Circulating exosomal miR-16-5p and let-7e-5p are associated with bladder fibrosis of diabetic cystopathy.

Diabetic cystopathy (DCP) is a prevalent etiology of bladder dysfunction in individuals with longstanding diabetes, frequently leading to bladder interstitial fibrosis. Research investigating the initial pathological alterations of DCP is notably scarce. To comprehend the development of fibrosis and find effective biomarkers for its diagnosis, we prepared streptozotocin-induced long-term diabetic SD rats exhibiting a type 1 diabetes phenotype and bladder fibrosis in histology detection. After observing myofibroblast differentiation from rats' primary bladder fibroblasts with immunofluorescence, we isolated fibroblasts derived exosomes and performed exosomal miRNA sequencing. The co-differentially expressed miRNAs (DEMis) (miR-16-5p and let-7e-5p) were screened through a joint analysis of diabetic rats and long-term patients' plasma data (GES97123) downloaded from the GEO database. Then two co-DEMis were validated by quantitative PCR on exosomes derived from diabetic rats' plasma. Following with a series of analysis, including target mRNAs and transcription factors (TFs) prediction, hubgenes identification, protein-protein interaction (PPI) network construction and gene enrichment analysis, a miRNA-mediated genetic regulatory network consisting of two miRNAs, nine TFs, and thirty target mRNAs were identified in relation to fibrotic processes. Thus, circulating exosomal miR-16-5p and let-7e-5p are associated with bladder fibrosis of DCP, and the crucial genes in regulatory network might hold immense significance in studying the pathogenesis and molecular mechanisms of fibrosis, which deserves further exploration.

Incidence trends and survival of metastatic prostate cancer with bone and visceral involvement: 2010-2019 surveillance, epidemiology, and end results.

Background: The incidence of prostate cancer (PCa) has continued to increase since the US Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA)-based screening for all men in 2012, approximately half of additional diagnosed cases are advanced-stage, including regional PCa and metastatic PCa (mPCa). It is very important to investigate the shift in mPCa incidence and mPCa-related mortality risk, as the survival of mPCa remains poor. Objective: To investigate the incidence temporal trend of mPCa stratified by metastatic site, including bone and visceral metastatic involvement, and potential survival improvements. Materials: Based on the recently released Surveillance, Epidemiology, and End Results (SEER) data (2010-2019), the age-adjusted incidence rates of mPCa with bone and visceral involvement with annual percentage changes (APCs) were assessed by a joinpoint regression model in men aged 45 years and older by age and race groups, and potential recent improvements in overall survival (OS) and cancer-specific survival (CSS) were estimated by the Kaplan-Meier method and Cox regression model. Results: From 2010 to 2019, a total of 19081 (84.8%) and 3413 (15.2%) mPCa patients with bone and visceral involvement, respectively, were recorded in the SEER database. Considering all races and age groups, the incidence rate of mPCa with bone metastasis remained stable during 2017-2019 (APC, 0.9%; p=0.421) after increasing during 2010-2017 (APC, 5.8%; p<0.001). For visceral metastasis, the incidence rate increased by 12.3% (p<0.001) per year from 2010-2019. Non-Hispanic Black men have higher incidence rates than other populations, and the Non-Hispanic Black to Non-Hispanic White incidence rates ratios of mPCa declined with the greater increasing pace of incidence of Non-Hispanic White men. There was a slight improvement in both OS and CSS among men with bone and visceral metastasis involvement when comparing the 2013-2016 period to the pre-2013 period. Conclusion: Our findings show that the incidence of mPCa with bone and visceral involvement has increased in recent years and that there has been a potential improvement in survival. Future efforts are still needed to watch closely if the rising incidence trends continue.

MUC20 as a novel prognostic biomarker in ccRCC correlating with tumor immune microenvironment modulation.

