ObjectiveTo investigate the clinical characteristics of fumarate hydratase-deficient renal cell carcinoma（FH-RCC）in kidney transplant patients so as to improve the diagnosis and treatment of the disease clinically.MethodsWe retrospectively analyzed and summarized the clinical data of one kidney transplanted patient with FH-RCC who was treated in the urological department of our medical center in March 2022, including clinical characteristics, treatment and prognosis. A literature review was also performed to analyze and summarize its characteristics.ResultsA 52-year-old female patient who received a kidney transplant 20 years ago was diagnosed with right kidney cancer with multiple metastases. Cytoreductive nephrectomy was performed and pathological type was FH-RCC based on Revised Version of WHO 2022 Classification of Renal Tumors. She then received targeted therapy until discontinuation due to elevated serum creatinine and the disease progressed rapidly.ConclusionFH-RCC is characterized by rapid progress and poor prognosis. Its diagnosis relies on immunohistochemistry and genetic test. There are no currently standard-of-care treatment options for kidney transplant patients with renal cell carcinoma. Individualized treatment regimens should be suggested for these patients.

Objective To preliminarily investigate the safety and effectiveness of robot-assisted kidney transplantation (RAKT) in the perioperative period. Methods Clinical data of 14 patients undergoing renal transplantation in our department from June 2018 to March 2022 were collected and retrospectively analyzed. They were 8 males and 6 females, and at an age of 22 to 45 years. There were 4 patients receiving robotic-assisted laparoscopic living-donor kidney transplantation (RAKT group), and 10 cases receiving open kidney transplantation (OKT group) with deceased donor kidney. Arterio-venous anastomoses (AVAs) time, length of post-operative stay, pre- and post-operative serum creatinine levels, intraoperative blood loss, and incidence of post-operative complications were retrospectively analyzed between the patients of the 2 groups. Results The surgeries went well in the 14 patients. The amount of intraoperative blood loss was 162.5±47.8 mL in the RAKT group and 245.1±68.5 mL in the OKT group(P < 0.05). The arterial anastomosis time was 32.5±6.5 min in the RAKT group and 24.3±5.3 min in the OKT group. The venous anastomosis time was 16.5±3.8 min in the RAKT group and 14.6±1.5 min in the OKT group. The blood creatinine level was 98.1±33.2 μmol/L in the RAKT group and 142.8±42.1 μmol/L in the OKT group in 7 d after surgery. The retention time of drainage tube was 10.0±1.2 d in the OKT group and 6.5±0.5 d in the RAKT group(P < 0.01). The length of stay after surgery was 13.0±2.5 d in the RAKT group and 16.3±2.1 d in the OKT group(P=0.01). Conclusion RAKT is safer than OKT in the perioperative period and causes fewer postoperative complications.

Objective To explore whether therapeutic dosing timing of proteasome inhibitor bortezomib(BZ) would impact its clinical efficacy .Methods From 2012 to 2018 ,35 biopsy-confirmed cases of acute antibody-mediated kidney transplant rejection (AMR) were collected .They received intravenous immunoglobulin (IVIG) plus sirolimus (Sir) plus bortezomib (BZ) .Three groups were assigned according to dosing timing of BZ .After a diagnosis of AMR ,ET (early treatment ) group began BZ dosing within 7 days (n=16) while DT (delayed treatment) group within 8-14 days (n=11) and LT (late treatment) group > 14 days (n= 8).Their clinical parameters and incidence of complications were analyzed .Results DSA reversal rate of ET ,DT and LT groups was 87 .5％ , 45 .5％ and 25 .0％ (P=0 .006) while DSA declining rate 93 .8％ ,90 .9％ and 50％ respectively (P=0 .019);recurrent rate of AMR was lower in ET/DT group than LT group (6 .6％ vs 10％ vs 75％ , P=0 .042) .No significant differences existed in blood perfusion score of allograft at 1 month post-dosing among three groups .In three groups ,creatinine (Cr) of ET group was lower than DT group at month 1/3/12 while DT group was lower than LT group .No significant difference existed in the incidence of adverse reactions among 3 groups .Conclusions More likely to enter the window period , early dosing of BZ is more effective for treating acute AMR .An earlier intervention yields a better efficacy .

