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Objective: Explore the clinical application value of urethral mucosal pretreatment at the tip of the prostate in preventing stress urinary incontinence (SUI) after thulium laser enucleation of the prostate (ThuLEP). Methods: Eighty-seven patients with benign prostatic hyperplasia (BPH) treated with ThuLEP from June 2021 to December 2022 were divided into two groups. Of these, 42 patients (group A) underwent conventional ThuLEP and 45 patients (group B) were enucleated after pretreatment of the urethral mucosa. At the tip of the prostate, pretreatment of the urethral mucosa consisted of pushing the gland separately on both sides at the level of the verumontanum and cutting off the mucosa near the external urethral sphincter clockwise and counterclockwise. The perioperative and postoperative follow-up indicators [operation time, hemoglobin reduction, complications, Qmax, International Prostate Symptom Score (IPSS), quality of life (QoL), and post-void residual (PVR) volume] of the two groups of patients were collected and compared. All patients were followed up 1â month after surgery. Results: All 87 procedures were successfully completed. There was no significant difference in age and gland size between the two groups (P > 0.05). There was no significant difference between operating time and hemoglobin reduction in the two groups (P > 0.05). The Qmax, IPSS, QOL, and PVR volume were significantly improved postoperatively in both groups (P < 0.05). Temporary SUI occurred in both groups [12 cases (28.5%) in group A and 3 cases (6.7%) in group B (P < 0.05)]. There was no significant difference in the incidence of infection and urethral stricture between the two groups (P > 0.05). Conclusion: Pretreatment of the urethral mucosa before ThuLEP for BPH significantly reduces the incidence of SUI after surgery. This technique, which preconditions the apical urethral mucosa of the prostate, is safe and effective, has few complications, and is worthy of clinical application.
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BACKGROUND: The etiology of chronic prostatitis remains unclear; consequently, this disease is associated with recurrence and ineffective clinical therapy. Therefore, there is an urgent need to investigate the underlying pathogenesis of chronic prostatitis in order to develop more efficacious treatments. OBJECTIVE: The previous study found that knocking out of PEBP4 leads to chronic prostatitis in the male mice. This research aimed to identify the role of PEBP4 in prostatitis, determine the molecular pathogenic mechanisms associated with chronic prostatitis, and provide guidelines for the development of new treatment strategies for chronic prostatitis. MATERIALS AND METHODS: A PEBP4 exon knockout strain (PEBP4-/-) was established in C57BL/6 mice via the Cre-loxP system. Hematoxylin-eosin (H&E) staining was used to investigate histological changes. RNA-sequencing was used to investigate the gene expression signature of the prostate and the levels of inflammatory cytokines were determined by real-time polymerase chain reaction (RT-PCR). The expression of PEBP4 protein in prostate tissue was determined by immunohistochemistry in specimens from patients with BPH and BPH combined with chronic prostatitis. Finally, we used a CRISPR-Cas9 plasmid to knockout PEBP4 in RWPE-1 cells; western blotting was subsequently used to measure the level of activation in the NF-κB signaling pathway after activating with TNF-α. RESULTS: Hemorrhage and inflammatory cell infiltration were incidentally observed in the seminal vesicles and prostate glands of PEBP4-/- mice after being fed with a normal diet for 1 year. In addition, we found significantly lower (p < 0.001) expression levels of PEBP4 protein in prostate tissues from patients with benign prostate hyperplasia (BPH) and chronic and non-bacterial prostatitis (CNP) when compared to those with BPH only. The reduced expression of PEBP4 led to a higher risk of prostatitis recurrence in patients after 2 years of follow-up. Increased levels of NF-κB and IκB phosphorylation were observed in PEBP4-knockout RWPE-1 cells and prostate glands from PEBP4-/- mice. CONCLUSION: The knockout of PEBP4 in experimental mice led to chronic prostatitis and the reduced expression of PEBP4 in patients with higher risk of chronic and non-bacterial prostatitis suggested that PEBP4 might act as a protective factor against chronic prostatitis. The knockout of PEBP4 in RWPE-1 cells led to the increased activation of NF-κB and IκB, thus indicating that inhibition of PEBP4 faciliated the NF-κB signaling cascade. Our findings provide a new etiology and therapeutic target for chronic prostatitis.
