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BackgroundTo investigate the surgical methods and clinical results of robot-assisted laparoscopic antegrade inguinal lymphadenectomy.MethodsA retrospective study was performed on clinical data from 19 patients with penile cancer admitted from March 2013 to October 2017. Among them, nine patients underwent robot-assisted laparoscopic antegrade inguinal lymphadenectomy (robot-assisted group) and 10 patients underwent open inguinal lymphadenectomy (open group). In the robot-assisted group, preoperative preparation, patient position, robot placement, design of operating channel and establishment of operating space are described. Key surgical procedures and techniques are also summarized. In addition, the number of lymph nodes removed, postoperative complications and follow-up in both groups were statistically analyzed.ResultsFor the 9 patients in the robot-assisted group, surgery was successfully accomplished at 17 sides without intraoperative conversion to open surgery. The surgery time for each side was 45~90 min using laparoscope with an average of 68.5 ± 13.69 min/side. The intraoperative blood loss was estimated to be P = 0.84). There were no postoperative complications such as skin necrosis, delayed wound healing and cellulitis in the robot-assisted group. Skin-related complications occurred in 9 (45%) of the 20 sides in the open group. During a median follow-up of 25 months in robot-assisted group and 52.5 mouths in open group, was not significantly different there were no statistical differences in recurrence-free survival between the groups (75% vs 60%,p = 0.536).ConclusionRobot-assisted laparoscopic antegrade inguinal lymphadenectomy achieved the desired surgical outcomes with fewer intraoperative and postoperative complications. The robotic arms of the surgical system were placed between the lower limbs of each patient. There was no need to re-position the robotic arms during bilateral inguinal lymphadenectomy. This simplified the procedure and reduced the use of trocars. If necessary, pelvic lymphadenectomy could be performed simultaneously using the original trocar position.

In recent decades, with the increase in extreme climate duration and the continuous development of urbanization in China, the threat of landslide disasters has become increasingly serious. More and more scholars pay attention to the problem of the prevention of landslide disasters. Therefore, the landslide susceptibility prediction is generated, which can play an important role in the design of land development and urban development schemes in mountainous areas. In this paper, the frequency ratio (FR) model is used to quantitatively analyze the relationship between each factor and the occurrence of landslide (elevation, slope, aspect, plan curvature, profile curvature, distance to faults, rainfall, distance to rivers, soil types, land cover, Normalized Difference Vegetation Index (NDVI) and distance to roads). Based on the analysis of landslide distribution, 12 influencing factors were selected to establish the landslide susceptibility evaluation index system. Historical landslide points were randomly divided into training (70% of the total) and validation (30%) sets. Thereafter, decision tree (DT), logistic regression (LR), and random forest (RF) models were used to generate the landslide susceptibility mapping (LSM), and the predictive performance of the three models was evaluated using receiver operating characteristic (ROC) curves. The FR model results showed that landslides mostly occurred at slopes of 0–15°, elevations of

Robot-assisted laparoscopic minimally invasive surgery has gained significant attentions due to its enhanced dexterity, improved precision, natural eye-hand coordination, etc. In these procedures, stick-like surgical tools with distal wrists are usually maneuvered by multiple patient-side manipulators to perform an operation. These patient-side manipulators shall realize remote center of motion movements and are subject to risks of mutual collisions during motion. On the other hand, the continuum surgical manipulators, often with multiple segments, usually have several degrees of freedom (DoFs) for the movements in a patient's cavity, and only need a lockable bedside stand, rather than a manipulator. However, the continuum segments inherently have limited bending curvature such that large orientation changes of the surgical end effector around confined anatomical features can be challenging. This letter, hence, proposes a modular continuum-articulated laparoscopic robotic tool design with simple and decoupled kinematics. An inverted dual-continuum mechanism is used in the tool to realize pure translations, while a 2-DoF cable-driven distal wrist is incorporated for orientations. The utilized dual-continuum mechanism maintains a constant length across its entire cross section to significantly facilitate maintaining tensions for the actuation cables of the distal wrist. Design concept, kinematics, system descriptions, actuation calibration, and experimental characterizations are reported, demonstrating effectiveness of the proposed idea.

Numerous studies have been made on the effect of coal wastes (CWs) on asphalt binders and mixtures, while the investigations on the interpretation of this effect are still rare. This study investigated the effect of coal waste ash (CWA, retreated from CWs by reheating) on asphalt mastics and mixtures, and tried to explain this effect from the physical and chemical characteristics of CWA. Firstly, X-ray diffraction (XRD), thermo gravimetric-differential scanning calorimetry (TG-DSC), particle size distribution (PSD), and Brunauer-Emmet-Teller (BET) gas adsorption model were employed to study the differences between CWA and fine limestone powder (FLP); then the effect of CWA on asphalt mastics and mixtures in different mass fractions (20%, 40%, 60%, 80%) to replace FLP as filler were studied; finally, an economic analysis was also discussed. Results show that the physical and chemical characteristics of CWA can significantly affect the performance of asphalt mastics and mixtures by using equal mass substitution method to replace FLP. And the equal mass substitution method should be prudent to apply for the different density substitution. Moreover, test results also show that the factors of CWA affecting asphalt mastics and asphalt mixtures are not always the same.

