Objective To investigate the association between body roundness index (BRI) and urge urinary incontinence (UUI) in a nationally representative U.S.population, so as to provide a new indicator for the prevention and management of UUI. Methods A total of 17226 participants from the 2015—2023 National Health and Nutrition Examination Survey (NHANES) were included in the study. The association between BRI and UUI was assessed with weighted multivariable logistic regression, and the nonlinear relationship was analyzed with weighted restricted cubic spline (RCS). Subgroup analyses were conducted based on demographic and clinical characteristics to explore potential heterogeneity in the association. Receiver operating characteristic (ROC) curves were plotted to compare the predictive performance of BRI with body mass index (BMI) and waist circumference for UUI, and the area under the curve (AUC) was calculated. Results A total of 4879 UUI patients (28.32%, UUI group) and 12347 non UUI participants (71.68%, NUUI group) were included in the 17226 participants. Significant differences were observed between the UUI and NUUI groups in terms of age, sex, race, marital status, BIM, height, waist circumference, poverty income ratio (PIR), diabetes, alcohol consumption and smoking (P<0.001). The participants in the UUI group had significantly higher BRI than that in the NUUI group [ (6.53±2.63) vs. (5.47±2.34), P<0.001]. As BRI increased from Q2 to Q4, the incidence of UUI also rose (P_(trend)<0.0001). After the confounding factors were fully adjusted, participants in the Q4 group had a 104% increased risk of UUI compared to the Q1 group (OR=2.04, 95% CI:1.81-2.30, P<0.0001). There was a significant positive nonlinear trend in the dose-response relationship between UUI and BRI (P_(overall trend)<0.001, P_(nonlinear association)=0.886). Subgroup analysis showed that the association between UUI and BRI was more significant in diabetic patients, different racial and BMI stratifications (P<0.05).ROC curve analysis showed that, compared with BMI (AUC=0.59) and waist circumference (AUC=0.59), BRI demonstrated superior predictive accuracy (AUC=0.63, P<0.001). Conclusion Based on US 2015—2023 NHANES, the study shows that increased BRI is independently associated with an increased risk of UUI, and its predictive performance is superior to traditional obesity metrics.BRI has the potential to serve as a risk stratification tool for UUI.

Objective Bladder cancer(BLCA)is a common disease,and the pathogenesis of which is not clear.This study aims to find the key genes of bladder cancer for future prevention and treatment.Methods The bladder cancer dataset GSE121711 was obtained from the Gene Expression Omnibus(GEO)database of NCBI.The weighted gene coexpression network analysis(WGCNA)was performed on GEO data to identify the gene modules highly associated with BLCA in the samples.The intersecting genes of differentially expressed genes(DEG)and genes in the module were extracted.The common genes were analyzed by Gene Ontology(GO)and Kyoto Encyclopedi-a of Genes and Genomes(KEGG),and the key genes with the highest degree were further screened through the Protein-protein interac-tion(PPI)network.The cluster analysis is carried out.Finally,the LASSO is used to establish the diagnostic model.The expression of hub genes in BLCA tissues and normal tissues was detected by using reverse transcription real-time quantitative polymerase chain reaction(RT-qPCR).Results WGCNA showed the most significant association between the black module and bladder cancer.There were 611 genes in the black module and intersected with DEG for 449 common genes.A diagnostic model consisting of RAC3,APOL4,FASN and CLASRP was constructed using LASSO,and analysis was conducted using receiver operating characteristic(ROC)curves at time points of 365 days(1 year),1095 days(3 years)and 1825 days(5 years).The Area Under Curve(AUC)of 365(1 year),1095(3 years)and 1825(5 years)were 80％,82％and 85％,respectively.The results were verified on the combined dataset of GSE101723 and GSE83586,which were found to be similar to those of bioinformatics.The relative expression levels of hub genes RAC3,APOL4,FASN and CLASRP mRNA in BLCA tissues were significantly higher than those in normal tissues(t=8.074,P＜0.0001;t=3.577,P＜0.001;t=12.241,P＜0.0001;t=8.846,P＜0.0001).Conclusion We constructed a BLCA diagnostic model and found that RAC3,APOL4,FASN and CLASRP were potential biomarkers that may provide new insights to improve the early diagnosis and treatment of blad-der cancer.

