BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is r...BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is recommended by the European Association of Urology and can improve prognosis,its long-term use can cause toxic side effects,reduce treatment compliance,and increase psycho-logical burden.Therefore,an appropriate intervention mode is necessary.METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023.Patients were divided into conventional(n=55)and joint inter-vention(n=55)groups.The conventional group received mitomycin and routine nursing,while the joint intervention group received EPI and mindfulness intervention.Both groups underwent three cycles of chemotherapy.Immune function(CD4+cells,CD8+cells,CD4+/CD8+ratio),tumor marker levels[urinary bladder cancer antigen(UBC),bladder tumor antigen(BTA)and nuclear matrix protein 22(NMP22)],quality of life questionnaire-core 30(QLQ-C30),17-item Hamilton depression scale(HAMD-17),and cancer-related fatigue[cancer fatigue scale(CFS)]were assessed.Adverse reactions and nursing satisfaction were recorded and evaluated.RESULTS Post-intervention,CD4+,CD8+,and CD4+/CD8+levels increased in both groups,with the joint intervention group showing more significant improvement(P<0.05).Tumor marker levels(NMP22,BTA,and UBC)were lower in the joint intervention group compared to the conventional group(P<0.05).The joint intervention group also showed a greater reduction in HAMD-17 scores(9.38±3.12 vs 15.45±4.86,P<0.05),higher QLQ-C30 scores,and lower CFS scores(both P<0.05).Additionally,the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction(P<0.05).CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.展开更多
Urinary system tumors include malignancies of the bladder,kidney,and prostate,and present considerable challenges in diagnosis and treatment.The conventional therapeutic approaches against urinary tumors are limited b...Urinary system tumors include malignancies of the bladder,kidney,and prostate,and present considerable challenges in diagnosis and treatment.The conventional therapeutic approaches against urinary tumors are limited by the lack of targeted drug delivery and significant adverse effects,thereby necessitating novel solutions.Intelligent nanomedicine has emerged as a promising therapeutic alternative for cancer in recent years,and uses nanoscale materials to overcome the inherent biological barriers of tumors,and enhance diagnostic and therapeutic accuracy.In this review,we have explored the recent advances and applications of intelligent nanomedicine for the diagnosis,imaging,and treatment of urinary tumors.The principles of nanomedicine design pertaining to drug encapsulation,targeting and controlled release have been discussed,with emphasis on the strategies for overcoming renal clearance and tumor heterogeneity.Furthermore,the therapeutic applications of intelligent nanomedicine,its advantages over traditional chemotherapy,and the challenges currently facing clinical translation of nanomedicine,such as safety,regulation and scalability,have also been reviewed.Finally,we have assessed the potential of intelligent nanomedicine in the management of urinary system tumors,emphasizing emerging trends such as personalized nanomedicine and combination therapies.This comprehensive review underscores the substantial contributions of nanomedicine to the field of oncology and offers a promising outlook for more effective and precise treatment strategies for urinary system tumors.展开更多
Objective: to analyze the advantages of microbial testing. Methods: a total of 200 patients with urinary system infection were selected and divided into two groups, and different testing methods were used. Results: th...Objective: to analyze the advantages of microbial testing. Methods: a total of 200 patients with urinary system infection were selected and divided into two groups, and different testing methods were used. Results: the detection rate of pathogenic bacteria in the observation group was 90.00% higher than that in the control group, which was 60.00% (P<0.05). Conclusion: microbial testing has many advantages, which can not only ensure the curative effect of patients, but also prevent and reduce the occurrence of infection risk in patients.展开更多
As the organ-system oriented integration of medical education has been carried out in many domestic medical schools for years,an urgent need of discussions on various problems of integrated medical education emerges.T...As the organ-system oriented integration of medical education has been carried out in many domestic medical schools for years,an urgent need of discussions on various problems of integrated medical education emerges.This paper reviews the urinary integrated educational work in Shanghai Jiao Tong University School of Medicine(SJTU-MS)and introduces the contents of the integrated curriculum of urinary system.We focus on whether we should apply the single cycle integration mode or dual cycle mode,and compare the vocational medical education and elite medical education,and demonstrate the importance of inter-system integration and the ideal integrated textbooks.Multifarious teaching methods and other issues are also mentioned.The future development of integrated medical education is prospected positively.展开更多
From May 1970 to May 1988,the authortreated 182 cases of abdominal colic due to cal-culi in the urinary system with satisfactory anal-gesic effect,and this is briefly summarized asfollows.
