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Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease in the clinic. The predominant clinical manifestation is bilateral and progressive cysts formation in the kidneys, impairs normal renal parenchyma, and ultimately leads to endstage renal disease (ESRD). ADPKD is a heterogenic disease which is resulted from the mutations of PKD1 or PKD2 genes which encode polycystin-1 (PC1) and -2 (PC2), thereby multiple cell signaling pathways are involved., Method: Although causative genes and aberrant signaling pathways have been investigated for decades, lack of effective and less side-effect treatment for the disease still perplex vast clinicians. Therefore, development of new therapeutic approaches for ADPKD is currently very much desired., Conclusion: This review will center on pathogenesis of ADPKD, and thereafter gene transfer will be discussed as potential treatment for the disease. New therapeutic interventions will bring further hope to improve prognosis of this incurable disease., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Introduction: Perivascular epithelioid cell tumor (PEComa) is a mesenchymal neoplasm composed of perivascular epithelioid cells with clear to eosinophilic cytoplasm. Pigmented PEComa arising from kidney is extraordinarily rare and sometimes can exhibit aggressive biological behavior., Case Report: We present here a rare case of pigmented renal PEComa in a 46-year-old female. The patient had complained of lumbago complicated with nausea and vomiting for 2 weeks and therefore was referred to our department. An enhanced computed scan revealed a 4 × 3 × 3 cm round-like mass in the lower pole of right kidney with inhomogeneous enhancement. The tumor cells immunestained was positive for HMB-45, focally positive for c-Kit (CD117), and negative for vimentin, S-100, AE1/AE3, CK-7, CK-18, CD-10, RCC antigen, CgA, DOG-1, EMA, smooth muscle actin, and synaptophysin. We successfully performed 3-dimensional laparoscopic resection of the neoplasm, which was then diagnosed as pigmented PEComa by postoperative pathology. No further growing lesion or metastasis was observed during a 1-year follow-up., Conclusion: This case report shows that pigmented renal PEComa is often presented as a renal mass with nonspecific symptoms and imaging features. The gold diagnosis of renal pigmented PEComa is mainly based on the combination of histopathology and immunohistochemistry. Complete resection by 3-dimensional laparoscopic nephron-sparing surgery can be an effective therapeutic management.

Background and Objective: The gene betaine-homocysteine methyltransferase (BHMT) has drawn much attention during the past decades. An increasing number of clinical and genetic investigations have supposed that BHMT rs3733890 polymorphism might be associated with risk of breast cancer and ovarian cancer. As no consistent conclusion has been achieved, we conducted an up-to-date summary of BHMT rs3733890 polymorphism and cancer risk through a meta-analysis., Materials and Methods: The articles were collected from PubMed, Google Scholar, and CNKI (Chinese) databases up to December 2015. Then, the correlations were determined by reading the titles and abstracts and by further reading the full text to filter the unqualified articles. Odds ratio (OR) and the corresponding 95% confidence intervals (CI) were used to assess the results., Results: Among 187 articles collected in the analysis, seven studies with a total of 2,832 cases and 3,958 controls were included for evaluation of the association between BHMT rs3733890 polymorphism and susceptibility of cancer risk. The heterogeneity test showed no significant differences. Furthermore, we found that BHMT -742G>A polymorphism in case and control groups showed no statistically significant association with susceptibility in various cancer types except for uterine cervical cancer (A vs G: OR =0.641, 95% CI =0.445-0.923, P=0.017; AA+AG vs GG: OR =0.579, 95% CI =0.362-0.924, P=0.022). In addition, no statistically significant association was uncovered when stratification analyses were conducted by ethnicity and genotyping methods., Conclusion: Our results have shown no obvious evidence that rs3733890 polymorphism in BHMT gene affected the susceptibility of head and neck squamous cell carcinoma, breast cancer, ovarian cancer, colorectal adenoma, and liver cancer. In contrast, we found the protective role of BHMT -742G>A polymorphism in uterine cervical cancer incidence. Future well-designed studies comprising larger sample size are warranted to verify our findings.

