Clinical significance of prognostic nutritional index (PNI)-monocyte-to-lymphocyte ratio (MLR)-platelet (PLT) score on postoperative outcomes in non-metastatic clear cell renal cell carcinoma.

BACKGROUND: Prognositic nutritional index (PNI), monocyte-to-lymphocyte ratio (MLR) and platelet (PLT) are associated with tumor survival in many human malignancies. Whereas, no study combined PNI-MLR-PLT score and indicated its predictive significance on the prognosis of patients with non-metastatic clear cell renal cell carcinoma (ccRCC). METHODS: In this study, we retrospectively collected the clinicopathological characteristics and prognostic data from 164 cases of non-metastatic ccRCC and aimed to determine the clinical significance of PNI-MLR-PLT score on patients' outcomes after surgery. The optimal cut-off values of PNI (PNI > 47.40 vs PNI < 47.40), MLR (MLR > 0.31 vs MLR < 0.31) and PLT (PLT > 245 vs PLT < 245) were identified with relative operating characteristic (ROC) curve analysis. The PNI-MLR-PLT score system was established by the value of three indexes, each indication was assigned a score of 0 or 1. Overall survival (OS) and metastasis-free survival (MFS) were analyzed using Kaplan-Meier estimate and Cox regression models. RESULTS: The mean follow-up period was 85.67 months. Eight (5.0%) patients died, 4 (2.0%) relapsed, and 7 (4.0%) developed metastasis after surgery. The 3-year OS and MFS rates were 98.2% and 97.6%, and the 5-year OS and MFS rates were both 90.2%. Our results suggested that PNI-MLR-PLT score negatively correlated with pathological T stage and tumor grade. Survival outcomes revealed that lower PNI-MLR-PLT score is associated with inferior OS (P < 0.001) and MFS (P < 0.001) after surgery. Subgroup analysis regarding pathological T stage, tumor grade and surgical modalities obtained consistent results. univariable and multivariable Cox analysis showed that high PNI-MLR-PLT score was the independent protective factor of tumor survival in non-metastatic ccRCC patients. CONCLUSIONS: Our data suggested that PNI-MLR-PLT score could serve as a promising independent prognostic factor in patients with non-metastatic ccRCC.

Combining UBR5 and CD163+ tumor-associated macrophages better predicts prognosis of clear cell renal cell carcinoma patients.

PURPOSE: Identification of reliable postoperative indicators for accurately evaluating prognosis of clear cell renal cell carcinoma (ccRCC) patients remains an important clinical issue. This study determined the prognostic value of UBR5 expression in ccRCC patients by combining with CD163+ tumor-associated macrophages (TAMs) and the established clinical parameters. METHODS: The expression of UBR5 was analyzed in ccRCC patients from TCGA databases. A total of 310 ccRCC patients were randomly divided into the training and validation cohorts at a 3:2 or 1:1 ratio, and immunohistochemistry (IHC) and statistical analyses were performed to examine the prognostic value of UBR5 and CD163+ TAMs. RESULTS: UBR5 expression was commonly downregulated in human ccRCC specimens, which was associated with TNM stage, SSIGN, WHO/ISUP Grading and poor prognosis of ccRCC patients. In addition, UBR5 expression was negatively correlated with CD163 expression (a TAM marker) in ccRCC tissues, and combining expressions of UBR5 and CD163 better predicted worse overall survival and progression-free survival of ccRCC patients. Even after multivariable adjustment, UBR5, CD163, TNM stage and SSIGN appeared to be independent risk factors. By time-dependent c-index analysis, the integration of intratumoral UBR5 and CD163 achieved higher c-index value than UBR5, CD163, TNM stage or SSIGN alone in predicting ccRCC patients' prognosis. Moreover, the incorporation of both UBR5 and CD163 into the clinical indicators TNM stage or SSIGN exhibited highest c-index value. CONCLUSIONS: Integrating intratumoral UBR5 and CD163+ TAMs with the current clinical parameters achieves better accuracy in predicting ccRCC patients' postoperative prognosis.

LncRNA PLAC2 upregulates miR-663 to downregulate TGF-ß1 and suppress bladder cancer cell migration and invasion.

