Application of flexible ureteroscope in the treatment of middle and upper ureteral calculi complicated with lower ureteral stricture / 现代泌尿外科杂志

【Objective】 To explore the safety and efficacy of flexible ureteroscope in the treatment of upper and middle ureteral calculi complicated with lower ureteral stricture after the failure of rigid ureteroscopy. 【Methods】 Clinical data of 36 patients with middle and upper ureteral calculi and lower ureteral stricture treated with rigid ureteroscopy but failed during Oct.2019 and Oct.2021 were retrospectively analyzed. The patients’ average age was (46.2±13.2) years, and the maximum diameter of calculi was (1.3±0.3) cm. The intraoperative, postoperative and follow-up data were recorded. 【Results】 All 36 patients successfully completed first-stage operation. Intraoperatively, the stenosis degree was F6-8 and could be dilated to F9-11. The mean length of stenosis was (1.1±0.34) cm. No serious postoperative complications such as infection or bleeding occurred. Two patients were lost and 34 patients were followed up. There was no obvious hydronephrosis on ultrasound examination. The stone removal rates were 76.5%, 88.2% and 97.1%, respectively, in months 1, 2 and 3 after operation. One patient with residual stones underwent secondary ureteroscopy in month 3 and large stones were removed with stone removal basket. 【Conclusion】 In patients with middle and upper ureteral calculi and lower ureteral stricture, after the failure of rigid ureteroscopy, flexible ureteroscope is safe and effective, and can significantly increase the success rate of first-stage surgery.

Effect of 17β-estradiol on renal tubular cells apoptosis and inflammation induced by renal ischemia /reperfusion injury in rats / 临床与实验病理学杂志

Purpose To investigate the effects and mechanism of 17β-estradiol on the apoptosis and inflammation of renal tubular cells in rats with renal ischemia/reperfusion injury. Methods All the female Sprague-Dawley rats were ovariectomized and randomly divided into four groups: Control group, Sham group, I/R group and estrogen plus I/R (E2 + I/R) group (n = 8). Right kidney of the rat was excised and artery of the left kidney was blockaded for 45 min.24 h after the reperfusion, we collected the blood and nephridial tissue of each group. An automatic biochemical analyzer was used to measure the expression level of BUN and Cr in blood. Hematoxylin-eosin (HE) staining was used to observe the pathological changes and the degree of inflammatory reaction of the ischemia/reperfusion injury kidney. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) method was used to detect the apoptosis of renal tubular cells. The expression levels of Cleaved-Caspase-3 protein were measured by Western blot, while the numbers of CD4+ T lymphocyte infiltration in each group were tested by immunofluorescence (IF). Results Compared with the Sham group, expression level of BUN, Cr and Cleaved-Caspase-3 in I/R group significantly increased (P＜0.05) as well as the number of apoptotic cells (P＜0.05). In the meantime, inflammatory reaction significantly aggravated (P＜0.05) and the number of CD4 + T lymphocytes increased remarkably (P＜0.05). However, expression level of BUN, Cr and Gleaved-Caspase-3 in E2 + I/R group decreased significantly (P＜0.05) and the pathological damage in the kidney was alleviated (P＜0.05) compared with I/R group, furthermore, the number of apoptotic cells decreased (P＜0.05) compared with I/R group. The inflammatory reaction significantly blunted (P＜0.05) and the infiltration of CD4 + T lymphocytes decreased remarkably (P＜0.05) compared with I/R group. Conclusion Estrogen can inhibit the expression of Cleaved-Caspase-3 in renal tissue during ischemia/reperfusion injury and reduce the apoptosis of renal tubular cells. It can also reduce the infiltration of CD4 + T lymphocytes, thus playing a protective role on renal ischemia/reperfusion injury.