Objective Bladder cancer(BLCA)is a common disease,and the pathogenesis of which is not clear.This study aims to find the key genes of bladder cancer for future prevention and treatment.Methods The bladder cancer dataset GSE121711 was obtained from the Gene Expression Omnibus(GEO)database of NCBI.The weighted gene coexpression network analysis(WGCNA)was performed on GEO data to identify the gene modules highly associated with BLCA in the samples.The intersecting genes of differentially expressed genes(DEG)and genes in the module were extracted.The common genes were analyzed by Gene Ontology(GO)and Kyoto Encyclopedi-a of Genes and Genomes(KEGG),and the key genes with the highest degree were further screened through the Protein-protein interac-tion(PPI)network.The cluster analysis is carried out.Finally,the LASSO is used to establish the diagnostic model.The expression of hub genes in BLCA tissues and normal tissues was detected by using reverse transcription real-time quantitative polymerase chain reaction(RT-qPCR).Results WGCNA showed the most significant association between the black module and bladder cancer.There were 611 genes in the black module and intersected with DEG for 449 common genes.A diagnostic model consisting of RAC3,APOL4,FASN and CLASRP was constructed using LASSO,and analysis was conducted using receiver operating characteristic(ROC)curves at time points of 365 days(1 year),1095 days(3 years)and 1825 days(5 years).The Area Under Curve(AUC)of 365(1 year),1095(3 years)and 1825(5 years)were 80％,82％and 85％,respectively.The results were verified on the combined dataset of GSE101723 and GSE83586,which were found to be similar to those of bioinformatics.The relative expression levels of hub genes RAC3,APOL4,FASN and CLASRP mRNA in BLCA tissues were significantly higher than those in normal tissues(t=8.074,P＜0.0001;t=3.577,P＜0.001;t=12.241,P＜0.0001;t=8.846,P＜0.0001).Conclusion We constructed a BLCA diagnostic model and found that RAC3,APOL4,FASN and CLASRP were potential biomarkers that may provide new insights to improve the early diagnosis and treatment of blad-der cancer.

Objective:To investigate the effects of Wnt5a on the vasculogenic mimicry(VM)and cancer stem cell(CSC)properties of prostate cancer(PCa)cells by upregulating the expression of miR-141-3p.Methods:Human prostate epithelial cell line RWPE-1 and PCa cell lines PC-3,LNCaP,and DU145 were cultured.qPCR was employed to detect miR-141-3p expression,and Western blotting(WB)was used to measure Wnt5a protein levels.Stable Wnt5a-knockdown or miR-141-3p-knockdown LNCaP and DU145 cell lines were established respectively via plasmid transfection.VM formation ability was assessed by three-dimensional culture assay.Cell proliferation ability and drug sensitivity were measured by CCK-8 assay.Cell migration and invasion abilities were detected using wound healing and Transwell assays,respectively.The expressions of VM-related molecules and CSC markers were detected by qPCR and WB.Colony formation ability was determined by clonogenic assay.The proportion of CD133+cells was sorted and calculated by flow cytometry.The expressions of miR-141-3p and Wnt5a in CD133+and CD133-cells were detected by qPCR and WB.Stable Wnt5a-overexpressing PCa cell lines were constructed via plasmid transfection.The effects of Wnt5a and different Wnt pathway downstream inhibitors on miR-141-3p expression and promoter activity were detected by qPCR and dual-luciferase reporter assays.Expression of c-Jun was knocked down in Wnt5a-overexpressing cells using si-c-Jun transfection.The target binding relationship between c-Jun and the miR-141-3p promoter was verified by qPCR,dual-luciferase reporter assay,and chromatin immunoprecipitation assay.Results:The expressions of miR-141-3p and Wnt5a were significantly higher in PCa cells compared with those in RWPE-1 cells,with the highest relative expression in DU145 cells and the lowest in LNCaP cells(P<0.001).Downregulation of Wnt5a or miR-141-3p significantly inhibited VM formation ability and stemness of PCa cells,and significantly suppressed the proliferation,migration,invasion abilities,and enhanced the sensitivity to bicalutamide of PCa cells(P<0.05 or P<0.01 or P<0.001).Downregulation of Wnt5a significantly inhibited miR-141-3p expression and promoter transcriptional activity(P<0.01 or P<0.05),whereas upregulation of Wnt5a significantly promoted miR-141-3p expression and promoter transcriptional activity(P<0.01 or P<0.001).The promoting effect of Wnt5a on miR-141-3p expression and promoter transcriptional activity could be inhibited by a JNK/c-Jun pathway inhibitor(P>0.05).Downregulation of c-Jun significantly inhibited the promoting effect of Wnt5a on miR-141-3p expression and promoter transcriptional activity(P>0.05).c-Jun could bind to the-348 to-295 sequence of the miR-141-3p promoter.In absence of this fragment Wnt5a wouldn't promote miR-141-3p expression(P>0.05).Conclusion:The Wnt5a/JNK/c-Jun signaling pathway can upregulate miR-141-3p expression,and thereby promote VM formation in PCa cells,possibly by activating CSC properties.

