The diagnosis and treatment of hemospermia presents significant difficulty, especially if it persists or recurs. In this retrospective study, we assessed whether transurethral seminal vesiculoscopy is feasible and effective in the diagnosis and treatment of hemospermia. To address this complex condition, we report our experience in a population of patients treated with transurethral seminal vesiculoscopy. From February 2006 to July 2008, 72 hemospermic patients underwent transurethral seminal vesiculoscopy examination and treatment at our urology center. Transurethral seminal vesiculoscopy was performed by a 7-F or 8-F rigid ureteroscope. The endoscopic procedure was conducted through the normal anatomic route of the seminal tracts. In this series, the mean follow-up period was 21.7 months. Definite diagnosis was made for 93.1% patients, and 94.4% patients were cured or showed a decrease in their symptoms. Postoperative complications were not observed in the study. Our study proves that transurethral seminal vesiculoscopy is effective in the diagnosis and treatment of hemospermia with minimal complication.

Background: Membranous nephropathy (MN) is an autoimmune disease. It is an important cause of end-stage renal disease in primary glomerulonephritis. Significant breakthroughs in its diagnosis have been made in previous studies, however, the pathogenesis of MN has still remained elusive. In recent years, bioinformatics has provided new research strategies to investigate the mechanisms of kidney disease. This study aimed to explore potential biomarkers of MN through bioinformatics analysis. Methods: Differentially expressed genes (DEGs) were identified by performing a differential expression analysis with the "limma" R package, and then, the weighted gene co-expression network analysis (WGCNA) was applied to obtain the most MN-related genes. After intersecting these genes, the least absolute shrinkage and selection operator (LASSO) and the support vector machine-recursive feature elimination (SVM-RFE) algorithms were utilized to identify hub genes. To assess the diagnostic value of hub genes, the receiver operating characteristic (ROC) curve analysis was performed. Finally, the relationship between hub genes and the immune microenvironment (IME) was analyzed. Results: The differential expression analysis yielded 1,466 DEGs, and using the WGCNA, 442 genes, which were the most MN-related genes, were obtained. From the intersection of these genes, 130 genes were identified. Subsequently, two hub genes (ECM1 and ATP8B1) were detected by the LASSO and SVM-REF algorithms. It was found that they were associated with components of the IME (natural killer T cells, gamma delta T cells, macrophages, etc.). Conclusion: Two hub genes (ECM1 and ATP8B1) were identified by machine learning, and their diagnostic value was evaluated. It was revealed that these two genes were associated with the components of the IME. Our findings may provide new ideas for developing new biomarkers for MN.

BackgroundTo analyze the effect of two different trocar layout methods, which include the midline and lateral transperitoneal approach, on the robotic-assisted partial nephrectomy (RAPN).MethodsTransperitoneal approach was used in all the cases. In the midline layout group, 12-mm camera port was placed 2 cm to navel, besides the rectus abdominis. An 8-mm robotic trocar was placed on the lateral margin of the rectus abdominis, 3 cm from the costal margin approximately. Another 8-mm robotic arm trocar was placed to the point that 5 cm away from anterior superior iliac spine. Insert the 12-mm assistant trocar next to the rectus abdominis and on the right side, 5-mm assistant trocar was planted in the central line of the lower abdomen. For the lateral transperitoneal approach, place the 12-mm Trocar located in the midpoint between the nephroid projection and navel. The 8-mm robot Trocar is placed on the side of the lens hole, with the distance greater than 3 cm. The other 8-mm robot trocar was suggested to be put in the place greater than 3 cm from the iliac crest. The 12-mm auxiliary Trocar is placed above the navel. A 5-mm auxiliary Trocar was placed in the midline of the xiphoid process.ResultsIn the midline layout group, 50 cases were included, among which, the mean operation duration was 254.8 min (140–380 min), blood loss was 164.8 mL (30–1,000 mL), warm ischemic time was 27.2 min (7–50 min). In these cases, the conversion to open surgery was required in one case because of the limited operation view and 2,400 mL blood was transfused to that patient. In the lateral transperitoneal approach group, 8 cases were included and the mean operation duration was 239 min (160–310 min), blood loss during the surgery was 140 mL (100–200 mL), warm ischemic time is 28.5 min (12–46 min). In the midline layout cases, the operative field of vision is much closer to that of an ordinary laparoscopic view and the scope is relatively far from the kidney. No open surgery was conversed and no blood transfusion happened. In these cases, the field of view was larger and the robot arm had a wider range of motion. In the side layout group, the speculum was relatively closer to the kidney with the small operation view. The robot arm had a small range of motion, but it had a more complete field of vision for the upper pole of the dorsal kidney.ConclusionsBoth surgical methods are suitable for RAPN. The midline layout method is closer to the traditional laparoscopic view, which can be used more widely. The lateral layout is more suitable for kidney tumors located on the dorsal upper pole of the kidney.