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Purpose:Cancer stem-like cells (CSCs) contribute to bladder cancer chemotherapy resistance and progression, but the associated mechanisms have not been elucidated. This study determined whether blocking an autocrine signaling loop in CSCs improves the therapeutic effects of cis-platinum on bladder cancer.Experimental Design:The expression of the epithelial marker OV6 and other markers in human bladder cancer specimens was examined by IHC. The CSC properties of magnetic-activated cell sorting (MACS)-isolated OV6+ and OV6− bladder cancer cells were examined. Molecular mechanisms were assessed through RNA-Seq, cytokine antibody arrays, co-immunoprecipitation (co-IP), chromatin immunoprecipitation (ChIP) and other assays. An orthotopic bladder cancer mouse model was established to evaluate the in vivo effects of a YAP inhibitor (verteporfin) and a PDGFR inhibitor (CP-673451) on the cis-platinum resistance of OV6+ CSCs in bladder cancer.Results:Upregulated OV6 expression positively associated with disease progression and poor prognosis for bladder cancer patients. Compared with OV6− cells, OV6+ bladder cancer cells exhibited strong CSC characteristics, including self-renewal, tumor initiation in NOD/SCID mice, and chemotherapy resistance. YAP, which maintains the stemness of OV6+ CSCs, triggered PDGFB transcription by recruiting TEAD1. Autocrine PDGF-BB signaling through its receptor PDGFR stabilized YAP and facilitated YAP nuclear translocation. Furthermore, blocking the YAP/TEAD1/PDGF-BB/PDGFR loop with verteporfin or CP-673451 inhibited the cis-platinum resistance of OV6+ bladder cancer CSCs in an orthotopic bladder cancer model.Conclusions:OV6 could be a helpful indicator of disease progression and prognosis for patients with bladder cancer, and targeting the autocrine YAP/TEAD1/PDGF-BB/PDGFR loop might serve as a remedy for cis-platinum resistance in patients with advanced bladder cancer.

Supplementary Figures and Figure Legends

The beet webworm, Loxostege sticticalis (Linnaeus) (Lepidoptera: Crambidae), is a destructive pest inhabiting the northern temperate zone. In Xinjiang, China, this species has only occasionally infested certain areas, but has been causing severe damage since 2005. Early studies showed that most of the outbreak populations in northern Xinjiang are immigrant populations. However, the specific source area is still unknown. In this study, we determined the source area of the immigrant population of L. sticticalis in northern Xinjiang from 2010 to 2013 using daily monitoring data of L. sticticalis adults; we explained the causation of why an overwintering area of L. sticticalis could build up in Central Asia. Results showed that the direct source area of L. sticticalis in northern Xinjiang was eastern Kazakhstan, and the initial source area could be traced further to Altai Krai, Russia. Both regions were located at the foothills of the westernmost portion of Altai Mountains. The thermal conditions in these regions could not support L. sticticalis development for two generations before 1990. Hence, a few cocoons could be formed in the autumn. Influenced by global warming, L. sticticalis in these regions could complete two whole generations most years after 2001. The increased generation number, combined with sufficient precipitation, and mountainous terrain in the westernmost portion of Altai Mountains have created an overwintering area for L. sticticalis.

Purpose: Urothelial carcinoma is a malignant cancer with frequent chromosomal aberrations. Here, we investigated the application of a cost-effective, low-coverage whole-genome sequencing technology in detecting all chromosomal aberrations. Experimental Design: Patients with urothelial carcinomas and nontumor controls were prospectively recruited in clinical trial NCT03998371. Urine-exfoliated cell DNA was analyzed by Illumina HiSeq XTen, followed by genotyping with a customized bioinformatics workflow named Urine Exfoliated Cells Copy Number Aberration Detector (UroCAD). Results: In the discovery phase, urine samples from 126 patients with urothelial carcinomas and 64 nontumor disease samples were analyzed. Frequent chromosome copy-number changes were found in patients with tumor as compared with nontumor controls. A novel diagnosis model, UroCAD, was built by incorporating all the autosomal chromosomal changes. The model reached performance of AUC = 0.92 (95% confidence interval, 89.4%–97.3%). At the optimal cutoff, |Z| ≥ 3.21, the sensitivity, specificity, and accuracy were 82.5%, 96.9%, and 89.0%, respectively. The prediction positivity was found correlated with tumor grade (P = 0.01). In the external validation cohort of 95 participants, the UroCAD assay identified urothelial carcinomas with an overall sensitivity of 80.4%, specificity of 94.9%, and AUC of 0.91. Meanwhile, UroCAD assay outperformed cytology tests with significantly improved sensitivity (80.4% vs. 33.9%; P < 0.001) and comparable specificity (94.9% vs. 100%; P = 0.49). Conclusions: UroCAD could be a robust urothelial carcinoma diagnostic method with improved sensitivity and similar specificity as compared with cytology tests. It may be used as a noninvasive approach for diagnosis and recurrence surveillance in urothelial carcinoma prior to the use of cystoscopy, which would largely reduce the burden on patients.

