Using a fretsaw in treating chronic penial incarceration: A case report.

BACKGROUND: Penial incarceration (PI) is a rare situation. It is usually caused by a foreign object which strangulates at the base of the penis. PI may derive from pranks, sexual demand, mental disease, or intention to prohibit urinary disease. Generally, these situations are emergent and immediate treatments are needed. Cases of chronic PI are less reported, and their treating methods are yet to be discussed. CASE SUMMARY: We reported a case on treating a 73-year-old male who had PI with a metallic hoop for three months. After multidisciplinary consultation, the operation was performed successfully with the help of a fretsaw. Despite the chronic strangulation, the prognosis of the patient was satisfying. To the best of our knowledge, this case was rare and precious as it featured the longest strangulating time, which might enlighten the treating process of future PI cases. Also, we have reviewed and summarized major published cases to encapsulate appropriate approaches when facing diverse strangulation situations. CONCLUSION: The selection of surgical tools depends on the material of the strangulating objects, the availability of equipment, and the severity of the penial damage. The urination function may not be affected after three months of incarceration as in our case, whilst prudent preoperative measures and multidisciplinary evaluations are always essential. Although using a fretsaw is comparatively slow, it is safe and feasible to treat metallic penial incarceration.

Knockdown of KNTC1 Inhibits the Proliferation, Migration and Tumorigenesis of Human Bladder Cancer Cells and Induces Apoptosis.

Aim - To explore the role and possible mechanism of KNTC1 gene in the development of bladder cancer. Methods - The expression level of KNTC1 in bladder cancer tissues and adjacent tissues was detected by immuno-histochemistry. Mann-Whitney U, Spearman, and Kaplan-Meier analyses were used to analyze the correlation between KNTC1 expression level and various characteristics of bladder cancer cases. KNTC1 was knocked down by RNA interference to detect the proliferation, apoptosis, cell cycle, migration, and in vivo tumorigenesis of bladder cancer cells. Human apoptosis antibody array and Western blot were used to detect the expression level changes of related proteins after KNTC1 knockdown to explore the possible mechanism. Results - KNTC1 was highly expressed in bladder cancer tissues and was related to the pathological grade and overall survival rate of bladder cancer. Knockdown of KNTC1 can inhibit the proliferation, migration, and in vivo tumorigenesis of bladder cancer cells and promote apoptosis. KNTC1 knockdown changes the levels of many proteins in bladder cancer cells, including Caspase 3, Fas, p-Akt, CDK6, PIK3CA, and MAPK9. Conclusion - KNTC1 plays a crucial role in the development of bladder cancer, and our findings provide evidence for its use as a therapeutic target.

LncRNA CARLo-7 facilitates proliferation, migration, invasion, and EMT of bladder cancer cells by regulating Wnt/ß-catenin and JAK2/STAT3 signaling pathways.

BACKGROUND: Aberrant expression of long noncoding RNAs (lncRNAs) has been found to enroll in the initiation and progression of bladder cancer (BC). Earlier results show cancer-associated region long noncoding RNA-7 (CARLo-7) can be a prognostic marker for BC, but its biological function and the underlying mechanism is still to be discovered. Our study aims to explore the effects of CARLo-7 on the initiation and progression of BC and the potential mechanisms. METHODS: The expression of CARLo-7 in BC tissues and cell lines was determined by quantitative real-time polymerase chain reaction (qRT-PCR). T24 and HT1197 cells were transfected with CARLo-7 expression vector or sh-CARLo-7, then cell viability assay, BrdU assay, flow cytometry, Transwell cell migration, and invasion assay, and western blot were conducted to evaluate cell proliferation, apoptosis, invasion, migration, and epithelial-mesenchymal transition (EMT). RESULTS: CARLo-7 was dramatically upregulated in BC tissues and cell lines. Silencing CARLo-7 by sh-CARLo-7 significantly suppressed proliferation and induced apoptosis of BC cells, while enforced CARLo-7 expression promoted cell proliferation. Meanwhile, silencing CARLo-7 attenuated migration, invasion, and EMT of BC cells, while CARLo-7 overexpression had the contrary effects. The ß-catenin, p-JAK2 and p-STAT3 levels were decreased by CARLo-7 knockdown, while activation of Wnt/ß-catenin or JAK2/STAT3 pathways abolished the effects of CARLo-7 knockdown on cell proliferation and migration. CONCLUSIONS: Collectively, CARLo-7 plays a critical role in regulating BC development by regulating cell proliferation, migration, invasion, and EMT through Wnt/ß-catenin and JAK2/STAT3 signaling. Therefore, CARLo-7 might be a promising therapeutic target for BC.

Long non-coding RNA MEG3 functions as a competing endogenous RNA of miR-93 to regulate bladder cancer progression via PI3K/AKT/mTOR pathway.

