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Objective:To evaluate the effect of uncoupling protein 1 (UCP1) expression of perirenal fat on the prognosis of clear cell renal cell carcinoma (ccRCC) .Methods:From Feb. 2013 to Oct. 2013 and Mar. 2015 to Oct. 2015, 98 patients with ccRCC who underwent retroperitoneal laparoscopic radical nephrectomy were analyzed. UCP1 mRNA of perirenal fat around tumor was detected by RT-qPCR. Preoperative Computed tomography (CT) images were used to evaluate the thickness and adhesiveness of perirenal fat. According to the UCP1 mRNA value, the patients were divided into high UCP1 group (42 cases) and low UCP1 group (56 cases) . The general clinical data, perirenal fat thickness and adhesiveness were compared, and Kaplan Meier curve was used to evaluate the difference of progression free survival (PFS) between the two groups. Univariate and multivariate Cox analysis were used to determine the potential independent prognostic factors of PFS.Results:In the high UCP1 group, the renal fat thickness, the ratio of fat adhesion, the ratio of Ⅲ to Ⅳ in Fuhrman grade and the ratio of >T2 in T stage were higher than those in the low UCP1 group[ (13.84±2.41) vs (10.75±1.99) , 42.86% vs 16.07%, 28.57% vs 8.93%, 21.43% vs. 5.36%; P=0.000, P=0.003, P=0.011, P= 0.037]. During the follow-up period (median, 62.0 months) , 15 cases (12 cases of high UCP1 group, 3 case of low UCP1 group) developed tumor progression. Kaplan Meier curve showed that PFS of high UCP1 group was worse than that of low UCP1 group (71.43% vs 94.64%, P=0.001) . Cox regression analysis showed that high UCP1 expression and high T stage were significantly correlated with low PFS ( β=1.334, RR=3.796, 95% CI=1.009-14.280, P= 0.048; β=2.886, RR=17.930, 95% CI=5.538-58.047, P=0.000) . Conclusions:The increased UCP1 expression of perirenal fat may be an independent risk factor of tumor progression in ccRCC. Combined with the assessment of browning of perirenal adipose tissue may be helpful for risk stratification of ccRCC patients after surgery.
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Objective:To evaluate whether urological patients at nutritional risk are at higher risk for complications after radical cystectomy than those not at nutritional risk .Methods:We performed a retro-spective observational study in the consecutive patients undergoing radical cystectomy between 2010 and 2013 .A total of 147 patients were enrolled in this study .The nutritional risk score was assessed preoper-atively by a specialized study nurse .The patients with NRS ( nutritional risk screening ,NRS2002) scores≥3 were considered to have nutritional deficiency .Postoperative complications were defined using the standardized Clavien-Dindo classification .Univariate and multivariate analyses were performed to identify the predictors of complications.Results:The patients aged ≥70 years(50.57%) were more prone to nutritional risk than those aged <70 years (31.67%, P=0.023).Of the 63 patients at nutritional risk, 39 (61.90%) presented with at least 1 complication compared with 29 of the 84 controls (34.52%, P=0 .001 ) .The patients at nutritional risk were at threefold risk for complications on binary Logistic analysis (OR=3.128,95%CI 1.538-6.361,P=0.002).The length of hospital stay of the patients at higher nutritional risk was longer than that of those without nutritional risk [(12.9 ±5.7) d vs.(10.4 ± 4.3) d, P=0.003].Conclusion:The patients aged ≥70 years are at higher nutritional risk than that of those aged <70 years .Patients at nutritional risk are more prone to complications after radical cystectomy .
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The clinical data of 24 bladder cancer patients reoperated shortly after laparoscopic radical cystectomy were retrospectively analyzed.The reoperative reasons included intestinal injury,wound bleeding,intestinal anastomosis fistula,deep vein thrombosis,ileus and single-J tube slipping.All of them were cured after reoperation.The postoperative complications were infected incisional wound (n =2),urinary leakage (n =1) and pulmonary infection (n =1).All were cured by symptomatic treatments.The keys of reducing the rate of reoperation shortly after laparoscopic radical cystectomy included selecting indications strictly,standardizing operative procedures and adopting special measures.
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Major histocompatibility complex class Ⅰ chain related gene A(MICA) is located within the MHC class Ⅰ region of chromosome 6,including six exons.The MICA locus encodes membrane-bound polypeptides,similar with the classic class Ⅰ molecules,including three extracellular domains (α1,α2 and α3),a transmembrane domain,and a cytoplasmic tail,but is not associated with β2-microglobulin.MICA gene is expressed on endothelial cells,epithelial cells as well as most epithelial tumor cells surfaces,and are involved in the process of cell differentiation,proliferation and infiltration in a variety of tumor cells.Soluble MICA (sMICA) can be used as the prognosis predicting factor for some tumors.MICA gene plays an important role in the pathogenesis of a variety of malignant tumors,which might bring new ideas in prevention and treatment for malignant tumors.
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The clinical data of 42 patients with impacted upper-ureteral calculi undergoing retroperitoneal laparoscopicureterolithotomy(RPLU)from January 2008toDecember 2010 were retrospectively analyzed.RPLU was successfully performed in 40 cases,and simultaneous laparoscopic electrocoagulation ablation was also performed in 11 cases complicated with ureteral inflammatory polyps.No massive bleeding occurred during the operations.The stone-free rate 3 d after operation was 100％,and no stone left as reviewed by kidney ureter bladder X-ray (KUB) and B-ultrasonography.During the follow-up of 3 to 24 months (mean 11 months),40 cases showed no stone recurrence and no ureteral stricture in KUB and B-ultrasonography.The hydronephrosis of all RPLU patients relieved.Results indicate that RPLU is a safe and effective minimally invasive operation for treatment of impacted upper-ureteral calculi.
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This paper reports the results of determinations for 53 cases of untreated NPC patients by measurement of serum ?_2-MG. The average is 3.83?3.71?g/ml ((?)?SD). In other 54 cases of relivf, according to the treatment, the level of serum ?_2-MG is 1.5?0.81?g/ml ((?)?SD). There is significant difference between the two groups (P