Objective To analyze the clinical characteristics of renal angiomyolipoma(rAML)without clear diagnosis before operation, so as to provide reference for avoiding excessive surgical treatment. Methods A total of 202 patients with pathologically confirmed rAML following surgical treatment in our hospital during Dec. 2019 and Nov. 2024 were collected. Among them, 42 patients undergoing surgical treatment due to suspected malignant tumor were classified as the undiagnosed group, while the remaining 160 patients with a preoperative diagnosis of rAML were classified as the diagnosed group. The general and clinical data of the two groups were compared. Results The undiagnosed group had smaller maximum diameter of tumor than the diagnosed group [(1.70(0.80-6.10)cmvs. 4.35(1.00-21.00)cm, P＜0.001], significantly shorter operation time [125(56-202)min vs. 150(60-360)min, P=0.025], and was less likely to have fat component in the preoperative imaging examination(26.2% vs. 100.0%, P＜0.001). Conclusion Poor fat component and small tumor size are the main factors leading to preoperative unclear diagnosis. Therefore, for atypical small volume lipid-poor renal tumors, advanced technology or further observation should be adopted to confirm the preoperative diagnosis and avoid excessive treatment.

Objective: To analyze and summarize the clinical characteristics and treatment methods of intraductal carcinoma of the prostate (IDC-P)，so as to improve the diagnosis and treatment of this disease. Methods: The clinical data of 48 IDC-P patients treated in Beijing Friendship Hospital during May 2017 and Mar.2024 were retrospectively analyzed.IDC-P was diagnosed by pathology in 27 cases by prostate puncture，in 2 cases by transurethral plasma resection of the prostate，and in 19 cases by radical prostatectomy.Of all patients，24 received radical prostatectomy，21 received direct endocrinotherapy，2 received prostate radioactive I implantation brachytherapy combine with androgen deprivation therapy，and 1 patient was observed and waiting.Kaplan-Meier method was used to analyze the main prognostic indicators. Results: One patient was lost to follow-up.Of the 47 patients followed up，24 underwent radical prostatectomy，of whom 22 underwent postoperative endocrinotherapy，and 10 had biochemical recurrence; 23 patients only received endocrinotherapy，and 14 of them had biochemical recurrence.Altogether 45 patients received endocrinotherapy，including 33 who received standardized treatment (21 had biochemical recurrence) and 12 who received novel treatment (3 had biochemical recurrence).Survival analysis showed that radical prostatectomy had no significant impact on the biochemical recurrence after endocrinotherapy (P=0.250).Novel endocrinotherapy could delay biochemical recurrence compared with standardized endocrinotherapy (P=0.003). Conclusion: Abiraterone or enzalutamide therapy can reduce the risk of biochemical recurrence，but further studies are needed to determine the optimal treatment for IDC-P patients.

The clinical data of 10 patients with prostate abscess admitted to our hospital were retrospectively analyzed. Summarize its diagnosis and treatment characteristics and its clinical efficacy. Prostatic abscess can generally be effectively controlled by timely, adequate and effective antibiotic treatment and active control of comorbidities. Prostate abscess deroofing might be an effective treatment for patients with the failure of conservative antibiotic treatment.

