Search

This study aims to establish a nomogram model by combining traditional clinical parameters with immunohistochemical markers to predict the recurrence of non-muscle invasive bladder urothelial carcinoma (NMIBUC) after resection. In total, 504 patients were included in this study. Of these patients, 353 underwent transurethral resection of bladder tumor (TURBT) in the Yongchuan Hospital of Chongqing Medical University and were identified as a training cohort. Univariate and multivariate Cox regression analyses were used to determine the risk factors associated with recurrence in the training cohort and to establish a nomogram model. A total of 151 patients who were hospitalized in the Second Affiliated Hospital of Chongqing Medical University (validation cohort) were used for further validation. The calibration curve was generated for internal and external model validation. The clinical practicability of this model was further verified by comparing the consistency index (C-index) among various models. The mean follow-up time of the training cohort was 45.6 months (range 4–90). In total, 146 patients relapsed in training cohort. After univariate analysis, multivariate analysis further confirmed tumor grade (p=.034), immediate postoperative instillation therapy (p=.025), Ki67 (p=.047), P53 (p=.038) and CK20 (p=.049) as independent risk factors for recurrence, and these factors were included in the nomogram model. The model more accurately predicted recurrence compared with other models based on the highest C-index of 0.82 (95% CI, 0.78–0.86) in the training cohort and 0.80 (95% CI, 0.77–0.83) in the validation cohort. This proposed nomogram model based on traditional clinical parameters and immunohistochemical markers can more accurately predict postoperative recurrence in patients with NMIBUC. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the pain intensity and tolerability of a new catheter applied to urethral surface anesthesia during rigid cystoscopy in male patients, and explore the prospects of its application and the anesthetic method in hospitals at primary levels.Materials and Methods: 252 adult male patients were randomly divided into the experimental group and the control group.1% lidocaine solution was irrigated into the posterior urethra of the experimental group using the new catheter before cystoscopy, while the control group was administered with lidocaine gel. Both groups were assessed by visual analogue scale(VAS) with their pain perceived during administration of lidocaine (control group) /during insertion of catheter and administration of lidocaine (experimental group) (T1),during the insertion of cystoscope (T2),at the beginning of cystoscopy (T3),The third minute of cystoscopy (T4), during the first urination after the procedure (T5), as well with the maximum pain(Pmax) perceived during the whole procedure. The fluctuations of blood pressure and heart rate in each group before, after and during the procedure were recorded, and the anesthesia costs in both groups were calculated.Results: Except a slightly higher score in T1, the scores of VAS in experimental group were lower than those of control group in T2,T3 and T4. The Pmax of the control group was 4.92(SD=1.20), which was higher than in the experimental group of 3.89(SD=0.95,P<0.01).There was no significant difference on blood pressure variation in both groups. While heart rate variation in experimental group was lower than that in control group (16.3%,SD=3.4 vs. 22.6%,SD=5.0, P<0.01).No obvious complications were found in both groups. The anesthesia cost of the experimental group is about 1.53 dollars, with 1.75 dollars lower than that of the control group.Conclusion: It is tolerable and beneficial to apply the new catheter for male urethral anesthesia. It can significantly relieve the pain during rigid cystoscopy in male patients, and is low in cost and easy in operation. Thus this method is worth being recommended to hospitals, especially at community hospitals or primary hospitals. [ABSTRACT FROM AUTHOR]

Purpose: Patients with non-muscle invasive bladder cancer (NMIBC) have a high possibility of recurrence after surgery. We aimed to assess the factors associated with tumor recurrence and to construct a nomogram model that can contribute to personalized treatment plans of each patient., Methods: 496 patients with primary bladder cancer (BC) from 2 centers were retrospectively analyzed. Preoperative neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and traditional clinical parameters were collected, then using univariate and multivariate Cox regression analysis to find out the independent risk factors associated with tumor recurrence among them, and then these independent factors were incorporated into the nomogram model. The internal calibration curves and the external calibration curves were used to verify their usefulness., Results: In the training cohort, 150 patients (43.1%) experienced recurrence. After Cox regression analysis, the independent risk factors affecting recurrence-free survival (RFS) were tumor grade, immediate postoperative instillation therapy (IPPIT), NLR, and SII. These factors were used to construct a model to predict RFS 1, 2, 3, and 5 years of NMIBC patients after surgery. And then, we found that the constructed model outperforms the conventional model in terms of accuracy and predictability, the results were verified by statistical tests., Conclusion: Preoperative inflammatory response markers have a predictive value for postoperative recurrence in patients with NMIBC. The constructed nomogram model can be helpful in guiding personalized clinical evaluation and subsequent treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yi, Pi, Liu, Xiong, Liu, Fu, Wang and Zhao.)

Objective: By comparing with rigid ureteroscopy (r-URS), we explored the application value of flexible holmium laser sheath combined with r-URS in treating impacted upper ureteral stones. We also verified its effectiveness, safety and economy and investigated its application prospects at community or primary hospitals., Methods: From December 2018 to November 2021, 158 patients with impacted upper ureteral stones were selected from Yongchuan Hospital of Chongqing Medical University. Seventy-five patients in the control group were treated with r-URS, and 83 patients in the experimental group were treated with r-URS combined with a flexible holmium laser sheath if necessary. The operation time, postoperative hospital stay, hospitalization expenses, stone clearance rate after r-URS, auxiliary extracorporeal shock wave lithotripsy (ESWL) ratio, auxiliary flexible ureteroscope, the incidence of postoperative complications and the stone clearance rate after one month were observed., Results: The postoperative hospital stay, stone clearance rate after r-URS, the ratio of auxiliary ESWL, the ratio of the auxiliary flexible ureteroscope, and total hospitalization expenses in the experimental group were significantly less than those in the control group ( p < 0.05). There was no significant difference in operation time, postoperative complications, and stone clearance rate after one month between the two groups ( p > 0.05)., Conclusions: r-URS combined with flexible holmium laser sheath in treating impacted upper ureteral stones can improve the stone clearance rate and reduce hospitalization expenses. Therefore, it has a certain application value in community or primary hospitals.