Analysis of risk factors for susceptibility of frequent gout attacks: A case-control study of 579 patients with primary gout / 中华内分泌代谢杂志

Objective@#To analyze the risk factors of frequent gout flare, and to evaluate its susceptibility to identify patients with≥2 acute attacks per year.@*Methods@#A total of 579 of cases gout patients with no history of taking urate lowering treatment (ULT) in recent 12 months were enrolled. The patients were divided into frequent group (gout episodes≥twice per year) and non-frequent group(gout attacks<twice per year). The clinical information was collected and relevant biochemical indices were detected.@*Results@#There were significant differences in involvement of upper limb joints, tophi, combining hypertension and renal stone between two groups. The two groups had no statistical differences in family history, gender, history of smoking and drinking, ratios of regular exercise, and combining diabetes, hepatic insufficiency, hypertriglyceridemia, hypercholesterolemia, and overweight/obesity. There was significant differences in the number of joints involved, the history of disease duration, the level of SUA and TG[(4.66±2.54) vs (2.77±1.64), (6.68±5.11) vs (5.14±3.89) years, (525.82±132.11) vs (489.33±139.81) μmol/L, (2.51±1.94) vs (2.05±1.22) mmol/L, P<0.05 or P<0.01]; There were no statistical differences in age of onset, SBP, DBP, age of initial diagnosis, fasting blood glucose, TC, creatinine, glomerular filtration rate, AST, ALT, body mass index, waist circumference, and waist-to-hip ratio. Logistic regression analysis indicated that a large number of joints involved and higher serum uric acid level were risk factors of frequent gout attacks. The ROC curve showed that the number of joints involved had qualified performance in identifying patients with frequent gout attacks. When the number of joints involved was >2, and the sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 43.3%, 85.6%, and 56.6%, respectively, and the difference was significant.@*Conclusion@#Higher SUA and a larger number of joints involved associate independently with frequent gout attacks. The number of joints involved at initial diagnosis>2, which can predict the frequent flare, and start ULT as earlier as possible. Patients with joints involved at initial diagnosis>2 are at greater risk of frequent gout flare.

Research progress on risk factors of tophus formation / 中华全科医师杂志

Tophus is the sign of chronic gout, which can lead to bone destruction, joint dysfunction, and significantly increase the risk of cardiovascular disease and death. Tophus has a structure of chronic foreign body granuloma,and extracellular reticular trap of neutrophils may be the main mechanism for the formation of tophi. Several factors can lead to the tophus formation. This article reviews the recent advances in the study of biology,risk factors and therapy of tophus.

Analysis of risk factors for hypogonadism in male patients with hyperuricemia / 中华内分泌代谢杂志

Objective:To explore the risk factors for hypogonadism in male patients with hyperuricemia(HUA).Methods:A total of 245 male patients with HUA were enrolled. Height, weight, waist circumference (WC), blood pressure, serum uric acid(SUA), triglyceride (TG), total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, alanine aminotransferase(ALT), aspartate aminotransferase, glutamyltranspeptidase, blood urea nitrogen, serum creatinine, fasting blood glucose (FPG), fasting insulin (FINS)and sex hormones were measured in all patients. And then body mass index (BMI), free testosterone(FT), and homeostasis model assessment of insulin resistance index (HOMA-IR)were calculated. Male androgen deficiency questionnaire (ADAM)and male aging symptom questionnaire (AMS)were conducted. The patients were divided into hypogonadism group ( n=102)and normal gonadal function group ( n=143) according to FT level as well as ADAM and AMS questionnaires. The differences in different metabolic indicators between the two groups and the correlation with hypogonadism were analyzed. Results:Compared with the normal gonadal function group, WC, SUA, BMI, FPG, FINS, HOMA-IR, TG, and ALT were significantly increased, while estradiol level was significantly reduced in the hypogonadism group (all P<0.05). The proportions of nonalcoholic fatty liver, hyperlipidemia, and obesity were significantly increased in the hypogonadism group (all P<0.05). Logistic regression analysis showed that SUA, BMI, WC, HOMA-IR, and TG were independent risk factors for hypogonadism in male HUA patients. Multivariate regression analysis showed that SUA still was a risk factor after adjusting for other factors. Conclusion:Male patients with HUA were often accompanied by hypogonadism. SUA, BMI, WC, HOMA-IR, and TG were risk factors for hypogonadism in male patients with HUA.

