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Objective To study the impact of preprocedure intravenous urography(IVU)on the outcome of shock wave Iithotripsy(SWL)for the middle and lower ureteral stones.Methods 112 patients with solitary radiopaque the middle and lower ureterat stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were divided randomly to two treatment groups.IVU group(n=56)had IVU before the start of SwL,whereas patients in the control group(n=56)underwent SWL without IVU.Postoperative success,stone-free rates and complications were evaluated in both groups.Results Eleven patients in the IVU group were excluded from the study.The SUCCESS rate[91.1%(41/45)in IVP group VS 94.6%(53/56)in control group],stone-free rate[88.9%(40/45)vs 89.3%(50/56)],and complication rate[22.2%(10/45)vs 21.4%(12/56)]were similar in two groups(P＞0.05).ConclusionIt is not necessary to obtain an IVU for patients who have solitary radiopaque the middle and lower calculi on plain radiographs with no severe hydronephrosis on ultrasonographic examination before scheduling them for SWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.
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Objective To evaluate the clinical efficacy of expulsive therapy using alpha 1-selective adrenoblocker and prostaglandin synthetase inhibitor for distal ureteral stones.Methods 94 patients with distal ureteral stone were randomly divided into study group and control group.In study group,47 cases received tamsulosin 0.2mg daily and dielofenac rectal suppositories 50mg 2 times daily,while watchful waiting without tamsulosin and diclofenac suppository in 47 cases of control group.Observation lasted 2 weeks and also stone expelled as end point.Results No severe adverse reactions related to the drugs were noted and no patients withdrew from the study.The stone-free rate was 91.5%(43/47) of the study group and 25.5% (12/47) of the control group (P＜0.01).A mean stone expelling date of the control group was(8.9±4.3)d and that of the study group was(6.4±3.7)d(P＜0.01).Rates of renoureteral colic recurred in the study group and the control group were 4.3%(2/47) and 48.9%(23/47),respectively (P＜0.01).Conclusion Treatment of distal ureteral stones wlth tamsulosin and dielofenac suppository can increase the stone-free rate,shorten mean stone expelling date,decrease rate of renottreteral colic recurred.
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Objective To study the impact of preprocedure intravenous urography (IVU) on the extracorporeal shock wave lithotripsy(ESWL) for proximal ureteral stones.Methods One hundred patients with solitary radiopaque proximal ureteral stones on plain radiographs and no severe hydronephrosis on ultrasonographic examination were allocated randomly to two treatment groups.IVU group (n=50) had IVU before the start of ESWL,whereas patients in control group (n=50) underwent ESWL without IVU.Postop- erative success,the stone-free rates and complications were evaluated in both groups. Results Seven patients in IVU group were excluded from the study. The success rate [95.3%(41/43) in IVU group vs 94.0% (47/50) in control group],stone-free rate [83.7% (36/43)vs 86.0% (43/50)] and complication rate[27.9% (12/43 ) vs 26.0% (13/50)]were similar in two groups (P＞0.05).Conclusions It is not necessary to obtain an IVU for patients who have solitary radiopaque proximal ureteral calculi on plain radiographs with no severe hydronephrosis on uhrasonographie examination before scheduling them for ESWL,thus minimizing the cost,avoiding exposure to contrast medium,and reducing radiation exposure.
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Objective To investigate the prevention and mechanism of Extracorporeal shock wave lithotripsy(ESW) induced renal Injury by pre-treating kidneys with low-energy shock waves(LESW).Methods Forty healthy female domestic rabbits were surgically managed to the mono-nephron models and random divided into 4 groups consisting of ten each: Control,LESW,ESW and ESWL plus LESW pretreated groups.LESW group received 100 LESW,ESW group received 1500 standard ESW,and same dose on ESW group except 100 LESW pretreatment in ESW plus LESW pretreated group.The rabbit kidney tissues were obtained 24 hours after ESW.Activity of superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the renal tissue,and the level of N-acetyl-β-D-glucosaminidase(NAG) in urinary were measured.Renal cell apoptosis was detected by TdT-mediated dUTP Nick End Labelling(TUNEL).Results The MDA,the urinary level of NAG and rate of apoptosis in the LESW groups were reduced(P<0.01),and the activity of SOD increased significantly(P<0.05) as compared with ESW group,and these changes in LESW group had no statistics difference compared with the control group(P>0.05).Conclusions LESW pretreatment protocol substantially limits the renal injury that often caused by ESW.LESW may suppress oxidative stress and antagonize the process of renal cellular apoptosis.
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Objective To investigate the effects of ?-aescin on the germ cell apoptosis and expression of bcl-2 and Bax proteins in bilateral testes following ipsilateral testicular torsion and detorsion. Methods Thirty adolescent male Wistar rats were randomly divided into control group (C group), model group of testicular torsion and detorsion (M group) and ?-aescin treatment group (T group), each group containing 10 animals. In M and T groups, rats underwent a clockwise 720? ipsilateral testicular torsion for 2 h followed by detorsion, and the rats in T group were intraperitoneally injected with ?-aescin 15 min before detorsion. 48h after operation, bilateral testes were collected, and used to detect cell apoptosis and expressions of bcl-2 and Bax by TUNEL technique and immunohistochemical method, respectively. Results In M group, the apoptotic index of the germ cells and Bax expression of bilateral testes significantly increased compared with C group (P
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Objective To observe whether recent sexual intercourse might cause microscopic hematuria, and investigate the cause of hematuria. Methods Eighty healthy volunteers (40 men and 40 women) consented to have intercourse with their married couples and provide samples of urine for testing before intercourse and the first day morning, noon, evening and the second day morning after intercourse. After appropriate instruction, volunteers tested their own urine for the presence of blood using standard dipsticks. Any volunteer with hematuria after intercourse was offered a comprehensive hematuria assessment and followed-up for two years. Results None of the volunteers had positive hematuria before sexual intercourse. 9 of the 40 women, but no men, had positive hematuria at the first day morning after intercourse, and 3 of the nine patients with hematuria still had positive hematuria at the noon of the first day. Five women of 9 patients with hematuria accepted two years follow-up and no abnormal was identified. Conclusion It suggested that recent sexual intercourse was a cause of asymptomatic microscopic hematuria in women, and a history of recent sexual intercourse should be considered when assessing the clinical significance of microscopic hematuria in women.
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Objective To investigate the relationship between oxidative stress and cell apoptosis in the kidney of rabbit induced by high energy shock wave(HESW).Methods Forty healthy male rabbits were surgically managed to the mono-nephron models and randomized into 4 groups consisting of ten each: control group,1 000 HESW group,2 000 HESW group and allopurinol pretreated plus 2 000 HESW group.The rabbit kidney tissues were obtained.The activity of superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the renal tissue were measured 24 hours after HESW application.The cell apoptosis was detected by TdT-mediated dUTP nick end labelling(TUNEL) and flow cytometry.Results Compared with the control group,the MDA level and the rate of apoptosis in the HESW groups increased,and the activity of SOD reduced significantly(P