Application of simulated puncture in percutaneous nephrolithotomy.

OBJECTIVE: This study aimed to explore the clinical value of simulated puncture in percutaneous nephrolithotomy in the treatment of complex kidney stones. PATIENTS AND METHODS: A total of 120 patients with complex kidney stones who were treated with percutaneous nephrolithotomy in our hospital between March 2017 and March 2020 were enrolled in this study and randomly divided into two groups: the research group and the control group (n = 60 in each). Each subject underwent a dual-source computed tomography (CT) scan of the pelvis and both kidneys before the operation. The research team imported the CT data into Mimics19 software to create a three-dimensional (3D) reconstruction of the skin, bones, kidneys, collecting system, and stones. Based on the 3D reconstruction model, the target renal calyx to be punctured was determined, the best puncture channel was designed, and puncture was simulated. Data regarding the simulated puncture were imported into 3-Matics11 software; the angle and depth of the puncture were measured, and then these data were used to guide percutaneous nephrolithotomy. 3D reconstruction and simulated puncture were not undertaken for the patients in the control group before the operation. The effects of treatment in the two groups were compared. RESULTS: First-stage percutaneous nephrolithotomy was successfully completed in both groups of patients. The outcome was better in the research group than in the control group in terms of operation time, number of punctures required for successful establishment of a percutaneous renal channel, number of percutaneous kidney puncture channels, and intraoperative blood loss, and the differences were statistically significant (p < 0.05 for all). The stone clearance rate was higher in the research group than in the control group, but the difference was not statistically significant (p = 0.471). The incidence of penetrating kidney injury was lower in the research group than in the control group, but the difference was not statistically significant (p = 0.154). CONCLUSIONS: For patients due to undergo percutaneous nephrolithotomy for the treatment of complex kidney stones, preoperative simulated puncture helps to improve the puncture accuracy and to reduce the number of punctures required for successful establishment of a percutaneous renal channel, the number of puncture channels, the operation time, and the blood loss, and therefore it is worth promoting.

[In vitro and in vivo effects of 5-aminolevulinic acid-mediated photodynamic therapy against oral squamous cell carcinoma].

Objective: To investigate the in vitro and in vivo effects of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy against oral squamous cell carcinoma (OSCC) and preliminarily explore the possible mechanisms. Methods: SCC25 cells were divided into the control group (5-ALA of 0 mg/L) and the experimental group (5-ALA of 10, 25, 50, 100 and 150 mg/L). The production of protoporphyrin Ⅸ (PpⅨ) induced by 5-ALA in SCC25 cells was detected using the flow cytometry. SCC25 cells were divided into the control group (5-ALA of 0 mg/L), lazer alone group, 5-ALA alone group (5-ALA of 100 mg/L) and the 5-ALA combined with laser irradiation group (5-ALA of 5, 10, 25, 50 and 100 mg/L), the cytotoxicity of 5-ALA combined with laser irradiation (wave length 635 nm, power density 87 mW/cm(2) and laser dose 10.4 J/cm(2)) was evaluated in SCC25 cells using the methyl thiazolyltetrazolium assay (incubation times of 4, 8 and 12 h in each group) and the induction effect of combination treatment on the cell apoptosis was assessed by the flow cytometry (incubation time of 12 h in each group). The intracellular production of reactive oxygen species (ROS) triggered by 5-ALA combined with laser irradiation was determined using a fluorescence probe method (incubation time of 12 h in each group). A mouse OSCC xenograft model bearing SCC25 tumor was built, and the mice were divided into control group (saline), 5-ALA group (5-ALA of 50 mg/kg) and 5-ALA combined with laser irradiation group (5-ALA of 10, 25 and 50 mg/kg). Antitumor effect of 5-ALA combined with laser irradiation (wave length 635 nm, power density 158 mW/cm(2) and laser dose 94.8 J/cm(2)) was further measured. Results: 5-ALA induced the production of PpⅨ in SCC25 cells in a drug concentration (0-150 mg/L)-and incubation time (0-24 h)-dependent manner. When the 5-ALA concentration was 100 mg/L, the intracellular PpⅨ production was in a relatively stable state. Cell viability and apoptosis rate of 5, 10, 25, 50, 100 mg/L 5-ALA combined with laser irradiation are, respectively, (82.3±5.2)%, (3.13±0.38)%; (74.6±9.3)%, (5.38±0.55)%; (38.3±9.7)%, (17.97±2.72)%; (9.2±3.8)%, (24.47±3.37)%; (7.2±0.8)%, (43.01±5.96)%, which indicated that 5-ALA combined with laser irradiation notably inhibited the growth of SCC25 cells and also induced significant cell apoptosis compared with the control group [(96.3±6.0)%, (0.35±0.13)%, P<0.05]. After combination treatment (5-ALA of 5, 10, 25, 50 and 100 mg/L combined with laser irradiation, the mean fluorescence intensity of dichlorofluorescein is (1.46±0.12)×10(4), (2.16±0.30)×10(4), (3.57±0.34)×10(4), (81.70±13.05)×10(4), (113.00±7.35)×10(4), respectively, a large amount of ROS was produced in SCC25 cells compared with the control group [(0.96±0.15) ×10(4), P<0.05], which was in positive correlation with the intracellular PpⅨ content. 5-ALA (concentration of 10, 25 and 50 mg/kg) combined with laser irradiation greatly suppressed the tumor growth in SCC25 tumor-bearing mice compared to the control group (P<0.05). Conclusions: 5-ALA-mediated photodynamic therapy can trigger the generation of intracellular ROS that has significant cytotoxicity and apoptosis induction effect, and thus inhibit the tumor growth both in vitro and in vivo.

[Studies of radiosensitizative effect of BSO on Acc-2 cells]

OBJECTIVE:To study the radiosensitizative effect of buthione sulfoximin (BSO) on Acc-2 cells.METHODS:First,the pharmotoxicity of BSO to Acc-2 cells under hypoxic or aerobic conditions was measured.Second,the radiosensitizative effect of BSO on Acc-2 cells under hypoxic or aerobic conditions was studied.Plating efficiency assay was used in this experiment.RESUTS:The 50% inhibition dose (ID50) of BSO to Acc-2 cells under hypoxic or aerobic condition was 80 micromol/L,120micromol/L,respectively.When the dose of BSO was ID20 and ID10 under hypoxic or aerobic condition the SER was 1.521,1.263 and 1.296,1.153,respectively.CONCLUSION:BSO had radiosensitizative effect on Acc-2 cells both under hypoxic or aerobic condition.The radiosensitizative effect of BSO on Acc-2 cells under hypoxic condition was stronger than that under aerobic condition.

[Experimental study of radiosensitization of buthionine sulffoximine (BSO) on Acc-2 transplanted tumor]

OBJECTIVE:The effect of radiosensitization of BSO on Acc-2 transplanted tumor was studied in vivo.METHODS: There were four groups in this experiment:control group,radiation group and BSO+radiation group.The drug dose of BSO is 5mmol/kg and the radiation dose was 10Gy. RESULTS:The result demonstrated that the tumor inhibitive rate was 8.5%,12.6% and 45.37% respectively compared with control group. CONCLUSION: BSO has radiosensitizative effect on Acc-2 transplanted tumor.