Tumor microenvironment (TME) broadly participates in genesis development of clear cell renal cell carcinoma (ccRCC). To recognize the immune and stromal modulation in TME, we screened the differentially expressed TME-related genes generated by the ESTIMATE algorithm in ccRCC specimens. Following the construction of protein-protein interaction (PPI) network and univariate COX regression, mucin 20 (MUC20) was judged to be a predictive factor. Further analysis, including immunohistochemistry (IHC) showed that MUC20 was positively correlated with survival and negatively correlated with the clinicopathologic characteristics (grade, clinical and TNM stages) in ccRCC patients. Gene Set Enrichment Analysis suggested that the low-expression MUC20 group was primarily enriched in immune-related activities, inflammation and epithelial-mesenchymal transition. Based on the CIBERSORT analysis for tumor-infiltrating immune cells (TICs), MUC20 was positively correlated with CD8+ T cells and resting mast cells and negatively correlated with activated CD4+ memory T cells, Treg cells, and plasma cells, implying that MUC20 may contribute to immune component in TME. Additionally, the patients with low MUC20 expression had better response to immune checkpoint blockades (ICBs) and 17 potential anticancer drugs were screened regarding calculating IC50 value. Thus, MUC20 may contain a value of prognosis assessment for ccRCC patients and indicate the immune modulation status of TME, which provided a novel insight for comprehensive immunotherapy.

[Diagnosis and treatment of ovotesticular disorder of sex development: A report of 2 cases].

OBJECTIVE: To investigate the characteristics, diagnosis, and treatment of ovotesticular disorder of sex development (OT-DSD). METHODS: We retrospectively analyzed 2 cases of OT-DSD treated in our hospital. The patients were 19 and 15 years old, respectively, and both received systematic physical examination and examinations of the karyotype, sex hormone, adrenocorticotropic hormone (ACTH), color Doppler ultrasonography, urethrocystoscopy, and human chorionic gonadotropin (HCG) test. Under the laparoscope, we performed surgical gonad exploration, gonadectomy, and vulvar orthopedics. Intraoperative exploration and pathology confirmed true hermaphroditism in both cases, with sex selection as female. One underwent laparoscopic resection of the ovotestis, and the other removal of the testis with the ovarian tissue reserved. RESULTS: The patients were followed up for 12 months postoperatively, which found no abnormality in either the vulvas or the genital glands. CONCLUSION: Surgical exploration of the gonad is the only method for the diagnosis of OT-DSD and sex selection is the key to treatment. Laparoscopic surgical exploration of the gonad and vulvar orthopedics are the first treatment options.

Surgical treatment of a ventricular aneurysm in a patient with essential thrombocythemia complicated by acute myocardial infarction: A case report.

Essential thrombocythemia (ET) is a chronic clonal myeloproliferative disorder, which is often complicated by arterial or venous thrombosis and idiopathic bleeding diathesis. The present study reports a female patient with ET complicated by acute myocardial infarction, leading to ventricular aneurysm following interventional therapy for 3 years and a subsequent in-stent restenosis. Following careful examination, a ventricular aneurysm resection and coronary artery bypass graft were carried out. During this case, the monitoring and controlling of the platelet count, pre- and post-operatively, was extremely important for successful surgery.

[Expression of RhoC and ROCK-1 and their effects on MAPK and Akt proteins in prostate carcinoma].

OBJECTIVE: To detect the expression of RhoC and Rho kinase 1 (ROCK-1) in prostate carcinoma, and explore the possible mechanism of RhoC/ROCK-1 in the pathogenesis of prostate carcinoma. METHODS: Tissue specimens from 73 patients with prostate carcinoma and corresponding paracancerous tissues were obtained by prostate cancer biopsy or radical prostatectomy. The expression of RhoC/ROCK-1 mRNA was detected by RT-PCR. Western blot and immunohistochemistry were performed to dertect the expression of RhoC/ROCK-1 protein. Eukaryotic expression plasmids of RhoC were constructed and transfected into PC-3M-2B4 cells. p-MAPK and p-Akt were detected by Western bolt. RESULTS: The expression levels of RhoC and ROCK-1 mRNA in the prostate carcinomas were significantly higher than those in corresponding paracancerous tissues [72.6% (53/73) vs. 34.2% (25/73); 68.5% (50/73) vs. 38.4% (28/73), P < 0.01], respectively. The results indicated that RhoC/ROCK-1 mRNA expression had no significant correlation with Gleason grade. However, the expression of RhoC/ROCK-1 mRNA showed a significant positive correlation with distant metastasis. The RhoC/ROCK-1 protein expression in prostate cancer was also higher than corresponding paracancerous tissues, and showed a significant positive correlation with p-MAPK and p-Akt expression levels. In addition, p-MAPK and p-Akt expression levels were up-regulated in the transcripts. CONCLUSION: Expression levels of RhoC and ROCK-1 in prostate carcinoma are higher than those in corresponding paracancerous tissues, showing a significant positive correlation with distant metastasis. RhoC/ROCK-1 may be involved in the development, invasion and metastasis of prostate carcinoma.

