28 January 2024, Volume 77 Issue 1
    

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  • Review
    Martina Sande-Rivadulla, Alejandra Alonso-Calvete, Mercedes Soto-González
    Archivos Españoles de Urología. 2024, 77(1): 1-15. https://doi.org/10.56434/j.arch.esp.urol.20247701.1
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    Introduction: Prostate cancer is one of the most frequently diagnosed cancers in males. Treatment options cause a series of side effects that can lead to a deterioration in the physical and quality of life of patients, such as musculoskeletal changes, atrophy or muscle weakness, due to the testosterone suppression. Scientific evidence has shown that exercise mitigates the side effects induced by cancer treatment. This study aimed to analyse the effects of muscular strength work on the organism of patients with prostate cancer in the treatment phase.

    Material and Methods: PubMed, Scopus, SPORTDiscus, CINAHL, Medline, Web of Science and PEDro databases were searched in January 2022. The Medical Subject Headings “resistance training”, “prostatic neoplasms”, “strength training” and “prostate cancer” were used.

    Results: A total of 13 articles were analysed. In all of them, statistically significant changes were found in strength, physical performance, muscle mass and cardiovascular and respiratory health after the implementation of a strength exercise program. Other variables did not achieve the expected changes.

    Conclusions: A strength exercise program improves strength, physical performance, muscle mass and cardiovascular health in patients with prostate cancer. However, whether it improves other parameters, such as body fat, power, bone density and quality of life, is unclear.

  • Article
    Zhe Zhang, Xiaoyi Liu, Peiyi Ye, Chao Xie, Yaozhong Kong
    Archivos Españoles de Urología. 2024, 77(1): 16-24. https://doi.org/10.56434/j.arch.esp.urol.20247701.2
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    Aim: The purpose of this study was to determine efficacy and safety of hydroxychloroquine (HCQ) for patients with IgA nephropathy (IgAN).

    Methods: PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Wanfang database, Chinese National Knowledge Infrastructure and VIP database up to February 2023 were searched for associated studies comparing HCQ with any other nonHCQ for treating IgAN. The effects of proteinuria, a 50% decrease in proteinuria, estimated glomerular filtration rate (eGFR) and adverse events in patients with IgAN were examined in a meta-analysis. Data were extracted and pooled using RevMan 5.3.

    Results: Three randomized controlled trials (RCTs), two retrospective and two prospective studies (675 patients) that matched our inclusion criteria were identified. Compared with a control group, HCQ significantly reduced proteinuria (mean difference (MD): −0.26, 95% confidence interval (CI): −0.44 to −0.08, p < 0.01). Patients receiving HCQ plus renin-angiotensin system inhibitors (RASSi) had a better efficacy in proteinuria alleviation and a 50% decrease in proteinuria compared with control groups (MD: −0.38, 95% CI: −0.50 to −0.25, p < 0.001 and relative risk (RR) = 3.31, 95% CI: 1.73 to 6.36, p < 0.001). No appreciable variations were observed in eGFR between HCQ groups and control groups in treating patients with IgAN (MD: −2.00, 95% CI: −4.36 to 0.36, p = 0.10). Moreover, no serious adverse events were observed during HCQ treatment.

    Conclusions: Our results indicate HCQ is an efficient, secure treatment for IgAN.

  • Article
    Ning Liu, Chen Su, Jianghua Xue
    Archivos Españoles de Urología. 2024, 77(1): 25-30. https://doi.org/10.56434/j.arch.esp.urol.20247701.3
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    Objective: This study aims to analyse the clinical value of computed tomography (CT) scanning parameters combined with serum teratoma-derived growth factor-1 (Cripto-1) in the diagnosis of renal cell carcinoma (RCC).

    Methods: A retrospective analysis was conducted on 256 patients with renal tumour admitted to our hospital from July 2020 to December 2022. They were divided into malignant group (n = 180) and benign group (n = 76) based on the final pathological results. All subjects underwent CT scans and serum Cripto-1 testing. The CT signs and serum Cripto-1 levels of the patients were analysed, and their diagnostic efficacy was evaluated.

