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Objective:To investigate the application of 3D printing technique in percutaneous nephrolithotomy (PCNL) of patients with complicated kidney stones.Methods:From January 2015 to December 2017, 60 patients with complicated kidney stones were enrolled in the First Affiliated Hospital of Hebei North University for prospective study, and PCNL was proposed.All the patients were randomly divided into 3D print group (30 cases) and conventional image inspection group (30 cases, control group). Before operation, CT urography (CTU) was used in both groups.In 3D printing group, digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image postprocessing, and thermoplastic materials were used to print 3D model.In the 3D printing group, the digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image post-processing, and the 3D model was printed with thermoplastic materials.According to the comprehensive planning of 3D kidney model, a virtual safe and reliable percutaneous renal access was established for each patient, and PCNL was executed.The patients in the two groups were compared before, during and after operation.Preoperative: age, sex, body mass index, blood creatinine, stone size and CT value.During the operation: (1) the target renal calices location time; (2) the conformity between the preoperative planning and the actual operation; (3) the operation completion time.After operation: (1) stone removal rate; (2) hemoglobin reduction level; (3) postoperative recovery.Results:All the 60 patients successfully completed the operation, 30 patients successfully printed out the 3D model, which can accurately express the relationship between the stone and the adjacent anatomical structure, the internal renal artery and the collecting system.Positioning time of 3D printing group in target renal calices((2.9 ± 1.5) min vs.(5.8 ± 1.7) min, P=0.023), coincidence between simulated and actual puncture calices((89.5 ± 3.5)% vs.(60.2 ± 5.7)%, P=0.005), postoperative stone removal rate ((89.9 ± 4.5)% vs.(75.9 ± 5.2)%, P=0.009), and hemoglobin levels((1.4 ± 0.5) g/L vs.(2.9 ± 1.4) g/L, P=0.032) were superior to the control group, and the difference was statistically significant.But there was no significant difference between the two groups (all P>0.05). Conclusion:The 3D printed kidney model truly restores the anatomical details around the kidneys and stones, providing a stereoscopic and intuitive way to perform surgery, so it maybe has a significance guidance for percutaneous nephrolithotomy.
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Objective Tamm-Horsfall protein (THP) may play a role in kidney stone formation.The article aimed to conduct a preliminary study on the role of THP in kidney stone formation by investigating the changes of THP in rat urine, pathological changes of renal tissue and the formation of calcium salt crystals after establishing CNPs rat model of kidney stones.Methods Stone samples of 40 patients from February to June 2015 in our department were collected to establish the model of CNPs-induced kidney stone in rats and prepare CNPs suspension.48 SD rats were randomly divided into experimental group (group A) and blank control group (group B).Group A were injected with CNPs and the same amount of sterile saline injection in the group B.The urine of rats was collected after injection at 3h, 6h, 12h, 24h, 1w, 2w, 4w and 8w.ELISA were applied to detect THP levels in the urine.Then the rats were killed to take the kidney tissue.HE staining was used to investigate the pathological changes of the cells and evaluate the formation of the calcium salt crystals.Results THP levels in group A at 24h, 1w, 2w, 4w and 8w ([166.03±3.02], [173.50±1.78], [174.55±2.05], [176.54±2.45], [177.11±1.76]pg/mL) were significantly higher than that at 3h(165.89±2.23pg/mL)(P<0.05), which was the same case in comparison with those of group B ([157.65±2.22], [156.54±1.43], [159.45±3.21], [158.63±2.98], [157.33±2.05]pg/mL).Compared with the calcium salt crystal score at 6h (1 point), the scores at 3,6,12,24h (average score 2 points) increased.At 2w the score increased significantly to 3 points and reached the top score(6.7points) at 8w, which was of significant difference.The score of calcium salt crystals was in positive correlation with THP content (r=0.843,P<0.05).Conclusion THP in urine may contribute to the aggregation of calcium salt crystals and the formation of kidney stones.
