Identifying prognostic characteristics of m6A-related glycolysis gene and predicting the immune infiltration landscape in bladder cancer.

BACKGROUNDS: Glucose metabolism is associated with the development of cancers, and m6A RNA methylation regulator-related genes play vital roles in bladder urothelial carcinoma (BLCA). However, the role of m6A-related glucose metabolism genes in BLCA occurrence and development has not yet been reported. Our study aims to integrate m6A- and glycolysis-related genes and find potential gene targets for clinical diagnosis and prognosis of BLCA patients. METHODS: Sequencing data and clinical information on BLCA were extracted from common databases. Univariate Cox analysis was used to screen prognosis-related m6A glucose metabolism genes; BLCA subtypes were distinguished using consensus clustering analysis. Subsequently, genes associated with BLCA occurrence and development were identified using the "limma" R package. The risk score was then calculated, and a nomogram was constructed to predict survival rate of BLCA patients. Functional and immune microenvironment analyses were performed to explore potential functions and mechanisms of the different risk groups. RESULTS: Based on 70 prognosis-related m6A glucose metabolism genes, BLCA was classified into two subtypes, and 34 genes associated with its occurrence and development were identified. Enrichment analysis revealed an association of genes in high-risk groups with tricarboxylic acid cycle function and glycolysis. Moreover, significantly higher levels of seven immune checkpoints, 14 immune checkpoint inhibitors, and 32 immune factors were found in high-risk score groups. CONCLUSIONS: This study identified two biomarkers associated with BLCA prognosis; these findings may deepen our understanding of the role of m6A-related glucose metabolism genes in BLCA development. We constructed a m6A-related glucose metabolism- and immune-related gene risk model, which could effectively predict patient prognosis and immunotherapy response and guide individualized immunotherapy.

Circ_0002623 promotes bladder cancer progression by regulating the miR-1276/SMAD2 axis.

Circular RNAs (circRNAs) are key regulatory factors in the development of multiple cancers. This study is targeted at exploring the effect of circ_0002623 on bladder cancer (BCa) progression and its mechanism. Circ_0002623 was screened out by analyzing the expression profile of circRNAs in BCa tissues. Circ_0002623, miR-1276, and SMAD2 mRNA expression levels in clinical sample tissues and cell lines were detected through quantitative real-time polymerase chain reaction (qRT-PCR). After circ_0002623 had been overexpressed or silenced in BCa cells, the cell proliferation, migration, and cell cycle were evaluated by CCK-8, BrdU, Transwell assay, and flow cytometry. Tumor xenograft model was used to validate the biological function of circ_0002623 in vivo. Bioinformatics analysis and dual-luciferase reporter gene assay were conducted for analyzing and confirming, respectively, the targeted relationship between circ_0002623 and miR-1276, as well as between miR-1276 and SMAD2. The regulatory effects of circ_0002623 and miR-1276 on the expression levels of TGF-ß, WNT1, and SMAD2 in BCa cells were detected by Western blot. We reported that, in BCa tissues and cell lines, circ_0002623 was upregulated, whereas miR-1276 was downregulated. Circ_0002623 positively regulated BCa cell proliferation, migration, and cell cycle progression. Additionally, circ_0002623 could competitively bind with miR-1276 to increase the expression of SMAD2, the target gene of miR-1276. Furthermore, circ_0002623 could regulate the expression of TGF-ß and WNT1 via modulating miR-1276 and SMAD2. This study helps to better understand the molecular mechanism underlying BCa progression.

Spermidine protects against acute kidney injury by modulating macrophage NLRP3 inflammasome activation and mitochondrial respiration in an eIF5A hypusination-related pathway.

