Clinical analysis of percutaneous nephrolithotomy for staghorn calculi with different stone branch number / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the impact of staghorn stone branch number on outcomes of percutaneous nephrolithotomy (PNL).</p><p><b>METHODS</b>From January 2009 to January 2013, the 371 patients with staghorn stones who were referred to our hospital for PNL were considered for this study. All calculi were showed with CT 3-dimentional reconstruction (3-DR) imaging. The computerized database of the patients had been reviewed. Our exclusion criterion was patients with congenital renal anomalies, such as horse-shoe and ectopic kidneys. And borderline stones that branched to one major calyx only were also not included. From 3-DR images, the number of stone branching into minor renal calices was recorded. We made "3" as the branch breakdown between groups. And the patients were divided into four groups. The number of percutaneous tract, operative time, staged PNL, intra-operative blood loss, complications, stone clearance rate, and postoperative hospital day were compared.</p><p><b>RESULTS</b>The 371 patients (386 renal units) underwent PNL successfully, included 144 single-tract PNL, 242 multi-tract PNL, 97 staged PNL. The average operative time was (100 ± 50) minutes; the average intra-operative blood loss was (83 ± 67) ml. The stone clearance rate were 61.7% (3 days) and 79.5% (3 months). The postoperative hospital stay was (6.9 ± 3.4) days. A significantly higher ratio of multi-tract (χ(2) = 212.220, P < 0.01) and staged PNL (χ(2) = 49.679, P < 0.01), longer operative time (F = 4.652, P < 0.01) and postoperative hospital day (F = 2.067, P = 0.043) and lower rate of stone clearance (χ(2) = 10.691 and 47.369, P < 0.05) were found in PNL for calculi with stone branch number ≥ 5. There was no statistically meaningful difference among the 4 groups based on Clavien complication system (P = 0.460).</p><p><b>CONCLUSION</b>The possibility of multi-tract and staged PNL, lower rate of stone clearance and longer postoperative hospital day increase for staghorn calculi with stone branch number more than 5.</p>

Effects of siRNA against Ki67 gene on the proliferation and apoptosis of human renal carcinoma cells / 中华泌尿外科杂志

Objective To evaluate the effects of small interfering RNA(siRNA)against Ki67 gene on the proliferation and apoptosis of human renal carcinoma cell line 786-0 cells.Methods The human renal carcinoma 786-0 cells were treated with Ki67-siRNA(100 nmol/L).The mRNA expression of Ki67 was detected by RT-PCR.The protein expression of Ki67 was detected by Western blot and immunohisto- chemical technique,respectively.The proliferation of 786-0 cells was detected by MTT assay.The apoptosis of 786-0 cells was detected by TUNEL assay.Results RT-PCR and Western blot analysis showed that the Ki67 mRNA and Ki67 protein expression levels of the 786-0 cells treated with Ki67-siRNA were(37.6?1.9)% and(46.4?0.9)% ,respectively,which were significantly lower than those of controls [(97.3?0.9)% and(95.3?0.9)%,P＜0.01],The Ki67 positive expression rate of 786-0 cells treated with Ki67-siRNA by immunohistochemical technique was 52.5?2.3,which was significantly lower than that of controls(114.5?4.9 ,P＜0.01).The proliferation-inhibiting rate and apoptosis rate of the 786-0 cells trea- ted with Ki67-siRNA were( 63.6?1.6)% and(41.7?0.6)% ,respectively,which were significantly higher than those of controls [(2.8?0.2)% and(10.3?1.4)%,P＜0.01].Conclusions siRNA against Ki67 gene can inhibit the proliferation and induce the apoptosis by blocking Ki67 expression of hu- man renal carcinoma 786-0 cells.The inhibition of Ki67 expression by siRNA may be a promising approach in gene therapy for renal cancer.