Thulium (Tm:YAG) laser vaporesection of prostate and bipolar transurethral resection of prostate in patients with benign prostate hyperplasia: a systematic review and meta-analysis.

Thulium laser vaporesection (ThuVARP) and bipolar transurethral resection of the prostate (B-TURP) are novel surgeries for benign prostate hyperplasia (BPH). This paper is a systematic review and analysis of literatures comparing efficacy indicators, operative parameters, as well as safety indicators between ThuVARP and B-TURP for the treatment of BPH. A systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science, Embase, and China National Knowledge Internet (CNKI), was carried out up to December 1, 2015 (updated on March 1, 2016). The captivating outcomes included basic clinical characteristics, perioperative parameters, local complications, and efficacy indicators which included International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR). After assessing the quality of methodology and extracting data, a meta-analysis was carried out by using STATA 12.0 software. Five studies involving 500 patients met the standard. The outcomes of this analysis were as follows: (a) efficacy indicators: there were no significant differences in IPSS, QoL, PVR, and Qmax between the two groups (all P > 0.05); (b) perioperative indicators: ThuVARP had longer operative time [standardized mean difference (SMD) = 0.843; 95% confidence interval (CI) - 0.391, 1.296; P < 0.001] but less serum hemoglobin decreased (SMD = - 0.561; 95% CI - 0.796, - 0.327; P < 0.001), shorter hospital stay (SMD = - 1.558; 95% CI - 2.709, - 0.407; P < 0.01), and catheterization time (SMD = - 1.274; 95% CI - 2.158, - 0.390; P < 0.01). Additionally, no significant difference was found in estimated resected weight (P > 0.05); (c) safety indicators: no significant difference was found in local complication rates (all P > 0.05) between ThuVARP and B-TURP. In our analysis, there exists no statistical difference between ThuVARP and B-TURP group in efficacy. However, in spite of requiring longer surgical time, ThuVARP was better in terms of less blood loss as well as shorter hospitalization and catheterization time.

The analysis of microbial spectrum and antibiotic resistance of uropathogens isolated from patients with urinary stones.

PURPOSE: The characteristics and resistance patterns of urine bacteriology in patients with urinary tract stones have not been extensively studied. This study aims to investigate the microbial spectrum and antibiotic resistance of uropathogens isolated from urinary tract infections in patients with urinary stones and provide a basis for appropriate antimicrobial treatments. METHODS: The results of positive bladder midstream urine cultures and their antimicrobial susceptibility were retrospectively analysed from hospitalised patients with diagnosis of urinary calculi and urinary tract infections between January 2010 and December 2015. RESULTS: A total of 3892 samples were analysed during the study period: 2201 were female patients (56.6%) and 1691 were male patients (43.4%). The 4 most common uropathogens were Escherichia coli (48.7%), Klebsiella pneumoniae (10.4%), Enterococcus faecalis (8.7%) and Proteus mirabilis (5.2%). Both E. coli (60.8%) and Proteus mirabilis (7.5%) were higher in female patients than in male patients (32.8%; 2.3%; P < .05). ESBL-positive E. coli accounted for 59.5% of total number of E. coli, while ESBL-positive K. pneumoniae comprised 42.0% of total K. pneumoniae. The majority of uropathogens in patients with stones had high resistance to fluoroquinolones, ceftriaxone, ceftazidime, cefepime, penicillins, sulfonamides and monobactams (resistance >20%). CONCLUSIONS: The microbial spectrum in patients with urinary stones had a complex pattern. The uropathogens showed marked multidrug resistance and a large proportion of the uropathogens were able to produce ß-lactamase.

Does green tea consumption increase urinary oxalate excretion? Results of a prospective trial in healthy men.

OBJECTIVE: To investigate the impact of green tea on urinary oxalate excretion in healthy male volunteers. MATERIALS AND METHODS: The oxalate concentrations after different brewing times (2-60 min) of different qualities (2-8 g) of green tea were measured in in vitro experiment. In in vivo experiment, the effects on urine composition were assessed in 12 healthy men with an age of 24-29 years. Each subject was requested to collect two 24-h urine samples under normal dietary conditions. Green tea prepared from tea bags containing 2 g of tea leafs was consumed by the subjects for 7 consecutive days, and 24-h urine samples were collected and analyzed on days 6 and 7. After 3-week washout interval, all subjects consumed green tea containing 4 g of leaf tea for another 7 consecutive days. Two 24-h urine samples were collected on the last 2 days. Urine volume, pH, calcium, magnesium, sodium, phosphate, potassium, chloride, citrate, oxalate, urate and creatinine were measured. RESULTS: In the in vitro experiments, oxalate in solution increased with brewing time (p < 0.05) and tea quality (p < 0.05). In the in vivo experiment, 24-h urinary oxalate increased significantly (0.24 ± 0.09 mmol to 0.32 ± 0.13 mmol, p = 0.045) when tea was prepared from 2-g bags of green leaf tea. Consumption of green tea containing 4 g of leaf tea resulted in 24-h urinary oxalate increase (0.25 ± 0.25 mmol to 0.34 ± 0.22 mmol, p = 0.041). CONCLUSIONS: In vitro studies showed that there was a gradual increase in solution concentrations of oxalate that was associated with increased brewing time and increased quality of green tea. Studies in normal men showed that green tea consumption was associated with increased urinary exertion of oxalate.