To investigate whether the reverse mode of sodium/calcium exchanger subtype 1 (NCX1) plays an important role in the excitability of detrusor cells in rats with partial bladder outflow obstruction (PBOO), PBOO was maintained for 6 weeks in forty female Wistar rats. Thirty of the animals exhibited non-voiding bladder contraction and comprised the DO group. An additional thirty sham-operated female Wistar rats were used as the control group. The expression levels of NCX1 were compared between the two groups by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR), western blotting (WB), and double-label immunofluorescence. The contractions of detrusor strips in NCX reverse mode were measured in both groups using isometric tension. The role of NCX in the regulation of the intracellular Ca2+ concentration ([Ca2+]i) of smooth muscle cells was observed in reverse mode using confocal microscopy, and the current was evaluated in the presence of the antagonist KB-R7943 (5 μM and 10 μM) using the whole-cell patch-clamp technique. The expression of NCX1 was significantly higher in the DO group than in the control group, as assessed by qRT-PCR, WB analysis and immunofluorescence. The volume and rate of Ca2+ ion flux through the NCX, as well as the NCX currents, were higher in the DO group than in the control group in both modes. Increased NCX1 levels may contribute to the establishment of DO after PBOO by elevating [Ca2+]i in reverse mode under depolarization, potentially inducing cell excitability.

Objective To investigate the expression of sodium/calcium exchanger subtype 2 (NCX2) and explore its physiological role in detrusor cells of rats.Methods The bladder tissue was taken from 7 female and 3 male Wistar rats with the brain tissue as the control,and the detrusor cells were isolated from the bladder tissue using acute enzyme digestion technique.RT-PCR and Western blotting were used to detect the expression of NCX2 at mRNA and protein respectively in the bladder and brain tissues of the rats.Double-label immunofluorescence assay was used to verify the localization of NCX2 expression in the detrusor cells.NCX2 current was recorded using the whole-cell patch-clamp technique on the detrusor cells in the presence of the antagonist KB-R7943 (5 μmol/L).Results The acutely isolated detrusor cells showed predominantly a spindle-shaped morphology under microscope and were immunocytochemically positive for α-actin.NCX2 expression was detected in both the bladder and brain tissues of the rats with similar expression levels between the 2 tissues.Double-label immunofluorescence confirmed that NCX2 expression was localized on the detrusor cells,and NCX2 currents were detected in the detrusor cells with a current density of 0.79 ± 0.45 pA/pF.Conclusion NCX2 is expressed on the detrusor cells of rats and the electrophysiological evidence obtained suggests that NCX2 contributes to the maintenance of intracellular calcium homeostasis in the detrusor cells,but its exact physiological role still needs further investigation.

目的 探讨在后腹腔镜肾盂肾窦切开取石术中应用CT血管造影(CTA)对于规避各种血管相关并发症的价值.方法 回顾性分析我科2015年2月至2017年3月157例行后腹腔镜肾盂肾窦切开取石术治疗的病例;比较入院行肾CTA检查后再实施后腹腔镜肾盂肾窦切开取石术治疗的患者(术前CTA组)和入院后直接实施后腹腔镜肾盂肾窦切开取石术的患者(常规手术组)手术中转率、术中出血量、手术时间、术中术后血管相关并发症、术后漏尿率、术后住院时间的情况.结果 术前CTA组患者,其手术中转率、术中出血量、手术时间、术中术后血管相关并发症、术后漏尿率、术后住院时间均优于常规手术组,2组比较差异有统计学意义(P<0.05);术后1周复查超声肾积水均有不同程度恢复,2组比较差异无统计学意义(P>0.05);术后并发症、术后住院时间比较,术前CTA组优于常规手术组,差异有统计学意义(P<0.05).结论 行肾CTA检查后再实施后腹腔镜肾盂肾窦切开取石术治疗,可以明显减少术中血管相关并发症的发生、减少术中出血量、缩短手术及术后住院时间等,对于提高手术安全性及提高医疗资源应用效率具有较高的应用价值.

