Comparison of safety and efficacy of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in patients with large renal pelvic stones: a meta-analysis.

To compare percutaneous nephrolithotomy (PCNL) and laparoscopic pyelolithotomy (LP) for surgical management for large (>2 cm) renal stones. We searched MEDLINE, Cochrane, and EMBASE databases until March 11, 2015, using the following search terms: renalpelvic stone, percutaneous nephrolithotomy, laparoscopic pyelolithotomy. Randomized controlled and prospective and retrospective two-armed studies were included. Sensitivity analysis and assessment of the quality of the included studies and publication bias were performed. Nine studies were included in the study with a patient population of 622. The studies were homogeneous with respect to the primary end point of stone-free rate, but were heterogeneous with respect to operation time, length of hospital stay, and blood loss. A higher percentage of patients who received LP remained stone-free following surgery compared with patients who were treated with PCNL (p=0.001). However, the mean operation time was longer for patients with LP than for those treated with PCNL (p=0.002). There was no difference between procedures with regard to length of hospital stay or blood loss (p≥0.071). Sensitivity and quality analysis indicated that the data are reliable and the included studies are of good quality. No publication bias was observed. The study suggests that both procedures are effective and safe for removing large renal stones. However, LP may be more efficacious than PCNL in treating large kidney stones.

A novel rabbit anti-hepatocyte growth factor monoclonal neutralizing antibody inhibits tumor growth in prostate cancer cells and mouse xenografts.

The hepatocyte growth factor and its receptor c-Met are correlated with castration-resistance in prostate cancer. Although HGF has been considered as an attractive target for therapeutic antibodies, the lack of cross-reactivity of monoclonal antibodies with human/mouse HGFs is a major obstacle in preclinical developments. We generated a panel of anti-HGF RabMAbs either blocking HGF/c-Met interaction or inhibiting c-Met phosphorylation. We selected one RabMAb with mouse cross-reactivity and demonstrated that it blocked HGF-stimulated downstream activation in PC-3 and DU145 cells. Anti-HGF RabMAb inhibited not only the growth of PC-3 cells but also HGF-dependent proliferation in HUVECs. We further demonstrated the efficacy and potency of the anti-HGF RabMAb in tumor xenograft mice models. Through these in vitro and in vivo experiments, we explored a novel therapeutic antibody for advanced prostate cancer.

Ultrasonographic diagnosis and typing of renal tuberculosis.

AIM: To evaluate the clinical value of sonography in the diagnosis and typing of renal tuberculosis. METHODS: A total of 258 cases of renal tuberculosis with complete sonographic data were reviewed. The distinguishing features of the ultrasound images of these cases were retrospectively analyzed. RESULTS: The coincidence rate of ultrasonography in the diagnosis of renal tuberculosis was 58.9% (152/258). According to the distinguishing features of the ultrasound images, renal tuberculosis could be classified under six types. Type I: nephrectasia type, 23 cases; type II: hydrops type, 21 cases; type III: empyema type, 13 cases; type IV: inflammatory and atrophy type, 15 cases; type V: calcification type, 34 cases; type VI: mixed type, 46 cases. CONCLUSION: Ultrasonographic examination has convenient, low-priced and non-invasive advantages. The typing of renal tuberculosis based on the distinguishing features of the ultrasound images provides important and reliable information for the clinical diagnosis, differential diagnosis and treatment of renal tuberculosis.

[Diagnosis and surgical management of renal cell carcinoma with inferior vena cava tumor thrombus--a report of 6 cases with literature review].

BACKGROUND & OBJECTIVE: The management of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus is difficult in clinical practice. Complete surgical removal of the primary tumor with its extension along the IVC is the only hope for a potential cure. The diagnosis of vena caval invasion, especially the determination of tumor thrombus extension, is important for surgical approach planning. This report was to summarize our experiences on treating RCC with IVC tumor thrombus, and explore the diagnosis and surgical management. METHODS: Clinical data, including preoperative diagnosis, operation pattern, and prognosis, of 6 RCC patients with IVC tumor thrombus, treated from 2000 to 2004 in our hospital, were reviewed retrospectively. RESULTS: Diagnoses of the 6 cases of RCC with IVC tumor thrombus were made by ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI) preoperatively. Of the 6 cases, 1 was renal vein thrombus, 3 were infrahepatic thrombus, 2 were hepatic thrombus. Operations were performed for all 6 patients with 5 successes except 1 death during the operation. The patients were followed-up for 3-30 months after operation; 2 died of distant metastases 3 and 9 months after operation, and the other 3 survived disease-freely. CONCLUSIONS: CT and MRI are the best ways to diagnose RCC with IVC tumor thrombus. Surgical treatment is the preferred approach for the patients without distant metastases and lymph node involvement. Surgical strategy depends on the tumor thrombus extension and the vena wall involvement status.

[Spiral CT urography and CT virtual endoscopy in detecting urological diseases].

OBJECTIVE: To evaluate spiral CT urography (SCTU) and CT virtual endoscopy (CTVE) in detecting urologic diseases. METHODS: SCTU was performed in 46 patients with urological diseases including renal neoplasms (2), paropelvic cysts (2), ureteral calculi (6), ureteral stenosis (4), ureteral neoplasms (2), double kidneys and ureter malformation (1), bladder neoplasms (28) and bladder endometreosis (1). The 6 patients with ureteral diseases and 29 patients with bladder diseases underwent CTVE based on spiral CT scan. All CTVE findings were compared with those of B-mode ultrosonography, intravenous urography (IVU), retrograde pyelography (RGP), conventional CT or cystoscopy. RESULTS: All upper urinary tract diseases and bladder diseases (28 cases) were detected by SCTU and CTVE scans and they were confirmed operatively or pathologically except one case of bladder neoplasm (diameter less than 5 mm) was missed. CONCLUSION: SCTU and CTVE have proved to be non-invasive and reliable in the diagnosis of urological diseases and are superior to IVU or conventional CT. CTVE can serve as a supplementary method to fiberoptic cystoscopy or ureteroscopy.