Anti-sulfatide antibody associated GBS with headache and abdominal pain: a case report.

BACKGROUND: Guillain‒Barre syndrome (GBS) is an acute inflammatory peripheral neuropathy caused by autoimmunity. Gangliosides and sulfatides are important components of peripheral nerves. Anti-sulfatide antibody-mediated complement is associated with acute sensorimotor peripheral neuropathy in GBS, which is characterized by pain and paresthesias. CASE PRESENTATION: The child was a 7-year-old girl with headache and abdominal pain, followed by limb numbness and pain. Cranial imaging showed ventricular dilatation, peripheral nerve function conduction examination showed polyradiculopathy, and cerebrospinal fluid tests showed normal cell counts but elevated protein levels, all of which led to the diagnosis of GBS. After treatment with intravenous immunoglobulin (400 mg/kg × 5 days), the symptoms did not improve, and muscle strength progressively worsened, accompanied by paroxysmal complexion flushing, heart rate fluctuation, hyperhidrosis, and a progressive increase in cerebrospinal fluid protein (up to 3780.1 mg/L). On the basis of these findings combined with serum anti-sulfatide IgM positivity, anti-sulfatide antibody-related GBS was considered, and treatment with low-dose prednisolone (1 mg/kg/d) led to symptom improvement. CONCLUSIONS: Anti-sulfatide antibody-associated GBS is associated with small fiber peripheral neuropathy. The main manifestations are pain, paresthesias and autonomic dysfunction. In addition to the dysfunction of spinal nerve root absorption caused by increased cerebrospinal fluid protein, autonomic dysfunction may be involved in pain. When the therapeutic effect of immunoglobulin is not satisfactory, a low dose and short course of corticosteroids can be considered, and the prognosis is good.

Bisphosphonate Use May Reduce the Risk of Urolithiasis in Astronauts on Long-Term Spaceflights.

Long-duration spaceflight is associated with an increased risk of urolithiasis, and the pain caused by urinary calculi could result in loss of human performance and mission objectives. The present study investigated the risk of urolithiasis in astronauts during 6 months on the International Space Station, and evaluated whether the suppression of bone resorption by the bisphosphonate, alendronate (ALN), can reduce the risk. A total of 17 astronauts were included into the analysis: exercise using the advanced resistive exercise device (ARED) plus weekly oral 70 mg alendronate (ARED+ALN group, n = 7) was compared to resistive exercise alone (ARED group, n = 10). Urine volume decreased in both groups during spaceflight but recovered after return. The ARED group showed increased urinary calcium excretion from the 15th to 30th day of spaceflight, whereas urinary calcium was slightly decreased in the ARED+ALN group. Urinary N-terminal telopeptide (NTX) and helical peptide (HP) of type I collagen, as bone resorption markers, were elevated in the ARED group during and until 0 days after spaceflight, while there was no elevation in these parameters in the ARED+ALN group. Urinary oxalate and uric acid excretion tended to be higher in the ARED group than in the ARED+ALN group during spaceflight. These results demonstrate that astronauts on long-duration spaceflights may be at high risk for the formation of urinary calcium oxalate and calcium phosphate stones through increased urinary excretion of oxalate and uric acid, from degraded type I collagen, as well as of calcium from enhanced bone resorption. Our findings suggest that increased bone resorption during spaceflight, as a risk factor for urinary calculus formation, could be effectively prevented by an inhibitor of bone resorption. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Effects of video combined with action-oriented teaching on self-management and complications in patients with urinary calculus after indwelling tube / 中国实用护理杂志