The preparation of high degradation rate and recyclable photocatalytic material for automobile exhaust degradation is a hot and difficult issue in the field of automobile exhaust degradation. In this paper, a modified Rubber-Titanium-Aluminum(RTA) degradation material based on TiO2/Al2O3 composite carrier was prepared. The effects of particle size, RTA content, initial concentration of NO2, light source type, light intensity, ambient temperature and humidity on the degradation effect of RTA were studied by the self-designed indoor test equipment, and the skid resistance performance, noise reduction performance, durability, impermeability and repeatability of NO2-degradation of the RTA ultrafine grained micro-surfacing material were further studied. The results showed that compared with pure nano-TiO2, RTA had a higher degradation rate of NO2, and the smaller the particle size of RTA was, the higher the degradation rate was. With the increase of the RTA content, the NO2-degradation rate of the material also increased, but there was an upper limit. RTA could achieve the best effect of NO2-degradation under the appropriate temperature and suitable wavelength of the light source, but the air humidity and light illumination had little effect on the degradation rate of NO2. Moreover, the higher the initial concentration of automobile exhaust was, the smaller the degradation rate of NO2 was. In addition, the RTA ultrafine grained micro-surfacing material had good durability, which could improve the skid resistance performance, noise reduction performance and impermeability of the pavement. The effect of automobile wear on RTA’s ability of repeated NO2-degradation was not significant. With the skid resistance, degradation rate, durability and economic benefits taken into account, the optimum coating amount of RTA was 800 g.m−2.

ObjectivesThe purpose of this study was to evaluate the feasibility and diagnostic performance of prostate-specific membrane antigen (PSMA) based 18F-DCFPyL PET/CT-ultrasound (PET/CT-US) or PET/MRI-ultrasound (PET/MRI-US) fusion targeted biopsy for intra-prostatic PET-positive lesions.MethodsFrom April 2018 to November 2019, we prospectively enrolled 55 candidates to perform PET/CT-US or PET/MRI-US fusion targeted biopsies for solitary PET-positive prostate lesions (two to four cores/lesion). The positive rates of prostate cancer based on patients and biopsy cores were calculated respectively. With reference to the pathological results of biopsy cores, the MR signal characteristics in the area of the PET-positive lesion were analyzed for the patients who underwent PET/MRI.ResultsA total of 178 biopsy cores were taken on the 55 patients. One hundred forty-six biopsy cores (82.0%, 146/178) from 51 (92.7%, 51/55) patients were positive for prostate cancer; 47 (85.5%, 47/55) were clinically significant prostate cancer. It is noteworthy that nine patients underwent both 18F-DCFPyL PET/CT and PET/MRI examinations; the seven patients with prostate cancer showed abnormal MR signal in the area of the PET-positive lesion while the other two patients with prostatic hyperplasia and prostatitis showed normal MR signal in the area of the PET-positive lesion.ConclusionThis study indicated that 18F-DCFPyL PET/CT-US or PET/MRI-US fusion targeted prostate biopsies may be valuable for prostate cancer diagnosis and have a high detection rate of clinically significant prostate cancer for PET-positive lesions. PET/MR can rule out some false PET-positive lesions, which may potentially reduce unnecessary prostate biopsies.

Purpose The retroperitoneal robotic assisted partial nephrectomy (RAPN) is suitable for tumors locating on the posterior side of the kidney. However, the posterior hilar tumor poses an additional surgical challenge due to the special location and poor tumor exposure. We developed a novel kidney ventrally rotation technique to overcome this difficulty during retroperitoneal RAPN and evaluated its efficacy in a retrospective case-control comparative study. Methods From March 2016 to April 2019, a total of 39 patients with posterior renal hilar tumor underwent retroperitoneal RAPN. The kidney ventrally rotation technique, which improved the tumor exposure by opening the peritoneum and rotating the kidney ventrally, was applied in 24 cases, and the conventional RAPN was performed in the other 15 cases (control group). Perioperative data was analyzed to evaluate the efficacy of the kidney ventrally rotation technique. Results In kidney rotation group, the 24 patients underwent RAPN successfully without converting to open surgery or radical nephrectomy. The warm ischemia time was 17.4 ± 6.6 min, which was significantly shorter than 24.5 ± 8.3 min in control group. The mean operation time (80 ± 24 min) and estimated blood loss (104 ± 65 ml) were not different from the control group. No sever complications occurred, and no positive surgical margin was found in all the malignant cases. After 14 months follow-up, no recurrence or metastasis occurred in all cases. Conclusion Kidney ventrally rotation technique is safe and feasible for improving the exposure of posterior renal hilar tumor during retroperitoneal RAPN. It could be regarded as an efficient option for the management of posterior hilar tumor.

A horseshoe kidney is a congenital kidney malformation commonly associated with complications such as hydronephrosis, renal calculi, and infections of the renal pelvis. Renal cell carcinoma is extremely rare in a horseshoe kidney; once it occurs, however, it is intractable because of vascular abnormalities. This is especially true in laparoscopic nephron-sparing surgery, even for tumors of

Objective: To evaluate the diagnostic value of fluorescence in situ hybridization (FISH) in bladder cancer. Methods: We enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) values were calculated for both the FISH and urine cytology tests. Results: A cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population. A total of 4807 patients with hematuria were prospectively, randomly enrolled for the simultaneous analysis of urine cytology, FISH testing, and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen. Overall, the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%, while that of cytology was 33.4% (p

