Ting Rao

The effects of artery-ligating and artery-preserving varicocelectomy on the ipsilateral testes in rats.

OBJECTIVES To investigate the effects of artery-ligating varicocelectomy (ALV) and artery-preserving varicocelectomy (APV) on the ipsilateral testes in experimental varicocele (EV) rats. METHODS Fifty adolescent male Sprague-Dawley rats (6 weeks old, weighing 170 +/- 10 g) were randomly divided into 4 groups: EV without treatment group (EV group), EV with ALV group (EV+ALV group), EV with APV group (EV+APV group), and a control group. EV was induced by partial ligation of the left renal vein to an external diameter of 50% of its original at the position of medialis to both the adrenal and internal spermatic veins. ALV was performed by total ligation of the dilated left internal spermatic vein, along with the internal spermatic artery. APV was performed by ligation of the dilated left internal spermatic vein only. Johnsens score, ultrastructure of seminiferous tubules, and intratesticular testosterone concentration (ITC) of the left testes were measured. RESULTS ITC and Johnsens score in the control group were significantly higher than those in the EV group (P < .05) and markedly higher than those in the EV+ALV group (P < .01), and no statistical difference compared with those in the EV+APV group (P > .05). Ultrastructural abnormalities of seminiferous tubules were observed in the EV group, especially in the EV+ALV group. CONCLUSIONS APV was able to repair the varicocele-induced lesions of ipsilateral testes; whereas, the ALV caused further lesions.

Retrograde ureteroscopic treatment for upper ureteral stones: a 5-year retrospective study.

PURPOSE To review our 5-year experience with retrograde ureteroscopic treatment for patients with upper ureteral stones and to compare the outcome, safety, and efficiency of pneumatic and holmium laser lithotripsy in managing upper ureteral stones. PATIENTS AND METHODS We retrospectively analyzed the hospital records of 372 patients who underwent 384 retrograde ureteroscopic procedures for upper ureteral stones at our center from January 2003 to December 2007. Patient and stone characteristics, treatment variables. and clinical outcomes were assessed. Factors such as failure of the procedure, stone clearance, intraoperative and postoperative morbidity, procedure duration, and hospital stay were analyzed and compared between pneumatic (group 1) and laser lithotripsy (group 2). RESULTS Overall, the stone-free rate was 90.4%, the mean operative duration was 41.2 ± 10.7 minutes, the mean postoperative hospital stay was 2.7 ± 0.9 days, and the rates of intraoperative and postoperative complications were 14.6% and 3.9%, respectively, for groups 1 and 2. In comparing group 1 and group 2, the significantly higher number of intraoperative complications coincide with a significantly lower stone-free rate. Nevertheless, the incidence of intraoperative and postoperative complications between the two groups was not statistically significant except in the case of stone upward migration. The mean operative time of group 2 was 43.3 ± 11.1 minutes, which was significantly longer than that for group 1, which was 38.7 ± 9.1 minutes (P < 0.05). CONCLUSION Retrograde ureteroscopy is a safe and effective method for managing upper ureteral stones. A high postoperative stone-free rate is associated with the refined use of a holmium laser lithotriptor to ensure thoroughness while avoiding migration of the stones into the renal pelvis. Although laser lithotripsy has a longer operative time, it remains the more appropriate choice for managing upper ureteral stones.

Laparoscopic Varicocelectomy in Adolescents: Artery Ligation and Artery Preservation

OBJECTIVE To evaluate and compare the perioperative outcomes and improvements of testicular performance between artery preservation (AP) and artery ligation (AL) during laparoscopic varicocelectomy (LV) in adolescents. MATERIALS AND METHODS Data on 122 adolescents with unilateral varicocele who underwent laparoscopic varicocelectomy by a single urologist at our hospital were retrospectively studied. Age, varicocele grade, and testicular volume were collected, and postoperative data, including the operative time, recurrence, hydrocele, and catch-up growth, were assessed. Pre- and postoperative semen parameters in partial patients were compared between the groups. RESULTS The preoperative data were comparable between the groups, and there were no significant intergroup differences in the postoperative recurrence rate, hydrocele rate, or the 12th- and 24th-month catch-up growth rates; however, the 12th-month catch-up growth rate was relatively low in the AL group compared with the AP group. The postoperative semen parameters in terms of concentration, motility, and morphology were (62.5 ± 39.2) million/ml, (52.2 ± 16.6)%, and (11.5 ± 1.5)% in AP group, and (60.4 ± 38.2) million/ml, (49.1 ± 19.9)%, and (10.7 ± 1.5)% in AL group, respectively. The semen parameters were improved in both groups (P < .05) when compared with preoperative data, and there was no statistically significant difference between the two procedures (P > .05). CONCLUSIONS Considering the short-term impact on testicular restoration of the AL procedure, we suggest the AP procedure with fast and gentle dissection of the artery as the first choice. We also suggest a timely conversion to the AL procedure without hesitation when the first attempt fails.

