Long noncoding RNA lung cancer associated transcript 1 promotes proliferation and invasion of clear cell renal cell carcinoma cells by negatively regulating miR-495-3p.

Recently, long noncoding RNAs have emerged as new gene regulators and prognostic markers in several cancers, including renal cell carcinoma (RCC). Here, we focused on the long noncoding RNA lung cancer associated transcript 1 (LUCAT1) based on clear cell RCC (ccRCC) the cancer genome atlas (TCGA) data. However, whether aberrant expression of LUCAT1 in ccRCC is correlated with malignancy, metastasis or prognosis has not been elucidated. In the current study, we found that the expression of LUCAT1 was upregulated in ccRCC tissues and cancer cell lines. Upregulated LUCAT1 was positively correlated with larger tumor size, advanced tumor-node-metastasis (TNM) stage, higher smoking frequency, nodal metastasis and shorter overall survival in patients with ccRCC. Inhibition of LUCAT1 by small interfering RNA reduced cell proliferation and invasion of ccRCC cells in vitro. In vivo assay showed that the tumor volume and weight were lower in the group of LUCAT1 inhibition than that in the control group. We then found that LUCAT1 directly bound and inhibited the expression of micoRNA-495-3p (miR-495-3p), which subsequently regulated the expression of special adenine-thymine (AT)-rich DNA-binding protein 1 (SATB1). Collectively, LUCAT1 was critical for proliferation and invasion of ccRCC cells by regulating miR-495-3p and SATB1. Our findings indicated that LUCAT1 and miR-495-3p may offer potential novel therapeutic targets of treatment of ccRCC.

[Safety and efficacy of China-made sildenafil citrate in the treatment of erectile dysfunction].

OBJECTIVE: To evaluate the safety, efficacy and tolerability of China-made sildenafil citrate (Jinge) in the treatment of ED. METHODS: We conducted a multi-center, randomized, double-blind and placebo-controlled clinical trial among 222 ED patients in five urological or andrological clinics of China. The patients were randomly assigned to receive sildenafil citrate (SC, n = 111) or placebo (n = 111) for 8 weeks. We obtained and analyzed the demographic and clinical characteristics of the patients, the scores of International Index of Erectile Function (IIEF), the success rate of sexual intercourse, and the incidence of adverse events. RESULTS: No statistically significant differences were found between the patients of the SC and those of the placebo group in the mean age (ï¼»47.2±11.32ï¼½ yr vs ï¼»46.67±13.08ï¼½ yr, P>0.05), psychological etiology (27.93% vs 23.42%, P>0.05), organic etiology (21.62% vs 29.73%, P>0.05) or mixed etiology (50.45% vs 46.85%, P>0.05), nor in height, weight, nationality, or history of smoking, drinking or allergy. Compared with the placebo controls, the SC-treated patients showed significant increases in the excellence rate of effectiveness (29.91% vs 78.90%, P<0.01), success rate of sexual intercourse (29.16% vs 63.87%, P<0.01), and total effectiveness rate (34.58% vs 77.98%, P<0.01). The effectiveness rates on organic, psychogenic and mixed types ED were remarkably higher in the SC group (64.52%, 83.33%, and 82.14%) than in the placebo control (46.15%, 21.21%, and 25.00%) (P<0.01). Mild or temporary adverse events were observed in 32 cases in the SC group as compared with 13 in the placebo control. CONCLUSIONS: China-made sildenafil citrate is an effective, safe and well-tolerated drug for ED of different etiologies in the Chinese population.

Visceral fat accumulation is associated with different pathological subtypes of renal cell carcinoma (RCC): a multicentre study in China.

OBJECTIVE: To investigate whether visceral obesity is associated with certain histological subtypes of renal cell carcinoma (RCC) ina multicentre Chinese cohort. PATIENTS AND METHODS: A kidney tumour database was created using three tertiary centres in China; 487 patients were enrolled presenting with localised RCC and complete computer tomography(CT)/magnetic resonance imaging (MRI) information. A single-slice CT image was used to measure the area of visceral and subcutaneous adipose tissues in each patient. Statistical methods were used to analyse clear-cell RCC (ccRCC) and non-clear-cell RCC (non-ccRCC) as they relate to visceral fat area (VFA) and other risk factors, such as age, gender, tumour size, diabetes, hypertension, total fat area (TFA) and body mass index (BMI). RESULTS: In all, 418 patients had a ccRCC subtype and 69 had a non-ccRCC subtype. For all the patients with RCC, the mean VFA was 102 cm2, while mean BMI was 24 kg/m2. The mean VFA was greater in ccRCC than non-ccRCC patients by 25 cm2. There were significant differences in the mean VFA and TFA between patients with ccRCC and those with non-ccRCC.Multivariate analysis showed that the presence ofVFA was more important than the effects of BMI and Type 2 diabetes on pathology prediction. In patients with a normal BMI, those with a higher quartile of VFA were more likely to develop ccRCC than those with a low VFA. CONCLUSIONS: Increased visceral fat was found to be associated with ccRCC and the significance of VFA outweighed the effects of BMI and Type 2 diabetes for the prediction of RCC pathology in multivariate analyses. As a result, VFA could constitute a primary explanation for the link between obesity and ccRCC.

