Bladder cancer (BCa) is a prevalent genitourinary malignancy characterized by limited specific diagnostic and therapeutic options. Although hypoxia is known to drive tumor progression via exosome-mediated communication, the specific oncogenic roles of hypoxia-induced exosomal long non-coding RNAs (lncRNAs) remain poorly elucidated. Here, we profiled exosomes from normoxic and hypoxic BCa cells using high-throughput sequencing, identifying LNCOC1 as a significantly upregulated lncRNA under hypoxic conditions. Mechanistically, hypoxia-inducible factor 1α (HIF1A) directly binds to the LNCOC1 promoter to drive its transcription and subsequent exosomal encapsulation. Upon transfer to recipient cells, exosomal LNCOC1 promotes BCa cell proliferation, migration, and invasion. It acts as a nuclear scaffold, directly recruiting the transcription factor YBX1 to the PIK3CA promoter, thereby upregulating PIK3CA expression and hyperactivating the PI3K/AKT signaling pathway. Clinically, elevated LNCOC1 levels in tumor tissues and circulating plasma exosomes from 96 BCa patients positively correlated with advanced tumor grade, metastasis, and poor prognosis. Furthermore, circulating exosomal LNCOC1 demonstrated moderate diagnostic efficacy in distinguishing BCa patients from healthy controls (AUC = 0.789) and metastatic from non-metastatic cases (AUC = 0.765). Collectively, these findings elucidate a novel HIF1A/LNCOC1/YBX1/PIK3CA regulatory axis, highlighting circulating exosomal LNCOC1 as a preliminary candidate biomarker for BCa diagnosis that warrants further validation in independent cohorts.

To identify and validate clinical and radiological predictors of perirenal fat adherence and develop a prediction model for perirenal fat adhesions in infectious nonfunctioning kidneys. A retrospective study was conducted on 277 patients who underwent robotic-assisted or laparoscopic nephrectomy from January 1, 2018, to July 1, 2024. The 277 patients were divided into two groups based on the presence or absence of intraoperative renal adhesions: the adherent perinephric fat (APF) and non-APF groups. Radiological elements were assessed by two readers blinded to the presence of APF. Perirenal fat on cross-sectional computed tomography (CT) was selected as the region of interest (ROI) for texture feature extraction and analysis. To assess APF risk factors, we developed a SAPS risk scoring system using univariate and multivariate logistic regression analyses. The predictive model’s discriminatory power, calibration, and clinical utility were evaluated using receiver operating characteristic curves (ROC), calibration plots, and decision curves. The APF was observed in 116 patients. Univariate analysis associated preoperative creatinine, perinephric fat stranding (PFS), posterior perinephric fat thickness (PPFT), and radscore with APF. Multivariate regression determined PFS, PPFT, and texture features as predictors of APF. Based on this, the SAPS score (0–6) was created to predict APF. Patients with a score of 0 had a 4

Background:Neurogenic bladder-bowel dysfunction remains refractory to conventional therapies in many patients. While unilateral sacral neuromodulation (SNM) is established, comparative evidence for bilateral stimulation in combined dysfunction is lacking. This study evaluated whether bilateral SNM outperforms unilateral stimulation in this population. Methods:In this two-center retrospective study, 20 patients with neurogenic bladder and bowel dysfunction underwent a self-paired sequential testing protocol comparing pre-operative baseline, unilateral stimulation, and bilateral stimulation stages. Outcomes included voiding diary parameters, uroflowmetry, Neurogenic Bowel Dysfunction (NBD) score, and Wexner scores. Long-term follow-up was conducted at 1 and 2 years for patients receiving permanent bilateral implantation (n=12). Results:Bilateral stimulation significantly outperformed unilateral stimulation in 6 of 8 parameters (all P<0.05). Voided volume increased from 109.0±38.6 to 165.5±39.3 mL, while post-void residual decreased from 254.5±113.9 to 177.5±79.3 mL. Maximum flow rate improved from 7.5±2.0 to 12.0±2.4 mL/s. Bowel function also improved significantly: NBD score decreased by 33.3%, Wexner constipation score by 21.4%, and Wexner incontinence score by 40.0%. However, no significant additional benefit was observed for 24-hour voiding frequency or urgency/UUI episodes when comparing bilateral to unilateral stimulation. Among 12 patients with permanent implants, therapeutic improvements were sustained at 2-year follow-up, with further significant gains in voided volume, post-void residual, and bowel function compared to Year 1. Conclusions:Bilateral SNM provides superior and sustained improvements in both voiding and defecatory functions compared with unilateral stimulation, offering an effective treatment for refractory neurogenic bladder-bowel dysfunction.

