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Objective To compare the safety and efficiency of totally ultrasonography-guided super-mini-percutaneous nephrolithotomy(SMP) in the treatment of upper urinary stone in adults and children (＜ 14years).Methods From May 2015 to July 2018,81 cases of children(53％) and 71 (47％) cases of adults with upper tract stones underwent the SMP by total ultrasound guidance.In the group of children,it's including 53 male and 28 female with 85 channels in total,the patients age ranged from 10 months to 14 years,[mean (56.0 ± 39.7) months],The stone size ranged from 0.8-3.5 cm,[mean (1.7 ± 0.7) cm].About stone distribution,42 cases of pelvic stones,25 cases of calyceal and pelvic stones,5 cases of calyceal stones,7 cases of upper uretaral stones,1 case of upper ureteral and calyceal stones,1 case of malformation with double renal pelvis and ureter.Urinary infection rate was 86.4％ (70/81),positive rate of urinary culture was 39.5％ (32/81).In the group of adults,it's including 43 male and 28 female,the patients aged from 18 to 81 years,[mean (44.1 ± 15.4) years],The stone size ranged from 1.0-3.0 cm,[mean (1.7 ± 0.6) cm].About Stone distribution,19 cases of pelvic stones,13 cases of calyceal and pelvic stones,7 cases of calyceal stones,24 cases of upper uretaral stones,3 cases of upper ureteral and calyceal stones,1 case of malformation with double renal pelvis and ureter.Urinary infection rate was 87.3％ (62/71),positive rate of urinary culture was 26.8％ (19/71).The patient was placed in the lithotomy position under general anesthesia.A 5F ureteric catheter was retrogradely inserted into the collecting system and urethral catheter was placed in the bladder.The patient was then turned prone.The selected calix was punctured under ultrasound guidance by 18G puncture needle and a 0.032 inch guidewire was inserted into the collecting system.Nephrostomy tract was established using Dilators(it was done in one step for 12F and in two steps for 14F).After the corresponding size of suction-evacuation sheath was placed,the sheath was connected to the specimen collection bottle via the oblique branch of a metal connector.The miniature endoscope was inserted into the sheath to observe the collecting system and stone fragmentation was completed by using YAG laser or pneumatic lithotripter.Stone free rate after surgery at lday(SFR) and 1 month(1 month SFR),stone size,operative time(from starting fragmentation to the end of the surgery),hemoglobin drop and hematocrit drop in the first day after surgery,rate of surgecal complications,tubeless rate (totally tubless:no ureteric stent and nephrostomy tube;tubeless:no nephrostomy tube but ureteric stent),average length of hospital stay and urinary infection were recorded and compared.Results In children group,mean operative time was (27.7 ± 13.0)min(range 5-60 min),SFR and SFR at 1 month were 96.3％ (78/81)and 98.8％ (80/81),mean hemoglobin drop was (8.0 ± 9.1) g/L(range 0-41 g/L),mean hematocrit drop was 0.026 ±0.029(range 0-0.135),totally tubeless rate was 86.4％ (71/81),mean hospital stay was (2.5 ±0.9)days(range 1-5 days).Complications were observed in 9 cases and classified using Calvien grading system,Grade Ⅰ in 8 cases:postoperative fever in 4,hematuresis in 1,perirenal hematoma,postoperative distal ureteral stone in 1 cases and delayed recovery of intestinal function in 1 case,all had a spontaneous recovery without special managements;Grade Ⅲ b in 1 case,massive ascites was discovered during the surgery,and rcovered by puncture drainage.In adult group,mean operative time was (31.2 ± 15.3) min(range 7-80 min),SFR and SFR at 1 month were 97.2％ (69/71) and 98.6％ (70/71),mean hemoglobin drop was (11.9 ± 8.7) g/L (range 0-32 g/L),mean hematocrit drop was 0.030 ± 0.027 (range 0-0.106),totally tubeless rate was 87.3％ (62/71),mean hospital stay was (2.4 ± 1.1) days (range 1-8 days),urinary infection rate was 87.3％ (62./71),positive rate of urinary culture was 26.8％ (19/71).Complications were observed in 4 cases,Grade Ⅰ in 3 cases:hematuresis in 2 and delayed recovery of intestinal function in 1 case,all had a spontaneous recovery without special managements;Grade Ⅲ b in 1 case,postoperative distal ureteral stone in 1 cases and cured by ureteroscopic lithotripsy.According to data about Hb drop,risk of hemorrhage is lower in children than adult significantly (P ＜ 0.05).There is not significant difference in stone free rate,stone size,operative time,hematocrit drop,surgery complications,totally tubeless rate,stone complexity,average length of hospital stay and urinary infection (P ＞ 0.05).Conclusions With the characteristics of safe,efficacious and rapid recovery,super-mini-percutaneous nephrolithotomy (SMP) can be used as the first choice of the treatment for upper urinary stone both in adults and children.
