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After the introduction of anticholinergic drugs for the treatment of overactive bladder (OAB), the discovery of β-adrenergic agonists has helped reduce the side effects associated with the former. Currently, the two available medications, mirabegron and vibegron, are β-adrenergic agonists. However, clinical practitioners are still faced with the dilemma of which drug to choose. To analyze and compare the efficacy and adverse effects of the two medications. A literature search was conducted to identify randomized controlled trials using mirabegron and vibegron for the treatment of OAB. Databases such as PubMed, Web of Science, Cochrane Library, and Embase were searched. The search cutoff date was July 25 2024. Data extraction and quality assessment were performed using standardized methods. A meta-analysis was then conducted using RevMan software and a random-effects model, with studies weighted according to sample size and variance. Heterogeneity was assessed using the I² statistic. All statistical analyses were performed using RevMan, and results were presented as effect sizes (e.g., mean difference or risk ratio). Three randomized controlled trials compared the safety and efficacy of mirabegron and vibegron head-to-head, involving 368 patients. The trials, each lasting 8 or 12 weeks. The trials compared the changes in various indices of the OABSS (Overactive Bladder Symptom Score) between the two drugs. The statistical methods used in the analysis included Mean Difference (MD), 95% Confidence Interval (CI), p-value, and I² statistic. For OABSS: MD =  0.38, 95% CI =  - 0.19 to 0.95, p =  0.28, I² =  21%; for Q1: MD =  0.08, 95% CI =  - 0.01 to 0.26, p =  0.31, I² =  4%; for Q2: MD =  0.08, 95% CI =  - 0.21 to 0.37, p =  0.67, I² =  0%; for Q3: MD =  0.05, 95% CI =  - 0.45 to 0.56, p =  0.90, I² =  0%; for Q4: MD =  - 0.21, 95% CI =  - 0.68 to 0.27, p =  0.35, I² =  0%. The relative risk (RR) of adverse effects between the two drugs was: RR =  0.87, 95% CI =  0.57 to 1.34, p =  0.27, I² =  25%; for constipation: RR =  0.73, 95% CI =  0.37 to 1.43, p =  0.27, I² =  25%; and for dry mouth: RR =  0.98, 95% CI =  0.42 to 2.30, p =  0.78, I² =  0%. There appears to be no statistically significant difference in efficacy and safety between mirabegron and vibegron for OAB patients. Further high-quality prospective studies are needed to confirm these results.

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a poor prognosis, and its clinical management remains a significant challenge due to the high recurrence rates and limited treatment options. Despite advances in understanding the molecular mechanisms underlying ACC, no reliable biomarkers have been validated for routine clinical use. We analyzed RNA sequencing data from The Cancer Genome Atlas (TCGA) database (n=79) and Genotype Tissue Expression (GTEx) database (n=128) to investigate the expression of VGF in ACC and normal adrenal tissues. Gene expression levels of VGF were quantified and correlated with clinicopathological features and survival outcomes. Statistical methods included Cox proportional hazards models and Kaplan-Meier analysis, while Gene Set Enrichment Analysis (GSEA) was utilized to identify relevant biological pathways associated with VGF expression. Clinical data from 7 ACC patients from YANTAI YUHUANGDING Hospital were also analyzed. The expression of VGF in ACC and normal adrenal gland tissue was further validated through IHC experiments. Our results demonstrate that VGF expression is elevated in ACC tissues compared to normal adrenal tissues and is significantly associated with advanced disease stages, lymph node involvement, metastasis and poor overall survival. VGF levels also correlate with immune cell infiltration, including Th2 cells, T helper cells, and Neutrophils. Importantly, our study establishes VGF as a potential prognostic biomarker for ACC and highlights its role in tumor progression and immune modulation. Additionally, GSEA analysis suggests that VGF is involved in cytokine receptor interaction and the P13K-Akt signaling pathway, possibly relating to tumor immunity. VGF could serve as a valuable marker for patient stratification, monitoring disease progression, and predicting responses to immunotherapies. Future studies should focus on investigating circulating VGF levels as a non-invasive biomarker for ACC to improve clinical management and treatment outcomes.

