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Objective: To present the extraperitoneal laparoscopic radical cystectomy (ELRC) technique, and initial outcomes of organ-preserving and orthotopic neobladder (ONB) techniques for bladder cancer in selected females., Materials and Methods: Data including patient characteristics, operative time, blood loss, transfusion rate, length of hospital stay, and pathologic outcomes, as well as 30- and 90-day complications were collected between April 2018 and May 2021 from females who underwent ONB after ELRC. Regular follow-up focused on patients' oncological and functional outcomes, and postoperative sexual function status was assessed using the Female Sexual Function Index (FSFI)., Results: Eleven females with a mean age of 53 years who underwent ELRC with pelvic organ-preservation and ONB were analyzed retrospectively. All procedures were completed successfully. The mean operative time was 264.82 ± 33.81 min, and the average intraoperative blood loss was 128 ± 18.19 mL. All patients had negative pathological margins and no lymph node metastases. The average hospital stay was 10.72 days. The single J ureteral stent and catheter were usually removed 3-4 weeks after the procedure. The FIFS assessment of postoperative sexual function showed that the patients were relatively satisfied., Conclusion: ELRC with pelvic organ preservation and ONB technology was a safe and feasible surgical strategy for the selected female patients. Preserving organs and vascular nerve bundles seemed to be safe in oncological and produced encouraging functional results. Further rigorous prospective studies with more patients and long-term follow-up data are needed to assess the oncologic and functional results., Competing Interests: Conflict of Interest The authors declare that they have no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: To improve the complications of traditional laparoscopic radical cystectomy (LRC), a novel technique of extraperitoneal laparoscopic radical cystectomy (ELRC) with preservation of fertility was described., Materials and Methods: Selected patients with bladder cancer were treated with the ELRC technique. The seminal vesicles and the vas deferens were preserved. Patient's perioperative conditions, tumor prognosis, and follow-up data were analyzed retrospectively., Results: We successfully completed ELRC surgery in dozens of patients. The orthotopic ileal neobladder was placed in the extraperitoneal area, completely preserving the peritoneum. The postoperative complications caused by postoperative peritoneal loss were reduced. Moreover, the perioperative period was strictly managed with the concept of enhanced recovery after surgery (ERAS). We described the operation process in detail through a typical case of a child. All patients were free of complication at short-term follow-up, and reported satisfied sexual function with normal erections., Conclusion: The ELRC technique has benefits in terms of decreased ileus, reoperation rates, hospital stay, ease of management of urinary leaks, and improves the patient quality of life. ELRC is also an oncologically safe approach with excellent significant functional outcomes in carefully selected transitional cell carcinoma (TCC) or non-TCC patients who expect to maintain sexual function and fertility, especially for young patients. In addition, more patient groups and longer follow-ups are needed to further understand the safety and practicality of the ELRC technology., Competing Interests: COMPETING INTERESTS The authors declare that they have no competing interests., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the expression of androgen receptor (AR) with clinical and pathologic features in patients with renal cell carcinoma (RCC) and to explore the function of AR using human RCC cells., Materials and Methods: The expression of AR was detected by immunohistochemistry in 44 adjacent normal kidney tissues of 120 RCC patients and also in 16 metastatic RCC patients with their respective primary and metastatic tissue samples. The expression of AR was examined by western blot in commonly used human RCC cell lines and normal kidney epithelial cells, and the luciferase assay was performed in those AR-positive RCC cells., Results: The expression rate of AR was higher in adjacent normal kidney (90.9%) than in RCC tissues (30.0%, P <.001), and it was negatively associated with pT stage and Fuhrman's grade. Specifically, there were 40.7% AR-positive cases in pT1 compared with 8.0% in pT3 (P = .013), and 50.0% of grade I cases were found to be AR positive compared with 12.9% in grade III (P = .008). AR expression was slightly higher in primary RCC tissues (12.5%) than their respective metastases (0%, P = .484). AR strongly expressed in CAKI-2 and OSRC-2 cells with little transactivation, which might indicate that AR in those 2 RCC cells has little function., Conclusion: Our results suggest that any attempt to investigate the roles of AR in RCC progression might need to combine the detection of AR expression in tissue samples with examining its function to make a correct correlation between AR and RCC progression., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: To investigate whether ischemic postconditioning effects on the development of tubulointerstitial fibrosis follow acute renal ischemia-reperfusion., Methods: Rat models of warm renal I/R were established by clamping left pedicles for 45 minutes after right nephrectomy, both with and without treatment with ischemic postconditioning, and then reperfused for up to 12 weeks. Hematoxylin-eosin (H&E) and Masson's trichrome staining were used to assess renal fibrosis. The expression spot and protein levels of α-smooth muscle actin (α-SMA), transforming growth factor-β1 (TGF-β1), and phospho-Smad2 were also analyzed., Results: Our data showed that patchy inflammation and tubulointerstitial fibrosis were found 12 weeks later in rats subjected to I/R alone or with postconditioning. Tubulointerstitial fibrosis worsened further in rats subjected to 45-minute ischemia-reperfusion, accompanied by the increased expressions of α-SMA, TGF-β1, and phospho-Smad2 at the end of 12 weeks. In contrast, the above histologic changes and molecular expressions were significantly attenuated in rats of ischemic postconditioning group., Conclusion: The results indicated that 45-minute I/R injury may cause tubulointerstitial fibrosis in the long term, and ischemic postconditioning has beneficial effects on renal fibrosis. Its mechanisms may involve inhibition of the TGF-β1/phospho-Smad2 pathway to exert protective effects., (Copyright © 2012 Elsevier Inc. All rights reserved.)