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Objective:To compare the efficacy and safety of three minimally invasive methods, transurethral rigid ureteroscopic holmium laser lithotripsy (URL), transurethral flexible ureteroscopic holmium laser lithotripsy (FURS), and percutaneous nephroscopic holmium laser lithotripsy (PCNL), in the treatment of complicated upper ureteral calculi.Methods:The clinical data of 60 patients with complex upper ureteral calculi admitted to the urology department of the Second People's Hospital of Wuhu from January 2016 to December 2018 were retrospectively analyzed.All patients were divided into three groups according to treatment methods: URL group (20 cases), FURS group (20 cases) and PCNL group (20 cases). The efficacy of the three methods was compared in terms of stone removal rate, operation time, intraoperative and postoperative bleeding, length of hospital stay and other indicators.Results:The success rate of one-time lithotripsy in the URL group was significantly lower than that in the FURS group and the PCNL group(FURS vs.URL, χ 2=5.83, P<0.05, URL vs.PCNL, χ 2=8.03, P<0.05). The operative time(FURS vs.PCNL, t=2.436, P<0.05, URL vs.PCNL, t=2.634, P<0.05), hospital stay, intraoperative and postoperative bleeding in the URL group and FURS group were significantly less than those in the PCNL group(FURS vs.PCNL, t=2.243, P<0.05, URL vs.PCNL, t=2.320, P<0.05). There were no statistically significant differences among intraoperative, postoperative infection, fever, renal colic and other complications (all P>0.05). Conclusion:FURS in the treatment of complicated upper ureteral calculi, the one-time stone removal rate is better than URL operation, compared with PCNL, the intraoperative and postoperative bleeding is significantly less than the latter, and the operative time and hospital stay are shorter than PCNL.It is suggested that FURS operation should be given priority in the treatment of complicated upper ureteral calculi.
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Objective To study the role and clinical significance of chemokine receptor-4 (CXCR4) and vascular endothelial growth factor (VEGF) in the occurrence and development of renal cell carcinoma. Methods Expression of CXCR4 and VEGF were detected by SP immunohistochemical technique in 56 cases of kidney carcinoma tissues (including 20 cases of lymph node metastasis), 10 normal tissues nearby kidney cancer. Results The positive rates of CXCR4 and VEGF were 66. 1% (37/56) and 73. 2% (41/56),which were significantly higher than those in normal tissues( 20. 0% (2/10) and 30. 0% (3/10), respectively) (P ＜ 0. 05 ＝. The expression of CXCR4 protein was significantly positively correlated with that of VEGF protein (r = 0. 315 ,P ＜ 0.05 ＝ in renal cell carcinoma. The expression of CXCR4 and VEGF was closely related to stages of tumor ( χ2 = 9. 520, P = 0. 023; χ2 = 9. 072, P = 0. 027 ), lymphatic metastasis, degree of invasion ( χ2 =4. 972, P = 0. 026; χ2 = 3.910, P = 0. 034 ), and microvessel density ( MVD) ( P ＜ 0. 05 ＝. However, they were not related to sex ( χ2 = 0. 020, P= 0. 887; χ2 = 0. 001, P = 0. 716 ), tumor size ( χ2 = 0. 003, P = 0. 995; χ2 =0. 108, P = 0. 990) and pathologic types ( χ2 = 1. 960, P = 0. 900; χ2 = 0. 112, P = 0. 994). Conclusion There is a significant positive correlation between high expressions of CXCR4 and VEGF proteins in renal cell carcinoma,the high expressions of CXCR4 and VEGF proteins may be related to the metastasis and prognosis of renal cell carcinoma,thus they could be used as important indicators in judging the metastasis prognosis of renal cell carcinoma,and offer prospects for the treatment of renal cell carcinona.
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Objective To study the efficacy of comprehensive treatment for type ⅢA prostatitis.Methods One hundred and eighty-four patients with type Ⅲ A prostatitis, recruited to this study, were comprehensively treated for 8 - 12 weeks by oral antibiotics and α-1 receptor antagonist,indometacin suppository applied into rectal, prostate massage and psychological counseling. The clinical effects of the treatment were evaluated according to the NIH chronic prostatitis symptom index (NIH-CPSI) and leukocyte counts in the expressed prostatic secretions ( EPS ). Results Before and after the treatment, the NIH-CPSI scores were 28. 6 ± 6. 5 and 12. 9 ± 3. 8 ( t = 28. 3, P ＜ 0. 05 ); the pain or discomfort scores were 14. 1 ± 3. 3 and 6. 4 ± 2.2( t = 26. 3, P ＜ 0. 05 ), the urinary symptoms scores were 5.6 ± 1.8 and 2. 1 ± 0. 9 ( t = 23.6, P ＜ 0. 05 ), the scores of life quality were 8.9 ± 3. 1 and 4. 4 ± 2.4 ( t = 15.6, P ＜ 0. 05 ), the leukocyte counts were ( 24. 5 ±4. 4)/HP and ( 6. 2 ± 2. 7 )/HP ( t = 48.1, P ＜ 0. 05 ) respectively, all comparisons showed significantly differences. Seventy-nine cases recovered completely, 57 cases recovered excellently, 36 cases recovered effectively and 12 cases did not recover, the overall effective rate was 93.5%. Conclusion Comprehensive treatment is an effective method for type Ⅲ A prostatitis.