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Three cases of renal pelvic neoplasm associated with staghorn calculi were enrolled to the study from March 2015 to June 2019. All patients underwent minimally invasive procedures previously including extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopic lithotripsy(FURL), or percutaneous nephrolithotripsy (PCNL). 3 patients of renal pelvic neoplasm with giant staghorn calculus were diagnosed by resection biopsy during laparoscopic pyelolithotomy intraoperatively and then treated by laparoscopic radical nephroureterectomy (LRNU). Case 1 was identified retroperitoneal lymph node metastasis 16 months after operation. Case 2 and 3 remained disease free. The timely diagnosis of renal pelvic neoplasm associated with staghorn calculi is always difficult, nevertheless, the laparoscopic pyelolithotomy with resection biopsy intraoperatively can be more effective in selected cases compared with routine endoscopic biopsy.
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<p><b>BACKGROUND</b>Overactive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.</p><p><b>METHODS</b>This was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.</p><p><b>RESULTS</b>At baseline, the mean OABSS for all patients was 9.41 ± 2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P < 0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P < 0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.</p><p><b>CONCLUSIONS</b>We showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Muscarinic Antagonists , Therapeutic Uses , Prospective Studies , Quality of Life , Quinuclidines , Therapeutic Uses , Solifenacin Succinate , Tetrahydroisoquinolines , Therapeutic Uses , Treatment Outcome , Urinary Bladder, Overactive , Drug TherapyABSTRACT
Objective To study the efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) in treatment of benign prostate hyperplasia in elderly patients aged 80 years and over. Methods Retrospective clinical analysis of 180 case of high risk of benign prostate hyperplasia treated by PKRP in patients aged 80 years and over. Results All the 180 patients underwent the operation successfully. The average time for operation was (45.5±23.3) min and the resected prostate was in an average of (60.3±23.3) g. Neither of blood transfusion during the operation nor aductor reflex and transurethral resection syndrome occurred. International prostate symptom score,residual urine and quality of life decreased from (29.5±5.3) to (10.2±2.8),from (130.5±45.5) ml to (13.5±7.1)ml and from (7.2±1.1) to (1.0±0.5) respectively. The maximum flow rate elevated from (6.2±1.8) ml/s to (24.5±3.1) ml/s. The differences in the above indicators were statistically significant between pre- and post- operation (P＜0.05). Conclusions Transurethral plasmakinetic prostatectomy is a reliable and effective surgical method, especially for the aged patients with benign prostate hyperplasia.
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Objective To evaluate the clinical application of superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage. Methods The iatrogenic renal hemorrhage in fifteen patients was first demonstrated by renal arterigraphy to diagnose the rupture site and degree of injury. And then they were treated by percutaneous catheterized superselective renal arterial embolization through guidance of guide wire. Results In all 15 patients, the occlusive ruption of bleeding arteries and disappearance of extravasation staining were found after the superselective catheterized renal arterial embolization. Clinically, the bloody urine turned clear without macroscopic hematuria during 1-3 days in all patients after the procedure. Conclusions Superseclective renal arterial embolization treatment signified a less invasion, less complications, good hemostatic efficacy, and maximal preservation of renal tissue and function for iatrogenic renal hemorrhage. The treatment is worthy to be recommended.
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Objective To evaluate the accuracy and clinical practicality of DNA chip in comparison with serology in typing of human leukocyte antigen A (HLA-A) in Han's individuals of donor-recipients of transplantation. Methods 120 peripheral blood samples were obtained from donor-recipients of transplantation. Each sample was divided into two parts and HLA-A antigens were identified by DNA chip in one part and by serology in another. Samples in which the HLA-A typing results by these 2 methods were discordant were verified by polymerase chain reaction with sequence specific primers (PCR-SSP). Accuracy and clinical practicability of both methods were compared according to the typing results. Results Serological typing for HLA-A took 3 h, while DNA chip typing 4. 5-5 h. 112 samples have been typed successfully. Typing results were same in 91 samples and discordant in 21 cases. The verified results showed that DNA chip made 2 incorrect typing and the error rate was 2%. Meanwhile, serology made 19 mistakes, consisting of 5 antigens being incorrectly interpreted and 14 "blanks" turning out to be definable alleles. The discrepancy rate was 17 %. Conclusions DNA chip typing for HLA-A is suitable for clinical application in Chinese Han's population with a greater precision than serology. It may replace the serology in future after being improved and perfected.
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Objective To develop an oligoneucleotide array for HLA-DR52 group rapid genotyping.Methods According to the special allele sequences of HLA-DRB loci in Chinese Han's population, HLA-DR52 group typing probes which were immobilized on a glass supports were synthesized. A pair of group-special primers labeled by the Cy5-dCTP were designed and were used in the PCR. The labeled PCR products with Cy5 were hybridized with array. The signals were scanned by a scanner and analyzed by Image software. 83 samples were typed by this array and the results were compared with PCR-SSP typing.Results Among 57 HLA-DR52 group loci typed by PCR-SSP,2 samples had no HLA-DR52 loci typed by array,3 DR52 group homozygotes typed by PCR-SSP were actually heterozygotes by array. The other 1 non-DR52 group homozygote identified by PCR-SSP was a heterozygote with one DR52 group locus. Conclusion The oligoneucleotide array technique is a precise, rapid molecular method for HLA-DR52 genotyping. Compared with PCR-SSP method, the genotyping chip is more sensitive and intuitionistic and suitable for clinic practice.
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Objective To develop a DNA microarray for HLA-DR1,DR51 group genotyping. Methods According to the specific allelic sequences coding HLA-DR1,DR51 loci,HLA- DR1,DR51 group typing probes which were immobilized on a glass support were synthesized.A pair of group-specific primers labeled by the Cy5-dCTP were designed,then the primers were used in the PCR,thus the PCR products were labeled with Cy5.The labeled PCR products were hybridized with array.The signals were scanned by scanner and analyzed by image software.The typing results were confirmed by standard DNA and PCR-SSO. Results A total of 130 samples were typed by this DNA array.There were 34 HLA-DR1,DR51 group loci typed by DNA array.Among them,18 loci were DR15,8 were DR16,6 were DR10 and 2 were DR1.No false positive or false negative typing results occurred.The accuracy and reproducibility were 100% and the overall time of genotyping was about 3.5 hours. Conclusions DNA array technique is a precise,rapid molecular method of high resolution power and high specificity for HLA-DR1,DR51 genotyping,which is applicable to clinical transplant practice.
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Objective To investigate the expression and clinical implication of CC chemokines and receptor in long surviving kidney grafted patients of different immune states. Methods 73 cases of recipients surviving more than 3 years were divided into three groups: control group of normal renal function(C group,n=32), group under low dosage of immunosuppressants(L group,n=20) and group with chronic allograft dysfounction(D group,n=21). The plasma RANTES、MCP 1 and MIP 1?were detected by sandwich ELISA.The expression of CCR5 was determined by flow cytometry(FACS). Results Concentrations of RANTES and MIP 1? as well as expression rate of CCR5 in L group were lower than those of C group ( P 0.05).Plasma level of MCP 1 was significantly higher in group D than that in group C( P 0.05). Conclusions Expression of CC chemokines and receptor closely correlated with the immune state of renal transplant recipients and could be valuable to estimate and monitor the immune state of patients.