Efficacy and feasibility of self-made negative pressure reflux system combined with rigid ureteroscope in the treatment of upper ureteral calculi in exercise-minded patients

Objective: To explore the efficacy and feasibility of self-made negative pressure reflux system combined with rigid ureteroscopy in the treatment of upper ureteral calculi.Methods: The clinical data of 379 Exercise-minded patients with upper ureteral calculi treated in our hospital from January 2018 to August 2022 were analyzed retrospectively. F8.0/9.8STORZ ureteroscope was used to explore the ureteral opening on the affected side, and then the 200μm wavelength holmium laser fiber and F4 ureteral catheter were inserted into the stone incarceration site through the rigid ureteroscope, and the residual stone fragments which were clinically meaningless (the maximum diameter of the stone < 2mm) were completely sucked out by negative pressure reflux system.Results: A total of 379 Exercise-minded patients were included in this study, with a one-time success rate of 97.1% (368/379), aged 26 to 76 years, with an average of (47.5) years. Most of the Exercise-minded patients (63.2%) had low back pain and hematuria before operation. The average diameter of stone was 0.8cm~2.8cm, the mean diameter of the stone was 1.8±1.0 cm.The operation time ranged from 18min to 52min, with an average of (37.86±25.64)min.The average length of hospital stay was (2.7±1.7) days (range, 1-8 days). On the first day after operation, the stone clearance rate was 84.43% (320/379), and the stone clearance rate was 90.77% (344/379) 3 months after operation. Among them, 4 Exercise-minded patients developed fever and 6 Exercise-minded patients had mild urinary fistula or renal pelvis perforation. Stone composition analysis was mainly ammonium phosphate stones and calcium oxalate stones.Conclusion: The treatment of upper ureteral calculi with self-made negative pressure reflux system combined with hard ureteroscope has the advantages of high stone clearance rate, low complications and greatly reducing the utilization rate of soft lens，and had high clinical promotion value. (AU)

HYOU1 promotes cell proliferation, migration, and invasion via the PI3K/AKT/FOXO1 feedback loop in bladder cancer.

BACKGROUND: Hypoxia up-regulated 1 (HYOU1) was identified as a proto-oncogene and involved in tumorigenesis and progression in several cancer. Nonetheless, the biological function and mechanism of HYOU1 in bladder cancer (BCa) remian unclear. METHODS: The HYOU1 level in BCa tissues and cells was examined using RT-qPCR and western blot methods. The relationship between HYOU1 expression and clinicopathologic characteristics of BCa was analyzed. The biological role of HYOU1 on BCa cell proliferation, apoptosis, migration and invasion were analyzed via counting kit-8 (CCK-8), flow cytometry, wound healing and Transwell assays, respectively. The association between HYOU1 and the PI3K/AKT/Forkhead box O1 (FOXO1) signalling was assessed via western blot assay, meanwhile the the association of FOXO1 with HYOU1 was also investigated. RESULTS: HYOU1 was up-regulated in BCa tissues and cell lines, and the high level of HYOU1 was associated with bladder cancer histological grade and pathologic stage. Moreover, patients with high expression of HYOU1 showed poor overall survival from Kaplan-Meier Plotter. HYOU1 depletion impeded cell proliferation, migration and invasion, and induced cell apoptosis, while HYOU1 overexpression promoted cell proliferation, migration and invasion. Mechanically, our results showed that HYOU1 knockdown repressed PI3K/AKT/FOXO1 pathway and HYOU1 was negative regulated by FOXO1 in BCa. Significantly, we confirmed that the HYOU1/PI3K-AKT/FOXO1 negative feedback loop was involved in BCa cell proliferation, migration and invasion. CONCLUSION: These findings revealed that HYOU1 acted as a pro-oncogene on BCa progression, and it will be a possible target for BCa treatment.