Table S3, S5-S7, S10-S18, S21

qPCR results of the expression of 4 deferent lncRNA in cytoplasm and nucleus. Three PCR by-wells were prepared for each sample.

INDEL was detected by whole-exome sequencing of 19 ccRCC samples.

qPCR results after ASO (5717 and 5608) treatment of 2 lncRNAs in caki-2 and 786-O cell lines.Three or six PCR by-wells were prepared for each sample. NC, negative control.

SNV was detected by whole-exome sequencing of 19 ccRCC samples.

Abstract Clear cell renal cell carcinoma (ccRCC) frequently features a high level of tumor heterogeneity. Elucidating the chromatin landscape of ccRCC at the single-cell level could provide a deeper understanding of the functional states and regulatory dynamics underlying the disease. Here, we performed single-cell RNA sequencing (scRNA-seq) and single-cell assay for transposase-accessible chromatin using sequencing (scATAC-seq) on 19 ccRCC samples, and whole-exome sequencing was used to understand the heterogeneity between individuals. Single-cell transcriptome and chromatin accessibility maps of ccRCC were constructed to reveal the regulatory characteristics of different tumor cell subtypes in ccRCC. Two long noncoding RNAs (RP11-661C8.2 and CTB-164N12.1) were identified that promoted the invasion and migration of ccRCC, which was validated with in vitro experiments. Taken together, this study comprehensively characterized the gene expression and DNA regulation landscape of ccRCC, which could provide new insights into the biology and treatment of ccRCC. Significance: A comprehensive analysis of gene expression and DNA regulation in ccRCC using scATAC-seq and scRNA-seq reveals the DNA regulatory programs of ccRCC at the single-cell level.

Objective:To investigate the feasibility and safety of suprapubic bladder puncture and gland fixation in transurethral enucleation of the prostate.Methods:The clinical data of 15 patients with benign prostatic hyperplasia admitted to the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2020 were retrospectively analyzed. The age was (70.27±5.35) years old, preoperative serum prostate-specific antigen (PSA) level was (3.03±1.37) ng/ml, preoperative total prostate weight was 80.3(70.49, 96.78)g, preoperative postvoid residual urine volume(PVR)was 80 (55, 108)ml, and the maximum urine flow rate (Q max) was (6.13±2.25) ml/s. The international prostate symptom score(IPSS) was 25(22, 27), quality of life (QOL)score was 5(5, 6), international erectile function index-5 (IIEF-5) score was (15.38±5.10). All 15 patients underwent conventional transurethral plasma enucleation of prostate by using the three-lobe method, and the enucleated gland was pushed into the bladder completely. Then a laparoscopic pneumoperitoneum needle was used to perform suprappubic cystipuncture, and ureteral grasping forceps were inserted through the outer sheath. The forceps were used to fix the enencied gland. A rapid harvesting electric resection was performed in the broad space of the bladder, and the Ellick was rinsed to remove the tissue fragments. Surgical indicators and complications were recorded. The improvement of subjective score (IPSS, QOL, IIEF-5) and objective index (Q max, PVR) was compared between preoperative and postoperative. Results:All the 15 operations were completed successfully and there were no complications such as blood transfusion, capsule perforation, transurethral resection syndrome, bladder injury, bladder puncture site laceration and bleeding. The weight of resected prostate tissue was 44(40, 60)g, with blood loss (79.20±18.93)ml.The time of enucleation operation was (54.13±10.88)min, with harvest cutting time (14.67±2.50)min, evisceration efficiency (0.89±0.08)g/min, harvesting efficiency (3.26±0.36)g/min, bladder irrigation time (2.47±0.52) d. The time of indwelling catheter was (3.73±0.80)d.The postoperative hospital stay was (4.40±0.91) d. Temporary urinary incontinence occurred in 1 case after operation. All patients were followed up for 6 months after operation. The IPSS score was 3(2, 3), QOL score was 0(0, 1), IIEF-5 score was (20.12±2.30), Q maxwas (21.80±2.14) ml/s and PVR was 10(5, 15)ml, which were all significantly different compared with those before surgery ( P<0.05). The symptoms of the patients were significantly improved. Conclusions:Transurethral plasma enucleation of prostate combined with suprapubic bladder puncture and fixed gland is effective in the treatment of benign prostatic hyperplasia. The subjective symptoms and objective examination of patients have been significantly improved, and no adverse operation-related complications have occurred. It is a suitable method for enucleation of prostate in units which are not equipped with transurethral tissue planer.

