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Objective To investigate the efficacy and safety of electronic flexible ureteroscope Holmium laser lithotripsy in the treatment of kidney stones larger than 2. 0 cm. Methods From October 2012 to December 2013,43 cases of kidney stones larger than 2. 0 cm in diam-eter were treated with holmium laser lithotripsy under electronic flexible ureteroscope. A double-J stent was indwelled in ureter for 1~2 weeks before operation in each patient. Ureteral catheter guide wire was firstly put into the ureter with F8. 0/9. 8 semi-rigid ureteroscope,and the ac-cess sheath was put along the wire. Then,the electronic flexible ureteroscope(Olympus V5) was introduced into the pelvis. Stones were frag-mented with holmium laser,and greater than 3 mm crushed stones were removed with a set of stone basket. Results The diameter of the stones of the 43 patients ranged from 2~3. 2 cm,with an average of 2. 4 cm. The operation time ranged from 35~120 min,with an average of 68 min. Three patients complicated with chills,fever and other symptoms of infection,who were improved by active anti-infective treatment. No serious complications occurred. Postoperative hospital stay was 2~4 d,with an average of 3. 2 d. After 12 weeks of follow-up,stone clearance rate was 86% (37/43). Conclusion It is safe and efficacy to treat kidney stones larger than 2. 0 cm with electronic flexible ureteroscope, especially for the elderly,solitary kidney,and patients with a previous incision or percutaneous nephrolithotomy.
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Objective To investigate the clinical efficacy and safety of flexible ureteroscopic lithotripsy ( FURL) using holmium laser for medullary sponge kidney stones. Methods A flexible ureteroscope was placed into renal calyx via a ureteral access sheath ( UAS) . The stones underlying the mucosa were found,and then broken by holmium laser following incision of renal papillary mucosa. The stone fragments were washed or clamped out. The remission of clinical symptoms and incidence of perioperative complications were observed,and a KUB plain film was rechecked postoperatively. Results Stones underlying mucosa were found and broken successfully in all 14 patients and there was no serious bleeding. Back pain symptoms of patients were relieved in 3 to 7 days postoperatively or after the removal of double J stent. The stone fragments were mainly discharged spontaneously. The rechecking KUB showed the amount of stones of most patients was significantly re-duced three months after operation. Conclusion FURL using holmium laser is effective for the treatment of medullary sponge kidney stones as it can significantly reduce the loads of stones without serious complications. It’ s a minimally invasive,effective,safe and suitable way which is suitable for further spread of clinical application.
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Objective To compare the safety and efficacy of flexible ureteroscopic lithotripsy (F-URS) and mini-percutaneous nephrolithotomy(MPCNL) for treating upper ureteral calculi by the randomized controlled clinical trial .Methods 120 cases of up-per ureteral calculi treated in this hospital from May to September 2013 were randomized into the F-URS group and the MPCNL group with 60 cases in each group .The postoperative clinical curative effects were compared between the two groups .Results The initial stone clearance rates of the F-URS group and the MPCNL group were 68 .33% and 95 .00% respectively ,and the difference was statistically significant (P0 .05) .The operating time of the F-URS group and the MPCNL group was (35 .33 ± 11 .57)min and (53 .75 ± 17 .31)min respectively ,the average hospital stay after operation was(3 .05 ± 0 .62)d and (5 .43 ± 1 .84)d respectively ,and the average visual analogue scale(VAS) score on first postoper-ative day was 1 .70 ± 1 .37 and 3 .68 ± 1 .57 respectively .These indicators had statistically significant differences between the two groups(P0 .05) .Conclusion For upper ureteral calculi with surgical indication ,the effect of F-URS is equivalence to MPCNL in the aspect of the stone clearance rate ,but F-URS has high-er security and shorter postoperative hospital stay .In the department with the condition to conduct F-URS ,F-URS should be ranked as the preferred treatment method for upper ureteral calculi .