BACKGROUND: Acute kidney injury (AKI) is still a critical problem in clinical practice, with a heavy burden for national health system around the world. It is notable that sepsis is the predominant cause of AKI for patients in the intensive care unit and the mortality remains considerably high. The treatment for AKI relies on supportive therapies and almost no specific treatment is currently available. Spermidine is a naturally occurring polyamine with pleiotropic effects. However, the renoprotective effect of spermidine and the underlying mechanism remain elusive. METHODS: We employed mice sepsis-induced AKI model and explored the potential renoprotective effect of spermidine in vivo with different administration time and routes. Macrophage depleting was utilized to probe the role of macrophage. In vitro experiments were conducted to examine the effect of spermidine on macrophage cytokine secretion, NLRP3 inflammasome activation and mitochondrial respiration. RESULTS: We confirmed that spermidine improves AKI with different administration time and routes and that macrophages serves as an essential mediator in this protective effect. Meanwhile, spermidine downregulates NOD-like receptor protein 3 (NLRP3) inflammasome activation and IL-1 beta production in macrophages directly. Mechanically, spermidine enhances mitochondrial respiration capacity and maintains mitochondria function which contribute to the NLRP3 inhibition. Importantly, we showed that eukaryotic initiation factor 5A (eIF5A) hypusination plays an important role in regulating macrophage bioactivity. CONCLUSIONS: Spermidine administration practically protects against sepsis-induced AKI in mice and macrophages serve as an essential mediator in this protective effect. Our study identifies spermidine as a promising pharmacologic approach to prevent AKI.

MiR-381-3p/RAB2A axis activates cell proliferation and inhibits cell apoptosis in bladder cancer.

Acting as a really common cancer in the world, bladder cancer has taken many people's life away. MiRNAs and mRNA have been reported can regulate the expression of cancers. In this study, the role of RAB2A and miR-381-3p was fully studied in bladder cancer. qRT-PCR assay probe the expression of RAB2A and miR-381-3p in bladder cancer cells. Meanwhile, colony formation assay, EdU assay, flow cytometry analysis, JC-1 assay and western blot assay were implemented to detect the progression of bladder cancer cells. Silenced RAB2A could reduce the cell proliferation of bladder cancer, and activate the apoptosis. Meanwhile, miR-381-3p could bind to RAB2A in bladder cancer cells and overexpressed miR-381-3p could inhibit the progression of bladder cancer cells. MiR-381-3p/RAB2A axis activates cell proliferation and inhibits cell apoptosis in bladder cancer.

MicroRNA-148a represents an independent prognostic marker in bladder cancer.

A previous study has demonstrated the roles of microRNA-148a (miR-148a) on apoptosis of bladder cancer cells. The goal of this study was to investigate whether the miR-148a expression level could serve as a new biomarker for the prognosis of bladder cancer patients. We collected a total of 126 bladder cancer samples. The expression level of miR-148a was determined with quantitative real-time polymerase chain reaction (qRT-PCR). Kaplan-Meier method was used to analyze the overall survival. Cox regression analysis was further used to identify prognostic factors. The expression levels of miR-148a in bladder cancer tissues were identified (1.5 ± 0.3; P < 0.001). The bladder cancer patients in the low-expression group more frequently had a high tumor grade (P = 0.025), increased tumor recurrence (P = 0.002), and advanced lymph node (LN) metastasis (P = 0.001). Patient survival analysis revealed a clear positive correlation between miR-148a expression level and survival time of bladder cancer patients (P = 0.005, log-rank = 7.714). In univariate Cox proportional hazards regression analysis, we found that a low-expression level of miR-148a (P = 0.018), tumor grade (P = 0.006), lymph node metastasis (P = 0.001), and recurrence (P < 0.001) were associated with the prognosis of bladder cancer. In multivariate analysis, we found that miR-148a expression (RR = 0.206, 95 % CI 0.095-0.813, P = 0.029), tumor grade (RR = 0.714, 95 % CI 0.224-0.958, P = 0.714), lymph node metastasis (RR = 6.604, 95 % CI 3.192-12.547, P < 0.001), and recurrence (RR = 15.126, 95 % CI 6.714-22.025, P < 0.001) retained significance as an independent prognostic factor of bladder cancer survival (Table 3). All results have showed that miR-148a expression was decreased in bladder cancer specimens and reduced miR-148a expression was associated with poorer survival time, indicating that miR-148a may become a candidate factor for predicting the prognosis of bladder cancer.

