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Background: Benign prostate hyperplasia (BPH) is a common health problem amongst men worldwide. It has a multifactorial ethiology, and in some societies, urinating in a standing position is believed to cause BPH. Although the effect of urination position on voiding parameters has been extensively investigated, whether they have a role in the aetiology of BPH is not known.
Material and Methods: The patients who had (n = 89) and had not ever used (n = 213) alpha-blockers were included in the study. All patients were divided into four groups in accordance with their past urination habits: Group 1 (I always pee in a standing position), group 2 (I mostly pee in a standing position), group 3 (I mostly pee in a sitting position) and group 4 (I always pee in a sitting position). The current uroflowmetry results, prostate volumes (PVs) and International Prostate Symptom Score (IPSS) of the groups were compared.
Results: The IPSSs of groups 1–4 (total n = 213) who had not used alpha-blockers before were 10 (9–16), 10 (7–14), 10 (7–14) and 10 (8–13) points, respectively; Their median PVs were 40, 35, 40 and 40 mL, respectively; And their average maximum urinary flow rate (Qmax) values were 17 (12.7–20.5), 1.46 (11.1–20), 15 (12.4–18.9) and 15.6 (11.7–19.5) mL/s, respectively. No statistical difference was observed between the groups. Alpha-blockers were started in 104 patients who had not used alpha-blockers before in accordance with their clinical results. When these 104 patients who were started on alpha-blockers for the first time and 89 patients who were started on alpha-blockers before were examined together, the average ages of starting alpha-blockers were 59.9 ± 7.1, 60.5 ± 6.7, 59.6 ± 6.5 and 60.8 ± 6.7 years. No statistical difference was observed between the groups. Patients with and without clinical BPH were compared in terms of past urination habits. In both groups, the rates of patients who always or mostly urinated whilst sitting (60%–61%) and those of patients who always or mostly urinated whilst standing (39%–40%) were similar.
Conclusions: This retrospective study showed that positional urination habits do not have a role in the aetiology of BPH. However, multicentre prospective studies with a larger patient population are needed.
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Introduction: The COVID-19 pandemic affected the presentation and management of many diseases. Lifestyle and dietary habit changes caused by social limitations and quarantine may alter the incidence of chronic diseases such as urolithiasis. This epidemiology study aimed to investigate the impact of the COVID-19 pandemic on the incidence of kidney stones in the Canadian province of New Brunswick.
Methods: Reports of 3253 kidney stone analysis from 1 January 2021, to 31 December 2023, were retrospectively reviewed from the laboratory information system. All stone compositions were analysed by Fourier transforminfrared spectrometry technology. Incident rates were compared with 3838 urolithiasis reports from 1 October 2016, to 30 September 2019, stratified by different ages, sexes and the geographic regional health authority (RHA) zones.
Results: The overall incidence of urolithiasis in New Brunswick significantly dropped from 148 (95% confidence interval (CI) 139–157) per 100,000 person-years in 2016–2019 to 115 (95% CI 110–120) per 100,000 person-years in the period of 2021–2023 (χ2: 94.167, p < 0.01, risk ratio: 0.78). The decrease occurred in both sexes, most age groups and the most densely populated RHA zones (Zones 1 and 2; p < 0.01). However, geographic differences on the impact of COVID-19 on prevalence were observed. Similar to that of the pre-COVID-19 period, calcium oxalate monohydrate remained as the predominant (61.27%) kidney stone type in 2021–2023. Struvite stone decreased from 2.19% to 0.86%.
Conclusions: The incidence rate of urolithiasis in New Brunswick was significantly lower in the COVID-19 pandemic than in the pre-COVID-19 period. However, we found no significant change in kidney stone compositions.
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Background: Lower urinary tract symptoms are observed in individuals with pathologies affecting the lower urinary system. This survey aimed to evaluate the prevalence of lower urinary tract symptoms and the contributing factors amongst medical students, a young population undergoing a stressful educational process.
