Percutaneous renal access for percutaneous nephrolithotomy guided by contrast enhanced ultrasound: a single-center preliminary experience in China / 北京大学学报(医学版)

Objective:Contrast enhanced ultrasound (CEUS) is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion.Ultrasound contrast agent was reported to be directly used in human internal lumen to improve the observation capacity of ultrasound.However,CEUS has never been reported to be used in the guidance of percutaneous renal access in percutaneous nephrolithotomy (PCNL).This study aimed to assess the efficacy of CEUS-guided renal access in PCNL.Methods:In this retrospective study,percutaneous renal access was performed under real-time monitoring of CEUS during PCNL in a cohort of 20 patients with renal stones at Peking University First Hospital.Data regarding patients' demographic and clinical characteristics,therapeutic regimens,and postoperative information were collected from a comprehensive database containing comprehensive medical records of the patients undergoing PCNL.Briefly,the procedure was as follows.With the patient under general anesthesia,renal access was established by the guidance of CEUS.Afterwords,holmium laser,pneumatic or ultrasonic lithotripsy was used by the same urologist.The patient demographics,stone characteristics and procedure details were noted.Finally,appropriate statistical analyses were performed to evaluate the effectiveness and safety of the CEUS-guided percutaneous renal access in PCNL.Results:All the 20 patients underwent PCNL successfully with the help of CEUS guidance for tract creation.The collecting system was successfully accessed in all the patients,and only one patient underwent re-puncture.All the patients approached through a middle-pole percutaneous access.The median puncture time was 3.9 (2.9-4.6) min,and the median operating time was 112 (98.5-134.5) min.The preliminary stonefree rate of PCNL was 95.0％ (19/20) as shown by the kidney,ureter,and bladder (KUB) radiographs 48 h postoperation,and the median decline in hemoglobin level was 10 (5.5-14.5) g/L.Two patients had transient postoperative fever and responded well to antibiotics.In addition,no other major complications were observed.Conclusion:CEUS is a safe and effective alternative way of guidance for percutaneous renal access for PCNL beginners.It makes this procedure more visualized and simpler,and produces clearer images than common ultrasonic ones.PCNL beginners might benefit from this method to shorten the learning curve of PCNL,while it warrants further comparative studies to clarify.

Effect of ecdysterone on the proliferation of human umbilical cord mesenchymal stem cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of ecdysterone on the proliferation of human umbilical cord mesenchymal stem cells (hUCMSCs) in vitro.</p><p><b>METHODS</b>hUCMSCs isolated by enzyme digestion from human umbilical cord tissues were cultured and identified for the surface antigens using fluorescence-activated cell sorting (FACS). The cells were treated with ecdysterone at the concentrations of 0, 25, 50, 100, 150, and 200 µg/ml, and the changes in the cell proliferation were detected using MTT assay.</p><p><b>RESULTS</b>The third-passage hUCMSCs were positive for CD29 and CD105 and negative for CD34 and CD45 as shown by flow cytometry. Treatment with ecdysterone resulted in significantly increased cell proliferation as compared to the control cells (P<0.05), but no significant differences were found in cells treated with 100, 150, and 200 µg/ml ecdysterone (P>0.05). The growth curves of the cells also demonstrated the definite effect of ecdysterone in promoting the proliferation of hUCMSCs.</p><p><b>CONCLUSION</b>Ecdysterone can promote the proliferation of hUCMSCs in vitro with the optimal concentration of 100 µg/ml, suggesting its potential value in the enrichment of mesenchymal stem cells.</p>

Effect of ecdysterone on the proliferation of human mesenchymal stem cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of ecdysterone (EDS) on the proliferation of human bone marrow mesenchymal stem cells (hMSCs) in vitro.</p><p><b>METHODS</b>hMSCs were isolated from human bone marrow cell suspension by density gradient centrifugation. The expression of integrins CD44, CD105, CD34 and CD29 were examined by immunocytochemical method. EDS at 10, 25, 50 or 100 microg/ml were added in hMSC culture system, using the routine culture medium for hMSCs as control. The cell viability were analyzed by MTT assay and the cell cycle changes were examined by flow cytometry.</p><p><b>RESULTS</b>The optical density (OD) differed significant between the EDS treatment groups and the control group (P<0.01), and 25 microg/ml EDS group showed the highest OD value (P<0.01) without significant differences among 10, 50 and 100 microg/ml EDS groups (P>0.05). Flow cytometry showed that treatment of the cells with 25 microg/ml EDS significantly increased the cell percentages in S and G(2)M phases and the proliferation index (PI) of the cells as compared with the control group.</p><p><b>CONCLUSION</b>Within a given concentration range, EDS can promote the proliferation of hMSCs in vitro, and this effect can be the most obvious at the concentration of 25 microg/ml. The effect of EDS in promoting the proliferation of hMSCs does not positively correlate to EDS concentration administered.</p>