[Clinical research on the correlations between type 2 diabetes mellitus and renal clear cell carcinoma].

OBJECTIVE: To investigate the relationship between renal clear cell carcinoma and type 2 diabetes mellitus (DM). METHODS: Two hundreds and sixty-four patients with renal clear cell carcinoma and four hundred controls who suffered from non-urinary system, non-neoplastic or non-hormone-related disorders, were enrolled from January 2008 to December 2012. The incidence of diabetes between the 2 groups and the relationship between renal clear cell carcinoma and duration of diabetes were compared, moreover, renal clear cell carcinoma patients with DM were compared with patients without DM for their clinical features, laboratory examinations and histological characteristics. RESULTS: The comparison of renal clear cell carcinoma group and control group: the incidence of DM in the two groups were 19.7% and 12.8% respectively, and the difference was significant (χ(2) = 5.86, P < 0.05, OR = 1.68). In the renal clear cell carcinoma group, the proportion of patients with DM diagnosed within 2-4 years was 4.92%, which were significant higher than those in the control group 1.70% (χ(2) = 5.49, P < 0.05, OR = 2.91). And men with diabetes had high occurrence risk 86% of renal clear cell carcinoma (OR = 1.86, 95%CI: 1.09-3.15). The comparison of diabetes patients subgroup and non-diabetic patients subgroup in renal clear cell carcinoma group: in respect of clinical features, greatest tumor diameter in the two subgroups were (4.9 ± 2.3) cm and (4.2 ± 2.1) cm respectively, and the difference was significant (t = 1.96, P < 0.05). However, there was no significant difference in terms of age, gender and cancer location between the two subgroups (P > 0.05). In respect of laboratory examinations, serum creatinine in the two subgroups were (72 ± 20) µmol/L and (65 ± 17) µmol/L, and the difference was significant (t = 2.34, P < 0.05); serum urea nitrogen in the 2 subgroups were (7.1 ± 2.1) mmol/L and (6.0 ± 1.5) mmol/L respectively, and the difference was significant too (t = 1.47, P < 0.05). In respect of histological characteristics, the proportion of well differentiated clear cell carcinoma were 80.8% and 81.1% respectively, and the difference was significant (χ(2) = 4.23, P < 0.05). The proportion of stage II were 25.0% and 27.8% respectively and the difference was significant (χ(2) = 4.08, P < 0.05). CONCLUSIONS: DM is closely related with renal clear cell carcinoma and DM may be a possible risk factor for the tumor. And for elderly patients with diabetes who appear waist discomfort or hematuria, a careful examination of kidney is important to make early diagnosis, give timely treatment and improve survival prognosis.

[Effects of neoadjuvant chemotherapy on the prognostic mortality risk of invasive transitional bladder cancer: a meta-analysis].

OBJECTIVE: To systematically assess the effects of neoadjuvant chemotherapy on the prognostic risk of invasive transitional bladder cancer. METHODS: All known randomized controlled trials (RCTs) on neoadjuvant chemotherapy in the treatment of invasive transitional bladder cancer, published from the date of database building to September 2012, were retrieved from such databanks as Pubmed, CBMdisc, Embase and Cochrane. The data on 5-year survival rate of included studies were extracted for further heterogeneity exploration, subgroup analysis and statistical pooling with the RevMan 5.10 software. RESULTS: Fourteen subjects involving 2072 cases and 2086 controls were published from 1991 to 2012. The overall odds ratio of survival suggested a 21% relative reduction in mortality risk for neoadjuvant chemotherapy compared to that on control (OR = 0.79, 95%CI:0.70-0.90). In subgroup analysis according to different neoadjuvant chemotherapies, MCV (methotrexate, cisplatin and vinblastine) and MVAC (methotrexate, vinblastine, adriamycin and cisplatin) chemotherapies showed significant benefit to overall survival with 28% and 25% reduction in risk of death respectively (OR = 0.72,95%CI:0.60-0.86, OR = 0.75,95%CI:0.59-0.96) . However, no significant difference existed in effects between C (cisplatin) chemotherapy, CM (cisplatin and methotrexate) chemotherapy and CD (cisplatin and docetaxel) chemotherapy and controls. In subgroup analysis according to local treatment of cystectomy or radiotherapy after neoadjuvant chemotherapy, the patients with cystectomy showed significant benefits in overall survival with 25% reduction in risk of death (OR = 0.75, 95%CI:0.65-0.87). However, the patients with radiotherapy or radiotherapy plus cystectomy showed no significant benefits in overall survival. CONCLUSIONS: MCV and MVAC neoadjuvant chemotherapies improve survival among patients with bladder cancer. And neoadjuvant chemotherapy has better long-term survival after cystectomy.

