Jiangping Gao

miR-708 promotes the development of bladder carcinoma via direct repression of Caspase-2

PurposeBladder cancer is one of the world’s top ten malignant tumors. The crucial role of microRNA in carcinogenesis has been well emphasized. Considering miRNA expression was tumor stage-, tissue-, or even development-specific, more experimental evidences about the functions of miRNAs in bladder cancer should be discovered to advance applying of miRNA in the diagnosis or therapy of cancer.MethodsMiR-708 level in bladder carcinoma and adjacent noncancerous tissues was tested by real-time qPCR. Cell apoptosis was analyzed by using flow cytometry. The tumorigenicity of bladder carcinoma cells was evaluated in nude mice model. Luciferase reporter gene assays were performed to identify the interaction between miR-708 and 3′UTR of Caspase-2 mRNA. The protein level of Caspase-2 was determined by western blotting.ResultsIn this study, we reported that miR-708 was frequently dysregulated in human bladder carcinoma tissues compared to normal tissues. In addition, we found that silencing of miR-708 could promote the T24 and 5637 cells to apoptosis and inhibit the bladder tumor growth in vivo. Also, Caspase-2 was proved to be one of direct targets of miR-708 in T24 and 5637 cells. Further results showed that Caspase-2 was involved in the miR-708 regulated cell apoptosis.ConclusionsAll together, these results suggest miR-708 may act as an oncogene and induce the carcinogenicity of bladder cancer by down-regulating Caspase-2 level.

Nutcracker phenomenon: A new diagnostic method of multislice computed tomography angiography

Objective:  We evaluated 3‐D computed tomography angiography (3‐D CTA) in the diagnosis of the nutcracker phenomenon, and its significance in postoperative follow up.

Photoselective laser vaporization prostatectomy for acute urinary retention in China.

PURPOSE To assess the clinical efficacy and safety of photoselective laser vaporization of the prostate (PVP) in the treatment of patients with acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH). PATIENTS AND METHODS Forty-two patients (mean age 72 +/- 5 years, range 65-89) with AUR because of BPH were treated with a prospective trial of PVP with the potassium-titanyl-phosphate (KTP) laser. The treatment outcome was evaluated with subjective and objective tests at 1, 3, 6, and 12 months after PVP using the International Prostate Symptom Score (IPSS), disease-specific quality of life (QoL) score, postvoid residual (PVR) urine volume, and maximum urinary flow rate (Qmax). The International Index of Erectile Function questionnaire and a self-designed ejaculatory questionnaire were completed at different follow-up times to determine patient satisfaction and changes in sexual function. RESULTS After preliminary urine drainage and adequate preoperative preparation, PVP was performed and bladder outlet obstruction was effectively relieved. The mean prostate volume was 62.5 +/- 11.7 cc, and the mean residual volume with retention was 650 mL (range 240-1200 mL). Mean operative time was 28.6 +/- 5.7 minutes. Mean catheterization duration was 5.6 days (range 3-14 d). There was significant subjective improvement of symptoms and objective improvement in urinary flow rates at 12 months. The mean IPSS and QoL score decreased significantly (P < 0.05). Mean PVR volume also decreased. The mean Qmax was 16.2 +/- 4.6 mL/sec after treatment. Only two patients had recurrent urinary retention during follow-up. There were no intraoperative or postoperative adverse events. CONCLUSIONS The early clinical results suggest that the PVP is a promising safe, effective, and less-invasive treatment with minimal morbidity for patients with urine retention secondary to BPH.

Expression of pituitary tumor transforming gene 1 is an independent factor of poor prognosis in localized or locally advanced prostate cancer cases receiving hormone therapy.

We investigated the prognostic value of pituitary tumor transforming gene 1 (PTTG1) expression according to clinicopathological features among localized or locally advanced prostate cancer cases receiving hormone therapy. A retrospective study involved 64 patients receiving combined androgen blockade treatment was performed. PTTG1 expression was determined by immunohistochemical staining using initial needle biopsy specimens for diagnosis. Associations of PTTG1 with various clinicopathological features and disease-free survival were examined via uni- and multivariate analyses. No association between PTTG1 expression and clinical T stage, Gleason score, pretreatment PSA levels, risk groups was found (p=0.682, 0.184, 0.487, 0.571, respectively). Univariate analysis revealed that increased PTTG1 expression, T3 stage and high risk group were associated with increased risk of disease progression (p=0.000, 0.042, and 0.001), and high PSA level had a tendency to predict disease progression (p=0.056). Cox hazard ratio analysis showed that PTTG1 low expression (p=0.002), PTTG1 high expression (p=0.000) and high risk group (p=0.0147) were significantly related to decreased disease-free survival. In conclusion, PTTG1 expression determined by immunohistochemical staining in needle biopsy specimens for diagnosis is a negative prognostic factor for progression in localized or locally advanced prostate cancer receiving hormone therapy.

