Comparing Balloon Dilation to Non-Balloon Dilation for Access in Ultrasound-Guided Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis.

PURPOSE: This study aims to evaluate the safety and efficacy of ultrasound-guided balloon dilation compared to non-balloon dilation for percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and the Cochrane Library. Results were filtered using predefined inclusion and exclusion criteria as described and meta-analysis was performed using Review Manager 5.4 software. RESULTS: A total of six studies involving 1189 patients who underwent PCNL were included. The meta-analysis results demonstrated that compared to non-balloon dilation, balloon dilation was associated with reduced haemoglobin drop [mean difference (MD) = -0.26, 95% CI = -0.40 ~ -0.12, P = 0.0002], decreased transfusion rate [odds ratio (OR) = 0.47, 95% CI = 0.24 ~ 0.92, P = 0.03], shorter tract establishment time (MD = -1.30, 95% CI = -1.87 ~ -0.72, P < 0.0001) and shorter operation time (MD = -5.23, 95% CI = -10.19 ~ -0.27, P = 0.04). CONCLUSIONS: Overall, ultrasound-guided balloon dilatation offered several advantages in PCNL procedures. It facilitated faster access establishment, as evidenced by shorter access creation time. Additionally, it reduced the risk of kidney injury by minimizing postoperative haemoglobin drop and decreasing the need for transfusions. Moreover, it enhanced the efficiency of surgery by reducing the operation time. However, it is important to note that the quality of some included studies was subpar, as they did not adequately control for confounding factors that may affect the outcomes. Therefore, further research is necessary to validate and strengthen these findings.

Comparing Balloon Dilation to Non-Balloon Dilation for Access in Ultrasound-Guided Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

ABSTRACT Purpose: This study aims to evaluate the safety and efficacy of ultrasound-guided balloon dilation compared to non-balloon dilation for percutaneous nephrolithotomy (PCNL). Materials and methods: A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and the Cochrane Library. Results were filtered using predefined inclusion and exclusion criteria as described and meta-analysis was performed using Review Manager 5.4 software. Results: A total of six studies involving 1189 patients who underwent PCNL were included. The meta-analysis results demonstrated that compared to non-balloon dilation, balloon dilation was associated with reduced haemoglobin drop [mean difference (MD) = -0.26, 95% CI = -0.40 ~ -0.12, P = 0.0002], decreased transfusion rate [odds ratio (OR) = 0.47, 95% CI = 0.24 ~ 0.92, P = 0.03], shorter tract establishment time (MD = -1.30, 95% CI = -1.87 ~ -0.72, P < 0.0001) and shorter operation time (MD = -5.23, 95% CI = -10.19 ~ -0.27, P = 0.04). Conclusions: Overall, ultrasound-guided balloon dilatation offered several advantages in PCNL procedures. It facilitated faster access establishment, as evidenced by shorter access creation time. Additionally, it reduced the risk of kidney injury by minimizing postoperative haemoglobin drop and decreasing the need for transfusions. Moreover, it enhanced the efficiency of surgery by reducing the operation time. However, it is important to note that the quality of some included studies was subpar, as they did not adequately control for confounding factors that may affect the outcomes. Therefore, further research is necessary to validate and strengthen these findings.

Shade stress on maize seedlings biomass production and photosynthetic traits / Efeitos do estresse de sombra na produção de biomassa de mudas de milho e características fotossintéticas

The responses of two maize (Zea mays L.) cultivars, 'LY336' (shade tolerant) and 'LC803' (shade sensitive), to shade stress in a pot experiment conducted in the 2015 and 2016 growing seasons were investigated. The impact of 50% shade stress treatment on shoot biomass, photosynthetic parameters, chlorophyll fluorescence, and malondialdehyde (MDA) content was evaluated. The shoot biomass of the two maize hybrids was decreased significantly by shade stress treatment, for shade stress 7 d, the LC803 and LY336 were reduced by 56.7% and 44.4% compared with natural light. Chlorophyll fluorescence parameters of LY336 were not significantly affected by shade stress, whereas those of LC803 were significantly affected, the Fo increased under shade stress; however Fm, FV/FM and ΦPSII were decreased under shade stress. Among photosynthetic parameters measured, net photosynthetic rate (Pn), stomatal conductance (Gs), and transpiration rate were significantly decreased compared with natural light, LY336 and LC803 reduction by 28.0%, 22.2%, 57.7% and 35.5%, 18.9%, 62.4%; however, intercellular CO2 concentration (Ci) was significantly increased, for the two cultivars. Under shade stress for different durations (1, 3, 5, 7 d), Pn, Gs, Ci, and MDA content differed significantly between the two cultivars. Results indicated that different maize genotypes showed different responses to shading. Shade-tolerant genotypes are only weakly affected by shade stress.

As respostas de duas cultivares de milho (Zea mays L.), 'LY336' (tolerante à sombra) e 'LC803' (sensível à sombra), ao estresse de sombra em um experimento em vaso conduzido nas safras de 2015 e 2016 foram investigadas. O impacto do tratamento de estresse de sombra de 50% na biomassa da parte aérea, parâmetros fotossintéticos, fluorescência da clorofila e teor de malondialdeído (MDA) foi avaliado. A biomassa da parte aérea dos dois híbridos de milho foi reduzida significativamente pelo tratamento de estresse de sombra, para estresse de sombra 7 d, o LC803 e LY336 foram reduzidos em 56,7% e 44,4% em comparação com a luz natural. Os parâmetros de fluorescência da clorofila de LY336 não foram significativamente afetados pelo estresse de sombra, enquanto aqueles de LC803 foram significativamente afetados, o Fo aumentou sob estresse de sombra, porém Fm, FV / FM e ΦPSII diminuíram sob estresse de sombra. Entre os parâmetros fotossintéticos medidos, a taxa fotossintética líquida (Pn), a condutância estomática (Gs) e a taxa de transpiração diminuíram significativamente em comparação com a luz natural, redução de LY336 e LC803 em 28,0%, 22,2%, 57,7% e 35,5%, 18,9%, 62,4 %, porém a concentração intercelular de CO2 (Ci) aumentou significativamente para as duas cultivares. Sob estresse de sombra para diferentes durações (1, 3, 5, 7 d), os teores de Pn, Gs, Ci e MDA diferiram significativamente entre as duas cultivares. Os resultados indicam que diferentes genótipos de milho apresentam diferentes respostas ao sombreamento. Os genótipos tolerantes à sombra são apenas fracamente afetados pelo estresse de sombra.