Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is im...Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is important to prevent adverse events in normal tissues. In the present study, we evaluated the impact of variation in bladder volume on the doses to various organs. A total of 35 patients underwent definitive radiotherapy at Saitama Medical Center. A Light Speed RT16 (GE Healthcare) was used for planning and to obtain examination CT images. Such images were acquired after 4 - 6 days of planning CT image acquisition. The IMRT plans were optimized using the planning CT data to satisfy the dose constraints set by our in-house protocols for the PTV and the OARs. The dose distributions were then re-calculated using the same IMRT beams, and checked on examination CT images. It was clear that bladder volume affected the doses to certain organs. We focused on the prostate, bladder, rectum, small bowel, and large bowel. Regression coefficients were calculated for variables that correlated strongly with bladder volume (p < 0.05). We found that variation in bladder volume [cm<sup>3</sup>] predicted deviations in the bladder V<sub>70Gy</sub>, V<sub>50Gy</sub>, and V<sub>30Gy</sub> [%];the maximum dose to the small bowel [cGy];and the maximum dose to the large bowel [cGy]. The regression coefficients were -0.065, -0.125, -0.180, -10.22, and -9.831, respectively. We evaluated the impacts of such variation on organ doses. These may be helpful when checking a patient’s bladder volume before daily IMRT for localized prostate cancer.展开更多
Objective: to explore the effect of simple bladder volume-pressure measurement technology and its effect on the quality of life.Methods: choose computer random method from June 2020 to June 2022, 68 cases of hospital ...Objective: to explore the effect of simple bladder volume-pressure measurement technology and its effect on the quality of life.Methods: choose computer random method from June 2020 to June 2022, 68 cases of hospital stroke neurogenic bladder patients are divided into two groups, a control group, a total of 34 patients, the implementation of intermittent catheterization, the other is observation group, there are 34 cases, on the basis of control group treatment, increase the simple bladder capacity-pressure measurement technique.Compare the various clinical indicators.Results: the data of the observed group were better than the control group showed in Table 1-Table 4, with P < 0.05. Conclusion: the application of simple bladder volume-pressure measurement technology in neurogenic bladder combined with intermittent catheterization can help restore autonomous urination, reduce the incidence of symptomatic urinary tract infection, help increase bladder capacity, reduce residual urine volume, and higher quality of life for patients, which is worthy of practice in various medical institutions.展开更多
Underactive bladder(UAB)patients experience straining to void and typically cannot sense bladder fullness.Previous closed-loop bladder volume control systems are limited in neurogenic UAB patients and face infection r...Underactive bladder(UAB)patients experience straining to void and typically cannot sense bladder fullness.Previous closed-loop bladder volume control systems are limited in neurogenic UAB patients and face infection risk due to wired connections.Here,we propose an intelligent bladder volume control system(IBCS)combining an implantable meshed magnetic soft robot(MMR)with a wearable magnetic field sensor.The MMR,tightly sutured to the bladder,compresses the bladder to facilitate urination under magnetic actuation,achieving a voiding efficiency of 94.8%.The wearable magnetic field sensor outside the abdomen achieves continuous and wireless monitoring of bladder volume with a 4.8%error in time.The MMR was validated on a UAB pig model,demonstrating a pressure increase of up to 33 cmH_(2)O and voiding efficiency of over 83%.Our IBCS provides a biocompatible solution for wireless and continuous bladder volume management by integrating wearable sensors and magnetic robotics.展开更多
BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the commo...BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the common comorbidities associated with DMA but is often refractory to current treatments.AIM To investigate the therapeutic effect of human amniotic fluid stem cell-derived extracellular vesicles(hAFSC-EVs)on the recovery of bladder dysfunction in DMA rats.METHODS Eighty rats were divided into normal control,streptozotocin-induced diabetic rats,diabetic rats subjected to arterial balloon endothelial injury of common iliac artery(DMA),and DMA rats treated with hAFSC-EVs(DMA+hAFSC-EVs).At 4 weeks and 12 weeks after DMA induction,levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homeostasis model assessment(HOMA)-insulin resistance,and HOMA-βwere measured.Cystometry,common iliac artery wall thickness,and bladder tumor necrosis factor(TNF)-α,interleukin(IL)-6,transforming growth factor(TGF)-β1,Smad3,connective tissue growth factor(CTGF)and fibronectin were also evaluated.RESULTS Bladder weight and blood glucose,triglyceride,HOMA-insulin resistance,common iliac artery intima thickness,voided volume,intercontraction interval,bladder capacity,and mRNA expression of TNF-α,IL-6,TGF-β1,Smad3,CTGF and fibronectin were significantly increased at 4 weeks and 12 weeks after induction,while the HOMA-βlevel decreased at 4 weeks and 12 weeks,and the high-density lipoprotein cholesterol level decreased at 12 weeks.hAFSC-EVs treatment in DMA rats significantly reduced bladder weight and blood glucose,thickness of common iliac arterial intima,voided volume,intercontraction interval and bladder capacity at 4 weeks.The mRNA expression of TNF-α,TGF-β1,and CTGF in DMA rats treated with hAFSC-EVs were significantly decreased at 4 weeks,while the mRNA expressions of IL-6 and Smad3 were significantly decreased 12 weeks.CONCLUSION hAFSC-EVs treatment can help restore DMA-induced bladder dysfunction,which is associated with lowered blood glucose levels,reduced arterial wall thickness,and decreased TNF-α,IL-6,TGF-β1,Smad3,and CTGF expression.展开更多
Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underw...Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underwent surgical treatment from September 2024 to September 2025 was randomly divided into groups using a random number table. Group A received motivational nursing under the solution-focused approach, while Group B received conventional nursing. Health behavior scores and complication indicators were compared between the two groups. Results: Group A had higher scores on the Health-Promoting Lifestyle Profile II (HPLP-Ⅱ) than Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: For bladder cancer patients undergoing surgery, receiving motivational nursing under the solution-focused approach can improve health behaviors, alleviate negative emotions, and is highly feasible and effective.展开更多
Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of ce...Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.展开更多
