首页 > 最新文献

中华泌尿外科杂志最新文献

英文 中文
The efficacy and safety of docetaxel chemotherapy in the treatment of localised high-risk prostate cancer: a Meta-analysis 多西他赛化疗治疗局部高危前列腺癌的疗效和安全性:一项荟萃分析
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.012
Qing-Feng Qin, Na Li, Shengzi Wang, Xue Zhao, Zhaohui S. Qin, Yuanhu Yao
Objective The role of additional docetaxel chemotherapy in the treatment of localised high-risk prostate cancer (PCa) remains a controversy. This meta-analysis aimed to investigate the effect of additional docetaxel chemotherapy on localised high-risk PCa. Methods A computerized search was performed in Pubmed, Embase, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang Data to collect clinical controlled trails on localised high-risk PCa treated with docetaxel chemotherapy from the inception to April 2019. The Review Manager 5.3 software was used to perform meta-analysis of survival data and adverse events. Results Six literatures were enrolled, including 3 187 patients. Compared with the standard treatment (local treatment combined with endocrine therapy) group, the progression-free survival (PFS) was prolonged in the standard treatment plus docetaxel group, and the difference was statistically significant. [hazard ratio(HR)=0.75, 95%CI 0.65-0.86, P<0.01]. Patients in the standard treatment plus docetaxel group had longer overall survival (OS) and biochemical recurrence-free survival (BRFS) in comparison with standard treatment group, but the difference was not statistically significant (HR=0.843, 95%CI 0.68-1.01, P=0.06; HR=0.86, 95%CI 0.69-1.07, P=0.17). In terms of safety, the incidence of adverse reactions was increased in the standard treatment plus docetaxel group, including the incidence of grade ≥3 neutropenia (RR=44.14, 95%CI 19.15-101.71, P<0.01), the incidence of grade ≥3 febrile neutropenia (RR=13.4, 95%CI 7.93-22.65, P<0.01) and the incidence of grade ≥3 diarrhea (RR=13.43, 95%CI 3.21-56.16, P<0.01). Conclusions Additional docetaxel chemotherapy could significantly improve the PFS in localised high-risk PCa patients. OS and BRFS were prolonged, but the difference was not statistically significant. Key words: Prostatic neoplasms; High-risk; Docetaxel; Prognosis; Meta-analysis
目的多西他赛联合化疗在局部高危前列腺癌(PCa)治疗中的作用仍存在争议。本荟萃分析旨在探讨额外的多西他赛化疗对局部高危PCa的影响。方法计算机检索Pubmed、Embase、Cochrane Library、Web of Science、CBM、CNKI、VIP、万方数据等数据库,收集自成立以来至2019年4月多西他赛化疗治疗局部高危PCa的临床对照试验。使用Review Manager 5.3软件对生存数据和不良事件进行荟萃分析。结果纳入6篇文献,包括3 187例患者。与标准治疗(局部治疗联合内分泌治疗)组相比,标准治疗加多西他赛组无进展生存期(PFS)延长,差异有统计学意义。(风险比(人力资源)= 0.75,95% ci 0.65 - -0.86, P < 0.01)。标准治疗加多西他赛组患者的总生存期(OS)和生化无复发生存期(BRFS)较标准治疗组更长,但差异无统计学意义(HR=0.843, 95%CI 0.68-1.01, P=0.06;Hr =0.86, 95%ci 0.69-1.07, p =0.17)。在安全性方面,标准治疗加多西他赛组不良反应发生率升高,包括≥3级中性粒细胞减少发生率(RR=44.14, 95%CI 19.15 ~ 101.71, P<0.01)、≥3级发热性中性粒细胞减少发生率(RR=13.4, 95%CI 7.93 ~ 22.65, P<0.01)和≥3级腹泻发生率(RR=13.43, 95%CI 3.21 ~ 56.16, P<0.01)。结论多西他赛化疗可显著改善局部高危PCa患者的PFS。OS和BRFS均有延长,但差异无统计学意义。关键词:前列腺肿瘤;高风险;多西他赛;预后;荟萃分析
{"title":"The efficacy and safety of docetaxel chemotherapy in the treatment of localised high-risk prostate cancer: a Meta-analysis","authors":"Qing-Feng Qin, Na Li, Shengzi Wang, Xue Zhao, Zhaohui S. Qin, Yuanhu Yao","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.012","url":null,"abstract":"Objective \u0000The role of additional docetaxel chemotherapy in the treatment of localised high-risk prostate cancer (PCa) remains a controversy. This meta-analysis aimed to investigate the effect of additional docetaxel chemotherapy on localised high-risk PCa. \u0000 \u0000 \u0000Methods \u0000A computerized search was performed in Pubmed, Embase, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang Data to collect clinical controlled trails on localised high-risk PCa treated with docetaxel chemotherapy from the inception to April 2019. The Review Manager 5.3 software was used to perform meta-analysis of survival data and adverse events. \u0000 \u0000 \u0000Results \u0000Six literatures were enrolled, including 3 187 patients. Compared with the standard treatment (local treatment combined with endocrine therapy) group, the progression-free survival (PFS) was prolonged in the standard treatment plus docetaxel group, and the difference was statistically significant. [hazard ratio(HR)=0.75, 95%CI 0.65-0.86, P<0.01]. Patients in the standard treatment plus docetaxel group had longer overall survival (OS) and biochemical recurrence-free survival (BRFS) in comparison with standard treatment group, but the difference was not statistically significant (HR=0.843, 95%CI 0.68-1.01, P=0.06; HR=0.86, 95%CI 0.69-1.07, P=0.17). In terms of safety, the incidence of adverse reactions was increased in the standard treatment plus docetaxel group, including the incidence of grade ≥3 neutropenia (RR=44.14, 95%CI 19.15-101.71, P<0.01), the incidence of grade ≥3 febrile neutropenia (RR=13.4, 95%CI 7.93-22.65, P<0.01) and the incidence of grade ≥3 diarrhea (RR=13.43, 95%CI 3.21-56.16, P<0.01). \u0000 \u0000 \u0000Conclusions \u0000Additional docetaxel chemotherapy could significantly improve the PFS in localised high-risk PCa patients. OS and BRFS were prolonged, but the difference was not statistically significant. \u0000 \u0000 \u0000Key words: \u0000Prostatic neoplasms; High-risk; Docetaxel; Prognosis; Meta-analysis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41739622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors of parastomal hernia in patients undergoing laparoscope radical cystectomy and ileal conduit diversion 腹腔镜根治性膀胱切除术和回肠导管引流术患者并发造口旁疝的危险因素
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.009
Xiong Yifan, Shao Haiyan, W. Shuai, Zheng Wei, Qi Xiaolong, Zhang Da-hong
ObjectiveTo investigate the incidence rate of parastomal hernia(PH) among patients who have received laparoscope radical cystectomy and ileal conduit diversion and to discover the risk factors for PH.MethodsData of 162 patients who underwent surgery of laparoscope radical cystectomy and ileal conduit diversion for bladder cancer between Jan 2012 and Dec 2017 were studied. The patients who had suffered other tumors before surgery or without follow-up data were excluded. At last, 148 patients were enrolled in this retrospective study. According to the occurrence of PH, the patients were divided into two groups: PH group and non-PH group. There were 21 patients (12 males and 9 females) in PH group. The mean age was (66.5±8.6) years old, and mean body mass index (BMI) was (33.4±5.2) kg/m2. 11 patients with synchronous disease and 10 patients without synchronous disease before operation in PH group. Postoperative T stage
目的了解腹腔镜根治性膀胱切除术和回肠导管引流术后造口旁疝(PH)的发病率,探讨PH的危险因素。排除了在手术前或没有随访数据的患者。最后,148名患者被纳入这项回顾性研究。根据PH的发生情况,将患者分为两组:PH组和非PH组。PH组21例,男12例,女9例。平均年龄(66.5±8.6)岁,平均体重指数(BMI)为(33.4±5.2)kg/m2。PH组术前同步病变11例,无同步病变10例。术后T分期<T3者17例,≥T3者4例。4例接受新辅助化疗,5例接受辅助化疗。肿瘤复发6例。低蛋白血症16例。经腹部切口制作回肠导管9例,腹腔镜下制作回肠导管12例。术后出现严重咳嗽7例,腹胀7例。3例有腹部手术史,5例有糖皮质激素使用史。造瘘口的平均大小为(3.0±0.6)cm,流出道的平均长度为(11.2±1.3)cm。经直肌造瘘4例,副直肌造瘘17例。非PH组127例(男82例,女45例)。平均年龄为(71.4±7.4)岁,平均BMI为(28.8±4.1)kg/m2。同步性疾病60例,无同步性疾病67例。术后T分期
