Dongjie Li

miRNA-205 is a candidate tumor suppressor that targets ZEB2 in renal cell carcinoma.

SummaryBackground: This study aims to characterize the function of downregulated MicroRNA miR-205 in renal cell carcinoma (RCC), and show how the downstream zinc finger E-box-binding homeobox 2 (ZEB2) is negatively regulated by miR-205. Materials and Methods: The expression of miR-205 was detected in RCC and adjacent non-tumor tissues using real-time polymerase chain reaction (PCR). The expression of miR-205 and ZEB2 was detected in RCC cell lines using real-time PCR. The luciferase reporter assay was used to assess ZEB2 as a target of miR-205. Protein levels of ZEB2, E-cadherin, and vimentin were measured by western blot after overexpression of miR-205 in ACHN cells. In vivo functions of miR-205 in ACHN cells were measured by MTT assays, migration and invasion assays, and flow cytometry. Results: MiR-205 was significantly downregulated in RCC samples and cell lines compared with matched non-tumor tissues and HK-2 cells, respectively. No significant difference was found in miR-205 expression between well differentiated and poorly to moderately differentiated groups or between phase I and phase II-III. ZEB2 was upregulated in RCC cell lines compared with expression in HK-2 cells. Upregulation of miR-205 expression caused the downregulation of ZEB2 and vimentin, and the upregulation of E-cadherin in ACHN cells. miR-205 also inhibited proliferation, migration, and invasion, and induced apoptosis of ACHN cells. Conclusion: miR-205 is a candidate tumor suppressor that targets ZEB2 in RCC.

Laparoendoscopic Single-Site Ureteroureterostomy with Intraoperative Retrograde Ureteroscopy-Assisted Technique for Benign Proximal and Middle Ureteral Strictures: A Single-Center Experience

OBJECTIVE To report a minimally invasive and reproducible technique that greatly facilitates the identification of the stricture during laparoendoscopic single-site ureteroureterostomy (LESS-UU) for benign proximal and middle ureteral strictures, using the intraoperative retrograde ureteroscopy-assisted technique. PATIENTS AND METHODS Between April 2011 and January 2013, 13 patients with a benign proximal or middle ureteral stricture underwent LESS-UU at our institution. A combination of diuretic renal scans, antegrade/retrograde ureteropyelography and/or computed tomography, and stent placement or exchange was preoperatively performed to assess all patients. The intraoperative retrograde ureteroscopy-assisted technique was used to identify the exact position of the stricture and place the stenting during LESS-UU. RESULTS Intraoperative retrograde ureteroscopy was successfully performed in all cases. The mean operative time was 156 minutes (range, 125-190 minutes), and the estimated blood loss was 80 mL (range, 20-160 mL). The mean hospital stay was 5 days (range, 4-7 days). One patient required conversion to open surgery because of the severe adhesions surrounding the stricture that resulted in failure to progress. Urine leakage occurred in 1 patient postoperatively and was successfully treated by conservative management. Postoperative fever occurred in another patient, who was treated with a dose of oral antibiotics. No major intraoperative or postoperative complication occurred. Clinical and radiographic success was achieved in 100% (13/13) of patients during a mean follow-up of 13.1 months (range, 9-27 months). CONCLUSIONS LESS-UU is feasible and safe for repairing benign proximal and middle ureteral stricture. The intraoperative retrograde ureteroscopy-assisted technique during LESS-UU is useful for localizing the stricture.

Management of Intravenous Migration of Urologic Catheter

OBJECTIVE To summarize the management of an intravenous urologic catheter. METHODS We retrospectively studied 2 patients in our hospital and all relevant literature published in English between 1980 and 2012. The treatment processes of our patients are described in detail. All patients (including those reported in the literature) are characterized by age, sex, relevant history, operation, location, method of retrieval, and prognosis. RESULTS The patients were a median age of 48.5 years (range, 29-63 years). Female patients were younger (median age, 41 vs 54 years) and had greater percentage of migration (70% vs 30%) than male patients. Most patients (90%) had a history of chronic inflammation or operation on the affected kidney. All migrations (3 right and 7 left) occurred during or after endourologic procedures. Most were managed with bed rest, antibiotics, and thromboprophylaxis, and the catheters were eventually retrieved using noninvasive methods. Removal in 1 patient required open surgery. CONCLUSION Some elements, such as relevant history, may be a risk factor for intravenous migration of a urologic catheter. Most of these patients could be managed uneventfully by minimally invasive approaches.

Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China.

OBJECTIVE To assess the pathophysiologic composition and age structure of erectile dysfunction (ED) in men visiting outpatient clinics in China. METHODS We studied 3327 consecutive ED outpatients (median age 39 years) from 2006 to 2010 in the 5 training hospitals in China. Every patient was independently evaluated by an experienced urologist/andrologist using comprehensive diagnostic procedures. The simplified International Index of Erectile Function was used to assess the severity of ED. RESULTS Most patients (95.0%) were <60 years old, and none were >70 years old. The psychogenic patients were younger and had greater percentage than any other patients. Vasculogenic factors were a major etiology of organic ED. A significant difference was found in the age distribution between the patients with psychogenic ED and those with organic ED (P = .000). Diabetes, hypertension, coronary artery disease, and hyperlipidemia played significant roles in affecting the severity of ED in a statistical model, including age. The International Index of Erectile Function scores decreased with age (rs = -0.199, P = .000). Moreover, the percentage of severe and moderate cases increased with age (P = .003 and P = .002, respectively). However, the constituent ratio of patients sharply declined from 30.3% to 4.5% with age. CONCLUSION The number of men visiting outpatient clinics with psychological ED is greater than the number with organic causes in China. The age of the Chinese patients with ED who seek medical help is young and this is mainly because of inadequate sex education to young men and because most older patients are reluctant to visit the hospital just for the loss of erectile function.

Re: Intracaval migration: an uncommon complication of ureteral double-J stent placement. (From: Falahatkar S, Hemmati H, Gholamjani Moghaddam K. J Endourol 2012;26:119-121).

We read with great interest the rare complication of ureteral stent placement report by Falahatkar and associates. Our group also had a similar case and would like to share our clinical experience in managing migration of a Double-J stent into the inferior vena cava. A 41-year-old woman underwent percutaneous nephrolithotomy (PCNL) at a local hospital because of a right renal calculus. The Double-J stent was placed in the right ureter during surgery. She was discharged uneventfully 7 days after that procedure. Six weeks later, as scheduled, the patient was in clinic to have the Double-J stent removed through cystoscopy. Unfortunately, the lower end of the ureteral stent could not be visualized during this cystoscopy. Radiography of the kidneys, ureters, and bladder showed that the Double-J stent was not within ureter, only with its distal portion in the right renal pelvis and the residual catheter along the course of the inferior vena cava (Fig. 1). Her laboratory examination was unremarkable except urinalysis (occult blood + + + , white blood cell + + + ). Although the patient did not have any symptom or sign, she was transferred to our hospital 2 days later to prevent further serious complication. At our hospital, radiography (Fig. 2) and CT (Fig. 3) confirmed this unusual migration of the Double-J stent. Different from the the authors’ case, the stent was not entirely in the

AB163. Which the specific pathophysiologies is higher in simplified international index of erectile function (IIEF-5) among ED patients?

Objectives To compare the IIEF-5 score among ED patients with specific pathophysiologies. Methods We studied the IIEF-5 score of 3,327 ED patients (median age 39 years) whose primary pathophysiological causes were established by comprehensive diagnostic procedures in the urology/andrology clinics of five training hospitals in China. Results One hundred and seventy-six patients were excluded, other patients (n=3,151) with duration of ED between 0.5 year and 20 years were enrolled. The causes of ED was found be psychogenic (59.2%), vasculogenic (21.3%), neurogenic (4.1%), anatomical/structural (2.8%), hormonal (7.1%) or drug-induced (5.5%). A significant difference was detected in the median IIEF-5 score between the subjects with psychogenic and organic ED [15 (IQR: 13, 17) vs. 12 (IQR: 9.5, 14.5), P<0.001]. There was no significant difference among the organic groups (P=0.073), and no significant difference was found between arteriogenic and venogenic cause [13 (IQR: 10.5, 15.5) vs. 13 (IQR: 11, 15), P=0.912 (adjusted α =0.017)]. Conclusions Although the IIEF-5 score of men with psychological ED is greater than those with organic causes, there is no difference among patients with different organic pathophysiologies. The IIEF-5 is suitable to be a screening tool; however, our data indicate that IIEF-5 is not a definitive diagnostic tool to discriminate the pathophysiological causes of ED.