Objectives:The study aimed to evaluate quality of nephrolithometric nomograms to predict stone-free rates(SFRs)and complication rates(CRs)in case of minimally invasive percutaneous nephrolithotomy(PNL).In the last dec...Objectives:The study aimed to evaluate quality of nephrolithometric nomograms to predict stone-free rates(SFRs)and complication rates(CRs)in case of minimally invasive percutaneous nephrolithotomy(PNL).In the last decade,nomograms have been introduced to estimate the SFRs and CRs of PNL.However,no data are available regarding their reliability in case of utilization of miniaturized devices.Herein we present a prospective multicentric study to evaluate reliability of Guy’s stone score(GSS),the stone size,tract length,obstruction,number of involved calyces,and essence of stone(S.T.O.N.E.)nephrolithometry score and Clinical Research Office of the Endourological Society(CROES)score in patients treated with minimally invasive PNL.Methods:We evaluated SFRs and CRs of 222 adult patients treated with miniaturized PNL.Patients were considered stone-free if no residual fragments of any size at post-operative unenhanced computed tomography scan.Patients demographics,SFRs,and CRs were reported and analyzed.Performances of nomograms were evaluated with the area under the curve(AUC).Results:We included 222 patients,the AUCs of GSS,CROES score,and S.T.O.N.E.nephrolithometry score were 0.69(95%confidence interval[CI]0.61-0.78),0.64(95%CI 0.56-0.73),and 0.62(95%CI 0.52-0.71),respectively.Regarding SFRs,at multivariate binomial logistic regression,only the GSS had significance with an odds ratio of 0.53(95%CI 0.31e0.95,p=0.04).We did not find significant correlation with complications,with only a trend for GSS.Conclusion:This is the first study evaluating nomograms in miniaturized PNL.They still show good reliability;however,our data showed lower performances compared to standard PNL.We emphasize the need of further studies to confirm this trend.A dedicated nomogram for minimally invasive PNL may be necessary.展开更多
Objective:Indocyanine green(ICG)with near-infrared fluorescence absorption is approved by the United States Food and Drug Administration for clinical applications in angiography,blood flow evaluation,and liver functio...Objective:Indocyanine green(ICG)with near-infrared fluorescence absorption is approved by the United States Food and Drug Administration for clinical applications in angiography,blood flow evaluation,and liver function assessment.It has strong optical absorption in the near-infrared region,where light can penetrate deepest into biological tissue.We sought to review its value in guiding prostate cancer treatment.Methods:All related literature at PubMed from January 2000 to December 2020 were reviewed.Results:Multiple preclinical studies have demonstrated the usefulness of ICG in identifying prostate cancer by using different engineering techniques.Clinical studies have demonstrated the usefulness of ICG in guiding sentinel node dissection during radical prostatectomy,and possible better preservation of neurovascular bundle by identifying landmark prostatic arteries.New techniques such as adding fluorescein in additional to ICG were tested in a limited number of patients with encouraging result.In addition,the use of the ICG was shown to be safe.Even though there are encouraging results,it does not carry sufficient sensitivity and specificity in replacing extended pelvic lymph node dissection during radical prostatectomy.Conclusion:Multiple preclinical and clinical studies have shown the usefulness of ICG in identifying and guiding treatment for prostate cancer.Larger randomized prospective studies are warranted to further test its usefulness and find new modified approaches.展开更多
Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a ...Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a narrative review of relevant English-language articles up to October 2022 using the PubMed and Web of Science databases.The following keywords were used in the search:“percutaneous nephrolithotomy”,“minimally invasive percutaneous nephrolithotomy”,“mini-PCNL”,“mini-perc”,“mPCNL”,and“miniaturization”.Results:A series of new progress has been made in many aspects of mini-PCNL,such as further reduction of tract sizedneedle perc and further improvement of robotic-assisted PCNLdartificial intelligence-powered robotic devices.Conclusion:Many studies and trials have been conducted to reduce morbidity and increase the safety and effectiveness of mini-PCNL.It is crucial to realize that miniaturization of PCNL requires not only a smaller percutaneous tract size,but also an adjustment strategically in renal access,stone removal,lithotripsy,and surgical model in general.More large-scale prospective research needs to be carried out to further validate and optimize the safety and effectiveness of mini-PCNL.展开更多