BACKGROUND: The roles of lncRNA PLAC2 in bladder cancer (BC) were explored. METHODS: The expression of PLAC2 in two types of tissue of BC patients was detected by RT-qPCR and the expression data were compared by paired t test. The 56 patients were staged according to the AJCC criteria, and 12, 15, 15 and 14 cases were classified into stage I-IV, respectively. The expression of TGF-ß1 and miR-663 in BC tissues were also detected by RT-qPCR experiments. RESULTS: Our data showed that the expression levels of PLAC2 were significantly lower in BC tissues than that in non-cancer tissues. The expression of PLAC2 was not affect by clinical stages and low expression levels of PLAC2 predicted lower survival rate. The expression of PLAC2 was positively correlated with miR-663 and inversely correlated with TGF-ß1 in BC tissues. In BC cells, downregulated TGF-ß1 and upregulated miR-663 were observed after the overexpression of PLAC2. Overexpression of PLAC2 also resulted in suppressed invasion and migration of BC cells. Overexpression of miR-663 resulted in downregulated TGF-ß1 but did not affect the expression of PLAC2. Overexpression of TGF-ß1 reduced the inhibitory effects of overexpression of PLAC2 and miR-663 on cell migration and invasion. CONCLUSION: PLAC2 can upregulate miR-663 to downregulate TGF-ß1 and suppress BC cell migration and invasion.

Micropercutaneous versus Retrograde Intrarenal Surgery for the Management of Moderately Sized Kidney Stones: A Systematic Review and Meta-Analysis.

INTRODUCTION: To compare the effect of micropercutaneous surgery (microperc) and retrograde intrarenal surgery (RIRS) in the management of moderately size kidney stones. METHODS: A systematic literature search was conducted in March 2019 using PubMed, Google Scholar, Web of Science, Embase, the Cochrane Library, and Medline to identify relevant studies. A subgroup analysis was performed to compare microperc with RIRS in patients with lower-pole stones (LPS) and non-LPS (NLPS), respectively. RESULTS: Three randomized controlled trials (RCTs) and 4 non-RCTs were analyzed. Microperc provided a significantly lower rate of double-J stent insertion (p < 0.00001) but a larger decrease in hemoglobin levels (p = 0.0002). In contrast, RIRS led to a shorter hospital stay (p = 0.01) and a lower stone-free rate (SFR) (p = 0.03). IN the subgroup analysis, RIRS provided a significantly lower drop in hemoglobin drop than microperc in patients with LPSs (p = 0.0003). Microperc showed a longer operative time (p = 0.03), longer hospital stay (p = 0.04), and greater drop in hemoglobin (p = 0.04) in patients with NLPS. CONCLUSIONS: Microperc is associated with fewer double-J stent insertions and higher SFR at the expense of a greater drop in hemoglobin and longer hospital stay. Given the differences between the procedures, urologists should synthesize the individual characteristics of patients and unique advantages of these therapies so as to choose the optimal treatment for individual patients.

A rare entity of Primary Ewing sarcoma in kidney.

BACKGROUND: Ewing sarcoma (ES) or primitive neuroectodermal tumors (PNET) represents a spectrum of poorly differentiated and aggressive malignancies. It rarely arises from the kidney and accounts for less than 1% of renal mass. Given the uncharacteristic clinical symptoms and imaging features, renal Ewing sarcoma (RES) is often diagnosed by postoperative pathology. CASE PRESENTATION: Herein, we depicted a case of RES, which was administrated in our institution by chief complaints of intermittent left plank pain and palpable abdominal mass. We demonstrated the aggressive behavior of this renal malignancy and summarized its therapeutic modalities and outcomes. CONCLUSION: The diagnosis of RES relies on integrated analysis including histomorphology, immunohistochemical staining and confirmation of molecular-genetic testing. Despite the surgery and adjuvant therapy, optimized and potent therapeutic regimes are still urgently needed to improve the poor prognosis of RES.

[Role of the lncRNA H19/ microRNA-203a/PTEN axis in ischemia-reperfusion injury of mouse GC-1 cells and its mechanism].

