Objective To explore the expression of insulin-like growth factor 2 (IGF2) in urinary exosomes of patients with bladder urothelial carcinoma, and to evaluate its clinical value in the diagnosis of bladder urothelial carcinoma. Methods Patients with bladder urothelial carcinoma or non-urothelial carcinoma diagnosed and treated by Peking Union Medical College Hospital from September to December 2020 were prospectively selected as the research subjects. Fluorescence quantitative reverse transcription PCR was used to detect the expression levels of IGF2 in the urine exosomes of the two groups. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma were calculated, using pathological results as the gold standard. Results A total of 35 patients with bladder urothelial carcinoma and 60 non-urothelial carcinoma patients who met the inclusion and exclusion criteria were selected. The positive expression rate of IGF2 in urinary exosomes in patients with bladder urothelial carcinoma was significantly higher than that in patients with non-urothelial carcinoma (71.4% vs. 10.0%, P=0.000). The sensitivity of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma was 71.43% (95% CI: 53.48%-84.76%), the specificity was 90.00% (95% CI: 78.83%-95.87%), the positive likelihood ratio was 7.14 (95% CI: 3.25-15.70), the negative likelihood ratio was 0.32 (95% CI: 0.19-0.54). Conclusions IGF2 is highly expressed in urinary exosomes of patients with bladder urothelial carcinoma, which has high diagnostic specificity for bladder urothelial carcinoma, but a slightly lower sensitivity. IGF2 is expected to be used as a primary screening index for bladder urothelial carcinoma.

Prostate cancer(PCa) is a common malignancy in males. Exosomes are lipid bilayer vesicles containing protein, mRNA and miRNA, which are active in intercellular communications. Exosomes promotes the development of prostate cancer, support immune evading and chemotherapy resistance, stimulate angiogenesis, induce epithelial-mesenchymal transition(EMT) of tumor cells, and contribute to the formation of pre-metastasis niche, thus promoting the invasion and metastasis of prostate cancer. Based on the role in tumor biological behavior and heterogeneity in different cells, exosomes hold great potentials as biomarker for diagnosis and prognosis of prostate cancer, and are expected to become a favorable drug carrier. It has a promising prospect for cancer therapy.

Abstract Purpose To investigate the therapeutic effect and possible mechanism of PI3K inhibitor 5d on prostate cancer. Methods The MTT cell proliferation assay was used to assess the PC-3 prostate cancer cell viability. The effect of compound 5d on cell cycle and apoptosis was detected by flow cytometry, and the expression of proteins was estimated by Western blotting. The xenograft models of DU145 and PC-3 cell lines were established to further explore the inhibitory activity of 5d on prostate cancer in vivo. Results The results of MTT experiment showed that 5d could significantly inhibit the proliferation of PC-3 cells in vitro. The flow cytometry results showed that 5d could arrest PC-3 cell cycle in G0 / G1 phase and promote apoptosis. Western blot analysis showed that 5d could effectively inhibit the activation of PI3K signaling pathway. The results of in vivo experiments showed that the tumor weights in the 5d treatment group was significantly reduced compared with the control group, and western blot results show that 5d can effectively inhibit the expression of PI3K signaling pathway in both tumor tissues. Conclusion PI3K inhibitor 5d can effectively inhibit the proliferation of prostate caner in vitro and in vivo.

IgA肾病(IgAN)是常见的原发性肾小球肾炎之一,也是导致终末期肾病的重要危险因素.肾移植是IgAN导致的终末期肾病患者的首选治疗方式,但肾移植术后仍存在IgAN复发风险.目前有关肾移植术后IgAN复发的相关研究进展缓慢.IgAN复发的发病机制尚未明确,其病理表现不具备特异性,确诊仍依赖于肾活组织检查,且尚未见有效的复发性IgAN防治方案.本文主要从肾移植术后IgAN复发的发病机制、诊断、危险因素及治疗手段等方面介绍肾移植术后IgAN复发的最新进展,以期为临床肾移植术后IgAN复发的防治提供参考,改善肾移植受者的预后.