Objective To investigate the correlation of Wnt5a expression and vasculogenic mimicry (VM) in prostate cancer tissues, and analyze their relationships with cancer stem cells (CSCs) characteristics and epithelial–mesenchymal transition (EMT). Methods Immunohistochemistry was conducted to detect the expression of Wnt5a in 50 prostate cancer tissues and 50 benign prostatic hyperplasia tissues. The expression levels of CD133, vimentin, and E-cadherin were detected in the prostate cancer tissues, and CD34/PAS double staining was used to detect VM structures. We analyzed the difference in Wnt5a level between prostate cancer and benign prostatic hyperplasia tissues, the clinical significance of Wnt5a and VM, the relationship of Wnt5a expression and VM, and the relationships of Wnt5a expression and VM with CD133, Vimentin, E-cadherin. Results The expression of Wnt5a was significantly higher in prostate cancer tissues than in benign prostatic hyperplasia (P < 0.05). A positive correlation was observed between Wnt5a expression and VM (P < 0.05). The expression levels of Wnt5a and VM were positively correlated with those of CD133 and vimentin (P < 0.05). Wnt5a expression and VM were positively correlated with Gleason score, vas deferens invasion and lymphatic metastasis (P < 0.05) of prostate cancer, and VM was also positively correlated with T stage of prostate cancer (P < 0.05). Conclusion The expression level of Wnt5a in prostate cancer tissues is elevated and positively related with VM formation. Wnt5a expression and VM are correlated with cancer stem cells characteristics and the expression of epithelial–mesenchymal transition marker proteins.

[Objective] To investigate the clinical application of microscope-assisted subinguinal hierarchical dissection in the treatment of varicocele (VC), so as to provide reference for clinicians. [Methods] The clinical data of 113 VC patients admitted to our hospital during Jul.2021 and Jun.2022 were retrospectively analyzed.All patients were treated with microscope-assisted hierarchical anatomical spermatic vein ligation under the external ring, with layered isolation.The number of intraoperative ligations of the internal spermatic veins and external spermatic vein, preserved arteries as well as the number of lymphatic vessels were recorded. [Results] Among the 13 patients with a mean age of (28.7±6.0) years, 98 had left-side lesion and 15 had bilateral lesion.The degree of varicocele: degree Ⅱ in 44 cases and degree Ⅲ in 69 cases.Intraoperative ligation of the internal spermatic veins: (9.18±3.21) on the left side and (9.02±3.39) on the right side.Intraoperative ligation of the external spermatic veins: (1.47±0.93) on the left side and (1.41±1.10) on the right side.Preservation of the internal spermatic arteries: (2.03±1.07) on the left side, (1.97±0.99) on the right side.Preservation of the external spermatic arteries: (1.42±0.50) on the left side and (1.40±0.50) on the right side.Preservation of lymphatics: (3.87±2.07) on the left and (3.89±1.99) on the right. [Conclusion] Hierarchical dissection ensures the integrity of the vas deferens and its vascular system, and tubular isolation aids in intraoperative reference identification, avoid omission of tiny veins and injury to lymphatic vessels, which helps to improve the surgical skills of beginners or less experienced surgeons.

【Objective】 To investigate the clinical effects of electrophysiological technique combined with pelvic floor muscle training on urinary incontinence after electroresection of benign prostatic hyperplasia (BPH) based on the concept of enhanced recovery after surgery (ERAS). 【Methods】 A total of 86 patients with urinary incontinence treated with electroresection of BPH during Oct.2019 and Feb.2022 were randomly divided into control group and observation group, with 43 cases in either group. All patients received health education plus pelvic floor muscle training, and the observation group also received electrophysiological treatment. The differences in the indexes before and after treatment were compared between the two groups. 【Results】 There were no significant differences in the 1 h pad test, ICIQ-SF score, maximum urinary flow rate (Qmax), post void residual (PVR), International Prostate Symptom Score (IPSS), 24 h urinary incontinence frequency, and Urinary Incontinence Quality of Life Questionnaire Score (I-QoL) before treatment between the two groups (P>0.05). However, after treatment, Qmax and I-QoL score were significantly higher in the observation group than in the control group, while the other 5 indicators were significantly lower in the observation group than in the control group (all P<0.05). The total clinical effective rate was significantly higher in the observation group than in the control group (P<0.05). 【Conclusion】 Electrophysiological technique combined with pelvic floor muscle training can effectively improve the symptoms of urinary incontinence and promote the recovery of urinary control function, which is in line with the concept of ERAS and is worthy of further research and promotion.