Effect of benzbromarone on body fat in patients with gout / 中华内分泌代谢杂志

Objective:To investigate the effect of urate-lowering therapy (ULT) on body fat and visceral fat areas in patients with gout and to analyze the related risk factors.Methods:A total of 140 patients with gout eligible for enrollment were recruited from the gout clinic in the Affiliated Hospital of Qingdao University from Sept. 2018 to Sept. 2019. After 2 weeks of washout, all patients were treated with benzbromarone for consecutive 12 weeks. The data of blood biochemical, body fat (BF), body fat percentage (BFP) and visceral fat area (VFA) were collected, and the differences before and after ULT as well as the risk factors affecting the changes of BF, BFP, and VFA were analyzed.Results:The diastolic blood pressure (DBP), alanine aminotransferase (ALT), serum uric acid (sUA), BF, BFP, and VFA were significantly decreased after ULT ( P<0.05). The results of multivariate stepwise linear regression analysis showed that sUA, creatinine (Cr) and glomerular filtration rate (eGFR) were independent risk factors affecting the improvement of BF and VFA (P<0.05). Lower serum uric acid levels in patients with gout before and after ULT indicated better improvement effect of body fat and visceral fat areas( P<0.05). Conclusion:Gout combined with hyperuricemia is closely related to visceral obesity. In addition to lowering the serum uric acid level, ULT could also benefit the body fat and visceral fat area in patients with gout to some extent.

Analysis of risk factors for susceptibility of frequent gout attacks: A case-control study of 579 patients with primary gout / 中华内分泌代谢杂志

Objective:To analyze the risk factors of frequent gout flare, and to evaluate its susceptibility to identify patients with≥2 acute attacks per year.Methods:A total of 579 of cases gout patients with no history of taking urate lowering treatment (ULT) in recent 12 months were enrolled. The patients were divided into frequent group (gout episodes≥twice per year) and non-frequent group(gout attacks<twice per year). The clinical information was collected and relevant biochemical indices were detected.Results:There were significant differences in involvement of upper limb joints, tophi, combining hypertension and renal stone between two groups. The two groups had no statistical differences in family history, gender, history of smoking and drinking, ratios of regular exercise, and combining diabetes, hepatic insufficiency, hypertriglyceridemia, hypercholesterolemia, and overweight/obesity. There was significant differences in the number of joints involved, the history of disease duration, the level of SUA and TG[(4.66±2.54) vs (2.77±1.64), (6.68±5.11) vs (5.14±3.89) years, (525.82±132.11) vs (489.33±139.81) μmol/L, (2.51±1.94) vs (2.05±1.22) mmol/L, P<0.05 or P<0.01]; There were no statistical differences in age of onset, SBP, DBP, age of initial diagnosis, fasting blood glucose, TC, creatinine, glomerular filtration rate, AST, ALT, body mass index, waist circumference, and waist-to-hip ratio. Logistic regression analysis indicated that a large number of joints involved and higher serum uric acid level were risk factors of frequent gout attacks. The ROC curve showed that the number of joints involved had qualified performance in identifying patients with frequent gout attacks. When the number of joints involved was >2, and the sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 43.3%, 85.6%, and 56.6%, respectively, and the difference was significant. Conclusion:Higher SUA and a larger number of joints involved associate independently with frequent gout attacks. The number of joints involved at initial diagnosis>2, which can predict the frequent flare, and start ULT as earlier as possible. Patients with joints involved at initial diagnosis>2 are at greater risk of frequent gout flare.

