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ABSTRACT: To investigate impacts of different nephrostomy tubes and their fixation ways on patients with nephrolithiasis complicated with renal insufficiency after percutaneous nephrolithotomy.
A total of 72 renal insufficiency patients were enrolled in this study, who were randomized into three groups with 24 patients in each group according to nephrostomy tube diameter and its fixation way: Group I, i.e. stretch group with 14 Fr silicon tube (Urovision)with balloon; Group II, i.e. not strech group with 14 Fr silicon tube (Urovision) with balloon; Group III, i.e. not strech group with 20Fr latex tube without balloon. The data collected included preoperative serum cretinine, hemoglobin value, midstream urine culture, stone volume, and operative time, and number of operative tract. It was also recorded that the change of hemoglobin between preoperation and 24 h or 72 h postoperation, presence of postoperative extravasation, systemic inflammatory respose syndrome, narcotic usage and blood transfusion.
There were no statistically significant differences among the three groups in terms of the incidence of postooperative extravasation(P=0.301), SIRS(P=0.099) and narcotic usage(P=0.898). In the aspects of the change of hemoglobin between preoperation and 24 h or 72 h postoperation, there were significant differences between group I and group II (P=0.001, P=0.009) or group III(P=0.021, P=0.003). No difference was found between groups II and III(P=0.989, P=0.962). In the aspect of blood transfusion cases, group I (1 case)<group III (6 cases)<group II (10 cases). The number of patients needing blood transfusion in group I was significantly lower than that in group II (P=0.002), but the differences between group III and group I (P=0.102) or group II (P=0.221) were not statistically significant.
It is worth recommending indwelling 14 Fr silicon nephrostomy tube with balloon oppressing the operative tracts, because it could reduce blood loss 24 h and 72 h after operation in patients with nephrolithiasis complicated with renal insufficiency.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 12/2011; 43(6):878-81.
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ABSTRACT: To investigate the significance of change of urine microalbumin/urine cretinine (mALB/Ucr) in nephrolithiasis patients with renal dysfunction (experimental group) before and after percutaneous nephrolithotomy (PCNL).
mALB/Ucr value and serum cretinine (Scr) value were analyzed in 21 nephrolithiasis patients with renal dysfunction before PCNL, and 1, 7, 30 and 90 days after PCNL. Operative time and the number of tract were recorded and analyzed in the experimental group. The same work was done in 27 nephrolithiasis patients with normal renal function (control group) before surgery.
The levels of mALB/ Ucr in experimental group patients before PCNL were significantly higher than those in control group (P<0. 001) . The levels of mALB /Ucr between 7 days after operation and 30 days (P=0.054) or 90 days (P=0.062) after operation were not statistically significant. The levels of Scr of 30 days after operation in experimental group were lower than those of 7 days after surgery (P<0.001); But they were not statistically significant compared with those of 90 days after surgery (P=0.106). The mALB/Ucr difference between before PCNL and 7 days after PCNL (ΔmALB/Ucr) was positively correlated to the number of operation tract (r=0.486,P=0.030), but it was not correlated to operation time (r=0.323, P=0.129). The ΔmALB/Ucr was not correlated to Scr difference between before PCNL and 7 days after PCNL (r=0.323, P=0.153). Actually the ΔmALB/Ucr was correlated to Scr difference between before PCNL and 30 days (r=0.632, P=0.002), or 90 days (r=0.476, P=0.003) after PCNL.
The damage to kidney filtration of experimental group was more severe than that of control group. The mALB/Ucr or Scr level of experimental group trends to be stable in 7 or 30 days after operation. Increasing operation tracts (less than 3 tracts) can help to restore kidney filtration function. A reliable assessment, of a long-term outcome of the patients' renal function can be reached, by calculating the patients' ΔmALB/Ucr in the experimental group.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 10/2011; 43(5):757-60.
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ABSTRACT: To evaluate the safety and efficacy of a new intracorporeal pneumatic and ultrasonic lithotriptor (CQS-01).
