Omnidirectional (Flexible) Ureteral Access Sheath: Safety, Efficacy, and Initial Experience Report.

Background: Recently a novel omnidirectional (OD) ureteral access sheath (UAS) has been developed. By retrospectively reviewing and comparing the flexible ureteroscopic lithotripsy (FURL) cases in our institution with either a conventional Cook UAS or an OD UAS in the past year, we shared our experience of the safety, efficacy, and relevant issues on the usage of OD UAS. Materials and Methods: The medical history and surgery details of 199 patients with kidney stones or ureterojunctional stones who underwent FURL in Xinhua Hospital, including 61 Cook UAS and 138 OD UAS, were reviewed and compared. The maximal deflection angle was measured by steering four different types of ureteroscopes to bend the OD UAS in different states. Result: The deflection angle of OD UAS was ∼110° to 130° free load, and 90° to 130° when loaded with different instruments. The stone burden and position were similar in two groups. Given a similar prestent ratio and operation time, the OD UAS group achieved a higher single-session stone-free rate (SFR) (63.9% vs 94.2%, p < 0.0001) at 1-month follow-up evaluated by a CT scan. Conclusion: OD UAS is a novel device with high safety and efficacy. The unique flexible design allows it to bend with the ureteroscope and enter renal calices and be set close to the stone. Combined with the suction port, OD UAS contributes greatly to dealing with large-burden kidney stones, shortens operation time, and improves single-session SFR.

Urine Macrophages Polarization Predicts Renal Function Recovery after Nephron-Sparing Surgery in Patients with Renal Cell Carcinoma.

INTRODUCTION: This study was conducted to investigate the underlying associations between urine macrophages polarization and renal function recovery after nephron-sparing surgery (NSS) in patients with renal cell carcinoma (RCC) and to explore the potential application values of urine macrophages polarization in predicting the severity of renal ischemia/reperfusion injury (RIRI). METHODS: Sixty-two patients with unilateral RCC who underwent NSS in our departments were prospectively recorded and followed up for long-term renal function to assess the onset of acute kidney injury (AKI) and chronic kidney disease (CKD). Urine samples of patients were collected 72 h after surgery for analyzing pro-inflammatory (classically activated/M1) and pro-reparative (alternatively activated/M2) macrophages polarization by flow cytometry. The detailed correlations between urine macrophages polarization and renal function recovery after NSS were explored by statistical analyses. RESULTS: The cumulative incidence of postoperative AKI was 27.4% (17/62), and 47.0% (8/17) of those eventually developed to CKD during the follow-up. The mean urine M1/M2 ratio was 10.54 ± 8.13 in the AKI group and 3.93 ± 3.10 in the non-AKI group, presenting a significant statistical difference (p < 0.0001). Meanwhile, the urine M1/M2 ratio presented amazing potential in predicting postoperative CKD as well, with a mean ratio of 12.54 ± 9.41 in the CKD group and 4.28 ± 3.21 in the non-CKD group (p < 0.0001). Though univariate analysis implied that urine M1/M2 ratio was a relevant factor of both postoperative AKI and CKD in NSS surgical patients, multivariate analysis did not show satisfying predicting potential in postoperative CKD, mainly due to the very limited candidates enrolled in this study. CONCLUSION: Urine macrophages polarization could predict renal function recovery after NSS in patients with RCC. The urine M1/M2 ratio might a potential biomarker of RIRI but needs to be further verified in clinical settings.

MtMAPKK4 is an essential gene for growth and reproduction of Medicago truncatula.

Mitogen-activated protein kinase (MAPK) cascades are universal signaling modules in eukaryotes, including yeasts, animals and plants. They are involved in responses to various biotic and abiotic stresses, hormones, cell division and developmental processes. A MAPK cascade is composed of three functionally tiered protein kinases, namely MAPK, MAPK kinases (MAPKKs) and MAPK kinase kinases (MAPKKKs). These kinases have been intensively studied for their roles in developmental and physiological processes in various organisms. In this study, a Medicago truncatula MtMAPKK4 mutant with the tobacco retrotransposon Tnt1 insertion was identified using reverse genetics methods. No homozygous progeny could be produced by self-pollination of mapkk4/+ heterozygotes for 5 generations. Heterozygous mapkk4/+ mutant plants exhibited growth retardation, chlorosis symptoms and significantly reduced numbers of infection threads and nodules. The interaction between MtMAPKK4 and MtMAPK3/6 occurred both in yeast and in planta. Green fluorescent protein-tagged MtMAPKK4, MtMAPK3 and MtMAPK6 were all localized to membranes, cytoplasm and nuclei. Expression of MtMAPKK4, MtMAPK3 and MtMAPK6 was detected in various tissues of M. truncatula plants at the nodule maturation stage. Transcript levels of these genes were decreased in roots at the early symbiotic stage.

microRNA-372 Suppresses Migration and Invasion by Targeting p65 in Human Prostate Cancer Cells.