Infection of the urinary system is frequently seen in the paraplegic patients with urinary complications,which is one of the main reasons for the late death in such cases. The effects of the therapeutic method adopted...Infection of the urinary system is frequently seen in the paraplegic patients with urinary complications,which is one of the main reasons for the late death in such cases. The effects of the therapeutic method adopted for the urinary rehabilitation are directly related to the life quality and survival time of the paraplegic patients. Since 1999-2002, the authors had applied Chinese herbal medicine combined with acupuncture for the urinary rehabilitation in 52 paraplegic patients, with quite good therapeuticresults as reported in the following.展开更多
DNA methylation is a crucial epigenetic regulatory mechanism that can modify chromatin structure,DNA conformation,DNA stability,and the interactions between DNA and proteins,thereby controlling gene expression.It has ...DNA methylation is a crucial epigenetic regulatory mechanism that can modify chromatin structure,DNA conformation,DNA stability,and the interactions between DNA and proteins,thereby controlling gene expression.It has been shown to play a significant role in pathological processes such as fibrosis and tumorigenesis.DNA methyltransferases(DNMTs)are key players in this process.This study aims to investigate the role of DNMTs in the development of urinary system diseases,such as renal fibrosis and prostate cancer,revealing how they regulate gene expression by modulating DNA methylation levels,thereby significantly promoting the progression of these diseases.Additionally,this review explores their potential clinical applications as therapeutic targets,which may offer new research directions for understanding the pathogenesis and treatment of urinary system diseases in the future.展开更多
Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhib...Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.展开更多
With the development of aggregation-induced emission(AIE)materials,the draw-backs of conventionalfluorescence materials subjected to aggregation-caused quenching(ACQ)have been resolved.This has allowed for the improvem...With the development of aggregation-induced emission(AIE)materials,the draw-backs of conventionalfluorescence materials subjected to aggregation-caused quenching(ACQ)have been resolved.This has allowed for the improvement of novel AIEfluorescent materials that exhibit enhanced photostability,a higher signal-to-noise ratio,and better imaging quality.Meanwhile,the enhanced phototherapeutic effect of AIE materials has garnered widespread attention in the realm of tumor treatment.The distinct physiological and anatomical characteristics of the urinary system make it suitable for the use of AIE materials.Additionally,AIE-based pho-totherapy provides a superior solution to deal with the weaknesses of conventional treatments for urologic neoplasms.In this review,the scientific advancement on the use of AIE materials in urinary system diseases since the emergence of the AIE con-cept is reviewed in detail.The review highlights the promise of AIE materials for biomarkers detection,fluorescence imaging(FLI)in vivo and in vitro,AIE-based phototherapy,and synergistic therapy from both diagnostic and therapeutic view-points.It isfirmly believed that AIE materials hold immense untapped potential for the diagnosis and treatment of urologic disease,as well as all diseases of the human body.展开更多
The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomy...The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomyelitis, peritonitis, empyema, salpingitis, septic arthritis, liver abscess, sinusitis, intestinal surgery or post-traumatic wound infections, and bacteremia, such as pelvic inflammatory disease. This paper analyzes the experimental method of anaerobic bacteria to human urinary system through the influence of literature.展开更多
Objectives:This review aimed to explore the independent risk factors of postpartum urinary retention(PUR)after a vaginal delivery.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)w...Objectives:This review aimed to explore the independent risk factors of postpartum urinary retention(PUR)after a vaginal delivery.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)was followed and relevant studies were retrieved from eleven databases.The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies.The data analysis was performed using Review Manager version 5.3.Results:A total of nine articles were included and five risk factors were identified,namely,episiotomy(OR=2.99,95%CI=1.31e6.79,P=0.009),epidural analgesia(OR=2.48,95%CI=1.09e5.68,P=0.03),primiparity(OR=2.17,95%CI=1.06e4.46,P=0.03),instrumental delivery(OR=4.01,95%CI=1.97 e8.18,P<0.001),and the duration of the second stage of labor(MD=15.24,95%CI=11.20e19.28,P<0.001).However,fetal birth weights of more than 3800 g were not identified as an independent risk factor(MD=64.41,95%CI=-12.59 to 141.41,P=0.10).Conclusion:This systematic review indicated that the independent risk factors for PUR were found to include episiotomy,epidural analgesia,instrumental delivery,primiparity,and a longer second stage of labor.In clinical practice,healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.展开更多
