Bilateral electrical pudendal nerve stimulation as additional therapy for lower urinary tract dysfunction when stage II sacral neuromodulator fails: a case report.

BACKGROUND: Sacral neuromodulation (SNM) has become an effective therapy for patients with lower urinary tract dysfunction (LUTD) who do not respond to conservative treatment. However, an effective treatment strategy for patients who fail SNM has not yet been identified. An option for LUTD is needed when the clinical response to the SNM diminishes. CASE PRESENTATION: A 51-year-old Chinese man presented to an outpatient clinic complaining of difficulty in urination for > 3 years. The patient also complained of urinary frequency and urgency, accompanied by perineal discomfort. He was diagnosed with LUTD based on his symptoms and previous examinations. The patient underwent sacral neuromodulation with a permanent implantable pulse generator (IPG) (provided free of charge by Chengnuo Medical Technology Co., Ltd.; General Stim, Hangzhou, China) in the left buttock, as he participated in the company's clinical trial to test the long-term effects of IPG. He reported loss of efficacy of the device 3 months after the implantation. We performed bilateral electrical pudendal nerve stimulation (EPNS) therapy for him. After 2 weeks of treatment, he began to report smooth voiding within 2 h after EPNS, and a moderate improvement in urinary frequency, urgency, and perineal discomfort. After 4 weeks of EPNS, the patient reported > 50% improvement in his urination, evaluated with the short form of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. He reported smooth voiding, moderate improvements in urinary frequency and urgency, and the disappearance of the perineal discomfort. He also reported improved sleep and erections. The patient was discharged after 8 weeks of EPNS treatment. CONCLUSION: EPNS could be an option as an additional therapy for patients with LUTD who have failed SNM.

A flux-gradient system for simultaneous measurement of the CH4, CO2, and H2O fluxes at a lake-air interface.

Inland lakes play important roles in water and greenhouse gas cycling in the environment. This study aims to test the performance of a flux-gradient system for simultaneous measurement of the fluxes of water vapor, CO2, and CH4 at a lake-air interface. The concentration gradients over the water surface were measured with an analyzer based on the wavelength-scanned cavity ring-down spectroscopy technology, and the eddy diffusivity was measured with a sonic anemometer. Results of a zero-gradient test indicate a flux measurement precision of 4.8 W m(-2) for water vapor, 0.010 mg m(-2) s(-1) for CO2, and 0.029 µg m(-2) s(-1) for CH4. During the 620 day measurement period, 97%, 69%, and 67% of H2O, CO2, and CH4 hourly fluxes were higher in magnitude than the measurement precision, which confirms that the flux-gradient system had adequate precision for the measurement of the lake-air exchanges. This study illustrates four strengths of the flux-gradient method: (1) the ability to simultaneously measure the flux of H2O, CO2, and CH4; (2) negligibly small density corrections; (3) the ability to resolve small CH4 gradient and flux; and (4) continuous and noninvasive operation. The annual mean CH4 flux (1.8 g CH4 m(-2) year(-1)) at this hypereutrophic lake was close to the median value for inland lakes in the world (1.6 g CH4 m(-2) year(-1)). The system has adequate precision for CH4 flux for broad applications but requires further improvement to resolve small CO2 flux in many lakes.

Efficacy of electrical pudendal nerve stimulation versus pelvic floor muscle training in treating postradical prostatectomy urinary incontinence: study protocol for a randomised controlled trial.

INTRODUCTION: Urinary incontinence (UI) is one of the main complications of radical prostatectomy. Electrical pudendal nerve stimulation (EPNS) has been used to treat stress UI based on its mechanism of passive pelvic floor muscle contraction reported in the previous research. However, there are no studies comparing the effects of EPNS and active pelvic floor muscle training (PFMT) in the treatment of postradical prostatectomy UI (PPUI). Here, we describe the protocol for a randomised controlled trial to evaluate the efficacy of EPNS in treating PPUI compared with PFMT. METHODS AND ANALYSIS: This study is designed as an open-label randomised controlled trial with blinded assessment and analysis. A total of 90 eligible men will be randomly allocated to two groups. The treatment group (n=45) will receive EPNS while the control group will perform PFMT by doing the Kegel exercise. Forty EPNS treatment sessions will occur over a period of 8 weeks. The primary outcome measure will be improvement rate, and the secondary outcome measures, the number of pads used, 24-hour pad test, and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form will be compared between baseline and the study endpoint. The International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life and care compared as the quality of life and satisfaction outcomes between groups. ETHICS AND DISSEMINATION: This protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (approval no. 2021 KL-040-02). Written informed consent will be obtained from each participant. The results of the study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ChiCTR2200055461.

