Background and objective:Renal angiomyolipomas associated with tuberous sclerosis complex (TSC-RAML) may lead to progressive renal damage and hemorrhage. Everolimus is recommended as first-line therapy, but predictors of treatment response and optimal dosing strategies remain unclear. We aimed to evaluate the efficacy of everolimus and to determine whether tumor fat composition predicts treatment response, as well as whether a reduced-dose regimen provides comparable outcomes. Methods:In this multicenter prospective cohort study conducted across multiple centers in China, 183 consecutive patients with TSC-RAML were enrolled. Three prespecified, outcome-specific analytical subsets were generated from the overall cohort according to the data required for each analysis: (1) standard-dose everolimus efficacy analysis, (2) CT-based tumor fat-composition analysis, and (3) exploratory dose-comparison analysis. Radiographic evaluations were performed at baseline, 3 months, and 6 months. The primary outcome was the RAML response rate, defined as ≥50% reduction in target tumor volume. Key findings and limitations:A ≥50% reduction in tumor volume occurred in 44% (34/78) of patients at 3 months and 83% (60/72) at 6 months. Tumor reduction was significantly greater in fat-poor than in fat-rich lesions. No significant difference in response was observed between the standard- and low-dose groups. Oral mucositis was the most common adverse event but occurred less frequently in the low-dose group (P = .002). Tumor regrowth was observed after treatment discontinuation. Limitations include the nonrandomized design, in which dose selection was based on clinical criteria from previously published protocols, unequal group sizes in the dose-comparison analysis, and the open-label nature of treatment administration, which may introduce selection and ascertainment bias. Conclusions and clinical implications:In this large Chinese cohort of patients with TSC-RAML, everolimus effectively reduces tumor volume, particularly in fat-poor lesions. CT-derived tumor fat composition may help predict treatment response. In this exploratory cohort, low-dose everolimus showed promising short-term activity with potentially improved tolerability, but randomized studies are needed to confirm comparative efficacy.

The aging kidney is both a prime target of age-related damage and an independent risk factor for renal diseases; as populations grow older, chronic kidney disease in the elderly has become a major emerging health threat. Over recent decades, our understanding of the molecular and cellular mechanisms behind the changes associated with renal aging and age-related diseases has expanded dramatically, revealing the potential role of these changes in renal aging. This review summarizes the pathological alterations that occur in the aging kidney, systematically explores the disease models of renal senescence and the potential delaying strategies, and provides a theoretical reference for future research on kidney aging and the prevention of age-related renal diseases.

This study aimed to investigate the molecular mechanisms through which dietary salt affects blood pressure and cholesterol homeostasis. We established a hypertension and hypercholesterolemia model via feeding a high salt diet (8% NaCl, HSD) to Dahl salt-sensitive (SS) rats for 5 weeks. This diet regime successfully induced hypertension and increased serum TC and LDL-C. RNA-seq and RT-qPCR analyses confirmed that activation of cholesterol biosynthesis in liver tissues by an HSD led to elevated serum cholesterol levels. In vivo experiments suggested that the HSD-induced elevation of serum IL-17 likely contributes to hypertension and dyslipidemia as a co-pathogenic factor. Knockdown or overexpression of IL-17RA in HepG2 cells and HUVECs further confirmed that upregulating this signaling pathway promotes the nuclear entry of SREBP2, a protein critical to cholesterol biosynthesis. In HUVECs, IL-17RA inhibition enhanced NO production, whereas IL-17RA overexpression suppressed it. Administration of rat-specific anti-IL-17A antibody significantly attenuated salt-induced hypertension and reduced serum TC and LDL-C levels. These findings demonstrate that a high-salt diet elevates the risk of hypertension and hypercholesterolemia by activating IL-17 signaling pathway. This suggests that IL-17A inhibitors may serve as potential therapeutic agents for treating salt-induced hypertension and hypercholesterolemia.

