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Objectives:To validate the Chinese version of the Ureteral Stent Symptoms Questionnaire(Chinese-USSQ) in patients with an indwelling ureteral stent.Methods:The original USSQ was translated into Chinese and linguistically validated following the cross-cultural adaptation of health-related quality of life measures.A total of 83 patients (cases) with indwelling ureteral stent and 90 healthy subjects (controls) were asked to complete the Chinese-USSQ as well as European Quality of Life Visual Analogue scale(EQ-VAS)(for both genders), the International Prostate Symptom Scale (IPSS) (for male), and Urogenital Distress Inventory-6 (for female). Patients were evaluated at weeks 1 and 4 after stent placement and at week 4 after removal. The psychometric properties of the questionnaire were analyzed.Results:The Chinese version of USSQ include 43 items, which addressed various domains of health(6 sections) covering urinary symptoms, pain, general health, work performance and sexual matters with additional problems. A total of 78 patients(45 males and 33 females) and 90 controls (41 males and 49 females)were included for analysis. Internal consistencies (Cronbach′s α coefficients: 0.60-0.78) and test-retest reliability (Spearman correlation coefficient: 0.69-0.91) were satisfactory for urinary symptom, body pain, general health, and work performance domains. Most USSQ domains showed moderate correlations with each other. The convergent validity determined by correlation between other instruments and corresponding USSQ domain was satisfactory. At week 4 it was moderate for the urinary symptoms index compared to the IPSS in men(Spearman correlation coefficient>0.60), for the urinalry symptoms index compared to the UDI-6 score in women(Spearman correlation coefficient 0.52).Sensitivity to change and discriminant validity were also good in most domains ( P<0.01). Only a small proportion of the study population had an active sexual life with the stent in situ, which limited its analysis. Only 1(1.3%) and 6(7.7%) patients had an active sex life at week 1 and 4 after stent placement; meanwhile, 34(43.6%) patents were sexually active at week 4 after stent removal. Conclusion:The Chinese version of the USSQ is a reliable and valid instrument that can be used for Chinese patients with a indwelling ureteral stent in the clinical and research settings.
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Objective:To discuss the clinical manifestation, diagnosis and treatment of upper urinary tract calculi complicating with emphysematous pyelonephritis(EPN).Methods:The clinical data of 5 cases of upper urinary tract calculi complicating with EPN diagnosed in our department from July 2012 to December 2019 were retrospectively analyzed, and literatures were reviewed. 5 patients were identified by computed tomography scanning to upper urinary tract calculi complicating with EPN, 3 female and 2 male, aged 40-67 years, 2 staghorn calculi and 3 multiple stones. One patient suffered from diabetes mellitus. All cases presented with fever at the enrollment point, and the body temperature were 38.7℃, 38.8℃, 37.5℃, 38.6℃, 40.0℃, respectively. And the number of white blood cells and neutrophile granulocyte of these cases were higher than normal reference value, were 17.2×10 9/L, 0.90; 14.9×10 9/L, 0.89; 11.2×10 9/L, 0.85; 15.1×10 9/L, 0.87; 13.3×10 9/L, 0.88, respectively. The C-reactive protein were increased in all of the cases, especially in case 1(68 mg/l), case 2(253 mg/l), and case 5(67 mg/l). And 3 cases with renal insufficiency. Case 3 and case 4 were controlled the infection with medical management alone, and case 5 with percutaneous drainage plus medical management. The pyelonephritis of other 2 cases were uncontrolled, the body temperature of case 1 returned to normal after treated with percutaneous drainage of perirenal abscess plus nephrostomy plus medical management, but the imaging findings of kidney was not relief by CT scan after 4 weeks. Case 2 was persistent fever until treated with fluconazole according to the medicine sensitive experiment’s result of urine culture after undergoing nephrostomy plus indwelled a double J tube in ureter, but the CT findings of kidney grew worse 1 week later. Results:Of the 5 patients, 1 received first-stage nephrostomy and second-stage percutaneous nephrolithotomy, 2 received same session surgery, 2 received nephrectomy. There was no complications occurred except postoperative fever in 1 case. Postoperative pathology of the nephrectomy revealed glomerular sclerosis, glomerulus dilation, and inflammatory granulation tissue was formed. And 1-84 months follow-up showed no recurrence in all the cases.Conclusions:Upper urinary tract calculi complicating with EPN is an rare acute severe infection, CT is the best choice of early diagnosis, double J stenting or percutaneous drainage of abscess with broad-spectrum antibiotics could be the preferred treatment.