OBJECTIVE To describe a novel technique of laparoscopic partial nephrectomy (LPN) with direct lateral access (DLA) to renal artery and to report our early outcomes with this technique. MATERIALS AND METHODS A retrospective review of 135 cases of transperitoneal LPN done by a single surgeon at our tertiary care institution from August 2014 to December 2016 was performed. Standard LPN (n = 73) or DLA-LPN (n = 62) was performed. Relevant clinical data were recorded including baseline patient and tumor characteristics, and surgical outcomes (operative time, artery mobilization time, warm ischemia time, estimated blood loss, complications, and so on). A comparative analysis between standard LPN cases and DLA-LPN was performed. RESULTS The use of DLA technique had shorter operative time (P

A cholesteryloxyallene (1) bearing chiral cholesteryl pendant group was designed and synthesized. Living polymerization of this monomer with an allylnickel complex as a catalyst give poly(cholesteryloxyallene)s (poly-1ms) in high yields with controllable molecular weights and narrow molecular weight distributions. These polymers were found to possess a dynamic helical conformation with a preferred handedness in n-hexane as confirmed by circular dichroism and absorption spectra as well as optical ratios. The helical conformation of the polymers was revealed to stabilize as the number of repeat units increased until the degree of polymerization reached 100. The helical conformation of poly-1100 could be controlled by altering the temperature of solutions. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 2227–2233

We herein report a “grafting from” strategy to immobilize optically active helical poly(phenyl isocyanide)s onto graphene oxide (GO) nanosheets. After covalently bounding alkyne-Pd(II) initiator onto GO nanosheets, the designed GO/polymer composites P1@GO and P1-b-P2@GO featuring single-handed helical poly(phenyl isocyanide)s growing from GO nanosheets were prepared by sequential addition of the chiral and achiral isocyanide monomers. Post-synthetic hydrolysis rendered P1-b-P3@GO to improve the hydrophilicity. The successful covalent bonding of poly(phenyl isocyanide)s chains onto GO nanosheets was certified by several cross evidences including scan emission microscopy, atomic force microscopy, Raman spectroscopy, X-ray photoelectron spectroscopy, and thermogravimetric analysis. Circular dichroism spectra proved that the chiral information was introduced through the grafted single-handed helical polymer chains successfully. In addition, the resulting GO/polymer composites were explored as a chiral additive to induce enantioselective crystallization of racemic organic molecules. Preferential formation of rod-like L-alanine crystals was induced by composites bearing right-handed helical poly(phenyl isocyanide)s. The enantiomeric excess value of the induced crystals reached 76%, displaying the potential in future applications. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 2092–2103

CeO2 desulfurization sorbent was prepared by calcination of Ce(NO3)3 ● 6H2O and the effect of regeneration conditions on its properties in SO2 atmosphere was investigated in a fixed bed reactor. The regeneration conversion and the yield of elemental sulfur for CeO2 desulfurization sorbent were tested and calculated. And the composition and the morphology of CeO2 desulfurization sorbent before and after regeneration were obtained by X-ray diffraction and scanning electron microscope. It was found that the main components of the regeneration products of Ce2O desulfurization sorbent were solid CeO2 and gaseous elemental S in SO2 atmosphere. The optimum regeneration condition of CeO2 desulfurization sorbent is that the regeneration temperature of 750 °C and the SO2 concentration of 4.25 %, under which the CeO2 desulfurization sorbent shows the higher regeneration conversion of 96 % and the yield of elemental sulfur of 68.95 wt. %.

