Treatment of ureteropelvic junction obstruction in patients with renal calculi via laparoscopic pyeloplasty and flexible vacuum-assisted ureteral access sheath ureteroscopy: a multicenter retrospective observational study.

BACKGROUND: Ureteropelvic junction obstruction (UPJO) is a common obstructive disease of the urinary tract. UPJO patients commonly exhibit coexistent renal calculi. The main aim of therapy is to relieve the obstruction and remove the stones at the same time. METHODS: This retrospective study included 110 patients diagnosed with UPJO coexisting with multiple renal calculi at Shanxi Bethune Hospital and the First Hospital of Shanxi Medical University between March 2016 and January 2022. Patients were divided according to the methods used for dealing with UPJO and renal calculi. In Group A, patients underwent traditional open pyeloplasty and pyelolithotomy. In Group B, patients underwent percutaneous nephrolithotomy first and then laparoscopic pyeloplasty. In Group C, patients underwent flexible cystoscopy to remove stones and then laparoscopic pyeloplasty. In Group D, patients underwent flexible vacuum-assisted ureteral access sheath (FV-UAS)assisted flexible ureteroscopy (f-URS) and underwent laparoscopic pyeloplasty. The stones were broken up using a holmium laser. The pyeloplasty success rate, stone clearance rate, operation time, bleeding amount, complication occurrence rate, postsurgical pain, length of stay, and hospitalization cost were compared between the groups. The follow-up period was at least 2 years. RESULTS: The use of f-URS and the FV-UAS, significantly increased the renal stone clearance rate and significantly reduced the complication incidence and operation time in UPJO patients with multiple coexisting renal calculi. CONCLUSIONS: Laparoscopic pyeloplasty combined with f-URS and FV-UAS is safe and effective for treating UPJO in patients complicated by renal caliceal stones. TRIAL REGISTRATION: Retrospectively registered.

Effects of Inherent Minerals on Pyrolysis Behavior and Kinetics of Jimsar Oil Shale.

In order to reveal the influences of different inherent minerals on the pyrolysis behavior and kinetics of oil shale, decarburization, and desilication, samples were obtained by pickling and demineralization. The influence of inherent minerals on the activation energy of oil shale at different conversion rates and the pyrolysis kinetic model were researched by the equal conversion method and principal curve method. The results demonstrated that the average and maximum weight loss rates and volatile release characteristic index of JM-C were lower than that of JM-R; however, JM-S appeared with the opposite trend. At the initial stage (α = 0.2-0.6), the pyrolysis activation energy of JM-C was basically the same as that of JM-R, while the pyrolysis activation energy of JM-S decreased. At the later stage (α = 0.6-0.8), the pyrolysis activation energy of JM-C was higher than that of JM-R, while the activation energy of JM-S was between JM-C and JM-R. The existence of inherent carbonates reduced the pyrolysis activation energy of oil shale, but only at the later stage of pyrolysis. In addition, the existence of inherent carbonates changed the pyrolysis kinetic model of oil shale from an order model to a one-dimensional diffusion model, encompassing f(α) = (1 - α)2.5 and f(α) = 0.5α-1. However, the existence of inherent silicates increased the activation energy of oil shale pyrolysis. Moreover, its mechanism was consistent with the original model, namely, an order model, f(α) = 1 - α.

Comparative study on the pyrolysis behavior and pyrolysate characteristics of Fushun oil shale during anhydrous pyrolysis and sub/supercritical water pyrolysis.

Injected steam can be converted to the sub/supercritical state during the in situ exploitation of oil shale. Thus, the pyrolysis behavior and pyrolysate characteristic of Fushun oil shale during anhydrous pyrolysis and sub/supercritical water pyrolysis were fully compared. The results revealed that the discharged oil yields from sub/supercritical water pyrolysis were 5.44 and 14.33 times that from anhydrous pyrolysis at 360 °C and 450 °C, which was due to the extraction and driving effect of sub/supercritical water. Also, sub/supercritical water could facilitate the discharge and migration of shale oil from the pores and channels. The H2 and CO2 yields in sub/supercritical water pyrolysis were higher than that in anhydrous pyrolysis, resulting from the water-gas shift reaction. The component of shale oil was dominated by saturated hydrocarbons in anhydrous pyrolysis, which accounted for 50-65%. In contrast, a large amount of asphaltenes and resins was formed during pyrolysis in sub/supercritical water due to the solvent effect and weak thermal cracking. The shale oil from anhydrous pyrolysis was lighter than that from sub/supercritical water pyrolysis. Sub/supercritical water reduced the geochemical characteristic indices and lowered the hydrocarbon generation potential and maturity of solid residuals, which can be attributed to the fact that more organic matter was depolymerized and released. The pyrolysate characteristic of oil shale in sub/supercritical water pyrolysis was controlled by multiple mechanisms, including solvent and driving effect, chemical hydrogen-donation and acid-base catalysis.

Overexpressed CD39 mitigates sepsis­induced kidney epithelial cell injury via suppressing the activation of NLR family pyrin domain containing 3.

Unfettered inflammation is a leading cause of multiple organ failures in sepsis. The anti­inflammatory role of cluster of differentiation (CD)39 has been previously reported. The present study aimed to investigate the role of unfettered inflammation in sepsis­induced acute kidney injury (AKI). Lipopolysaccharide (LPS) was introduced to construct a sepsis mouse model. Kidney function and pathological changes in mice were measured at 12, 24 and 48 h. CD39 overexpression and inhibition vectors were transfected into renal tubular epithelial (HK­2) cells, followed by LPS treatment (10 µg/ml), and the cell viability changes at 24 h after treatment were assessed and the expression of NLR family pyrin domain containing 3 (NLRP3), cleaved caspase­1 and CD39 were determined by performing ELISAs. Cell apoptosis and reactive oxygen species (ROS) levels were determined by flow cytometry. It was found that after LPS administration, kidney injury was the most serious at 24 h in mice. CD39 overexpression could suppress the upregulation of pro­inflammatory cytokines induced by LPS treatment. In addition, the cell apoptosis and ROS level exhibited an obvious decrease, while cell viability increased. The NLRP3 expression and activity also showed a great inhibition in CD39­overexpressed cells. By contrast to CD39 overexpression, CD39 inhibition promoted the activation of the NLRP3 inflammasome. These data indicate the protective role of CD39 in LPS­induced renal tubular epithelial cell damage through inhibiting NLRP3 inflammasome activation and that CD39 might be a potential therapeutic target in sepsis­induced AKI.