OBJECTIVE: To investigate the expression of long non-coding RNA (lncRNA) H19 in mouse GC-1 cells in vitro and its effects on the proliferation and apoptosis of GC-1 cells. METHODS: We established an in vitro hypoxia-reoxygenation model in GC-1 cells and detected the expression of lncRNA H19 in the GC-1 cells at different time points of reoxygenation injury by qRT-PCR. We determined the effects of silencing lncRNA H19 on the proliferation and apoptosis of the GC-1 cells by MTT and flow cytometry, the expressions of apoptosis-related proteins Bax and caspase-3 in the GC-1 cells by Western blot, and the expressions of microRNA-203a and PTEN by qRT-PCR and Western blot, respectively. RESULTS: With the prolonging of the time of reoxygenation injury, the expression of lncRNA H19 was increased significantly in the GC-1 cells and peaked at 3-hour hypoxia and 12-hour reoxygenation, but that of microRNA-203a markedly decreased. Silencing lncRNA H19 enhanced the proliferation and inhibited the apoptosis of the GC-1 cells, and up-regulated the expression of microRNA-203a and down-regulated that of PTEN in the GC-1 cells. CONCLUSIONS: LncRNA H19 is highly expressed in GC-1 cells in vitro, which may influence the proliferation and apoptosis of GC-1 cells by regulating the microRNA-203a /PTEN signaling pathway.

miR-30e-5p suppresses cell proliferation and migration in bladder cancer through regulating metadherin.

Recent studies have suggested that miR-30e-5p is dysregulated in several human carcinomas; however, the mechanism of miR-30e-5p in bladder cancer (BCa) remains unknown. Here, we confirmed that the expression of miR-30e-5p was decreased in human BCa specimens and cell lines by quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Upregulation of miR-30e-5p decreased the proliferation and migration in T24 and UM-UC-3 cells. Metadherin (MTDH) was a potential target for miR-30e-5p through bioinformatics analysis. Dual-luciferase assays were conducted to validate the interaction between miR-30e-5p and MTDH, which demonstrates that the relative luciferase activity was significantly downregulated after transfected miR-30e-5p mimic compared with control mimic in 293T cells. We also detected that whether silencing of MTDH by using small interfering(si)-MTDH matched effects caused by miR-30e-5p overexpression in BCa cells lines by Cell Counting Kit-8 (CCK-8), colony formation, and transwell assay, and we found the effects of silencing of MTDH same as miR-30e-5p overexpression. Furthermore, we verified that the restoration of MTDH in miR-30e-5p-overexpressed BCa cells rescued the inhibitory effects of miR-30e-5p. In conclusion, these results demonstrated that miR-30e-5p may inhibit BCa cells growth and invasiveness by targeting MTDH and may be a promising therapeutic agent for treating clinical BCa patients.

A Study of Diet and Lifestyle and the Risk of Urolithiasis in 1,519 Patients in Southern China.

BACKGROUND This study aimed to evaluate the risk factors associated with the development of urolithiasis in a population in Southern China. MATERIAL AND METHODS A questionnaire-based study was conducted between March 2017 to April 2018 that included 1,519 patients in Southern China and included questions on patient demographics, diet, and lifestyle. Patients were divided into the urolithiasis group who had urinary calculi and the control group. RESULTS There were 829 patients (54.6%) in the urolithiasis group and 690 patients (45.4%) in the control group. Using a chi-squared (χ²) test, 13 variables were found to be significantly associated with urolithiasis, including age, physical activity, and dietary factors that included high sodium, protein, fat, lean meat, vegetables, pickled food, fluid intake, drinking habits and tea consumption, and frequency and duration of physical exercise. Multivariate logistic regression analysis showed that dietary factors, including vegetables (OR, 0.856; 95% CI, 0.769-0.948), pickled foods (OR, 1.271; 95% CI, 1.030-1.357), and animal protein intake (OR, 1.138; 95% CI, 1.031-1.258), drinking strong tea (OR, 0.793; 95% CI, 0.702-0.897), fluid intake (OR, 0.758; 95% CI, 0.644-0.816), and duration of physical exercise (OR, 0.840; 95% CI, 0.808-0.973) were significantly associated with the occurrence of urolithiasis and were independent risk factors. CONCLUSIONS High consumptions of pickled foods and animal protein were the main risk factors for the development of urolithiasis in a population of southern China, but high fluid intake with a preference for strong tea, a diet of vegetables, and physical exercise were protective factors.

