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Can we predict the incidence of high-grade Clavien-Dindo complications in patients with forgotten encrusted stents undergoing endourologic management?

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Asian Journal of urology 2024年第1期11卷 99-104页

作者： Praanjal Gupta Ramanitharan Manikandan Lalgudi Narayanan Dorairajan Kodakattil Sreenivasan Sreerag Sidhartha Kalra Swapnil Singh Kushwaha Department of urology Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Objective:Ureteral stents are customarily inserted to facilitate urinary drainage,but they come with their own glitches of being forgotten and/or encrusted leading to serious *** present study aimed to report the complications in patients with forgotten and encrusted stents according to the Clavien-Dindo system specific to urological procedures and identify the factors leading to high-grade(Clavien-Dindo Grade 4A or above)***:The hospital records of patients with forgotten encrusted double-J stents over a period of 8 years were *** parameters recorded included patient demographics,indwelling time,need for percutaneous nephrostomy,hemodialysis,urine culture,blood culture,total blood counts,serum creatinine,radiologic findings,management techniques,number of surgical interventions,modified Clavien-Dindo complications,follow-up,and mortality,if ***:Forty patients were included in the *** median age was 52(range 6-85)*** the total,25(62.5%)patients had a“significant”stent load;31(77.5%)had renal failure or acute kidney injury on presentation;19(47.5%)patients had sepsis at *** the patients presented with sepsis,11(57.9%)patients demonstrated a positive urine culture;and 7/11(63.6%)patients exhibited pan-resistant *** out of 40(30.0%)patients in our series developed high-grade Clavien-Dindo *** univariate analysis,sepsis at presentation(p=0.007),stent load(p=0.031),diabetes(p=0.023),positive urine culture(p=0.007),and stent indwelling time of more than 1 year(p=0.031)were found to be *** multivariate logistic regression analysis,sepsis at presentation(p=0.017)and positive urine culture(p=0.016)were significant predictors for high-grade ***:It is prudent to identify specific risk factors,namely sepsis at presentation and positive urine culture to triage and optimize these patients before surgical management.

关键词： Forgotten Encrusted stent Outcome Predictor Clavien-Dindo complication

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Treatment-induced neuroendocrine prostate cancer and de novo neuroendocrine prostate cancer:Identification,prognosis and survival,genetic and epigenetic factors

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World Journal of Clinical Cases 2024年第13期12卷 2143-2146页

作者： Mohamed Wishahi Department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Neuroendocrine prostate cancer(NEPC)shows an aggressive behavior compared to prostate cancer(PCa),also known as prostate *** foci in PCa can harbor genetic alternation that can arise in a heterogeneity of prostate *** may arise de novo or develop following androgen deprivation therapy(ADT).NEPC that arise following ADT has the nomenclature“treatmentemerging/induced NEPC(t-NEPC)”.t-NEPC would be anticipated in castration resistant prostate cancer(CRPC)and metastatic PCa.t-NEPC is characterized by low or absent androgen receptor(AR)expression,independence of AR signaling,and gain of neuroendocrine phenotype.t-NEPC is an aggressive metastatic tumor,develops from PCa in response to drug induced ADT,and shows very short response to conventional therapy.t-NEPC occurs in 10%-17%of patients with *** novo NEPC is rare and is accounting for less than 2%of all *** molecular mechanisms underlying the trans-differentiation from CRPC to t-NEPC are not fully *** kinase 1 plays a significant role in t-NEPC *** neuroendocrine markers:Synaptophysin,chromogranin A,and insulinoma associated protein 1(INSM1)are expressed in t-NEPC,they are non-specific for diagnosis,prognosis,and follow-up of therapy.t-NEPC shows enriched genomic alteration in tumor protein P53(TP53)and retinoblastoma 1(RB1).There are evidences suggest that t-NEPC might develop through epigenetic *** are genomic,epigenetic,and transcriptional alterations that are reported to be involved in development of ***-outs of TP53 and RB1 were found to contribute in development of *** is resistant to immunotherapy,and at present there are running trials to approach immunotherapy for PCa,CRPC,and t-NEPC.

关键词： Prostate cancer Neuroendocrine carcinoma Treatment induced neuroendocrine prostate cancer Androgen deprivation therapy Genetic and epigenetic factors Castration resistant prostate cancer De novo neuroendocrine prostate cancer

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M2 macrophage-related molecular subtypes and prognostic index for prostate cancer patients through integrating single-cell and bulk RNA sequencing analysis

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Genes & Diseases 2024年第4期11卷 131-133页

作者： Dechao Feng Xu Shi Dengxiong Li Ruicheng Wu Jie Wang Wuran Wei Ping Han Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengduSichuan 610041China

Prostate cancer(PCa)is considered as an age-related disease and accounts for the most prevalence of urinary malignancies in men.1 We previously analyzed the cellular landscape of tumor microenvironment in PCa patients,where we found that cancer-related fibroblasts might play an important role in tumorigenesis and the development of PCa and tumor-associated macrophage(TAM)could function synergistically with them.2 Thus,we further integrated single-cell and bulk RNA sequencing with meta-analysis to specify the prognostic effect of TAM on PCa and construct molecular subgroups and predictive index to guide clinical practice.

