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
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
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: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
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
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: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
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
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: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
BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a univer...BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a university hospital for UTI.METHODS We conducted a retrospective observational study,enrolling all kidney transplant patients hospitalized for UTI,with the objective to evaluate the epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients.RESULTS From our real-life experience,infection with multidrug-resistant germs was confirmed as a risk factor for the severe evolution of the infection.At the same time,the re-evaluation of immunosuppressive therapy could be an important therapeutic strategy in the course of infection.CONCLUSION Prompt initiation of empiric antibiotic therapy upon initiation of microbiological investigations may reduce the risk of severe infection progression.展开更多
Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted t...Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.展开更多
Objective: To study risk factors for urinary incontinence (UI) in pregnant women in six health facilities in the city of Ouahigouya. Methodology: We conducted a cross-sectional, analytical observational study from May...Objective: To study risk factors for urinary incontinence (UI) in pregnant women in six health facilities in the city of Ouahigouya. Methodology: We conducted a cross-sectional, analytical observational study from May 1 to August 30, 2023 in six health facilities in the city of Ouahigouya. Binary logistic regression was used to identify risk factors associated with UTI. Results: The prevalence of UI was 39.3%. The mean age of incontinent women was 26.5 ± 6.2 years, with extremes of 18 and 44 years. Stress UI (55%) was the most frequent type. On univariate analysis, age over 25 (OR = 2.6), multiparity (OR = 2.8), number of gestures, body mass index greater than or equal to 25 kg/m2 (OR = 2.1), infantile enuresis (OR = 2.6), recurrent urinary tract infections (OR = 2.6), previous vaginal delivery (OR = 14.5) and third trimester of pregnancy (OR = 1.7) significantly increased the risk of UTI. Independent risk factors were previous vaginal delivery (OR = 17.6), previous caesarean section (OR = 5.2), third trimester of pregnancy (OR = 2.01), body mass index greater than or equal to 25 kg/m2 (OR = 2.09) and coffee consumption (OR = 4.5). Conclusion: UTI is highly prevalent in pregnant women. Obstetrical parameters are strongly associated with the risk of UTI during pregnancy.展开更多
Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment me...Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment method. Infection-related complications after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome, and urinary sepsis, especially urinary sepsis, which are considered to be common causes of death after percutaneous nephrolithotomy. Therefore, early identification and timely intervention of biomarkers can reduce the incidence and mortality of postoperative sepsis, as well as the length of hospital stay and hospitalization costs. This article reviews the biomarkers for early identification of urinary tract infection after PCNL, such as traditional inflammatory indicators, new inflammatory indicators, and composite inflammatory indicators.展开更多
BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the ef...BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.展开更多
ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted usin...ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.展开更多
Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract sympto...Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.展开更多
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.
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 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: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.
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 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.
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.
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.
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.
文摘BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a university hospital for UTI.METHODS We conducted a retrospective observational study,enrolling all kidney transplant patients hospitalized for UTI,with the objective to evaluate the epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients.RESULTS From our real-life experience,infection with multidrug-resistant germs was confirmed as a risk factor for the severe evolution of the infection.At the same time,the re-evaluation of immunosuppressive therapy could be an important therapeutic strategy in the course of infection.CONCLUSION Prompt initiation of empiric antibiotic therapy upon initiation of microbiological investigations may reduce the risk of severe infection progression.
文摘Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.