Oxidative Damage and Mitochondrial Injuries Are Induced by Various Irrigation Pressures in Rabbit Models of Mild and Severe Hydronephrosis.

Objective We aimed to study whether tolerance to irrigation pressure could be modified by evaluating the oxidative damage of obstructed kidneys based on rabbit models experiencing different degrees of hydronephrosis. Methods A total of 66 rabbits were randomly divided into two experimental groups and a control group. In the experimental groups, the rabbits underwent a surgical procedure inducing mild (group M, n=24) or severe (group S, n=24) hydronephrosis. In each experimental group, the rabbits were then randomly divided into 4 subgroups (M0-M3 and S0-S3) consisting of 6 rabbits each. Group 0 received no perfusion. Groups 1 through 3 were perfused with 20, 60 and 100 mmHg fluid, respectively. For the control group, after a sham operation was performed, the rabbits were divided into 4 subgroups and were perfused with fluid at 0, 20, 60 or 100 mmHg of pressure. Kidney injuries was evaluated by neutrophil gelatinase associated lipocalin (NGAL). Oxidative damage was assessed by analyzing superoxide dismutase (Mn-SOD) activity, malondialdehyde (MDA) levels, glutathione reductase (GR), catalase (CAT) and peroxide (H2O2) levels, mitochondrial injuries was assessed by mitochondrial membrane potential (MMP), the mitochondrial ultrastructure and tubular cell apoptosis. Results In the experimental groups, all results were similar for groups 0 and 1. In group 2, abnormalities were observed in the S group only, and the kidneys of rabbits in group 3 suffered oxidative damage and mitochondrial injuries with increased NGAL, decreased Mn-SOD, GR and CAT,increased MDA and H2O2, lower levels of MMP, mitochondrial vacuolization and an increased apoptotic index. Conclusion In rabbits, severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure.

Effects of artery-ligating and artery-preserving varicocelectomy on ipsilateral epididymis of varicocele-induced rats.

OBJECTIVES To investigate the effects of artery-ligating varicocelectomy (ALV) and artery-preserving varicocelectomy (APV) on the ipsilateral epididymis of varicocele-induced rats. METHODS A total of 50 adolescent male rats were randomly divided into the 4 groups: control group (n = 8), experimental varicocele (EV) without treatment (EV group, n = 14), EV with ALV (ALV group, n = 14), and EV with APV (APV group, n = 14). The EV was induced by partial ligation of the left renal vein. ALV was performed by total ligation of the left internal spermatic artery and vein. APV was performed by ligation of the left internal spermatic vein only. The microstructure, epithelial ultrastructure, sialic acid and carnitine concentration, and epithelial apoptotic index of the left epididymis were measured. RESULTS Microstructural and ultrastructural abnormalities of the left epididymis were observed in the EV group and especially in the ALV group. Both the mean epididymal tubular diameter and the concentration of sialic acid, carnitine gradually decreased or increased from the control group to the EV group then to the ALV group (P < .05). However, the epithelial apoptotic index orderly increased for the control group, EV group, and ALV group (P < .05). Furthermore, no significant difference was found between the control and APV groups for these parameters (P > .05). CONCLUSIONS Varicocele was demonstrated to cause lesions of the ipsilateral epididymis. APV was able to repair the lesions; however, ALV led to additional lesions.