    Results: The pathological diagnosis results showed 180 cases of malignant tumours, including 73 cases of clear cell carcinoma, 60 cases of papillary RCC and 47 cases of chromophobe cell carcinoma as well as 76 cases of benign tumour, including 31 cases of renal angiomyolipoma, 25 cases of eosinophilic tumour and 20 cases of renal fibroma. The malignant group had significantly higher incidence of cystic necrosis, uneven enhancement and rapid progression than the benign group (p < 0.01). The incidence of calcification was not statistically different between the two groups (p > 0.05). The malignant group had lower CT value of focus (p < 0.01) and relative corrected CT value of the renal cortex (p < 0.05), and significantly higher serum levels of Cripto-1 (p < 0.01) than the malignant group. The area under the curve of the combined diagnosis was significantly higher than that of serum Cripto-1 alone and comprehensive diagnosis of CT parameters (pcombined diagnosis vs serum Cripto−1 < 0.001, pcombined diagnosis vs comprehensive diagnosis of CT parameters = 0.002). The sensitivity of the combined diagnosis was also higher than that of serum Cripto-1 and CT parameters alone.

    Conclusions: The combination of CT scanning parameters and serum Cripto-1 has high value in the diagnosis of renal tumours, and the area under the curve and sensitivity of the combined diagnosis are high. This work provides reference for clinical diagnosis and treatment of renal tumours.

  • Article
    Rongfu Lin, Xinyang Fu, Jianhou Huang
    Archivos Españoles de Urología. 2024, 77(1): 31-37. https://doi.org/10.56434/j.arch.esp.urol.20247701.4
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    Objective: This study aims to explore the changes of serum vascular endothelial growth factor (VEGF) and folate receptor-α (FR-α) levels in patients with bladder cancer before and after treatment with toripalimab and to analyse the relationship between the changes of VEFG and FR-α and the clinical efficacy of patients.

    Methods: A total of 176 patients with bladder cancer admitted to our hospital from January 2020 to January 2022 were selected as the research subjects. All patients were treated with toripalimab. The clinical efficacy and changes of serum VEGF and FR-α levels before and after treatment were observed. Logistic regression was used to analyse the relationship between serum VEGF and FR-α levels and the therapeutic effect of toripalimab, and receiver operating characteristic curve was used to evaluate the predictive value of serum VEGF and FR-α on the efficacy.

    Results: The objective response rate and disease control rate after treatment were 31.82% and 70.45%, respectively. The serum VEGF and FR-α levels in patients after treatment were significantly lower than those before treatment (p < 0.001). The patients were divided into an effective group (n = 124) and an ineffective group (n = 52) according to clinical efficacy. The serum VEGF and FR-α levels of patients in the effective group were significantly lower than those of the ineffective group (p < 0.001). Logistic regression analysis showed that the elevated levels of serum VEGF (odds ratio = 1.226) and FR-α (odds ratio = 1.384) were the risk factors affecting the therapeutic effect of toripalimab (p < 0.05). The area under curve of the combined prediction of VEGF and FR-α was 0.920, the Youden index was 0.722, the sensitivity was 89.52%, the specificity was 82.69%, and the predictive value was higher than the single detection of VEGF or FR-α (p = 0.001, p < 0.001).

    Conclusions: The changes of serum VEGF and FR-α levels in patients with bladder cancer can predict the therapeutic effect of toripalimab. Before clinical treatment, the detection of the two indicators must be strengthened, and intervention measures must be formulated as early as possible to improve the prognosis of patients.

  • Article
    Yao Ma, Jie Zheng, Luwei Jin, Ting Li, Jin Luan
    Archivos Españoles de Urología. 2024, 77(1): 38-42. https://doi.org/10.56434/j.arch.esp.urol.20247701.5
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    Background: Thoracotomy under general anaesthesia is one of the most difficult surgeries and is prone to result in postoperative complications. This study explored risk factors for postoperative dysuria in patients undergoing thoracotomy under general anaesthesia to provide a reference for the formulation and selection of subsequent clinical management programs.

    Methods: Patients undergoing thoracotomy under general anaesthesia (n = 179) admitted to our hospital from June 2019 to June 2021 were selected. They were divided into dysuria group (n = 79) and normal urination group (n = 100) according to whether they had dysuria after surgery. Logistic regression analysis was conducted to explore risk factors affecting postoperative dysuria.

