A retrospective comparison of Sun's tip-flexible semirigid ureterorenoscopy, super-mini percutaneous nephrolithotomy and flexible ureteroscopy applied to treat upper urinary tract calculi.

BACKGROUND: This retrospective study was conducted to compare the safety and efficacy of Sun's tip-flexible semirigid ureterorenoscopy (tf-URS), super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy (FURS) in treating upper urinary tract calculi, including upper ureteral or renal calculi. METHODS: We included patients with upper ureteral calculi or renal calculi 1.0-2.0 cm in size, who underwent tf-URS, SMP or FURS, respectively. The indicators reflecting safety and efficacy were compared among the three surgical techniques. RESULTS: SMP presented with higher single stone crushing success rate, but longer operation time and postoperative hospital stay, more blood loss, and higher postoperative pain score compared with FURS and tf-URS (P < 0.05). The hospitalization cost of tf-URS group was lower than that of SMP and FURS groups (P < 0.05). The incidence of postoperative fever in tf-URS group was significantly higher than that in SMP group (P < 0.05). No significant difference was found in mucosal injury, perirenal hematoma, and stone-free rate at 3 months after surgery (P > 0.05). CONCLUSIONS: tf-URS and FURS have the advantages in minimal invasion, hospitalization cost, patient comfort, and hospital stay while SMP has higher stone-free rate. These three surgical techniques are safe, reliable and complementary, which should be selected according to the actual situation.

The effectiveness and safety of Sun tip-flexible ureterorenoscope for the management of kidney stones: A protocol for systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Kidney stone is one of the urinary system diseases with a high incidence. In this study, we will evaluate the effectiveness and safety of Sun tip-flexible ureterorenoscope treating patients with kidney stone. METHODS AND ANALYSIS: English and Chinese literature about Sun tip-flexible ureterorenoscope treatment for kidney stones published before October 31, 2020 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only randomized controlled trials (RCTs) of patients with kidney stones will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. RESULTS: The current study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings in the fourth quarter of 2021. CONCLUSION: This study will provide recommendations for the effectiveness and safety of Sun tip-flexible ureterorenoscope for patients with kidney stones (KS), which may help to guide clinician. ETHICS AND DISSEMINATION: Ethical approval is not required as the review is a secondary study based on published literature. The results of the study will be published in peer-reviewed publications and disseminated electronically or in print. PROTOCOL REGISTRATION NUMBER: INPLASY2020110099.

A Retrospective Study of Kidney Stone Recurrence in Adults.

BACKGROUND: Nephrolithiasis or kidney stone disease (KSD) is a common disorder worldwide. Despite the availability of a variety of effective management strategies, KSD recurrence remains a problem. In the present study, we investigated the KSD recurrence after the treatment of the first stone episode. METHODS: Medical records of all patients who had KDS treated in our department from January 2012 to January 2016 were retrospectively reviewed. A total of 146 patients who had KDS recurrence were identified. The demographic information, biochemical data, treatment methods, report of hydronephrosis severity and stone chemical compositions were collected and analyzed. RESULTS: We reported that: 1) Sixty four (43.8%) out of 146 patients with stone recurrence were overweight or obese; 2) Of all 146 patients with stone recurrence, 86 (58.9%) had hyperlipidemia, 77 (52.4%) had hyperuricemia and 64 (43.8%) had hyperglycemia; 3) Mini-invasive methods were mostly used for the treatment of the first stone episode; 4) The most chief complaint differed during the first episode and recurrence; 5) The number of patients who had grades 3 and 4 hydronephrosis was significantly lower during recurrence compared with that in the first stone episode; 6) Seventy nine (54.1%) patients with recurrence had stone of calcium oxalate. CONCLUSIONS: Majority of patients with KSD recurrence have overweight/obesity, hyperlipidemia, hyperuricemia and hyperglycemia, indicating a role of metabolic disorders in stone recurrence. Mini-invasive methods are the mainstay for the management of the first stone episode. The degree of hydronephrosis is significantly reduced during stone recurrence, possibly due to increased awareness of the disease and thereafter the change of lifestyle in patients. Over half of recurrent stones are of calcium oxalate.

Unusual Features of Clear Cell Adenocarcinoma of the Female Urethra: A Case Report and Literature Review.

BACKGROUND: There has been scarce information about clear cell adenocarcinoma of the urethra (CCAU), an extremely rare type of cancer. A few case reports show that CCAU tends to have similar clinical manifestation to the other urethral carcinomas, urethrocystoscopy can easily identify tumoral lesions in the urethra, and bloody drainage from the urethral meatus is often seen during physical exams. METHODS: A 52-year-old woman presented with dysuria for 6 months. Urethrocystoscopy did not reveal abnormality, and there was no bloody vaginal drainage or bloody drainage from the urethral meatus during physical exams. Ultrasonography demonstrated a solid mass with well-defined margins located between the anterior vaginal wall and the posterior urethral wall. Computed tomography showed the mass with smooth margins at the level of vaginal fornix, and magnetic resonance imaging showed the same location of the tumor as ultrasonography. RESULTS: Surgical removal of the tumor was successfully performed and histological and immunohistochemical analysis confirmed the final diagnosis of CCAU. CONCLUSION: Abnormality in urethrocystoscopy and bloody drainage during the physical exam were not found in this case, which is in contrast to the findings reported in literature. These unusual features add new knowledge about CCAU that deserves dissemination for improved CCAU diagnosis and management.