UGT2B15 (uridine diphosphate-glucuronosyltransferase 2B15) catalyzes the conversion of lipophilic C19 steroid androgens such as dihydrotestosterone (DHT) into water-soluble metabolites that can be excreted. Studies of the association between the UGT2B15 gene D85Y polymorphism and prostate cancer have yielded contradictory results. We therefore systematically searched in the PubMed, EMBASE, Science Direct/Elsevier, CNKI, and Cochrane Library databases, and identified six relevant studies with which to perform a meta-analysis of the relation between UGT2B15 D85Y polymorphism and prostate cancer risk. Our meta-analysis revealed a significant association between UGT2B15 D85Y gene polymorphism and prostate cancer in all genetic models (P<0.05). The combined odds ratios and 95% confidence intervals were as follows: additive model, 0.53 and 0.32-0.88; dominant model, 0.51 and 0.33-0.79; recessive model, 0.76 and 0.60-0.96; co-dominant model, 0.55 and 0.35-0.86; and allele model, 0.70 and 0.55-0.89. These results are consistent with the idea that the UGT2B15 D85Y enzyme variant reduces the risk of prostate cancer by efficiently metabolizing dihydrotestosterone (DHT), which is associated with prostate cancer progression.

Objective To discuss the application of laparoscopic situ hypothermia perfusion in partial nephrectomy of renal tumors and evaluate its feasibility and safety.Methods A total of 26 cases were randomly divided into experimental group and control group(each 13 cases),All cases of inclusion criteria were single vessel,T1 tumor,The experimental group used a self-priming device:the specific step was to free the arterial vein first,the two pipe from Trocar import clearance by the body,exports the venous reflux fluid.The control group operated on a routine procedure.The two groups were compared with average operation time,the bleeding,the bleeding and the bleeding.Results All 26 cases were successful surgery,the experimental group body mass index(BMI)was(24.5±3.1)kg/m2,the Radius Exophytic Nearness Anterior Location score(RENAL)was 3.1±1.1,tumor size was (3.1±1.1)cm,the average operation time was (15.8±4.1)min,the bleeding was (58±8)ml,perfusion time average was 5.4s,preoperative creatinine was(58±11)mmol/L.BMI of control group was(26.0±2.4)kg/m2,RENAL score was3.3±0.7,tumor size was(3.2±0.9)cm,the average operation time was(16.5±7.5)min,the bleeding was (46±9)ml.The two group had a weekly,one month,and three month creatinine comparision,there were statistically significant(P<0.05),and the postoperative renal function of experimental group was better than the control group in all cases.All tumor cutting edge was negative.Conclusion the laparoscopic situ perfusion technique in low temperature,can chang kidney warm into kidney cold ischemia,which can provide security to prolong operation time,at the same time can protect renal function very well.

Effective doctor-patient communication is essential for establishing a successful doctor-patient relationship and implementing high-quality health care. In this study, a novel urinary system-simulating physical model was designed and fabricated, and its content validity for improving doctor-patient communication was examined by conducting a randomized controlled trial in which this system was compared with photographs. A total of 240 inpatients were randomly selected and assigned to six doctors for treatment. After primary diagnosis and treatment had been determined, these patients were randomly divided into the experimental group and the control group. Patients in the experimental group participated in model-based doctor-patient communication, whereas control group patients received picture-based communication. Within 30 min after this communication, a Demographic Information Survey Scale and a Medical Interview Satisfaction Scale (MISS) were distributed to investigate patients' demographic characteristics and their assessments of total satisfaction, distress relief, communication comfort, rapport, and compliance intent. The study results demonstrated that the individual groups were comparable with respect to demographic variables but that relative to patients in the picture-based communication group, patients in the model-based communication group had significantly higher total satisfaction scores and higher ratings for distress relief, communication comfort, rapport, and compliance intent. These results indicate that the physical model is more effective than the pictures at improving doctor-patient communication and patient outcomes. The application of the physical model in doctor-patient communication is helpful and valuable and therefore merits widespread clinical popularization.

To investigate changes in the expression and function of the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, interstitial cells of Cajal (ICCs) were isolated from detrusor overactivity (DO) rats induced with partial bladder outlet obstruction (PBOO). We hypothesized that increased expression of HCN channels in ICCs would enhance the excitability of ICCs and bladder in DO rats.