Introduction Therapeutic strategies targeting Alzheimer's disease-related molecule β- amyloid (Aβ), Tau protein and β-site amyloid precursor protein cleaving enzyme (BACE) have been recently explored. However, the treatment effect for single target is not ideal. Based on multiaspect roles of Rho kinase inhibitor Fasudil on neuroprotection, neurorepair and immunomodulation, we observed therapeutic potential of Fasudil and explored possible mechanisms in amyloid precursor protein/ presenilin-1 transgenic (APP/PS1 Tg) mice, an animal model of Alzheimer's disease. Methods APP/PS1 Tg mice were treated with Fasudil (25 mg/kg/day) for 2 months by intraperitoneal injection. Mouse behavior tests were recorded every day. The expression of Aβ deposition, Tau protein phosphorylation, BACE and postsynaptic density 95 (PSD-95) in hippocampus was assayed. The levels in the brain of Toll-like receptors (TLRs)-nuclear factor kappa B/p65（NF-κB/p65)- myeloid differentiation primary response gene 88 (MyD88) inflammatory cytokine axis were measured. Results Fasudil treatment ameliorated learning and memory deficits, accompanied by reduced Aβ deposition, Tau protein phosphorylation, and BACE expression, as well as increased PSD-95 expression in hippocampus. Fasudil intervention also inhibited TLR-2/4, p-NF-κB/p65, MyD88, interleukin-1beta, interleukin-6 and tumor necrosis factor-α for TLRs-NF-κB-MyD88 inflammatory cytokine axis and the induction of interleukin-10. Conclusion Fasudil exhibited multitarget therapeutic effect in APP/PS1 Tg mice. The study provides preclinical evidence that Fasudil treatment ameliorated memory deficits in APP/PS1 Tg mice, accompanied by the reduction of Aβ deposition and Tau protein phosphorylation, the decrease of BACE and the increase of PSD-95, as well as inhibition of TLRs-NF-κB-MyD88 inflammatory cytokine axis. However, these results still need to be repeated and confirmed before clinical application.

Objective To create multivariable models with readily available clinicopathologic variables for predicting the prognosis of upper tract urothelial carcinomas (UTUC). Patients and methods We retrospectively analyzed patients diagnosed as UTUC and underwent radical nephroureterectomy in 2 high volumes, tertiary care centers. A total of 445 patients and 227 patients met the inclusion criteria were included for constructing the prediction model and external validation, respectively. Univariable and multivariable Cox regression models were used to analyze independent risk factors, and nomogram and calibration curve were constructed by R project. Results The median follow-up for the development and external validation cohorts were 33.5 and 32.5 months, respectively. Multivariable analysis detected older age (≥65 years), with concurrent bladder cancer at diagnosis, with both ureter and renal pelvic tumor, lymphovascular invasion, urothelial carcinoma with divergent differentiation, higher pathological grade and stage, and positive lymph node were significantly associated with poorer outcome of UTUC. The c-index of the nomogram with these above-mentioned independent risk factors to predict the cancer specific survival was 0.74 (95% CI, 0.64–0.84) and 0.73 (95%CI, 0.59–0.87) for the development cohort and external validation cohort, respectively. Conclusions We developed and externally validated a novel and accurate nomogram with readily available clinicopathological information for predicting the cancer specific survival of UTUC. This nomogram could help clinicians stratify patients with UTUC into different risk groups with distinct prognosis by the total scores obtained from the prediction tool, thus facilitate decision-making and clinical trial designing.

The influences of the regeneration temperature and SO2volume fraction on regeneration kinetics behavior of Fe2O3 sorbent as a high-temperature desulfurization sorbent were researched by TGA (Thermos gravimetric analyzer) in this work. The main regeneration product of iron oxide desulfurization sorbent was Fe2O3 and sulfur in SO2 atmosphere which has an important practical significance for pollution control of H2Sandrecycleofsulfur. The results indicate that Fe2O3 desulfurization sorbent was completely regenerated at temperature of 725-775 °C and the higher regeneration temperature and volume fraction of SO2 is benefit to improve regeneration reaction rate. The regeneration reaction of Fe2O3 sorbent in SO2atmosphere can be first order reaction obtained by the equivalent grain model, and the controlling process of regeneration reaction is change from the chemical reaction control to the diffusion control in the whole regeneration process. The chemical reaction apparent activation energy and the corresponding frequency factor of chemical reaction are 145.31 kJ/mol and 0.0063 m/s, respectively. And that of diffusion are 50.73 kJ/mol and 4.38×10-3 m2/s, respectively.

The regeneration behavior of manganese oxide sorbent under O2atmosphere was investigated in a fixed bed micro-reactor under the influence of different temperatures and O2 concentrations. The change in phase of the sulfided and the regenerated sorbents was analyzed by X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) techniques. MnS, Mn3O4 and MnSO4 were found in regenerated sorbent at 400 °C, which indicated that the regeneration of the sulfided sorbent was not complete, however, MnS was converted to Mn3O4, Mn2O3 and few MnSO4 at 800 °C. The manganese sulfate formed during the regeneration but decomposed to Mn2O3 at 800 °C. MnS reacts with O2 to form Mn3O4 and MnSO4, and then MnSO4 was decomposed at 800 °C. The results show that the optimum regeneration temperature and O2 concentration obtained from this experiment are 800 °C and 2.2 vol %, respectively, and the regeneration conversion ratio was about 95%.

