Epidemiology of urolithiasis in Asia

In Asia,about 1%-19.1% of the population suffer fromurolithiasis.However,due to variations in socio-economic status and geographic locations,the prevalence and incidence have changed in different countries or regions over the years.The research for risk factors of urinary tract stones is of predominant importance.In this review,we find the prevalence of urolithiasis is 5%-19.1% in West Asia,Southeast Asia,South Asia,aswellas somedevelopedcountries(SouthKorea and Japan),whereas,it is only 1%e8%inmost part of East Asia and North Asia.The recurrence rate ranges from 21% to 53% after 3e5 years.Calciumoxalate(75%-90%)is themost frequent component of calculi,followed by uric acid(5%-20%),calciumphosphate(6%-13%),struvite(2%-15%),apatite(1%)and cystine(0.5%-1%).The incidence of urolithiasis reaches its peak in population agedover 30 years.Males aremore likely to suffer fromurinary calculi.Because of different dietary habits or genetic background,differences of prevalence among races or nationalities also exist.Geneticmutation of specific locus may contribute to the formation of different kinds of calculi.Dietary habits(westernized dietary habits and less fluid intake),as well as climatic factors(hot temperature andmany hours of exposure to sunshine)play a crucial role in the development of stones.Other diseases,especially metabolic syndrome,may also contribute to urinary tract stones.

Survivin (BIRC5) regulates bladder fibrosis in a rat model of partial bladder outlet obstruction

To the Editor:Fibrosis is a long duration wound healing process triggered by complex cellular and molecular responses that contributes to tissue or organ reconstruction.[1]Bladder fibrosis is initiated by pathological pressure such as hydrostatic pressure,stretching force,and fluid shear stress.Increased pressure leads to a bladder inflammatory microenvironment,smooth muscle hypertrophy,and fibrosis.

Cellular mechanotransduction in health and diseases:from molecular mechanism to therapeutic targets

Cellular mechanotransduction,a critical regulator of numerous biological processes,is the conversion from mechanical signals to biochemical signals regarding cell activities and metabolism.Typical mechanical cues in organisms include hydrostatic pressure,fluid shear stress,tensile force,extracellular matrix stiffness or tissue elasticity,and extracellular fluid viscosity.Mechanotransduction has been expected to trigger multiple biological processes,such as embryonic development,tissue repair and regeneration.However,prolonged excessive mechanical stimulation can result in pathological processes,such as multi-organ fibrosis,tumorigenesis,and cancer immunotherapy resistance.Although the associations between mechanical cues and normal tissue homeostasis or diseases have been identified,the regulatory mechanisms among different mechanical cues are not yet comprehensively illustrated,and no effective therapies are currently available targeting mechanical cue-related signaling.This review systematically summarizes the characteristics and regulatory mechanisms of typical mechanical cues in normal conditions and diseases with the updated evidence.The key effectors responding to mechanical stimulations are listed,such as Piezo channels,integrins,Yes-associated protein(YAP)/transcriptional coactivator with PDZ-binding motif(TAZ),and transient receptor potential vanilloid 4(TRPV4).We also reviewed the key signaling pathways,therapeutic targets and cutting-edge clinical applications of diseases related to mechanical cues.

Quality of urodynamics:a national cross-sectional study in China

To the Editor:Urodynamics is the general term used to describe measurements that assess the function and dysfunction of the lower urinary tract(LUT).[1]For most LUT disorders,using only an imaging auxiliary examination cannot provide effective clinical evidence of a specific disorder.Hence,some specific approaches are needed to evaluate the function of the bladder and urethra.The pressure-flow study is the most effective method for quantitatively analyzing the storage and voiding functions of the LUT.[2]

Rigid ureteroscopy, a neglected choice for stent removal: a randomized controlled trial to compare rigid ureteroscopy, flexible cystoscopy, and rigid cystoscopy

To the Editor:As one of the most powerful tools for urologists,ureteral stents are often used in diseases such as calculi,obstruction,ureteral injury,and kidney transplantation and are removed after 3 days to 4 weeks with a visualization instrument.Initially,rigid cystoscopy(RC)was most often used for stent removal,but due to its inflexibility and large diameter,RC often results in pain and potential damage to patients like hematuria,pain,and lower urinary tract symptoms,especially to men.

Transvaginal mesh implant for pelvic organ prolapse:Huaxi protocol

With increasing age,pelvic organ prolapse(POP),due to its high incidence,has become a common disease that seriously affects patients’quality of life and places a heavy economic burden on families and society.Transvaginal mesh(TVM)is a minimally invasive and effective treatment for POP,although its use remains controversial due to the potential risk of mesh-related complications.The US Foods and Drugs Administration,along with authorities in England,Australia,New Zealand,and other countries,have banned the sale and distribution of commercial TVM kits designed for POP.The TVM procedure remains an option for POP treatment and still appeals to many surgeons and patients today in Asia and most European countries,which suggests that a considerable number of POP patients can benefit from its continued refinement.Here we introduce the Huaxi protocol of the TVM plant for the treatment of POP.