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Penile cancer (PeCa) ranks as the 30th most prevalent cancer globally, predominantly affecting populations in developing countries. Phimosis and Human Papillomavirus (HPV) infection are recognized as the primary risk factors. Early-stage diagnosis typically warrants limited excision or non-invasive therapies. However, recent research into the carcinogenesis, tumour microenvironment, and the role of the host immune system in its development suggests that immunotherapy could be a promising treatment for PeCa. The rarity of the disease, combined with the success of standard treatments and the fact that many patients in clinical trials lack alternative options, contributes to the challenges in patient recruitment for these studies. Additionally, the psychological burden stemming from the stigma associated with such an aggressive genital disease and the preference for quicker treatment options, such as surgery with reconstructive procedures, exacerbates these recruitment difficulties. This systematic review aimed to explore various immunotherapy approaches in treating PeCa to elucidate the potential role of immunotherapy in this context. The literature was sourced from freely accessible, full-text randomized controlled trials, non-randomized controlled trials, and original articles published in English between 2017 and 2023. Eligible clinical trials were required to be in phase 2 and have published results. Although only one study met the inclusion criteria—a significant limitation—the objective response rate recorded was 6% across nineteen patients with different tumour histologies, of which only six had PeCa. Currently, other studies are either recruiting or ongoing, necessitating further observation, as results from a single study cannot be generalized to the broader population.
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Background: We aimed to assess the rates of urethral stricture in transplant recipients, analyse patients with urethral strictures and present the posttreatment follow-up outcomes.
Methods: Between 2004 and 2023, a retrospective examination was conducted on kidney transplant recipients who underwent removal of ureteral catheters through retrograde cystoscopy at our facility or referred from external centres. The collected data encompassed patient demographics, pre- and posttransplant maximum urinary flow rate, specifics of stenosis, surgical interventions and outcomes from a 1-year follow-up. The treatment approach for urethral strictures was contingent on the severity, length and location, which encompass methods, such as dilation and transurethral internal urethrotomy. Urethra reconstruction was performed to address the instances of recurring strictures. Treatment decisions were made in accordance with established guidelines, which evolved with contemporary methodologies throughout the study period.
Results: This study included 497 transplant patients, with a 3.4% rate of urethral strictures observed in 17 patients (average age: 39.8 years). All patients with urethral stricture were male. Posttransplant, cystourethroscopy aided catheter removal and retrograde urethrography diagnosed membranous urethra strictures in 64.7% of the patients. The average stricture length was 1.05 cm. The symptoms varied, and 64.7% were asymptomatic. Treatment comprised dilatation (23.5%), internal urethrotomy (70.5%) and urethroplasty (5.8%). The average maximum urinary flow rate at 3 and 12 months postoperatively reached 22.2 (range: 14–30) and 19.1 (range: 16–26), respectively.
Conclusions: Urethral strictures post kidney transplantation are uncommon and can be safely and efficiently managed through urethral dilation, internal urethrotomy or urethra reconstruction. Mitigation of the risk of this complication involves the prevention of iatrogenic injuries and minimization of catheterisation duration.
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Purpose: Urinary tract infections (UTIs) in neonates pose notable challenges in diagnosis and management because of non-specific clinical manifestations and unique physiological characteristics. Understanding the clinical features and pathogen characteristics of UTIs in this population is crucial for tailored diagnostic and therapeutic strategies. This study aimed to investigate varying clinical features and pathogen characteristics of UTIs, thereby offering a holistic perspective on the multifaceted aspects of UTIs in neonates.
Methods: We retrospectively analysed the clinical data of 57 neonates with UTIs admitted to the neonatology department of our hospital from December 2013 to December 2023. Examination methods included aseptic urine collection for bacterial culture, urinalysis and blood tests.
Results: The study revealed that the majority of UTI cases in neonates were initial infections (54.39%), with 45.61% experiencing second or more episodes. Clinical characteristics varied based on gestational age, with premature infants exhibiting a higher incidence of fever (85.71%) compared with full-term and large-for-gestational-age infants. Urinary system malformations were prevalent, with pelviureteric junction obstruction being the most common (29.82%). Urinalysis indicated a high prevalence of positive nitrite tests (59.65%) and elevated white blood cell counts. The 57 presented 2 mixed infection (bacterial colony = 59). Pathogenic bacteria analysis revealed Escherichia coli (40.68%) and Enterococcus spp. (33.90%) as the most prevalent strains. Antibiotic susceptibility testing showed varying susceptibility profiles among bacterial species, emphasising the importance of tailored antibiotic selection based on resistance patterns.