BACKGROUND:Kidney stones represent a prevalent and economically burdensome urinary system disorder with rising global incidence. Although dyslipidemia is a recognized risk factor for nephrolithiasis, the association of the Triglyceride-Cholesterol-Body Weight Index (TCBI)-a novel measure integrating lipid metabolism and body weight-with both incident and recurrent kidney stones has not been investigated in the general population. METHODS:Data from the 2007-2016 cycles of the National Health and Nutrition Examination Survey (NHANES) formed the basis of this cross-sectional analysis. Analyses included 9929 participants for kidney stone risk evaluation and 724 for assessing recurrence risk. We employed multivariable logistic regression, extensively controlling for demographic, socioeconomic, and clinical factors, to assess associations. The dose-response relationship and effect consistency were then examined using restricted cubic splines (RCS) and subgroup analyses. We further analyzed an independent external validation dataset of 201 participants to validate the results. RESULTS:A positive association was observed between TCBI and kidney stone prevalence after full adjustment: each 1-unit increase in log-transformed TCBI (Lg TCBI) was associated with a 50.3% higher risk. A strong association was found between the highest Lg TCBI quartile and increased prevalence of both incident and recurrent kidney stones, relative to the lowest quartile. This positive association followed a monotonic dose-response pattern (P for nonlinearity >0.05), as confirmed by RCS, and was upheld across subgroups. External validation reinforced the positive link between Lg TCBI and kidney stone development and recurrence. CONCLUSIONS:TCBI was demonstrated to be independently associated with the presence of both new-onset and recurrent kidney stones. Given its ease of calculation, TCBI holds value as a clinical indicator for assessing associated risk and identifying individuals who may benefit from evaluation, notably those with underlying metabolic abnormalities.

BACKGROUND:The urosepsis after percutaneous nephrolithotomy (PCNL) is a critical health risk necessitating prompt medical identification and intervention. Nevertheless, a deficiency exists in the availability of a tool for precise and timely predictive analysis. The purpose is to establish a machine learning (ML) model using radiomic features and clinical data to predict urosepsis following PCNL. METHOD:This study retrospectively included 401 patients with kidney stones from two centers who underwent PCNL. To enhance the dataset's equilibrium, the synthetic minority over-sampling technique for regression with Gaussian noise (SMOGN) was used to resample the training set. The screening of radiomics features and the construction of radiomics scores were completed by applying the Absolute Shrinkage Selection Operator (LASSO). Subsequently, the critical clinical indicators for urosepsis were pinpointed through the application of a multivariate logistic regression. The performance of seven ML algorithms was compared for the combined dataset that incorporated clinical variables and radiomics scores. The efficacy of these models was assessed through the implementation of a fivefold cross-validation process. Ultimately, the Shapley Additive exPlanations (SHAP) methodology was utilized to provide a visual and interpretative analysis of the optimal model. RESULT:Among 401 patients, 30 cases (7.48%) were diagnosed with urosepsis. The radiomics score, established by 13 radiomics features, was combined with six important clinical features (including urine nitrite positivity, stone volume, mean intrarenal pressures, urine white blood cells, and operation time) to construct a combined dataset. Comparative analysis of seven machine learning (ML) models revealed that CatBoost demonstrated superior predictive performance. The model achieved area under the receiver operating characteristic curve (AUC-ROC) values of 0.88, 0.94, and 0.89 on the training, internal test, and external validation sets, respectively. Corresponding area under the precision-recall curve (AUC-PR) values were 0.92, 0.75, and 0.63. The SHAP value method identifies key features influencing prediction outcomes, with the radiomics score and urine nitrite positivity being the top contributors to the model. We deployed the optimal prediction model to a web for clinical application ( https://predictive-model-for-urosepsis.streamlit.app/ ). CONCLUSION:This study constructed a predictive model that incorporates clinical risk characteristics and radiomics scores to assess the risk of urosepsis after PCNL, with SHAP visualization for clinical physicians to formulate evaluation strategies.

