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
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
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
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
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgica...BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.展开更多
Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the as...Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.展开更多
Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problem...Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problems such as poor compliance and uneven allocation of medical resources,making it difficult to meet individualized health management needs.Remote follow-up provides a novel solution to optimize long-term management,improve health literacy,and enhance clinical outcomes.This study aims to evaluate the effect of remote follow-up under an intelligent medical collaborative model on quality of life and health-promoting lifestyle in patients with urinary calculi,and to assess its short-term impact on clinical outcomes.Methods:A total of 118 patients with urinary calculi admitted to a tertiary hospital in Hunan Province between August and November 2024 were recruited and randomly assigned to a control group(n=59)or an intervention group(n=59).The control group received routine departmental follow-up,while the intervention group underwent remote follow-up based on an intelligent medical collaborative model for one month.Assessments were conducted before discharge(T0),15 days after discharge(T1),and one month after discharge(T2),using the Wisconsin Stone Quality of Life Questionnaire and the Health-Promoting Lifestyle Profile.At T2,the incidence of forgotten ureteral stents(FUS),ureteral stent-related complications,unplanned readmissions,and patient satisfaction were evaluated.Results:No significant differences were observed between groups at T0 in baseline characteristics or outcome measures(all P>0.05).At T1 and T2,the intervention group had significantly higher health-related quality of life scores than the control group(P<0.05).Generalized estimating equation(GEE)analysis showed significant between-group effects(Wald's χ^(2)=22.961,P<0.001),time effects(Wald's χ^(2)=23.065,P<0.001),and interaction effects(Wald's χ^(2)=6.930,P<0.05).Similarly,at T1 and T2,the intervention group scored significantly higher on health-promoting lifestyle than the control group(P<0.05),with significant between-group effects(Wald's χ^(2)=22.936,P<0.001),time effects(Wald's χ^(2)=10.694,P<0.001),and interaction effects(Wald's χ^(2)=18.921,P<0.05).No significant differences were found between groups in the incidence of FUS,ureteral stent-related complications,or unplanned readmissions(all P>0.05).Patient satisfaction was significantly higher in the intervention group(t=4.089,P<0.001).Conclusion:Remote follow-up under an intelligent medical collaborative model helps improve quality of life,promote health-oriented lifestyles,and enhance patient satisfaction among individuals with urinary calculi.展开更多
Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor...Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.展开更多
Objective:To explore the predictive value of the combined test of urinary sodium,urinary potassium excretion fraction(FEK),and urinary potassium concentration/urine creatinine concentration(UK/UCr)in sepsis-induced ea...Objective:To explore the predictive value of the combined test of urinary sodium,urinary potassium excretion fraction(FEK),and urinary potassium concentration/urine creatinine concentration(UK/UCr)in sepsis-induced early acute kidney injury(AKI).Methods:Sixty sepsis patients admitted to the Northern Hospital of National Pharmaceuticals from 2022.4 to 2024.4 were selected and divided into the AKI group(n=21)and the non-AKI group(n=39)according to whether AKI occurred or not,and another 20 health check-up subjects from our hospital were selected to be included in the control group during the same period of time,and we compared the urinary sodium,urinary FEK,and urinary UK/UCr tests of the three groups,and analysed the urinary potassium concentration/urine creatinine concentration(UK/UCr)in the early stage of sepsis-induced acute kidney injury(AKI)by plotting the working characteristics of the subjects(ROC)curve graph to analyse the predictive value of the combined detection of urinary sodium,urinary FEK and urinary UK/UCr in sepsis-induced early AKI.Results:The levels of urinary FEK and urinary UK/UCr in the non-AKI group were higher than those in the control group,and the levels of urinary sodium were lower than those in the control group(P<0.05),while the levels of urinary FEK and urinary UK/UCr in the AKI group were higher than those in the non-AKI group,and the levels of urinary sodium were lower than those in the non-AKI group(P<0.05);the ROC was plotted and found that the combined test of urinary sodium,urinary FEK,and urinary UK/UCr was useful for the prediction of early AKI caused by sepsis.The area under the curve(AUC)values ranged from 0.694-0.940,with high sensitivity and specificity,and the value of predicting sepsis-induced early AKI was high.Conclusion:Urinary sodium,urinary FEK and urinary UK/UCr can be used as effective biomarkers for the early prediction of AKI,and the combined test has high value in predicting early AKI caused by sepsis.展开更多
BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial fo...BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.展开更多
Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which...Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.展开更多
