the data obtained by statistical analysis. RESULTS: The TPV, TZV and TZI of the BPH patients were shown to be (32.27 +/- 15.76) ml, (9.55 +/- 98) ml and 0.28 +/- 0.13 in the 50-59 y group; (40.93 +/- 17.45) ml, (14.94 +/- 11.83) ml and 0.34 +/- 0. 16 in the 60-69 y group; (46.56 +/- 20.31) ml, (19.54 +/- 19.25) ml and 0.39 +/- 0.16 in the 70-79 y group; and (47.85 +/- 26.63) ml, (20.40 +/- 16.78) ml and 0.41 +/- 0.19 in the 80-89 y group. Both TPV and TZV were positively correlated with the patients' age, (r1 = 0.232, r2 = 0.256). CONCLUSION: TPV and TZV increase with age in BPH patients, the latter even more obviously than the former.

Dirac Semimetal Heterostructures: 3D Cd3 As2 on 2D Graphene.

Dirac semimetal is an emerging class of quantum matters, ranging from 2D category, such as, graphene and surface states of topological insulator to 3D category, for instance, Cd3 As2 and Na3 Bi. As 3D Dirac semimetals typically possess Fermi-arc surface states, the 2D-3D Dirac van der Waals heterostructures should be promising for future electronics. Here, graphene-Cd3 As2 heterostructures are fabricated through direct layer-by-layer stacking. The electronic coupling results in a notable interlayer charge transfer, which enables us to modulate the Fermi level of graphene through Cd3 As2 . A planar graphene p-n-p junction is achieved by selective modification, which demonstrates quantized conductance plateaus. Moreover, compared with the bare graphene device, the graphene-Cd3 As2 hybrid device presents large nonlocal signals near the Dirac point due to the charge transfer from the spin-polarized surface states in the adjacent Cd3 As2 . The results enrich the family of van der Waals heterostructure and should inspire more studies on the application of Dirac/Weyl semimetals in spintronics.

Segmental ureteroileal conduit resection for the treatment of distal upper urinary tract recurrence of bladder cancer following cystectomy.

Segmental ureterectomy is less invasive than radical nephroureterectomy and results in nephron preservation and satisfactory tumor control. This study was to determine the feasibility of segmental ureteroileal conduit resection (SUICR) for patients with distal upper urinary tract recurrence of bladder cancer following radical cystectomy. Four patients with high-grade distal upper urinary tract recurrence underwent SUICR 15-108 months after radical cystectomy. The surgical technique details of SUICR, operative results, and follow-up outcomes are reported. The median operation time was 280 min, and estimated blood loss was less than 100 mL. One patient suffered from ileus 5 days after surgery and was managed conservatively. Histopathologic evaluation showed high-grade stages pTa-pT1 diseases for these patients, and ureteral margins were all negative. No patient suffered from tumor recurrence, with a median follow-up of 39 months. SUICR preserved the ipsilateral renal unit and conformed to oncological principles during surgery. The oncological outcome was satisfactory for these properly selected patients. This technique provides a valid alternative to nephroureterectomy for patients with imperative indications and high-grade upper urinary tract recurrence of bladder cancer following radical cystectomy.

Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way.

OBJECTIVE: To evaluate the impact of increasing irrigation pressure when performing flexible cystoscopy for male patients on visual analog scale pain scores. PATIENTS AND METHODS: A total of 168 male patients admitted to our clinic for flexile cystoscopy by the same urologist between March 2011 and December 2012 were randomized to three equal groups, each of which had 56 patients. Different irrigation pressures were easily achieved by adjusting the height of irrigation solution bag (1000 mL of 0.9% saline). The height difference between the bag and the bed (for cystoscopy) of group 1, 2, and 3 was 80, 100, and 150 cm, respectively. All patients received 10 mL lidocaine gel for 3 minutes for local anesthesia before flexible cystoscopy. Patients' pain feeling was recorded on a visual analog scale (VAS) ranging from 0 to 10 after the cystoscopy. The duration of the procedure for each patient was also recorded. RESULTS: The mean pain score on VAS was 2.95±1.31, 2.48±1.26, and 1.66±1.00 in group 1, 2, and 3, respectively. Compared to group 1 and 2, the mean pain score was significantly lower in group 3 (p<0.001, Mann-Whitney U-test), and the mean pain score in group 2 was statistically significantly lower than that in group 1 (p=0.045, Mann-Whitney U-test). Patients who were with high irrigation pressure experienced less discomfort at cystoscopy. Patient age and duration of the procedure for each group were comparable. CONCLUSION: Achieving higher irrigation pressure for flexible cystoscopy by adjusting the height of irrigation solution bag improves male patients' comfort. It is recommended for male patients.