BACKGROUND:Bladder cancer (BC), a prevalent genitourinary malignancy, poses a substantial threat to public health, particularly among middle-aged and elderly populations. Given the increasing life expectancy, understanding the BC burden in these demographic groups is imperative. METHODS:Based on the GBD 2021 dataset encompassing 371 diseases and injuries with 88 risk factors globally, this study analyzed bladder cancer data from 204 countries and territories (1990-2021) for populations aged ≥55 years, with core metrics including incidence, deaths, and disability-adjusted life years (DALYs). We used Joinpoint regression analysis to assess temporal trends, calculating the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). We conducted a decomposition analysis to break down the changes in mortality rates into contributions from aging, population growth, and epidemiological changes. We performed a frontier analysis using the Socio-demographic Index (SDI) to evaluate the relationship between bladder cancer burden in people aged 55 and above and socio-demographic development. Among them, we further combined the National Health and Nutrition Examination Survey (NHANES) database for risk analysis related to bladder cancer. Finally, we used the Bayesian age-period-cohort (BAPC) model to project bladder cancer trends from 2022 to 2036. RESULTS:From 1990 to 2021, bladder cancer cases among adults ≥55 years increased by 113% (226 421 to 483 234), while crude incidence rates declined slightly. Mortality rates decreased from 16.83 to 14.11 per 100 000, and DALYs rates dropped from 337.59 to 257.76. High-income regions (North America: 76.85/100 000; Western Europe: 77.62/100 000) had the highest incidence but showed downward trends, whereas Central Europe experienced rising mortality. Males consistently bore a 3.8-fold higher incidence burden than females. Smoking (26.6%) and high fasting glucose (8.2%) were key risk factors. According to NHANES data, elevated fasting blood glucose levels and smoking are both associated with an increased risk of bladder cancer. Projections to 2036 suggest continued declines: incidence (-13.3%), mortality (-16.4%), and DALYs (-17.9%). Health inequality persisted but improved marginally. CONCLUSION:The current data and future prediction of this study show that the incidence rate, mortality and DALYs rate of bladder cancer in middle-aged and elderly people have declined. However, disparities in disease burden still exist across regions. Thus, tailored measures are needed to reduce inequalities in high-burden areas.

OBJECTIVE:To investigate the pharmacological mechanism of Compound Xuanju Capsule in the treatment of erectile dysfunction (ED) by using network pharmacology and molecular docking technology. METHODS:The active ingredients and targets of Compound Xuanju Capsule were screened using Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform (TCMSP). TTD, OMIM, DrugBank and GeneCards databases were used to obtain genes related to ED, and the union of the results was taken as the disease genes of ED. The common target of drug and disease was taken as the potential target of Compound Xuanju Capsule in ED, and the drug-disease interaction network was constructed by using Cytoscape software. The protein-protein interaction (PPI) network was constructed by using String database, which was then imported into Cytoscape to identify the key target. Based on the drug-disease intersection genes, GO and KEGG enrichment analyses were performed to predict the relevant signaling pathways and molecular mechanisms of Compound Xuanju Capsule for the treatment of ED. Autodock software was used to perform molecular docking between the active ingredients and the core targets. RESULTS:Forty chemical components of Compound Xuanju Capsule were screened, and 239 predicted targets were obtained. A total of 1 907 ED-related genes were screened, and 97 common targets were identified between Compound Xuanju Capsule and ED, among which the core targets included EGFR, ESR1, HIF1A, PTGS2, and STAT3. The signaling pathways obtained by KEGG enrichment analysis included calcium signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway, cGMP-PKG signaling pathway, relaxin signaling pathway, Serotonergic synapse signaling pathway. The molecular docking results showed that there were molecular binding sites between the key active ingredients and the core targets with strong binding activity. CONCLUSION:Compound Xuanju Capsule may treat ED through multi-target pathways such as anti-inflammatory and improving cellular oxidative stress.