Eighty-six patients with renal or upper ureteral stones suitable for percutaneous nephrolithotomy (PNL) treatment were randomly divided into trial group (treated with CQS-01 device) and control group (treated with EMS-III device), with 43 patients in either group respectively. All the patients were followed up for 7 ± 3 days post-operation. The data were collected and analyzed with regard to stone burden, postoperative stone clearance rate, operation time, stone fragmentation and extraction time, volume of extracted stones, changes of red blood cells (RBC) and hemoglobin (Hb), occurrence rate of transfusion, changes of blood urea nitrogen (BUN) and creatinine (Cr), serum electrolytes, white blood cells (WBC), as well as body temperature and adverse events rate at 24 hours and 7 ± 3 days post PNL operation.
No significant differences were found between the trial group and the control group (P>0.05), in terms of patients demography, renal characteristics and stone characteristics. In the trial group and the control group, respectively: the postoperative stone-free rate was 76.74% and 79.07% (P=0.796) and the partial stone clearance rate was 23.26% and 20.93% (P=0.796), the operation time was (92.49 ± 76.59) min and (87.28 ± 50.01) min (P=0.485), the stone fragmentation and extraction time was (50.16 ± 57.11) min and (40.59 ± 31.01) min (P=0.976), the volume of extracted stones was (10.85 ± 20.08) mL and (5.05 ± 6.00) mL (P=0.041). There were also no significant differences in postoperative RBC and Hb drops, occurrence rate of transfusion, post-operative BUN and Cr, body temperature changes, postoperative systemic inflammatory response and adverse events rate at 24 hours and 7 ± 3 days post-operation between the trial and control groups (P>0.05).
There is no significant difference in clinical safety, efficacy, and the stone clearance capability between CQS-01 device and EMS-III device.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2011; 43(4):548-55.
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ABSTRACT: In this paper, we propose a methodology of the automated bitstream generation for conducting high-testability FPGA tests. In order to study the efficiency of our solution we will explore our methodology in the test of an SOI-based FPGA. We use a semi-automated approach of the bitstream generation for ease of test vector design with high functionality and fault coverage. The methodology from this research is extensively exercised in the design process. The quality of this methodology is proven by the efficiency of the test vector suite used in the wafer and packaged tests. The same approach can also be used in the bitstream generation for FPGA application.
Solid-State and Integrated Circuit Technology (ICSICT), 2010 10th IEEE International Conference on; 12/2010
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ABSTRACT: To provide theoretic rationales for treatment and prevention of staghorn calculi by analyzing stone composition and studying the relationship between stone and urinary tract infections.
The clinical data of 51 staghorn calculi patients were analyzed retrospectively. The stone compositions were studied by infrared spectrophotometry.
Six types of stone compositions were obtained. There were calcium oxalate monohydrate, calcium oxalate dehydrate, carbonate apatite, magnesium ammonium phosphate hexahydrate, uric acid and L-cystine. The majority of stones were of mixed compositions, pure stones were found in 15 cases (29.4%). Among all stones, calcium oxalate stones were found in 41 cases (80.4%) and uric stones in 10 cases (19.6%). Infectious stones were found in 26 cases (51.0%). Urinary tract infections were found in 40 (78.4%) patients and positive urine/stone culture was detected in 33 (64.7%) patients.
With multiple crystalline compositions and etiological factors, the staghorn calculi are closely correlated with urinary tract infections.
Zhonghua yi xue za zhi 11/2010; 90(44):3150-2.
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Liu-lin Xiong,
Xiao-bo Huang,
Xiong-jun Ye,
Jian-xing Li,
Bo Yang,
Qing-quan Xu,
Kai Ma, Liang Chen,
Xiao-feng Wang,
Jian Gao,
Long Jin,
Lei Chen
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ABSTRACT: To investigate the characteristics of severe renal hemorrhage after percutaneous nephrolithotomy (PNL) and timing of selective transarterial embolization(TAE) .
Between May 2005 and March 2010, superselective renal angiography was used to control severe bleeding in 15 of 1418 cases (1520 PNL procedures, 1.06%). In the 15 cases, superselective renal angioembolization was used to control severe bleeding in 13 (0.92%) . The medical records of all the patients who underwent renal angiography and angioembolization were reviewed.
