Miniaturised percutaneous nephrolithotomy:Its role in the treatment of urolithiasis and our experience

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.

Predictive significance of serum inhibin B on testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men

The purpose of this study was to determine the diagnostic accuracy of serum inhibin B(INHB)as a predictor of the retrieval outcome of testicular haploid gametes(spermatids and testicular spermatozoa)in nonobstructive azoospermic men.Serum hormone levels,testicular volume,and histological evaluation were performed in 403 Chin ese non obstructive azoospermic men.Testicular haploid gamete was successfully retrieved in 213 of 403 patients(52.85%).The haploid gamete group always had higher INHB levels than the non-haploid gamete group.According to the receiver operating characteristic(ROC)curve analysis,INHB was a good predictor of testicular haploid gamete retrieval outcome in all patients(sensitivity:77.93%and specificity:91.58%)and patients with normal follicle-stimulating hormone(FSH;sensitivity:88.52%and specificity:70.83%).The area under the ROC curve(AUC)of INHB was similar to that of FSH in all patients or patients with normal FSH.In patients with elevated FSH,INHB was superior to FSH in predicting the presence of haploid gamete(AUC:0.73 vs 0.55,P<0.05),with a sensitivity of 60.00%and a specificity of 80.28%.It con eluded that serum INHB as an effective marker for spermatoge nesis was a sign ificant predictor of testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men.Especially,INHB is superior to FSH in predicting the presenee of haploid gamete in the patients with elevated FSH.

Reversing cold tumors to hot: An immunoadjuvant-functionalized metalorganic framework for multimodal imaging-guided synergistic photoimmunotherapy

Immunotherapy assays using immunoadjuvants and tumor antigens could greatly increase the survival rates of patients with malignant tumors.As effective carriers,metal-organic frameworks(MOFs)have been widely utilized in cancer therapy due to their remarkable histocompatibility and low toxicity.Herein,we constructed a multimodal imaging-guided synergistic cancer photoimmunotherapy by employing a specific MOF(MIL101-NH2)as the core carrier;the MOF was dual-dressed with photoacoustic and fluorescent signal donors(indocyanine green,ICG)and immune adjuvants(cytosine-phosphate-guanine sequence,CpG)and named ICGCpG@MOF.This nanocarrier could passively target the tumor site through the EPR effect and achieve multimodal imaging(fluorescence,photoacoustic,photothermal and magnetic resonance imaging)of the tumor.Synergistic cancer photoimmunotherapy was achieved via simultaneous photodynamic and photothermal methods with 808 nm laser irradiation.ICG-CpG@MOF achieved the GSH-controlled release of immunoadjuvant into the tumor microenvironment.Furthermore,the released tumor-associated antigen along with CpG could induce the transformation of tumor cells from cold to hot by activating the immune system,which significantly enhanced tumor cytotoxicity and achieved high cure rates with minimal side-effects.This strategy utilizing multimodal imaging and synergistic cancer photoimmunotherapy provides a promising approach for the diagnosis and treatment of cancer.