BACKGROUND:Here, we aim to develop and validate a viable prognostic nomogram model for predicting a stone-free rate of kidney stones patients based on retrospective cohort analysis. METHODS:This is a retrospective study that obtained a continuous cohort from the databases of two hospitals (General Hospital of Southern Theater Command, and Guangdong Second Provincial General Hospital), including 522 patients with kidney stones who underwent Endoscopic Combined Intrarenal Surgery (ECIRS) from January 2015 to December 2022.The characteristics of the primary cohort between the SF (stone-free) and SR (stone residue) groups were identified using single factor and multivariate logistic regression analyses. Factors in the main cohort were identified using minimal absolute shrinkage and selective operator regression. A nomogram was then constructed using these factors for subsequent analyses. Finally, a calibration curve, a receiver operating characteristic curve (ROC), and a decision curve analysis (DCA) curve were analyzed and plotted, and then used to test the predictive value of the nomogram in both calibration and discrimination. RESULTS:Hydronephrosis, Renal Infundibular Length (RIL), Renal Infundibular Width (RIW), stone burden, and number of calyces involved were revealed to be significant factors in the prediction of stone-free rate after ECIRS. These five factors were used to develop a nomogram with good calibration and differentiation. The area under the curve (AUC) was 0.811 (95% CI: 0.766-0.856). The DCA demonstrated that the nomogram has clinical utility. CONCLUSIONS:Hydronephrosis, renal infundibular length, renal infundibular width, stone burden, and number of involved calyces were all significantly linked with residual stone after ECIRS. A nomogram created with these five factors showed good calibration, differentiation, and clinical usefulness.

To evaluate the feasibility, safety and efficacy of robot-assisted laparoscopic modified ureteroplasty using a lingual mucosa graft (LMG) or an appendiceal flap (AF) for complex ureteral strictures and summarize our experience. A total of 16 patients with complex ureteral strictures (range: 1.5–5 cm) who underwent robotic-assisted laparoscopic-modified ureteroplasty and were admitted to our hospital from May 2022-October 2023 were retrospectively analyzed. We used modified presuture methods in patients who needed the posteriorly augmented anastomotic technique to reduce anastomotic tension. Perioperative variables and outcomes were recorded for each patient. The operation under robot-assisted laparoscopy was successfully performed in all sixteen patients (12 with LMG ureteroplasty and 4 with AF ureteroplasty) without conversion to open surgery. The mean length of the ureteral structure was 2.90 ± 0.90 cm (range: 1.5–5 cm), the mean operation duration was 209.69 ± 26.74 min (range: 170–255 min), the median estimated blood loss was 75 (62.5) ml (range: 50–200 ml), and the duration of postoperative hospitalization was 10.44 ± 2.10 d (range: 7–14 d). The follow-up time in this group was 6 21 months. The success rate of the surgery was 100

