Objective To assess the necessity and safety of ureteral stenting after ureteroscopic lithotripsy in treatment of middle and distal ureteral calculi. Methods We electronically searched MEDLINE, EMbase, Cochrane Library, CBM, VIP and CNKI to collect randomized controlled trials (RCTs) involving men with or without ureteral stenting after ureteroscopic lithotripsy from 2000 to March 2010. The quality of included trials was assessed. Data were extracted and analyzed with RevMan5.0 software. Results Six RCTs involving 543 patients were identified. The results of meta-analysis showed that: a) There was no statistical difference between two groups in stone clearance rate (RR=0.45, 95% CI 0.98 to 1.01, P=0.15), dysuria rate (RR=1.35, 95% CI 0.99 to 1.84, P=0.06), and hematuria rate (RR=2.12, 95% CI 1.00 to 4.49, P=0.05); b) There was statistical difference between two groups in frequent micturition rate (RR=2.17, 95% CI 1.13 to 4.17, P=0.02), the mean visual analog score 3 days postoperatively (WMD=0.94, 95% CI 0.47 to 1.42, P=0.000?1), and the operation time (WMD=3.57, 95% CI 1.40 to 5.72, P=0.001). Without postoperative ureteral stenting can shorten the operation time, decrease the irritation signs of bladder, and can improve quality of postoperative life without influence on stone clearance. Couclusions The routine ureteral stenting after ureteroscopic lithotripsy may be not necessary in order to keep patients from unsafety. More reasonable randomized double blind controlled trails with large sample are required to provide proofs with high quality because the methodology quality of included studies is lower.
Biological markers play a pivotal role in the early and accurate diagnosis of Alzheimer’s disease, enabling precise identification and monitoring of therapeutic interventions. The detection of central β-amyloid and Tau proteins has become an indispensable tool in clinical trials. Recent years have witnessed substantial progress in the development of readily accessible and cost-effective blood biomarkers. This comprehensive article provides a comprehensive overview of the clinical applications of blood biomarkers, encompassing β-amyloid, phosphorylated Tau protein, neurofilament light chain protein, and glial fibrillary acidic protein, all of which have demonstrated clinical relevance in Alzheimer’s disease diagnosis. Notably, phosphorylated Tau protein exhibits superior diagnostic efficacy. The incorporation of blood biomarkers facilitates early screening, accurate diagnosis, and efficacious treatment of Alzheimer’s disease.
Objective To analysis the original articles published in Chinese Journal of Urology and to evaluate the present situation of the clinical and scientific research in the field of urology, providing clue to raise the clinical and scientific research level. Methods Chinese Journal of Urology and Journal of Urology in American were hand-searched and all original articles were divided into eight types and were identified and analyzed. The classes include descriptive studies, therapeutic studies, studies on diagnosis, etiology, prognosis etc. Results The decreased trend year by year were observed for the descriptive studies (χ2=286.179, Plt;0.005), number of such publications accounting for 71.90% in 1980-1984 down to 26.48% in 1999-2001. Number of randomized controlled trials and clinical controlled trials present distinct increasing trend, especially number of RCT increased from none in 1980-1984 to thirteen articles in 1995-1998. The proportion of laboratory research in all original articles have increased greatly and have exceeded that of Journal of Urology. Conclusions The clinical and scientific research level of urology have been elevating in our country, the constituent ratio of descriptive studies is decreasing and that of RCT and CCT is increasing. The constituent ratio of laboratory research has increased greatly and has exceeded that of similar foreign Journal in some years. Attention needs to be paid to this trend and mechanism of it should be further explored.