The effects of temperature and concentration of sulfur dioxide on regeneration behavior of manganese oxide sorbent were studied in a fixed-bed reactor. The sorbents were characterized by X-ray diffraction and X-ray photoelectron spectroscopy. Subsequently, the regeneration mechanism was inferred and the yield of export elemental sulfur was calculated. The study shows that, the major regeneration products are Mn3O4, MnSO4 and a small amount of elemental sulfur under SO2 atmosphere.The sulfate can be converted to Mn3O4and Mn2O3 at 800 °C under N2 atmosphere. The elemental sulfur productivity increases with the increase of temperature and concentration of sulfur dioxide.The regeneration conversion attains maximum value (68%) at 800 °C under the atmosphere of 1.68% SO2, and the productivity of elemental sulfur reaches to maximum value (29%) under the conditions.

Facile synthesis of hybrid block copolymers containing two segments that cannot be synthesized under the same polymerization mechanism still remains a great challenge in the field of polymer synthesis. Here we report on one-pot synthesis of hybrid block copolymers containing conjugated poly(phenyleneethylene) (PPE) and stereoregular poly(phenyl isocyanide) (PPI) using palladium(II) complex as a single catalyst. Although the two blocks were polymerized via distinct polymerization mechanism, the block copolymerization were revealed to proceed in a living/controlled chain-growth manner, afforded PPE-b-PPI block copolymers in high yields with controlled molecular weights, narrow molecular weight distributions, and tunable compositions. By using this synthetic method, amphiphilic PPE-b-PPI block copolymers containing hydrophobic PPE and hydrophilic PPI segments were facilely prepared. Such block copolymer can self-assembly into well-defined supramolecular structure in selective solvents. In addition, the one-p...

Summary: Objective: To evaluate the possibility and efficiency of a modified margin strategy in laparoscopic partial nephrectomy with selective renal artery clamping. Methods: Seventy-six cases of laparoscopic partial nephrectomy with segmental renal artery clamping in Shanghai Changhai Hospital between July 2014 and September 2017 were retrospectively reviewed. Relevant clinical data were recorded including baseline patient and tumor characteristics, and surgical outcomes (segmental artery mobilization time, operating time, warm ischemic time, estimated blood loss, complications, and so on). A comparative analysis between standard technique and margin strategy was performed. Results: In 38 cases, margin strategy to mobilize segmental artery was successfully performed. In the other 38 cases, the surgery was performed in traditional method. The use of new strategy led to a shortened segmental artery mobilization time (5 min vs 12 min, p

Purpose: Cancer stem-like cells (CSCs) contribute to bladder cancer chemotherapy resistance and progression, but the associated mechanisms have not been elucidated. This study determined whether blocking an autocrine signaling loop in CSCs improves the therapeutic effects of cis-platinum on bladder cancer. Experimental Design: The expression of the epithelial marker OV6 and other markers in human bladder cancer specimens was examined by IHC. The CSC properties of magnetic-activated cell sorting (MACS)-isolated OV6+ and OV6− bladder cancer cells were examined. Molecular mechanisms were assessed through RNA-Seq, cytokine antibody arrays, co-immunoprecipitation (co-IP), chromatin immunoprecipitation (ChIP) and other assays. An orthotopic bladder cancer mouse model was established to evaluate the in vivo effects of a YAP inhibitor (verteporfin) and a PDGFR inhibitor (CP-673451) on the cis-platinum resistance of OV6+ CSCs in bladder cancer. Results: Upregulated OV6 expression positively associated with disease progression and poor prognosis for bladder cancer patients. Compared with OV6− cells, OV6+ bladder cancer cells exhibited strong CSC characteristics, including self-renewal, tumor initiation in NOD/SCID mice, and chemotherapy resistance. YAP, which maintains the stemness of OV6+ CSCs, triggered PDGFB transcription by recruiting TEAD1. Autocrine PDGF-BB signaling through its receptor PDGFR stabilized YAP and facilitated YAP nuclear translocation. Furthermore, blocking the YAP/TEAD1/PDGF-BB/PDGFR loop with verteporfin or CP-673451 inhibited the cis-platinum resistance of OV6+ bladder cancer CSCs in an orthotopic bladder cancer model. Conclusions: OV6 could be a helpful indicator of disease progression and prognosis for patients with bladder cancer, and targeting the autocrine YAP/TEAD1/PDGF-BB/PDGFR loop might serve as a remedy for cis-platinum resistance in patients with advanced bladder cancer.