Methods: A 43-question survey was prepared for the first to sixth year medical students, incorporating the constipation scoring system to evaluate constipation, the generalized anxiety disorder 7-item scale to assess anxiety levels, and the core lower urinary tract symptom score to explore the lower urinary tract symptoms. The survey collected data on dietary habits, smoking status, consumption of alcoholic and caffeinated drinks, living conditions, age, gender, body mass index and educational level of the participants.
Results: The sample included 222 participants, with a median age of 22 years. The participants consisted of male (46.4%) and female (53.6%) students. The prevalence of lower urinary tract symptoms was 83.78%. Amongst storage symptoms, urgency was the most frequent, affecting 59.0% of participants. Additionally, 58.10% of individuals experienced at least one voiding symptom, with the feeling of incomplete bladder emptying being the most common. In multivariate analyses, constipation (p < 0.001), gender (p = 0.016), anxiety (p = 0.027) and smoking (p = 0.014) were risk factors for storage symptoms, and increased body mass index (p = 0.048) and constipation (p < 0.001) were risk factors for voiding symptoms.
Conclusions: This study highlights the high prevalence of lower urinary tract symptoms amongst medical students and identifies various contributing factors. The findings underscore the need for awareness and interventions to address lower urinary tract symptoms in this population, particularly considering its effect on quality of life.
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Background: Prostate cancer (PCa) is the most commonly diagnosed cancer in men worldwide. Prostate-specific antigen (PSA) is widely used in PCa suspicion but lacks specificity. Additional markers, such as PSA density, free:total PSA ratio and multiparametric prostate magnetic resonance imaging (MRI), are employed. This study evaluated the role of hypothalamo-pituitary axis hormones and adrenal-derived androgens in predicting PCa and clinically significant PCa (csPCa).
Patients and Methods: This prospective cohort study included 464 male patients scheduled for transrectal prostate biopsy due to elevated PSA or abnormal digital rectal examination findings. Patients were divided into two groups on the basis of biopsy results: Group 1 (benign) and Group 2 (PCa). Prebiopsy levels of PSA, total testosterone (TTE), luteinising hormone (LH), follicle-stimulating hormone (FSH), oestradiol (EST), prolactin (PRL), testosterone density (TTEd), PSA density (PSAd) and dehydroepiandrosterone sulphate (DHEAS) were examined. Patients were also categorised into three groups to assess csPCa: Group A (no malignancy or clinically insignificant PCa), Group B (csPCa) and Group C (clinically insignificant PCa).
Results: Group 2 had significantly lower DHEAS levels (p = 0.03) and higher TTEd (p < 0.05) and PSAd (p < 0.05) levels than Group 1. No significant differences were found in FSH, LH, EST, TTE and PRL levels between groups (p > 0.05). The comparison of patients with csPCa (Group B) with patients in other groups revealed that DHEAS (p < 0.05) levels were significantly lower and PSAd (p < 0.05) was significantly higher in Group B than in other groups. DHEAS levels showed a negative correlation with age (r = –0.387, p < 0.05). In patients over 65 years of age, low DHEAS levels were significantly associated with csPCa (p < 0.05).
Conclusions: Serum PSA alone is insufficient for PCa diagnosis. DHEAS and TTEd are useful in predicting PCa and csPCa. The decrease in DHEAS levels is associated with an increased risk of PCa and csPCa, suggesting its potential role as a marker in patient management. Further large-scale studies are needed to confirm these findings.
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Background: To evaluate the correlation between prebiopsy free-to-total prostate-specific antigen ratio (f/t PSA) and biopsy Gleason score (GS) results and determine the diagnostic accuracy of f/t PSA ratio for prostate carcinoma in patients with a PSA grey zone.
Methods: Data on 808 patients were retrospectively reviewed. Based on the f/t PSA ratio results, the patients were classified into three groups. Group 1 consisted of 210 patients having an f/t PSA ratio between 0–0.15; Group 2 comprised 327 patients having an f/t PSA ratio between 0.16–0.25; Group 3 included 271 patients having an f/t PSA ratio >0.25. Demographic and clinical data, including detailed pathological results, were analysed. Assessment of diagnostic accuracy was achieved through receiver operating characteristic (ROC) curve evaluation, and the optimal threshold value of the f/t PSA ratio for the prediction of prostate carcinoma was determined, along with its sensitivity and specificity.