Urolithiasis is a common condition that affects 5%-10%of the population globally[1].Once afflicted,urolithiasis tends to be recurrent,with up to 50%in most cases in 5 years since the first stone event[2].Despite the s...Urolithiasis is a common condition that affects 5%-10%of the population globally[1].Once afflicted,urolithiasis tends to be recurrent,with up to 50%in most cases in 5 years since the first stone event[2].Despite the significant progress in understanding the pathogenesis and management of urolithiasis,the condition remains a significant public health concern.The aim of this special issue of the Asian Journal of Urology was to provide an update on the current state of knowledge regarding the pathogenesis,diagnosis,and management of urolithiasis.展开更多
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 ...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.展开更多
Miniaturized percutaneous nephrolithotomy(PCNL)procedures have gained increased popularity in recent years.They aim to reduce percutaneous tract size in order to lower complication rates,while maintaining high stone-f...Miniaturized percutaneous nephrolithotomy(PCNL)procedures have gained increased popularity in recent years.They aim to reduce percutaneous tract size in order to lower complication rates,while maintaining high stone-free rates.Recently,miniaturized PCNL techniques have further expanded,and can currently be classified into mini-PCNL,minimally invasive PCNL(MIP),Chinese mini-PCNL(MPCNL),ultra-mini-PCNL(UMP),micro-PCNL,mini-micro-PCNL,and super-mini-PCNL(SMP).However,despite its minimally-invasive nature,its potential superiority in terms of safety and efficacy when compared to conventional PCNL is still under debate.The aim of this review is to summarise different available modalities of miniaturized PCNL,details of instruments involved,and their corresponding safety and efficacy.In particular,this article highlights the role of the SMP and our experience with this novel technique in management of urolithiasis.Overall,miniaturized PCNL techniques appear to be safe and effective alternatives to conventional PCNL for both adult and pediatric patients.Well-designed,randomized studies are required to further investigate and identify specific roles of miniaturized PCNL techniques before considering them as standard rather than alternative procedures to conventional PCNL.展开更多
Objective:To examine differences in outcomes of semi-rigid ureteroscopy(URS)with or without a modified-ureteral-access-sheath(mUAS)to treat large upper ureteral stones.Methods:Patients with single,radio-opaque large u...Objective:To examine differences in outcomes of semi-rigid ureteroscopy(URS)with or without a modified-ureteral-access-sheath(mUAS)to treat large upper ureteral stones.Methods:Patients with single,radio-opaque large upper ureteral stone(≥10 mm)treated using semi-rigid URS between August 2013 and October 2016 were retrospectively evaluated.The stone-free status was determined from Kidney-ureter-bladder(KUB)X-ray films taken on postoperative Day 1 and after 1 month.Results:Of 103 patients meeting inclusion criteria,43(41.75%)and 60(58.25%)were treated with semi-rigid URS with and without mUAS,respectively.The immediate stone-free rate(SFR)for the mUAS group was significantly higher than the non-mUAS group(40[93.0%]vs.46[76.7%];p=0.033).The SFR at 1 month was also high for patients treated using mUAS,but not statistically different from patients not treated with mUAS(41[95.3%]mUAS vs.51[85.0%]non-mUAS;p=0.115).Auxiliary procedure rates were significantly lower for mUAS patients compared to non-mUAS patients(2[4.7%]vs.14[23.3%];p=0.01).There were no significant differences in surgical duration and hospital stays,and the overall complication rates were statistically similar for mUAS patients compared to non-mUAS patients(1[2.3%]vs.3[5.0%];p=0.638).展开更多
Embarking on a scholarly exploration of the intricate landscape of urolithiasis,the second part of the special section in the Asian Journal of Urology serves as a continuum to the scholarly discourse initiated in its ...Embarking on a scholarly exploration of the intricate landscape of urolithiasis,the second part of the special section in the Asian Journal of Urology serves as a continuum to the scholarly discourse initiated in its predecessor.Urolithiasis is a common condition affecting 5%-10%of the global population[1].Despite significant progress in understanding the pathogenesis and management of urolithiasis,it remains a substantial public health concern.The objective of the special section in the Asian Journal of Urology is to provide an updated knowledge on the pathogenesis,diagnosis,and management of urolithiasis.In this part two of the special section,we stillfocus on the aspects of stone pathogenesis,treatment,complications prevention,and the application of new technologies.展开更多