Objective:To investigate the effect of different concentrations of human adipose-derived mesenchymal stromal cells (hADMSCs) derived exosome-mimetic nanovesicles (NVs)and exosomes (EXOs) on the biological function of human umbilical vein endothelial cells (HUVECs) .Methods:(1) Through hydrodynamic liposuction, adipose tissue was obtained from the thighs of 10 women (aged 18-65 years) in Fujian Medical University Union Hospital from June 2019 to August 2020. The hADMSCs were isolated by enzymatic hydrolysis, cultured to passage 4 and induced into adipocytes and osteocytes. The surface protein markers were identified by flow cytometry. (2) hADMSCs-NVs and hADMSCs-EXOs were prepared and observed under an electron microscope. Their surface protein markers were analyzed with particle size analyzer, particle size was analyzed with nanoparticle tracker. Protein quantitative analysis and nanoparticle tracking were used to detect the total protein and particle number of NVs and EXOs produced by 1×10 6 hADMSCs. (3) The control group (DMEM basic medium), 40, 60, 80 μg/ml NVs groups and 20, 40, 60 μg/ml EXOs groups were set to compare the proliferation, migration and angiogenesis of HUVECs through CCK-8 proliferation test, cell scratch test and angiogenesis test respectively. Graphpad Prism 7.0 was used for statistical analysis, and the measurement data were expressed as Mean±SD. Repeated measurement analysis of variance was applied to the comparison between multiple groups, and Tukey test was applied to pairwise comparison. P<0.05 represented statistical significance. Results:(1) The fourth generation of hADMSCs were slender spindle-shaped cells under optical microscope. After 21 days of adipogenesis induction, the transparent lipid droplets inside the cells were stained red by oil red O staining. After 14 days of osteogenesis induction, a large proportion of brown black staining area was observed by alkaline phosphatase calcium cobalt staining. The surface protein markers CD90 and CD29 of hADMSCs were positive. (2) Under transmission electron microscope, the structures of hADMSCs-NVs and EXOs were similar, both were discoid vesicles. The expression levels of CD9, CD81 and IgG were similar between NVS and EXOs. The particle sizes of NVs and EXOs were about the same, which were (72.0 ± 21.51) nm and (81.27±22.37) nm. The total protein content of NVs produced by 1×10 6 hADMSCs was (140.7±5.1) μg, about 100 times that of EXOs, which was (1.3±0.3) μg. The number of NVs [(644.5 ± 17.1)×10 8/ml] particles was about 90 times that of EXOs [(7.1±0.1)×10 8/ml]. (3) In CCK-8 proliferation assay, at 12, 24 and 48 hours after culture, the growth trend of HUVECs in the groups were generally consistent, and the difference in absorbance value was statistically significant ( P<0.01); at 48 hours after culture, the absorbance values of 60 μg/ml NVs and 40 μg/ml EXOs were higher than those in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). At 8 and 24 hours after cell scratch assay, the changes of scratch width in each group were different, and the difference was statistically significant ( P<0.01); at 24 hours after scratch, the change of scratch width in 60 μg/ml NVs and 40 μg/ml EXOs groups were greater than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). In the angiogenesis assay, the number of branch points and the length of blood vessels in each group were different, and the difference was statistically significant ( P<0.01). The number of capillary branches formed by HUVECs in 60 μg/ml NVs and 40 μg/ml EXOs groups were higher than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups (all P>0.05). The capillary length of 60 μg/ml NVs and 40 μg/ml EXOs groups were longer than that of the control group ( all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). Conclusions:The shape and size of NVs were similar to EXOs, while the total protein content of NVs was about 100 times that of EXOs. The effects of hADMSCs-NVs and EXOs on the biological functions of HUVECs are similar and the optimum concentrations of NVs and EXOs are 60 μg/ml and 40 μg/ml, respectively.