Obesity,a chronic,complex disease characterized by excess fat deposits,has become a major public health issue worldwide.Epidemiological studies have demonstrated that obesity can result in a greater risk of several ha...Obesity,a chronic,complex disease characterized by excess fat deposits,has become a major public health issue worldwide.Epidemiological studies have demonstrated that obesity can result in a greater risk of several harmful outcomes,such as diabetes mellitus and cardiovascular diseases[1].展开更多
Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The d...Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.展开更多
Objective:This study aimed to investigate the clinicopathological features and prognosis of small cell carcinoma of the urinary bladder(SCCUB).Methods:Clinicopathological data and prognosis of 24 patients with primary...Objective:This study aimed to investigate the clinicopathological features and prognosis of small cell carcinoma of the urinary bladder(SCCUB).Methods:Clinicopathological data and prognosis of 24 patients with primary SCCUB treated at the Affiliated Hospital of Qingdao University(from January 2016 to December 2021)were retrospectively collected and compared with 335 patients with primary high-grade urothelial carcinoma(HG-UC)during the same period.The study endpoints were disease-free survival(DFS)and overall survival(OS).Results:Of the 24 patients with SCCUB,19 were male and five were female.Eight(33%)cases were pure SCCUB(pSCCUB).Sixteen(67%)cases were mixed SCCUB(mSCCUB),all of which were mixed with urothelial carcinoma.All patients underwent surgery and 13(76%,13/17;seven patients were lost to follow-up)patients received postoperative adjuvant chemotherapy.We found no significant difference in clinicopathological features between pSCCUB and mSCCUB.However,compared to HG-UC,SCCUB had higher lymph node metastasis(p=0.014),more lymphovascular invasion(p=0.024),higher Ki-67 expression(p<0.001),and more disease progression events(p=0.001).Median DFS and OS for SCCUB were 22 months and 38 months,respectively.The Kaplan-Meier survival curve showed that the pathological type or surgical type did not affect DFS or OS of SCCUB.However,SCCUB patients had worse DFS and OS than HG-UC patients(both p<0.05).The multivariate Cox analysis showed that the tumor size(hazard ratio 1.44,95%CI 1.96–2.15,p=0.048)was an independent factor affecting DFS of SCCUB patients.Conclusion:Compared with the common HG-UC,SCCUB is rare with specific clinicopathological features and a worse prognosis.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.
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.
文摘BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
基金supported by the Science and Technology Innovation Program of Hunan Province,China(2020SK2073).
文摘Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.
基金supported by the Innovation Platform’s Open Foundation of Education Department of Hunan Province(18K004)the Natural Science Foundation of Hunan Province(2025JJ50508),China.
文摘Objective:Urinary calculi are characterized by a high recurrence rate,and patients’adherence to self-management after discharge directly affects health outcomes.Traditional offline follow-up models often face problems such as poor compliance and uneven allocation of medical resources,making it difficult to meet individualized health management needs.Remote follow-up provides a novel solution to optimize long-term management,improve health literacy,and enhance clinical outcomes.This study aims to evaluate the effect of remote follow-up under an intelligent medical collaborative model on quality of life and health-promoting lifestyle in patients with urinary calculi,and to assess its short-term impact on clinical outcomes.Methods:A total of 118 patients with urinary calculi admitted to a tertiary hospital in Hunan Province between August and November 2024 were recruited and randomly assigned to a control group(n=59)or an intervention group(n=59).The control group received routine departmental follow-up,while the intervention group underwent remote follow-up based on an intelligent medical collaborative model for one month.Assessments were conducted before discharge(T0),15 days after discharge(T1),and one month after discharge(T2),using the Wisconsin Stone Quality of Life Questionnaire and the Health-Promoting Lifestyle Profile.At T2,the incidence of forgotten ureteral stents(FUS),ureteral stent-related complications,unplanned readmissions,and patient satisfaction were evaluated.Results:No significant differences were observed between groups at T0 in baseline characteristics or outcome measures(all P>0.05).At T1 and T2,the intervention group had significantly higher health-related quality of life scores than the control group(P<0.05).Generalized estimating equation(GEE)analysis showed significant between-group effects(Wald's χ^(2)=22.961,P<0.001),time effects(Wald's χ^(2)=23.065,P<0.001),and interaction effects(Wald's χ^(2)=6.930,P<0.05).Similarly,at T1 and T2,the intervention group scored significantly higher on health-promoting lifestyle than the control group(P<0.05),with significant between-group effects(Wald's χ^(2)=22.936,P<0.001),time effects(Wald's χ^(2)=10.694,P<0.001),and interaction effects(Wald's χ^(2)=18.921,P<0.05).No significant differences were found between groups in the incidence of FUS,ureteral stent-related complications,or unplanned readmissions(all P>0.05).Patient satisfaction was significantly higher in the intervention group(t=4.089,P<0.001).Conclusion:Remote follow-up under an intelligent medical collaborative model helps improve quality of life,promote health-oriented lifestyles,and enhance patient satisfaction among individuals with urinary calculi.