[Efficacies of sorafenib plus interferon in advanced renal cell carcinoma: a report of 57 cases].

OBJECTIVE: To explore the efficacies and adverse events of sorafenib in the treatment of advanced metastatic renal cell carcinoma. METHODS: A total of 57 patients with advanced kidney cancer were recruited from our hospital from April 2007 to October 2011. They were divided into sorafenib group (A, n = 24) and sorafenib + IFN group (B, n = 33). The primary endpoints included objective response rate and progression-free survival (PFS). And the secondary endpoints were overall survival (OS) and incidence of adverse events. RESULTS: The mean medication time of group A was 15 (7-56) months. The outcomes were partial response (PR, n = 1), stable disease (SD, n = 8), progressive disease (PD, n = 1) and death (n = 14). The rates of objective response and disease control were 4.2% (1/24) and 37.5% (9/24) respectively. For group B, the mean medication time was 15 (4-30) months. The outcomes were PR (n = 2), and include 2 patients of PR, 21 examples of SD, 1 patient of PD and death. The rates of objective response and disease control were 6.1% (2/33) and 69.7% (23/33) respectively. Two groups had no significant difference in incidence or severity of adverse events (both P > 0.05). CONCLUSIONS: As a safe and effective agent for advanced kidney cancer, sorafenib is well-tolerated in patients. The combined use of interferon may improve the therapeutic efficacies without an occurrence of adverse events.

Large ureteral fibroepithelial polyp lacking epithelium due to ischemic infarction.

We describe a woman with flank pain and hydronephrosis. Computed tomography (CT) urography and maximum intensity projection (MIP) reformatted images clearly showed that a long finger-like intraluminal filling defects mass in the left middle ureter. The pathologic biopsy by ureteroscopy revealed that the lesion mainly consists of benign fibrinoid necrosis. A large soft smooth, spindle-like, dark brown mass (approximately 13.5 cm in length) was identified in left middle ureter when open surgery was performed. The segment of the ureter part attached to the stalk of the polyp was excised, then a dismembered ureteroplasty was performed. Pathologic examination revealed that the total polyp was an ischemic infarction, characteristic of cellular swelling, tissue degeneration, fibrinoid necrosis, and thrombosis in its vessels. The surface of the polyp was hardly covered with urothelium, but fibroepithelial polyp was still diagnosed. There was no recurrence during the 3 years of follow-up.

[Transurethral prostatectomy with the bipolar plasmakinetic technique for benign prostate hyperplasia: a report of 712 cases].

OBJECTIVE: To evaluate the effect and safety of transurethral prostatectomy with the bipolar plasmakinetic technique (PKRP) in the treatment of benign prostate hyperplasia (BPH). METHODS: A total of 712 BPH patients underwent transurethral prostatectomy with the bipolar plasmakinetic technique. The patients averaged 70.6 years of age and 52 g (range 35-102 g) in estimated prostate weight preoperatively. Comparative analyses were made on the maximum urine flow rate (Qmax), residual urine volume and scores on IPSS and QOL obtained pre- and post-operatively. RESULTS: The operations lasted 20-120 minutes (mean 51 min), the resected tissues weighed 15-96 g (mean 46 g), and no transurethral resection syndrome (TURS) occurred. The catheters were removed 4 -5 days after surgery. The patients were followed up for 1 -52 months (mean 27.6 mo). Obvious reduction was observed in the average Qmax from 4.7 ml/s preoperatively to 19. 1 ml/s postoperatively, in the mean IPSS score from 26.6 to 5. 8, and in the mean QOL score from 5.4 to 1.7, all with significant differences (P < 0.01). CONCLUSION: Transurethral prostatectomy with the bipolar plasmakinetic technique is a safe and effective means for the treatment of BPH.