{"title":"Risk factors of parastomal hernia in patients undergoing laparoscope radical cystectomy and ileal conduit diversion","authors":"Xiong Yifan, Shao Haiyan, W. Shuai, Zheng Wei, Qi Xiaolong, Zhang Da-hong","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.009","url":null,"abstract":"ObjectiveTo investigate the incidence rate of parastomal hernia(PH) among patients who have received laparoscope radical cystectomy and ileal conduit diversion and to discover the risk factors for PH.MethodsData of 162 patients who underwent surgery of laparoscope radical cystectomy and ileal conduit diversion for bladder cancer between Jan 2012 and Dec 2017 were studied. The patients who had suffered other tumors before surgery or without follow-up data were excluded. At last, 148 patients were enrolled in this retrospective study. According to the occurrence of PH, the patients were divided into two groups: PH group and non-PH group. There were 21 patients (12 males and 9 females) in PH group. The mean age was (66.5±8.6) years old, and mean body mass index (BMI) was (33.4±5.2) kg/m2. 11 patients with synchronous disease and 10 patients without synchronous disease before operation in PH group. Postoperative T stage <T3 in 17 cases, ≥T3 in 4 cases. 4 Cases received neoadjuvant chemotherapy and 5 cases received adjuvant chemotherapy. Tumor recurrence was found in 6 cases. 16 cases had hypoproteinemia. Ileal conduit was made through abdominal incision in 9 cases, and 12 cases was made with laparoscopy. After the surgery, there was severe cough in 7 cases and abdominal distension in 7 cases. 3 cases had previous abdominal operation, and 5 cases had history of glucocorticoid use. The mean size of the stoma was (3.0±0.6) cm. The mean length of the outflow tract was (11.2 ±1.3) cm. We did trans-rectus stoma in 4 cases, and para-rectus stoma in 17 cases. There were 127 patients (82 males and 45 females) in non-PH group. The mean age was (71.4 ±7.4) years, and the mean BMI was (28.8±4.1)kg/m2. 60 patients with synchronous disease and 67 patients without. Postoperative T stage <T3 in 96 cases, ≥T3 in 31 cases. 29 patients received neoadjuvant chemotherapy and 39 cases received adjuvant chemotherapy. Tumor recurrence was found in 38 cases. 66 cases had hypoproteinemia. Ileal conduit was made through abdominal incision in 55 cases, under laparoscopy in 72 cases. There was severe cough in 34 cases and abdominal distension in 38 cases. 21 cases had previous abdominal operation, and 35 cases had history of glucocorticoid use. The mean size of the stoma was (2.3±0.4) cm. The mean length of the outflow tract was (12.2±1.6) cm. 4 cases had trans-rectus stoma, and 17 cases had para-rectus stoma. Postoperative rate of PH was estimated using the Kaplan-Meier methods. Chi-square test were used for the univariate analysis between group of PH and the normal one. Multivariate Logistic regression analysis was used to judge the independent risk factors of PH.ResultsPatients were followed up for 24 months. PH occurred in 21 cases, the 1, 2, 5 year cumulative incidence of PH was 9.9%, 5.4% and 16.7% respectively. Clinical characteristics, including age at surgery(χ2=4.018, P=0.045), obesity(χ2=3.949, P=0.047), perioperative hypoproteinemia(χ2=4.279, P=0.039), chronic consti","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43673180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comparative analysis of Bracka and Duckett in the treatment of primary proximal hypospadias repair Bracka和Duckett治疗原发性尿道下裂近端修复术的对比分析
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.005
Y. Guan, Qingya Meng, Xin Wang, Yong Wu, Heyang Guan
Objective To compare the efficacy of Bracka method and Duckett method in the treatment of proximal hypospadias. Methods Forty patients with hypospadias were treated by 2 stages(Bracka), 42 patients treated by transverse preputial island flap (Duckett) from January 2014 to January 2016. Mean age at first stage surgery were (19.70±6.62) months and (20.33±5.03) months in Bracka group and Duckett group, respectively. There were 10 cases of proximal penile type, 25 cases of penoscrotal type, 5 cases of perineal type in group 1. There were 11 cases of proximal penile type, 27 cases of penoscrotal type, 4 cases of perineal type in group 2. There was no significant difference in age and hypospadias classification between the two groups(P>0.05). All operations were performed by the same doctor. Urethral plate reconstruction with preputial graft was performed in group 1; stage Ⅱ Duplay urethroplasty repair was carried out 6-8 months after stage Ⅰ. Results Urine tube was placed for 2 weeks after operation and followed up for 36-63 months(mean 47.6 months). After stage I repair, penile straightening and wide, smooth appearance of graft were confirmed. There was no fistula, split, urethral diverticulum or other complications, one case with urethral opening stenosis who was restored after urethral dilatation .After stage II repair, urethral fistula was noted in 3 cases(7.5%), stricture in 1 cases(2.5%). No other complications occurred . The total rate of complications was 10%(10/40). Urethral fistula was noted in 7 cases(16.7%), stricture in 3 cases(7.1%), penile head dehiscence in 3 cases(7.1%) and diverticulum in 1 case(2.4%) in group 2. The total rate of complications was 33.3%(14/42). The incidence of total complications between the two groups was statistically significant (P=0.011). Conclusions Bracka method can be used to treat proximal hypospadias. It has high safety and low incidence of complications. Key words: Hypospadias; Proximal; Staged repair; Autograft repairt
目的比较Bracka法和Duckett法治疗尿道下裂的疗效。方法2014年1月至2016年1月,40例尿道下裂患者分2期(Bracka)治疗,42例患者采用包皮横岛状皮瓣(Duckett)治疗。Bracka组和Duckett组第一阶段手术的平均年龄分别为(19.70±6.62)个月和(20.33±5.03)个月。第1组为近端阴茎型10例,阴茎旋转型25例,会阴型5例。第2组为近端阴茎型11例,阴茎旋转型27例,会阴型4例。两组患者年龄及尿道下裂分型差异无统计学意义(P>0.05)。第1组采用包皮移植重建尿道板;Ⅱ期Duplay尿道成形术在Ⅰ期后6~8个月进行修复。结果术后放置尿管2周,随访36~63个月,平均47.6个月。在第一阶段修复后,证实了阴茎伸直和移植物宽阔、光滑的外观。无瘘、尿道裂、尿道憩室等并发症,1例尿道开口狭窄,经尿道扩张术后恢复,Ⅱ期修复后发现尿道瘘3例(7.5%),尿道狭窄1例(2.5%),无其他并发症发生。并发症总发生率为10%(10/40)。第2组尿道瘘7例(16.7%),狭窄3例(7.1%),阴茎头裂开3例(71%),憩室1例(2.4%)。并发症总发生率为33.3%(14/42),两组总并发症发生率有统计学意义(P=0.011)。它安全性高,并发症发生率低。关键词:尿道下裂;近端;分期修复;自体移植物修复术
{"title":"A comparative analysis of Bracka and Duckett in the treatment of primary proximal hypospadias repair","authors":"Y. Guan, Qingya Meng, Xin Wang, Yong Wu, Heyang Guan","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.005","url":null,"abstract":"Objective \u0000To compare the efficacy of Bracka method and Duckett method in the treatment of proximal hypospadias. \u0000 \u0000 \u0000Methods \u0000Forty patients with hypospadias were treated by 2 stages(Bracka), 42 patients treated by transverse preputial island flap (Duckett) from January 2014 to January 2016. Mean age at first stage surgery were (19.70±6.62) months and (20.33±5.03) months in Bracka group and Duckett group, respectively. There were 10 cases of proximal penile type, 25 cases of penoscrotal type, 5 cases of perineal type in group 1. There were 11 cases of proximal penile type, 27 cases of penoscrotal type, 4 cases of perineal type in group 2. There was no significant difference in age and hypospadias classification between the two groups(P>0.05). All operations were performed by the same doctor. Urethral plate reconstruction with preputial graft was performed in group 1; stage Ⅱ Duplay urethroplasty repair was carried out 6-8 months after stage Ⅰ. \u0000 \u0000 \u0000Results \u0000Urine tube was placed for 2 weeks after operation and followed up for 36-63 months(mean 47.6 months). After stage I repair, penile straightening and wide, smooth appearance of graft were confirmed. There was no fistula, split, urethral diverticulum or other complications, one case with urethral opening stenosis who was restored after urethral dilatation .After stage II repair, urethral fistula was noted in 3 cases(7.5%), stricture in 1 cases(2.5%). No other complications occurred . The total rate of complications was 10%(10/40). Urethral fistula was noted in 7 cases(16.7%), stricture in 3 cases(7.1%), penile head dehiscence in 3 cases(7.1%) and diverticulum in 1 case(2.4%) in group 2. The total rate of complications was 33.3%(14/42). The incidence of total complications between the two groups was statistically significant (P=0.011). \u0000 \u0000 \u0000Conclusions \u0000Bracka method can be used to treat proximal hypospadias. It has high safety and low incidence of complications. \u0000 \u0000 \u0000Key words: \u0000Hypospadias; Proximal; Staged repair; Autograft repairt","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49349332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical value of early renal damage index in children hydronephrosis 儿童肾积水早期肾损害指数的临床价值
