Causal relationship between rheumatoid arthritis and bronchiectasis: a bidirectional mendelian randomization study.

BACKGROUND: Epidemiological observational studies have elucidated a correlation between rheumatoid arthritis (RA) and bronchiectasis. However, the causal nature of this association remains ambiguous. To clarify this potential causal linkage, we conducted a two-sample Mendelian randomization (MR) analysis to explore the bidirectional causality between RA and bronchiectasis. METHODS: Summary statistics for RA and bronchiectasis were obtained from the IEU OpenGWAS database We employed various methods, including inverse variance weighting (IVW), MR-Egger, weighted median, weighted mode, and simple mode, to explore potential causal links between RA and bronchiectasis. Additionally, a series of sensitivity studies, such as Cochran's Q test, MR Egger intercept test, and leave-one-out analysis, were conducted to assess the MR analysis's accuracy further. RESULTS: In the forward MR analysis, the primary analysis indicated that a genetic predisposition to RA correlated with an increased risk of bronchiectasis in European populations (IVW odds ratio (OR): 1.28, 95% confidence interval (CI): 1.20-1.37, p = 1.18E-13). Comparable results were noted in the East Asian subjects (IVW OR: 1.55, 95% CI: 1.30-1.34, p = 8.33E-07). The OR estimates from the other four methods were consistent with those obtained from the IVW method. Sensitivity analysis detected no evidence of horizontal pleiotropy or heterogeneity. Conversely, in the reverse MR analysis, we found no evidence to support a genetic causality between bronchiectasis and RA in either European or East Asian populations. CONCLUSION: This study indicates that genetic predisposition to RA correlates with a heightened risk of bronchiectasis in both European and East Asian populations. These results imply that routine screening for bronchiectasis in RA patients could be beneficial, and effective management of RA may contribute to a reduced risk of bronchiectasis. Future research should aim to clarify the underlying mechanisms linking these two conditions.

Association between a body shape index and prostate cancer: a cross-sectional study of NHANES 2001-2018.

OBJECTIVE: Abdominal obesity, especially visceral fat, may have negative effects on the development and progression of prostate cancer (PCa). A body shape index (ABSI) can more accurately measure visceral fat accumulation. This study aimed to investigate the association between ABSI and PCa in US adults. METHODS: 11,013 participants were enrolled in the National Health and Nutrition Examination Survey from 2001 to 2018. Weighted multivariate logistic regression analyses were employed to explore the independent relationship between ABSI and PCa. Moreover, restricted cubic spline (RCS) analysis, subgroup analysis, and interaction tests were performed. RESULTS: ABSI was positively associated with the presence of PCa. When comparing the second, third, and fourth ABSI quartile to the lowest quartile, the adjusted odds ratios (95% confidence intervals) for PCa risk were 1.34 (0.77, 2.31), 1.75 (1.03, 3.00), and 1.91 (1.12, 3.27), respectively (p for trend = 0.011). The restricted cubic spline regression analysis did not reveal a non-linear correlation between ABSI and PCa (p for non-linearity = 0.076). Subgroup analysis showed a significant interaction effect in subgroups of different BMI (p for interaction = 0.01). CONCLUSIONS: Elevated ABSI is significantly associated with an increased risk of PCa, particularly among individuals who are under/normal weighted or obese.

Ultrasonographic manifestations and the effective diagnosis of epididymal leiomyosarcoma: Case report and systematic literature review.

Background: Epididymal leiomyosarcoma is an extremely rare tumor. In this study, we describe the sonographic features of this uncommon tumor. Methods: A case of epididymal leiomyosarcoma diagnosed at our institute was retrospectively analyzed. Ultrasonic images, noted clinical manifestations, treatment procedures, and pathology results were collected for this patient. The same information was collected from a systematic literature search on epididymal leiomyosarcoma, including the PUBMED, Web of Science and Google Scholar databases. Results: The literature search resulted in 12 articles; we were able to extract data from 13 cases of epididymal leiomyosarcomatosis. The median patient age was 66 (35-78) years, and the average tumor diameter was 2-7 cm. All patients had unilateral epididymal involvement. The lesions were all solid, irregular-shaped in almost half of the cases, featured clear borders in six cases, and had unclear borders in four cases. The internal echogenicity was heterogeneous in the majority of lesions: six cases were hypoechoic (7/11) and three cases moderately echoic (3/10). Information on blood flow within the mass was provided in four cases, but all were noted with significant vascularity. Surrounding tissue invasion was discussed in 11 cases, with 4 featuring peripheral invasion or metastasis. Conclusion: Epididymal Leiomyosarcoma demonstrates sonographic characteristics common to many malignant tumors, such as increased density, irregular shape, heterogeneous internal echogenicity, and hypervascular. Ultrasonography is helpful to differentiate benign epididymal lesions, and can provide some reference for clinical diagnosis and treatment. However, compared with other malignant tumors of the epididymis, it has no characteristic sonographic features,and pathological confirmation is required.