Objective:To explore the effects of video combined with action-oriented teaching on self-management skill and complications in patients with urinary calculus after indwelling tube, and to provide basis for improving the effect of clinical health education.Methods:A total of 100 patients with urinary calculus after indwelling double J tube from department of urological surgery of the First Affiliated Hospital of Zhengzhou University from March 2018 to October 2019 were divided into experimental group and control group, 45 cases in each group by ramdom digits table method. The patients in the control group recieved routine care and oral health education, the experimental group implemented video combined with action-oriented teaching. The levels of health self-management skill as well as complications were compared between the two groups.Results:After extubation, self-management behavioral scores, self-management cognitive scores, self-management environment scores and total scores in Adults Health Self-Management Skill Rating Scale were (54.26 ± 4.39), (57.22 ± 6.93), (39.91 ± 7.91), (151.39 ± 13.37) points, which were significantly higher than those in the control group (47.92 ± 6.96) , (52.69 ± 6.45), (34.63 ± 8.53), (135.24 ± 12.71) points, the difference were statistically significant ( t values were 2.64-6.04, all P<0.05). The total incidence of tube related complications was 39.1% (18/46) in the experimental group, which was significantly lower than that in the control group 61.2% (30/49). The incidence of lumbago, bladder irritation symptom and shematuria were 10.9% (5/46), 13.0% (6/46), 10.9% (5/46) in the experimental group, significantly lower than those in the control group 28.6% (14/49), 32.7% (16/49), 30.6%(15/49), the differences were statistically significant ( χ2 values were 4.63-5.56, all P<0.05). Conclusions:Video combined with action-oriented teaching can effectively improve self-management skill and reduce tube-related complications of patients with urinary calculi after indwelling double J tube.

Three-channel ion chromatograph for improved metabolic evaluation of urolithiasis.

BACKGROUND: Urolithiasis is a multi-etiological disease resulting from a combination of environmental and genetic factors. One of the most challenging aspects of this disease is its high recurrence rate. For most patients, an in-depth metabolic evaluation may reveal the presence of urinary stones. The fact that different urinary stone-related compounds (USRCs) are measured by different methods renders the metabolic evaluation of urolithiasis quite tedious and complex. METHODS: A three-channel ion chromatograph (IC) that automatically measures the concentration of common metabolic indicators of urolithiasis in urine (i.e., oxalate, citrate, uric acid, calcium, and magnesium) was developed to improve the efficiency. To validate its precision and specificity, standard curves were prepared using working solution of these indicators. 100 standard solutions of these indicators were measured with our new IC and three other ICs as the control instruments; analyte concentrations in 100 24-h urine samples from volunteers and 135 calculi patients were also measured. RESULTS: All analytes had good linear relationships in concentration ranges of 0-10 mg/L. The precision experiments in the standard and urine samples showed that the measurement errors of the newly developed IC were all less than 5%. In urine, the recovery rate ranged from 99.6 to 100.4%, the coefficient of variation ranged from 1.39 to 2.99%, and the results matched between our newly developed IC and the control ICs. The results of the efficiency test showed that we can finish the analysis at the average number of 14 people per day with the new IC. While the average number in the control group is 3.85/day (p = 0.000). CONCLUSIONS: Overall, this multi-channel system significantly improves the efficiency of metabolic evaluation while retaining accuracy and precision.

Nutritional status assessed by the Controlling Nutritional Status (CONUT) score as a predictor of recurrence of urolithiasis.

PURPOSE: We aimed to determine the influence of nutritional status on urinary metabolic abnormalities and stone recurrence in patients with urolithiasis. MATERIALS AND METHODS: We analyzed data for 464 stone-formers and 464 propensity-score-matched control patients that had been collected between 2003 and 2015. Nutritional status was evaluated by use of the Controlling Nutritional Status (CONUT) score, and patients were placed into two CONUT score categories (0-1 and ≥2). Serum and 24-hour urinary metabolites were evaluated in 464 stone-formers. Kaplan-Meier and multivariate Cox regression analyses were performed to assess the influence of nutritional status on stone recurrence. Stone recurrence was defined as radiographic appearance of new stones during the follow-up period. RESULTS: Stone-formers showed a higher prevalence of poor nutrition (CONUT score ≥2) than did the propensity-score-matched control patients (p<0.001). Stone-formers who had poor nutritional status had significantly lower 24-hour urinary calcium but higher oxalate excretion (each p<0.05). Kaplan-Meier estimates demonstrated that stone-formers with poor nutritional status also experienced stone recurrence more rapidly (log-rank test, p=0.014). Multivariate Cox regression revealed that poor nutritional status was independently associated with stone recurrence (hazard ratio, 1.736; 95% confidence interval, 1.041-2.896; p=0.034). CONCLUSIONS: The CONUT score, an easily measured immunonutritional biomarker, is independently associated with a higher risk for stone recurrence in patients with urolithiasis. This implies that not only dietary excess, but also undernourished status, may be associated with aberrations in urine physicochemistry and stone recurrence.

