1.Comparison of the effects of transperineal prostate laser ablation versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia:a single center prospective randomized controlled study
Zhen YAO ; Yunhua JI ; Linmeng WANG ; Qi XUE ; Manman SHI ; Zhirong LUO ; Bo ZHANG
Journal of Modern Urology 2024;29(6):486-491
Objective To compare the clinical efficacy of transperineal prostate laser ablation(TPLA)and transurethral resection of the prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH).Methods A total of 60 BPH patients diagnosed during Oct.2021 and Oct.2022 at Tangdu Hospital were selected as the research subjects and randomly divided into the TPLA group(n=30)and TURP group(n=30).The intraoperative bleeding volume,operation time,catheter indwelling time,length of hospital stay,postoperative sexual dysfunction,and surgical related complications were compared between the two groups.The international prostate symptom score(IPSS),international index of erectile function-5(IIEF-5),maximum urinary flow rate(Qmax),quality of life score(QoL),postvoid residual(PVR)and prostate volume(PV)were compared between the two groups before surgery and 1,3,and 12 months after surgery.Results The TPLA group had significantly less intraoperative bleeding volume,shorter operation time and length of hospital stay compared to the TURP group,but longer catheter indwelling time(P<0.05).Both groups showed significant improvement in IPSS and Qmax 1,3,and 12 months postoperatively compared to preoperative(P<0.05),the IPSS of the TPLA group was significantly higher than that of the TURP group 1 and 3 months after surgery(P<0.05);the Qmax of TPLA group 1,3,and 12 months after surgery was lower than that of the TURP group(P<0.05).The IIEF-5 score was significantly better in the TPLA group than in the TURP group after surgery(P<0.05).The postoperative QoL,PV,and PVR levels in both groups improved after surgery(P<0.05),the QoL of the TPLA group was lower than that of the TURP group 1 and 12 months after surgery(P<0.05),the PV and PVR of the TPLA group were higher than those of the TURP group 1,3,and 12 months after surgery(P<0.05).The incidence of surgery-related complications(3.33%vs.26.67%)and postoperative sexual dysfunction(3.33%vs.36.67%)in the TPLA group were lower than those in the TURP group(P<0.05).Conclusion TPLA shows significant efficacy in treating BPH with minimal impact on the sexual function.It provides a new approach for BPH patients and can serve as an effective complementary method in clinical practice.
2.Analysis of the causal relationship between gut microbiota and bladder cancer with Mendelian randomization
Xuyan GUO ; Zhirong LUO ; Qi XUE ; Yunhua JI ; Xiao TAN ; Yong JIAO
Journal of Modern Urology 2025;30(5):400-407
Objective: Previous observational studies have confirmed the correlation between gut microbiota and bladder cancer,but the causal relationship is still unclear.This study aimed to explore the causal relationship between them with Mendelian randomization. Methods: Genetic variation summary data of 211 gut microbiota and bladder cancer genome-wide association studies (GWAS) were obtained from the MiBioGen Consortium and Finngen database.Single nucleotide polymorphisms (SNPs) closely related to these studies were screened as instrumental variables.The causal relationship between gut microbiota and bladder cancer were analyzed with inverse variance weighting (IVW),MR-Egger,weighted median,maximum likelihood,robust adjustment feature score and MR-PRESSO,with IVW as the primary analysis method.Additionally,sensitivity analysis was used to test the heterogeneity (Cochran Q) and horizontal pleiotropy (MR-Egger intercept term and global test from MR-PRESSO estimator) to ensure the robustness of the results. Results: The IVW results indicated that Lachnospiraceae UCG004 (OR:1.42),Desulfovibrionales (Order) (OR:1.48),Eubacterium ruminantium group (OR:1.33),Olsenella (OR:1.24),Ruminococcaceae UCG002 (OR:1.39),Ruminococcaceae UCG005 (OR:1.42) and Ruminococcaceae UCG013 (OR:1.64) significantly increased the risk of bladder cancer.Conversely,Bacteroidetes (Phylum) (OR:0.61),Eubacterium brachy group (OR:0.80),Ruminococcaceae UCG004 (OR:0.73),Rikenellaceae (Family) (OR:0.67),Lachnospiraceae ND3007 group (OR:0.47), Adlercreutzia (OR:0.73) and an unknow genus (OR:0.75) were associated with a reduced risk of bladder cancer.Sensitivity analyses did not reveal any heterogeneity or horizontal pleiotropy. Conclusion: This study reveals the causal role of 14 gut microbiota in the pathogenesis of bladder cancer,among which Lachnospiraceae UCG004,Desulfovibrionales (Order),Eubacterium ruminantium group,Olsenella,Ruminococcaceae UCG002,Ruminococcaceae UCG005 and Ruminococcaceae UCG013 are risk factors for bladder cancer,while Bacteroidetes (Phylum),Eubacterium brachy group,Ruminococcaceae UCG004,Rikenellaceae (Family),Lachnospiraceae ND3007 group,Adlercreutzia and an unknown genus are the protective factors.
