北京大学学报（医学版）最新文献

{"title":"[Analysis of endoscopic surgical strategies for duplex kidney and ureteral malformation complicated with upper urinary tract calculi].","authors":"Xinji Yang, Xiushi Lin, Zhifei Xie, Yuqing Liu, Chunlei Xiao, Shudong Zhang, Xiaofei Hou, Min Qiu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the endoscopic surgical management strategies for duplex kidney and ureteral duplication anomalies complicated by upper urinary tract calculi, to summarize individualized diagnostic and therapeutic experiences for different anomaly subtypes, and to provide a reference for standardized clinical management of this condition.</p><p><strong>Methods: </strong>The clinical data of patients with duplex kidney and ureteral duplication anomalies and upper urinary tract calculi who underwent endoscopic surgery at the Department of Urology, Peking University Third Hospital from November 2012 to December 2025 were retrospectively analyzed. Baseline characteristics, imaging findings, perioperative parameters, complications, and changes in renal function were collected. Endoscopic surgical techniques and key diagnostic and therapeutic points for different anomaly subtypes were summarized. Statistical analysis was performed using SPSS 22.0 and R 3.6.1 software.</p><p><strong>Results: </strong>A total of 38 patients were enrolled, including 16 males and 22 females, with a mean age of (49.92±14.27) years. The median follow-up duration was 17.80 months (1.60-41.90). The predominant clinical symptom was flank pain (32 cases, 84.21%). The most common anomaly subtype was unilateral incomplete duplex kidney and ureteral duplication (24 cases, 63.16%). Based on the anomaly subtype and stone characteristics, all the patients underwent precise preoperative assessment using CT urography and other imaging modalities, and indivi-dualized surgical approaches were selected: In the study, 15 patients underwent ureteroscopic lithotripsy (URL), 15 underwent flexible ureteroscopic lithotripsy (FURL), 7 underwent percutaneous nephrolithotomy (PCNL), and 1 patient received PCNL combined with FURL. The median operative time was 74.00 (64.75-92.50) min, the median intraoperative blood loss was 2.00 (1.00-4.25) mL, and the median postoperative hospital stay was 3.00 (2.00-5.75) d. The overall postoperative stone-free rate was 94.74%. No severe perioperative complications occurred. Postoperative fever occurred in 14 patients (36.84%), all of whom recovered after symptomatic treatment. Postoperative serum creatinine levels were significantly lower than preoperative levels (<i>P</i> < 0.05), indicating significant improvement in renal function.</p><p><strong>Conclusion: </strong>Endoscopic surgery is safe and effective for the treatment of duplex kidney and ureteral duplication anomalies complicated by upper urinary tract calculi, offering advantages of minimal trauma, rapid recovery, and a high stone-free rate. The strategy of \"precise diagnosis-individualized surgical approach selection\" allows the formulation of tailored treatment plans for different anomaly subtypes and is worthy of clinical promotion and application.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"754-761"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of thulium laser enucleation of the prostate <i>versus</i> transurethral resection of the prostate on sexual function in patients with benign prostatic hyperplasia: A retrospective cohort study].","authors":"Kaiyue Chen, Shuhui Yu, Jianing Han, Ziwei Liu, Jiahui Ma, Kai Zhang, Yisen Meng, Xinyan Che","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the effects of thulium laser enucleation of the prostate (ThuLEP) and monopolar transurethral resection of the prostate (TURP) on sexual function in patients with benign prostatic hyperplasia (BPH).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study was conducted involving patients who underwent ThuLEP or TURP at the Department of Urology, Peking University First Hospital, between January 2022 and December 2023. Participants were recruited &lt;i&gt;via&lt;/i&gt; convenience sampling. Propensity score matching (PSM) was subsequently employed to balance preoperative baseline characteristics between the two cohorts.Following propensity score matching, we conducted a comparative analysis of sexual function and voiding improvement metrics between the two cohorts. Sexual function was assessed using the international index of erectile function-5 (IIEF-5) scores and the incidence of retrograde ejaculation. Voiding outcomes were evaluated based on the international prostate symptom score (IPSS), qua-lity of life (QOL) scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following propensity score matching, the study included 98 patients in both the ThuLEP and the TURP groups. Preoperative comparisons between the two groups regarding age, prostate volume, IIEF-5 scores, incidence of retrograde ejaculation, IPSS, and QOL showed no statistically significant differences (&lt;i&gt;P&lt;/i&gt;&gt;0.05), indicating comparability between the groups. Regarding erectile function, postoperative IIEF-5 scores at 