The present study aimed to investigate presurgical neoadjuvant targeted therapy for patients with kidney cancer and vena cava tumor embolus, in order to examine its indications, therapeutic effects and optimal timing of surgery. Between June 2009 and June 2014, 12 patients from The People's Liberation Army General Hospital (Beijing, China) were diagnosed with kidney cancer with superior vena cava tumor embolus, and received presurgical neoadjuvant targeted therapy (sorafenib 400 mg twice a day or sunitinib 50 mg/day) for a median of 13.3 weeks. Patients included 8 males and 4 females, with a median age of 49.8 years. Kidney cancer was present on the left side in 3 patients and in the right side in 9 patients. The median tumor embolus length was 9.7 cm (range, 6.5–14.0 cm). Tumor embolus levels II, III and IV, classified by the Mayo Clinic standard, were observed in 2, 6 and 4 patients, respectively. Median treatment time and average targeted therapy discontinuation time were observed to be longer in sunitinib-treated patients compared with sorafenib-treated patients. In total, 2 patients in the present study had partial remission (PR) and 8 patients had stable disease (SD); for tumor embolus, 4 patients had PR and 8 patients had SD. Tumor embolus length decreased by a median value of 18.7% (range, 0.0–42.1%) or 1.8 cm (range, 0.1–5.2 cm). Tumor diameter decreased by a median value of 8.6% (range, 0.0–38.9%) or 0.7 cm (range, 0.0–3.5 cm). The level of the tumor thrombus, classified by the Mayo Clinic standard, was observed to decrease following sunitinib treatment, including two cases downgraded from tumor thrombus level IV to II, one case from level IV to III and two cases from level III to II. Presurgical neoadjuvant targeted molecular therapy may have the potential to reduce the tumor stage of patients, as well as decreasing the surgical difficulty for radical nephrectomy.

Background Methylation plays a key role in the aetiology and pathogenesis of prostate cancer (PCa). This study aimed to identify aberrantly methylated differentially expressed genes (DEGs) and pathways in PCa and explore the underlying mechanisms of tumourigenesis. Methods Expression profile (GSE29079) and methylation profile (GSE76938) datasets were obtained from the Gene Expression Omnibus (GEO). We used R 3.4.4 software to assess aberrantly methylated DEGs. The Cancer Genome Atlas (TCGA) RNA sequencing and Illumina HumanMethylation450 DNA methylation data were utilized to validate screened genes. Functional enrichment analysis of the screened genes was performed, and a protein–protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Gens (STRING). The results were visualized in Cytoscape. After confirmation using TCGA, cBioPortal was used to examine alterations in genes of interest. Then, protein localization in PCa cells was observed using immunohistochemistry. Results Overall, 536 hypomethylated upregulated genes were identified that were enriched in biological processes such as negative regulation of transcription, osteoblast differentiation, intracellular signal transduction, and the Wnt signalling pathway. Pathway enrichment showed significant changes in factors involved in AMPK signalling, cancer, and adherens junction pathways. The hub oncogenes were AKT1, PRDM10, and FASN. Additionally, 322 hypermethylated downregulated genes were identified that demonstrated enrichment in biological processes including positive regulation of the MAPK cascade, muscle contraction, ageing, and signal transduction. Pathway analysis indicated enrichment in arrhythmogenic right ventricular cardiomyopathy (ARVC), focal adhesion, dilated cardiomyopathy, and PI3K-AKT signalling. The hub tumour suppressor gene was FLNA. Immunohistochemistry showed that AKT1, FASN, and FLNA were mainly expressed in PCa cell cytoplasm, while PRDM10 was mainly expressed in nuclei. Conclusions Our results identify numerous novel genetic and epigenetic regulatory networks and offer molecular evidence crucial to understanding the pathogenesis of PCa. Aberrantly methylated hub genes, including AKT1, PRDM10, FASN, and FLNA, can be used as biomarkers for accurate PCa diagnosis and treatment. In conclusion, our study suggests that AKT1, PRDM10, and FASN may be tumour promoters and that FLNA may be a tumour suppressor in PCa. We hope these findings will draw more attention to these hub genes in future cancer studies.

Background: In the large amount of hematuria patients, a considerable part of them originate in upper tract urinary carcinoma(UTUC). The most important in the evaluation of hematuria is to find accurate and economical method to discriminate between non-malignant and malignant causes. Liquid biopsy for urine samples can be helpful for UTUC diagnosis in patients with hematuria and rule out individuals with low-risk. Methods: In this study, we combined high-throughput sequencing of 17 genes and methylation analysis for ONECUT2 CpG sites as a liquid biopsy panel. We developed a prediction model which contained several significant features to evaluate the risk of UTUC in hematuria patients. Findings: 94 healthy, 70 UTUC- and 70 UTUC+ cases’ samples are qualified for this study, our liquid biopsy panel resulting in a sensitivity of 94% (66/70), and a specificity of 96% (158/164), the positive predication value of 92% and a negative predication value of 98% in this study. With age as additional factor, our model was able to stratify patients into a low or high-risk group with an accuracy score at 94%. Further validation in a large prospective cohort will answer whether this early screening tool can also be used in monitoring postoperative patients who need serials of follow-ups. Interpretation: Urine based liquid biopsy can assist evaluating upper tract urinary carcinoma risk of patients with hematuria and outperformed FISH for accurately ruling out patients who do not have UTUC. Funding Statement: In this research, no funding or other financial supports was received. Declaration of Interests: The authors declared that they have no conflicts of interest to this study. Ethics Approval Statement: Informed written consent was obtained from patients at PLA General Hospital and the study was approved by the Committees on Clinical Research Ethics of the Chinese PLA General Hospital.

