Stone Occlusion Device with Drainage Function Is Effective in Ureteral Calculi Treatment: A Preliminary Report.

INTRODUCTION: The aim of the study was to assess the efficacy and safety of ureterolithotripsy (URS) in treating ureteral calculi with holmium-YAG laser through adding retropulsion prevention and drainage function to ureteral catheter. METHODS: An inner wire was fixed at the top of an Fr5 ureteral catheter and run through a tee joint. The proximal catheter was split into 4 strips. When the wire was pulled, the strips become arcuate, thus trapping the stone. The end of the tee branch was connected to the suction evacuation. Continuous irrigation and negative pressure suction were delivered after the strips passed the stones. Eighty-two consecutive patients with solitary ureteral stones underwent URS with the new device. RESULTS: Seventy-eight patients had no observed stone retropulsion with successful insertion of the device. Four patients failed URS owing to the stone retropulsion and excessive kink of the ureter, which was followed by flexible ureteroscopy. Patient with successful insertion of the device had an immediate stone-free rate of 88.5% and 100% in a 1-month follow-up. Complications included one fever and one minor ureteral perforation. CONCLUSION: This new device has a low stone migration and minor complications and improves visual field with a negative pressure suction. Future studies are needed to evaluate it in randomized trials.

Identification of Four Novel Prognostic Biomarkers and Construction of Two Nomograms in Adrenocortical Carcinoma: A Multi-Omics Data Study via Bioinformatics and Machine Learning Methods.

Background: Adrenocortical carcinoma (ACC) is an orphan tumor which has poor prognoses. Therefore, it is of urgent need for us to find candidate prognostic biomarkers and provide clinicians with an accurate method for survival prediction of ACC via bioinformatics and machine learning methods. Methods: Eight different methods including differentially expressed gene (DEG) analysis, weighted correlation network analysis (WGCNA), protein-protein interaction (PPI) network construction, survival analysis, expression level comparison, receiver operating characteristic (ROC) analysis, and decision curve analysis (DCA) were used to identify potential prognostic biomarkers for ACC via seven independent datasets. Linear discriminant analysis (LDA), K-nearest neighbor (KNN), support vector machine (SVM), and time-dependent ROC were performed to further identify meaningful prognostic biomarkers (MPBs). Cox regression analyses were performed to screen factors for nomogram construction. Results: We identified nine hub genes correlated to prognosis of patients with ACC. Furthermore, four MPBs (ASPM, BIRC5, CCNB2, and CDK1) with high accuracy of survival prediction were screened out, which were enriched in the cell cycle. We also found that mutations and copy number variants of these MPBs were associated with overall survival (OS) of ACC patients. Moreover, MPB expressions were associated with immune infiltration level. Two nomograms [OS-nomogram and disease-free survival (DFS)-nomogram] were established, which could provide clinicians with an accurate, quick, and visualized method for survival prediction. Conclusion: Four novel MPBs were identified and two nomograms were constructed, which might constitute a breakthrough in treatment and prognosis prediction of patients with ACC.

[Holmium: YAG laser lithotripsy under ureteroscopy for treating urinary caluli combined with acute renal failure].

OBJECTIVE: To evaluate the therapeutic effect and safety of holmium:YAG laser lithotripsy for treating ureteral calculi combined with acute renal failure. METHODS: Ureteroscopic holmium: YAG laser lithotripsy was used in 13 cases of ureteral calculi. RESULTS: After the operation the serum Bun and Cr levels in the patients decreased to different degrees or returned to normal and the stone free rate was up to 92.3% (12/13). CONCLUSION: The ureteroscopic holmium:YAG laser lithotripsy can be the first choice for the upper urinary tract obstruction associated with acute renal failure,due to its safety and efficiency. It can also deal with the double sites of ureteral diseases.

[Smad4 and TGF-beta1 expression and clinical significance in bladder transitional cell carcinoma].

OBJECTIVE: To determine the expression of Smad4 and TGF-beta1 in bladder transitional cell carcinoma (BTCC), and to understand the mechanism of invasion, angiogenesis, and metastasis of BTCC. METHODS: The expressions of Smad4 and TGF-beta1 in samples of 42 human bladder carcinoma and 12 normal bladder mucosa tissues were determined with standard immunohistochemical analysis. We also analyzed the relationship among the expressions of Smad4 and TGF-beta1 and invasion, angiogenesis, and metastasis of BTCC, and the correlation between Smad4 and TGF-beta1. RESULTS: The positive rate of Smad4 in BTCC was significantly lower than those in normal bladder mucosa tissues (33.3% vs 83.3%, P < 0.01). The expressions of Smad4 in poorly differentiated, invasive, recurrent, or with lymph node metastasis of BTCCs were lower than those in well differentiated, superficial, nonrecurrent, or without lymph node metastasis ones (P <0.05). The positive rate of TGF-beta1 in BTCC was significantly lower than that in normal bladder mucosa tissues (64.3% vs 100%, P <0.01), which was positively correlated to that of Smad4 (P = 0.000). CONCLUSION: The expressions of Smad4 and TGF-beta1 in BTCC decrease with the increase in clinical stage, poor pathological grade, and the recurrence and metastasis of BTCC.

[Cause and treatment of dysuria post trans-urethral resection of prostate].

OBJECTIVE: To evaluate the cause and treatment of dysuria post trans-urethral resection of prostate (TURP). METHODS: The clinical data and the treatment of 22 cases of dysuria post TURP were analyzed retrospectively. RESULTS: All cases including 3 cases of glandular and extraneous material residual, 5 cases of urethrostenosis, 7 cases of bladder neck contracture, and 7 cases of detrusor muscle weakness, were cured after the treatment. CONCLUSION: The main causes of dysuria post TURP were glandular residual, urethrostenosis, bladder neck contracture, and detrusor muscle weakness. Correct preoperative diagnosis and treatment during/post operation are the key to the prevention of dysuria post TURP.

[Therapeutic effect of harnal and proscar in treating benign prostatic hyperplasia].

OBJECTIVE: To evaluate the therapeutic effect of harnal and proscar in treating benign prostatic hyperplasia (BPH). METHODS: Two hundreds and twenty-two patients with BPH were randomly assigned into 2 groups:harnal (0.2 mg/d) group (n = 112) and proscar (5 mg/d) group (n = 108). American Urologic Association Symptom Index (AUA-SI) scores, the maximal urinary flow rate (Qmax) and prostatic volume were analyzed in the 2 groups. RESULTS: After 12 weeks of treatment, 54.5% of the harnal group improved in AUA-SI score; 54.6% of the proscar group improved in AUA-SI score; and there was no significant difference between the 2 groups (P > 0.05). After 24 weeks of treatment, the proscar group (79.6%) had a greater improvement in AUA-SI score than the harnal group (64.3%) (P < 0.05); Qmax in the 2 groups was significantly increased than that before the treatment, and it is proportional to the therapeutic time. The prostatic volume in 2 groups had no significant change. CONCLUSION: Harnal and proscar can significantly improve BPH symptoms and the urinary flow rate. The therapeutic effect of harnal and proscar has their own characteristics.