[Mechanism of ultrafiltration extract of Angelicae Sinensis Radix and Hedysari Radix regulates HIF-1α signaling pathway mediated by renal hypoxia to ameliorate renal fibrosis in DKD rats].

This study explored the mechanism of the ultrafiltration extract of Angelicae Sinensis Radix and Hedysari Radix in ameliorating renal fibrosis in the rat model of diabetic kidney disease(DKD) based on the expression of hypoxia-inducible factor-1α(HIF-1α)/vascular endothelial growth factor(VEGF) and HIF-1α/platelet-derived growth factor(PDGF)/platelet-derived growth factor receptor(PDGFR) signaling pathways in the DKD rats. After 1 week of adaptive feeding, 50 male SPF-grade Wistar rats were randomized into a blank group(n=7) and a modeling group. After 24 h of fasting, the rats in the modeling group were subjected to intraperitoneal injection of streptozocin and fed with a high-sugar and high-fat diet to establish a DKD model. After modeling, the rats were randomly assigned into model(n=7), low-dose ultrafiltration extract(n=7), medium-dose ultrafiltration extract(n=7), irbesartan(n=8), and high-dose ultrafiltration extract(n=8) groups. After intervention by corresponding drugs for 12 weeks, the general conditions of the rats were observed. The body weights and blood glucose levels of the rats were measured weekly, and the 24 h urinary protein(24hUP) was measured at the 6th and 12th weeks of drug administration. After the last drug administration, the renal function indicators were determined. Masson staining was employed to observe the pathological changes of the renal tissue. The expression of prolyl hydroxylase domain 2(PHD2) and HIF-1α in the renal tissue was detected by immunohistochemistry(IHC). Real-time qPCR was employed to determine the mRNA levels of PHD2, VEGF, PDGF, and PDGFR in the renal tissue. Western blot was employed to determine the protein levels of HIF-1α, VEGF, PDGF, and PDGFR in the renal tissue. The results showed that compared with the model group, drug administration lowered the levels of glycosylated serum protein(GSP), aerum creatinine(Scr), and blood urea nitrogen(BUN) in a dose-dependent manner(P<0.05 or P<0.01) and mitigated the pathological changes in the renal tissue. Furthermore, drug administration up-regulated mRNA level of PHD2(P<0.05 or P<0.01), down-regulated the mRNA levels of VEGF, PDGF, and PDGFR(P<0.05 or P<0.01) and the protein levels of HIF-1α, VEGF, PDGF, and PDGFR(P<0.01) in the renal tissue, and increased the rate of PHD2-positive cells(P<0.01). In conclusion, the ultrafiltration extract of Angelicae Sinensis Radix and Hedysari Radix effectively alleviated the renal fibrosis in DKD rats by inhibiting the expression of key proteins in the HIF-1α signaling pathway mediated by renal hypoxia and reducing extracellular matrix(ECM) deposition.

Targeting silencing androgen receptor gene by shRNA with low-intensity focused ultrasonic irradiation inhibits growth of prostate cancer xenografts in nude mice.

The androgen receptor (AR) plays a pivotal role in prostate cancer, making it a potential therapeutic target. Short-hairpin RNA (shRNA) inhibits gene expression and offers a novel strategy to eradicate disease. Ultrasound-mediated gene transfection is a promising gene delivery method. This study sought to determine whether targeting silencing androgen receptor gene by shRNA with low-intensity focused ultrasonic irradiation could be used as effective therapy for prostate cancers in vivo. A plasmid-based short-hairpin RNA combined with low-intensity focused ultrasonic irradiation approach was used to specifically knock down the expression of AR in prostate cancer 22RV1 cells in vivo. The growth of 22RV1 tumors that had been subcutaneously xenografted was evaluated and expression level of AR was determined by immunohistochemical staining. The proliferative index (PI) and the apoptotic index (AI) were respectively derived from the percentage of positive cells by Ki-67 immunohistochemical staining and TUNEL assay. The plasmid-based AR shRNA administrated intravenously significantly inhibited the tumor growth and AR expression. These inhibitory effects of AR shRNA were augmented when the region of tumor received low-intensity focused ultrasound irradiation. Immunohistochemical staining and TUNEL assay confirmed AR shRNA with low-intensity focused ultrasonic irradiation exhibited growth-inhibitory, antiproliferative, and apoptotic effects on prostate cancer xenografts. The authors showed for the first time that the knockdown of AR expression by plasmid-based AR shRNA with low-intensity focused ultrasonic irradiation significantly suppressed the tumor growth of prostate cancer in vivo.