目的 总结1例腹膜后神经鞘瘤合并胃神经鞘瘤的临床诊疗方法。 方法 2010年12月收治1例女性患者，因呕血行CT检查发现胃体前壁及右肾上腺区占位入院，行胃楔形切除术及右肾上腺肿瘤切除术治疗。 结果 术后病理证实为腹膜后神经鞘瘤合并胃神经鞘瘤，随访半年无复发。 结论 腹膜后神经鞘瘤合并胃神经鞘瘤病例罕见且诊断困难，影像学检查缺乏特异性，可依靠术后病理检查确诊；外科手术完整切除肿瘤是有效的治疗方法，预后较好。
【摘要】 目的 了解行肾切除手术疾病谱、疾病的临床表现及诊治方法的演变，探讨避免肾脏切除保留肾单位的术式，以期提高对肾脏疾病的诊治水平。 方法 回顾性分析泌尿外科1955年1月－2001年12月收治入院22 603例患者的临床资料，对其中行肾切除手术的1 952例进行分析。根据肾切除手术病因，将疾病分为3类:肾肿瘤、肾结核、其他疾病。将47年分为5个时段:50、60、70、80、90年代。应用平均值、构成比、中位数、率等对各项指标进行统计学分析。 结果 5个时段年平均入院人数与年均切肾率呈上升趋势。疾病谱构成中肾肿瘤共计663例，占33.97%；肾结核共计599例，占30.69%；其他疾病共计690例，占35.35%。肾肿瘤与其他疾病的例数及构成比分别随着年代的推进不断增加。而肾结核则未显示出该特点。各年代3类疾病发病年龄（中位数）在肾肿瘤、肾结核与其他疾病亦沉陷；体检发现疾病自70年代分别为1.10%、5.10%、8.80%。 结论 90年代后，肾切除手术的术式更加标准和成熟，保留肾单位的肾脏手术正在受到临床的重视和推广。【Abstract】 Objective To study the spectrum of diseases subjected to nephrectomy, to find out the clinical manifestations of the diseases, to summarize the evolvement of operational technology of kindney removal, to discuss the method of nephron sparing surgery in the purpose of avoiding nephrectmoy and reducing the operational risk, and to promote the level of diagnosing and treating nephropathy. Methods There were 1 952 cases of nephrectomy selected in the total 22 603 cases treated in the Department of Urology from January 1955 to December 2001. According to the diseases subjected to the surgery, these 1 952 cases were assigned into 3 groups: renal tumor group, renal tuberculosis group and other diseases group. The 47 years from 1955 to 2001 were divided into 5 periods: the 1950s (1955-1960), 60s (1961-1970), 70s (1971-1980), 80s (1981-1990) and 90s (1991-2001). Indexes such as average, proportion, median, and ratio were analyzed statistically. Results From the 1950s to 1990s, the number of patients undergoing nephrectomy increased from period to period. Among the diseases causing the surgery, the number of renal tumor cases was 663 (33.97%), the number of renal tuberculosis cases was 599 (30.69%), and the number of other disease cases was 690 (35.35%). The number and proportion of renal tumor and other disease cases increased from year to year, while the nuber of renal tuberculosis cases did not show this feature. The median age of patients treated with nephrectomy increased year by year, and the patient’s age of renal tumor was older than that of renal tuberculosis and other diseases. The proportion of patients whose diseases were found out by physical examination since the 1970s was respectively 1.10%, 5.10% and 8.80%. Conclusion Since the 1990s, the technology of nephrectomy has become maturer and more standardized, and nephron sparing surgery has caught more attention and has been applied more in clinics.
