Analysis of the Efficacy and Safety of PCNL and ESWL in Patients with Complicated Upper Urinary Tract Renal Calculi.

Objective: This study aimed to investigate the clinical efficacy and safety of combining percutaneous nephrolithotomy (PCNL) with extracorporeal shock wave lithotripsy (ESWL) for the treatment of patients with complicated upper urinary calculi. Methods: We employed a randomized controlled experimental design to examine data from patients diagnosed with complex upper urinary tract renal calculi at our hospital from April 2019 to March 2020. A total of 98 eligible patients were included in the study. To ensure the integrity of the research, we computerized and randomized the patient data according to the study's protocol. Subsequently, we divided the patients into two groups: a control group (n = 49) that received ESWL as the treatment modality and an experimental group (n = 49) that underwent a combined treatment approach involving both PCNL and ESWL. Following the completion of the treatments, we analyzed stone clearance rates and other outcome indicators. Additionally, we carefully documented any post-treatment adverse events to evaluate patient safety comprehensively. Results: The experimental group exhibited a higher stone clearance rate compared to the control group. Comparison of visual Analog Scale/Score (VAS) pain scores, operation time, and hospitalization time revealed statistically significant differences (P < .05), with the experimental group showing slightly worse performance than the control group. After treatment, both groups experienced varying degrees of complications, with the experimental group demonstrating fewer complications, a statistically significant result (P < .05). Conclusions: Extracorporeal shock wave lithotripsy significantly improved stone clearance rates in patients with complex upper urinary tract renal calculi. Simultaneously, it positively impacted surgical outcomes and reduced the incidence of post-treatment adverse events. This intervention offers clinical benefits.

Development and Validation of an IL6/JAK/STAT3-Related Gene Signature to Predict Overall Survival in Clear Cell Renal Cell Carcinoma.

Background: Traditional clinicopathological features (TNM, pathology grade) are often insufficient in predictive prognosis accuracy of clear cell renal cell carcinoma (ccRCC). The IL6-JAK-STAT3 pathway is aberrantly hyperactivated in many cancer types, and such hyperactivation is generally associated with a poor clinical prognosis implying that it can be used as a promising prognosis indicator. The relation between the IL6-JAK-STAT3 pathway and ccRCC remains unknown. Methods: We evaluated the levels of various cancer hallmarks and filtered out the promising risk hallmarks in ccRCC. Subsequently, a prognosis model based on these hallmark-related genes was established via weighted correlation network analysis and Cox regression analysis. Besides, we constructed a nomogram based on the previous model with traditional clinicopathological features to improve the predictive power and accuracy. Results: The IL6-JAK-STAT3 pathway was identified as the promising risk hallmarks in ccRCC, and the pathway-related prognosis model based on five genes was built. Also, the nomogram we developed demonstrated the strongest and most stable survival predictive ability. Conclusion: Our study would provide new insights for guiding individualized treatment of ccRCC patients.

[Real-time fluorescence constant-temperature simultaneous amplification and testing of nucleic acid for detection of mycoplasma genitalium infection in the genitourinary tract].