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INTRODUCTION: The current treatment of non-muscle-invasive bladder cancer is suboptimal. However, in recent years, hyperthermia intravesical chemotherapy (HIVEC) has emerged as a more effective alternative to conventional bladder perfusion. This novel treatment approach appears to have a similar therapeutic effect as Bacillus Calmette-Guérin (BCG) perfusion. This study aims to evaluate the safety and effectiveness of HIVEC compared to conventional bladder perfusion chemotherapy for non-muscle-invasive bladder cancer. Additionally, it aims to evaluate the safety and effectiveness of HIVEC in comparison to BCG perfusion therapy for non-muscle-invasive bladder cancer. METHODS: We conducted a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases to gather relevant studies on HIVEC for non-muscle-invasive bladder cancer. The analysis of the collected data was carried out using RevMan 5.3 software. RESULTS: A total of 8 randomized controlled trials were included in this meta-analysis, involving 1,203 patients. Among them, 629 cases received HIVEC, 419 cases received conventional bladder perfusion chemotherapy with mitomycin C, and 155 cases received BCG. The combined analysis revealed that the recurrence rate of bladder hyperthermic perfusion was significantly lower than that of conventional perfusion chemotherapy (RR = 0.65, 95% CI: 0.52, 0.82, p = 0.0003). However, there was no significant difference in recurrence rate between HIVEC and BCG perfusion (RR = 0.78, 95% CI: 0.56, 1.09, p = 0.14). Furthermore, no significant difference was found in the progression rate between the HIVEC group and either the conventional bladder chemotherapy group (RR = 1.08, 95% CI: 0.52, 2.26, p = 0.83) and the BCG perfusion group (RR = 0.48, 95% CI: 0.19, 1.25, p = 0.13). However, compared with the conventional bladder perfusion chemotherapy group, there was no significant statistical difference in adverse events between the bladder hyperthermia chemotherapy group and the conventional bladder perfusion chemotherapy group (RR 1.08, 95% CI: 0.80, 1.45, p = 0.63). No significant difference in the incidence of adverse events was observed between HIVEC and BCG perfusion (RR 1.03, 95% CI: 0.83, 1.29, p = 0.79). CONCLUSION: The existing results indicate that HIVEC, when compared to conventional bladder perfusion chemotherapy, can lower the recurrence rate of non-muscle-invasive bladder cancer. However, it does not significantly affect the progression rate. There was no statistically significant difference observed in the incidence of adverse events between the use of HIVEC and conventional chemotherapy. Additionally, there was no significant difference in the recurrence rate, progression rate, and incidence of adverse events when compared to BCG.
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Hipertermia Inducida , Invasividad Neoplásica , Neoplasias de la Vejiga Urinaria , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/terapia , Humanos , Administración Intravesical , Resultado del Tratamiento , Vacuna BCG/administración & dosificación , Vacuna BCG/efectos adversos , Vacuna BCG/uso terapéutico , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia Local de Neoplasia , Neoplasias Vesicales sin Invasión MuscularAsunto(s)
Neoplasias de los Genitales Masculinos , Enfermedad de Paget Extramamaria , Escroto , Humanos , Masculino , Escroto/cirugía , Enfermedad de Paget Extramamaria/cirugía , Enfermedad de Paget Extramamaria/patología , Enfermedad de Paget Extramamaria/diagnóstico , Neoplasias de los Genitales Masculinos/cirugía , Neoplasias de los Genitales Masculinos/patología , Neoplasias de los Genitales Masculinos/diagnóstico , Resultado del Tratamiento , AncianoAsunto(s)
Linfoma de Células B Grandes Difuso , Neoplasias de la Vejiga Urinaria , Humanos , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/cirugía , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/patología , Neoplasias de la Vejiga Urinaria/cirugía , PelvisAsunto(s)
Fibrosarcoma , Testículo , Masculino , Humanos , Testículo/cirugía , Fibrosarcoma/diagnóstico por imagen , Fibrosarcoma/cirugíaRESUMEN
The only existing approach for assessing the risk of developing acute ischemic stroke (AIS) necessitates that individuals possess a strong understanding of their health status. Our research gathered compelling evidence in favor of our hypothesis, suggesting that the likelihood of developing AIS can be assessed by analyzing the green autofluorescence (AF) of the skin and fingernails. Utilizing machine learning-based analyses of AF images, we found that the area under the curve (AUC) for distinguishing subjects with three risk factors from those with zero, one, or two risk factors was 0.79, 0.76, and 0.75, respectively. Our research has revealed that green AF serves as an innovative biomarker for assessing the risk of developing AIS. Our method is objective, non-invasive, efficient, and economic, which shows great promise to boost a technology for screening natural populations for risk of developing AIS.
