Objective To present a novel miniature endoscopic system designed to improve the safety and efficacy of percutaneous nephrolithotomy, named the ‘super‐mini percutaneous nephrolithotomy’ (SMP). Patients and Methods The endoscopic system consists of a 7‐F nephroscope with enhanced irrigation and a modified 10–14 F access sheath with a suction‐evacuation function. This system was tested in patients with renal stones of <2.5 cm, in a multicentre prospective non‐randomised clinical trial. In all, 146 patients were accrued in 14 centres. Nephrostomy tract dilatation was carried out to 10–14 F. The lithotripsy was performed using either a Holmium laser or pneumatic lithotripter. A nephrostomy tube or JJ stent was placed only if clinically indicated. Results SMP was completed successfully in 141 of 146 patients. Five patients required conversion to larger nephrostomy tracts. The mean (sd) stone size was 2.2 (0.6) cm and the mean operative duration was 45.6 min. The initial stone‐free rate (SFR) was 90.1%. The SFR at the 3‐month follow‐up was 95.8%. Three patients required auxiliary procedures for residual stones. Complications occurred in 12.8% of the patients, all of which were Clavien grade ≤II and no transfusions were needed. In all, 72.3% of the patients did not require any kind of catheter, while 19.8% had JJ stents and 5.7% had nephrostomy tubes placed. The mean hospital stay was 2.1 days. Conclusions SMP is a safe and effective treatment for renal stones of <2.5 cm. SMP may be particularly suitable for patients with lower pole stones and stones that ae not amenable to retrograde intrarenal surgery.

BackgroundFork head box M1 (FoxM1) is a proliferation-associated transcription factor essential for cell cycle progression. Numerous studies have documented that FoxM1 has multiple functions in tumorigenesis and its elevated levels are frequently associated with cancer progression. The present study was conducted to investigate the expression of FoxM1 and its prognostic significance in clear cell renal cell carcinoma (ccRCC). Meanwhile, the function of FoxM1 in human ccRCC was further investigated in cell culture models.MethodsReal-time quantitative PCR, western blot and immunohistochemistry were used to explore FoxM1 expression in ccRCC cell lines and primary ccRCC clinical specimens. FoxM1 expression was knocked down by small interfering RNA (siRNA) in Caki-1 and 786-O cells; proliferation, colony formation, cell cycle, migration, invasion, and angiogenesis were assayed.ResultsFoxM1 expression was up-regulated in the majority of the ccRCC clinical tissue specimens at both mRNA and protein levels. Clinic pathological analysis showed that FoxM1 expression was significantly correlated with primary tumor stage (P <0.001), lymph node metastasis (P = 0.01), distant metastasis (P = 0.01), TNM stage (P < 0.001) and histological grade (P = 0.003). The Kaplan–Meier survival curves revealed that high FoxM1 expression was associated with poor prognosis in ccRCC patients (P < 0.001). FoxM1 expression was an independent prognostic marker of overall ccRCC patient survival in a multivariate analysis (P = 0.008). Experimentally, we found that down-regulation of FoxM1 inhibited cell proliferation and induced cell cycle arrest with reduced expression of cyclin B1, cyclin D1, and Cdk2, and increased expression of p21 and p27. Also, down-regulation of FoxM1 reduced expression and activity of matrix metalloproteinase-2 (MMP-2), MMP-9 and vascular endothelial growth factor (VEGF), resulting in the inhibition of migration, invasion, and angiogenesis.ConclusionsThese results suggest that FoxM1 expression is likely to play important roles in ccRCC development and progression, and that FoxM1 is a prognostic biomarker and a promising therapeutic target for ccRCC.

Circular RNAs (circRNAs) are a class of non-coding RNAs formed by covalently closed loops through back-splicing and exon-skipping. circRNAs have been confirmed to play a vital role in various biological functions, acting as microRNA sponges and reservoirs, as well as combining with RNA-binding proteins during the progression of multiple cancer types. Therefore, the present review evaluated recent research articles in PubMed that were published between November 2017 and September 2020. Key word search strings included: ‘Circular RNA (circRNA) AND bladder cancer (BC)’, ‘circular RNA (circRNA) AND prostate cancer (PCa)’ and ‘circular RNA (circRNA) AND renal cell cancer (RCC)’. In total, >58 circRNAs were found to be implicated in urological cancers, with several of the circRNAs targeting common carcinogenic pathways, such as the AKT, TGF-β, MAPK, VEGF and even metabolic pathways. circRNAs are important modulators of BC, PCa and RCC. circRNAs are functionally implicated in the pathogenesis of these cancer types, and have been found to act as biomarkers for the diagnosis and prognosis of urological cancer. However, to the best of our knowledge, the functions of circRNAs in tumors of the urinary system remain largely unknown and require further research.

Compared with open surgery retroperitoneoscopic lateral adrenalectomy for pheochromocytoma is a safe, minimally invasive and effective procedure.

The Notch family expression pattern in papillary bladder transitional cell carcinoma is different from that in invasive bladder transitional cell carcinoma. Low expression of Notch-1 as well as Jagged-1 is potentially a useful marker for survival in patients with papillary bladder transitional cell carcinoma.