Ultrasound-guided percutaneous intracystic deroofing is effective in the treatment of simple renal cysts.

OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided percutaneous intracystic deroofing for the treatment of simple renal cysts. METHODS: A retrospective study was conducted to analyze the clinical data of 46 patients with dorsal exophytic simple renal cysts treated at the First Affiliated Hospital of Nanchang University between February 2017 and June 2022. The patients were divided into two groups according to the surgical method, with 20 cases undergoing ultrasound-guided percutaneous intracystic deroofing being assigned to the observation group and 26 cases treated by retroperitoneal laparoscopic renal cyst removal included in the control group. The operation time, blood loss, postoperative catheterization time, postoperative drainage tube indwelling time, postoperative hospital stay, and complications were compared. RESULTS: None of the 46 patients converted to open surgery. The observation group showed significantly less blood loss, shorter operation time, drainage tube drainage time, postoperative hospital stay, and indwelling catheter time than the control group (all P<0.05). The two procedures had a success rate of 100%. There were no statistical significances in K+, Na+, or serum creatinine between the two groups (all P>0.05). All patients were followed up (3 to 6 months) after surgery, and no cyst recurrence was found by imaging examination. CONCLUSIONS: Ultrasound-guided percutaneous intracystic deroofing of renal cysts is worthy of clinical application in the treatment of simple renal cysts due to its significant advantages such as short operation time, less trauma, quick recovery, safety, effectiveness, and low cost.

HAPLN3 inhibits apoptosis and promotes EMT of clear cell renal cell carcinoma via ERK and Bcl-2 signal pathways.

Hyaluronan and proteoglycan link protein 3 (HAPLN3) is a member of the hyaluronan and proteoglycan link protein family expressed in the extracellular matrix closely associated with the development and occurrence of various malignant tumors; yet, its function in clear cell renal cell cancer (ccRCC) is still poorly understood. The following study investigated the progress and mechanism of HAPLN3 on ccRCC using bioinformatics analysis and in vitro experiments. In order to determine whether HAPLN3 is differentially expressed in ccRCC, we analyzed data from the Cancer Genome Atlas (TCGA) and GSE40435 and further validated them in the Human Protein Atlas (HPA) database. Simultaneously, the TCGA dataset was utilized to study the relationship between HAPLN3 expression and the progression of ccRCC and its prognostic value in ccRCC. Gene enrichment analysis (GSEA) was used to explore HAPLN3-related signaling pathways in ccRCC. The TIMER database investigates the link for both HAPLN3 and immune cell infiltration. Different ccRCC cell lines the role of HAPLN3 on cell biological behavior in vitro. HAPLN3 was increased in ccRCC, and its high expression was related to the patients' survival rates and clinical characteristics. GSEA showed that HAPLN3 is mainly enriched in proliferative and metastatic pathways. In addition, HAPLN3 was an independently associated significant predictor in patients with ccRCC. Functional experiments demonstrated that HAPLN3 could promote the proliferation, migration, and invasion of ccRCC cells through the ERK1/2 signaling pathway. To sum up, our data suggest that HAPLN3 may serve as a new prognostic biomarker and potential therapeutic target for ccRCC.

ORC6 acts as a biomarker and reflects poor outcome in clear cell renal cell carcinoma.

Purpose: To explore the role of ORC6 in clear cell renal cell carcinoma (ccRCC). Methods: The Cancer Genome Atlas Kidney Clear Cell Carcinoma (TCGA-KIRC) database was used to investigate the association between ORC6 expression and clinicopathological parameters. Furthermore, the expression level of ORC6 was determined in human RCC tissues and cell lines by western blot and PCR. Receiver operating characteristics curves and Kaplan-Meier curves were performed to assess the diagnostic and prognostic value of ORC6 in RCC. Results: High expression of ORC6 predicted shorter overall survival (OS) (P<0.0001) and acted as an independent prognostic factor. ORC6 could distinguish the tumor from the normal patient (area under the curve=0.8827, P<0.0001). The expression of ORC6 was associated with the P53 signaling pathway, cell cycle, and DNA replication. Conclusion: ORC6 could serve as a useful diagnostic and prognostic biomarker and a potential therapeutic target for ccRCC.