Retroperitoneal laparoendoscopic single-site radical nephrectomy using a low-cost, self-made device: initial experience with 29 cases.

Objectives. To introduce a low-cost, self-made device for single-port retroperitoneal laparoscopic radical nephrectomy and to evaluate outcomes compared with conventional laparoscopy after initial experience using this device. Methods. Twenty-nine renal cancer patients underwent retroperitoneal laparoendoscopic single-site radical nephrectomy using a self-made single-port device with multiple manipulation channels for passage of routine laparoscopic instruments and specimen removal. A control group of 29 patients who were matched by age, gender, and cancer stage underwent conventional laparoscopy. Outcomes were analyzed retrospectively. Results. There were no significant differences in age, gender, body mass index, T stage, and maximum tumor diameter between groups (P > .05). The laparoendoscopic single-site surgery group had a significantly shorter duration of postoperative hospitalization than the conventional laparoscopy group (7.14 ± 1.38 days vs 8.17 ± 1.54 days, P = .009). Conclusions. Retroperitoneal laparoscopic radical nephrectomy using our self-made single-port device appears to be a feasible, safe, and low-cost surgical strategy.

Laparoscopic-Assisted Partial Nephrectomy Combined With Open Procedure for Posteromedial Renal Tumors

OBJECTIVE To describe the technique of laparoscopic-assisted partial nephrectomy melded with open procedure in resection of postero-medial renal tumors. METHODS Six patients with postero-medial renal tumors were admitted between July 2008 and March 2009. They included 4 diagnosed renal cell carcinomas and 2 renal angiomyolipomas on preoperative imaging, and their tumors ranged from 2.5-4.3 cm in diameter. They underwent laparoscopic-assisted nephron-sparing surgery combined with a small-incision procedure. RESULTS All 6 patients underwent successful resection. The mean operating time was 124 minutes and the average duration of pneumoperitoneum was 25 minutes. The duration of renal arterial blockage ranged from 19-36 minutes, with an average of 23 minutes. The intraoperative hemorrhage volume averaged 160 mL. Postoperative pathology revealed negative margins in all resected specimens. No urinary fistula or secondary hemorrhage occurred postoperatively, and renal function showed no impairment. The patients were followed for 1-8 months. Ultrasonographic or computed tomography examination revealed no recurrence. CONCLUSIONS The laparoscopic-assisted partial nephrectomy combined with an open procedure is a novel technique for the resection of posterior medial renal tumors. The technique is safe and effective.

Bilateral Synchronous Sporadic Renal Cell Carcinoma: Retroperitoneoscopic Strategies and Intermediate Outcomes of 60 Patients

Objective To evaluate the presentation, management, pathology, and functional and oncological outcomes of patients undergoing retroperitoneoscopic treatment of bilateral synchronous sporadic RCC at our institution. Methods We retrospectively evaluated the records of 60 patients with bilateral synchronous sporadic RCC who underwent retroperitoneoscopic treatment at the General Hospital of Peoples Liberation Army from 2008 to 2014. The estimated glomerular filtration rate was calculated and compared among different surgical procedures. The overall survival and recurrence free survival were assessed based on information from recent follow-up. Results Fifty-six patients underwent bilateral retroperitoneoscopic surgeries in staged procedures, and four patients underwent bilateral retroperitoneoscopic surgeries in simultaneous procedures. Among the former group of patients, 34 underwent bilateral partial nephrectomy, 12 underwent radical nephrectomy followed by partial nephrectomy, and 10 underwent partial nephrectomy followed by radical nephrectomy. Bilateral partial nephrectomy can better preserve renal function (p = 0.040) and the sequence of partial nephrectomy and radical nephrectomy did not affect functional outcomes (p = 0.790). One patient undergoing simultaneous procedures developed acute renal failure and required temporary hemodialysis. At 3 and 5 years, overall survival rates were 93.0% and 89.4%, and recurrence free survival rates were 90.5% and 81.6%. High nuclear grade (p = 0.014) was related to disease recurrence. Conclusions Staged bilateral partial nephrectomy was efficient in preserving renal function. The survival of patients with bilateral synchronous sporadic renal tumors was similar to that of patients with unilateral nonmetastatic tumors. Nuclear grade was an independent prognostic factor of disease recurrence.