Background: Urosepsis is a serious complication after percutaneous nephrolithotomy (PCNL). This study aimed to develop and validate a nomogram model that can effectively predict urosepsis following PCNL. Methods: A total of 839 patients who underwent PCNL at General Hospital of Southern Theater Command from January 2018 to January 2023 and a total of 609 patients who underwent PCNL at Guangdong Second Provincial General Hospital from January 2020 to January 2023 were retrospectively analyzed in this study. The center with 839 patients was used to develop the model, and another center with 609 patients was used as an external validation group. Multivariate analysis was used to determine the optimal variables. The validation of the nomogram was assessed using the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA). Results: Urosepsis was observed in 47 (5.6%) and 33 (5.4%) patients in the two centers. Four variables were selected to establish the nomogram through multivariate analysis, including operative time [P<0.001, odds ratio (OR): 1.035, 95% confidence interval (CI): 1.019-1.051], accumulated time of renal pelvic pressure >= 30 mmHg (0 vs. 0-60 s, P=0.011, OR: 3.180, 95% CI: 1.300-7.780; 0-60 vs. >= 60 s, P<0.001, OR: 6.389, 95% CI: 2.603-15.685), bladder urine culture (P<0.001, OR: 6.045, 95% CI: 2.454-14.891) and hydronephrosis (none or light vs. moderate, P=0.003, OR: 3.403, 95% CI: 1.509-7.674; moderate vs. several, P=0.002, OR: 4.704, 95% CI: 1.786-12.391). The calibration results showed that the model was well calibrated and ROC curve demonstrated excellent discrimination of the nomogram. In addition, the DCA showed that the nomogram had a positive net benefit. Conclusions: A prediction nomogram was developed and validated to assist clinicians in assessing the probability of urosepsis after PCNL.

Bladder cancer (BC) is one of the most common malignant neoplasms worldwide. Competing endogenous RNA (ceRNA) networks may identify potential biomarkers associated with the progression and prognosis of BC. The OCT4-pg5/miR-145-5p/OCT4B ceRNA network was found to be related to the progression and prognosis of BC. OCT4-pg5 expression was significantly higher in BC cell lines than in normal bladder cells, with OCT4-pg5 expression correlating with OCT4B expression and advanced tumor grade. Overexpression of OCT4-pg5 and OCT4B promoted the proliferation and invasion of BC cells, whereas miR-145-5p suppressed these activities. The 3' untranslated region (3'UTR) of OCT4-pg5 competed for miR-145-5p, thereby increasing OCT4B expression. In addition, OCT4-pg5 promoted epithelial-mesenchymal transition (EMT) by activating the Wnt/β-catenin pathway and upregulating the expression of matrix metalloproteinases (MMPs) 2 and 9 as well as the transcription factors zinc finger E-box binding homeobox (ZEB) 1 and 2. Elevated expression of OCT4-pg5 and OCT4B reduced the sensitivity of BC cells to cisplatin by reducing apoptosis and increasing the proportion of cells in G1. The OCT4-pg5/miR-145-5p/OCT4B axis promotes the progression of BC by inducing EMT via the Wnt/β-catenin pathway and enhances cisplatin resistance. This axis may represent a therapeutic target in patients with BC.

Objective To investigate the effect of transumbilical single port laparoscopy varicocelectomy with precise five-step procedure for testicular artery preservation in the treatment of varicocele. Methods The clinical data of 36 varicocele patients treated with transumbilical single port laparoscopy varicocelectomy with precise five-step procedure for testicular artery preservation between January 2019 and June 2020 in Department of Urology,the General Hospital of Southern Theater Command were retrospectively analyzed to investigate operation time,preoperative and postoperative semen quality and symptoms of scrotal pain,and postoperative complications.Result All the surgical operations for the 36 patients were completed successfully. The unilateral operation time was（33.21 ± 4.34）min and the bilateral operation time was（57.57 ± 5.83）min. The incisions in all the patients were primarily healed. The postoperative hospitalization time was 2 ～ 4 days. Compared with the preoperative data,the total number of sperm[（37.89±4.81）×10~6vs.（48.03±4.63）×10~6],sperm concentration[（13.22±1.64）×10~6/ml vs.（17.06±2.64）×10~6/mL],（PR + NP）total sperm motility[（38.44±5.86）% vs.（50.50±6.38）%],and PR forward motile sperm rate[（30.64±4.20）% vs.（39.83±6.24）%]were significantly increased. There was no testicular atrophy,epididymitis,scrotal edema,testicular hydrocele and recurrence of varicocele at 6 months after operation. Conclusion Transumbilical single port laparoscopy varicocelectomy with precise five-step procedure for testicular artery preservation has the advantages of accurate preservation of testicular artery,rapid recovery and less complications,worthy of popularization.

