Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This s...Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This study aims to investigate the effects of 272 and 365μm holmium laser probes on operative time,clinical efficacy,and complication rates in RIRS.Materials and Methods:A total of 285 patients with proximal ureteral or kidney stones who met the inclusion criteria were enrolled in the study.Patients were divided into two groups based on laser probe thickness:272μm and 365μm.Stone-free rates,operative time,and complication rates were compared between the groups.Factors affecting stone-free rates were analyzed using multivariate logistic regression analysis.Results:Patient and stone characteristics were similar between the two groups.No significant differences were found in stone-free or complication rates.However,operative time was significantly shorter in the 365μm probe group.In univariate analysis,risk factors for postoperative residual stones included multi-calyceal stones,lower pole stones,high Hounsfield unit(HU)values on noncontrast computed tomography,and larger stone size.In multivariate analysis,independent prognostic factors for residual stones were identified as multi-calycal stones,lower pole stones,and high HU values.Conclusion:Compared to 272μm laser probes,operative time was shorter in surgeries performed with 365μm laser probes.The 365μm holmium laser can be effectively and safely used in the treatment of proximal ureteral and renal stones,demonstrating high clinical efficacy and safety.展开更多
BACKGROUND Degenerative disc disease(DDD)is characterized by the loss of nucleus pulposus cells(NPCs).Inducing differentiation of bone marrow mesenchymal stem cells(MSCs)into NPCs has emerged as a novel therapeutic st...BACKGROUND Degenerative disc disease(DDD)is characterized by the loss of nucleus pulposus cells(NPCs).Inducing differentiation of bone marrow mesenchymal stem cells(MSCs)into NPCs has emerged as a novel therapeutic strategy for DDD.However,the efficiency of MSC differentiation and the underlying mechanisms remain to be fully elucidated.AIM To investigate the role and mechanism of miR-365 in promoting the differentiation of MSCs into NPCs for DDD treatment.METHODS In vitro,the effects of miR-365 on MSC proliferation,apoptosis,and differentiation were assessed by cell counting kit-8 assay,flow cytometry,and quantitative realtime polymerase chain reaction(qRT-PCR).In vivo,the expression levels of miR-365,HIF-1α,Sox9,Kdm6a,and HOXA9 in the spinal cord of rats with spinal cord injury were determined by qRT-PCR and Western blot.RESULTS In vitro,miR-365 significantly promoted MSC proliferation and inhibited MSC apoptosis.The expression levels of glycosaminoglycans,proteoglycan,and type 2 collagen were significantly increased with miR-365 ectopic expression.In vivo,the expression levels of miR-365,HIF-1α,Sox9,and Kdm6a were significantly increased,whereas HOXA9 was remarkably decreased.Mechanically,miR-365 inhibited HOXA9 expression by directly binding to its 3’untranslated region.HOXA9 could inhibit HIF-1αexpression by binding to the Hif-1αpromoter,thereby affecting the expression levels of Sox9 and Kdm6a.Moreover,HOXA9 knockdown significantly reversed the differentiation of MSCs into NPCs induced by miR-365.CONCLUSION miR-365 promotes HOXA9-mediated differentiation of MSCs into NPCs by interacting with HIF-1αand may serve as a potential target for DDD treatment.展开更多
文摘Introduction:Surgeons typically prefer 270μm and 272μm laser probes in retrograde intrarenal surgery(RIRS)due to the reduced deflection capacity of flexible ureterorenoscopes when using larger probe diameters.This study aims to investigate the effects of 272 and 365μm holmium laser probes on operative time,clinical efficacy,and complication rates in RIRS.Materials and Methods:A total of 285 patients with proximal ureteral or kidney stones who met the inclusion criteria were enrolled in the study.Patients were divided into two groups based on laser probe thickness:272μm and 365μm.Stone-free rates,operative time,and complication rates were compared between the groups.Factors affecting stone-free rates were analyzed using multivariate logistic regression analysis.Results:Patient and stone characteristics were similar between the two groups.No significant differences were found in stone-free or complication rates.However,operative time was significantly shorter in the 365μm probe group.In univariate analysis,risk factors for postoperative residual stones included multi-calyceal stones,lower pole stones,high Hounsfield unit(HU)values on noncontrast computed tomography,and larger stone size.In multivariate analysis,independent prognostic factors for residual stones were identified as multi-calycal stones,lower pole stones,and high HU values.Conclusion:Compared to 272μm laser probes,operative time was shorter in surgeries performed with 365μm laser probes.The 365μm holmium laser can be effectively and safely used in the treatment of proximal ureteral and renal stones,demonstrating high clinical efficacy and safety.
基金Supported by Academic Subject Boosting Plan in Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine,No.SY-XKZT-2019-3002Academic Project from the Health Commission of Hongkou District,Shanghai,No.2202-25Clinical Key Specialty Construction Unit from The Health Commission of Hongkou District,Shanghai,No.HKLCZD2024B03.
文摘BACKGROUND Degenerative disc disease(DDD)is characterized by the loss of nucleus pulposus cells(NPCs).Inducing differentiation of bone marrow mesenchymal stem cells(MSCs)into NPCs has emerged as a novel therapeutic strategy for DDD.However,the efficiency of MSC differentiation and the underlying mechanisms remain to be fully elucidated.AIM To investigate the role and mechanism of miR-365 in promoting the differentiation of MSCs into NPCs for DDD treatment.METHODS In vitro,the effects of miR-365 on MSC proliferation,apoptosis,and differentiation were assessed by cell counting kit-8 assay,flow cytometry,and quantitative realtime polymerase chain reaction(qRT-PCR).In vivo,the expression levels of miR-365,HIF-1α,Sox9,Kdm6a,and HOXA9 in the spinal cord of rats with spinal cord injury were determined by qRT-PCR and Western blot.RESULTS In vitro,miR-365 significantly promoted MSC proliferation and inhibited MSC apoptosis.The expression levels of glycosaminoglycans,proteoglycan,and type 2 collagen were significantly increased with miR-365 ectopic expression.In vivo,the expression levels of miR-365,HIF-1α,Sox9,and Kdm6a were significantly increased,whereas HOXA9 was remarkably decreased.Mechanically,miR-365 inhibited HOXA9 expression by directly binding to its 3’untranslated region.HOXA9 could inhibit HIF-1αexpression by binding to the Hif-1αpromoter,thereby affecting the expression levels of Sox9 and Kdm6a.Moreover,HOXA9 knockdown significantly reversed the differentiation of MSCs into NPCs induced by miR-365.CONCLUSION miR-365 promotes HOXA9-mediated differentiation of MSCs into NPCs by interacting with HIF-1αand may serve as a potential target for DDD treatment.