Objective To investigate the effect of multiple treatments on cystospasm after transurethral resection of prostate(TURP). Methods From 2006 to 2013, 663 patients who had received TURP for BPH were civided into 6 groups:2 were treated by kieselgel or lac-toprene urethral catheter,defined as catheter observe group. 2 were treated by warmed or ordinary temperature douche,defined as temperature observe group. 2 were treated by dicaine mixed or normal douche,defined as mixed douche observe group. The incidence rates and duration of cystospasm and visual analogue scores of pain were observed and the diversities were measured by statistics within each pair groups. Results The incidence rates and duration of cystospasm and visual analogue scores of pain of groups treated by kieselgel urethral catheter,warmed douche and dicaine mixed douche were obviously lower than the groups treated by lactoprene urethral catheter,ordinary temperature douche and normal douche. The kieselgel urethral catheter and warmed douche decreasing the irritation on mucous membrane of bladder,the dicaine decreasing the sensibility of bladder nerves may be the mechanism. Conclusion The incidence rates and duration of cystospasm and visual analogue scores of pain can be obviously decreased by treatments of kieselgel urethral catheter,warmed douche and dicaine mixed douche.

Objective To investigate the effect of indwelling double-J ureteral stents before flexible ureteroscope lithotrity in terms of operation time, postoperative hospitalization time and operation effect. Methods All clinical data of flexible ureteroscope lithotrity from 2009 to 2013 were reviewed. Operation time, postoperative hospitalization time and recurrence rate of calculus of patients who received operation directly and patients who received indwelling of double-J ureteral stents 2 weeks before operation were observed and compared. Results Op-eration time, postoperative hospitalization time, and recurrence rate of calculus of patients who received indwelling of double-J ureteral stents 2 weeks before receiving operation were obviously lower than patients who received operation directly. Conclusion Operation time, postoper-ative hospitalization time and recurrence rate of calculus can be decreased by indwelling double-J ureteral stents 2 weeks before operation.

Objective: This randomized controlled study compared a novel transparent urinary tract simulator with the traditional opaque urinary tract simulator as an aid for efficiently teaching urological surgical procedures. Methods: Senior medical students were tested on their understanding of urological theory before and after lectures concerning urinary system disease. The students received operative training using the transparent urinary tract simulator (experimental group, n = 80) or the J3311 opaque plastic urinary tract simulator (control, n = 80), specifically in catheterization and retrograde double-J stent implantation. The operative training was followed by a skills test and student satisfaction survey. Results: The test scores for theory were similar between the two groups, before and after training. Students in the experimental group performed significantly better than those in the control group on the procedural skills test, and also had significantly better self-directed learning skills, analytical skills, and greater motivation to learn. Conclusion: During the initial step of training, the novel transparent urinary tract simulator significantly improved the efficiency of teaching urological procedural skills compared with the traditional opaque device.

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

OBJECTIVE To investigate the regulation of intracellular store-operated calcium channels (SOCCs) in detrusor overactivity (DO) during detrusor function changes in Sprague-Dawley rats. METHODS Sixty female Sprague-Dawley rats were randomized into control and DO groups. The contraction of the smooth muscle of the bladder was evaluated in vivo using smooth muscle strips. Changes in intracellular calcium ions were observed using confocal microscopy with preload fluo-4 AM, the SOCC agonist cyclopiazonic acid (CPA; 10 mu M) and inhibitor SKF-96365 (10 mu M). Cell currents were recorded with the whole-cell patch-clamp technique. RESULTS The in vitro frequencies of bladder smooth muscle contraction were significantly different (P < .05) between the DO and control groups, and the amplitudes were not significantly different (P > .05). The changes in intracellular calcium ions and current density were significantly different between the 2 groups (P < .05). CONCLUSION SOCCs were involved in DO and caused variations in muscle contraction. (C) 2014 Elsevier Inc.

Objective To investigate the effect of transparent urinary system model in clinical nursing teaching. Methods 59 nursing students in our department from 2013 July to 2014 February were randomly divided into two groups. The control group recieved traditional teaching with urinary system model,the experiment group adopted the transparent urinary system model for teaching. Other teaching methods and the assessment methods of two group were the same. Results The theory scores and operation scores of experiment group were significantly higher than those of control group( P 0. 001). Conclusion The urinary system model can strengthen the knowledge of anatomical transparent for nursing studentsand improve the nursing students' theory and operation scores,which is very important to improve the teaching quality of nursing students.

目的 总结腹腔镜下配合肾盂拉钩行肾盂切开取石术治疗无肾盂积水肾内型肾盂结石初步经验.方法 在腹腔镜下配合肾盂拉钩行肾盂切开取石术治疗无肾盂积水肾内型肾盂结石23例,回顾分析23例病例资料.结果 23例手术均取得成功,手术时间(53±19)min,出血量(50±15) ml,平均住院时间(8±2)d,无一例漏尿,无一例中转开放手术,无输血病例等情况,随访除1例肾下盏残留0.7 cm结石外,其余无结石残留.结论 腹腔镜下配合肾盂拉钩行肾盂切开取石术治疗无肾盂积水肾内型肾盂结石可行,选择合适病例,术中操作快速,适当游离、牵拉暴露肾内型肾盂,可以有效避免开放手术、经皮肾镜等手术重创,此种手术方式术后恢复快、疗效确切,值得推广.