Aging increases the global burden of disease, yet its molecular basis remains incompletely understood. Recent studies indicate that reversible epigenetic drift-spanning DNA methylation clocks, histone codes, three-dimensional chromatin, and noncoding RNA networks-constitutes a central regulator of organismal decline and age-related diseases. How these epigenetic layers interact across different tissues-and how best to translate them into therapeutic strategies-are still open questions. This review outlines the specific mechanisms by which epigenetic changes influence aging, highlighting their impact on genomic instability, stem-cell exhaustion, and mitochondrial dysfunction. We critically evaluate emerging rejuvenation strategies-partial OSKM reprogramming, CRISPR-dCas9 epigenome editing, NAD⁺/sirtuin boosters, HDAC inhibitors, microbiota transfer, and precision lifestyle interventions-detailing their efficacy in resetting epigenetic age and restoring tissue homeostasis. Integrating single-cell multiomics and second-generation epigenetic clocks, we propose a roadmap for translating these insights into safe, personalized antiaging medicine.

Inflammatory bowel diseases (IBD) are chronic and recurrent gastrointestinal disorders affecting millions worldwide, imposing significant social and economic burdens. Safe and effective medications for IBD prevention and treatment are urgently needed. SNX10 has emerged as a potential therapeutic target, while traditional Chinese medicine (TCM) active compounds offer unique advantages in drug development due to their inherent safety and therapeutic properties. This study aimed to identify TCM compounds targeting SNX10 using molecular docking, molecular dynamics (MD) and MMGBSA binding free energy calculations. From a pool of 300 + TCM compounds, vitexin-4″-O-glucoside, scutellarin, diosmin and alpha-hederin were identified as promising candidates. Alpha-hederin exhibited the strongest binding affinity (-50.19 kJ/mol) via robust electrostatic and hydrophobic interactions, as revealed by MMGBSA, correlating with its superior efficacy in alleviating DSS-induced IBD in mice. Additionally, surface plasmon resonance (SPR) results showed that alpha-hederin can directly bind to SNX10 with a dissociation constant (Kd) of 3.02 μM. RNA-sequencing results show that alpha-hederin works by reducing inflammation and promoting gut cell proliferation. These findings not only propose novel TCM candidates for IBD management but also reinforce SNX10 as a therapeutic target and provide a scalable screening framework for TCM-based drug discovery.

Limited treatment options are available for bladder cancer (BCa) resulting in extremely high mortality rates. Cyclovirobuxine D (CVB-D), a naturally alkaloid, reportedly exhibits notable antitumor activity against diverse tumor types. However, its impact on CVB-D on BCa and its precise molecular targets remain unexplored. This study conducts CCK8 assay, colony formation assay, and flow cytometry experiments to demonstrate that CVB-D inhibits long-term proliferation and viability of BCa cell lines, thereby inducing apoptosis in vitro. It employs PPI networks and the CytoHubba algorithm to identify COL1A1, COL6A1, COL6A2, COL5A2, COL5A1, COL12A1, COL18A1, ITGA5, VCL, FLNA, and GSN as crucial therapeutic targets for CVB-D that can halt the malignant progression of BCa. GO and KEGG analyses indicate that the PI3K/AKT signaling pathway potentially may play a pivotal role in mediating the anti-BCa growth effects of CVB-D. The ROC curve and K-M survival analyses reveal the significant clinical value of all the 11 identified therapeutic targets, with GSN as the most effective target of CVB-D in combating BCa. This study also uncovers a potential interaction between GSN and CVB-D through molecular docking and molecular dynamics simulations. RT-qPCR and Western blotting experiments provide further evidence that CVB-D effectively suppresses GSN mRNA and protein expression in a concentration-dependent fashion. Our comprehensive study is the first report on the molecular mechanism of CVB-D against BCa, identifying GSN as a pivotal target in CVB-D-based anti-BCa therapy. We believe that our study results may help establish a theoretical basis for the possible utilization of CVB-D in cancer therapeutics.