[Clinical observation of transurethral holmium laser enucleation of prostate by two-way rendezvous and trenching].

OBJECTIVE: Exploring the clinical efficacy, safety, and surgical techniques of two-way rendezvous and trenching method for transurethral holmium laser prostatectomy in the treatment of benign prostatic hyperplasia. METHODS: Retrospective analysis of clinical data on preoperative, intraoperative, and postoperative follow-up of 326 patients with benign prostatic hyperplasia who underwent two-way rendezvous and trenching method of transurethral holmium laser prostatectomy at the Urology Department of Wujin People's Hospital in Changzhou City from January 2020 to January 2023. RESULTS: Compared with preoperative measures, IPSS symptom score, quality of life (QoL) score, maximum urinary flow rate (Qmax), and residual urine volume (PVR) were significantly improved at 1, 6, and 12 months postoperatively (P<0.05). Thirty two patients with normal and regular sexual life pre-operation were observed. There were no significant changes in their IIEF-5 score and Erectile Hardness Scale (EHGS) score after surgery compared with pre-operation (P<0.05). There were 9 patients (28.12%) with retrograde ejaculation after surgery. CONCLUSION: The two-way rendezvous and trenching method of transurethral holmium laser prostatectomy is a safe and effective method for treating benign prostatic hyperplasia, with precise results, high safety, minimal trauma, and fast postoperative recovery.

[Comparison of therapeutic effects between holmium laser and plasma transurethral enucleation in the treatment of benign prostatic hyperplasia].

OBJECTIVE: Comparison of clinical efficacy between transurethral holmium laser prostate enucleation (two-way rendezvous and trenching method) and transurethral plasma enucleation. METHODS: A total of 483 patients with benign prostatic hyperplasia who were admitted to our hospital from December 2019 to December 2022 were randomly divided into an observation group (245 cases) and a control group (238 cases) using a random number table method. The observation group underwent transurethral holmium laser prostatectomy, while the control group underwent transurethral plasma prostatectomy,evaluate the efficacy of two surgical methods. RESULT: The IPSS symptom score, quality of life (QOL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and other indicators were significantly improved in both groups after 6 months of surgery compared to before (P<0.05), and there was no statistically significant difference between the two groups (P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). There was no statistically significant difference in sexual function and retrograde ejaculation between the two groups of patients(P>0.05). CONCLUSION: Both surgical methods have good surgical efficacy, but compared with prostate plasma resection, holmium laser prostatectomy can reduce intraoperative bleeding in patients with BPH, effectively shorten catheter retention time, patient hospitalization time, and postoperative bladder flushing time, resulting in higher quality of life and safety.

One-Step Microfluidic Fabrication of Multi-Responsive Liposomes for Targeted Delivery of Doxorubicin Synergism with Photothermal Effect.

INTRODUCTION: Cancer of the bladder is one of the most common and life-threatening. Compared with traditional delivery methods, intravesical administration reduces the amount of drugs required, increases the amount of drugs reaching the lesion site, and minimizes systemic exposure to therapeutic agents. To overcome the limitations of urinary voiding, low urothelium permeability, and intermittent catheterization for large dilution and irrigation of drugs in the bladder, magnetic and photothermal-responsive folate receptor-targeted thermal liposomes (FA-TMLs) were designed for the targeted delivery of doxorubicin (DOX) to bladder cancer cells. METHODS: Through a microfluidic mixer chip, the magnetic nanoparticles (MNPs), gold nanorods (GNRs) and DOX were encapsulated in folate-modified thermosensitive liposomes to form FA-TMLs@MNPs-GNRs-DOX. DLS, TEM, DSC, and magnetic hysteresis loop were used to characterize the construction of FA-TMLs@MNPs-GNRs-DOX. RESULTS: FA-TMLs@MNPs-GNRs-DOX had a size of about 230 nm and exhibited superparamagnetic properties with the saturation magnetization of 20 emu/g. The DOX loading capacity was as high as 0.57 mg/mL. Additionally, drug release of the FA-TMLs@MNPs-GNRs-DOX could be controlled by temperature change through the photothermal effect. A 980 nm laser beam was selectively irradiated on the FA-TMLs@MNPs-GNRs-DOX to trigger the structural changes of the FA-TMLs, and an average of 95% of the drug was released after 3 hours. The results of cell uptake experiments reveal indicated that FA-TMLs@MNPs-GNRs-DOX were able to specifically bind folate-receptor-positive cells and exhibited toxicity to bladder tumor cells. CONCLUSION: The present results suggest FA-TMLs@MNPs-GNRs-DOX have a promising multifunctional response and can act as an ideal multifunctional drug delivery system (DDS) for the treatment of bladder tumors.

