ABSTRACT
Objective: To compare the therapeutic effects of visual standard channel combined with visual superfine precision puncture channel or super-mini percutaneous nephrolithotomy [PCNL] on multiple renal calculi
Methods: A total of 86 patients with multiple renal calculi were retrospectively analyzed. According to different working channels, they were divided into a visual puncture channel group [visual puncture standard channel combined with visual superfine precision puncture channel, n=38] and a conventional puncture channel group [standard channel combined with super-mini channel, n=48]. The two groups were compared in terms of time of channel establishment, surgical time, reduction of hemoglobin, phase I clearance rate of calculi, and surgical complications
Results: The time of establishing visual/conventional standard channel was [4.5+/-1.5] min vs. [6.8+/-1.8] minutes [t=6.326, P=0.000], and the time of establishing visible superfine/super-mini channel was [4.52+/-0.97] minutes vs. [7.76+/-1.35] minutes [t=2.017, P=0.000]. The surgical time was [92+/-15] minutes vs. [115+/-13] minutes [t=26.640, P=0.000]. The Phase-I clearance rate was 86.7% [33/38] vs. 87.5% [42/48] [?2=0.008, P=0.928], the reduction of hemoglobin was [12.21+/-2.5] g/L vs. [13.22+/-3.5] g/L [t=2.017, P=0.137], the blood transfusion rate was 13.16 [5/38] vs. 8.33% [4/48] [?2=0.006, P=0.941], the postoperative fever rate was 7.89% [3/38] vs. 14.58 [7/48] [?2=0.006, P=0.941], and the hospitalization stay length was [6.5+/-1.0] vs. [6.6+/-1.2] [t=0.413, P=0.681]. There were no significant differences between the two groups
Conclusion: Both surgical approaches had high clearance rates of multiple renal calculi, safety, reliability and few complications. However, compared with the conventional puncture channel, the visual one was easy to operate and dramatically shortened the time of establishment, thus being safer and more accurate
ABSTRACT
Objective:To investigate the MUC1 specific immune response enhanced by thmosinα1(Tα1)using MUC1-MBP as the specific antigen,and to discuss the feasibility of MUC1-MBP as an adjuvant.Methods:The C57BL/6 mice were randomly divided into normal saline group,MUC1-MBP+BCG group and MUC1-MBP+Tα1 group.The T cellular immune activities,MUC1 special antibody and subclass,anti-tumor effect of Tα1 combined with MUC1-MBP were detected.4-7 d after the 3rd immunization,the spleen indexes of the mice in various groups were measured;the lymphocyte proliferation response was used to detect the stimulate index(SI)of the mice in various groups;the levels of specific cytokines IFN-γ,IL-2,IL-4 and IL-10 in the supernatant of spleen cells of the mice were detected by ELISA;the level of serum MUC1-specific antibody was detected by ELISA.The C57BL/6 mice were inoculated with B16-MUC1 7 d after the last immunization and the survival of the mice was observed.Results:Compared with normal saline group,the spleen index and SI of the mice in MUC1-MBP+Tα1 and MUC1-MBP+BCG groups were significantly increased(P< 0.05 or P<0.01);the specific SI of MUC1 were significantly increased(P< 0.05).Compared with normal saline group,the levels of IFN-γ and IL-2 in the supernatant of spleen cells of the mice in MUC1-MBP+BCG group were obviously increased(P<0.05);the levels of IL-4 and IL-10 were slightly increased,but there were no significant differences(P>0.05);compared with normal saline group,the level of IL-4 in MUC1-MBP+Tα1 group was obviously increased(P< 0.01);the levels of IFN-γ,IL-2 and IL-10 were slightly increased,but there were no significant differences(P>0.05).The titer of MUC1 specific antibody was increased with the increase of concentration of Tα1.The antibody subtype detection results showed that compared with normal saline group,the level of IgG1 in MUC1-MBP+BCG group was significantly increased(P< 0.05 or P< 0.01),and the level of IgG2a had no obvious change.The tumor prevention experiment results showed that compared with normal saline group,the survival rates of the mice in MUC1-MBP+BCG group and MUC1-MBP+Tα1 group had no significant differences.Conclusion:MUC1-MBP combined with Tα1 prefers to Th2 immune responses in the mice.It indicates that Tα1 can be used as an adjuvanted preventive vaccines,but not suitable for therapeutic vaccines.
ABSTRACT
Objective To observe ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst. Methods From May 2014 to November 2015, 23 patients of parapelvic cyst underwent a ransurethral flexible ureteroscopey for two-step precise method treatment, then analyze the clinical data of patients, observe the therapeutic effect. Results All patients underwent primary surgery successfully while 4 cases among them were confirmed as urine level puncture calyceal diverticulum treated with flexible ureteroscopy diverticulum expand drainage, the other 19 cases were confirmed as renal cyst and treated with cyst incision drainage successfully. The hemoglobin before and after surgery showed no changes. With no blood transfusion, the average postoperative hospitalization time was 2 d. 1 day after surgery, KUB was to locate the DJ tube position; 1 month later, ultrasound or CT check show that the cyst volume was significantly reduced, postoperative follow-up range from 6 months to 1 year. All the patients had no long-term complications. Conclusion Ransurethral flexible ureteroscopey for two-step precise method treatment of parapelvic cyst and renal pelvis lamp beside diverticulum provide a clear direction for the next operation. It's simple operation with no significant complications and recovered quickly, which is an ideal method for the treatment of renal pelvic.
ABSTRACT
Objective To evaluate the safety and effectiveness of modular flexible ureteroscope combined with holmium laser lithotripsy in treatment of bilateral renal calculi smaller than 1.5 cm. Methods Clinical data of 24 patients from August 2013 to March 2016 using a modular flexible ureteroscope in treatment of bilateral renal calculi smaller than 1.5 cm was retrospectively analyzed. The clinical data included operation time, stone clearance rate and occurrence of complications. Results All the 24 patients were successfully placed in bilateral ureteral sheath soft lenses, and enter lithotripsy smoothly. The operation time was 40~105 (71.0 ± 21.5) min. Lithotripsy success rate was 100.00% and 1 month stone clearance rate was 89.50% (43/48), 5 sides with residual stones diameter 7~10 mm, were given extracorporeal shock wave lithotripsy, 3 months stone clearance rate was 93.75% (45/48), 3 sides with residual stones 5~7 mm located lower calyx accepted regular review. 4 cases with postoperative fever were cured after anti-inflammatory treatment. There was no bleeding, ureteral perforation, postoperative avulsion, renal dysfunction, septic shock and other complications. Conclusion Modular flexible ureteroscope lithotripsy in treatment of bilateral renal calculi smaller than 1.5 cm is safe and effective.