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Objective@#To compare the safety and efficiency of totally ultrasonography-guided super-mini-percutaneous nephrolithotomy(SMP) in the treatment of upper urinary stone in adults and children(<14years).@*Methods@#From May 2015 to July 2018, 81 cases of children(53%) and 71(47%) cases of adults with upper tract stones underwent the SMP by total ultrasound guidance. In the group of children, it’s including 53 male and 28 female with 85 channels in total, the patients age ranged from 10 months to 14 years, [mean (56.0±39.7) months], The stone size ranged from 0.8-3.5 cm, [mean (1.7±0.7)cm]. About stone distribution, 42 cases of pelvic stones, 25 cases of calyceal and pelvic stones, 5 cases of calyceal stones, 7 cases of upper uretaral stones, 1 case of upper ureteral and calyceal stones, 1 case of malformation with double renal pelvis and ureter. Urinary infection rate was 86.4%(70/81), positive rate of urinary culture was 39.5%(32/81). In the group of adults, it’s including 43 male and 28 female, the patients aged from 18 to 81 years, [mean (44.1±15.4)years], The stone size ranged from 1.0-3.0 cm, [mean (1.7±0.6)cm]. About Stone distribution, 19 cases of pelvic stones, 13 cases of calyceal and pelvic stones, 7 cases of calyceal stones, 24 cases of upper uretaral stones, 3 cases of upper ureteral and calyceal stones, 1 case of malformation with double renal pelvis and ureter. Urinary infection rate was 87.3%(62/71), positive rate of urinary culture was 26.8%(19/71). The patient was placed in the lithotomy position under general anesthesia. A 5F ureteric catheter was retrogradely inserted into the collecting system and urethral catheter was placed in the bladder. The patient was then turned prone. The selected calix was punctured under ultrasound guidance by 18G puncture needle and a 0.032 inch guidewire was inserted into the collecting system. Nephrostomy tract was established using Dilators(it was done in one step for 12F and in two steps for 14F). After the corresponding size of suction-evacuation sheath was placed, the sheath was connected to the specimen collection bottle via the oblique branch of a metal connector. The miniature endoscope was inserted into the sheath to observe the collecting system and stone fragmentation was completed by using YAG laser or pneumatic lithotripter. Stone free rate after surgery at 1day(SFR) and 1 month(1 month SFR), stone size, operative time(from starting fragmentation to the end of the surgery), hemoglobin drop and hematocrit drop in the first day after surgery, rate of surgecal complications, tubeless rate(totally tubless: no ureteric stent and nephrostomy tube; tubeless: no nephrostomy tube but ureteric stent), average length of hospital stay and urinary infection were recorded and compared.@*Results@#In children group, mean operative time was (27.7±13.0)min(range 5-60 min), SFR and SFR at 1 month were 96.3%(78/81)and 98.8%(80/81), mean hemoglobin drop was (8.0±9.1)g/L(range 0-41 g/L), mean hematocrit drop was 0.026±0.029(range 0-0.135), totally tubeless rate was 86.4%(71/81), mean hospital stay was (2.5±0.9)days(range 1-5 days). Complications were observed in 9 cases and classified using Calvien grading system, Grade Ⅰ in 8 cases: postoperative fever in 4, hematuresis in 1, perirenal hematoma, postoperative distal ureteral stone in 1 cases and delayed recovery of intestinal function in 1 case, all had a spontaneous recovery without special managements; Grade Ⅲb in 1 case, massive ascites was discovered during the surgery, and rcovered by puncture drainage.In adult group, mean operative time was (31.2±15.3)min(range 7-80 min), SFR and SFR at 1 month were 97.2%(69/71) and 98.6%(70/71), mean hemoglobin drop was (11.9±8.7)g/L(range 0-32 g/L), mean hematocrit drop was 0.030±0.027(range 0-0.106), totally tubeless rate was 87.3%(62/71), mean hospital stay was(2.4±1.1)days(range 1-8 days), urinary infection rate was 87.3%(62/71), positive rate of urinary culture was 26.8%(19/71). Complications were observed in 4 cases, Grade Ⅰ in 3 cases: hematuresis in 2 and delayed recovery of intestinal function in 1 case, all had a spontaneous recovery without special managements; Grade Ⅲb in 1 case, postoperative distal ureteral stone in 1 cases and cured by ureteroscopic lithotripsy. According to data about Hb drop, risk of hemorrhage is lower in children than adult significantly(P<0.05). There is not significant difference in stone free rate, stone size, operative time, hematocrit drop, surgery complications, totally tubeless rate, stone complexity, average length of hospital stay and urinary infection(P>0.05).@*Conclusions@#With the characteristics of safe, efficacious and rapid recovery, super-mini-percutaneous nephrolithotomy(SMP) can be used as the first choice of the treatment for upper urinary stone both in adults and children.