Various cells within the adrenal microenvironment are important in maintaining the body homeostasis. However, our understanding of adrenal disease pathogenesis is limited by an incomplete molecular characterization of the cell types responsible for the organ's multiple homeostatic functions. We report a cellular landscape of the human adrenal gland using single-cell RNA sequencing. We reveal characteristic features of cell types within the human adrenal microenvironment and found immune activation of nonimmune cells in the adrenal endothelial cells. We also reveal that abundant immune cells occupied a lot of space in adrenal gland. Additionally, Sex-related diversity in the adrenocortical cells and different gene expression profiles between the left and right adrenal gland are also observed at single-cell resolution. Together, at single-cell resolution, the transcriptomic map presents a comprehensive view of the human adrenal gland, which serves as a fundamental baseline description of this organ and paves a way for the further studies of adrenal diseases.

目的:观察机器人辅助与后腹腔镜肾部分切除术治疗复杂性肾肿瘤的临床应用效果。方法:将64例复杂性肾肿瘤患者根据治疗方法分为对照组与观察组,每组32例。对照组行后腹腔镜肾部分切除术,观察组行机器人辅助肾部分切除术。比较两组手术时间、热缺血时间、术中出血量,术后并发症情况、术后病理检查结果及随访结果。结果:观察组手术时间、热缺血时间短于对照组,术中出血量少于对照组（P＜0.05）;两组住院时间及术后迟发性出血、急性肾衰竭、尿瘘、肾功能减退等并发症发生率差异无统计学意义（P＞0.05）;两组术后病理检查结果差异亦无统计学意义（P＞0.05）。随访结果显示,观察组复发率低于对照组（P＜0.05）;术后1个月,两组肌酐水平均高于术前,观察组高于对照组（P＜0.05）。结论:机器人辅助肾部分切除术可能利于降低术后复发率、尽可能保留术后患肾肾单位及肾功能。

OBJECTIVE:To evaluate the value of preoperative red cell distribution width-to-lymphocyte ratio (RLR) and albumin-to-fibrinogen ratio (AFR) to the prognosis of patients after renal cell carcinoma (RCC).METHODS:From 2012 to 2016, a total of 273 RCC patients underwent radical nephrectomy or partial nephrectomy. This study retrospectively analyzed this group of patients. X-tile software was used to determine the optimal values of RLR and AFR in the peripheral blood. The nomogram constructed with independent factors was used to predict the survival outcome of the patients after RCC.RESULTS:The RLR of the RCC group was higher than that of the normal control group (P=0.002), whereas the AFR of the RCC group was lower than that of the normal control group (P < 0.001). RLR and AFR are related to tumour type and tumour-node-metastasis (TNM) stage (P < 0.05 for all). Cox regression analysis showed that the independent prognostic factors affecting overall survival and disease-free survival in the RCC group were symptom, tumour type, TNM stage, Fuhrman grade, RLR, and AFR (P < 0.05 for all). The nomogram constructed by multiple factors has better predictive power for patients after RCC.CONCLUSION:Preoperative RLR and AFR can serve as potential biomarkers to predict the prognosis of postoperative RCC patients and improve the predictability of patient recurrence and survival.

Background and purpose: Growing evidence indicates that inflammation plays an important role in the development and progression of tumors. Preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin have been estimated as independent prognostic factors of various cancers. This study aimed to investigate the relationship between LMR or serum albumin and the prognosis of patients with clear cell renal cell carcinoma (ccRCC). Methods: Data of 147 patients who underwent radical or partial nephrectomy from 2012 to 2015 were retrospectively studied at a single tertiary academic center. Preoperative LMR and serum albumin were calculated 1 week before surgical intervention. Patients were categorized using a median value of LMR cutoff of 3.42. Dichotomization of serum albumin was according to the lower range of normal measurement at 40 g/L. The relationship between LMR or serum albumin with other clinical factors and overall survival (OS) was analyzed using univariate analysis and COX regression model. LMR and serum albumin combined with TNM stage and Fuhrman grade were used for further analysis. The influences of the LMR and serum albumin on the predictive accuracy were investigated using the Harrell concordance index. A nomogram, which predicted the 3- and 5-year survival rates for patients with ccRCC, was established by incorporating LMR and serum albumin into a prognostic model with TNM stage and Fuhrman grades. Results: LMR and serum albumin were independent prognostic factors for OS (P=0.001). Low LMR was significantly associated with high Fuhrman grade (P=0.006) and the presence of tumor necrosis (P=0.039). Low serum albumin was significantly correlated with high Fuhrman grade (P＜0.001) and high Mayo clinic stage, size, grade and necrosis (SSIGN) score (P=0.001). Multivariate analysis identified low LMR and low serum albumin as independent prognostic factors for patient’s OS (HR=0.37; 95% CI: 0.145-0.942; P=0.037; HR=0.325; 95% CI: 0.136-0.775; P=0.011). The C-index rose when LMR and serum albumin were combined with TNM stage and Fuhrman grade. A nomogram predicted the 3- and 5-year survival rates for patients with ccRCC. Conclusion: Incorporating LMR and serum albumin into traditional clinicopathological analysis can improve the predictive value for patients with ccRCC after surgery intervention.