The association between the triglyceride-glucose index and prognosis in postoperative renal cell carcinoma patients: a retrospective cohort study.

Background: Insulin resistance has been proven to be associated with renal cell carcinoma (RCC). However, the prognostic value of the triglyceride-glucose (TyG) index, as a marker for insulin resistance (IR), is still unclear. Therefore, we conducted research to explore the prognostic value and the predictive performance of the TyG index in postoperative RCC patients. Methods: A total of 651 postoperative RCC patients from January 2016 to June 2018 were enrolled in the final study. Their clinical and laboratory parameters were collected from medical records and through follow-up by phone. The triglyceride-glucose (TyG) index was calculated as follows: TyG = Ln[TG (mg/dl) × FBG (mg/dL)/2]. The overall survival (OS) and disease-free survival (DFS) were identified as the main outcomes. Results: The TyG index is an independent prognostic factor for OS (HR = 2.340, 95% CI = 1.506 to 3.64, P < 0.001) and DFS (HR = 2.027, 95% CI = 1.347 to 3.051, P < 0.001) in postoperative RCC patients. Kaplan-Meier survival curves of the different TyG index levels showed statistically significant differences in terms of OS and DFS (log-rank test, P < 0.0001). Furthermore, the TyG index was significantly associated with RCC risk factors. Conclusion: The TyG index is significantly associated with RCC survival. The mechanisms responsible for these results may contribute toward the improvement of RCC prognosis and immunotherapy efficacy and the development of new immunotherapeutic targets.

FTO promotes proliferation and migration of bladder cancer via enhancing stability of STAT3 mRNA in an m6A-dependent manner.

N6-Methyladenosine (m6A) plays a key role in the occurrence and development of various cancers. Fat mass and obesity-associated protein (FTO) was is involved in multiple cancers owing to its demethylase activity, and the molecular mechanism underlying FTO-promoted bladder cancer proliferation and migration via the regulation of RNA stability requires further investigation. In the present study, FTO was upregulated in bladder cancer and related to poor prognosis. Gain- and loss-of-function experiments showed that the upregulation of FTO promoted bladder cancer proliferation and migration. Mechanistic studies showed that FTO enhanced the stability of signal transducer and activator of transcription 3 (STAT3) mRNA in an m6A-dependent manner, thereby increasing STAT3 expression, which subsequently promoted P-STAT3 expression and activated STAT3 signalling pathway. Overall, this study revealed that the critical role of FTO in the progression of bladder cancer and could provide a novel avenue to regulate oncogene STAT3.

Tripartite motif-containing 9 promoted proliferation and migration of bladder cancer cells through CEACAM6-Smad2/3 axis.

Studies have shown that tripartite motif-containing (TRIM) family proteins function as E3 ubiquitin ligases and play essential roles in cancer biology. In the present study, we validated a contribution of TRIM9 to bladder cancer progression. 296 patients derived from The Cancer Genome Atlas (TCGA) database and 22 clinical specimens were included, in which accumulated TRIM9 correlated with the poor prognosis and higher relapse in bladder patients. In vitro, TRIM9 promoted bladder cancer cells Biu-87 and T24 cell proliferation and migration. Meanwhile, overexpression of TRIM9 reduced the chemosensitivity in Biu-87 and T24 to mitomycin C (MMC) and gemcitabine (GEM). As an underlying mechanism, we found that TRIM9 stimulated carcinoembryonic antigen 6 (CEACAM6) upregulation, which further facilitated Smad2/3-matrix metalloproteinase 2 (MMP2) signaling activation both in vitro and in vivo. Those results indicated that TRIM9 facilitated bladder cancer development and chemoresistance by CEACAM6-Smad2/3 axis. TRIM9 and its associated molecules could be a potential diagnostic indicator and therapeutic target in bladder cancer.