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.003
X. Cui, Li-fei Ma, Xiaoguang Zhou, T. Tao, H. Cao, Huixia Zhou
Objective To explore urinary NAG, Cr, MA, α1-MG andβ2-MG as the early renal damage index in children hydronephrosis. Methods The clinical data of 206 patients in the Bayi Children′s Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively. Among them, 152 children with hydronephrosis were set as observation group, 54 children without hydronephrosis were set as control group. In the observation group, the age ranged from 1 month to 18 years old, and the median age was 2 years old. There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis. In the control group, the age ranged from 1 month to 15 years old, with a median age of 5 years. There were 18 hypospadias cases, 15 occult penis cases and 21 phimosis. All children with hydronephrosis underwent nuclear medicine renal dynamic imaging. Urine specimens were tested for urinary NAG, Cr, MA, α1-MG, and β2-MG. According to renal dynamic results, the observed components were the renal function injury group and the normal renal function group. The above indicators analyzed to judge the clinical value to find the early renal damage. Results The expression levels of urinary NAG, MA, α1-MG and β2-MG in the observation group were higher than those in the control group, and the difference was statistically significant. The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P=0.647, P=0.572). The expression levels of urinary NAG, MA, α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P=0.365, P=0.448, P=0.379, P=0.338). The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P=0.436, P=0.478). MA got the highest sensitivity of (58.8%), and NAG had the highest specificity of 89.3% to detect early renal demage. Four indexes combined analysis, sensitivity, negative predictive rate, diagnostic coincidence rate improved obviously. Joint analysis of posterior urethral valves combined with hydronephrosis, the abnormal rate was 89.7%(26/29). The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9%(11/29). Conclusions The combined analysis of urinary NAG, MA, α1-MG and β2-MG can accurately predict early renal injury. The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury. Key words: Hydronephrosis; Children; Early renal damage index; Clinical application
目的探讨尿NAG、Cr、MA、α1-MG和β2-MG作为儿童肾积水早期肾损害指标的意义。方法回顾性分析2018年5月至2019年1月在中国人民解放军总医院第七医学中心附属八一儿童医院就诊的206例患者的临床资料。其中152例有肾积水患儿作为观察组,54例无肾积水患儿为对照组。观察组年龄为1个月至18岁,中位年龄为2岁。肾盂输尿管连接部梗阻(UPJO)引起的肾积水123例,后尿道瓣膜并发肾积水29例。对照组的年龄为1个月至15岁,中位年龄为5岁。尿道下裂18例,隐匿性阴茎15例,包茎21例。所有患有肾积水的儿童都接受了核医学肾脏动态成像。尿液标本检测尿液NAG、Cr、MA、α1-MG和β2-MG。根据肾脏动力学结果,观察到的成分为肾功能损伤组和肾功能正常组。通过以上指标的分析,判断早期发现肾损害的临床价值。结果观察组尿NAG、MA、α1-MG和β2-MG的表达水平均高于对照组,差异有统计学意义。尿Cr的表达及异常率两组间无显著性差异(P=0.647、P=0.572),α1-MG和β2-MG在正常肾积水组和肾功能损害组之间无显著性差异(P=0.365,P=0.448,P=0.379,P=0.338)NAG检测早期肾水肿的特异性最高,为89.3%。四项指标综合分析,敏感性、阴性预测率、诊断符合率均有明显提高。后尿道瓣膜合并肾积水的联合分析,异常率为89.7%(26/29)。后尿道瓣膜肾功能不全显示肾动力学功能障碍率仅为37.9%(11/29)。结论尿NAG、MA、α1-MG和β2-MG的联合分析可准确预测早期肾损伤。早期肾功能丧失指标可作为判断后尿道瓣膜是否合并上尿路功能损伤的早期依据。关键词:肾病;儿童;早期肾损伤指数;临床应用
{"title":"Clinical value of early renal damage index in children hydronephrosis","authors":"X. Cui, Li-fei Ma, Xiaoguang Zhou, T. Tao, H. Cao, Huixia Zhou","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.003","url":null,"abstract":"Objective \u0000To explore urinary NAG, Cr, MA, α1-MG andβ2-MG as the early renal damage index in children hydronephrosis. \u0000 \u0000 \u0000Methods \u0000The clinical data of 206 patients in the Bayi Children′s Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital from May 2018 to January 2019 were analyzed retrospectively. Among them, 152 children with hydronephrosis were set as observation group, 54 children without hydronephrosis were set as control group. In the observation group, the age ranged from 1 month to 18 years old, and the median age was 2 years old. There were 123 cases of hydronephrosis caused by ureteropelvic junction obstruction (UPJO) and 29 cases of posterior urethral valve complicated with hydronephrosis. In the control group, the age ranged from 1 month to 15 years old, with a median age of 5 years. There were 18 hypospadias cases, 15 occult penis cases and 21 phimosis. All children with hydronephrosis underwent nuclear medicine renal dynamic imaging. Urine specimens were tested for urinary NAG, Cr, MA, α1-MG, and β2-MG. According to renal dynamic results, the observed components were the renal function injury group and the normal renal function group. The above indicators analyzed to judge the clinical value to find the early renal damage. \u0000 \u0000 \u0000Results \u0000The expression levels of urinary NAG, MA, α1-MG and β2-MG in the observation group were higher than those in the control group, and the difference was statistically significant. The expression of urinary Cr and the abnormal rate were no significant difference between any two groups(P=0.647, P=0.572). The expression levels of urinary NAG, MA, α1-MG and β2-MG were not significantly different between the normal renal hydronephrosis group and the renal function impairment group (P=0.365, P=0.448, P=0.379, P=0.338). The abnormal expression rate of Urine MA and β2-MG was not statistically significant in the patients with normal renal hydronephrosis and the renal function impairment group (P=0.436, P=0.478). MA got the highest sensitivity of (58.8%), and NAG had the highest specificity of 89.3% to detect early renal demage. Four indexes combined analysis, sensitivity, negative predictive rate, diagnostic coincidence rate improved obviously. Joint analysis of posterior urethral valves combined with hydronephrosis, the abnormal rate was 89.7%(26/29). The renal dysfunction of the posterior urethral valve showed that the renal dynamics dysfunction rate was only 37.9%(11/29). \u0000 \u0000 \u0000Conclusions \u0000The combined analysis of urinary NAG, MA, α1-MG and β2-MG can accurately predict early renal injury. The index of early renal loss may be the early evidence to judge whether the posterior urethral valve is complicated with upper urinary tract function injury. \u0000 \u0000 \u0000Key words: \u0000Hydronephrosis; Children; Early renal damage index; Clinical application","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41481973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of the effect about tubularized urethral plate disassembly for one-stage midshaft epispadias repair in infant 管状尿道板拆卸术在婴幼儿一期腹膜中轴修补术中的效果分析
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.006
Fuming Deng, W. Fu, Kai Fu, Zhongmin Li, Guochang Liu