Objective To evaluate the effectiveness and safety of chemotherapeutics bladder irrigation (CBI) after transurethral resection (TR) in the treatment of cystitis glandularis (CG). Methods Databases including MEDLINE, The Cochrane Library, EMbase, VIP, CNKI and CBM were searched from January 2001 to November 2011 to collect randomized controlled trials (RCTs) and case-control studies (CCSs) on pirarubicin or mitomycin bladder irrigation after TR in the treatment of CG. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.0. Results A total of 11 articles involving 5 RCTs and 6 CCSs were included. Among the total 1032 patients involved, 497 patients were in the control group treated by TR alone, while the other 535 patients were in the treatment group given CBI after RT. There were two subgroups, one involving 347 patients irrigated by pirarubicin in 7 studies, and the other involving 188 patients irrigated by mitomycin in 4 studies. The results of meta-analysis showed: (a) pirarubicin bladder irrigation after TR could increase both short-term and long-term cure rates and decrease both short-term and long-term relapse rates, but no significant differences were found in both short-term and long-term improvement rates, compared with the control group. As for the safety, pirarubicin was similar to the control group in the incidence of urinary irritation, but it was superior in the incidence of bloody urine; and (b) mitomycin bladder irrigation after TR could increase long-term cure rate and decrease long-term relapse rate, but no significant differences were found in short-term cure rate and short-term improvement rate, compared with the control group. Mitomycin was similar to the control group in incidence of urinary irritation and bloody urine. Sensitivity analyses indicated the outcomes regarding to some indexes in different studies were inconsistent. Conclusion Based on the current evidence, pirarubicin or mitomycin bladder irrigation after TR can increase long-term cure rate and decrease long-term relapse rate in treating CG, but pirarubicin tends to easily cause bloody urine. For the inconsistent outcomes of different studies, the results of this meta-analysis are instable and highly possible to be inconsistent to the future outcomes, hereby it is uncertain of the better effectiveness of CBI after, TR compared with TR alone, and more high-quality and large-scale RCTs are needed to be performed.
ObjectiveTo compare the clinical efficacy of transurethral plasmakinetic resection of bladder tumors (PKRBT) and holmium laser resection of bladder tumors (HOLBT), and discuss the effcacy, safety, indication, and complications of PKRBT for the treatment of bladder tumors compared with HOLBT. MethodsA hundred patients with bladder tumors were divided into two groups randomly, who were selected from patients in the Department of Urology of West China Hospital from March 2011 to March 2013. Among all the 100 cases, half of them were treated with PKRBT, and all others treated with HOBLT. The significant markers in both groups were recorded and evaluated, including the situation of before operation, during operation and after operation. The data recorded consisted of the general records of patients' medical background, concomitant disease, laboratory examination, and the position, amount, pathology of the tumor, total operative duration, the time of gross hematuria, the time of postoperative bladder irrigation and catheterization, the length of stay, postoperative complications and patients' conditions at month 3, 6, and 12 during the follow-up. ResultsAll operations were successfully performed, and there was no significant diTherences between the two groups in preoperative indexes (P>0.05). No abnormalities were detected in the postoperative laboratory examinations. The diTherences in operatative duration, time of bladder irrigation, duration of indwelling catheter, and postoperative length of stay between the two groups were not significant (P>0.05). But the mean time of gross hematuria was significantly shorter after operation in the HOLBT patients [(6.1±7.6) hours] than in those treated with PKRBT [(15.3±17.2) hours] (P<0.05). There was no significant diTherence between the two groups in the recurrence rate 3, 6, and 12 months after operation (P>0.05). ConclusionHOLBT can be used safely and effectively in treating bladder tumors, and it is easy for clinical manipulation. HOLBT is as effective and safe as PKRBT with similar adverse side-effect rate within and after operation.
ObjectiveTo systematically review the safety and efficacy of greenlight laser photoselective vaporization (PV) for nonmuscle-invasive bladder tumors (NMIBTs). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP and WanFang Data were systemically searched from inception to February 2016, to collect randomized controlled trials (RCTs) investigating the efficacy and safety of greenlight PV for NMIBTs. Two reviewers independently screened literature, extracted data, assessed the risk of bias of included studies. Then RevMan 5.3 software was used for meta-analysis. ResultsA total of 11 RCTs involving 921 patients met the predefined criteria. The results of meta-analysis showed that: Compared with electrocautery transurethral resection and plasmakinetic resection in treating NMIBTs, greenlight PV could significantly shorten indwelling catheter time and hospital stay, decrease bladder perforation, obturator nerve reflex, blood loss rate and tumor recurrence rate; but the operative time between the greenlight PV group and the routine surgery group was not statistically different. ConclusionCurrent evidence shows that greenlight PV is safe and effective in treating NMIBTs. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are warranted to further assess these results.