AIM: To investigate the molecular mechanisms underlying the antitumor effect of trichostatin A(TSA) on LNCaP prostate cancer cells.METHODS: Colony formation analysis was performed to assay the effect of TSA on LNCaP colony forming ability.Western blotting was used to analyze protein acetylation standard as well as the expression of a panel of signaling molecules after TSA exposure.RESULTS: TSA inhibited the colony forming ability of LNCaP cells at a very low concentration.TSA exposure caused elevated acetylation of total cellular proteins as well as accumulation of acetylated-H_3.In addition,signaling molecules which play key roles in prostate cancer such as AR,ErbB2,Raf-1,CDK4,and Akt were depleted by TSA in a dose and time-dependent manner.CONCLUSION: TSA exhibits significant antitumor activity against LNCaP cells by simultaneously interfering with multiple signaling pathways such as HER2/MAPK,AR,and PI-3K-AKT pathways.

Objective To provide reliable technical method by identifying referential anatomic landmarks for retroperitoneal laparoscopic renal surgery,with respect to the renal hilum and renal artery.Methods The regional anatomy of the posterior abdominal wall was studied in 35 cases of retroperitoneal laparoscopic renal surgery from January to August 2010.These included 27 cases of renal cancer,6 cases of renal pelvis cancer and 2 cases of renal tuberculosis.Distended the retroperitoneal space using balloon dilation along with sharp and dull dissection.We recorded the forms and positions of the posterior abdominal cavity's anatomical landmarks and evaluated the relationship between each anatomical landmark with respect to the renal hilum and renal artery.Results The perirenal fascia posterior layer and perinephric fat on the renal side were observed,and several anatomical landmarks gradually appeared on the posterior abdominal wall.The diaphragm extended across the upper retroperitoneal space near the superior pole of the kidney,and the psoas major and the quadratus lumborum muscles were located at the lower retroperitoneal space,near the inferior part of the kidney.The intersection of the upper diaphragm muscle with the lower psoas major and quadratus lumborum muscles were bordered by the lateral and medial arcuate ligaments.The lateral arcuate ligament arched across the upper part of quadratus lumborum,while the medial arcuate ligament arched across the upper part of psoas major.The medial arcuate ligament points extended towards the upper border of the renal hilum.These landmarks enable us to locate the position of the kidney,reach the renal hilum and identify the renal vessels in all 35 cases.Conclusions The relative position of the muscles and ligaments of the posterior abdominal wall are consistent and can be clearly seen under retroperitoneoscopy.Based on the position of the diaphragm and psoas major,the kidney can be located.In addition,based on the position of the medial arcuate ligament,the renal hilum and renal artery can be located.Assistance from these anatomical landmarks will simplify the retroperitoneal laparoscopic renal surgery.

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.

Objective To evaluate the accuracy and efficiency of the Monte Carlo software in measuring the radiation dose to the patients who received the CCTA (Coronary Computed Tomography Angiography) examination.Methods A anthropomorphic chest phantom underwent CCTA using three scan parameters (tube voltage 80 kV,100 kV and 120 kV).Computer Software ImpactDose 2.0 was used to compute the chest organ dose on the basis of the three groups tube voltage CT scan characteristic,and the stimulation results of ImpactDose 2.0 software was verified by use of anthropomorphic phantom thermoluminescence dosimeter experiment method.Results For all the measured organs except for lung,the absorbed organ dose and effective dose of three groups of tube voltages of CCTA measured by the InpactDose 2.0 was lower than those as measured by anthropomorphic phantom study.The relative error of both methods was within ± 50％.Conclusions Monte Carlo software can be used to estimate the levels of radiation dose during CCTA examination with a tolerable error within the acceptable range.

Organ shortage is a critical factor limiting the development of organ transplantation. Xenotransplantation is expected to resolve the problem of organ shortage, which has become a new research hotspot. Study of costimulatory signaling pathway related to T cell regulation is a hot topic in terms of immunity of xenotransplantation. Since the discovery of costimulatory molecule CD28, multiple costimulatory molecules have been identified, including costimulatory and coinhibitory receptors and their related ligands. Specific T cell activation of donors is the key factor leading to acute immune rejection. The expression and induction of costimulatory molecules on T cells differ during different immune stages, and these costimulatory molecules play a key role in maintaining T cell tolerance and the balance of T cell immune response. At present, increasing attention has been diverted to the role of costimulatory signaling pathway in organ transplantation. In this article, the latest research progress in costimulatory signaling pathway related to xenotransplantation immunity was reviewed, aiming to provide reference for the optimization of xenotransplantation immunosuppression regimen.