A 13 year hospital based study on the Trend of Urinary Stone Disease in Uttarakhand, India.

BACKGROUND: The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet. METHODS: A 13 year retrospective study (from 2005 to 2018) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated. RESULTS: The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts. However, in all religious groups, 21-40 years old subjects were found to be most susceptible to the problem and approximately 90% of the urinary stones were recovered from the kidneys and primarily composed of calcium oxalate. CONCLUSION: The co-relationship between the occurrence of urinary stones with age, sex of the patients, their religion & site of stones on diagnosis was found to be statistically significant.

A preliminary study on the role of Bacteroides fragilis in stent encrustation.

OBJECTIVE: To preliminarily study the characteristics of bacterial flora distribution in the urine of ureteral stent encrustation patients as well as the relation between Bacteroides and stent encrustation. METHODS: Patients undergoing ureteral stenting were included in the study and divided into encrustation group and non-encrustation group based on the condition of stent encrustation. The urine of patients was collected to undergo 16s DNA test to compare the bacterial flora distribution characteristics of the two groups. The bacterial genus with highest abundance in the urine of encrustation group was used for animal experiment. A rat model with a foreign body in the bladder was created, in which the rats were injected with the aforesaid bacterial genus. A control group injected with normal saline was also formed. The incidence of foreign body tube encrustation between the two groups was compared. RESULTS: The urine collected from the patients in encrustation group contained a variety of bacteria, while dominant bacteria genera included g_Lactobacillus (23.1%), g_Bacteroides (18.8%) and g_norank_Bacteroides (17.1%). While the urine from the non-encrustation group was less diverse in bacteria flora, as the major bacteria genera were g_Escherichia-Shigella (32.2%), g_Enterococcus (24.9%) and g_Pseudomonas (18.2%). Bacteroidetes in the encrustation group were significantly higher, therefore Bacteroides fragilis in this genus was adopted for animal experiment, resulting in a higher incidence of foreign body tube encrustation in the bladder among rats. CONCLUSION: The present study enriches our knowledge about ureteral stent encrustation and reveals that the target regulation of urine bacteria is worth further research and clinical application.

Preliminary analysis of serum electrolytes and body mass index in patients with and without urolithiasis.

OBJECTIVES: To compare body mass index (BMI); serum parameters; and urine parameters between patients with and without urolithiasis. METHODS: Data from 1164 patients admitted to our Department of Urology from January 2011 to July 2013 were retrospectively reviewed; 714 patients (age, 5-87 years; male:female ratio, 1.8:1) exhibited urolithiasis, and 450 patients (age, 12-94 years; male:female ratio, 3.8:1) did not. Blood and urine were collected from patients the morning after hospital admission. Serum and urine parameters were checked by an automatic biochemistry analyzer. Statistical analysis included the Mann-Whitney U test and binary logistic regression. RESULTS: Serum sodium, potassium, chloride, calcium, phosphorus, and carbon dioxide combining power significantly differed between groups. In male patients, serum sodium, calcium, and phosphorus levels were higher in the urolithiasis group, whereas serum potassium and urine pH levels were lower. In female patients, serum sodium was higher in the urolithiasis group. BMI was higher in the urolithiasis group in all patients, male and female. Respective ß-values of serum sodium and BMI in male patients were 0.077 and 0.084; in female patients, these values were 0.119 and 0.102. CONCLUSIONS: Changes in serum sodium and BMI may be involved in the pathogenesis and treatment of urolithiasis.

Urothelial hyperplasia with calculi (papillomatosis) in the urinary bladder of a male spontaneous diabetic Torii rat.