BACKGROUND:To explore the preliminary safety and efficacy of domestic single-port robot-assisted pyeloplasty in ureteropelvic junction obstruction. METHODS:Data from patients undergoing single-port robotic-assisted pyeloplasty (November 2023-May 2024) using the 'SHURUI' SP system through a single-site approach were reviewed. Details included patient demographics, intraoperative and postoperative data, and surgical outcomes. RESULTS:The study included 20 patients, ages 13-39, with a male-to-female ratio of 4:1. CLINICAL PRESENTATIONS:abdominal pain (7cases), infection (2cases), and asymptomatic (11cases). All surgeries were successful, with an average operation time of 147(IQR, 125-175) minutes, blood loss of 35(IQR, 30-60) mL, and a hospital stay of 5(IQR, 3-6)days. The ureteral stent was removed 6-8 weeks post-surgery, with a subsequent CT scan at 4 months showing 100% success based on pain and obstruction resolution. CONCLUSION:The 'SHURUI' single-port robotic-assisted pyeloplasty is a safe and feasible treatment for UPJO in both adults and paediatric patients.

This study analyzes and compares the clinical efficacy and safety of transurethral blue laser vaporization of the prostate (BL-PVP) and transurethral green laser vaporization of the prostate (GL-PVP) in the treatment of benign prostatic hyperplasia (BPH). A retrospective analysis was conducted on the clinical data of 97 patients with BPH who were treated at the Urology and Nephrology Department of Xi’an People’s Hospital (Fourth Hospital of Xi’an) from June 2022 to June 2024. Patients were divided into 2 groups based on the surgical technique: the BL-PVP group (n = 46), which underwent transurethral BL-PVP, and the GL-PVP group (n = 51), which underwent transurethral GL-PVP. Additionally, patients were further categorized based on prostate volume into group A (medium volume, 30–80 mL) and group B (large volume, >80 mL). Perioperative indices and postoperative follow-up data were compared between the 2 groups. Both the BL-PVP and GL-PVP groups demonstrated significant improvements in International Prostate Symptom Score, maximum flow rate, and postvoid residual at 1, 3, and 6 months postoperatively, with overall comparable efficacy between the 2 procedures ( P < .05). The BL-PVP group showed a significant advantage in bladder irrigation time, catheter indwelling time, and length of hospital stay, particularly in patients with medium prostate volume ( P < .05). Furthermore, the BL-PVP group exhibited faster recovery of urinary control in the early postoperative period, with lower residual urine volume and symptom scores at 1 and 3 months compared with the GL-PVP group. BL-PVP demonstrates an advantage in preserving sexual function in patients with medium-sized prostates ( P < .05). BL-PVP is a safe and effective surgical approach for the treatment of BPH, offering comparable therapeutic outcomes to GL-PVP, with notable advantages in postoperative recovery speed and early improvement in urinary control. Due to its precise vaporization effect and minimal thermal injury, BL-PVP demonstrates certain functional advantages, particularly for patients with a high demand for fast recovery and sexual function preservation. This study indicates that BL-PVP is a promising innovative treatment with significant clinical application potential, providing important guidance for selecting surgical options for BPH patients.

To compare the clinical efficacy and safety of three minimally invasive surgical approaches—percutaneous aspiration and sclerotherapy (PNA), laparoscopic retroperitoneal decortication (LRD), and percutaneous nephroscopic decortication (PCNL)—in the treatment of simple renal cysts, and to explore the optimal surgical strategy. A retrospective analysis was conducted on 90 patients with simple renal cysts treated at our institution between December 2021 and December 2023. Patients were divided into three groups based on the surgical approach received: PNA group, LRD group, and PCNL group, with 30 patients in each. Baseline characteristics (sex, age, cyst location, and size) were collected and compared. Clinical outcomes, including operative time, hospital stay, postoperative drainage volume, time to drain removal, pain scores (VAS at 24 h), perioperative complications, stress markers (hemoglobin, C-reactive protein, procalcitonin, interleukin-6, creatinine), and cure rates, were analyzed among the groups. There were no statistically significant differences in baseline characteristics among the three groups. The PNA group demonstrated significantly shorter operative time, hospital stay, earlier drain removal, and lower 24-h VAS scores compared with the PCNL and LRD groups (P < 0.05), indicating advantages in minimal invasiveness and rapid recovery. The LRD group achieved the highest cure rate (93.33