Objectives:To date,predictive and prognostic biomarkers for Bladder Cancer(BC)remain lacking.Existing literature underscores the potential of metabolomics as a valuable tool for biomarker identification.The primary ob...Objectives:To date,predictive and prognostic biomarkers for Bladder Cancer(BC)remain lacking.Existing literature underscores the potential of metabolomics as a valuable tool for biomarker identification.The primary objective of this study is to characterize the serum metabolic profile of BC patients undergoing platinumbased chemotherapy(Pt-CT)to identify potential biomarkers.Methods:In this pilot study,we investigated the metabolomic profiles of 14 BC patients undergoing Pt-CT in different settings.We compared their baseline profiles with those of healthy controls and tracked key metabolites throughout chemotherapy cycles.Metabolomics profiling was conducted using nuclear magnetic resonance(NMR)spectroscopy.All experiments were performed on a Bruker Avance™600 spectrometer.Results:Serum samples of BC patients had elevated levels of acetate,acetone,hypoxanthine,trimethylamine N-oxide(TMAO),glutamate,lactate,phenylalanine,and ornithine.Conversely,there were decreased levels of carnitine,choline,betaine,aspartate,threonine,2-hydroxybutyrate,2-aminobutyrate and histidine when compared with healthy controls.Throughout the CT course,hypoxanthine,glutamate,and aspartate levels increased,while acetone,acetate and TMAO levels decreased.Conclusions:The results of our study confirm perturbations in several metabolic pathways in the serum samples of BC patients,including glycolysis,fatty acid,purine,and amino acid metabolism.Additionally,TMAO may contribute to BC development by fostering a pro-inflammatory and oxidative stress state.Furthermore,monitoring these metabolites could serve as a valuable tool for predicting treatment response.To the best of our knowledge,no metabolomic studies have assessed BC patients undergoing CT with longitudinal monitoring to identify changes in the metabolic profile induced by treatment.展开更多
Objective:While cisplatin-based chemotherapy is pivotal for advanced bladder cancer,acquired resistance remains a major obstacle.This study investigates key molecular drivers of this resistance and potential reversal ...Objective:While cisplatin-based chemotherapy is pivotal for advanced bladder cancer,acquired resistance remains a major obstacle.This study investigates key molecular drivers of this resistance and potential reversal strategies.Methods:We established GC(Gemcitabine and Cisplatin)-resistant T24-R and UC3-R cell lines from T24 and UM-UC-3(UC3)cells.Transcriptomic and proteomic analyses identified differentially expressed molecules.Apoptosis and cell viability were assessed by flow cytometry and CCK-8(Cell Counting Kit-8)assays,while RT-qPCR(Reverse Transcription Quantitative Polymerase Chain Reaction)and Western blot analyzed gene and protein expression.Immunofluorescence evaluated FAK(Focal Adhesion Kinase)phosphorylation,and a xenograft mouse model validated the findings in vivo.Results:Integrated transcriptomic and proteomic analysis identified FN1(fibronectin)as a consistently upregulated top candidate in resistant cells(T24-R transcript log_(2)FC=2.8,protein log_(2)FC=0.9;UC3-R transcript log_(2)FC=3.7;all p<0.001).Knockdown of FN1 reduced chemoresistance(Resistance Index:5.2 in T24-R and 2.0 in UC3-R cells,p<0.001)and enhanced apoptosis(approximately 4.5-fold in T24-R and 7.5-fold in UC3-R,p<0.001).ITGB4(Integrin Subunit Beta 4)was upregulated in resistant cells(transcript log_(2)FC:4.2 in T24-R and 3.03 in UC3-R;protein log_(2)FC:0.67 in T24-R;all p<0.01).Critically,ITGB4 knockdown abolished the chemoresistance promoted by exogenous FN1,which was associated with increased FAK(Y397)phosphorylation.Conclusion:Our results demonstrate that the FN1-ITGB4 axis drives chemoresistance in bladder cancer via FAK signaling.Targeting this axis represents a promising strategy to overcome chemoresistance.展开更多
Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan b...Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.展开更多
Objectives:Bladder cancer(BCa)progression is closely linked to the immune microenvironment.However,the key molecules that regulate this microenvironment and their specific mechanisms remain poorly understood.This stud...Objectives:Bladder cancer(BCa)progression is closely linked to the immune microenvironment.However,the key molecules that regulate this microenvironment and their specific mechanisms remain poorly understood.This study aims to identify a key molecule and elucidate its mechanisms,providing a theoretical basis for identifying novel therapeutic targets.Methods:Immune microenvironment-related genes in BCa were identified using The Cancer Genome Atlas and Shanghai Tenth People’s Hospital datasets.Proteasome 26S subunit non-ATPase 2(PSMD2)expression was validated via quantitative polymerase chain reaction(qPCR),Western blot(WB)analysis,and immunofluorescence(IF).In vitro and in vivo experiments confirmed the role of PSMD2 in cell proliferation,invasion,and migration.Kyoto encyclopedia of genes and genomes(KEGG)and Gene Ontology(GO)analyses were conducted to assess PSMD2’s influence on immune microenvironment remodeling.A pathomics model predicted PSMD2 expression in patients with BCa.Results:PSMD2 was identified as a critical factor in BCa,with high expression correlating with poor prognosis and tumor progression.Mechanistically,PSMD2 enhances malignancy by promoting mitogen-activated protein kinase kinase(MEK)and extracellular signal-regulated kinase(ERK)phosphorylation within the mitogen-activated protein kinase(MAPK)signaling pathway.Combined bioinformatics and experimental analyses reveal that PSMD2 downregulates chemokine(C-X-C motif)ligand 14(CXCL14)expression and secretion via the MAPK pathway,thereby remodeling the immune microenvironment and driving tumor progression.Pathomics analysis further supports the potential of PSMD2 expression as a predictive marker in BCa tissues.Conclusion:PSMD2 is overexpressed in BCa and significantly correlates with poor prognosis and tumor progression.It promotes malignant development and immune microenvironment remodeling through the MAPK pathway.Pathological analysis can predict PSMD2 expression,offering valuable insights into immunotherapy responses and survival outcomes.展开更多
Aim:This study was performed to assess the extent of interfraction uterine motion during radiotherapy for cervical cancer and uterine body carcinoma while maintaining a strict bladder filling protocol.Methods:Twenty-f...Aim:This study was performed to assess the extent of interfraction uterine motion during radiotherapy for cervical cancer and uterine body carcinoma while maintaining a strict bladder filling protocol.Methods:Twenty-four patients with cervical cancer or uterine body carcinoma who were treated on a linear accelerator,were recruited.During the course of external beam radiotherapy,cone beam computed tomographic scans were taken,once at the start of treatment and then weekly until the completion of the radiotherapy course.Patients were instructed to maintain a strict bladder filling protocol.After negating the effect of patient’s setup error by offline cone beam computed tomographic imaging,the position of the uterus was defined in the clinical target volume.Then the position of the uterus was compared in the following weekly scans.The position of the uterus was also correlated with the position and the filling of the bladder.This change in uterus position was measured separately in the anterioposterior(AP),superioinferior(SI),and lateral directions.Results:According to calculations based on weekly imaging,The mean values of shift in AP,SI,and lateral directions were respectively 0.67,0.29,and 0.23 The mean extent of motion in the uterine position on a daily basis for individual patients ranged from-2.28 to+1.3 in AP,-0.56 to+0.71 in SI,and from-0.6 to+0.45 in lateral directions.Conclusion:At least once a week cone beam computed tomography might be necessary to minimize the geometrical miss and deliver the planned doses to the target tissue and normal structure provide best results with minimum toxicity by maintaining a bladder volume of about 100 mL and an empty rectum during the whole course of treatment.The daily anatomical shift and contour of the patients maintaining a bladder volume of approximately 100 mL with an empty rectum may result in asymmetrical conforming to the planning target volume and hence appropriate and adequate planning target volume margins are required.展开更多
