Jiexiu Zhang

Interdigitating dendritic cell sarcoma presenting in the kidney combined with retroperitoneal leiomyosarcoma: A case report and literature review

Interdigitating dendritic cell sarcoma (IDCS) and retroperitoneal leiomyosarcoma are rare tumors. The optimal diagnosis, treatment and prognosis remain unknown. The current case report presents a 46-year-old male who exhibited with a left renal mass combined with a periprostatic mass. The patient underwent surgery twice, respectively for the resection of the two masses. The postoperative pathological examination confirmed the diagnosis of IDCS presenting in the kidney and retroperitoneal leiomyosarcoma in the pelvis. To the best of our knowledge, it is the first report of IDCS in the kidney and of the combined appearance of IDCS and retroperitoneal leiomyosarcoma in the same patient.

Diagnosis and treatment of cystic renal cell carcinoma

BackgroundTo summarize the diagnosis and treatment of cystic renal cell carcinoma (CRCC).MethodsA retrospective study was conducted on 13 patients with CRCC at our center from August 2004 to April 2012. The pathologic features, clinical manifestation, imaging characteristics, treatment, and prognosis of CRCC were summarized according to available literature.ResultsOf the 13 patients, 11 were diagnosed with CRCC by preoperative B ultrasonography and computed tomography (CT) scan. The remaining two cases were initially misdiagnosed with simple renal cysts. Open radical nephrectomy was performed on two of the 13 cases, laparoscopic radical nephrectomy on seven cases, and open partial nephrectomy on four cases. All diagnoses of CRCC were confirmed by pathological examination. After the operation, all patients had an uneventful recovery. During the follow-up (range, 6–60 months), the serum creatinine concentrations and GFR of the partially removed kidneys remained stable within the normal range. No tumor recurrence or metastasis occurred.ConclusionsBy combining imaging examinations (B ultrasonography and CT scan) with intraoperative pathological examination, most cases of CRCC can be diagnosed and treated promptly and accurately. Nephrectomy is the first-line therapy. Nephron-sparing surgery should be preferred for CRCC. After a successful operation, the prognosis of CRCC is good.

The risks, degree of malignancy and clinical progression of prostate cancer associated with the MDM2 T309G polymorphism: a meta-analysis.

To determine the risk, malignant degree and clinical progression of prostate cancer (PCa) associated with mouse double-minute 2 protein (MDM2) T309G variants, a meta-analysis was performed on all eligible published studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess these associations in seven studies that included 5151 cases and 1003 controls. In the overall analysis, the 309G allele was significantly associated with a decreased PCa risk (OR=0.85, 95% CI: 0.74-0.97); this was also the case for the homozygous comparison (OR=0.72, 95% CI: 0.55-0.95) and the dominant genetic model (OR=0.79, 95% CI: 0.65-0.96). The 309G allele was also found to be significantly associated with lower degrees of PCa malignancy (OR=0.85, 95% CI: 0.75-0.96) in the overall analysis, as well as in the heterozygous comparison (OR=0.79, 95% CI: 0.65-0.96), homozygous comparison (OR=0.76, 95% CI: 0.58-0.98) and dominant genetic model (OR=0.81, 95% CI: 0.68-0.96). Furthermore, grouping analysis showed that the 309G allele in Caucasians was significantly correlated with a decreased PCa risk (OR=0.77, 95% CI: 0.61-0.96); this was also the case in the homozygous comparison (OR=0.51, 95% CI: 0.31-0.86). The grouping analysis also showed that the 309G variant in Caucasians was significantly associated with a lower degree of PCa malignancy in all of the genetic models. In addition, we found that the 309G variant in Caucasians was significantly associated with a slower PCa clinical progression in all of the genetic models. In summary, our meta-analysis showed that the MDM2 309G variant was significantly associated with a decreased PCa risk, lower malignant degree and slower clinical progression in Caucasians, but there was no obvious association in the Asian population.

Direct-acting antiviral agent efficacy and safety in renal transplant recipients with chronic hepatitis C virus infection: A Prisma-compliant study

Background: The efficacy and safety of direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV)-infected renal transplant recipients (RTRs) has not been determined. Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and assessed the quality of eligible studies using the Joanna Briggs Institute scale. DAA efficacy and safety were assessed using standard mean difference (SMD) with 95% confidence intervals (95%CIs). Results: Six studies (360 RTRs) were included. Two hundred thirty six RTRs (98.3%) achieved sustained virological response within 12 weeks; HCV infection was cleared in 239 RTRs after 24-week treatment. Liver function differed significantly pre- and posttreatment (alanine aminotransferase, SMD: 0.96, 95%CIs: 0.65, 1.26; aspartate aminotransferase, SMD: 0.89, 95%CIs: 0.60, 1.18); allograft function pre- and posttreatment was not statistically different (serum creatinine, SMD: −0.13, 95%CIs: −0.38, 0.12; estimated glomerular filtration rate, SMD: 0.20, 95%CIs: −0.11, 0.51). General symptoms (fatigue nausea dizziness or headache) were the most common adverse events (AEs) (39.3%). Severe AEs, that is, anemia, portal vein thrombosis, and streptococcus bacteraemia and pneumonia, were present in 1.1%, 0.6%, and 1.1% of RTRs, respectively. Conclusion: Our findings suggest that DAAs are highly efficacious and safe for treating HCV-infected RTRs and without significant AE.