1 month and 12 months in both the ThuLEP and TURP groups did not differ significantly from preoperative scores (&lt;i&gt;P&lt;/i&gt;&gt;0.05). At 1 month postoperatively, there was no significant difference in IIEF-5 scores between the ThuLEP and TURP groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05). At the 12-month postoperative follow-up, the incidence of severe erectile dysfunction was significantly lower in the ThuLEP group compared with the TURP group (&lt;i&gt;Z&lt;/i&gt;=8.522, &lt;i&gt;P&lt;/i&gt;=0.036). Regarding ejaculatory function, the incidence of retrograde ejaculation at 1 month and 12 months postoperatively in both the ThuLEP and TURP groups differed significantly from preoperative rates (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Moreover, the incidence of retrograde ejaculation increased with time after surgery. At 1 month postoperatively, 9.2% of the ThuLEP group and 14.3% of the TURP group experienced retrograde ejaculation, which was not statistically different (&lt;i&gt;Z&lt;/i&gt;=1.231, &lt;i&gt;P&lt;/i&gt;=0.267). At 12 months postoperatively, the incidence of retrograde ejaculation in the ThuLEP and TURP groups was 19.4% and 25.5%, respectively, also showing no significant difference (&lt;i&gt;Z&lt;/i&gt;=1.055, &lt;i&gt;P&lt;/i&gt;=0.304). In terms of surgical parameters, comparisons of operative time, intraoperative blood loss, decrease in hemoglobin levels, and weight of resected prostate tissue between the ThuLEP and TURP groups revealed no significant differences (&lt;i&gt;P&lt;/i&gt;&gt;0.05). However, compared with the TURP group, the ThuLEP group had a shorter ho","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"762-769"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of coexistent low-grade components on the prognosis of high-grade non-muscle invasive bladder cancer].","authors":"Jiaxiang Ji, Chinhui Lai, Fei Wang, Hao Hu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of coexisted low-grade components on the prognosis of patients with high-grade solitary primary non-muscle invasive bladder cancer (NMIBC).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with primary, solitary, high-grade non-muscle invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumor (TURBT) at Peking University People' s Hospital between January 2015 and December 2019. All patients received single-dose intravesical chemotherapy within 24 hours after TURBT. Only patients accetpting adequate adjuvant intravesical chemotherapy were included for further analysis. Adequate intravesical chemotherapy was defined as weekly instillation for 8 weeks and monthly instillation for at least 6 months. All patients were strictly followed up according to the preestablished schedule with cystoscopic surveillance. The primary endpoint was recurrence free survival. Kaplan-Meier curve was used to compare the recurrence free survival of mHG group and pHG group. Univariable and multivariable Cox regression was conducted to evaluate the risk factors for tumor recurrence. Patients with variant histology, concurrent upper tract urothelial carcinoma, and incomplete resection which required re-TURBT were excluded. Patients without single instillation postoperative were also eliminated from the final cohort.</p><p><strong>Results: </strong>A total of 167 patients were enrolled in the final cohort, with 35 patients having mixed high-grade tumors (mHG) and 132 patients having pure high-grade tumors (pHG). The median follow-up time was 39.32 (26.82, 61.37) months. Baseline characteristics were well balanced between the two groups with regard to age, gender, pathological characteristics and instillation doses. Compared with the mHG group, the 5-year recurrence-free survival rate (RFS) of the pHG group was significantly lower (80.0% <i>vs.</i> 50.5%, <i>P</i>=0.01). Multivariate Cox regression analysis further confirmed that the presence of mixed low-grade components was an independent protective factor for recurrence free survival (<i>HR</i>=0.42, <i>P</i>=0.02), and other risk factors included T1 stage (<i>HR</i>=2.09, <i>P</i>=0.01). while tumor size was not associated with recurrence free survival.</p><p><strong>Conclusion: </strong>Coexistence of low-grade component in pathological specimen was associated with lower recurrence rate in patients with primary, solitary high-grade non-muscle invasive bladder cancer. Thus, it should be considered as a favorable pathological feature in bladder cancer patients.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"803-807"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy and safety of laparoscopic nephron-sparing surgery for giant renal angio-myolipoma].","authors":"Peichen Duan, Le Yu, Fan Zhang, Xiaofei Hou, Guoliang Wang, Yichang Hao, Shudong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Giant renal angiomyolipoma (RAML), typically defined as having a maximum diameter of ≥8 cm, presents formidable surgical challenges and heightened clinical risks. These challenges primarily stem from the tumor's extensive volume, highly enriched but fragile vascularization, and significant susceptibility to spontaneous rupture and life-threatening hemorrhage. This study aims to comprehensively evaluate the clinical effectiveness and safety of laparoscopic nephron-sparing surgery (NSS) for the management of these complex giant lesions.