Using recycled rubber waste in the construction of asphalt pavements not only improves pavement performance, but also promotes sustainable development. Consequently, rubber asphalt pavements have received significant attention in recent years. However, conventional rubber asphalt has numerous disadvantages such as low solubility, high viscosity, uneven dispersion, and poor storage stability. In this study, a composite method involving waste engine oil addition and microwave desulfurization to prepare highly dissolved rubber asphalt was proposed. Four types of rubber asphalt—conventional rubber asphalt, microwave-treated rubber asphalt, rubber asphalt with added waste engine oil, and highly dissolved rubber asphalt using the proposed composite method—were prepared and tested. The solubility, rheological properties, and storage stability of the prepared rubber asphalt specimens were studied. Specifically, the extraction of undissolved rubber was used to characterize the solubility of rubber asphalt. The results demonstrate that the solubility of the highly dissolved rubber asphalt prepared using the composite method was around 40%, which is 10%–20% higher than that of conventional rubber asphalt. The low-temperature performance and storage stability of the highly dissolved rubber asphalt improved significantly, and it also exhibited good high-temperature performance. The findings obtained herein indicate that the proposed composite treatment method for waste crumb rubber can significantly improve the performance of rubber asphalt, thereby promoting the application of rubber asphalt in the construction of asphalt pavements.

Background: Upper tract urinary carcinoma (UTUC) includes renal pelvic cancer and ureteral cancer. For its diagnosis, ureteroscopy is the only method to obtain pathological result before surgery. However, there are also some problems with ureteroscopy. In addition to the trauma and infection risks, the possibility of exudation and adhesion of surrounding tissues after ureteroscopy is significantly increased, hypertension in the cavity may cause tumor spread, and the use of ureteroscopy and biopsy may cause recurrence of bladder tumors after surgery. These unfavorable factors make clinically urgent need for a sensitive and non-invasive method for the diagnosis of UTUC. Materials and Methods: In this study, 150 hematuria patients with upper tract urinary disease and 100 healthy people were enrolled. Among the patients, 75 were pathologically confirmed with upper tract urinary carcinoma while 75 with benign urinary diseases. A Genetron Urinary Assay was designed to maximize the number of unique driver gene variants of UTUC by a limited number of amplicons. Next-generation sequencing libraries were constructed using multiplex PCR methods. We also detected CpG-sites on ONECUT2 gene by performing bisulfite-specific real-time PCR for bisulfite converted DNA. Furthermore, we developed a prediction model based on several significant features to evaluate the risk of UTUC. Results: 234 samples were available for analysis. Our liquid biopsy assay demonstrated a sensitivity of 94%, a specificity of 96%, a positive predication value (PPV) of 92% and a negative predication value(NPV) of 98% in this study. By using a decision tree model, we found age, gene mutations of HRAS, TERT and TP53 and methylation of ONECUT2 did place at some key nodes to classify the risk of patients of UTUC, and age around 48.5, the frequencies of mutated genes above certain value and ΔCt value of ONECUT2 about 7.6 would be good cutoffs. This model was able to stratify patients into a low or high-risk group with an accuracy score at 94%. After further analysis, we found that ONECUT2 methylation and TP53 mutations were more common in high grade UTUC (p Conclusion: In this study, Genetron Urinary Assay has a good performance in the diagnostic of UTUC. Its high sensitivity, high specificity, and non-invasiveness make it a potential clinical alternative to ureteroscopy. Further validation in a large prospective cohort of wide population is necessary to prove the true clinical value of this newly developed method. Citation Format: Xin Ma, Yansheng Xu, Hongzhao Li, Xing Ai, Jiangping Gao, Yiming Liang, Qiaosong Zheng, Kaisheng Mao, Tonghui Ma, Xu Zhang. A urine-based liquid biopsy method for detection of upper tract urinary carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2293.

Proinflammatory macrophage (M1) is now being suggested as a potential therapeutic strategy for cancer because of its tumoricidal capacity. However, few studies have been focused directly on the effects of M1 macrophages on cancer cells. Here, we found that M1 induced a subpopulation of CD44high/CD24-/low or ALDH1+ cells with CSC-like phenotypes from different types of breast cancer cells (BCCs) in a paracrine manner. Stat3/NF-κB pathways in BCCs were activated by proinflammatory cytokines, igniting Lin-28B-let-7-HMGA2 axis to induce CSC through epithelial-mesenchymal transition (EMT). Previously, we reported that Stat3-coordinated Lin-28B-let-7-HMGA2 axis initiated EMT in BCCs. Here, inhibition of Stat3/NF-κB pathways or Lin-28B-let-7-HMGA2 axis suppressed EMT/CSCs program. Notably, HMGA2 knockdown directly repressed M1-induced CSC formation and expression of Klf-4 and Nanog. Meanwhile, prolonged coculture with BCCs endowed M1 with M2 properties. M1 supernatant induced CSC from non-stem cancer cells, while M2 supernatant sustained a higher proportion of ALDH1+ cells. Our data suggest that macrophages might modulate CSC formation and maintenance by transferring between M1/M2 phenotype. Given that M1 are being considered as a promising immunotherapy tool, it is important to inhibit their CSC-inducing potential by targeting key molecules and pathways.