Conclusions: This study provides valuable insights into the diverse clinical presentations, bacterial aetiology and antimicrobial resistance patterns of UTIs in neonates. The findings underscore the critical need for tailored approaches to diagnosis, management and prevention of UTIs in neonates, taking into account their unique characteristics and the complex nature of UTIs in this vulnerable patient population.
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Background: Kidney stone disease poses a significant challenge in the geriatric population. Preoperative renal function has been speculated to influence the composition of renal calculi, and consequently, the management approach. We studied the correlation between preoperative renal function and the composition of renal calculi in elderly patients, which could have implications for optimizing therapeutic strategies.
Methods: This retrospective cohort study investigated patients aged 60 years and older who were hospitalized for kidney stones from January 2021 to December 2023. Based on their preoperative renal function, patients were categorized into two groups: Those with normal renal function (reduced glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2) and those with abnormal renal function (eGFR <90 mL/min/1.73 m2). The composition of renal stones was determined through infrared spectroscopy. In addition, data on demographics, kidney stone size, location, number, and biochemical profiles were collected and analyzed.
Results: A total of 1154 elderly patients with kidney stones were included, comprising 903 patients with normal renal function and 251 with abnormal renal function. The mean ages for the normal renal and abnormal renal function groups were (72.25 ± 5.67) and (71.82 ± 4.92) years, respectively. Stone composition analysis revealed significant differences between the two groups. Patients with abnormal renal function had a higher occurrence of uric acid stones (11.16% vs. 6.76%, p = 0.029) and a lower occurrence of calcium oxalate stones (42.63% vs. 51.50%, p = 0.016). Moreover, the abnormal renal function displayed significantly elevated serum creatinine levels (1.92 ± 0.75 mg/dL vs. 0.87 ± 0.21 mg/dL, p < 0.001), lower eGFR (38.24 ± 12.67 mL/min/1.73 m2 vs. 108.53 ± 15.42 mL/min/1.73 m2, p < 0.001), and higher urea levels (32.18 ± 9.74 mg/dL vs. 16.25 ± 4.68 mg/dL, p < 0.001).
Conclusions: This study highlights a significant association between preoperative renal function and the composition of renal calculi in geriatric patients. Abnormal renal function is linked to a higher occurrence of uric acid stones and a reduced occurrence of calcium oxalate stones, alongside notable alterations in biochemical profile.
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Background: Hemorrhage is the most common and dangerous complication after percutaneous nephrolithotripsy (PCNL). Therefore, this study introduces the management experience of bleeding complications in our center.
Methods: This retrospective study included 77 patients with severe bleeding after PCNL. Forty patients were included in the conservative group, 13 in the transfusion group, and 24 in the embolization group. The characteristics of postoperative bleeding were analyzed, including changes in hemoglobin and hematocrit, bleeding inducement, bleeding management, and clinical results.
Results: Forty patients received conservative treatment. Their mean hemorrhage time was 6.5 days (range, 3–14 days), and their mean decreased hemoglobin was 33.8 g/L (range, 13–61 g/L). Thirteen patients received only conservative treatment and blood transfusions. Their mean hemorrhage time was 11 days (range, 2–17 days), and their mean decreased hemoglobin was 49 g/L (range, 25–85 g/L). Twenty-four patients required renal angiography and renal artery embolization (RAE). Their average time from PCNL to RAE was 11 days (range, 3–25 days). Hemoglobin levels decreased by an average of 52.8 g/L (range, 19–89 g/L). A decrease in hematocrit ≥14.65% was a significant indicator for post-PCNL RAE.
Conclusions: A decreased hemoglobin level can be used as a reference for decisions regarding embolization; However, it should not be used as an absolute criterion. Conservative treatment and embolization are effective for achieving hemostasis. Appropriate treatment methods should be comprehensively determined based on clinical manifestations, bleeding inducement, and blood index changes.