The microbiota, also referred to as the microbial community, is a crucial component of the human microenvironment. It is located predominantly in various organs, including the intestines, skin, oral cavity, respiratory tract, and reproductive tract. The microbiota maintains a symbiotic relationship with the human body, influencing physiological and pathological functions to a significant degree. There is increasing evidence linking the microbial flora to human cancers. In contrast to the traditional belief that the urethra and urine of normal individuals are sterile, recent advancements in high-throughput sequencing technology and bacterial cultivation methods have led to the discovery of specific microbial communities in the urethras of healthy individuals. Given the prevalence of bladder cancer (BCa) as a common malignancy of the urinary system, researchers have shifted their focus to exploring the connection between disease development and the unique microbial community within tumors. This shift has led to a deeper investigation into the role of microbiota in the onset, progression, metastasis, prognosis, and potential for early detection of BCa. This article reviews the existing research on the microbiota within BCa tumors and summarizes the findings regarding the roles of different microbes in various aspects of this disease.

Background: Medical expulsive therapy demonstrates efficacy in managing ureteral stones in patients amenable to conservative interventions. This meta-analysis aims to evaluate the effectiveness of mirabegron in the treatment of ureteral stones. Methods: From conception to November 2023, we examined PubMed databases, the Cochrane Library, Embase, Ovid, Scopus, and trial registries for this systematic review and meta-analysis. We chose relevant randomized controlled trials (RCTs) evaluating the efficacy of mirabegron as an expulsive treatment for ureteral stones. The Cochrane risk of bias method was used to assess the quality of the evidence. Outcome measures, which included the stone expulsion rate (SER), expulsion time, and pain episodes, were analyzed using RevMan 5.4 and Stata 17. Results: Seven RCTs (N = 701) had enough information and were ultimately included. In patients with ureteral stones, mirabegron-treated patients had a substantially higher SER [odds ratio (OR) = 2.57, 95% confidence interval (CI) = 1.41–4.68, p = 0.002] than placebo-treated patients. Subgroup analysis revealed that mirabegron was superior to placebo in patients with small ureteral stones (OR = 2.26, 95% CI = 1.05–4.87, p = 0.04), with no heterogeneity between studies ( p = 0.54; I 2 = 0%). Mirabegron patients had a higher SER than the control group for distal ureteral stones (DUSs) (OR = 2.48, 95% CI = 1.31–4.68, p = 0.005). However, there was no difference in stone ejection time or pain episodes between groups. Conclusion: Mirabegron considerably improves SER in patients with ureteral stones, and the effect appears to be more pronounced for small and DUSs. Nevertheless, mirabegron treatment was not associated with improved stone expulsion time or pain management.

Background: Catheter-related bladder discomfort (CRBD) is a frequent occurrence following urinary catheterization during surgical procedures, as well as a commonly experienced bladder pain syndrome after surgery. There have been various studies on drugs and interventions to manage CRBD, but their comparative efficacy and safety are still a topic of debate. We conducted a meta-analysis to assess the efficacy and safety of nefopam for managing postoperative CRBD. Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to find randomized controlled trials (RCTs) on using nefopam in postoperative CRBD. The study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data analysis was performed using RevMan version 5.4.1. Results: Five RCTs with 405 patients were analyzed to evaluate the efficacy of nefopam on postoperative CRBD. Short-term and long-term periods were defined as within 6 h and longer than 12 h after surgery, respectively. The incidence and severity of CRBD were compared between the two groups during these time periods. The analysis proved that nefopam reduced the short-term incidence of postoperative CRBD (RR 0.36; 95% CI, 0.18–0.70; p = 0.003, I 2 = 78%) and the long-term incidence (RR 0.49; 95% CI, 0.32–0.74; p = 0.0007, I 2 = 0%) significantly. We compared the incidence of moderate-to-severe CRBD between groups based on the scaling system (none, mild, moderate, and severe). This was used to assess the severity of postoperative CRBD. The results showed that patients in the nefopam group had a significantly lower incidence of moderate-to-severe CRBD compared to those in the placebo group in the short-term (RR 0.19; 95% CI, 0.10–0.34; p < 0.00001; I 2 = 0%). However, there were no significant differences between the two groups in the incidence of moderate-to-severe CRBD in the long-term (RR 0.61; 95% CI, 0.21–1.76; p = 0.36; I 2 = 0%). There were no significant variations in the occurrence of adverse events between the nefopam and control groups, mainly including postoperative nausea and vomiting (PONV) (RR 1.14; 95% CI, 0.40–3.21; p = 0.81), and tachycardia (RR 0.25; 95% CI, 0.03–2.11, p = 0.20). Conclusion: The findings of this meta-analysis indicate that nefopam significantly reduced the incidence of short or long-term postoperative CRBD. Nefopam decreased the severity of postoperative CRBD, particularly significantly reducing the occurrence of moderate to severe CRBD in the short-term. Overall, patients have good tolerance and no apparent side effects. Systematic Review Registration : identifier PROSPERO ( CRD42023475012 )