    Results: Univariate analysis showed that dysuria was related to gender, age, surgical time, intraoperative and postoperative infusion volume, usage time of analgesic pump and retention time of urethral catheter (p < 0.001). Logistic regression analysis showed that male, age ≥60 years, surgical time ≥120 min, intraoperative infusion volume >1200 mL, postoperative infusion volume >800 mL, analgesic pump usage time ≥18 h and urethral catheter retention time of ≥72 h were risk factors for postoperative dysuria.

    Conclusions: The occurrence of postoperative dysuria in patients undergoing thoracotomy under general anaesthesia is related to gender, age, surgical time, intraoperative infusion volume, postoperative infusion volume, usage time of analgesic pump and retention time of urethral catheter. Clinical attention should be given to this patient group, and targeted intervention measures should be implemented.

  • Article
    Mihnea Bogdan Borz, Vlad Horia Schitcu, Nicolae Crisan, Bogdan Petrut, Bogdan Adrian Buhas, Paul Cristian Borz, Dan Valean, Igor Duquesne, Ioan Coman
    Archivos Españoles de Urología. 2024, 77(1): 43-48. https://doi.org/10.56434/j.arch.esp.urol.20247701.6
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    Purpose: This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period.

    Methods: We analysed data from 423 patients who underwent radical prostatectomy between 2016 and 2022, with a cut-off date of March 16, 2020. Patients were categorised into two groups, namely, pre-lockdown (n = 289) and during lockdown (n = 134). Perioperative variables, histopathological findings and oncological outcomes, including prostate-specific antigen (PSA) levels and biochemical recurrence (BCR), were assessed.

    Results: The number of radical prostatectomy increased by 24.26% during lockdown. The study included patients with a mean follow-up of 21 months. A nonsignificant trend towards a higher PSA level at presentation was found (14.22 vs. 12.53 ng/dL, p = 0.216). The International Society of Urological Pathology grade was not significantly different among radical prostatectomy specimens (p = 0.669). Lymph node involvement increased during the COVID-19 period (p = 0.046). The pT classification in prostatectomy specimens increased during the pandemic, but the difference from the pre-pandemic value was not statistically significant. The BCR rates were 24.6% pre-lockdown and 29.9% during lockdown (p = 0.136).

    Conclusions: The COVID-19 pandemic led to poor postoperative results. Through a 2-year follow-up, this research investigated the effect of the pandemic on the oncological outcomes, particularly BCR, of patients who underwent radical prostatectomy. Further extended investigations and multi-institutional studies should be conducted to quantify the effect of the pandemic on various cancer outcomes and inform crisis management strategies.

  • Article
    Meng Liu, Xiufen Ge, Zhen Yan
    Archivos Españoles de Urología. 2024, 77(1): 49-56. https://doi.org/10.56434/j.arch.esp.urol.20247701.7
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    Objective: This study aims to explore the effect of the solution-focused approach on the insight and psychological emotion of patients with nephrotic syndrome (NS).

    Methods: The clinical data of 185 Qingdao Municipal Hospital patients with NS from December 2020 to December 2022 were selected for retrospective analysis. According to different nursing modes, the patients were divided into the control group (CG, conventional nursing, n = 90) and the study group (SG, conventional nursing + solution-focused approach, n = 95). The Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression levels of the patients, and the insight and treatment attitudes questionnaire (ITAQ) was adopted to evaluate their insight. The short form-36 health survey (SF-36) was used to evaluate the patients’ quality of life. The relationship of patients’ anxiety and depression levels with their insight was analysed.

    Results: No statistical difference in the gender, age, body mass index, education level, disease types, hypertension, hyperlipidaemia, oedema, monthly family per capita income and residence indicators of the patients in the two groups (p > 0.05) was found. The SG had distinctly lower HADS-A and HADS-D scores and a significantly higher ITAQ score than the CG after intervention (p < 0.001). After intervention, the physiological function, physiological role, vitality, social function, physical pain, general health, emotional role and mental health scores of the SG were overtly higher than those of the CG (p < 0.05). Results of the Pearson analysis show that the anxiety and depression scores are negatively correlated with the insight scores (r = –0.265, –0.255; All p < 0.001).