Results: An inverse correlation was observed between the f/t PSA ratio and biopsy GS results. In Group 1, 19% of patients were found to have a GS of 6, but this percentage was nearly halved to 10.7% in Group 3. For those with a GS of 7, the proportion dropped considerably from 40% in Group 1 to 6.6% in Group 3. Similarly, the percentage of patients with a GS of 8 decreased from 9.5% in Group 1 to 1.4% in Group 3. ROC curve analysis revealed an area under curve of 0.756 for the f/t PSA with a 95% confidence interval ranging from 0.724 to 0.785. A threshold value of ≤0.16 provided 57.1% sensitivity and 86.4% specificity.
Conclusions: Although the prebiopsy f/t PSA ratio shows promise as an indicator for the prediction of biopsy GS results, its diagnostic accuracy for the detection of prostate carcinoma is inferior to that of PSA density and prostate volume. Nevertheless, additional research with larger patient groups is needed to confirm these results.
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Background: A multitude of options can be used to image the prostate, but transrectal ultrasound and magnetic resonance imaging are the mainstays. Accuracy in prostate measurements is key to the preoperative planning of any surgical intervention planned on the prostate such as tissue resection or prostatectomy. Some evidence exists that magnetic resonance imaging is the most accurate modality, but given its cost, the clinical significance remains uncertain. This study aimed to compare transrectal ultrasound and magnetic resonance imaging prostate volumes with prostate gross specimens in men having tissue-confirmed prostate cancer who underwent robotic-assisted radical prostatectomy to determine accuracy in sizing.
Methods: This study was a retrospective analysis conducted on men who underwent robotic prostatectomy for prostate cancer and had a preoperative transrectal ultrasound and magnetic resonance imaging prostate size measurement (147 men in total) between 2012–2024. Patients were required to undergo robotic prostatectomy ≤2 months from the time of transrectal ultrasound and magnetic resonance imaging prostate-size determination.
Results: Mean transrectal ultrasound was significantly smaller on average than magnetic resonance imaging prostate volume (–4.8 mL; p < 0.001). Transrectal ultrasound (–14.4 mL) and magnetic resonance imaging (–9.5 mL) were significantly smaller than actual prostate weight (p < 0.001). The mean difference between transrectal ultrasound volume and prostate weight was significantly greater from the mean difference between magnetic resonance imaging volume and prostate weight (p < 0.001). Participants with high-grade (Gleason grade ≥8) and non-high-grade cancer (Gleason grade <8) did not differ in actual prostate weight after robotic radical prostatectomy or in estimated prostate volume (p > 0.05).
Conclusions: Although transrectal ultrasound appears to be less accurate than magnetic resonance imaging in estimating prostate size, the difference is small, and it remains an adequate imaging modality in patients with prostate cancer.
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Background: We aimed to investigate the effect of the difference in apnoea severity on the degree of lower urinary tract symptoms (LUTS) and of erectile dysfunction (ED) in patients diagnosed with obstructive sleep apnoea (OSA).
Materials and Methods: Between March 2019 and June 2024, 81 patients diagnosed with OSA were included in the study. Polysomnography (PSG) reports were analysed, and patients were divided into three groups according to the apnoea-hypopnea index. PSG parameters were recorded. Patients were evaluated by urologic examination, ultrasonography, uroflowmetry and blood tests. Scales such as the International Prostate Symptom Score (IPSS), quality of life (QoL) related to urinary symptoms and International Index of Erectile Function (IIEF) were used for scoring. Intergroup comparisons were made using the Kruskal–Wallis test and Chi-square test.