BACKGROUND Cancer patients often suffer from severe stress reactions psychologically, such as anxiety and depression. Prostate cancer (PC) is one of the common cancer types, with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis. Therefore, attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment. AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model. METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022. The patient cohort was divided into a training group (n = 84) and a validation group (n = 36) at a ratio of 7:3. The patients’ anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS), respectively. Logistic regression was used to analyze the risk factors affecting negative mood, and a risk prediction model was constructed. RESULTS In the training group, 35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50, respectively. Based on the scores, we further subclassified patients into two groups: a bad mood group (n = 35) and an emotional stability group (n = 49). Multivariate logistic regression analysis showed that marital status, castration scheme, and postoperative Visual Analogue Scale (VAS) score were independent risk factors affecting a patient's bad mood (P < 0.05). In the training and validation groups, patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients (P < 0.0001). The area under the curve (AUC) of the risk prediction model for predicting bad mood in the training group was 0.743, the specificity was 70.96%, and the sensitivity was 66.03%, while in the validation group, the AUC, specificity, and sensitivity were 0.755, 66.67%, and 76.19%, respectively. The Hosmer-Lemeshow test showed a χ 2 of 4.2856, a P value of 0.830, and a C-index of 0.773 (0.692-0.854). The calibration curve revealed that the predicted curve was basically consistent with the actual curve, and the calibration curve showed that the prediction model had good discrimination and accuracy. Decision curve analysis showed that the model had a high net profit. CONCLUSION In PC patients, marital status, castration scheme, and postoperative pain (VAS) score are important factors affecting postoperative anxiety and depression. The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.

Prostate cancer (PCa) is associated with poor immunogenicity and lymphocytic infiltration, and immunotherapy effective against PCa remains unavailable. Pyroptosis, a novel immunotherapeutic modality for cancer, promotes systemic immune responses leading to immunogenic cell death in solid tumors. This paper describes the preparation and analysis of PSMAscFv-EVN-GSDMD; this genetically engineered recombinant extracellular vesicle (EV) expresses a single-chain variable antibody fragment (scFv) with high affinity for prostate-specific membrane antigen (PSMA) on their surfaces and is loaded with the N-terminal domain of gasdermin D (GSDMD). Both in vitro and in vivo, PSMAscFv-EVN-GSDMD effectively targeted PSMA-positive PCa cells and induced pyroptosis through the carrier properties of EVs and the specificity of PSMAscFv. In the 22RV1 and PSMA-transfected RM-1-inoculated PCa mouse models, PSMAscFv-EVN-GSDMD efficiently inhibited tumor growth and promoted tumor immune responses. In conclusion, PSMAscFv-EVN-GSDMD can convert the immunosuppressive "cold" tumor microenvironment of PCa into an immunogenic "hot" tumor microenvironment.