[Efficacy of European Organization for Research and Treatment of Cancer (EORTC) risk tables for the prediction of recurrence and progression of non-muscle invasive bladder cancer after intravesical pirarubicin instillation].

OBJECTIVE: To analyze the influence of intravesical Pirarubicin (THP) instillation on the prediction results of European Organization for Research and Treatment of Cancer (EORTC) risk tables and to discuss the efficacy of EORTC risk tables in clinical application. METHODS: We retrospectively reviewed the clinical data of 389 patients with non-muscle invasive bladder cancer after TURBT treated with intravesical pirarubicin instillation. According to the EORTC Scoring System, all the cases were divided into low risk group, intermediate risk group and high risk group. The 1-year and 5-year recurrence and progression rates of each group were calculated and compared with the prediction results of the EORTC risk tables. RESULTS: The 1-year recurrence and progression rates of the low risk group were 8.0% and 0, those of the intermediate risk group were 31.0% and 2.8%, and those of the high risk group were 52.5% and 18.6%, respectively. The 5-year recurrence and progression rates of low risk group were 16.0% and 5.3%, those of the intermediate risk group were 42.6% and 10.7%, and those of the high risk group were 63.9% and 41.9%, respectively. The prediction results of progression rate were similar to that of the EORTC risk tables while the overall recurrence rate was lower. CONCLUSIONS: The EORTC risk tables can be effectively used to predict the recurrence rate and progression rate of non-muscle invasive bladder cancer. However, the EORTC risk tables have a tendency to overestimate the recurrence rate. Intravesical pirarubicin instillation is helpful to reduce the recurrence rate, yet has no obvious influence on the tumor progression.

[Safety of solifenacin and tolterodine in the treatment of overactive bladder: a meta-analysis].

OBJECTIVE: To evaluate the safety of solifenacin and tolterodine in the treatment of overactive bladder (OAB). METHODS: Studies on the solifenacin, tolterodine and OAB were searched and those fulfilling the inclusion criteria were selected. RevMan 5.0 software was used to perform meta-analysis. Three studies were included with an overall sample size of 1013 cases. The experimental group of solifenacin contained 517 cases while the control group had 496 cases. RESULTS: The incidence rates of overall adverse event, dry mouth, constipation and blurred vision of the experimental group (solifenacin 5 mg once per day) was 26.69% (138/517), 10.64% (55/517), 5.42% (28/517) and 6.55% (26/397) while those of the control group (tolterodine 2 mg twice per day) 33.27% (165/496), 16.73% (83/496), 2.22% (11/496) and 4.20% (16/381) respectively. There was no statistically significant difference in overall adverse event (RR = 0.76, 95%CI: 0.52 - 1.12, P = 0.170) and blurred vision (RR = 1.59, 95%CI: 0.88 - 2.90, P = 0.130) between two groups. However, the incidence rate of key antimuscarinic adverse events such as dry mouth (RR = 0.63, 95%CI: 0.46 - 0.87, P = 0.005) and constipation (RR = 2.38, 95%CI: 1.21 - 4.66, P = 0.010) showed statistically significant difference. CONCLUSIONS: Dry mouth is the most common adverse event of solifenacin (5 mg once per day) and tolterodine (2 mg twice per day). Solifenacin has a lower incidence rate of dry mouth and a higher rate of constipation than tolterodine. A clinical physician should consider the incidence of adverse events during treating OAB, especially for those patients prone to constipation.

Mucin-poor mucinous tubular and spindle cell carcinoma of the kidney: one case report and review of the literature.

Mucinous tubule and spindle cell carcinoma (MTSCC) of the kidney is a rare renal pleomorphic tumor considered as low-grade malignant, with occurring mainly in female. Few mucin-poor MTSCC cases have been reported so far. A typical MTSCC is composed of closely arranged tubules with pale mucus matrix and spindle cell components. Mucin-poor MTSCC is difficult to distinguish from other renal cell carcinomas due to small amount of mucus. We reported a case of mucin-poor MTSCC in a 37-year-old male with detailed imaging, histology, immunohistochemical and next-generation sequencing information, looking forward to providing an insight into mucin-poor MTSCC.

miR-148a-3p inhibits the proliferation and migration of bladder cancer via regulating the expression of ROCK-1.