Interleukin-8 (IL-8) is a kind of chemokine that plays an important role in the development and progression of many human malignancies. Previous studies have uncovered that polymorphisms in IL-8 is associated with the risk of many cancer types, but the results were inconsistent and inconclusive. In the present study, we aimed to explore the roles of IL-8 polymorphisms (rs2227307, rs2227306, +678T/C, rs1126647, and +1633C/T) and cancer risk through a systematic review and meta-analysis. Potential source of heterogeneity was sought out through sensitivity analysis. Desirable data were extracted and registered into databases. Finally, a total of ten publications comprising of 22 case-control studies, including 4,259 cases and 7,006 controls were ultimately eligible for the meta-analysis. No significant association was uncovered for all the five polymorphisms and the overall cancer risk. However, in the stratification analysis by cancer type, a significantly decreased risk of hepatocellular carcinoma was identified for rs2227306 polymorphism (T vs C: odds ratio [OR] =0.721, 95% confidence interval [CI] =0.567-0.916, Pz =0.007; TT vs CC: OR =0.447, 95% CI =0.274-0.728, Pz =0.001; TT vs TC + CC: OR =0.480, 95% CI =0.304-0.760, Pz =0.002). In conclusion, our data shows that rs2227306 polymorphism plays a protective role in hepatocellular carcinoma risk. Future well-designed studies with a larger sample size are warranted to verify our findings.

The aim of this case report was to evaluate the results of isthmusectomy and pyeloplasty of horseshoe kidney with the da Vinci robotic-assisted laparoscopy system.This case presented 1 patient with left back pain, associated with lower abdominal pain, and then she underwent the isthmusectomy and dismembered pyeloplasty using robotic-assisted laparoscopy simultaneously. The operation was performed by a transperitoneal approach using 5 ports.We cut the renal isthmus by means of bipolar scissors and then closed the renal parenchyma with 3-0 absorbed stitches. The total operation time was 123 min including simultaneous dismembered pyeloplasty. Blood loss was <50 mL. There were no complications either during or after the procedure. The oral nutrition and mobilization were included on the second day after surgery. The peritoneal drainage was removed on the eighth day. Long-term follow-up after treatment showed good results.The da Vinci robotic-assisted laparoscopy is an alternative to open surgery and laparoscopy, particularly in the correction of congenital defects of the urinary tract. Furthermore, the da Vinci robotic-assisted laparoscopy technique in isthmusectomy and pyeloplasty is safe for patient as shown by our results.

Primitive neuroectodermal tumor (PNET) is a malignant small round cell tumor and typically arises from bone or soft tissue in adolescents and young adults. Renal PNET is extraordinarily rare and exhibits highly aggressive biological behavior with poor prognosis.We present here a new case of renal PNET in a 31-year-old female. The patients were referred to our hospital because of left flank pain with nausea and vomiting for 1 week. A computed tomography scan revealed a 14.7 × 12.7 cm well-defined, unevenly mass lesion with both solid and cystic components and the tumor was not enhanced uniformly.A preoperative diagnosis of cystic renal cell carcinoma and urinary tract infection was made. The patient undergone anti-inflammatory therapy followed by a left radical nephrectomy. Taken with morphological pattern and immunohistochemical markers, a diagnosis of renal PNET was made. Two cycles of combined chemotherapy were executed. At the 14-month follow-up, no evidence of metastasis or recurrence was indicated.This case reminds clinicians that for adolescents and young adults with a suspicious renal mass, a diagnosis of renal PNET should be always considered. An initial surgery followed by radiotherapy and chemotherapy is suggested for the therapeutic management., Competing Interests: The authors have no conflicts of interest to disclose.

