【Objective】 To investigate the clinical features, treatment methods and prognosis of advanced renal cell carcinoma (RCC) patients in Xinjiang, especially the Han population. 【Methods】 Clinical data of 233 patients with advanced RCC treated in The First Affiliated Hospital and The Affiliated Cancer Hospital of Xinjiang Medical University were retrospectively analyzed, including 133 Han patients.The median age of patients was 52 years (range: 23 to 87), and the maximum tumor diameter was (7.73±4.04) cm.Survival curves were plotted using the Kaplan-Meier method.Multivariate and univariate Cox regression analysis were conducted for all patients, and further analysis was performed for the Han patients. 【Results】 Among the 233 patients, 131 died during the average follow-up of 27.6 months (range: 1 to 120), and the median survival time was 12 months.In this cohort, 110 patients had lymph node metastasis, and 200 had distant metastasis, among them, 21 (10.5%) patients had brain metastasis and 45 (22.5%) patients had adrenal metastasis.The 1-, 3-, and 5-year survival rate were 48.9%, 18.3% and 6.1%, respectively.Univariate analysis revealed that International mRCC Database Consortium (IMDC) score, pathological type, lymph node metastasis, distant metastasis, number of metastatic foci and treatment methods impacted the prognosis in Xinjian (P<0.05).Multivariate analysis indicated that IMDC score, pathological type and distant metastasis were significant factors influencing the prognosis, which were also the prognostic factors of the Han patients (P<0.05). 【Conclusion】 In Xinjiang, patients with advanced renal cell carcinoma have a 6.1% 5-year survival rate and a median survival time of 12 months.Brain and adrenal metastases are common.Prognostic factors include IMDC score, pathological type, and distant metastasis for all patients, including the Han patients.

T cell immunoglobulin and immune receptor tyrosine-based inhibitory motif domain (TIGIT) is a co-inhibitory receptor, which is highly expressed in a variety of malignant tumors.It can inhibit T cells and NK cells, and plays a key role in regulating immune response and tumor immune escape.TIGIT is closely related to the growth, metastasis and prognosis of urologic tumors, and its overexpression is associated with tumor progression and poor prognosis.Currently, TIGIT-based urologic tumors treatment strategies include monoclonal antibody therapy and combined immunotherapy, such as combination therapy with PD-1/PD-L1 and other drugs.Experimental and clinical studies on TIGIT are also being carried out and significant progress has been made.Therefore, TIGIT is expected to become a new target for immunotherapy and a biomarker for predicting the prognosis of patients with urologic tumors.This article reviews the research progress of TIGIT in urologic tumors.

Objective:To examine the location and the reparative impact of iatrogenic ureteral injury.Methods:Retrospectively analyzed the clinical data of 43 patients with iatrogenic ureteral injury admitted from May 2019 to May 2022. The median age of the patients was 39 years. The injuries were predominantly on the left side in 26 patients (60.5%), in addition, there were 16 patients (37.2%) on the right side, and 1 patient on(2.3%)bilateral sides. The types of injuries were upper ureteral (8 patients, 18.6%), middle ureteral (8 patients, 18.6%), and lower ureteral (27 patients, 62.8%). The average injury length was 5.9 cm with a standard deviation of 2.4.During intraoperative diagnosis, 7 cases were found to have damage, transection, or ligation of the ureteral luminal structure. Surgical areas displayed extensive exudation and the presence of adipose tissue was observed during ureteroscopy. There were 36 cases manifested symptoms such as lumbar and abdominal pain (13 cases), fever (12 cases), peritoneal irritation sign (9 cases), vaginal discharge (9 cases), or hematuria (5 cases). Among these cases, 10 showed contrast agent spillage on urinary enhanced CT or intravenous urography, while 27 exhibited hydronephrosis or ureteral dilatation. Additionally, one case presented a renal tumor on the affected side, and creatinine examination was performed on drainage fluid in 7 cases. Furthermore, a unilateral renal nonfunction was identified in 1 case through renal ECT examination.Results:Out of the 43 patients followed up for a median of 18 months (range 11-47), 41 patients had no urinary symptoms such as hematuria, urine extravasation, or hypochondriac pain. Their urine tests (routine, urea nitrogen, and serum creatinine) were normal. Thirteen patients showed mild hydronephrosis on urinary ultrasonography, which remained stable during the follow-up period. One patient experienced restenosis at the ureterovesical anastomosis after renal autograft transplantation, but symptoms improved after balloon dilatation. Another patient underwent nephrostomy puncture and was found to have a clamped left ureteral end and a fistula in the sigmoid colon. This patient successfully underwent bilateral ureteroneocystostomy with a bladder flap and had a positive postoperative outcome.Conclusions:Iatrogenic ureteral injuries occur at seven specific sites, with gynecological surgeries posing a higher risk of injury at the ureter and external iliac artery, pelvic infundibulum ligament, and uterine artery intersection or adjacent areas. Similarly, colorectal surgeries can result in injury at the parallel segment of the ureter and mesenteric vessels, colon adjacent region, and vas deferens intersection. Urological surgeries are more likely to cause injury at the intersection of the ureter and external iliac artery, as well as the ureteropelvic junction.When treating ureteral injuries, it is important to consider the cause, location, and length of the injury. For short and deep injuries, options such as ureteral anastomosis or ureterovesical anastomosis may be considered. In cases of longer injuries, alternatives like renal autograft transplantation, ureteral surgery involving other tissues, or techniques such as the Boari flap or buccal/oral mucosal transplantation can be explored. The primary focus during repair surgeries should be on achieving tension-free anastomosis while maintaining sufficient blood supply to the ureter and placing it in an area with better blood circulation.