【Objective】 To analyze the clinical characteristics of children with ammonium urate stones in Xinjiang, so as to provide reference for the prevention and treatment of this disease. 【Methods】 The clinical data of all children with ammonium urate stones admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region from 2016 to 2021 were retrospectively analyzed, including age, sex, body mass index, stone site, stone size, stone component, urine pH, urine culture and biochemical examination results. The serum total protein, albumin, sodium, potassium, calcium, magnesium, uric acid and urine pH were compared between the pure and mixed groups. 【Results】 A total of 61 children (31.6%) had ammonium urate stones, their average age was (4.05±3.37) years, and the male to female ratio was 2.21∶1. Among them, there were 37 cases (60.7%) of renal calculi and 50 cases (82.0%) of upper urinary calculi. The most common component of mixed ammonium urate stones was calcium oxalate, including calcium oxalate monohydrate, calcium oxalate monohydrate and calcium oxalate dihydrate. Compared with mixed type, children with pure stone type had a younger age (P=0.001) and a smaller stone size (P=0.003). Positive urine culture was detected in 14 cases (23.0%), 7 of which (50% were infected with Escherichia coli, and 11 (78.6%) with non-urease bacteria. 【Conclusion】 Non-urease bacteria are the main pathogens of urinary tract infection in children with ammonium urate stones. The incidence is higher in boys, and the most common stone location is upper urinary tract. Calcium oxalate is the most common mixed component. Pure type is more common in young children and the stones are relatively small.

Objective:To analyze the composition and clinical characteristics of urinary calculi in infants in Xinjiang.Methods:The clinical data of 75 infants with urinary calculi admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2021 were retrospectively analyzed, including the general situation of the children, stone-related parameters, random urine pH value, urine culture and biochemical examination results. The serum uric acid, serum calcium, urine pH value, positive rate of urine culture, and stone length between infants with and without ammonium urate stones were compared. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for inter-group comparison. Measurement data that did not conform to the normal distribution were expressed as the median (interquartile distance) [ M ( Q1, Q3)], and Mann-Whitney U test was used for comparison between groups. The Chi-square test, continuity-corrected Chi-square test or Fisher exact probability method were used for the comparison of count data. Results:The median age of infants with urinary calculi was 23.04 months, and the ratio of male to female was 3.2∶1. More than half of the infants (81.3%, 61/75) came from rural areas, 57.3% (43/75) were malnourished, 33.3% (25/75) were complicated with urinary tract infection, and 8.0% (6/75) were combined with urinary system congenital malformation. The calculi were found in 53 cases (70.67%) of kidney, 27 cases (36.0%) of ureter, 17 cases (22.67%) of urethra and 16 cases (21.33%) of bladder. The analysis of calculi composition showed that there were 44 cases (58.67%) of ammonium urate, 39 cases (52.0%) of calcium oxalate, 14 cases (18.67%) of apatite carbonate and 7 cases (9.33%) of uric acid. Kidney calculi was more common in female infants ( P=0.011). Compared with the infant group ( n=19), calcium oxalate stones were more common in the preschooler group ( n=56) ( P=0.039), but there were not statistical difference in the incidence of ammonium urate, apatite carbonate and uric acid stones. There were not statistical difference in gender, age, place of residence, nutritional status, serum uric acid, serum calcium, urine pH value, positive rate of urine culture, stone maximum diameter and incidence of bladder stones between ammonium urate group and non-ammonium urate group. Conclusions:The incidence of urinary calculi in infants is higher in boys, and the most common site of calculi is the upper urinary tract, especially in female kidney calculi. Ammonium urate is the main component of urinary calculi in infants. Calcium oxalate stones are more common in preschooler group. Infants with urinary calculi are mostly rural residents, and malnutrition and urinary tract infection are more common.

Objective:To evaluate the application value of dual-source CT in detecting the components of urinary calculi in children.Methods:A retrospective analysis of 433 children treated for urinary calculi in the Urological Center, People′s Hospital of Xinjiang Uygur Autonomous Region from March 2018 to January 2021 was performed in parallel with dual-source CT examination. The data was processed by the post-processing workstation and the stone composition was analyzed. The analysis results were compared with the results of infrared spectroscopy, and the accuracy of dual-source CT analysis of stones and the predictive value of dual-source CT various measurement indexes for the types of stones were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison of the measurement indexes of each stone type [average CT value, dual energy difference, dual energy ratio and dual energy index (DEI)] were compared by One-way Anova analysis of variance. Draw receiver operator characteristic curve and calculate the area under the curve (AVC), then evaluate the diagnostic efficacy of each index. Results:Dual-source CT detected 282 calcium oxalate stones, 238 calcium phosphate stones, 39 uric acid stones and 7 cystine stones. Compared with the results of infrared spectroscopy, the accuracy rates of dual-source for calcium oxalate stones and hydroxyapatite stones were 84.2% and 81.8%, respectively. Both uric acid stones and cystine stones were accurately detected. In addition, dual energy difference, dual energy ratio, and DEI have reliable predictive value for calcium oxalate stones and calcium phosphate stones, especially dual energy ratio and DEI, both AUC>0.75.Conclusion:Using advanced post-processing analysis methods, dual-source CT can reliably analyze the components of children′s urinary tract stones, and provide a reference for choosing personalized treatment plans.