Efficacy of flexible ureterorenoscopy with holmium laser in the management of calyceal diverticular calculi.

The purpose of this study was to evaluate the efficacy and safety of flexible ureteroscopy with holmium laser lithotripsy in the management of calyceal diverticular calculi. In this study, we retrospectively analyzed the clinical data of 27 patients with calyceal diverticular calculi admitted to the Department of Urology of the Zigong First People's Hospital from May 2018 to May 2021. Intraoperatively, the diverticular neck was found in all 27 patients, but flexible ureterorenoscopy lithotripsy was not performed in 2 cases because of the slender diverticular neck, and the success rate of the operation was 92.6%. Of the 25 patients with successful lithotripsy, the mean operative time was 76.9 ± 35.5 (43-200) min. There were no serious intraoperative complications such as ureteral perforation, mucosal avulsion, or hemorrhage. Postoperative minor complications (Clavien classification I-II) occurred in 4 (16%) patients. The mean hospital stay was 4.4 ± 1.7 (3-12) days. The stone-free rate was 80% at the 1-month postoperative follow-up. After the second-stage treatment, the stone-free rate was 88%. In 22 cases with complete stone clearance, no stone recurrence was observed at 5.3 ± 2.6 (3-12) months follow-up. This retrospective study demonstrated that flexible ureterorenoscopy with holmium laser is a safe and effective choice for the treatment of calyceal diverticular calculi, because it utilizes the natural lumen of the human body and has the advantages of less trauma, fewer complications, and a higher stone-free rate.

Transurethral en bloc resection of a bladder perivascular epithelioid cell tumor (PEComa): a case report.

BACKGROUND: Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor with distinct histologic and immunologic features. PEComas that originate in the bladder are extremely rare clinically, with only 35 cases reported in the English literature thus far. Here, we report a case of bladder PEComa resection by transurethral en bloc resection of bladder tumor (ERBT). CASE PRESENTATION: A 66-year-old female with a history of poorly controlled type 2 diabetes with associated complications of frequent urinary tract infections presented to our hospital for a routine physical examination. Outpatient ultrasound examination revealed a strong echogenic mass of approximately 1.5 × 1.3 × 1.3 cm in size on the posterior wall of the bladder. The enhanced computed tomography and enhanced magnetic resonance imaging after admission both suggested a well-defined isolated nodular mass on the posterior wall of the bladder with significant enhancement on the enhanced scan. The tumor was successfully and completely resected by ERBT. Postoperative pathological examination and immunohistochemical results confirmed the mass was a bladder PEComa. No tumor recurrence was observed in the six-month postoperative follow-up. CONCLUSION: Bladder PEComa is an extremely rare mesenchymal tumor of the urinary system. When imaging and cystoscopy reveal a nodular mass with an abundant blood supply in the bladder, PEComa should be included in the differential diagnosis of bladder tumors. Surgical resection is currently the primary option for the treatment of bladder PEComa. For a solitary, pedunculated, narrow-based, small-sized bladder PEComa, resection of the tumor by ERBT was a safe and feasible approach in our patient and may be considered for similar cases in the future.

Protecting quantum correlations of the XXZ model by topological boundary conditions.

The differences between the XXZ model with topological and periodical boundary conditions were compared by studying their entanglement, quantum discord, and critical temperature above which the entanglement vanishes. It shows that the different boundary conditions mainly affect bipartite quantum correlations of the boundary spins rather than that of other spin pairs. The topological boundary spins can protect entanglement and discord against strong magnetic fields while the periodical boundary spins can protect them against nonuniform magnetic fields. Compared with the periodical XXZ model, the critical temperature is significantly improved for the topological XXZ model. The topological XXZ model also allows us to improve significantly its critical temperature by increasing the strength of magnetic field, which is not feasible for the periodical XXZ model. It is therefore more promising for preparing entangled states at high temperature in the topological XXZ model.

Expression of serum Dickkopf-1 in gastric cancer patients.

OBJECTIVE: To explore the expression and clinical significance of DKK-1 protein in patients with gastric cancers. METHODS: Enzyme linked immuno sorbent assay was used to detect expressions of serum DKK-1 protein in 90 cases of gastric cancers, 50 cases of gastric benign disease and 40 healthy cases. The dynamic change in serum DKK-1 protein of gastric cancer patients who accepted radical operation for a month was also observed. RESULTS: The expression of serum DKK-1 protein in gastric cancer groups was significantly higher than that in gastric benign group's (P < 0.01) and in health control (P < 0.01). Serum DKK-1 level was increased gradually along with the progress of the disease. Serum DKK-1 levels were significantly higher in patients at TNM staging III and IV than patients at TNM staging I and II. Level of serum DKK-1 was related to microvascular invasion, differentiation degree and infiltration depth. Level of serum DKK-1 was significantly reduced in patients after radical surgery (P < 0.01). CONCLUSIONS: The expression of serum DKK-1 protein in gastric cancer patients is increased. Level of serum DKK-1 is related to TNM staging, microvascular invasion, differentiation degree and infiltration depth. DKK-1 detection can be used as a reference index in monitoring gastric cancer progress and biological behavior.

Expression of ornithine decarboxylase in precancerous and cancerous gastric lesions.

AIM: To investigate the expression of ornithine decarboxylase (ODC) in precancerous and cancerous gastric lesions. METHODS: We studied the expression of ODC in gastric mucosa from patients with chronic superficial gastritis (CSG, n=32), chronic atrophic gastritis [CAG, n=43; 15 with and 28 without intestinal metaplasia (IM)], gastric dysplasia (DYS, n=11) and gastric cancer (GC, n=48) tissues using immunohistochemical staining. All 134 biopsy specimens of gastric mucosa were collected by gastroscopy. METHODS: The positive rate of ODC expression was 34.4%, 42.9%, 73.3%, 81.8% and 91.7% in cases with CSG, CAG without IM, CAG with IM, DYS and GC, respectively (P<0.01), The positive rate of ODC expression increased in the order of CSG < CAG (without IM) < CAG (with IM) < DYS and finally, GC. In addition, ODC positive immunostaining rate was lower in well-differentiated GC than in poorly-differentiated GC (P<0.05). CONCLUSION: The expression of ODC is positively correlated with the degree of malignity of gastric mucosa and development of gastric lesions. This finding indicates that ODC may be used as a good biomarker in the screening and diagnosis of precancerous lesions.