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Background: Urinary tract stones present significant health risks to pregnant women and their foetuses. However, the specific risk factors contributing to stone formation during pregnancy, particularly within the Chinese population, remain poorly understood. This retrospective survey aimed to identify demographic, clinical, and obstetric risk factors associated with urinary tract stones in pregnant women at a tertiary hospital in China.
Methods: The study population included pregnant women admitted to our hospital between May 2022 and July 2023. Participants were categorised into a control group and a stone group based on the presence of urinary tract stones. The study assessed demographic, clinical, obstetric, urinary, and blood chemistry parameters to identify risk factors for urinary tract stones during pregnancy. Statistical analyses, including logistic regression and correlation analyses, were used to examine the associations between these variables and urinary tract stone formation.
Results: A total of 102 pregnant women were included in the study, with 67 in the control group and 35 in the stone group. The stone group demonstrated a significantly higher body mass index (odds ratio (OR) = 1.407, 95% confidence interval (CI) 1.015–1.949, p = 0.040) and a higher prevalence of diabetes mellitus (OR = 0.437, 95% CI 0.635–0.689, p < 0.001), hypertension (OR = 0.017, 95% CI 0.000–0.614, p = 0.026), and a history of urinary tract stones (OR = 0.104, 95% CI 0.014–0.277, p = 0.027) compared to the control group. Additionally, the stone group exhibited higher levels of urinary calcium (OR = 1.089, 95% CI 1.009–1.174, p = 0.028), urinary oxalate (OR = 1.307, 95% CI 1.021–1.673, p = 0.034), and serum sodium (OR = 2.015, 95% CI 1.200–3.381, p = 0.008), along with significantly lower levels of serum albumin (OR = 0.083, 95% CI 0.014–0.502, p = 0.007). Moreover, the incidence of preterm labour was higher in the stone group (OR = 23.250, 95% CI 1.118–483.587, p = 0.042).
Conclusions: Our study identified several risk factors associated with urinary tract stone formation during pregnancy, including metabolic and renal health parameters, as well as a history of urinary tract stones. These findings underscore the multifactorial nature of stone formation risk during pregnancy and highlight the importance of comprehensive prenatal care.
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Background: Prostate cancer (PCa) is a common malignant tumour in males, with radical prostatectomy (RP) being the typical treatment. The concept of enhanced recovery after surgery (ERAS) and Roy’s adaptation model (RAM) have been proved effective and reliable nursing methods in clinical practice. However, the combined effect of these two methods on patients undergoing RP remains unclear. This study aims to analyse the application effect of ERAS combined with RAM in the perioperative period of patients receiving RP.
Methods: A total of 286 patients with PCa who underwent RP from March 2020 to May 2023 were selected in this retrospective analysis. After excluding five patients, 281 were finally included. According to the administered management methods, the patients were divided into a routine (n = 92), ERAS (n = 93), and ERAS + RAM group (n = 96). The Connor–Davidson Resilience Scale (CD-RISC) score, Quality of Life Questionnaire-Core 30 (QLQ-C30) score, recovery conditions, and the incidences of postoperative complications were compared between the three groups using the chi-square and Kruskal–Wallis tests.
Results: Compared with the routine and ERAS groups, the ERAS + RAM group had significantly higher CD-RISC scores 1 day before surgery and 1 day before discharge and elevated QLQ-C30 scores 3 months after discharge, along with the shortest postoperative recovery time (all p < 0.001). Complication incidences in the ERAS + RAM and ERAS groups were lower than those in the routine group (p < 0.05).
Conclusions: The ERAS concept combined with RAM can significantly improve perioperative mental health, promote postoperative recovery, and enhance the quality of life in patients with PCa undergoing RP. Therefore, this combined programme offers certain benefits in the perioperative period of RP, emphasising the value of its clinical promotion.
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Purpose: Urinary tract infections (UTIs) frequently occur in patients with type 2 diabetes mellitus (T2DM), presenting a complex pathogenesis that significantly impairs patient quality of life. Despite the availability of various clinical treatments, challenges remain regarding their efficacy and safety. Therefore, this retrospective study aimed to observe the therapeutic effects of Re-Lin-Qing granules in treating T2DM complicated by UTIs, aiming to provide more scientifically validated and effective treatment options for clinical practice.