Objective:To investigate the effect of different intrarenal pressures on perioperative complications in patients undergoing percutaneous nephrolithotomy (PCNL).Methods:The clinical data of 189 cases of complex kidney stones who underwent PCNL in General Hospital of the Southern Theater Command of the People's Liberation Army of China from August 2017 to December 2019 were retrospectively analyzed. According to the intraoperative pressure measurement in the renal pelvis, the patients were divided into instant high pressure group, transient high pressure group and sustained high pressure group. The operation time, flushing volume, extravasation of perfusate, primary stone clearance rate and other indicators of patients in each group were analyzed; postoperative conditions of patients were compared and analyzed: postoperative fever, incidence of septic shock, postoperative Hb, HCT, Na+ decrease degree, postoperative blood WBC, PCT elevation and so on.Results:There were significant differences in the extravasation of perfusate among the three groups, among which the instant high pressure group (8%) < transient high pressure group (18.4%) < sustained high pressure group (22.6%) (P< 0.05). The incidence of postoperative fever and septic shock, the degree of postoperative, HCT, Na+ decline, and the postoperative blood WBC and PCT elevations were statistically different among the three groups: instant high pressure group [20.69%, 2.30%, (0.09±0.01), (9.3±0.6), (2.6±0.2), (2.1±0.4)]< transient high pressure group [28.57%, 6.12%, (0.13±0.01), (12.3±0.9), (3.3±0.4), (5.2±1.7)]< sustained high pressure group [45.28%, 11.32%, (0.16±0.01), (13.8±0.9), (5.1±0.5), (9.8±1.8)] (P<0.05).Conclusion:Long-term maintenance of high pressure in the renal pelvis during percutaneous nephrolithotomy can significantly increase the incidence of perioperative complications.

Abstract To predict and compare machine-learning models with logistic regression (LR) for transfusion requirement among complex renal stones patients receiving PCNL. The data of 513 patients with complex renal stones receiving PCNL between January 2016 and December 2021 from 2 centers were analyzed retrospectively and reviewed the pre-, intra-, and post-operation factors. We used 80% training set and 20% test set for the predictions of transfusion by LR and machine-learning algorithms, random forest (RF), support vector machine (SVM), and extreme gradient boosting trees (XGBoost), and compared the prediction accuracies, precisions, and area under curve (AUC) values of receiving operating characteristic (ROC) curves in each model. In our study, the prediction accuracies of RF (Accuracy = 0.974), SVM (Accuracy = 0.968) and XGBoost (Accuracy = 0.968) models all outperformed LR (Accuracy = 0.948), and the precision of RF (Precision = 0.818) was higher than XGBoost (Precision = 0.8), SVM (Precision = 0.8) and LR (Precision = 0.8). Moreover, RF (AUC = 0.962), SVM (AUC = 0.786) and XGBoost (AUC = 0.867) offered higher AUC values than LR (AUC = 0.77). The RF confirmed size of tract, number of tracts, and puncture correctness as significant risk factors, which was the same as LR model, while the size of tract was the main factor in XGBoost. All machine-learning algorithms yielded better predictions than LR for transfusion among PCNL patients. The importance of machine learning algorithm can give matched insights to domain knowledge on effective and influential factors for transfusion requirement.

Objective:To investigate the effect of high mobility group protein A2 (HMGA2) gene regulating microRNA (miR)-497-5p in the bladder cancer cells.Methods:Real-time reverse transcription-polymerase chain reaction (RT-qPCR) and Western blot were used to determine HMGA2 expression. Different HMGA2 expression plasmids were transfected into EJ cells, and to detect miR-497-5p and p65 and p-p65 expression in EJ cells of each group. The abilities of proliferation and invasion were detected by colony formation and Transwell assay. The difference between two groups were analyzed by independent- t test. Results:The expression of HMGA2 in 5 bladder cancer cell lines (10.31±0.86, 138.38±19.32, 34.55±3.95, 10.88±0.56, 220.55±15.32) was higher than SV-HUC-1 (2.02±0.32, t=15.648, 12.223, 14.218, 23.793, 24.701, P<0.01). The number of clones and invasive cells in the HMGA2 group (254.33±7.64, 380.67±7.10) were higher than blank group (170.67±14.79, 267±11.37, t=9.768, 17.168, P<0.01). The miR-497-5p mimic group (174.00±1.73, 109.00±3.46) were lower than miR-NC group (189.00±7.55, 219.00±16.64, t=3.354, 11.207, P<0.01). The si-HMGA2+ miR-497-5p inhibitor group (203.00±13.08, 305.00±3.46) were higher than si-HMGA2 group (138.67±19.04, 170.33±24.99, t=4.825, 9.247, P<0.01). The ratio of p-p65/p65 in the HMGA2-transfected group (254.33±7.64) was higher than control group (254.33±7.64, t=18.557, P<0.01). Conclusion:HMGA2 gene negatively regulates miR-497-5p to promote the progression of bladder cancer cells.