Overactive bladder(OAB)is the most bothersome symptom in lower urinary tract symptoms(LUTS).Current pharmacologic treatment aims to inhibit detrusor contraction;however,shows unsatisfied efficacy and high discontinuat...Overactive bladder(OAB)is the most bothersome symptom in lower urinary tract symptoms(LUTS).Current pharmacologic treatment aims to inhibit detrusor contraction;however,shows unsatisfied efficacy and high discontinuation rate.LIM kinases(LIMKs)promote smooth muscle contraction in the prostate;however,their function in the bladder smooth muscle remains unclear.Here,we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both in vitro and in vivo experiments.Bladder expressions of LIMKs are elevated in OAB rat detrusor tissues.Two LIMK inhibitors,SR7826 and LIMKi3,inhibit contraction of human detrusor strip,and cause actin filament breakdown,as well as cell proliferation reduction in cultured human bladder smooth muscle cells(HBSMCs),paralleled by reduced cofilin phosphorylation.Silencing of LIMK1 and LIMK2 in HBSMCs resulted in breakdown of actin filaments and decreased cell proliferation.Treatment with SR7826 or LIMKi3 decreased micturition frequency and bladder detrusor hypertrophy in rats with bladder outlet obstruction.Our study suggests that LIMKs may promote contraction and proliferation in the bladder smooth muscle,which could be inhibited by small molecule LIMK inhibitors.LIMK inhibitors could be a potential therapeutic strategy for OAB-related LUTS.展开更多
We study the exfoliation of ultrathin ReS2 nanosheets from the prepared ReS2 powder and their application to Q-switched Er-doped fiber laser.XRD,Raman,and XPS spectra confirm the successful preparation of the layered ...We study the exfoliation of ultrathin ReS2 nanosheets from the prepared ReS2 powder and their application to Q-switched Er-doped fiber laser.XRD,Raman,and XPS spectra confirm the successful preparation of the layered ReS2.SEM images show that the obtained ReS2 sheets have lateral size below 200 nm.The thickness of the ReS2 nanosheets is smaller than 5 nm according to the AFM results.ReS2/PVA film is applied as a saturable absorber in an Er-doped Q-switched fiber laser,and a minimum pulse duration of 2.4μs and an output power of 1.25 mW are obtained,indicating the potential application to Q-switched lasers.展开更多
文摘Objectives:The study aimed to evaluate quality of nephrolithometric nomograms to predict stone-free rates(SFRs)and complication rates(CRs)in case of minimally invasive percutaneous nephrolithotomy(PNL).In the last decade,nomograms have been introduced to estimate the SFRs and CRs of PNL.However,no data are available regarding their reliability in case of utilization of miniaturized devices.Herein we present a prospective multicentric study to evaluate reliability of Guy’s stone score(GSS),the stone size,tract length,obstruction,number of involved calyces,and essence of stone(S.T.O.N.E.)nephrolithometry score and Clinical Research Office of the Endourological Society(CROES)score in patients treated with minimally invasive PNL.Methods:We evaluated SFRs and CRs of 222 adult patients treated with miniaturized PNL.Patients were considered stone-free if no residual fragments of any size at post-operative unenhanced computed tomography scan.Patients demographics,SFRs,and CRs were reported and analyzed.Performances of nomograms were evaluated with the area under the curve(AUC).Results:We included 222 patients,the AUCs of GSS,CROES score,and S.T.O.N.E.nephrolithometry score were 0.69(95%confidence interval[CI]0.61-0.78),0.64(95%CI 0.56-0.73),and 0.62(95%CI 0.52-0.71),respectively.Regarding SFRs,at multivariate binomial logistic regression,only the GSS had significance with an odds ratio of 0.53(95%CI 0.31e0.95,p=0.04).We did not find significant correlation with complications,with only a trend for GSS.Conclusion:This is the first study evaluating nomograms in miniaturized PNL.They still show good reliability;however,our data showed lower performances compared to standard PNL.We emphasize the need of further studies to confirm this trend.A dedicated nomogram for minimally invasive PNL may be necessary.