PURPOSE: To investigate the mechanism of miR-148a-3p regulating the proliferation and migration of bladder tumor cells. MATERIALS AND METHODS: We conducted a preliminary study to detect the relative expression of miR-148a-3p in bladder cancer and para-cancerous tissue samples. Three bladder tumor cell lines, T24, 5,637 and UM-UC-3, were selected. The expression levels of miR-148a-3p were artificially regulated with miR-148a-3p mimics and the miR-148a-3p inhibitor. The relative expression levels of miR-148a-3p in the samples of each cell line were determined. Cell Counting Kit-8 (CCK-8) was used to detect cell proliferation, while the effect of the miR-148a-3p mimics and inhibitor on tumor cell migration was detected by wound healing assay. Flow cytometry assay was carried out to explore the effect of miR-148a-3p on cell apoptosis. Dual-luciferase reporter assay was performed in order to verify miR-148a-3p's target gene. The expressions of ROCK-1 and Bcl-2 were analyzed by western blot. RESULTS: The relative expression of miR-148a-3p in tumor and adjacent tissues was assessed with qRT-PCR (P < 0.05) and found to be significantly lower in the tumor tissues than the adjacent tissues. The data obtained from the CCK-8 and wound healing assay showed that intracellular transfection of miR-148a-3p mimics could inhibit cell proliferation and migration, while the miR-148a-3p inhibitor promoted them. Overexpression of miR-148a-3p promoted cell apoptosis in the T24 and 5,637 cell lines. The dual-luciferase reporter assay verified that ROCK-1 is a direct target of miR-148a-3p. Western blot showed that miR-148a-3p overexpression downregulated the expression of ROCK-1 and Bcl-2, while miR-148a-3p knockdown upregulated the expression of ROCK-1 and Bcl-2. CONCLUSIONS: We confirmed that miR-148a-3p was significantly decreased in bladder cancer cells. miR-148a-3p overexpression inhibited bladder cancer cell proliferation and migration, whereas miR-148a-3p knockdown promoted bladder cancer cell proliferation and migration. Moreover, we found that ROCK-1 was a downstream target of miR-148a-3p. We also found that miR-148a-3p induced cell apoptosis by regulating the expression of Bcl-2. However, the deeper mechanism of this regulatory relationship needs further study.

"Two-zone and Three-segment" Laparoscopic Radical Cystectomy vs Conventional Laparoscopic Radical Cystectomy for Male Patients With Bladder Urothelial Carcinoma: A Retrospective Analysis.

PURPOSE: The aim of this study was to introduce an advanced surgical technique for laparoscopic radical cystectomy (LRC), evaluate the perioperative outcome and compare it to that of conventional LRC (CLRC). MATERIALS AND METHODS: Between March 2018 and March 2020, sixty patients were divided into the "two-zone and three-segment" laparoscopic radical cystectomy (TTLRC) group or the CLRC group. Patient baseline characteristics, preoperative characteristics and postoperative complications were collected. RESULTS: The TTLRC technique was developed based on the pelvic anatomy of six formalin fixed male cadavers. None of the patient baseline characteristics, including ECOG-PS score, comorbidity, ASA score and Hb, were significantly different between the two groups (p>0.05). There were significant differences in the operating time and estimated blood loss (total time: 3±0.2 vs 3.8±0.4, p<0.001; time to cystectomy and lymph node dissection: 1.7±0.2 vs 2.2±0.3, p<0.001; estimated blood loss 182.1±18.8 vs 264.3±27.4, p<0.001). Although there were no differences in late complications, early complications were significantly different between the two groups (p = 0.033). No statistically significant differences were found between the two groups in other outcomes (p>0.05). CONCLUSION: The TTLRC technique achieves a clearer surgical field, has a shorter operating time and produces less blood loss than CLRC. It is safe and feasible for urologists to perform this improved LRC procedure.