The usefulness of phosphorylated-signal transduction and activators of transcription 3 in detecting prostate cancer from negative biopsies.

AIMS To avoid the misdiagnosis of prostate cancer (PCA), many patients receive repeated biopsies, despite receiving prior negative biopsies for PCA. Signal transduction and activators of transcription 3 (STAT3), a component of the JAK-STAT signaling pathway, can be activated by tyrosine phosphorylation as P-STAT3 and involved in the regulation of cellular growth, survival and oncogenesis. We aimed to assess the reliability of detecting PCA from the expression of P-STAT3 in prostate tissue previously designated as a negative biopsy. METHODS Prostate tissues were obtained from the biopsies of 52 patients with localized PCA as well as from the biopsies of 80 patients free of PCA. Expression of P-STAT3 in these specimens was examined by immunohistochemical staining (IHC) and used to distinguish tissue with PCA from tissue designated as benign during a biopsy procedure. RESULTS P-STAT3 staining intensities in all samples (initial negative biopsies, cancer positive cores and other negative cores from the same-batch biopsies) of PCA patients was significantly higher than that of benign patients (F = 23.664, P < 0.001). Analysis of the receiver operating characteristics (ROC) curve showed that the area under curve (AUC) for P-STAT3 staining was 0.785. When positive immuno-labeling of P-STAT3 in samples from initial biopsies was used as a marker for PCA, it showed relatively high sensitivity (80.8%) and specificity (76.3%). CONCLUSIONS IHC of P-STAT3 could be utilized to detect PCA patients with initial negative biopsies. As a result, it can be a potential adjunctive tool for current PCA diagnostic programs. P-STAT3 can predict the onset of PCA up to 40 months earlier than currently used diagnostic approaches.

A fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy.

PURPOSE To evaluate a fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy. METHODS One hundred fifty retroperitoneal laparoscopic nephrectomies were performed from October 2003 to June 2006. The renal arteries were identified by following five steps: location, pulling, apophysis, pulsation,and fibrin. Then the renal arteries were severed or ligatured with a linear cutter or Hem-o-lok clips. The renal veins were exposed by dissecting toward the abdominal side under the renal arteries. The management for the renal veins was the same with that of the renal arteries. The fast method to identify the renal vessels during retroperitoneal laparoscopic nephrectomy were evaluated. RESULTS All 150 procedures were successfully completed, and the renal vessels could be identified in short time. The average time to operation was 90 min (range 45-120 min) with average blood loss of 105 mL (range 10-510 mL). The average specimen weight was 494 g (range 140-890 g). Intake of usual diet and walking were allowed within 3 days for all patients. Drains were removed within 2-4 postoperative days. No patient was converted into an open surgery and blood transfusion. Minor complications were found in 12 cases (8%), and no severe complication occurred in any of the 150 cases. The median time to hospitalization was 6.3 days. Following the five steps, the renal vessels could be identified quickly and easily. The duration of the operations, the risk of conversion to the open surgery, and the vessel injury were decreased. CONCLUSIONS Renal vessels could be identified quickly by the following the five steps during retroperitoneal laparoscopic nephrectomy: location, pulling, apophysis, pulsation, and fibrin. It proved to be a useful method suitable for clinic application.

Single-Port Laparoscopic Retroperitoneal Surgery Using a Modified Single-Port Device in Urology

Objectives: To investigate the use of a flexible instrument platform in performing single-port laparoscopic retroperitoneal urologic surgeries and to verify the safety and feasibility of these surgeries. Methods: The homemade instrument platform consisted of two control loops and a powder-free surgical glove to form multichannels. 56 patients underwent this kind of single-port surgery for different urologic diseases, including radical nephrectomy in 31 patients, nephroureterectomy in 7 patients, partial nephrectomy in 8 patients, living donor nephrectomy in 4 patients, adrenalectomy in 3 patients, renal cyst surgery in 2 patients and ureterolithotomy in 1 patient. Results: All surgeries were completed successfully with no switch to conventional laparoscopic or open surgery. The mean hospital stay was 13.13 days (range 6-36). All patients were satisfied without major complications. Conclusions: Retroperitoneal laparoendoscopic single-site surgery using our cost-effective homemade instrument platform appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urologic surgery.