Development and validation of a VHL-associated immune prognostic signature for clear cell renal cell carcinoma.

BACKGROUND: VHL mutation is the most common mutation in clear cell renal cell carcinoma (ccRCC). Here, we developed and validated an immune-related signature to predict the prognosis of ccRCC with VHL mutations. METHODS: VHL mutation status and RNA expression were analysed in the TCGA datasets and our cohort. LASSO Cox analysis was performed to develop an immune-related signature. Candidate genes for the immune-related signature were differentially expressed between VHLwt and VHLmut ccRCC patients. RESULTS: VHL mutations resulted in the downregulation of the immune response in ccRCC. To develop an immune-related signature, LASSO Cox analysis was constructed by immune-related genes that were differentially expressed between VHLwt (WHL wild type) and VHLmut (VHL mutation) ccRCC patients. The signature was developed and validated in the TCGA and our own cohort to classify patients into groups based on having a low or high risk of poor survival. Functional enrichment analysis showed that the immune-related pathway represented the major function and pathway. In addition, patients in the high-risk group had a positive correlation with low fractions of CD4 + T cells and dendritic cells and presented a lower expression of CTLA-4 and PD-1 than the low-risk group. CONCLUSION: In this study, we proposed a novel immune-related signature, which is a feasible biomarker for predicting the overall survival in VHLmut patients with ccRCC.

Comparative analysis of gene expression profiles in children with type 1 diabetes mellitus.

Type 1 diabetes (T1D) is an autoimmune disease that is typically diagnosed in children. The aim of the present study was to identify potential genes involved in the pathogenesis of childhood T1D. Two datasets of mRNA expression in children with T1D were obtained from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) in children with T1D were identified. Functional analysis was performed and a protein­protein interaction (PPI) network was constructed, as was a transcription factor (TF)­target network. The expression of selected DEGs was further assessed using reverse transcription­quantitative polymerase chain reaction (RT­qPCR) analysis. Electronic validation and diagnostic value analysis of the identified DEGs [cytokine inducible SH2 containing protein (CISH), SR­related CTD associated factor 11 (SCAF11), estrogen receptor 1 (ESR1), Rho GTPase activating protein 25 (ARHGAP25), major histocompatibility complex, class II, DR ß4 (HLA­DRB4) and interleukin 23 subunit α (IL23A)] was performed in the GEO dataset. Compared with the normal control group, a total of 1,467 DEGs with P<0.05 were identified in children with T1D. CISH and SCAF11 were determined to be the most up­ and downregulated genes, respectively. Heterogeneous nuclear ribonucleoprotein D (HNRNPD; degree=33), protein kinase AMP­activated catalytic subunit α1 (PRKAA1; degree=11), integrin subunit α4 (ITGA4; degree=8) and ESR1 (degree=8) were identified in the PPI network as high­degree genes. ARHGAP25 (degree=12), HNRNPD (degree=10), HLA­DRB4 (degree=10) and IL23A (degree=9) were high­degree genes identified in the TF­target network. RT­qPCR revealed that the expression of HNRNPD, PRKAA1, ITGA4 and transporter 2, ATP binding cassette subfamily B member was consistent with the results of the integrated analysis. Furthermore, the results of the electronic validation were consistent with the bioinformatics analysis. SCAF11, CISH and ARHGAP25 were identified to possess value as potential diagnostic markers for children with T1D. In conclusion, identifying DEGs in children with T1D may contribute to our understanding of its pathogenesis, and such DEGs may be used as diagnostic biomarkers for children with T1D.

