Effect of Preoperative Double-J Ureteral Stenting before Flexible Ureterorenoscopy on Stone-free Rates and Complications

The effect of preoperative Double-J(DJ)ureteral stenting before flexible ureterorenoscopy(FURS)in the treatment for urinary stones was evaluated.We retrospectively enrolled 306 consecutive patients who underwent FURS from Jan.2014 to Dec.2017.All the patients were classified into two groups according to whether they had DJ ureteral stenting before FURS.Baseline characteristics(age,sex,stone location,stone size,surgical success rate,operation time,stone-free rate of the first day after surgery,stone-free rate of the first month after surgery,total complication rate)were compared using Chi-square test for categorical variables and Kruskal-Wallis test for continuous variables.In total,306 patients were included in this study.The group of DJ stenting before FURS included 203(66.3%)patients,and non-DJ stenting before FURS was observed in 103(33.7%)patients.The group of DJ stenting before FURS was significantly associated with a shorter operation time(53.8 vs.59.3 min,P<0.001),a higher stone-free rate of the first day after surgery(69.0%vs.51.5%,P=0.003).However,statistical significant differences were not found in the age,sex,stone location,stone size,surgical success rate,stone-free rate of the first month after surgery(89.2%vs.81.6%,P=0.065)and total complication rate(5.4%vs.9.7%,P=0.161)between the two groups.Preoperative DJ ureteral stenting before FURS could reduce the operation time and increase stone-free rate of the first day after surgery.However,it might not benefit the stone-free rate of the first month after surgery and reduce the complication rate.Preoperative DJ stenting should be not routinely performed.

The Huashan risk calculators performed better in prediction of prostate cancer in Chinese population： a training study followed by a validation study

The performances of the Prostate Cancer Prevention Trial （PCPT） risk calculator and other risk calculators for prostate cancer （PCa） prediction in Chinese populations were poorly understood. We performed this study to build risk calculators （Huashan risk calculators） based on Chinese population and validated the performance of prostate-specific antigen （PSA）, PCPT risk calculator, and Huashan risk calculators in a validation cohort. We built Huashan risk calculators based on data from 1059 men who underwent initial prostate biopsy from January 2006 to December 2010 in a training cohort. Then, we validated the performance of PSA, PCPT risk calculator, and Huashan risk calculators in an observational validation study from January 2011 to December 2014. All necessary clinical information were collected before the biopsy. The results showed that Huashan risk calculators 1 and 2 outperformed the PCPT risk calculator for predicting PCa in both entire training cohort and stratified population （with PSA from 2.0 ng ml^-1 to 20.0 ng ml^-1）. In the validation study, Huashan risk calculator 1 still outperformed the PCPT risk calculator in the entire validation cohort （0.849 vs 0.779 in area under the receiver operating characteristic curve [AUC]） and stratified population. A considerable reduction of unnecessary biopsies （approximately 30%） was also observed when the Huashan risk calculators were used. Thus, we believe that the Huashan risk calculators （especially Huashan risk calculator 1） may have added value for predicting PCa in Chinese population. However, these results still needed further evaluation in larger populations.