RESUMO
【Objective】 To explore the safety and efficacy of a novel endoscopic two-wire guided dilation in the creation of channels in percutaneous nephrolithotomy (PCNL). 【Methods】 Clinical records of 180 patients undergoing PCNL during Oct.2020 and Oct.2022 were retrospectively analyzed. The patients were divided into three groups, 60 in AMD group (fascial amplatz dilation), 60 in OSD group (one shot dilation) and 60 in END group (endoscopic dilation). Time to establish channels, operating time, failure of access, stone clearance rate, drop in hemoglobin, embolization rate, fever rate, blood transfusion rate and postoperative hospitalization were compared among the three groups. 【Results】 There were no significant differences in the general data among the three groups (P>0.05). Compared with AMD and OSD groups, END group needed significantly reduced time to establish the first channel [(5.6±0.8) min vs. (4.9±1.4) min vs. (4.2±0.5) min, (P<0.05)] . Compared with OSD group, END and AMD groups had significantly more hemoglobin drop [(14.0±17.6) g/L vs. (19.4±12.6) g/L vs. (10.2±6.8) g/L, (P<0.05)] . There were no significant differences in terms of failure of establishing channels, operating time, stone clearance rate, embolization rate, fever rate, blood transfusion rate and postoperative hospitality. Four patients needed selective renal artery embolization (1 case in AMD group and 3 in OSD group). No serious complications such as organ injuries, septic shock or death occurred. 【Conclusion】 Endoscopic two-wire guided dilation is simple, with few complications and good application value.
RESUMO
OBJECTlVE To observe the effect of soybean isofIavone( SI)on the expression of nephrin and investigate its protection mechanism in the kidney of diabetic rats. METHODS A diabetic rat modeI was induced after streptozocin(STZ)60 mg·kg-1 was injected into Sprague-DawIey rats. After 72 h,SI 40,120 and 360 mg·kg-1 was ip given to rats in SI groups,respectiveIy,once daiIy,for 8 weeks. The concentration of fasting bIood gIucose( FBG)was determined by a bIood gIucose meter. Urine protein(UP)of 24 h was determined using ELISA. The concentration of serum creatinine(SCr),bIood urea nitrogen(BUN),maIondiaIdehyde(mDA)and superoxide dismutase(SOD)was determined by an automatic biochemicaI anaIyzer. The expression of nephrin,tumor necrosis factor-α(TNF-α)and NF-κB protein in renaI tissue was measured by Western bIotting,respectiveIy. RESULTS Compared with normaI controI group,the concentration of FBG,24 h UP,BUN,SCr and mDA in modeI group was aII siginificantIy increased(P﹤0.05,P﹤0.01),but SOD was decreased( P﹤0.01).Compared with modeI group,BUN in SI 40,120 and 360 mg·kg-1 groups decreased from(24.3±6.3)mmoI·L-1 to(16.8±4.9), (13.4±5.4)and(7.7±1.2)mmoI·L-1 ,respectiveIy,24 h UP in SI 360 mg·kg-1 group decreased from (1.26±0.45)mg to(0.88±0.15)mg( P﹤0.01),SCr decreased from(56.4±8.4)μmoI·L-1 to(35.3± 4.3)μmoI·L-1(P﹤0.01),mDA decreased from(8.32±1.40)μmoI·L-1 to(5.33±0.95)μmoI·L-1(P﹤0.01), but SOD in SI 120 and 360 mg·kg-1 groups increased from(125.5 ±2.4)kU·L-1 to 144.2 ±9.2 and (169.2±3.2)kU·L-1(P﹤0.01). Compared with SI 120 mg·kg-1 ,SCr,BUN and mDA in SI 360 mg·kg-1 group were aII siginificantIy Iower(P﹤0.05,P﹤0.01),but SOD was higher(P﹤0.01). Compared with normaI controI group,the expression of nephrin protein greatIy decreased(P﹤0.01),whiIe the expres-sion of TNF-α protein greatIy increased in modeI group( P ﹤0.01). Compared with modeI group,the expression of nephrin protein greatIy increased in SI 40,120 and 360 mg·kg-1 groups(P﹤0.01),whiIe the expression of TNF-α and NF-κB protein greatIy decreased in SI 120 and 360 mg·kg-1 groups(P﹤0.01). CONCLUSlON The mechanism by which SI protects the kidney may be partIy reIated to anti-infIammation,antioxidation and increasing the expression of nephrin in diabetic rats.