[Clinical analysis of primary hyperparathyroidism with kidney stones: 23 cases report].

OBJECTIVE: To discuss the clinical characteristics of primary hyperparathyroidism (PHPT) with kidney stones. METHODS: The clinical data of 23 cases undergoing diagnostic evaluation and surgery for PHPT combined with kidney stones between January 2004 and February 2012 was retrospectively analyzed. The 23 cases had undergone preoperative parathyroid neck color ultrasound, CT or (99)mTc-methoxy isobutyl isonitrile ((99)mTc-MIBI) diagnosis. The surgical treatment included parathyroid disease and kidney stones. The intravenous calcium, phosphorus and serum intact parathyroid hormone (iPTH) levels, 24 hours urinary calcium concentrations were measured 3 days before and 7 days after surgery. RESULTS: There were 8 male and 15 female patients. The stone diameter were (3.2 ± 0.7) cm (range 2.1-4.0 cm). All patients did both parathyroid surgery and kidney surgery. The statistical discrepancy of serum calcium (there were (3.31 ± 0.39) mmol/L before surgery and (2.12 ± 0.18) mmol/L at 7 days after surgery, t = 11.26), serum phosphorus ((0.70 ± 0.09) and (1.21 ± 0.21) mmol/L in before and after surgery respectively, t = 10.53), iPTH (there were (28.8 ± 10.0) pmol/L before surgery and (3.6 ± 2.6) pmol/L after surgery, t = 12.83) and 24-hours urine calcium (there were (7.2 ± 3.1) mmol/d before surgery and (3.6 ± 2.5) mmol/d after surgery, t = 8.81) before and after the operation was significant (all P < 0.01). PTH concentration with serum calcium concentration correlation coefficient was r = 0.59 (P < 0.01). Eighteen patients (78.3%) had solitary parathyroid adenomas, two patients (8.7%) had multiple parathyroid adenomas, and three patients (13.0%) had multiglandular hyperplasia confirmed at surgery and histology. During follow-up, 8 patients had stone recurrence and 3 patients were did operation again to deal with renal stone within 2 years. Among them, 7 cases were normal, 1 case of parathyroid adenomas recurrence and reoperation. CONCLUSIONS: The parathyroid operation may reduce the calculus recurrence remarkably. Early diagnosis and treatment of primary hyperparathyroidism is helpful to reduce the calculus recurrence and preserve the renal function.

[Prevention of Neisseria gonorrhoeae genital tract infection with patented technology of physical antimicrobial dermal film in a murine model].

OBJECTIVE: To explore a new method of preventing Neisseria gonorrhea (N. gonorrhoeae) by simulating intercourse in mice and verify the effect of a long-acting antibacterial material in the gonococcal infection in mice. METHODS: (1) Simulated male-female gonococcal transmission: the estradiol-treated BALB/c female mice were inoculated with N. gonorrhoeae WHO-L via a vaginal route. In treated group, the mice received the long-acting antibacterial material via vaginal route while deionized water was administered in the control group. At Days 2 - 10 post-inoculation, the average number of polymorphonuclear cells (PMNs) was monitored in stained smears of vaginal cells from test mice. And the vaginal fluid was cultured for N. gonorrhoeae at Days 2, 4, 5 post-inoculation. N. gonorrhoeae genital tract infection was determined to compare the difference between the two groups. (2) Simulated female-male gonococcal transmission: a treated or sham glass rod was used instead of male mice's penis to simulate intercourse in gonococcus-infected female mice. The vaginal fluid on top of glass top was eluted and cultured for N. gonorrhoeae and the difference of relevance ratios compared. RESULTS: (1) In the experiment of simulated male-female gonococcal transmission, At Days 4 and 5, the positive rates of culture for N. gonorrhoeae of the tested group were lower than those of the control group, and there was significant difference between both groups (10.0% vs 57.5%, 7.5% vs 45.0%, both P < 0.01). The percentage of PMNs in the treated group was significantly lower than that of the control group at Days 5 - 8 post-inoculation (all P < 0.05). (2) In the experiment of simulated female-male gonococcal transmission, the positive rates of culture for N. gonorrhoeae from the vaginal fluid on top of glass top were 8.3% and 0 at Days 1 and 2 in the tested group respectively. And they were significantly lower than those of the control group (72.7% and 45.5% respectively, both P < 0.01). CONCLUSION: After topical application in murine vagina, the long-acting antibacterial material forms a layer of physically antibacterial molecular film to prevent the occurrence of N. gonorrhoeae genital tract infection or colonization in mice. It may be used as a liquid condom for male mice.