Currently, many clinicians use tamsulosin as a medication to alleviate symptoms following double J (DJ) stent insertion. With the emerging advantages of -receptor agonists in relieving urinary tract spasms, the effectiveness of mirabegron in treating DJ stent-related symptoms has gained attention. To explore which medication, mirabegron or tamsulosin, is more effective in alleviating DJ stent-related symptoms. A literature search was conducted to identify randomized controlled trials (RCTs) that evaluated the use of mirabegron and tamsulosin in relieving DJ stent-related symptoms. Databases searched included PubMed, Web of Science, Cochrane Library, Embase, and CNKI, with the search cutoff date in June 2024. Inclusion criteria were patients who underwent percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) with DJ stent placement and were treated with either tamsulosin or mirabegron. Data extraction and quality assessment were performed using standardized methods, and a meta-analysis was conducted. One of the Ureteral Stent Symptom Questionnaire (USSQ) indicators, Work Performance Index (WPI), showed a mean difference (MD) of -1.01 (95% CI: -1.91 to -0.11,  = 0.03,  = 77%). For side effects: risk ratios (RR) = 0.34, (95% CI = 0.13 to 0.89,  = 0.03,  = 0%). This study shows that mirabegron demonstrates better efficacy in terms of WPI and has fewer side effects overall, particularly for patients experiencing tamsulosin-related side effects such as hypotension or ejaculatory dysfunction. However, no significant differences were found between the two drugs in other aspects of the USSQ or in the IPSS. Further large-scale, high-quality RCTs with longer follow-up periods and comprehensive safety data are needed to confirm these findings and identify patient groups who may benefit most from mirabegron treatment. https://www.crd.york.ac.uk/prospero/, CRD420251083374.

Peyronie's disease (PD), commonly known as penile induration, is a prevalent male reproductive system disorder with complex etiology. It is characterized by fibrosis of the tunica albuginea (TA), which may be accompanied by pain, deformity, erectile dysfunction, discomfort, and/or dissatisfaction with self‐image. This study aimed to investigate molecular and cellular changes in PD using single‐cell spatial transcriptomics. In this study, we induced PD by injecting adenovirus transforming growth factor‐β1 (TGF‐β1) into the TA of rats. The model was successfully induced after 45 days. We conducted single‐cell spatial transcriptomics sequencing and analysis on penile tissues from three PD‐induced rats and three sham‐operated control rats. Unbiased clustering of 28,779 cell nuclei from PD‐induced and sham‐operated control rats revealed 11 cell lineages and 29 clusters. Comparative analysis identified lineage‐specific alterations in gene expression, clusters composition, and intercellular communication in PD. Combining spatial transcriptomics data, we localized 17 cell clusters on rat penile tissue sections and confirmed the spatial activity patterns of these clusters, potential disease‐related differential genes, and signaling pathways. Differential regulatory network analysis of fibroblast cluster enriched for the unfolded protein response, ribosome pathway, and Egfr smrte pathway. Through single‐cell machine learning, we constructed diagnostic evaluation models for PD and found that LOC106360841 (Rpl37‐ps5), LOC102555453, Klf9, RT1‐A1, and Oasl2 have potential as biomarkers. By integrating differential gene expression and enriched pathways, we propose a potential PD mechanism. Dysfunctions in ribosomal proteins (e.g., LOC106360841/Rpl37‐ps5 and LOC102555453), the ribosome pathway, and unfolded protein response stress response induce endoplasmic reticulum stress in rat penile tissue. This activates fibroblasts, driving extracellular matrix production and deposition, and causing penile fibrosis. Additionally, Lum may promote this process via TGF‐β pathway activation. These findings enhance our understanding of PD's molecular mechanisms and diagnostic biomarkers, with potential clinical implications for prediction and management. Peyronie's disease (PD) is a common male reproductive system disorder. The exact etiology of PD remains unclear. This study aimed to investigate molecular and cellular changes in PD using single‐cell spatial transcriptomics.