Objectives:This study aimed to explore the clinical characteristics of patients with prostate cancer with prostate-specific antigen (PSA) concentrations of less than 4 ng/mL (normal PSA) to provide clinical insights regarding diagnosis and treatment. Methods:We recruited 35 patients with prostate cancer with normal PSA who were admitted to Xi'an People's Hospital from January 2013 to January 2018, and further determined their clinical characteristics, serum PSA concentration, prostate volume, tumor pathology, surgical margins, seminal vesicle invasion, lymph node metastasis, Gleason score, TNM staging, risk classification, and survival, and described the patients' interventions and treatments. All patients and their families signed informed consent forms before enrollment. Results:In our study, we observed a 3-year survival rate of 77.14% for patients with prostate cancer and normal PSA concentrations. This outcome can be attributed to several clinical characteristics, including the absence of obvious clinical presentation, a high detection rate of seminal vesicle invasion, as well as high Gleason scores and risk levels. The primary outcome, 3-year survival rate, reflects the long-term prognosis of this specific patient subgroup. We also conducted correlation analyses to better understand the relationships between these clinical characteristics and patient survival.

BACKGROUND:Castration-resistant prostate cancer (CRPC) is a deadly malignancy without effective therapeutics. Cyclovirobuxine (CVB) can play an anticancer role by inhibiting mitochondrial function, regulating tumor cell apoptosis, dysregulating autophagy, and other mechanisms. This study aimed to examine the function and mechanism of CVB in CRPC to provide new insights into CRPC treatment.METHODS:The effect of CVB on PC3 and C4-2 cell viability was determined using a CCK8 assay. Core therapeutic targets of CVB in CRPC cells were identified using RNA sequencing, online database, and PPI network analyses. Western blotting, RT-qPCR and molecular docking were performed to evaluate the regulation of core targets by CVB. Utilizing GO and KEGG enrichment analyses, the probable anti-CRPC mechanism of CVB was investigated. Immunofluorescence, flow cytometry and colony formation assays were used to verify the potential phenotypic regulatory role of CVB in CRPC.RESULTS:CVB inhibited CRPC cell activity in a concentration-dependent manner. Mechanistically, it primarily regulated BRCA1-, POLD1-, BLM-, MSH2-, MSH6- and PCNA-mediated mismatch repair, homologous recombination repair, base excision repair, Fanconi anemia repair, and nucleotide excision repair pathways. Immunofluorescence, Western blot, flow cytometry and colony formation experiments showed that CVB induced DNA damage accumulation, cell apoptosis, and cell cycle arrest and inhibited CRPC cell proliferation.CONCLUSION:CVB can induce DNA damage accumulation in CRPC cells by targeting DNA repair pathways and then induce cell apoptosis and cell cycle arrest, eventually leading to inhibition of the long-term proliferation of CRPC cells.

结节性硬化症相关肾血管平滑肌脂肪瘤(tuberous sclerosis complex-renal angiomyolipoma,TSC-RAML)是一种罕见的良性肿瘤,由不同比例的脂肪、血管和平滑肌构成,目前的临床治疗手段包括mTOR抑制剂、选择性动脉栓塞和外科手术等.影像学检查为TSC-RAML的诊疗及随访监测提供重要依据,但电子计算机断层扫描及磁共振成像结果受临床经验的限制,存在主观差异性,且二维图像的不直观、不立体、不能融合为整体等缺陷容易造成诊疗偏差.近些年三维重建技术的出现为充分认识病情、合理术前规划及精确手术操作提供了客观依据,另外三维立体图像清晰、直观的特点让其在临床中得到了广泛的应用.本文就三维重建在TSC-RAML治疗中的应用进行综述.