This manuscript comments on the article published in a recent issue of World Journal of Psychology.We emphasize the potential of combining Epirubicin(EPI)chemotherapy with mindfulness-based interventions(MBIs)to optim...This manuscript comments on the article published in a recent issue of World Journal of Psychology.We emphasize the potential of combining Epirubicin(EPI)chemotherapy with mindfulness-based interventions(MBIs)to optimize cancer care for urinary system tumors.The long-term use EPI is associated with depression and in short-term has shown side effects such as fatigue,nausea,and occasional abdominal pain,which can impact patient adherence.MBIs address the psychological burdens,such as depression and anxiety,that accompany cancer treatment,enhancing emotional well-being,immune function,and treatment adherence.Integration of MBIs alongside EPI offers improved clinical outcomes by lowering stress and reducing side effects,ultimately supporting both psychological and physical recovery.This comprehensive care model can potentially promote long-term health and quality of life for cancer patients.展开更多
BACKGROUND Prostate artery embolization(PAE)is a promising minimally invasive therapy that improves lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH).Transurethral resection of the prostat...BACKGROUND Prostate artery embolization(PAE)is a promising minimally invasive therapy that improves lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH).Transurethral resection of the prostate(TURP)is the gold standard therapy for LUTS/BPH.AIM To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH.METHODS A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH.Sources included PubMed,Embase,Cochrane library databases,and Chinese databases before June 2022.A systematic review and meta-analysis were conducted.Outcome measurements were combined by calculating the mean difference with a 95%confidence interval.Statistical analysis was carried out using Review Manager 5.3.RESULTS Eleven studies involving 1070 participants were included.Compared with the TURP group,the PAE group had a similar effect on the International Index of Erectile Function(IPSS)score,Peak urinary flow rate(Qmax),postvoid residual volume(PVR),Prostate volume(PV),prostatic specific antigen(PSA),The International Index of Erectile Function short form(IIEF-5)scores,and erectile dysfunction during 24 mo follow-up.Lower quality of life(QoL)score,lower rate of retrograde ejaculation and shorter hospital stay in the PAE group.There was no participant death in either group.A higher proportion of haematuria,urinary incontinence and urinary stricture was identified in the TURP group.CONCLUSION PAE may be an appropriate option for elderly patients,patients who are not candidates for surgery,and patients who do not want to risk the potential adverse effects of TURP.Studies with large cases and long follow-up time are needed to validate results.展开更多
OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restriction...OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restrictions.We included randomized controlled trials(RCTs)involving women with SUI,but excluded other types of urinary incontinence or studies that were not RCTs.Two independent reviewers extracted study characteristics,with disagreements resolved by consensus.Data were pooled and expressed as mean difference(MD)for continuous outcomes and relative risk(RR)for dichotomous outcomes,with 95%confidence intervals(CI).This study was registered with the International Prospective Register of Systematic Reviews(number CRD42018089734).RESULTS:We found very low to high level evidence that EA improved the effective rate(RR=2.03,95%CI:1.40,2.95;P=0.0002)and reduced urine leakage as measured by the 1-hour pad test(MD=3.33,95%CI:0.89,5.77;P=0.008),International Consultation on Incontinence Questionnaire Short Form score(MD=3.14,95%CI:2.42,3.85;P<0.00001),and 72-hour incontinence episodes(MD=1.17,95%CI:0.56,1.78;P=0.0002)compared with sham electroacupuncture(SA),pelvic floor muscle training,and medication.CONCLUSION:The effectiveness and safety of EA for key outcomes for women with SUI are statistically significantly better than those of SA,but most available evidence is very low or low quality.More well-designed RCTs are needed to confirm these findings.展开更多
Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophilto-lymphocyte ratio(NLR)and prognosis of various malignant tumors.However,the relationship between NLR and ...Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophilto-lymphocyte ratio(NLR)and prognosis of various malignant tumors.However,the relationship between NLR and surgically resectable urinary cancers remains contradictory.Therefore,we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers.Methods After searching the Embase,PubMed/MEDLINE and Cochrane databases and screening the articles,we finally included 25 studies involving 15950 patients.Hazard ratios(HRs)and their 95%confidence intervals(CIs)were extracted to assess the association between preoperative NLR and the overall survival(OS)and cancerspecific survival(CSS)of surgically resectable urinary cancers.Results The pooled results revealed that an elevated preoperative NLR could predict a worse OS(HR=1.40,95%CI:1.26–1.54,P<0.001)and CSS(HR=1.43,95%CI:1.27–1.59,P<0.001)in urinary cancers.In addition,our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma(OS:HR=2.06,95%CI:1.54–2.76,P=0.131;CSS:HR=2.46,95%CI:1.46–4.16,P=0.178),upper tract urothelial carcinoma(OS:HR=1.91,95%CI:1.50–2.42,P=0.616;CSS:HR=1.84,95%CI:1.41–2.39,P=0.001),bladder cancer(OS:HR=1.09,95%CI:1.02–1.17,P<0.001;CSS:HR=1.05,95%CI:1.01–1.09,P=0.163)and prostate cancer(OS:HR=1.69,95%CI:1.19–2.41,P=0.714).Regardless of the participants’race or the cutoff value of the preoperative NLR,the results remained valid.Conclusion Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers,namely,renal cell carcinoma,bladder cancer,prostate cancer and upper tract urothelial carcinoma.展开更多