    Conclusions: The application of the solution-focused approach to NS patients can improve their insight and anxiety and depression levels with certain clinical application value, providing more directions for the follow-up treatment of NS.

  • Article
    Huandong Zhao, Ruimin Ding, Jiarui Han
    Archivos Españoles de Urología. 2024, 77(1): 57-66. https://doi.org/10.56434/j.arch.esp.urol.20247701.8
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    Objective: This study aimed to investigate the potential of combining cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors with curcumin (Cur), a natural compound known for its anti-aging properties, to enhance the anti-cancer efficacy in prostate cancer (PCa).

    Methods: The cell viability was determined by cell counting kit-8 assay, colony forming assay and cell invasion. The cell cycle and mRNA levels of p16 (cyclin dependent kinase inhibitor 2A, CDKN2A), p21 (cyclin dependent kinase inhibitor 1A, CDKN1A) and Rb (RB transcriptional corepressor) were detected by flow cytometry and quantitative real-time polymerase chain reaction, respectively. SA-β-gal staining and interleukin 6 (IL6) mRNA levels were used to evaluate cell aging. Western blot was used to detect mechanistic targets of rapamycin (mTOR) and signal transducer and activator of transcription 3 (STAT3) pathways. Moreover, Sphere formation assay and mRNA levels of aldehyde dehydrogenase (ALDH) 1A1, CD44 and Nanog were used to determine cell stemness.

    Results: The combination of LY2835219 (LY, CDK4/6 inhibitor) and Cur exhibited a synergistic inhibitory effect on PCa cell proliferation (p < 0.01) and invasion (p < 0.01) and Rb gene expression (p < 0.05), as well as a synergistic promotive effect on p61 expression (p < 0.01), p21 expression (p < 0.01) and cell cycle G1 arrest in PCa cells (p < 0.05) compared with LY or Cur alone. LY and LY + Cur increased the SA-β-gal-stained cells (p < 0.01). mTOR (p < 0.01) and STAT3 pathway (p < 0.01) were decreased by LY + Cur (p < 0.01). Furthermore, LY + Cur conditioned medium (CM) inhibited cell stemness by decreasing cell spheres (p < 0.05), ALDH1A1 (p < 0.01), CD44 (p < 0.01) and Nanog (p < 0.01) compared with LY CM.

    Conclusions: The findings of this study suggested that the combination of CDK4/6 inhibitor and curcumin may have clinical implications for the treatment of PCa.

  • Article
    Diwen Li, Yijun Zhu
    Archivos Españoles de Urología. 2024, 77(1): 67-71. https://doi.org/10.56434/j.arch.esp.urol.20247701.9
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    Background: Acute kidney injury (AKI) is common in patients with sepsis and may result in death. Systemic immune inflammation index (SII) is associated with kidney injury, but its predictive value for AKI in patients with sepsis remains unclear.

    Objective: This study aimed to explore the predictive value of SII in sepsis patients with AKI.

    Methods: From January 2020 to December 2022, 221 patients with sepsis treated in our hospital were retrospectively collected. The patients were divided into AKI group (n = 61) and control group (n = 160). Clinical characteristics and SII level were compared between the two groups, and the predictive value of SII for the occurrence of AKI was analysed.

    Results: The SII level (724.72 ± 235.50 vs. 522.38 ± 205.62, p < 0.001), the serum procalcitonin level (8.13 ± 15.52 vs. 4.52 ± 10.34 µg/L, p < 0.001), and the acute physiology and chronic health evaluation II score (14.26 ± 2.90 vs. 11.62 ± 2.26, p < 0.001) significantly increased in the AKI group compared with the control group, whereas the albumin level significantly decreased (30.60 ± 5.41 vs. 32.49 ± 5.31 g/L, p = 0.019). The receiver operating characteristic curve showed that SII was valuable in predicting AKI in patients with sepsis, with an area under the curve of 0.733 (95% confidence interval: 0.657–0.810, p < 0.001). The continuous renal replacement therapy intervention rate (88.52% vs. 0.00%, p < 0.001), the intervention rate of vasoactive drugs (34.43% vs. 3.75%, p < 0.001), and the hospital mortality rate (16.39% vs. 2.50%, p < 0.001) significantly increased in the AKI group compared with the control group.