Co-Incubation of Human Spermatozoa with Anti-VDAC Antibody Reduced Sperm Motility

Background: Voltage-dependent anion channel (VDAC), a channel protein, exists in the outer mitochondrial membrane of somatic cells and is involved in multiple physiological and pathophysiological processes. Up until now, little has been known about VDAC in male germ cells. In the present study, the relationship between VDAC and human sperm motility was explored. Methods: Highly motile human spermatozoa were incubated in vitro with anti-VDAC antibody. Total sperm motility, straight line velocity (VSL), curvilinear velocity (VCL), and average path velocity (VAP) were recorded. Intracellular free calcium concentration ([Ca2+]i), pH value (pHi), and ATP content were determined. Results: Co-incubation with anti-VDAC antibody reduced VSL, VCL, and VAP of spermatozoa. Co-incubation further reduced [Ca2+]i. Anti-VDAC antibody did not significantly alter total sperm motility, pHi and intracellular ATP content. Conclusion: The data suggest that co-incubation with anti-VDAC antibody reduces sperm motility through inhibition of Ca2+ transmembrane flow. In this way, VDAC participates in the modulation of human sperm motility through mediating Ca2+ transmembrane transport and exchange.

A Case Report of Unusual Retroperitoneal Castleman’s Disease in an Old Woman

Castleman’s disease (CD) is an uncommon disorder of the lymphoid hyperplasia. It is especially rare in the retroperitoneum or perirenal area. We report the case of a 62-year-old woman who had an abdominal mass localized above the right kidney in the region of the right adrenal gland found by computed tomography scan. The patient subsequently underwent an exploratory laparotomy. Pathological examination revealed retroperitoneal localized CD (LCD) of the hyaline vascular type. Diversity of disease sites and nonspecificity of clinical manifestations lead to diagnostic difficulties. Therefore, diagnosis is mainly achieved via lymph node biopsy or pathological examination. Like in the reported case, LCD usually has a good prognosis after complete resection of the lesion.

Retroperitoneal laparoscopic ureteroureterostomy for retrocaval ureter: A report of 15 cases

The aim of the current study was to present our techniques and experience with retroperitoneal laparoscopic ureteroureterostomy (LUUS) in 15 patients with retrocaval ureter.

The Potential Role of IL-33 in Renal Transplant Recipients with Chronic Allograft Dysfunction.

BACKGROUND Chronic allograft dysfunction (CAD) is the major factor endangering the long-term allograft survival in kidney transplantation. The mechanisms of CAD remain unclear. MATERIAL AND METHODS A total of 64 renal transplant recipients were enrolled in our study and divided into a stable group and CAD group according to their allograft function. A group of 32 normal controls (healthy volunteers) were also included. An ELISA was used to detect serum interleukin-33 (IL-33), IL-2, IL-4, IL-10, IL-17, and interferon-gamma (IFN-γ). Flow cytometry was performed to measure the percentage of CD3+CD4+ and CD3+CD8+ T cells in the peripheral blood from the three patient groups. The correlations among the study indexes were also analyzed using Pearsons method. RESULTS Levels of serum IL-33 was significantly higher in CAD patients than recipients with stable allograft function. Moreover, serum IL-2, IL-4, and IL-10 also increased statistically in patients with CAD. In addition, significant differences were observed in CD4+ T cells and the ratio of CD4+ and CD8+ T cells between CAD and stable patients. CONCLUSIONS Serum upregulated IL-33 could contribute to the pathogenesis of CAD in kidney transplant recipients.

Modified Retroperitoneoscopic Renal Pedicle Lymphatic Disconnection for Intractable Chyluria

INTRODUCTION To describe a modified retroperitoneoscopic renal pedicle lymphatic disconnection (MRRPLD) and to compare the efficacy and safety of MRRPLD with traditional retroperitoneoscopic renal pedicle lymphatic disconnection (RRPLD). TECHNICAL CONSIDERATIONS From September 2008 to July 2012, RRPLD and MRRPLD were performed respectively on 18 and 14 patients at our center. Comparison was conducted including operative time, intraoperative blood loss, postoperative time of bed rest, hospital stay, postoperative urine chyle test, and complications. All operations were completed without conversion to open surgery. The mean operative time, intraoperative blood loss, postoperative time of bed rest, and hospital stay from MRRPLD group were all decreased compared with data from RRPLD group. There was significant difference in operative time, postoperative time of bed rest, and hospital stay (P <.05). Complications occurred only in 1 patient receiving RRPLD. Chyluria disappeared in all patients after the operation. No recurrence was observed during the follow-up. CONCLUSION MRRPLD has a good effect and safety for chyluria. It is a simpler, more minimally invasive, and more economic surgical therapy compared with traditional RRPLD.

Downregulation of clusterin expression in human testicular seminoma.

Background: Clusterin, a heterodimeric glycoprotein of approximately 80 kDa, exists extensively in human body fluids. The abnormal expression of clusterin is closely related to the occurrence, progression, and prognosis of tumors. Up to now, few studies have focused on clusterin in human testicular cancer. This study describes an extensive exploration of the presence and expression of clusterin in testicular seminoma. Methods: Tumor tissues and normal testis tissues were collected from 13 patients with testicular seminoma and 16 patients undergoing surgical castration for prostate cancer. Real-time polymerase chain reaction (PCR) was performed to detect the expression difference of clusterin mRNA between testicular seminoma and normal testis. Western blot and immunohistochemical analysis were performed to detect the presence and expression difference of clusterin protein between two groups. Results: Real-time PCR showed the expression of clusterin mRNA in testicular seminoma to be significantly lower than in normal testis (only 13% relative quantification). Western blot analysis indicated marked reductions in the expression of clusterin protein in testicular seminoma. Similar results were observed upon immunohistochemical analysis. Conclusion: In testicular seminoma and normal testis, clusterin exists in its heterodimeric secretory isoform. Clusterin expression is significantly lower in testicular seminoma than in normal testis. This is the first comprehensive study of the presence and expression of clusterin in human testicular cancer.