Recently, an increasing number of studies have suggested that mTOR plays a critical role in the regulation of tumor cell motility, invasion and cancer metastasis. However, little is known about the signaling mechanisms in regulating epithelial-mesenchymal transition (EMT) of prostate cancer. In this study, we found that the expression levels of Raptor and Rictor in prostate cancer tissues were elevated, which may suggest that Raptor and Rictor signaling pathways are associated with prostate cancer progression and metastasis. Inhibition of mTORC1 or mTORC2 by knock down of Raptor or Rictor, respectively, migration and invasion of prostate cancer were attenuated. Furthermore, EMT, a characterized by the changed expression levels of various markers like E-cadherin, β-catenin, N-cadherin, and vimentin emergend following inhibition of Raptor or Rictor. Finally, the small GTPases (RhoA and Rac1) which were crucial regulatory proteins in cell migration and invasion were inactivited after downregulating Raptor and Rictor. These results suggest that mTOR regulate EMT at least in part by down regulation of RhoA and Rac1 signaling pathways. Our findings provide novel very attractive target strategies that the inhibition of mTOR signaling pathways may retard prostate cancer migration and invasion at early stages., (© 2014 Wiley Periodicals, Inc.)

Purpose: We aimed to evaluate the effectiveness of flexible ureteroscope for treating kidney stones and the risk factors for infectious complications following flexible ureteroscope (FURS) with a holmium laser., Methods: We retrospectively reviewed the data of 227 patients with kidney stones who underwent flexible ureteroscope with a holmium laser at our hospital from January 2012 to September 2014, including gender, age, comorbidity, urine analysis results, urine culture results, blood test results, stone size, operative duration, and residual stones. Patients with and without infectious complications were assigned to groups A and B, respectively. The dependent variables were postoperative infectious complications, and the risk factors for infectious complications following FURS were assessed using Chi-square tests and multivariate logistic regression analyses., Results: All the surgeries were successfully completed. The total stone-free rate was 81.9% (n = 186), and the incidence of infectious complications after FURS was 8.37% (n = 19). Fifteen patients (6.61%) developed fever postoperatively, 10 patients (4.41%) developed systemic inflammatory response syndrome (SIRS), 6 patients with fever were considered to have SIRS (2.64%), and 2 patients had sepsis (0.88%). Univariate analyses of groups A and B indicated that pyuria, stone size, operative duration, and infectious stones were risk factors for infectious complications after FURS (P < 0.05). Multivariate logistic regression analyses indicated that pyuria (P = 0.017), operative duration (P = 0.026), and infectious stones (P = 0.030) were independently related to infectious complications., Conclusion: Pyuria, operative duration, and infectious stones were risk factors for infectious complications following FURS. Hence, routine urinalysis findings should be carefully considered, particularly the finding of pyuria.

Prostate cancer is the leading malignancy and the second most common cause of cancer-related death in men. Despite high cure rates with surgery and/or radiation, 30%-40% of patients eventually develop advanced cancer. Docetaxel is one of the most effective and well established chemotherapeutic agents for prostate cancer. However, docetaxel resistance often develops within months. Combination therapies have been proposed to improve the therapeutic efficacy of docetaxel in prostate cancer, and there is an urgent need to identify agents that are effective for treatment of the disease, especially docetaxel-resistant prostate cancer. In this work, we investigated the activity of GSK1838705A, a potent insulin-like growth factor-1 receptor (IGF1R)/insulin receptor (IR) inhibitor, in prostate cancer, especially docetaxel-resistant prostate cancer. We found that GSK1838705A could effectively reduce the viability of both docetaxel-sensitive and docetaxel-resistant prostate cancer cells. GSK1838705A induced marked apoptosis in docetaxel-resistant cells, and also dramatically inhibited migration of these cells. Further, GSK1838705A significantly inhibited phosphorylation of IGF1R/IR. Importantly, GSK1838705A significantly suppressed docetaxel-resistant PC-3R tumor growth in vivo. This is the first study of GSK1838705A in prostate cancer. Our results indicate that GSK1838705A is a promising compound for the treatment of prostate cancer, especially for those who develop resistance to docetaxel, and might shed new light on treatment for prostate cancer.

