Background: Non-muscle invasive bladder cancer accounts for nearly 80% of newly diagnosed bladder cancer cases, which often recur and progress. This meta-analysis was evaluated by the adverse events and recurrence rate of thermal intravesical chemotherapy vs. normal temperature intravesical chemotherapy in the treatment of non-muscle invasive bladder cancer. Methods: A systematic review and cumulative analysis of studies reporting adverse events and recurrence rate of thermal intravesical chemotherapy vs. normal temperature intravesical chemotherapy was performed through a comprehensive search of Pubmed, Embase, Cochranelibrary.com, CNKI, Wanfang Med Online database and VIP database. All analyses were performed using the Revman manager 5. Result: Twelve studies (11 randomized controlled trials and 1 retrospective study) including 888 patients, 445 in the thermal intravesical chemotherapy group, and 443 in the normal temperature intravesical chemotherapy group, met the eligibility criteria. Patients in the thermal intravesical chemotherapy group had a lower risk of disease recurrence than those who had normal temperature intravesical chemotherapy (24 months follow-up group: RR = 0.30, 95% CI: 0.21–0.43, P < 0.00001, I² = 0%; 36 months follow-up group: RR = 0.27, 95% CI: 0.14–0.54, P = 0.0002, I² = 0%) while no significant difference in adverse events rate (RR = 0.89, 95% CI = 0.53–1.52; P = 0.67, I² = 78%). Conclusions: When compared with normal temperature intravesical chemotherapy, thermal intravesical chemotherapy can reduce the recurrence rate without increasing incidence of adverse events in patients with non-muscle invasive bladder cancer.

Diabetes mellitus (DM), which is closely related to microvascular dysfunction, is a risk factor for erectile dysfunction (ED). Furthermore, the upregulation of inducible nitric oxide synthase (iNOS) is associated with systemic vascular dysfunction in rats with diabetes. The purpose of this study was to investigate the role of iNOS in diabetes mellitus erectile dysfunction (DMED). First, we developed a type 1 DM rat model using streptozotocin and selected those that developed DMED. Then, we injected these rats with the 1400W, an iNOS inhibitor, for 10 weeks and subsequently assessed their ED. Lastly, we performed various molecular studies and histopathological analyses of penile tissues collected from these rats after the experiments. Through the histopathological studies, we also found that the treatment restored the ratios of the smooth muscle to collagen fibres, delayed the development of microvascular injury and alleviated the oxidative stress caused by hyperglycaemia. Based on these results, we confirmed that upregulation of iNOS leads to microvascular dysfunction in patients with ED. Overall, we found that inhibition of iNOS displayed beneficial effects in the treatment of ED, suggesting that its mechanism should be further explored.

Background: The early detection of high-grade prostate cancer (HGPCa) is of great importance. However, the current detection strategies result in a high rate of negative biopsies and high medical costs. In this study, the authors aimed to establish an Asian Prostate Cancer Artificial intelligence (APCA) score with no extra cost other than routine health check-ups to predict the risk of HGPCa. Patients and methods: A total of 7476 patients with routine health check-up data who underwent prostate biopsies from January 2008 to December 2021 in eight referral centres in Asia were screened. After data pre-processing and cleaning, 5037 patients and 117 features were analyzed. Seven AI-based algorithms were tested for feature selection and seven AI-based algorithms were tested for classification, with the best combination applied for model construction. The APAC score was established in the CH cohort and validated in a multi-centre cohort and in each validation cohort to evaluate its generalizability in different Asian regions. The performance of the models was evaluated using area under the receiver operating characteristic curve (ROC), calibration plot, and decision curve analyses. Results: Eighteen features were involved in the APCA score predicting HGPCa, with some of these markers not previously used in prostate cancer diagnosis. The area under the curve (AUC) was 0.76 (95% CI:0.74–0.78) in the multi-centre validation cohort and the increment of AUC (APCA vs. PSA) was 0.16 (95% CI:0.13–0.20). The calibration plots yielded a high degree of coherence and the decision curve analysis yielded a higher net clinical benefit. Applying the APCA score could reduce unnecessary biopsies by 20.2% and 38.4%, at the risk of missing 5.0% and 10.0% of HGPCa cases in the multi-centre validation cohort, respectively. Conclusions: The APCA score based on routine health check-ups could reduce unnecessary prostate biopsies without additional examinations in Asian populations. Further prospective population-based studies are warranted to confirm these results.

Background: Bladder cancer (BC), one of the most prevalent and aggressive urological malignancies, poses significant challenges in diagnosis, treatment, and recurrence management. Patient-derived organoid provides new directions for the precision diagnosis and treatment of bladder cancer. Objective: To make a comprehensive summary of the current bladder cancer organoid studies. Methods: A comprehensive database search was conducted to provide an in-depth overview of the current state of bladder cancer organoid models, with a focus on their applications in basic research, clinical translation, and therapeutic discovery. Results: We summarized the current bladder cancer organoid studies, highlighting their advantages, such as genetic fidelity and high-throughput drug screening capabilities. Additionally, we also address the challenges, including their limited representation of the tumour microenvironment and technical complexity. Finally, we discuss future directions, including the integration of immunotherapy, the development of co-culture systems, and the exploration of non-invasive sampling methods and organoid-on-chip systems. Conclusions: Traditional pre-clinical models have inherent limitations in mimicking the complexity of human tumours. The emergence of organoid technology has offered a groundbreaking approach to address this challenge, providing an innovative tool for studying tumour biology, genetic alterations, drug screening, and personalized medicine in bladder cancer.

(1) Objective: The aim of this study was to evaluate whether overweight and obese upper urinary tract carcinoma (UTUC) patients have better or worse survival outcomes. (2) Methods: The Clinical Research Office of the Endourology Society Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry was used to extract the data of normal-weight or overweight/obese UTUC patients between 2014 and 2019. Patients with a BMI between 18.5 and 24.9 kg/m² were defined as normal weight, while those with a BMI ≥ 25.0 kg/m² were considered as overweight/obese group. We compared baseline characteristics among groups categorized by different BMIs. The Kaplan–Meier plots with the log-rank test were used to explore the overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). Propensity score matching was performed to eliminate the differences in clinicopathologic features. The Declaration of Helsinki was followed during this study. (3) Results: Of 1196 UTUC patients, 486 patients (40.6%) were normal weight, while 710 patients (59.4%) presented with a BMI ≥ 25.0 kg/m². After propensity score matching, all baseline characteristics were balanced. For normal weight and overweight/obese patients, 2-year overall survival rates were 77.8% and 87.2%, 2-year cancer-specific survival rates were 85.2% and 92.7%, and 2-year recurrence rates were 50.6% and 73.0%, respectively. The overweight patients obtained a better RFS (p = 0.003, HR 0.548, 95% CI 0.368–0.916) while their OS (p = 0.373, HR 0.761, 95% CI 0.416–1.390) and CSS (p = 0.272, HR 0.640, 95% CI 0.287–1.427) were similar to normal weight patients. (4) Conclusions: Being overweight/obese (BMI ≥ 25.0 kg/m²) was associated with a decreased risk of recurrence in UTUC patients but not overall survival or cancer-specific survival.