Significance of margin in nephron sparing surgery for renal cell carcinoma of 4 cm or less.

BACKGROUND: Current surgical practice for nephron sparing surgery allows at least 1 cm margin of normal tissue around the tumour. However, recent studies show that the width of the margin is not important, even simple enucleation is as effective as partial nephrectomy. We explored whether margin size has significant impacts on clinical outcomes in nephron sparing surgery for renal cell carcinoma of 4 cm or less. METHODS: Between 1998 and 2006, 115 patients with sporadic, pathologically confirmed, renal cell carcinoma 4 cm or less (T1a) and normal contralateral kidney were treated by nephron sparing surgery using a margin less than 5 mm. The surgical margin status was evaluated from frozen and permanent paraffin sections. RESULTS: Mean and median tumour diameter were 3.3 cm and 3.5 cm (range 1.0-4.0). The mean margin width was 2.2 mm (median 2.0, range 0-6). In addition, 114 cases had margins 5 mm or less (99.1%), 97 cases (84.3%) had margin 3 mm or less, and 26 cases had margin zero (22.6%). None of the patients had positive surgical margins. No patients died during follow-up (mean 65 months). There were no any major surgical complications and no distant metastasis was detected. Local recurrence was detected in one case (0.9%) at a different site of the kidney. CONCLUSIONS: For early localized renal cell carcinoma of 4 cm or less, as long as tumour is completely excised, the size of margin in nephron sparing surgery is not important. Nephron sparing surgery with 5 mm margin is enough for tumour control. It provides excellent renal function preservation, favourable long term progression free survival and is not associated with an increased risk of local recurrence.

[Long-term outcomes of mini-margin nephron sparing surgery for renal cell carcinoma].

OBJECTIVE: To study the safety and effects of mini-margin nephron sparing surgery (NSS) for renal cell carcinoma (RCC). METHODS: From January 1998 to December 2006, 115 cases of RCC with diameter of 4 cm or less and stage of T1aN0M0 were treated with NSS using a margin of 5 mm or more. The mean diameter of the tumors was 3.3 cm (range 1.0-4.0 cm). Of the cases, 3 were with synchronous bilateral cancer while 112 cases were with normal opposite kidneys. The clinical results were followed and analyzed. RESULTS: All of the operations were technically successful. The mean duration of surgical procedures was 90 min (ranged 80-120 min). The blood loss was 50 -200 ml. No patient needed blood transfusion. Renal arteries were occluded in 98 cases under hypothermic technique for a mean duration of 22 min (20-25 min). While in 17 cases, renal parenchyma squeezing was used for bleeding control. All of the 115 cases were of negative margin by weather frozen or routine pathologic study. The mean follow-up was 62 months (6-96 months). Local recurrence was found in 1 case during follow-up, with a local recurrence rate of 0.9%, while no distant metastasis was detected. All the patients were alive with no evidence of tumor bearing until last evaluation. Secondary gross hematuria occurred in 3 cases during hospital stay and cured by bed limitation. There were no major complications such as bleeding and urinary leakage or urinoma requiring re-operation. CONCLUSIONS: Mini-margin nephron sparing surgery is likewise safe and effective in treating early localized renal cell carcinoma 4 cm or less. It provides excellent renal function preservation, favorable long-term progression-free survival, and is not associated with an increased risk of local recurrence.

Safety and efficacy of mini-margin nephron-sparing surgery for renal cell carcinoma 4-cm or less.

OBJECTIVES: To explore whether mini-margin nephron-sparing surgery (NSS) is clinically safe and effective for renal cell carcinoma (RCC) of 4 cm or less with a normal contralateral kidney. METHODS: A total of 115 patients with sporadic, pathologically confirmed RCC of 4 cm or less (Stage T1a), with a normal contralateral kidney, were treated by NSS using a mini-margin of less than 5 mm from 1998 to 2006. The surgical margin status was evaluated by both frozen and permanent paraffin section studies. The patients were followed up, and the data were analyzed. RESULTS: The mean and median tumor diameter was 3.3 and 3.5 cm (range 1.0 to 4.0). None of the patients had positive surgical margins detected at either frozen section or final paraffin section analysis. The mean margin width was 2.2 mm (median 2.0, range 0 to 6). Of the 115 patients, 114 had margins of 5 mm or less (99.1%), 97 (84.3%) had margins of 3 mm or less, and 26 had margins of 0 mm (22.6%). At a mean follow-up of 65 months (median 66, range 9 to 105), all patients were alive. No distant metastasis was detected. Local recurrence was detected in 1 patient (0.9%) at a different site in the kidney. No major surgical complications, such as hemorrhage or urinary leakage/urinoma requiring reoperation, occurred. Considering only the 97 patients with follow-up of more than 3 years in the analysis, the mean and median follow-up time was 73 and 69 months (range 37 to 105), respectively. All 97 patients were alive with no evidence of disease at the last visit. CONCLUSIONS: The results of our study have shown that mini-margin NSS is a safe and effective approach for treating early localized RCC of 4 cm or less.