Restoration of the penile sensory pathway through end-to-side dorsal root neurorrhaphy in rats.

Objective: Spinal cord injury often leads to the loss of penile sensation, and severely affects the individual's sexual function. The present study aimed to restore the penile sensory pathway through end-to-side dorsal root (DR) transfer neurorrhaphy in rats, and preliminarily verified the feasibility of the operation.Design: 40 male adult Sprague-Dawley rats were divided into three groups. In the model (n = 20) and resection (n = 10) groups, the right L6 DR, S1 DR, and the contralateral branch of the dorsal nerve of the penis (DNP) were transected. The distal stump of L6 DR in the model group was then anastomosed to the intact L4 DR. The sham group (n = 10) was not subjected to neural damage. Four months later, retrograde and transganglionic neural labeling, morphological examination, immunofluorescence (IF), and ultrastructural observation were carried out to test the reconstruction of the afferent pathway. Reflective erection (RE) was assessed by detecting the intracavernous pressure elicited by DNP stimulation.Results: The neural labeling tests indicated the integrity of the entire rebuilt penile afferent pathway. The morphological studies, IF, and ultrastructural observation showed that the regeneration of L6 axons in the model group was significantly better than that in the resection group; however, it had not reached the level of the sham group. The sham group rats exhibited typical RE following DNP stimulation, while the model and resection groups produced negative results.Conclusion: Our studies demonstrated the feasibility of end-to-side DR transfer neurorrhaphy for restoring the penile sensory pathway in rats.

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?-A retrospective comparative study.

BACKGROUND: Whether to use surgical drains after abdominal surgery or not has received much attention since a hundred years ago. Nowadays, lateral transperitoneal laparoscopic adrenalectomy (LTLA) is a widely used technique to treat adrenal tumors worldwide. However, the placement of drains after LTLA remains controversial. METHODS: Data of 150 patients, who underwent LTLA between October 2014 and September 2020 by the same lead surgeon, were collected, including demographic, pathology, preoperative, operative variables and postoperative complications. The patients were divided into two groups, with and without drainage. The postoperative recovery of the two groups was compared. RESULTS: Among 150 patients (65 men and 85 women, median age 48 years, median BMI 23.53), 89 patients had no drainage and 61 patients had drainage after surgery. Variables of the two groups were analyzed. Placement of drains correlated with long operative time (P<0.01). Patients with drain had longer hospital stays (P<0.001) and a higher incidence of postoperative complications (P=0.022). Other factors, including tumor size (P=0.61), tumor location (P=0.387), ASA score (P=0.687), pathology (P=0.55), VAS pain score (P=0.41), intraoperative blood loss (P=0.11), were not found to be significantly associated with drain placement. There was no conversion to open surgery in both groups. Moreover, no mortality was observed in either group. CONCLUSIONS: This study revealed that it is feasible and safe not to leave a drain in selective and uncomplicated patients and that surgical drainage should not be routine after LTLA.

A new technique for ureteral reconstruction using lingual mucosa grafts in a beagle model.

PURPOSE: To investigate the feasibility of ureteral reconstruction using lingual mucosa graft (LMG) and evaluate the histological changes of the engrafted LMG in beagles. METHODS: Twelve male beagle dogs were randomly divided into groups A, B and C (n = 4). A ventral ureteral defect was created by excising half of the ureteral wall. The length of the defect was 3 cm, 6 cm, and 10 cm in groups A, B, and C, respectively. The LMGs were harvested and employed to repair the ureteral defects in onlay fashion. Two dogs per group were sacrificed after 6 months, with additional two dogs per group sacrificed after 12 months. Intravenous urography (IVU) and macroscopic examination were performed to evaluate renal function and ureteral patency. Histological changes in the engrafted LMGs during the tissue incorporation process were assessed by histological analysis. RESULTS: There were no postoperative complications. Only one dog in group C developed a mild stricture near the proximal anastomosis. In the remaining 11 animals, IVU showed normal renal function and a wide ureteral caliber without stricture or fistula. The diameter of the LMG-reconstructed ureter was greater than that of the proximal and distal ureter (each p value < 0.01). The LMGs survived in situ with newly formed capillaries. The epithelium of the lingual mucosa resembled the urothelium in postoperative 12 months. CONCLUSION: This new technique for ureteral reconstruction using LMGs is feasible. This approach is a promising alternative clinical treatment for curing long ureteral strictures.