Severe bleeding cases after PNL were divided into 3 types according to the clinical characteristics: type I (urgency type), type II (intermittence type) and type III (persistent slow type). There were 3 patients in type I, 6 in type II and 6 in type III. All the patients had a normal coagulation profile before surgery. A total of 11 patients (84.6%) underwent the first-time successful embolization and 2 (15.4%) the second-time successful embolization. The longer time between angioembolization and bleeding was, the more blood loss and transfusion volume were, except for 1 patient in type II . Temporality serum creatinine abnormality was found in 2 patients, one with a solitary kidney patient and the other with angioembolization for both renal bleeding.
TAE is a minimally invasive, safe, simple, and highly effective modality for the management of post PNL renal bleeding. This option should be considered early in the management of these cases,especially for Urgency type bleeding.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):465-8.
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ABSTRACT: To establish nephrolithiasis rat model induced by nanobacteria and to determine the relationship of nanobacteria with nephrolithiasis.
Thirty adult male SD rats were randomized into 3 groups (n=10 each): group A, given an intravenous injection of nanobacteria; group B, given an intravenous injection of nanobacteria and taken tetracycline; group C, as normal control. Eight weeks later, all rats were sacrificed and the kidneys were examined for pathology and the 24-h urine N-acetyl-beta-D-aminoglycoside enzyme (NAG) and lactate dehydrogenase (LDH) were detected.
Histopathological studies revealed nanobacteria induced renal tubular crystallization, which was significantly different among the 3 groups (P=0.033). The crystallization was higher in group A than that in group B. The urinary NAG and LDH excretion were significantly different among the 3 groups (P<0.001).
Nanobacteria may be involved in the pathogenesis of nephrolithiasis. Tetracycline may inhibit stone formation.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):433-5.
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ABSTRACT: To study the damage of nanobacteria on HK-2 cells, the possible principles, the effect of crystals (COM) adhering to HK-2 cells after the damage.
Four groups were chosen for the study: control group, NB group, nHAP group and COM group. Morphological changes of the HK-2 cells were observed after HE stain and with TEM after 12 hours and 24 hours. Meanwhile, the levels of H2O2, LDH, MDA and ATPases were surveyed after 6 hours,12 hours and 24 hours, respectively. And 6, 12, and 24 hours later, COM crystals were mixed into the culture fluids of each group. Then phalloidin-FITC was used to finish fluorescent staining of the cells. At last, the adhering effects of each group with the laser scanning confocal fluorescence microscope were observed and contrasted.
After HE stain and with TEM: in NB and nHAP group, the shape of the cells changed, brush borders were arranged in disorder, vacuoles formed in the kytoplasms, the mitochondria became swelled up, the karyotheca dissolved and the nucleolus disappeared in some cells. After 24 hours, in NB group, the number of the cells in which the karyotheca dissolved was more than that in nHAP group. After 12 and 24 hours, the level of H2O2 in NB group was higher than that in control group and nHAP group; After 6 and 24 hours, the level of MDA in NB group was higher than that in control group and nHAP group; At each time point, there was no significant difference in the level of LDH between control group, nHAP group and NB group; After 12 hours, the activities of Na+/K+ ATPases in NB group and nHAP group were lower than those in control group. And after 24 hours, the activity of Na+/K+ ATPases in NB group was lower than that in control group; After 12 and 24 hours, the activities of Ca2+/Mg2+ ATPases in NB group was lower than those in control group. After 12 hours, the activity of Ca2+/Mg2+ ATPases in nHAP group was lower than that in control group. The observation with the laser scanning confocal fluorescence microscope: after 12 hours, showed that the number of the crystals adhering to the cells in NB group and COM group increased, and in COM group, some crystals had entered the cells; after 24 hours, the adhering effects of the crystals in NB and COM group were similar to those after 12 hours, but the number of adhered crystals was more than that after 12 hours; At each time point, there was no significant change in control and nHAP groups.
Nanobacteria has a damage effect on HK-2 cells, the damage increases with the acting time expanding. The damage is more severe than that of nHAP. In the damage process of nanobacteria, the lipid peroxidation may play an important role. After the damage of nanobacteria, the adhering effect of the COM crystals to the cells increases observably, and the number of crystals adhering to the cells becomes more and more with the acting time expanding. Although nHAP also has a damage effect on HK-2 cells, it does not effect the adhering process.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):436-42.
