To assess the feasibility and effectiveness of total laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma (UUTUC) under a single surgical position. The medical data of 89 UUTUC patients were collected, who were treated in our institution from Jan 2016 to Jun 2018. The 45 cases that underwent total laparoscopic nephroureterectomy with a single position were allocated in the test group, while the 44 patients who received retroperitoneal laparoscopy combined with hypogastric oblique incision were assigned in the control group. We compared the two groups in perioperative indicators and tumor recurrence rate and analyzed the clinical effect of the new surgical treatment of UUTUC. All 89 operations for UUTUC were successful and had no conversion to open surgery. No obvious complications occurred during the perioperative period. The test group had significantly shorter average operation time (96.58 ± 8.56 min versus 147.45 ± 9.16 min), less blood loss (39.58 ± 4.15 ml versus 46.50 ± 4.58 ml), earlier ambulation (7.47 ± 1.01 h versus 11.39 ± 1.82 h), and shorter length of stay in hospital (6.98 ± 1.14 days versus 9.89 ± 1.51 days) (P < 0.05). The visual analogue scale (VAS) scores of the test group at 1 h, 12 h, and 24 h after operation were lower compared with those of the control group (P < 0.05). No significant difference was found in the tumor stage, tumor grade, postoperative gastrointestinal function recovery time, follow-up time, and tumor recurrence rate between the two groups. Compared with the traditional surgical methods, the total laparoscopic treatment of UUTUC under a single surgical position had advantages of shorter operation time, less blood loss, and early postoperative ambulation. The new operative method could shorten the length of stay and accelerate recovery of patients, and it is a viable surgical procedure which deserved clinical application and promotion. Our trial was approved and has been registered in the ethics committee of the Yantai Yuhuangding Hospital (Approval NO.[2015]171) .

Advanced clear cell Renal Cell Carcinoma (ccRCC) is notoriously known for its poor prognosis. Synapse defective protein 1 homolog 2 encoded by the SYDE2 gene is a Rho GTPase-activating protein whose functional tumorigenic significance is still unclear. Recent pan-cancer analysis using the Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) data showed the potential tumor-suppressing effects of SYDE2 in ccRCC. Subsequently, the TCGA, GTEx data, and human protein atlas were employed to assess the correlation between the SYDE2 expression, clinical data, and overall survival (OS) in ccRCC patients. Furthermore, microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) contributing to SYDE2 down expression were identified by expression, relationship, and survival analysis. Eventually, two novel lncRNAs, AL162377.1 and AF111167.2, targeting the miR-21-5p axis, were identified in the SYDE2 upstream non-coding RNAs (ncRNAs)-related pathway in ccRCC. The expression level of SYDE2 highly depends on the tumor immune cell infiltration and immune checkpoint expression. In summary, these data demonstrated that lncRNAs/miRNAs-mediated down-regulation of SYDE2 is related to the tumor immune infiltration. Hence, giving an insight into the prognosis of ccRCC.

Renal ectopia occurs in 1:3,000–1:7,000 children. Simple ectopia refers to the abnormal kidney location on the same side; in crossed ectopia the ureter crosses the midline of the body. Pelvic ectopic solitary kidney with hydronephrosis due to ureteropelvic junction obstruction (UPJO) is even rarer in clinical practice. We report a case of a pelvic ectopic solitary kidney with hydronephrosis due to UPJO in an 18-year-old girl. Three-dimensional computed tomography (CT) scan showed the Single Ectopic Kidney with irregular shape lying in the pelvis and its cortex is very thin because of the grossly dilated renal pelvis and ureter. The terminal ureteral joined the right posterior wall of bladder. The renal artery originated from the bilateral common iliac artery, and laparoscopic pyeloplasty was performed. 18 months after the surgery, hydronephrosis was improved morphologically, and the estimated glomerular filtration rate was stable.

A meta-analysis of efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms Dongxu Zhang, Kai Sun, Tianqi Wang, Gang Wu, Jipeng Wang, Jitao Wu, Jian Ma, Yuanshan Cui

Custirsen is the second-generation antisense oligonucleotide (ASO), which can reduce cellular levels of clusterin to increase the cytotoxic effect of chemotherapeutic drugs. Our study assessed the efficacy and safety of custirsen in patients with metastatic castration-resistant prostate cancer (mCRPC). We conducted a comprehensive search to identify all the randomized controlled trials (RCTs) of custirsen for the treatment of mCRPC. The reference lists of the retrieved studies were investigated. Three publications involving a total of 1709 patients were used in the analysis. We found that overall survival (OS) (P = .25) was not statistically significant in the comparison. Safety assessments indicated custirsen were often associated with complications resulting from neutropenia (P < .001), anaemia (P < .001), thrombocytopenia (P < .001), and diarrhea (P = .002). Our meta-analysis shows that custirsen has no obvious effect on improving the OS of patients with mCRPC. Adverse reactions were more common among those patients treated with custirsen as compared to those treated with placebo.