Organ transplantation is the optimal treatment for end-stage organ failure. Nevertheless, organ shortage is a global problem, which limits further development of organ transplantation. Recent research shows that genetically modified pig may become a realistic alternative source of clinical organ transplantation donor. Xenotransplantation may serve as one of the effective measures to resolve the problem of organ shortage. Since 2021, 2 cases of living xenotransplantation and 6 cases of xenotransplantation in brain death recipients have been performed worldwide, and phase Ⅰ clinical trial of xenotransplantation has been launched, and the results have exceeded expectations. Therefore, in this article, recent clinical trial results of xenotransplantation in living and brain death recipients were retrospectively analyzed, and scientific, technical and ethical issues related to clinical research of xenotransplantation were illustrated, hoping to provide reference for clinical research of xenotransplantation in China and promote the development of xenotransplantation in clinical practice.

Effective preoperative matching of organ transplantation is essential for the success of organ transplantation.The current methods of preoperative matching for xenotransplantation are derived from human allogeneic organ transplantation.However,these methods are simple and cannot accurately predict whether rejection will occur after transplantation.A noteworthy feature of xenotransplantation lies in the stability of the donor source and the clarity of its genotype,which facilitate convenient sampling and ensure robust repeatability.The multi-link and multi-dimensional preoperative matching is conducive to accurately screening suitable donors and reducing the occurrence of postoperative rejection after xenotransplantation,including making full use of the advantages of donor control in xenotransplantation,expanding tissue level matching methods on the basis of improving traditional cytological matching,paying attention to the role of endothelial cells in matching,and developing organic-level matching methods.Therefore,this article reviews the methods of allogeneic organ transplantation matching,current methods,existing problems and possible breakthroughs of xenotransplantation matching,in order to provide reference for further research on xenotransplantation matching.

Objective To explore the public attitude towards kidney xenotransplantation in China by constructing and validating the prediction model based on xenotransplantation questionnaire. Methods A convenient sampling survey was conducted among the public in China with the platform of Wenjuanxing to analyze public acceptance of kidney xenotransplantation and influencing factors. Using random distribution method, all included questionnaires (n=2 280) were divided into the training and validation sets according to a ratio of 7:3. A prediction model was constructed and validated. Results A total of 2 280 questionnaires were included. The public acceptance rate of xenotransplantation was 71.3%. Multivariate analysis showed that gender, marital status, resident area, medical insurance coverage, religious belief, vegetarianism, awareness of kidney xenotransplantation and whether on the waiting list for kidney transplantation were the independent influencing factors for public acceptance of kidney xenotransplantation (all P<0.05). The area under the curve (AUC) of receiver operating characteristic (ROC) of the prediction model in the training set was 0.773, and 0.785 in the validation set. The calibration curves in the training and validation sets indicated that the prediction models yielded good prediction value. Decision curve analysis (DCA) suggested that the prediction efficiency of the model was high. Conclusions In China, public acceptance of kidney xenotransplantation is relatively high, whereas it remains to be significantly enhanced. The prediction model based on questionnaire survey has favorable prediction efficiency, which provides reference for subsequent research.