Prostate cancer (PCa) is one of the most prevalent malignant tumors. microRNAs (miRNAs) play an important role in cancer initiation, progression, and metastasis, and their roles in PCa are becoming more apparent. In this study, we found that microRNA-372 (miR-372) is downregulated in human PCa and inhibits the proliferation activity, migration, and invasion of DU145 cells. Subsequently, p65 is confirmed as a target of miR-372, and knockdown of p65 expression similarly resulted in decreased proliferation activity, migration, and invasion. CDK8, MMP-9, and prostate-specific antigen were involved in both these processes. Taken together, our results show evidence that miR-372 may function as a tumor suppressor gene by regulating p65 in PCa and may provide a strategy for blocking PCa metastasis.

The new insight of prostate-specific antigen reduction during finasteride therapy in aging men.

OBJECTIVE: To evaluate the effect of finasteride on prostate-specific antigen (PSA) in Chinese population. MATERIALS AND METHODS: From Feb 2011 to Jan 2012, 83 benign prostatic hyperplasia (BPH) patients with prostate volume (PV) >30 mL were enrolled in our study. All the patients were older than 50 years and all of them received combined therapy (finasteride + doxazosin). All the patients were required for 1-year follow-up. PSA level and PV was measured at the start, 6 and 12 months, respectively. RESULTS: 79 patients completed the follow up. PSA level reduced by approximately 40 % during finasteride therapy. We defined baseline PSA as PSA1, PSA at 6 months as PSA2, PSA at 12 months as PSA3. PSA1 was significantly correlated with PSA2/PSA1 and PSA3/PSA1. However, prostate volume was not correlated with PSA1. We divided the patients into three groups according to PSA level. Groups 1, 2, 3 represented the patients with PSA less than 2 ng/mL, between 2 and 4 ng/mL and greater than 4 ng/mL, respectively. Both the PSA2/PSA1 and the PSA3/PSA1 had significant difference among three groups. Furthermore, group 1 and group 2 both showed the fairly large data variance. CONCLUSIONS: When baseline PSA level was greater than 4 ng/mL, the doubling rule could be used for screening. When baseline PSA level was less than 4 ng/Ml, the doubling rule might not be an accurate predictor. We can use the PSA rise from nadir or proPSA to predict prostate cancer.

Tumor-suppressive microRNA-497 targets IKKß to regulate NF-κB signaling pathway in human prostate cancer cells.

BACKGROUND: Prostate cancer (PCa) is one of the most prevalent malignant tumors, PCa-related death is mainly due to the high probability of metastasis. MicroRNAs (miRNAs) play an important role in cancer initiation, progression and metastasis by regulating their target genes. METHODS: real-time PCR was used to detected the expression of microRNA-497. The molecular biological function was investigated by using cell proliferation assays, cell cycle assay, and migration and invasion assay. We used several Algorithms and confirmed that IKKß is directly regulated by miR-497. RESULTS: Here, we found miR-497 is downregulated in human prostate cancer (PCa) and inhibites the proliferation activity, migration and invasion of PC3-AR cells. Subsequently, IKKß is confi rmed as a target of miR-497. Furthermore, knockdown of IKKß expression resulted in decreased proliferation activity, migration and invasion. Finally, similar results was found after treatment with a novel IKK-ß inhibitor (IMD-0354) in PC3-AR cells. CDK8, MMP-9, and PSA were involved in all these process. CONCLUSION: Taken together, our results show evidence that miR-497 may function as a tumor suppressor genes by regulating IKK-ß in PCa, and may provide a strategy for blocking PCa metastasis.

Association of a common variant at 10q26 and benign prostatic hyperplasia aggressiveness in han chinese descent.

Recent studies reported that rs2252004 at 10q26 was significantly associated with prostate cancer (PCa) risk in a Japanese population and was subsequently confirmed in a Chinese population. We aimed to assess the relationship between this locus and risk/aggressiveness of benign prostatic hyperplasia (BPH). The current study included 426 BPH cases and 1,008 controls from Xinhua Hospital in Shanghai, China. All BPH patients were treated with α -adrenergic blockers and 5 α -reductase inhibitors for at least 9 months. Associations between rs2252004 and BPH risk/aggressiveness were tested using logistic regression. Associations between rs2252004 and clinical parameters including International Prostate Symptom Score (IPSS), total prostate volume (TPV), total PSA (tPSA), and free PSA (fPSA) were evaluated by linear regression. Allele "A" in rs2252004 was significantly associated with increased risk for aggressiveness of BPH in a Chinese population (OR = 1.42, 95% CI: 1.04-1.96, P = 0.03). Patients with the genotype "A/A" (homozygous minor allele) had an increase of IPSS and TPV after treatment (P = 0.045 and 0.024, resp.). No association was observed between rs2252004, BPH risk, and baseline clinicopathological traits (All P > 0.05). Our study is the first to show that rs2252004 at 10q26 was associated with BPH aggressiveness and efficacy of BPH treatment.