Music reduces panic: an initial study of listening to preferred music improves male patient discomfort and anxiety during flexible cystoscopy.

PURPOSE: To assess the impact of listening to preferred music on relieving male patients' pain and anxiety during flexible cystoscopy. PATIENTS AND METHODS: A total of 124 male patients were admitted to our hospital for flexile cystoscopy by a single urologist between January 2013 and September 2013 and randomized to two equal groups. Group 2 included 62 patients who could select and listen to their preferred music during flexible cystoscopy. Group 1 included 62 patients who were unable to listen to the music. All patients were administered the same amount of lidocaine (10 mL) for 3 minutes for local anesthesia before flexible cystoscopy. A visual analog scale (VAS) ranging from 0 to 10 was used to assess patients' pain feeling after the cystoscopy procedure. Anxiety levels were calculated according to the State Instrument of State-Trait Anxiety Inventory (STAI-S), and the pulse rate were recorded 5 minutes before and immediately after the procedure. The duration of the procedure of each group were also analyzed. RESULTS: Statistically significant differences were detected between group 1 and group 2 in the mean pain score on VAS (2.53 ± 1.34 vs 1.63 ± 1.09, P=0.002, Mann-Whitney U test), mean postprocedural State Anxiety Inventory pain score (39.4 ± 6.5 vs 34.5 ± 5.8), and postprocedural pulse rate (79.8 ± 5.5 vs 76.0 ± 7.3) (P<0.001 for both, t test). Patients who listened to their preferred music experienced less discomfort and lower anxiety at cystoscopy. Patient age, duration of the procedure, preprocedural STAI-S, and preprocedural pulse rate of each group were comparable. CONCLUSION: Listening to preferred music during flexible cystoscopy is an easy way to improves male patients' comfort and reduce their anxiety. It could be recommended for male patients.

Overexpression of transglutaminase 4 and prostate cancer progression: a potential predictor of less favourable outcomes.

Transglutaminase 4 has been shown to enhance various biological properties of prostate cancer cells, e.g., cell-matrix adhesion, invasiveness and the epithelial-mesenchymal transition. The objectives of this study were to investigate the associations between transglutaminase 4 expression and the established features and biochemical recurrence of prostate cancer. Transglutaminase 4 immunostaining was performed on a tissue microarray. The expression of transglutaminase 4 was evaluated by a scoring method based on the intensity and extent of staining. The clinical and pathological information was obtained through a review of medical records. Follow-up data were obtained by consulting the hospital medical records and the prostate cancer database of our department and by contacting patients or family members. We then compared the transglutaminase 4 expression levels between the prostate cancer tissues and the paracarcinoma tissues and evaluated the correlation of transglutaminase 4 expression with the clinical parameters and biochemical recurrence of prostate cancer. Our results indicated that the transglutaminase 4 staining was significantly higher in tumour tissue than in paracarcinoma tissue (P<0.001) and was positively associated with higher Gleason score (P<0.001) and higher prostate-specific antigen level (P=0.005). Patients with transglutaminase 4 overexpression experienced shorter biochemical recurrence-free survival after surgery (P=0.042) in the univariate analysis but not in the multivariate analysis (P=0.139), which indicated that transglutaminase 4 may serve as a potential predictor of biochemical recurrence of prostate cancer.

Seeing is believing: a randomized controlled study from China of real-time visualization of flexible cystoscopy to improve male patient comfort.