    Conclusions: AKI was associated with poor prognosis in patients with sepsis. SII, procalcitonin and acute physiology and chronic health evaluation II (APACHE II) score were valuable in predicting the occurrence of AKI. SII may serve as a new marker in patients with sepsis.

  • Article
    Xinxin Liu, Chunxiao Zhao, Jing Lin, Baolong Liu
    Archivos Españoles de Urología. 2024, 77(1): 72-78. https://doi.org/10.56434/j.arch.esp.urol.20247701.10
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    Objective: This study aims to analyse factors influencing bone metastasis in prostate cancer and the diagnostic value of serum prostate-specific antigen (PSA), and D-dimer (D-D) combined with cystatin C (CysC) in bone metastasis of prostate cancer.

    Methods: Data of 116 patients with prostate cancer admitted to our hospital were retrospectively analysed. They were divided into two groups: Bone metastasis group (46 cases) and non-bone metastasis group (70 cases). Univariate and multivariate logistic regression analyses were used to determine factors influencing bone metastasis in prostate cancer. The values of serum PSA, D-D and CysC were identified using a receiver operating characteristic diagnostic curve.

    Results: Of the 116 patients, 46 had bone metastases and 70 had non-bone metastases. Among 46 patients with bone metastasis, 8 cases (17.39%) had single bone metastasis and 38 cases (82.61%) had multiple bone metastasis. Based on the univariate analysis, bone metastasis was associated with increases in Gleason score, clinical stage, lymph node metastasis, systemic inflammatory response index, fibrinogen to albumin ratio and alkaline phosphatase and fibrinogen levels. The Gleason score was higher than 8 points, the clinical stages ranged from T3 to T4 and the serum levels of PSA, D-D and CysC were higher in the bone metastasis group (p < 0.05). The combined value of serum PSA, D-D and CysC in the diagnosis of bone metastasis in prostate cancer was higher than the three indicators alone.

    Conclusions: Lymph node metastasis in T3–T4 clinical stages with Gleason score >8 was a risk factor for bone metastasis in prostate cancer (all p < 0.05). The risk of bone metastasis in patients with prostate cancer increases with increasing Gleason clinical stage and the occurrence of lymph node metastasis. Serum PSA, D-D and CysC have certain diagnostic value in the diagnosis of bone metastasis, and their combination has the highest value.

  • Article
    Qingchao Li, Xiaolu Su, Liangliang Qing, Wenbo Xu, Yongjin Yang, Chengyu You, Jirong Wang, Zhilong Dong
    Archivos Españoles de Urología. 2024, 77(1): 79-91. https://doi.org/10.56434/j.arch.esp.urol.20247701.11
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    Objective: Given the growing recognition of molecular targets in oncology, this study aimed to examine the expression pattern and prognostic significance of human epidermal growth factor receptor-2 (HER2) in bladder cancer (BC) and the effects of HER2 knockdown on the biological behaviours of BC cells.

    Methods: A total of 126 BC tissue samples and 20 samples of normal bladder mucosa were collected for immunohistochemical staining. The clinicopathological data were obtained from patients with BC. HER2 was knocked down in two BC cell lines (T24 and 5637) using lentiviral delivery of short hairpin RNA (shRNA), referred to as shHER2, with a blank control group (shCtrl) for comparison. A range of assays, including cell counting kit-8, colony formation, transwell, wound healing, and flow cytometry, were performed to assess the effects of HER2 knockdown on the proliferation, migration, cell cycle entry, and apoptosis of BC cells.

    Results: The study revealed a notable overexpression rate of HER2 in BC tissues (57.1%) than in normal bladder mucosa (0%) (p < 0.001). HER2 overexpression was associated with tumour number (p < 0.0001), pathological grade (p < 0.0001), lymph node metastasis (p = 0.040), distant metastasis (p = 0.037), overall survival (p = 0.0006), and recurrence-free survival (RFS) (p < 0.0001). In contrast, no significant association was identified between HER2 overexpression and demographic factors such as sex (p = 0.687), age (p = 0.430), tumour size (p = 0.053), or T stage (p = 0.134). Furthermore, the experimental knockdown of HER2 in BC cells inhibited the proliferation and migration and promoted their apoptosis and cell cycle arrest in the G1 phase.