We performed a meta-analysis to compare treatment with a combination of solifenacin plus tamsulosin oral controlled absorption system （TOCAS） with placebo or TOCAS monotherapy. The aim of the meta-analysis was to cl...We performed a meta-analysis to compare treatment with a combination of solifenacin plus tamsulosin oral controlled absorption system （TOCAS） with placebo or TOCAS monotherapy. The aim of the meta-analysis was to clarify the efficacy and safety of the combination treatments method for lower urinary tract symptoms （LUTS）. We searched for trials of men with LUTS that were randomized to combination treatment compared with TOCAS monotherapy or placebo. We pooled data from three placebo-controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score （IPSS） and urinary frequency. We also assessed postvoid residual, maximum urinary flow rate, incidence of urinary retention （UR）, adverse events. Data were pooled using random or fixed effect models for continuous outcomes and the ManteI-Haenszel method to generate risk ratio. Reductions in IPSS storage subscore and total urgency and frequency score （TUFS） were observed with solifenacin 6 mg plus TOCAS compared with placebo （P 〈 0.0001 and P 〈 0.0001, respectively）. Reductions in IPSS storage subscore and TUFS were observed with solifenacin 9 mg plus TOCAS compared with placebo （P= 0.003 and P = 0.0006, respectively）. Reductions in TUFS was observed with solifenacin 6 mg plus TOCAS compared with TOCAS （P = 0.01）. Both combination treatments were well tolerated, with low incidence of UR. Solifenacin 6 mg plus TOCAS significantly improved total IPSS, storage and voiding symptoms compared with placebo. Solifenacin 6 mg plus TOCAS also improved storage symptoms compared with TOCAS alone. There was no additional benefit of solifenacin 9 mg compared with 6 mg when used in combination with TOCAS.展开更多
Objective: Lower urinary tract symptoms(LUTS) caused by benign prostatic hyperplasia(BPH) affect the quality of life of elderly individuals. Acupuncture and moxibustion are used in the clinic in China for improving LU...Objective: Lower urinary tract symptoms(LUTS) caused by benign prostatic hyperplasia(BPH) affect the quality of life of elderly individuals. Acupuncture and moxibustion are used in the clinic in China for improving LUTS symptoms due to BPH. However,there is no evidence to suggest which is the best option. We compared the efficacy of acupuncture and moxibustion to provide evidence for clinical decision-making.Methods: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP databases were searched from inception to July 2020 to identify the randomized controlled trials(RCTs) of acupuncture and moxibustion for LUTS due to BPH. Two researchers filtered studies and extracted the information independently. This study conducted a network meta-analysis using the Bayesian random method. The interventions ranking was evaluated using the surface under the cumulative ranking curve(SUCRA).Results: We finally included 40 studies comprising 10 treating therapies and 3,655 patients with LUTS caused by BPH. In terms of the International Prostate Symptom Score, maximum urinary flow rate, and quality of life, electroacupuncture(EA) [MD =-3.6,95% credible interval(CrI)(-5.5,-1.8), very low certainty of evidence;MD = 2.2, 95% CrI(1.1, 3.3), low certainty of evidence;MD =-1.3, 95% CrI(-2.2,-0.43), very low certainty of the evidence] may be consistently the optimal treatment compared with other interventions, with SUCRA values of 84%, 81%, and 89%, respectively.Conclusions: Of all treatments, EA may have the best efficacy with fewer adverse events for LUTS due to BPH. The quality of evidence supporting this result is low to very low certainty of the evidence due to the limitations of primary studies;thus, more highquality RCTs are needed for further evidence.展开更多
BACKGROUND Lymphoepithelioma-like carcinomas(LELCs)are rare,malignant epithelial tumors,generally considered a subtype of squamous cell carcinoma.LELCs are undifferentiated and can occur in multiple tissues,although L...BACKGROUND Lymphoepithelioma-like carcinomas(LELCs)are rare,malignant epithelial tumors,generally considered a subtype of squamous cell carcinoma.LELCs are undifferentiated and can occur in multiple tissues,although LELCs in the urinary tract are extremely rare.As such,evidence does not provide clinicians with guidelines for the best practices.Even though this is a rare disease,it is associated with high morbidity and mortality.Therefore,we must learn to differentiate LELC types and identify risk factors for early identification.AIM To develop an evidence base to guide clinicians treating primary LELCs of the upper urinary tract(UUT-LELC).METHODS We performed a systematic review of all reports on UUT-LELC from the first published case in 1998 until October 2019,according to the PRISMA.A database was then developed by extracting data from previously published reports in order to analyze interactions between clinical characteristics,pathological features,interventions and outcomes.Survival was analyzed using Kaplan–Meier estimates,which were compared using log rank tests.RESULTS A total of 28 previously published cases were identified for inclusion.The median age was 72 years with a male to female ratio of 4:3.Pure type LELCs were most common with 48.3%(n=14),followed by 37.9%(n=11)predominant LELCs and 3.4%(n=1)focal LELCs.Epstein-Barr virus testing was negative in all cases.Fourteen patients received radical nephroureterectomy(RNU)-based intervention.Twenty-three patients survived with no evidence of further metastasis,although six died before the median 18 mo follow-up point.Survival analysis suggests pure histological subtypes,and patients who receive complete tumor resection have more favorable prognoses.As always in cancer care,early identification generally increases the probability of interventional success.CONCLUSION The most effective treatment for UUT-LELC is RNU-based therapy.Since cases are few in number,case reporting must be enhanced and publishing encouraged to both save and prolong lives.展开更多
Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-...Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.展开更多
Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to...Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.展开更多
文摘BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is recommended by the European Association of Urology and can improve prognosis,its long-term use can cause toxic side effects,reduce treatment compliance,and increase psycho-logical burden.Therefore,an appropriate intervention mode is necessary.METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023.Patients were divided into conventional(n=55)and joint inter-vention(n=55)groups.The conventional group received mitomycin and routine nursing,while the joint intervention group received EPI and mindfulness intervention.Both groups underwent three cycles of chemotherapy.Immune function(CD4+cells,CD8+cells,CD4+/CD8+ratio),tumor marker levels[urinary bladder cancer antigen(UBC),bladder tumor antigen(BTA)and nuclear matrix protein 22(NMP22)],quality of life questionnaire-core 30(QLQ-C30),17-item Hamilton depression scale(HAMD-17),and cancer-related fatigue[cancer fatigue scale(CFS)]were assessed.Adverse reactions and nursing satisfaction were recorded and evaluated.RESULTS Post-intervention,CD4+,CD8+,and CD4+/CD8+levels increased in both groups,with the joint intervention group showing more significant improvement(P<0.05).Tumor marker levels(NMP22,BTA,and UBC)were lower in the joint intervention group compared to the conventional group(P<0.05).The joint intervention group also showed a greater reduction in HAMD-17 scores(9.38±3.12 vs 15.45±4.86,P<0.05),higher QLQ-C30 scores,and lower CFS scores(both P<0.05).Additionally,the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction(P<0.05).CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.
文摘Urinary system tumors include malignancies of the bladder,kidney,and prostate,and present considerable challenges in diagnosis and treatment.The conventional therapeutic approaches against urinary tumors are limited by the lack of targeted drug delivery and significant adverse effects,thereby necessitating novel solutions.Intelligent nanomedicine has emerged as a promising therapeutic alternative for cancer in recent years,and uses nanoscale materials to overcome the inherent biological barriers of tumors,and enhance diagnostic and therapeutic accuracy.In this review,we have explored the recent advances and applications of intelligent nanomedicine for the diagnosis,imaging,and treatment of urinary tumors.The principles of nanomedicine design pertaining to drug encapsulation,targeting and controlled release have been discussed,with emphasis on the strategies for overcoming renal clearance and tumor heterogeneity.Furthermore,the therapeutic applications of intelligent nanomedicine,its advantages over traditional chemotherapy,and the challenges currently facing clinical translation of nanomedicine,such as safety,regulation and scalability,have also been reviewed.Finally,we have assessed the potential of intelligent nanomedicine in the management of urinary system tumors,emphasizing emerging trends such as personalized nanomedicine and combination therapies.This comprehensive review underscores the substantial contributions of nanomedicine to the field of oncology and offers a promising outlook for more effective and precise treatment strategies for urinary system tumors.
文摘Objective: to analyze the advantages of microbial testing. Methods: a total of 200 patients with urinary system infection were selected and divided into two groups, and different testing methods were used. Results: the detection rate of pathogenic bacteria in the observation group was 90.00% higher than that in the control group, which was 60.00% (P<0.05). Conclusion: microbial testing has many advantages, which can not only ensure the curative effect of patients, but also prevent and reduce the occurrence of infection risk in patients.
基金financially supported by Shanghai Key Course Construction Project at Shanghai Jiao Tong University School of Medicine(2015)
文摘As the organ-system oriented integration of medical education has been carried out in many domestic medical schools for years,an urgent need of discussions on various problems of integrated medical education emerges.This paper reviews the urinary integrated educational work in Shanghai Jiao Tong University School of Medicine(SJTU-MS)and introduces the contents of the integrated curriculum of urinary system.We focus on whether we should apply the single cycle integration mode or dual cycle mode,and compare the vocational medical education and elite medical education,and demonstrate the importance of inter-system integration and the ideal integrated textbooks.Multifarious teaching methods and other issues are also mentioned.The future development of integrated medical education is prospected positively.
文摘From May 1970 to May 1988,the authortreated 182 cases of abdominal colic due to cal-culi in the urinary system with satisfactory anal-gesic effect,and this is briefly summarized asfollows.