A 40-week-old male spontaneous diabetic Torii rat, an animal model of type 2 diabetes mellitus, was found to have marked urinary calculi with hematuria in the urinary bladder on necropsy. Histological findings in the urinary bladder included a papillary growth pattern with a fibrovascular stroma without atypia. Fine granular materials in the bladder lumen were positive for Von Kossa staining but negative for periodic acid-Schiff or Gram staining, indicating no apparent bacterial infection in the urinary bladder. Scanning electron microscopy revealed that the urinary calculi were magnesium ammonium phosphate crystals (struvite). On the basis of the results, the lesion was diagnosed as urothelial hyperplasia with calculi (papillomatosis). Chronic inciting stimuli by struvite crystals were considered the primary cause of the bladder findings.

The necessity of presetting ureteral stents before ureteroscopic lithotripsy :a Meta-analysis / 中华泌尿外科杂志

Objective To systematically evaluate the necessity of presetting double-J stent before flexible ureteroscope lithotripsy.Methods Computer retrieved clinical studies on the effect of preoperative presetting double-J-catheter on flexible ureteroscope lithotripsy in PubMed,Cochrane Library,Embase,Scopus,Wan fang,CNKI and VIP databases were reviewed.The retrieval time was from the database construction to November 2018.All of the possible combinations of the following terms were used for the search:flexible ureteroscopic,preoperative,double J stent,and calculus.Two researchers independently conducted literature screening,quality evaluation and data extraction,and completed Meta analysis by using statistical software RevMan5.3.Results Thirty-two case-control trials and 14 randomized controlled trials were screened,with a total of 17 480 patients,including 6 211 patients in the experimental group and 11 269 patients in the control group.The results of meta-analysis showed that the experimental group was superior to the control group in term of the overall postoperative stone clearance rate (OR =1.69,95％ CI 1.37-2.08,P ＜0.05).In terms of postoperative kidney stone removal rate,the experimental group was superior to the control group (OR =1.67,95％ CI 1.41-1.99,P ＜ 0.05).In terms of the removal rate of ureteral calculi after surgery,there was no significant difference between the two groups (OR =1.71,95％ CI 0.91-3.20,P =0.10).The success rate of flexible ureteroscope access sheath implantation was higher in the experimental group (OR =5.77,95％ CI 3.32-10.31,P ＜0.05).The rate of passive usage balloon dilation in the control group was higher (OR =0.23,95％ CI 0.15-0.35,P ＜ 0.05).For the incidence of intraoperative complications,the experimental group was lower (OR =0.56,95％ CI 0.38-0.84,P =0.004).For the incidence of postoperative complications,the experimental group was also lower (OR =0.64,95％ CI 0.45-0.90,P =0.01).The operation time of the control group was longer (MD =-4.95,95 ％ CI -8.90--1.01,P =0.01).Conclusions Presetting double-J-catheter can improve the stone removal rate after flexible ureteroscope lithotripsy for the treatment of kidney stone,improve the success rate of flexible ureteroscope access sheath implantation,reduce the utilization rate of ureteral balloon dilator,reduce the incidence of intraoperative and postoperative complications,and shorten the operation time.

Ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization / 中国内镜杂志

Objective To evaluate the application value of ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization for clinical treatment. Methods From July 2015 to July 2017, we selected 307 cases of percutaneous nephrolithotomy with ultrasonic stereoscopic precision positioning, stones are antipyroid stones, renal calculi multiple kidney stones, ESWL treatment failure, isolated kidney stones, renal pelvis and ureteral junction (UPJ) obstruction with stones, open stone surgery recurrence, upper ureteral stones and so on. Refer to preoperative CT and KUB+IVP to determine the puncture angle and the puncture of the calyx. Then, in the ultrasonic stereo precise positioning to select the first mark line and the second mark line, two-line intersection for the final puncture point, this point with the first mark point connection with the vertical axis of the kidney.Finally, at the end of the puncture point in the ultrasonic stereo precise probe under the guidance of the probe to adjust the target angle of the calyx puncture. Results Of the 307 patients, 281 were 1 ~ 2 successful punctures, 21 were 3 ~ 5 times. The total success rate was 98.4% (302/307). 5 cases of small incision were separated to the kidney weeks under the guidance of the fingers.1 case of bleeding after 2 days (by selective renal artery embolization to stop bleeding).The net rate of calculi was 95.8% (294/307) and 13 residual stones were less than 0.5 cm. Conclusions The application of ultrasonic stereoscopic accurate positioning in percutaneous nephroscopy is safe and effective, and the localization method is refined and easy to be promoted.