[Safety and efficacy of China-made sildenafil citrate in the treatment of erectile dysfunction].

OBJECTIVE: To evaluate the safety, efficacy and tolerability of China-made sildenafil citrate (Jinge) in the treatment of ED. METHODS: We conducted a multi-center, randomized, double-blind and placebo-controlled clinical trial among 222 ED patients in five urological or andrological clinics of China. The patients were randomly assigned to receive sildenafil citrate (SC, n = 111) or placebo (n = 111) for 8 weeks. We obtained and analyzed the demographic and clinical characteristics of the patients, the scores of International Index of Erectile Function (IIEF), the success rate of sexual intercourse, and the incidence of adverse events. RESULTS: No statistically significant differences were found between the patients of the SC and those of the placebo group in the mean age (ï¼»47.2±11.32ï¼½ yr vs ï¼»46.67±13.08ï¼½ yr, P>0.05), psychological etiology (27.93% vs 23.42%, P>0.05), organic etiology (21.62% vs 29.73%, P>0.05) or mixed etiology (50.45% vs 46.85%, P>0.05), nor in height, weight, nationality, or history of smoking, drinking or allergy. Compared with the placebo controls, the SC-treated patients showed significant increases in the excellence rate of effectiveness (29.91% vs 78.90%, P<0.01), success rate of sexual intercourse (29.16% vs 63.87%, P<0.01), and total effectiveness rate (34.58% vs 77.98%, P<0.01). The effectiveness rates on organic, psychogenic and mixed types ED were remarkably higher in the SC group (64.52%, 83.33%, and 82.14%) than in the placebo control (46.15%, 21.21%, and 25.00%) (P<0.01). Mild or temporary adverse events were observed in 32 cases in the SC group as compared with 13 in the placebo control. CONCLUSIONS: China-made sildenafil citrate is an effective, safe and well-tolerated drug for ED of different etiologies in the Chinese population.

[Tuberculous prostatic abscess following intravesical bacillus Calmette-Guerin immunotherapy: a case report].

Intravesical bacillus Calmette-Guerin (BCG) was a common treatment for non-muscle invasive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor (TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound (TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Because of the good response to the medicine, no further aspiration or drainage of prostatic abscess was carried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

[Treatment of upper urinary calculi through novel modular flexible ureteroscope: a report of 36 cases].

OBJECTIVE: To evaluate the feasibility and efficacy of novel modular flexible ureteroscope in the treatment of upper urinary calculi. METHODS: From Nov. 2013 to Jul. 2014, 36 cases of upper urinary calculi were treated with holmium laser lithotripsy through novel modular flexible ureteroscope. The clinical data including the location and diameter of the calculi, time of operation, stone-free rate, complications and hospital stay after operation were analyzed retrospectively. RESULTS: The operation was performed successfully in 34 cases, the average time of operation was 108.5 min (70-145 min), the post-operation hospital stay was 2-5 d (average 2.3 d), and the stone-free rate was 83.33%. No serious complications occurred except postoperative fever in 2 cases and haemorrhage in 1 case. CONCLUSION: The novel modular flexible ureteroscope is a safe and effective medical instrumentation for treatment of upper urinary calculi.

[Bacterial culture and drug sensitivity analysis of upper urinary tract calculi complicating with infection].

OBJECTIVE: To investigate the bacteriology and drug sensitivity of upper urinary tract calculi patients, and to provide information for choosing suitable antibiotics. METHODS: In the study, 21 patients who suffered from lithiasis in upper urinary tract and required an emergency drainage for acute obstruction and infection were the "acute group"; 64 patients with calculi in upper urinary tract and accompanied with no infectious symptoms were the "common group". The bacteriology and drug sensitivity of the two groups were investigated. RESULTS: Gram-negative bacteria infected the most common of upper urinary tract calculi patients with infection, accounting for 71.4% in the acute group and 65.7% in the common group, among which Escherichia coli were the predominant ones (35.7% in the acute group and 32.9% in the common group). No difference was found between these two groups in bacterial distribution (P>0.05). Although the average drug resistance rate of Gram-negative bacteria in the acute group was higher than that in the common group, it revealed no significant difference (P>0.05). The drug resistance rate to semisynthetic penicillin, cefuroxime and ceftriaxone were more than 50%, 60%, and 50%, respectively. Quinolones, such as ciprofloxacin and levofloxacin, got a 45% drug resistance. Aminoglycoside, carbapenema were sensitive to Gram-negative bacteria. Cefoperazone/sulbactam and piperacillin/tazobactam were more effective than ceftriaxone and piperacillin, respectively. CONCLUSION: There was no significant difference between upper urinary tract calculi patients with acute infection and common infection in bacteriology and drug sensitivity. Semisynthetic penicillin, the second generation of cephalosporin and quinolone were no longer the good choices of empirical use. Antibiotics combined with ß-lactamase inhibitors would be an ideal empirical therapeutic choice.