    Conclusions: The findings suggest HER2 as a potential therapeutic target for BC and underscore the promise of developing anti-HER2-targeting strategies for BC management.

  • Article
    Zezhen Mi, Junyu Liu, Luowu Wang, Yuanman Luo, Ke Yang
    Archivos Españoles de Urología. 2024, 77(1): 92-97. https://doi.org/10.56434/j.arch.esp.urol.20247701.12
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    Objective: In this article, the associated factors for erectile dysfunction (ED) after radical prostatectomy (RP) were explored, and a clinical risk assessment model was constructed.

    Methods: A total of 155 patients who underwent RP in People’s Hospital of Hunan Province from November 2020, to November 2021, were selected as the study group. In accordance with the results of International Index of Erectile Function (IIEF-5) at 6 months after surgery, 88 patients were included in the ED group (IIEF-5 <22), and 67 patients were included in the non-ED group (IIEF-5 ≥22). Univariate and multivariate logistic regression analyses were conducted to screen the risk factors for ED after RP, and a risk model was constructed on this basis. In addition, 43 patients with ED after RP and 41 patients with non-ED after RP from January 2022, to January 2023, were included in the test group to evaluate the predictive efficacy of the clinical risk assessment model on the basis of the receiver operating characteristic curve.

    Results: The study group had a lower postoperative IIEF-5 score than before surgery (p < 0.001). The incidence of ED after RP in the study group was 56.77% (88/155). Multivariate analysis showed that advanced age (odds ratio (OR) = 1.155), large prostate volume (OR = 1.077), smoking (OR = 5.676), drinking (OR = 3.495), hypertension (OR = 8.079), diabetes (OR = 6.082), low preoperative serum testosterone (T) level (OR = 0.684) and high preoperative serum endothelin-1 (ET-1) level (OR = 1.192) were risk factors for ED after RP (p < 0.05). A risk model was constructed as follows: Z = 0.144 × (age) + 0.074 × (prostate volume) + 1.736 × (smoking) + 1.251 × (drinking) + 2.089 × (hypertension) + 1.805 × (diabetes) − 0.380 × (preoperative serum T) + 0.175 × (preoperative serum ET-1). The area under curve (AUC), sensitivity, specificity and 95% CI of this model were 0.906, 97.70%, 73.20%, and 0.848–0.964, respectively (p < 0.001).

    Conclusions: The clinical risk assessment model constructed on the basis of the above factors provides some references for the scientific prevention and treatment of ED after RP.

  • Article
    Yanyan Chang, Li Ma, Xiangyu Dang
    Archivos Españoles de Urología. 2024, 77(1): 98-103. https://doi.org/10.56434/j.arch.esp.urol.20247701.13
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    Objective: The current status and influencing factors of sleep quality in chronic nephritis patients (CNPs) were explored to provide clinical basis for improving the sleep quality of these patients.

    Methods: A total of 197 CNPs admitted to our hospital from June 2021 to June 2023 were retrospectively analysed. The sleep status of patients was evaluated by the Pittsburgh sleep quality index (PSQI). According to the PSQI scores, patients were divided into good sleep quality (n = 93) and poor sleep quality (n = 104) groups. The clinical indicators between the two groups were detected. The influencing factors of sleep quality in CNP were explored by univariate and multivariate logistic regression analysis.

    Results: Statistical differences existed in age, gender, course of disease, hypertension, neutrophilic granulocyte (NEUT) percentage (NEUT %), haemoglobin (Hb), urea, total carbon dioxide (TCO2), and serum phosphorus (P) between both groups (p < 0.05). Multivariate logistic regression analysis showed that age, course of disease, hypertension, NEUT %, Hb, and TCO2 were independent influencing factors for poor sleep quality in CNPs (p < 0.05).

    Conclusions: Older age, longer course of disease, hypertension, higher NEUT %, lower Hb, and higher TCO2 are associated with poorer sleep quality in CNPs. Therefore, targeted interventions for sleep quality should be given priority in clinical practice.