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Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular Isquémico/complicaciones , Accidente Cerebrovascular/diagnóstico por imagen , Uñas , Factores de Riesgo , BiomarcadoresRESUMEN
To present our experience with laparoscopic ureteroneocystostomy with bladder flap (LUCBF) for treating benign ureteral stenosis and evaluate its feasibility and efficacy. The clinical data of 27 patients with benign ureteral stenosis who underwent LUCBF were retrospectively analyzed. After identification and excision of the ureteral stenosis segment, the healthy ureteral stump was dissected and incised longitudinally. A U-shaped or spiral bladder flap was harvested from the anterolateral bladder wall for ureteroplasty. All patients underwent LUCBF successfully, including 14 patients were combined with psoas hitch technique, between 90 and 220 min (median, 155 min). The median length of ureteral defect was 6 cm (range, 5-17 cm). The median blood loss was 40 ml (20-150 ml). The median indwelling time of double-J stent was 8 weeks (range, 4-8 weeks). Five patients (10.6%) suffered postoperative complications during the follow-up period (range, 12-48 months), including fever, hematuria, urinary tract infection and recurrent stenosis. The success rate was 96.3% (26/27). Patients with long ureter defects had longer operative time and more blood loss than short ureter defects. LUCBF was a safe and feasible technique for benign ureteral stenosis. Long ureter defect was related to longer operative time and more blood loss.
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Escarabajos , Laparoscopía , Uréter , Humanos , Animales , Vejiga Urinaria , Constricción Patológica , Estudios RetrospectivosRESUMEN
Background: Accurate classification techniques are essential for the early diagnosis and treatment of patients with diabetic retinopathy (DR). However, the limited amount of annotated DR data poses a challenge for existing deep-learning models. This article proposes a difficulty-aware and task-augmentation method based on meta-learning (DaTa-ML) model for few-shot DR classification with fundus images. Methods: The difficulty-aware (Da) method operates by dynamically modifying the cross-entropy loss function applied to learning tasks. This methodology has the ability to intelligently down-weight simpler tasks, while simultaneously prioritizing more challenging tasks. These adjustments occur automatically and aim to optimize the learning process. Additionally, the task-augmentation (Ta) method is used to enhance the meta-training process by augmenting the number of tasks through image rotation and improving the feature-extraction capability. To implement the expansion of the meta-training tasks, various task instances can be sampled during the meta-training stage. Ultimately, the proposed Ta method was introduced to optimize the initialization parameters and enhance the meta-generalization performance of the model. The DaTa-ML model showed promising results by effectively addressing the challenges associated with few-shot DR classification. Results: The Asia Pacific Tele-Ophthalmology Society (APTOS) 2019 blindness detection data set was used to evaluate the DaTa-ML model. The results showed that with only 1% of the training data (5-way, 20-shot) and a single update step (training time reduced by 90%), the DaTa-ML model had an accuracy rate of 89.6% on the test data, which is a 1.7% improvement over the transfer-learning method [i.e., residual neural network (ResNet)50 pre-trained on ImageNet], and a 16.8% improvement over scratch-built models (i.e., ResNet50 without pre-trained weights), despite having fewer trainable parameters (the parameters used by the DaTa-ML model are only 0.47% of the ResNet50 parameters). Conclusions: The DaTa-ML model provides a more efficient DR classification solution with little annotated data and has significant advantages over state-of-the-art methods. Thus, it could be used to guide and assist ophthalmologists to determine the severity of DR.