Results: Age, smoking, prostate-specific antigen and number of periodic leg movements per hour were not correlated with apnoea severity. Body mass index (BMI), prostate volume, minimum and maximum partial oxygen pressure, uroflowmetry parameters, IPSS, QoL, bladder wall thickness and IIEF score were correlated with OSA severity.
Conclusions: Determining the factors associated with the severity of sleep apnoea could provide insights into mitigating the adverse effects associated with OSA. Increased severity of OSA leads to increased severity of LUTS and ED.
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Objective: This study aimed to investigate the effectiveness, safety and outcomes of the combination therapy of low-intensity extracorporeal shockwave therapy (Li-ESWT) and platelet-rich plasma (PRP) for the treatment of chronic-phase Peyronie’s disease.
Methods: The clinical outcomes of patients diagnosed with Peyronie’s disease and treated with Li-ESWT combined with PRP at our clinic between January 2018 and January 2024 were retrospectively reviewed and analysed. Twenty-three patients were excluded based on inclusion criteria, leaving 26 patients for the retrospective analysis. Each patient received three sessions of PRP and six sessions of Li-ESWT. The treatment regimen involved sessions administered twice weekly over a period of 3 weeks, followed by 1-week post-treatment follow-up. The patients were then monitored for 24 weeks.
Result: After treatment, no significant reduction in average plaque size was observed. However, a statistically significant average improvement of 10° was noted for penile curvature. Among the patients, 14 (53.8%) reported satisfaction with the treatment outcome, and 12 (46.2%) expressed dissatisfaction. No significant adverse effects were observed at the injection sites or in the areas subjected to Li-ESWT post-procedure.
Conclusions: The combination of Li-ESWT and PRP is effective and safe for the treatment of chronic-phase Peyronie’s disease.
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Objective: Approximately one-third of individuals diagnosed with prostate cancer (PCa) experience biochemical recurrence (BCR) following their initial curative therapy. BCR significantly increases the risk of distant metastases and is associated with higher mortality rates, particularly in patients with poor prognostic indicators. This study aims to investigate the strong correlation between positive surgical margins (PSMs) and BCR after radical prostatectomy, offering foundational insights and guidance for predicting patient survival and optimising postoperative intervention strategies.
Methods: A retrospective analysis was conducted on the clinical data of 498 patients who underwent laparoscopic radical prostatectomy between January 2015 and January 2021 at Ningbo Yinzhou No.2 Hospital. Pathological specimens and medical records were reviewed. Of these, 127 patients with PSMs and 279 patients with negative surgical margins (NSMs) were included in the statistical analysis. The analysis incorporated clinical and pathological parameters, including primary tumour characteristics, PSMs, pathological tumour staging, surgical margin status, Gleason grade group, and other relevant factors, with BCR-free survival as the primary endpoint.
Results: During the follow-up period of this study, 129 cases of BCR were identified among the 406 patients. Of these, 34 cases occurred in patients with PSMs, accounting for approximately 26.8% (34/127), and 95 cases occurred in patients with NSMs, accounting for approximately 34.1% (95/279). The difference in recurrence between the two groups was statistically significant (p < 0.001). The median time to BCR was 19.2 months for patients with PSMs, compared to 28.2 months for patients with NSMs, with this difference also reaching statistical significance (p < 0.001). The Gleason grading group in patients with PSMs was a stronger predictor of recurrence than the primary tumour characteristics.
Conclusions: The presence of PSMs is a significant independent predictor of BCR in patients undergoing radical prostatectomy for PCa. Early detection and timely intervention for patients with PSMs are crucial for improving postoperative outcomes.
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Background: This study aimed to investigate the impact of Watson’s Caring Model in Nursing (WCMN) on self-esteem, depression, resilience, quality of life, and patient satisfaction as well as determine potential outcome differences between patients receiving this personalised nursing care model and those provided with standard nursing care.
Methods: This retrospective study included 113 patients who underwent radical prostatectomy at our hospital from January 2023 to June 2023. According to the type of care received, the patients were categorised into a traditional nursing group (n = 67) and a WCMN group (n = 46). Data collected from the patients included demographic information and the measurements of self-esteem (Self-Esteem Scale), depression (Hamilton Depression Rating Scale), resilience (Connor-Davidson Resilience Scale), and quality of life (Short Form 12) at baseline and 1 week post-surgery.