Objective:To investigate the longitudinal changes and influencing factors of out-of-hospital functional exercise compliance in patients with lumbar disc herniation treated conservatively based on patient-based compliance curve (PBCC) .Methods:From April to September 2020, the convenient sampling method was used to select 88 patients with lumbar disc herniation treated conservatively in Hangzhou Hospital of Traditional Chinese Medicine as the research objects. The score of out-of-hospital functional exercise compliance questionnaire of patients with lumbar disc herniation was measured from the time of discharge, once every 2 weeks, and the PBCC of functional exercise was drawn after continuous measurement to the 24th week , taking time as independent variable ( x) and functional exercise compliance index as dependent variable ( y) . Univariate and multiple linear regression analyses were used to explore the influencing factors of 24-week compliance index. A total of 88 questionnaires were distributed, among which 3 patients withdrew due to surgery and 11 patients were lost to follow-up. A total of 74 valid questionnaires were finally recovered, with an effective recovery rate of 84.09% (74/88) . Results:Within 24 weeks of discharge, the PBCC formula of the total functional exercise score of patients was y=0.005 x3-0.196 x2+1.436 x+59.197 ( R2=0.898, F=26.517, P<0.01) . The PBCC formula of physical exercise was y=0.008 x3-0.337 x2+3.616 x+56.153 ( R2=0.878, F=21.570, P<0.01) . The formula of exercise effect supervision PBCC was y=-0.006 x3+0.309 x2-5.315 x+76.371 ( R2=0.910, F=30.458, P<0.01) . The PBCC formula of actively seeking advice was y=0.012 x3-0.460 x2+3.931 x+44.071 ( R2=0.865, F=19.217, P<0.01) . Except for the PBCC of effect supervision, the changes of other PBCC showed a trend of first increasing and then decreasing. The average compliance index in 24 weeks was (57.73±8.20) , the high peak appeared in the 4th week and the index was (64.08±8.91) . The low peak appeared in the 18th week and the index was (52.42±7.81) . The results of univariate analysis showed that there were statistically significant differences in the compliance level of rehabilitation exercise in patients with lumbar protrusion in different age, education level, course of lumbar protrusion, pain degree, accompanying symptoms, functional exercise methods and disease knowledge ( P<0.05) . The results of multiple linear regression analysis showed that the main influencing factors of functional exercise compliance of patients were disease knowledge, pain degree, course of lumbar protrusion and functional exercise method ( P<0.05) . Conclusions:The functional exercise compliance of lumbar disc herniation patients shows a horizontal "S" -like dynamic change. During the period of decreased compliance, regular rehabilitation guidance and health education, pain management and prevention of recurrence are necessary measures to improve functional exercise compliance of patients.

Objective:To investigate the effect of different concentrations of human adipose-derived mesenchymal stromal cells (hADMSCs) derived exosome-mimetic nanovesicles (NVs)and exosomes (EXOs) on the biological function of human umbilical vein endothelial cells (HUVECs) .Methods:(1) Through hydrodynamic liposuction, adipose tissue was obtained from the thighs of 10 women (aged 18-65 years) in Fujian Medical University Union Hospital from June 2019 to August 2020. The hADMSCs were isolated by enzymatic hydrolysis, cultured to passage 4 and induced into adipocytes and osteocytes. The surface protein markers were identified by flow cytometry. (2) hADMSCs-NVs and hADMSCs-EXOs were prepared and observed under an electron microscope. Their surface protein markers were analyzed with particle size analyzer, particle size was analyzed with nanoparticle tracker. Protein quantitative analysis and nanoparticle tracking were used to detect the total protein and particle number of NVs and EXOs produced by 1×10 6 hADMSCs. (3) The control group (DMEM basic medium), 40, 60, 80 μg/ml NVs groups and 20, 40, 60 μg/ml EXOs groups were set to compare the proliferation, migration and angiogenesis of HUVECs through CCK-8 proliferation test, cell scratch test and angiogenesis test respectively. Graphpad Prism 7.0 was used for statistical analysis, and the measurement data were expressed as Mean±SD. Repeated measurement analysis of variance was applied to the comparison between multiple groups, and Tukey test was applied to pairwise comparison. P<0.05 represented statistical significance. Results:(1) The fourth generation of hADMSCs were slender spindle-shaped cells under optical microscope. After 21 days of adipogenesis induction, the transparent lipid droplets inside the cells were stained red by oil red O staining. After 14 days of osteogenesis induction, a large proportion of brown black staining area was observed by alkaline phosphatase calcium cobalt staining. The surface protein markers CD90 and CD29 of hADMSCs were positive. (2) Under transmission electron microscope, the structures of hADMSCs-NVs and EXOs were similar, both were discoid vesicles. The expression levels of CD9, CD81 and IgG were similar between NVS and EXOs. The particle sizes of NVs and EXOs were about the same, which were (72.0 ± 21.51) nm and (81.27±22.37) nm. The total protein content of NVs produced by 1×10 6 hADMSCs was (140.7±5.1) μg, about 100 times that of EXOs, which was (1.3±0.3) μg. The number of NVs [(644.5 ± 17.1)×10 8/ml] particles was about 90 times that of EXOs [(7.1±0.1)×10 8/ml]. (3) In CCK-8 proliferation assay, at 12, 24 and 48 hours after culture, the growth trend of HUVECs in the groups were generally consistent, and the difference in absorbance value was statistically significant ( P<0.01); at 48 hours after culture, the absorbance values of 60 μg/ml NVs and 40 μg/ml EXOs were higher than those in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). At 8 and 24 hours after cell scratch assay, the changes of scratch width in each group were different, and the difference was statistically significant ( P<0.01); at 24 hours after scratch, the change of scratch width in 60 μg/ml NVs and 40 μg/ml EXOs groups were greater than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). In the angiogenesis assay, the number of branch points and the length of blood vessels in each group were different, and the difference was statistically significant ( P<0.01). The number of capillary branches formed by HUVECs in 60 μg/ml NVs and 40 μg/ml EXOs groups were higher than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups (all P>0.05). The capillary length of 60 μg/ml NVs and 40 μg/ml EXOs groups were longer than that of the control group ( all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). Conclusions:The shape and size of NVs were similar to EXOs, while the total protein content of NVs was about 100 times that of EXOs. The effects of hADMSCs-NVs and EXOs on the biological functions of HUVECs are similar and the optimum concentrations of NVs and EXOs are 60 μg/ml and 40 μg/ml, respectively.