Translumenal access site closure remains a major challenge in natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]). We assessed the feasibility and safety of using reserved threads to close the bladder perforation during NOTES and analyzed this novel technique in a live porcine model.Five female pigs were used in this study. With the animal under general anesthesia, a self-made trocar was inserted into the bladder. Under ureteroscopic guidance, the anterior bladder wall was punctured by a needle into the abdominal wall, and two reserved lines were placed. The bladder perforation was closed with the reserved lines. Procedure time and effectiveness of the closure were recorded and evaluated.We completed a total of 5 cases of animal experiments. The first case failed because the weight and size of the animal were too large. The remaining 4 cases were successful. The procedure times were 45, 30, 25, and 25 minutes, respectively. The perforations were closed completely.The novel method of using reserved thread to close the bladder perforation was safe and effective. Further large-scale survival studies are needed to prove its clinical potential.

In this study, we investigated the essential criteria for late-onset hypogonadism (LOH) syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone (TT) and sex hormone-binding globulin (SHBG) were performed, and the aging male symptoms (AMS) questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms (decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido) were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l-1 for a decreased ability/frequency to perform sex, 12.55 nmol l-1 for decreased frequency of morning erections, and 14.35 nmol l-1 for decreased sexual desire. The calculated free testosterone (CFT) thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l-1 , respectively. TT

Background This work explores the clinical significance of a laser-guided docking system for robot-assisted urologic surgery. Materials and Methods Between July 2013 and June 2014, 40 patients underwent robot-assisted laparoscopic prostatectomy (RALP), and 32 patients underwent robot-assisted laparoscopic partial nephrectomy (RAPN) performed by a single surgeon. In the RALP and RAPN groups, the robot was docked in the traditional way in 20 and 16 cases, respectively. A laser guiding system was used in the other cases. The docking time and the time required to adjust the angles were recorded. Result The docking time was significantly shorter for the laser-guided process performed by inexperienced nurses. The time required to adjust the angles was also lower. There were no significant differences between the processes performed by experienced nurses. Conclusion A laser-guided docking system may simplify and standardize the docking process and shorten the learning curve. Copyright © 2015 John Wiley & Sons, Ltd.

Background Long non-coding RNA (LncRNA) PCA3 has been a well-established urine biomarker for the detection of prostate cancer (PCa). Our previous study showed a novel LncRNA FR0348383 is up-regulated in over 70% of PCa compared with matched benign tissues. The aim of this study was to evaluate the diagnostic value of urinary FR0348383 for men undergoing prostate biopsy due to elevated PSA (PSA > 4.0 ng/ml) and/or abnormal digital rectal examination (DRE). Methods Post-DRE first-catch urine specimens prior to prostate biopsies were prospectively collected. After the whole transcriptome amplification, quantitative real time polymerase chain reaction was applied to quantify urine FR0348383 and PSA levels. The FR0348383 score was calculated as the ratio of PSA and FR0348383 mRNA (PSA mRNA/FR0348383 mRNA × 1000). The diagnostic value of FR0348383 score was evaluated by logistic regression and decision curve analysis. Results 213 cases with urine samples containing sufficient mRNA were included, 94 cases had serum PSA level 4.0–10.0 ng/ml. PCa was identified in 72 cases. An increasing FR0348383 score was correlated with an increasing probability of a positive biopsy (P

To evaluate the safety and efficacy of retrograde placement of single-J stent guided by a flexible cystoscope for management of ureteroenteral anastomotic stricture in patients after radical cystectomy and Bricker urinary diversion.Between January 2008 and June 2012, 11 patients with ureteroenteral anastomotic stricture after open radical cystectomy and Bricker urinary diversion were enrolled in this study. All patients were treated with retrograde placement of single-J stent guided by a flexible cystoscope. A 7F single-J stent was placed for 6 weeks.Of the 11 patients, seven strictures occurred on the left side, two on the right side, and two on both sides. The retrograde procedure was successfully performed in 10 cases, and the remaining 1 was successful on the right side but failed on the left side. Upper urinary tract infection was well controlled in all three patients with fever. After a follow-up of 12 to 66 months, eight patients had long-term symptom relief, one patient had open surgery to remove the stricture and re-implant the ureter, and one patient died because of tumor recurrence. The only failed case was that of a left side percutaneous nephrostomy, but the patient was lost to follow-up.Retrograde placement of a single-J ureteral stent guided by a flexible cystoscope is safe and effective for ureteroenteral anastomotic stricture in patients with Bricker urinary diversion, and it brings fewer complications. The procedure is minimally invasive and could avoid immediate surgery for most patients.