For the needs of bladder urinary volume noninvasive monitoring in clinical, we present a noninvasive bladder urinary volume monitoring system based on bio-impedance. The system uses a four-electrode structure,which is...For the needs of bladder urinary volume noninvasive monitoring in clinical, we present a noninvasive bladder urinary volume monitoring system based on bio-impedance. The system uses a four-electrode structure,which is composed of a pair of excitation electrodes and a pair of measurement electrodes. The Direct Digital Frequency Synthesis (DDS) is applied to generate a 50 kHz sine current excitation source. The impedance information extracted from phase sensibility demodulation technology is transferred to a computer through Zigbee wireless technology for real-time monitoring. Two experiments are taken to verify the accuracy and feasibility of the system. The experiments results show that the system can accurately measure the corresponding electrical impedance change of the bladder. The system provides a new way to continuously and noninvasively monitor the bladder urinary volume of patients with bladder dysfunction.展开更多
Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We prese...Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We present our experience managing 14 cases of primary UrCa. Methods: A retrospective analysis was conducted on the clinical records of a high-volume bladder cancer center in the UK to identify patients diagnosed with UrCa between May 2013 and June 2022. Results: 9 males and 6 females, aged between 30 and 85 years, were included. The diagnosis was most commonly made via flexible cystoscopy and CT for haematuria. 3 patients had metastasis at presentation, and while radiologically no patients showed positive lymph nodes, 2 patients were found to have positive lymph nodes on histopathology. 13 patients underwent partial cystectomy, with 1 undergoing radical cystoprostatectomy. 8 patients underwent concurrent umbilectomy and/or lymphadenectomy. The most common histological subtype was mucinous adenocarcinoma. 2 patients experienced local recurrence and underwent transurethral resection, while 6 patients experienced metastasis. Metastasis-free survival rate was 74.1% and 55.6% at 12 and 24 months, respectively. Umbilectomy and lymphadenectomy did not decrease rates of positive surgical margin, local recurrence, metastasis, or mortality. Conclusions: UrCa is a rare and aggressive malignancy that can occur at any age and may be advanced upon presentation. Bladder-sparing surgery is becoming more prevalent, with chemotherapy being reserved for recurrence or metastasis. In our series, routine umbilectomy and lymphadenectomy did not improve oncologic outcomes. However, lymphadenectomy may have a role in cancer staging.展开更多
Gall bladder cancer(GBC)remains a highly aggressive disease,with an overall 5-year dismal survival rate of 15%-20%.Its asymptomatic nature in very early stages and non-specific clinical presentations pose significant ...Gall bladder cancer(GBC)remains a highly aggressive disease,with an overall 5-year dismal survival rate of 15%-20%.Its asymptomatic nature in very early stages and non-specific clinical presentations pose significant challenges to timely detection.Consequently,GBC often presents late,making it one of the most challenging cancers to manage.Surgery offers the best chance for long-term survival;however,only 10%of GBC patients are candidates for upfront resection,with the majority presenting in locally advanced or metastatic stages.Further-more,GBC is generally resistant to chemotherapy and radiotherapy,limiting the effectiveness of systemic therapy.Therefore,early diagnosis is crucial to offer the best treatment through surgical resection and to improve the outcome.Recent advancements in imaging technologies,biomarker discovery,and molecular diagnostics offer promising avenues for enhancing detection rates.Though non-invasive,most of them lack specificity,and the majority fail as an early diagnostic tool.This review examines the current status of early detection strategies for GBC,addresses the limitations of existing approaches,and explores the newer emer-ging diagnostic tools and techniques and how they can be exploited in future for its early detection.展开更多
Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms...Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms around the acupuncture area that initiate the effects of acupuncture.Methods Adult female Sprague-Dawley rats were randomly divided into six groups,comprising a control group,model group,group treated with deep acupuncture at BL40,group treated with shallow acupuncture at BL40,group treated with acupuncture at non-acupoint next to BL40,and group treated with acupuncture at Xuanzhong(GB39).Urodynamic evaluation was used to observe the urination,and functional magnetic resonance imaging was used to observe the brain activation.The mechanism of acupuncture at BL40 in regulating bladder function was explored by toluidine blue staining and enzyme-linked immunosorbent assay,and the mechanism was verified by stabilizing mast cells(MCs)or blocking tibial nerve.Results Deep acupuncture at BL40 significantly increased the intercontraction interval in OAB rats and enhanced the mean amplitude of low frequency fluctuation of primary motor cortex(M1),periaquaductal gray matter(PAG),and pontine micturition center(PMC).It also increased the zero-lag functional connectivity between M1 and PAG and between PAG and PMC.Shallow acupuncture at BL40 and acupuncture at non-acupoint or GB39 had no effect on these indexes.Further studies suggested that deep acupuncture at BL40 increased the number and degranulation rate of MCs as well as the contents of 5-hydroxytryptamine,substance P,and histamine in the tissues around BL40.Blocking the tibial nerve by lidocaine injection or inhibiting MC degranulation by sodium cromoglycate injection obstructed the effects of acupuncture on restoring urinary function and modulating brain activation in OAB rats.Conclusion Deep acupuncture at BL40 may be more effective for inhibiting OAB by promoting degranulation of MCs around the acupoint and stimulating tibial nerve,thereby regulating the activation of the brain area that controls the lower urinary tract.展开更多
