Renal clear cell carcinoma undergoing cystic change: A cases report and review of the literature.

INTRODUCTION: We presented a case diagnosed the renal clear cell carcinoma undergoing cystic change (RCCCC) with detailed clinical data. Along with literature review, we aimed to investigate clinical diagnosis and treatment of RCCCC and explore the differential diagnosis of RCCCC and multilocular cystic renal cell carcinoma (MCRCC). CASE PRESENTATION: The patient was diagnosed with a right renal cyst after physical examination, which was misdiagnosed as a renal cyst by imaging examination. Intraoperative surgical treatment was performed to remove the roof and decompress the renal cyst. Rapid pathology revealed MCRCC with low malignant potential during laparoscopic right renal cyst decompression. Radical nephrectomy was performed with the family's signature. The postoperative pathological diagnosis was clear cell carcinoma cystic lesion of kidney (RCCCC). No recurrence or metastasis during 1 year follow-up. CLINICAL DISCUSSION: RCCCC cases were similar to classical clear cell renal carcinoma. Radical nephrectomy should be avoided in patients with MCRCC, and radical nephrectomy should be chosen in patients with RCCCC, with postoperative and close follow-up. Unroofing decompression of renal cyst was performed during the operation, and the risk of tumor implantation and metastasis was worried after the operation. The patient agreed to receive eight cycles of immune checkpoint inhibitor therapy after surgery. Adrenal insufficiency occurred after 8 cycles of immune checkpoint inhibitor therapy(ICIs), then the immunotherapy was discontinued. CONCLUSION: RCCCC is a rare and special type of renal clear cell carcinoma, and its prognosis is the same as that of renal clear cell carcinoma. The preoperative diagnosis of RCCCC mainly depends on imaging examination (CT or B-ultrasound). The early differential diagnosis from multilocular cystic renal cell carcinoma is difficult, and the diagnosis usually depends on postoperative pathological diagnosis.

One-pot reaction for the preparation of diatom hemostatic particles with effective hemostasis and economic benefits.

Effective hemostatic materials have been in demand for rapid pre-hospital hemostasis in emergency situations, which can significantly reduce accidental deaths. The development of emergency hemostatic materials with rapid hemostasis, biosafety, and economical preparation is a great challenge. In this study, Ca(OH)2-complexed diatom powder hemostatic particles (Ca(OH)2-Php) were prepared based on a one-pot reaction by directly mixing various raw materials and by rotary granulation. High-temperature calcination was able to carbonate and consume the organic matter in the hemostatic particles. The crosslinked hydrogen bonds in those particles were converted to silica-oxygen bonds, the particles became more stable, and the porous structure of diatom biosilica (DBs) was exposed. Ca(OH)2-Php has high porosity, can quickly adsorb the water in blood (water absorption: 75.85 ± 6.93%), and exhibits rapid hemostasis capacity (clotting time was shortened by 43% compared with that of the control group), good biocompatibility (hemolysis rate <7%, no cytotoxicity), and simplicity of handling (conveniently debride, no residues, no tissue inflammation). This study provides a new idea for the preparation of emergency hemostatic materials, and Ca(OH)2-Php prepared by one-pot reaction has various high-quality characteristics including rapid hemostasis, wide applicability, economical preparation, and potential for large-scale production.

Potential Mechanisms Responsible for the Antinephrolithic Effects of an Aqueous Extract of Fructus Aurantii.

The potential effects of Fa extract on the prevention and treatment of CaOx nephrolithiasis were analyzed in an ethylene glycol- (EG-) induced CaOx crystallization model in rats and an in vitro assay. Multiple biochemical variables were measured in the urine and kidney. Kidney sections were subjected to histopathological and immunohistochemical analyses. Urolithiasis-related osteopontin (OPN) was evaluated by Western blotting. The in vitro assay revealed the significant inhibition of crystal formation (3.50 ± 1.43) and dilution of formed crystals (12.20 ± 3.35) in the group treated with 1 mg/mL Fa extract compared with the control group (52.30 ± 4.71 and 53.00 ± 4.54, resp.) (p < 0.05). The in vivo experiments showed that prophylactic treatment with Fa aqueous extract significantly prevented EG-induced renal crystallization and pathological alterations compared with nephrolithic rats (p < 0.05). Significantly lower levels of oxidative stress, oxalate, and OPN expression as well as increased citrate and urine output levels were observed in both the low- and high-dose prophylactic groups (p < 0.05). However, in the low- and high-dose therapeutic groups, none of these indexes were significantly improved (p > 0.05) except for urinary oxalate in the high-dose therapeutic groups (p < 0.05). Fa extract prevented CaOx crystallization and promoted crystal dissolution in vitro. Additionally, it was efficacious in preventing the formation of CaOx nephrolithiasis in rats.