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Objective:To investigate the composition characteristics of urolithiasis patients in Chongqing.Methods:From May 2017 to July 2021, clinical data of 1 972 urinary stone patients treated in the Second Affiliated Hospital of Chongqing Medical University was retrospectively analyzed. Among 1 972 patients, there were 1 323 males and 649 females, the average age was (52.7±13.8) years (aged 14-92 years). In this study, all of the patients were first divided into the central and western areas of Chongqing group ( n=1 532) and southeastern areas of Chongqing group ( n=440) according to regional differences; then according to the difference of economic development level, all patients were divided into the more developed area of Chongqing group ( n=1 491) and the less developed area of Chongqing group ( n=481). To study and analyze the influence of gender, age, region and economic development level on stone composition in patients. The distribution characteristics of urinary calculi constituents in different groups of region, gender and age were analyzed by Chi-square test, and analysis of the proportion of various urinary calculi with age were conducted by Cochran-Armitage trend test. Results:The results of stone composition analysis showed that, among the 1 972 cases, the mixed urinary stones were dominant in the urinary stones [92.9%(1 832/1 972)], in which, the most component was the calcium oxalate monohydrate+ calcium oxalate dehydrate [40.8%(805/1 972)]; among the pure stones, the most component was the calcium oxalate dehydrate [2.5%(50/1 972)]. The proportion of carbonated apatite stones [53.6%(348/649) vs 43.5%(576/1 323), P<0.05], hydroxyapatite stones [25.1%(163/649) vs 17.2%(228/1 323), P<0.05] and magnesium ammonium phosphate stones [20.6%(134/649) vs 6.3%(83/1 323), P<0.05] in female patients were significantly higher than those in male patients, but the proportion of calcium oxalate stones [91.4%(1 209/1 323) vs 80.7%(524/649), P<0.05] and uric acid stones [9.4%(125/1 323) vs 1.5%(10/649), P<0.05] in male patients were significantly higher than those in female patients. Compared with patients aged 40-70 years and ≥70 years, the proportion of carbonated apatite stones [39.6%(155/391) vs 48.4%(673/1 391), 50.5%(96/190), P<0.05], magnesium ammonium phosphate stones [6.1% (24/391) vs 12.0% (167/1 391), 13.7% (26/190), P<0.05] and uric acid stones [3.3% (13/391) vs 7.4% (103/1 391), 10.0% (19/190), P<0.05] was significantly lower for patients aged <40 years; but the proportion of calcium oxalate stones in patients aged < 40 years was significantly higher [93.6%(366/391) vs 87.2%(1 213/1 391), 81.0%(154/190), P<0.05]. In this study, there were no significant difference in stone composition between the central and western areas of Chongqing and the southeastern areas of Chongqing, and between the more developed areas of Chongqing and the less developed areas of Chongqing ( P>0.05). Conclusions:There are gender and age differences in the distribution of urinary stone components in Chongqing, but the regional and economic development level differences are not particularly obvious. Carbonated apatite stones, hydroxyapatite stones and magnesium ammonium phosphate stones were more prevalent in females, calcium oxalate stones and uric acid stones were more common in males. Calcium oxalate stones were the most common in patients aged< 40 years, carbonate apatite, magnesium ammonium phosphate and uric acid stones were more common in patients aged ≥40 years.