OBJECTIVE:To investigate whether electroacupuncture(EA)therapy for overactive bladder(OAB)exerts its effect by modulating mechanosensitive channels in the urothelium,thereby improving bladder sensory function.METHODS:...OBJECTIVE:To investigate whether electroacupuncture(EA)therapy for overactive bladder(OAB)exerts its effect by modulating mechanosensitive channels in the urothelium,thereby improving bladder sensory function.METHODS:In this study,a rat model of OAB was created by using intraperitoneal injections of cyclophosphamide.We performed either EA or bladder perfusion with HC-067047[a transient receptor potential vanilloid 4(TRPV4)antagonist]and assessed the efficacy of electroacupuncture in the treatment of OAB in rats via urodynamic determination and Void spot assay.tissue morphology,distribution and expression of the TRPV4protein and the amount of adenosine triphosphate(ATP)and Ca2+released from urothelial cells in each group of rats were observed to identify the mechanism by which electroacupuncture improves OAB in rats.RESULTS:EA ameliorated bladder function and voiding behaviour,improved bladder uroepithelial tissue morphology,and significantly reduced the immunofluorescence intensity and the mRNA and protein expression levels of TRPV4 in the uroepithelium of OAB rats.Moreover,the simulated mechanical stimulationinduced increases in Ca^(2+)concentration and the release of ATP and acetylcholine(Ach)from bladder urothelial cells were inhibited.The changes in EA followed the same trend as those in HC-067047.CONCLUSIONS:These results suggest that EA inhibits bladder sensory function by downregulating the expression of mechanically activated TRPV4 ion channels distributed in bladder urothelial cells,which correspondingly decreases the inward flow of extracellular Ca^(2+)and reduces the release of ATP and Ach,thereby attenuating excitatory signals.展开更多
Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here...Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here,we introduce pyropheophorbide a-bisaminoquinoline conjugate lipid nanoparticles(PPBC LNPs)as a bimodal system for image-guided phototherapy in bladder cancer treatment.PPBC LNPs not only demonstrate both powerful photodynamic and photothermal effects upon light activation,but also exhibit potent autophagy blockage,effectively inducing bladder cancer cell death.Furthermore,PPBC LNPs possess remarkable photoacoustic(PA)and fluorescence(FL)imaging capabilities,enabling imaging with high-resolution,deep tissue penetration and high sensitivity for tracking drug biodistribution and phototherapy efficacy.Specifically,PA imaging confirms the efficient accumulation of PPBC LNPs within tumor and predicts therapeutic outcomes of photodynamic therapy,while FL imaging confirms their prolonged retention at the tumor site for up to 6 days.PPBC LNPs significantly suppress bladder tumor growth,with several tumors completely ablated following just two doses of the nanoparticles and laser treatment.Additionally,PPBC LNPs were formulated with lipid-based excipients and assembled using microfluidic technology to enhance biocompatibility,stability,and scalability,showing potential for clinical translation.This versatile nanoparticle represents a promising candidate for further development in bladder cancer therapy.展开更多
Immune checkpoint inhibitors(ICIs)play a significant role in tumor treatment,but the immune-related adverse events(irAEs),which brings about have also attracted much attention.Among them,toxic epidermal necrolysis(TEN...Immune checkpoint inhibitors(ICIs)play a significant role in tumor treatment,but the immune-related adverse events(irAEs),which brings about have also attracted much attention.Among them,toxic epidermal necrolysis(TEN)is one of the most severe skin toxic reactions.This article reports a case of a bladder cancer patient who developed TEN after receiving ICIs treatment.The male patient was diagnosed with bladder cancer in November 2023.On April 29,2024,he was admitted to the Third Hospital of Changsha for antitumor treatment.In May 2024,he developed immune-related myocarditis after treatment with toripalimab.On July 6,2024,the patient switched to envafolimab treatment,and on July 16,he developed rashes and eventually progressed to TEN.After treatment with glucocorticoids and related symptomatic measures,the patient improved.TEN is a rare but serious irAE in ICIs treatment.Suspected patients should be intervened early,and patients who have already developed it should be actively treated,in order to enhance the understanding and management of TEN caused by ICIs treatment.展开更多
Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bla...Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bladder capacity,storage,and voiding functions through simple,realistic,and resource-friendly approaches.It involves a structured series of steps,from history-taking and physical examination to bladder-emptying procedures,monitoring urine leaks,assessing reflex voiding,measuring post-void residual(PVR),and calculating total bladder capacity.These evaluations help differentiate between upper motor neuron and lower motor neuron bladder dysfunction,providing critical insights for tailored management.The interpretation of findings focuses on identifying bladder type,assessing leak timing and volume,evaluating reflex voiding,and measuring PVR and total bladder capacity.The results guide interventions such as timing selfclean intermittent catheterization,adjusting fluid intake,and using bladder diaries to monitor patterns.Clinical bladder evaluation is particularly advantageous in low-resource settings,as it avoids the risks and costs associated with urodynamic studies while reflecting real-life patient conditions more effectively.Despite its benefits,no validation studies currently exist for clinical bladder assessment,and its parameters,like maximum voided volume,remain underexplored compared to urodynamic measures.Given the accessibility,affordability,and practicality of this approach,it holds promise for widespread application,especially in primary care settings and among economically disadvantaged populations.This editorial describes the process step-by-step and highlights its role in improving patient outcomes while minimizing complications.展开更多
Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,a...Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].展开更多
文摘Intensity-modulated radiation therapy (IMRT) has become the mainstay of treatment for localized prostate cancer. In IMRT, minimizing differences between the conditions used during planning CT and daily treatment is important to prevent adverse events in normal tissues. In the present study, we evaluated the impact of variation in bladder volume on the doses to various organs. A total of 35 patients underwent definitive radiotherapy at Saitama Medical Center. A Light Speed RT16 (GE Healthcare) was used for planning and to obtain examination CT images. Such images were acquired after 4 - 6 days of planning CT image acquisition. The IMRT plans were optimized using the planning CT data to satisfy the dose constraints set by our in-house protocols for the PTV and the OARs. The dose distributions were then re-calculated using the same IMRT beams, and checked on examination CT images. It was clear that bladder volume affected the doses to certain organs. We focused on the prostate, bladder, rectum, small bowel, and large bowel. Regression coefficients were calculated for variables that correlated strongly with bladder volume (p < 0.05). We found that variation in bladder volume [cm<sup>3</sup>] predicted deviations in the bladder V<sub>70Gy</sub>, V<sub>50Gy</sub>, and V<sub>30Gy</sub> [%];the maximum dose to the small bowel [cGy];and the maximum dose to the large bowel [cGy]. The regression coefficients were -0.065, -0.125, -0.180, -10.22, and -9.831, respectively. We evaluated the impacts of such variation on organ doses. These may be helpful when checking a patient’s bladder volume before daily IMRT for localized prostate cancer.
