Evaluation of Three-Dimensional Printing-Assisted Laparoscopic Cryoablation of Small Renal Tumors: A Preliminary Report.

PURPOSE: This study aimed to explore the security and feasibility of three-dimensional (3D) printing technology- assisted laparoscopic cryoablation to treat small renal tumors. PATIENTS AND METHODS: Four patients recruited from our hospital from April 2016 to August 2017 underwent 3D printing technology-assisted laparoscopic cryoablation. Three-dimensional reconstruction technology was used to mimic cryoablation treatment before operations to determine the number of needles needed for the operation and the depth and angle required for needle insertion into the tumor to preserve nephron integrity. CT scans were used to assess the treatment's efficacy after operation during regular follow-up. RESULTS: The operation was performed successfully in all cases and all patients recovered without major complications. The operation times ranged from 106 to 118 minutes and blood loss ranged from 50 to 100 mL. The follow-up times were between 8-16 months and the mean time was 13.3 months. Follow-up surveys were conducted regularly based on a standard outpatient protocol. Results showed no abnormal reinforcing signals in cryoablation treated areas. CONCLUSION: 3D printing technology-assisted laparoscopic cryoablation is a feasible method for the treatment of renal tumors and may be a way to better preserve nephrons, especially in elderly patients and/or those with comorbidities.

Low expressions of EHD2 and E-cadherin correlate with a poor prognosis for clear cell renal cell carcinoma / 中南大学学报(医学版)

To explore roles of expressions of EHD2 and E-cadherin in clear cell renal cell carcinoma (ccRCC).
 Methods: Four couples of fresh ccRCC tissues and adjacent non-cancerous tissues were collected to evaluate the expression of EHD2 and E-cadherin protein by Western blotting. A total of 65 paraffin-embedded renal ccRCC tissues were collected, and immunohistochemical assay was used to detect the expression of EHD2 and E-cadherin in the samples. The correlation between their expression and clinical and pathological indicators of ccRCC was analyzed, and the relationship between EHD2 and E-cadherin proteins and prognosis for patients with ccRCC was also explored.
 Results: The results of Western blotting showed that the expression levels of EHD2 and E-cadherin were low in 4 ccRCC tissues compared with the adjacent noncancerous tissues. Immunohistochemical results revealed that the expressions of EHD2 and E-cadherin were higher in the localized ccRCC tissues than those in the metastatic ccRCC tissues; the expression levels of EHD2 and E-cadherin were decreased, while the TNM staging and Fuhrman grade were increased (P<0.05 or P<0.01). There was positive correlation between the expressions of EHD2 and E-cadherin in ccRCC (r=0.390, P<0.01). The progression-free survival in ccRCC patients with lower expression of both EHD2 and E-cadherin was better than that in ccRCC patients with higher expressions of EHD2 and E-cadherin (P<0.05). 
 Conclusion: The low expressions of EHD2 and E-cadherin are the potential indicators for the ccRCC patients with poor prognosis.

Expression and mechanism of osteoactivin in the kidney of SD rats after acute cyclosporine A toxicity / 中南大学学报(医学版)

OBJECTIVE@#To determine the expression and mechanism of osteoactivin (OA) in the kidney by establishing SD rat model of acute cyclosporine A (CsA) toxicity.@*METHODS@#SD rats were fed with normal diet for a week, which they were then randomly divided into 3 groups: an experimental group (gavage with cycloporin A and olive oil), a vector group (gavage with olive oil), and a control group (gavage with normal saline). SD rats were killed 2 days, 1 week, or 2 weeks after the gavage to examine the serum creatinine (SCr) and body weight. HE staining was used to detect the kidney histopathological change. Immunohistochemistry was used to observe the staining degree and area of OA. Western blot was used to detect the OA protein.The mRNA expressions of the OA, matrix metalloproteinase-13(MMP-13), and collagen type III(Col III) were examined by RT-PCR.@*RESULTS@#The body weight and SCr of the rats in the experimental group 1 week and 2 days after the gavage had no significant difference compared with the vector group or the control group (P>0.05).On the end of 2nd week, the rats' body weight was significantly reduced, and SCr significantly increased compared with the vector group or the control group (P<0.001).The main histopathological changes in the experimental group were inflammatory cell infiltration, vacuolar degeneration of interstitial cells, or tubular epithelial cell necrosis. Intense OA expression located in the tubular epithelium and interstitial fibroblasts in the kidney of the experimental group was observed by immunohistochemistry. After CsA gavage, the relative mRNA expressions of OA, MMP-13, and Col III significantly increased with time. Western blot did not find the expression of OA protein in the control and the vector group, which increased with time in the experimental group.@*CONCLUSION@#OA expresses in the kidney of SD rats after acute CsA toxicity and mainly expresses in the tubular epithelial cells and renal interstitium. OA is more sensitive to the damage of kidney tissue caused by CsA than by SCr. The early-phase up-regulation of OA expression in the tubular epithelium in response to renal injury caused by acute CsA toxicity might play a key role in triggering the renal interstitial fibrosis via activating expression of MMPs and collagen remodeling in SD rats.

Immune tolerance induced by bone marrow cell infusion / 中国组织工程研究

OBJECTIVE: To summarize the study of bone marrow cell infusion-induced immune tolerance. METHODS: The Pubmed database was researched using the computer for articles published from January 2000 to December 2008 using the key words of "bone marrow cells, transplantation immune tolerance" in English. Simultaneously, Chinese Biomedical Literature Database and China Journal Full-text Database were retrieved for articles published from January 2000 to December 2008 using the key words of "bone marrow cells, immune tolerance" in Chinese. Besides, Organ Transplantation, Transplantation Immune Tolerance and Conference Proceedings of English and Chinese were retrieved by hand. Inclusion criteria: relevant mechanism of immune tolerance; scheme of bone marrow cell infusion-induced immune tolerance; advantages and disadvantages of bone marrow cell infusion-induced immune tolerance; articles in the same circle published in recent years or in authorized journals. Exclusion criteria: repetitive studies or irrelevant articles. RESULTS: Mechanism of immune tolerance comprised cleaning, inability, regulation or inhibition, and ignorance. The scheme of bone marrow cell infusion-induced immune tolerance mainly contained bone marrow cell infusion combined with myeloablative pretreatment, bone marrow cell infusion combined with non-myeloablative pretreatment, pretreatment with immunosuppressive drug or chemotherapeutics, pretreatment of costimulatory signaling blockage, bone marrow cell combined with mesenchymal stem cell infusion. Bone marrow cell infusion-induced immune toleranca could induce long-lasting stable specific immune tolerance by effective immune tolerance mechanism, and had been an effective main method for inducing transplanted tolerance. CONCLUSION: Up to now, clinical immune tolerance is still uncontrollable and facultative. Bone marrow cell infusion-induced stable immune tolerance can develop a new space for organ transplantation.