Results: The WCMN group showed a significant increase in follow-up self-esteem scores compared to those in the traditional nursing group (t = 2.547, p = 0.012). Additionally, the WCMN group exhibited significantly lower follow-up depression scores (t = 2.035, p = 0.044) and higher resilience scores (t = 2.046, p = 0.044) and quality of life scores (t = 2.100, p = 0.038) than the traditional nursing group. Lastly, patient satisfaction scores, including overall satisfaction, nursing care satisfaction, information satisfaction, emotional support satisfaction, and involvement satisfaction scores, were significantly higher in the WCMN group than in the traditional nursing group (p < 0.05).
Conclusions: WCMN has a beneficial effect on self-esteem, depression, resilience, quality of life, and patient satisfaction in patients who undergo radical prostatectomy for prostate cancer.
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Objectives: The current research focuses on a systematic analysis of the expression patterns of the apolipoprotein B editing complex 3 (APOBEC3) gene family in clear cell renal cell carcinoma (ccRCC) and their impact on disease progression, prognosis, and somatic gene mutations associated with ccRCC.
Methods: A differential expression analysis was performed using the R “limma” package, while a survival analysis was performed using Kaplan–Meier and log-rank tests. A Gene Set Enrichment Analysis performed by the R “clusterProfiler” package compared the high- and low-expression groups. The 10 genes with the highest tumor mutation frequency in the patients with ccRCC were evaluated and presented using the R “maftool” package. The Tumor Immune Estimation Resource (TIMER) algorithm was utilized to predict the immune cell infiltration levels in ccRCC.
Results: All members of the APOBEC3 gene family members were found to be upregulated in ccRCC tumor tissues versus adjacent normal tissues. Higher expressions of APOBEC3A, APOBEC3B, APOBEC3C, APOBEC3D, APOBEC3G, and APOBEC3H were associated with a poorer prognosis for ccRCC. Conversely, higher APOBEC3F expression was associated with a more favorable ccRCC prognosis. Mutation frequencies of genes VHL, PBRM1, TTN, SETD2, and BAP1 genes were higher in the high-expression group of various APOBEC3 compared to the low-expression group. Multiple APOBEC3 gene family (particularly APOBEC3C, APOBEC3D, APOBEC3F, APOBEC3G, and APOBEC3H) also correlated with immune cell infiltration in the ccRCC.
Conclusions: These study findings suggest that APOBEC3 genes are commonly overexpressed in ccRCC, and their expression levels are associated with poor prognosis in ccRCC, somatic gene mutations, cancer immunomodulation, and immune cell infiltration levels in the tumor microenvironment.
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Objective: This meta-analysis evaluates the effect of immune checkpoint inhibitors (ICIs) on advanced prostate cancer, assessing efficacy and safety profiles compared with non-ICI regimens.
Methods: We searched PubMed, Web of Science, Embase and Cochrane Library for pertinent studies, including randomised controlled trials and nonrandomised controlled trials on immunotherapy for prostate cancer. R software was employed for meta-analysis to assess hazard ratios (HRs) for median survival, overall survival (OS), objective response rate (ORR) and serum prostate-specific antigen (PSA) response rate. Egger test, funnel plot analysis and sensitivity analysis were performed to evaluate the results. Heterogeneity sources were explored via meta-regression.
Results: Our study included 19 studies with 3661 participants. Findings indicated no significant improvement in OS (HR = 1.04, 95% confidence interval (CI) = 0.9–1.18), progression-free survival (HR = 0.95, 95% CI = 0.83–1.09) or response rates (PSA = 0.12, 95% CI = 0.08–0.18; ORR = 0.12, 95% CI = 0.08–0.18), with substantial variation in outcomes (I2 ≥60%). The rates of adverse events (AEs) varied, with notable incidences of Grade ≥3 reactions. The incidence rates for immune-related AEs were Grade ≥3 AEs, and all-grade AEs 0.37 (95% CI = 0.12–0.72, I2 = 96%, p < 0.01), 0.90 (95% CI = 0.83–0.94, I2 = 92%, p < 0.01) and 0.38 (95% CI = 0.28–0.49, I2 = 94%, p < 0.01). In the meta-regression analysis of confounding factors, only therapy was determined to be significant in PSA response rate.