Recent findings suggest that clinical hepatocellular carcinoma (HCC) progression is driven by hepatic cancer stem cells (HCSCs) through their capacity for self-renewal, generation of heterogeneous lineages of cancer cells, resistance to chemotherapy and their ability to divide limitlessly, which may contribute to the failure of existing therapies to consistently eradicate malignant tumors. Therefore, HCSC-directed therapeutic approaches might represent strategies to improve clinical HCC therapy. In previous studies, we showed that BC047440 was found to play a critical role in mediating HCC cell proliferation. The present study sought to determine whether BC047440 is involved in maintaining HCSC malignant behavior (including proliferation and differentiation). We demonstrated that BC047440 expression was markedly upregulated in HCSCs. Furthermore, we inhibited BC047440 in HCSCs using short hairpin RNA (shRNA). The effects of BC047440 on proliferation and differentiation were investigated. We also analyzed the involvement of critical molecular events known to regulate the proliferation and the differentiation machinery. Excluding apoptosis-related effects, we found that BC047440 inhibition resulted in enhanced cell proliferation through enhancing cytoplasmic accumulation of nuclear factor-κB (NF-κB) with a concomitant decrease in the nuclear fraction. BC047440 inhibition also resulted in inducing HCSC differentiation into hepatocytes. Furthermore, following downregulation of BC047440, the level of hepatocyte nuclear factor 4α (HNF4α) increased. Finally, tumorigenicity suppression following BC047440 depletion was confirmed in a nude mouse model. In conclusion, our findings indicate that BC047440 plays an important role in the proliferation and differentiation of HCSCs and may represent a novel therapeutic target for the treatment of HCC.

Objective: In this study, we screened microRNA (miRNA) target genes of prostate cancer by integrating miRNA and mRNA expression profiles after target prediction and performed function enrichment analysis for selected candidate genes. Methods: The miRNA expression profile (GSE36802) and mRNA expression profile (GSE36801) were downloaded from the Gene Expression Omnibus database. We processed data and identified the differentially expressed miRNAs and mRNAs with R packages. Verified targets of miRNAs were identified through miRecods and miRTarBase. Then, software of Search Tool for the Retrieval of Interacting Genes was used to construct the interaction network of target genes. Finally, we performed function enrichment analysis for genes in the interaction network with the Functional Classification Tool. Results: A total of 22 upregulated and 8 downregulated miRNAs were detected in this study, of which, hsa-miR-31 was the most overexpressed miRNA in prostate cancer. Both ITGA5 and RDX, two target genes of hsa-miR-31, were found to be differentially expressed from mRNA profiles by overexpressing hsa-miR-31. The cell adhesion molecule was found to be the most significant pathway enriched by ITGA5 and RDX. Conclusion: Overexpression of hsa-miR-31 can be a significant marker to distinguish cancer tissues from benign tissues. The targets such as ITGA5 and RDX regulated by hsa-mir-31 are candidate genes of prostate cancer, which provide new treatment strategies for its gene therapy.

目的 改良大鼠膀胱平滑肌细胞急性酶分离方法,为利用膜片钳技术研究膀胱疾病提供必要的技术平台.方法 采用木瓜蛋白酶和胶原酶Ⅱ,采用一步法和二步法,分别消化5只新生和成年Wistar大鼠膀胱组织,在膜片钳工作台上分别对平滑肌细胞钠钙交换体电流行全细胞记录.结果 建立了稳定的新生和成年大鼠膀胱平滑肌细胞急性酶分离方法.新生大鼠钠钙交换体(Na+/Ca2+ exchanger,NCX)电流密度(pA/pF)为[(0.21±0.07),n=4],成年大鼠NCX电流密度为[(0.19±0.06),n=6],差异有统计学意义(P＜0.05).KB-R7943在5μm浓度下,有阻滞NCX正向模式的能力.结论 本方法改良了大鼠膀胱平滑肌细胞急性酶分离,并成功应用于膜片钳技术检测.