Objective To investigate the relationship between the polymorphism of purine / pyrimidine endonuclease 1 (APE1)T1349G and the susceptibility to bladder cancer. Methods Using forward-looking research methods,a total of 297 cases of bladder cancer patients in our hospital from January 2013 to January 2017 were selected as objects of the study. 300 healthy subjects were selected as the control group. The peripheral blood of each subject was collected and the genomic DNA was extracted. The APE1 gene polymorphism was detected by Two pairs of primers - polymerase chain reaction (PCR-CTPP)and was analyzed whether it was consistent with the Hardy - Weinberg equilibrium (HWE) law. The relationship between APE1 gene polymorphism and bladder cancer susceptibility was analyzed by Logistic regression. Results APE1 had single nucleotide polymorphism at 1349 locus,which were wild type homozygous TT genotype,mutant heterozygous TG type and mutant homo-zygous GG type. The frequency distribution of APE1 T1349G gene polymorphism conforms to the Hardy-Weinberg equilibrium (HWE)law. The risk of bladder cancer with APE1 1349GG genotype was higher than that of APE1 1349TT genotype (OR＝2.18,95%CI 1.99～2.39,P ＜0.05). The risk of bladder cancer with APE1 1349TG genotype was higher than that of APE1 1349TT genotype (OR＝1.12,95%CI 0.95～1.32,P ＞0.05). The risk of bladder cancer with APE1 1349 allele G was significantly higher than that of APE1 1349 allele T (OR＝1.89,95%CI 1.69～2.11,P ＜0.05). There was no significant correlation between the genotype of APE1 T1349G polymorphism and the pathological grade or TNM staging of bladder cancer (P ＞0.05). Conclusion The APE1 T1349G gene polymorphism is associated with the pathogenesis of bladder canc-er. The genotype GG genotype and G allele can increase the risk of bladder cancer.

目的 探讨Toll样受体4(Toll-like receptor 4,TLR4)、Toll样受体9(Toll-like receptor 9,TLR9)基因多态性与浅表性膀胱癌肿瘤复发之间的关系.方法 选取2013年3月～2017年3月笔者医院收治的300例膀胱癌患者为研究对象,其中初发膀胱癌150例、复发膀胱癌150例,同期选取100例体检健康者作为对照组,利用限制性内切酶片段长度多态性PCR(poly-merase chain reaction-restriction fragment length polymorphism,PCR-RFLP)技术检测TLR4、TLR9基因多态性,分析TLR4 rs10759932、TLR91486T/C、C2848T基因多态性与浅表性膀胱癌肿瘤复发之间的关系.结果 3组TLR4 rs10759932、TLR91486T/C、C2848T基因多态性分布均符合Hardy-Weinberg平衡.与对照组比较,初发膀胱癌组及复发膀胱癌组TLR4rs10759932基因多态位点T/C、C/C基因型频率及C等位基因频率明显降低,差异有统计学意义(P<0.05),T/T、T等位基因明显升高(P<0.05),且复发膀胱癌组TLR4rs10759932基因多态位点T/C、C/C基因型频率及C等位基因频率明显低于初发膀胱癌组(P<0.05),T/T、T等位基因明显高于初发膀胱癌组(P<0.05).3组TLR91486T/C、C2848T基因多态性比较,差异无统计学意义(P>0.05).结论 TLR4基因rs10759932多态性与浅表性膀胱癌肿瘤复发密切相关,该基因位点T/C、C/C基因型及C等位基因可能会降低浅表性膀胱癌复发风险.

Prostate cancer is a common malignancy of the male genitourinary system that occurs worldwide. The current research aims to investigate caveolin-1 expression in prostate cancer tissue and its relationship with pathological grade, clinical pathologic staging, and preoperative prostate-specific antigen (PSA) levels.