[Intrarectal local anesthesia versus periprostatic nerve block in transrectal prostate biopsy for patients with different prostate volumes: A prospective randomized controlled trial].

OBJECTIVE: To evaluate the analgesic effect of intrarectal local anesthesia (IRLA) versus that of periprostatic nerve block anesthesia (PPNB) in initial transrectal ultrasound-guided prostate biopsy (TRUS-PB) for patients with different prostate volumes (PV). METHODS: A total of 253 patients undergoing initial TRUS-PB in our hospital from January 2014 to November 2017 were divided into three PV groups (<50 ml, 50－100 ml, and >100 ml), each again randomized into three subgroups (control, IRLA, and PPNB) with the random number table method. The pain during the procedure was assessed based on the Visual Analogue Scale (VAS) scores and the blind method was used by the biopsy operator, VAS valuator and data analyst. RESULTS: Among the patients with PV <50 ml, the VAS scores in the blank control, IRLA, and PPNB subgroups were 4.39±0.87, 3.51±0.84 and 3.43±1.07, respectively, remarkably higher in the control than in the IRLA and PPNB groups (P<0.05), but with no statistically significant differences between the latter two (P>0.05). Among those with PV of 50－100 ml, the VAS scores in the three subgroups were 4.50±1.05, 4.38±1.13 and 3.38±1.44, respectively, markedly higher in the control and IRLA than in the PPNB group (P<0.05), but with no statistically significant differences between the former two groups (P>0.05). Among those with PV >100 ml, the VAS scores in the three subgroups were 5.19±1.05, 5.00±1.25 and 4.19±0.91, respectively, remarkably higher in the former two groups than in the latter (P<0.05), but with no statistically significant differences between the former two groups (P>0.05). CONCLUSIONS: Either IRLA or PPNB can be recommended for initial TRUS-PB in patients with PV <50 ml, PPNB for those with PV of 50－100 ml, and PPNB with other painkillers for those with PV >100 ml.

Low-dose whole organ CT perfusion of the pancreas: preliminary study.

OBJECTIVES: To investigate the feasibility of low-dose whole pancreas CT perfusion in the clinical practice. METHODS: Sixty-one patients suspected pancreatic disease underwent low-dose whole pancreas CT perfusion scan (by body weight, group A: 70 kV, 120 mAs; group B: 80 kV, 100 mAs) and the individualized pancreas scan. Forty-six patients were enrolled. Perfusion characteristics, such as, blood flow, blood volume and permeability, were analyzed. The effective radiation dose of the whole pancreas CT perfusion and the total CT scan protocol were recorded. CT findings were histologically confirmed by surgical intervention or diagnostic puncture. RESULTS: Of the 46 cases, 33 were pancreatic adenocarcinoma, 5 were solid-pseudo-papillary tumors of pancreas, 8 cases of pancreatic endocrine tumors on the perfusion study. There was significant interobserver agreement on the measurement of normal pancreatic CT perfusion parameters of group A (n = 28)and group B (n = 18), respectively (p > 0.05). For the normal pancreas, there was no significant difference on CT perfusion parameters between group A and group B (p > 0.05). There were significant differences on blood flow as well as blood volume between the pancreatic adenocarcinomas and the normal pancreas (p < 0.001), whereas no difference on the permeability (p > 0.05). The time to peak of the normal pancreas is 28.94 ± 4.37 s (range from 24 to 38 s). Different pancreatic tumors had different types of time attenuation curve (TAC). TACs were different between pancreatic adenocarcinomas and normal pancreas. The effective radiation dose of the whole pancreas CT perfusion of Group A and Group B were 3.60 and 4.88 mSv (DLP 246 and 325 mGy cm), respectively, and the total radiation dose was around 8.01-16.22 mSv. CONCLUSIONS: Low-dose whole pancreatic CT perfusion can effectively reduce radiation dose, and provide the best phase for the individualized pancreas scan, which has great value in the clinical practice.

Comparison of the One-Step Prone Split-Leg Position to the Traditional Prone Position for Percutaneous Nephrolithotomy: A Single-Center Retrospective Study.