PURPOSE: To assess the impact on visual analog scale (VAS) pain scores of allowing male patients to view the procedure of flexible cystoscopy. PATIENTS AND METHODS: A total of 86 male patients admitted to our hospital for flexile cystoscopy by a single urologist between 2010 and 2011 were randomized to two equal groups. Group 1 included 43 patients who were allowed to watch the video screen with the urologist. Group 2 included 43 patients who were unable to view the video monitor. All patients received the same real-time explanation during the cystoscopy. Patients recorded their pain feeling on a VAS ranging from 0 to 10 after the physician completed the cystoscopy. The pulse and respiratory rate were also recorded 5 minutes before the procedure and immediately after the procedure. RESULTS: There was no statistically significant difference in the postprocedure pulse rate and respiratory rate between groups. The mean pain score on the VAS in group 1 was statistically significantly lower than that in group 2 (1.12±0.96 vs 3.33±2.50, P<0.001, Mann-Whitney U test). Patients who were allowed to watch the video screen experienced less discomfort at cystoscopy. CONCLUSION: Real-time visualization of flexible cystoscopy with simultaneous explanation improves male patients' comfort.

Long-term efficacy and safety of tamsulosin hydrochloride for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: data from China.

BACKGROUND: Tamsulosin hydrochloride can significantly improve benign prostatic hyperplasia (BPH) symptoms after the first dose and achieve long-term efficacy in European and American populations; however, the corresponding studies from China are rarely seen. The purpose of this study was to evaluate the long-term efficacy and safety of tamsulosin hydrochloride 0.2 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of BPH in China. METHODS: Chinese patients with LUTS suggestive of BPH were enrolled in a 4-week placebo run-in period and subsequent 60-week open-label study. Tamsulosin hydrochloride 0.2 mg was administered daily during the period of the study. The efficacy and safety parameters were evaluated at the end of treatment period I (0 - 12 weeks) and period II (13 - 60 weeks). The BPH patients were divided into tamsulosin monotherapy group and combination therapy group which received concomitant medication of finasteride 5 mg once daily after the evaluation at the end of treatment period I. RESULTS: A total of 113 patients were recruited to the study. Eighty-two patients received tamsulosin monotherapy and twenty-nine received combination therapy during the treatment period II. Tamsulosin hydrochloride produced a great improvement in mean maximum urinary flow rate (Q(max)) (1.7 ml/s, 3 ml/s) and a significant decrease in mean international prostate symptom score (IPSS) (4.1, 6.4) after 12-week and 60-week treatments, respectively. At the end of treatment period II, there were significant improvement in IPSS, quality of life (QOL) score, Q(max) and average flow rate (Q(ave)) for combination therapy group compared with the treatment period I (all P < 0.05). No serious adverse events (SAE) were recorded during the study. CONCLUSION: Long-term tamsulosin hydrochloride therapy is a safe, effective and well-tolerated method for the treatment for LUTS suggestive of BPH in China.

A novel training model for retroperitoneal laparoscopic dismembered pyeloplasty.

PURPOSE: To create and evaluate an inexpensive novel model for training in retroperitoneal laparoscopic dismembered pyeloplasty. MATERIALS AND METHODS: The retroperitoneal cavity was simulated by five boards fixed together by detachable hinges; the extent of operating difficulty could be adjusted by changing the angle of inclination. The middle of a plasticine model kidney was imbedded into a metal clip, and a carp swim bladder was fitted to the kidney to model the dilated pelvis. The "ureter" was a 10-cm long porcine ureter. Semicircular-shaped simulator, laparoscopic camera system, scissors, needle holder, and surgical forceps specific for training were used. Ten rounds of intensive training of the "ureteropelvic" anastomosis procedure was provided for five laparoscopic surgeons. Each trainee's mean time of achieving dismembered pyeloplasty in three patients was recorded; the corresponding index in the last three ureteropelvic junction obstruction operations performed by each person before intensive training was retrospectively revised. Subjective evaluation was also performed, and a general self-efficacy (GSE) scale was applied to evaluate the self-confidence of trainees. RESULTS: This model reproduced the technical complexity of laparoscopic dismembered pyeloplasty. The operative time significantly declined from 41.84 +/- 3.00 minutes to 25.04 +/- 2.37 minutes after intensive training. GSE scores after training were also higher than before (27.60 +/- 1.14 vs 22.20 +/- 1.79). Correlation between operative time and GSE was significant. After training, all participants were more skillful in performing ureteropelvic anastomosis. This is a small study with a middle-term follow-up. The operation also cannot be simulated completely because the ureter is separate from the renal pelvis in the beginning. CONCLUSIONS: This model demonstrates satisfying fidelity and practicality; it could easily be built and reused, and could result in lower costs than those incurred using the traditional model.