Background After the introduction of anticholinergic drugs for the treatment of overactive bladder (OAB), the discovery of [beta]-adrenergic agonists has helped reduce the side effects associated with the former. Currently, the two available medications, mirabegron and vibegron, are [beta]-adrenergic agonists. However, clinical practitioners are still faced with the dilemma of which drug to choose. Objective To analyze and compare the efficacy and adverse effects of the two medications. Methods A literature search was conducted to identify randomized controlled trials using mirabegron and vibegron for the treatment of OAB. Databases such as PubMed, Web of Science, Cochrane Library, and Embase were searched. The search cutoff date was July 25 2024. Data extraction and quality assessment were performed using standardized methods. A meta-analysis was then conducted using RevMan software and a random-effects model, with studies weighted according to sample size and variance. Heterogeneity was assessed using the I² statistic. All statistical analyses were performed using RevMan, and results were presented as effect sizes (e.g., mean difference or risk ratio). Results Three randomized controlled trials compared the safety and efficacy of mirabegron and vibegron head-to-head, involving 368 patients. The trials, each lasting 8 or 12 weeks. The trials compared the changes in various indices of the OABSS (Overactive Bladder Symptom Score) between the two drugs. The statistical methods used in the analysis included Mean Difference (MD), 95% Confidence Interval (CI), p-value, and I² statistic. For OABSS: MD = 0.38, 95% CI = - 0.19 to 0.95, p = 0.28, I² = 21%; for Q1: MD = 0.08, 95% CI = - 0.01 to 0.26, p = 0.31, I² = 4%; for Q2: MD = 0.08, 95% CI = - 0.21 to 0.37, p = 0.67, I² = 0%; for Q3: MD = 0.05, 95% CI = - 0.45 to 0.56, p = 0.90, I² = 0%; for Q4: MD = - 0.21, 95% CI = - 0.68 to 0.27, p = 0.35, I² = 0%. The relative risk (RR) of adverse effects between the two drugs was: RR = 0.87, 95% CI = 0.57 to 1.34, p = 0.27, I² = 25%; for constipation: RR = 0.73, 95% CI = 0.37 to 1.43, p = 0.27, I² = 25%; and for dry mouth: RR = 0.98, 95% CI = 0.42 to 2.30, p = 0.78, I² = 0%. Conclusion There appears to be no statistically significant difference in efficacy and safety between mirabegron and vibegron for OAB patients. Further high-quality prospective studies are needed to confirm these results.

The human body harbors a vast array of microorganisms. Changes in the microbial ecosystem can potentially lead to diseases, including cancer. Traditionally, research has focused more on the gut microbiota and its influence on cancer. However, with the advancement of sequencing technologies, scholars have discovered that microorganisms within kidney tissues are significant components of tumor tissues. Intratumoral microorganisms may affect tumor growth and development through certain mechanisms, influence the function of immune cells, or impact the effectiveness of chemotherapy or immunotherapy in patients. This paper reviews the latest progress in the research on intratumoral microorganisms in renal cancer (RCa). It summarizes the types and distribution characteristics of these microorganisms, discusses the close association between specific viral infections (such as HPV and EBV) and RCa, and highlights the role of microorganisms in the pathogenesis of RCa. This review provides new perspectives for understanding the pathogenic mechanisms of RCa, thereby offering potential clinical applications.

Neuromorphic devices that mimic the energy-efficient sensing and processing capabilities of biological neurons hold significant promise for developing bioelectronic systems capable of precise sensing and adaptive stimulus-response. However, current silicon-based technologies lack biocompatibility and rely on operational principles that differ from those of biological neurons. Organic electrochemical neurons (OECNs) address these shortcomings but typically require multiple components, limiting their integration density and scalability. Here, we report a single-transistor OECN (1T–OECN) that leverages the hysteretic switching of organic electrochemical memtransistors (OECmTs) based on poly(benzimidazobenzophenanthroline). By tuning the electrolyte and driving voltage, the OECmTs switch between high- and low-resistance states, enabling action potential generation, dynamic spiking, and logic operations within a single device with dimensions comparable to biological neurons. The compact 1T–OECN design (~180 µm 2 footprint) supports high–density integration, achieving over 62,500 neurons/cm 2 on flexible substrates. This advancement highlights the potential for scalable, bio-inspired neuromorphic computing and seamless integration with biological systems. Organic electrochemical neurons typically require multiple components, limiting their integration density and scalability. Here, the authors develop a single-transistor organic electrochemical neuron mimicking biological spiking, sensing, and logic.