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Objective To evaluate the feasibility,safety and efficacy of tubeless percutaneous nephrolithotomy ( PCNL).Methods Patients who underwent PCNL were randomized into 2 groups by extracting a random number generated from random number table,tubeless PCNL group and traditional PCNL group when the stones were cleared.Each patient in tubeless PCNL group was treated with insertion of a F5 ureteral double pigtail stent without placement of nephrostomy tube,while both double pigtail stent and F16 nephrostomy tube were placed in patients in traditional PCNL group.Exclusion criteria were severe bleeding requiring blood transfusion,stone residual requring a second PCNL,severe hydronephrosis with the thickness of renal parenchyma less than 5 mm,pyonephrosis,stricture of ureter or ureteropelvic junction,and severe perforation of the collecting system.A total of 50 patients were enrolled in this study.Tubeless PCNL and traditional PNCL were performed in 25 patients,including 27 kidney units,respectively.The two groups had comparable demographic data.All the operations were performed by the same surgeon.Evaluation factors included postoperative pain,decreased hemoglobin,blood transfusion rate,incidence of fever and perirenal hematoma,and duration of hospitalization.Results The average visual analogue scale (VAS) score on postoperative day 1 in tubeless PCNL group was 2.24 compared with 5.04 in traditional PCNL group (P ＜ 0.01 ).The average hospital stay in tubeless PC NL group (3.04 d) was significantly shorter than that in traditioal PCNL group (6.88 d) (P ＜0.01 ).The differences in average hemoglobin drop and stone clearance in the 2 groups were not significant.The differences between the 2 groups in blood transfusion ( 1/25 in tubeless PCNL group vs 3/25 in traditional PCNL group,P ＞0.05),renal hematomas rate (6/27 in tubeless PCNL group vs 7/27 in traditional PCNL group,P ＞ 0.05) and fever rate (3/25 in tubeless PCNL group vs 4/25 in traditional PCNL group,P ＞0.05 ) were not significant.There was no incidence of urinary leakage from the nephrostomy site in the 2 groups.Conclusions Tubeless PCNL can significantly decrease postoperative pain and discomfort and shorten the duration of hospitalization without increase of complications.Tubeless PCNL is safe,effective and performable,but the contraindications such as massive haemorrhage,pyonephrosis,ureteral obstruction,severe perforation of the collecting system,residual stone requring a second PCNL,should be kept in mind.
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Objective To compare the efficacy of pirarubicin with other intravesical chemothera peutic agents in preventing bladder tumor recurrence. Methods Databases such as Medline,EM Base,CBMDisc and PubMed,ScienceDirect,LWW,Springer,CJFD(Chinese Journal Fulhext Data base)and Chinese Periodicals Database of Science and Technology were systematicallv searehed for controlled studies involved with intravesical pirarubicin for the treattnent of bladder cancer.Eligible studies according to inclusion and exclusion criteria were selected,then recurrence data from included studies were retrieved for a meta-analysis. Results Fifteen studies met the inclusion criteria.Of these studies 10 compared efficacy of pirarubicin with mitomycin C,and the meta-analysis based on these 10 studies showed that pirarubicin was statistically superior to mitomycin C(OR=0.41,95%CI 0.27～0.61,P＜0.01).Of 6 studies,pirarubicin was compared with thiotepa(OR=0.35,95%CI 0.11～1.13,P＞0.05),adriamyein(OR=0.15,95% CI 0.03～O.76,P＜0.05),epirubicin(OR=0.53,95% CI 0.23～1.23,P＞0.05),hydroxycamptothecin(OR=0.25,95% CI 0.10～0.64,P＜0.05)and blank control respectively,statistical analysis indicated pirarubicin was significantly better than adriamycin,hydroxycamptothecin and blank control,and not statistically different from thiotepa and epirubicin. Conclusion Pirarubicin is effective in preventing bladder tumor recurrence,with efficacy better than chemotherapeutic agents such as mitomycin C,hydroxyeamptothecin,and adriamycin,thus can be a novel optional intravescial chemotherapeutic agent for bladder cancer.
