ABSTRACT
Growth plate,the developmental center of endochondral osteogenesis,can be divided morphologically and functionally into a resting zone,a proliferative zone,a prehypertrophic zone and a hypertrophic zone.Injuries to growth plate often lead to bone growth defects including limb length discrepancy and angulation deformity in children.Currently,their orthopedic corrective surgeries are invasive and limitedly effective and no effective biotherapy has been available.Previous studies on animal models of growth plate damage have investigated the related cellular and molecular events in the repair of damaged growth plates in the 4 distinct inflammatory,fibrogenic,osteogenic and remodeling phases.Related molecules involved in the regulation of the above processes,such as inflammatory cytokines tumor necrosis factor alpha,mitogenic platelet-derived growth factor and bone morphogenetic protein,are found to participate in the regulation of growth plate injury.Exploration of the mechanisms may provide new targets for biotherapy.In addition,development of cartilage tissue engineering,especially application of mesenchymal stem cells,also provides potential interventions for growth plate injury.
ABSTRACT
Objective To investigate factors affecting residual stones in pediatric patients with the upper urinary calculi un ‐dergoing minimally invasive percutaneous nephrolithotomy (MPCNL ) and evaluate MPCNL curative effect before the operation . Methods A total of 240 children underwent MPCNL to remove the upper urinary calculi in People′s Hospital of Xinjiang Uygur Autonomous Region during the period of January 2009 to November 2014 were analyzed retrospectively .Pediatric patients were di‐vided into two groups by the stone‐free rate after the first operation :those who were stone‐free after the first operation (n= 202) as the control group and those who were residual stones (n= 38) as residual stones observation group .Then the clinical data were sta‐tistically analyzed and find out risk factors which lead to residual stone .Results The stone‐free rate after primary M PCNL was 84 . 2% (202/240) .Univariate analysis showed that stone size (P= 0 .001) ,stone location(P= 0 .014) and number of stones(P= 0 .005) were significant factors which could affect residual stones between the two groups ,while did not relate with gender ,age ,stone side , urinary irritation symptom ,hematuria ,renal colic ,preoperative infection and the degree of hydronephrosis (P > 0 .05) .Multivariate analysis showed that stone size(OR = 2 .593 ,95% CI :1 .228 - 5 .475) ,stone location(OR = 2 .674 ,95% CI :1 .290 - 5 .540)and num‐ber of stones(OR = 2 .397 ,95% CI :1 .145 - 5 .019)were independent predictors of the surgical outcome .Conclusion Stone size , stone location and number of stones are significant factors affecting residual stones in pediatric patients with the upper urinary cal ‐culi undergoing MPCNL .According to the the clinical features of pediatric patients ,we can chose suitable management of upper uri‐nary tract calculi .