Primary macronodular adrenal hyperplasia (PMAH), also known in the past as bilateral macronodular adrenalhyperplasia or adrenocorticotropin (ACTH)-independent macronodular adrenal hyperplasia, is a rare type of Cushing's syndrome (CS) and is associated with bilateralenlargement of the adrenal glands. It accounts for

To further enhance the antitumor efficacy of DNA vaccine, we proposed a synergistic strategy that targeted tumor cells and angiogenesis simultaneously. In this study, a Semliki Forest Virus (SFV) replicon DNA vaccine expressing 1-4 domains of murine VEGFR2 and IL12 was constructed, and was named pSVK-VEGFR2-GFc-IL12 (CAVE). The expression of VEGFR2 antigen and IL12 adjuvant molecule in 293T cells in vitro were verified by western blot and enzyme-linked immune sorbent assay (ELISA). Then CAVE was co-immunized with CAVA, a SFV replicon DNA vaccine targeting survivin and β-hCG antigens constructed previously. The antitumor efficacy of our combined replicon vaccines was evaluated in mice model and the possible mechanism was further investigated. The combined vaccines could elicit efficient humoral and cellular immune responses against survivin, β-hCG and VEGFR2 simultaneously. Compared with CAVE or CAVA vaccine alone, the combined vaccines inhibited the tumor growth and improved the survival rate in B16 melanoma mice model more effectively. Furthermore, the intratumoral microvessel density was lowest in combined vaccines group than CAVE or CAVA alone group. Therefore, this synergistic strategy of DNA vaccines for tumor treatment results in an increased antitumor efficacy, and may be more suitable for translation to future research and clinic.

Background: Transurethral resection of bladder tumor (TURBT) is the current gold standard for treatment of non-muscle-invasive bladder cancer. However, obturator nerve reflex (ONR) remains as a threat during treating lateral wall tumors. The present study aimed to describe a simple and reliable method which provides en bloc resection without ONR. Methods: Forty-six patients planned for TURBT with superficial bladder carcinoma nested in lateral bladder wall received transurethral needle electrode resection of bladder tumor (TUNER-BT) under epidural anesthesia without obturator nerve block. Intraoperative and postoperative complications were observed. The resected tissues were examined by a pathologist who recorded grade, invasion of the muscularis propria and the presence of muscular invasion. Results: Tumors were multiple in 11 (24%) patients and single in 35 (76%) patients. Mean tumor size was 1.79 ± 0.43 cm with a mean resection time of 10.8 ± 4.8 minutes. None of the 46 patients developed obturator jerks or perforation. Precise histological evaluation was achieved in all cases: 32.5% pTa, 56.4% pT1, and 11.1% pT2. Conclusions: The needle electrode can be used safely and conveniently during transurethral electroresection of bladder tumors located in the lateral bladder wall. This technique is easy to perform and allows en bloc resection of tumors. The ONR privilege makes TUNER-BT a preferable option when treating tumors located in lateral bladder wall. World J Nephrol Urol. 2015;4(3):232-236 doi: http://dx.doi.org/10.14740/wjnu221w

Objective To study the inhibitory effect of matrine on bladder cancer cell growth and invasion in vitro through PI3K/AKT signaling pathway. Methods Human T24 bladder cancer cell lines were cultured and treated with different doses of matrine (0.25 mg/mL, 0.5 mg/mL and 1.0 mg/mL) as well as 20 μmol/L PI3K inhibitor LY294002 for 24 h, and the cell proliferation activity, the number of invasive cells as well as the expression of p-PI3K, p-AKT, proliferation genes and invasion genes were determined. Results Different doses of matrine could decrease the cell viability value, the number of invasive cells as well as the expression of p-PI3K, p-AKT, MMP2 and MMP9, and increase the expression of p16, p21 and p27 in dose-dependent manner; p16, p21 and p27 expression in cells of 20 μmol/L LY29002 group were significantly higher than those of 0 μmol/L LY29002 group while MMP2 and MMP9 expression were significantly lower than those of 0 μmol/L LY29002 group ( P Conclusions Matrine can inhibit bladder cancer cell proliferation and invasion in vitro and regulate the expression of cell cycle-inhibiting molecules and invasion-related genes through PI3K/AKT signaling pathway.

Objective To establish a human bladder cancer cell line stably co-expressing human sprouty2 (hSPRY2) and luciferase (Luc) genes simultaneously, and develop its subcutaneous tumor xenograft model in nude mice. Methods The hSPRY2 and Luc gene segments were amplified by PCR, and were cloned into lentiviral vector pCDH and pLVX respectively to produce corresponding lentivirus particles. The J82 human bladder cancer cells were infected with these two kinds of lentivirus particles, and then further screened by puromycin and G418. The expressions of hSPRY2 and Luc genes were detected by bioluminescence, immunofluorescence and Western blot analysis. The screened J82-hSPRY2/Luc cells were injected subcutaneously into BALB/c nude mice, and the growth of tumor was monitored dynamically using in vivo fluorescence imaging system. Results J82-hSPRY2/Luc cell line stably expressing hSPRY2 and Luc genes was established successfully. Bioluminescence, immunofluorescence and Western blot analysis validated the expressions of hSPRY2 and Luc genes. The in vivo fluorescence imaging system showed obvious fluorescence in subcutaneous tumor xenograft in nude mice. Conclusion The J82-hSPRY2/Luc bladder cancer cell line and its subcutaneous tumor xenograft model in nude mice have been established successfully.

The goals of the work described here were to analyze the ultrasonographic characteristics of urinary bladder paraganglioma and to evaluate the use of ultrasonography (US) in diagnosis. Ten patients with bladder paraganglioma (3 males, 7 females) and 51 patients with urothelial carcinoma (37 males, 14 females) were enrolled. Ultrasonographic characteristics as well as clinical features were analyzed. Patients with urothelial carcinoma were significantly older than those with paraganglioma (62.9 y vs. 48.1 y, p = 0.001). The patients with paraganglioma had higher average systolic blood pressure than those with urothelial carcinoma (146.7 mm Hg vs. 130.7 mm Hg, p = 0.012). All bladder paragangliomas were solitary, and 40% were located on the dome. There was a statistically significant difference in location of lesions between the bladder paraganglioma and urothelial carcinoma groups ( p = 0.014). The longest diameters in 80% of the bladder paragangliomas were in the range 1.1–3.0 cm; 60% were hypoechoic, and 40% were located in the submucosa of the bladder. Color Doppler revealed that 40% of the bladder paragangliomas were highly vascular. One patient with paraganglioma and four patients with urothelial carcinoma underwent contrast-enhanced ultrasound, which revealed rapid contrast enhancement and slow wash-out, with a non-enhanced area. Contrast-enhanced ultrasound of urothelial carcinomas revealed rapid homogeneous enhancement and variable wash-out patterns. Pre-operative ultrasonography detected all neoplasms of the urinary bladder in the 10 patients with pathologically confirmed paraganglioma, but made the correct diagnosis in only 2 cases (20%). Although there is overlap in US findings among different diseases, solitary, submucosal masses arising on the dome may be the key US imaging characteristic for bladder paraganglioma.