Survey of clinical epidemiology of urinary calculi patients in Hubei province / 中华泌尿外科杂志

Objective A retrospective study was conducted to investigate the clinical epidemiology of ufinary calculus in Hubei province to provide the population characteristics,stone distribution characteristics,treatment methods,surgical costs and other clinical epidemiological data of patients with trinary calculus,and to provide clinical evidence for the development of prevention and treatment measures for urinary calculi.Methods According to the geographical position,local tertiary hospitals were selected as survey objects and medical records such as age,sex,occupation,stone position,type of operation,and cost of surgical treatment of urinary stone disease were retrospectively investigated between January,2015 and December,2017.Result A total of 193 784 patients were enrolled in this study from 27 hospitals in Hubei province.In which,76 209 were admitted to the hospital for urinary calculus,accounting for 39.33％.Among them,49 460 patients were males (64.90％) and 26 749 were females(35.10％),which the ratio was 1.85∶ 1.All age groups can suffer from urinary calculus,with the peak age range from 41 to 70 years old with 58 985 cases,accounting for 77.40％.The main proportion of patients with urinary calculus were farmers with 21 818 cases (28.63％),comparing with workers (9.74％),busioess man (5.58％),government employees (5.14％),retirees (11.25％) and unemployed (12.58％).A total of 71 439 patients with upper urinary calculus and 4 770 patients with lower urinary calculus and the ratio of upper and lower urinary calculus was 14.98∶ 1.From 2015 to 2017,23 567 patients with urinary calculi underwent ureteroscopic]ithotripsy,and 14 681 patients underwent percutaneous nephrolithotomy.The average operation cost of patients with urolithiasis was 18 395.52 RMB,18 566.31 RMB,19 080.91 RMB in 2015,2016,2017 respectively.Conclusion Hubei province is an area with high incidence of urinary calculus,accounting for 39.33％.The high incidence age is 41-70 years.The occupation composition is mainly farmers.In the past three years,the cost of surgery gradually increased.

High (18)F-FDG uptake in urinary calculi on PET/CT: An unrecognized non-malignant accumulation.

AIM: To assess the high (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in urinary calculi on positron-emission tomography/computed tomography (PET/CT). METHODS: In this study, (18)F-FDG PET/CT examinations were retrospectively reviewed from November 2013 to February 2016 in a single center, and patients with high (18)F-FDG uptake in urinary calculi were identified. The following data were collected from each patient, including age, sex, primary disease, method to verify the urinary calculus, and imaging characteristics of the calculus. RESULTS: A total of 2758 PET/CT studies (2567 patients) were reviewed, and 52 patients with urinary calculi were identified, in which 6 (11.5%, 6/52) patients (5 males, 1 female, age 34-73 years, median age 60.5 years) demonstrated high (18)F-FDG uptake in the urinary calculi. Among the 6 patients, 3 patients had bladder calculi, 2 patients had renal calculi, and 1 patient had both bladder and renal calculi. The size of the urinary calculi varied from sandy to 19mm on CT. The maximal Hounsfield units of the calculi ranged from 153 to 1078. The SUVmax of the calculi on the routine PET/CT scan ranged from 11.7 to 143.0. Delayed PET/CT scans were performed on 4 patients, which showed the calculi SUVmax increasing in 2 patients, while decreasing in the other 2 patients. One patient with bladder calculus underwent a follow-up PET/CT, which showed enlargement of the calculus as well as the increased SUVmax. CONCLUSION: This study shows an uncommon high (18)F-FDG uptake in urinary calculi. Recognition of this non-malignant accumulation in urinary calculi is essential for correct interpretation of PET/CT findings.