Hsa_circ_0065217 promotes growth and metastasis of renal cancer through regulating the miR-214-3p-ALPK2 axis.

Circular RNA (circRNA) deregulation impacts on normal cell physiology leading to malignant phenotypic changes. Here, we determined the function of the circRNA, hsa_circ_0065217 in malignant renal cell carcinoma (RCC). Hsa_circ_0065217 was abundantly expressed in RCC tissue and cell lines, and its expression linked to advanced TNM stages, large tumor sizes, and lymph-node metastasis. Hsa_circ_0065217 silencing reduced in vitro RCC cell-line growth and aggressiveness. Mechanistically, hsa_circ_0065217 promoted alpha protein kinase 2 (ALPK2) expression via its competing endogenous RNA (ceRNA) activity toward miR-214-3p. Moreover, ALPK2 overexpression reversed hsa_circ_0065217 knockdown effects on RCC cell-line malignancy. Thus, hsa_circ_0065217/miR-214-3p/ALPK2 signaling putatively promotes RCC tumorigenesis and is a putative RCC treatment target.

Methane flux dynamics in a submerged aquatic vegetation zone in a subtropical lake.

Submerged macrophytes are important primary producers for shallow lake systems. So far, their overall role in regulating lake methane flux is a subject of debate because the oxygen produced by their roots can promote methane oxidation in the sediment but they can also enhance methanogenesis through organic substrate production. In this study, we used the eddy covariance method to investigate the temporal dynamics of the CH4 flux in a habitat of submerged macrophytes in Lake Taihu. The results show that the nighttime CH4 flux is on average 33% higher than the daytime flux, although a clear diurnal pattern is evident only in the spring. At the daily to the seasonal time scale, the sediment temperature is the main driver of the CH4 flux variations, implying higher methane production in the sediment at higher temperatures. The annual CH4 emission (6.12 g C m-2 yr-1) is much higher than the published whole-lake mean flux (1.12 g C m-2 yr-1) and that reported previously in the eutrophic phytoplankton zone of the lake (1.35 g C m-2 yr-1), indicating that the net effect of the submerged macrophytes is to enhance methane emission. At the annual time scale, 3.5% of the carbon gained by the net ecosystem production is lost to the atmosphere in the form of CH4.

Rare foreign body in bladder: A case report.

RATIONALE: The bladder is the most common site of foreign bodies in the urinary tract. Presenting complaints in patients with a foreign body are urinary retention, dysuria, frequent urination, decreased urine volume, nocturia, hematuria, painful erection, as well as pain in the urethra and pelvis. PATIENT CONCERNS: A 50-year-old married male presented with complaints of severe lower abdominal pain and dysuria. DIAGNOSES: A plain radiograph of the pelvis showed a metallic dense foreign body that was composed of many small magnetic balls in the pelvic region. INTERVENTIONS: The foreign body was removed under cystoscopy, and 67 magnetic balls were detected without any surgical or postsurgical complications. OUTCOMES: During operation, A cystoscopic examination confirmed no residue. LESSONS: The bladder is the most common site of a foreign body in the urinary tract.Most intravesical foreign bodies can be removed transurethrally and with minimum access. The best mode of management depends on the nature of the foreign body, lodged site, expertise of the surgeon, and available instruments.

Spatiotemporal variability of the near-surface CO2 concentration across an industrial-urban-rural transect, Nanjing, China.