Methods: A retrospective analysis was conducted on 115 patients with T2DM complicated by UTIs to compare the efficacy of routine treatment alone (routine group, n = 56) vs. routine treatment combined with Re-Lin-Qing granules (combined treatment group, n = 59). Baseline characteristics, UTI parameters, inflammatory marker levels, and adverse events were evaluated.
Results: The combined treatment group demonstrated lower leukocyte counts in urine (120.28 ± 30.14 cells/µL vs. 100.23 ± 25.16 cells/µL, p < 0.001), a reduced percentage of positive nitrite in urine (39.29% vs. 20.34%, p = 0.043), and a lower rate of positive urine cultures (55.36% vs. 33.90%, p = 0.033) for bacteria compared to the routine group. Additionally, inflammatory marker levels, including C-reactive protein (14.68 ± 1.25 vs. 14.15 ± 1.09, p = 0.017) and interleukin-6 (4.29 ± 0.81 vs. 3.97 ± 0.75, p = 0.028), were significantly lower in the combined treatment group. The occurrence of adverse events did not differ significantly between the two groups (p > 0.05).
Conclusions: The study provides evidence supporting the potential therapeutic benefits of Re-Lin-Qing granules as an adjunct therapy for T2DM complicated by UTIs. The findings indicate improvements in UTI parameters and inflammatory markers in the combined treatment group, highlighting the potential clinical benefits of incorporating Re-Lin-Qing granules into managing these comorbid conditions.
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Background: Doxorubicin (DOX) is a widely used anticancer drug; However, its nephrotoxicity limits its therapeutic efficacy. This study investigates the protective effects of Perilla Alcohol (PA) against DOX-induced nephrotic syndrome (NS), focusing on its antioxidant and anti-inflammatory properties through the nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways.
Methods: A DOX-induced nephrotic syndrome (NS) rat model and a DOX-treated Mouse Podocyte Cell line 5 (MPC5) cell model were used to evaluate the renal protective effects of PA. The rat model was divided into control, DOX, DOX + Prednisone, DOX + PA (50 mg/kg) and DOX + PA (100 mg/kg) groups. The effects of PA were assessed by measuring urinary protein excretion, blood biochemical markers, serum urea nitrogen, creatinine levels, cell viability, mitochondrial function and oxidative stress status. Additionally, Western blot and immunofluorescence staining were used to examine Nrf2 nuclear translocation, NF-κB signalling pathway, and intracellular antioxidant protein expression.
Results: Compared to the DOX group, rats in the DOX + PA groups showed significant reductions in 24-hour urinary protein and improvements in blood biochemical parameters (p < 0.01), indicating that PA enhanced renal function. At the cellular level, PA mitigated DOX-induced damage in MPC5 cells (p < 0.05, p < 0.01, and p < 0.001). Moreover, PA alleviated podocyte injury caused by DOX, reduced intracellular reactive oxygen species levels and improved mitochondrial membrane potential (p < 0.05, p < 0.01, and p < 0.001). Mechanistic studies revealed that PA protects against DOX-induced renal injury by inhibiting the NF-κB signalling pathway and restoring podocyte protein expression, while also alleviating oxidative stress through the activation of the Nrf2/antioxidant response element (ARE) pathway, contributing collectively to its protective effects (p < 0.05, p < 0.01, and p < 0.001).
Conclusions: PA ameliorates DOX-induced NS by modulating the NF-κB and Nrf2/ARE pathways, reducing oxidative stress. These findings provide a theoretical and experimental basis for the potential use of PA in preventing and treating DOX-induced renal injury, with implications for drug development and clinical applications.
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Objective: Patients with urological tumours frequently experience compromised quality of life and mental health issues. This study aimed to evaluate the impact of a primary caregiver training programme conducted by a community health service centre on these patients.
Methods: This retrospective study assessed a primary caregiver training programme for patients with urological tumours conducted across ten community health centres in China over 6 weeks from March 2020 to March 2024. Patients were divided into control and observation groups based on their programme completion. Both groups were assessed for quality of life, nutritional status, and mental health after the programme to determine the programme’s effectiveness.