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The incidence of prostate cancer (PCa), the most prevalent malignancy, is currently at the forefront. RNA modification is a subfield of the booming field of epigenetics. To date, more than 170 types of RNA modifications have been described, and N6-methyladenosine (m6A) is the most abundant and well-characterized internal modification of mRNAs involved in various aspects of cancer progression. METTL3, the first identified key methyltransferase, regulates human mRNA and non-coding RNA expression in an m6A-dependent manner. This review elucidates the biological function and role of METTL3 in PCa and discusses the implications of METTL3 as a potential therapeutic target for future research directions and clinical applications.
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Metiltransferasas , Neoplasias de la Próstata , Masculino , Humanos , Metiltransferasas/genética , Metiltransferasas/metabolismo , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/genética , ARNRESUMEN
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common and non-lethal urological condition with painful symptoms. The complexity of CP/CPPS's pathogenesis and lack of efficient etiological diagnosis results in incomplete treatment and recurrent episodes, causing long-term mental and psychological suffering in patients. Recent findings indicate that the autonomic nervous system involves in CP/CPPS, including sensory, sympathetic, parasympathetic, and central nervous systems. Neuro-inflammation and sensitization of sensory nerves lead to persistent inflammation and pain. Sympathetic and parasympathetic alterations affect the cardiovascular and reproductive systems and the development of prostatitis. Central sensitization lowers pain thresholds and increases pelvic pain perception in chronic prostatitis. Therefore, this review summarized the detailed processes and mechanisms of the critical role of the autonomic nervous system in developing CP/CPPS. Furthermore, it describes the neurologically relevant substances and channels or receptors involved in this process, which provides new perspectives for new therapeutic approaches to CP/CPPS.
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Neoplasias de las Glándulas Suprarrenales , Linfoma de Células B Grandes Difuso , Humanos , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/patología , Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Neoplasias de las Glándulas Suprarrenales/cirugía , Neoplasias de las Glándulas Suprarrenales/patologíaRESUMEN
In this study, germanene-nanosheets (NSs) were synthesized by liquid-phase exfoliation, followed by an experimental investigation into the nonlinear saturable absorption characteristics and morphological structure of germanene. The germanene-NSs were employed as saturable absorbers, exhibiting saturation intensity and modulation depth values of 22.64M W/c m 2 and 4.48%, respectively. This demonstrated the feasibility of utilizing germanene-NSs passively mode-locked in an erbium-doped fiber laser (EDFL). By optimizing the cavity length, improvements in the output of EDFL characteristics were achieved, resulting in 883 fs pulses with a maximum average output power of 19.74 mW. The aforementioned experimental outcomes underscore the significant potential of germanene in the realms of ultrafast photonics and nonlinear optics.
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RNA modification is a post-transcriptional level of regulation that is widely distributed in all types of RNAs, including mRNA, tRNA, rRNA, miRNA, and lncRNA, where N6-methyladenine (m6A) is the most abundant mRNA methylation modification. Significant evidence has depicted that m6A modifications are closely related to human diseases, especially cancer, and play pivotal roles in RNA transcription, splicing, stabilization, and translation processes. The most common urological cancers include prostate, bladder, kidney, and testicular cancers, accounting for a certain proportion of human cancers, with an ever-increasing incidence and mortality. The recurrence, systemic metastasis, poor prognosis, and drug resistance of urologic tumors have prompted the identification of new therapeutic targets and mechanisms. Research on m6A modifications may provide new solutions to the current puzzles. In this review, we provide a comprehensive overview of the key roles played by RNA modifications, especially m6A modifications, in urologic cancers, as well as recent research advances in diagnostics and molecularly targeted therapies.