3.Single-cell Transcriptome Analysis of Sertoli Cells under High-altitude Environment Reveals Reproductive Toxicity Mechanisms
Yunhua JI ; Linmeng WANG ; Zhen YAO ; Xiao TAN ; Xuyan GUO ; Haozhong HOU ; Bo ZHANG
Medical Journal of Peking Union Medical College Hospital 2024;15(3):587-597
To construct a single-cell transcriptomic map of testicular tissue under hypobaric hypoxia exposure and perform diversity analysis of supportive cells, aiming to provide new insights into the mechanisms of reproductive toxicity for future research. Twenty healthy male mice were randomly divided into a control group ( A single-cell transcriptomic map of testicular tissue was successfully constructed, including 6 samples with a total of approximately 49 027 cells covering 11 cell types. Supportive cells were clustered into 4 subgroups using non-negative matrix factorization algorithm. Subgroup 3 may be more sensitive to hypoxic stimulation and could reduce reproductive cell function damage caused by hypobaric hypoxia by affecting Based on single-cell sequencing technology, the molecular basis and regulatory signals of supportive cells under hypobaric hypoxia exposure is revealed for the first time. It provides an in-depth exploration of the mechanisms of reproductive toxicity induced by hypobaric hypoxia at the single-cell level, offering a new perspective for future clinical research in this field.
4.Influencing factors of bladder management practices in patients with spinal cord injury
Zhirong LUO ; Xuyan GUO ; Qi XUE ; Xiao TAN ; Yunhua JI ; Fuxun ZHANG ; Yong JIAO ; Bo ZHANG
Journal of Modern Urology 2025;30(4):284-289
Objective: To explore the key factors affecting the selection and effectiveness of bladder management modalities in patients with spinal cord injury,so as to provide reference for the optimization of individualized bladder management strategies. Methods: The clinical and follow-up data of 78 patients with spinal cord injury treated in our hospital during Jan.1,2013 and Dec.31,2022 were retrospectively analyzed.The distribution of bladder management modalities among different grades of injuries was analyzed. Bowker symmetry test was used to evaluate the difference between bladder management modalities at discharge and at the end of follow-up. Multiple linear regression was used to explore the influencing factors of bladder management effects. Plotting Kaplan-Meier survival curves were adopted to calculate the median time of changes in bladder management. Results: At discharge,there were 9 cases of self-catheterization,19 cases of intermittent catheterization,22 cases of reflexive voiding,26 cases of long-term catheterization,and 2 cases using urinary collector.At the end of follow-up,there were 15 cases of self-catheterization,8 cases of intermittent catheterization,34 cases of reflexive voiding,14 cases of long-term catheterization,and 7 cases using urinary collector.There was a significant difference between the modalities of bladder management at discharge and at the end of follow-up (χ
=21.43,P=0.018).Multiple linear regression showed a significant decrease of 8.60 in the total neurogenic bladder symptom score (NBSS) for grade D injuries compared with grade A injuries (P=0.026). The median time to bladder management change was 7.93 months (95%CI:5.44-9.44), with approximately 50% of patients experiencing a change in bladder management within 8 months after discharge. Conclusion: The modalities of bladder management changed significantly after discharge.The grade of injury was a key factor affecting the effectiveness of bladder management.Higher grade was associated with worse effectiveness of bladder management.