Objective:To explore the application value of enhanced recovery after surgery (ERAS) in laparoscopic radical resection of bladder cancer and ileal bladder surgery under modular operation procedures.Methods:A retrospective selection of 42 cases of laparoscopic radical radical resection of bladder cancer and ileal bladder surgery performed by the Department of Urology, General Hospital of Southern Theater Command from January 2017 to December 2019 were divided into two groups according to the different management methods adopted during the perioperative period: ERAS management group and conventional management group, each with 21 cases. Among them, patients in the ERAS management group were managed by ERAS during the perioperative period, and patients in the conventional management group were managed by conventional management during the perioperative period. The postoperative hospital stay, first exhaust time, first defecation time, first time to get out of bed, first liquid food time, postoperative visual analogue scale (VAS) score, as well as transferrin, upper arm circumference, body mass index, plasma albumin, total protein, and total protein were compared between the two groups of patients after surgery. The measurement data conforming to the normal distribution were expressed as mean±standard deviation ( Mean± SD), and the in dependent t-test was used for comparison between groups; the measurement data of non-normal distribution were expressed as the median (interquartile range) [ M( P25, P75)], the independent sample Mann-Whitney U test was used for comparison between groups; the Chi-square test was used for comparison of enumeration data between groups. Results:The postoperative hospital stay in the ERAS group was (8.9±1.8) d, the first exhaust time was (33.4±3.2) h, the first defecation time was (60.3±7.8) h, the first time to get out of bed was (23.1±6.7) h, the first liquid food time was (82.7±18.5) h and postoperative VAS was (1.3±0.6), that were significantly reduced compared with the conventional treatment group [(12.3±2.3) d, (51.4±5.2) h, (73.0±8.1) h, (34.7±8.2) h, (109.7±21.6) h, (3.6±0.8)], the difference were statistically significant ( P<0.05). In the ERAS group, the decreased value of transferrin was [0.8 (-0.4, 2.2) g/L], the decreased value of body mass index was[1.61±0.73], the decreased value of plasma albumin was [3.5±1.5 g/L], the decrease value of total protein was[10.1±5.6 g/L] and the decrease value of prealbumin was [90.5±11.3 mg/L] were significantly lower than those of the conventional management group[(1.9(0.9, 3.6) g/L, (2.32±1.05) kg/m 2, (9.6±2.0) g/L, (16.3±4.9) g/L, (131.3±7.4) g/L], and the difference were statistically significant ( P<0.05). Conclusion:Modular laparoscopic precision resection of bladder cancer and ERAS concept after ileal bladder surgery is beneficial to shorten the hospital stay, reduce postoperative pain, have less impact on the patient′s body loss and immune function, and can speed up the patient′s postoperative recovery.

