Background:Upper tract urothelial carcinoma (UTUC) is a rare and highly malignant urothelial tumor originating from the renal pelvis and ureter associated with poor prognosis. It has been established that 70% of ureteral tumors occur in the lower ureter. Radical nephroureterectomy (RNU) with ipsilateral bladder cuff excision is regarded as the standard treatment for UTUC. Current evidence supports the role of lymph node dissection (LND) in determining tumor staging, but no consensus has been reached on the potential survival benefits. The present study retrospectively analyzed cases of UTUC limited to the lower ureter to evaluate the survival benefits of LND during RNU.Methods:The present study retrospectively analyzed data from patients with UTUC limited to the lower ureter from two medical centers from 2000 to 2016 and assessed the survival outcomes, including recurrence-free survival (RFS) and cancer specific survival (CSS). During subgroup analysis, we stratified by pathological tumor (pT) stages and postoperative adjuvant chemotherapy (AC).Results:The study cohort included 297 patients separated into LND (n=111) and non-LND (n=186) groups. The two groups were comparable except for the pathological N stage. The LND group was associated with superior survival in terms of RFS (27.0% vs. 18.3%, p=0.044) and CSS (53.2 vs. 39.8%, p=0.031) compared to the non-LND group (n=186). In pT2-4 patients, the LND group was associated with better 3-year RFS (50.5% vs. 32.3%, p<0.05), 5-year RFS (29.7% vs. 12.0%, p<0.05), and overall RFS (18.7% vs. 6.0%, p<0.05) than the non-LND group. Besides, the LND group was associated with a significantly better 3-year CSS (68.1% vs. 49.6%, p=0.003), 5-year CSS (51.6% vs. 30.8%, p<0.05) and overall CSS (45.1% vs. 24.1%, p<0.05). In patients that underwent AC, the LND group had better survival benefits in terms of RFS (29.4 vs. 16.7%, p=0.023) and CSS (52.9% vs. 40.5%, p=0.038) compared to the non-LND group.Conclusion:LND has survival benefits in patients with UTUC localized to the lower ureter, especially for≥pT2 stage UTUC and AC cohorts. Overall, the therapeutic effect of LND in UTUC cannot be replaced by AC.

Background: There are paradoxical results regarding whether carbonic anhydrase IX (CAIX) is a prognostic biomarker for patients with clear cell renal cell carcinoma (ccRCC). The objective of this study was to evaluate prognostic significance of CAIX in nonmetastatic ccRCC patients of different stages. Materials and Methods: This is a retrospective study on 1263 patients with nonmetastatic ccRCC from January 2005 to June 2018. Patients were stratified into eight subgroups (pT1a, pT1b, pT2a, pT2b, pT3a, pT3b, pT3c, and pT4) according to the 2016 TNM classification system. Immunohistochemical staining of membranous CAIX was quantified. Cancer-specific survival (CSS) rates in patients with high (>85%) and low (<85%) CAIX expressions were compared by Kaplan-Meier curves with log-rank test. Results: There were 220 tumors (17.42%) with low CAIX expression and 1043 tumors (82.58%) with high CAIX expression. The cumulative CSS rates were statistically significant between all patients with low and high CAIX expression (p-value <0.001). In pT2a, pT2b, and pT3a subgroups, the patients with low CAIX expression exhibited markedly decreased cumulative CSS rates compared to patients with high CAIX expression (p-value <0.05). Univariable and multivariable Cox regression analysis showed that CAIX expression was an independent predictor of prognosis in patients with pT2a, pT2b, and pT3a ccRCC (p-value <0.05), rather than in all nonmetastatic patients. Conclusion: CAIX expression is of independent prognostic value for ccRCC patients in pT2a, pT2b, and pT3a stages. CAIX expression combined with tumor stage would further improve risk stratification of nonmetastatic ccRCC patients and provide directions for therapies.