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Objective To analyze the incidence of urinary stone formation in the contralateral kidney of unilateral nephrectomy patients.Methods 1048 patients,including 596 males and 452 females,underwent unilateral nephrectomy from June 2010 to June 2016.Their age ranged from 16-87 years old (mean 58.7 years old).532 patients combined with components of metabolic syndrome and 213 patients with metabolic syndrome.164 patients had a previous history of urolithiasis.The incidence of urinary stone formation in the contralateral kidney after nephrectomy was recorded and analyzed.The urolithiasis incidences in different gender,age,comorbidity and history of urolithiasis patients after uninephrectomy were compared.Results All patients were followed up within 0.5 to 6 years (mean 3.2 years).89 patients suffered from urinary stones in the contralateral kidney after uninephrectomy.The incidence of urinary stone formation in the contralateral kidney was 8.5％ (89/1048),which was higher than that in general population of China.1％-5％.The urolithiasis incidence was 9.1％ (54/596)in male patients and 7.7％ (35/452)in female patients after nephrectomy.The incidence of urinary stone formation was 8.6％ (3/35)in patients aged under 30 years old,12.5％ (34/272) in patients aged 30-49 years old,7.3％ (37/504) in patients aged 50-69 years old,6.3％ (15/237)in patients aged 70 and over.The incidence of urinary stone formation was 12.2％ (65/532) in patients with components of metabolic syndrome after nephrectomy and 19.7％ (42/213) in patients with metabolic syndrome,while the incidence was 4.7％ (24/516)in patients without components of metabolic syndrome.In patients with history of urolithiasis,the incidence was up to 30.5％ (50/164) after nephrectomy,while 4.4％ (39/884)in patients without history of urolithiasis.Conclusions The incidence of urinary stone formation in the contralateral kidney of uninephrectomy patients was higher,especially in patients with metabolic syndrome or urolithiasis history.Patients after unilateral nephrectomy are more vulnerable to urolithiasis.
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Objective To analyze the incidence of urinary stone formation in the contralateral kidney of unilateral nephrectomy patients.Methods 1048 patients,including 596 males and 452 females,underwent unilateral nephrectomy from June 2010 to June 2016.Their age ranged from 16-87 years old (mean 58.7 years old).532 patients combined with components of metabolic syndrome and 213 patients with metabolic syndrome.164 patients had a previous history of urolithiasis.The incidence of urinary stone formation in the contralateral kidney after nephrectomy was recorded and analyzed.The urolithiasis incidences in different gender,age,comorbidity and history of urolithiasis patients after uninephrectomy were compared.Results All patients were followed up within 0.5 to 6 years (mean 3.2 years).89 patients suffered from urinary stones in the contralateral kidney after uninephrectomy.The incidence of urinary stone formation in the contralateral kidney was 8.5％ (89/1048),which was higher than that in general population of China.1％-5％.The urolithiasis incidence was 9.1％ (54/596)in male patients and 7.7％ (35/452)in female patients after nephrectomy.The incidence of urinary stone formation was 8.6％ (3/35)in patients aged under 30 years old,12.5％ (34/272) in patients aged 30-49 years old,7.3％ (37/504) in patients aged 50-69 years old,6.3％ (15/237)in patients aged 70 and over.The incidence of urinary stone formation was 12.2％ (65/532) in patients with components of metabolic syndrome after nephrectomy and 19.7％ (42/213) in patients with metabolic syndrome,while the incidence was 4.7％ (24/516)in patients without components of metabolic syndrome.In patients with history of urolithiasis,the incidence was up to 30.5％ (50/164) after nephrectomy,while 4.4％ (39/884)in patients without history of urolithiasis.Conclusions The incidence of urinary stone formation in the contralateral kidney of uninephrectomy patients was higher,especially in patients with metabolic syndrome or urolithiasis history.Patients after unilateral nephrectomy are more vulnerable to urolithiasis.