Background Octamer-binding transcription factor 4 pseudogene 5 (OCT4-pg5) contributes to tumor progression in many cancer types, but contributions to bladder cancer (BC) have not been investigated. Methods Real-time quantity PCR ( RT-qPCR) was performed to measure OCT4-pg5 and OCT4B expressions in different bladder cell lines and different grades of cancer. The effects of OCT4-pg5, OCT4B and miR-145 on proliferation and metastasis were determined by in vitro and in vivo experiments. Luciferase reporter assay was carried out to reveal the interaction among OCT4-pg5, OCT4B and miR-145. Flow cytometry was performed to explore the effects of OCT4-pg5 and OCT4B expression on the cell cycle stage distribution of T24 cells. Results OCT4-pg5 expression was significantly increased in BC cell lines, which was correlated with OCT4B expression and advanced tumor grade. Overexpression of OCT4-pg5 and OCT4B promoted the proliferation and invasion of BC cells, while miR-145 suppressed these activities. Mechanically, OCT4-pg5 3’ untranslated region (3’UTR) competed for miR-145, thereby increasing OCT4B expression. In addition, OCT4-pg5 promoted EMT by activating the Wnt/β-catenin pathway and upregulating the expression levels of matrix metalloproteinases (MMPs) 2 and 9 as well as transcription factors zinc finger E-box binding homeobox (ZEB) 1 and 2. Furthermore, elevated expression of OCT4-pg5 and OCT4B reduced the sensitivity of BC cells to cisplatin by reducing apoptosis and increasing the proportion of cells in G1. Conclusions These findings indicate that OCT4-pg5/miR-145/OCT4B axis promotes the progression of BC by inducing EMT via Wnt/β-catenin pathway and enhances the cisplatin resistance. It could be prospect for the therapeutic approaches for BC.

目的 研究针对精索静脉曲张的患者使用不同术式治疗方式的临床疗效.方法 选取2017年12月～2019年12月于我院接受治疗的精索静脉曲张患者110例,通过随机抽签法将其分为对照组(n=55)及研究组(n=55).对照组患者采用单一静脉结扎术治疗方式;研究组采用动静脉结扎术进行治疗.对比对照、研究两组患者的治疗效果(精子质量、并发症发生概率、复发概率).结果 研究组患者治疗效果显著优于对照组,数据差异具有统计学价值P<0.05.结论 动静脉结扎术治疗方式较单一静脉结扎术治疗方式,可以有效改善患者的精索静脉曲张的临床症状,明显提高了患者的精子质量,降低了并发症的发生概率,减少了复发概率,对患者的治疗效果的达成有极大的帮助,推荐使用.

Objective To investigate the effects of octamer-binding transcription factor 4 pseudogene 5 (OCT4-pg5) and octamer-binding transcription factor 4B (OCT4B) expression on cisplatin sensitivity of bladder cancer T24 cells. Methods The expression of OCT4-pg5 and OCT4B in bladder cancer cells and tissues were quantified by real-time quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR). To examine the effect of OCT4-pg5 and OCT4B on cisplatin sensitivity, cells were transfected with OCT4-pg5 si-RNA, OCT4B si-RNA and their control si-RNA by lipofectamine 2000 followed by a 48 h cisplatin treatment. CCK8 was used to assess the half-maximal inhibitory concentration (IC50) of cisplatin in T24 cells. OCT4-pg5 and OCT4B expression were detected by RT-qPCR or Western blot. Next, flow cytometry was used to examine the effects of OCT4-pg5 and OCT4B on T24 cells apoptosis and cell-cycle distribution. Results RT-qPCR results showed that OCT4-pg5 and OCT4B were highly expressed in bladder cancer cells and tissues. Moreover, OCT4-pg5 expression was positively correlated with OCT4B expression in 23 bladder cancer tissues. Cells transfected with OCT4-pg5 si-RNA or OCT4B si-RNA showed a much lower IC50 of cisplatin, compared with cells in the control group. RT-qPCR or Western blot results showed OCT4-pg5 or OCT4B expression was significantly down-regulated after being transfected with OCT4-pg5 si-RNA or OCT4B si-RNA in cisplatin treated T24 cells. The flow cytometry results showed that OCT4-pg5 suppression or OCT4B suppression of cisplatin treated T24 cells resulted in a significant increase of cell apoptosis and marked the transition from the S phase to G0/G1 phase. Conclusions Downregulating OCT4-pg5 and OCT4B could enhance the sensitivity of bladder cancer T24 cells to cisplatin. DOI: 10.11855/j.issn.0577-7402.2020.02.11