To improve the lower immune intensity of DNA vaccines, we developed a DNA vaccine based on prostate cancer-specific antigen (PSA), which has been suggested as a potential target for prostate cancer therapy, and enhanced the DNA vaccine potency using interleukin-12 (IL-12) as an intramolecular adjuvant. A series of DNA plasmids encoding human PSA, IL-12, and their conjugates was constructed and injected into female mice intramuscularly, followed by an electric pulse. The humoral and cellular immune responses after immunization were detected by ELISA and ELISPOT, respectively. To evaluate the therapeutic efficacy of these plasmids, a mouse model with a PSA-expressing tumor was constructed. Mice vaccinated with PSA-IL-12 plasmids elicited the strongest PSA-specific humoral and cellular immune responses. Furthermore, these vaccinations inhibited the growth of PSA-expressing tumors and prolonged mouse survival. These observations emphasize the potential of the IL-12 gene as an intramolecular adjuvant for DNA vaccines. Moreover, the vaccine based on PSA and IL-12 may be a promising treatment for prostate cancer.

Objectives: To investigate the use of a flexible instrument platform in performing single-port laparoscopic retroperitoneal urologic surgeries and to verify the safety and feasibility of these surgeries. Methods: The homemade instrument platform consisted of two control loops and a powder-free surgical glove to form multichannels. 56 patients underwent this kind of single-port surgery for different urologic diseases, including radical nephrectomy in 31 patients, nephroureterectomy in 7 patients, partial nephrectomy in 8 patients, living donor nephrectomy in 4 patients, adrenalectomy in 3 patients, renal cyst surgery in 2 patients and ureterolithotomy in 1 patient. Results: All surgeries were completed successfully with no switch to conventional laparoscopic or open surgery. The mean hospital stay was 13.13 days (range 6-36). All patients were satisfied without major complications. Conclusions: Retroperitoneal laparoendoscopic single-site surgery using our cost-effective homemade instrument platform appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urologic surgery.

ACTH independent macronodular adrenal hyperplasia (AIMAH) is a rare disorder characterized by bilateral macronodular hyperplasia of the adrenal glands and increased cortisol production with subclinical or overt Cushing's syndrome. Although the family clustering of AIMAH is infrequent, we have tried our best to find such a familial affected pedigree with complete clinical information and successfully collect adrenalectomy tissue samples from two members of this family. Using whole exome sequencing and several variant prioritization strategies based on disease network analysis, we identified Endothelin receptor type A (EDNRA) Ser420Thr mutation as a causative mutation of AIMAH. EDNRA is a member of G protein coupled receptor family and is involved in cardiovascular or polycystic kidney disease. Our findings indicate that the mutation of EDNRA at S420T site should be regard as a potential AIMAH causative variation in familial and sporadic affected patients.

Bladder cancer is one of the world’s top ten malignant tumors. The crucial role of microRNA in carcinogenesis has been well emphasized. Considering miRNA expression was tumor stage-, tissue-, or even development-specific, more experimental evidences about the functions of miRNAs in bladder cancer should be discovered to advance applying of miRNA in the diagnosis or therapy of cancer. MiR-708 level in bladder carcinoma and adjacent noncancerous tissues was tested by real-time qPCR. Cell apoptosis was analyzed by using flow cytometry. The tumorigenicity of bladder carcinoma cells was evaluated in nude mice model. Luciferase reporter gene assays were performed to identify the interaction between miR-708 and 3′UTR of Caspase-2 mRNA. The protein level of Caspase-2 was determined by western blotting. In this study, we reported that miR-708 was frequently dysregulated in human bladder carcinoma tissues compared to normal tissues. In addition, we found that silencing of miR-708 could promote the T24 and 5637 cells to apoptosis and inhibit the bladder tumor growth in vivo. Also, Caspase-2 was proved to be one of direct targets of miR-708 in T24 and 5637 cells. Further results showed that Caspase-2 was involved in the miR-708 regulated cell apoptosis. All together, these results suggest miR-708 may act as an oncogene and induce the carcinogenicity of bladder cancer by down-regulating Caspase-2 level.

This work presented a detailed study on pH-responsive self-supporting microfiltration membranes via the non-solvent-induced phase separation (NIPS) process from mixtures of THF and DMF. The well-defined pH-responsive polymers polystyrene-block-poly (N,N-diethylaminoethyl methacrylate) (PS-b-PDEAEMA) were synthesized via atom transfer radical polymerization (ATRP) evidenced by 1H-NMR and GPC studies. Two amphiphilic diblock copolymers were used, St71-b-DEAEMA31 and St71-b-DEAEMA82. The influence of pH value in the coagulation bath, the solvent composition, the “open-time” before immersion into the coagulation bath and the polymer composition onto the membrane morphology were investigated, and flux values obtained for the different membrane systems were compared. The SEM images and polarized optical microscopy revealed that the size and the number of pores in the membranes were larger along with the decreasing THF content and “open time”. For the copolymer with the longer PDEAEMA block, St71-b-DEAEMA82, the...

