RIRS with FV-UAS vs. MPCNL for 2-3-cm upper urinary tract stones: a prospective study.

To observe the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with flexible vacuum-assisted ureteral access sheath (FV-UAS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in patients with 2-3 cm upper urinary tract stones. A total of 160 patients with 2-3 cm upper urinary tract stones were prospectively randomized into 2 groups-80 in the FV-UAS group and 80 cases as control in the MPCNL group. The stone-free rates (SFRs) at different times (postoperative 1st day and 4th week) were considered as the primary outcome of the study. The secondary end points were operative time, hemoglobin decrease, postoperative hospital stay, and operation-related complications. There was no obvious difference between the two groups in patient's demographics and preoperative clinical characteristics (all P > 0.05). Postoperative data showed that mean decrease in hemoglobin level was less in FV-UAS group than that in MPCNL group (5.3 vs. 10.8 g/L, P < 0.001). Postoperative hospital stay in FV-UAS group was more shorten than that in MPCNL group (2.7 vs. 4.9 days, P < 0.001). There was no statistical significance between the two groups in SFRs during postoperative 1st day and 4th week (both P > 0.05). However, in terms of the rates of bleeding and pain, MPCNL group were both significantly higher than FV-UAS group (6.2 vs. 0.0%, P = 0.023; 16.2 vs. 2.5%, P = 0.003; respectively). Our study showed that RIRS with FV-UAS, a new partnership to treat 2-3 cm upper urinary tract stones, was satisfying as it achieved a high SFR rate and a low rate of complications. This method was safe and reproducible in clinical practice.

Mirabegron in medical expulsive therapy for distal ureteral stones: a prospective, randomized, controlled study.

OBJECTIVE: To observe the efficacy and safety of Mirabegron in patients with distal, ureteral stones ≤ 10 mm. PATIENTS AND METHODS: A total of 90 patients with distal ureteral stones ≤ 10 mm were prospectively randomized into two groups. Forty-five cases in the study group and 45 cases as control. The stone-free rates (SFRs) and renal colic episodes between two groups were compared at the 1st, 2nd and 4th week end by imaging examinations. RESULT: All of 90 patients were randomly assigned to two groups. In patients with ≤ 5 mm stones, the SFRs in the 1st week (63.6% vs. 33.3%, P = 0.040), the 2nd week (86.4% vs. 54.2%, P = 0.018), and the 4th week (90.9% vs. 66.7%, P = 0.046) after treatment were all significantly higher than that in the control group by the stratification analysis of stone size. Even though SFRs were all higher for patients with > 5 mm stones in study group, there was no statistically significant difference (All P > 0.05). In terms of renal colic episodes, the frequency of occurrence of the study group was significantly lower than that of the control group and need less antalgic. CONCLUSIONS: The MET with Mirabegron has a significant role in improve SFR for the patients with distal ureteral stones ≤ 5 mm and no effect in > 5 mm stones. Furthermore, Mirabegron reduces the need for antalgic in ≤ 10 mm stones with low incidence of adverse effects.

[Genomic imprinting of insulin-like growth factor II in prostate cancer and its clinical significance].

BACKGROUND & OBJECTIVE: The incidence of prostate cancer is increasing rapidly in China, and most patients are advanced cases when they were confirmed. Advanced prostate cancer is very difficult to control, although the patients could get transient recovery after total androgen blockade. Insulin-like growth factor II (IGF-II) can improve cell proliferation and inhibit cell apoptosis. Loss of imprinting (LOI) of IGF-II, or activation of the normally silent and maternally inherited allele, was discovered in some types of cancer. Our study was to explore the genomic imprinting of IGF-II in prostate cancer and its correlation to disease progression. METHODS: LOI of IGF-II in 41 specimens of prostate cancer, 27 specimens of benign prostate hyperplasia, and 13 specimens of normal prostate tissue was detected by polymerase chain reaction-based restrictive fragment length polymorphism (PCR-RFLP) analysis. RESULTS: Rates of heterozygote of IGF-II DNA were 70.7% (29/41) in prostate cancer group, 55.5% (15/27) in benign prostate hyperplasia group, and 61.5% (8/13) in normal prostate tissue group. In the specimens with IGF-II DNA heterozygote, the occurrence rate of LOI of IGF-II was significantly higher in prostate cancer than in benign prostate hyperplasia and normal prostate tissue (58.6% vs. 13.3% and 12.5%, P<0.05). LOI of IGF-II had no correlation to patients'age, serum level of prostate-specific antigen (PSA), presence of bone metastasis, and cell differentiation before endocrinotherapy. Received total androgen blockade, the 1-year progress-freely survival rate was significantly lower in the patients with LOI of IGF-II than in the patients without LOI of IGF-II (70% vs. 100%, P=0.039). CONCLUSION: LOI of IGF-II occurred frequently in advanced prostate cancer, and maybe correlated to progression of prostate cancer after total androgen blockade.