Adsorption characteristics of amino acids on to calcium oxalate.

Adsorption of amino acids on to calcium oxalate found in urinary calculus has been studied and the adsorption characteristics were analyzed. Pseudo-first-order, pseudo-second-order and intraparticle diffusion models were used to fit the kinetics data. The pseudo-second-order model best described the dynamic behavior of the adsorption process. The uptake of glutamic acid and aspartic acid were found to decrease as solution pH increasing from 4 to 8. The experimental data obtained at different pH conditions were analyzed and fitted by Langmuir, Freundlich, Redlich-Peterson, Temkin and Sips isotherm models using linear and nonlinear regression analysis. Error analysis (correlation coefficient, residual root mean square error and chi-square test) showed that the Langmuir I isotherm model and the non-linear form of Sips isotherm model should be primarily adopted for fitting the equilibrium data. The maximum adsorption capacity of glutamic acid and aspartic acid onto calcium oxalate monohydrate crystals are 0.059 and 0.066µmol/g at pH 4, respectively. These studies have the vital significance for research aimed at exploring the role of urinary amino acids effect the formation process of calcium oxalate crystals found in urinary calculus and for potential application in the design of synthetic peptides used for urinary calculi therapy.

Effect of indwelling double-J ureteral stents before flexible ureteroscope lithotrity / 局解手术学杂志

Objective To investigate the effect of indwelling double-J ureteral stents before flexible ureteroscope lithotrity in terms of operation time, postoperative hospitalization time and operation effect. Methods All clinical data of flexible ureteroscope lithotrity from 2009 to 2013 were reviewed. Operation time, postoperative hospitalization time and recurrence rate of calculus of patients who received operation directly and patients who received indwelling of double-J ureteral stents 2 weeks before operation were observed and compared. Results Op-eration time, postoperative hospitalization time, and recurrence rate of calculus of patients who received indwelling of double-J ureteral stents 2 weeks before receiving operation were obviously lower than patients who received operation directly. Conclusion Operation time, postoper-ative hospitalization time and recurrence rate of calculus can be decreased by indwelling double-J ureteral stents 2 weeks before operation.

Clinical curative effect comparison of partial tubeless and traditional percutaneous nephrolithotomy for the treatment of upper urinary calculus / 局解手术学杂志

Objective To compare the clinical curative effect of partial tubeless and traditional percutaneous nephrolithotomy ( PCNL) in treatment of upper urinary calculus and to evaluate the clinical feasibility and value. Methods 206 patients with upper urinary calculus were enrolled in a randomized clinical trial from May 2013 to May 2014 according to the inclusion and exclusion criteria. These patients were randomized into the observation group (tubeless PCNL group) and the control group (traditional PCNL group). The operation time,stone clearance rate,visual analogue scale (VAS) pain score,usage of analgesic drugs,hemoglobin decrease,blood transfusion,bleeding,fever, leakage of urine,postoperative hospital stay,hospitalization expenses and the time of patients return to normal life were compared. Results All the operations were successfully finished. There were no statistically significant difference in operation time,stone clearance rate,hemoglo-bin decrease,bleeding,blood transfusion and fever (P>0. 05),but the visual analogue scale (VAS) pain score,usage of analgesic drugs, leakage of urine,postoperative hospital stay,hospitalization expenses and the time of patients return to normal life of the observation group were evidently lower than those of the control group (P<0. 05). Conclusion As partial tubeless PCNL have a great advantage on ease post-operative pain,shorten postoperative hospital stay,reduce hospitalization expenses and accelerate patients return to normal life,it is safe and effective for the treatment of upper urinary calculus,and it should be popularized and applied.

