Applying urinary ultrasound to predict the risk of spontaneous ureteral stone passage: a retrospective cohort study.

BACKGROUND: To assess the value of urological ultrasound in predicting the risk of spontaneous passage of ureteral stones. METHODS: Clinical and ultrasound data were collected consecutively from patients receiving conservative treatment for ureteral stones, and the outcome of spontaneous passage was followed up for 1 month. Ultrasound variables independently associated with the risk of spontaneous stone passage were screened. A logistic regression prediction model was constructed based on the independent risk factors, and the discriminative efficacy and clinical utility of the prediction model in inferring the risk of spontaneous passing were assessed by the receiver operating characteristic (ROC) curve, calibration curve and clinical decision curve. RESULTS: A total of 163 patients undergoing conservative treatment for ureteral stones were included in the study, with a mean age of 45.95 ± 13.01 years. Among them, 47 cases (28.83%) experienced failure of spontaneous stone passage. Multivariable analysis revealed that stone length (OR: 2.622, P = 0.027), distal stone location (OR: 0.219, P = 0.003), and ureteral jetting frequency (OR: 6.541, P < 0.001) were independent risk factors for spontaneous stone passage. A prediction model incorporating stone length, stone location, and affected ureteral jetting frequency was developed to assess the risk of spontaneous stone passage. The area under the ROC curve was 0.814 (95% CI: 0.747-0.882), indicating good discriminatory power. The prediction model also demonstrated favorable net clinical benefit. CONCLUSION: A prediction model based on ultrasound-derived stone length, location, and ureteral jetting frequency can accurately evaluate the risk of spontaneous stone passage in patients with ureteral stones, providing a basis for optimizing the clinical decision-making on ureteral stones, and has reliable clinical application value.

Analysis of Left Atrial Function after Percutaneous Intramyocardial Septal Radiofrequency Ablation in Hypertrophic Cardiomyopathy.

INTRODUCTION: The main goal of our research was to explore the effect of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) on left atrial (LA) phasic function in hypertrophic cardiomyopathy (HCM). METHODS: The study included 13 patients who underwent PIMSRA at our hospital. The function of LA including reservoir, conduit, and booster pump was analyzed and compared before and 6 months after PIMSRA in HCM patients. LA reservoir function parameters contain maximal LA volume, minimal LA volume (LAV min), LA ejection fraction (LAEF), LA expansion index (LAEI), and reservoir strain; LA conduit function includes LA volume before atrial systole, LA passive volume, LA passive ejection fraction, and conduit strain; LA booster function involves LA booster volume, LA active ejection fraction, and LA contraction strain. Additionally, 20 healthy controls were selected to compare the LA function of HCM patients. RESULTS: The preoperative LA reservoir and conduit function in HCM patients were significantly impaired compared with the control group, while the change in booster pump function was not obvious. HCM patients at 6 months after PIMSRA had remarkably enhanced reservoir and conduit functions which were manifested by lower LAV min, higher LAEF, LAEI, reservoir, and conduit strain than before the operation, and the differences among these parameters between patients after PIMSRA and the healthy control group were not significant. However, with regard to LA contraction function, there was no significant improvement at 6 months after PIMSRA compared with before operation. CONCLUSION: PIMSRA is effective in the amelioration of LA reservoir and conduit function in patients with HCM but not in a marked improvement of LA contraction function in these individuals in short term.

Role of contrast-enhanced ultrasound with Sonazoid in management of small testicular Leydig cell tumours: A case report with literature review.

Small testicular solid lesions are discovered accidentally due to the extensive use of ultrasound in urology and andrology. Early differentiation between benign and malignant testicular neoplasms is crucial for the determination of treatment options, especially for sub-centimetre lesions. We report a case of a male patient with an incidental discovery of a small testicular lesion on ultrasonography with the chief complaint of left testicular discomfort. The blood-flow distribution and microbubble dynamics in the lesion were evaluated through contrast-enhanced ultrasound using Sonazoid intravenous bolus injection, the rapid and intense enhancement pattern tended to be testicular Leydig cell tumour. Through testicular-sparing surgery, the lesion was excised, and benign testicular Leydig cell tumour was confirmed by post-operative pathology and immunohistochemical pathology. No sign of recurrence or metastasis was detected during follow-up.