Background: LINC00958 is involved in bladder cancer, but its mechanism of action remains indistinct. This study further analyzed its potential targets, aiming to search for therapeutic targets. Materials and Methods: miR-378a-3p was predicted to bind to LINC00958 and IGF1R, which was verified by double-luciferase reporter analysis. The levels of LINC00958 and miR-378a-3p in bladder cancer tissues and cells, and their correlation were further analyzed. Then LINC00958, miR-378a-3p, and IGF1R in bladder cancer cells were up- or downregulated, and their effects on cell viability, migration, and invasion of cells were detected, respectively. Results: LINC00958 binds to miR-378a-3p whose target gene was IGF1R. The expression of miR-378a-3p was negative relative with the level of LINC00958 and IGF1R. Overexpressed miR-378a-3p restrained the activity, migration, and invasion of bladder cancer cells, which was the same as the effects of silent LINC00958 and downregulated IGF1R. Nonetheless, upregulated LINC00958 rescued the antitumor effect of overexpressed miR-378a-3p, whereas miR-378a-3p inhibitor acted as a cancer promoter to reverse the inhibition of downregulated IGF1R on cell activity, migration, and invasion. Conclusion: LINC00958 accelerated the propagation and metastasis of bladder cancer cells through sponging miR-378a-3p to elevate IGF1R, which might trigger a new direction for the treatment of bladder cancer.

Background: Long noncoding RNAs could serve as a candidate target for prostate cancer (PCa) diagnosis and treatment. The current study aimed to investigate the role and functions of SNHG1 in PCa cells. Materials and Methods: Abnormal expression of SNHG1, survival analysis, and target gene were determined or predicted by bioinformatics techniques. Gene expressions at transcriptional and translational levels were determined by Quantitative Real-time PCR and Western blotting, respectively. Cell viability, growth, and apoptosis rate were detected by Cell Counting Kit-8, colony formation assay and flow cytometry. Results: The results showed that SNHG1 was highly expressed in PCa tissues, which was accompanied by decreased miR-377-3p expression and poor overall survival rate, and that miR-377-3p was predicted as the target of SNHG1 in PCa cells. Moreover, SNHG1 counteracted the effects of miR-377-3p on inhibiting cell growth and promoting apoptosis of PCa cells. Furthermore, miR-377-3p counteracted the effects of AKT2 on promoting cell viability, growth, and suppressing apoptosis of PCa cells. In addition, AKT2 expression was proved to be regulated by miR-377-3p. Conclusions: The SNHG1/miR-377-3p/AKT2 regulatory axis in PCa cells was disclosed. The upregulated AKT2 might be a result of dysregulated interaction balance between the expressions of miR-377-3p and SNHG1. Based on such discoveries, the intervention of SNHG1/miR-377-3p/AKT2 axis could be further explored in the treatment of PCa.

Renal ectopia occurs in 1:3,000-1:7,000 children. Simple ectopia refers to the abnormal kidney location on the same side; in crossed ectopia the ureter crosses the midline of the body. Pelvic ectopic solitary kidney with hydronephrosis due to ureteropelvic junction obstruction (UPJO) is even rarer in clinical practice. We report a case of a pelvic ectopic solitary kidney with hydronephrosis due to UPJO in an 18-year-old girl. Three-dimensional computed tomography (CT) scan showed the Single Ectopic Kidney with irregular shape lying in the pelvis and its cortex is very thin because of the grossly dilated renal pelvis and ureter. The terminal ureteral joined the right posterior wall of bladder. The renal artery originated from the bilateral common iliac artery, and laparoscopic pyeloplasty was performed. 18 months after the surgery, hydronephrosis was improved morphologically, and the estimated glomerular filtration rate was stable.

Based on the important functions of phosphatase and tensin homolog (PTEN)-Long for renal diseases, the present study aimed to investigate the expression of PTEN-Long in patients and mice with nephritis and its effect on nephritis. Expression levels of PTEN-Long in serum of patients with nephritis, renal cell carcinoma (RCC) as well as normal controls, and in serum and renal tissues of mice were measured by western blotting. PTEN-Long knock-in and knock-out mice were constructed via the CRISPR-Cas9 technique. Intraperitoneal injection of lipopolysaccharide+renal homogenate was performed to construct a mouse nephritis model. Mice were divided into control group, model group, knock-in group and knock-out group. A Bio-Plex system was used to detect secretion of serum inflammatory factors. Expression of inflammatory factors in renal tissues of different groups was detected by reverse transcription semi-quantitative polymerase chain reaction. Hematoxylin and eosin staining was used to observe the pathological changes of renal tissue. PTEN-Long was downregulated in patients with nephritis and RCC compared with controls, whereas the expression levels of inflammatory factors were increased. PTEN-long knock-in significantly reduced the serum content and expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β and IL-18. PTEN-long knock-out also decreased the expression levels of TNF-α and IL-6 but exhibited no effects on expression of IL-1β and IL-18. Compared with knock-out and model groups, renal tissue inflammation was significantly reduced in knock-in group. The protein level of PTEN-Long was significantly lower in serum than in renal tissue. These findings suggest that PTEN-long can inhibit the progression of nephritis by interacting with inflammatory factors to protect kidney.