Autophagy may play an important role in varicocele

The present study aimed to determine the expression of autophagy and investigate whether the hypoxia-inducible factor 1α (HIF-1α)/BCL2 interacting protein (BNIP3)/Beclin-1 autophagy signaling pathway serves an important role in activating autophagy in varicocele (VC) rat testes cells. Furthermore, the current study aimed to explain the possible association between autophagy and apoptosis. A total of 48 adult male Sprague Dawley rats were divided into group A (control), group B (VC 15-day), group C (VC 30-day) and group D (VC 45-day), with 12 rats in each group. The rats in group A did not receive any interventions, and in groups B, C, and D the VC model was established simultaneously. At 0, 15, 30, and 45 days, an orchidectomy on the left testes was performed in groups A-D, each on its respective day. Transmission electron microscopy was used to investigate the expression of autophagy. Compared with groups A and B, it was demonstrated that the expression of autophagy in groups C, and D was significantly increased. Hematoxylin and eosin staining revealed that as the rats survived VC longer, the testicular tissue damage became more serious. Furthermore, the Johnson score revealed that VC impaired the spermeiogenesis function of the male rats. Additionally, it was demonstrated that the apoptosis index of the seminiferous epithelia cells in VC rat testes increased over time, as measured using TUNEL staining. Immunohistochemical analysis revealed that as the VC was prolonged, the expression of HIF-1α gradually increased while the expression of (apoptosis regulator Bcl-2) Bcl-2 gradually decreased. Furthermore, western blot analysis revealed that the protein expression of Bcl-2 decreased and apoptosis regulator Bax increased. Furthermore, HIF-1α, BNIP3, Beclin1 and microtubule associated protein 1 light chain 3 α (LC3)II/LC3I expression gradually increased. However, significant increases in Beclin 1 and LC3II/LC3I were only observed between the day 0 and day 30 groups. In addition, the expression of p62 significantly increased between day 0 and day 15, but gradually decreased between day 15 and day 45. The results of the present study revealed that VC can lead to testicular tissue hypoxia, and that the HIF-1α/BNIP3/Beclin1 autophagy signaling pathway may upregulate autophagy in VC rats testes. Thus, the association between autophagy and apoptosis may serve an important role in male infertility caused by VC.

The protective effects of GYY4137 on ipsilateral testicular injury in experimentally varicocele‑induced rats

The aim of the present study was to evaluate whether morpholin-4-ium 4 methoxyphenyl (morpholino) phosphonodithioate (GYY4137) exhibits a protective effect on ipsilateral testicular injury in experimentally varicocele (VC)-induced rats. A total of 48 rats were randomly divided into the following 6 groups (n=8 each): Group A (control group); group B (sham group); group C (VC group); group D (VC group administered 5 mg/kg/day GYY4137); group E (VC group administered 10 mg/kg/day GYY4137) and group F (VC group administered 20 mg/kg/day GYY4137). Indicators of oxidative stress, apoptosis and inflammation were measured to evaluate the effect of GYY4137 on ipsilateral testicular injury. Compared with groups A and B, rats in group C exhibited severe histological changes and an increase in oxidative stress, apoptosis and inflammation. By contrast, amelioration of testicular damage was evident in the group D, E and F that were treated with GYY4137. These results demonstrate that GYY4137 may be a promising therapy to treat VC as it alleviates oxidative stress, apoptosis and inflammation in experimentally VC-induced rats.

Acute Kidney Injuries Induced by Various Irrigation Pressures in Rat Models of Mild and Severe Hydronephrosis

OBJECTIVE To clarify whether tolerance to irrigation pressure could be modified over varying degrees of kidney obstruction during the endoscopic treatment of kidney stones in a rat model. METHODS A total of 126 rats were randomly allocated into 2 experimental groups and a control group. The experimental groups underwent a surgical procedure to induce mild (group M, n = 60) or severe (group S, n = 60) hydronephrosis. In each group, the rats were then randomly allocated into 4 subgroups (M0 to M3 and S0 to S3) of respectively 6, 18, 18, and 18 rats. Groups 0 to 3 were respectively perfused with 0 (no irrigation), 20, 60, and 100 mm Hg pressure fluid. The control group underwent no surgical procedures and was only perfused with 100 mm Hg pressure fluid. Acute kidney injuries were assessed by analyzing the kidney microstructure, tubular cell apoptosis, kidney injury molecule-1, and cysteine-rich 61 (Cyr61/CCN1) expression using immunohistochemistry. RESULTS No abnormalities were observed for the control group, groups 0, or 1. In group 2, abnormalities were observed only in the S group, whereas all kidneys in group 3 suffered acute kidneys injuries, along with occurrence of tubular cells necrosis, increased apoptosis, and increased expression of kidney injury molecule-1 and Cyr61. CONCLUSION Rats with severely obstructed kidneys were more likely to suffer acute kidney injuries than those with less obstructed kidneys when exposed to higher kidney irrigation pressures. This suggests that the pressure should be controlled and reduced when performing endourologic procedures in the context of kidney obstruction.

