Endoscopic Ureteral Dilation Balloon Catheter for a Difficult Ureter: A New Novel Approach.

OBJECTIVES: This study aims to assess the safety and efficacy of INNOVEXTM ureteral dilation balloon catheter to promote the likelihood of passing the ureter to complete primary ureteroscopy (URS). METHODS: This was a prospective case series of patients during URS between August 2018 and January 2020 at the Pudong New District People's Hospital. A 12-Fr INNOVEXTM ureteral dilation balloon catheter was used to dilate the ureter when a 5° Wolf 6.0/7.5-Fr ureteroscope encounters an unpredictable hindrance to retrograde access for ureteral stones. Patients with documented ureteral strictures, radiation therapy, or urothelial cancer were excluded from the analysis. The primary outcomes were to characterize the use, safety, and efficacy of ureteral dilation balloon catheter to promote stone treatment during URS. RESULTS: Eight hundred and sixty-two patients underwent primary URS of ureteral stones over the study period. The use of a ureteral dilation balloon catheter to promote ureteral access was performed in 65 (7.54%) cases and effectively allowed completion of the procedure in 58 (89.23%) cases. No ureteral perforation and access loss occurred during the operation. Seven patients required ureteral stent placement for passive ureteral dilation, with definitive stone treatment later. Postoperative radiographic follow-up was available for 63 (96.92%) cases, and no ureteral stenosis was observed after balloon dilation. CONCLUSION: The use of a new ureteral dilation balloon catheter before endoscopic treatment of ureteral stones was associated with a high success rate and few complications. The convenient use method under direct vision at the whole process may increase the willingness of doctors to use it. In addition, it may reduce the need for secondary procedures for patients undergoing URS to manage ureteral stones.

Palliative TURP Combined with Intermittent ADT Is A Curative Therapy to Some Elderly Men with Localized Prostate Adenocarcinoma.

Background: Radical prostatectomy is the preferred therapeutic option for patients with localized prostate adenocarcinoma whose life expectancy is greater than 10 years. But for elderly patients, this may not be the best option. In clinical work, we have observed that palliative transurethral resection of prostate (pTURP) combined with intermittent androgen deprivation therapy (ADT) has achieved significant good results in the treatment of elderly patients with localized prostate adenocarcinoma. Methods: Retrospective analysis was conducted on 30 elderly patients aged 71 to 88 years who were hospitalized for urinary retention from March 2009 to March 2015. These patients were diagnosed as localized prostate adenocarcinoma with stage T1 to T2 and benign prostatic hyperplasia (BPH) through MRI and prostate biopsy. Fifteen cases (group A) were given pTURP and intermittent ADT after surgery. Fifteen cases (group B) were given sustained ADT. Serum total prostate specific antigen (TPSA), testosterone, alkaline phosphatase (ALP), prostate acid phosphatase (PAP), International Prostate Symptom Score (IPSS), Quality of Life (QOL) score, maximum urinary flow rate (Qmax), average urinary flow rate (Qave), prostate volume and post-void residual urine (PVR) data were followed up for 5 years, and the differences between the two groups were compared. Results: The 5-year cumulative survival rate of group A was 100%. Prostate specific antigen (PSA) progression-free survival was 60.00%. The average duration of intermittent ADT was 23.93 months. Prostate volume reduction was significantly. The dysuria in all patients was significantly improved. Nine patients had TPSA lower than 4 ng/ml and had no local progression and metastasis. At the same time the 5-year cumulative survival rate of group B was 80%. PSA progression-free survival was 26.67%. Six cases of dysuria improved. There was no significant difference in serum TPSA, ALP and PAP between the two groups in five years (P>0.05). Serum testosterone, IPSS score, QOL score, prostate volume, Qmax, Qave, and PVR were significantly different between the two groups in five years (P<0.05). Conclusion: pTURP for elderly patients with localized prostate adenocarcinoma and BPH combined with intermittent ADT is an effective treatment. It is able to solve dysuria. The overall ADT time is short. The risk of progression to castrated resistant prostate cancer is low. Some of them have achieved tumor-free survival.

Tea Drinking and the Risk of Carcinoma of the Urinary Bladder: A Meta-Analysis.

Objective: For evaluation of the correlation between tea drinking and the risk of carcinoma of the urinary bladder. Methods: By searching PubMed, Embase, and Cochrane Library databases, the original studies on tea drinking and carcinoma of the urinary bladder risk were collected, the data were extracted, and meta-analysis package 5.2-0 of R language was used for meta-analysis. Results: This study contained 11 researches, composed of 7686 patients and 10320 controls. Tea drinking was not linked to carcinoma of the urinary bladder risk (OR:1.02, 95%CI: 0.95-1.11). Conclusion: Tea drinking may not be linked to carcinoma of the urinary bladder, but more definitive results are needed from higher-quality trials.

Endoscopic removal of giant fungus balls growing in the renal pelvis and urinary bladder due to long-term retention of ureteral stent: A case report.

It is exceedingly rare for fungus balls both 3 cm diameter in the renal pelvis and 6 cm diameter in urinary bladder simultaneously. An elderly woman has been successfully cured by several endoscopic operations. Transurethral bladder fungus ball removal was performed first. Then septic shock and pseudoaneurysm occurred after removal of fungus ball by percutaneous nephroscope. This case highlights the importance of the ureteral stent should not be left for a long time. Once there is fungal infection, the ureteral stent should be removed immediately. Endoscopic operation is an effective remedy for fungus balls.

Discovery of novel 1,3,5-triazines as potent antibacterial agent against urinary tract infection-causing clinical isolates of Escherichia coli via inhibition of DNA Gyrase.