[P53 expression and its clinical significance in prostatic carcinoma].

OBJECTIVE: To investigate the expression of P53 protein and its clinical significance in prostatic carcinoma. METHODS: Formalin-fixed, paraffin-embedded tissue sections from 45 cases of prostatic carcinoma (PCa) and 10 cases of benign prostate hyperplasia (BPH) were analyzed retrospectively with immunohistochemical Elivision staining method. The relationship of P53 expression with prostate cancer stage, grade, PSA, endocrine therapeutic effect and prognosis was evaluated. RESULTS: The positive staining rates of p53 protein expression were 51.1% and 10.0% respectively in patients with PCa and BPH (P < 0.05); 70.0% and 25.0% in PCa patients at pathological stage D and stages A approximately C respectively (P < 0.05); 14.3% and 56.7% in those with Gleason score < or = 7 and > 7 (P < 0.05); 20.0% and 60.0% in those with PSA < or = 10 microg/L and PSA > 10 micro/L (P > 0.05 ); 25.0% and 72.3% in those who responded to endocrine therapy and those who failed to respectively (P < 0.05). Log Rank analyses showed that the survival time of the PCa patients with negative P53 expression was obviously longer than those with the positive (P < 0.05 ). CONCLUSION: There were correlations between P53 expression and tumor grade, tumor stage and survival time, so the expression of P53 could be regarded as a prognostic molecular marker and a predictor of endocrine therapeutic effect for prostate cancer.

[Transurethral prostatectomy with the bipolar plasma kinetic technique for benign prostate hyperplasia: a report of 297 cases].

OBJECTIVE: To evaluate the effect and safety of transurethral prostatectomy with the bipolar plasma kinetic technique (PKRP) in the treatment of benign prostate hyperplasia(BPH). METHODS: Two hundred and ninty-seven BPH patients underwent transurethral prostatectomy with the bipolar plasma kinetic technique. The preoperative estimated weight of the prostate ranged from 35 g to 102 g, averaging 52 g. RESULTS: The operation lasted 40 approximately 65 min, averaging 51 min. The resected tissues weighed 40 approximately 80 g, averaging 46 g. During the operation no transurethral resection (TUR) syndrome occurred. The catheter was removed 4 approximately 5 days after the operation, all with fluent urination. The patients were followed up for 2 approximately 33 months. IPSS decreased from average 31.5 preoperatively to average 6.8 postoperatively (P < 0.001). Average maximum flow-rate (Q(max)) decreased from 6.3 ml/s preoperatively to 18.6 ml/ s postoperatively (P < 0.001). Preoperative average residual urine was 97 ml and reduced to average 9 ml after the operation. Temporary incontinence occurred in 4 cases, perioperative hemorrhage in 2, and urethral stricture in 1. CONCLUSION: Transurethral prostatectomy with the bipolar plasma kinetic technique is a safe and effective means for the treatment of BPH.

[The combined therapy of intervention, operation and biology in patients with middle-advanced renal cell carcinoma].

OBJECTIVE: To observe the effect of the combined therapy of intervention, operation and biology in patients with middle-advanced renal cell carcinoma. METHODS: Combined therapy was used in 52 cases as combined care groups and the single operational therapy was used in 50 cases as control group. Compare their resection rates, surgical risks and 3, 5 years survival rates. RESULTS: In the combined care group, the excision rate was 100%, the average amount of blood transfusion during the operation was 280 ml, the average operation time was 100 minutes, and the 3, 5 years survival rates were 73% and 50%; While in the control group, the results were 90%, 396 ml, 130 minutes, 55% and 27% respectively. There were significant differences between 2 groups (P < 0.05). CONCLUSION: Combined therapy could elevate resection rates and 3, 5 years survival rates and decrease surgical risks.