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Aim To explore the antidepressant effect and the mechanism of self-made prescription of strengthening spleen and replenishing Qi ( SMP-SS-RQ) . Methods The depression model of chronic un-predictable mild stress ( CUMS ) was established in mice. The animals were randomly divided into control group, model group, SMP-SSRQ low, middle and high dose groups (8, 16, 32 mg·kg-1), with 12 mice for each group. The control group and the model group were given the same volume of saline, and other groups were given corresponding dose of SMP-SSRQ. Animals of each group were administered by gavage twice a day for two weeks. Behavioral indexes of mice were deter-mined by open field experiment, sugar consumption test, forced swimming test and tail suspension test. Quantitative real-time PCR (qPCR) and Western blot were respectively performed to detect mRNA and pro-tein expression levels of Igsf11 , Pdia2 and Sec14 l2 inprefrontal cortex and hippocampus. Results Com-pared with model group, depressed mice' s horizontal mobile score, upright number and the sugar water pref-erence index increased and FST as well as TST de-creased in all SMP-SSRQ groups(P<0.05). The de-pression symptoms in mice were obviously improved by SMP-SSRQ therapy. Low and high doses of SMP-SSRQ significantly reduced mRNA and protein expression lev-el of Igsf11 , Pdia2 and Sec14 l2 in the prefrontal cortex and hippocampus of the depressed mice, presenting significant statistical difference compared with model group ( P<0.05 ) . Conclusions SMP-SSRQ can ef-fectively improve mouse depressive behavior, and its mechanism may be related to the down-regulation of Igsf11 , Pdia2 and Sec14 l2 in mouse prefrontal cortex and hippocampus.
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ABSTRACT: The objective of this study was to compare two methods of evaluation of potencial acidity (H+Al) and two methods to estimate liming requirement (LR) for soils from the west region of Santa Catarina State, Brazil. Fourteen soils were incubated with 7 lime rates for 120 days, obtaining the real values of H+Al at pH 7.0 and LR. These values were used as reference to evaluate the accuracy of two H+Al estimating methods: SMP buffer and calcium acetate at pH 7.0, and to evaluate the accuracy of two LR methods: base saturation (BS) and SMP index. On average, H+Al was underestimated in 6 and 40% by SMP and calcium acetate methods, respectively, especially in soils with high buffer capacity. The LR was underestimated in 20 and 30% by SMP index and BS, respectively. The SMP Index showed a better LR estimative than BS, especially in soils with high buffer capacity.
RESUMO: O estudo objetivou comparar dois métodos de avaliação de acidez potencial (H+Al) e de estimativa da necessidade de calagem (NC) para solos da região Oeste de Santa Catarina (SC). Quatorze solos foram incubados com 7 doses de calcário durante 120 dias, obtendo-se ao final os valores reais de H+Al a pH 7,0 e a NC dos solos. Esses valores serviram de referência para avaliar a exatidão dos métodos de estimativa do H+Al: tampão SMP e acetato de cálcio a pH 7,0 e a exatidão dos métodos de estimativa da NC: índice SMP e saturação por bases (V%). Em média, o H+Al foi subestimado em 6 e 40% pelos métodos SMP e acetato de cálcio, respectivamente, sendo mais problemático nos solos de maior tamponamento. Já a NC foi subestimada em 20 e 30% pelo Índice SMP e V%, respectivamente. O índice SMP estimou melhor a NC que o método V%, principalmente em solos de maior tamponamento.