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Objective: To investigate the position and the size of ureteral stone in patients before treated with ureteroscopic lithotripsy or percutaneous nephrolithotomy (PCNL), as well as the dilatation of ureter caused by stone, which may be helpful for better understanding of pathogenesis of ureteral stone and improvement of the diagnosis and treatment in clinic.Methods: A total of 129 cases with ureteral stone for endourologic lithotripsy in Peking University People''s Hospital from Aug.2016 to Mar.2017 were included for the retrospective review.The CT data of the ureteral stones and the ureteral dilatation were collected, including the position of stone, the transverse and longitudinal diameter of stone, and the transverse diameter of dilated upper ureter and ureteropelvic junction (UPJ).The distribution of ureteral stones and dilatation in different parts of ureter were compared and analyzed.Results: All of the 129 cases of ureteral stone, stones were located at UPJ in 9 cases (7.0%), proximal ureter in 75 (58.0%), ureter crossing external iliac vessel (UEIV) in 6 (4.7%), distal ureter in 26 (20.2%), and ure-terovesical junction (UVJ) in 13 (10.1%).The mean transverse diameter of proximal ureteral stones was greater than that of distal ureteral stones [(8.47±2.36) mm vs.(6.74±1.99) mm, P<0.001], as the same as the mean longitudinal diameter [(11.00±4.41) mm vs.(7.50±4.28) mm, P<0.001].In 114 cases of dilated ureter for stone, the UPJ had a greater transverse diameter compared with the upper ureter [(14.39±6.09) mm vs.(11.45±3.85) mm, P<0.001].Conclusion: The most common location of stone is the proximal ureter in patients for endourologic lithotripsy, as the location in UEIV is rare.Both transverse and longitudinal diameters of stone in proximal ureter are greater than those in distal ureter.For dilated ureter, it is more severe in UPJ than in upper ureter.Traditionally, it is accepted that the stones lodge at 3 sites of natural narrowing in ureter, which may be questioned.
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Objective@#To evaluate the effects of percutaneous nephrolithotomy (PNL) in the treatment of medullary sponge kidney with calculi.@*Methods@#A total of 77 patients (91 renal units) of medullary sponge kidney with calculi (MSK group) and 77 patients (77 renal units) with common kidney stone (control group) received PNL at Department of Urology in Peking University People′s Hospital from September 2006 to February 2016 were analyzed retrospectively. The MSK group included 33 males and 44 females with a mean age of (42.1±13.2) years, the mean stone burden was (3.9±1.8) cm. The control group included 36 males and 41 females with a mean age of (45.3±13.0) years, the mean stone burden was (3.6±1.5) cm. The numbers of tracts, the time of operation, the drop of hemoglobin, the change of creatine, the time of hospitalization, the stone free rate and major complications were compared between the two groups. The measurement data and numeration data were compared with t test and χ2 test.@*Results@#There were no significant differences in sex, age, preoperative urinary tract infection, stone type, and stone burden between the two groups (all P>0.05). The proportion of bilateral renal calculus in MSK group was higher (18.2% vs. 0, χ2=15.400, P=0.000). There were 159 percutaneous channels were established in MSK group while 90 percutaneous channels were established in control group. Compared with the control group, the operation time ((88.1±37.5) minutes vs. (68.5±30.1) minutes, t=3.543, P=0.000) and hospitalization time ((15.1±8.3) days vs. (10.1±3.6) days, t=4.816, P=0.000) were longer, the creatinine level increased ((101.2±62.6) μmol/L vs. (71.3±23.6) μmol/L, t=3.777, P=0.000), the rate of stone free decreased (27.5% vs. 83.1%, χ2=51.840, P=0.000) and the rate of complications increased (29.9% vs. 11.7%, χ2=8.114, P=0.004) in MSK group. There was no statistically difference in hemoglobin drop ((12.5±13.2) g/L vs. (13.0±10.9) g/L, t=-0.260, P=0.795).@*Conclusions@#Using PNL for patients of MSK with calculi has a lower stone free rate and a higher complications. It is an effective method for patients of MSK with large and complex calculi.