PURPOSE: To evaluate the one-step prone split-leg position compared to the traditional prone position for percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: This study retrospectively analyzed the clinical data for 102 patients with upper urinary tract calculi who underwent PCNL at our hospital from April 2019 to December 2022. All PCNL procedures were performed by the same senior urologist. According to different surgical positions, the patients were divided into a one-step prone split-leg position group (observation group, n = 39) and a traditional bladder lithotomy position followed by prone position group (control group, n = 63). Then, the two groups were compared regarding the time of catheter insertion and channel establishment, channel size, time required for double-J stent placement, total operative time, postoperative hospital stay, stone removal rate, secondary operation rate and postoperative complications. RESULTS: There was no significant difference in the preoperative baseline characteristics of the patients between the two groups (all P > .05). Patients in the observation group had shorter total operative times, higher stone removal rates (76.9% [30/39] vs. 57.1% [36/63], P = .042), and lower secondary operation rates (10.3% [4/39] vs. 28.6% [18/63], P = .029) than those in the control group. There were no significant differences in the time of working channel establishment, channel size, postoperative hospital stay, or postoperative complications between the two groups (all P > .05). CONCLUSION: The one-step prone split-leg position is a safe and reliable surgical posture for treating upper urinary calculi in PCNL patients. It can not only shorten the overall operation time of PCNL but also improve the stone removal rate of the operation, thus reducing the secondary operation rate of multiple renal stones.

M6A-mediated-upregulation of lncRNA BLACAT3 promotes bladder cancer angiogenesis and hematogenous metastasis through YBX3 nuclear shuttling and enhancing NCF2 transcription.

Lymphatic metastasis is recognized as the leading manner of metastasis in bladder cancer (BLCa), but hematogenous metastasis accounts for a majority of cancer-associated deaths. The past two decades have witnessed tremendous attention in long non-coding RNAs (lncRNAs), which are a new hope for the development of targeted drug therapy for metastatic cancers; however, the underlying mechanism of lncRNAs involved in BLCa hematogenous metastasis remains to be elucidated. Here, we identified BLCa-associated transcript 3 (BLACAT3), a lncRNA, which was aberrantly upregulated in BLCa and corelated with poor prognosis of patients with muscle-invasive bladder cancer. Methodologically, m6A epitranscriptomic microarray, RNA sequencing and mass spectrometry (MS) were used to screen the key molecules of the regulatory axis. Functional assays, animal models and clinical samples were used to explore the roles of BLACAT3 in BLCa in vitro and in vivo. Mechanistically, m6A modification contributes to BLACAT3 upregulation by stabilizing RNA structure. BLACAT3 recruits YBX3 to shuttle into the nucleus, synergistically enhances NCF2 transcription, and promotes BLCa angiogenesis and hematogenous metastasis by activating downstream NF-κB signaling. Our findings will develop prognosis prediction tools for BLCa patients and discover novel therapeutic biological targets for metastatic BLCa.

Pain-Related Risk Factors Among Radiologic Stages of Knee Osteoarthritis: Data From the Osteoarthritis Initiative.

OBJECTIVE: To investigate whether risk factors related to pain vary at different stages of knee osteoarthritis (OA). METHODS: Individuals from the Osteoarthritis Initiative with available Kellgren/Lawrence (K/L) grade and numerical rating scale (NRS) data at baseline were included in this study. Pain severity was classified into 3 categories based on NRS scores: no pain, mild pain, and moderate/severe pain. Knee OA severity was stratified into 4 categories according to the K/L system. Pain risk factors were evaluated using generalized ordinal logistic regression analysis, and a heatmap was created to compare differences in standardized regression coefficients between subgroups of patients with different knee OA severities. RESULTS: A total of 4,446 subjects were included in this study: 1,574 individuals without pain (35.4%), 1,138 individuals with mild pain (25.6%), and 1,734 individuals with moderate/severe pain (39.0%). For the entire population and subjects in the premorbid-stage subgroup, knee injury history, diabetes mellitus, depression, use of nonsteroidal anti-inflammatory drugs (NSAIDs), and valgus malaligned knees were associated with more severe pain. Older age and stronger quadriceps muscles were associated with milder pain. As the disease progressed, the number of significant risk factors decreased. Only age and quadriceps muscle force remained significant in end-stage disease. CONCLUSION: Multiple factors are associated with pain in patients with knee OA. As the disease progresses, the number of significant risk factors gradually reduces. These findings suggest that strategies for managing pain related to knee OA should vary depending on radiographic grades.