【Objective】 To investigate the risk factors and clinical significance of incidental prostate cancer (IPCa) in patients undergoing radical cystoprostatectomy (PCR). 【Methods】 The clinicopathological data of 260 patients undergoing RCP in our hospital during Jan. 2010 and Jan. 2022 were retrospectively analyzed, including 39 cases of IPCa detected with postoperative pathology, and 221 non-IPCa cases. 【Results】 The detection rate of IPCa was 15%. Univariate logistic regression analysis showed age (P<0.001), smoking (P<0.05), T stage (P<0.05), number of tumors (P<0.05), involvement of trigone (P<0.05), prostate volume (P<0.05), and preoperative total prostate-specific antigen (tPSA) (P<0.05) were influencing factors of prostate cancer. Multivariate logistic regression analysis showed that age (OR=1.061, 95%CI: 1.021-1.107, P=0.004), smoking (OR=2.852, 95%CI: 1.296-6.677, P=0.012), involvement of trigone(OR=2.967, 95%CI: 2.365-3.657, P=0.019) and preoperative tPSA (OR=1.109, 95%CI: 1.011-1.223, P=0.030) were independent risk factors of IPCa. 【Conclusion】 Advanced age, smoking, bladder tumor in trigone and preoperative PSA abnormality are risk factors for incidental prostate cancer in bladder cancer patients.

Objective:To assess the evidence for relevant factors associated with mortality in COVID-19 kidney transplantation recipients(KTR) through Meta-analysis.Methods:A complete search of PubMed, Web of Science, Medline, Scopus, Cochrane Library, CNKI and Wanfang Database were performed to search for eligible studies on 18 August 2022.Results:twenty-nine studies involving 7 978 Cases were included in our Meta-analysis.Patients with mean age ≥60 years( OR=1.09, 95% CI: 1.06-1.13), Comorbidities including diabetes mellitus( OR=1.49, 95% CI: 1.26-1.76), cardiovascular disease( OR=1.88, 95% CI: 1.33-2.65), and acute kidney injury( OR=3.46, 95% CI: 1.35-8.89) significantly increased mortality risk.KTR with dyspnea ( OR=2.17, 95% CI: 1.38-3.42), higher Hemoglobin ( OR=1.09, 95% CI: 1.00-1.19), Use of mycophenolic ( OR=1.18, 95% CI: 1.02-1.37) and Antibiotics( OR=7.26, 95% CI: 2.11-25.07) at presentation were at higher mortality risk, while diarrhea( OR=0.57, 95% CI: 0.34-0.96) and higher eGFR( OR=0.95, 95% CI: 0.92-0.98) decreased the risk.Overall in-hospital mortality in COVID-19 KTR was 19%, 95% CI: 15%-23%. Conclusions:Our systematic review and -analysis results suggest that overall in-hospital mortality in COVID-19 KTR declined progressively over time.KTR with these risk factors should receive more intensive monitoring and early therapeutic interventions to optimize health outcomes.

