Background:T2-stage renal cell carcinoma (RCC) is associated with high postoperative recurrence risk and heterogeneous outcomes, but stage-specific prognostic factors remain insufficiently explored. This study aimed to systematically analyze the clinicopathological factors influencing postoperative recurrence-free survival (RFS) (defined as the time from surgical resection to the first occurrence of local recurrence, distant metastasis, or death from any cause) in patients with T2-stage RCC and explore reliable independent prognostic indicators for this specific subgroup. Methods:We retrospectively collected clinicopathological data and follow-up records of T2-stage RCC patients who underwent surgery at the Second Hospital of Lanzhou University from January 2018 to December 2023. Postoperative RFS was the primary endpoint. The Kaplan-Meier method was used for survival analysis and survival curve plotting; univariate and multivariate Cox proportional hazards regression models were applied to identify independent prognostic factors. Internal stability of the identified prognostic factors was evaluated using bootstrap resampling (1,000 iterations) and Harrell's concordance index (C-index). Results:A total of 182 patients were included (mean age: 55±13 years; median follow-up: 40 months). After rigorous variable screening (including collinearity elimination and biological independence assessment), five independent prognostic factors for postoperative RFS were identified: the aspartate transaminase to alanine transaminase ratio (AST/ALT ratio) [hazard ratio (HR) =3.295, 95% confidence interval (CI): 1.899-5.719, P<0.001], Fuhrman grade (HR =2.380, 95% CI: 1.412-4.012, P=0.001), systemic immune-inflammation index (SII) (HR =3.009, 95% CI: 1.567-5.776, P<0.001), sarcomatoid differentiation (HR =3.463, 95% CI: 1.981-6.054, P<0.001), and carbonic anhydrase IX (CAIX) (HR =5.425, 95% CI: 2.555-11.519, P<0.001). Internal validation showed a mean C-index of 0.835 (95% CI: 0.780-0.885), indicating good and stable discriminatory ability of the identified factors. Conclusions:The AST/ALT ratio, Fuhrman grade, SII, sarcomatoid differentiation, and CAIX are independent prognostic indicators for postoperative RFS in T2-stage RCC patients. These factors can facilitate accurate risk stratification and provide a scientific basis for formulating individualized follow-up and treatment strategies. Given the limitations of single-center retrospective design and small sample size, future large-scale prospective multicenter studies are needed to validate these findings.

To evaluate the efficacy and safety of disitamab vedotin (DV) plus a PD-1 inhibitor combined with different local intensification strategies for the bladder-preserving management of muscle-invasive bladder cancer (MIBC). This single-center retrospective cohort study enrolled patients with MIBC who underwent maximal transurethral resection of bladder tumor (TURBT), followed by DV plus a PD-1 inhibitor between January 1, 2023, and September 30, 2025. According to the local intensification strategy, patients were classified into three groups: group A, maximal TURBT followed by DV plus a PD-1 inhibitor; group B, maximal TURBT followed by DV plus a PD-1 inhibitor combined with intravesical Bacillus Calmette-Guérin (BCG); and group C, maximal TURBT followed by DV plus a PD-1 inhibitor combined with radiotherapy. Treatment selection was based on multidisciplinary evaluation of patients’ clinical characteristics and treatment accessibility; because treatment allocation was nonrandomized, between-group comparisons were considered exploratory. The primary endpoint was bladder-intact event-free survival (BI-EFS). Secondary endpoints included clinical complete response (cCR), progression-free survival (PFS), overall survival (OS), bladder preservation rate, salvage or delayed radical cystectomy (RC) rate, and safety. Patient-level reasons for not receiving RC, conventional TMT, or radiotherapy were not uniformly documented, limiting assessment of treatment-selection bias. A total of 81 patients were included, comprising 41 in group A, 30 in group B, and 10 in group C. The median follow-up duration was 18.5 months (IQR, 13.7–26.6). The 12-month BI-EFS rates were 58.5