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<p><b>OBJECTIVE</b>To report our experiences in retroperitoneoscopic renal pedicle lymphatic stripping for chyluria.</p><p><b>METHODS</b>Six cases of filarial chyluria were admitted to our hospital from November 2001 to June 2002. Of these cases, 4 were men and 2 women, with age ranging from 34 to 52 years (mean, 42 years). Diagnosis was made by using urine test for the presence of chyle and fat globule, cystoscopy, excretory urogram and retrograde pyelography. Chyluria was found on the left renal unit in 2 cases and on the right side in 4 cases. The technique of retroperitoneoscopic management of chyluria consisted of nephrolympholysis, hilar vessel stripping and ureterolympholysis.</p><p><b>RESULTS</b>Operative time ranged from 69 to 120 minutes (mean, 95 minutes). Intraoperative blood loss was 50-180 ml (mean, 85 ml). Chyluria disappeared in all patients immediately after operation. Mild hematuria occurred in 4 cases within 12 hours and disappeared at 24 hours. Subcutaneous emphysema around the lesions was found in 2 cases and was spontaneously absorbed 3 days after the treatment. There was no lymphatic leak at the lesions. The patients were discharged from the hospital 5-9 days after the treatment. All patients gained weight and their haemoglobin and serum protein increased by 13.5 g/L and 3.66 g/L respectively. No chyluria recurrence was reported during 1-1.6 years follow-up.</p><p><b>CONCLUSIONS</b>Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a safe, effective and efficient surgical procedure with minimal invasion, less pain, lower morbidity, short hospital stay and rapid recovery.</p>
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Adult , Humans , Male , Middle Aged , Chyle , Endoscopy , Lymphatic Diseases , General Surgery , Lymphatic System , General Surgery , Retroperitoneal Space , UrineABSTRACT
Objective To construct the prostatic specific promoter used to induce the gene therapy aiming at androgen independent prostatic carcinoma and evaluate the activity. Methods Through two steps of polymerase chain reaction (PCR), androgen response elements (AREs) in rPB were replaced by synthetic retinoic acid response elements (RAREs). Then the modified rPBs were connected with the plasmid. The activity was evaluated. Results Constructions were confirmed to be successful by electrophoresis and gene sequencing. Conclusion Modified rPB should be the prostatic specific promoter which can induce the gene therapy aiming at androgen-independent prostatic carcinoma controlled by retinoic acid. After being constructed, the modified rPBs were used to confirm our ideas about the experiment design and the capability inducing the gene expression of different modified rPBs was compared.
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Objective To investigate the changes of androgen receptor (AR) and AR mRNA of the ventral lobe, lateral lobe part 1(LP1) and lateral lobe part 2 (LP2) in the Wistar rat prostate after androgen manipulation. Methods Healthy adult male Wistar rats were randomly divided into 3 groups: control group(N), castration group(C) and androgen replacement group (T). In castration group, orchiectomy was performed through the scrotum. In androgen replacement group, testosterone propionate (2 5 mg/d) was injected subcutaneously for 14 d after castration. Expressions of AR and AR mRNA in the separate lobes of the adult Wistar rat prostate after androgen ablation and replacement were determined by immunohistochemistry and semi quantitative PCR. Results Different autoregulation of AR protein and mRNA was observed in the ventral lobe, LP1 and LP2 of rat prostate after androgen manipulation. In the ventral lobe and LP1, immunoreactive nuclear AR markedly decreased in staining intensity in the glandular epithelium 2 d after castration compared to that in the intact rats. Epithelial immunostaining continued to decline and was absent at day 7 and returned to normal level 3 d after testosterone replacement. There was a transient increase in AR mRNA demonstrated by RT PCR within 3 d and returned to control level within 7 d after castration in the ventral lobe and LP1 of rat prostate. In contrast, in LP2, the epithelial cells showed continued expressions of both AR protein and mRNA 14 d following androgen withdrawal. Conclusion These results suggest that there might be a different regulation of AR mediated by androgen in ventral lobe, LP1 and LP2 of rat prostate.
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This paper reports that the protective effects of SOD on the experimental gastric ulcers in the mice and erythrocyte membranes, as well as the 125I-SOD traced examination to be studied. The radioactive 125I labelling SOD is using by Iodogen solid phase method. The results of traced examination demonstrated that 125I-SOD could be absorbed into the blood rapidly,and distributed to various organs. The renal radioactivity is highest. The radioactivity in erythrocytes (peak phase) has been accounting for 18. 2% in the whole blood. The radioactivity of bound form in the plasma is only accounted for 12. 5%. It shows that the 125I-SOD was mostly degradation and deiodination. The action of theexogenous O2 free radicals on the erythrocytes showed that the SOD have been markedly inhibited the peroxide damage of O2on the erythrocyte membranes, which inhibitory effect was increased with the concentration of the SOD raised. The effect of SOD on the IM-HCI induced the gastric ulcers, an inhibitory and protective action occur too. In the group of SOD treatment, the gastric mucosal membranes lipid peroxidation was inhibited and the pathological changes remited.
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Effects of different concentrations of Zinc-glycine chelates and their combination with ( SAC ) on DNA synthesis in human peripheral lymphocytes were observed. These results indicated that incorporation of 〔3H〕 -TdR in DNA of lymphocytes were risen (SI and cpm ) with a concentrations of 4.5 and 9?10-5mol/L Zinc -glycine ( P