文摘Infection of the urinary system is frequently seen in the paraplegic patients with urinary complications,which is one of the main reasons for the late death in such cases. The effects of the therapeutic method adopted for the urinary rehabilitation are directly related to the life quality and survival time of the paraplegic patients. Since 1999-2002, the authors had applied Chinese herbal medicine combined with acupuncture for the urinary rehabilitation in 52 paraplegic patients, with quite good therapeuticresults as reported in the following.
基金The Anqing Medical Self-Financing Program,Grant/Award Number:2024Z4002。
文摘DNA methylation is a crucial epigenetic regulatory mechanism that can modify chromatin structure,DNA conformation,DNA stability,and the interactions between DNA and proteins,thereby controlling gene expression.It has been shown to play a significant role in pathological processes such as fibrosis and tumorigenesis.DNA methyltransferases(DNMTs)are key players in this process.This study aims to investigate the role of DNMTs in the development of urinary system diseases,such as renal fibrosis and prostate cancer,revealing how they regulate gene expression by modulating DNA methylation levels,thereby significantly promoting the progression of these diseases.Additionally,this review explores their potential clinical applications as therapeutic targets,which may offer new research directions for understanding the pathogenesis and treatment of urinary system diseases in the future.
文摘Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.
基金Jiangsu Provincial Key Research and Development Program,Grant/Award Numbers:BE2020655,BE2020654General Program of Jiangsu Health Commission,Grant/Award Number:H2019040Gusu Health Personnel Training Project of Suzhou City,Grant/Award Number:GSWS2019033。
文摘With the development of aggregation-induced emission(AIE)materials,the draw-backs of conventionalfluorescence materials subjected to aggregation-caused quenching(ACQ)have been resolved.This has allowed for the improvement of novel AIEfluorescent materials that exhibit enhanced photostability,a higher signal-to-noise ratio,and better imaging quality.Meanwhile,the enhanced phototherapeutic effect of AIE materials has garnered widespread attention in the realm of tumor treatment.The distinct physiological and anatomical characteristics of the urinary system make it suitable for the use of AIE materials.Additionally,AIE-based pho-totherapy provides a superior solution to deal with the weaknesses of conventional treatments for urologic neoplasms.In this review,the scientific advancement on the use of AIE materials in urinary system diseases since the emergence of the AIE con-cept is reviewed in detail.The review highlights the promise of AIE materials for biomarkers detection,fluorescence imaging(FLI)in vivo and in vitro,AIE-based phototherapy,and synergistic therapy from both diagnostic and therapeutic view-points.It isfirmly believed that AIE materials hold immense untapped potential for the diagnosis and treatment of urologic disease,as well as all diseases of the human body.
文摘The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomyelitis, peritonitis, empyema, salpingitis, septic arthritis, liver abscess, sinusitis, intestinal surgery or post-traumatic wound infections, and bacteremia, such as pelvic inflammatory disease. This paper analyzes the experimental method of anaerobic bacteria to human urinary system through the influence of literature.
基金We would like to appreciate Alice May and tutors in the personal development department and library from Birmingham City University for their guidance and assistance.We are grateful to Affiliated Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University.
文摘Objectives:This review aimed to explore the independent risk factors of postpartum urinary retention(PUR)after a vaginal delivery.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)was followed and relevant studies were retrieved from eleven databases.The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies.The data analysis was performed using Review Manager version 5.3.Results:A total of nine articles were included and five risk factors were identified,namely,episiotomy(OR=2.99,95%CI=1.31e6.79,P=0.009),epidural analgesia(OR=2.48,95%CI=1.09e5.68,P=0.03),primiparity(OR=2.17,95%CI=1.06e4.46,P=0.03),instrumental delivery(OR=4.01,95%CI=1.97 e8.18,P<0.001),and the duration of the second stage of labor(MD=15.24,95%CI=11.20e19.28,P<0.001).However,fetal birth weights of more than 3800 g were not identified as an independent risk factor(MD=64.41,95%CI=-12.59 to 141.41,P=0.10).Conclusion:This systematic review indicated that the independent risk factors for PUR were found to include episiotomy,epidural analgesia,instrumental delivery,primiparity,and a longer second stage of labor.In clinical practice,healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.
文摘This manuscript comments on the article published in a recent issue of World Journal of Psychology.We emphasize the potential of combining Epirubicin(EPI)chemotherapy with mindfulness-based interventions(MBIs)to optimize cancer care for urinary system tumors.The long-term use EPI is associated with depression and in short-term has shown side effects such as fatigue,nausea,and occasional abdominal pain,which can impact patient adherence.MBIs address the psychological burdens,such as depression and anxiety,that accompany cancer treatment,enhancing emotional well-being,immune function,and treatment adherence.Integration of MBIs alongside EPI offers improved clinical outcomes by lowering stress and reducing side effects,ultimately supporting both psychological and physical recovery.This comprehensive care model can potentially promote long-term health and quality of life for cancer patients.