Background:Renal cell carcinoma (RCC) is a prevalent malignancy of the urinary system that presents significant health and economic burdens. Despite existing treatments such as surgery and targeted therapies, challenges remain due to suboptimal efficacy and high recurrence rates. Previous studies have indicated that metformin and everolimus individually exhibit inhibitory effects on RCC. However, their synergistic potential when combined has not been fully elucidated. Therefore, this paper identified the antiproliferative effect and the hub genes that undergo significant changes in 786-O cells when treated with the combination drugs and their underlying mechanisms to inform the search for kidney renal clear cell carcinoma (KIRC) therapeutic targets. Methods:The effects of the combination of metformin and everolimus on 786-O cells viability, migration and invasion were investigated. Differentially expressed genes (DEGs) among different drug treatment groups were identified through ribonucleic acid (RNA) sequencing, raw data processing and differential expression analysis. The target genes were obtained by taking the intersection of different DEGs, and hub genes were identified by Maximal Clique Centrality (MCC) and Molecular Complex Detection (MCODE) algorithms, expression validation, and Kaplan-Meier (K-M) survival curve plotting. Subsequently, transcription factors (TFs) regulating the hub genes were identified and drug-hub gene interactions were explored through molecular docking. In addition, gene set enrichment analysis (GSEA) demonstrated hub gene-related biological functions and pathways, and gene set variation analysis (GSVA) explored differential pathways between different drug treatment groups. Finally, quantitative real-time polymerase chain reaction (qRT-PCR) was performed to verify the expression difference of hub genes among four groups. Results:The combination of metformin and everolimus is more effective than monotherapy at inhibiting cell viability, migration, and invasion in 786-O cells. In total, 3,030 DEG1, 2,953 DEG2, 3,591 DEG3, 1,571 DEG4 and 4,064 DEG5 were identified, yielding five target genes. After MCC and MCODE algorithms, expression validation, and K-M survival curve plotting, target genes were all noted as hub genes (SPC25, NCAPH, MCM10, UHRF1, SMC4). Eleven TFs regulated more than two hub genes, and the binding energy of metformin with SPC25 and everolimus with SMC4 was the lowest. Hub genes were negatively correlated with lysosome and positively associated with cell cycle, and the P13K/Akt/mTOR signaling pathway was significantly positively correlated with hub genes. Conclusions:Metformin and everolimus are synergistic in anticancer effects on RCC. Based on transcriptomic data, this study obtained five hub genes associated with everolimus and metformin combination therapy in KIRC to inform KIRC-related research.

BackgroundRhabdomyosarcoma of the bladder is an infrequent neoplastic condition characterized by a pronounced malignant situation with challenges in treatment due to the lack of standardized guidelines and large-scale of clinical studies. The patient in this case is tested TP53 mutation that may provide new diagnostic and therapeutic options.Case presentationHere, we reported a 34-year-old male who received bladder tumor resection, and diagnosed as bladder rhabdomyosarcoma with TP53 mutation after the pathology test. This patient underwent 6 rounds of chemotherapy. However, the pelvic tumor recurred 11 months after the first surgery. So, the patient accepted the pelvic tumor resection. Only 3 months after the surgical intervention, the patient underwent abdominal massive metastasis and ultimately succumbed to the illness six months following the second surgery. The course of the illness was 22 months.ConclusionBladder rhabdomyosarcoma is a disease with an extremely poor prognosis. Genetic testing holds significant value in the diagnosis and treatment. Perhaps targeted therapy against TP53 is potential valuable for such rare diseases.

Background: Clear cell renal cell carcinoma (ccRCC) is a worldwide malignancy with high morbidity and mor-tality. Translation initiation factor 4A1 (eIF4A1), which is an ATP-dependent RNA helicase as a part of eIF4F complex, has been linked to malignant transformation and progression, and a variety of cancers display dysre-gulation of this enzyme. However, its role in ccRCC remains unclear. In our study, we examined its potential effects in ccRCC. Methods: Based on Proteomic data, TCGA and ONCOMINE database, RCC cell lines and tissues, the expression of eIF4A1 between ccRCC and normal tissues were investigated. A correlation was evaluated between the prog-nostic model for OS and ccRCC progression. Analysis of functional enrichment and PPI network were performed. After examining differentially expressed genes between the eIF4A1 high and low-expression groups, we per-formed GSEA analysis. Furthermore, we investigated immune cell infiltration of eIF4A1. Then we determined eIF4A1 functions in the establishment and maintenance of cell viability, migration and invasion of cell lines. Flow cytometry was utilized to detect cell cycle. Results: The eIF4A1 was up-regulated in ccRCC tissues and cell lines. An increased level of eIF4A1 was linked to lower survival rates and impaired immunity. Depletion of eIF4A1 could arrest tumor cells in G1 phase, so as to seriously limit cell proliferation and weaken the capacity of cell migration. Conclusion: ccRCC patients with high eIF4A1 expression are at increased risk of poor prognosis, furthermore eIF4A1 plays a prominent role in facilitating tumor cell proliferation and migration which may further be a potential prognostic biomarker and therapeutic target.

内脏反位(situs inversus totalis ,SIT )是一种罕见的先天性畸形 ,具有常染色体隐形遗传倾向,发病率约1/104 [1-3 ] ,包括全内脏反位和部分内脏反位.全内脏反位患者 ,因脏器解剖位置与正常人完全相反 ,呈镜像改变 ,故又称"镜面人"[4 ] .部分内脏反位较全内脏反位少见[5 ] ,而合并恶性肿瘤更为少见.2018年5月兰州大学第二医院泌尿外科收治1例部分内脏反位合并右侧肾癌患者 ,现报道如下.