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Objective@#To explore the effects of oleic acid and palmitic acid on lipid deposition and mTOR/S6K1/SREBP-1c pathways in HepG2 cells.@*Methods@#The model of steatosis was established with induction of oleic acid and palmitic acid and was intervened by rapamycin. The changes in lipid droplets were observed after staining the cells with oil Red O. Intracellular triglyceride (TG) contents in cells were measured by TG kit. mTOR, S6K1, and SREBP-1c mRNA expression levels were detected using QRT-PCR. Western blot was used to determine protein expression levels of mTOR, S6K1 and SREBP-1c.@*Results@#Both fatty acids increased lipid droplets in HepG2 cells. Fatty degeneration with elevated TG occurred with significant changes in oleic acid group lipids. Rapamycin alleviated lipid deposition caused by oleic acid and palmitic acid and inhibited their induction of increased expression of mTOR, S6K1, and SREBP-1c. QRT-PCR and Western blot results showed that mRNA and protein expressions of mTOR, S6K1, and SREBP-1c in oleic acid and palmitic acid group were significantly higher than the control group (P < 0.05). The increase was more pronounced in the palmitic acid group (P < 0.05); however, after rapamycin intervention, the expression of mRNA and protein in the three groups were significantly lower (P < 0.05), and the change in palmitic acid group was more pronounced (P < 0.05).@*Conclusion@#Oleic acid and palmitic acid can induce lipid deposition in HepG2 cells and increase expression of every component of mTOR/S6K1/SREBP-1c pathway; however, Oleic acid-induced lipid deposition is more pronounced, and the mTOR, S6K1, and SREBP-1c pathway change is more obvious in palmitic acid. Rapamycin has high potent inhibitory effect on palmitic acid-induced lipid deposition. These results specify that lipid synthesis involved in the mTOR/S6K1/SREBP-1c pathways are mainly associated to palmitic acid in HepG2 cells, whereas other signaling pathway may mediate oleic acid-induced lipid synthesis.
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Objective To evaluate the effectiveness and safety of flexible ureteroscopy lithotripsy (FURL) combined with holmium laser for the concurrent treatment of bilateral upper ureteral tract calculi.Methods The clinical data in 43 patients with bilateral upper ureteral tract calculi concurrently treated by FURL combined with holmium laser in our hospital from September 2014 to November 2016 were retrospectively analyzed.All cases conducted CT scanning before operation.The flexible ureteroscope was intraoperatively placed and the lithotripsy was conducted by using 200 μm optical fiber at a power of 0.8-1.0 J/10-20Hz,which was coordinated by reticular basket.After lithotripsy,bilateral urethral stents were placed.KUB or CT was re-examined on postoperative 1 d.The cases of residual stone were performed KUB again after removing urethral stent after 4-6 weeks.Results All cases were successfully placed the flexible ureteroscope by one time.The mean operation time was (101.5±37.2) min and the overall stone-free rate (SFR) was 81.4 ％ (35/43).SFR was 100％ in the patients with the stone burden less than 30 mm and 63.2％ in the patients with the stone burden ≥30 mm,the difference was statistically significant(P＜0.05).One case appeared fever (39.5 ℃) after operation,1 case developed subcapsular renal hematoma and no other severe complications occurred.Conclusion FURL combined with holmium laser is an effective means to concurrently treating bilateral upper ureteral calculi,especially for the patients with stone burden ＜30 mm,which has higher stone clearance rate with good safety.
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Objective To evaluate the effectiveness and safety of flexible ureteroscopy lithotripsy (FURL) combined with holmium laser for the concurrent treatment of bilateral upper ureteral tract calculi.Methods The clinical data in 43 patients with bilateral upper ureteral tract calculi concurrently treated by FURL combined with holmium laser in our hospital from September 2014 to November 2016 were retrospectively analyzed.All cases conducted CT scanning before operation.The flexible ureteroscope was intraoperatively placed and the lithotripsy was conducted by using 200 μm optical fiber at a power of 0.8-1.0 J/10-20Hz,which was coordinated by reticular basket.After lithotripsy,bilateral urethral stents were placed.KUB or CT was re-examined on postoperative 1 d.The cases of residual stone were performed KUB again after removing urethral stent after 4-6 weeks.Results All cases were successfully placed the flexible ureteroscope by one time.The mean operation time was (101.5±37.2) min and the overall stone-free rate (SFR) was 81.4 ％ (35/43).SFR was 100％ in the patients with the stone burden less than 30 mm and 63.2％ in the patients with the stone burden ≥30 mm,the difference was statistically significant(P＜0.05).One case appeared fever (39.5 ℃) after operation,1 case developed subcapsular renal hematoma and no other severe complications occurred.Conclusion FURL combined with holmium laser is an effective means to concurrently treating bilateral upper ureteral calculi,especially for the patients with stone burden ＜30 mm,which has higher stone clearance rate with good safety.