Pre-transplant donor HBV DNA+ and male recipient are independent risk factors for treatment failure in HBsAg+ donors to HBsAg- kidney transplant recipients.

BACKGROUND: In order to reduce the burden on organ shortage around the world, using potential infectious donor might be an option. However, scarce evidences have been published on kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg) + donors to HBsAg- recipients [D (HBsAg+)/R(HBsAg-)] without hepatitis B virus (HBV) immunity. Here, we reported the results of D(HBsAg+/HBV DNA- or +)/R(HBsAg-) living KTx recipients with or without HBV immunity. METHODS: We retrospectively identified 83 D(HBsAg+)/R(HBsAg-) living KTx recipients, and 83 hepatitis B core antibody (HBcAb) + living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as control group by reviewing medical archives and propensity score matching. Treatment failure (defined as any HBV serology conversion, liver injury, graft loss, or recipient death) is the primary endpoint. RESULTS: Twenty-four donors (28.9%) were HBV DNA+, and 20 recipients had no HBV immunity in the D(HBsAg+)/R(HBsAg-) group pre-transplantation. HBV prophylaxis was applied in all D(HBsAg+)/R(HBsAg-) recipients, while none was applied in the D(HBcAb+)/R(HBcAb-) group. We observed a significant higher treatment failure in D(HBsAg+)/R(HBsAg-) than D(HBcAb+)/R(HBcAb-) group (21.7% vs. 10.8%, P < 0.001). Interestingly, no significant difference was found between groups on HBV seroconversion, liver and graft function, rejection, infection, graft loss, or death. However, 2/20 recipients without HBV immunity in the D(HBsAg+)/R(HBsAg-) group developed HBV DNA+ or HBsAg+, while none observed in the D(HBcAb+)/R(HBcAb-) group. HBV DNA+ donor and male recipient were significant risk factors for treatment failure. CONCLUSION: D(HBsAg+)/R(HBsAg-) should be considered for living kidney transplantation, but with extra caution on donors with HBV DNA+ and male candidates.

Risk factors for recurrence in female urethral diverticulectomy: a retrospective study of 66 patients.

PURPOSE: We aimed to report surgical outcomes in female urethral diverticula and to investigate the risk factors for diverticula recurrence. METHODS: A total of 66 patients underwent urethral diverticulectomies from January 2009 to October 2015 at out institution. Patient and diverticula characteristics were collected. Mean follow-up was 28.8 months (range 4-85 months). Recurrence was defined as requiring a repeat diverticulectomy. RESULTS: Mean age was 44.9 years. Mean duration of symptoms was 28.1 months. Seven cases had previous urethral surgeries. Mean diverticula size was 2.8 cm. Main clinical symptoms included dribbling (n = 41), vaginal mass (n = 41), dysuria (n = 33), frequency/urgency (n = 29), infection (n = 24), stress urinary incontinence (SUI) (n = 20) and dyspareunia (n = 8). 10 cases had proximal diverticula, 10 cases had multiple diverticula, and 35 cases had horseshoe/circumferential diverticula. Postoperatively, the recurrence rate was 19.7 %. Preoperative SUI disappeared in 14 cases, and de novo SUI was developed in six cases. One case developed urethral stricture, and no cases reported urinary fistula. Among 60 cases with pathological results, neoplastic change was seen in one case (1.7 %). Besides, atypical hyperplasia (n = 2) and metaplasia (n = 3) were observed. Univariate analysis suggested that age, duration, follow-up, diverticula size and diverticula shape were not associated with surgical outcomes. Patients with multiple diverticula (p = 0.032), proximal diverticula (p = 0.042) and those with previous urethral procedures (p = 0.004) were at risk of recurrent diverticula confirmed by multivariate logistic regression analysis. CONCLUSIONS: The surgical outcomes of urethral diverticulectomies were acceptable. Multiple diverticula, proximal diverticula and previous urethral surgery were three independent risk factors for recurrent diverticula.

Modulatory effect of aquaporin 5 on estrogen-induced epithelial-mesenchymal transition in prostate epithelial cells.