In this study, a new ileal orthotopic bladder (Urumqi Bladder) modified by our center based on the ileal "W" type orthotopic bladder and Studer bladder was used on 8 patients with invasive bladder cancer. All of patients were male and aged between 54 and 66 years. The history of disease ranged from 1 month to 3 years, including 5 patients with initial onset, 3 patients with ≥2 TURBT history. 6 patients had multiple tumors, tumor size from 0.5 cm to 2.5cm. There were 2 patients with single tumor. Preoperative PET-CT examination showed no distant metastasis and pelvic lymph node enlargement, no urinary tract hydronephrosis, and cystoscopy showed no suspected tumor in the urethra. Preoperative pathological results: high-grade invasive urothelial carcinoma was found in 6 cases and muscular invasive urothelial carcinoma in 2 cases. In 8 patients, 50cm ileum was taken from 15cm away from ileocecum after radical cystectomy, which was crimped clockwise inward from the right end into a nearly circular shape, with 10cm left at the left end. The remaining 40cm ileum was formed into 3 sections of about 13cm each, which were decanted to form a storage capsule. The last 10cm intestinal tube was crossed from the front of sigmoid colon. The end of intestine was anastomosed with the left ureter. The right ureter was anastomosed with the top of the right intestine pouch, and the urethra was anastomosed with the pouch to complete the diversion of urine flow. During 3-12 months of postoperative follow-up, 4 patients had short-term mild urinary incontinence. All had complete urinary control at 12 months. 1 patient still had mild left ureter reflux 12 months after surgery, and the other 7 patients had no ureter reflux. In this group of 8 patients, postoperative excretory cystography showed satisfactory effect of bladder voiding, residual, and bladder capacity. Follow-up review of chest CT, urinary CT and abdominal ultrasound showed no hydronephrosis, and no tumor recurrence or distant metastasis.

Objective:To discuss the clinical features, treatment and prognosis of renal mesenchymal malignancy.Methods:Retrospective analysis was performed on the clinical data of 48 patients with renal mesenchymal malignancies admitted from January 2005 to June 2019.The patients' age ranged from 16-79 years, including 29 males and 19 females. There were 21 cases of Han nationality and 27 cases of ethnic minorities. The main complained of lumbago were 31 cases, bloating 8 cases, blood urine 2 cases, and 6 cases by physical examination. And one case was seen in orthopedics due to upper arm pain. The patient's completion of the examination indicated a tumor of kidney origin. CT examination mostly showed renal space-occupying lesions. After enhancement, the tumor was irregularly enhanced, with unclear edges, which was difficult to distinguish from renal carcinoma. The tumors were on the left in 30 cases and on the right in 18 cases. All patients perfected preoperative blood routine, biochemical, coagulation and other examinations. Prothrombin time was normal in 39 cases. Clinical staging was conducted according to the imaging results at the time of initial diagnosis. 7 were in clinical Stage T 1, 16 were in Stage T 2, 20 were in stage T 3, and 5 were in stage T 4.Distant metastases were found in 8 cases, including 4 lung metastases, 2 retroperitoneal metastases, and 2 bone metastases. 13 patients underwent needle biopsy to confirm the diagnosis. Among the 48 cases in this group, 29 cases were diagnosed as renal tumor, 12 cases were diagnosed as renal space occupying lesions, and 7 cases were diagnosed as retroperitoneal space occupying. 17 underwent radical nephrectomy, 22 underwent partial nephrectomy, and 9 did not receive surgical treatment after needle biopsy. Results:Among the 48 patients, Conventional pathology confirmed 17 cases as leiomyosarcoma, 17 cases as liposarcoma, and 14 cases as other types of mesenchymal malignancies. Follow-up ranged from 7 to 180 months, with an average follow-up of 38.8 months. Thirty patients died, and the average survival time was 39 months. The 5-year survival rates of leiomyosarcoma, liposarcoma and other types of tumors were 18.2%, 30.8% and 50.1%, and the difference was statistically significant ( P=0.047). The 5-year survival rates of patients with normal and abnormal prothrombin time were 36.8% and 11.0%, the difference was statistically significant ( P=0.018). The 5-year survival rates of radical surgery and partial nephrectomy were 44.6% and 29.8%, and the difference was statistically significant ( P<0.05). The 5-year survival rates of T 1, T 2, T 3 and T 4 patients were 40.0%, 31.6%, 35.4% and 0, and the differences were statistically significant ( P=0.020). Multivariate analysis showed that preoperative prothrombin time ( P=0.013), clinical T stage ( P=0.030) and surgical method ( P=0.006) were independent factors affecting the prognosis of patients with RMM. Conclusions:Renal mesenchymal malignant tumor is rare, and highly malignant. Preoperative needle biopsy did not affect the prognosis of RMM. Patients with normal prothrombin time, early clinical staging and radical surgery had better prognosis. Renal liposarcoma has a better prognosis than renal leiomyosarcoma.