[Effect of chronic enhanced external counterpulastion on gene expression profiles of arterial endothelial cells of pigs fed with high-cholesterol diet].

OBJECTIVE: To investigate the effect of chronic enhanced external counterpulastion (EECP) on gene expression profiles of arterial endothelial cells (ECs) of pigs fed with high-cholesterol diet. METHODS: Eight male pigs were fed with high-cholesterol diet for 12 weeks to induce arteriosclerosis and subjected to EECP for accumulative 36 h (2 h every other day for 18 sessions). Another 8 pigs on cholesterol-enriched diet and 6 normally fed pigs served as the arteriosclerosis model group and normal control group, respectively, and the high-cholesterol diet was maintained until the end of EECP treatment. The coronary artery was then isolated for transmission electro microscopy, and the abdominal aorta was observed using Sudan III staining. The gene expression profiles in ECs from the thoracic aorta using cDNA microarrays. RESULTS: Macrophages and foam cells were detected beneath the ECs in the coronary artery of pigs in the model group, but not in the other two groups. The ratios of Sudan III-positive area in the celiac aorta were significantly lower in normal control and EECP groups than in the model control group (P<0.05). Compared with the normal control group, the gene expressions of integrins-beta1 and CTGF were up-regulated in the model group. Compared with the model group, the expressions of integrins-beta1, CTGF and VCAM-1 were down-regulated and eNOS up-regulated in EECP group. CONCLUSION: Chronic EECP may reduce endothelial injury, down-regulate the gene expression level of integrin-beta1, CTGF and VCAM-1, lower cholesterol uptake and attenuate arterial endothelial inflammation to protect the pigs fed with high-cholesterol diet from arteriosclerosis.

Transplantation of fetal liver epithelial progenitor cells ameliorates experimental liver fibrosis in mice.

AIM: To investigate the effect of transplanted fetal liver epithelial progenitor (FLEP) cells on liver fibrosis in mice. METHODS: FLEP cells were isolated from embryonal day (ED) 14 BALB/c mice and transplanted into female syngenic BALB/c mice (n = 60). After partial hepatectomy (PH), diethylnitrosamine (DEN) was administered to induce liver fibrosis. Controls received FLEP cells and non-supplemented drinking water, the model group received DEN-spiked water, and the experimental group received FLEP cells and DEN. Mice were killed after 1, 2, and 3 mo, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA), and laminin (LN) in serum, and hydroxyproline (Hyp) content in liver were assessed. Alpha-smooth muscle actin (alpha-SMA) of liver was tested by immunohistochemistry. Transplanted male mice FLEP cells were identified by immunocytochemistry for sry (sex determination region for Y chromosome) protein. RESULTS: Serum ALT, AST, HA, and LN were markedly reduced by transplanted FLEP cells. Liver Hyp content and alpha-SMA staining in mice receiving FLEP cells were lower than that of the model group, which was consistent with altered liver pathology. Transplanted cells proliferated and differentiated into hepatocytes and bile duct epithelial cells with 30%-50% repopulation in the liver fibrosis induced by DEN after 3 mo. CONCLUSION: Transplanted FLEP cells proliferate and differentiate into hepatocytes and bile duct epithelial cells with high repopulation capacity in the fiberized liver induced by DEN, which restores liver function and reduces liver fibrosis.