Ultrasonic diagnosis and vasoactive substances examination in patients with cirrhosis.

OBJECTIVE: To investigate hemodynamic change of patients with cirrhosis by using Color Doppler ultrasound technique and to explore the significance of change in the content of vasoactive substances-plasma endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP). METHODS: A total of 178 cases with cirrhosis were regarded as study groups, and were divided into three degrees: A, B and C according to child-pugh and meanwhile 60 cases were regarded as normal control group. Portal vein and splenic vein of patients were explored by adopting Color Doppler ultrasound technique, related indexes were recorded and the blood flow as well as their ration in the two groups was calculated. Radio immunoassay was adopted to detect the content of plasma ET-1 and CGRP in both study group and contrast group. RESULTS: Compared with the healthy cases in the contrast group, there was abnormal hemodynamics in the system of portal vein of patients with cirrhosis and the content of plasma ET-1 and CGRP was increased obviously. In the Child-Pugh liver function grades, the content of ET-1 and CGRP was increased as the degree of cirrhosis became more and more serious. There was no significant difference in the comparison between those without ascites and those in contrast group (P>0.05), the content of plasma ET-1 and CGRP in patients without ascites was increased remarkably. Besides, there was positive correlation between the content of plasma ET-1 and CGRP and Dpv, Dsv and Qsv. CONCLUSION: Detection of abnormal hemodynamics of portal vein and splenic vein by Color Doppler ultrasound technique can be one of the means for diagnosis of hypertension. Plasma ET-1 and CGRP of patients with cirrhosis reflect the serious degree of the damage in live function and play an important role in the formation and development of portal hypertension.

[Radiation-induced oxidative stress and claudin-11 mRNA expression in the testis].

OBJECTIVE: To investigate the role of claudin-11, a tight junction component of Sertoli cells, in spermatogenic dysfunction induced by oxidative stress in mice exposed to local radiation. METHODS: We randomly allocated 48 male Kunming mice to a blank control group (A) and three radiation groups (B, C and D) of equal number, the latter three exposed to local radiation of the lower abdomen with 2 Gy, 6 Gy and 10 Gy of 60Co-gamma-ray, respectively, to induce oxidative stress. Four weeks later, we killed the animals, obtained their body and testis weights, observed the histological changes of the testis by HE staining, measured the levels of serum FSH, testosterone and LH by ELISA, and determined the mRNA levels of claudin-11 and inhibin beta B in Sertoli cells by real time quantitative PCR. RESULTS: After exposure to 60Co-gamma-ray radiation, the testis weights were (129.4 +/- 10.81), (87.5 +/- 16.83) and (56.1 +/- 12.36) mg in groups B, C and D, significantly decreased as compared with (182.9 +/- 8.43) mg in group A (P < 0.05); the testis indexes were (3.39 +/- 0.57), (2.46 +/- 0.46) and (1.63 +/- 0.44) mg/g in groups B, C and D, remarkably lower than (4.28 +/- 0.31) mg/g in group A (P < 0.01). Histological analysis revealed obviously decreased diameters of seminiferous tubules, reduced seminiferous epithelia and disarranged spermatogenic cells in the three radiation groups. The tubule differentiation indexes (TDI) were markedly lower in groups B, C and D than in A (P < 0.01). The levels of serum FSH were (6.74 +/- 1.95), (8.41 +/- 2.44) and (10.93 +/- 3.16) IU/L in groups B, C and D, 1.9 times higher in D than in A. With increased dose of radiation, the mRNA levels of inhibin beta in the testis tissue were descended, while the transcription levels of claudin-11 elevated, significantly higher in groups C and D than in A (P < 0.01). CONCLUSION: Local radiation-induced testicular oxidative stress can decrease the mRNA level of inhibin beta , increase serum FSH, damage Sertoli cells and elevate the expression of claudin-11 in the testis tissue. Increased claudin-11 and serum FSH may delay the cyclical restitution of hemo-testicular barrier and reduce the number of meiotic spermatocytes in the seminiferous epithelium, which consequently leads to male infertility.