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Objective:To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL).Methods:In this study,461 patients with type 2 diabetes who received PCNL in Peking Uni-versity People’s Hospital from June 2006 to December 2015 were reviewed.There were 281 males and 180 females with an average age of 57 years were included,of whom,137 were diagnosed with SIRS after PCNL.The demographic data,clinical features,and test results were compared between the patients with SIRS and without SIRS,trying to identify the correlation between their clinical characters and the occur-rence of SIRS.Results:The SIRS was significantly correlated with the patients’preoperative white blood cell counting (×109 /L)[7.76 (4.00 -17.96)vs.6.31 (2.00 -17.40),P <0.001 ],preopera-tional blood glucose level (mmol /L)[7.30 (3.08 -19.90)vs.6.40 (3.42 -16.78),P <0.001], operative time (min)[75 (20 -270)vs.60 (20 -200),P <0.001 ],length of stay (d)[12 (2 -46)vs.11 (3 -29),P =0.019],staghorn stones [38.8% (33 /85)vs.27.7% (104 /376),P =0.042],and preoperational urinary tract infection [36.8% (50 /136)vs.26.6% (81 /304),P =0.032].There was no significant correlation between the SIRS and the patients’age,body mass index, preoperative hemoglobin level,preoperative serum creatinine,and transfusion.In multivariate analysis, abnormal preoperative white blood cell counting (OR =3.194,95% CI:1.531 -6.666,P =0.002), operative time longer than 60 min (OR =1.635,95% CI:1.088 -2.456,P =0.018),and preopera-tional blood glucose level higher than normal 7.1 mmol /L were significantly correlated with the presence of SIRS.Conclusion:The high level of preoperational blood glucose,abnormal preoperative white blood cell counting,and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.
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Objective To analyze clinical characteristics of premenopausal and postmenopausal female patients with kidney stones.Methods The clinical data of 1 194 female adults with kidney stones from December 2004 to December 2014 were analyzed retrospectively.The incidence of kidney stones in different age groups was analyzed firstly.The post-hysterectomy patients or those taking estrogen for breast cancer were excluded, and then 1 166 patients were enrolled.The patients were divided into premenopausal group (464 cases, 39.8％) and postmenopausal group (702 cases, 60.2％), and clinic features of different groups were evaluated.Results The peak age of female patients with kidney stones is between 50 and 59 years old.There were 105 (22.6％) patients in premenopausal group and 204 (29.1％) patients in postmenopausal group complicated with urinary infection.Fifty-eight (12.5％) patients had genitonrinary malformations such as horseshoe kidney, medullary sponge kidney, ectopic kidney, duplex kidney or pyeloplasty for ureteropelvic junction (UPJ) stricture in premenopausal group, as well as 36 (5.1％) in postmenopausal group.Twenty patients (4.3％) had renal insufficiency in premenopausal group, and 66 (9.4％) in postmenopausal group.These differences were statistically significant (P ＜ 0.05).The patients complicated with hydronephrosis (251 vs.346) and ureteral calculi (63 vs.110) of two groups were not significant different (P ＞ 0.05).Multiple factors Logistic analysis indicated that age and urinary infection were statistically significant factors in the occurrence of renal insufficiency (OR =1.037,1.772, P ＜ 0.05).Conclusions The occurrence of genitourinary malformations was higher among premenopausal female patients with kidney stones, while urinary infection and renal insufficiency were more common for postmenopausal patients.Age and urinary infection were the independent factors for the occurrence of renal insufficiency.
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SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.
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<p><b>OBJECTIVE</b>To compare the efficacy between total ureterectomy and partial ureterectomy in treatment of ureteral carcinoma.</p><p><b>METHODS</b>The clinical data and follow-up results of 102 patients with ureteral urothelial carcinoma from August 1996 to August 2011 were analyzed retrospectively. According to surgical procedures, the patients were divided into total ureterectomy group (61 cases) and partial ureterectomy group (41 cases). The subsequent bladder cancer incidence, ureteral carcinoma recurrence rate, distant metastasis rate and survival rate were compared between two groups. The prognostic factors of ureteral carcinoma were analyzed by multivariable Cox regression.