文摘Objective: To study risk factors for urinary incontinence (UI) in pregnant women in six health facilities in the city of Ouahigouya. Methodology: We conducted a cross-sectional, analytical observational study from May 1 to August 30, 2023 in six health facilities in the city of Ouahigouya. Binary logistic regression was used to identify risk factors associated with UTI. Results: The prevalence of UI was 39.3%. The mean age of incontinent women was 26.5 ± 6.2 years, with extremes of 18 and 44 years. Stress UI (55%) was the most frequent type. On univariate analysis, age over 25 (OR = 2.6), multiparity (OR = 2.8), number of gestures, body mass index greater than or equal to 25 kg/m2 (OR = 2.1), infantile enuresis (OR = 2.6), recurrent urinary tract infections (OR = 2.6), previous vaginal delivery (OR = 14.5) and third trimester of pregnancy (OR = 1.7) significantly increased the risk of UTI. Independent risk factors were previous vaginal delivery (OR = 17.6), previous caesarean section (OR = 5.2), third trimester of pregnancy (OR = 2.01), body mass index greater than or equal to 25 kg/m2 (OR = 2.09) and coffee consumption (OR = 4.5). Conclusion: UTI is highly prevalent in pregnant women. Obstetrical parameters are strongly associated with the risk of UTI during pregnancy.
文摘Urinary calculi are a common and frequently occurring disease in urology. For patients with kidney stones, especially large, multiple or staghorn stones, percutaneous nephrolithotomy (PCNL) is a preferred treatment method. Infection-related complications after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome, and urinary sepsis, especially urinary sepsis, which are considered to be common causes of death after percutaneous nephrolithotomy. Therefore, early identification and timely intervention of biomarkers can reduce the incidence and mortality of postoperative sepsis, as well as the length of hospital stay and hospitalization costs. This article reviews the biomarkers for early identification of urinary tract infection after PCNL, such as traditional inflammatory indicators, new inflammatory indicators, and composite inflammatory indicators.
基金Supported by Huzhou Science and Technology Bureau,No.2023GYB16.
文摘BACKGROUND Postpartum stress urinary incontinence(SUI)symptoms affect a patient’s daily activities and quality of life and increase the negative emotions that they experience.At present,there is no research on the effect of fractional CO_(2)laser treatment combined with Kegel exercise on postpartum SUI and postpartum depression and anxiety.AIM To investigate the effect of lattice CO_(2)laser treatment combined with Kegel exercise on mild to moderate postpartum SUI and its influence on postpartum depression and anxiety.METHODS Using a retrospective study,data from 82 cases of mild to moderate postpartum SUI in Huzhou Maternal&Child Health Care Hospital from January to April 2024 were retrospectively collected.The cases were divided into groups according to the different treatment methods,namely Group S(41 cases,only receiving lattice CO_(2)laser treatment)and Group L(41 cases,receiving lattice CO_(2)laser combined with Kegel exercise treatment).The baseline data of the two groups were compared.In addition,we analyzed and compared the scores of the international commission on urinary incontinence questionnaire short form(ICI-Q-SF),incontinence quality of life questionnaire(I-QOL),Edinburgh postnatal depression scale(EPDS),and postpartum specific anxiety scale(PSAS)before treatment,at the end of treatment,and 3 months after the end of treatment between the two groups.Furthermore,the clinical efficacy and adverse reactions of the two groups were analyzed and compared at the end of treatment and 3 months after the end of treatment.RESULTS There was no significant difference in the baseline data and the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between the two groups before treatment.However,at the end of treatment,the ICI-Q-SF,I-QOL,EPDS,and PSAS scores between Groups L and S were significantly different.The overall effective rate of treatment in Group L was significantly higher than that in Group S.During the 3-month follow-up after treatment,it was found that the ICIQ-SF,EPDS,and PSAS scores of Group L were still lower than those of Group S.In comparison,the I-QOL score and total effective rate of treatment were still higher in Group L than those in Group S,and this difference was significant.There was no significant difference in the adverse reactions between Group L and Group S.CONCLUSION The combination of dot lattice CO_(2)laser and Kegel exercise has a significant therapeutic effect on mild to moderate postpartum SUI.It can prolong the duration of therapeutic effects,improve a patient’s quality of life,and alleviate postpartum depression and anxiety.
文摘ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.
基金supported by National High Level Hospital Clinical Research Funding[BJ-2023-112,BJ-2018-204]Central Government Guidance Fund for Local Science and Technology Development[202407AB110013].
文摘Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.