Integrative Analysis of miRNA and mRNA Expression Profiles in Calcium Oxalate Nephrolithiasis Rat Model.

The microRNA (miRNA) expression profiles and their biological functions in calcium oxalate nephrolithiasis remain unclear. In this study, we investigate the miRNA and mRNA expression profiles of kidney tissues in calcium oxalate stone rats. 16 Sprague Dawley rats were divided into control group and stone-forming group. 24-hour urine samples and kidney tissues were collected for biochemical and histological determination after 4 weeks. MiRNA and mRNA microarray were applied to evaluate the miRNA and mRNA expression profiles. To validate the microarray results, the quantitative real-time PCR (qRT-PCR) was performed. A total of 38 miRNAs and 2728 mRNAs were significantly and differentially expressed in kidney tissues of stone-forming group versus control group. Gene Ontology (GO) analysis revealed that most of the target genes were enriched in terms of oxidation reduction, ion transport, inflammatory response, and response to wounding. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of these targets highlights their critical role in cytokine-cytokine receptor interaction, gap junction, and chemokine signaling pathway. Furthermore, the reliability of the microarray-based results was confirmed by using qRT-PCR determination. The miRNA and mRNA expressions in calcium oxalate stone rat kidneys might provide a basis for further research on urolithiasis mechanism.

Metabolic disturbances in Chinese children with urolithiasis: a single center report.

Urinary stones and urine composition are the first steps in the process of recurrence prevention, but data concerning the association between the two compositions are scarce in Chinese children with urolithiasis. We retrospectively analyzed the records of children (age range 0-18 years) with urolithiasis in our center between March 2004 and December 2013. Stone analysis was carried out in 382 children and 24-hour urine analysis in 80 children. Analysis of both stone and 24-hour urine composition was completed in 56 children. Stone samples were analyzed by Fourier transform-infrared spectrometry. The major stone constituents were calcium oxalate (78.8 %). Of 80 children with 24 h urine analysis, only 2.5 % were without urinary metabolic abnormalities. Hypocitraturia was recorded in 97.5 %, high sodium excretion in 50.0 %, cystinuria in 48.7 %, hypercalciuria in 18.8 %, small urine volumes in 12.5 %, hyperoxaluria in 5.0 % and hyperuricosuria in 1.3 %. Interestingly, higher urine volumes were recorded in girls than in boys (73.2 ± 58.5 vs 51.3 ± 45.3 mL/kg, p = 0.036). Urine sodium (p = 0.002) and oxalate (p = 0.004) were significantly higher in children >9 year old. Moreover, compared with calcium oxalate stone formers, the urine volume (p = 0.040), citrate (p = 0.007) and cystine (p = 0.004) were higher in patients with cystine stones. Hypocitraturia was the common abnormality among Chinese children with urolithiasis. The surprisingly high incidence of cystinuria is of note.

Difference in urinary stone composition between Uyghur and Han children with urolithiasis.

The Objective of this study is to analyze the difference in renal stone composition between Uyghur and Han children with urolithiasis in China and possible reasons. From May 2011 to September 2013, we analyzed the stone compositions of 274 Chinese children with urolithiasis, including 151 Uyghur children from Xinjiang Province and 123 Han children from Guangdong Province. All the stone components were determined by Infrared spectroscopy and the main components were recorded. We also evaluated the data, including age, gender and geographic region of the patients. The mean age of Uyghur children was less than Han children (5.3 ± 4.2 vs 8.6 ± 5.7 years, p < 0.001). Calcium oxalate (CaOx) was the main stone composition in both Uyghur (35.1 %) and Han (64.2 %) children, but was more common in Han children (p < 0.0001). Cystine stone was also more abundant in Han children (8.9 % vs 0.7 %, p = 0.001). While, both uric acid (20.5 % vs 3.3 %, p < 0.0001) and magnesium ammonium phosphate (16.6 % vs 2.5 %, p < 0.0001) stones were more common in Uyghur. Interestingly, the significant differences in stone composition between the two groups were only observed in males. When the pediatric patients were further divided into three age groups which were 0-5, 6-12 and >12, the prevalence of calcium oxalate stones increased with age in both groups and was higher in Han children at each age level. The compositions of urinary stones were significantly different between Uyghur and Han children with urolithiasis, factors such as diet habit, life style, genetic diversity, environmental and medical conditions may all contribute to the variances.

ß-arrestin1 promotes epithelial-mesenchymal transition via modulating GSK-3ß/ß-catenin pathway in prostate cancer cells.

Recently, ß-arrestin1 was indicated as a tumor promoter in prostate cancer, but its exact role in cancer metastasis still have not been well clarified. Here, our data revealed that ß-arrestin1 could promote the migration and invasion of prostate cancer cells via initiating epithelial-mesenchymal transition (EMT). Mechanically, ß-arrestin1 could increase the transcriptional activity and expression of ß-catenin, together with Akt activity, whereas decrease the activities of GSK-3ß and PP2A. In addition, ß-arrestin1 could function as a scaffold protein in modulating the interactions between PP2A, Akt, GSK-3ß and ß-catenin. These results reveal a novel mechanism of ß-arrestin1 in modulating EMT and GSK-3ß/ß-catenin signaling in prostate cancer, thereby suggest that assessment of ß-arrestin1 may provide a potential therapeutic target for prostate cancer.