Cystic pheochromocytoma is an uncommon neuroendocrine tumor, which mostly has no obvious clinical symptoms, and difficult to make correct diagnosis before surgical operation. When a cystic mass in the adrenal gland is found by imaging examination, the possibility of cystic pheochromocytoma should be screened. At present, the most curative treatment is surgical resection. Laparoscopic adrenalectomy is the first choice. Adequate preoperative preparation and strict postoperative monitoring are important pre-requisites for ensuring the safety of patients during the peri-operative period.

Objective: The objective of this study was to assess the possibility of using urinary exosomal CA9 mRNA as a novel liquid biopsy for the molecular diagnosis of bladder cancer. Patients and Methods: A total of 168 bladder cancer patients and 90 control subjects were included in the study. An isolation kit was used to isolate urinary exosomes. Transmission electron microscopy (TEM) was used to examine the presence of exosomes. Flow cytometry was used to examine the exosomal marker CD63. The expression level of exosomal CA9 mRNA was detected by RT-qPCR. The diagnostic performance of urinary urinary exosomal CA9 mRNA was evaluated. Results: TEM confirmed the enriched exosomes from urinary bladder patients. Flow cytometry indicated a strong positive expression of exosome marker CD63. Successful extraction of RNA was performed from exosome samples. The level of urinary exosomal CA9 mRNA was significantly higher in bladder cancer group than in control group (p<0.001). The area under the ROC curve was 0.837 (95% CI: 0.743-0.859) with a sensitivity of 85.18% and a specificity of 83.15% for the diagnosis of bladder cancer. Conclusion: We found that the urinary exosomes were abundant in the urine of bladder cancer patients. CA9 mRNA could be detectable in urinary exosomes. The urinary exosomal CA9 mRNA may present a new liquid biopsy for the diagnosis of bladder cancer.

Objective To investigate the incidence of surgical site infection(SSI)following conversion from laparoscopic to open cholecystectomy and to analyze the related risk factors. Methods The clinical data of 179 patients who had experienced conversion from laparoscopic to open cholecystectomy in Peking Union Medical College Hospital from January 2014 to August 2019 were analyzed retrospectively.Univariate and multivariate logistic regression analyses were performed to evaluate the associations between clinical variables and SSI. Results The incidence of SSI was 19.0%(34/179)after conversion from laparoscopic to open cholecystectomy.The multivariable analysis demonstrated that preoperative endoscopic retrograde cholangiopancreatography(ERCP)(OR=4.208,95% CI:1.590-11.135,P=0.004)was the only independent risk factor of SSI. Conclusions The incidence of SSI after conversion from laparoscopic to open cholecystectomy increased remarkably,especially in those who had preoperative ERCP.Preventive interventions should be taken to reduce the incidence of SSI.

Objective:To investigate the clinical manifestations, endoscopic features, potential risk factors for cancerization, surveillance and therapeutics of duodenal adenomas in familial adenomatous polyposis (FAP).Methods:Forty-five cases with FAP at Peking Union Medical College Hospital were collected. The clinical data including clinical manifestations, endoscopic features, pathological results, surveillance, and therapies of the 45 patients were retrospectively analyzed.Results:Duodenal adenomas was present in 15 patients (33%, 8 males), with a mean age of (46.8±12.8) years, which was 9 years older than those without duodenal adenomas ( P<0.001). No gender difference was found ( P=0.904). The mean endoscopic follow-up time was (35.5±22.1) months. The Spigelman stage increased in 3 patients. The polyp size was greater than 20 mm in 5 patients and duodenal papilla was involved in 4 of them. Two of the 5 patients were diagnosed as ampullary carcinoma. Whipple′s procedure was performed in one of them and pylorus preserving pancreaticoduodenectomy (PPPD) was performed in the other. Endoscopic mucosal resection was performed in the rest of the patients who required intervention. Conclusions:Duodenal adenomas are common in FAP. Upper gastrointestinal endoscopy is recommended in patients diagnosed with FAP. Combining with Spigelman scoring system, the location and the size of the polyp are risk factors associated with the development of duodenal carcinoma.