Objective To explore the application effect of enhanced recovery after surgery (ERAS) nursing during perioperative offlexible ureteroscope holmium laser lithotripsy.Method 301 patients who underwent transurethral ureteroscope holmium laser lithotripsy from October 2016 to June 2017 in our hospital were selected as research objects, and they were divided into ERAS group (ERAS nursing, 154 cases) and conventional group (conventional nursing, 147 cases) according to the different care program during perioperative. The first feeding time, the first postoperative exhaust time, the indwelling time of the catheter, the rate of postoperative complications, the postoperative hospital day and the total hospitalization expenses were observed and compared between the two groups.Result The first feeding time, the first postoperative exhaust time, the indwelling time of the catheter and the postoperative hospital day of ERAS group were significantly shorter than those of conventional group (P<0.05), the rate of postoperative complications and the total hosp italization expenses were significantly lower than those of conventional group (P<0.05).Conclusion Applying perioperative ERAS nursing programme to patients treated withflexible ureteroscope holmium laser lithotripsy is beneficial to patients' rapid recovery, and it's worth promoting.

PTEN-Long is a translational variant of PTEN (Phosphatase and Tensin Homolog). Like PTEN, PTEN-Long is able to antagonize the PI3K-Akt pathway and inhibits tumor growth. In this study, we investigated the role PTEN-Long plays in the development and progression of clear cell renal cell carcinoma (ccRCC) and explored the therapeutic possibility using proteinaceous PTEN-Long to treat ccRCC. We found that the protein levels of PTEN-Long were drastically reduced in ccRCC, which was correlated with increased levels of phosphorylated Akt (pAkt). Gain of function experiments showed overexpression of PTEN-Long in the ccRCC cell line 786-0 suppressed PI3K-Akt signaling, inhibited cell proliferation, migration and invasion, and eventually induced cell death. When purified PTEN-Long was added into cultured 786-0 cells, it entered cells, blocked Akt activation, and induced apoptosis involving Caspase 3 cleavage. Furthermore, PTEN-Long inhibited proliferation of 786-0 cells in xenograft mouse model. Our results implicated that understanding the roles of PTEN-Long in renal cell carcinogenesis has therapeutic significance.

Objective To study the distribution,radioimmunoimaging and anti-tumor effect of 131I labeling prostate stem cell antigen monoclonal antibody (1n I-PSCA-McAb) in nude mice bearing orthotopic implantation of prostate carcinoma.Methods Thirty-six male nude mice were randomly divided into 2 groups:LNCap cell group (androgen dependent prostate cancer) and PC3 cell group (androgen independent prostate cancer).Each group were then subdivided into 3 subgroups:experimental group (were intravenoused 131I-PSCA-McAb 200 μg),monoclonal control group (were intravenoused PSCA-McAb 200 μg),iodic control group (were intravenoused 131I 200 μg).Continuous images of nude mice bearing LNCap cell and PC3 cell were carried out respectively at 1,4,8,12 and 24 h after drugs injection.Transplantation tumor images were then observed and the radioactivity ratio of tumor/non-tumor (T/NT) was calculated.48 h later,nude mice were sacrificed and the apoptosis of tumor tissues were measured by TdT-mediated dUTP nick end labeling (TUNEL).Results The models of nude mice bearing orthotopic implantation of prostate carcinoma were successfully established.The peak uptake of 131I-PSCA-McAb in orthotopic tumor of prostate carcinoma was at 8h after injection with a T/NT ratio of 4.37 ±0.76 (LNCap cell group) and 4.21-0.71 (PC3 cell group) respectively.The number of TUNEL positive cells in experimental group was larger than that of the two other control groups.Conclusion 131I-PSCA-McAb could effectively target PSCA and inhibit the growth of tumor,therefore was a promising radioimmunotherapy radiophamaceutical for prostate carcinoma.

