[Efficacy and safety of superpulse thulium laser lithotripsy in the intracavitary treatment of urinary calculi].

Objective: To evaluate the efficacy and safety of superpulse thulium laser lithotripsy in the intracavitary treatment of urinary calculi. Methods: From May 2021 to July 2022, patients diagnosed with urinary calculi were screened in four medical centers. Those who met the criteria were treated with superpulse thulium fiber laser under endoscope. The patients' perioperative conditions were recorded. The main effective index was stone-free rate (SFR) 4 weeks after operation, the main safety index was the failure rate of the experimental instruments during operation, and the secondary safety index was the incidence rate of perioperative complications. Results: A total of 76 eligible patients completed superpulse thulium fiber laser lithotripsy, with an average age of (52.0±11.1) years, 54 males and 22 females. There were 31 renal stones, 43 ureteral stones and 2 bladder stones. Percutaneous nephrolithotomy was performed in 17 patients. Ureteroscopy lithotripsy/flexible ureteroscopy lithotripsy was performed in 57 patients and transurethral bladder lithotripsy was in 2 patients. The lithotripsy time of all patients was (50.9±31.4) minutes. There was no failure of experimental instruments during the operation. Six patients refused follow-up examination after operation. The incidence of postoperative adverse events was 61.8% (47/76). One patient needed hospitalization due to inguinal hernia after operation, and the rest were classified as Clavien-dindo grade 1-2. The SFR was 94.3% (66/70) at 4 weeks after operation. Conclusion: It is effective and safe to use superpulse thulium fiber laser in the treatment of urinary calculi.

[Comparison of multi-tract PCNL and single-tract ECIRS in semisupine-lithotomy position for staghorn renal calculi].

Objective: To compare the outcomes of multi-tract percutaneous nephrolithotomy (PCNL) and simultaneous combined single-tract percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy (ECIRS) as treatment for staghorn stones. Methods: The clinical data of patients with staghorn stones who were treated with multi-tract PCNL or single-tract ECIRS in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2015 to December 2019 were retrospectively analyzed. Two group of patients were placed in semisupine-lithotomy position (Galdakao-modified supine Valdivia position). We punctured into the renal calyces guided by ultrasonography. A F6 double J stent and a nephrostomy tube were routinely inserted in both groups. Kidney-ureter-bladder radiography (KUB) or computed tomography (CT) were done within 24 hours and 1 month after procedure to determine stone free rate (SFR). Stone free was defined as no residual stones or residual stones of <4 mm in diameter. The SFR, operating time, intraoperative and postoperative complications, and hospitalization time of the two groups were compared and analyzed. Results: A total of 135 patients were included in the study, 70 patients were female, 65 patients were male. The average age were 50.8 years. A total of 74 patients were managed by multi-tract PCNL, while 61 patients were treated by single-tract ECIRS. The mean stone diameter was (58.5±11.4) mm in the PCNL group and (57.7±11.6) mm in the ECIRS group (P=0.658). Neither the 24-hour SFR (81.1% vs 80.3%) nor one-month SFR (91.9% vs 90.2%) after procedure was significantly different between the groups (both P>0.05). The operating time was significantly longer in PCNL group compared with ECIRS group [130(100,171) vs 105(90,135) min, P=0.015]. The rate of Clavien-Dindo grade 2 or higher were significantly higher in the PCNL group than the ECIRS group (18.92% vs 1.64%, P<0.01). The PCNL group required longer hospitalization time than the ECIRS group [8 (7, 9) vs 6 (5, 8) d, P<0.01]. Conclusions: Both multi-tract PCNL and single-tract ECIRS treating staghorn stones in semisupine-lithotomy position are safe and effective. The two procedures have comparable SFR. However, the ECIRS group has lower rates of postoperative complications, shorter operating time and hospitalization time.

[Management of complex renal stones by a novel ureterorenoscope with vacuum suctioning system combined with flexible ureteroscope].