</p><p><b>RESULTS</b>Nineteen patients (31.1%) suffered subsequent bladder cancer in total ureterectomy group, and 10 (24.4%) in partial ureterectomy group(χ² = 0.550, P = 0.458). Ten patients (16.4%) re-suffered contralateral ureteral carcinoma in total ureterectomy group, and 6 (14.6%) in partial ureterectomy group, 2 (4.9%) ipsilateral and 4 (9.7%) contralateral (χ² = 0.057, P = 0.811). Eight patients (13.1%) occurred distant metastasis in total ureterectomy group, and 3 (7.3%) in partial ureterectomy group (χ² = 0.360, P = 0.549). Twenty patients died of carcinoma in total ureterectomy group, and 18 in partial ureterectomy group. The median survival time was 78 months in total ureterectomy group, and 75 months in partial ureterectomy group. The 1-year, 3-year and 5-year survival rates in total ureterectomy group were 97.8%, 76.8% and 63.6%, and in partial ureterectomy group were 93.0%, 66.9% and 58.8%. The multivariable Cox regression analysis revealed that tumor stage (RR = 2.468, P = 0.009) and local lymph node status (RR = 3.081, P = 0.020) were independent prognostic factors of ureteral carcinoma. The 5-year survival rate of Ta-2 stage tumor was 73.4%, and of T3-4 stage was 42.8%.</p><p><b>CONCLUSIONS</b>Tumor stage and local lymph node status are key prognostic factors of ureteral carcinoma. The efficacy between total ureterectomy and partial ureterectomy in treating early stage of low ureteral carcinoma is similar. Partial ureterectomy can be used in selective patients.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Follow-Up Studies , Prognosis , Retrospective Studies , Treatment Outcome , Ureter , General Surgery , Ureteral Neoplasms , General SurgeryABSTRACT
Objective To compare the histopathologic and immunohistochemical differences between primary renal cell carcinomas and paired bone metastases in order to discuss the significance in the selection of standard targeted therapies.Methods The clinical data of 19 patients who underwent nephrectomy and resection of bone metastases successively from January 2003 to September 2013 were analysed retrospectively.The paraffin-embedded surgical samples of all the patients were obtained for histopathologic and immunohistochemical analysis.The differences of Fuhrman grades,expression of Ki-67,CD34,vascular endothelial growth factor receptor 2 (VEGFR2),epidermal growth factor receptor (EGFR) and CXC subfamily receptor 4 (CXCR4) were compared between primary renal cell carcinomas and their paired bone metastases.Microvessel density (MVD) was evaluated by the CD34 immunostaining.Results The Fuhrman grades of samples from bone metastases were higher than that of primary tumors (36.8％,7/19) (P=0.008).The Ki-67 label index was (4.00±3.96)％ in primary tumors and (7.90±7.38)％ in bone metastases (P=0.033).The microvessel density (MVD) was 58.13±22.90 in primary tumors and 46.71±25.40 in the bone metastases (P=0.026).The immunohistochemistry scores of VEGFR2 were 4.68±1.20 in primary tumors and 4.05±1.58 in bone metastases (P=0.014).The immunohistochemistry scores of EGFR were 5.89±1.05 in primary tumors and 5.47± 1.12 in bone metastases (P=0.134).The immunohistochemistryscores of CXCR4 in cytomembrane and cytoplasm were 1.74±1.97 in primary tumors and 2.16± 1.64 in bone metastases (P=0.414).The inununohistochemistry scores of CXCR4 in cell nucleus were 2.52±2.09 in primary tumors and 3.42±1.95 in bone metastases (P=0.009).Conclusions The Fuhrman grades and the expression of Ki-67 and CXCR4 in cell nucleus were higher in bone metastases than that in the primary renal cell carcinomas.The MVD and the expression of VEGFR2 were lower in bone metastases than that in the primary tumors.The above alternations may contribute to the poor prognosis of bone metastasis and the poor result of angiosuppressive therapy.
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Objective To evaluate the efficacy of combination of traditional educational methodology with problem-based learning pedagogy in urology.Method The traditional educational pedagogy of urological tuberculosis was modified by combining with PBL methodology.Result More students were interested and active in this pedagogy.Conclusion The combination of traditional educational methodology with PBL is a helpful pedagogy.
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Objective To evaluate the efficacy and safety of ultrasonography-guided percutaneous nephrolithotomy(PCNL).Methods Between May 2006 and June 2008,110 patients underwent PCNL by a single urological team at our hospital.The clinical data of the patients were retrospectively reviewed.Of the cases,supracostal access(the 11th intercostal space) was made in 62 patients(supracostal group),and subcostal access was obtained in 48 patients(subcostal group).Forty-five patients in the supracostal group(45/62) and 36 of the subcostal group(36/48) received CT three dimensional reconstruction.Results The stone free rate of the supracostal group was 72.6%(45/62),while that of the subcostal group was 60.4%(29/48;?2=1.818,P=0.178).The mean operation time of the supracostal group was(78.6?5.1) min,while that of the subcostal group was(102.4?7.1) min(t=-20.454,P=0.000).There was one patient in each group received blood transfusion.One patient in the supracostal group had pneumothorax and recovered uneventfully by conservative treatments.Conclusion Ultrasonography-guided PCNL via the supracostal approach is effective and safe with short operation time.