Objective To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant. Methods From January 2016 to September 2018, 10 boys aged between 18 to 36 months old with mishaft epispadias were included. The main complaint was that the urethral opening was found on the dorsal side of the penis. Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ), and white blood cells in routine urinary in all 10 patients were negative. Physical examination: the penis is short and flat, the width is 17-25 mm, average is 20.7 mm, the penis curvature is 15°-30°, average is 21.5°, and the urethral opening located on the dorsal side of the penis. The anesthesia method was selected for tracheal intubation, intravenous anesthesia combined with caudal anesthesia, and the surgical position was supine position. The surgical method: one stage of tabularized urethral plate disassembly urethroplasty: during the operation, the penile curve was corrected by free urethral plate and penile degloving. Two of them were unsatisfied with the correction of the curvature, and the ventral tunica folded was applicate. To avoid urethral plate ischemia, attention should pay to blood supply protection. The two corpus cavernosum are separated in the root, and the urethra is completely displaced to the ventral side of the cavernous body. The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy. The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature. Result The operation time was 130-200 min with an average of 157 mins. Intraoperative hemorrhage 5-30 ml, average is 16 ml, 1 case of glans skin was black one day after surgery, with enhanced dressing change. After 1 month, the glans was local atrophy and scar formation. No skin incision infection case. After discharge from the hospital, the follow up through the internet and outpatients for 3-40 months, average is 21 months, 2 cases with urethral fistula, more surgery to repair the fistula successfully after 6 months. The penile curvature was corrected in 8 cases, and the residual curvature of 2 cases was about 10-15°, which was temporarily observed. Patients with unilateral vesicoureteral reflux preoperatively, they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine. All cases had urinary patency and no cases with urethral stricture. Conclusion Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant. Key words: Epispadias; Prognosis; Penis
目的探讨平板式尿道板拆卸术在婴幼儿尿道外壁修补术中的安全性和有效性。方法选取2016年1月至2018年9月收治的10例18 ~ 36月龄外膈畸形男童。主要的抱怨是发现尿道开口在阴茎的背面。术前膀胱造影显示3例患者单侧膀胱输尿管反流(级别Ⅰ),10例患者尿常规白细胞均为阴性。体格检查:阴茎短而扁平,宽度17- 25mm,平均20.7 mm,阴茎弯曲15°-30°,平均21.5°,尿道开口位于阴茎背侧。麻醉方式选择气管插管,静脉麻醉加尾侧麻醉,手术体位为仰卧位。手术方法:一期平板尿道板拆卸尿道成形术,术中通过游离尿道板和阴茎脱套矫正阴茎曲线。其中2例曲率矫正不满意,均采用腹侧膜折叠术。为避免尿道板缺血,应注意血供保护。两个海绵体在根部分离,尿道完全移位到海绵体的腹侧。龟头下尿道的腹侧呈裂隙状,符合解剖结构。结合文献讨论了腹壁中轴疝的预后及手术选择。结果手术时间130 ~ 200 min,平均157 min。术中出血5-30 ml,平均16 ml, 1例术后1天龟头皮肤发黑,换药加强。1个月后,龟头局部萎缩,瘢痕形成。无皮肤切口感染病例。出院后通过网络及门诊随访3-40个月,平均为21个月,2例出现尿道瘘,6个月后多行手术成功修复尿道瘘。矫正阴茎弯曲8例,2例剩余弯曲约10-15°,暂观察。术前单侧膀胱输尿管反流患者,术后6-12个月定期复查,由于尿常规白细胞阴性,未进行任何干预,仍存在膀胱输尿管反流。所有病例均有尿路通畅,无尿道狭窄。结论尿道管状钢板拆卸术是一种简便、有效的婴幼儿尿道中轴上裂矫治方法。关键词:伊比斯帕底亚;预后;阴茎
{"title":"Analysis of the effect about tubularized urethral plate disassembly for one-stage midshaft epispadias repair in infant","authors":"Fuming Deng, W. Fu, Kai Fu, Zhongmin Li, Guochang Liu","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.006","url":null,"abstract":"Objective \u0000To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant. \u0000 \u0000 \u0000Methods \u0000From January 2016 to September 2018, 10 boys aged between 18 to 36 months old with mishaft epispadias were included. The main complaint was that the urethral opening was found on the dorsal side of the penis. Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ), and white blood cells in routine urinary in all 10 patients were negative. Physical examination: the penis is short and flat, the width is 17-25 mm, average is 20.7 mm, the penis curvature is 15°-30°, average is 21.5°, and the urethral opening located on the dorsal side of the penis. The anesthesia method was selected for tracheal intubation, intravenous anesthesia combined with caudal anesthesia, and the surgical position was supine position. The surgical method: one stage of tabularized urethral plate disassembly urethroplasty: during the operation, the penile curve was corrected by free urethral plate and penile degloving. Two of them were unsatisfied with the correction of the curvature, and the ventral tunica folded was applicate. To avoid urethral plate ischemia, attention should pay to blood supply protection. The two corpus cavernosum are separated in the root, and the urethra is completely displaced to the ventral side of the cavernous body. The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy. The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature. \u0000 \u0000 \u0000Result \u0000The operation time was 130-200 min with an average of 157 mins. Intraoperative hemorrhage 5-30 ml, average is 16 ml, 1 case of glans skin was black one day after surgery, with enhanced dressing change. After 1 month, the glans was local atrophy and scar formation. No skin incision infection case. After discharge from the hospital, the follow up through the internet and outpatients for 3-40 months, average is 21 months, 2 cases with urethral fistula, more surgery to repair the fistula successfully after 6 months. The penile curvature was corrected in 8 cases, and the residual curvature of 2 cases was about 10-15°, which was temporarily observed. Patients with unilateral vesicoureteral reflux preoperatively, they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine. All cases had urinary patency and no cases with urethral stricture. \u0000 \u0000 \u0000Conclusion \u0000Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant. \u0000 \u0000 \u0000Key words: \u0000Epispadias; Prognosis; Penis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44144676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of robot-assisted laparoscopic ureteral reimplantation for primary obstructive megaureter in children 机器人辅助腹腔镜输尿管再植术治疗儿童原发性梗阻性输尿管
Q4 Medicine Pub Date : 2019-11-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.11.001
H. Cao, Huixia Zhou, Li-fei Ma, Dehong Liu, Xiaoguang Zhou, T. Tao
Objective To evaluate the clinical efficacy of robot-assisted laparoscopic ureteral reimplantation (RAUR) for primary obstructive megaureter (POM) in children. Methods Twenty-one patients who underwent RAUR for POM in Bayi Children’s Hospital between 2017 April and 2018 April were retrospectively analyzed. The study population consisted of 15 boys and 6 girls aged between 2 months and 11 years. Ten patients had left POMs, 9 had right POMs and two had bilateral POMs. All patients were preoperatively diagnosed with a POM based on urinary system ultrasonography, magnetic resonance urography, and diuretic renal dynamic imaging. Our main technique key steps include: Under general anesthesia, the patients were placed in a Trendelenburg position approximately 40 degrees from the horizon. An 8.5-mm camera port was placed at the level of the umbilicus. Followed by two 5-mm robotic Trocars placed under direct vision 6 cm to the camera port separately, a 5-mm assistant port was placed on the right upper abdominal quadrants which was located 3 cm from the camera and robotic port. The ureter was identified at the pelvic brim. The peritoneum covering the ureter was incised and the ureter was mobilized to the level of the vesico-ureteric junction. The bladder was filled with 60 ml saline and a 5 cm length and 1.5 cm wide submucosal detrusor tunnel was created. The ureter was transected at the bladder mucosa and the narrowed ureteral segment was discarded. The ureteroneocystostomy was performed using 6-0 absorbable suture. Dissecting the perivesical fascia appropriately and using down-top suturing approach, use of an apical stay stitch, and incorporation of the ureteral adventitia during detrusorraphy. Postoperative complications were analysed using the Clavien-Dindo classification. Success was defined as symptomatic relief, decreased hydronephrosis on ultrasound and no evidence of vesicoureteral reflux on voiding cystourethrography. Results All surgeries were successfully completed without conversion and no intra-operative complication was encountered. The mean operative time was 117.6±18.1(89-165)min, the mean estimated blood loss was 11.9±4.3(5-25)ml, the abdominal drainage tubes were removed after a mean of 4.9±1.1(3-8)days, and the mean postoperative hospital stay was 6.3±1.3(4-10) days. Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 9.5% (two patients had recurrent urinary tract infections postoperatively) children, no grade Ⅲ-Ⅳ complication was observed. The pre-operative symptoms in all patients disappeared. One patient had grade Ⅱ VUR on VCUG, who were followed conservatively. Ultrasound at postoperative follow-up showed that the hydronephrosis was disappeared in 20 ureters and significantly decreased in 3 ureters. The success rate was 95.7% at a mean follow-up of 16.3±4.0(10-23)months. Conclusion RAUR is a safe and feasible option for the treatment of POM in children with higher success rate and lower complication rate. K