  • Article
    Fuxing Dong, Luli Zheng, Guokai Yang
    Archivos Españoles de Urología. 2024, 77(1): 104-112. https://doi.org/10.56434/j.arch.esp.urol.20247701.14
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    Background: This study aims to elucidate the microRNA (miRNA)-messenger RNA (mRNA)-transcription factors (TFs) network relevant to diabetic nephropathy (DN).

    Methods: To investigate the molecular mechanisms underlying DN, we conducted an extensive analysis using a Gene Expression Omnibus (GEO) database, specifically GSE51784, GSE30528, GSE30529 and GSE1009. RNA samples from 66 subjects were analysed to identify differentially expressed mRNAs (DEGs) and microRNAs (DEMs) between individuals with DN and healthy controls. The data underwent preprocessing, followed by Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene Set Enrichment Analysis (GSEA) to unveil enriched pathways. Additionally, we constructed protein-protein interaction networks and subnetworks of modules to identify key molecular players.

    Results: A total of 163 DEMs and 188 DEGs were identified among the four datasets. Furthermore, we identified 37 hub genes with high connectivity and four TFs, namely E1A Binding Protein P300 (EP300), SP100 Nuclear Antigen (SP100), Nuclear Receptor Subfamily 6 Group A Member 1 (NR6A1) and Jun Dimerization Protein 2 (JDP2), which may play crucial roles in the molecular pathogenesis of DN. Additionally, we constructed a co-regulatory network involving miRNAs, mRNAs and TFs, revealing potential involvement of pathways such as the Mitogen-Activated Protein Kinase (MAPK) signalling pathway, phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signalling pathway and metabolic pathways in the pathogenesis of DN. Finally, using a docking model, we established drug-gene interactions involving key genes in the network, providing potential insights into therapeutic options.

    Conclusions: This study explores a gene regulation network of miRNA-mRNA-TFs, identifying potential molecular targets in the aetiology of DN. It also suggests potential targets for genetic counselling and prenatal diagnosis for DN.

  • Case Report
    Junbing Ye, Kefei Deng, Ke Zeng, Guishu Huang, Yusong Weng, Kunru Yang, Qian Chen
    Archivos Españoles de Urología. 2024, 77(1): 113-118. https://doi.org/10.56434/j.arch.esp.urol.20247701.15
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    Background: The conventional approach for managing ureteral stenosis involves the placement of a double-J stent. In recent years, the utilisation of Allium ureteral stent (URS) has emerged as a novel treatment alternative for ureteral stenosis. Allium URS has several advantages over traditional stents, including an extended indwelling time and reduced incidence of complications. The number of cases reported worldwide on the use of Allium URS in the treatment of ureteral stenosis is currently limited. In this paper, we present the details of a case involving the use of an Allium URS to treat ileal-ureteral anastomotic stenosis in a 67-year-old patient. We aim to assess the feasibility of using Allium URS in such cases.

    Case Presentation: A 67-year-old Chinese woman was referred to our hospital for the treatment of left lumbago. Urography showed left ileal-ureteral anastomotic stenosis. Computed tomography (CT) revealed severe hydronephrosis in the left kidney. Subsequently, an Allium URS was implanted via ureteroscopy. We found no instances of haematuria, lumbago or urinary tract irritation during the follow-up period. After 8 months, the patient was readmitted because of left lumbago. CT re-examination revealed that the left hydronephrosis had modestly improved. The Allium URS had detached and showed stone formation on its surface. For further treatment, ureteroscopy was performed and a new Allium URS was implanted. At 3-month follow-up, CT re-examination demonstrated that the stent had dislodged again but that the hydronephrosis in the left kidney had remarkably improved. Cystoscopy revealed that the stent had completely detached and that wall stones had attached on this surface. The stent was removed via cystoscopy. After 1 month, CT scanning showed that the left hydronephrosis of the patient had almost disappeared.

    Conclusion: Allium URS is effective in the treatment of hydronephrosis caused by ileal-ureteral anastomotic stenosis. Although complications, such as haematuria, lumbago and urinary tract irritation, are rare, complications, such as stent displacement and stone formation, may occur. Hence, caution must be exercised when considering the use of Allium URSs in the treatment of patients with ileal-ureteral anastomotic stenosis.