Intravenous leiomyomatosis: CT findings.

Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor. Although IVL is histologically benign, it might be aggressive in its behavior and can grow into pelvic veins and the inferior vena cava (IVC) extending into the heart chambers and pulmonary vasculature. Occasionally, it was found to have lung metastasis. We describe four cases of IVL in the IVC with a history of hysterectomy for uterine leiomyoma, one extending into the left renal vein and three growing into the right heart chamber. We report the computed tomography (CT) findings in the four cases and briefly discuss the CT features of IVL in order to help making accurately preoperative diagnosis and improve the rate of surgical resection and survival.

MSCT diagnosis of aneurysms associated with an unusual variant: atypical triplication anterior cerebral artery.

Atypical triplication anterior cerebral artery is a rare entity and the variation is an important factor leading to aneurysm. A patient with aneurysm that arises from the bifurcation of the distal anterior cerebral arteries is presented. The contralateral anterior cerebral artery is also presented, and there is no communication between the left and the right anterior cerebral artery. The findings from multiple slice CT angiography in this case are illustrated and discussed. The recognition of this variant is important for the therapy planning.

Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery after Surgery: A Single-Centered Retrospective Study.

PURPOSE: To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURSL) based on the concept of enhanced recovery after surgery (ERAS). MATERIALS AND METHODS: This study retrospectively analyzed 435 patients diagnosed with upper urinary calculi between 2017-2020 and categorized them into ERAS (ERAS management) and control groups (traditional management). The operative time, postoperative ambulation time, postoperative hospital stay, the total cost of hospitalization, postoperative complications, and stone removal rate between the two groups were subsequently compared. RESULTS: The FURSL procedure was successfully performed in 427 patients but failed in 4 patients of the ERAS group (n = 216) and 4 of the control group (n = 219). No postoperative complications occurred in either group except for fever and hematuria. There was no significant difference in postoperative fever and stone removal between the two groups (all P > .05). However, patients in the ERAS group had a shorter operative time, shorter postoperative ambulation time, less postoperative severe hematuria, shorter postoperative hospital stay, and lower total cost of hospitalization than those in the control group (all P < .05). CONCLUSION: FURSL, based on the concept of ERAS, is safe and reliable for the treatment of upper urinary calculi, with rapid postoperative recovery and a low cost of hospitalization. It is worthy of clinical promotion.

The inhibition of TRIM35-mediated TIGAR ubiquitination enhances mitochondrial fusion and alleviates renal ischemia-reperfusion injury.

Tripartite motif 35 (TRIM35) is a member of the tripartite motif protein family and has been recognized to play a key role in immune-inflammatory diseases. However, the role of TRIM35 in renal ischemia-reperfusion injury (IRI) remains unclear. Our study proved that knockdown of TRIM35 alleviates kidney IRI by inhibiting oxidative stress and enhancing mitochondrial fusion. In addition, our experimental results found that TRIM35 interacts with TP53-induced glycolysis and apoptosis regulator (TIGAR) and promotes the polyubiquitination of TIGAR and induces its degradation in the proteasome pathway. Furthermore, TIGAR knockdown significantly inhibited mitochondrial fusion. These results indicate that TRIM35 is a potential therapeutic target for renal IRI.

Allicin protects against renal ischemia-reperfusion injury by attenuating oxidative stress and apoptosis.

BACKGROUND: Studies have demonstrated that allicin may play critical roles in the procession of ischemia-reperfusion(I/R) injury. The purpose of this study was to investigate the protective effects of allicin on renal I/R injury by attenuating oxidative stress and apoptosis. METHODS: To establish a model of renal I/R, the right kidney underwent 12 h reperfusion after 45 min ischemia, allicin was administered intraperitoneally at concentrations of 40, 50 or 60 mg/kg. NRK-52E cells were treated with allicin at concentrations of 1, 3 or 5 µM in 24 h hypoxia/ 6 h reoxygenation(H/R) treatments. Indicators of HE, oxidative stress, apoptosis were measured to evaluate the effect of aliicin on renal I/R injury. RESULTS: Allicin protected renal I/R injury by ameliorating histological injury and decreasing the oxidative stress in renal tissues. Meanwhile, allicin significantly downregulated the expression of Bax and caspase-3, upregulated the expression of Bcl-2 in I/R renal tissues and H/R treated NRK-52E cells. CONCLUSIONS: Allicin may exert anti-apoptotic and antioxidative effects to promote renal function recovery in I/R renal tissues and H/R treated NRK-52E cells. Taken together, allicin may be a potential novel therapy option for future renal injury protection.