目的评价机器人辅助腹腔镜输尿管再植入术(RAUR)治疗儿童原发性梗阻性巨输尿管(POM)的临床疗效。方法对2017年4月至2018年4月在八一儿童医院接受POM RAUR治疗的21例患者进行回顾性分析。研究人群包括15名男孩和6名女孩,年龄在2个月至11岁之间。10名患者患有左侧POM,9名患者患有右侧POM,2名患者患有双侧POM。所有患者术前均根据泌尿系统超声、磁共振尿路造影和利尿肾动态成像诊断为POM。我们的主要技术关键步骤包括:在全身麻醉下,将患者置于距离地平线约40度的特伦德伦堡体位。一个8.5毫米的相机端口被放置在脐的水平面上。随后,将两个5毫米的机器人Trocar分别放置在距离相机端口6厘米的直视下,在距离相机和机器人端口3厘米的右上腹象限放置一个5毫米辅助端口。在骨盆边缘识别输尿管。切开覆盖输尿管的腹膜,将输尿管移动到膀胱-输尿管连接处。用60ml生理盐水填充膀胱,形成5cm长、1.5cm宽的粘膜下逼尿肌隧道。在膀胱粘膜处横切输尿管,并丢弃狭窄的输尿管段。使用6-0可吸收缝线进行输尿管新囊肿造口术。在逼尿肌切开术中,适当解剖膀胱周围筋膜,采用自上而下的缝合方法,使用顶端留置针,并合并输尿管外膜。采用Clavien-Dindo分类法对术后并发症进行分析。成功被定义为症状缓解,超声检查肾积水减少,排尿膀胱尿道造影检查无膀胱输尿管反流迹象。结果所有手术均顺利完成,未发生术中并发症。平均手术时间为117.6±18.1(89-165)min,平均估计失血量为11.9±4.3(5-25)ml,平均4.9±1.1(3-8)天后取下腹部引流管,平均术后住院时间为6.3±1.3(4-10)天。术后并发症(ClavienⅠ-Ⅱ)发生率为9.5%(2例术后复发性尿路感染),无Ⅲ-Ⅳ级并发症发生。所有患者术前症状消失。1例患者在VCUG上为Ⅱ级VUR,并进行保守随访。术后随访超声显示20个输尿管积水消失,3个输尿管积水明显减少。平均随访16.3±4.0(10-23)个月,成功率为95.7%。结论RAUR是一种安全可行的儿童POM治疗方案,成功率高,并发症发生率低。关键词:腹腔镜;机器人辅助;输尿管再植入术;原发性梗阻性巨输尿管;儿童
{"title":"Efficacy of robot-assisted laparoscopic ureteral reimplantation for primary obstructive megaureter in children","authors":"H. Cao, Huixia Zhou, Li-fei Ma, Dehong Liu, Xiaoguang Zhou, T. Tao","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.11.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.11.001","url":null,"abstract":"Objective \u0000To evaluate the clinical efficacy of robot-assisted laparoscopic ureteral reimplantation (RAUR) for primary obstructive megaureter (POM) in children. \u0000 \u0000 \u0000Methods \u0000Twenty-one patients who underwent RAUR for POM in Bayi Children’s Hospital between 2017 April and 2018 April were retrospectively analyzed. The study population consisted of 15 boys and 6 girls aged between 2 months and 11 years. Ten patients had left POMs, 9 had right POMs and two had bilateral POMs. All patients were preoperatively diagnosed with a POM based on urinary system ultrasonography, magnetic resonance urography, and diuretic renal dynamic imaging. Our main technique key steps include: Under general anesthesia, the patients were placed in a Trendelenburg position approximately 40 degrees from the horizon. An 8.5-mm camera port was placed at the level of the umbilicus. Followed by two 5-mm robotic Trocars placed under direct vision 6 cm to the camera port separately, a 5-mm assistant port was placed on the right upper abdominal quadrants which was located 3 cm from the camera and robotic port. The ureter was identified at the pelvic brim. The peritoneum covering the ureter was incised and the ureter was mobilized to the level of the vesico-ureteric junction. The bladder was filled with 60 ml saline and a 5 cm length and 1.5 cm wide submucosal detrusor tunnel was created. The ureter was transected at the bladder mucosa and the narrowed ureteral segment was discarded. The ureteroneocystostomy was performed using 6-0 absorbable suture. Dissecting the perivesical fascia appropriately and using down-top suturing approach, use of an apical stay stitch, and incorporation of the ureteral adventitia during detrusorraphy. Postoperative complications were analysed using the Clavien-Dindo classification. Success was defined as symptomatic relief, decreased hydronephrosis on ultrasound and no evidence of vesicoureteral reflux on voiding cystourethrography. \u0000 \u0000 \u0000Results \u0000All surgeries were successfully completed without conversion and no intra-operative complication was encountered. The mean operative time was 117.6±18.1(89-165)min, the mean estimated blood loss was 11.9±4.3(5-25)ml, the abdominal drainage tubes were removed after a mean of 4.9±1.1(3-8)days, and the mean postoperative hospital stay was 6.3±1.3(4-10) days. Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 9.5% (two patients had recurrent urinary tract infections postoperatively) children, no grade Ⅲ-Ⅳ complication was observed. The pre-operative symptoms in all patients disappeared. One patient had grade Ⅱ VUR on VCUG, who were followed conservatively. Ultrasound at postoperative follow-up showed that the hydronephrosis was disappeared in 20 ureters and significantly decreased in 3 ureters. The success rate was 95.7% at a mean follow-up of 16.3±4.0(10-23)months. \u0000 \u0000 \u0000Conclusion \u0000RAUR is a safe and feasible option for the treatment of POM in children with higher success rate and lower complication rate. \u0000 \u0000 \u0000K","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44420908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of modified transperineal template-guided prostate biopsy in the diagnosis of prostate cancer 改良经腹膜模板引导前列腺活检在前列腺癌症诊断中的应用
Q4 Medicine Pub Date : 2019-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.10.009
Xue-fei Ding, Y. Luan, Fei Wang, Xu Yaozong, Tian-bao Huang, Guo Chenghao, Zhu Liangyong, Guang-chen Zhou
Objective To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer. Methods A total of 217 patients were enrolled in this study. All the patients were randomly divided into 2 groups. The control group (n=112) underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy. On the basis of the control group, the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB). The positive rate of apex and the incidence of complications were analyzed. The prostatic specimens from the radical prostatectomy underwent whole mount sections examination. The prostate biopsy results were compared with the postoperative pathological results. Results The average age of the control group and the observation group were (68.5±7.9) years and (67.3±8.5) years, PSA were (31.2±18.9) ng/ml and (29.7±19.5) ng/ml, prostate volume were (44.6±15.2) ml and (41.3±17.3) ml, respectively. In the control group, the positive rates of prostate cancer in 1-10 region were 24.1% (27/112), 27.7%(31/112), 23.2% (26/112), 28.6% (32/112), 26.8% (30/112), 25.0% (28/112), 26.8% (30/112), 19.6% (22/112), 25.9% (29/112), 25.0% (28/112), respectively, with an average of 25.3%. In the observation group, the positive rates in 1-10 region were 27.6% (29/105), 28.6% (30/105), 22.9% (24/105), 26.7% (28/105), 25.7% (27/105), 24.8% (26/105), 27.6% (29/105), 21.9% (23/105), 27.6% (29/105), 26.7% (28/105), respectively, with an average of 26.0%. There was no statistical difference between the two groups (P=0.904). The positive rate of apical prostate cancer in the control group and observation group was 37.5% (42/112) and 44.8% (47/105), respectively, and there was no statistical difference between the two groups (P=0.277). Patients were grouped according to PSA>20 ng/ml and PSA≤20 ng/ml. When PSA>20 ng/ml, the positive rate of apex was 58.6% (34/58) and 56.6% (30/53) respectively in the control group and the observation group, and there was no statistical difference between the two groups (P=0.830). When PSA≤20 ng/ml, the positive rate of apex was 14.8% (8/54) in the control group and 32.7% (17/52) in the observation group, with statistically significant differences (P=0.030). Before radical prostatectomy, 12 cases (57.1%) in the control group and 19 cases (73.1%) in the observation group showed apical invasion by biopsy. Results of whole mount sections examination in the control group showed that there were 19 cases (90.5%) with apical invasion, which was statistically different from that before surgery (P=0.035). The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5%) with apex invasion, which had no statistical difference compared with that before surgery (P=0.291). There were no significant differences in the incidence of hematuria, fever, urinary retent