[Diagnosis and treatment of hydrocephalus-accompanied renal calculi complicated with renal tumor: 5 case reports].

OBJECTIVE: To investigate the diagnosis and treatment of renal pelvic tumor combined with renal urinary calculi and hydronephrosis. METHODS: Five patients with renal pelvic tumor who underwent relief of the upper urinary obstruction were reviewed. RESULTS: One of the cases lost the opportunity of surgical therapy when pelvic tumor was detected at the advanced stage, and the other 4 cases had received surgery and were followed up. CONCLUSION: As pelvic tumor progresses rapidly after the renal blood flow is improved, and renal urinary calculi with hydronephrosis relieved; the patients with renal pelvic tumor need early diagnosis, aggressive treatment and close follow-up.

[Percutaneous renal puncture guide by a novel real-time needle-tracking ultrasound system for percutaneous nephrolithotomy: analysis of 16 cases].

OBJECTIVE: To evaluate the feasibility and efficacy of percutaneous renal puncture in percutaneous nephrolithotomy guided by novel needle-tracking ultrasound system. METHODS: From may to october 2013, 16 cases of percutaneous nephrolithotomy were performed under the guidance of ultrasound system. The clinical data including the time of completing percutaneous renal puncture, the color of urine sucked out from the kidney calices, and the complications were analyzed retrospectively. RESULTS: Of the 16 patients, 18 percutaneous renal access were established guided by ultrasound system. All of them were successtul for the first time, and the average time of completing percutaneous renal punctures was (26.90 ± 11.37) s (15 to 54 s). After the operation, the hemoglobin decreased by (9.56 ± 5.27)%(1.41% to 24.06%), and no complications occurred except for postoperative fever in 2 case. CONCLUSION: The novel ultrasound system is a safe and effective technique that can reduce the technical difficulty of percutaneous renal puncture in percutaneous nephrolithotomy.

[Balloon dilation by B ultrasound monitoring for treatment of urethral stricture: 5 case reports].

Urethral stricture is a common urologic disease and there are many therapeutic methods for it. Here we investigated the application of balloon dilation under B-mold ultrasound monitoring in the treatment of urethral stricture. Five male patients suffering from urethral stricture were treated with balloon dilation under B-mold ultrasound monitoring.Their urination was assessed after operation. All the patients underwent the operation successfully, without serious complications. The urinary catheter was removed 3-4 weeks after operation. The patients were followed up for 8 to 15 months. Four patients were voiding well and one improved. Balloon dilation under B-mold ultrasound monitoring in the treatment of urethral stricture was intuitive, safe and effective.

[Androgen receptor silencing by shRNA inhibits human prostate cancer xenograft growth in nude mice].

OBJECTIVE: To investigate the inhibitory effect of silencing androgen receptor (AR) gene by AR short-hairpin RNA (shRNA) on the growth of human prostate cancer xenograft in nude mice. METHODS: Human 22RV1 prostate cancer cells were inoculated subcutaneously into nude mice to establish xenograft models of human prostate cancer. Meanwhile, a short-hairpin RNA that was capable of suppressing the expression of AR was constructed and then recombinant plasmids producing AR shRNA were prepared in a large number. The tumor-bearing mice were randomly divided into 2 groups: the control group and the experimental group. When the tumor volume grew to about 300 mm(3), the plasmids prepared previously were injected into the tail veins of the mice once at the dose of 2 µg/g in the experimental group, whereas the mice in the control group was injected with the same amount of saline as control. The tumor volumes were monitored every other day until 14 days after the treatment.At the endpoint,the mice were sacrificed and the tumors were excised, weighed, fixed in buffered-formalin, and embedded in paraffin for the immunohistochemical analysis of AR,Ki-67 (a marker of proliferative cell) levels and apoptotic cell labeling by TUNEL (terminal deoxynucleotidyl transterase-mediated dUTP nick end labeling) assay. A semiquantitative immunohistochemical scoring system, HSCORE system, was used to evaluate the expression of AR and proliferative index/Ki-67 labeling index (PI/Ki-67 LI) and apoptotic index (AI) were used to assess the cell proliferation and cell apoptosis, respectively. RESULTS: Compared with the control group, the treatment induced an evident inhibitory effect on the tumor growth in the nude mice with prostate cancer. At the endpoint, the tumor volume of (1 199.56±86.48) mm(3) in the experimental group was significantly smaller than that of (1 742.02±98.16) mm3 in the control group (P=0.002). The tumor weight of (1 006.2±79.1) mg in the experimental group significantly decreased compared with that of (1 383.4±74.8) mg in the control group (P=0.005). The AR HSCORE,PI and AI in the experimental group were 25.8±6.7, (26.0±3.1)%, (55.6±7.9)%, respectively, and those in the control group were 268.8± 18.7, (87.6±7.9)%, (27.2±3.9)%, respectively. There were significant differences between the two groups (all P<0.01). CONCLUSION: AR shRNA could be injected intravenously to suppress the expression of AR in vivo and hence inhibit the growth of human prostate cancer xenograft in nude mice.