文摘Objective: to explore the effect of simple bladder volume-pressure measurement technology and its effect on the quality of life.Methods: choose computer random method from June 2020 to June 2022, 68 cases of hospital stroke neurogenic bladder patients are divided into two groups, a control group, a total of 34 patients, the implementation of intermittent catheterization, the other is observation group, there are 34 cases, on the basis of control group treatment, increase the simple bladder capacity-pressure measurement technique.Compare the various clinical indicators.Results: the data of the observed group were better than the control group showed in Table 1-Table 4, with P < 0.05. Conclusion: the application of simple bladder volume-pressure measurement technology in neurogenic bladder combined with intermittent catheterization can help restore autonomous urination, reduce the incidence of symptomatic urinary tract infection, help increase bladder capacity, reduce residual urine volume, and higher quality of life for patients, which is worthy of practice in various medical institutions.
基金supported by the National Natural Science Foundation of China(nos.T2350001,52173280)the China Postdoctoral Science Foundation(no.2022M711256)+2 种基金the HUST Interdisciplinary Research Project(no.2023JCYJ044)the Taihu Lake Innovation Fund for Future Technology,HUST(no.2023A3)conducted by protocols approved by the Committee on Animal Care of Hubei Yizhicheng Biotechnology Co.Ltd.(Approval No.WDRM-202403003).
文摘Underactive bladder(UAB)patients experience straining to void and typically cannot sense bladder fullness.Previous closed-loop bladder volume control systems are limited in neurogenic UAB patients and face infection risk due to wired connections.Here,we propose an intelligent bladder volume control system(IBCS)combining an implantable meshed magnetic soft robot(MMR)with a wearable magnetic field sensor.The MMR,tightly sutured to the bladder,compresses the bladder to facilitate urination under magnetic actuation,achieving a voiding efficiency of 94.8%.The wearable magnetic field sensor outside the abdomen achieves continuous and wireless monitoring of bladder volume with a 4.8%error in time.The MMR was validated on a UAB pig model,demonstrating a pressure increase of up to 33 cmH_(2)O and voiding efficiency of over 83%.Our IBCS provides a biocompatible solution for wireless and continuous bladder volume management by integrating wearable sensors and magnetic robotics.
基金the Ministry of Science and Technology Taiwan,No.MOST 109-2314-B-182A-091,No.NSTC 112-2314-B-182A-062, No.NSTC 113-2314-B-182A-125.
文摘BACKGROUND The incidence of diabetic atherosclerosis(DMA)is increasing worldwide,but its pathogenesis remains incompletely understood.In addition to cardiovascular complications,bladder dysfunction is one of the common comorbidities associated with DMA but is often refractory to current treatments.AIM To investigate the therapeutic effect of human amniotic fluid stem cell-derived extracellular vesicles(hAFSC-EVs)on the recovery of bladder dysfunction in DMA rats.METHODS Eighty rats were divided into normal control,streptozotocin-induced diabetic rats,diabetic rats subjected to arterial balloon endothelial injury of common iliac artery(DMA),and DMA rats treated with hAFSC-EVs(DMA+hAFSC-EVs).At 4 weeks and 12 weeks after DMA induction,levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homeostasis model assessment(HOMA)-insulin resistance,and HOMA-βwere measured.Cystometry,common iliac artery wall thickness,and bladder tumor necrosis factor(TNF)-α,interleukin(IL)-6,transforming growth factor(TGF)-β1,Smad3,connective tissue growth factor(CTGF)and fibronectin were also evaluated.RESULTS Bladder weight and blood glucose,triglyceride,HOMA-insulin resistance,common iliac artery intima thickness,voided volume,intercontraction interval,bladder capacity,and mRNA expression of TNF-α,IL-6,TGF-β1,Smad3,CTGF and fibronectin were significantly increased at 4 weeks and 12 weeks after induction,while the HOMA-βlevel decreased at 4 weeks and 12 weeks,and the high-density lipoprotein cholesterol level decreased at 12 weeks.hAFSC-EVs treatment in DMA rats significantly reduced bladder weight and blood glucose,thickness of common iliac arterial intima,voided volume,intercontraction interval and bladder capacity at 4 weeks.The mRNA expression of TNF-α,TGF-β1,and CTGF in DMA rats treated with hAFSC-EVs were significantly decreased at 4 weeks,while the mRNA expressions of IL-6 and Smad3 were significantly decreased 12 weeks.CONCLUSION hAFSC-EVs treatment can help restore DMA-induced bladder dysfunction,which is associated with lowered blood glucose levels,reduced arterial wall thickness,and decreased TNF-α,IL-6,TGF-β1,Smad3,and CTGF expression.
文摘Objective: To analyze the impact of motivational nursing under the solution-focused approach on health behaviors in surgical care for bladder cancer patients. Methods: A sample of 72 bladder cancer patients who underwent surgical treatment from September 2024 to September 2025 was randomly divided into groups using a random number table. Group A received motivational nursing under the solution-focused approach, while Group B received conventional nursing. Health behavior scores and complication indicators were compared between the two groups. Results: Group A had higher scores on the Health-Promoting Lifestyle Profile II (HPLP-Ⅱ) than Group B, with p < 0.05. The postoperative complication rate in Group A was lower than that in Group B, with p < 0.05. Conclusion: For bladder cancer patients undergoing surgery, receiving motivational nursing under the solution-focused approach can improve health behaviors, alleviate negative emotions, and is highly feasible and effective.
基金Yunnan Provincial High-Level Traditional Chinese Medicine Talent Training ProjectYunnan Provincial Department of Science and Technology Traditional Chinese Medicine Basic Research Joint Special Project(Project No.:202101AZ070001-138)。
文摘Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.