2008年10月至2012年1月,我院对36例输尿管下段癌患者行后腹腔镜联合腹股沟切口根治性肾输尿管切除术,效果满意,现报告如下.对象与方法 本组36例.男26例,女10例.年龄42～74岁,平均58岁.因血尿就诊20例,腰痛9例,不明原因肾积水7例.36例术前均经影像学检查明确诊断且证实无远处转移,对侧肾功能正常.肿瘤均位于输尿管下段,左侧21例、右侧15例.肿瘤大小1.0cm×1.2 cm～3.6 cm×5.5 cm,平均1.4 cm ×3.5 cm.术前发现髂血管及闭孔周围组织淋巴结转移8例,膀胱镜检查发现肿瘤累及同侧输尿管口2例,伴发膀胱肿瘤1例.尿脱落细胞阳性10例。

Objective To study the effects of androgen receptor (AtR) gene small interfering RNA (siRNA) on adhesion and invasion of human bladder cancer cells.Methods Human bladder cancer T24 cells with AR expression were transfected with AR-siRNA.The expression of AR mRNA and protein was detected by using real-time quantitative polymerase chain reaction (Real-time PCR) and Western blotting,respectively.The cell adhesion was evaluated by using methyl thiazol tetrazolium (MTT) assay,and invasion was examined by Transwell chamber.Results T24 cells with AR expression were successfully transfected with AR-siRNA.The Real-time PCR and Western blotting revealed that the expression of AR mRNA and protein was reduced.The adhesive rate in AR-siRNA group was (38.7 ± 4.4) ％,lower than that in blank control group (P ＜ 0.05).The Transwell results showed that the invasion cells were (30.5 ± 6.7)and (59.2 ± 8.1) in AR-siRNA and blank control groups,respectively (P ＜ 0.05).Conclusion AR gene might play an important role in adhesion and invasion of human bladder cancer cells.siRNA targeted AR could effectively inhibit adhesion and invasion of human bladder cancer.

Objective:To compare techniques and clinical effect of laparoscopic partial nephrectomy by retroperitoneal and transperitoneal approaches.Methods:68 patients with small renal cell carcinoma underwent transperitoneal(35patients,group A)and retroperitoneal(33 patients,group B)laparoscopic partial nephrectomy.Tumor size,specimen weight,gender,age,operative time,blood loss,hot ischemia time,post-operative intestinal function recovery time,the post-operative hospital stay and peri-operative complications were compared between group A and group B,respectively.Two groups of a total of 68 patients were followed up and compared on two surgical oncology effect.Results:Tumor size,specimen weight,gender,age,specimen weight,operative time,blood loss,hot ischemia time,peri-operative complications and tumor free survival rate were not significantly different(P0.05) between two groups.In group B, postoperative intestinal function recovery time and postoperative hospital stay were reduced than those of group A(P0.05). Conclusions:The result of laparoscopic treatment for patients with retroperitoneal or transperitoneal approach was similar.The advantage in retroperitoneal approach had little interference to intestinal tract and less postoperative intestinal function recovery time and postoperative hospital stay postoperatively.The centre used methed called the three step-to cut off tumor with knife,finish hemostasis with bipolar electrocoagulation,suture with Hem-o-lok ligation clip in a double loop like 8,is safe,efficient and reliable. Inosine,mannitol and diuretic may reduce ischemia-reperfusion injury,and protect renal function.

Objective To improve the technology of retroperitoneal laparoscopic living donor nephrectomy and observe its clinical effect.Methods Forty-one cases of living donors subject to nephrectomy by the new retroperitoneal laparoscopic technique from July 2009 to June 2012 were retrospectively.The new technique was modified as follows: (1) Alternate use of blunt dissection,sharp dissection and harmonic scalpel; (2) After separation of renal vein,artery and ureter,a 5-6 cm incision parallel to rectus abdominis from Trocar was made in order to put a hand inside retroperitoneum; (3) A biopsy of the kidney was made from Trocar with the help of a hand for holding the kidney; (4) Pulling the kidney with a proper strength and blocking renal artery and renal vein with Hem-o-lock,then cutting off them and taking out the kidney.Results Forty-one cases of live donors subject to nephrectomy were operated on successfully,and were not converted to open operation.The operative time was 65-130 min (mean 85 min).The warm ischemia time was 58-110 s (average 78 s).Living donor kidney artery length was 2.1-3.7 cm (average 2.9 cm).Living donor kidney vein length was 2.5-4.1 cm (average 3.5 cm).Blood loss was 15-80 ml (average 28 ml).Hospital stay after surgery was 4-7 days (average 4.8 days).All biopsy specimens were achieved from 41 cases.None suffered from complications except two cases of perilymphorrhea.Forty-one recipients recovered well after renal transplantation.Conclusion The improved retroperitoneal laparoscopic living donor nephrectomy is considered to be safe,effective and feasible.It is a good way to protect renal function and reduce injury.