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Objective:To compare expression levels of matrix Gla protein (MGP) and bone morphogenetic protein 2 (BMP-2) in Randall's plaque of renal papillary tissues in patients with calcium oxalate kidney stones and the underlying mechanism for stone formation.Methods:A total of 30 samples of Randall's plaque in renal papillary tissues from patients with calcium oxalate kidney stones were collected from the Department of Urology of Xiangya Hospital of Central South University from April,2015 to December,2015 and served as an experimental group.Ten samples of renal papillary tissues in patients undergone renal tumor nephrectomy were collected from the same hospital and served as a control group.The expressions of MGP and BMP-2 mRNA and protein were detected by quantitative real-time PCR and Western blot.Meanwhile,immunohistochemical technique was used to observe the expressions of MGP and BMP-2 in different parts of renal papillary tissues in the 2 groups.Results:1) The mRNA expression levels of MGP in the experimental group and the control group were 0.760±0.804 and 1.365±0.348,respectively,with significant difference between them (P＜0.05).Them RNA levels of BMP-2 in the experimental group and the control group were 2.500±0.725 and 1.485±0.870,respectively,with significant difference between them (P＜0.05).The expression levels of MGP protein in the experimental group and the control group were 0.130±0.424 and 0.202±0.704,respectively,with no significant difference between them (P＞0.05).The expression levels of BMP-2 protein in the experimental group and the control group were 0.885±0.220 and 0.682±0.272,respectively,with significant difference between them (P＜0.05).T-he immunohistochemistry showed that the protein expression of MGP in the experimental group was lower than that in the control group,while the protein expression of BMP-2 in the experimental group was higher than that in the control group (both P＜0.05).Conclusion:The BMP-2 expression is increased while MGP expression is decreased in renal papillary tissues in patients with calcium oxalate kidney stones,and the formation of calcium oxalate kidney stone might be a kind ofosteogenetic reaction or ectopic calcification.
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OBJECTIVE@#To evaluate the safety and effect of foley catheter traction for hemorrhage after postmicrochannel percutaneous nephrolithotomy (mPCNL).@*METHODS@#Eighty-eight patients with upper urinary calculi were collected prospectively at the Department of Urology of Xiangya Hospital of Central South University from November 2010 to June 2011. The patients underwent mPCNL, and were divided into 2 groups randomly: 45 patients with 16F foley catheter but without traction served as the control group, and the other 43 patients with 16F foley catheter traction served as the experiment group. Blood loss was estimated by the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN. The blood loss and bleeding time were compared in the 2 groups, and analyzed by Wilcoxon rank sum test.@*RESULTS@#There was statistical difference in the average blood loss between the control group (13.830 g) and the experiment group (7.959 g, P<0 .001). The mean bleeding time was 4 and 3 days in the control group and the experiment group respectively.@*CONCLUSION@#Foley catheter traction for mPCNL can reduce the blood loss, suggesting that Foley catheter traction is safe, effective and feasible.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Blood Loss, Surgical , Hemostatic Techniques , Kidney Calculi , General Surgery , Nephrostomy, Percutaneous , Methods , Postoperative Hemorrhage , Therapeutics , Prospective Studies , Traction , Ureteral Calculi , General Surgery , Urinary CatheterizationABSTRACT
Objective:To evaluate and compare the effciency and safety of Cyberwand dual probe lithotriptor and Swiss lithoclast master in percutaneous nephrolithotomy for renal staghorn calculi. Methods:A total of 138 patients with renal staghorn calculi were divided randomly into a Cyberwand dual probe lithotripter group (Group A, n=71) and a Swiss lithoclast master group(Group B, n=67). hTe data for operative time, blood loss volume, one-stage calculus clearance rate, hospitalization time, cost of hospitalization and complication in the two groups were collected and compared. Results: The renal access was established successfully and the one-stage percutaneous nephrolithotomy (PCNL) was performed in the 2 groups. There was no significant difference in the size of stones, the age of patients and the complications between the 2 groups before the operations. Intraoperative gravel time in the Group A was signiifcantly shorter than that in the Group B (77.14±21.39 vs 84.25±20.62, P=0.049). There was no significant difference in the one-staged stone clearance rate, blood loss volume in the operation between the 2 groups. hTe one-staged stone clearance rate in the 2 groups were 67.6%(48/71) and 70.1%(47/67) respectively, with no signiifcant difference (P=0.854). Conclusion:Two lithotrities were safe and effcient for renal staghorn calculi. But comparing with Swiss lithoclast master, Cyberwand dual probe lithotriptor is more effcient and convenient.