Objective:To investigate the technical points and clinical effect of thulium fiber laser lobes-enucleation of the prostate (ThuLLEP).Methods:A total of 90 patients underwent ThuLLEP and plasmakinetic enucleation of prostate (PKEP) in our hospital from November 2018 to December 2020 were collected. The age of patients in the two groups was (67.7±6.8) years and (65.7±7.1) years, the prostate volume was 56.0 (46.0-83.5) ml and 61.0 (53.5-79.5) ml, the serum PSA was 3.6 (2.2-6.0) ng/ml and 4.4 (1.8-7.3) ng/ml, the international prostate symptom score (IPSS) was 27 (22-31) and 28 (23-30), the quality of life score (QOL) was 5 (5-6) and 5 (5-6), the maximum urinary flow rate (Q max) was (8.5±5.7) ml/s and (7.8±3.8) ml/s, the post-void residual volume (PVR) was 127 (47-250) ml and 100 (27-209) ml. The differences had no statistical significance ( P>0.05). The glands were bluntly dissected to establish the surgical capsule plane on both sides of the verumontanum after the verumontanum being located. And then the middle lobe was removed. The glands formed grooves at 12 o'clock after vaporization, which served as anatomical marker. The left and right lobes were removed step by step. Finally, tissue crushing was performed. The PKEP group was enucleated by three lobes enucleation. Perioperative indicators were compared between the two groups. Results:All the operations were completed successfully. The median operative time in ThuLLEP and PKEP groups was 60 (50-73) minutes and 75 (60-100) minutes, the postoperative bladder irrigation time was 2.8 (2.3-3.6) d and 3.8 (2.6-4.7) d, the catheter indwelling time was 4.1 (3.7-4.9) d and 4.9 (4.7-6.0) d, the postoperative hospital stay was 5 (4-6) d and 6 (5-7) d. The decreased hemoglobin was 8.0 (1.5-14.5) g/L and 15.0 (6.5-21.0) g/L. The differences had statistical significance ( P<0.05). Follow-up was performed for 6 months after surgery. The median IPSS score of the two groups was 5 (2-11) and 6 (3-9), the QOL score was 1 (1-2) and 1 (1-2) respectively, which had statistical significance compared with the preoperative parameters ( P<0.05), but no statistical significance between the two groups ( P>0.05). The ThuLLEP group had 1 case of postoperative blood transfusion, 1 case of transient urinary incontinence and 2 cases of urethral stricture. The PKEP group had 1 case of fever and blood transfusion, 3 cases of transient urinary incontinence and 3 cases of urethral stricture. Conclusions:ThuLLEP has definite clinical effect because of less bleeding, quicker recovery and fewer complications. The relatively simple operation steps are beneficial for beginners to master.

Objective:To investigate the effect of total anatomical reconstruction (TAR) during robot-assisted radical prostatectomy (RARP) .Methods:The clinical data of 99 patients with RARP performed by a single doctor in our hospital from January 2018 to January 2021 were analyzed retrospectively.There were 38 patients in the TAR+ vesicourethral anastomosis (VUA) group and 61 patients in the VUA group. There were no significant differences between the two groups in the age of patients [ 65.5 (60.8, 71.0) years vs. 66.0 (61.5, 69.0) years], body mass index[ (24.92±2.65) kg/m 2 vs. (25.51±2.80) kg/m 2], prostate volume [28.13 (25.21, 36.53) ml vs. 26.33 (19.75, 47.84) ml], PSA [15.67 (9.02, 31.49) ng/ml vs. 14.58 (9.23, 30.06) ng/ml], neoadjuvant therapy [50.0% (19/38) vs. 63.9% (39/61)], Gleason score (6/7/8/9-10 scores: 8/16/5/9 cases vs. 16/25/9/11 cases) and clinical T stage (T 1/T 2/T 3 stage: 4/29/5 cases vs. 3/53/5 cases)(all P>0.05). The TAR technique was performed as follows. ①The two layers of posterior reconstruction involved the residual Denonvilliers fascia, the striated sphincter and medial dorsal raphe (MDR), and the vesicoprostatic muscle (VPM), the fascia which was 1-2 cm from the cranial side of the bladder neck and MDR. ②The one layer of anterior reconstruction involved detrusor apron, tissues around the urethra and the visceral and parietal layers of the endoplevic fascia. The VUA technique was suturing the bladder neck and urethra consecutively. Perioperative indexes were compared between the two groups. Results:All 99 operations were successfully completed. There were no statistically significant differences between the TAR+ VUA and VUA groups in operation time [ (174.16±47.21) min vs. (188.70±45.39) min], blood loss [ 50 (50, 100) ml vs. 100 (50, 100) ml], incidence of postoperative complications [10.5% (4/38) vs. 14.8% (9/61)], phathological T stage [pT 2/pT 3~4 stage: 25/12 cases vs. 42/19 cases, P=0.895], and the time of indwelling catheter [ 21.0 (19.0, 21.0) d vs. 21.0 (21.0, 21.0) d] (all P>0.05). The difference in postoperative length of stay between the two groups was statistically significant[6.0 (5.0, 6.0) d vs. 7.0 (6.0, 7.5)d, P<0.001]. Follow-up was performed for 1 year after surgery. The recovery rate of urinary continence 3 months after surgery in TAR+ VUA and VUA groups were 86.8% (33/38) vs. 65.6% (40/61), which were statistically significant( P=0.019). There were no significant differences between TAR+ VUA and VUA groups in recovery rate of urinary continence 1 months after surgery [47.4% (18/38) vs. 45.9% (28/61)], 6 months after surgery [94.7% (36/38) vs. 85.2% (52/61)], and 12 months after surgery [94.7% (36/38) vs. 93.4% (57/61)] (all P>0.05). Conclusions:TAR technique has good surgical safety, and can promote recovery of early urinary continence after RARP.