Jian Guo Wen

This study aims to explore the association between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) through a meta-analysis and evaluate the im

Background Clean intermittent catheterization (CIC) is an effective method of bladder emptying in children with neurogenic and non-neurogenic disorders that cause difficulty in urination. However, there is a lack of expert consensus on the standardized application of CIC in pediatric populations. This guideline intends to outline recommendations for standardizing CIC in children. Methods A comprehensive literature review was performed by searching key academic databases, specifically PubMed, Embase, the Cochrane Library, and Web of Science. Eligible literature—including peer-reviewed clinical trials, cohort studies, case series, and expert consensus statements—was systematically identified, screened, and critically appraised. This guideline was developed according to the “WHO Handbook for Guideline Development (2nd edition)”. Results For children with symptoms of increased post-void residual (PVR) that may threaten the upper urinary tract, CIC is recommended regardless of the cause. Safe bladder capacity (SBC) and maximum bladder capacity measurement could guide optimal CIC frequency. When infants or young children require CIC, their caregivers should receive specialized training. The CIC procedure includes thorough hand and genital area cleansing, followed by careful catheter insertion to avoid contamination of surrounding tissues. Depending on the individual’s ability to void, CIC will be either partial or complete. Partial CIC is recommended for individuals who are able to void partially. When implementing CIC, a collaborative model involving the patient, caregivers, and a multidisciplinary pediatric team specializing in lower urinary tract management should be adopted, and regular follow-up and efficacy assessments are required. Urodynamic study to determine the PVR and SBC in conjunction with a voiding/catheterization diary provides an objective basis for adjusting the frequency of catheterization and for determining whether to continue catheterization. Conclusion This guideline established a standardized protocol for children who require CIC to facilitate bladder emptying. Graphical abstract Video abstract (MP4 11229 kb)

KIN17, well known as a DNA and RNA binding protein, is highly involved in the regulation of tumorigenesis of diverse human cancers, but its function in the cancer progression and metastasis of Renal Cell Carcinoma (RCC) remains unclear. The aims of this study were to identify the role of KIN17 in RCC. We performed the study with the PI3K/mTOR inhibitor PF-04691502 in vivo and vitro, detected the tumor invasion and migration dysfunction by using Bioinformatics Analysis, IHC, Scratch Wound Healing Assay, Cell Viability Assay, Colony Formation Assays, EdU-647 Labeling, Cell Cycle and Apoptosis Detection by flow cytometer, Western Blotting, Animal Experiment. These findings suggest that the ability of KIN17 is to promote RCC cell proliferation, cycle progression, reduce cell apoptosis, increase cell clone formation, invasion, and increase cell migration and so on. As expected, PI3K/mTOR pathway inhibitor can reverse the ability of KIN17 in vivo and vitro. Meanwhile, PI3K/mTOR pathway inhibitor can reverse the activation of the PI3K/AKT/mTOR signaling pathway. Overall, our findings provide preliminary data which suggests KIN17 could be a promising migration and invasion prognostic biomarker, as well as a potential therapeutic target in RCC.

This study aimed to investigate the possibility of Multi-modal ultrasound (MMU) replacing urodynamic study (UDS) in the evaluation of neurogenic bladder (NB) in Pediatrics. MMU examinations were conducted on 73 NB patients (NB group) and 100 healthy group (HG). MMU parameters of vesical volume (VV), bladder wall thickness (BWT), shear wave velocity (SWV), resistance index (RI), vascularization index (VI), and ultrasound bladder compliance (△C) were collected. Then, the above parameters were compared between the groups and a diagnosis model was constructed. The correlation of MMU parameters with bladder compliance (BC) and detrusor leak point pressure (DLPP) was analyzed. NB group showed increased emptying VV, mean BWT, filling SWV, emptying SWV, and VI, with a decrease in △C compared to the HG. Parameters of filling SWV, △C, emptying SWV, mean BWT, and VI all demonstrated high diagnostic values, particularly filling SWV, which showed the highest value. An equation was formulated using the three MMU parameters with the highest AUC values: Logit (P: NB) = -12.816–0.040 × △C + 3.518 × filling SWV + 2.009 × VI. No significant difference was observed between the diagnostic model and UDS in the diagnosis of NB. In the NB group, BC and DLPP were correlated with most MMU parameters. The constructed diagnostic model based on filling SWV, △C, and VI shows a high possibility of replacing UDS in Pediatrics to evaluate NB.

Background To compare the therapeutic effect of desmopressin (DDAVP) and enuresis alarm (EA) in treating primary monosymptomatic nocturnal enuresis (MNE) and identified prognostic factors. Methods A total of 213 children (6–16 years) with MNE were randomized to the DDAVP or EA group at five hospitals in mainland China from January 2019 to December 2023. Comprehensive medical histories were collected, and voiding diaries were maintained for two consecutive weeks. All participants underwent 12-week follow-up evaluations, with therapeutic outcomes assessed at the endpoint. Children achieving complete response were monitored for relapse for an additional 3 months post-treatment. Results After excluding 28 patients (16 lost to follow-up, 12 incomplete diaries), 185 completed the study (63.24% male, mean age 10.25 ± 2.36 years). The loss to follow-up rate in the EA group was higher than in the DDAVP group (11.71% vs. 2.94%, P < 0.05). Ninety-four children were treated with EA and 91 children with DDAVP. After 12 weeks, there was no significant difference in the therapeutic effect between the DDAVP and EA group (P > 0.05). Relapses occurred in 1/30 children in the EA group and 6/30 children in the DDAVP group (P < 0.05). Family history (OR = 2.37, 95%CI: 1.16–4.84), enuresis frequency > 4 times/week (OR = 2.30, 95%CI: 1.08–4.89), and reduced bladder capacity (OR = 2.29, 95%CI: 1.12–4.66) were negative prognostic factors. Conclusion Both therapies showed comparable short-term efficacy, but EA exhibited superior durability with lower relapse. Family history, severity of enuresis, and reduced bladder capacity are negative prognostic factors for therapeutic effect. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information