Yu-Jie Wang

Diagnosis and Surgical Treatment of Renal Hydatid Disease: a Retrospective Analysis of 30 Cases

Echinococcosis (CE) is an infection which is caused by the larval stage of a tapeworm and is endemic in stockbreeding regions of developing countries. The kidney is the most commonly affected organ in the urinary tract. However, reports on renal hydatid disease are limited in the literature, and usually there are no specific clinical characteristics and promising operative methods. The purpose of this study is to assess the most appropriate surgical technique for the patient with urinary tract CE. We retrospectively analyzed thirty patients with renal hydatid cysts who received different surgical treatments in the urology department of the First Affiliated Hospital of Xinjiang Medical University from February 1985 to April 2010. Twenty patients were males and ten were females. The diagnostic accuracy was 74%, 87.5%, and 66.6% respectively by using of ultrasound, CT, and laboratory tests. Thirty patients were followed up for 1–15 years after surgery. One patient experienced a recurrence of renal CE. The ultrasound, CT, and immunological tests are an important means of diagnosis. The surgical treatment principle of renal hydatid should be based on residual renal function, hydatid cyst size, number, location, and surgical techniques to determine the surgical plan to retain the renal function.

Functional analysis of serum microRNAs miR-21 and miR-106a in renal cell carcinoma

OBJECTIVE microRNAs (miRNAs) plays an important role in tumor development and progression and act as oncogenes or tumor suppressor genes in the carcinogenesis process. miRNA is stable in serum, and recent studies have demonstrated the feasibility of using circulating miRNA as biomarkers in cancer patients. However, currently, no serum biomarkers for the early diagnosis and prognosis of renal cell carcinoma (RCC) have been reported. Therefore, a new molecular marker for early diagnosis and evaluation of recurrence after surgery is required. Our purpose was to identify miRNA signatures that could distinguish the serum of RCC patients from matched healthy controls and validate identified miRNAs as potential biomarkers for RCC. METHOD Serum samples from 30 RCC patients were collected before and 1 month after surgery. 30 cancer-free blood donor volunteers with no history of any cancer were recruited from the same institute. miR-21 and miR-106a expression levels were determined by real-time PCR. RESULT The serum miR-21 level was significantly higher in RCC patients (median, 8.34) than in healthy control individuals (median, 0.70; p= 0.001). A month after surgery, serum miR-21 levels (median, 0.69) were significantly reduced (p= 0.032). The serum miR-106a level was higher in RCC patients (median, 8.99) compared with controls (median, 0.96; p= 0.000), while miR-106a levels (median, 1.01) were reduced a month after surgery (p= 0.028). The expression level of miR-21 and miR-106 a in RCC patients increased significantly, while miR-21 and miR-106a decreased after surgery. This outcome suggests that serum miR-21 and miR-106a expression level was closely related with kidney cancer tissue. CONCLUSION We conclude that serum miR-21 and miR106a are expected to be molecular markers for RCC.

Differential expression and clinical significance of serum protein among patients with clear-cell renal cell carcinoma

BACKGROUND AND OBJECTIVE Looking for tumor markers by using protein chip technology is one of the hot topics, but many studies are still limited on short term detection of differential expressed proteins before and after surgery among patients with RCC. This study analyzed differential expressed serum protein and its clinical significance with clear-cell renal cell carcinoma to further measurement of the rule of variable expressing. METHODS Eighty-nine patients with clear-cell renal cell carcinoma who underwent surgery from November 2013 to 2014 and postoperatively confirmed by pathology were entered in RCC group, 100 healthy volunteers and patients without RCC who underwent medical examination in the same period were entered in control group. The serum protein were analyzed in both group before surgery and every regular follow-up period in 1 year after surgery with RCC group. The surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) and weak cation exchange protein chip (CM10) technology systems were used for identifying differential expressed serum protein in RCC group and controls. The linear support vector machine (SVM) was applied to establish the diagnostic model of protein fingerprints and the leave-one-out cross validation was used for determining model discriminating effect. The differential expressed proteins were analyzed by ZUCI-PDAS protein spectral data analysis system. RESULTS Five kinds of proteins were identified as potential biomarker, ultimately. The M/Z of these proteins was 15953, 7987, 9304, 8948, 5911, respectively. There were significant difference on expression level of these proteins with two groups preoperatively (P< 0.05). Comparison of all postoperative expression levels to preoperative one and each differential level mutually between a year in postoperative period also revealed statistical significance (P< 0.05). With taking identified proteins as biomarker, the sensitivity and specificity in predicting clear-cell renal cell carcinoma was 88.8% (79/89) and 91.0% (91/100), respectively. CONCLUSION The corresponding specific protein was Bcl-2 family apoptosis regulatory proteins, WAP four-disulfide core protein, Krueppel-like factor 8, monocyte chemotactic protein-1, serum amyloid β -protein-4, respectively, and will may serve as tumor markers of kidney cancer. These proteins manifests high predictive value for clear-cell renal cell carcinoma, and may contribute to therapeutic evaluation, prognosis and targeted therapy for clear-cell renal cell carcinoma.