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Objective To evaluate the effect of hydrogen peroxide (H2O2) on a senescence marker protein-30 (SMP30) and an autophagy-related protein microtubule-associated protein 1 light chain 3 type Ⅱ (LC3-Ⅱ) in normal human skin fibroblasts (NHSFs).Methods NHSFs were isolated from the foreskin of children,and subjected to culture in vitro.The second-to fourth-passage NHSFs were treated with 150 μmol/L H2O2 for 2 hours to establish a model for cellular senescence,while un-treated NHSFs served as control group.Senescence-associated β-galactosidase (SA-β-gal) staining was performed to determine the percentage of senescent cells,indirect immunofluorescence assay to determine the expression of the autophagy-related protein LC3,reverse transcription PCR (RT-PCR) to measure the mRNA expression of SMP30,and Western blot analysis to measure the protein expression of SMP30 and LC3.Results The percentage of senescent (SA-β-gal-positive) cells was significantly higher in the H2O2 group than in the control group (41.70％ ± 2.95％ vs.3.03％ ± 0.25％,t =22.59,P ＜ 0.05).Indirect immunofluorescence assay showed that the percentage of LC3-positive cells was significantly lower in the H2O2 group than in the control group (12.60％ ± 1.57％ vs.23.67％ ± 3.04％,t =5.61,P ＜ 0.05).As Western blot analysis showed,no significant difference in the expression of LC3-Ⅰ (LC3-Ⅰ/glyceraldehyde-3-phosphate dehydrogenase [GAPDH] ratio) was observed between the H2O2 group and control group (0.40 ± 0.02 vs.0.41 ± 0.04,P ＞ 0.05),while the H2O2 group showed significantly lower expression of LC3-Ⅱ (LC3-Ⅱ/GAPDH ratio:0.20 ± 0.02 vs.0.80 ± 0.03,t =29.69,P ＜ 0.05) and lower LC3-Ⅱ/LC3-Ⅰ ratio (0.51 ± 0.03 vs.1.98 ± 0.23,t =10.967,P ＜ 0.05) compared with the control group.Moreover,the mRNA and protein expression of SMP30 (SMP30/GAPDH ratio) was significantly lower in the H2O2 group than in the control group (mRNA:0.16 ± 0.01 vs.0.35 ± 0.01;protein:0.27 ± 0.02 vs.0.63 ± 0.02,both P ＜ 0.05).Conclusion H2O2 can decrease the expression of SMP30 and LC3-Ⅱ in NHSFs,and accelerate the senescence of NHSFs.
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Objective To evaluate the safety and efficacy of super mini-percutaneous nephrolithotomy (SMP) by ultrasound-guided renal access in pediatric with renal calculus.Methods From May to August 2015, 20 pediatric patients with upper tract stones underwent the SMP by ultrasound guidance.The patients aged 11-144 months , median age 31.5 months, The stone size ranged 0.8-2.5 cm, mean(1.48 ±0.59) cm.Among the 20 children, single pelvis stones were in 8, multiple stones in 10 and upper ureter stones in 2.All patients had no previous surgery treatment.The SMP system consists of a F6.0 -7.5 nephroscope and a modified F12-14 access sheath with suction-evacuation function.Nephrostomy tract dilation was performed up to F12-14 and lithotripsy procedure was performed by using pneumatic lithotripter.Nephrostomy tube or double J stent was placed only if clinically indicated.Results The stone size was 0.8-2.5 cm ,mean (1.48 ± 0.59)cm.Among the 20 children, there were 8 patients with single pelvis stone, 10 with multiple stones and 2 with upper ureter stones.All the patients were completed successfully without surgery conversion.Mean operative time ranged 6-40 minutes ,mean(17.6 ± 11.6) minutes.The stone free rate was 100％ after the evaluation in the postoperative day.The hemoglobin drop was 2-16 g/L,mean (7.6-± 4.1) g/L.No major complications occurred, neither patient required transfusion.The tubeless PCNL without double J stents and nephrostomy tubes placed were achieved in all patients.Only 14 patients had a ureter catheter placement for one day.The average hospital stay ranged 1-4 days, mean (2.4 ± 0.8) days.Conclusions SMP could be a safe and effective treatment for kidney stone up to 2.0 cm in pediatric cases with advantages of short recovery time, high stone free rate and no catheter placement.SMP could be the ideal procedure for children with upper urinary tract calculus.
