Neuro-immune interactions are critical in cancer, yet their molecular features in bladder cancer remain unclear. We analyzed transcriptomic data from TCGA and UCSC Xena to investigate the expression profiles and molecular subtypes of neuro-immune–related genes, and constructed a neuro-immune–related score (NAS) model. Single-cell transcriptomic data were integrated to explore the immune microenvironmental features, and functional validation was performed by knocking down SERPINE2 with shRNA in T24 cells. The results showed that six core genes (SERPINE2, NXPH4, SERPINB2, C2orf40, SERPINB12, SERPINB10) were identified to stratify patients into high- and low-risk groups, with robust predictive power across clinical subgroups and validation cohorts. Single-cell RNA-seq data revealed significant NAS heterogeneity among cell populations. The NAS-high state was enriched in TGFβ, EGF, and FGF signaling with activation of EZH2 and SMARCA4, while the NAS-low state showed immune-regulatory features. Functional assays confirmed that SERPINE2 knockdown suppressed proliferation, migration, invasion, while increasing apoptosis of T24 cells, highlighting its oncogenic role. Moreover, genome-wide association studies (GWAS) suggested that genetic variants in SERPINE2 and related genes may increase bladder cancer susceptibility. Collectively, our findings provide novel insights into neuro-immune–driven tumor heterogeneity and immune remodeling, establish the NAS model as an innovative prognostic tool, and identify SERPINE2 as a promising therapeutic target for precision management of bladder cancer.

INTRODUCTION:Hepatocellular carcinoma (HCC) remains one of the most predominant types of digestive system malignancies worldwide. TNF-related apoptosis-inducing ligand (TRAIL) is a biological cytokine with the mentioned specificity, but some tumor cells' resistance limits its use as a therapeutic approach. The present study aimed to investigate thymoquinone (TQ) and TRAIL's combined effect and the potential mechanisms in human hepatic HepG2 carcinoma cells.METHODS:Cell viability and IC50 dose for TQ and TRAIL, alone and in combination, were determined using the MTT method. ELISA evaluated the expression levels of 8-Hydroxy-2'-deoxyguanosine. The apoptosis rate was assessed by flow cytometry, ELISA cell death assay, and caspase 8 activity assays. The mRNA and protein evaluation of candidate genes, including survivin, Bcl-2, XIAP, c-IAP1, c-IAP2, and c-FLIP, were accomplished before and after the treatment using qRT-PCR and Western blot analysis, respectively.RESULTS:Our results showed that TQ synergistically increased TRAIL's cell toxic effects as follows: TQ plus TRAIL > TRAIL > TQ. TQ could sensitize the HepG2 cells against the TRAIL-induced apoptosis and amplify the caspase 8 activity. This outcome is achieved by decreasing the mRNA and protein expression levels of anti-apoptotic genes.CONCLUSIONS:Our findings suggest that TQ can sensitize the human HCC cell line HepG2 against TRAIL by inducing the death receptor pathway. Moreover, these agents' combinational therapy might promise a therapeutic regimen for improving the clinical efficacy of TRAIL-induced apoptosis in patients with HCC.

Objective To investigate the safety and clinical efficacy of negative pressure aspiration sheath combined with minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for complex renal calculi. Methods 440 patients with renal calculus in our hospital from January 2017 to December 2018 were randomly divided into two groups: observation group and control group, 220 cases in each group. Patients in the observation group underwent MPCNL with negative pressure suction sheath in oblique supine position, while the control group in conventional prone position with single hole sheath (atmospheric sheath). Operation time, stone removal rate, bleeding volume and complications of each group were recorded. The clinical data of the two groups were retrospectively analyzed and compared. Results Stone removal rate was higher in observation group (P<0.05), while operation time, intraoperative bleeding volume, incidence of serious complications, incidence of fever, PCT value and CRP value of one day after operation in the observation group were significantly less than those in the control group (P<0.05). Conclusion MPCNL with negative pressure sheath in oblique supine pospine has fewer complications and higher stone removal rate, and oblique supine position does not need to change position for transurethral retrograde ureteral intubation. Key words: Renal calculi; Percutaneous nephrolithotomy; Oblique supine position, negative; pressure aspiration sheath

Objective To explore the application of one-step trocar insertion visibility for observation port establishment in transperitoneal laparoscopic adrenalectomy. Methods A retrospective analysis was conducted by collecting the data of 26 patients who had been performed transperitoneal laparoscopic adrenalectomy from April 2015 to December 2017. One-step trocar insertion visibility were performed for the observation group(13 cases), while conventional open incision(Hasson) method was used for the control group(13 cases). The same process was performed in subsequent adrenalectomy. The time of trocar insertion, operation time(removal of adrenal gland), total operation time, blood loss, post-operative fasting time, post-operative drainage time, and the hospitalization time after operation between two groups were compared. Results Operations were successfully performed in all cases, and no patient was converted to open surgery. The time of trocar insertion and total operation process in observation group were less than control group. However, between two groups, there were no significant differences in time of removal of adrenal gland, blood loss, post-operative fasting time, drainage and the hospitalization time after operation. Conclusions One-step trocar insertion visibility to establish observation port in transperitoneal laparoscopic adrenalectomy is safe and effective which can reduce the time of trocar insertion and total operation process, improve the safety of the operation as well.

Objective: To analyze the changes of procalcitonin (PCT) and C-reactive protein (CRP) levels in urinary tract infection o elder patients and its clinical significance. Methods: Randomly, we selected a total of 68 elder patients with urinary tract infection. 32 patients with upper urinary tract infection were enrolled into the Group 1, 36 with lower urinary tract infection into the Group II, and 30 healthy subjects who attended the physical examinations into the control ,group. White blood cell count of blood and urine, PCT and CRP were determined for all patients, and comparison of the levels of PCT and CRP before and after treatment and the correlation analysis between the levels of PCT and CRP were carried out for patients in the observation group. Results: In two observation ,groups, white blood cell counts of blood and urine and levels of PCT and CRP were higher than those in the control ,group, while the levels of PCT and CRP in Group 1 were higher than those in Group II (p<0.05); after active treatment, significant decreases were identified in levels of PCT and CRP in observation groups (p<0.05); Pearson correlation analysis showed positive correlation between PCT and CRP (r=0.73, p<0.01). Conclusion: Levels of PCT and CRP are sensitive indicators for diagnosis and auxiliary diagnosis of urinary tract infection of elder patients, and conduces to guiding the clinical medication, which are worthy being promoted in clinical practice.

Objective To detect the expression of SOX9 in renal cell carcinoma and its correlation with the pathogenesis of renal cell carcinoma. Methods The tissue microarray, including 110 cases of renal carcinoma and 10 normal renal tissues, were selected. Immunohistochemistry was used to detect the expression of SOX9 and the differences were compared. The correlation between the SOX9 expression and the gender, age, histological grade, clinical stage and TNM stage was analyzed. Results The expression of SOX9 in renal cell carcinoma was higher than that in normal renal tissue (P ＜ 0. 05), there was significant correlation between low differentiated tissue grade (grade I) and high grade clinical stage (II to IV) (P ＜ 0. 05), but the expression of SOX9 was not related to gender, age and TNM stage (P＞ 0. 05) .Conclusions SOX9 protein has a high positive expression rate in renal cell carcinoma, and SOX9 gene may be involved in the pathogenesis of renal cell carcinoma and promote or accelerate the formation of tumor.