[Transurethral holmium laser enucleation of the prostate for benign prostatic hyperplasia in patients with a history of transrectal prostate biopsy].

OBJECTIVE: To evaluate the efficiency and safety of transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of BPH in patients with a history of transrectal prostate biopsy (TRPB). METHODS: We retrospectively analyzed the clinical data on 102 cases of BPH treated by HoLEP in our hospital between November 2015 and May 2017, of which 42 had received TRPB prior to HoLEP (the PB group) but not the other 60 (the non-TRPB ï¼»NPBï¼½ group). We compared the preoperative, perioperative and postoperative follow-up data between the two groups of patients. RESULTS: There were no statistically significant differences in the mean age, prostate volume, and preoperative post-void residual urine volume (PVR), IPSS, quality of life (QOL) score and maximum urinary flow rate (Qmax) between the two groups of patients. The preoperative PSA level was significantly higher in the PB than in the NPB group (ï¼»10.30 ± 3.62ï¼½ vs ï¼»2.62 ± 1.75ï¼½ µg/L, P < 0.01), and the operation time markedly longer in the former than in the latter (ï¼»78.00 ± 18.25ï¼½ vs ï¼»67.93 ± 15.89ï¼½ min, P < 0.01), particularly in the patients with an interval of <2 weeks between HoLEP and TRPB than in those with an interval of ≥2 weeks (ï¼»91.17 ± 16.51ï¼½ vs ï¼»68.13 ± 12.45ï¼½ min, P < 0.01). Statistically significant differences were not found in the postoperative hemoglobin level, continuous bladder irrigation duration, catheter-indwelling time and hospital stay, nor in the incidence rate of transient urinary incontinence between the PB and NPB groups (47.62% vs 45%, P = 0.794). There were no transurethral resection syndrome, bladder or rectal injury, or blood transfusion in either group, nor statistically significant differences in PVR, Qmax, IPSS and QOL score between the two groups of patients at 3, 6 or 12 months after operation. CONCLUSIONS: HoLEP is a safe and effective surgical treatment of BPH for patients with a history of TRPB, which can reduce the time and increase the safety of operation when performed at ≥2 weeks after TRPB.

[Relationship between the intrapelvic perfusion pressure in minimally invasive percutaneous nephrolithotomy and postoperative recovery].

OBJECTIVES: To introduce the method to monitor intrapelvic perfusion pressure during minimally invasive percutaneous nephrolithotomy (MPCNL), and to observe the effect of high pressure intrapelvic perfusion on recovery. METHODS: The end of F5 ureteral catheter and aseptic transducer were connected by self-made connecter. During the operation, 46 renal calculi cases were monitored, and the early complication, such as fever, pain index, drop of hemoglobin, the stone-free rate and hospital stay were investigated. And the relationship between the variation of pressure and recovery was studied. RESULTS: Intrapelvic perfusion pressure ranged from 3 mm Hg (1 mm Hg = 0.133 kPa) to 50 mm Hg during the course of MPCNL. The definition of high pressure was the time of the pressure more than 30 mm Hg not less than 10 min. Postoperative fever rate, pain index, drop of hemoglobin and hospital stay in the high pressure were significantly higher than low pressure group (P< or =0.05). There was no difference of the stone-free rate in two groups. CONCLUSIONS: During the course of MPCNL intrapelvic perfusion pressure should be monitor immediately. It should be careful to maintain the time of pressure more than 30 mm Hg less than 10 min for stable postoperative recovery.

[Detection of DD3 mRNA in the urine of prostate cancer patients and its clinical significance].

OBJECTIVE: To detect the differential display code 3 mRNA (DD3 mRNA) in the urine sample of patients with prostate cancer and to evaluate its clinical significance. METHODS: DD3 mRNA in the urine collected from 48 patients with prostate cancer, 23 patients with benign prostate hyperplasia (BPH) and 9 healthy male volunteers was measured by reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: DD3 products could not be detected in the urine samples of the BPH patients and healthy male volunteers, but could in 39/48 urine samples of the patients with prostate cancer. Significant difference was found between them (P < 0.01). CONCLUSION: The detection of DD3 mRNA in the urine promises to be a non-invasive, simple and sensitive method for the early diagnosis and post-treatment monitoring of prostate cancer.