Elevated plasma concentrations of transforming growth factor-beta 1 in patients with unilateral ureteral obstruction

We measured plasma concentrations of TGF-beta 1 in patients with obstructive ureteral calculi and compared them with the plasma concentrations of healthy volunteers. The present study was a prospective study containing a homogenous group of patients with unilateral ureteral obstruction (UUO). The study consisted of patients with ureteral stones less than 7 mm in diameter that caused mild to moderate obstruction. All patients were referred by the emergency department of our hospital and examined between April 2003 and April 2004. The presence and characteristics of both stone and obstruction were determined by plain abdominal x-ray and gray-scale ultrasonography (US). Blood samples were collected from both patients and control individuals on admission and 1 week after conservative follow-up. The plasma TGF-beta 1 concentration was determined using a quantitative sandwich enzyme immunoassay specific for TGF-beta 1. There were 35 patients with 20 women and 15 men (average age 26.8±5.9 years), and 15 volunteers in the control group, with nine women and six men (average age 24.2±4.5 years). Average stone size was 5.6 mm±1.2 mm (range 3.5–7) for the patient group. US showed the presence of mild hydronephrosis in 24 and moderate hydronephrosis in 11 patients. Plasma concentrations of TGF-beta 1 in patients with ureteral obstruction (1,117±5.8 ng/ml, range 36–2,442 ng/ml) were significantly higher than those in the healthy control group (32±4 ng/ml) on admission (P<0.001). There was a significant increase in TGF-beta 1 plasma concentrations in the patient group (33,525±6.8 ng/ml, range 1,107–73,288 ng/ml) after 1 week follow-up (P<0.001). Ureteral obstruction increases plasma TGF-beta 1 concentrations in patients with ureteral stones as in UUO models in animal studies. A concomitant treatment with an anti-fibrotic agent may reduce the incidence of renal injury during obstruction.     

Effects of urinary prothrombin fragment 1 in the formation of calcium oxalate calculus

PURPOSE: We investigated the effects of urinary prothrombin fragment 1 in the formation of calcium oxalate urolithiasis. MATERIALS AND METHODS: Fresh urine and renal parenchyma from patients with calcium oxalate calculus and normal controls were collected. Urinary prothrombin fragment 1 was isolated and purified from urine. It was identified by sodium dodecyl sulfide-polyacrylamide gel electrophoresis and analysis of its first 13 N-amino acids. The inhibitory activity of urinary prothrombin fragment 1 on calcium oxalate crystal growth was tested by the seeded crystallization technique. Meanwhile, the gamma-carboxyglutamic acid composition of urinary prothrombin fragment 1 was analyzed by a previously described method and genetic mutation of the gamma-carboxyglutamic acid domain of urinary prothrombin fragment 1 from renal parenchyma was detected by polymerase chain reaction-single strand conformational polymorphism sequencing. RESULTS: The gamma-carboxyglutamic acid composition of urinary prothrombin fragment 1 was significantly decreased from normal (24.4 to 1.7 mol/1,000 amino acids) in patients with calcium oxalate calculus. The mean growth index +/- SD of urinary prothrombin fragment 1 to calcium oxalate crystals was 42.3 +/- 4.2 compared with the normal index of 19.2 +/- 2.8 (p <0.01). The polymerase chain reaction-single strand conformational polymorphism sequencing technique revealed no genetic mutation of the gamma-carboxyglutamic acid domain of urinary prothrombin fragment 1 in patients with calcium oxalate calculus. CONCLUSIONS: The gamma-carboxyglutamic acid composition of urinary prothrombin fragment 1 as well as its ability to inhibit calcium oxalate crystal growth was significantly decreased in patients with calcium oxalate calculus. This was not caused by genetic mutation of the gamma-carboxyglutamic acid domain of urinary prothrombin fragment 1. It is important to elucidate the mechanisms of calcium oxalate stones in view of urinary prothrombin fragment 1.     

泌尿系结石行ESWL时易碎性与CT值的关系

目的:探讨CT是否可以被用来预测泌尿系结石行体外冲击波碎石(ESWL)时的易碎性。方法:随机选择2004年3月～2006年12月间40枚开放手术获得的结石,测定CT值,将结石放入ESWL模型中行ESWL。结果:40枚结石平均CT值与每毫升结石碎石冲击波次数进行直线相关分析,Person相关系数0.786,P=0.004,认为结石平均CT值与每毫升碎石次数之间有直线相关关系,而且相关性很高。结论:结石平均CT值与ESWL碎石次数之间存在正相关关系,根据术前患者结石的平均CT值可以估计ESWL的难易程度。     

The protective effects of in vitro cultivated calculus bovis on the cerebral and myocardial cells in hypoxic mice