[Tea polyphenol protects against HK-2 cell injury induced by oxalate and calcium oxalate monohydrate crystals].

OBJECTIVE: To test whether the antioxidants tea polyphenol (TP) can provide protection against oxalate and calcium oxalate monohydrate (COM) crystals toxicity in HK-2 cells. METHODS: Four groups were chosen for the study: Negative control group, positive control group (COM+oxalate), TP group (TP+COM+oxalate), VitE group (vitamin E+COM+oxalate). HK-2 cells were exposed for 4, 8, 12 and 24 h. The viability of the cells was assessed by MTT. The cellular injury was assessed by the concentration of lactate dehydrogenase (LDH), hydrogen peroxide and viability of Na+/K+ ATP enzyme. The peroxidation level was assessed by malondialdehyde (MDA) content and viability of superoxide dismutase (SOD). The morphological changes of HK-2 cells after being exposed for 4 and 12 h in each group were observed by transmission electron microscope (TEM). RESULTS: The effects of TP and vitamin E on oxalate and COM exposed cells were tested. The HK-2 cells exposed to oxalate and COM showed a significant reduction in viability of cells, Na+/K+ ATPase and SOD. LDH release, MDA content and concentration of H2O2 were significantly increased. In TP group, the addition of TP significantly increased viability of cells, activity of Na+/K+ ATPase and SOD while LDH release, MDA content and concentration of H2O2 were significant decreased compared with the positive control group. In the Vitamn E group, compared with the positive control group, viability of cells, and activity of Na+/K+ ATPase were not significantly changed and after addition of vitamin E, SOD activity was restored, LDH release, MDA content and concentration of H2O2 were significant decreased compared with the positive control group. The morphological changes of HK-2 cells were observed by TEM in the positive control group, TP group and VitE group. In the VitE and TP groups, the amount of the cells with vacuoles formed in kytoplasms, mitochondria swelling, karyotheca dissolved and nucleolus disappearing were less than in the positive group. The morphological changes in the TP group were less than in the VitE group. CONCLUSION: TP and vitamin E administration may prevent oxalate and COM mediated peroxidative injury and restore intracellular antioxidant enzyme activity. The protection rendered by TP was greater than that of vitamin E.

[Application of a novel intracorporeal combined pneumatic and ultrasonic lithotriptor (CQS-01) in percutaneous nephrolithotomy].

OBJECTIVE: To evaluate the safety and efficacy of a new intracorporeal pneumatic and ultrasonic lithotriptor (CQS-01) in percutaneous nephrolithotomy (PNL). METHODS: In the study, 408 patients with renal or upper ureteral stones suitable for PNL treatment were treated with CQS-01 ultrasonic and pneumatic lithotripter. Their stone position: Single side 368 patients and bilaterial 40 patients. Simple kidney stones: 312 patients, combined ureteral and kidney 42 patients, and simple ureteral stones 54 patients. Stone burden: staghorn stone: 95 patients. All the patients were followed up for 1 week post-operation. The data were collected and analyzed with regard to stone burden, postoperative stone clearance rate, operation time, occurrence rate of adverse events. RESULTS: The postoperative stone-free rate was 91.2% and the residual stone rate 8.8%; The mean operation time was (90.5±68.0) min; There were 6 patients (1.5%) who received selective renal artery embolism because of bleeding after operation. One patient had severe urinary infection and no other severe complications happened. CONCLUSION: CQS-01 ultrasonic and pneumatic lithotriptor is safe and effective in PNL, and suitable for clinical application.