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 45 patients with giant (≥8 cm) RAML who received NSS at Peking University Third Hospital between January 2012 and September 2025. The cohort comprised 11 males and 34 females with a mean age of (40.9±14.1) years and a mean body mass index (BMI) of (23.7±4.0) kg/m². Preoperatively, 5 patients had a history of spontaneous hemorrhage, and 2 were pregnant. The mean maximum tumor diameter was (10.3±2.2) cm, ranging from 8.0 to 15.4 cm. Surgical procedures included standard laparoscopy (39 cases) and Da Vinci robotic-assisted laparoscopy (6 cases), utilizing either a retro-peritoneal approach (32 cases, 71.1%) or a transperitoneal approach (13 cases, 28.9%). Pathological diagnosis and differentiation were conducted in strict accordance with the 2022 World Health Organization (WHO) classification of tumors. Key outcome measures included operative time, warm ischemia time, estimated blood loss, postoperative complications, and length of postoperative hospital stay.</p><p><strong>Results: </strong>All the 45 operations were successfully completed with complete tumor resection and nephron preservation, although 5 cases required conversion to open surgery due to severe adhesions or bleeding. The operative time was (180.6±55.7) min (range: 86-312 min), the warm ischemia time was (21.9±9.8) min (range: 6-40 min); 36 cases had a warm ischemia time ≤30 min, while a zero-ischemia technique was employed in 3 cases. The postoperative hospital stay was (6.2±2.6) days (range: 3-14 days), and the time to drainage tube removal was (5.1±2.2) days (range: 2-14 days). Postoperative patho-logy confirmed RAML in all cases, and all surgical margins were negative. Postoperative complications included one case of pulmonary infection and one case of renal insufficiency. During a follow-up of 3 to 43 months, no tumor recurrence or significant loss of renal function was documented.</p><p><strong>Conclusion: </strong>NSS for selected patients with giant RAML is effective in preserving renal function while ensuring complete tumor resection, negative margins, and avoiding short-term and long-term complications. Robotic-assisted systems, in particular, offer distinct advantages in complex wound reconstruction and the reduction of surgical complications.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"860-864"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Report on oral health literacy of children and adolescents in Nagqu, Xizang].","authors":"Zitong Shan, Shuhao Wei, Jiahao Han, Yan Si, Wensheng Rong, Shuguo Zheng, Xiaomo Liu, Shanshan Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To understand the oral health literacy of children and adolescents in Nagqu City, and to evaluate the effect of a single online digital integrated media science popularization course on improving oral health literacy.</p><p><strong>Methods: </strong>A cluster sampling method was employed in which all students aged 9-15 years in the Seni District of Naqu City, Xizang Autonomous Region, 406 students were surveyed class-by-class using a paper questionnaire. After baseline data collection, the students received a single remote digital-multimedia oral-health education lesson; a follow-up questionnaire was administered one week later to evaluate whether the online course improved oral-health literacy. The instrument collected demographic information, basic oral-health knowledge, beliefs, self-care practices, and dental-service utilization. Data were analyzed with R 4.4.1 and SPSS 27.0.</p><p><strong>Results: </strong>The awareness rate of oral health knowledge among the children and adolescents in Xizang was less than 50%. More than half of the adolescents consumed high-sugar foods, such as desserts and sugary beverages daily. Only 15.98% of the adolescents brushed their teeth twice or more daily, 7.71% used dental floss daily before the course, and the usage rate of fluoride toothpaste was 45.45%. Oral health issues among the children and adolescents in Xizang severely impacted their daily lives, particularly in eating, pronunciation, and brushing. A single oral health education session showed no significant impact on the awareness rate or the conversion of knowledge into behavior.</p><p><strong>Conclusion: </strong>The awareness rate of oral health knowledge among the children and adolescents in Xizang is lower than the national average a decade ago, and a significant portion has yet to develop good personal oral hygiene habits. Targeted measures are needed to improve oral health awareness among the children and adolescents in Xizang. These may include utilizing interactive digital education tools and emphasizing oral disease prevention to enhance both the awareness rate of oral health knowledge and the conversion of knowledge into behavior.