文摘Objectives:To date,predictive and prognostic biomarkers for Bladder Cancer(BC)remain lacking.Existing literature underscores the potential of metabolomics as a valuable tool for biomarker identification.The primary objective of this study is to characterize the serum metabolic profile of BC patients undergoing platinumbased chemotherapy(Pt-CT)to identify potential biomarkers.Methods:In this pilot study,we investigated the metabolomic profiles of 14 BC patients undergoing Pt-CT in different settings.We compared their baseline profiles with those of healthy controls and tracked key metabolites throughout chemotherapy cycles.Metabolomics profiling was conducted using nuclear magnetic resonance(NMR)spectroscopy.All experiments were performed on a Bruker Avance™600 spectrometer.Results:Serum samples of BC patients had elevated levels of acetate,acetone,hypoxanthine,trimethylamine N-oxide(TMAO),glutamate,lactate,phenylalanine,and ornithine.Conversely,there were decreased levels of carnitine,choline,betaine,aspartate,threonine,2-hydroxybutyrate,2-aminobutyrate and histidine when compared with healthy controls.Throughout the CT course,hypoxanthine,glutamate,and aspartate levels increased,while acetone,acetate and TMAO levels decreased.Conclusions:The results of our study confirm perturbations in several metabolic pathways in the serum samples of BC patients,including glycolysis,fatty acid,purine,and amino acid metabolism.Additionally,TMAO may contribute to BC development by fostering a pro-inflammatory and oxidative stress state.Furthermore,monitoring these metabolites could serve as a valuable tool for predicting treatment response.To the best of our knowledge,no metabolomic studies have assessed BC patients undergoing CT with longitudinal monitoring to identify changes in the metabolic profile induced by treatment.
基金supported by grants from the National Natural Science Foundation of China(82372881 to Weiyang He)the Chongqing Biomedicine Key R&D Project(CSTB2021TIAD-KPX0041 to Weiyang He).
文摘Objective:While cisplatin-based chemotherapy is pivotal for advanced bladder cancer,acquired resistance remains a major obstacle.This study investigates key molecular drivers of this resistance and potential reversal strategies.Methods:We established GC(Gemcitabine and Cisplatin)-resistant T24-R and UC3-R cell lines from T24 and UM-UC-3(UC3)cells.Transcriptomic and proteomic analyses identified differentially expressed molecules.Apoptosis and cell viability were assessed by flow cytometry and CCK-8(Cell Counting Kit-8)assays,while RT-qPCR(Reverse Transcription Quantitative Polymerase Chain Reaction)and Western blot analyzed gene and protein expression.Immunofluorescence evaluated FAK(Focal Adhesion Kinase)phosphorylation,and a xenograft mouse model validated the findings in vivo.Results:Integrated transcriptomic and proteomic analysis identified FN1(fibronectin)as a consistently upregulated top candidate in resistant cells(T24-R transcript log_(2)FC=2.8,protein log_(2)FC=0.9;UC3-R transcript log_(2)FC=3.7;all p<0.001).Knockdown of FN1 reduced chemoresistance(Resistance Index:5.2 in T24-R and 2.0 in UC3-R cells,p<0.001)and enhanced apoptosis(approximately 4.5-fold in T24-R and 7.5-fold in UC3-R,p<0.001).ITGB4(Integrin Subunit Beta 4)was upregulated in resistant cells(transcript log_(2)FC:4.2 in T24-R and 3.03 in UC3-R;protein log_(2)FC:0.67 in T24-R;all p<0.01).Critically,ITGB4 knockdown abolished the chemoresistance promoted by exogenous FN1,which was associated with increased FAK(Y397)phosphorylation.Conclusion:Our results demonstrate that the FN1-ITGB4 axis drives chemoresistance in bladder cancer via FAK signaling.Targeting this axis represents a promising strategy to overcome chemoresistance.
基金Clinical Study on the Treatment of Neurogenic Bladder in Elderly Patients with Type 2 Diabetes Mellitus by Auricular Point Pressing Needle TherapyZhejiang Provincial Traditional Chinese Medicine Science and Technology Project,Zhejiang Provincial People’s Hospital(Project No.:2024ZL252)。
文摘Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.
基金supported by the National Natural Science Foundation of China Commission,Youth Project(No.82203150,No.82302304)Anhui Health Commission Research Project(No.2024Aa30184)+7 种基金The Bengbu City Health and Medical Research Project(BBWK2024A103)Cultivation grant for clinical and basic integration research of Shanghai Tenth People’s Hospital(SYYYRH2025020)Doctoral Workstation Foundation of Guangdong Second Provincial General Hospital,China(Grant No.2022BSGZ011)Elevate Engineering Foundation of Guangdong Second Provincial General Hospital,China(Grant No.TJGC2022009)Science and Technology Program of Guangzhou,China(2024A04J4159)China Postdoctoral Science Foundation(2021M702137)Natural Science Foundation of Chongqing(cstc2021jcyj-msxmX1176)Chongming District Sustainable Development Science and Technology Innovation Initiative Project(CKY2022-30).
文摘Objectives:Bladder cancer(BCa)progression is closely linked to the immune microenvironment.However,the key molecules that regulate this microenvironment and their specific mechanisms remain poorly understood.This study aims to identify a key molecule and elucidate its mechanisms,providing a theoretical basis for identifying novel therapeutic targets.Methods:Immune microenvironment-related genes in BCa were identified using The Cancer Genome Atlas and Shanghai Tenth People’s Hospital datasets.Proteasome 26S subunit non-ATPase 2(PSMD2)expression was validated via quantitative polymerase chain reaction(qPCR),Western blot(WB)analysis,and immunofluorescence(IF).In vitro and in vivo experiments confirmed the role of PSMD2 in cell proliferation,invasion,and migration.Kyoto encyclopedia of genes and genomes(KEGG)and Gene Ontology(GO)analyses were conducted to assess PSMD2’s influence on immune microenvironment remodeling.A pathomics model predicted PSMD2 expression in patients with BCa.Results:PSMD2 was identified as a critical factor in BCa,with high expression correlating with poor prognosis and tumor progression.Mechanistically,PSMD2 enhances malignancy by promoting mitogen-activated protein kinase kinase(MEK)and extracellular signal-regulated kinase(ERK)phosphorylation within the mitogen-activated protein kinase(MAPK)signaling pathway.Combined bioinformatics and experimental analyses reveal that PSMD2 downregulates chemokine(C-X-C motif)ligand 14(CXCL14)expression and secretion via the MAPK pathway,thereby remodeling the immune microenvironment and driving tumor progression.Pathomics analysis further supports the potential of PSMD2 expression as a predictive marker in BCa tissues.Conclusion:PSMD2 is overexpressed in BCa and significantly correlates with poor prognosis and tumor progression.It promotes malignant development and immune microenvironment remodeling through the MAPK pathway.Pathological analysis can predict PSMD2 expression,offering valuable insights into immunotherapy responses and survival outcomes.