Relationship between vitmin D receptor rs2228570 polymorphism and susceptibility to gout in Chinese Han male population / 中华内分泌代谢杂志

Objective To explore gene polymorphism of G/A genotype of Fok Ⅰ rs2228570 (G/A) of vitamin D receptor (VDR) gene in Han male population of Chinese coastal area,and thus to investigate the relationship between the gene polymorphism of VDR and gout.Methods Altogether 504 gout patients and 523 healthy controls were enrolled.The possible association between the polymorphism of VDR rs2228570 and gout in Chinese coastal area was investigated and genotype frequencies and allelic frequencies were calculated by realtime PCR with Taqman(R)probe method.Hardy-Weinberg was used to verify the representativeness of the sample.Comparison between the groups were performed withx2 test and t-test.Results The frequencies of GG,AG,and AA genotypes were 32.1％,50.0％,and 17.9％,respectively among gout patients,while they were 27.9％,50.5％,and 21.6％ respectively among the controls.There was no statistically significant difference in VDR rs2228570 genotype frequencies between gout patients and controls(x2 =3.366,P＞0.05).The allele frequencies of G and A in gout cases were different from those in the controls(57.1％,42.9％;53.2％,46.8％;x2 =3.300,P＞0.05).Conclusions Results of the present study suggest that the G/A genotype of VDR Fok Ⅰ rs2228570 of the VDR gene is not associated with gout in male population of Chinese coastal area.

Association of single nucleotide polymorphisms of cytochrome P450 gene with susceptibility to gout in ethnic Han males from coastal regions of Shandong province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of cytochrome P450 gene single nucleotide polymorphisms (SNPs) with susceptibility to gout in ethnic Han males from coastal regions of Shandong province.</p><p><b>METHODS</b>Four hundred and eighty male patients with gout and 480 healthy male controls were included. Genotyping was carried out with a custom Illumina GoldenGate Genotyping assay to detect SNP rs2275620 of CYP2C8 gene, SNP rs2070676 of CYP2E1 gene, SNP rs837395 of CYP4B1 gene, and SNP rs194150 of TBXAS1 gene. The association was assessed with chi-square test.</p><p><b>RESULTS</b>No significant difference has been found between the two groups in regard to the genotypic and allelic frequencies of the TT, AT, AA genotypes and A, T alleles of the SNP rs2275620 of the CYP2C8 gene (P=0.88; P=0.97), the CC, CG, GG genotypes and C,G alleles of SNP rs2070676 of the CYP2E1 gene (P=0.24; P=0.09), the TT, AT, AA genotypes and A, T alleles of SNP rs837395 of the CYP4B1 (P=0.88; P=0.97), and TT, AT, AA genotypes and the A,T alleles of SNP rs194150 of TBXAS1 gene (P=0.15; P=0.06).</p><p><b>CONCLUSION</b>This study has identified no association of SNP loci rs2275620(A/T) of CYP2C8, rs2070676(C/G) of CYP2E1, rs837395(A/T) of CYP4B1 and rs194150(A/T) of TBXAS1 with gout in ethnic Han males from coastal regions in Shandong province. However, our result needs to be replicated in larger sets of patients collected from other regions and populations.</p>

Association of single nucleotide polymorphisms of susceptibility genes of type 2 diabetes mellitus with liability to gout among ethnic Han Chinese males from coastal region of Shandong / 中华医学遗传学杂志

OBJECTIVE To assess the association of single nucleotide polymorphisms (SNPs) of susceptibility genes of type 2 diabetes mellitus (T2DM) with liability to gout among ethnic Han Chinese males from coastal region of Shandong province. METHODS Seven SNPs within the susceptibility genes of T2DM, including rs10773971(G/C) and rs4766398(G/C) of WNT5B gene, rs10225163(G/C) of JAZF1 gene, rs2069590(T/A) of BDKRB2 gene, rs5745709(G/A) of HGF gene, rs1991914(C/A) of OTOP1 gene and rs2236479(G/A) of COL18A1 gene, were typed with a custom-made Illumina GoldenGate Genotyping assay in 480 male patients with gout and 480 male controls. Potential association was assessed with the chi-square test. RESULTS No significant difference was detected for the 7 selected SNPs in terms of genotypic and allelic frequencies (P > 0.05). When age and body mass index (BMI) were adjusted, the 7 genetic variants still showed no significant association with gout. CONCLUSION The genotypes of the 7 selected SNPs are not associated with gout in ethnic Han Chinese male patients from the coastal region of Shandong province. However, the results need to be replicated in larger sets of patients collected from other regions and populations.