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"848-854"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Primary hyperparathyroidism in pregnancy resulting in hypercalcemic crisis and acute pancreatitis: A case report].","authors":"Xiaoqi Xie, Xiuying Zhang, Xiangqing Wang, Ling Chen, Fang Zhang, Rui Zhang, Linong Ji, Xueyao Han, Wei Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Primary hyperparathyroidism (PHPT) is caused by excessive production of parathyroid hormone by the parathyroid gland. PHPT discovered for the first time during pregnancy is extremely rare and has serious adverse effects on both the mother and the fetus. This article reports a case of pregnancy complicated by PHPT, hypercalcemic crisis, and acute pancreatitis. The patient was a 30-year-old woman at 32 weeks of gestation who presented with a four-day history of progressive abdominal pain and vomiting. Laboratory evaluation on admission revealed a markedly elevated serum total calcium of 3.56 mmol/L and a parathyroid hormone (PTH) level of 388.6 ng/L, with the normal reference range being 15 to 65 ng/L. Imaging studies confirmed the presence of acute pancreatitis, left nephrolithiasis, right hydronephrosis, and a suspicious cystic-solid mass at the lower pole of the right thyroid lobe measuring 2.1 cm × 2.0 cm × 1.2 cm. Due to rapid clinical deterioration and the development of a hypercalcemic crisis, an emergency cesarean section was performed, resulting in the delivery of a live premature male infant with a birth weight of 2 400 g and a length of 45 cm. The neonate's initial serum calcium was 3.08 mmol/L, and several episodes of hypocalcemic seizures occurred shortly after birth, necessitating admission to the neonatal intensive care unit. Postpartum, the mother was managed with aggressive intravenous fluid resuscitation, subcutaneous calcitonin, and intravenous bisphosphonate therapy. Notably, her serum PTH level decreased substantially after delivery, ranging from 48.91 to 53.08 ng/L. This spontaneous decline was likely attributable to reduced effective circulating blood volume during the episode of acute pancreatitis and partial ischemic necrosis of the parathyroid adenoma. At 47 days postpartum, the patient underwent successful surgical resection of a right inferior parathyroid adenoma measuring approximately 3 cm in diameter. Pathological examination of the resected specimen confirmed the diagnosis and revealed focal vascular proliferation and congestion, interstitial fibrosis with hyaline degeneration, and hemosiderin deposition. Following parathyroidectomy, her serum calcium and PTH levels normalized rapidly and remained stable. At the 9-month follow-up visit, the mother was completely asymptomatic with normal biochemical parameters, and the infant demonstrated appropriate growth and development. Clinicians should be vigilant about the presence of PHPT during pregnancy, especially during preconception and early pregnancy, monitoring blood calcium levels and taking preventive measures early to avoid complications and adverse pregnancy outcomes.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"885-888"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy of thermo-expandable nickel-titanium alloy ureteral stent placement as maintenance therapy for ureteral strictures].","authors":"Guowei Chen, Zunke Xie, Lei Shi, Xuejing Guo, Junxin Wang, Ben Cao, Hao Hu, Lianchao Jin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy and safety of thermo-expandable nickel-titanium alloy ureteral stents (Memokath-051) for maintenance therapy of ureteral strictures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 16 patients with ureteral strictures admitted to Beijing Geriatric Hospital from January 2024 to April 2025. The cohort comprised 3 males and 13 females, with a mean age of (57.60±9.79) years. Etiologies included post-radiation stricture following abdominopelvic tumor radiotherapy in 13 patients, retroperitoneal fibrosis in 2, and ureteral granuloma in 1. All the 16 patients had experienced failure of previous indwelling double-J stent placement and subsequently underwent conversion to thermo-expandable nickel-titanium alloy ureteral stent insertion. Among the 16 patients, 7 had bilateral ureteral lesions, with a total of 23 ureteral units treated. Operative time, complications (graded according to the Clavien-Dindo classification), stent patency rate, and ureteral stent symptom questionnaire (USSQ) scores were recorded. Follow-up assessments of serum creatinine levels and hydronephrosis improvement were performed 3, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>All 23 stents were successfully placed in the 16 patients (technical success rate, 100%), with a mean operative time of (51.52±9.55) min. The overall stent patency rate 12 months postoperatively was 82.61% (19/23). Early complications occurred in 7 patients. Long-term complications developed in 4 patients, including stent migration (<i>n</i>=1), tissue hyperplasia-induced obstruction (<i>n</i>=2), and stone-related obstruction (<i>n</i>=1); the remaining 5 patients had no complications. Three months postoperatively, serum creatinine decreased from the preoperative baseline of 186.80 (111.80, 244.93) μmol/L to 103.05 (96.20, 135.97) μmol/L (<i>P</i> < 0.01), and hydronephrosis width decreased from 3.20 (2.78, 3.40) cm to 2.05 (1.08, 2.20) cm (<i>P</i> < 0.01). Serum creatinine levels and hydronephrosis remained stable 6 and 12 months postoperatively. Compared with the previous indwelling period of double-J stents, USSQ scores showed significant improvements in urinary symptoms (34.75±2.34 <i>vs</i>. 