[Comparison of efficacy and safety between two different methods of nephroureterectomy in two centers].

OBJECTIVE: To compare the efficacy and safety of complete transperitoneal laparoscopic nephroureterectomy (CTNU) and traditional retroperitoneoscopic nehroureterectomy (TRNU) for the management of upper urinary tract urothelial carcinoma(UTUC). METHODS: We retrospectively collected the clinical data of UTUC patients who underwent CTNU or TRNU surgery from January 2011 to December 2018 in Peking University First Hospital and Fujian Provincial Hospital, and compared the clinical characteristics, perioperative parameters, and follow-up results between the CTNU and TRNU surgeries. RESULTS: Finally, a total of 266 cases were included, with 94 cases in the CTNU group and 172 cases in the TRNU group. The proportion of left side lesions was bigger in TRNU group when compared with CTNU group (P<0.05). No significant differences were observed in clinical characteristics, such as age, gender, body mass index (BMI), American society of anesthesiologists score (ASA score) and tumor laterality. All surgery procedures were completed. The vascular resparing was performed by reason that left arteria renalis was injured accidently during surgical operation in one case of TRNU group. No serious complications were observed in both CTNU and TRNU groups. In CTNU group, operating time was (202.9±76.7) min, estimated blood loss was (68.4±73.3) mL, drainage duration was (3.9±1.5) d, drainage volume was (181.7±251.5) mL, and postoperative hospital stay was (7.8±4.1) d. In TRNU group, operating time was (203.5±68.7) min, estimated blood loss was (130.2±252.1) mL, drainage duration was (4.3 ±1.6) d, drainage volume was (179.1±167.5) mL, and postoperative hospital stay was (8.2±3.7) d. The estimated blood loss in CTNU group was significantly less than that in TRNU group (P=0.005).The median follow-up time was 39 months (range: 1-88 months). The 5-year overall survival rate (OS), cancer specific survival rate (CSS), intra-vesical recurrence free survival rate (IvRFS), disease free survival rate (DFS) of CTNU group was 75.6%, 86.9%, 73.8%, 57.5%, respectively. The OS, CSS, IvRFS and DFS of TRNU group was 66.3%, 83.5%, 75.9%, 58.6%, respectively.No significant differences were observed in the OS, CSS, IvRFS and DFS between the CTNU and TRNU groups. CONCLUSION: CTNU technique is a safe and effective surgical option, and further prospective randomized controlled trial is needed for further evaluation.

Analysis of quality nursing of postoperative incision infection in urological patients.

To study the effect of quality nursing on postoperative incision infection in urological patients, 200 subjects admitted to our hospital between June 2016 and June 2017 were included in this study and divided into a quality nursing group (group A) and a general nursing group (group B), 100 in each group. Blood loss, blood transfusion, hospital stay, incision healing, incision infection, and self-rating depression scale (SDS) scores in both groups were compared. It was found that the bleeding volume in group A was significantly less than that in group B, and there was significant difference between the two groups (P less than 0.05) while the difference in blood transfusion rate and hospital stay between the two groups was not significant (P> 0.05); the number of patients of level 1 healing in group A was larger than that of group B while the number of patients of level 2 and level 3 healing was smaller than that of group B, with significant differences (P less than 0.05); the number of infection cases in group A was significantly lower than that in group B, and the difference was significant (P less than 0.05); the SDS score of group A was lower than that of group B, with significant differences (P less than 0.05). Therefore, quality nursing had a certain effect on the infection of postoperative incision of urological patients, which had positive significance for incision healing. Reducing the effect of bacterial infections in operated patients is important for rapid healing and patient health. Using a long-lasting antibacterial can protect the patient and reduce the incidence of other infections.

Effect of hyperphosphatemia on gene expression of the Na-Pi cotransporter in rats.

We investigated the effect of high phosphorus content on the sodium-phosphate cotransporter (NaPi-IIa and NaPi-IIl). Forty-eight Sprague-Dawley rats were divided into 3 groups: high-phosphorus group (HP) with fructose diphosphate sodium injection; self-manufactured low-phosphorus diet group (LP); and normal diet group (NP). At the 1st, 2nd, 4th, and 6th weeks, 4 rats from each group were sacrificed for detecting serum levels of calcium, phosphorus, and intact parathyroid hormone. Semi-quantitative retrovirus-polymerase chain reaction was used to detect the expression of NaPi-IIa and NaPi-III mRNA in kidney. At the 1st, 2nd, 4th, and 6th weeks, serum phosphorus and parathyroid hormone levels in HP group were significantly higher than those in LP and NP groups (P < 0.05). Serum calcium levels in the 3 groups showed no difference (P > 0.05). Comparing the expression of NaPi-IIa mRNA in HP group with LP and NP groups, NaPi-IIa mRNA expression was significantly reduced in HP group (P < 0.05), while NaPi-IIa mRNA expression in LP group began increasing at the 4th week (P < 0.05). At the 1st, 2nd, and 4th weeks, the expression of NaPi-III mRNA in HP, LP, and NP groups showed no clear differences (P > 0.05), while at the 6th week in HP group, NaPi-III mRNA expression was slightly increased compared to in LP and NP groups (P < 0.05). Hyperphosphatemia significantly affected NaPi-IIa and NaPi-III mRNA expression, and a factor promote an increase in intact parathyroid hormone independently of calcium.