Objective: To investigate the clinical features of chromophobe renal cell carcinoma (chRCC) and analyze the factors affecting its prognosis. Methods: Retrospectively analyze the case data of 66 patients with chRCC admitted to Beijing Friendship Hospital, Capital Medical University from October 2003 to September 2018, including 32 males and 34 females; the average age was (53.9±13.9) years and the age range was 24-85 years. To analyze the clinical symptoms, whether have hypertension, diabetes, tumor characteristics (size, side, location), surgical methods, TNM staging and other clinical features of patients, with disease-free survival (DFS) as the study endpoint. The survival curve was drawed by the kaplan-Meier method. Survival analysis was performed using Log-rank test, and the clinical features of prognosis were analyzed by Cox regression models. Results: Among the 66 patients, the mean diameter of the tumor was (5.4±3.5) cm, 17 cases were ≥7 cm, 49 cases were <7 cm; 48 cases were asymptomatic, and 18 cases were symptomatic; 45 cases in T₁, 15 cases in T₂, 6 cases in T₃; 33 cases were underwent radical nephrectomy, 32 cases were underwent nephron sparing surgery, 1 case was under the therapy of watchful waiting. The median follow-up time was 61 months, and the DFS in 1, 5, and 10 years were 94.6%, 91.3%, and 82.2%, respectively. Log-rank results showed that the maximum diameter of the tumor was related to the T stage and the survival time of the patients (P<0.05). Cox multivariate analysis showed that T stage was an independent risk factor for DFS (HR=8.102, P=0.027). Conclusions ChRCC is a type of kidney cancer with a good prognosis. Tumor staging is more common in T₁ and T₂ phases, patients with higher DFS in 5 and 10 years, and T staging is an independent risk factor for DFS in patients.