Results: This study included 95 patients, 46 in the control group and 49 in the observation group. Before the training, no significant differences were observed between the groups in terms of baseline characteristics, Nutritional Risk Screening 2002 (NRS2002), or Self-Assessment Scale for Anxiety (SAS) scores (p > 0.05). Post-training, the observation group showed significantly better quality of life scores, reduced nutritional risk, and improved SAS scores than the control group (p < 0.05 for all comparisons).
Conclusions: A 6-week primary caregiver training programme in community health centres significantly improves the quality of life and mental health of patients with urological tumours, warranting further implementation.
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Background: This study aimed to explore factors affecting adherence to targeted therapy in patients with renal cell carcinoma, focusing on the fear of adverse drug reactions.
Methods: This retrospective case-control study selected patients with renal cancer who received targeted therapy at our hospital from June 2021 to April 2023, categorising them based on their adherence to oral targeted drugs.
Results: Patients with good compliance reported significantly lower levels of fear related to disease progression and adverse drug reactions (p < 0.05). This group showed greater perceived necessity of medication, fewer concerns about medication, and higher trust in their prescribed treatments (p < 0.05). Furthermore, while these patients rated their relationships with doctors lower, their perceptions were more positive overall (p < 0.05). Moreover, they reported more robust social support networks (p < 0.05). The heightened impact of the disease on their lives led them to adopt more proactive coping strategies (p < 0.05). The incidence of drug-related events at 1, 3, 6, 9, and 12 months was significantly lower in the good compliance group than in the poor compliance group (p < 0.001). Fear of adverse drug reactions emerged as an independent predictor of compliance (p < 0.001).
Conclusions: Adherence to targeted cancer therapy is significantly influenced by fear of adverse drug reactions, with psychological factors, patient-provider relationships, and the personal impact of the disease playing crucial roles.
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Background: Targeted therapies, including axitinib, a vascular endothelial growth factor receptor inhibitor, and sintilimab, a programmed cell death protein-1 inhibitor, have shown promise in the treatment of advanced renal cell carcinoma (RCC). Although their individual efficacies have been demonstrated, the potential synergistic effects of combining these two agents are still being explored.
Methods: This study retrospectively analysed patients with advanced RCC admitted to our hospital from January 2022 to December 2023. Based on their adopted treatment, the patients were divided into an axitinib group or an axitinib plus sintilimab group. The progression-free survival (PFS), objective response rate, quality of life (QoL) score, laboratory indexes, and adverse reactions of the patients were compared between the two groups.
Results: A total of 34 patients, including 19 who received axitinib alone and 15 who were treated with combined axitinib and sintilimab, were included. The axitinib plus sintilimab group exhibited a significantly higher PFS than the axitinib group (17.00 ± 0.25 months vs 12.15 ± 0.26 months, p < 0.001). The combination treatment group also exhibited superior outcomes in various QoL domains, including physical, role, emotional, and cognitive function, social capabilities, and overall health status/QoL and lesser impacts on fatigue and financial concerns compared to those of the axitinib group. Additionally, the patients in the combination treatment group experienced diminished symptomatology in terms of decreased nausea, vomiting, pain, breathing difficulties, sleep disturbances, appetite reduction, constipation, and diarrhoea. Furthermore, assessment of the haemoglobin, platelet count, serum creatinine, Alanine aminotransferase, and Aspartate aminotransferase values revealed no significant differences between the two treatment groups (p > 0.05). Finally, no significant differences in adverse reaction incidence were observed between the two groups (p > 0.05).
Conclusions: Combination therapy with axitinib and sintilimab demonstrated enhanced anti-tumour activity, improved disease control, and a favourable safety profile, underscoring its potential as a valuable therapeutic approach in advanced RCC management.
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Background: Neurogenic bladder dysfunction is a common consequence of stroke, and it substantially impacts the quality of life and functional independence of affected individuals. Traditional treatment modalities have limitations in achieving optimal outcomes. This study aims to explore the effects of electroacupuncture treatment on bladder function and neurogenic bladder urodynamic characteristics in stroke patients.