目的探讨改良经腹膜模板引导前列腺活检术(mPTTPB)在前列腺癌症诊断中的临床应用价值。方法本研究共纳入217例患者。所有患者随机分为2组。对照组(n=112)接受了经会阴模板引导的前列腺活检(TTPB),这是传统的经会阴模板指导的11区活检。在对照组的基础上,观察组(mTTPB)将前列腺尖分为四个区域进行活检。分析心尖的阳性率及并发症的发生率。对前列腺根治术后的前列腺标本进行了全支架切片检查。将前列腺活检结果与术后病理结果进行比较。结果对照组和观察组的平均年龄分别为(68.5±7.9)岁和(67.3±8.5)岁,PSA分别为(31.2±18.9)ng/ml和(29.7±19.5)ng/ml,前列腺体积分别为(44.6±15.2)ml和(41.3±17.3)ml。对照组1-10区前列腺癌症阳性率分别为24.1%(27/112)、27.7%(31/112)、23.2%(26/112%(24/105),分别为26.7%(28/105)、25.7%(27/105)和24.8%(26/105),27.6%(29/105,两组患者按PSA>20ng/ml和PSA≤20ng/ml分组,差异无统计学意义(P=0.277)。当PSA>20ng/ml时,对照组和观察组的心尖阳性率分别为58.6%(34/58)和56.6%(30/53),两组之间无统计学差异(P=0.830),有统计学意义(P=0.030)。前列腺根治术前,对照组12例(57.1%)和观察组19例(73.1%)活检显示根尖侵犯。对照组根尖侵犯19例(90.5%),与术前比较差异有统计学意义(P=0.035),观察组根尖侵犯23例(88.5%),与术前比较差异无统计学意义(P=0.291),结论mTTPB能显著提高前列腺尖部癌症的检出率,且不增加并发症的发生率,特别是PSA≤20ng/ml的前列腺尖部癌患者。因此是安全有效的。关键词:前列腺肿瘤;活检;诊断
{"title":"Application of modified transperineal template-guided prostate biopsy in the diagnosis of prostate cancer","authors":"Xue-fei Ding, Y. Luan, Fei Wang, Xu Yaozong, Tian-bao Huang, Guo Chenghao, Zhu Liangyong, Guang-chen Zhou","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.10.009","url":null,"abstract":"Objective \u0000To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer. \u0000 \u0000 \u0000Methods \u0000A total of 217 patients were enrolled in this study. All the patients were randomly divided into 2 groups. The control group (n=112) underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy. On the basis of the control group, the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB). The positive rate of apex and the incidence of complications were analyzed. The prostatic specimens from the radical prostatectomy underwent whole mount sections examination. The prostate biopsy results were compared with the postoperative pathological results. \u0000 \u0000 \u0000Results \u0000The average age of the control group and the observation group were (68.5±7.9) years and (67.3±8.5) years, PSA were (31.2±18.9) ng/ml and (29.7±19.5) ng/ml, prostate volume were (44.6±15.2) ml and (41.3±17.3) ml, respectively. In the control group, the positive rates of prostate cancer in 1-10 region were 24.1% (27/112), 27.7%(31/112), 23.2% (26/112), 28.6% (32/112), 26.8% (30/112), 25.0% (28/112), 26.8% (30/112), 19.6% (22/112), 25.9% (29/112), 25.0% (28/112), respectively, with an average of 25.3%. In the observation group, the positive rates in 1-10 region were 27.6% (29/105), 28.6% (30/105), 22.9% (24/105), 26.7% (28/105), 25.7% (27/105), 24.8% (26/105), 27.6% (29/105), 21.9% (23/105), 27.6% (29/105), 26.7% (28/105), respectively, with an average of 26.0%. There was no statistical difference between the two groups (P=0.904). The positive rate of apical prostate cancer in the control group and observation group was 37.5% (42/112) and 44.8% (47/105), respectively, and there was no statistical difference between the two groups (P=0.277). Patients were grouped according to PSA>20 ng/ml and PSA≤20 ng/ml. When PSA>20 ng/ml, the positive rate of apex was 58.6% (34/58) and 56.6% (30/53) respectively in the control group and the observation group, and there was no statistical difference between the two groups (P=0.830). When PSA≤20 ng/ml, the positive rate of apex was 14.8% (8/54) in the control group and 32.7% (17/52) in the observation group, with statistically significant differences (P=0.030). Before radical prostatectomy, 12 cases (57.1%) in the control group and 19 cases (73.1%) in the observation group showed apical invasion by biopsy. Results of whole mount sections examination in the control group showed that there were 19 cases (90.5%) with apical invasion, which was statistically different from that before surgery (P=0.035). The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5%) with apex invasion, which had no statistical difference compared with that before surgery (P=0.291). There were no significant differences in the incidence of hematuria, fever, urinary retent","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49216642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical features and management of primary bladder lymphoma 原发性膀胱淋巴瘤的临床特点及治疗
Q4 Medicine Pub Date : 2019-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.10.007
Shiming Zhao, Tiejun Yang, Chaohong He, B. Fang
Objective To summarize the clinical experience of primary bladder lymphoma. Methods From September 2012 to May 2019, 8 cases of primary bladder lymphoma treated in our institute were analyzed retrospectively, including 4 males and 4 females. The mean age was 50.5 years old, ranged from 15 to 85. There were 3 cases of localized bladder lymphoma and 5 cases of metastatic bladder lymphoma. Three cases presented with painless gross hematuria primarily and 5 cases suffered from abdominal pain and bloating. Imaging examination showed the bladder tumor or pelvic mass with maximum diameter ranged from 3 to 22 cm, with 11.3 cm on average. Preoperative diagnosis of bladder tumor in 3 cases, and pelvic malignant tumor in 5 cases. Two patients underwent TURBT and 6 cases underwent pelvic mass resection and partial cystectomy. Results Postoperative pathological diagnosis showed 6 cases of diffuse large B-cell lymphoma, 1 case of mucosa-associated lymphoid tissue lymphoma, 1 case of anaplastic large cell lymphoma. Follow-up after surgery ranged 3 to 60 months, with 28.1 months on average. Two patients can not tolerate radiotherapy or chemotherapy for postoperative complications of vesico-vaginal fistula and intestinal fistula, and both were alive at the last follow-up. Six patients underwent CHOP regimen (cyclophosphamide, doxorubicin, vincristine, prednisone), 3 cases were addd with rituximab. Three patients died during the follow-up. One 85-year-old patient died 10 months after surgery. Two cases of metastatic bladder lymphoma died 3 or 6 months after surgery respectively. Three cases were alive after chemotherapy, including 2 young patients undergoing chemotherapy with DICE regime and one patient undergoing pelvic radiotherapy. Conclusion The primary bladder lymphoma has no special clinical symptoms, and TURBT and needle biopsy are critical for the diagnosis, based on the pathological and immunohistochemical examination. The most common pathological type is diffuse large B-cell lymphoma. R-CHOP chemotherapy is recommended, which can be followed by DICE regime for young patients. Metastasis and aging predict poor prognosis. Key words: Lymphoma; Urinary Bladder; Treatment; Prognosis
目的总结原发性膀胱淋巴瘤的临床经验。方法回顾性分析我院2012年9月至2019年5月收治的原发性膀胱淋巴瘤8例,其中男4例,女4例。平均年龄50.5岁,年龄范围15 ~ 85岁。局限性膀胱淋巴瘤3例,转移性膀胱淋巴瘤5例。3例以无痛性肉眼血尿为主,5例伴有腹痛和腹胀。影像学检查显示膀胱肿瘤或盆腔肿块,最大直径3 ~ 22 cm,平均11.3 cm。术前诊断膀胱肿瘤3例,盆腔恶性肿瘤5例。2例行TURBT, 6例行盆腔肿块切除术和部分膀胱切除术。结果术后病理诊断为弥漫性大b细胞淋巴瘤6例,粘膜相关淋巴组织淋巴瘤1例,间变性大细胞淋巴瘤1例。术后随访3 ~ 60个月,平均28.1个月。2例患者因术后膀胱阴道瘘和肠瘘并发症不能耐受放疗或化疗,最后随访时均存活。6例患者采用CHOP方案(环磷酰胺、阿霉素、长春新碱、强的松),3例患者加用利妥昔单抗。3例患者在随访期间死亡。一名85岁的患者在手术后10个月死亡。2例转移性膀胱淋巴瘤分别于术后3、6个月死亡。化疗后存活3例,其中年轻患者2例采用DICE方案化疗,1例采用盆腔放疗。结论原发性膀胱淋巴瘤无特殊临床症状,在病理和免疫组化检查的基础上,TURBT和穿刺活检对诊断至关重要。最常见的病理类型是弥漫性大b细胞淋巴瘤。推荐R-CHOP化疗,年轻患者可采用DICE方案。转移和衰老预示预后不良。关键词:淋巴瘤;膀胱;治疗;预后