Analysis of resistance to second-line drugs in 174 strains of multidrug resistance mycobacterium tuberculosis / 国际检验医学杂志

Objective To analyze the resistance to second-line anti-TB drugs in multi-drug resistant mycobacterium tuberculosis to provide reference for the treatment of multi drug resistant tuberculosis.Methods The data of the sputum culture and the drug sensitivity results from May 2011 to May 2013 were analyzed by the retrospective analysis method.The drug resistant rates of multi-drug resistant mycobacterium tuberculosis to 5 kinds of second-line anti-TB drug were compared.Results The resistance rates of multi-drug resistant mycobacterium tuberculosis in the initial treatment to the second-line anti-TB drugs of levofloxacin, para aminosalicylic acid,protionamide,amikacin and capreomycin in sequence from high to low were 17.7%,14.5%,12.9%,8.1%and 3.2% respectively.The resistance rate to two kinds of anti-TB drugs was 4.8%,which to 3 kinds and more than 3 kinds of an-ti-TB drugs were all 3.2%.The sequence of the drug resistance rates in the retreatment was same as to that in the initial treatment. But the resistance rates were different,which to levofloxacin,para aminosalicylic acid,protionamide,amikacin and capreomycin were 50.0%,33.9%,25.9%,21 .4% and 16.1 % respectively.The resistance rate to 2 kinds of anti-TB drugs was 16.1%,which to 3 kinds and more than 3 kinds of anti-TB drugs were 13.4% and 12.5% respectively.There were statistical significant differences in the drug resistance rate between the retreatment and the initial treatment in all various circumstances(all P <0.05).Conclusion The drug resistance rate of multi-drug resistant mycobacterium tuberculosis in our hospital is lower than the average level in our country and the drug resistance rate in the retreatment is higher than that in the initial treatment.

Clinical characteristics study of 431 cases of famili al gout in Shandong coastal regions / 中华风湿病学杂志

Objective To analyze the clinical characteristics of familial and sporadic gout patients to provide information for the classification,individual treatment and prognosis of gout.Methods The clinical and biochemical characteristies of 431 patients with familial gout and 1899 patients with sporadic gout were compared and analyzed.T test and X2 test were used for statistical analysis.Results The age at onset [(47±13) years ] and the serum uric acid level [ (472±125) μmol/L] of the familial gout patients in the acute phase were significantly lower than those of the sporadic gout patients (P＜0.05).The percentage of patients whose attack were induced by purine-rich food (67.7％ vs 88.2％),drinking (31.3％ vs 44.5％) and the first metatarsophalangeal joint involvement (69.1％ vs 77.4％ ) were significantly lower in the familial gout patients than those in the sporadic group of patients.The percentage of female was lower in the familial gout (9.7％) than in the sporadic patients(6.6％,P＜0.05).The percentage of patients with ankle joint (18.1％ vs 11.3％) and no obvious predisposing causes (25.2％ vs 2.5％ ) were higher in the familial gout patients than in the sporadic patients (P＜0.05).The percentage of patients with complicated lipid metabolism disorders was significantly higher in the familial gout patients than in the sporadic patients (P＜0.05).Conclusion The familial gout patients in Shandong coastal regions are early in disease onset,with lower serum uric acid level and more frequent in women.Detailed family history should be collected,and early prevention and appropriate treatment should be emphasized.