FTO promotes tumour proliferation in bladder cancer via the FTO/miR-576/CDK6 axis in an m6A-dependent manner.

The aberrant expression of fat mass and obesity-associated protein (FTO) has been confirmed to be associated with a variety of cancers and participates in the regulation of multiple biological behaviours. FTO plays an oncogenic role in bladder cancer, but few studies have focused on how FTO promotes bladder cancer progression by regulating miRNA synthesis. Here, we confirmed that FTO expression was significantly increased in bladder cancer and was associated with a poor prognosis. FTO overexpression promoted bladder cancer cell proliferation, whereas FTO knockdown inhibited bladder cancer cell proliferation. We also demonstrated that FTO promoted bladder cancer cell proliferation via the FTO/miR-576/CDK6 pathways. Taken together, our work revealed that FTO plays a critical role in bladder cancer and could be a potential diagnostic or prognostic biomarker for this disease.

Expression of apolipoprotein C1 in clear cell renal cell carcinoma: An oncogenic gene and a prognostic marker.

This study aimed to explore whether APOC1 expression has a function in the biological behavior of clear cell renal cell carcinoma (ccRCC) cells and its possible mechanism. Bioinformatics analysis of data TCGA and OnComine was conducted to explore the expression pattern and prognostic value of APOC1, as well as the relationship between APOC1 expression and clinical indicators. Loss- and gain- of APOC1 function assays were carried out to assess the biological functions of APOC1. Western blotting was applied to detect protein expression. We revealed that APOC1 was upregulated in ccRCC tissues. APOC1 expression was related to gender, grade, pathologic-T, pathologic-stage, and pathologic-M in patients with ccRCC. Meanwhile, Kaplan-Meier analysis evidenced that the high APOC1 expression indicated unfavorable outcomes of ccRCC. Functional experiments in vitro revealed that upregulation of APOC1 in UT33A cells promoted cell proliferation, invasion, and migration, while downregulation of APOC1 in 786-O cells had the opposite effect. Furthermore, epithelial mesenchymal transition (EMT) was activated in cells with upregulated APOC1 but inhibited in cells with down-regulated APOC1. Collectively, our data suggested that APOC1 was overexpressed in ccRCC cells and promoted the malignant biological behaviors and EMT of ccRCC cells.

Bulbocavernosus reflex to stimulation of prostatic urethra in patients with lifelong premature ejaculation.

INTRODUCTION: Lifelong premature ejaculation (LPE) is a prevalent sexual dysfunction among men, while its precise pathologic mechanisms have remained poorly understood. AIM: In our study, the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of the prostatic urethra and LPE was studied. METHODS: Twenty normal potent male volunteers and 42 patients with LPE were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra. Also, sensitivity of glans penis to electrical stimulation was detected by two surface electrodes. MAIN OUTCOME MEASURES: Sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis to electrical stimulation. RESULTS: The mean sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis were 12.38±3.71 mA (0.2 ms in duration, 1 Hz), 23.81±5.55 mA (0.2 ms, 1 Hz), 70.48±6.33 ms, and 11.89±2.26 mA (0.04 ms in duration,3 Hz) in the patients with LPE, respectively, and were 18.20±2.68 mA (0.2 ms, 1 Hz), 34.76 ± 4.15 mA (0.2 ms, 1 Hz), 71.20±5.77 ms, and 14.16±1.94 mA (0.04 ms, 3 Hz) in the normal potent men, respectively (mean±SD). Statistically significant differences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra, the thresholds to evoke stable BCR and the sensory thresholds of glans penis between the two groups (P<0.001). No statistically significant differences were seen regarding the latencies of BCR between the two groups (P>0.05). CONCLUSIONS: Patients with LPE might have hyperexcitable BCR to stimulation of prostatic urethra, which is probably one of the important factors for its etiology.