{"title":"Clinical features and management of primary bladder lymphoma","authors":"Shiming Zhao, Tiejun Yang, Chaohong He, B. Fang","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.10.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.10.007","url":null,"abstract":"Objective \u0000To summarize the clinical experience of primary bladder lymphoma. \u0000 \u0000 \u0000Methods \u0000From September 2012 to May 2019, 8 cases of primary bladder lymphoma treated in our institute were analyzed retrospectively, including 4 males and 4 females. The mean age was 50.5 years old, ranged from 15 to 85. There were 3 cases of localized bladder lymphoma and 5 cases of metastatic bladder lymphoma. Three cases presented with painless gross hematuria primarily and 5 cases suffered from abdominal pain and bloating. Imaging examination showed the bladder tumor or pelvic mass with maximum diameter ranged from 3 to 22 cm, with 11.3 cm on average. Preoperative diagnosis of bladder tumor in 3 cases, and pelvic malignant tumor in 5 cases. Two patients underwent TURBT and 6 cases underwent pelvic mass resection and partial cystectomy. \u0000 \u0000 \u0000Results \u0000Postoperative pathological diagnosis showed 6 cases of diffuse large B-cell lymphoma, 1 case of mucosa-associated lymphoid tissue lymphoma, 1 case of anaplastic large cell lymphoma. Follow-up after surgery ranged 3 to 60 months, with 28.1 months on average. Two patients can not tolerate radiotherapy or chemotherapy for postoperative complications of vesico-vaginal fistula and intestinal fistula, and both were alive at the last follow-up. Six patients underwent CHOP regimen (cyclophosphamide, doxorubicin, vincristine, prednisone), 3 cases were addd with rituximab. Three patients died during the follow-up. One 85-year-old patient died 10 months after surgery. Two cases of metastatic bladder lymphoma died 3 or 6 months after surgery respectively. Three cases were alive after chemotherapy, including 2 young patients undergoing chemotherapy with DICE regime and one patient undergoing pelvic radiotherapy. \u0000 \u0000 \u0000Conclusion \u0000The primary bladder lymphoma has no special clinical symptoms, and TURBT and needle biopsy are critical for the diagnosis, based on the pathological and immunohistochemical examination. The most common pathological type is diffuse large B-cell lymphoma. R-CHOP chemotherapy is recommended, which can be followed by DICE regime for young patients. Metastasis and aging predict poor prognosis. \u0000 \u0000 \u0000Key words: \u0000Lymphoma; Urinary Bladder; Treatment; Prognosis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47908548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of partial nephrectomy with positive margin on recurrence and metastasis in patients with renal cancer: a Meta-analysis 边缘呈阳性的部分肾切除术对肾癌复发和转移的影响:一项荟萃分析
Q4 Medicine Pub Date : 2019-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.10.011
Sheng Zeng, Z. Bai, Zhe Li, Hong-shun Ma, Qian Liu
Objective Systematic assessment of the effect of positive margin on recurrence and metastasis in patients with renal cell carcinoma who underwent partial nephrectomy. Methods The literature were searched on the rate of recurrence and metastasis in patients with positive margin and partial nephrectomy published in PubMed, Embase, Cochrane, China Biomedical Literature Database, China Knowledge Network, VIP Chinese Science and Technology Journal Database, and Wanfang Chinese Database up to December 2018. The quality of the literature included in this study was evaluated by two reviewers, and a meta-analysis was performed on the literature that met the inclusion criteria using the Revman 5.0 statistical software provided by Cochrane Collaboration. Results A total of seven articles were included, six of which were case-control studies, and the other one was a cohort study. These seven articles consisted of 6 928 patients, including 407 positive margins and 6 521 negative margins. For recurrence and metastasis, 407 positive margins were composed of 25 recurrences and 21 distant metastases, while 6 521 negative margins consisted of 68 recurrence and 96 distant metastasis. The disease-free survival rate of patients with positive margins is lower than that with negative margins (OR=4.92, 95%CI 2.66-9.08, P<0.001). The results of subgroup analysis of patients with recurrence and metastasis based on positive margin exhibited that positive margin increased the risk of recurrence in patients undergoing partial nephrectomy (OR=5.05, 95%CI 2.06-12.37, P<0.001), as well as the risk of metastasis (OR=3.70, 95%CI 2.18-6.26, P<0.001). Since different studies consisted of patients with different tumor staging, a stratified analysis was conducted and the disease-free survival rate of patients with positive margins decreased compared with that of negative margins (OR=4.13, 95%CI 2.54-6.70, P<0.001), although there were differences in the staging of tumor patients included in different studies, which did not weaken the results. Conclusions Positive margins increase the risk of recurrence and metastasis in patients undergoing partial nephrectomy. Key words: Kidney neoplasms; Partial nephrectomy; Positive margin; Recurrence; Metastasis; Meta-analysis
目的系统评价阳性切缘对肾细胞癌部分切除后复发转移的影响。方法检索截至2018年12月PubMed、Embase、Cochrane、中国生物医学文献数据库、中国知识网、维普中文科技期刊库、万方中文数据库中发表的关于肾缘和部分切除阳性患者复发转移率的文献。本研究纳入的文献质量由两位审稿人进行评估,并使用Cochrane Collaboration提供的Revman 5.0统计软件对符合纳入标准的文献进行meta分析。结果共纳入7篇文献,其中6篇为病例对照研究,1篇为队列研究。这7篇文章包括6 928例患者,其中阳性切缘407例,阴性切缘6 521例。407例阳性切缘复发25例,远处转移21例;6521例阴性切缘复发68例,远处转移96例。切缘阳性患者的无病生存率低于切缘阴性患者(OR=4.92, 95%CI 2.66 ~ 9.08, P<0.001)。基于阳性切缘的复发转移患者亚组分析结果显示,阳性切缘增加部分肾切除术患者复发风险(OR=5.05, 95%CI 2.06 ~ 12.37, P<0.001)和转移风险(OR=3.70, 95%CI 2.18 ~ 6.26, P<0.001)。由于不同研究纳入的患者肿瘤分期不同,我们进行了分层分析,虽然不同研究纳入的肿瘤患者的分期存在差异,但阳性切缘患者的无病生存率较阴性切缘患者降低(OR=4.13, 95%CI 2.54-6.70, P<0.001),但这并没有削弱结果。结论切缘阳性增加了部分肾切除术患者复发和转移的风险。关键词:肾肿瘤;部分切除;积极的保证金;复发;转移;荟萃分析
{"title":"Effect of partial nephrectomy with positive margin on recurrence and metastasis in patients with renal cancer: a Meta-analysis","authors":"Sheng Zeng, Z. Bai, Zhe Li, Hong-shun Ma, Qian Liu","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.10.011","url":null,"abstract":"Objective \u0000Systematic assessment of the effect of positive margin on recurrence and metastasis in patients with renal cell carcinoma who underwent partial nephrectomy. \u0000 \u0000 \u0000Methods \u0000The literature were searched on the rate of recurrence and metastasis in patients with positive margin and partial nephrectomy published in PubMed, Embase, Cochrane, China Biomedical Literature Database, China Knowledge Network, VIP Chinese Science and Technology Journal Database, and Wanfang Chinese Database up to December 2018. The quality of the literature included in this study was evaluated by two reviewers, and a meta-analysis was performed on the literature that met the inclusion criteria using the Revman 5.0 statistical software provided by Cochrane Collaboration. \u0000 \u0000 \u0000Results \u0000A total of seven articles were included, six of which were case-control studies, and the other one was a cohort study. These seven articles consisted of 6 928 patients, including 407 positive margins and 6 521 negative margins. For recurrence and metastasis, 407 positive margins were composed of 25 recurrences and 21 distant metastases, while 6 521 negative margins consisted of 68 recurrence and 96 distant metastasis. The disease-free survival rate of patients with positive margins is lower than that with negative margins (OR=4.92, 95%CI 2.66-9.08, P<0.001). The results of subgroup analysis of patients with recurrence and