A clinical analysis of multilocular cystic renal cell carcinoma and its correlation with mutation of the von Hippel-Lindau gene / 中华泌尿外科杂志

Objective To discuss the diagnosis and surgical management of multilocular cystic renal cell carcinoma (MCRCC) and to evaluate the gene function of the mutation of von Hippel-Lindau (VHL) gene in MCRCC. Methods Seventeen MCRCC cases (11 men and 6 women) out of 512 cases of renal cell carcinoma from 2000 to 2010 were retrospectively analyzed. The mean age of the 17 patients was 46 years (37-61 years). Ultrasonography and CT were available in all 17 cases, and 1 case was misdiagnosed as parapelvic renal cyst. The mutation of VHL gene was detected by PCR in the specimens of can-cerous tissue and adjacent normal tissue from 11 cases of MCRCC. Results Three of 17 cases underwent nephron sparing surgery, the others underwent radical nephrectomy. One case underwent unroofing of parapelvic renal cyst, but the rapid frozen pathology of the cyst wall showed renal cell carcinoma of clear type. As a result, radical nephrectomy was eventually performed. All 17 cases were confirmed as MCRCC by eva-luating pathological characteristics, such as the cyst wall lined by single or several layers of clear tumor cells and the nuclei which were small and anachromasis. Clinical stages of all cases were T1N0M0, in which there were 14 cases with pathological T1G1 and 3 cases with pathological T1G2. All patients underwent a follow-up of 9 to 36 months (mean, 12 months) without recurrence or metastasis. Mutation of VHL gene was detected in 7 of 11 cases (64%), but all adjacent normal tissues were negative. Conclusions As a rare subtype of renal cell carcinoma, MCRCC is difficult to diagnose. CT is an essential measure in diagnosis of MCRCC preoperatively. Because of the good prognosis of reported cases, nephron sparing surgery for the treatment of MCRCC is recommended. VHL gene mutations may play an important role in the carcinogenesis of MCRCC.

The progress on the research of the relationship between hyperuricemia and cardiovascular disease / 中华内分泌代谢杂志

Lots of studies have identified the relationship between hyperuricemia and cardiovascular diseases. Many factors affect the metabolism of uric acid, such as diet, drug, internal environment of organism, etc. However, the relationship between hyperuricemia and cardiovascular diseases is not quite clear. In this review, we present recently published data about the association between hyperuricemia and selected cardiovascular diseases.

Clinical analysis of iatrogenic ureteral injury and bladder injury / 中华泌尿外科杂志

Objective To investigate the etiology and treatment of iatrogenic ureteral injury(IUI) and bladder injury(IBI). Methods Forty-seven patients(7 males, 40 females) with ureteral and bladder inju-ries caused as a result of any medical procedures were reviewed from 1996 to 2007. Obstetrics and gynecolog-ical, urological,general surgical procedures were involved in 38, 6, and 4 of the injuries respectively. Re-sults Sixteen cases of IUI were found during operation, including 14 cases of entire ureteral laceration, 4 cases of partial ureteral laceration. Thirteen cases received ureteral anastomosis, one case received uretero-neopyelostomy. One case of ureteral perforations during ureteroscopic procedure was indweUed of double-J after the operation was terminated immediately. Three cases received nephrectomy. Four cases of lower ure-teric suture ligation and three cases of ureterovaginal fistula were detected at 3 days～ one week of postopera-tion. These 7 cases were received ureteroneocystomy during 2 weeks after the initial surgical procedure. Nineteen cases of IBI were found during operation, the length of cystic wound was ranging from 1 cm to 3 cm. 17 cases underwent repairing, 2 eases of bladder perforation which caused by endourologic or TVT procedure received catheterization for 1 week. Five cases of vesicovaginal fistula which were found during one week--one month of post-operation, were received fistula resection and bladder repairing 3 months after of initial operation. Forty-seven cases were follow-up ranging from 5 months to 11 years after the second opera-tion,mean time were 47 months. All cases were recovered. Conclusions Intraoperative findings and effec-tive treatments can achieve good therapeutic effects and avoid injury during secondary operation. Correct treatment of urinary fistula can promote cure rate.