Quantum dot‑based fluorescent probes for targeted imaging of the EJ human bladder urothelial cancer cell line

QDs are a type of inorganic nanoparticle with unique optical properties. As a fluorescent label, QDs are widely used in biomedical fields. In the present study, fluorescent probes of quantum dots (QDs) conjugated with a prostate stem cell antigen (PSCA) monoclonal antibody (QD-PSCA) were prepared to study the targeted imaging of QD-PSCA probes in EJ human bladder urothelial cancer cells and analyze the feasibility of QD-based non-invasive tumor-targeted imaging in vivo. QDs with an emission wavelength of 605 nm (QD605) were conjugated with PSCA to prepare QD605-PSCA fluorescent probes by chemical covalent coupling. The optical properties of the probes coupled and uncoupled with PSCA were measured and assessed using an ultraviolet spectrophotometer and a fluorescence spectrophotometer. Direct immune-fluorescent labeling was utilized to detect and analyze imaging of the probes for EJ cells. The results revealed that QD605-PSCA probes retained the fluorescent properties of QD605 and the immunogenicity of the PSCA protein. The probes were able to specifically recognize the PSCA protein expressed in bladder cancer cells, while fluorescence was stable and had a long duration. The present study suggests that QD-PSCA fluorescent probes may be useful for specific targeted labeling and imaging in bladder urothelial cancer cells. Furthermore, the probes possess good optical stability and may be useful for research into non-invasive targeted imaging, early diagnosis and targeted in vivo tumor therapy.

MALAT1 Promotes Cell Apoptosis and Suppresses Cell Proliferation in Testicular Ischemia-Reperfusion Injury by Sponging MiR-214 to Modulate TRPV4 Expression.

Background/Aims: Accumulating evidences has indicated that aberrant expression of long non-coding RNAs (lncRNAs) is tightly associated with the progression of ischemia-reperfusion injury (IRI). Previous studies have reported that lncRNA MALAT1 regulates cell apoptosis and proliferation in myocardial and cerebral IRI. However, the underlying mechanism of MALAT1 in testicular IRI has not been elucidated. Methods: The levels of MALAT1, some related proteins and apoptosis in the testicular tissues were determined by quantitative real-time PCR, HE staining, immunohistochemistry, western blot and TUNEL assays. Relative expression of MALAT1, miR-214 and related proteins in cells were measured by western blot and quantitative real-time PCR. Cell viability and apoptosis were examined using MTT assay and flow cytometry. Results: In the present study, we found that MALAT1 was up-regulated in animal samples and GC-1 cells. The expression level of MALAT1 was positively related to cell apoptosis and negatively correlated with cell proliferation as testicular IRI progressed. In gain and loss of function assays, we confirmed that MALAT1 promotes cell apoptosis and suppresses cell proliferation in vitro and in vivo. Furthermore, we found that MALAT1 negatively regulates expression of miR-214 and promotes TRPV4 expression at the post-transcriptional level. Consequently, we investigated the correlation between MALAT1 and miR-214 and identified miR-214 as a direct target of MALAT1. In addition, we found that TRPV4 acted as a target of miR-214. Over-expression of miR-214 efficiently abrogated the up-regulation of TRPV4 induced by MALAT1, suggesting that MALAT1 positively regulates the expression of TRPV4 by sponging miR-214. Conclusion: In sum, our study indicated that the lncRNA MALAT1 promotes cell apoptosis and suppresses cell proliferation in testicular IRI via miR-214 and TRPV4.