[Compare the outcome of ureteroscopic lithotripsy with ureteroscopic management after failed extracorporeal shock wave lithotripsy for ureteral calculi].

OBJECTIVE: To compare the efficacy and complication of ureteroscopic lithotripsy and ureteroscopic management for ureteral calculi after failed extracorporeal shock wave lithotripsy (ESWL). METHODS: One hundred and thirty-six cases with ureteral calculi after failed ESWL and 189 cases with ureteral calculi were treated with ureteroscopic lithotripsy (URSL). Clinical data of two groups were analyzed retrospectively. RESULTS: The mean operating time and therapeutic time in ESWL-URSL group was longer than that in URSL group, while the rate of polypi hyperplasia and open-surgery in ESWL-URSL group was 34.6%, 5.88% versus 28.3%, 1.59% in URSL group. There is no significant statistical difference in stone-free rate between two groups. CONCLUSION: Ureteroscopic management can be preferred for the patients with disadvantage of ESWL in some condition.

[Surgical treatment of congenital heart diseases in pediatric patients with body weight less than 10 kg].

OBJECTIVE: To report the experience of the surgical treatment of congenital heart diseases (CHD) in pediatric patients with body weight less than 10 kg. METHODS: Between January 2000 and December 2007, 105 children with CHD, aged 2 months to 3 years and weighing between 3.5 to 10 kg, underwent surgical treatment. Of the 105 patients, 56 were concomitant with moderate to severe pulmonary hypertension or repeated pulmonary infections, and 35 with complex cardiac abnormalities. Operations were performed through median sternotomy with moderate hypothermic cardiopulmonary bypass in 88 cases, with normothermic extracorporeal circulation on beating heart in 14 cases, and with deep hypothermic circulatory arrest in 3 cases. RESULTS: There were 5 early deaths (4.8%). During a follow-up of 2 month to 3 year, 97 survivors with corrective procedure had no late mortality or complications with NYHA class I of cardiac function, excepting 2 cases with little residual shunt. Three survivors with palliative procedure enjoyed higher quality of life. CONCLUSIONS: The surgical treatment of CHD in pediatric patients with body weight less than 10 kg seems to be feasible and safe, with satisfactory early and long-term results.

[Expression of P-selectin in the penile vascular epithelia of smoking rats].

OBJECTIVE: To observe the expression of P-selectin in the penile vascular epithelial cells and the morphological changes in the ultrastructure of the penile cavernous tissues of smoking rats, and to explore the pathogenesis of smoking-induced erectile dysfunction. METHODS: Fifty healthy Wistar rats were randomly divided into a normal control, a long-term heavy smoking group, a long-term light smoking, a short-term heavy smoking and a smoking cessation group. Their erectile function was tested by subcutaneous injection of apomorphine (APO), the P-selectin expression in the penile vascular epithelial cells detected by ELISA and the morphological changes in the ultrastructure of the penile cavernous tissues observed under the transmission electron microscope (TEM). RESULTS: The levels of P-selectin were 10.78 +/- 1.71 ng/L, 62.62 +/- 5.95 ng/L, 40.06 +/- 3.97 ng/L, 41.37 +/- 4.06 ng/L and 22.80 +/- 3.15 ng/L respectively in the normal control, long-term heavy smoking, long-term light smoking, short-term heavy smoking and smoking cessation groups, with significant differences between the control group and the other four (P < 0.05). Electron microscopy showed abnormal arrangement of endothelia, penile cavernous sinuses and smooth muscle cells, disrupted continuity of endothelia, damaged ultrastructure of endothelial and smooth muscle cells in the penile cavernous tissue, and obvious proliferation and fibrosis of interstitial tissues in the smoking rats. CONCLUSION: Smoking increases the P-selectin expression in the penile vascular epithelial cells and damages the ultrastructure of the penile cavernous tissue, which may be the main contributors to smoking-induced erectile dysfunction.