Objective To analyze the clinicopathological features and prognostic factors of common subtypes of non-transparent renal cell carcinoma.Methods Retrospective analysis of 115 patients with pathologically confirmed non-transparent renal cell carcinoma from January 2003 to December 2017,including 67 males and 48 females,with a male to female ratio of 1.4∶ 1.The average age is (51.2 ± 13.4)years old.71 cases were asymptomatic renal cancer,44 cases had clinical symptoms,including 10 cases of gross hematuria,28 cases of low back pain,4 cases of hematuria with low back pain,and 2 cases of abdominal mass.There were 49 open surgery and 66 laparoscopic surgery.58 patients underwent radical nephrectomy and 57 underwent partial nephrectomy.Of the 115 patients,17 (14.9％) had abnormal hemoglobin (Hb),22 (19.1％) had abnormal platelet (PLT) count,18 (15.7％) had abnormal alkaline phosphatase,and abnormal lactate dehydrogenase 16 cases (13.9％).The Kaplan-Meier survival analysis method was used to calculate the survival rate of patients,and the Cox proportional regression risk model was used to analyze the prognostic factors.Results The postoperative pathological stage was 57 cases in T1a stage,38 cases in T1b stage,12 cases in T2a stage,8 cases in T2b stage,2 cases of regional lymph node positive,and 113 cases negative;no distant metastasis.Pathological types:42 cases of renal chromophobe cell carcinoma,37 cases of papillary renal cell carcinoma type Ⅰ,36 cases of type Ⅱ.The average follow-up time was 38.6 months,and the rate of loss of follow-up was 3.5％ (4/115).The 1,3,and 5 year overall survival rates of 115 patients with common subtypes of non-transparent renal cell carcinoma were 99.1％,95.8％,and 81.1％,respectively.Multivariate Cox regression analysis found that the pathological type (OR =4.625,P =0.014),four indicators ≥ 3 abnormalities (OR =30.853,P =0.024),lymph node metastasis (OR =35.663,P =0.006) were the group.An independent factor in the survival time of patients with common subtypes of non-transparent renal cell carcinoma.Conclusions Compared with papillary renal cell carcinoma type Ⅰ and renal chromophobe cell carcinoma,papillary renal cell carcinoma type Ⅱ has a higher degree of malignancy and a poor prognosis.The pathological types of the common subtypes of nontransparent renal cell carcinoma,four indicators (Hb,PLT count,alkaline phosphatase,and lactate dehydrogenase) ≥3 abnormalities and lymph node metastasis are independent prognostic factors for overall survival.

