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Clear cell renal cell carcinoma (ccRCC) is the most lethal urological cancer and is characterized by a high rate of metastasis and relapse. N6-Methyladenosine (m 6 A) is implicated in various stages of cancer development. However, a thorough understanding of m 6 A-modified lncRNAs in ccRCC is lacking. The results showed that METTL14 had decreased expression in ccRCC tissues. In addition, the expression of METTL14 was negatively correlated to the prognosis, stage, and ccRCC tumor grade. The silencing of METTL14 was shown to significantly increase metastasis in vitro and in vivo. Highthroughput methylated RNA immunoprecipitation sequencing (MeRIP-seq) showed that the m 6 A levels of Lnc-LSG1 could be regulated by METTL14. Lnc-LSG1 can directly bind to ESRP2 protein and promote ESRP2 degradation via facilitating ESRP2 ubiquitination. However, m 6 A modification on Lnc-LSG1 can block the interaction between Lnc-LSG1 and ESRP2 via the m 6 A reader, YTHDC1. Taken together, our findings unraveled the novel mechanism of METTL14 inhibiting ccRCC progression, and explored the correlation between m 6 A and lncRNA in ccRCC for the first time.

The white blood count decreased drastically within the first 2 hours during the development of uroseptic shock. This could be an ideal predictor of uroseptic shock after upper urinary tract endoscopic lithotripsy. In patients with high risk factors for uroseptic shock the white blood count should be measured within 2 hours after upper urinary tract endoscopic lithotripsy.

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ObjectiveTo compare the clinical and radiological outcomes of patients who underwent rotator cuff repair (RCR) concomitant with long head of the biceps tendon (LHBT) tenotomy or subpectoral mini‐open tenodesis.MethodsProspectively collected data was reviewed on 154 patients, who underwent a LHBT procedure (tenotomy or tenodesis) concomitant with RCR between January 2010 and January 2017. The exclusion criteria were irreparable massive rotator cuff tear, rotator cuff partial tear, subscapular tendon tear, glenohumeral arthritis, and prior shoulder surgery. The two patient groups are as follows: RCR + Tenotomy (Group A) and RCR + Subpectoral mini‐open tenodesis (Group B). The visual analog scale (VAS) for pain, Constant Score scale, American Shoulder and Elbow Surgeons (ASES) scores, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores preoperatively and 1 month, 3 months, 6 months, 1 year postoperatively and the latest out‐patient clinic were compared between the two groups.ResultsNinety‐two patients in Group A and 62 patients in Group B completed the follow‐up, with a median follow‐up time of 27 and 42 months respectively. At the final follow‐up, the VAS, Constant, ASES, and DASH scores in Group A were 0.1 ± 0.2, 87.0 ± 12.8, 96.4 ± 4.3 and 6.6 ± 4.8 respectively, and the VAS, Constant, ASES, and DASH scores in Group B were 0.1 ± 0.3, 92.5 ± 3.9, 96.3 ± 3.6 and 2.9 ± 1.3 respectively. Clinical evaluation scales showed satisfactory results in both groups, and there were no statistically significant differences between the two groups at the same follow‐up time. Popeye sign was detected in one case of Group A (1.1%) and in one case of Group B (1.6%, P > 0.05).ConclusionBoth tenotomy and subpectoral mini‐open tenodesis are effective for concomitant lesions of the LHBT in patients with reparable rotator cuff tears, and subpectoral mini‐open tenodesis of the LHBT does not provide any significant clinical or functional improvement than isolated tenotomy.

This study investigated whether early intervention based on leukocyte count (WBC) of less than 2.85 × 10/L obtained within 2 h post-operatively may ameliorate the uroseptic shock induced by upper urinary tract endoscopic lithotripsy (UUTEL). Urosepsis was induced in 30 rabbits and assigned to three groups: Control-I, WBC-I, and Shock-I. Control-I: Non-intervention control. WBC-I: Immediate resuscitation when there was a drastic drop of WBC within 2 h post-operatively but without signs or symptoms of shock. Shock-I: Resuscitation only when there were signs or symptoms of shock. In total, 107 patients whose WBC were less than 2.85 × 10/L within 2 h after UUTEL were retrospectively analyzed. Patients were assigned into two groups based on the time of the intervention. Shock-II included 59 patients who were started on the resuscitation bundle when there were signs or symptoms of shock. WBC-II included 48 patients who were started immediately on the resuscitation bundle when the WBC decreased drastically. All Control-I rabbits developed shock within 72 h and died. None of the WBC-I rabbits developed shock and all survived for 72 h. In total, 60% of Shock-I died within 72 h. Overall, 43 patients in Shock-II and six patients in WBC-II experienced uroseptic shock. The average lengths of hospitalization for Shock-II and WBC-II were 17.8 ± 9.7 days and 7 ± 4.2 days, respectively. Six patients in the Shock-II and none in WBC-II died of the uroseptic shock. Early intervention based on WBC measured within 2 h post-operatively might avert the uroseptic shock induced by UUTEL.

Urosepsis after upper urinary tract endoscopic lithotripsy (UUTEL) may cause uroseptic shock with high mortality, which can be prevented if early diagnosis and timely intervention are implemented with help of a diagnostic protein panel. The plasma of five rabbits of uroseptic shock and five controls was subjected to exploratory proteomics to search biomarker candidates from proteomic profiles related to uroseptic shock. Then, plasma from 21 nonsepsis and 20 urosepsis patients according to European diagnostic criteria of sepsis was enrolled in the validation study via targeted proteomics. Changes in a massive number of plasma proteins, mainly enriched in immune regulation, coagulation, structural repair, and transport activity, were observed in the rabbit model of septic shock. Fifteen proteins were identified as differential expression proteins between sepsis and nonsepsis patients. A diagnostic model composed of three proteins lipopolysaccharide-binding protein (LBP), clusterin (CLU), and vascular cell adhesion protein 1 (VCAM1) was developed for the early detection (2 hours postoperatively) of urosepsis after UUTEL, with a high area under the receiver operating characteristic (ROC) curve of 0.921. In conclusion, changes in the proteomic profile may reflect the underlying biological mechanisms during the development of urosepsis and produce diagnostic biomarkers for the early detection of urosepsis after UUTEL.

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