文摘Aim:This study was performed to assess the extent of interfraction uterine motion during radiotherapy for cervical cancer and uterine body carcinoma while maintaining a strict bladder filling protocol.Methods:Twenty-four patients with cervical cancer or uterine body carcinoma who were treated on a linear accelerator,were recruited.During the course of external beam radiotherapy,cone beam computed tomographic scans were taken,once at the start of treatment and then weekly until the completion of the radiotherapy course.Patients were instructed to maintain a strict bladder filling protocol.After negating the effect of patient’s setup error by offline cone beam computed tomographic imaging,the position of the uterus was defined in the clinical target volume.Then the position of the uterus was compared in the following weekly scans.The position of the uterus was also correlated with the position and the filling of the bladder.This change in uterus position was measured separately in the anterioposterior(AP),superioinferior(SI),and lateral directions.Results:According to calculations based on weekly imaging,The mean values of shift in AP,SI,and lateral directions were respectively 0.67,0.29,and 0.23 The mean extent of motion in the uterine position on a daily basis for individual patients ranged from-2.28 to+1.3 in AP,-0.56 to+0.71 in SI,and from-0.6 to+0.45 in lateral directions.Conclusion:At least once a week cone beam computed tomography might be necessary to minimize the geometrical miss and deliver the planned doses to the target tissue and normal structure provide best results with minimum toxicity by maintaining a bladder volume of about 100 mL and an empty rectum during the whole course of treatment.The daily anatomical shift and contour of the patients maintaining a bladder volume of approximately 100 mL with an empty rectum may result in asymmetrical conforming to the planning target volume and hence appropriate and adequate planning target volume margins are required.
文摘For the needs of bladder urinary volume noninvasive monitoring in clinical, we present a noninvasive bladder urinary volume monitoring system based on bio-impedance. The system uses a four-electrode structure,which is composed of a pair of excitation electrodes and a pair of measurement electrodes. The Direct Digital Frequency Synthesis (DDS) is applied to generate a 50 kHz sine current excitation source. The impedance information extracted from phase sensibility demodulation technology is transferred to a computer through Zigbee wireless technology for real-time monitoring. Two experiments are taken to verify the accuracy and feasibility of the system. The experiments results show that the system can accurately measure the corresponding electrical impedance change of the bladder. The system provides a new way to continuously and noninvasively monitor the bladder urinary volume of patients with bladder dysfunction.
文摘Introduction: Primary urachal cancer (UrCa) is rare, with an estimated incidence of 0.2% - 0.5% of all bladder tumors. Although the preferred treatment is surgical, there is no consensus on the best approach. We present our experience managing 14 cases of primary UrCa. Methods: A retrospective analysis was conducted on the clinical records of a high-volume bladder cancer center in the UK to identify patients diagnosed with UrCa between May 2013 and June 2022. Results: 9 males and 6 females, aged between 30 and 85 years, were included. The diagnosis was most commonly made via flexible cystoscopy and CT for haematuria. 3 patients had metastasis at presentation, and while radiologically no patients showed positive lymph nodes, 2 patients were found to have positive lymph nodes on histopathology. 13 patients underwent partial cystectomy, with 1 undergoing radical cystoprostatectomy. 8 patients underwent concurrent umbilectomy and/or lymphadenectomy. The most common histological subtype was mucinous adenocarcinoma. 2 patients experienced local recurrence and underwent transurethral resection, while 6 patients experienced metastasis. Metastasis-free survival rate was 74.1% and 55.6% at 12 and 24 months, respectively. Umbilectomy and lymphadenectomy did not decrease rates of positive surgical margin, local recurrence, metastasis, or mortality. Conclusions: UrCa is a rare and aggressive malignancy that can occur at any age and may be advanced upon presentation. Bladder-sparing surgery is becoming more prevalent, with chemotherapy being reserved for recurrence or metastasis. In our series, routine umbilectomy and lymphadenectomy did not improve oncologic outcomes. However, lymphadenectomy may have a role in cancer staging.
文摘Gall bladder cancer(GBC)remains a highly aggressive disease,with an overall 5-year dismal survival rate of 15%-20%.Its asymptomatic nature in very early stages and non-specific clinical presentations pose significant challenges to timely detection.Consequently,GBC often presents late,making it one of the most challenging cancers to manage.Surgery offers the best chance for long-term survival;however,only 10%of GBC patients are candidates for upfront resection,with the majority presenting in locally advanced or metastatic stages.Further-more,GBC is generally resistant to chemotherapy and radiotherapy,limiting the effectiveness of systemic therapy.Therefore,early diagnosis is crucial to offer the best treatment through surgical resection and to improve the outcome.Recent advancements in imaging technologies,biomarker discovery,and molecular diagnostics offer promising avenues for enhancing detection rates.Though non-invasive,most of them lack specificity,and the majority fail as an early diagnostic tool.This review examines the current status of early detection strategies for GBC,addresses the limitations of existing approaches,and explores the newer emer-ging diagnostic tools and techniques and how they can be exploited in future for its early detection.
基金supported by grants from the Shanghai Science and Technology Commission(No.21ZR1461000)Shanghai Municipal Health Commission(No.ZY[2021–2023]−0204).
文摘Objective The present study evaluated the effects of deep acupuncture at Weizhong acupoint(BL40)on bladder function and brain activity in a rat model of overactive bladder(OAB),and investigated the possible mechanisms around the acupuncture area that initiate the effects of acupuncture.Methods Adult female Sprague-Dawley rats were randomly divided into six groups,comprising a control group,model group,group treated with deep acupuncture at BL40,group treated with shallow acupuncture at BL40,group treated with acupuncture at non-acupoint next to BL40,and group treated with acupuncture at Xuanzhong(GB39).Urodynamic evaluation was used to observe the urination,and functional magnetic resonance imaging was used to observe the brain activation.The mechanism of acupuncture at BL40 in regulating bladder function was explored by toluidine blue staining and enzyme-linked immunosorbent assay,and the mechanism was verified by stabilizing mast cells(MCs)or blocking tibial nerve.Results Deep acupuncture at BL40 significantly increased the intercontraction interval in OAB rats and enhanced the mean amplitude of low frequency fluctuation of primary motor cortex(M1),periaquaductal gray matter(PAG),and pontine micturition center(PMC).It also increased the zero-lag functional connectivity between M1 and PAG and between PAG and PMC.Shallow acupuncture at BL40 and acupuncture at non-acupoint or GB39 had no effect on these indexes.Further studies suggested that deep acupuncture at BL40 increased the number and degranulation rate of MCs as well as the contents of 5-hydroxytryptamine,substance P,and histamine in the tissues around BL40.Blocking the tibial nerve by lidocaine injection or inhibiting MC degranulation by sodium cromoglycate injection obstructed the effects of acupuncture on restoring urinary function and modulating brain activation in OAB rats.Conclusion Deep acupuncture at BL40 may be more effective for inhibiting OAB by promoting degranulation of MCs around the acupoint and stimulating tibial nerve,thereby regulating the activation of the brain area that controls the lower urinary tract.