Conclusions: ICI therapy exhibits potential efficacy in some patients with prostate cancer. However, its widespread application is limited by its uncertain efficacy and potential adverse reactions. Future research should focus on optimising patient selection through biomarkers and improving ICI treatment strategies to enhance efficacy and safety.
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Background: In clinical practice, the prevalence of upper urinary tract uric acid stones is increasing. This research seeks to pinpoint the factors that contribute to the development of upper urinary tract uric acid stones and create a predictive model for this condition.
Methods: In this study, we retrospectively analysed the clinical records of 267 patients diagnosed with urinary calculi from our hospital’s Department of Urology from January 2019 to May 2024. Patients were categorised into two groups: The uric acid stone in the upper urinary tract group (n = 43) and the other types of stones in the upper urinary tract group (n = 224). We collected general clinical characteristics, urinary test results, liver and kidney function parameters and glucose and lipid metabolism indicators for multivariate logistic regression and receiver operating characteristic (ROC) analysis.
Results: The uric acid stones in the upper urinary tract group showed a substantially higher average body mass index (BMI), a greater proportion of obese patients and more patients with diabetes than the other types of stones in the upper urinary tract group (p < 0.05). Conversely, the urine pH and total protein levels in the former were lower than those in the latter. Moreover, the levels of blood urea nitrogen (BUN), serum creatinine (SCr), uric acid (UA), fasting blood glucose (FBG), total cholesterol (TC) and triglyceride (TG) in the former were higher than those in the latter (p < 0.05). Logistic regression identified BMI, BUN, SCr, UA, FBG and TC as risk factors for uric acid stone formation, with urine pH as a protective factor (p < 0.05). ROC analysis confirmed the high predictive value of these factors (p < 0.05).
Conclusions: BMI, obesity, diabetes, markers of renal function and the indicators of glucose and lipid metabolism play crucial roles as risk factors in the prediction of upper urinary tract uric acid stones. Regularly monitoring these parameters can aid in the prompt detection of upper urinary tract uric acid stones.
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Objective: This study aims to explore the effects of traditional Chinese medicine (TCM) emotional care on improving the urinary incontinence symptoms and quality of life of patients after transurethral resection of the prostate (TURP).
Methods: This retrospective cohort study included urinary incontinence patients who underwent TURP at our hospital from June 2021 to August 2023. The patients were divided into an observation group (receiving TCM emotional care) and a control group (receiving conventional care). Urinary incontinence symptoms, quality of life and psychological status were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Incontinence Quality of Life Questionnaire (I-QOL), the Hamilton Depression Scale (HAMD) and the Hamilton Anxiety Scale (HAMA). Differences between the two groups were analysed using t-tests and repeated measures Analysis of Variance (ANOVA).
Results: A total of 119 patients with post-TURP urinary incontinence were included in this study. In the observation group, the ICIQ-SF score decreased significantly (p < 0.001), whilst the control group also demonstrated improvement (p < 0.001). The I-QOL score in the observation group increased significantly (p < 0.001) compared with the control group (p < 0.001). For psychological health, the HAMD score improved in the observation group (p = 0.012), whilst the control group showed less improvement (p = 0.012). The HAMA score decreased significantly in the observation group (p = 0.029) compared with in the control group (p = 0.029).
Conclusions: TCM emotional care significantly improves outcomes in patients with post-TURP urinary incontinence. It effectively reduces the severity of urinary incontinence, enhances quality of life and alleviates depressive and anxious symptoms.