Bone marrow mesenchymal stem cells induce angiogenesis and promote bladder cancer growth in a rabbit model.

OBJECTIVES: To investigate the effect of mesenchymal stem cells (MSCs) in the process of tumor development and the possibility of MSCs differentiating into vascular endothelial cells in the tumor microenvironment. MATERIAL AND METHODS: Twenty male New Zealand rabbits were randomly divided into 2 groups: a test group and a control group. MSCs were isolated and cultured by bone marrow cell adherence. The bladder tumor models were built by embedding a VX2 mass in swelled bladder mucosa in all of the rabbits (n = 20). One week later, 4',6-diamidino-2-phenylindole-labeling MSCs were transplanted into tumor tissue in the test group (n = 10). Culture medium was injected into the tumor tissue of the control group (n = 10). The maximum diameter of the tumor mass was measured by ultrasound at 2 and 4 weeks after the VX2 tumor mass was embedded. All animals were sacrificed at 4 weeks. The double labeling immunofluorescence for CD146 was performed to reveal whether engrafted cells can differentiate into vascular endothelial cells. Vascular density was compared between the 2 groups. RESULTS: There was no significant difference in the maximum diameters of the tumor masses between the 2 groups at 2 weeks (test group 0.77 +/- 0.15 cm vs. control group 0.71 +/- 0.15 cm, p > 0.05). The maximum diameters appeared larger in the test group at 4 weeks (test group 3.82 +/- 0.94 cm vs. control group 2.28 +/- 0.54 cm, p < 0.05). Immunofluorescence studies revealed some engrafted MSCs expressing a vascular endothelial cell phenotype (CD146). Furthermore, vascular density was augmented in the test group in comparison to the control group (10.1 +/- 0.70/0.2 mm(2) vs. 8.24 +/- 0.81/0.2 mm(2), p < 0.05). CONCLUSIONS: Engrafted MSCs can differentiate into vascular endothelial cells and contribute to angiogenesis in the tumor microenvironment, which may be the major pathway of promoting tumor growth.

Correlation between preoperatively predicted and postoperatively observed renal function using an imaging-based approach: A retrospective cohort study.

The aim of the present study was to preoperatively predict renal function following partial nephrectomy (PN) using an imaging-based approach and to examine the correlation between preoperatively predicted and postoperatively observed renal function in the study cohort. A total of 128 consecutive patients who underwent PN between May 2015 and March 2018 and had available clinical data were included in this study. A hand-scripting method was used to estimate the defected volume (Vdef) from preoperative computerized tomography scans, whereas a cylindrical method was used to obtain preoperative renal volume (Vpre). The function index (FI) was proposed as a new term to estimate preserved parenchyma percentage following PN. The FI was defined as f=(Vpre-Vdef)/Vpre for the operated kidney and adjusted as FI=0.5 × (f + 1) for the bilateral kidneys. The estimated glomerular filtration rates (GFRs) before surgery, one day after surgery and ~12 months after surgery were calculated using the Modification of Diet in Renal Disease Study equation. The GFR rate after PN was predicted by multiplying the preoperative GFR by the FI. The predictive role of the FI was further tested using multiple linear regression and correlation analyses. The median FI in the present study was 94% for unilateral kidney surgery and adjusted to 97% for bilateral kidneys. Linear correlation analysis revealed that the predicted GFR significantly correlated with the observed immediate postoperative GFR (R2, 0.594) and observed late postoperative GFR (R2, 0.828). In multivariate regression analysis, preoperative GFR (P<0.01) and warm ischemic time (P<0.01) were identified as independent determinants of the immediate postoperative renal function, whereas only FI (P<0.01) and preoperative GFR (P<0.01) were identified as independent determinants of late renal function after PN. The preoperatively predicted renal function using an imaging-based approach had a significant positive correlation with the postoperatively observed renal function. The FI estimated from the preoperative diagnostic images in the present study was identified as an independent determinant of long-term renal function after PN.