Objectives. To introduce a low-cost, self-made device for single-port retroperitoneal laparoscopic radical nephrectomy and to evaluate outcomes compared with conventional laparoscopy after initial experience using this device. Methods. Twenty-nine renal cancer patients underwent retroperitoneal laparoendoscopic single-site radical nephrectomy using a self-made single-port device with multiple manipulation channels for passage of routine laparoscopic instruments and specimen removal. A control group of 29 patients who were matched by age, gender, and cancer stage underwent conventional laparoscopy. Outcomes were analyzed retrospectively. Results. There were no significant differences in age, gender, body mass index, T stage, and maximum tumor diameter between groups ( P > .05). The laparoendoscopic single-site surgery group had a significantly shorter duration of postoperative hospitalization than the conventional laparoscopy group (7.14 ± 1.38 days vs 8.17 ± 1.54 days, P = .009). Conclusions. Retroperitoneal laparoscopic radical nephrectomy using our self-made single-port device appears to be a feasible, safe, and low-cost surgical strategy.

Objective To evaluate the presentation, management, pathology, and functional and oncological outcomes of patients undergoing retroperitoneoscopic treatment of bilateral synchronous sporadic RCC at our institution. Methods We retrospectively evaluated the records of 60 patients with bilateral synchronous sporadic RCC who underwent retroperitoneoscopic treatment at the General Hospital of People's Liberation Army from 2008 to 2014. The estimated glomerular filtration rate was calculated and compared among different surgical procedures. The overall survival and recurrence free survival were assessed based on information from recent follow-up. Results Fifty-six patients underwent bilateral retroperitoneoscopic surgeries in staged procedures, and four patients underwent bilateral retroperitoneoscopic surgeries in simultaneous procedures. Among the former group of patients, 34 underwent bilateral partial nephrectomy, 12 underwent radical nephrectomy followed by partial nephrectomy, and 10 underwent partial nephrectomy followed by radical nephrectomy. Bilateral partial nephrectomy can better preserve renal function (p = 0.040) and the sequence of partial nephrectomy and radical nephrectomy did not affect functional outcomes (p = 0.790). One patient undergoing simultaneous procedures developed acute renal failure and required temporary hemodialysis. At 3 and 5 years, overall survival rates were 93.0% and 89.4%, and recurrence free survival rates were 90.5% and 81.6%. High nuclear grade (p = 0.014) was related to disease recurrence. Conclusions Staged bilateral partial nephrectomy was efficient in preserving renal function. The survival of patients with bilateral synchronous sporadic renal tumors was similar to that of patients with unilateral nonmetastatic tumors. Nuclear grade was an independent prognostic factor of disease recurrence.

Background Myeloid ecotropic viral integration site 1 (MEIS1) protein plays a synergistic causative role in acute myeloid leukemia (AML). However, MEIS1 has also shown to be a potential tumor suppressor in some other cancers, such as non-small-cell lung cancer (NSCLC) and prostate cancer. Although multiple roles of MEIS1 in cancer development and progression have been identified, there is an urgent demand to discover more functions of this molecule for further therapeutic design. Methods MEIS1 was overexpressed via adenovirus vector in clear cell renal cell carcinoma (ccRCC) cells. Western blot and real-time qPCR (quantitative Polymerase Chain Reaction) was performed to examine the protein and mRNA levels of MEIS1. Cell proliferation, survival, in vitro migration and invasion were tested by MTT, colony formation, soft-agar, transwell (in vitro invasion/migration) assays, and tumor in vivo growthwas measured on nude mice model. In addition, flow-cytometry analysis was used to detect cell cycle arrest or non-apoptotic cell death of ccRCC cells induced by MEIS1. Results MEIS1 exhibits a decreased expression in ccRCC cell lines than that in non-tumor cell lines. MEIS1 overexpression inhibits ccRCC cells proliferation and induces G1/S arrest concomitant with marked reduction of G1/S transition regulators, Cyclin D1 and Cyclin A. Moreover, MEIS1-1 overexpression also induces non-apoptotic cell death of ccRCC cells via decreasing the levels of pro-survival regulators Survivin and BCL-2. Transwell migration assay (TMA) shows that MEIS1 attenuates in vitro invasion and migration of ccRCC cells with down-regulated epithelial-mesenchymal transition (EMT) process. Further, in nude mice model, MEIS1 inhibits the in vivo growth of Caki-1 cells. Conclusions By investigating the role of MEIS1 in ccRCC cells’ survival, proliferation, anchorage-independent growth, cell cycle progress, apoptosis and metastasis, in the present work, we propose that MEIS1 may play an important role in clear cell renal cell carcinoma (ccRCC) development.

To determine the effect of obesity on prostate specific antigen (PSA) in men with benign prostatic hyperplasia (BPH) and develop a PSA-related parameter that can eliminate the effect of obesity.We reviewed the clinical data of 706 patients with BPH. Two PSA-related parameters, namely PSA mass (total circulating PSA protein) and PSA mass ratio (total circulation PSA protein per prostate volume), were calculated for all the patients and the association of BMI with PSA, PSA mass, and PSA mass ratio was assessed.A higher BMI was significantly associated with a greater plasma volume and prostate volume (P0.05). Linear regression analysis revealed a greater adjusted R2 of BMI versus plasma volume than of BMI PSA (0.569 vs 0.027). PSA was positively associated with the prostate volume and negatively with BMI and plasma volume (P0.05). PSA mass was positively associated with prostate volume (P0.05) but was not associated with BMI or plasma volume (P0.05). PSA mass ratio was not associated with prostate volume (P0.05) but negatively associated with BMI and plasma volume. Plasma volume and prostate volume, PSA, and PSA mass ratio (P0.05), but not PSA mass (P0.05), differed significantly among normal-weight, overweight, and obese patients.A higher BMI is associated with a greater plasma volume in BPH patients. In obese patients with BPH, a lower PSA concentration may result from hemodilution caused by a greater plasma volume, and PSA mass can eliminate the effect of obesity on PSA.