BACKGROUND: Estrogen is involved in the pathophysiological process of benign prostatic hyperplasia (BPH), in which epithelial-mesenchymal transition (EMT) plays an important role. Upregulation of aquaporin (AQP) 5, which is directly activated by estrogen, has been reported to promote EMT in multiple cells. This study aimed to examine the effects of AQP5 on estrogen-induced EMT in the prostate. METHODS: Normal prostate (NP) tissue samples without any histopathological changes and BPH tissue samples with pathologically confirmed hyperplasia were obtained. An EMT cell model was subsequently established by adding estradiol (E2) to RWPE-1 cells, after which AQP5 knockdown was performed. Tissue morphological and immunohistochemical features were examined using hematoxylin-eosin and immunohistochemical staining. Western blot analysis was performed to determine the expression of AQPs, estrogen receptors, and EMT-related proteins. Cell proliferation was assessed and supernatants were collected for enzyme-linked immunosorbent assay to determine transforming growth factor-ß1 (TGF-ß1) concentrations. Immunofluorescence staining was performed to assess protein expressions in RWPE-1 cells. RESULTS: BPH tissues exhibited greater EMT (TGF-ß1: 1.362 ±â€Š0.196 vs. 0.107 ±â€Š0.067, P = 0.003; vimentin: 1.581 ±â€Š0.508 vs. 0.221 ±â€Š0.047, P < 0.001; E-cadherin: 0.197 ±â€Š0.188 vs. 1.344 ±â€Š0.088, P < 0.001), higher AQP5 (1.268 ±â€Š0.136 vs. 0.227 ±â€Š0.055, P < 0.001) and estrogen receptor (ER) α (1.250 ±â€Š0.117 vs. 0.329 ±â€Š0.134, P < 0.001) expression but lower ERß (0.271 ±â€Š0.184 vs. 1.564 ±â€Š0.130, P < 0.001) expression than NP tissues. E2-stimulated cells had higher AQP5 expression (1.298 ±â€Š0.058 vs. 1.085 ±â€Š0.104, P = 0.049), increased cell proliferation (1.510 ±â€Š0.089 vs.1.000 ±â€Š0.038, P < 0.001), and EMT (TGF-ß1 concentration: 0.352 ±â€Š0.021 ng/mL vs. 0.125 ±â€Š0.014 ng/mL, P < 0.001; vimentin: 1.641 ±â€Š0.120 vs. 0.188 ±â€Š0.020, P = 0.002; E-cadherin: 0.075 ±â€Š0.030 vs. 0.843 ±â€Š0.046, P < 0.001) than controls. E2-stimulated cells with AQP5 knockdown exhibited decreased EMT (TGF-ß1 concentration: 0.223 ±â€Š0.041 ng/mL vs. 0.352 ±â€Š0.021 ng/mL, P = 0.016; vimentin: 0.675 ±â€Š0.056 vs. 1.641 ±â€Š0.120, P = 0.001; E-cadherin: 0.159 ±â€Š0.037 vs. 0.075 ±â€Š0.030, P = 0.040) than E2-stimulated cells with non-related small interfering RNA (siRNA). CONCLUSION: Our findings suggest that estrogen induces BPH possibly by promoting AQP5 expression. Hence, AQP5 might be a novel target for modulating EMT in prostate epithelial cells.

Is there a relationship between phosphodiesterase type 5 inhibitors and biochemical recurrence after radical prostatectomy: a systematic review and meta-analysis.

PURPOSE: Conduct a systematic review and meta-analysis of studies to evaluate the association between the use of PDE5I and biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS: We searched Embase (from 1996 to Feb 2018), PubMed (from 1996 to Feb 2018), and Cochrane library (from 1999 to Feb 2018), then manually searched the reference lists of key retrieved articles. Original studies that reported the risk of postoperative BCR for PDE5I users, as compared with non-PDE5I users, were included. Data including the characteristic of participants, the risk of BCR after RP and key criteria of study quality were collected. The pooled relative risks (RRs) were calculated with random-effects model. RESULTS: A total of 5 cohort studies and 1 case-control study were conducted for data analysis (a total of 17752 participants). Only 1 cohort study reported adjusted RR greater than 1 (range for all derived RRs, 0.7-1.47). The meta-analysis revealed that the PDE5I users had no higher risk of BCR after RP (RR = 1.04, 95% confidence interval [CI], 0.79-1.36). Sensitivity analysis showed that the remaining pooled RR and 95% CI were not changed significantly by omitting each study. In addition, the 5-year BCR rate had no significant difference between PDE5I users and non-PDE5I users. CONCLUSIONS: Our meta-analysis indicated that PDE5I treatment in men following RP did not increase the risk of BCR. The results preliminarily suggested that the use of PDE5I for erectile dysfunction after RP was oncologically safe. Nevertheless, more large sample cohort studies are needed to validate this conclusion.

