Evaluation of a novel circulation system for ureteroscopic laser lithotripsy in vitro.

PURPOSE: To evaluate the cooling effect and other advantages of a novel circulation system for ureteroscopic holmium laser lithotripsy (URSL) in a standardized in vitro model. MATERIALS AND METHODS: The novel circulation system was assembled by connecting a 4Fr ureteral catheter and a filter. Trails were divided into a new URSL group and a conventional URSL group. First, different power settings (18-30 W) of the holmium laser and irrigation flow rates (20-50 mL/min) were used to evaluate the thermal effect on the lithotripsy site of all groups. Then, renal pelvic temperature and pressure were assessed during URSL at a power of 1.5 J/20 Hz and irrigation flow rates of (20-50 mL/min). Finally, the whole process of lithotripsy was performed at 1.5 J/20 Hz (operator duty cycle ODC: 50%) with an irrigation flow rate of 30 mL/min. The time required for lithotripsy, visual field clarity, and stone migration were observed. RESULTS: Temperature of the lithotripsy point was significantly lower in the new URSL group than in the conventional group (P < 0.05) with irrigation rates (20, 30 mL/min). The renal pelvic pressure of the new group was significantly lower than that of the conventional group in which intrarenal hypertension developed at an irrigation rate of 50 ml/min. The new group had better visual clarity and lesser stone upward migration when lithotripsy was performed at 1.5 J/20 Hz and 30 ml/min. CONCLUSION: The novel circulation system is more effective in reducing the thermal effects of URSL, pelvic pressure, stone upward migration, and improving the visual clarity of the operative field.

Evaluating the efficacy of recombinant human growth factors in scar remodelling for patients with facial soft tissue injuries.

Facial soft tissue injuries, often resulting in scarring, pose a challenge in reconstructive and aesthetic surgery due to the need for functional and aesthetic restoration. This study evaluates the efficacy of recombinant human growth factors (rhGFs) in scar remodelling for such injuries. A retrospective evaluation was conducted from January 2020 to January 2023, involving 100 patients with facial soft tissue injuries. Participants were divided equally into a control group, receiving standard cosmetic surgical repair, and an observation group, treated with rhGFs supplemented cosmetic surgery. The study assessed scar characteristics (pigmentation, pliability, vascularity, height), hospital stay duration, tissue healing time, complication rates and patient satisfaction. The observation group demonstrated significant improvements in all scar characteristics, with notably better pigmentation, pliability, vascularity and height compared with the control group. The rhGF treatment also resulted in reduced hospital stay duration and faster tissue healing. Notably, the total complication rate was significantly lower in the observation group (10%) compared with the control group (34%). Additionally, patient satisfaction levels were higher in the observation group, with 98% combined satisfaction compared with 76% in the control group. The application of rhGFs in treating facial soft tissue injuries significantly enhances scar remodelling, expedites healing, reduces complications and improves patient satisfaction. These findings establish rhGFs as a valuable tool in the management of facial soft tissue injuries, highlighting their potential in improving both functional and aesthetic outcomes.

Peri- and postoperative outcomes of laparoscopic adrenalectomy in nonobese versus obese patients: a systematic review and meta-analysis.

Introduction: Obesity is generally thought to increase the difficulty and complications of surgery. Laparoscopic adrenalectomy has become the standard operation for adrenal tumors at present. Aim: To assess whether laparoscopic adrenalectomy (LA) can be used for obese patients with adrenal tumor. Material and methods: We systematically searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Science databases and Cochrane Library, and the search time is up to January 2022. We used STATA 16.0 and RevMan 5.4 software for data processing and statistical analysis. Results: Eight studies were included in the meta-analysis. The meta-analysis results showed that compared with the nonobese group, the obese group had a significantly longer operation time (OT) (weighted mean difference (WMD): -10.02, 95% confidence interval (CI): -19.16 to 0.87, p = 0.03). It also had higher estimated blood loss (WMD: -13.15, 95% CI: -35.92 to 9.63, p = 0.26) and conversion rate (odds ratio (OR): 0.70, 95% CI: 1.31 to 1.60, p = 0.40), longer length of hospital stay (LOS) (WMD: -0.04, 95% CI: -0.47 to 0.39, p = 0.86), and a higher number of complications (odds ratio (OR) = 0.71, 95% CI: 0.49 to 1.02, p = 0.06), but these differences were not statistically significant. Additionally, in subgroup analysis longer OT (p = 0.0001) and LOS (p = 0.007) were associated with retroperitoneal laparoscopic adrenalectomy for obesity. Conclusions: Our meta-analysis suggests that LA is feasible and effective in patients with obesity.

Expression analysis of the estrogen receptor target genes in renal cell carcinoma.

The aim of the present study was to investigate the differentially expressed genes (DEGs) and target genes of the estrogen receptor (ER) in renal cell carcinoma. The data (GSE12090) were downloaded from the gene expression omnibus database. Data underwent preprocessing using the affy package for Bioconductor software, then the DEGs were selected via the significance analysis of microarray algorithm within the siggenes package. Subsequently, the DEGs underwent functional and pathway enrichment analysis using Database for Annotation Visualization and Integrated Discovery software. Following data analysis, transcriptional regulatory networks between the DEGs and transcription factors were constructed. Finally, the ER target genes were subjected to gene ontology enrichment analysis. A total of 215 DEGs were identified between the chromophobe renal cell carcinoma samples and the oncocytoma samples, including 126 upregulated and 89 downregulated genes. Functional enrichment analysis indicated that 25% of the DEGs were significantly enriched in functions associated with the plasma membrane. Among those DEGs, 105 were regulated by the ER. Further regulatory network analysis indicated that the ER was mainly involved in the regulation of oncogenes and tumor suppressor genes, including protease serine 8, claudin 7 and Ras-related protein Rab-25. In the present study, the identified ER target genes were demonstrated to be closely associated with tumor development; this knowledge may improve the understanding of the ER regulatory mechanisms during tumor development and promote the discovery of predictive markers for renal cell carcinoma.

[Application of traction therapy for Peyronie's disease: present and prospect].

Peyronie's disease is an acquired connective tissue disorder affecting the tunica albuginea of the corpus cavernosum, causing penile plaque formation and persistent scar. It typically affects males between the ages of 45 and 60 years. The exact cause of Peyronie's disease is not clear and its pathological and physiological performance is the local deposition of fibrin and collagen. Men afflicted by this disorder may present with erectile pain, penile deformity (such as penile curvature or penile shortening), psychological disorder and/or erectile dysfunction. Though many medical and surgical options have been developed for the treatment of Peyronie's disease and each has its own indications, advantages and disadvantages, none of them produces very desirable effect. The studies of traction therapy for Peyronie's disease have been gradually increased in recent years. Traction therapy can be employed as a solo therapy or a part of combination therapy, preoperative or postoperative therapy for Peyronie's disease. Recent researches show that traction therapy can prevent the progression of scar, restore the length and diameter of a short penis, reduce the curvature of the penis and improve sexual function. However, large sample, multi-center, randomized controlled studies are needed to confirm its validity for Peyronie's disease. In addition, more endeavors should be exerted at its pathogenesis in order to achieve effective prevention and cure of the disease.