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ABSTRACT: To detect, culture, and characterize the nanobacteria (NB) from sera of patients with kidney calculi in our department.
Blood samples of 24 patients with kidney calculi and of 3 healthy volunteers in our department were collected for NB culture in this study. We used immunohistochemistry, von kossa staining, scanning electron microscopy (SEM), transmission electron microscopy (TEM) to investigate the appearance and components of cultural NB.
Twenty-two blood samples out of 24 (91.67%) showed growth of NB, while no NB were detected in volunteers' blood samples. The infection rate of stone group was obviously higher than that of healthy volunteers. After a 4-week culture period, the light microscope revealed coccoid-shaped NB with a diameter of 100-500 nm, which could be identified by immunohistochemistry and von kossa staining. SEM and TEM (negative staining) revealed NB with a hollow interior coated in needle-like apatite crystals. Such nanoparticles could bud-off new ones and therefore appeared like living organisms.
NB can be identified from sera of most patients involved in kidney calculi. It may have intimate relation to the formation of kidney calculi because the infection rate of NB blood samples of stone patients was significantly higher than that of healthy volunteers. Immunohistochemistry, von kossa staining, SEM and TEM are special methods for identifying NB from different aspects. The appearance and character are important points to distinguish NB from other nano-sized particles.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):443-6.
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ABSTRACT: To define the difference of serum calcium (Ca), phosphorus (P), potassium (K), sodium (Na), chlorine (Cl), carbon dioxide combining power (CO2CP), hydrogen ion concentration (pH) of urine and urine specific gravity (SG) between those patients suffering from urolithiasis and non-urolithiasis at the same time period.
Data from 1 164 patients admitted to the Department of Urology, Peking University People's Hospital from January, 2005 to July, 2007 were retrospectively reviewed. Seven hundred fourteen patients suffered from urolithiasis, and 450 patients were diagnosed as non-urolithiasis. Blood and urine were taken from the patient the next morning after admission. Serum levels of Ca, P, K, Na, Cl, CO2CP and urine pH and SG were checked by automatic biochemistry analyzer. The data were analyzed by software SPSS 13.0.
Patients' ages in urolithiasis group varied from 5 to 87 years and the male to female ratio was 1.8:1. The patients in non-urolithiasis group aged from 12 to 94 years and the male to female ratio was 3.8:1. There was difference in the levels of serum Na, K, Cl, CO2CP, Ca and P between urolithiasis and non-urolithiasis groups (P<0.05). In male patients, serum Na, Ca and P levels in urolithiasis group were higher than those in non-urolithiasis group(P<0.05), serum K and urine pH levels were lower in urolithiasis group than those in non-urolithasis group (P<0.05). In female patients, serum Na level was higher in urolithiasis group than that in non-urolithiasis group (P=0.080). Logistic regression analysis showed that beta value of serum Na level in male and female group was 0.10 (P<0.01) and 0.09 (P=0.054) respectively.
There was difference in serum electrolyte levels between urolithiasis group and non-urolithiasis group. The chang of serum Na level may play role in pathogenesis of urolithiasis.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 08/2010; 42(4):451-3.
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ABSTRACT: To analyze the pathogenic bacterial's distribution and the drug resistance in the upper urinary tract stones, and to provide the information for choosing suitable antibiotics.
Stone samples were taken for culture and for drug sensitivity test in 146 patients undergoing percutaneous nephrolithotomy between April 2007 and October 2008, and the results were analyzed.
Pathogens presented in 72 (49.3%) patients. There were 70 (86.4%) Gram-negative bacteria strains. Escherichia coli, Pseudomonas aeruginosa and Enterobacter cloacae were the predominant bacteria, accounted for 30.9%(25 strains), 23.5% (19 strains) and 12.3% (10 strains), respectively. There were 10 (12.3%) Gram-positive bacteria strains, the predominant bacteria was Staphylococcus epidermidis (6 strains), accounting for 7.4%. And there was 1 fungi strain (1.2%). Resistance to ampicillin/sulbactam (88.7%), ceftriaxone (81.3%) and ciprofloxacin (67.5%) was most commonly found in pathogen, and the rate of resistance to amikacin, imipenem and piperacillin/tazobactam were 8.6%, 10.0%, 10.0%, respectively. Erythromycylamine, teicoplanin, SMZ-TMP, nitrofurantoin were sensitive to Gram-positive bacteria.