Different Tract Sizes of Miniaturized Percutaneous Nephrolithotomy Versus Retrograde Intrarenal Surgery: A Systematic Review and Meta-Analysis.

PURPOSE: Miniaturized percutaneous nephrolithotomy (MPCNL), including minipercutaneous nephrolithotomy (PCNL), ultramini-PCNL, and micro-PCNL, have been developed recently. The aim of this meta-analysis was to compare the safety and efficacy of different tract sizes of MPCNL with retrograde intrarenal surgery (RIRS) in the management of kidney stones. MATERIALS AND METHODS: We searched PubMed, Embase, and Web of Science to identify case-control trials and randomized controlled trials, which evaluated MPCNL vs RIRS before February 2017. Two reviewers independently evaluated the methodologic quality of the included studies, and the disagreements were solved by discussion. Meta-analysis was performed with Review Manager version 5.3 software. RESULTS: Fourteen publications involving 1279 patients were included. Mini-PCNL provided a significantly higher stone-free rate (SFR; odds ratio [OR] OR 1.66; p = 0.005), especially for lower pole renal stones (OR 2.65; p = 0.003), but brought longer hospital stay (weighted mean difference [WMD] 1.23; p = 0.0001) and larger hemoglobin drop (WMD 0.77; p < 0.00001). There were no statistically significant differences between mini-PCNL and RIRS in the complications (OR 0.77; p = 0.23) and operative time (WMD: -6.52; p = 0.42). For ultramini-PCNL and micro-PCNL, the safety and efficacy were similar to RIRS. CONCLUSIONS: Mini-PCNL offers a significantly higher SFR than RIRS, for lower pole renal stones, the advantage of mini-PCNL is more obvious. However, RIRS is associated with shorter hospital stay and less hemoglobin drop. For ultramini-PCNL and micro-PCNL, tract size is smaller than mini-PCNL, and the SFR is similar to RIRS. In terms of the evidence at present, we recommend mini-PCNL for patients focusing more on the high SFR.

Prognostic significance of osteopontin in patients with lung cancer: a meta-analysis.

Both plasma/serum/pleural effusion osteopontin concentration (PSPO) and tumor tissue osteopontin expression (TTO) have recently been reported to be involved in the prognosis of lung cancer. In this study, we performed a meta-analysis to demonstrate the association between PSPO/TTO and survival in patients with lung cancer. We searched in PubMed, EMBASE, Cochrane library, Web of Science and Chinese Biomedical database (CBM) for relevant literatures. Stata 12.0 was applied to pool the eligible studies and synthesize hazard ratios (HRs) and its corresponding 95% confidence interval (CI). For PSPO, a total of 8 studies with 1000 patients were included in final analysis. Combined HR suggested high PSPO predicted an unfavorable overall survival (OS) (HR=1.52, 95% CI: 1.13-2.05) and progress-free survival (PFS) (HR=1.73, 95% CI: 1.35-2.21). For TTO, 5 studies with a total of 747 patients were employed in final analysis. Pooled HR indicated that elevated TTO was associated with poor OS (HR=2.16, 95% CI: 1.65-2.83) and disease/relapse-free survival (D/RFS) (HR=2.36, 95% CI: 1.79-3.12). Subgroup analysis was performed to explore the causes of heterogeneity. Publication bias by begg's test was not statistically significant. Sensitivity analysis showed that the pooled results were robust. This study revealed that both high TTO and PSPO are associated with poor prognosis in patients with lung cancer.