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.

Atomic-resolution transmission electron microscopy of electron beam-sensitive crystalline materials.

High-resolution imaging of electron beam-sensitive materials is one of the most difficult applications of transmission electron microscopy (TEM). The challenges are manifold, including the acquisition of images with extremely low beam doses, the time-constrained search for crystal zone axes, the precise image alignment, and the accurate determination of the defocus value. We develop a suite of methods to fulfill these requirements and acquire atomic-resolution TEM images of several metal organic frameworks that are generally recognized as highly sensitive to electron beams. The high image resolution allows us to identify individual metal atomic columns, various types of surface termination, and benzene rings in the organic linkers. We also apply our methods to other electron beam-sensitive materials, including the organic-inorganic hybrid perovskite CH3NH3PbBr3.

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.

Vasectomy and the risk of prostate cancer: a meta-analysis of cohort studies.

BACKGROUND: The relationship of vasectomy to prostate cancer has great public health significance. However, the results of observational studies were conflicting. To determine whether vasectomy is associated with the risk of prostate cancer, we performed a meta-analysis of cohort studies. METHODS: A literature search was carried out using Pubmed, Embase, Cochrane Libraryl, and China National Knowledge Infrastructure (CNKI) between January 1966 and July 2013. Before meta-analysis, between-study heterogeneity and publication bias were assessed using adequate statistical tests. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses and sensitivity analysis were also performed. RESULTS: A total of nine cohort studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Pooled results indicated that vasectomy was not associated with a significant increase of total prostate cancer risk (RR = 1.07, 95% CI [0.79, 1.46]). When stratified the various studies by geographic location, we found a significant association between vasectomy and increased PCa risk among studies conducted in the USA (RR = 1.54, 95% CI [1.23, 1.93]), however, there was no significant association between vasectomy and PCa risk among studies conducted in non-USA countries (RR = 0.74, 95% CI [0.50, 1.09]). Furthermore, sensitivity analysis confirmed the stability of the results. CONCLUSIONS: In conclusion, the present meta-analysis of cohort studies suggested that vasectomy was not associated with increased risk of prostate cancer. More in-depth studies are warranted to report more detailed results, including stratified results by age at vasectomy, tumor grade, and tumor stage.

Robot-assisted versus laparoscopic partial nephrectomy for localized renal tumors: a meta-analysis.

BACKGROUND: Robot-assisted partial nephrectomy (RAPN) is being performed more frequently for the minimally invasive management of localized renal tumors. However, it's unclear whether RAPN is more efficacious than the standard laparoscopic partial nephrectomy (LPN). The objective of this meta-analysis is to compare RAPN and LPN in terms of perioperative and oncologic outcomes for the treatment of localized renal tumors. METHODS: A systematic search of electronic databases including MEDLINE, EMBASE and OVID was conducted. Comparative studies comparing RAPN and LPN for the treatment of localized renal tumors were regarded eligible. The mean difference (MD), odds ratio (OR) and their corresponding 95% confidence intervals (CI) were calculated for each outcome. The methodologic quality of the included studies was evaluated using the strict criteria of the Newcastle-Ottawa scale. RESULTS: 14 comparative studies (n = 1539 participants) were included in the present meta-analysis. Operative time was similar for RAPN and LPN (MD = 6.33, 95% CI [-23.93, 36.59]), however, warm ischemia time favored RAPN (MD = -3.29, 95% CI [-6.47, -0.10]). There was no significant difference in estimated blood loss (EBL) (MD = -42.24, 95% CI [-87.10, 2.61]) and length of stay (LOS) (MD = -0.29, 95% CI [-0.89, 0.32]). The incidence of intraoperative complications was similar for RAPN and LPN (OR = 0.68, 95% CI [0.29, 1.58]), as well as incidence of postoperative minor complications (OR = 1.10, 95% CI [0.80, 1.51]) and postoperative major complications distributions by Clavien classification (OR = 0.99, 95% CI [0.61, 1.61]). In addition, no significant difference was found in terms of positive surgical margin rate (OR = 1.12, 95% CI [0.56, 2.25]). CONCLUSIONS: RAPN had similar operative time, LOS, EBL, and perioperative complications compared with LPN, as well as positive margin rates. RAPN appears to offer the advantage of decreased WIT compared with LPN. Studies with long-term follow up are needed to compare RAPN and LPN in terms of long-term complications and oncologic outcomes.