Bacterial's distribution of upper urinary tract stones are multiple, and the majority pathogen is Gram-negative bacteria. A big variant resistance is found among different bacterium. The suitable antibiotics should be chosen according to the different bacterium in the patients who underwent percutaneous nephrolithotomy.
Zhonghua wai ke za zhi [Chinese journal of surgery] 02/2010; 48(4):293-5.
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ABSTRACT: To analyze the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) and to quantitatively predict the probability of SIRS after PCNL.
Medical records on 209 patients who underwent PCNL were retrospectively analyzed. The chi2 test, the t-test and a logistic regression model were used to identify key risk factors of SIRS after PCNL. A predictive equation was then formulated to assess the risk of SIRS according to the results from the logistic model. Subsequently, the accuracy of the equation by calculating sensitivity, specificity, overall correct percentage, and positive and negative predictive values was tested.
The incidence of SIRS after PCNL was 23.4%. The key risk factors for SIRS following PCNL were: the number of tracts, receipt of a blood transfusion, stone size, and presence of pyelocaliectasis. Other factors added no independent risk to the development of SIRS. The calculated values for sensitivity, specificity, overall percentage correct, positive predictive value and negative predictive value were 44.9%, 95.0%, 83.3%, 73.3%, and 84.9%, respectively.
Number of tracts, receipt of a blood transfusion, stone size and presence of pyelocaliectasis are identified as the key risk factors for SIRS after PCNL. The predictive equation allows for an individualized and quantitative assessment of the probability of SIRS after PCNL.
International Journal of Urology 01/2009; 15(12):1025-8. · 1.75 Impact Factor
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ABSTRACT: To investigate the efficacy of inducing apoptosis in human bladder cancer cells by adriamycin and mitomycin and relevant mechanism.
Human bladder cancer cells of the lines RT4, MGH-U1, FJ, and T24 were cultured. Adriamycin of the concentrations of 0.1, 1, and 10 microg/ml, and mitomycin of the concentrations of 0.01, 0.1, and 1 microg/ml were added into the culture fluid respectively. CCK-8 colorimetric assay was used to detect the survival rates of the cells so as to select the cell line sensitive and tolerable to the drugs. Flow cytometry was used to detect the cell apoptosis. Western blotting was used to detect the levels of X-kinked inhibitor of apoptosis protein (XIAP) and the cleavage of caspase-3 precursor.
It was found that RT4 cells were the most sensitive and the T24 cells were the most tolerable to adriamycin and mitomycin. Treated with adriamycin of the concentrations of 0.1, 1, and 10 microg/ml for 24 hours, the apoptotic rates of the RT4 cells were 15.3% +/- 4.3%, 29.3% +/- 6.4%, and 45.0% +/- 5.5% respectively; and the apoptotic rates of the T24 cells were 7.3% +/- 3.1%, 12.5% +/- 4.3%, and 18.2% +/- 6.3% respectively, all significantly lower than those of the RT4 cells (P < 0.05 or P < 0.01). Treated with mitomycin of the concentrations of 0.01, 0.1, and 1 microg/ml for 24 hours, the apoptotic rates of the RT4 cells were 12.7% +/- 2.9%, 31.3% +/- 4.4%, and 48.9% +/- 5.8% respectively, and the apoptotic rates of the RT4 cells were 7.2% +/- 3.3%, 15.5% +/- 5.2%, and 21.2% +/- 4.4% respectively, all significantly lower than those of the RT4 cells (all P < 0.05). The XIAP expression was not significantly different in these 4 cell lines before the adriamycin and mitomycin treatment. After the treatment of adriamycin and mitomycin, the expression of XIAP was down-regulated dose-dependently, however, being weaker in the T24 cells than in the RT4 cells; and caspase-3 precursor cleavage was enhanced, however, being weaker in the T24 cells too.
Adriamycin and mitomycin dose-dependently kill the human bladder cancer cells. Such cytotoxic effect may be realized through inducing the cell apoptosis which is associated with the down-regulation of XIAP and cleavage of caspase-3 precursor.
Zhonghua yi xue za zhi 08/2006; 86(25):1774-7.