metastasis based on positive margin exhibited that positive margin increased the risk of recurrence in patients undergoing partial nephrectomy (OR=5.05, 95%CI 2.06-12.37, P<0.001), as well as the risk of metastasis (OR=3.70, 95%CI 2.18-6.26, P<0.001). Since different studies consisted of patients with different tumor staging, a stratified analysis was conducted and the disease-free survival rate of patients with positive margins decreased compared with that of negative margins (OR=4.13, 95%CI 2.54-6.70, P<0.001), although there were differences in the staging of tumor patients included in different studies, which did not weaken the results. \u0000 \u0000 \u0000Conclusions \u0000Positive margins increase the risk of recurrence and metastasis in patients undergoing partial nephrectomy. \u0000 \u0000 \u0000Key words: \u0000Kidney neoplasms; Partial nephrectomy; Positive margin; Recurrence; Metastasis; Meta-analysis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45086777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect and mechanism of atorvastatin on cellular inflammatory response induced by calcium oxalate crystals 阿托伐他汀对草酸钙晶体诱导的细胞炎症反应的影响及机制
Q4 Medicine Pub Date : 2019-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6702.2019.10.012
Yan Sun, Z. Tao, Juening Kang, Quan Liu, Xiang Wang, Shibin Long, Derong Li, Yao-liang Deng
Objective To investigate the effect and mechanism of atorvastatin (ATV) on the inflammatory response of human renal tubular epithelial cells (HK-2 cells) induced by calcium oxalate crystals. Methods HK-2 cells were divided into control group (normal medium), ATV group (after 3 h pretreatment with 40 μmol/L ATV, replaced with normal medium), calcium oxalate crystal stimulation group (4 mmol/L calcium oxalate crystal) and ATV treatment group (after 3 h pretreatment with 40 μmol/L ATV, replaced with 4 mmol/L calcium oxalate crystals). After 12 h, the cells were collected, and the expression levels of NLRP3 and Cleaved caspase-1 were detected by immunohistochemical staining and Western blotting. The expression level of NF-κB was detected by immunofluorescence and Western blotting. The cell culture supernatant was collected to detecte the concentrations of interleukin-1β (IL-1β) and interleukin-18 (IL-18) by enzyme linked immunosorbent assay (ELISA). Results Western blot analysis showed that the relative expression of NLRP3 (0.125±0.013 vs. 0.135±0.007) and Cleaved caspase-1 (0.090±0.014 vs. 0.095±0.006) was decreased in the ATV group compared with the control group, but the difference was not statistically significant (P>0.05). The relative expression of NLRP3 (0.315±0.021 vs. 0.135±0.007, P 0.05] and IL-18 [(176.50±24.12)pg/ml vs.(182.50±20.51)pg/ml, P>0.05] in the ATV group was lower than that in the control group, but the difference were not statistically significant (P>0.05). The concentrations of IL-1β[(850.50±48.79)pg/ml vs. (183.50±7.78)pg/ml, P 0.05). The relative expression of NF-κB (0.295±0.035 vs. 0.100±0.014, P<0.001) in the calcium oxalate crystal stimulation group was significantly increased compared with the control group. While the relative expression of NF-κB (0.160±0.012 vs. 0.295±0.035, P<0.05) in the ATV treatment group was significantly lower than that in the calcium oxalate crystal stimulation group. The expression of NF-κB by immunofluorescence staining was consistent with the results of Western blotting. Conclusions Calcium oxalate crystals can induce the inflammatory response of HK-2 cells, while ATV can exert anti-inflammatory effects by inhibiting the activation of NLRP3 inflammasome and decreasing the secretion of inflammatory factors IL-1β, IL-18 and the expression of NF-κB. Key words: Inflammation; Cytokines; Atorvastatin; Calcium oxalate; Human renal tubular epithelial cells
目的探讨阿托伐他汀(ATV)对草酸钙结晶诱导的人肾小管上皮细胞(HK-2细胞)炎症反应的影响及其机制。方法将HK-2细胞分为对照组(正常培养基)、ATV组(用40μmol/L ATV预处理3h后,用正常培养基代替)、草酸钙晶体刺激组(用4mmol/L草酸钙晶体代替)和ATV处理组(用40mmol/L ATV处理3h后用4mmol/L草酸盐晶体代替)。12小时后,收集细胞,通过免疫组织化学染色和Western印迹检测NLRP3和Cleaved胱天蛋白酶1的表达水平。用免疫荧光和蛋白质印迹法检测NF-κB的表达水平。收集细胞培养上清液,采用酶联免疫吸附法(ELISA)检测白细胞介素-1β(IL-1β)和白细胞介蛋白-18(IL-18)的浓度。结果与对照组相比,ATV组NLRP3(0.125±0.013 vs.0.135±0.007)和裂解的胱天蛋白酶-1(0.090±0.014 vs.0.095±0.006)的相对表达降低,但差异无统计学意义(P>0.05)。ATV组NLRP3(0.315±0.021 vs.0.135±0.007,P>0.05)和IL-18[(176.50±24.12)pg/ml vs.(182.50±20.51)pg/ml,P>0.05]的相对表达低于对照组,IL-1β浓度[(850.50±48.79)pg/ml vs.(183.50±7.78)pg/ml,P<0.05)。草酸钙晶体刺激组NF-κB的相对表达(0.295±0.035 vs.0.100±0.014,P<0.001)显著高于对照组ATV治疗组(0.160±0.012 vs.0.295±0.035,P<0.05)显著低于草酸钙晶体刺激组。免疫荧光染色显示NF-κB的表达与Western印迹结果一致。结论草酸钙结晶可诱导HK-2细胞的炎症反应,而ATV可通过抑制NLRP3炎症小体的激活、减少炎症因子IL-1β、IL-18的分泌和NF-κB的表达而发挥抗炎作用。关键词:炎症;细胞因子;阿托伐他汀;草酸钙;人肾小管上皮细胞
{"title":"Effect and mechanism of atorvastatin on cellular inflammatory response induced by calcium oxalate crystals","authors":"Yan Sun, Z. Tao, Juening Kang, Quan Liu, Xiang Wang, Shibin Long, Derong Li, Yao-liang Deng","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.10.012","url":null,"abstract":"Objective \u0000To investigate the effect and mechanism of atorvastatin (ATV) on the inflammatory response of human renal tubular epithelial cells (HK-2 cells) induced by calcium oxalate crystals. \u0000 \u0000 \u0000Methods \u0000HK-2 cells were divided into control group (normal medium), ATV group (after 3 h pretreatment with 40 μmol/L ATV, replaced with normal medium), calcium oxalate crystal stimulation group (4 mmol/L calcium oxalate crystal) and ATV treatment group (after 3 h pretreatment with 40 μmol/L ATV, replaced with 4 mmol/L calcium oxalate crystals). After 12 h, the cells were collected, and the expression levels of NLRP3 and Cleaved caspase-1 were detected by immunohistochemical staining and Western blotting. The expression level of NF-κB was detected by immunofluorescence and Western blotting. The cell culture supernatant was collected to detecte the concentrations of interleukin-1β (IL-1β) and interleukin-18 (IL-18) by enzyme linked immunosorbent assay (ELISA). \u0000 \u0000 \u0000Results \u0000Western blot analysis showed that the relative expression of NLRP3 (0.125±0.013 vs. 0.135±0.007) and Cleaved caspase-1 (0.090±0.014 vs. 0.095±0.006) was decreased in the ATV group compared with the control group, but the difference was not statistically significant (P>0.05). The relative expression of NLRP3 (0.315±0.021 vs. 0.135±0.007, P 0.05] and IL-18 [(176.50±24.12)pg/ml vs.(182.50±20.51)pg/ml, P>0.05] in the ATV group was lower than that in the control group, but the difference were not statistically significant (P>0.05). The concentrations of IL-1β[(850.50±48.79)pg/ml vs. (183.50±7.78)pg/ml, P 0.05). The relative expression of NF-κB (0.295±0.035 vs. 0.100±0.014, P<0.001) in the calcium oxalate crystal stimulation group was significantly increased compared with the control group. While the relative expression of NF-κB (0.160±0.012 vs. 0.295±0.035, P<0.05) in the ATV treatment group was significantly lower than that in the calcium oxalate crystal stimulation group. The expression of NF-κB by immunofluorescence staining was consistent with the results of Western blotting. \u0000 \u0000 \u0000Conclusions \u0000Calcium oxalate crystals can induce the inflammatory response of HK-2 cells, while ATV can exert anti-inflammatory effects by inhibiting the activation of NLRP3 inflammasome and decreasing the secretion of inflammatory factors IL-1β, IL-18 and the expression of NF-κB. \u0000 \u0000 \u0000Key words: \u0000Inflammation; Cytokines; Atorvastatin; Calcium oxalate; Human renal tubular epithelial cells","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49016815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
中华泌尿外科杂志
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1