A new tetrahydrofuran-type lignan, episesaminone (1), was isolated from Asarum heterotropoides Fr. Schmidt var. mandshuricum (Maxim.) Kitag. Its structure was established by spectroscopic techniques (HR-MS, 1D NMR, 2D NMR, and circular dichroism). The anti-inflammatory activity in RAW 264.7 macrophages was carried out on 1 and other eight known compounds, the epimer of 1 (2) and seven known furofurans-type lignan (3-9) obtained from A. heterotropoides Fr. Schmidt var. mandshuricum. Compounds 1, 2, 3, 4, 5, 7, and 9 showed significant anti-inflammatory activity, particularly 50 μM compound 3 inhibited 69.2% NO production compared with the lipopolysaccharide group.

Objective Fibroepithelial polyps of ureter prolapsing into the bladder are a rare urological condition. We report the imaging findings and our experience with endoscopic treatment for ureteral fibroepithelial polyps prolapsing into the bladder. Patients and results Four patients with frank pain and hematuria were enrolled. Intravenous urography and computed tomography revealed a ureteral mass with filling defects in affected ureter and mild hydronephrosis. Endoscopic examination showed ureteral polyps prolapsing in the bladder. The histopathologic diagnosis on 4 cases was benign fibroepithelial polyps of ureter. The largest polyps (from 4-10 cm in length) were successfully resected and vaporized by Holmium: YAG laser. A double-pigtail ureteral stent at 7F was placed and left for 6 weeks after the procedure. Neither recurrence nor ureter stricture was observed after up to 12 years of follow-up. Conclusions Ureteral malignancy must be excluded in cases where a ureteral mass is detected. Endoscopic management is recommended to minimize morbidity and complications in treatment of ureteral fibroepithelial polyps that prolapse into the bladder.

OBJECTIVES Complete haemostasis of the dorsal venous complex (DVC) is of great importance in robot-assisted radical prostatectomy. In this study, we investigated the efficacy of blunt-tip needles in the surgery. METHODS Cases of robot-assisted laparoscopic radical prostatectomy were reviewed. If a blunt-tip needle had been used to suture the DVC, the patient was recruited to the blunt-tip group. If a regular needle was used, the patient was recruited to the control group. Patient characteristics and perioperative outcomes were recorded. RESULTS One hundred and nine cases were reviewed. A blunt-tip needle was used to suture the DVC in 67 cases, and a regular needle in 42 cases. All characteristics of the two groups are comparable (p > 0.05). In 66 cases in the blunt-tip group, no sutures or coagulations were needed when suturing the DVC, Five cases of DVC-related bleeding were observed in the control group, which is higher than in the blunt-tip group (p = 0.031). At the same time, no catheter was sutured in the blunt-tip group. All patients were followed for at least six months. The continence rate in the blunt-tip group is 89.6%, significantly higher than in the control group (73.8%, p = 0.031). CONCLUSIONS Using a blunt-tip needle to suture the DVC may reduce DVC-related bleeding and provide a better surgical field. It may be helpful in improving postoperative continence. However, its effect on positive margin at the apex still needs further investigation.

To evaluate the feasibility of Hem-o-lok clips tied with threads to improve surgical view in retroperitoneal laparoscopic surgery for renal cell carcinoma.Laparoscopic radical and partial nephrectomies performed by a single surgeon from May 2013 to April 2015 were reviewed. If Hem-o-lok clips tied with threads were applied to improve surgical view, the patient was recruited to the Hem-o-lok group. The other patients were recruited to the control group. Patient information, time of exposure procedure, number of clips used, number of trocars, exposure satisfaction, operation time, estimated blood loss, and perioperative complications were recorded.Sixty-eight laparoscopic radical/partial nephrectomies were performed by a single surgeon. For 31 cases, Hem-o-lok clips were tied with threads to improve surgical view. For the other 37 cases, no Hem-o-lok clips were used. All cases were successfully performed. It took 30 to 178 seconds to finish the exposure procedure. In the Hem-o-lok group, less trocar usage, shorter operation time, and better exposure satisfaction were observed than control group (P .05).This new technique is feasible and easy to improve surgical view in retroperitoneal laparoscopic surgery for renal cell carcinoma. This technique may be helpful to shorten operation time and avoid the use of the fourth trocar in certain cases. Large scale randomized controlled studies are needed to further prove its efficiency.