基金Natural Science Foundation-funded Project:Research on the Effect of Acupuncture in Regulating Bladder Excitability based on the Generation and Transmission of Afferent Information from Urinary Control(No.82174516)Investigation into the Mechanism of Acupuncture-regulated Bladder Excitability based on Sensory Nerve Mechanotransduction Signaling(No.82474645)。
文摘OBJECTIVE:To investigate whether electroacupuncture(EA)therapy for overactive bladder(OAB)exerts its effect by modulating mechanosensitive channels in the urothelium,thereby improving bladder sensory function.METHODS:In this study,a rat model of OAB was created by using intraperitoneal injections of cyclophosphamide.We performed either EA or bladder perfusion with HC-067047[a transient receptor potential vanilloid 4(TRPV4)antagonist]and assessed the efficacy of electroacupuncture in the treatment of OAB in rats via urodynamic determination and Void spot assay.tissue morphology,distribution and expression of the TRPV4protein and the amount of adenosine triphosphate(ATP)and Ca2+released from urothelial cells in each group of rats were observed to identify the mechanism by which electroacupuncture improves OAB in rats.RESULTS:EA ameliorated bladder function and voiding behaviour,improved bladder uroepithelial tissue morphology,and significantly reduced the immunofluorescence intensity and the mRNA and protein expression levels of TRPV4 in the uroepithelium of OAB rats.Moreover,the simulated mechanical stimulationinduced increases in Ca^(2+)concentration and the release of ATP and acetylcholine(Ach)from bladder urothelial cells were inhibited.The changes in EA followed the same trend as those in HC-067047.CONCLUSIONS:These results suggest that EA inhibits bladder sensory function by downregulating the expression of mechanically activated TRPV4 ion channels distributed in bladder urothelial cells,which correspondingly decreases the inward flow of extracellular Ca^(2+)and reduces the release of ATP and Ach,thereby attenuating excitatory signals.
文摘Rational design of multifunctional nanoplatforms capable of combining therapeutic effects with real-time monitoring of drug distribution and tumor status is emerging as a promising approach in cancer nanomedicine.Here,we introduce pyropheophorbide a-bisaminoquinoline conjugate lipid nanoparticles(PPBC LNPs)as a bimodal system for image-guided phototherapy in bladder cancer treatment.PPBC LNPs not only demonstrate both powerful photodynamic and photothermal effects upon light activation,but also exhibit potent autophagy blockage,effectively inducing bladder cancer cell death.Furthermore,PPBC LNPs possess remarkable photoacoustic(PA)and fluorescence(FL)imaging capabilities,enabling imaging with high-resolution,deep tissue penetration and high sensitivity for tracking drug biodistribution and phototherapy efficacy.Specifically,PA imaging confirms the efficient accumulation of PPBC LNPs within tumor and predicts therapeutic outcomes of photodynamic therapy,while FL imaging confirms their prolonged retention at the tumor site for up to 6 days.PPBC LNPs significantly suppress bladder tumor growth,with several tumors completely ablated following just two doses of the nanoparticles and laser treatment.Additionally,PPBC LNPs were formulated with lipid-based excipients and assembled using microfluidic technology to enhance biocompatibility,stability,and scalability,showing potential for clinical translation.This versatile nanoparticle represents a promising candidate for further development in bladder cancer therapy.
基金supported by Research Project of Health Commission of Hunan Province,China(D202313016450)。
文摘Immune checkpoint inhibitors(ICIs)play a significant role in tumor treatment,but the immune-related adverse events(irAEs),which brings about have also attracted much attention.Among them,toxic epidermal necrolysis(TEN)is one of the most severe skin toxic reactions.This article reports a case of a bladder cancer patient who developed TEN after receiving ICIs treatment.The male patient was diagnosed with bladder cancer in November 2023.On April 29,2024,he was admitted to the Third Hospital of Changsha for antitumor treatment.In May 2024,he developed immune-related myocarditis after treatment with toripalimab.On July 6,2024,the patient switched to envafolimab treatment,and on July 16,he developed rashes and eventually progressed to TEN.After treatment with glucocorticoids and related symptomatic measures,the patient improved.TEN is a rare but serious irAE in ICIs treatment.Suspected patients should be intervened early,and patients who have already developed it should be actively treated,in order to enhance the understanding and management of TEN caused by ICIs treatment.
文摘Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bladder capacity,storage,and voiding functions through simple,realistic,and resource-friendly approaches.It involves a structured series of steps,from history-taking and physical examination to bladder-emptying procedures,monitoring urine leaks,assessing reflex voiding,measuring post-void residual(PVR),and calculating total bladder capacity.These evaluations help differentiate between upper motor neuron and lower motor neuron bladder dysfunction,providing critical insights for tailored management.The interpretation of findings focuses on identifying bladder type,assessing leak timing and volume,evaluating reflex voiding,and measuring PVR and total bladder capacity.The results guide interventions such as timing selfclean intermittent catheterization,adjusting fluid intake,and using bladder diaries to monitor patterns.Clinical bladder evaluation is particularly advantageous in low-resource settings,as it avoids the risks and costs associated with urodynamic studies while reflecting real-life patient conditions more effectively.Despite its benefits,no validation studies currently exist for clinical bladder assessment,and its parameters,like maximum voided volume,remain underexplored compared to urodynamic measures.Given the accessibility,affordability,and practicality of this approach,it holds promise for widespread application,especially in primary care settings and among economically disadvantaged populations.This editorial describes the process step-by-step and highlights its role in improving patient outcomes while minimizing complications.
文摘Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].