23.75±3.26), bodily pain (6.50±2.26 <i>vs</i>. 3.00±1.22), general health status, and work performance (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Placement of thermo-expandable nickel-titanium alloy ureteral stents (Memokath-051) as maintenance therapy for ureteral strictures is safe and effective. Compared with double-J stenting, it improves renal function and hydronephrosis, and enhances patient quality of life. This approach is particularly applicable to patients with long-segment ureteral strictures secondary to post-radiation etiologies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"827-832"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Visceral leishmaniasis with suspected autoimmune disease: A report of 2 cases].","authors":"Fan Sun, Maomao Chen, Aixin Huo, Wen Zhang, Zhuo Li, Lan Cheng, Yuhong Liu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Visceral leishmaniasis (VL) is a rare parasitic infection characterized by distinctive features, including the overproduction of various autoantibodies by B cells, which may mimic manifestations and antibody profiles associated with autoimmune diseases. In this report, we presented two patients diagnosed with visceral leishmaniasis who were initially suspected of having an autoimmune disease. We discussed the similarities and differences between visceral leishmaniasis and autoimmune diseases based on clinical presentation, physical examination findings, laboratory tests, diagnosis, and treatment. Case 1 involved a 69-year-old female patient who was admitted to the hospital due to irregular fever. Physical examination revealed splenomegaly. Laboratory investigations indicated pancytopenia along with an abnormal autoantibody profile. The initial bone marrow aspirate demonstrated: Proliferative changes in the bone marrow, and abnormal lymphocytes in peripheral blood accounting for approximately 6%. Auto-immune disease was initially considered, and hormone therapy did not respond well. Further screening for immunological disorders, infections, tumors, and other related conditions was conducted. A second bone marrow aspirate was performed actively which revealed Leishman-Donovan body. Subsequent nuc-leic acid detection of pathogenic microorganisms confirmed the presence of Leishmania through real-time fluorescence PCR analysis; thus, confirming a diagnosis of visceral leishmaniasis. Case 2 involved a 41-year-old male patient who presented with fever and abdominal distension. Similar to Case 1, physical examination also showed splenomegaly alongside an abnormal autoantibody profile. During treatment, he tested positive for Leishmania infection and was ultimately diagnosed with visceral leishmaniasis complicated by hemophagocytic syndrome. The symptoms observed in the two patients included recurrent fever, anorexia, and splenomegaly. To further investigate the cause of pancytopenia and to rule out factors such as surgery, infection, tumors, and other related conditions, an abnormal antinuclear antibody profile was assessed. The initial misdiagnosis pointed towards autoimmune diseases; however, during treatment, visceral leishmaniasis infection was identified, leading to a final diagnosis of visceral leishmaniasis. The gold standard for diagnosing visceral leishmaniasis involves detecting Leishmania bodies through aspiration of bone marrow, lymph nodes, or spleen. The positive rate for bone marrow puncture is approximately 80% to 90%. However, clinical practice may encounter missed detections due to limitations associated with the puncture site. This underscores the necessity for secondary punctures when warranted. Addi-tionally, patients presenting with splenomegaly accompanied by trilineage cytopenia often seek care from Department of Hematology or Department of Rheumatology and Immunology rather than Department of Infection. This tendency can co","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"889-893"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical application progress, hot topics, controversies and future prospects of segmental metallic ureteral stents].","authors":"Hao Hu, Xiaolong Bian, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ureteral stricture (US) is a common urological disease with complex etiologies, including benign and malignant lesions, iatrogenic injuries, and idiopathic factors. Without timely intervention, it can lead to upper urinary tract obstruction and progressive, irreversible renal impairment. Traditional re-constructive surgeries are often limited by high technical demands, significant surgical risks, and strict requirements for patient fitness. To address these challenges, segmental metallic ureteral stents (SMUSs) have gained prominence in recent years. Featuring a non-full-length design for targeted support, excellent radial strength, and a large caliber, SMUSs provide reliable drainage and allow for long-term retention. They effectively overcome the common drawbacks of traditional double-J stents, such as frequent encrustation, the need for regular replacement, and severe bladder irritation. Consequently, SMUSs have become a vital maintenance therapy for patients with malignant obstructions or those unsuitable for re-constructive surgery. Moreover, they have shown curative potential by providing long-term efficacy for certain benign strictures. However, due to the high heterogeneity of stricture etiologies, significant controversies and knowledge gaps remain in clinical practice. These mainly pertain to the precise selection of stent types for specific indications, the standardization of surgical implantation, optimal indwelling durations, and strategies for preventing and managing long-term complications. Drawing upon the latest global evidence-based medicine and large-sample follow-up data from our center, this article systematically reviews the clinical application and efficacy differences of SMUSs across malignant, benign, and radiotherapy-induced ureteral strictures. We provide an in-depth analysis of major ongoing clinical controversies and propose practical management strategies for complications leading to stent failure, including stent obstruction, migration, encrustation, recurrent infections, and high-risk ureteral fistulas.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"679-685"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expression characteristics and clinical significance of <i>ERBB2</i> in bladder urothelial carcinoma based on the TCGA database].","authors":"Guangwei Zheng, Yun Peng, Yiqing DU, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the expression pattern of Erb-B2 receptor tyrosine kinase 2 (&lt;i&gt;ERBB2&lt;/i&gt;) in bladder urothelial carcinoma (BLCA) and its clinical relevance, prognostic value, and potential molecular mechanisms, thereby providing evidence for biomarker identification and targeted therapy research in BLCA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;RNA sequencing expression data and clinical information were obtained from The Cancer Genome Atlas bladder urothelial carcinoma cohort (TCGA-BLCA). Differences in &lt;i&gt;ERBB2&lt;/i&gt; expression between tumor and normal tissues were analyzed, and associations with American Joint Committee on Cancer (AJCC) pathological stage and tumor grade were evaluated. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of &lt;i&gt;ERBB2&lt;/i&gt;. Patients were stratified into high- and low-expression groups based on both the median value and the optimal cutoff, followed by Kaplan-Meier survival analysis and Cox regression to evaluate prognostic significance. Differentially expressed genes associated with &lt;i&gt;ERBB2&lt;/i&gt; were identified, and Kyoto Encyclopedia of Genes and Genomes (KEGG), gene ontology (GO), and single-gene gene set enrichment analysis (GSEA) were conducted. Correlations between &lt;i&gt;ERBB2&lt;/i&gt; and immune checkpoint molecules were further analyzed. In addition, immunohistochemistry data from the Human Protein Atlas (HPA) database and reverse transcription quantitative PCR (RT-qPCR) experiments were used to validate &lt;i&gt;ERBB2&lt;/i&gt; expression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;HPA immunohistochemistry demonstrated stronger &lt;i&gt;ERBB2&lt;/i&gt; staining in BLCA neoplastic tissues, and RT-qPCR confirmed elevated &lt;i&gt;ERBB2&lt;/i&gt; mRNA expression in BLCA neoplastic tissues. TCGA analysis showed that &lt;i&gt;ERBB2&lt;/i&gt; expression was significantly higher in tumor tissues than in normal tissues (&lt;i&gt;P&lt;/i&gt;=0.005), with overall differences observed across AJCC pathological stages (&lt;i&gt;P&lt;/i&gt;=0.004), whereas no significant difference was found between tumor grades (&lt;i&gt;P&lt;/i&gt;=0.238). Receiver operating characteristic curve analysis indicated a moderate discriminatory ability of &lt;i&gt;ERBB2&lt;/i&gt; [area under the curve (AUC) =0.689]. No significant difference in overall survival was observed between high- and low-expression groups based on either the median cutoff or the optimal cutoff (&lt;i&gt;P&lt;/i&gt;=0.240 and &lt;i&gt;P&lt;/i&gt;=0.148, respectively), and both univariate and multivariate Cox analyses suggested that &lt;i&gt;ERBB2&lt;/i&gt; was not an independent prognostic factor for OS. Functional enrichment analyses revealed that &lt;i&gt;ERBB2&lt;/i&gt;-associated differentially expressed genes were mainly enriched in cytokine-cytokine receptor interaction, interleukin 17 (IL-17) signaling pathway, phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway, Janus kinase/signal transducer and activator of transcription (JAK-STAT) signaling pathway, chemokine signaling pathway, inflammatory response, immune response, e","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"818-826"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}