Objective To investigate the prognostic factors of patients with upper urinary tract urothelial carcinoma (UTUC) treated with gemcitabine plus cisplatin (GC).Methods The clinical and follow-up data of 80 patients with UTUC admitted to Beijing Friendship Hospital,Capital Medical University from January 2013 to July 2018 were retrospectively analyzed.All patients underwent UTUC radical surgery.All patients were treated with GC regimen:1,8,and 15 days,Gemcitabine 800 mg/m2,intravenous infusion over 30 min;day 2 Cisplatin 70 mg/m2,protected from light 2 h intravenous drip;28 d for 1 cycle.Adjuvant treatments such as acid suppression,hydration,and antiemetic were given before and after chemotherapy.Patients completed 1 to 5 cycles with an average of 2 cycles.The patient's age,gender,presence or absence of water,primary tumor site,tumor stage and grade,lymphatic vascular infiltration,tumor recurrence,lymph node metastasis,organ metastasis,chemotherapy cycle,total Survival,etc.are used as indicators ofobservation.Univariate analysis of the patient's overall survival,screening for clinical variables associated with prognosis,and then using the COX proportional hazards model for multivariate prognostic analysis to determine independent influencing factors.Results Eighty patients with UTUC were followed up for 2 to 72 months with a median follow-up of 27 months.Sixteen patients (20％) died of UTUC recurrence or metastasis,and 64 (80％) patients survived.The 1-year cumulative survival rate was 78.26％ (18/23),and the 2-year cumulative survival rate was 54.18％ (9/13 ×78.26％),the 3-year cumulative survival rate was 39.41％ (8/1 1 × 54.18％),the 4-year cumulative survival rate was 31.53％ (12/15 × 39.41％),and the 5-year cumulative survival rate was 28.66％ (10/11 × 31.53％).Univariate analysis showed combined hydronephrosis (P =0.023),lymphatic vessel infiltration (LVI) (P =0.001),tumor TNM stage (P =0.002),tumor recurrence (P =0.008),simple lymph node metastasis (P =0.005),organ metastasis (P ＜ 0.001) was related to survival rate.COX model multivariate analysis showed that the independent risk factors associated with survival of patients with UTUC receiving chemotherapy with GC regimen were hydronephrosis (HR =4.355,95％CI:1.232-15.390,P=0.022),LVI (HR =0.133,95％ CI:0.035-0.509,P=0.003),TNM stage (HR=0.099,95％CI:0.010-0.929,P=0.043).Conclusion The presence or absence of hydronephrosis,LVI,and tumor TNM staging are independent factors influencing the prognosis of patients with UTUC who have adjuvant chemotherapy.

Hyperuricemia is the result of purine metabolic or excretion disorder.Continuous hyperuricemia can cause chronic uric acid nephropathy (gouty nephropathy),which will induce varying degrees of renal disfunction and impair life.Uric acid contributes to kidney injury by inducing inflammation,endothelial dysfunction,oxidative stress,and activation of the renin-angiotensin system(RAS),and cause chronic uric acid nephropathy.Thorough tnderstanding of.the pathogenesis of chronic uric acid nephropathy is beneficial for dru development and evaluating disease prognosis.Here,we reviewed of the pathogenesis of chronic uric acid nephropathy.

Objective To explore the relationship between intermedin (IMD) and renal interstitial capillary loss in IgA nephropathy (IgAN) patients.Methods Renal biopsy specimens collected from primary IgAN patients in our hospital (n=80) were compared with normal renal tissues.Expressions of IMD,CD31 and VE-cadherin were examined by immunohistochemical method,and plasma concentrations of IMD and TGF-β1 in 37 cases from the 80 cases were compared.The relationship between IMD and renal interstitial capillary loss in IgAN patients was analyzed.Results IMD and VE-cadherin in renal tubule interstitium expressions increased compared to the control group at the early stage of IgAN (P ＜ 0.05).CD31 expression remained unchanged at the early stage of pathological lesions of IgAN (P ＞ 0.05),but decreased at the early stage of clinical stage of IgAN compared to the control (P ＜ 0.05).Expressions of IMD,CD31 and VE-cadherin were reducing as the disease progressed,and the correlations of CD31 and VE-cadherin (r=0.517,P ＜ 0.01),IMD and CD31(r=0.655,P ＜ 0.01) or IMD and VE-cadherin (r=0.576,P ＜ 0.01) were positive.Plasma concentrations of IMD and TGF-β1 were higher than those of the control group at the early stage of IgAN (P ＜ 0.05),and the changes of IMD and TGF-β1were correlated positively (r=0.582,P ＜ 0.01).Conclusion Compared with the control group,expression of IMD in kidney tubules increases at the early stage of IgAN,and change of IMD correlates closely with the renal interstitial capillary loss.Plasma concentrations of IMD and TGF-β1 increase compared with the control group at the early stage of IgAN,and the changes of IMD and TGF-β1 are related closely.