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We studied how consumption of vitamin C (VC) affects the oxidative stress regulation system. SMP30/GNL knockout mice (males, n = 33), which cannot synthesize VC, were randomly divided into three groups: the VC 100 Group consuming 1.5 g/L VC, the VC 2.5 Group consuming 0.0375 g/L VC, and the VC 0 Group consuming 0 g/L VC. To examine the oxidative stress regulation system, the reactive oxygen metabolites (d-ROM test) and biological anti-oxidant potential (BAP test) values were measured, and the BAP/d-ROM ratio was calculated. We obtained measurements at the beginning of the study (5 weeks old: baseline) and after VC consumption for 9 weeks (14 weeks old: 9 wk). For the plasma VC concentration, plasma reduced (ascorbic acid (AA)) and plasma oxidized (dehydroascorbic acid (DHA)) were measured at 9 wk, and the total VC (AA + DHA: total) concentration was calculated. Compared to the other groups at 9 wk, the VC 100 Group showed a significantly lower value for the d-ROM test, a significantly higher value for the BAP/d-ROM ratio, no significant difference in the BAP test, and a significantly lower senescence grading score. The VC 100 Group showed a significantly higher total VC concentration compared with the other groups. Differences in consumption of VC caused a change in the d-ROM test, the BAP/d-ROM ratio, and the plasma VC concentration.<br>
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Este artigo analisa como a regulação do Serviço Móvel Pessoal (SMP), implementada pela Anatel em 2001, alterou a estrutura do mercado e as estratégias das operadoras do setor de telefonia móvel no Brasil, entre 2002 e 2007. Foi realizada uma pesquisa qualitativa e um estudo de caso múltiplo acerca das maiores operadoras do setor: Vivo, Tim, Claro e Oi. Diante da análise setorial e da influência de fatores externos sobre a estrutura do mercado, adotou-se o referencial teórico clássico de estratégia competitiva a fim de se entender as estratégias das operadoras. Adotou-se também um referencial mais específico do setor de telecomunicações, com destaque para trabalhos que discutem a convergência entre as telefonias fixa e móvel. Entre as conclusões do trabalho estão os efeitos de caráter deliberado das mudanças na regulação sobre as estratégias empresariais do setor, entre elas a adoção generalizada de estratégias de custo até o lançamento de serviços inovadores no mercado nacional, caracterizados pela integração entre as operadoras de telefonias fixa e móvel, promovendo estratégias de diferenciação, claramente representadas pela formação de dois grupos estratégicos: um com serviços convergentes do tipo bundle e relações de quase integração vertical entre operadoras fixas e móveis e outro com serviços convergentes entre operações de telefonia fixa e móvel verticalmente integradas.
This article analyzes how PMS (Personal Mobile Service) regulation made by Anatel in Brazil in 2001 changed the market structure and the operators' strategies for the telephony sector between 2002 and 2007. It was carried out a quantitative research and a multiple case study about the main operators in Brazil: Vivo, Tim, Claro and Oi. According to this sector analysis and the influence of external factor as regards the market structure, the classic theoretical reference of competitive strategy was used to better understand the operators' strategies. It was also used a more specific reference for the telecommunications sector featuring the works related to the convergence between the landline and mobile telephony. Within the conclusions of this paper, there are the effects related to cost strategy until the rollout of innovative service on a marketwide basis. They are deemed by the integration between the operators of landline and mobile telephony by promoting strategies of differentiation clearly presented by the formation of two strategic groups: the former related to convergent services bundle type and relations of quasi-vertical integration between the landline and mobile operators and the latter related to convergent services between vertically integration landline and mobile operators.