A cluster of metabolism-related genes predict prognosis and progression of clear cell renal cell carcinoma.

Clear cell renal cell carcinoma (ccRCC) has long been considered as a metabolic disease characterized by metabolic reprogramming due to the abnormal accumulation of lipid droplets in the cytoplasm. However, the prognostic value of metabolism-related genes in ccRCC remains unclear. In our study, we investigated the associations between metabolism-related gene profile and prognosis of ccRCC patients in the Cancer Genome Atlas (TCGA) database. Importantly, we first constructed a metabolism-related prognostic model based on ten genes (ALDH6A1, FBP1, HAO2, TYMP, PSAT1, IL4I1, P4HA3, HK3, CPT1B, and CYP26A1) using Lasso cox regression analysis. The Kaplan-Meier analysis revealed that our model efficiently predicts prognosis in TCGA_KIRC Cohort and the clinical proteomic tumor analysis consortium (CPTAC_ccRCC) Cohort. Using time-dependent ROC analysis, we showed the model has optimal performance in predicting long-term survival. Besides, the multivariate Cox regression analysis demonstrated our model is an independent prognostic factor. The risk score calculated for each patient was significantly associated with various clinicopathological parameters. Notably, the gene set enrichment analysis indicated that fatty acid metabolism was enriched considerably in low-risk patients. In contrast, the high-risk patients were more associated with non-metabolic pathways. In summary, our study provides novel insight into metabolism-related genes' roles in ccRCC.

TMSB10 acts as a biomarker and promotes progression of clear cell renal cell carcinoma.

Clear cell renal cell carcinoma (ccRCC) is one of the most common urological malignancies. Identifying novel biomarkers and investigating the underlying mechanism of ccRCC development will be crucial to the management and treatment of ccRCC in patients. Thymosin b10 (TMSB10), a member of the thymosin family, is involved in various physiological processes, including tissue regeneration and inflammatory regulation. Moreover, it has been found to be upregulated in many types of carcinoma. However, its roles in ccRCC remain to be elucidated. The present study aimed to explore the expression of TMSB10 in ccRCC through mining The Cancer Genome Atlas (TCGA) and Oncomine databases, and to investigate the association between TMSB10 expression and clinicopathological factors. Furthermore, immunohistochemistry assays and western blotting were conducted to verify TMSB10 expression levels in human ccRCC tissues and cell lines. Functional analyses were also performed to identify the roles of TMSB10 in vitro. The results revealed that TMSB10 was significantly upregulated in RCC tissues and cell lines. The expression of TMSB10 was closely associated with various clinicopathological parameters. In addition, high expression of TMSB10 predicted poor clinical outcome. The receiver operating characteristic curve revealed that TMSB10 could sufficiently distinguish the tumor from normal kidney (area under the curve = 0.9543, P<0.0001). Furthermore, knockdown of TMSB10 impaired the proliferation of ccRCC cells, and attenuated cell and invasion in vitro. In addition, TMSB10 knockdown downregulated reduced the phosphorylation of PI3K and the expression of vascular endothelial growth factor. In conclusion, the present study demonstrated that high expression of TMSB10 could serve as a useful diagnostic and prognostic biomarker and a potential therapeutic target for ccRCC.

Overexpression of LINC00160 predicts poor outcome and promotes progression of clear cell renal cell carcinoma.

Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal carcinoma and exhibits a high risk of invasion and metastasis. It is urgent to uncover a novel biomarker and clarify the underlying mechanism for ccRCC progression and metastasis. Although accumulating research has demonstrated that long non-coding RNAs (lncRNAs) play crucial roles in tumor progression, numerous lncRNAs in ccRCC are largely unknown. Therefore, we screened the differentially expressed lncRNAs among several GEO datasets and chose LNC00160 for further investigation. LNC00160 was significantly upregulated in ccRCC and high expression predicted poor prognosis; higher expression of LNC00160 was associated with advanced clinic pathological parameters in TCGA_KIRC Cohort. Knockdown of LNC00160 suppressed malignancy of ccRCC in vitro and in vivo. Correlation analysis and gene set enrichment analysis (GSEA) revealed that LNC00160 might be associated with Wnt signaling pathway, mTOR signaling pathway, fatty acid metabolism and cell cycle. In conclusion, our results demonstrated that LNC00160 acted as an oncogenic gene and a specific prognostic indicator for patients with ccRCC, and that LNC00160 might be a targeted intervention for ccRCC patients in the future.

The immune infiltration in clear cell Renal Cell Carcinoma and their clinical implications: A study based on TCGA and GEO databases.

The tumor immune microenvironment in clear cell Renal Cell Carcinoma (ccRCC) still remains poorly understood. Previous methods to study the tumor immune microenvironment have a limitation when accounting for the functionally distinct cell types. In this study, we investigated the differently infiltrated immune cells and their clinical significance in ccRCC for the purpose of shedding some important light on the complex immune microenvironment in ccRCC. The devolution algorithm (CIBERSORT) was applied to infer the proportion of 22 immune infiltrating cells based on gene expression profiles of ccRCC bulk tissue, which were downloaded from TCGA and GEO databases. As a result, we observed considerable differences in immune cells percentage between ccRCC tumor tissue and paired normal tissue; meanwhile, we uncovered their internal correlations and associations with Fuhrman grade. Moreover, dendritic cells resting, dendritic cells activated, mast cells resting, mast cells activated and eosinophils were associated with favorable prognosis, whereas B cells memory, T cells follicular helper and T cells regulatory (Tregs) were correlated with poorer outcome.

Identification of a 5-Gene Signature Predicting Progression and Prognosis of Clear Cell Renal Cell Carcinoma.

BACKGROUND Although the mortality rates of clear cell renal cell carcinoma (ccRCC) have decreased in recent years, the clinical outcome remains highly dependent on the individual patient. Therefore, identifying novel biomarkers for ccRCC patients is crucial. MATERIAL AND METHODS In this study, we obtained RNA sequencing data and clinical information from the TCGA database. Subsequently, we performed integrated bioinformatic analysis that includes differently expressed genes analysis, gene ontology and KEGG pathway analysis, protein-protein interaction analysis, and survival analysis. Moreover, univariate and multivariate Cox proportional hazards regression models were constructed. RESULTS As a result, we identified a total of 263 dysregulated genes that may participate in the metastasis of ccRCC, and established a predictive signature relying on the expression of OTX1, MATN4, PI3, ERVV-2, and NFE4, which could serve as significant progressive and prognostic biomarkers for ccRCC. CONCLUSIONS We identified differentially expressed genes that may be involved in the metastasis of ccRCC. Moreover, a predictive signature based on the expression of OTX1, MATN4, PI3, ERVV-2, and NFE4 could be an independent prognostic factor for ccRCC.

TMSB10 promotes migration and invasion of cancer cells and is a novel prognostic marker for renal cell carcinoma.

OBJECTIVE: The study aims to examine the effect of thymosin ß10 (TMSB10) on renal cell carcinoma (RCC) progression and metastasis. METHODS: Real-time PCR and immunohistochemistry analysis were used to evaluate TMSB10 expression in RCC tissue samples and renal cancer cells. Statistical analyses were applied to investigate the association between TMSB10 expression and the clinicopathological characteristics and prognosis of RCC patients. In vitro migration and invasion assays were performed in 786-O and ACHN cells. RESULTS: The expression of TMSB10 was significantly higher in renal cancer cells and tissues compared with normal kidney cells and tissues. TMSB10 expression was significantly related to tumor stage (P=0.002), lymph node metastasis (P=0.034), and distant metastasis (P=0.039). Kaplan-Meier analysis suggested that high TMSB10 expression was significantly associated with unfavorable overall (P=0.004) and recurrent-free survival (P=0.025) of RCC patients. Furthermore, TMSB10 knockdown inhibited the migration and invasion abilities of renal cancer cells in vitro. CONCLUSION: TMSB10 is overexpressed in RCC and regulates malignant cell metastasis by inducing epithelial-mesenchymal transition, which makes TMSB10 a candidate therapeutic target for RCC.