Bladder cancer (BCa) is a urinary tumor with limited treatment options and high mortality. Liensinine (LIEN), a natural bisbenzylisoquinoline alkaloid, has shown excellent anti-tumor effects in numerous preclinical studies. However, the anti-BCa effect of LIEN remains unclear. To the best of our knowledge, this is the first study to investigate the molecular mechanism of LIEN in the management of BCa. First, we identified the treatment-related targets of BCa; those that repeatedly occur in more than two databases, including GeneCards, Online Mendelian Inheritance in Man, DisGeNET, Therapeutic Target Database, and Drugbank. The SwissTarget database was used to screen LIEN-related targets, and those with a probability >0 were possible LIEN targets. The prospective targets of LIEN in the treatment of BCa were then determined using a Venn diagram. Second, we discovered that the PI3K/AKT pathway and senescence mediated the anti-BCa action of LIEN by using GO and KEGG enrichment analysis to explore the function of LIEN therapeutic targets. A protein-protein interaction network was created using the String website, and six algorithms of the CytoHubba plug-in were then used in Cytoscape to assess the core targets of LIEN for the therapy of BCa. The outcomes of molecular docking and dynamics simulation demonstrated that CDK2 and CDK4 proteins were the direct targets of LIEN in the management of BCa, among which CDK2 was more stable in binding to LIEN than CDK4. Finally, in vitro experiments showed that LIEN inhibited the activity and proliferation of T24 cells. The expression of p-/AKT, CDK2, and CDK4 proteins progressively decreased, while the expression and fluorescence intensity of the senescence-related protein, γH2AX, gradually increased with increasing LIEN concentration in T24 cells. Therefore, our data suggest that LIEN may promote senescence and inhibit proliferation by inhibiting the CDK2/4 and PI3K/AKT pathways in BCa.

Enzalutamide (Enz) is a next-generation androgen receptor (AR) antagonist used to treat castration-resistant prostate cancer (CRPC). Unfortunately, the relapsing nature of CRPC results in the development of Enz resistance in many patients. Non-coding RNAs (ncRNAs) are RNA molecules that do not encode proteins, which include microRNAs (miRNA), long ncRNAs (lncRNAs), circular RNAs (circRNAs), and other ncRNAs with known and unknown functions. Recently, dysregulation of ncRNAs in CRPC, particularly their regulatory function in drug resistance, has attracted more and more attention. Herein, we introduce the roles of dysregulation of different ncRNAs subclasses in the development of CRPC progression and Enz resistance. Recently determined mechanisms of Enz resistance are discussed, focusing mainly on the role of AR-splice variant-7 (AR-V7), mutations, circRNAs and lncRNAs that act as miRNA sponges. Also, the contributions of epithelial-mesenchymal transition and glucose metabolism to Enz resistance are discussed. We summarize the different mechanisms of miRNAs, lncRNAs, and circRNAs in the progression of CRPC and Enz resistance, and highlight the prospect of future therapeutic strategies against Enz resistance.

OBJECTIVE:In various cancers, migration and invasion inhibitory protein (MIIP) is expressed at low level and is involved in cancer pathogenesis. Herein, we sought to explore the function of MIIP in clear cell renal cell carcinoma (ccRCC).METHODS:CCK-8, colony formation, cell cycle, and endothelial cell tube formation assays were performed to evaluate the roles of MIIP in ccRCC proliferation and angiogenesis. To explore the underlying mechanism, we conducted RNA-sequencing, GSEA, qRT-PCR, Western blot, ELISA, cell transfection, coimmunoprecipitation, and ubiquitination assays in ccRCC cell lines. Furthermore, xenograft tumor growth in nude mice, and Ki-67 and CD31 staining in xenograft tissues were examined. Finally, the association of MIIP expression with clinical pathology and the expression status of HIF-2α and cysteine-rich 61 (CYR61) were further analyzed in human RCC tissues through Western blot and immunohistochemistry.RESULTS:Both in vitro and in vivo functional experiments indicated that forced expression of MIIP inhibited ccRCC proliferation and angiogenesis, whereas silencing MIIP either in normal HK-2 cells or in ccRCC cells had the opposite effect (P < 0.05). Mechanistically, CYR61 was identified as a gene significantly downregulated by MIIP overexpression, and was required for the suppressive role of MIIP in ccRCC. MIIP was found to promote HSP90 acetylation and thus impair its chaperone function toward HIF-2α. Consequently, RACK1 binds HIF-2α and causes its ubiquitination and proteasomal degradation, thus decreasing the transcription of its target, CYR61. Finally, analyses of clinical samples demonstrated that MIIP is significantly downregulated in cancer vs. normal tissues in RCC cases, and its expression is negatively associated with histological grade, metastasis, the prognosis of patients with RCC, and the expression of HIF-2α and CYR61 (P < 0.05).CONCLUSIONS:MIIP is a novel tumor suppressor in ccRCC via negative regulation of HIF-2α-CYR61 axis.