基金supported by the Project of National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affi liated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.
文摘Objective:To explore the predictive value of the combined test of urinary sodium,urinary potassium excretion fraction(FEK),and urinary potassium concentration/urine creatinine concentration(UK/UCr)in sepsis-induced early acute kidney injury(AKI).Methods:Sixty sepsis patients admitted to the Northern Hospital of National Pharmaceuticals from 2022.4 to 2024.4 were selected and divided into the AKI group(n=21)and the non-AKI group(n=39)according to whether AKI occurred or not,and another 20 health check-up subjects from our hospital were selected to be included in the control group during the same period of time,and we compared the urinary sodium,urinary FEK,and urinary UK/UCr tests of the three groups,and analysed the urinary potassium concentration/urine creatinine concentration(UK/UCr)in the early stage of sepsis-induced acute kidney injury(AKI)by plotting the working characteristics of the subjects(ROC)curve graph to analyse the predictive value of the combined detection of urinary sodium,urinary FEK and urinary UK/UCr in sepsis-induced early AKI.Results:The levels of urinary FEK and urinary UK/UCr in the non-AKI group were higher than those in the control group,and the levels of urinary sodium were lower than those in the control group(P<0.05),while the levels of urinary FEK and urinary UK/UCr in the AKI group were higher than those in the non-AKI group,and the levels of urinary sodium were lower than those in the non-AKI group(P<0.05);the ROC was plotted and found that the combined test of urinary sodium,urinary FEK,and urinary UK/UCr was useful for the prediction of early AKI caused by sepsis.The area under the curve(AUC)values ranged from 0.694-0.940,with high sensitivity and specificity,and the value of predicting sepsis-induced early AKI was high.Conclusion:Urinary sodium,urinary FEK and urinary UK/UCr can be used as effective biomarkers for the early prediction of AKI,and the combined test has high value in predicting early AKI caused by sepsis.
文摘BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.
文摘Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.
基金supported in part by the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.82304253).
文摘Obesity,a chronic,complex disease characterized by excess fat deposits,has become a major public health issue worldwide.Epidemiological studies have demonstrated that obesity can result in a greater risk of several harmful outcomes,such as diabetes mellitus and cardiovascular diseases[1].
基金financially supported by the Natural Science Foundation of China(No.82003766)Taishan Scholars Program(NO.tsqn202211219)+1 种基金the Key Research and Development Project of Shandong Province(No.2021ZDSYS27)Shandong Province nature fund surface project(Grant No.ZR2024MH088)。
文摘Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.
基金financially supported by the National Natural Science Foundation of China(82071750 and 81772713 to Niu H)Taishan Scholar Program of Shandong Province(tstp20221165 to Niu H).
文摘Objective:This study aimed to investigate the clinicopathological features and prognosis of small cell carcinoma of the urinary bladder(SCCUB).Methods:Clinicopathological data and prognosis of 24 patients with primary SCCUB treated at the Affiliated Hospital of Qingdao University(from January 2016 to December 2021)were retrospectively collected and compared with 335 patients with primary high-grade urothelial carcinoma(HG-UC)during the same period.The study endpoints were disease-free survival(DFS)and overall survival(OS).Results:Of the 24 patients with SCCUB,19 were male and five were female.Eight(33%)cases were pure SCCUB(pSCCUB).Sixteen(67%)cases were mixed SCCUB(mSCCUB),all of which were mixed with urothelial carcinoma.All patients underwent surgery and 13(76%,13/17;seven patients were lost to follow-up)patients received postoperative adjuvant chemotherapy.We found no significant difference in clinicopathological features between pSCCUB and mSCCUB.However,compared to HG-UC,SCCUB had higher lymph node metastasis(p=0.014),more lymphovascular invasion(p=0.024),higher Ki-67 expression(p<0.001),and more disease progression events(p=0.001).Median DFS and OS for SCCUB were 22 months and 38 months,respectively.The Kaplan-Meier survival curve showed that the pathological type or surgical type did not affect DFS or OS of SCCUB.However,SCCUB patients had worse DFS and OS than HG-UC patients(both p<0.05).The multivariate Cox analysis showed that the tumor size(hazard ratio 1.44,95%CI 1.96–2.15,p=0.048)was an independent factor affecting DFS of SCCUB patients.Conclusion:Compared with the common HG-UC,SCCUB is rare with specific clinicopathological features and a worse prognosis.