Objective: To investigate current status of diagnosis and treatment of bladder cancer in China., Methods: A database was generated by Chinese Bladder Cancer Consortium (CBCC). From January 2007 to December 2012, 14,260 cases from 44 CBCC centers were included. Data of diagnosis, treatment and pathology were collected., Results: The average age was 63.5 year-old and most patients were male (84.3%). The most common histologic types were urothelial carcinoma (91.4%), adenocarcinoma (1.8%), and squamous carcinoma (1.9%). According to 1973 and 2004 WHO grading system, 42.0%, 41.0%, and 17.0% of patients were grade 1, 2, and 3, and 16.0%, 48.7%, and 35.3% of patients were papillary urothelial neoplasms of low malignant potential, low, and high grade, respectively. Non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC) were 25.2% and 74.1%, respectively (0.8% not clear). Carcinoma in situ was only 2.4%. Most patients were diagnosed by white-light cystoscopy with biopsy (74.3%). Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%, respectively. Diagnostic transurethral resection (TUR) provided detection rate of 16.9%. Most NMIBCs were treated with TUR (89.2%). After initial TUR, 2.6% accepted second TUR, and 45.7%, 69.9%, and 58.7% accepted immediate, induced, and maintenance chemotherapy instillation, respectively. Most MIBCs were treated with radical cystectomy (RC, 59.7%). Laparoscopic RCs were 35.1%, while open RC 63.4%. Extended and standard pelvic lymph node dissection were 7% and 66%, respectively. Three most common urinary diversions were orthotopic neobladder (44%), ileal conduit (31%), and ureterocutaneostomy (23%). Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18% of T3 and T4 patients accepted adjuvant chemotherapy., Conclusion: Disease characteristics are similar to international reports, while differences of diagnosis and treatment exist. This study can provide evidences for revisions of the guideline on bladder cancer in China.

Objective: To evaluate the incidence of prostatitis-like symptoms (PLS) in men with or without PE, and the differences among the 438 outpatients with the four PE syndromes., Subjects and Methods: Between January 2012 and January 2013, 438 consecutive heterosexual men complaining of PE and another 493 male healthy subjects without the complaint were included in this study. Each of them completed a detailed face-to-face questionnaire for information of demographics, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Index of Erectile Function-5 (IIEF-5). Each patient was classified as one of the four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED)., Results: There were no significant difference between patients and control subjects regarding demographics. In the PE group, the prevalence of PLS were 32%, showing statistical significance compared with control subjects (15.8%, P<0.001). And the NIH-CPSI score was 10.0±7.9, showing significant difference compared with control subjects (6.0± 5.4, P<0.001). Among the four PE syndromes, patients with PLED had the highest prevalence of PLS (42.3%, P<0.001), but the difference of NIH-CPSI scores among the four PE syndromes was not significant (P=0.055)., Conclusions: PLS were more common in patients with PE. Also, patients had worse NIH-CPSI scores than the control subjects. Therefore, patients with PLED had the highest incidence of PLS.

There have been a troublesome problem to treat with obliterative urethral strictures, the challenge is how to reduce wound of surgery and improve therapeutic success rates. In this study, we reported single-hospital institution case-series including 97 patients with obliterative urethral strictures were enrolled with "three lines lie within one imaginary plane (TLLWOIP)" to treat with patients with the obliterative urethral strictures. Perioperative variables and success rates were evaluated. Urinary flow rate, residual urine (RU) volume and quality-of-life score (QoLs) of patients were analyzed. In the obliterative urethral strictures, postoperative maximum urinary flow rate was 24.36 ± 10.69 ml, and postoperative RU volume and QoLs outcomes were significantly lower than preoperative outcomes with TLLWOIP. A total of success rate was 62.9% with TLLWOIP. Our results suggested that it was ideal candidates for initial treatment with TLLWOIP for the obliterative urethral strictures.

Objective: To investigate the prevalence of sexual dysfunction in chronic prostatitis patients and its relation with patients' age and the course of disease., Methods: Questionnaire surveys were completed by 2 000 subjects who met the criteria for chronic prostatitis after clinical examination and expressed prostatic secretion analysis. Included in the questionnaire were: (1) age, height, weight, occupation, course of disease and treatment received; (2) NIH-CPSI; and (3) IIEF-5., Results: The prevalence of sexual dysfunction in patients with chronic prostatitis was 49.0% : 26.2% of the subjects with premature ejaculation, 15.0% with erectile dysfunction and 7.7% with both premature ejaculation and erectile dysfunction., Conclusion: The prevalence of sexual dysfunction in patients with chronic prostatitis is high, which is negatively correlated with both the age of the patients (P < 0.001) and the course of the disease (P < 0.001).