Epidemiologic Status and Risk Factors of Urinary Calculus in Zhuozhou City / 天津医药

Objective To analyze the epidemiological status and risk factors of urinary calculus in residents of zhuo-zhou city. Methods A total of 19 446 residents in zhuozhou city were surveyed with a stratified random sampling method. The questionnaire included body mass index (BMI), daily water consumption, sweets, meals taste, cooking oil, high-protein diet and family history. A 1∶1 ratio was used to select the matched normal control group. Logistic regression analysis was used to compare BMI, diet habits, family history of renal stones and other risk factors of urinary calculus between two groups. Results There were 1 752 (9.8%) patients were confirmed as urinary calculus in 17 854 follow-up members, in which there were 1 125 male and 627 female. A total of 843 patients were at 0-40 years of age (48.04%). The incidence of urinary calculus was mainly in the second and third quarter of the year, and mainly was ureteral stones. There were significant differ-ences in BMI, daily water consumption, sweets, meals taste, cooking oil, high-protein diet and family history between two groups. Logistic regression analysis showed that the protective factors included more daily water consumption, lower level of BMI and eating vegetable oil. And the risk factors of urinary calculus were salty taste, sweet taste, high protein diet and fami-ly history of urinary calculus. Conclusion Prevention measures of urinary calculus included controlling body mass, drink-ing more water, and controlling high-protein, high-sugar, high-salt food intake.

Optimal shock wave rate for shock wave lithotripsy in urolithiasis treatment: a prospective randomized study.

PURPOSE: We aimed to compare the effects of a fast shock wave rate (120 shocks per minute) and a slow shock wave rate (60 shocks per minute) on the shock wave lithotripsy (SWL) success rate, patient's pain tolerance, and complications. MATERIALS AND METHODS: A total of 165 patients with radiopaque renal pelvis or upper ureter stones were included in the study. Patients were classified by use of a random numbers table. Group I (81 patients) received 60 shock waves per minute and group II (84 patients) received 120 shock waves per minute. For each session, the success rate, pain measurement, and complication rate were recorded. RESULTS: No statistically significant differences were observed in the patients according to age, sex, body mass index, stone size, side, location, total energy level, or number of shocks. The success rate of the first session was greater in group I than in group II (p=0.002). The visual analogue pain scale was lower in group I than in group II (p=0.001). The total number of sessions to success and the complication rate were significantly lower in group I than in group II (p=0.001). CONCLUSIONS: The success rate of SWL is dependent on the interval between the shock waves. If the time between the shock waves is short, the rate of lithotripsy success decreases, and the pain measurement score and complications increase. We conclude slow SWL is the optimal shock wave rate.

Efficacy of X-ray localization in ESWL (report of 15 019 cases in 23 years) / 中华泌尿外科杂志

Objective To summarize the experience of management of upper urinary tract calculi by Extracorporeal Shock Wave Lithotripsy (ESWL) in our department in order to improve the gravel success rate and decrease the incidence of complications.Methods 15 019 patients with upper urinary calculi from October 1988 to September 2011 treated by ESWL with X-ray localization were analyzed retrospectively.The maximum diameter of the stones ranged from 0.8 cm to 3.2 cm,with 1 3 794 cases with maximum stone diameter less than 2 cm (guoup A),and with 1225 cases with maximum stone diameter more than 2 cm (guoup B).All patients had normal or nearly normal renal function,and 56.0％ patients (8 410/15 019)had varying degrees of hydronephrosis.Results The effective rate of first ESWL was 84.5％ ( 12 691/15 019) and the effective rate of second ESWL was 12.0％ (1 802/15 019),and 313 cases need a third ESWL.The clearance rate in group A was 90.2％ ( 12 443/13 794 ),in group B was 50.9％ (623/1225),and the overall stone clearance rate within three months was 87.0％ ( 13 066/15 019).The majority of patients ( about 93％ ) had postoperative gross hematuria,which disappeared after drinking lots of water.46cases (0.3％) of patients had postoperative fever,which returned to normal after usage of antibiotics.There were no serious complications such as kidney hematoma,continuous high fever,continuous hematuria,ureteral stones jams.Conclusions ESWL.with X-ray localization had the advantage of low energy,minor injury,easy localization,uniform stone fragment,because of which it could reduce the complications such as continuity fever,ureter stone james,continuious hematuria.ESWL with X-ray localization could be preferred treatment for upper urinary calculi with diameters between 10 to 20 mm.