Objective To compare the efficacy of extended pelvic lymph node dissection (ePLND) and standard pelvic lymph node dissection (sPLND) in open radical cystectomy.Methods We retrospectively analyzed the clinical data of 139 patients with bladder cancer cases in our hospital from January 2007 to January 2017,who underwent open radical cystectomy and pelvic lymph node dissection performed by the same group of surgeons.There were 117 males and 22 females,aged from 20 to 84 years old,with an average of (64.6 ± 11.7) years,91 patients were underwent ePLND group and 48 patients were underwent sPLND group.The preoperative anemia-free patients was compared between the ePLND group and the sPLND group [24 (50.0％)] vs.58 (54.9％),respectively],the patients with anemia were [24 (50.0％) vs.41 (45.1％)].The range of ePLND is:sway to the common iliac artery and the lower aortic (unreaching the inferior mesenteric artery);the lateral boundary to the reproductive femoral nerve;the distal end of the iliac artery at the groin level,the posterior border to the iliac vessels and closure,which contains the anterior tibial lymph nodes between the two sides.The range of sPLND is below the level of the common iliac artery bifurcation,and the rest of the range is the same as ePLND.The average operative time,average intraoperative blood loss,intraoperative blood transfusion,intraoperative and postoperative complications,postoperative eating time,postoperative activity time,postoperative exhaust time,postoperative hospital stay,mean gastric tube indwelling time,average pelvic drainage tube indwelling time,lymph nodes positive rate,lymph node density,and cancer-free survival were evaluated.Results All 139 patients underwent surgery successfully.The average operative time in the ePLND group and the sPLND group were [(351.2 ±79.5)min vs.(342.5 ± 69.3) min],average intraoperative blood loss [(314.6 ± 120.6) ml vs.(298.3 ± 126.3)ml],intraoperative blood transfusion [(702.9 ± 645.7) ml vs.(936.9 ± 818.1) ml],no intraoperative complications,postoperative complications [29 cases (31.9 ％) vs.18 cases (37.5 ％)],postoperative eating time [(5.4 ± 1.9) d vs.(4.8 ± 2.1) d],postoperative activity time [(2.1 ± 0.9) d vs.(1.9 ± 0.8) d],postoperative exhaust time [(3.8 ± 0.9) d vs.(3.6 ± 1.0) d],postoperative hospital stay [(14.9 ± 7.8) d vs.(15.5 ± 6.9) d],average gastric tube indwelling time [(4.8 ± 2.6) d vs.(4.53 ± 1.9) d],average pelvic drainage tube indwelling time [(11.1 ± 4.9) d vs.(10.9 ± 4.9) d],the difference was not statistically significant (P ＞ 0.05).A total of 2 359 lymph nodes were dissected from the two groups.The number of lymph nodes dissected in each of the ePLND group and the sPLND group was [(20.3 ± 3.8) vs.(10.6 ± 3.1),P ＜ 0.01],and the average number of positive lymph nodes was [(0.6 ± 1.3) vs.(0.3 ±1.0),P =0.034],the ratio of lymph node positive patients was [33 (36.3％) vs.9 (18.8％),P =0.026],and the lymph node density was [7.9％ (146/1848) vs.4.1％ (21/511)],the difference was statistically significant (P ＜ 0.05).In regard to prognosis,the disease-free survival rate (DFS) of ePLND group was 94.5％,91.0％,84.4％,81.1％,75.3％ at 1,2,3,4 and 5 years follow-up respectively.The other group was 70.5％,63.5％,57.8％,51.4％,41.1％ respectively.DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups.The difference between the two groups was statistically significant (P ＜ 0.001).Conclusions In open radical cystectomy,ePLND and sPLND have similar surgical safety,but expanded lymph node dissection can improve disease-free survival in patients and improve the prognosis by increasing the detection range of positive lymph nodes.

BACKGROUND: As an emerging stem cell family, urine-derived stem cells have attracted more and more attentions in the tissue engineering construction. OBJECTIVE: To study the culture method of urine-derived stem cells, and to identify the biological characteristics of urine-derived stem cells. METHODS: Cleaning urine samples were harvested and centrifuged, and urine-derived stem cells were isolated from the urine samples and extensively expanded in vitro.Cell growth curve was measured by MTT method,and cell surface markers were detected by flow cytometry. Meanwhile, the cells were subjected to osteogenic and adipogenic induction. RESULTS AND CONCLUSION: Urine-derived stem cells were successfully isolated from the urine samples, which grew and proliferated rapidly. After subculture, the cells exhibited an S-shaped growth. The isolated urine-derived stem cells expressed CD29, CD44, CD73 and CD90, indicating that the cells maintained the activity of stem cells. Moreover, the isolated cells had the ability of osteogenic and adipogenic differentiation. To conclude, urine-derived stem cells have strong proliferation and differentiation potentials, as a kind of economic, convenient, non-invasive source of cells, which can provide great convenience for urethral defect repair and organ reconstruction.