Summary The protective effects of in vitro cultivated calculus bovis (ICCB) on the cerebral and myocardial cells in hypoxic mice and the mechanism were examined. In one group, mice were intragastrically (i.g.) given ICCB for 15 days and then they were subjected to acute cerebral ischemia by decapitation, and then the panting time was recorded. In the other group, 12 min after exposure to hypoxia, mice was administered the ICCB i.g. for 5 days, and then the blood serum and tissues of brain, heart, liver were harvested and examined for SOD, GSH-px and T-AOC activity and content of MDA. The tissues of brain and heart were observed electron-microscopically for ultrastructural changes. The corpus striatum and hippocampus of brain were collected and examined for content of dopamine (DA) and norepinephrine (NE). The ultrastrural examination showed that the pathological change in brain and heart in the ICCB group was very slight, while abnormal changes in the control group were obviously more serious. ICCB significantly prolonged the panting time of the hypoxic mice (P<0.001), increased the activity of SOD, GSH-px, T-AOC in serum and tissues of brain, liver, heart and elevated the content of DA and NE. ICCB also pronouncedly reduced content of MDA in serum and tissues of brain, heart and liver. Significant differences in these parameters were noted between ICCB group and controls. It is concluded that ICCB can exert protective effect on the cells of brain and myocardium by enhancing the tolerance of the tissues to hypoxia and the body’s ability to remove free radicals and regulating the neurotransmitters.     

微创经皮肾镜取石术的手术护理体会

目的：探讨微创经皮肾镜取石术的手术护理特点及注意事项。方法：对我院2005年12月-2007年8月42例上尿路结石的患者行一期微创经皮肾镜取石术的术中配合进行总结。结果：42例患者均为一期取石，手术时间20分钟-4小时，术中配合顺利，无并发症发生。结论：充分的术前准备，术中熟练的配合、仔细的观察及周到的术后护理是微创经皮肾镜取石手术取得成功的重要环节。     

肾镜下超声碎石清石术治疗膀胱结石的临床应用(附30例)

目的:总结肾镜下超声碎石清石术治疗膀胱结石的经验。方法:回顾性分析我院自2009年7月-2011年8月间经尿道及经皮耻骨上膀胱造瘘肾镜下超声碎石清石术治疗膀胱结石30例的临床资料。结果:本组病例均顺利一次性完成碎石取石术,成功率100%,手术时间15-55分钟(平均37分钟)。术后留置尿管l-2天,无膀胱大出血及膀胱穿孔等并发症。结论:肾镜下超声碎石清石术治疗膀胱结石,疗效满意,是一种安全、有效、简便的方法,适合临床推广应用。     

腹膜后腔镜下输尿管切开取石术137例

目的探讨经腹膜后途径入路腹腔镜下输尿管切开取石术治疗输尿管结石的临床疗效。方法回顾性分析2008年6月-2012年7月本院采用后腹腔镜下输尿管切开取石术治疗的137例输尿管结石患者的临床资料。结果本组137例患者均顺利完成手术，均取石成功并取净，取石成功率为100％；手术时间为（72±11）min．术中出血量为（30±5）mL；术后住院时间为（5．6±1．2）d；随访6-24个月，患者肾功能术后均有不同程度的改善，均未见复发和并发症。结论采用腹膜后腔镜下输尿管切开取石术治疗输尿管结石疗效显著，具有创伤小、出血少、痛苦小、恢复快、并发症少及安全可靠等优点，值得临床推广。     

体外冲击波碎石治疗泌尿系结石8702例临床总结

目的探讨体外震波碎石（ESWL）治疗泌尿系结石的临床效果。方法回顾性分析ESWL治疗的8702例泌尿系病人的临床资料。结果7572例泌尿系结石2月内排尽；673例6月内排尽；376例未排尽；81例无效，无效者在最后一次治疗后1月行开放性手术。结论ESWL是治疗泌尿系结石的首选方法，安全有效，易被患者接受，但要注意病例的选择。     

输尿管镜下气压弹道碎石术治疗输尿管结石的护理体会

目的：总结输尿管镜下气压弹道碎石术治疗尿路结石的护理经验。方法：对输尿管镜下行URSL的320例患者给予相应护理措施。结果：所有患者均康复出院。结论：术前充分准备,术后严密观察,勤于护理,才能保证手术的成功。     

超声在经皮肾镜气压弹道联合超声碎石治疗复杂性肾结石中的应用

目的评估超声在经皮肾镜气压弹道联合超声碎石治疗复杂性肾结石中的应用方法及效果。方法对45例超声引导下经皮肾镜气压弹道联合超声治疗复杂性肾结石的患者进行回顾性分析,其中多发性结石42例,鹿角形结石3例。结果45例患者均成功建立皮-肾通道,平均手术时间90min,平均结石处理时间为58min,结石清除率为85.1%。3例患者术中输血400ml,无气胸、内脏损伤等严重并发症发生。结论在超声引导下行经皮肾镜气压弹道联合超声治疗复杂性肾结石,不仅可以提高穿刺的安全性和准确性,更可以实时监测手术,为手术成功提供保障,值得临床推广应用。