To evaluate a fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy.One hundred fifty retroperitoneal laparoscopic nephrectomies were performed from October 2003 to June 2006. The renal arteries were identified by following five steps: location, pulling, apophysis, pulsation,and fibrin. Then the renal arteries were severed or ligatured with a linear cutter or Hem-o-lok clips. The renal veins were exposed by dissecting toward the abdominal side under the renal arteries. The management for the renal veins was the same with that of the renal arteries. The fast method to identify the renal vessels during retroperitoneal laparoscopic nephrectomy were evaluated.All 150 procedures were successfully completed, and the renal vessels could be identified in short time. The average time to operation was 90 min (range 45-120 min) with average blood loss of 105 mL (range 10-510 mL). The average specimen weight was 494 g (range 140-890 g). Intake of usual diet and walking were allowed within 3 days for all patients. Drains were removed within 2-4 postoperative days. No patient was converted into an open surgery and blood transfusion. Minor complications were found in 12 cases (8%), and no severe complication occurred in any of the 150 cases. The median time to hospitalization was 6.3 days. Following the five steps, the renal vessels could be identified quickly and easily. The duration of the operations, the risk of conversion to the open surgery, and the vessel injury were decreased.Renal vessels could be identified quickly by the following the five steps during retroperitoneal laparoscopic nephrectomy: location, pulling, apophysis, pulsation, and fibrin. It proved to be a useful method suitable for clinic application.

Purpose: To present our preliminary experience with laparoscopic ureter reimplantation for distal ureteral stricture without an everted ureteral nipple or submucosal tunneling, and to evaluate its clinical feasibility, safety, and validity. Patients and Methods: Six patients with distal ureteral stricture underwent transperitoneal laparoscopic ureteral reimplantation. The ureter was reimplanted into the bladder without everting the ureter or tunneling construction. The seromuscular wall of the ureter was anastomosed circumferentially to the detrusor muscle using continuous absorbable sutures. Results: All patients had no intraoperative complications or need for open conversion. Intravenous urography 3 months later showed normal drainage without obstruction or reflux. In three patients, hydronephrosis was not revealed by ultrasonography 6 months later. Conclusions: Laparoscopic noneverted ureteral reimplantation is technically simple, reliable, effective, and feasible.

To investigate the effect of p53-regulated apoptosis-inducing protein 1 (p53AIP1) gene on the proliferation, cell cycle, apoptosis, invasion and migration of PC-3M human prostate cancer cells in vitro.The eukaryotic expression vector pDC316-p53AIP1 was constructed and confirmed by double enzyme digestion and PCR analysis. Then it was transfected into PC-3M human prostate cancer cells by Lipofectamine (TM) 2000. The expression of p53AIP1 protein was detected by Western blotting. The proliferation of PC-3M cells was tested by CCK-8 assay; the cell cycle and apoptosis rate were analyzed by flow cytometry combined with annexin V-FITC/PI staining; the effect of p53AIP1 on the cell invasion and migration was detected by Transwell(TM) assay. RESULTS The eukaryotic expression vector pDC316-p53AIP1 was constructed successfully. After transfected into PC-3M cells, Western blotting demonstrated that the protein p53AIP1 was effectively expressed. CCK-8 assay revealed that the proliferation of PC-3M cells was significantly inhibited by p53AIP1 (P0.05). Flow cytometry indicated that the cells were arrested at S/G2-M phase (P0.05) and cell apoptosis was evidently promoted (P0.05). Transwell(TM) chamber experiments showed that p53AIP1 decreased the abilities of both invasion and migration of the cells (P0.05).The p53AIP1 inhibits the proliferation of PC-3M cells, arrests cell cycle at S/G2-M phase, decreases the abilities of invasion and migration and promotes cell apoptosis.

To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150-220) and 187 (range: 170-205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10-30) and 28.75 (range: 15-20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4-6) and 5.75 (range: 5-6) d, respectively, and the indwelling catheter time was 6.33 (range: 4-8) d and 7 (range: 7-7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7-8) d and 8 (range: 7-10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter.

Objective: To verify the feasibility and safety of retroperitoneal laparoendoscopic single-site radical nephrectomy and assess the value of our proposed approach to search for renal artery. Methods: A total of 60 cases of retroperitoneal laparoendoscopic single-site radical nephrectomy were performed using our homemade single-port multi-channel device. An incision of 5-6 cm was cut forward from the posterior axillary line under the lower margin of the 12th rib, and a single-port multi-channel device comprised of two control rings and a No. 7 glove was placed into the incision. Retroperitoneal laparoendoscopic single-site radical nephrectomy was then performed via locating renal artery through muscle and ligament on the posterior abdominal. Results: The 60 cases were all successful. None of the 60 patients developed surgical complications. Conclusion: The application of homemade device is safe and feasible. Our proposed method is of greater practical significance for the relatively narrow operating space in retroperitoneal laparoendoscopic single-site surgery.