OBJECTIVE: To investigate the infection of reproductive Mycoplasma genitalium (MG) detected by real-time fluorescence constant-temperature simultaneous amplification and testing (SAT) of nucleic acid among patients present at the clinics of urology, gynecology or venereal diseases. METHODS: We retrospectively analyzed the clinical data on 5 711 patients with suspected genitourinary tract (GUT) infection present at the clinics of urology, gynecology or sexually transmitted diseases in Hangzhou Third People's Hospital, Shaoxing People's Hospital and General Hospital of Eastern Theater Command from January 2018 to December 2018. The patients were aged 16－73 (38.77 ± 11.32) years, 3 425 males and 2 286 females. We collected urine samples from 3 666, GUT secretion samples from 2 095, and both urine and GUT samples from 50 of the patients. Using the SAT technique, we detected the infections of MG, Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) in the patients. RESULTS: Of the 5 711 patients, 294 (5.15%) were found MG-positive, with a significantly higher positive rate in the males than in the females (5.96% ï¼»206/3 425ï¼½ vs 3.85% ï¼»88/2 286ï¼½, P < 0.05). The laboratory results with the urine and GUT secretion samples from 50 of the cases showed a consistency rate of 100%. Simple MG infection accounted for 52.04% in the 294 MG-positive cases, 63.11% in the 206 MG-positive males, and 26.13% in the 88 females, with a significantly higher positive rate in the males than in the females (P < 0.05). MG combined with UU infection had the highest rate among the mixed infections in both the males and females and in those aged ≤20 years, even higher in the females than in the males (P < 0.05) and in the ≤20-year-old males than in the ≤20-year-old females (8.65% ï¼»9/104ï¼½ vs 5.13% ï¼»4/78ï¼½, P < 0.05). There were statistically significant differences in the MG-positive rate among different age groups (χ2 = 32.74, P < 0.05). CONCLUSIONS: Among patients with suspected GUT infection, the MG-positive rate is higher in men than in women, with MG + UU-positive as the most common mixed infection, and it decreases with the increase of age. The results of SAT of urine and GUT secretion have a high consistency rate.

Expression of claudin­11 in a rat model of varicocele and its effects on the blood­testis barrier.

Varicocele (VC) is an abnormal tortuosity and venous distension of the pampiniform plexus in the spermatic cord. VC is the most common surgically correctable cause of male infertility. The purpose of the present study was to investigate the effects of VC on the tight junctions and the blood­testis barrier (BTB) of Sertoli cells in the bilateral testes of rats. A model of VC was established by left renal vein narrowing in Sprague­Dawley rats; control rats underwent dissection of the vein without narrowing. The bilateral testes were harvested at 4, 6 and 8 weeks after the operation. The relative expression of claudin­11 and transforming growth factor (TGF)­ß in the testis was determined by reverse transcription­polymerase chain reaction analysis and immunohistochemistry (IHC). The expression level of claudin­11 was prominently downregulated in the VC model group compared with the control group, while the level of TGF­ß in the testes was higher in the VC group. IHC examination demonstrated that VC led to destruction of the integrity of the BTB, and the degree of destruction increased with time. Furthermore, it was also observed that unilateral VC affected contralateral testicular function. In conclusion, the present study partially explained the molecular mechanisms underlying the pathogenesis of VC and provided grounds for further research into the treatment of male infertility.

Metformin therapy and prostate cancer risk: a meta-analysis of observational studies.

OBJECTIVE: Several observational studies have shown that metformin therapy may modify the risk of prostate cancer. We carried out a meta-analysis of relevant studies evaluating the effect of metformin therapy on prostate cancer risk. METHODS: We searched pubmed database (January 1966-February 2014) for case-control and cohort studies that assessed metformin therapy and prostate cancer risk. Two authors independently assessed eligibility and extracted data. Summary RRs was calculated using fixed-effects model or random-effects model. Heterogeneity among studies was examined using Q and I(2) statistics. RESULTS: We included six cohort studies and four case-control studies in the present meta-analysis, comprising 863,769 participants and 39,073 prostate cancer cases. The pooled RR of prostate cancer in relation to metformin therapy was 0.92 (95% CI: 0.84-1.02, P = 0.112). When we stratified the various studies by study type, we found that metformin therapy was associated with a significant reduced risk of prostate cancer among cohort studies (RR = 0.92, 95% CI [0.87, 0.96], P<0.001); however, no significant association was detected among case-control studies (RR = 0.95, 95% CI [0.78, 1.16], P = 0.632). There was also no indication of publication bias as suggested by Begg's test (P = 0.421) and Egger's test (P = 0.627). CONCLUSION: Our findings indicate that metformin therapy is not significantly associated with lower prostate cancer risk.