erated. The small sample size and limited, including studies, were the main limitations.

In the treatment of large and proximal ureteral calculi, LTU has a significantly higher single-procedure success rate and a higher rate of postoperative paralytic ileus than LRU. However, the complication was well-tolerated. The small sample size and limited, including studies, were the main limitations.

The effects of metformin on prostate volume and prostate-specific antigen (PSA) were investigated.

We enrolled 384 newly diagnosed diabetes mellitus (DM) patients and 152 controls all of whom were >50 years into our prospective cross-sectional observational study. The first group contained patients receiving metformin only, the second group were taking a mixture of medications, including metformin plus other oral anti-diabetics, and the third was the control group. Before beginning treatment, body mass indices (BMI) of all cases were obtained. Prostate volumes evaluated using transabdominal ultrasonography at the sixth and twelfth month. Insulin, glycosylated hemoglobin (HbA1C), insulin sensitivity index (ISI), insulin-rich growth factor (IGF-1), PSA, free PSA, and total testosterone levels were measured.

The differences in BMI between the first and third group were statistically significant (p <0.05). There were no statistical differences among the groups in terms of prostate volumes (> 0.05). The differences between the groups for insulin, HbA1C, ISI, IGF-1 (somatomedin), PSA, free PSA and total testosterone levels were insignificant (p >0.05). Free PSA and total testosterone levels in groups 1 and 2 were not statistically different at the beginning of treatment and the sixth month (p >0.05), but within groups 1 and 2, only PSA levels were different at the start of the study until completion. No differences were seen in the third group.

Metformin appears to cause a decrease in PSA levels. The mechanism and any effects on prostate tissue will be studied in future randomized, prospective studies.

Metformin appears to cause a decrease in PSA levels. The mechanism and any effects on prostate tissue will be studied in future randomized, prospective studies.Mesothelioma is an aggressive tumor originating from mesothelial cells. Mesothelioma of the spermatic cord is a very rare disease, and the most common presentation of this disease is that of aggressive mesothelioma with no description of mesothelioma in situ. We report an extremely rare case of mesothelioma in situ of the spermatic cord arising from a patent processus vaginalis. To our best knowledge, this is the first report of this finding. The identification of a patent processus vaginalis and investigation of single-layered atypical mesothelial cells led to the final diagnosis.

To evaluate the impact of diabetes mellitus (DM) on the recovery of urinary continence (UC) after radical prostatectomy (RP).

Trials were identified in a literature search of PubMed, Embase, Cochrane Library and Web of Science using appropriate search terms. All comparative studies reporting diabetes mellitus, study characteristics, and outcome data including the relationship between diabetes mellitus and urinary continence data were included. Continence rates at different time after RP were compared. Odds ratio (OR) was used for the comparison and all the results were presented with 95% confidence intervals (CIs).

7 cohort studies comprising with 5944 participants were included, the percentage of DM patients was 8.7%. The results showed that DM increased urinary incontinence risk at 12 months after RP (OR 0.54, 95%CI 0.36 to 0.81, ????=0.003). The continence rates were not significantly different between DM and Non-DM groups at short-term (catheter removal, 3 months, 6 months) and long-term (>12 months). When stratified by the surgical methods, the pooled results showed similar results in patients who underwent robot -assisted radical prostatectomy (RARP).

DM has an adverse impact on the recovery of UC during the intermediate-term after RP. Well-designed trials with strict control of confounders are needed to make results more comparable.

DM has an adverse impact on the recovery of UC during the intermediate-term after RP. INCB39110 Well-designed trials with strict control of confounders are needed to make results more comparable.

Approximately 10% of all primary pyeloplasty will require at least one secondary intervention. Our aim was to analyze whether secondary repair will pose additional challenges during robotic pyeloplasty compared with the primary pyeloplasty.

114 patients who underwent robot-assisted laparoscopic pyeloplasty (RALP) between February 2015 and August 2018 were retrospectively reviewed. Patients were divided into; primary and secondary repair pyeloplasty. The demographics, intraoperative parameters, postoperative parameters, and success rate of these two groups were collected and compared. Primary RALP data were further stratified into those who previously underwent ipsilateral endourological surgeries (IES) at the obstruction site and those who did not, to evaluate the effect of IES has on the outcome of RALP. Success was defined as symptomatic and radiological relief.

Of the 114 patients, five complicated cases (three horseshoe kidneys, one duplicated system, and one retrocaval ureter) were excluded from the comparison. The remaining 96 primary and 13 secondary repairs were compared. Intraoperative and postoperative parameters showed no significant difference between the two groups. The results of 99 patients (87 vs. 12 in primary vs. secondary, respectively) were available after 27.5 months mean follow-up. The overall success was 92%, 8 patients failed (5 vs. 3 in primary vs. secondary, respectively) and required further surgical interventions.

Though surgically challenging with increased recurrence rates according to the literature we reviewed. However, our data failed to show any significant difference between the primary and redo RALP perhaps due to the smaller size in the redo RALP group.

