Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi

ABSTRACTPurpose:To evaluate the clinical efficacy of flexible ureteroscope (F-URS) combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney.Materials and Methods:From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9±11.6 years, range 26-66 years), including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29±8 mm (range 17-42 mm2). Mean stone digitized surface area (DSA) was 321±94 mm2 (range 180-538 mm2). Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed.Results:The average operative time was 92±16 minutes (range 74-127 min.). No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole.Conclusions:F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm) in HSKs with high clearance rates and low complication rates.

Tachyplesin inhibited the growth of multidrug-resistant cell line HL-60/VCR / 肿瘤

Objective: To investigate whether tachyplesin, a kind of peptide isolated from the hemocytes of horseshoe crabs, can inhibit the growth of multidrug-resistant leukemia cell line HL-60/VCR. Methods: Through continuous exposures to low-concentration of vincristine (VCR) and intermittant exposures to gradually increased-concentrations of VCR, HL-60 cells were induced to form multi-drug-resistant cell line HL-60/VCR. The resistance of HL-60/VCR cells to chemotherapeutic agents and the effect of tachyplesin on the growth of HL-60/VCR cells were evaluated by MTT assay. The expressions of P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) in HL-60/VCR cells were detected by flow cytometry. Results: HL-60/VCR cells had multidrug resistance to chemotherapeutic agents. The expressions of P-gp and MRP were up-regulated by 78.3% and 58.3%, respectively (P <0.01). Tachyplesin inhibited the growth of HL-60/VCR and HL-60 cells in a dose-dependent manner. HL-60/VCR cells had similar sensitivity to tachyplesin with HL-60 cells. Tachyplesin enhanced the sensitivity of HL-60/VCR cells to VCR but had no effects on the expressions of P-gp and MRP. Conclusion: Tachyplesin reverses multidrug resistance of HL-60/VCR cells and enhances its sensitivity to VCR.