Development and validation of a predictive model for diagnosing prostate cancer after transperineal prostate biopsy.

Objective: This study aimed to develop and validate a nomogram to predict the probability of prostate cancer (PCa) after transperineal prostate biopsy by combining patient clinical information and biomarkers. Methods: First, we retrospectively collected the clinicopathologic data from 475 patients who underwent prostate biopsy at our hospital between January 2019 to August 2021. Univariate and multivariate logistic regression analyses were used to select risk factors. Then, we established the nomogram prediction model based on the risk factors. The model performance was assessed by receiver operating characteristic (ROC) curves, calibration plots and the Hosmer-Lemeshow test. Decision curve analysis (DCA) was used to evaluate the net benefit of the model at different threshold probabilities. The model was validated in an independent cohort of 197 patients between September 2021 and June 2022. Results: The univariate and multivariate logistic regression analyses based on the development cohort indicated that the model should include the following factors: age (OR = 1.056, p = 0.001), NEUT (OR = 0.787, p = 0.008), HPR (OR = 0.139, p < 0.001), free/total (f/T) PSA (OR = 0.013, p = 0.015), and PI-RADS (OR = 3.356, p < 0.001). The calibration curve revealed great agreement. The internal nomogram validation showed that the C-index was 0.851 (95% CI 0.809-0.894). Additionally, the AUC was 0.851 (95% CI 0.809-0.894), and the Hosmer-Lemeshow test result presented p = 0.143 > 0.05. Finally, according to decision curve analysis, the model was clinically beneficial. Conclusion: Herein, we provided a nomogram combining patients' clinical data with biomarkers to help diagnose prostate cancers.

Comprehensive analysis of MFN2 as a prognostic biomarker associated with immune cell infiltration in renal clear cell carcinoma.

BACKGROUND: Treatment of advanced kidney renal clear cell carcinoma (KIRC) remains challenging in clinic. The functional role and prognostic significance of MFN2 in KIRC are still unclear. METHODS: In this study, we first performed a bioinformatic analysis to determine the expression level and prognostic value of MFN2 in KIRC using The Cancer Genome Atlas (TCGA) dataset, and then validated the MFN2 mRNA expression in our cohort of clinical tissue samples and cell lines of KIRC via RT-qPCR. Cox regression model was used to identify the independent prognostic factors. A nomogram was constructed to predict the prognosis of KIRC patients. Gene set enrichment analysis (GSEA) was performed to predict the involved functional pathways of MFN2 co-expressed genes. The association between MFN2 expression level and immune cell infiltration was assessed using the TIMER and the TIDISB databases. In addition, cell proliferation and migration abilities of two KIRC cell lines with MFN2 overexpression were evaluated by MTS and wound healing assays, respectively. RESULTS: Downregulation of MFN2 was observed in KIRC tissues and cell lines compared to the normal controls. Kaplan-Meier curve analysis indicated an inferior survival outcomes in KIRC patients with lower MFN2 expression, uncovering the tumor-suppressive role of MFN2 in KIRC. Cox regression results showed that higher MFN2 expression was one of the independent protective factors in KIRC. Besides, function predictive analysis revealed that MFN2 co-expressed genes were enriched in the biological processes of energy metabolism and autophagy. Moreover, MFN2 expression was observed to be significantly associated with immune cell infiltration and a variety of markers of tumor infiltrating immune cells (TIICs) including multiple immune checkpoints in KIRC tissues. Finally, MFN2 overexpression significantly inhibited cell proliferation and migration abilities of two KIRC cell lines examined. CONCLUSION: Generally, our data suggested that MFN2 may serve as a potential prognostic biomarker and therapeutic target in KIRC.