文摘Objective:Indocyanine green(ICG)with near-infrared fluorescence absorption is approved by the United States Food and Drug Administration for clinical applications in angiography,blood flow evaluation,and liver function assessment.It has strong optical absorption in the near-infrared region,where light can penetrate deepest into biological tissue.We sought to review its value in guiding prostate cancer treatment.Methods:All related literature at PubMed from January 2000 to December 2020 were reviewed.Results:Multiple preclinical studies have demonstrated the usefulness of ICG in identifying prostate cancer by using different engineering techniques.Clinical studies have demonstrated the usefulness of ICG in guiding sentinel node dissection during radical prostatectomy,and possible better preservation of neurovascular bundle by identifying landmark prostatic arteries.New techniques such as adding fluorescein in additional to ICG were tested in a limited number of patients with encouraging result.In addition,the use of the ICG was shown to be safe.Even though there are encouraging results,it does not carry sufficient sensitivity and specificity in replacing extended pelvic lymph node dissection during radical prostatectomy.Conclusion:Multiple preclinical and clinical studies have shown the usefulness of ICG in identifying and guiding treatment for prostate cancer.Larger randomized prospective studies are warranted to further test its usefulness and find new modified approaches.
文摘Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a narrative review of relevant English-language articles up to October 2022 using the PubMed and Web of Science databases.The following keywords were used in the search:“percutaneous nephrolithotomy”,“minimally invasive percutaneous nephrolithotomy”,“mini-PCNL”,“mini-perc”,“mPCNL”,and“miniaturization”.Results:A series of new progress has been made in many aspects of mini-PCNL,such as further reduction of tract sizedneedle perc and further improvement of robotic-assisted PCNLdartificial intelligence-powered robotic devices.Conclusion:Many studies and trials have been conducted to reduce morbidity and increase the safety and effectiveness of mini-PCNL.It is crucial to realize that miniaturization of PCNL requires not only a smaller percutaneous tract size,but also an adjustment strategically in renal access,stone removal,lithotripsy,and surgical model in general.More large-scale prospective research needs to be carried out to further validate and optimize the safety and effectiveness of mini-PCNL.
文摘Urolithiasis is a common condition that affects 5%-10%of the population globally[1].Once afflicted,urolithiasis tends to be recurrent,with up to 50%in most cases in 5 years since the first stone event[2].Despite the significant progress in understanding the pathogenesis and management of urolithiasis,the condition remains a significant public health concern.The aim of this special issue of the Asian Journal of Urology was to provide an update on the current state of knowledge regarding the pathogenesis,diagnosis,and management of urolithiasis.
基金supported by 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University,China[No.ZY2016104]Central Financial Fund,Guangzhou Medical University,China[No.2010A060801016].
文摘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.
基金financed by a grant from the National Natural Science Foundation of China(Nos.81670643 and 81370804)the Science and Technology Program of Guangzhou,China(No.201604020001).
文摘Miniaturized percutaneous nephrolithotomy(PCNL)procedures have gained increased popularity in recent years.They aim to reduce percutaneous tract size in order to lower complication rates,while maintaining high stone-free rates.Recently,miniaturized PCNL techniques have further expanded,and can currently be classified into mini-PCNL,minimally invasive PCNL(MIP),Chinese mini-PCNL(MPCNL),ultra-mini-PCNL(UMP),micro-PCNL,mini-micro-PCNL,and super-mini-PCNL(SMP).However,despite its minimally-invasive nature,its potential superiority in terms of safety and efficacy when compared to conventional PCNL is still under debate.The aim of this review is to summarise different available modalities of miniaturized PCNL,details of instruments involved,and their corresponding safety and efficacy.In particular,this article highlights the role of the SMP and our experience with this novel technique in management of urolithiasis.Overall,miniaturized PCNL techniques appear to be safe and effective alternatives to conventional PCNL for both adult and pediatric patients.Well-designed,randomized studies are required to further investigate and identify specific roles of miniaturized PCNL techniques before considering them as standard rather than alternative procedures to conventional PCNL.
基金This work was financed by grants from the National Natural Science Foundation of China(No.81370804 and No.81670643)Guangzhou Science,Technology and Innovation Commission(No.201604020001,No.201607010162 and No.201704020193).