Objective: To evaluate the feasibility and safety of Sotn ureterorenoscope combined with flexible ureteroscope on managing complex renal stones. Methods: Patients treated with the Sotn ureterorenoscope combined with flexible ureteroscope between January 2010 and December 2019 were employed from the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and Jiangmen Wuyi Traditional Chinese Medicine Hospital. The patients' information of age, gender, comorbidities, stone characteristics (stone size, hounsfield units, stone composition, stone location, etc.), operative time and console time, stone-free rate (SFR), and perioperative complication rate were collected. The primary outcome was defined as primary SFR in 1 month of operation, and the secondary outcome was the perioperative complication rate. The differences in preoperative and postoperative data between patients with different kinds of stones were compared. Results: A total of 347 patients were included in the study, with 220 males and 127 females. The age [M(Q1,Q3)] was 51 (42, 58) years. There were 94 patients suffered from multiple renal stones and 253 patients with staghorn renal stones. The operative time and console time age [M(Q1,Q3)] for all patients were 87 (55, 115) min and 59 (27, 75) min, respectively. The primary SFR was 81.3% [83.8% for multiple renal stones and 74.5% for staghorn renal stones (P=0.048)]. Complications occurred in 80 patients (23.1%), of which 79 cases were classified as Clavien-Dindo grade 1-2, and 1 case (0.3%) was grade 3-4. For patients with multiple renal stone, compared with the residual stone group, the complete stone-free group had smaller stone size [15.5 (12.0, 21.0) vs 22.0 (17.5, 28.1) mm, P<0.001], and lower hounsfield units [920.0 (658.0, 1 172.5) vs 1 125.0 (944.9, 1 247.5), P=0.022]. Patients with complications had longer operative time than those without complications [60.0 (38.5, 90.0) vs 75.0 (51.3, 110.0) min, P=0.022]. The SFR was higher in patients with stones size ≤ 20 mm compared to those with stones size > 20 mm (91.8% vs 67.5%, P<0.001), while the difference in complication rate was not statistically significant (P>0.05). In the staghorn renal stones group, compared with the residual stone group, the complete stone-free group had smaller stone size [35.0 (25.8, 45.3) vs 53.5 (39.3, 67.5) mm, P<0.001]. Patients with complications had larger stone size than those without complications [43.5 (34.8, 56.5) vs 36.0 (27.0, 50.0) mm, P=0.007]. Patients with stone size ≤ 40 mm had higher SFR (87.5% vs 55.3%, P<0.001) and lower complication rate(10.7% vs 31.6%, P=0.012) compared to those with stone size >40 mm. Conclusion: Sotn ureterorenoscope combined with flexible ureteroscope is an effective and safe choice for the treatment of complex renal calculi.

High-quality, single-layered epitaxial graphene fabricated on 6H-SiC (0001) by flash annealing in Pb atmosphere and mechanism.

High-quality epitaxial graphene is produced on silicon carbide by flash annealing of 6H-SiC in a lead (Pb) atmosphere at ∼1400 °C for 30 s. Nearly three top bilayers of SiC are decomposed due to fast heating and cooling, and sublimation of Si atoms from SiC is retarded by the Pb atmosphere. The synergetic effects promote the growth of continuous single-layered graphene sheets on the SiC terraces, and a model is established to elucidate the effects and growth mechanism.

Influences of Sr dose on the crystal structure parameters and Sr distributions of Sr-incorporated hydroxyapatite.

Stoichiometric strontium-incorporated hydroxyapatite (Sr-HA) with different Sr concentrations [Sr/(Sr+Ca)] were synthesized using a wet chemical approach and characterized by X-ray diffraction, Fourier-transformed infrared absorption, X-ray photoelectron spectroscopy, and Rietveld Structure Refinement. The crystal lattice parameter, Sr distribution, chemical state of Sr, and also the relationships between their variations and the Sr concentrations have been intensively studied. The results show that both the crystal lattice parameters and crystal plane space of Sr-HA remarkably increase with the Sr concentration increasing. Whether Sr preferably occupies the Ca(I) site or Ca(II) site after incorporated into apatite lattice depends on the Sr number incorporated into apatite. All the Sr ions completely occupy the Ca(II) sites when the Sr concentration is below 5%. With the exception of partial Sr ions occupying the Ca(II) sites, the other Sr ions start to occupy the Ca(I) sites when the Sr concentration doped in HA is beyond 10%. The ratio of Sr ions occupying the Ca(I) sites increases with the further raising Sr concentration up to 20%. The Sr ions inherit the chemical state and environment of the original Ca(I) or Ca(II) site after incorporated into apatite.

Subpopulations of stem-like cells in side population cells from the human bladder transitional cell cancer cell line T24.

Cancer stem cells can be isolated from human tumours using specific cell surface markers. Bladder cancer cells, however, lack specific cell surface markers, making this approach impracticable. In this study an alternative method was used, involving isolation of side population cells to explore the stem cell characteristics of bladder cancer. Side population cells were isolated from the bladder transitional cell cancer cell line T24 and examined for potential stem cell characteristics related to proliferation, cell cycle distribution, self-renewal and differentiation. It was observed that T24 side population cells have stronger proliferative and colony formation abilities than non-side population cells. Side population cells were also more resistant to chemotherapy and radiotherapy, which may be due to expression of the ATP-binding cassette half-transporter, sub-family G, member 2 protein. Overall, the results suggest that side population cells from the human bladder transitional cell cancer cell line T24 harbour stem-like cells.

Asymmetrical reorientation of bimetallic core-shell nanowires.