目的:通过构建头孢曲松钠结石大鼠模型,探讨TRPV5(辣椒素受体-5)在结石模型组大鼠肾脏中和正常对照组大鼠肾脏中的表达差异,分析其表达量与头孢由松钠应用时间的关系,为研究头孢曲松钠相关肾结石的发生机制提供新的理论依据.方法:30只雄性SD大鼠随机分为3组,A组给予120 mg·kg-1·d-1纯化水灌胃4周,B组、C组分别以120 mg·kg-1 ·d-1头孢曲松钠灌胃2周和4周;试剂盒检测各组血、尿生化指标;用相差显微镜观察各组结石结晶形成情况;采用免疫组化、双抗体夹心法分别定性、定量大鼠肾组织TRPV5的表达.结果:3组血钙浓度无统计学差异(P＞0.05),C组与A组、B组比较血肌酐明显升高[(96.29±21.81)μmol·L-1 vs(34.72±10.49) μmol·L-1、(59.98±20.45) μmol· L-1,P＜0.05],C组尿钙浓度相比较A组明显升高[(0.72±0.25)mmol· L-1 vs (0.46±0.23) mmol·L-1,P＜0.01],C组与A组、B组比较尿肌酐降低[(2 488.28±435.75) μ-mol·L-1 vs(3 463.57±221.76)μmol·L-1、(2 971.37±319.27)μmol·L-1,P＜0.01].光镜下C组可见有大量结石结晶形成.TRPV5在3组血液中表达无明显差异(P＞0.05),C组中TRPV5在肾脏中表达明显低于A组、B组[(217.79±48.31)ng·L-1 vs(395.66±74.69)ng·L-1、(343.08±74.08)ng·L-1,P＜0.01].结论:TRPV5在头孢曲松钠干预4周组大鼠肾组织中的表达降低,表达量且与头孢曲松钠干预时间呈负相关,可能由于头孢曲松钠抑制了钙离子通道蛋白TRPV5在肾脏的表达,增加肾小管尿钙排泄从而参与了头孢曲松结石的形成.

前列腺癌是老年男性常见的疾病之一,发现时多为晚期.对于晚期前列腺癌而言,其首选的治疗手段为内分泌治疗,其中以最大雄激素阻断疗法即去势+抗雄激素治疗最为常用,有关去势方式又可分为手术去势和药物去势.目前临床上对于手术或药物去势的选择虽有大量文献进行比较分析,但尚无统一的选择标准.本文就晚期前列腺癌内分泌治疗中不同去势方式的选择做一综述.

Purpose. To use in vitro and in vivo models to evaluate Glechoma longituba extract to provide scientific evidence for this extract's antiurolithic activity. Materials and Methods. Potassium citrate was used as a positive control group. Oxidative stress (OS) markers and the expression of osteopontin (OPN) and kidney injury molecule-1 (KIM-1) were measured to assess the protective effects of Glechoma longituba. Multiple urolithiasis-related biochemical parameters were evaluated in urine and serum. Kidneys were harvested for histological examination and the assessment of crystal deposits. Results. In vitro and in vivo experiments demonstrated that treatment with Glechoma longituba extract significantly decreased calcium oxalate- (CaOx-) induced OPN expression, KIM-1 expression, and OS compared with the positive control group (P < 0.05). Additionally, in vivo rats that received Glechoma longituba extract exhibited significantly decreased CaOx deposits and pathological alterations (P < 0.05) compared with urolithic rats. Significantly lower levels of oxalate, creatinine, and urea and increased citrate levels were observed among rats that received Glechoma longituba (P < 0.05) compared with urolithic rats. Conclusion. Glechoma longituba has antiurolithic effects due to its possible combined effects of increasing antioxidant levels, decreasing urinary stone-forming constituents and urolithiasis-related protein expression, and elevating urinary citrate levels.

目的 探讨微创经皮肾镜碎石取石术(MPCNL)治疗婴幼儿肾结石的安全性与疗效.方法 回顾性分析10例肾结石患儿行MPCNL的临床资料.结果 10例患儿共11侧行单通道MPCNL治疗,1侧因碎石时间超过预定手术时间而行2次手术完成.经B超引导下一期建立经皮通道成功率为100％.术后全部留置肾造瘘管,5～7d后拔除.1例女婴术后当天造瘘管脱落,出现膀胱填塞.绝大多数患儿术后均留置双J管,1个月后在小儿肾镜下拔除.1例1岁男孩拔完肾造瘘后持续漏尿,留置双J管后缓解.术中未损伤胸膜、肝脏、肠管,术后未出现输血、肾功能恶化等严重并发症.术后住院9～12d.结石清除率90％ (10/11).结论 采用MPCNL治疗婴幼儿肾结石安全有效.