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Background: Percutaneous nephrolithotomy (PCNL) has become a standard surgical procedure for treating complex renal calculi. This study aims to explore the effect of ultrasound combined with computed tomography (CT) image fusion technology and to guide PCNL for treating complex renal calculi.
Methods: A total of 130 patients with complex renal calculi who were admitted in our hospital from April 2021 to April 2023 were selected. After excluding four cases who did not meet the inclusion criteria, 126 cases were finally included. Based on the different treatment paths of PCNL, patients were divided into two groups. Among them, 60 patients who received CT guidance combined with ultrasound image fusion technology were selected as the observation group, and 66 patients who received routine guidance were included in the control group. The perioperative parameters and postoperative complications of patients in both groups were compared.
Results: The observation group had shorter operation time and lower reoperation rate than the control group (p < 0.05). The first calculi clearance rate of the observation group was 88.33%, which was distinctly higher than that of the control group (71.21%, p < 0.05). However, no significant difference in length of hospital stay after surgery was found between the two groups (p > 0.05). The establishment time of a single channel and the average number of puncture channels were lower in the observation group than in the control group (p < 0.05). The success rate of establishing an initial channel in the observation group was 93.33%, which was significantly higher than that in the control group (80.30%, p < 0.05). The observation group had a significantly higher postoperative hemoglobin level than the control group (p < 0.05). No significant difference in serum creatinine level was found between the two groups (p > 0.05). The postoperative incidence of complications in the observation group was 6.67%, which was distinctly lower than that in control group (19.70%, p < 0.05).
Conclusions: The combination of CT and ultrasound image fusion technology for PCNL in the treatment of complex renal calculi demonstrates good clinical efficacy and high safety.
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Objective: This study explored an infection control management mode effect that prevents catheter-associated urinary tract infection (CAUTI) in an intensive care unit (ICU).
Methods: A retrospective cohort study was conducted on patients who received indwelling catheters from February 2020 to February 2022 in the ICU ward. Patients were categorised into two groups, including the study (implemented the infection control management model) and reference groups (received the usual clinical management protocols), based on different clinical management protocols. The CAUTI results at different moments of the patients’ lives were examined, and the groups were compared in terms of CAUTI incidence, catheter retention time, Family Satisfaction with Care in the Intensive Care Unit-24 (FS-ICU-24) and Acute Physiology and Chronic Health Evaluation II (APACHE-II).
Results: A total of 102 patients were included in this study, with 48 and 54 allotted to the study and reference groups, respectively. No significant difference in the CAUTI control rate was found between the groups at 2 and 5 days (p > 0.05), whereas the CAUTI control rate at 7 days in the study group was significantly lower than that in the reference group (p < 0.05). The FS-ICU-24 score of the study group was significantly higher than that of the reference group, whereas the APACHE-II score was significantly lower (p < 0.001). The study group’s catheter retention and ICU treatment times were significantly lower than those of the reference group (p < 0.001).
Conclusions: The implementation of infection control management mode can effectively reduce the incidence of CAUTI in ICU patients, improve clinical satisfaction and shorten catheter retention time, and thus, it exhibits a certain clinical application value.
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Background/Purpose: Addressing perioperative anxiety, pain and restlessness and promoting family involvement through the family-centred care (FCC) model and video education may lead to improved postoperative outcomes. This study aimed to evaluate the effect of combining the FCC model with video education on the postoperative recovery of paediatric patients who underwent urological surgery.
Methods: This prospective randomised controlled study enrolled 200 paediatric patients who were undergoing general anaesthesia and recovery in the post-anaesthesia care unit at The First Affiliated Hospital of Sun Yat-sen University from January to April 2024. They were randomly assigned to Group A (routine care), Group B (routine care + video education), Group C (routine care + FCC model) and Group D (routine care + video education + FCC model), with 50 cases in each group. Various indicators, including recovery trajectory, agitation and pain scores, psychological states and treatment compliance, were assessed and compared amongst the groups.