文摘Objective:To examine differences in outcomes of semi-rigid ureteroscopy(URS)with or without a modified-ureteral-access-sheath(mUAS)to treat large upper ureteral stones.Methods:Patients with single,radio-opaque large upper ureteral stone(≥10 mm)treated using semi-rigid URS between August 2013 and October 2016 were retrospectively evaluated.The stone-free status was determined from Kidney-ureter-bladder(KUB)X-ray films taken on postoperative Day 1 and after 1 month.Results:Of 103 patients meeting inclusion criteria,43(41.75%)and 60(58.25%)were treated with semi-rigid URS with and without mUAS,respectively.The immediate stone-free rate(SFR)for the mUAS group was significantly higher than the non-mUAS group(40[93.0%]vs.46[76.7%];p=0.033).The SFR at 1 month was also high for patients treated using mUAS,but not statistically different from patients not treated with mUAS(41[95.3%]mUAS vs.51[85.0%]non-mUAS;p=0.115).Auxiliary procedure rates were significantly lower for mUAS patients compared to non-mUAS patients(2[4.7%]vs.14[23.3%];p=0.01).There were no significant differences in surgical duration and hospital stays,and the overall complication rates were statistically similar for mUAS patients compared to non-mUAS patients(1[2.3%]vs.3[5.0%];p=0.638).
文摘Embarking on a scholarly exploration of the intricate landscape of urolithiasis,the second part of the special section in the Asian Journal of Urology serves as a continuum to the scholarly discourse initiated in its predecessor.Urolithiasis is a common condition affecting 5%-10%of the global population[1].Despite significant progress in understanding the pathogenesis and management of urolithiasis,it remains a substantial public health concern.The objective of the special section in the Asian Journal of Urology is to provide an updated knowledge on the pathogenesis,diagnosis,and management of urolithiasis.In this part two of the special section,we stillfocus on the aspects of stone pathogenesis,treatment,complications prevention,and the application of new technologies.
基金financed by grants from the National Natural Science Foundation of China(Nos.81900689 and 81870483)China Postdoctoral Science Foundation(2018M643047)
文摘Overactive bladder(OAB)is the most bothersome symptom in lower urinary tract symptoms(LUTS).Current pharmacologic treatment aims to inhibit detrusor contraction;however,shows unsatisfied efficacy and high discontinuation rate.LIM kinases(LIMKs)promote smooth muscle contraction in the prostate;however,their function in the bladder smooth muscle remains unclear.Here,we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both in vitro and in vivo experiments.Bladder expressions of LIMKs are elevated in OAB rat detrusor tissues.Two LIMK inhibitors,SR7826 and LIMKi3,inhibit contraction of human detrusor strip,and cause actin filament breakdown,as well as cell proliferation reduction in cultured human bladder smooth muscle cells(HBSMCs),paralleled by reduced cofilin phosphorylation.Silencing of LIMK1 and LIMK2 in HBSMCs resulted in breakdown of actin filaments and decreased cell proliferation.Treatment with SR7826 or LIMKi3 decreased micturition frequency and bladder detrusor hypertrophy in rats with bladder outlet obstruction.Our study suggests that LIMKs may promote contraction and proliferation in the bladder smooth muscle,which could be inhibited by small molecule LIMK inhibitors.LIMK inhibitors could be a potential therapeutic strategy for OAB-related LUTS.
基金Project supported by the Pearl River Talent Program of Guangdong Province,China(No.2017GC010278)the Science and Technology Program of Guangzhou,China(No.202002030027)+1 种基金the National Natural Science Foundation of China(No.61705044)the Distinctive Innovation Project of Regular Colleges in Guangdong Province,China(No.2018KTSCX052)。
文摘We study the exfoliation of ultrathin ReS2 nanosheets from the prepared ReS2 powder and their application to Q-switched Er-doped fiber laser.XRD,Raman,and XPS spectra confirm the successful preparation of the layered ReS2.SEM images show that the obtained ReS2 sheets have lateral size below 200 nm.The thickness of the ReS2 nanosheets is smaller than 5 nm according to the AFM results.ReS2/PVA film is applied as a saturable absorber in an Er-doped Q-switched fiber laser,and a minimum pulse duration of 2.4μs and an output power of 1.25 mW are obtained,indicating the potential application to Q-switched lasers.