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Angiogenesis is an essential process in the growth and metastasis of cancer cells, which can be hampered by an anti-angiogenesis mechanism, thereby delaying the progression of tumors. However, the benefit of this treatment modality could be restricted, as most patients tend to develop acquired resistance during treatment. Vasculogenic mimicry (VM) is regarded as a critical alternative mechanism of tumor angiogenesis, where studies have demonstrated that patients with tumors supplemented with VM generally have a shorter survival period and a poorer prognosis. Inhibiting VM may be an effective therapeutic strategy to prevent cancer progression, which could prove helpful in impeding the limitations of lone use of anti-angiogenic therapy when performed concurrently with other anti-tumor therapies. This review summarizes the mechanism of VM signaling pathways in urological tumors, i.e., prostate cancer, clear cell renal cell carcinoma, and bladder cancer. Furthermore, it also summarizes the potential of VM as a therapeutic strategy for urological tumors.
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OBJECTIVES: To compare the safety and efficacy of novel tip-flexible suctioning ureteral access sheath (NTFS-UAS) and traditional ureteral access sheath (T-UAS) combined with flexible ureteroscope for treating unilateral renal calculi. MATERIALS AND METHODS: The clinical data of 214 patients with unilateral renal calculi treated by NTFS-UAS (n = 102) and T-UAS (n = 112) combined with flexible ureteroscope from August 2021 to April 2022 were analyzed retrospectively. Demographic characteristics, stone-related parameters, operative time, stone-free rates (SFR), hospitalization time and complication rate (CR) were analyzed. RESULT: No significant difference was observed between the two groups in terms of demographic characteristics, stone-related parameters, intraoperative CR, and hospitalization time. The operative time of NTFS-UAS group was significantly shorter than T-UAS group (55.25 ± 11.42 min vs. 59.36 ± 15.59 min; P = 0.028). The NTFS-UAS group obtained significantly higher SFR on 1 day postoperatively (86.3% vs. 75.0%; P = 0.038), and higher SFR on 30 days postoperatively than T-UAS group (91.2% vs. 81.3%; P = 0.037). The hemoglobin loss of NTFS-UAS group (- 0.54 ± 0.69 g/dl) was significantly lower than T-UAS group (- 0.83 ± 0.66 g/dl; P = 0.002). There was a significantly lower incidence of overall CR (11.8% vs. 22.3%; P = 0.041), and infectious CR (8.8% vs. 18.8%; P = 0.037) in the NTFS-UAS group. CONCLUSION: Compared to T-UAS combined with flexible ureteroscope for treating unilateral renal calculi, NTFS-UAS had superiority in higher SFR on 1 day and 30 days postoperatively. Shorter operation time, lower hemoglobin loss, lower incidences of overall and infectious CR were observed in NTFS-UAS group. REGISTRATION NUMBER AND DATE: ChiCTR2300070210; April 5, 2023.
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Cálculos Renales , Uréter , Cálculos Ureterales , Masculino , Humanos , Ureteroscopios , Estudios Retrospectivos , Ureteroscopía/efectos adversos , Cálculos Renales/terapia , Hemoglobinas , Resultado del Tratamiento , Cálculos Ureterales/terapiaRESUMEN
As a common aggressive head and neck cancer, nasopharyngeal carcinoma (NPC) received cisplatin treatment as a first-line chemotherapy. Platinum-induced resistance is a major limitation of current treatment strategy in the advanced NPC. Increased indoleamine 2,3-dioxygenase (IDO1) activities are found in cisplatin-resistant NPC cells versus cisplatin-sensitive NPC cells. As an IDO1 immunosuppressant, NLG-919 has entered clinical phase I to treat advanced solid tumors. To reverse cisplatin resistance, we investigated the combinatory application of cisplatin and NLG-919 in NPC treatment. In vitro biological studies on cisplatin-resistant and cisplatin-sensitive NPC cells were taken to imply that the combination of NLG-919 and cisplatin got a stronger impact on the induction of cell apoptosis and the inhibition of cell migration, exploring superior effect of antitumor over single drug. We proved that the mechanism of the combined therapy could inhibit the activity of IDO1, blocking amino acid tryptophan conversion to kynurenine through the kynurenine pathway, which further inhibited the aryl hydrocarbon receptor expression. Our study underscored the combination of cisplatin and NLG-919 as a potent therapeutic way for the reversal of cisplatin resistance.