关键词： patients macrophage cancer

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Erdafitinib and checkpoint inhibitors for first-line and second-line immunotherapy of hepatic,gastrointestinal,and urinary bladder carcinomas:Recent concept

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World Journal of Hepatology 2024年第4期16卷 490-493页

作者： Mohamed Wishahi Department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Cancer immunotherapy is administered for first-line,second-line,neoadjuvant,or adjuvant treatment of advanced,metastatic,and recurrent cancer in the liver,gastrointestinal tract,and genitourinary tract,and other solid *** is a fibroblast growth factor receptor(FGFR)inhibitor,and it is an adenosine triphosphate competitive inhibitor of FGFR1,FGFR2,FGFR3,and *** checkpoint inhibitors are monoclonal antibodies that block programmed cell death protein 1(PD-1)and its ligand that exert intrinsic antitumor *** promising results of first-line treatment of advanced and metastatic urothelial carcinoma with PD-1 blockades with single or combined agents,indicate a new concept in the treatment of advanced,metastatic,and recurrent hepatic and gastrointestinal *** immunotherapy as first-line treatment will improve overall survival and provide better quality of *** is arising as to whether to apply the cancer immunotherapy as first-line treatment in invasive carcinomas,or as second-line treatment in recurrent or metastatic carcinoma following the standard *** literature in the field is not definite,and so far,there has been no consensus on the best approach in this *** present,as it is described in this editorial,the decision is applied on a case-by-case basis.

关键词： Programmed cell death protein-ligand 1 Erdafitinib Liver cancer Fibroblast growth factor receptor inhibitors Checkpoint inhibitors Bladder cancer Metastases

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Icaritin inhibits the progression of urothelial cancer by suppressing PADI2-mediated neutrophil infiltration and neutrophil extracellular trap formation

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Acta Pharmaceutica Sinica B 2024年第9期14卷 3916-3930页

作者： Zezhong Mou Yiling Chen Jinzhong Hu Yun Hu Lujia Zou Xinan Chen Shenghua Liu Qiuping Yin Jian Gong Shuchen Li Shanhua Mao Chenyang Xu Haowen Jiang Department of urology Huashan HospitalFudan UniversityShanghai 200040China Fudan institute of urology Fudan UniversityShanghai 200040China National Clinical research Center for Aging and Medicine Fudan UniversityShanghai 200040China

Tumor relapse and metastasis are the major causes of mortality associated with urothelial *** the tumor microenvironment,negative regulatory molecules and various immune cell subtypes suppress antitumor *** inflammatory microenvironment,associated with neutrophils and neutrophil extracellular traps(NETs),promotes tumor ***,no drugs are currently available to specifically inhibit neutrophils and *** this study,we first demonstrated that icaritin(ICT),a Chinese herbal remedy that is a first-line treatment for advanced and incurable hepatocellular carcinoma,reduces NETs caused by suicidal NETosis and prevents neutrophil infiltration in the tumor ***,ICT binds to and inhibits the expression of PADI2 in neutrophils,thereby suppressing PADI2-mediated histone ***,ICT inhibits ROS generation,suppresses the MAPK signaling pathway,and inhibits NET-induced tumor ***,ICT inhibits tumoral PADI2-mediated histone citrullination,which consequently suppresses the transcription of neutrophil-recruiting genes such as GM-CSF and *** downregulation of IL-6 expression,in turn,forms a regulatory feedback loop through the JAK2/STAT3/IL-6 *** a retrospective study of clinical samples,we found a correlation between neutrophils,NETs,UCa prognosis,and immune *** ICT with immune checkpoint inhibitors may have synergistic *** summary,our study demonstrated that ICT could be a novel inhibitor of NETs and a novel UCa treatment.

关键词： Icaritin Neutrophil Neutrophil extracellular trap PADI2 Urothelial cancer

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Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?

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Asian Journal of urology 2024年第2期11卷 156-168页

作者： Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang Department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduSichuanChina

Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient ***: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time ***: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse ***: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.

关键词： Laser lithotripsy Urolithiasis Thulium laser Holmium:yttrium-aluminum-garnet Moses effect

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Curcumin Interferes with TGF-β1-Induced Fibrosis in NRK-49F Cells by Reversing ADAMTS18 Gene Methylation

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Chinese Journal of Integrative Medicine 2024年第7期30卷 600-607页

作者： XU Ben ZHANG Jia-en YE Lin YUAN Chang-wei Department of urology Peking University First Hospital and Institute of UrologyPeking UniversityNational Urological Cancer CenterBeijing100034China