Methods: A retrospective analysis was conducted on 100 stroke patients with neurogenic bladder admitted to our hospital from January 2020 to October 2023 to compare traditional treatment (n = 51) with electroacupuncture treatment (n = 49). Baseline characteristics, urodynamic parameters, bladder function parameters, bladder symptoms, quality of life assessments, adverse events and patient satisfaction were collected from medical records and compared between the two groups.
Results: No significant difference was observed in age, sex distribution, body mass index, duration of stroke and alcohol intake between the two groups (p > 0.05). Compared with the traditional treatment group, the electroacupuncture group showed significant improvements in urodynamic parameters such as maximum cytometric capacity, detrusor pressure at maximum capacity, postvoid residual volume, bladder compliance, maximum flow rate and average flow rate, and the differences were significant between groups (p < 0.05). The electroacupuncture treatment group showed a significant reduction in bladder symptoms such as frequency of micturition and incontinence episodes (p < 0.001) and a significant improvement in cognitive function and social return function (p < 0.05). The incidence rates of urinary tract infection, haematuria, skin allergy and treatment discontinuation in the electroacupuncture treatment group (6.12%, 2.04%, 4.08% and 12.24%, respectively) were significantly lower than those in the traditional treatment group (23.53%, 27.45%, 29.41% and 35.29%, respectively) (p < 0.05). The patient satisfaction score in the electroacupuncture treatment group (97.96%) was significantly higher than that in the traditional treatment group (70.58%) (p < 0.001).
Conclusions: Electroacupuncture has certain clinical value and holds promise as an adjunctive treatment for neurogenic bladder dysfunction in stroke patients.
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Objective: This study aimed to explore the application effect of superficial large vessel insulation combined with self-heating warm paste on intraoperative hypothermia in patients undergoing urologic surgery.
Methods: This study included 313 patients who underwent urologic surgery in Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University from May 2023 to March 2024. After 13 patients with incomplete clinical data, abnormal basal metabolism and preoperative skin injury were excluded, 300 patients were finally included. In accordance with the intraoperative methods of insulation, the patients were divided into three groups: Conventional insulation group (group A, n = 102), superficial large vessel insulation group (group B, n = 100) and superficial large vessel insulation combined with self-heating warm paste group (group C, n = 98). Baseline data, intraoperative core temperature, and incidence of intraoperative hypothermia, intraoperative skin injury and postoperative chills in patients were retrospectively evaluated.
Results: A difference was found in the core temperature amongst the three groups at 1, 2 and 3 h after anaesthesia. The core temperature in groups A and B was overtly lower than that in group C (p < 0.001). No statistically significant difference was observed in the incidence of intraoperatively acquired pressure injury amongst patients in groups A–C (p > 0.05). The incidence of thermal injury and postoperative shivering in group C was significantly lower than that in groups A and B (p < 0.05).
Conclusions: Broader adoption of superficial large vessel warming combined with self-heating thermal paste is recommended whilst acknowledging that feasibility and resource constraints in various surgical settings may influence practical application. Future research should focus on the implementation of these techniques in different clinical environments and their associated resource requirements.
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Background: Perivascular epithelioid-cell tumour (PEComa) is a rare mesenchymal tumour with low malignant potential. PEComa can be found in many organs throughout the body. In the urinary system, it can be found in the prostate, bladder, and kidney. Given the rarity of bladder PEComas, a multidisciplinary approach is often required for diagnosis, encompassing radiological imaging, histopathological examination, and immunohistochemical staining.
Methods: A 3 cm-diameter mass outside the bladder but related to the anterolateral wall of the bladder was excised by laparoscopic method. A minimally invasive approach was selected to minimise the potential for complications and to preserve bladder function.
Results: The case was diagnosed as PEComa based on the findings of the histopathological examination. Immunohistochemical analysis demonstrated robust positivity for melanocytic and myogenic markers, thereby substantiating the diagnosis. No clear algorithm for disease management was found. However, the patient, who did not have any malignancy criteria specified in literature, was followed up for about 19 months without any problems.
Conclusions: This case highlighted the importance of considering PEComa in the differential diagnosis of bladder masses, even in asymptomatic patients. Further research and case studies are needed to establish a clear management algorithm for PEComa in the urinary system. We present a case of asymptomatic, incidentally detected bladder PEComa in a 27-year-old male patient.