Does preoperative urine culture still play a role in predicting post-PCNL SIRS? A retrospective cohort study.

There is controversy regarding the predicting value of preoperative urine culture for post-percutaneous nephrolithotripsy (PCNL) infection. The purpose of our study was to re-evaluate the importance of preoperative urine culture for developing post-PCNL systemic inflammatory response syndrome (SIRS) in China. A total of 303 patients undergone PCNL from March 2012 to January 2018 were recruited. Urine tests, urine cultures and the perioperative data were prospectively recorded and analyzed. 95 patients (31.4%) were identified with positive preoperative urine cultures. Female patients had significantly higher rate of urine cultures positivity than that in male patients (42.9% vs. 21.5%, p < 0.01). Escherichia coli was the most common organism (56 cases, 58.9%) in patients with positive urine cultures and 35.7% of E. coli-positive patients developed SIRS after PCNL. Even with intensive perioperative prophylaxis, patients with positive urine cultures had a higher rate of post-PCNL SIRS than those patients with negative urine cultures (p = 0.043). On multivariable analysis, preoperative positive urine cultures (OR 1.943, 95% CI 1.11-3.39, p = 0.019), preoperative neutrophils (OR 1.228, 95% CI 1.07-1.41, p = 0.003), intraoperative pyonephrosis (OR 3.37, 95% CI 1.44-9.71, p = 0.01) and postoperative hospitalization (OR 1.154, 95% CI 1.05-1.28, p = 0.005) were independent risk factors for postoperative SIRS. These results demonstrated that preoperative urine culture still played a role in predicting post-PCNL SIRS, but it was unable to prevent the occurrence of SIRS even with intensive perioperative prophylaxis based on urine culture results. Further studies are required to explore the predicting role of advanced preoperative bacterial detecting techniques in post-PCNL infectious complications.

Three-dimensional nephrometry scoring system: a precise scoring system to evaluate complexity of renal tumors suitable for partial nephrectomy.

PURPOSE: Several nephrometry scoring systems have been developed based on two-dimensional computerized tomography images to quantify anatomical features of renal tumors. We have developed an accurate three-dimensional nephrometry scoring system to respond to the urgent need for advanced systems based on three-dimensional images. MATERIALS AND METHODS: We retrospectively reviewed 135 patients who underwent partial nephrectomy in our institution. Stereoscopic models were reconstructed from preoperative computerized tomography images and three-dimensional scores were assigned directly on stereoscopic models. All tumors were analyzed for following features: tumor volume; endophytic tumor proportion; renal vascular variations; tumor's relationships with urinary collecting system or renal sinus; longitudinal distance from tumor to equatorial plane. Correlation between three-dimensional score and warm ischemic time was calculated compared with existing classical nephrometry scoring systems. The value of nephrometry scoring systems predicting longer warm ischemic time was explored by receiver operating characteristic curves. RESULTS: Mean tumor volume was 31.25 ml; endophytic volume was less than 50% in 42 cases, more than 50% in 79 cases, and 100% in 14 cases; mean longitudinal distance from tumor to equatorial plane was 1.41 cm; 30 patients (22.2%) presented renal vascular variations; 18 cases (13.3%) involved both urinary collecting system and sinus. Mean three-dimensional score was 8.3. Variance analysis and covariance analysis revealed warm ischemic time a significant association with all evaluated tumor features. Furthermore, three-dimensional scores most highly correlated with warm ischemic time (rs = 0.64, p < 0.001), followed by R.E.N.A.L. scores (rs = 0.21, p = 0.012), centrality index (rs = - 0.20, p = 0.019) and Preoperative Aspects and Dimensions Used for Anatomy score (rs = 0.20, p = 0.019). Area under curve of above nephrometry scoring systems was 0.91, 0.67, 0.68 and 0.67 respectively (p < 0.05). CONCLUSIONS: The three-dimensional scoring system developed in this study was a highly-accurate system to quantify the anatomical features of renal tumors. It was identified to have a value in predicting duration of warm ischemic time.