Establishment and characterization of a rat model of hyperphosphatemia.

We established a rat model of hyperphosphatemia and investigated the systemic effects of high phosphorus (P). Sprague Dawley rats were randomly divided into high (HP), low (LP), and normal (NP) P groups (N = 12 each), which received injections of fructose diphosphate sodium, or were fed self-manufactured low phosphorus or normal diets, respectively. In each group, 4 rats were sacrificed at the first, third, and sixth week to detect the serum (Scr) and urinary creatinine and P, and calcium (Ca) levels. The HP group's serum P and intact parathyroid hormone (iPTH) were significantly higher than those in the other groups at the first, third, and sixth weeks, (P < 0.05); the LP group's serum P was lower than the NP group's at the third week (P < 0.05), while at the sixth week, the serum P and iPTH were lower (P < 0.05). No significant differences were detected for blood Ca+ (P > 0.05). The HP group's Scr increased (P < 0.01), whereas the fractional excretion decreased (P < 0.05) significantly. Thighbone and lumbar spine bone densities differed significantly between groups in the third week (P < 0.05); LP group densities were lower than NP group measures (P < 0.05). Crystallized stones were not observed microscopically following hematoxylin and eosin staining of the kidney. We successfully established a hyperphosphatemia rat model, and high blood P was found to significantly influence renal function and bone density. These results might provide a foundation to study the effects of hyperphosphatemia in rats.

Expression and clinical value of the soluble major histocompatibility complex class I-related chain A molecule in the serum of patients with renal tumors.

We investigated the expression and clinical value of the soluble major histocompatibility complex class I-related chain A (sMICA) molecule in the serum of patients with renal tumors. Sixty patients diagnosed with renal tumors were enrolled in the experimental group, whereas 20 healthy volunteers served as the control group. The sMICA levels were measured via enzyme-linked immunosorbent assay, and the results were analyzed in combination with data from pathol-ogy examination. The experimental group had a statistically significant higher sMICA level (P < 0.05) than the control group. The sMICA level was higher in patients with malignant tumors than in those with be-nign tumors. We also observed a positive relationship among different tumor-node-metastasis (TNM) pathological stages with more advanced diseases exhibiting higher sMICA levels. As a tumor-associated antigen, MICA has a close relationship with renal tumorigenesis and immune es-cape. Our results indicated that sMICA levels were related to tumor pathol-ogy, TNM stage, and metastasis. Therefore, sMICA might be a potential marker for tumor characteristics, prognosis, and recurrence prediction.

Substance P receptor expression in human skin keratinocytes and fibroblasts.

BACKGROUND: There is increasing evidence that neuropeptides, especially substance P (SP), may be involved in the pathogenesis of cutaneous allergic inflammation (CAI). OBJECTIVES: To investigate expression of the SP receptor (neurokinin-1 receptor, NK-1R) in human epidermal keratinocytes and dermal fibroblasts and its potential influence in CAI. METHODS: HaCaT cells (a human epidermal keratinocyte cell line) and dermal fibroblasts were cultured. The expression of NK-1R protein was examined by immunohistochemistry, and the mRNA level was detected by semiquantitative reverse transcriptase-polymerase chain reaction. The modulation of NK-1R expression in HaCaT cells and fibroblasts was detected by flow cytometry and Western blotting analysis. RESULTS: NK-1R expression was found in HaCaT cells and fibroblasts. The expression of NK-1R mRNA in fibroblasts was weaker than in HaCaT cells. SP and interferon (IFN)-gamma significantly upregulated the expression of NK-1R. [d-Arg(1), d-Trp(7,9) Leu(11)]-SP (Spantide I), a panspecific NK-1R antagonist, reduced the expression of NK-1R stimulated by SP. CONCLUSIONS: HaCaT cells and fibroblasts can express NK-1R at protein and transcription levels, and the expression was modulated by SP, IFN-gamma and Spantide I. This indicates that keratinocytes and fibroblasts are involved in the regulation of skin immunity and that NK-1R may play an important role in the pathogenesis of CAI.