A novel series of 1,3,5-triazine-phenylthiazole-pyrazole derivatives were synthesized and subsequently tested for Escherichia coli DNA Gyrase inhibitory activity where they showed excellent inhibitory activity. The top-three ranked DNA gyrase inhibitor (4e, 4g and 4h) were further subjected to antibacterial and anti-biofilm activity against clinical isolates of resistant E. coli strains obtained from Urinary Tract Infection (UTI) patients (CREC81, CREC106, CREC163). Compound 4h was identified as most potent antibacterial agent in the above study. The compound 4h was further evaluated in murine model of E. coli UTI in BALB/c mice infected by transurethral injection of CREC106 strain. Results of the study suggest that compound 4h reduces bacterial load of CREC106 in the treated mice and found approximately equipotent to Novobiocin as standard.

Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study.

BACKGROUND: Identifying the temporal trends of kidney cancer (KC) incidence in both the past and the future at the global and national levels is critical for KC prevention. METHODS: We retrieved annual KC case data between 1990 and 2017 from the Global Burden of Disease (GBD) online database. The average annual percentage change (AAPC) was used to quantify the temporal trends of KC age-standardized incidence rates (ASRs) from 1990 to 2017. Bayesian age-period-cohort models were used to predict KC incidence through 2030. RESULTS: Worldwide, the number of newly diagnosed KC cases increased from 207.3 thousand in 1990 to 393.0 thousand in 2017. The KC ASR increased from 4.72 per 100,000 to 4.94 per 100,000 during the same period. Between 2018 and 2030, the number of KC cases is projected to increase further to 475.4 thousand (95% highest density interval [HDI] 423.9, 526.9). The KC ASR is predicted to decrease slightly to 4.46 per 100,000 (95% HDI 4.06, 4.86). A total of 90, 2, and 80 countries or territories are projected to experience increases, remain stable, and experience decreases in KC ASR between 2018 and 2030, respectively. In most developed countries, the KC incidence is forecasted to decrease irrespective of past trends. In most developing countries, the KC incidence is predicted to increase persistently through 2030. CONCLUSIONS: KC incidence is predicted to decrease in the next decade, and this predicted decrease is mainly driven by the decreases in developed countries. More attention should be placed on developing countries.

Long non-coding RNA small nucleolar RNA host gene 7 expression level in prostate cancer tissues predicts the prognosis of patients with prostate cancer.

Long non-coding small nucleolar RNA host gene 7 (lncRNA SNHG7) is located on chromosome 9q34.3 in length of 984 bp. SNHG7 has been found to play the role of oncogene in varieties of cancers, and its dysregulation has been found to be associated with carcinogenesis and progression. In the present study, we examined the expression of SNHG7 in prostate cancer tissues and in paired adjacent normal prostate tissues, and we further explored the clinical significance and prognostic value of SNHG7 in prostate cancer patients.A total of 127 prostate cancer tissues were collected from prostate cancer patients who underwent radical prostatectomy between April 2011 and March 2019 at the department of urology, Pudong New Area People's Hospital. Real-time quantitative polymerase chain reaction experiment was performed to detect the relative expressions of SNHG7 in the prostate cancer tissues and normal prostate tissues. The Kaplan-Meier method was used to create survival curves and the log-rank test was used to determine statistical significance. A Cox proportional hazard analysis was used to evaluate the prognostic factors in univariate and multivariate analyses.Compared with paired adjacent normal prostatic tissues, SNHG7 expression was increased in prostate cancer tissues (P < .001). Increased SNHG7 expression correlated with Gleason score (P = .021), bone metastasis (P = .013), pelvic lymph node metastasis (P = .008), and TNM stage (P = .007). Multivariate Cox regression analyses revealed increased SNHG7 expression was independently associated with a poor prognosis of prostate cancer patients (hazard ratio [HR] = 2.839, 95% confidence interval [CI] = 1.921-8.382, P = .038).This study showed that lncRNA-SNHG7 was overexpressed in prostate cancer tissues, and it might contributes to the development and progression of prostate cancer. Furthermore, the SNHG7 expression was associated with the prognosis of prostate cancer, suggesting a potential target for the treatment and prognosis of prostate cancer. Nevertheless, the underlying modulatory mechanism by which SNHG7 aggravates prostate cancer progression need to be further studied.

Evaluating the microRNA-target gene regulatory network in renal cell carcinomas, identification for potential biomarkers and critical pathways.

Variant microRNA (miRNA) expression is a character of many cancer types. The combined analysis of miRNA and messenger RNA (mRNA) expression profiles is crucial to identifying links between deregulated miRNAs and oncogenic pathways. The aim of this study was to screen several novel genes associated with renal cell carcinoma (RCC), and analyze the gene functions and signal pathways which were critical to RCCs with DNA microarray. The gene expression profile of GSE6344 was downloaded from Gene Expression Omnibus database, including 10 RCC samples and 10 healthy controls. Compared with the control samples, differentially expressed genes (DEGs) of RCC was identified. The selected DEGs were further analyzed using bioinformatics methods. Gene ontology (GO) enrichment analysis was performed using Gene Set Analysis Toolkit and protein-protein interaction (PPI) network was constructed with prePPI. Then, pathway enrichment analysis to PPI network was performed using WebGestalt software. We found that a total of 521 DEGs were down-regulated and 473 DEGs were up-regulated in RCC samples compared to healthy controls. A total of 15 remarkable enhanced functions and 17 suppressed functions were identified. PPI nodes of high degrees, such as RHCG, RALYL, SLC4A1, UMOD and CA9, were obtained. The DEGs were classified and significantly enriched in cytokine and cytokine receptor pathway. The hub genes we find from RCC samples are not only biomarkers, but also may provide the groundwork for a combination therapy approach for RCCs.