Effect of Xuefu Zhuyu Decoction Pretreatment on Myocardium in Sepsis Rats.

Xuefu Zhuyu Decoction (XFZYD), the classical recipe for promoting blood circulation by removing blood stasis, has been used in China for a long history clinically. XFZYD has been found to improve cardiac function through reducing inflammation. However, the effect of XFZYD on myocardial apoptosis remains unclear. Herein, we investigated the mechanism of XFZYD preconditioning on myocardial injury in sepsis rats. The rats were treated with XFZYD one week, followed with intraperitoneal injection of lipopolysaccharide (LPS: 10 mg/kg) to induce sepsis. Pretreatment with XFZYD could reverse the effects of LPS-induced decreased mean arterial pressure (MAP) and increased heart rate (HR). XFZYD decreased the levels of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and interleukin-6 (IL-6) in serum or in heart. TUNEL staining revealed that the apoptotic index of XFZYD was significantly lower compared with the LPS group (P<0.05). Western blot results showed that the high doses of pretreatment XFZYD group can reduce the Bax expression of myocardial tissue in rats (P<0.05, P<0.01). The expression of Bcl-2 in XFZYD group was significantly higher than that in the LPS group (P<0.01), while the expression of caspase-3 in treatment group was significantly lower than that in the LPS group only after 12 h modeling (P<0.01). In addition, caspase-3 activity in rat cardiomyocytes of XFZYD-treated animals was significantly decreased. These findings suggest that pretreatment with XFZYD exerts a protective effect in the myocardium of septic rats by inhibiting myocardial cell apoptosis and antioxidation.

Effective treatment of ketamine-associated cystitis with botulinum toxin type a injection combined with bladder hydrodistention.

Objective Ketamine-associated cystitis (KAC) has been described in a few case reports, but its treatment in a relatively large number of patients has not been documented. This study aimed to describe our experience of treatment of 36 patients with KAC. Methods Thirty-six patients (30 males and 6 females, aged 19-38 years) with KAC, who had previously taken a muscarinic receptor blocker and/or antibiotics, but without symptomatic relief, were treated with botulinum toxin A injection combined with bladder hydrodistention. Urodynamic testing, and the O'Leary-Sant interstitial cystitis symptom index (ICSI) and problem index (ICPI) were used to evaluate baseline values and improvement before and after the treatment. Results One month post-treatment, all patients achieved marked relief of symptoms. The nocturia time was markedly reduced, while bladder capacity, the interval between micturition, the void volume, and the maximum flow rate were remarkably increased at 1 month. Additionally, the ICSI and ICPI were significantly improved. Conclusion Botulinum toxin A injection along with bladder hydrodistention is effective for managing KAC.

Effects of peptide nucleic acids against Ki-67 gene on the proliferation and apoptosis of human renal carcinoma cell line.

To investigate the effects of anti-sense peptide nucleic acids (PNAs) targeting Ki-67 gene on modulation of the proliferation and apoptosis of human renal carcinoma cell lines, human renal carcinoma cell line 786-0 cells were treated with anti-sense PNAs at different concentrations (1.0 micromol/L, 2.0 micromol/L, 10.0 micromol/L). The Ki-67 expression of 786-0 cells was detected by immunohistochemical technique and Western blot method respectively. The proliferation of 786-0 cells was studied by cell growth curves and 3H-thymidine incorporation. The apoptosis of 786-0 cells was detected by TUNEL assay. The control groups were treated with anti-sense oligonucleotide (ASODNs) targeting Ki-67 gene. Our results showed that the Ki-67 expression of 786-0 cells treated with anti-sense PNAs (16.9+/-0.7) was significantly inhibited as compared with that of the control groups (28.6+/-0.4) (P<0.01). The Ki-67 protein rate of 786-0 cells treated with anti-sense PNAs (42.1 +/-2.2) was significantly reduced when compared with that of the control groups (83.6+/- 1.4) (P<0.01). Proliferation of 786-0 cells treated with anti-sense PNAs (20.7+/- 1.5) was significantly inhibited as compared with that of the control groups (58.6+/- 1.4) (P<0.01). The apoptosis rate of 786-0 cells treated with anti-sense PNAs (28.7+/- 2.3) was significantly increased higher compared with that of the control groups (13.8 +/- 1.0) (P<0.01). From these finds we are led to conclude that anti-sense PNAs targeting Ki-67 gene have stronger effects on the inhibition of the proliferation and induction of apoptosis of human renal carcinoma cells than ASODNs targeting Ki-67 gene. The strategies using anti-sense PNAs targeting Ki-67 gene may be a promising approach for the treatment of renal cell carcinoma.