[Clinical safety and efficacy of a novel intracorporeal combined pneumatic and ultrasonic lithotriptor (CQS-01) compared with Swiss LithoClast Master (EMS-III)].

OBJECTIVE: To evaluate the safety and efficacy of a new intracorporeal pneumatic and ultrasonic lithotriptor (CQS-01). METHODS: 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. RESULTS: 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). CONCLUSION: There is no significant difference in clinical safety, efficacy, and the stone clearance capability between CQS-01 device and EMS-III device.

[Clinical efficacy and safety of percutaneous nephrolithotomy for upper urinary tract calculi patients with metabolic syndrome].

OBJECTIVE: To investigate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi patients complicated with metabolic syndrome (MS). METHODS: The clinical data of 66 PCNL cases with upper urinary tract calculi from March 2010 to February 2011 were retrospectively reviewed. Patients were divided into two groups according to 2004 Diagnostic Criteria of Metabolic Syndrome by the Chinese Diabetes Society (CDS). Twenty six upper urinary tract calculi patients complicated with metabolic syndrome were defined as case group (average aged 52.4 years, 16 males and 10 females). The other 40 cases without MS served as control group (average aged 45.9 years, 21 males and 19 females). The stone burden was (7.2 ± 1.8) cm(3) in case group and (6.4 ± 1.3) cm(3) in control group (P=0.712). The stone free rate, operative time, drop in hemoglobin level and fever were compared between the two groups. RESULTS: The operation time was (87.1 ± 9.0) min in case group and (87.6 ± 6.0) min in control group (P=0.963). The stone free rate was 76.9% (20/26) vs. 75.0% (30/40), P=0.859. The drop in hemoglobin level was (8.4 ± 1.6) g/L vs. (9.1 ± 1.4) g/L, P=0.739. The incidence of post-operative fever was 38.5% (10/26) vs. 45.0% (18/40), P=0.599. CONCLUSION: MS will neither increase the difficulty of surgery, nor reduce the stone free rate of PCNL for upper urinary tract calculi. And it will not raise the incidence of postoperative complications.

Andrology in China: current status and 10 years' progress.

Andrology has a long history in traditional Chinese medicine. There are records of male sexual health, male sexual dysfunction and male infertility from over thousands of years ago. Modern andrology in China had a late start, with the Chinese Andrology Association founded in 1995. Within last decade, andrology in China has grown rapidly. In this review article, we summarized the progress of andrology in last 10 years and outlined the current status of Chinese andrology with a special focus on progress in male erectile dysfunction, prostate diseases, male infertility and male hormonal contraception.

[Effect of nanobacteria on cell damage and crystal retention in renal tubular epithelial cells].

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[Cultivation and morphology of nanobacteria in sera of patients with kidney calculi].

OBJECTIVE: To detect, culture, and characterize the nanobacteria (NB) from sera of patients with kidney calculi in our department. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[Analysis of serum electrolytes in urolithiasis patients].

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[Characteristics of renal hemorrhage after percutaneous nephrolithotomy and the timing of selective embolization: a report of 13 cases].

OBJECTIVE: To investigate the characteristics of severe renal hemorrhage after percutaneous nephrolithotomy (PNL) and timing of selective transarterial embolization(TAE) . METHODS: 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. RESULTS: 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. CONCLUSION: 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.

[Clinical implication of stone culture in percutaneous nephrolithotomy].

OBJECTIVE: To evaluate the correlation between stone culture and SIRS, ascertain the clinical implication of stone culture in PCNL. METHODS: Clinical data of 66 patients who underwent PCNL in our department were analyzed retrospectively. Eight risk factors including stone culture + drug sensitivity, urine culture + drug sensitivity, age, gender, prophylactic antibiotics, stone volume, operative time and the number of tract. Multiple statistics methods were used for analysis to evaluate the impact of SIRS, and compare the difference between stone culture and urine culture. RESULTS: Univariate analysis and Multivariate logistic regression model showed that positive stone culture was the risk factor of SIRS (P < 0.05). Positive stone culture was found in 48.48% patients, which was higher than that of urine culture (30.30%). Fourteen patients (66.67%) of 21 postoperative SIRS patients were prescribed antibiotics according to the stone culture result. And all of them recovered unevenly without developing septic shock or MODS. CONCLUSIONS: Positive stone culture is the important risk factor of post-PCNL SIRS. Stone culture is better than urine culture in directing postoperative antibiotics prescripsion and should be routinely used.