Results: In the analysis of recovery trajectories, no significant differences were found amongst the groups in terms of time to resume breathing and extubation duration (p > 0.05). However, a notable distinction was observed in the recovery time of anaesthesia across the groups (p < 0.001). Compared with Groups B and C, Group D exhibited significant improvement in agitation and pain scores (p < 0.05). In addition, Group D had significantly lower anxiety level and higher treatment compliance than Groups B and C (p < 0.05).
Conclusions: The combined approach of the FCC model and video education may improve postoperative recovery outcomes in paediatric patients who underwent urological surgery. Hence, this approach is worth promoting and applying in clinical practice.
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Background: Bladder cancer is a common malignancy that arises from the urothelium. Treatment options for advanced bladder cancer remain limited, particularly in patients who have progressed after first-line therapy. Immunotherapy with programmed death-ligand 1 (PD-L1) inhibitors, such as durvalumab, has shown promise in improving outcomes in these patients. Radiotherapy (RT) is another modality that can be integrated to enhance local tumour control. This study explored the efficacy and safety of combining durvalumab with RT as a second-line treatment for patients with advanced bladder cancer, aiming to provide insights into its potential therapeutic benefits. Bladder cancer is a type of malignant tumour that arises from the epithelial lining of the bladder and commonly manifests as haematuria and frequent urination.
Methods: A total of 58 patients who were diagnosed with advanced bladder cancer and treated at our hospital between January 2020 and June 2022 were retrospectively analysed. Patients were divided into two groups: A control group (n = 33) receiving durvalumab monotherapy and an observation group (n = 25) receiving durvalumab combined with RT. The remission rates, two-year survival rates, median survival times, serum tumour marker levels and adverse events of the two groups were compared.
Results: Before treatment, the differences in the serum tumour marker levels between the two groups (p > 0.05) were not significant. Compared with the control group, the observation group presented significantly lower serum tumour marker levels (p < 0.05). Furthermore, compared with the control group, the observation group had a higher overall clinical objective response rate (96.00% vs. 75.76%) and a better two-year survival rate (40.00% vs. 15.15%). Additionally, progression-free survival (PFS) was longer in the observation group (18 months vs. 16 months, p = 0.001).
Conclusions: Durvalumab combined with RT as a second-line treatment for advanced bladder cancer effectively reduces the expression of tumour markers and improves two-year survival and PFS, offering valuable clinical insights.
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Background: Extracellular microRNA (miRNA) (exosomal miRNA) embedded in exosomes plays a vital role in the progression of calcium oxalate disease. This study aimed to identify dysregulated miRNA expression profiles and their biological functions in the urinary exosomes of patients with calcium oxalate.
Methods: Ultrahigh-speed centrifugation and Illumina high-throughput sequencing were used to isolate and detect the expression levels of exocrine miRNAs in urine samples from 10 patients with calcium oxalate stones and 10 matched normal persons, and construct their differential expression profiles. Bioinformatics analysis of differentially expressed genes was carried out to determine the main biological functions of differentially expressed miRNAs and their possible signal pathways.
Results: Compared with normal people, 38 miRNAs in the urinary exosomes of patients with calcium oxalate stones showed significantly abnormal expression levels, of which 18 were up-regulated and 20 were down-regulated. Gene Ontology (GO) enrichment analysis showed that the differentially expressed miRNAs were related to biological processes such as calcium transport, inflammation, injury, oxidative stress and adhesion. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the differentially expressed miRNAs may participate in the occurrence and development of calcium oxalate stones through cytokines and inflammatory response-related signalling pathways such as chemokine signalling pathway, phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-protein kinase B (AKT) signalling pathway, mitogen-activated protein kinases (MAPK) signalling pathway and Rat sarcoma (RAS) signalling pathway.
Conclusions: The expression profile of miRNA in the urine exosomes of patients with calcium oxalate stones changed significantly. miRNAs, such as miR-130b, miR-192, miR-194 and miR-499, may play important roles in the occurrence and development of calcium oxalate stones through cytokines and inflammatory response-related signal pathways, including chemokine, PI3K-AKT, MAPK and RAS.
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