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Bonetumorisonekindofmalignanttumorwhichthreatslifeamongchildrenandadoles-cent.Osteosarcoma (OS ) and Ewing sarcoma (ES ) have been paid much attention by medical community because of their complex occurrence,development,metastasis mechanism and poor prognosis.The research showed that activation of protooncogene and mutation of suppressor gene,absence of apoptosis signal and hypox-ia-inducible factor (HIF)all participated in the occurrence,development and metastasis of OS and ES.It is suggested that clarified pathomechanism of bone tumors could provide more effective therapeutic strategies and lower the mortality of patients.
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Objective To explore the roles of biomarkers of the ratios of microRNA (miRNA)in osteosarcoma.Methods The blood samples from 20 patients with osteosarcoma and 30 healthy people with similar age were choosed.The miRNA expression profiles were filtered by gene chips of high flux.The results were verified by qRT-PCR.The miRNA expression ratio was analysed by receiver operating characteristic (ROC)curve aiming to find the most predictive potential combination-type markers.Results Two hundred and fifty-eight miRNAs were found to be significantly deregulated in blood samples from 30 patients with osteo-sarcoma as compared with their matching normal blood samples (F=5.564,P<0.05).Four miRNAs were choosed from blood samples of22 patients with osteosarcoma and normal blood samples.MiR-181b,miR-199b-5p and miR-451 were significantly higher than that in normal blood sample (F=6.283,P<0.05),while miR-124 showed low expression (F=7.201,P<0.05).Furthermore,the ratio of miR-199b-5p/miR-124 showed a high sensitivity (96%)and specificity (97%).Conclusion The abnormal expression of miRNA in osteosar-coma makes it have a predictive effect.The ratio of miR-199b-5p/miR-124 could be served as combination-type biomarkers in the diagnosis of osteosarcoma.
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Objective To investigate the significance of MTSS1 and E-cadherin expression in upper urinary tract transitional epithelial carcinoma.Methods Paraffin specimens of 60 patients with upper urinary tract transitional epithelial carcinoma between January 2005 and January 2014 were analyzed.At the same time,5 cm normal tissue adjacent to the cancerous tissue specimens in 30 patients were taken for comparison.Immunohistochemical method was used to detect the tissue MTSS1 and E-cadherin expression,and the relationships between their expression with different pathological stage,differentiated degree and lymph node metastasis were analyzed.Results MTSS1 expression rate in normal tissue (100.0％,30/30) was significantly higher than that in cancerous tissue (45.0％,27/60) and there was significant difference (P ＜ 0.05).E-cadherin expression rate in normal tissue (96.7％,29/30) was significantly higher than that in cancerous tissue (41.7％,25/60) and there was significant difference (P ＜ 0.05).The expression of MTSS1 and E-cadherin in different pathological stage,degree and with or without lymph node metastasis had significant difference (P ＜ 0.05).In patients with well differentiated,low TNM stage and no lymph metastasis,MTSS1 and E-cadherin expression rate was higher (P ＜ 0.05).There was no significant correlation between the expression of MTSS 1 and E-cadherin in cancerous tissue (P ＞ 0.05).Conclusion In upper urinary tract transitional cell carcinoma detection of both MTSS1 and E-cadherin has important significance with regards to judging the malignant degree of the tumor,lymph node metastasis and prognosis in patients.
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Objective To investigate the infection status of nanobacteria on patients with upper urinary calculi and healthy sub-jects ,and analyze the role of nanobacteria in the formation of upper urinary calculi .Methods The serum ,urine and calculus of 42 patients with upper urinary calculi were investigated by polymerase chain reaction (PCR) and by bacteria cultivation with 10% γ-FBS and PMBI 1640 .The resulting PCR products were sequenced for further comparison with the reported sequence in gene bank . The serum and urine from 30 healthy adults were used as controls .Results After 4 to 6 weeks′culture ,the white or yellow precipi-tate was visible at the bottom of the tube .The positive rate of PCR was 90 .4% in calculous patients urine and 6 .7% in healthy a-dults urine ,as the positive was 92 .8% and 6 .7% in serum .which there is significant difference (P<0 .01) .The positive rate of the nanabactria in urinary calculi was 95 .2% .The coincidence rate was 98 .72% between the PCR products and the reported sequence in gene bank .Conclusion Nanobacteria are widely existed in the serum ,urine and calculus of the patients with upper urinary calcu-li ,this indicate that the nanobacteria might be have the most important influence on the formation process of urinary calculi .