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<p><b>OBJECTIVE</b>To elucidate how chronic prostatitis affects the expression and activity of the plasminogen activator (PA) system and relates to male infertility.</p><p><b>METHODS</b>Twenty-three normal fertile males and 80 chronic prostatitis patients (40 fertile and 40 infertile) were included in this research. SDS polyacrylamide gel electrophoresis and fibrin overlay method were used to estimate the total PA, and tissue PA (tPA), urokinase type PA (uPA) in semen.</p><p><b>RESULTS</b>Total PA, tPA and uPA highly expressed in normal males, but decreased in the semen of the chronic prostatitis patients of both the fertile and infertile groups. However, there was no significant difference in total PA between the fertile and infertile patients.</p><p><b>CONCLUSION</b>Chronic prostatitis reduces the secretory function and PA synthesis and secretion of the prostate, but the decrease of PA alone does not cause infertility. PA may be one of the tools for estimating the function of the prostate.</p>
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Adult , Humans , Male , Case-Control Studies , Chronic Disease , Infertility, Male , Metabolism , Prostatitis , Metabolism , Semen , Metabolism , Tissue Plasminogen Activator , Urokinase-Type Plasminogen ActivatorABSTRACT
Objective:To investigate the characteristics of severe renal hemorrhage after percutaneous nephrolithotomy(PNL) and timing of selective transarterial embolization(TAE).Methods:Between May 2005 and March 2010,superselective renal angiography was used to control severe bleeding in 15 of 1 418 cases(1 520 PNL procedures,1.06%).In the 15 cases,superselective renal angioembolization was used to control severe bleeding in 13(0.92%).The medical records of all the patients who underwent renal angiography and angioembolization were reviewed.Results:Severe bleeding cases after PNL were dividide into 3 types according to the clinical characteristics:type Ⅰ(urgency type),type Ⅱ(intermittence type) and type Ⅲ(persistant slow type).There were 3 patients in type Ⅰ,6 in type Ⅱ and 6 in type Ⅲ.All the patients had a normal coagulation profile before surgery.A total of 11 patients(84.6%) underwent the first-time successful embolization and 2(15.4%) the second-time successful embolization.The longer time between angioembolization and bleeding was,the more blood loss and transfusion volume were,except for 1 patient in type Ⅱ.Temporality serum creatinine abnormity was found in 2 patients,one with a solitary kidney patient and the other with angioembolization for both renal bleeding.Conclusion:TAE is a minimally invasive,safe,simple,and highly effective modality for the management of post PNL renal bleeding.This option should be considered early in the management of these cases,especially for Urgency type bleeding.
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Objective:To study the damage of nanobacteria on HK-2 cells,the possible principles,the effect of crystals(COM) adhering to HK-2 cells after the damage.Methods:Four groups were chosen for the study:control group,NB group,nHAP group and COM group.Morphological changes of the HK-2 cells were observed after HE stain and with TEM after 12 hours and 24 hours.Meanwhile,the levels of H2O2,LDH,MDA and ATPases were surveyed after 6 hours,12 hours and 24 hours,respectively.And 6,12,and 24 hours later,COM crystals were mixed into the culture fluids of each group.Then phalloidin-FITC was used to finish fluorescent staining of the cells.At last,the adhering effects of each group with the laser scanning confocal fluorescence microscope were observed and contrasted.Results:After HE stain and with TEM:in NB and nHAP group,the shape of the cells changed,brush borders were arranged in disorder,vacuoles formed in the kytoplasms,the mitochondria became swelled up,the karyotheca dissolved and the nucleolus disappeared in some cells.After 24 hours,in NB group,the number of the cells in which the karyotheca dissolved was more than that in nHAP group.After 12 and 24 hours,the level of H2O2 in NB group was higher than that in control group and nHAP group;After 6 and 24 hours,the level of MDA in NB group was higher than that in control group and nHAP group;At each time point,there was no significant difference in the level of LDH between control group,nHAP group and NB group;After 12 hours,the activities of Na+/K+ ATPases in NB group and nHAP group were lower than those in control group.And after 24 hours,the activity of Na+/K+ ATPases in NB group was lower than that in control group;After 12 and 24 hours,the activities of Ca2+ /Mg2+ ATPases in NB group was lower than those in control group.After 12 hours,the activity of Ca2+/Mg2+ ATPases in nHAP group was lower than that in control group.The observation with the laser scanning confocal fluorescence microscope:after 12 hours,showed that the number of the crystals adhering to the cells in NB group and COM group increased,and in COM group,some crystals had entered the cells;after 24 hours,the adhering effects of the crystals in NB and COM group were similar to those after 12 hours,but the number of adhered crystals was more than that after 12 hours;At each time point,there was no significant change in control and nHAP groups.Conclusion:Nanobacteria has a damage effect on HK-2 cells,the damage increases with the acting time expanding.The damage is more severe than that of nHAP.In the damage process of nanobacteria,the lipid peroxidation may play an important role.After the damage of nanobacteria,the adhering effect of the COM crystals to the cells increases observably,and the number of crystals adhering to the cells becomes more and more with the acting time expanding.Although nHAP also has a damage effect on HK-2 cells,it does not effect the adhering process.