文摘BACKGROUND Prostate artery embolization(PAE)is a promising minimally invasive therapy that improves lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH).Transurethral resection of the prostate(TURP)is the gold standard therapy for LUTS/BPH.AIM To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH.METHODS A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH.Sources included PubMed,Embase,Cochrane library databases,and Chinese databases before June 2022.A systematic review and meta-analysis were conducted.Outcome measurements were combined by calculating the mean difference with a 95%confidence interval.Statistical analysis was carried out using Review Manager 5.3.RESULTS Eleven studies involving 1070 participants were included.Compared with the TURP group,the PAE group had a similar effect on the International Index of Erectile Function(IPSS)score,Peak urinary flow rate(Qmax),postvoid residual volume(PVR),Prostate volume(PV),prostatic specific antigen(PSA),The International Index of Erectile Function short form(IIEF-5)scores,and erectile dysfunction during 24 mo follow-up.Lower quality of life(QoL)score,lower rate of retrograde ejaculation and shorter hospital stay in the PAE group.There was no participant death in either group.A higher proportion of haematuria,urinary incontinence and urinary stricture was identified in the TURP group.CONCLUSION PAE may be an appropriate option for elderly patients,patients who are not candidates for surgery,and patients who do not want to risk the potential adverse effects of TURP.Studies with large cases and long follow-up time are needed to validate results.
文摘OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restrictions.We included randomized controlled trials(RCTs)involving women with SUI,but excluded other types of urinary incontinence or studies that were not RCTs.Two independent reviewers extracted study characteristics,with disagreements resolved by consensus.Data were pooled and expressed as mean difference(MD)for continuous outcomes and relative risk(RR)for dichotomous outcomes,with 95%confidence intervals(CI).This study was registered with the International Prospective Register of Systematic Reviews(number CRD42018089734).RESULTS:We found very low to high level evidence that EA improved the effective rate(RR=2.03,95%CI:1.40,2.95;P=0.0002)and reduced urine leakage as measured by the 1-hour pad test(MD=3.33,95%CI:0.89,5.77;P=0.008),International Consultation on Incontinence Questionnaire Short Form score(MD=3.14,95%CI:2.42,3.85;P<0.00001),and 72-hour incontinence episodes(MD=1.17,95%CI:0.56,1.78;P=0.0002)compared with sham electroacupuncture(SA),pelvic floor muscle training,and medication.CONCLUSION:The effectiveness and safety of EA for key outcomes for women with SUI are statistically significantly better than those of SA,but most available evidence is very low or low quality.More well-designed RCTs are needed to confirm these findings.
基金supported by National Natural Science Foundation of China(Granted Number 81670611)。
文摘Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophilto-lymphocyte ratio(NLR)and prognosis of various malignant tumors.However,the relationship between NLR and surgically resectable urinary cancers remains contradictory.Therefore,we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers.Methods After searching the Embase,PubMed/MEDLINE and Cochrane databases and screening the articles,we finally included 25 studies involving 15950 patients.Hazard ratios(HRs)and their 95%confidence intervals(CIs)were extracted to assess the association between preoperative NLR and the overall survival(OS)and cancerspecific survival(CSS)of surgically resectable urinary cancers.Results The pooled results revealed that an elevated preoperative NLR could predict a worse OS(HR=1.40,95%CI:1.26–1.54,P<0.001)and CSS(HR=1.43,95%CI:1.27–1.59,P<0.001)in urinary cancers.In addition,our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma(OS:HR=2.06,95%CI:1.54–2.76,P=0.131;CSS:HR=2.46,95%CI:1.46–4.16,P=0.178),upper tract urothelial carcinoma(OS:HR=1.91,95%CI:1.50–2.42,P=0.616;CSS:HR=1.84,95%CI:1.41–2.39,P=0.001),bladder cancer(OS:HR=1.09,95%CI:1.02–1.17,P<0.001;CSS:HR=1.05,95%CI:1.01–1.09,P=0.163)and prostate cancer(OS:HR=1.69,95%CI:1.19–2.41,P=0.714).Regardless of the participants’race or the cutoff value of the preoperative NLR,the results remained valid.Conclusion Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers,namely,renal cell carcinoma,bladder cancer,prostate cancer and upper tract urothelial carcinoma.