Case report of primary pigmented nodular adrenocortical disease and literature review / 中华泌尿外科杂志

Objective To investigate the clinical features and the management of primary pigmented nodular adrenocortical disease PPNAD) and to evaluate its relationship with Carney complex. Methods One case of PPNAD reported. The patient was a 52 years oldmale. He was hospitalized because of hypertension for one year. The patient had a Cushing's face with elevated plasma and urine cortisone levels which could not be suppressed by both low dose and high dose dexamethasone tests. Ultrasonography howed normal bilateral adrenal glands. CT scan found a 1.6 cm × 2.0 cm mass in the left adrenal gland and normal on tralateral adrenal gland. Results The patient had accepted left laparoscopic adrenalectomy. The pathological examination onfirmed the diagnosis of PPNAD. Micro scopic study showed that there were black-gray spots in the center of the specimen. Hyperplasia was found in all the three adrenal zones. Lipofuscin was observed in the cytoplasm of reticular zone cells. The patient's blood pressure had returned to normal level after the surgery. Conclusions PPNAD is a rare type of ypercortisolism. As there is no specific feature in clinical manifestation and radiological examination of this disease, it is very easy to make a misdiagnosis in clinical practice. PPNAD itself can be the comorbidity of Carney complex, careful differentiation is needed.

Experience of ipsilateral laparoseopic reoperations in urology / 中华泌尿外科杂志

Objective To evaluate the feasibility and clinical results of laparoseopic reoperation for patients with history of previous ipsilateral urology laparoscopic surgeries. Methods Thirteen patients that underwent second ipsilateral urology laparoscopic surgeries were retrospectively ana-lysed. The reasons for a second operation included nonfunctional kidney after pyeloplasty, ure-terolithotomy or pyelolithotomy in 4 cases, recurrence of urinary calculi in 3 cases, pelviureteric june-tional stenosis after pyeloplasty in 1 case, recurrence of renal cyst in 1 case, recurrence of adrenal tumor in 1 case, residual adrenal tumor in 1 case, progression of polycystic kidney in 1 case and renal carcinoma after laparoscopic surgery for renal cyst in 1 case. Transperitoneal laparoscopie surgeries were performed in all cases and the first trocar was placed with open incision to avoid puncture injury. The adhesion between intestines and retroperitoneal space was dissected to expose the operative field. The lateral peritoneum and perirenal fascia were sutured after surgery in all cases except nephrectomy cases. Results For the first operation, the mean operative time was 93 min, the mean estimated blood loss was 70 ml and the average postoperative hospital stay was 4.8 d. The second operations on the 13 cases were successfully performed with mean operative time of 97 rain, mean estimated blood loss of 62 ml and average postoperative hospital stay of 5.0 d which were not significantly different from the first operation parameters(P＞0.05). During the secondary operations, adhesions and abnor-mal anatomic structure observed increased the difficulty of surgery. All patients after secondary opera-tions were followed up for 2--24 months and no major complication was observed. Conclusion La-paroscopic reoperation on patients with history of ipsilateral urology laparoscopic surgery is feasible in skilled and experienced hands and in properly selected cases.

Effect of electrovaporization on the prostate and its surrounding tissues / 中华男科学杂志

<p><b>OBJECTIVE</b>Transurethral electrovaporization of the prostate (TVP) for benign prostatic hyperplasia (BPH) has proven to be efficacious with lower morbidity than transurethral resection of the prostate (TURP) on clinical studies. However, no histopathologic data are available to support the clinical findings in human studies. The following study was done using a canine model in an effort to evaluate these histopathologic changes.</p><p><b>METHODS</b>Nine canines received antegrade electrovaporization or resection of the prostate, via an open cystoma, using Storz series resectoscope and video equipment. The dogs were sacrificed and their prostates harvested at 0 week (immediately after operation), 1 week or 5 weeks after electrovaporization or resection. The prostates were evaluated grossly as well as histologically for cavitary defects and depth of necrosis.</p><p><b>RESULTS</b>Prostate examination revealed superficial necrosis (less than 1.8 mm deep) at 0 week following the 270 watts operation, and less than 3 mm deep necrosis with acute inflammation and focal hemorrhage at 1 week. The depths of necrosis were less than 1.3 mm and 2.2 mm at 0 week and 1 week after the 180 W electrovaporizion. And the 120 W resection resulted in necrosis 1.1 mm and 1.6 mm deep at most, which was localized in the vaporized prostate only, with no histopathologic change in the surrounding tissues. Epithelial stratification was underway by the fifth week, but with inflammation.</p><p><b>CONCLUSION</b>TVP in the canine model showed only shallow necrosis at the site of the vaporization. These data provide a histopathologic rationale for the minimal morbidity and efficacious nature of this technique demonstrated in clinical studies.</p>