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Objective:To detect,culture,and characterize the nanobacteria(NB) from sera of patients with kidney calculi in our department.Methods:Blood samples of 24 patients with kidney calculi and of 3 healthy volunteers in our department were collected for NB culture in this study.We used immunohistochemistry,von kossa staining,scanning electron microscopy(SEM),transmission electron microscopy(TEM) to investigate the appearance and components of cultural NB.Results:Twenty-two blood samples out of 24(91.67%) showed growth of NB,while no NB were detected in volunteers' blood samples.The infection rate of stone group was obviously higher than that of healthy volunteers.After a 4-week culture period,the light microscope revealed coccoid-shaped NB with a diameter of 100-500 nm,which could be identified by immunohistochemistry and von kossa staining.SEM and TEM(negative staining) revealed NB with a hollow interior coated in needle-like apatite crystals.Such nanopaticles could bud-off new ones and therefore appeared like living organisms.Conclusion:NB can be identified from sera of most patients involved in kidney calculi.It may have intimate relation to the formation of kidney calculi because the infection rate of NB blood samples of stone patients was significantly higher than that of healthy volunteers.Immunohistochemistry,von kossa staining,SEM and TEM are special methods for identifying NB from different aspects.The appearance and character are important points to distinguish NB from other nano-sized particles.
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Objective To evaluate the learning curve in percutaneous nephrolithotomy under the guidance of B ultrasonography.Methods From January 2006 to July 2007,totally 60 cases of percutaneous nephrolithotomy were performed under the guidance of B ultrasonography by a single urologist.The patients were divided into 6 groups according to the date of the operation(10 cases in each).The time for setting the renal access and the stone-free rate were compared among the groups.Results The time for setting the renal access was(15.0?2.7),(14.0?2.1),(10.2?1.2),(5.8?0.7),(7.5?1.2),and(6.6?0.9)minutes respectively in group 1 to 6.ANOVA analysis showed significant difference among the groups(F=5.734,P=0.000).Significant difference was detected between groups 1 and 4(q = 5.655,P
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Objective To investigate the genitourinar y phenotype in androgen receptor knockout (ARKO) mice. Methods Using Cre-lox technique, the female Flox-AR mice were crossed with male ACTB-Cre mice,and the genotype of their filial generations was confirmed by PCR .By screening,5 ARKO mice were generated as study subjects and 5 wild type mice served as controls.The genitourinary phenotypes of the 2 groups were compared.Th e anal genital distance and testis weight were measured;serum testosterone and e stradiol levels were assayed by ELISA. Results The anal genital distance in ARKO group was (0.5?0.1)cm,while it was (1.1?0.1)cm in wil d type group.The prostate,seminal vesicle, epididymis and spherical cavernous bo dy muscle were absent in ARKO group with the reduced testis weight of (0.006 ? 0.001)g;while those were normal with the testis weight of (0.086?0.002)g in w ild type group.The serum testosterone level in ARKO group was (0.056?0.045)nmol /L,and it was (0.843?0.736)nmol/L in wild type group.The serum estradiol level in ARKO group was (1390.1?294.3)pmol/L,and it was (786.2?150.8)pmol/L in wild type group.The differences were statistically significant between the 2 groups ( P