文摘We performed a meta-analysis to compare treatment with a combination of solifenacin plus tamsulosin oral controlled absorption system （TOCAS） with placebo or TOCAS monotherapy. The aim of the meta-analysis was to clarify the efficacy and safety of the combination treatments method for lower urinary tract symptoms （LUTS）. We searched for trials of men with LUTS that were randomized to combination treatment compared with TOCAS monotherapy or placebo. We pooled data from three placebo-controlled trials meeting inclusion criteria. Primary outcomes of interest included changes in International Prostate Symptom Score （IPSS） and urinary frequency. We also assessed postvoid residual, maximum urinary flow rate, incidence of urinary retention （UR）, adverse events. Data were pooled using random or fixed effect models for continuous outcomes and the ManteI-Haenszel method to generate risk ratio. Reductions in IPSS storage subscore and total urgency and frequency score （TUFS） were observed with solifenacin 6 mg plus TOCAS compared with placebo （P 〈 0.0001 and P 〈 0.0001, respectively）. Reductions in IPSS storage subscore and TUFS were observed with solifenacin 9 mg plus TOCAS compared with placebo （P= 0.003 and P = 0.0006, respectively）. Reductions in TUFS was observed with solifenacin 6 mg plus TOCAS compared with TOCAS （P = 0.01）. Both combination treatments were well tolerated, with low incidence of UR. Solifenacin 6 mg plus TOCAS significantly improved total IPSS, storage and voiding symptoms compared with placebo. Solifenacin 6 mg plus TOCAS also improved storage symptoms compared with TOCAS alone. There was no additional benefit of solifenacin 9 mg compared with 6 mg when used in combination with TOCAS.
基金supported by the Training Program of the Innovation Team of Tianjin Higher Education Institution(No.TD13±5047)through Tianjin Municipal Education Commission。
文摘Objective: Lower urinary tract symptoms(LUTS) caused by benign prostatic hyperplasia(BPH) affect the quality of life of elderly individuals. Acupuncture and moxibustion are used in the clinic in China for improving LUTS symptoms due to BPH. However,there is no evidence to suggest which is the best option. We compared the efficacy of acupuncture and moxibustion to provide evidence for clinical decision-making.Methods: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP databases were searched from inception to July 2020 to identify the randomized controlled trials(RCTs) of acupuncture and moxibustion for LUTS due to BPH. Two researchers filtered studies and extracted the information independently. This study conducted a network meta-analysis using the Bayesian random method. The interventions ranking was evaluated using the surface under the cumulative ranking curve(SUCRA).Results: We finally included 40 studies comprising 10 treating therapies and 3,655 patients with LUTS caused by BPH. In terms of the International Prostate Symptom Score, maximum urinary flow rate, and quality of life, electroacupuncture(EA) [MD =-3.6,95% credible interval(CrI)(-5.5,-1.8), very low certainty of evidence;MD = 2.2, 95% CrI(1.1, 3.3), low certainty of evidence;MD =-1.3, 95% CrI(-2.2,-0.43), very low certainty of the evidence] may be consistently the optimal treatment compared with other interventions, with SUCRA values of 84%, 81%, and 89%, respectively.Conclusions: Of all treatments, EA may have the best efficacy with fewer adverse events for LUTS due to BPH. The quality of evidence supporting this result is low to very low certainty of the evidence due to the limitations of primary studies;thus, more highquality RCTs are needed for further evidence.
文摘BACKGROUND Lymphoepithelioma-like carcinomas(LELCs)are rare,malignant epithelial tumors,generally considered a subtype of squamous cell carcinoma.LELCs are undifferentiated and can occur in multiple tissues,although LELCs in the urinary tract are extremely rare.As such,evidence does not provide clinicians with guidelines for the best practices.Even though this is a rare disease,it is associated with high morbidity and mortality.Therefore,we must learn to differentiate LELC types and identify risk factors for early identification.AIM To develop an evidence base to guide clinicians treating primary LELCs of the upper urinary tract(UUT-LELC).METHODS We performed a systematic review of all reports on UUT-LELC from the first published case in 1998 until October 2019,according to the PRISMA.A database was then developed by extracting data from previously published reports in order to analyze interactions between clinical characteristics,pathological features,interventions and outcomes.Survival was analyzed using Kaplan–Meier estimates,which were compared using log rank tests.RESULTS A total of 28 previously published cases were identified for inclusion.The median age was 72 years with a male to female ratio of 4:3.Pure type LELCs were most common with 48.3%(n=14),followed by 37.9%(n=11)predominant LELCs and 3.4%(n=1)focal LELCs.Epstein-Barr virus testing was negative in all cases.Fourteen patients received radical nephroureterectomy(RNU)-based intervention.Twenty-three patients survived with no evidence of further metastasis,although six died before the median 18 mo follow-up point.Survival analysis suggests pure histological subtypes,and patients who receive complete tumor resection have more favorable prognoses.As always in cancer care,early identification generally increases the probability of interventional success.CONCLUSION The most effective treatment for UUT-LELC is RNU-based therapy.Since cases are few in number,case reporting must be enhanced and publishing encouraged to both save and prolong lives.
文摘Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.
文摘Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.