目的:评估成年结节性硬化症相关的肾血管平滑肌脂肪瘤患者外周血DNA测序的价值.方法:分析2015年09月至2019年09月因双肾多发血管平滑肌脂肪瘤就诊于我院的所有患者的病史、家族史及辅助检查,提取符合结节性硬化症诊断标准的患者外周血DNA,通过二代测序检测TSC1与TSC2基因.结果:纳入研究的患者共47例,检测出TSC1/2基因突变的22例(46.8％).检测出有突变的患者中最大肾血管平滑肌脂肪瘤直径超过8 cm的比例明显高于未超过的,差异有统计学意义(P<0.05).检测出的TSC1/2基因突变位点26个,主要为错义突变,其中13个未见报道.结论:对成年结节性症相关的肾血管平滑肌脂肪瘤患者的外周血DNA进行基因测序,可能有很大比例无法检测出TSC1/2基因突变,肾血管平滑肌脂肪瘤肿瘤直径超过8 cm的患者外周血DNA更易检出突变.成年结节性症相关的肾血管平滑肌脂肪瘤患者中可能有较大比例是体细胞突变的嵌合体,基因测序不能仅提取外周血DNA样本.

目的 初步研究镭-223用于治疗前列腺癌骨转移的有效性及安全性.方法 回顾性分析西安国际医学中心医院2021年4月-11月行镭-223治疗的11例前列腺癌患者的临床资料,比较所有患者治疗前后血清碱性磷酸酶(ALP)、血清总前列腺特异性抗原(tPSA)、疼痛评分及白细胞、红细胞、血小板的变化情况.结果 11例患者中,镭-223治疗后有5例患者前列腺特异性抗原(PSA)下降,占总人数的45.5％;7例患者ALP下降,占总人数的63.6％;除3例患者初始无症状外,其余患者100％ 疼痛评分下降,其中6例患者疼痛完全缓解.所有患者治疗前后红细胞、白细胞计数均无明显变化,仅有1例患者血小板计数下降明显.结论 镭-223治疗前列腺癌骨转移是一种安全、有效的方法.

Objective:To investigate the clinical safety and effects of oblique supine lithotomy position percutaneous antegrade ureteral flexible/ rigid endoscopy combined with retrograde ureteroscopy in the treatment of ureteral stent implantation failure ureteral obstruction caused by malignant tumors.Methods:A retrospective study was conducted to collect and analyze the data of 25 patients with ureteral obstruction caused by malignant tumors treated in our hospital from October 2016 to January 2019. All these patients failed of double J stent placement under conventional retrograde cystoscopy or ureteroscopy. Under the oblique supine lithotomy position, a double J tube was placed by percutaneous renal channel antegrade ureteral flexible/ rigid endoscopy combined with ureteroscopy.Results:Double J tubes were successfully placed in 24 cases (30 sides of ureter, 93.7% success rate), except for 1 case failed due to complete occlusions of the bilateral ureteral lumen by tumor invasion. The average operation time was (57.4 ±22.4) minutes and the average hospital stay was (5.5±1.9) days. There was no severe renal hemorrhage and no ureteral perforation and avulsion during the operation. The nephrostomy tube was removed 6- 14 days after the operation. Hydronephrosis was significantly relieved during the 12 months follow-up.Conclusions:Oblique supine lithotomy position percutaneous antegrade ureteral flexible / rigid endoscopy combined with retrograde ureteroscopy for the treatment of ureteral stent implantation failure ureteral obstruction caused by malignant tumors is safe and effective, and worthy of clinical promotion.