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OBJECTIVE@#To determine the screening of the expression of membrane proteins in androgen-dependent prostate cancer (ADPC) and androgen-independent prostate cancer (AIPC) and to explore the mechanism of membrane proteins in these two cancers.@*METHODS@#Serum samples were collected from 3 patients with ADPC and another 3 patients with AIPC. The serum was incubated with ADPC cell line LNCaP and/or AIPC cell line PC-3 and detected by immunoprecipitation and Western blot. Differentially expressed proteins between ADPC and AIPC identified by mass spectrometry were compared and their expression level and location were analyzed by immunofluorescence.@*RESULTS@#Altogether 11 membrane proteins were identifited, such as the Neural-Cadherin precursor, ER60 precursor, Claudin-4, and so on. Immunofluorescence revealed that the expression level of Claudin-4 in PC-3 cells was higher than in LNCaP cells.@*CONCLUSION@#We can use the screening method to study membrane proteins in prostate cancer. Claudin-4 may play an important role in the pathogenesis and the development of AIPC.
Subject(s)
Aged , Humans , Male , Androgens , Genetics , Metabolism , Cell Line, Tumor , Claudin-4 , Genetics , Metabolism , Gene Expression Profiling , Membrane Glycoproteins , Genetics , Metabolism , Prostatic Neoplasms , Genetics , Metabolism , Pathology , Protein Disulfide-Isomerases , Genetics , MetabolismABSTRACT
Objective To discuss the diagnosis and treatment of carcinoma of renal pelvis ac-companied with kidney stones. Methods Twenty-one cases of carcinoma of renal pelvis with kidney stones were reviewed. The urinary stones history was from 10 d to 24 years with an average of 27 months. Four cases had recurrent fever, weight loss. Seventeen cases had gross hematuria. CT scan-ning was performed in 17 cases, which indicated 9 cases of carcinoma of renal pelvis, 4 cases of possi-ble renal mass and enlarged renal hilum lymph nodes. MRU was performed in 10 cases, which showed 9 cases of stones concomitant with carcinoma of renal pelvis. IVU indicated 13 cases of light filling of contrast and 8 cases of complete negative filling. Nine cases who had been diagnosed before surgery were performed radical nephrectomy and local lymph nodes dissection. Five cases were carried out ne-phrostomy first because of pyonephrosis, then secondary subcapsule nephrectomy was performed, 2 of them who were diagnosed with carcinoma of renal pelvis after surgery were performed with ureterecto-my and excision of bladder cuff. Three cases were performed with subcapsule nephrectomy because of dense perinephric adhesion. Three cases with complicated calculi and nonfunctional kidney were per-formed with nephroureterectomy, 2 of them who were diagnosed with carcinoma of renal pelvis were carried out with ureterectomy and excision of bladder cuff. One case who was performed PCNL under ultrasound guidance was found a mass in the renal pelvis. The pathological examination indicated ade-nocarcinoma. Radical nephrectomy and lymphadenectomy of renal hilum were performed afterwards. Resnlts Twenty-one cases were performed with pathological examination, in which there were 4 ca-ses of transitional cell carcinoma, 16 cases of squamous cell carcinoma and 1 case of adenocarcinoma. All the 21 cases were discharged after surgery. Nine of them were followed up with 4 to 28 months. Six cases were dead. The post-surgery survival time was 3 to 21 months. Two of them died of heart infarction, 4 died of metastasis. Conclusions The carcinoma of renal pelvis should be considered be-fore surgery in the patients with long history of renal calculi, hydronephrosis and infection. CT scan-ning and MRU are helpful for the diagnoses of renal calculi concomitant with carcinoma of renal pel-vis. Earlier diagnosis, earlier management of renal calculi can extend survival time of the patients with renal calculi concomitant with carcinoma of renal pelvis.
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Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.
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Objective To explore the effect of incision of the cervix renal calices for the treatment of complex intrarenal sinus renal calculi. Methods 52 cases of complex intrarenal sinus renal calculi with upper and/or lower calyx serious hydrops treated by incision of the cervix renal calices were studied.There were 38 men and 14 women.The mean age was 43 years (range,21 to 70 years).The mean diameter of the stones was 4.2 cm. Results The stones were totally removed in 44 cases.8 cases with residual stones were treated by percutaneous nephrolithotomy. The residual stones were totally removed in 4 cases while other 4 cases accepted further treatment with extracorporeal shock wave lithotripsy (ESWL).No blood transfusion and postoperative bleeding were observed.24 cases were followed up of 0.5 to 4 years.KUB plus IVU were conducted postoperatively which showed improved hydronephrosis.No intrarenal stricture and renal calculi recurrence were observed. Conclusions The procedure has advantages of less bleeding,preservating more renal function,less postoperative complications,which has a good application in the treatment of complex intrarenal sinus renal calculi with upper and/or lower calyx serious hydrops.