Background Single-port laparoscopy (SPL) requires specialized skills; however, there are currently no specialized training courses for SPL. The aim of this study is to present an effective specialized training course of basic skills for SPL. Methods We designed a specialized training course for single-port laparoscopic basic skills. The study included 10 male urology residents. The trainees practiced the traditional training course for laparoscopy basic skills for 5 days. Basic skills were assessed on day 6 and a self-efficacy confidence index was measured. On day 7, all trainees performed a traditional laparoscopic nephrectomy and single-port laparoscopic nephrectomy. The participants were then randomized into 2 groups: 5 trainees performed the specialized training course and the other 5 trainees continued to practice the traditional training course. Both groups were trained for 5 days. After completion, the trainees were tested on completing a porcine single-port laparoscopic nephrectomy. Operative performance was measured by 2 experts who were blinded to which training the student had received, using an altered global rating. In addition, participants completed a general self-efficacy instrument after performing surgeries. Results The overall operative performance score for single-port laparoscopic surgery was significantly better in the specialized training group. A significant difference in confidence index was seen between the traditional laparoscopy training and specialized single-port training groups (18.40 ± 2.70 vs 29.4 ± 3.51, respectively; P = .001.). Four relative instrument locations which avoided the problem of crowding were also noted in the specialized training group. Conclusion The specialized training course is effective for developing SPL skills.

Cyanoethyl cellulose (CEC) with high degree of substitution and uniform distribution was synthesized by solvent method. The choice of solvent, control of base volume, feeding methods and other factors were optimized , toluene/isopropanol (85/15) is the best solvent . Using FT-IR, elemental analysis, TG, DMA, X-ray and other means, we compared the structure, degree of substitution, the crystallinity, thermal stability, dynamic mechanical properties, dielectric properties and acid and alkali resistance between the CECs by solvent method and traditional method. The CEC products by solvent method showed lower crystallinity due to its more uniform distribution, better thermal stable, similar high dielectric with a lower DS , and higher Tg and better resistance to the acid and/or alkaline than CEC by traditional method.Those findings demonstrated solvent method was a new facile and industrial method to synthesize high substituted and uniform distributed cyanoethyl celluloses with good performances.

Ursolic acid (UA), a pentacyclic triterpenoid compound, has been demonstrated to have an antiproliferative effect in various tumors. We investigated the cell killing effects of UA in the human hormone refractory prostate cancer cell line, PC-3 cells. Also, the molecular mechanisms underlying its antigrowth effect were explored. We found that UA treatment in vitro can effectively inhibit PC-3 cell viability in a dose-dependent manner by inducing apoptosis, demonstrated by annexin V-FITC/propidium iodide staining. Both extrinsic and intrinsic apoptotic pathways appear to be triggered by UA treatment, because inhibiting activation of both caspase-8 and -9 could prevent UA-induced apoptosis in PC-3 cells. The c-Jun N-terminal kinase (JNK) was found to be activated, followed by Bcl-2 phosphorylation and activation of caspase-9. On the other hand, UA inhibited the Akt pathway, subsequently upregulating the expression of Fas ligand (FasL), which initiates death receptor-mediated apoptosis in PC-3 cells. Importantly, experimentally lowering FasL expression by siRNA significantly inhibited UA-induced caspase-8 activation and at least partly attenuated the consequent apoptosis, suggesting an involvement of FasL and its regulating pathway in the cell killing effect of UA. UA also inhibited cell invasion by downregulating matrix metalloproteinase-9 via inhibition of Akt in PC-3 cells. Although further evaluation of the UA effects in vivo is needed, the present results suggest the potential utility of UA as a novel therapeutic agent in advanced prostate cancer.

The purpose of this study was to create a simple model for teaching laparoscopic partial nephrectomy (LPN) for duplicating the blood supply setting and main technical points of the procedure.A fresh porcine kidney was placed on an unfolded metallic box to help trainees observe, practice, and develop LPN skills in both tumor incision and suturing. The metallic box was specially designed not only for fixing and positioning the kidney but also for storing the outflow of the kidney while its artery was kept artificially infused. A spherical renal parenchyma excision about 2 cm in diameter was initially made and the suture-repairing work followed. This model was used by trainees who had fair laparoscopic competency after completing dry laboratory training programs. During a 20-day training period the trainees were assessed with respect to the time needed to complete LPN. A mentor-trainee fellowship program was planned to guarantee the success of the operations and the quality of LPN.There was a good reduction in the total operative time from the fourth to the last attempt. There was also increasing improvement in the quality of the incision suturing during the attempts. By the end of 10 attempts all trainees were more confident in completing a good quality LPN in a mean time of 28.4 minutes.This model not only offers trainees the opportunities to acquire the skills necessary for LPN but also provides for more economical practice by using easily available porcine kidney.