BACKGROUND: Maternally expressed gene 3 (MEG3) is a long non-coding RNA (lncRNA) and involved in progression of various human tumors. However, its underlying regulatory mechanism in tumorigenesis of bladder cancer (BC) remains unclear. To demonstrate effects of MEG3 on BC cell proliferation and elaborate its regulatory mechanism in BC. METHODS: Aberrant expressions of MEG3 and miR-93-5p were induced by cell transfection. The mRNA and protein expression were analyzed using qRT-PCR and western blot. Cell proliferation was examined by CCK-8 assay and EdU staining. The targeted regulation effect of MEG3 on miR-93-5p was confirmed by luciferase reporter assay. The number of LC3 punctated cells was detected by immunofluorescence. Xeno-graft mouse model was constructed for in vivo validation. RESULTS: MEG3 was down-regulated with increased expression of miR-93-5p in BC cells and tissues. Luciferase reporter assay showed that miR-93-5p was a direct target of MEG3 and was negatively regulated by MEG3. MEG3 overexpression inhibited cell proliferation and the expression of proliferation-, apoptosis- and autophagy-related proteins. The activation of PI3K/AKT/mTOR pathway was also suppressed with elevated cell apoptosis. miR-93-5p overexpression counteracted these results. In vivo experiments, we confirmed that miR-93-5p overexpression reversed the MEG3 overexpression-mediated suppression on tumor growth and protein expression. CONCLUSIONS: lncRNA MEG3 could function as a competing endogenous RNA of miR-93 to regulate the tumorigenesis of BC via PI3K/AKT/mTOR pathway. The present research provided a new perspective to understanding the pathogenic mechanism of BC, and an effective therapeutic target for BC.

The Effectiveness of Sorafenib over Other Targeted Agents in the Second-Line Treatment of Metastatic Renal Cell Carcinoma: a Meta-Analysis.

The aim of the study was to perform a meta-analysis to compare the therapeutic effects and adverse events (AEs) of sorafenib in second-line treatments of metastatic renal cell carcinoma (mRCC). We searched online electronic databases: Pubmed, Embase, Cochrane library updated on November 2017.Trials of the effectiveness of sorafenib in second-line treatments of advanced RCC were included, of which the main outcomes were objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and grade 3/4 AE. Other TAs significantly reduced the risk of PFS compared to sorafenib with respect to second-line treatment (HR = 0.74; 95% CI, 0.65-0.83; p < 0.00001). No significant differences were, however, found in patients in terms of the ORR (HR = 1.82; 95% CI, 0.98-3.35; p = 0.06). Frequencies of the most common toxicities were overall similar and adverse events differed only in sensitivity analysis in rash with exclusion of other TAs (HR = 0.16; 95% CI, 0.05-0.52; p = 0.002). Overall survival was not debated between groups. In patients with mRCC, second-line sorafenib is associated with similar ORR as other target agents. While, sorafenib did not demonstrate a PFS advantage compared with other target agents, suggests sorafenib may not benefit patients with mRCC. Tolerability due to toxicities is similar compared sorafenib with other target agents. Further characterization of the RCC oncogenic pathway, and the ongoing clinical trials should help optimize the treatment option for second-line therapy of advanced renal cell carcinoma.

[Analysis of clinical features of retroperitoneal bronchogenic cyst].

OBJECTIVE: To analyze the clinical features of retroperitoneal bronchogenic cyst. METHODS: The clinical data of 6 cases with retroperitoneal brochogenic cyst treated in Peking Union Medical College Hospital from April 1996 to October 2014 were retrospectively analyzed. The clinical manifestation, diagnosis, treatment and prognosis were analyzed. RESULTS: Of the patients, 1 was male and 5 were female aging from 31 to 50 years with a mean age of 38.3 years. Three cases were diagnosed from physical examination, 2 cases from upper abdominal pain and 1 case from left flank pain. The cysts located in the left adrenal region, between the liver and the pancreas, and anterior aspect of the tail of the pancreas were seen in 4 cases, 1 case and 1 case, respectively. The major diameter was from 5 cm to 13 cm, and the mean major diameter was 7 cm. Ultrasonography and CT scan could reveal cystic, cystic-solid or solid masses. Color doppler flow imaging showed no obvious blood flow, and contrast-enhanced CT scans showed no enhancement or no obvious enhancement. Six cases were all misdiagnosed preoperatively. They all underwent operations via retroperitoneal laparoscopic resection for 3 cases, laparotomy for 2 cases and open flank resection for 1 case respectively. The pathological diagnoses were all bronchogenic cysts. Three symptomatic patients became asymptomatic after operations. Five patients had been followed up. During the follow-up of 2 months to 15 years, no recurrence had been found with CT scan. CONCLUSIONS: Retroperitoneal bronchogenic cyst is rare and easily misdiagnosed. It should be considered in the differential diagnosis of a retroperitoneal mass. Most cysts are positioned in the left adrenal region and adjacent regions. Some cysts demonstrate soft tissue characteristics in image. After surgical removal, the patients have a good prognosis.