Objective To explore the molecular mechanism by which curcumin affects renal interstitial fibrosis(RIF)progression by regulating ADAM metallopeptidase with thrombospondin type 1 motif 18(ADAMTS18)*** NRK-49F cells RIF model were induced with transforming growth factorβ1(TGF-β1).Effects of different concentrations of curcumin(0,10,20,and 30μmol/L)on cell proliferation,cell cycle,cell apoptosis as well as cyclin D1 expression were analyzed by cell counting kit-8,flow cytometry and Western blot,***18 methylation levels were determined by methylation-specific polymerase chain ***18,fibronectin(FN),type I collagen(Col-I)and alpha-smooth muscle actin(α-SMA)mRNA and protein expressions were analyzed by real-time PCR(RT-PCR)and Western blot,***,cells were treated with 50 mmol/L 5-aza-2′-deoxycytidine(5-aza-dC,demethylation agent)for 72 *** of curcumin on extracellular matrix(ECM)deposition was evaluated by immunochemical staining and Western ***-49F cells were transfected with ADAMTS18 small interfering RNA and grouped into a normal control,ADAMTS18-knock-out(KO),and ADAMTS18-KO+30μmol/L curcumin groups,and whether curcumin can reverse the effect of ADAMTS18 knockdown on RIF was *** Compared with the control group,TGF-β1 significantly inhibited the proliferation of NRK-49F cells,blocked the G1/G0 phase,promoted cell apoptosis and inhibited cyclin D1 expression(P<0.01).Among the different concentrations of curcumin,30μmol/L curcumin significantly reversed these processes(P<0.01).Immunochemical staining and Western blot results showed that curcumin significantly inhibited the deposition of FN,Col-I andα-SMA(P<0.01).Curcumin and 5-zaz-dC had synergistic effects,promoting ADAMTS18 expression,removing ADAMTS18 methylation,and reducing ECM ***18 knockdown promoted ECM accumulation,and curcumin reversed this process(P<0.01).Conclusion TGF-β1-induced fibrosis in NRK-49F ***

关键词： renal fibrosis curcumin Chinese medicine ADAMTS18 methylation modification

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Understanding female urinary continencedlessons from complications of female urethral surgery

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Asian Journal of urology 2024年第3期11卷 504-506页

作者： Sidhartha Kalra Atanu Kumar Pal Lalgudi Narayanan Dorairajan Department of urology and Renal Transplantation Jawaharlal Institute of Post Graduate Medical Education and ResearchPuducherryIndia

Dear Editor,We share our experience of two significant complications associated with female urethroplasty and their management in understanding the factors contributing to urinary *** have also tried to assess the different components of female urinary continence mechanism and the ways to combat the postoperative urinary continence while performing female urethral surgeries(Fig.1).Informed consent was taken from each of the patients before their evaluation and *** were explained properly and informed consents were taken from them before the publication of this article.

关键词： urinary female urethral

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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

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World Journal of Transplantation 2024年第1期14卷 154-163页

作者： Ameet Kumar Jesrani Syed M Faiq Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan Muhammed Mubarak Department of Radiology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Transplantation Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of urology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term *** and novel ultrasound-based investigations are being increasingly used for this purpose with variable *** To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological *** This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh institute of urology and Transplantation,Karachi,Pakistan,from August 2022 to February *** consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this *** and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic *** The mean age of all patients was 35.32±11.08 *** these,126(81.8%)were males and 28(18.2%)were *** mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 *** allograft biopsy results showed chronic changes in 55(37.66%)*** sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft *** can be of great help during the routine follow-up of kidney transplant recipients for screening a

关键词： Shear wave Sonoelastography Resistive index Chronic allograft changes Biopsy Histopathology

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The effect of bladder function on the efficacy of transurethral prostatectomy in patients with benign prostatic hyperplasia:a retrospective,single-center study

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Asian Journal of Andrology 2024年第1期26卷 112-118页

作者： Jin Li Xian-Yan-Ling Yi Ze-Yu Chen Bo Chen Yin Huang Da-Zhou Liao Pu-Ze Wang De-Hong Cao Jian-Zhong Ai Liang-Ren Liu West China School of Medicine Sichuan UniversityChengdu 610041China Department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China

We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia(BPH)on the efficacy of transurethral ***,imaging,and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University(Chengdu,China)from July 2019 to December 2021 were ***-up data included the quality of life(QoL),International Prostate Symptom Score(IPSS),and IPSS storage and voiding(IPSS-s and IPSS-v).Moreover,urinary creatinine(Cr),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),and prostaglandin estradiol(PGE2)were measured in 30 patients with BPH and 30 healthy *** indicators were determined by subgroup analyses and receiver operating characteristic(ROC)curve *** the 313 patients with BPH included,patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate ***,good bladder sensation,compliance,and detrusor contractility(Dc)were predictors of low postoperative IPSS and *** urinary concentrations of BDNF/Cr,NGF/Cr,and PGE2/Cr in patients were significantly higher than those in healthy participants(all P<***1).After evaluation,only DC was significantly related to both urinary indicators and postoperative recovery of *** with good DC,as predicted by urinary indicators,had lower IPSS and IPSS-v than those with reduced DC at the 1st month postoperatively(both P<0.05).In summary,patients with impaired bladder function had poor *** combined levels of urinary BDNF/Cr,NGF/Cr,and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladderfunction and postoperative recovery.

关键词： BPH function of bladder IPSS:urodynamics

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