There is currently no successful therapy for androgen-independent prostate cancer. Ursolic acid (UA), a pentacyclic triterpenoid compound, has been shown to have an anti-proliferative effect on various tumors. We investigated the effect of UA on cell viability in the human hormone-refractory prostate cancer cell line DU145, as well as the molecular mechanisms underlying its growth inhibiting effect. We demonstrated that UA induces apoptosis and the activation of caspase-3 in DU145 cells. UA also causes the activation of c-Jun N-terminal kinase (JNK), but has no effect on extracellular signal-regulated protein kinases (ERK1/2) and p38 MAP kinases (p38). UA-induced JNK activation could result in Bcl-2 phosphorylation (Ser70) and degradation in DU145 cells, which may be one of the molecular mechanisms by which it induces apoptosis. Although further evaluation, such as in vivo testing, is clearly needed, the present results suggest the potential utility of UA as a novel therapeutic agent in advanced prostate cancer.

This work explores the clinical significance of a laser-guided docking system for robot-assisted urologic surgery.Between July 2013 and June 2014, 40 patients underwent robot-assisted laparoscopic prostatectomy (RALP), and 32 patients underwent robot-assisted laparoscopic partial nephrectomy (RAPN) performed by a single surgeon. In the RALP and RAPN groups, the robot was docked in the traditional way in 20 and 16 cases, respectively. A laser guiding system was used in the other cases. The docking time and the time required to adjust the angles were recorded.The docking time was significantly shorter for the laser-guided process performed by inexperienced nurses. The time required to adjust the angles was also lower. There were no significant differences between the processes performed by experienced nurses.A laser-guided docking system may simplify and standardize the docking process and shorten the learning curve. Copyright © 2015 John WileySons, Ltd.

Long non-coding RNA (LncRNA) PCA3 has been a well-established urine biomarker for the detection of prostate cancer (PCa). Our previous study showed a novel LncRNA FR0348383 is up-regulated in over 70% of PCa compared with matched benign tissues. The aim of this study was to evaluate the diagnostic value of urinary FR0348383 for men undergoing prostate biopsy due to elevated PSA (PSA 4.0 ng/ml) and/or abnormal digital rectal examination (DRE).Post-DRE first-catch urine specimens prior to prostate biopsies were prospectively collected. After the whole transcriptome amplification, quantitative real time polymerase chain reaction was applied to quantify urine FR0348383 and PSA levels. The FR0348383 score was calculated as the ratio of PSA and FR0348383 mRNA (PSA mRNA/FR0348383 mRNA × 1000). The diagnostic value of FR0348383 score was evaluated by logistic regression and decision curve analysis.213 cases with urine samples containing sufficient mRNA were included, 94 cases had serum PSA level 4.0-10.0 ng/ml. PCa was identified in 72 cases. An increasing FR0348383 score was correlated with an increasing probability of a positive biopsy (P 0.001). Multivariable logistic analysis indicated FR0348383 score (P 0.001), PSA (P = 0.004), age (P = 0.007), prostate volume (P 0.001) were independent predictors of PCa. ROC analysis demonstrated FR0348383 score outperformed PSA, %free PSA, and PSA Density in the prediction of PCa in the subgroup of patients with grey area PSA (AUC: 0.815 vs. 0.562 vs. 0.599 vs. 0.645). When using a probability threshold of 30% in the grey zone cohort, The FR0348383 score would save 52.0% of avoidable biopsies without missing any high grade cancers.FR0348383 transcript in post-DRE urine may be a novel biomarker for detection of PCa with great diagnostic value, especially in the grey zone cohort. The application of FR0348383 score in clinical practice might avoid unnecessary prostate biopsies and increase the specificity of PCa diagnosis.

Impurity analysis plays an important role to guarantee the quality and safety of pharmaceuticals. However, identification of impurities remains challenging, especially for those unknown or at trace levels. We present an integrated approach to detect and characterize the trace impurities in drugs.Based on liquid chromatography-tandem mass spectrometry (LC-MS/MS), an approach integrating automatic impurity screening method using multiple mass defect filters (MMDFs) and background subtraction (BS) was developed. This approach was used to acquire the structural and semi-quantitative information in a single sample run, and even to discover the impurity signals submerged by background and drug ions. This approach was illustrated by the comprehensive impurity analysis of levofloxacin.This approach was sensitive to detect impurities at the level of 0.02% with respect to levofloxacin concentration. Nineteen impurities were detected, fourteen of which were structurally characterized and eight impurities were reported for the first time. Impurity profiles of levofloxacin drug substances and degradation samples were obtained reliably. A plausible degradation pathway of levofloxacin was proposed including descarboxyl reaction under acid, piperazinyl ring cleavage degradation under light, and N-oxidation under oxidative condition.The generic approach integrating LC-MS/MS and an automatic impurity screening method was developed for the detection, characterization and monitoring of impurities, especially those unknown or at trace levels. This approach was demonstrated to be rapid, sensitive and automatic for impurity profiling of drugs.