Low triiodothyronine syndrome can predict poor prognosis in peritoneal dialysis patients / 上海交通大学学报（医学版）

Objective· To investigate the prevalence of low triiodothyronine syndrome (LT3S) in peritoneal dialysis (PD) patients and to evaluate the predictive value of long-term prognosis. Methods · From Jan. 2009 to Dec. 2015, all patients who started PD for 3 months were enrolled. According to thyroid hormone levels, there were classified into LT3S group (218 cases) and normal T3group (259 cases). The association between FT3and mortality in PD patients was estimated using Cox risk regression model. Results · Compared to the patients in normal T3group, patients with LT3S had lower hemoglobin[(97.90±23.71)g/L vs(105.54±22.94)g/L],adjusted serum calcium[(2.06±0.35)mmol/L vs(2.17±0.27)mmol/L](all P<0.01).Patients with LT3S had higher BNP{[311.00(134.59,776.00)pg/mL]vs[159.00(58.28,378.75)pg/mL]},hrCRP{[2.85(0.95,6.81)mg/L]vs[1.34(0.54,3.32)mg/L]}and serum total cholesterol[(3.18±1.29)mmol/L vs(2.76±0.93)mmol/L]than that in patients with normal T3group(all P<0.01).LVMI of LT3S group [(154.16±58.15)g/m2] vs (125.24±42.67)g/m2] was much higher than that of normal T3group (P<0.01). Cox risk regression model indicated that FT3 was significantly associated with all-cause mortality(HR 0.51,95% CI 0.41-0.63;P<0.01)and cardiovascular mortality(HR 0.60,95% CI 0.45-0.81;P<0.01). Conclusion·LT3S is common in PD patients.Lower FT3was an independent risk factor of all-cause and cardiovascular mortality in PD patients.

Effects and Mechanism of Alcea Rosea Roots in Ethylene Glycol Induced Nephrolithiasis in Rats / 天津医药

Objective To study the beneficial effect and mechanism of Alcea rosea roots in nephrolithiasis model in-duced by 1%ethylene glycol in rats. Methods We randomly divided 60 male Wistar rats into six groups,including control group, model group, Alcea rosea roots lower-dose preventive group, Alcea rosea roots high-dose preventive group, Alcea ro-sea roots lower-dose curative group, Alcea rosea roots high-dose curative group. Control group was free to access food and water;model group was given 1%ethylene glycol drinking water and was fed with normal diet, preventive group was given 1%ethylene glycol drink and Alcea rosea roots in low (250 mg/kg) or high dose (500 mg/kg) each day, curative group re-ceived 1%ethylene glycol drink each day and Alcea rosea roots in low or high dose from day 15 to day 28. At the end of the experiment, various renal functional and injury markers such as urine volume, calcium, phosphate, magnesium, urea, creati-nine, and oxalate were evaluated using urine, serum, and kidney homogenates. The kidneys were removed and prepared for histological evaluation of calcium oxalate deposits. Results In model groups, urine output, urea, creatinine, 24 h urine Ca2+, and oxalate and MDA were increased compared to those in control group(P＜0.05). GSH and SOD were increased in preventative and curative groups compared to those in the model group(P ＜ 0.05). The urea, creatinine, 24 h urine Ca2+, urine oxalate, MDA were reduced in preventive and curative groups compared to those in the model group(P＜0.05). The number and size of calcium oxalate crystal deposits were also less and smaller, and the kidney damage was less severe in pre-ventive and curative groups compared to in the model group. Conclusion The extract of Alcea rosea roots can prevent and treat calcium oxalate urinary stone formation in rats and protect renal function.

Primary non-Hodgkin's lymphoma of the testis and penis: clinical analysis of 5 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the clinical diagnosis and treatment of primary non-Hodgkin's lymphoma of male genitalia.</p><p><b>METHODS</b>We retrospectively reviewed the clinical data of 5 cases of primary non-Hodgkin's lymphoma of male genitalia, 4 in the testis and 1 in the penis, we also analyzed the relevant literature and clinical significance of the disease.</p><p><b>RESULTS</b>All the 5 cases were treated by surgery and pathologically confirmed to be non-Hodgkin's lymphoma. Three of them received chemotherapy, and the other 2 (1 in the testis and 1 in the penis) underwent both chemotherapy and radiotherapy after the operation. Follow-up averaged 25 months, during which 1 of the patients died and the other 4 survived.</p><p><b>CONCLUSION</b>Primary non-Hodgkin's lymphoma of male genitalia is an uncommon disease with atypical clinical presentations and poor prognosis, which occurs mostly in elderly males. Definite diagnosis of the disease mainly depends on histopathology and immunohistochemistry. Surgery with multiagent chemotherapy and radiotherapy is advisable for its treatment.</p>

Distribution of vascular endothelial growth factor gene polymorphism in Uyghur Ethnic patients with urolithiasis in south Xinjiang / 中华泌尿外科杂志

Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.