The reorientation mechanism of core-shell nanowires is investigated and our theoretical studies reveal the significance of the structural configuration. In nanowires which have a larger lattice in the core region than in the shell, for example, Au-core and Pd-shell, the surface stress and interfacial stress may synergistically cause them to reorient spontaneously, but they can revert back to the original state upon an appropriate tensile loading. In contrast, the misfit interface is detrimental to spontaneous reorientation in nanowires which have a smaller lattice in the core than in the shell such as the Pd-core and Au-shell structure, but uniaxial tensile loading causes the nanowires to transform in another way. This asymmetrical reorientation is caused by the different intrinsic stress as well as distinctive slipping characteristics, namely partial slipping and perfect slipping in the compressive and tensile processes.

Characterization, physicochemical properties and biocompatibility of La-incorporated apatites.

In this study, the physicochemical properties and biocompatibilities of La-containing apatites were intensively investigated together with their characterizations in terms of composition, structure, valent state and morphology using X-ray diffraction, Fourier-transform infrared spectra, X-ray photoelectron spectroscopy, scanning electron microscopy and energy dispersive X-ray spectroscopy, respectively. The results indicate that the La(3+) ion can be incorporated into the crystal lattice of hydroxyapatite resulting in the production of La-incorporated apatites (La(x)Ca(10-x)(PO(4))(6)(OH)(2+x-2y)O(y square y-x) (x> or =0.5, y<1+x/2) or La(x)Ca(10-x)(PO(4))(6)O(y square y-x) (0.5

Surface analyses of micro-arc oxidized and hydrothermally treated titanium and effect on osteoblast behavior.

Osteoblast adhesion on the implant material surface is essential for the success of any implant in which osteointegration is required. Surface properties of implant material have a critical role in the cell adhesion progress. Titanium and its alloys are widespread and increasingly used as implant material in dentistry and orthopedics because of their excellent biocompatibility, which is attributed to a passive layer of TiO2 on the surface. In this study, the micro-arc oxidizing (MAO) and hydrothermally synthesizing (HS) methods were used to modify the TiO2 layer on the titanium surface. The surface microstructure was observed by scanning electron microscopy. The surface energy was assessed. The mouse osteoblastic cell line (MC3T3-E1) was seeded on the treated surfaces to evaluate their effect on cell behavior. This included cell adhesion kinetics, cell proliferation, cell morphology, and cytoskeletal organization. The surface structure of MAO samples exhibited micropores with a diameter of 1-3 microm, whereas the MAO-HS-treated samples showed additional multiple crystalline microparticles on the microporous surface. The surface energy of MAO and MAO-HS was higher than that of titanium. The cell adhesion rate was higher on the MAO-HS surface than on the MAO and titanium surface, but without any significant difference between them. After 3 days of culture, cells proliferated significantly more on the MAO and titanium surface than on the MAO-HS surface. The cytoskeletal organization was analyzed by actin and vinculin staining on all the samples. We conclude that the MAO and MAO-HS methods change the surface energy of TiO2 layer on the titanium surface. This may have an influence on the initial cell attachment. Other surface characteristics may be involved in the cell proliferation, which is different from cell attachment on the sample surface. A longer-duration cell experiment should be conducted to see the effect on cell differentiation. Future in vivo evaluation may give further evidence to optimize the surface character of this kind of implant material.

A study of the process and kinetics of electrochemical deposition and the hydrothermal synthesis of hydroxyapatite coatings.

Hydroxyapatite (HAp) coatings were prepared using electrochemical deposition and post-hydrothermal synthesis. The composition and morphology of coatings at each processing step was studied through the application of scanning electron microscopy (SEM), X-ray diffraction (XRD) and infra-red spectroscopy (IR). The mechanism and kinetics of hydrothermal synthesis were considered in particular, and the influence of the temperature and time on the HAp formation rate was also investigated. The results show that the electrochemical deposition coatings are composed of CaHPO42H2O crystals which are converted into needle-like HAp crystals after post-hydrothermal treatment. The HAp content of the coatings increases with the treatment temperature and time. The synthesis rate also increases with the pH value of the water. The formation of HAp coatings is considered to be a combination of several reactions. An Arrhenius relationship was found between the HAp formation rate and the temperature, and an apparent activation energy of 94.4 KJ/mol was obtained by calculation.

Improvement of osseointegration of titanium dental implants by a modified sandblasting surface treatment: an in vivo interfacial biomechanics study.

To study the effects of a modified sandblasting surface treatment on the osseointegration of dental implants at the level of interfacial biomechanics, an in vivo pullout test was conducted using bone-interfacial shear strength as a criterion. Titanium implants were inserted into the medialis condyli of dogs and harvested 2, 4, and 12 weeks after insertion. Shear strength was determined with an Instron pullout tester. Observation and analysis of the surface of modified sandblasted implants after pullout at 12 weeks were performed with scanning electron microscopy and x-ray spectroscopy. Results showed that the shear strength of implants with a modified sandblasted surface was about five times as high as that of implants with a smooth surface. We concluded that the rough surface of titanium dental implants created by the modified sandblasting treatment can greatly enhance the shear strength at the dental implant-bone interface and that, with this enhancement, the secondary micropores play a much more important role in implant-bone bonding.