An Experimental Model of Anterior Urethral Stricture in Rabbits With Local Injections of Bleomycin.

OBJECTIVE: To develop an experimental model of anterior urethral stricture in rabbits using a bleomycin (BLM) injection technique. MATERIALS AND METHODS: Thirty adult male New Zealand rabbits were randomly divided into 4 groups. In group 1 (BLM group), BLM was injected into the urethral submucosal tissue every other day through a catheter for 6 weeks at the 3-, 6-, 9-, and 12-o'clock positions of the urethra in 12 rabbits. In group 2 (phosphate-buffered saline [PBS] group), PBS was injected instead of BLM in 6 rabbits. In group 3 (stricture control group), an 8 × 20 mm urethral defect was created in 6 rabbits. In group 4 (normal group), 6 normal rabbits were included. All rabbits in the PBS group and stricture control group, as well as 6 rabbits in the BLM group, were sacrificed at 6 weeks. The remaining 6 rabbits in the BLM group were sacrificed at 10 weeks. Urethrography was performed in all rabbits before sacrifice, and the urethra was harvested for histologic analysis. RESULTS: All rabbits in the BLM group showed mild urethral stricture at 4 weeks and significant urethral stricture at 6 weeks, without spontaneous resolution of the stricture at 10 weeks. No urethral stricture was observed in the PBS group at 4 and 6 weeks. Histologic examination confirmed the presence of fibrosis in the BLM group without spontaneous improvement. CONCLUSION: BLM injection can induce an experimental model of anterior urethral stricture in rabbits. This simple, highly efficient, reproducible method can be carried out in any laboratory.

Bilateral duplex urinary collecting systems accompanied with horseshoe kidneys deformity and right renal ureteral calculi and hydronephrosis: Diagnosis in magnetic resonance urography.

Horseshoe kidney deformity with duplex urinary collecting systems is a rare congenital urinary tract defect. Clinically, it is very difficult to visually observe and examine the whole anatomic structure and information with the regular 2D diagnostic imaging tools. Here, we report a case in which a middle age patient has bilateral duplex urinary collecting systems and horseshoe kidney deformity accompanied with right renal ureteral calculi and hydronephrosis. It was diagnosed by magnetic resonance urography with urinary system 3D reconstruction. The imaging and display method provides valuable information about abnormal anatomic structures of the kidneys and the related stone diseases for preoperative planning.

High expression of constitutive photomorphogenic 1 (COP1) is associated with poor prognosis in bladder cancer.

The present study was to investigate the expression and prognostic value of constitutive photomorphogenic 1 (COP1) in bladder cancer. In our study, real-time quantitative PCR (RT-PCR) was performed to detect 10 pairs of fresh bladder cancer (BCa) and adjacent noncancerous tissues. In addition, immunohistochemistry was utilized to detect the expression of COP1 in 174 clinical bladder cancer samples. What is more, the correlation of COP1 expression and clinicopathological features and clinical outcomes were analyzed. The expression levels of COP1 in clinical bladder cancer were much higher than that in paired adjacent noncancerous tissues (p < 0.0001). High expression of COP1 was closely related with differentiation (p = 0.040) and recurrence (p = 0.001) of patients with bladder cancer. Kaplan-Meier analysis revealed that the expression of COP1 was closely correlated with overall survival (p = 0.048) of bladder cancer, while, recurrence-free survival (p = 0.201). Moreover, Cox multivariate regression analyses showed that COP1 expression was an independent predictor of overall survival (OS; p = 0.027, hazard ratio = 2.127, confidence interval 0.814 to 9.736). Based on our data, the present study suggests that high expression of COP1 may be a novel biological indicator for evaluation of poor prognosis in bladder cancer.