Spiral CT urography and CT virtual endoscopy in detecting urological diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate spiral CT urography (SCTU) and CT virtual endoscopy (CTVE) in detecting urologic diseases.</p><p><b>METHODS</b>SCTU was performed in 46 patients with urological diseases including renal neoplasms (2), paropelvic cysts (2), ureteral calculi (6), ureteral stenosis (4), ureteral neoplasms (2), double kidneys and ureter malformation (1), bladder neoplasms (28) and bladder endometreosis (1). The 6 patients with ureteral diseases and 29 patients with bladder diseases underwent CTVE based on spiral CT scan. All CTVE findings were compared with those of B-mode ultrosonography, intravenous urography (IVU), retrograde pyelography (RGP), conventional CT or cystoscopy.</p><p><b>RESULTS</b>All upper urinary tract diseases and bladder diseases (28 cases) were detected by SCTU and CTVE scans and they were confirmed operatively or pathologically except one case of bladder neoplasm (diameter less than 5 mm) was missed.</p><p><b>CONCLUSION</b>SCTU and CTVE have proved to be non-invasive and reliable in the diagnosis of urological diseases and are superior to IVU or conventional CT. CTVE can serve as a supplementary method to fiberoptic cystoscopy or ureteroscopy.</p>

Influential factors of Ho:YAG laser lithotripsy in management of ureteral calculi / 中华泌尿外科杂志

Objective To evaluate the clinical effect of Ho:YAG laser lithotripsy in management of ureteral calculi and to investigate its influential factors. Methods The data of 137 cases of ureteral calculi (66 males and 71 females;aged 19-71 years with a mean of [(45.0?10.4)years;disease course from 4 days to 10 years with a mean of (1.50?0.65)years] treated via ureteroscope with Ho:YAG laser lithotripsy were analyzed retrospectively.Of them 112 cases had 1 stone,and 25 had more than one.Fifty five cases had stones on the left side,71,on the right side;11,on both sides;107 cases had stones in the lower ureter and 30,in the middle or upper ureter.The size of the stones were 0.6-2.0 cm in diameter with a mean of ( 1.1? 0.3) cm.Of them 23 cases had ureteral polyp and they underwent Ho:YAG laser vaporization resection of the polyp;11 cases had ureteral stricture and they underwent ureter dilatation or Ho:YAG laser incision of the stricture and lithotripsy.Double J tube was placed after operation. Results The overall stone fragmentation rate was 94.9%(130/137) with a single procedure.Stone free time was 5-56 d with a mean of ( 21.5 ?13.4) d.Operating time was (20-120)min with a mean of (60.4?18.3)min.Post operative hospital stay was 1～10 d with a mean of (2.4?1.1)d.In the successful operation group (130/137),the mean stone size was (1.03?0.24)cm in diameter, while in the failure group it was (1.47?0.51) cm. Four cases of the failure group had ureteral stricture;2 of them underwent shift to open operation, the other 2 experienced failure because of difficulty of placing D J tube. Three cases also experienced failure because of stone shift in the operation;of them 1 underwent shift to open operation,the other 2 were treated by ESWL.The differences of the stone size,concomitant ureteral stricture, stone shift in operation between success group and failure group were statistically significant ( P