Urban lands are CO2 emission hotspots. In this paper, we report the CO2 concentration observations along an industrial-urban-rural transect and in a network of sites in the urban center, in Nanjing, China. The mean CO2 concentration was highest at the industrial site, not at the densely populated urban center (urban: 429.2±8.7ppm, rural: 421.2±10.0ppm, industrial: 443.88±18.3ppm), based on four sampling periods in four different seasons in 2014 and 2015. At the urban sites, a reversed weekend effect was observed, whereby the weekend CO2 concentration was higher than the weekday concentration by a mean of 0.9ppm over the four measurement periods and by 8.1ppm in the spring, suggesting higher traffic volume on weekends than on weekdays. The vertical CO2 gradient was weak above the urban canopy layer, with a mean difference of only 1.1ppm between the 60-m and 110-m measurement heights, reflecting efficient mixing in both daytime and nighttime periods. The average along-wind concentration gradient was 0.25±0.87ppmkm-1 at the height of 110m according to the observations made at five urban sites. Based on a simple box model, we estimated an anthropogenic surface flux of about 0.4mgCO2m-2s-1 for the urban center.

[Characteristics of Methane Emission from Urban Traffic in Nanjing].

Urban traffic is an important source of greenhouse gases such as CH4. The observations on CH4 are the basis for quantitative analysis of urban carbon emissions. Taken into consideration the weekly and daily changing characteristics of urban traffic, we conducted experiments to analyze the features of traffic CH4emission and its influential factors. The experiments were conducted on 3 main roads in Nanjing on Oct. 17, 18, 20, 23, 2014 with 5 periods of observation per day, and in Nanjing Yangtze River tunnel in the morning and at night of Sep.11 2014. The results showed that:① The average concentration of CH4 on the urban main road of Nanjing city was greater than that of the background atmosphere. Affected by traffic conditions, the spatial difference of ΔCH4 concentration was significant on three typical main roads. ΔCH4 concentration's diurnal variation showed inverted "W" type, and its peak appeared in the morning and evening rush hours. ② Due to the "piston wind" in the tunnel, the CH4 concentration in Nanjing Yangtze River tunnel gradually increased from the inlet to the outlet and the difference of concentration between the inlet and the outlet was 0.21×10-6-0.38×10-6. ③ There was a good linear correlation between CH4 concentration and CO2 concentration. The atmospheric ΔCH4:ΔCO2 value of urban main road in Nanjing was 0.0091 and the atmospheric ΔCH4:ΔCO2 value of Nanjing Yangtze River Tunnel was 0.00047-0.0014. ④ Traffic volume and the proportion of natural gas vehicles were the main factors influencing atmospheric ΔCH4 concentration and ΔCH4:ΔCO2.

[Direct Observation on the Temporal and Spatial Patterns of the CO2 Concentration in the Atmospheric of Nanjing Urban Canyon in Summer].

Direct observation of urban atmospheric CO2 concentration is vital for the research in the contribution of anthropogenic activity to the atmospheric abundance since cities are important CO2 sources. The observations of the atmospheric CO2 concentration at multiple sites/heights can help us learn more about the temporal and spatial patterns and influencing mechanisms. In this study, the CO2 concentration was observed at 5 sites (east, west, south, north and middle) in the main city area of Nanjing from July 18 to 25, 2014, and the vertical profile of atmospheric CO2 concentration was measured in the middle site at 3 heights (30 m, 65 m and 110 m). The results indicated that: (1) An obvious vertical CO2 gradient was found, with higher CO2 concentration [molar fraction of 427. 3 x 10(-6) (±18. 2 x 10(-6))] in the lower layer due to the strong influences of anthropogenic emissions, and lower CO2 concentration in the upper layers [411. 8 x 10(-6) (±15. 0 x 10(-6)) and 410. 9 x 10(-6) (±14. 6 x 10(-6)) at 65 and 110 m respectively] for the well-mixed condition. The CO2 concentration was higher and the vertical gradient was larger when the atmosphere was stable. (2) The spatial distribution pattern of CO2 concentration was dominated by wind and atmospheric stability. During the observation, the CO2 concentration in the southwest was higher than that in the northeast region with the CO2 concentration difference of 7. 8 x 10(-6), because the northwest wind was prevalent. And the CO2 concentration difference reduced with increasing wind speed since stronger wind diluted CO2 more efficiently. The more stable the atmosphere was, the higher the CO2 concentration was. (3) An obvious diurnal variation of CO2 concentration was shown in the 5 sites. A peak value occurred during the morning rush hours, the valley value occurred around 17:00 (Local time) and another high value occurred around 19:00 because of evening rush hour sometimes.