Though surgically challenging with increased recurrence rates according to the literature we reviewed. link2 However, our data failed to show any significant difference between the primary and redo RALP perhaps due to the smaller size in the redo RALP group.

The safety and feasibility of percutaneous nephrolithotomy (PCNL) compared with retrograde intrarenal surgery (RIRS) are debated. This systematic evaluation was performed to obtain comprehensive evidence with regard to the treatment outcomes of PCNL compared with RIRS for management of renal stones in patients with solitary kidney.

A systematic search of Medline, Embase, Pubmed, Web of Science, CNKI, Scopus and the Cochrane Library was performed to identify studies that compared PCNL with RIRS for management of renal stones in patients with solitary kidney and published up to Aug 2019. Outcomes of interest included perioperative variables, complications, and stone-free rate (SFR).

Four studies assessing PCNL vs. RIRS for renal stones larger than 2cm were included for meta-analysis. Although patients underwent PCNL have higher initial SFR than RIRS (OR 3.72, 95% CI2.38 to 5.83; P＜0.001), patients underwent RIRS have less intraoperative blood loss (dropped Hb WMD= 3.49 g/L, 95% CI2.83 to 4.15; P＜0.001), l blood loss and transfusion rate, may be an alternative in selected patients. But we need to pay more attention to the incidence rate of steinstrasse after RIRS.

Recreational use of illicit drugs is one of the main factors affecting male fertility. However, the mechanisms of heroin smoke-associated damage to mature spermatozoa are still completely unknown. The aim of this study was to concomitantly examine the levels of protamine-2 gene and protein concentrations, the amount of miRNA-122 in seminal plasma and semen analysis findings in heroin-addicted men.

In a case control study, twenty-four fertile men that lacked any recreational drug abuse were considered as the healthy group, and 24 addicted men who used only heroin for at least four months were selected as the addicted group. Semen samples were gathered by masturbation after 2 – 5 days of sexual abstinence. Following the preparation of a semen analysis by computer-assisted sperm analysis according to WHO (2010), the level of protamine-2 gene expression in sperm and miRNA-122 in seminal plasma was measured using real-time sqPCR. Also, protamine-2 protein concentrations were quantified by nuclear protein extrall RNAs expression levels. Heroin abuse may lead to male infertility by causing leukocytospermia, asthenozoospermia, protamine deficiency, and seminal plasma miRNA profile alteration.

This is one study on human infertility that evaluates the effects of heroin on protamine deficiency and seminal small RNAs expression levels. Heroin abuse may lead to male infertility by causing leukocytospermia, asthenozoospermia, protamine deficiency, and seminal plasma miRNA profile alteration.

In this study the role of nicotine (NCT) administration on the intensity of rat testicular tissue alterations induced by quinine (QU) was evaluated. Materials and Methods Forty adult Wistar rats were divided into four groups. Control (CON), NCT administrated (4 mg/kg) (NCT), QU treated (25 mg/kg for 7 days) (QU), and nicotine with quinine received (NCT+QU). After 28 days, serum testosterone and malondialdehyde (MDA) levels were measured. link3 Testes and epididymides samples were prepared for determining tissue MDA levels, histomorphometry, microscopic indices of spermatogenesis, immunohistochemistry of p53 and sperm analysis.

Testosterone levels were decreased significantly (P=.0004) in treated groups compared to CON group. Serum MDA levels were increased significantly (P=.0004) in NCT and QU groups compared to CON group. Tissue MDA levels were increased significantly (P=.0012) in NCT+QU group in comparison to CON group. These parameters were changed significantly in NCT+QU group compared to QU group. Seminifehowed the over-expression of p53 compared to CON group.

The administration of nicotine could be involved in the exacerbation of testicular tissue alterations related to quinine therapy.

The administration of nicotine could be involved in the exacerbation of testicular tissue alterations related to quinine therapy.

Poor sleep quality during hospitalization may lead to post-hospital symptoms and increase readmission rates and mortality. Patients in our intensive care unit (ICU) reported low mean scores on the Richards-Campbell Sleep Questionnaire (RCSQ) during their third and fifth days of hospitalization (49.7 mm and 51.7 mm, respectively). Therefore, a project to improve sleep quality in the ICU was established.

To increase the mean RCSQ score from 51.7 mm to 76.0 mm on the fifth day. The fifth day timeframe was chosen because of the disease conditions of the patients and related clinical-medical factors.

The project team proposed an evidence-based, sleep care bundle that included non-medication pain control, environmental regulation, improvement of the care process, and individualized sleep care.

After implementing the bundled intervention, the mean RCSQ score of patients in our ICU increased from 49.7 mm to 55.9 mm on the third day and from 51.7 mm to 80.9 mm on the fifth day.

This application of a sleep care bundle effectively improved the factors affecting sleep disturbance and improved quality of sleep in the patients in our intensive care unit.