目的 探讨直肠超声引导下经会阴12+X针前列腺穿刺活检在前列腺癌诊断中的应用价值.方法 方便选取2013年1月-2016年3月该院收治的160例疑似前列腺癌患者为研究对象,行经会阴前列腺穿刺活检术,将取得的组织送病理检查,对病理结果进行分析,并观察患者在穿刺活检中是否出现并发症.结果 160例患者中,前列腺癌61例,前列腺癌活检阳性率38.1％(61/160);不典型增生8例,占5.0％;上皮内瘤5例,占3.3％.结论 TURS引导下经会阴12+X针前列腺穿刺活检术对于前列腺癌的诊断是一种安全、有效的方法.

目的 探讨膀胱癌组织小窝蛋白1(Caveolin-1)表达与膀胱癌病理分级和临床分期的相关性.方法 检索PubMed、EMBASE、Cochrane Library、CNKI万方数据库,按照纳入和排除标准选择研究膀胱癌组织Caveolin-1表达与膀胱癌病理分级和临床分期的相关性文献,评价纳入文献质量并提取资料.将各文献中的资料合并,比较合并后的高、低病理分级膀胱癌患者和浅表型、浸润型膀胱癌患者膀胱癌组织Caveolin-1阳性表达率.结果 共10篇文献纳入本研究,共501例患者.10篇文献均涉及膀胱癌组织Caveolin-1表达与膀胱癌病理分级相关性,其中高、低病理分级患者膀胱癌组织Caveolin-1阳性表达率分别为60.1%±16.0%、18.1%±9.0%,高、低病理分级者膀胱癌组织Caveolin-1阳性表达率比较P<0.05.癌组织中Caveolin-1表达与膀胱癌病理分级有关,合并OR值为0.14,95%CI为0.08~0.23,P<0.05.8篇文献涉及膀胱癌组织Caveolin-1表达与膀胱癌临床分期相关性,其中表浅型、浸润型膀胱癌组中Caveolin-1阳性表达率分别为20.2%±13.9%、55.8%±14.3%,表浅型、浸润型膀胱癌组中Caveolin-1阳性表达率相比P<0.05.膀胱癌组织Caveolin-1表达与膀胱癌临床分期有关,合并OR值为0.15,95%CI为0.10~0.23,P<0.05.结论 膀胱癌组织中Caveolin-1表达与膀胱癌病理分级、临床分期有关.

患者，75岁。2016年3月11日因右侧附睾肿物渐进性增大3个月入院。入院前在外院诊断为“右侧附睾结核”，行抗结核治疗2个月无效。查体：全身未发现表浅淋巴结肿大；右侧附睾增大，质硬，大小约为3 cm ×4 cm，表面呈结节状，无压痛，双侧睾丸及左侧附睾无异常，双侧输精管无异常。实验室检查：尿常规正常，血甲胎蛋白、癌胚抗原、绒毛膜促性腺激素正常。 B超检查示右侧附睾实质性占位性病变。术前诊断：右侧附睾结核？外院行经右侧阴囊切口右侧附睾肿物切除术，大体标本示右侧附睾肿物质硬，切面灰白，呈漩涡状。术后病理检查：肿瘤细胞呈梭形，胞质丰富，平滑肌束交织，核异形性明显，符合低分化附睾平滑肌肉瘤。免疫组化染色检查：SMA（＋＋＋），Vimentin（＋），CD34（＋）， S-100（－），EMA（－），CK（－），支持平滑肌来源。术后转入我院治疗，进一步检查示：血沉、结核抗体、尿找抗酸杆菌无异常，全身CT检查示胸、腹部及盆腔无肿瘤转移。全麻下行经右侧腹股沟切口右侧根治睾丸切除术。术后大体标本：右侧睾丸切面灰白色，原右侧附睾处可见手术瘢痕。术后病理诊断：右侧睾丸慢性炎症，右侧睾丸及右侧输精管无肿瘤浸润。术后随访3个月，B超、CT、胸部X线片检查均未见肿瘤复发。

目的 提高后腹腔镜肾上腺手术治疗ACTH非依赖性皮质醇增多症患者的临床经验.方法 对确诊的52例因肾上腺腺瘤引起的ACTH非依赖性皮质醇增多症患者行后腹腔镜下肾上腺肿瘤切除术.结果 50例成功施行腹腔镜下手术,2例改开放手术,平均肿瘤直径2.2 em(2～4.5 em).病理检查示52例为肾上腺腺瘤,手术以切除肾上腺腺瘤为主;术后平均随访11.4个月(6～27个月),52例患者均未见有复发.结论 腹腔镜下治疗肾上腺腺瘤引起的ACTH非依赖性皮质醇增多症患者,主要以切除腺瘤为主,具有损伤小、恢复快、出血时间少等优点,可作为肾上腺疾病的首选治疗方法.