Minimally Invasive Percutaneous Nephrolithotomy in Children Less than Three Years of Age: Five-Year Experience in 234 Cases

Objective: The treatment of infant renal stones is still a huge challenge to the urologist. The present study aimed to evaluate the safety and efficiency of the minimally invasive percutaneous nephrolithotomy (MPCNL) method as a treatment for infant renal stones, and also to analyze the specific techniques and related complications of the procedure. Patients and Methods: From January 2008 to December 2012, 234 cases (72 girls and 162 boys, mean age 15.8 months, range 5-36 months) aged under 3 years and treated with MPCNL for renal stones were analyzed retrospectively. 125 cases were younger than 12 months, 67 cases were between 13 and 24 months and 42 cases between 25 and 36 months. The indications for MPCNL were (1) stone over 1 cm2, (2) hydronephrosis and (3) recurrent urinary tract infection. An initial percutaneous access to the targeted renal calyx was obtained through an ultrasound-guided peripheral calyceal puncture. Stones were fragmented by a holmium laser with a pediatric nephroscope via 14-F tract. Results: All the procedures were performed by single tract, and totally 247 tracts were established, including 245 14-F tracts, 1 16-F tract and 1 12-F tract, respectively. The stones were located in the left kidney (n = 91), right kidney (n = 105) and in both kidneys (n = 28), respectively. Regarding the puncture point, in 228 cases it was in the 12th subcostal space and in 19 cases in the 11th intercostal space. The distribution of target puncture calyx and the subsequent residual calculi were as follows: 39 cases in the upper calyx with 2 cases of stone residual, 148 in the middle calyx with 3 stone residuals, and 60 in the lower calyx with 2 stone residuals, respectively. As a result, completely stone-free state was achieved in 240 kidney units (97.2%). The mean operating time was 32.5 min. None of the patients required blood transfusion and no septic shock occurred after operation. A large quantity of washing fluid was infiltrated into the abdominal cavity in 3 cases. Conclusion: Using a single tract ≤14 F, MPCNL is a safe and effective procedure in the management of renal stones in infant less than 3 years old.

MicroRNA-145 regulates the differentiation of human adipose-derived stem cells to smooth muscle cells via targeting Krüppel-like factor 4

Understanding the molecular mechanisms underlying human adipose-derived stem cell (hASC) differentiation to smooth muscle may contribute to the development of effective therapies for relevant muscle defects, such as bladder wall and urethral defects. A previous study described the differentiation of hASCs to smooth muscle cells (SMCs) by transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein‑4 (BMP4) treatment. The present study investigated whether microRNA-145 (miR‑145) may be involved in the process of hASC differentiation. The expression of miR‑145 was significantly increased during differentiation of ASCs to SMCs. SMC‑specific genes and proteins, including a‑smooth muscle actin (α‑SMA), smooth muscle protein‑22α(SM22α), calponin and myosin heavy chain (SM‑MHC) were upregulated by transfection of a miR‑145 mimic. By contrast, these factors were downregulated following introduction of antisense oligonucleotides. In addition, Krüppel‑like factor 4 (KLF4) levels, which decreased during the differentiation of hASCs, were downregulated when the cells were transfected miR‑145 mimics. Futhermore, inhibition of KLF4 by treatment with short‑interfering‑RNA against KLF4, resulted in increased expression of SMC‑specific genes and proteins. In conclusion, the results of the present study demonstrated that by regulating KLF4, miR‑145 may be involved in regulating smooth muscle differentiation of ASCs induced by TGF‑β1 and BMP4.

The histocompatibility research of hair follicle stem cells with bladder acellular matrix

Background:Hair follicle stem cells (HFSCs) were reported to have multidirectional differentiation ability and could be differentiated into melanocytes, keratin cells, smooth muscle cells, and neurons. However, the functionality of HFSCs in bladder tissue regeneration is unknown. Methods:This study was conducted to build HFSCs vs bladder acellular matrix (BAM) complexes (HFSCs–BAM complexes) in vitro and evaluated whether HFSCs have well biocompatibility with BAM. HFSCs were separated from SD rats. BAM scaffold was prepared from the submucosa of rabbit bladder tissue. Afterwards, HFSCs were inoculated on BAM. Results:HFSCs–BAM complexes grew rapidly through inverted microscope observation. Cell growth curve showed the proliferation was in stagnate phase at 7th and 8th day. Cytotoxicity assay showed the toxicity grading of BAM was 0 or 1. Scanning electron microscopy, HE staining, and masson staining showed that cells have germinated on the surface of scaffold. Conclusion:The results provide evidence that HFSCs–BAM complexes have well biocompatibility and accumulate important experimental basis for clinical applying of tissue engineering bladder.