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As the final stage of disease-related tissue injury and repair, fibrosis is characterized by excessive accumulation of the extracellular matrix. Unrestricted accumulation of stromal cells and matrix during fibrosis impairs the structure and function of organs, ultimately leading to organ failure. The major etiology of fibrosis is an injury caused by genetic heterogeneity, trauma, virus infection, alcohol, mechanical stimuli, and drug. Persistent abnormal activation of "quiescent" fibroblasts that interact with or do not interact with the immune system via complicated signaling cascades, in which parenchymal cells are also triggered, is identified as the main mechanism involved in the initiation and progression of fibrosis. Although the mechanisms of fibrosis are still largely unknown, multiple therapeutic strategies targeting identified molecular mechanisms have greatly attenuated fibrotic lesions in clinical trials. In this review, the organ-specific molecular mechanisms of fibrosis is systematically summarized, including cardiac fibrosis, hepatic fibrosis, renal fibrosis, and pulmonary fibrosis. Some important signaling pathways associated with fibrosis are also introduced. Finally, the current antifibrotic strategies based on therapeutic targets and clinical trials are discussed. A comprehensive interpretation of the current mechanisms and therapeutic strategies targeting fibrosis will provide the fundamental theoretical basis not only for fibrosis but also for the development of antifibrotic therapies., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Background: Renal stone is a highly prevalent life-long disease with a high recurrence rate. Chronic bowel diseases, including chronic gastrointestinal symptoms (chronic constipation or chronic diarrhea), are common gastrointestinal problems. We aimed to evaluate the associations of chronic constipation and chronic diarrhea with renal stones., Methods: This large-scale, cross-sectional study was performed within participants (≥20 years old) from the National Health and Nutrition Examination Survey from 2007 to 2010. Logistic regression and sensitivity analyses were conducted to clarify the association between chronic bowel diseases and renal stones., Results: A total of 8,067 participants aged ≥20 years were included. The prevalence of renal stones is 9.14%. Chronic diarrhea was positively related to the risk of renal stones [odds ratio (OR) =1.681, 95% confidence interval (CI): 1.212 to 2.330, P=0.004] after adjusting for all covariates. In participants with body mass index (BMI) over 30 kg/m 2 , chronic constipation was correlated with kidney stones in fully adjusted model 2 (OR =2.142, 95% CI: 1.389 to 3.303, P=0.004)., Conclusions: Our findings provide evidence that chronic diarrhea is associated with an increased risk of renal stones. Chronic constipation is positively related to the risk of renal stones in participants with BMI over 30 kg/m 2 . Health care should focus more on bowel health status for the prevention of related diseases. More prospective cohort studies are needed., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-212/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Background: Kidney stones are among the most common urological conditions affecting ~9% of the world population. Although some unhealthy diets and unhealthy lifestyles are reportedly risk factors for kidney stone, the association between daily sitting time and kidney stone has not been explored., Materials and Methods: This large-scale, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database 2007-2016. Kidney stone history and daily sitting time were retrieved from the questionnaire and 24 hour (h) recall interviews. Logistic regression and subgroup analysis were conducted to investigate the association. The analysis was further stratified by vigorous recreational activity., Results: A total of 19 188 participants aged ≥20 years with complete information were included in this study. The overall prevalence of kidney stone was 9.6%. Among participants without vigorous recreational activity, a trend towards an increasing prevalence of kidney stone was observed with increased daily sitting time. However, the trend was not observed in individuals who participated in vigorous recreational activity, as they experienced a decreased risk of kidney stone despite having a daily sitting time of 6-8 h (crude model OR=0.659, 95% CI: 0.457-0.950, P =0.028), indicating that vigorous recreational activity may partially attenuate the detrimental effect of prolonged sitting time., Conclusion: Our study revealed an increasing trend of prevalence of kidney stone with increased daily sitting time among the population not performing vigorous recreational activity despite the difference was nonsignificant. Vigorous recreational activity may modify the association between daily sitting time and kidney stone. More prospective cohort studies are warranted to further examine this association., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Metal ureteral stents (MUS) has gained popularity as an endoscopic treatment alternative for the management of ureteral strictures. The aim of this study was to evaluate the safety, efficacy, and tolerability of MUS for treating ureteral strictures and to identify any factors that could influence the success of this intervention., Methods: This study is a prospective analysis of the efficacy and safety of MUS for treating ureteral strictures in a single-center setting. The study enrolled 246 patients who had been diagnosed with ureteral strictures and had undergone MUS placement between January 2019 and July 2021. The patients were followed-up for a duration of 2 years., Results: The overall success rate of MUS placement was 71.7%. Furthermore, the success rate of ureteral strictures after kidney transplantation (78.2%) was significantly higher than common ureteral strictures (73.0%) or recurrent ureteral strictures (67.6%). Additionally, postsurgery, there was a considerable reduction in hydronephrosis volume (68.9±96.1 vs. 32.1±48.8 cm 3 ), blood creatinine level (103.7±49.8 vs. 94.4±47.5 mol/l) and urea nitrogen level (6.7±7.2 vs. 5.1±2.4 mmol/l). The study also reported that the rate of adverse events associated with MUS was relatively low, included hematuria (7.9%), pain (6.8%), urinary tract infection (6.4%), and lower urinary tract symptoms (5.3%)., Conclusions: MUS appear to be a safe and effective treatment option for ureteral strictures, with a high success rate and low complication rate. These results have important implications for the management of ureteral strictures and can help guide clinical decision-making in the selection of treatment options., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)