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Organizations , Competitive Behavior , Cell Phone , BrazilABSTRACT
BACKGROUND: Peripheral nerve injury induces up-regulation of the calcium channel alpha2delta (alpha2delta) subunit and TRPM8 in the dorsal root ganglion (DRG) which might contribute to allodynia development. We investigated the expression of the alpha2delta subunit and TRPM8 in the DRG of sympathetically maintained pain (SMP) and sympathetic independent pain (SIP) rat model. METHODS: For the SMP model, the L5 and L6 spinal nerves were ligated tightly distal to the DRG. For the SIP model, the tibial and sural nerves were transected, while the common peroneal nerve was spared. After a 7 day postoperative period, tactile and cold allodynia were assessed using von Frey filaments and acetone drops, respectively. Expression of the alpha2delta subunit and TRPM8 in the L5 and L6 DRG were subsequently examined by a Western blot. RESULTS: There were no significant differences between the two models for the thresholds of tactile and cold allodynia. Expression of the alpha2delta subunit in the ipsilateral DRG to the injury was increased as determined on a Western blot as compared to that in the contralateral or sham-operated DRG of the SMP model, but there was no difference in expression seen with the use of the SIP model. There was no difference in the expression of TRPM8 in the ipsilateral DRG to the injury and the contralateral or sham-operated DRG of either model. CONCLUSIONS: Up-regulation of the alpha2delta subunit in injured DRG may play a role that contributes to tactile allodynia development in SMP, but not TRPM8 to cold allodynia after peripheral nerve injury.
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Animals , Rats , Acetone , Blotting, Western , Calcium Channels , Cold Temperature , Diagnosis-Related Groups , Ganglia, Spinal , Hyperalgesia , Organic Chemicals , Peripheral Nerve Injuries , Peroneal Nerve , Polyenes , Postoperative Period , Spinal Nerve Roots , Spinal Nerves , Sural Nerve , Up-RegulationABSTRACT
Pregabalin binds to the voltage-dependent calcium channel alphadelta subunit and modulates the release of neurotransmitters, resulting in analgesic effects on neuropathic pain. Neuropathic pain has both sympathetically maintained pain (SMP) and sympathetic independent pain (SIP) components. We studied the antiallodynic effects of pregabalin on tactile allodynia (TA) and cold allodynia (CA) in SMP-and SIP-dominant neuropathic pain models. Allodynia was induced by ligation of the L5 & L6 spinal nerves (SMP model) or by transection of the tibial and sural nerves (SIP model) in rats. For intrathecal drug administration, a PE-10 catheter was implanted through the atlantooccipital membrane to the lumbar enlargement. Pregabalin was administered either intraperitoneally (IP) or intrathecally (IT) and dosed up incrementally until an antiallodynic effect without sedation or motor impairment was apparent. TA was assessed using von Frey filaments, and CA was assessed using acetone drops. IP-administered pregabalin dose-dependently attenuated TA in both models and CA in the SMP model, but not CA in the SIP model. IT-administered pregabalin dose-dependently attenuated both TA and CA in both models. However, the dose response curve of IT-administered pregabalin in SMP was shifted to left from that of SIP and the ED50 of IT-administered pregabalin for CA in SMP was about 900 times less than that in SIP. These findings suggest that pregabalin exerts its antiallodynic effect mainly by acting at the spinal cord, and that IT-administered pregabalin has more potent antiallodynic effects in SMP. The alphadeltasubunit might be less involved in the CA in SIP.
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Objective: To study the effect of different ratios of n-6 to n-3 polyunsaturated fatty acid on serum lipid in mice, on the premise that the ratio of SFA to MUFA to PUFA is 1∶1.7∶1.2 or 1∶1∶1. Methods: Ten experimental diets were made from six oils different in fatty acid composition to raise the mice for 10 w. Then the blood lipids were determined in mice fed with different experimental diets. Results and conclusion: Based on the ratio of S/M/P 1∶1.7∶1.2, which is the current dietary fatty acid intake, n-6/n-3 at 1~5∶1 will have lower serum lipid level. Based on the ratio of S/M/P 1∶1∶1 , n-6/n-3 at 1∶1 will have lower serum lipid level. Based on the ratio of n-6 /n-3 10∶1 which is the current dietary fatty acid composition abroad , S/M/P 1∶1.7∶1.2 will have lower serum lipid level.