Objective To evaluate the learning curve in percutaneous nephrolithotomy under the guidance of B ultrasonography.Methods From January 2006 to July 2007,totally 60 cases of percutaneous nephrolithotomy were performed under the guidance of B ultrasonography by a single urologist.The patients were divided into 6 groups according to the date of the operation(10 cases in each).The time for setting the renal access and the stone-free rate were compared among the groups.Results The time for setting the renal access was(15.0?2.7),(14.0?2.1),(10.2?1.2),(5.8?0.7),(7.5?1.2),and(6.6?0.9)minutes respectively in group 1 to 6.ANOVA analysis showed significant difference among the groups(F=5.734,P=0.000).Significant difference was detected between groups 1 and 4(q = 5.655,P

Objective To evaluate the efficacy and safety of ultrasonography-guided percutaneous nephrolithotomy(PCNL).Methods Between May 2006 and June 2008,110 patients underwent PCNL by a single urological team at our hospital.The clinical data of the patients were retrospectively reviewed.Of the cases,supracostal access(the 11th intercostal space) was made in 62 patients(supracostal group),and subcostal access was obtained in 48 patients(subcostal group).Forty-five patients in the supracostal group(45/62) and 36 of the subcostal group(36/48) received CT three dimensional reconstruction.Results The stone free rate of the supracostal group was 72.6%(45/62),while that of the subcostal group was 60.4%(29/48;?2=1.818,P=0.178).The mean operation time of the supracostal group was(78.6?5.1) min,while that of the subcostal group was(102.4?7.1) min(t=-20.454,P=0.000).There was one patient in each group received blood transfusion.One patient in the supracostal group had pneumothorax and recovered uneventfully by conservative treatments.Conclusion Ultrasonography-guided PCNL via the supracostal approach is effective and safe with short operation time.

Objective To investigate the genitourinar y phenotype in androgen receptor knockout (ARKO) mice. Methods Using Cre-lox technique, the female Flox-AR mice were crossed with male ACTB-Cre mice,and the genotype of their filial generations was confirmed by PCR .By screening,5 ARKO mice were generated as study subjects and 5 wild type mice served as controls.The genitourinary phenotypes of the 2 groups were compared.Th e anal genital distance and testis weight were measured;serum testosterone and e stradiol levels were assayed by ELISA. Results The anal genital distance in ARKO group was (0.5?0.1)cm,while it was (1.1?0.1)cm in wil d type group.The prostate,seminal vesicle, epididymis and spherical cavernous bo dy muscle were absent in ARKO group with the reduced testis weight of (0.006 ? 0.001)g;while those were normal with the testis weight of (0.086?0.002)g in w ild type group.The serum testosterone level in ARKO group was (0.056?0.045)nmol /L,and it was (0.843?0.736)nmol/L in wild type group.The serum estradiol level in ARKO group was (1390.1?294.3)pmol/L,and it was (786.2?150.8)pmol/L in wild type group.The differences were statistically significant between the 2 groups ( P

Objective To explore the role of intercellular adhesion molecule-1(ICAM-1) in the metastasis of lung cancer.Methods The expression of ICAM-1 in the tissue and the serum ICAM-1(sICAM-1) level in the 52 cases of primary lung cancer were detected with immunohistochemical staining method(SP) and enzyme linked immunosorbent assay(ELISA),with 20 cases of adjacent non-cancerous tissue as the control.Results The positive rate of ICAM-1 expression in lung cancer was significantly higher than that of adjacent non-cancerous tissue.The expression of ICAM-1 in the cases with lymph node metastasis was higher than that of no lymph node metastasis.The expression of ICAM-1 in stage III+IV was higher than that of stage I+II,and that in adenocarcinoma was higher than that of squamous cell carcinoma.The level of sICAM-1 in patients with lymph node metastasis was higher than that without lymph node metastasis.The sICAM-1 level in patients of adenocarcinoma was higher than that of squamous cell carcinoma,and that in patients with positive expression of ICAM-1 in tissue was higher than that of negative expression of ICAM-1.Conclusion The expression of ICAM-1 may be associated with the metastasis in lung cancer.The sICAM-1 level reflects the expression of ICAM-1 in tissue and may be used as a tumor marker of metastasis and prognosis in lung cancer.

Objective To evaluate the efficacy of combination of traditional educational methodology with problem-based learning pedagogy in urology.Method The traditional educational pedagogy of urological tuberculosis was modified by combining with PBL methodology.Result More students were interested and active in this pedagogy.Conclusion The combination of traditional educational methodology with PBL is a helpful pedagogy.

Objective To compare the histopathologic and immunohistochemical differences between primary renal cell carcinomas and paired bone metastases in order to discuss the significance in the selection of standard targeted therapies.Methods The clinical data of 19 patients who underwent nephrectomy and resection of bone metastases successively from January 2003 to September 2013 were analysed retrospectively.The paraffin-embedded surgical samples of all the patients were obtained for histopathologic and immunohistochemical analysis.The differences of Fuhrman grades,expression of Ki-67,CD34,vascular endothelial growth factor receptor 2 (VEGFR2),epidermal growth factor receptor (EGFR) and CXC subfamily receptor 4 (CXCR4) were compared between primary renal cell carcinomas and their paired bone metastases.Microvessel density (MVD) was evaluated by the CD34 immunostaining.Results The Fuhrman grades of samples from bone metastases were higher than that of primary tumors (36.8％,7/19) (P=0.008).The Ki-67 label index was (4.00±3.96)％ in primary tumors and (7.90±7.38)％ in bone metastases (P=0.033).The microvessel density (MVD) was 58.13±22.90 in primary tumors and 46.71±25.40 in the bone metastases (P=0.026).The immunohistochemistry scores of VEGFR2 were 4.68±1.20 in primary tumors and 4.05±1.58 in bone metastases (P=0.014).The immunohistochemistry scores of EGFR were 5.89±1.05 in primary tumors and 5.47± 1.12 in bone metastases (P=0.134).The immunohistochemistryscores of CXCR4 in cytomembrane and cytoplasm were 1.74±1.97 in primary tumors and 2.16± 1.64 in bone metastases (P=0.414).The inununohistochemistry scores of CXCR4 in cell nucleus were 2.52±2.09 in primary tumors and 3.42±1.95 in bone metastases (P=0.009).Conclusions The Fuhrman grades and the expression of Ki-67 and CXCR4 in cell nucleus were higher in bone metastases than that in the primary renal cell carcinomas.The MVD and the expression of VEGFR2 were lower in bone metastases than that in the primary tumors.The above alternations may contribute to the poor prognosis of bone metastasis and the poor result of angiosuppressive therapy.

SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Objective To investigate the relationship of triglycerides/high-density lipoprotein (TG/HDL C) ratio with coronary heart disease (CHD) and its severity.Methods 158 patients with CHD were enrolled in this study.Patients were divided into 4 groups according to the selective coronary arteriography:the control group,single-vessel CHD group,double-vessel CHD group,multiple-vessel CHD group.The relationship between multiple risk factors and CHD was analyzed by stepwise multiple regression.The severity of coronary artery stenosis was analyzed by Gensini scoring system.Results TG/HDL-C ratio was elevated in patients with coronary artery stenosis as compared with the control group [(1.8±1.0) vs.(1.7±1.4),t=2.68,P＜0.05].TG/HDL-C ratio was elevated along with the severity of CHD.TG/HDL-C ratio was elevated in multiple-vessel C HD group as compared with the control group by ANOVA analysis (P＜0.05).Stepwise multiple regression showed that multiple-vessel CHD was positive related with total cholesterol (TC),LDL-C and TG/HDL-C ratio (β value:0.326,0.339,0.158,respectively,all P＜0.05).Conclusions TG/HDL C ratio is related with multiple vessel CHD,but it does not have more clinical significances than other indicators.

Objective: To investigate the position and the size of ureteral stone in patients before treated with ureteroscopic lithotripsy or percutaneous nephrolithotomy (PCNL), as well as the dilatation of ureter caused by stone, which may be helpful for better understanding of pathogenesis of ureteral stone and improvement of the diagnosis and treatment in clinic.Methods: A total of 129 cases with ureteral stone for endourologic lithotripsy in Peking University People''s Hospital from Aug.2016 to Mar.2017 were included for the retrospective review.The CT data of the ureteral stones and the ureteral dilatation were collected, including the position of stone, the transverse and longitudinal diameter of stone, and the transverse diameter of dilated upper ureter and ureteropelvic junction (UPJ).The distribution of ureteral stones and dilatation in different parts of ureter were compared and analyzed.Results: All of the 129 cases of ureteral stone, stones were located at UPJ in 9 cases (7.0%), proximal ureter in 75 (58.0%), ureter crossing external iliac vessel (UEIV) in 6 (4.7%), distal ureter in 26 (20.2%), and ure-terovesical junction (UVJ) in 13 (10.1%).The mean transverse diameter of proximal ureteral stones was greater than that of distal ureteral stones [(8.47±2.36) mm vs.(6.74±1.99) mm, P<0.001], as the same as the mean longitudinal diameter [(11.00±4.41) mm vs.(7.50±4.28) mm, P<0.001].In 114 cases of dilated ureter for stone, the UPJ had a greater transverse diameter compared with the upper ureter [(14.39±6.09) mm vs.(11.45±3.85) mm, P<0.001].Conclusion: The most common location of stone is the proximal ureter in patients for endourologic lithotripsy, as the location in UEIV is rare.Both transverse and longitudinal diameters of stone in proximal ureter are greater than those in distal ureter.For dilated ureter, it is more severe in UPJ than in upper ureter.Traditionally, it is accepted that the stones lodge at 3 sites of natural narrowing in ureter, which may be questioned.

Objective:To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL).Methods:In this study,461 patients with type 2 diabetes who received PCNL in Peking Uni-versity People’s Hospital from June 2006 to December 2015 were reviewed.There were 281 males and 180 females with an average age of 57 years were included,of whom,137 were diagnosed with SIRS after PCNL.The demographic data,clinical features,and test results were compared between the patients with SIRS and without SIRS,trying to identify the correlation between their clinical characters and the occur-rence of SIRS.Results:The SIRS was significantly correlated with the patients’preoperative white blood cell counting (×109 /L)[7.76 (4.00 -17.96)vs.6.31 (2.00 -17.40),P <0.001 ],preopera-tional blood glucose level (mmol /L)[7.30 (3.08 -19.90)vs.6.40 (3.42 -16.78),P <0.001], operative time (min)[75 (20 -270)vs.60 (20 -200),P <0.001 ],length of stay (d)[12 (2 -46)vs.11 (3 -29),P =0.019],staghorn stones [38.8% (33 /85)vs.27.7% (104 /376),P =0.042],and preoperational urinary tract infection [36.8% (50 /136)vs.26.6% (81 /304),P =0.032].There was no significant correlation between the SIRS and the patients’age,body mass index, preoperative hemoglobin level,preoperative serum creatinine,and transfusion.In multivariate analysis, abnormal preoperative white blood cell counting (OR =3.194,95% CI:1.531 -6.666,P =0.002), operative time longer than 60 min (OR =1.635,95% CI:1.088 -2.456,P =0.018),and preopera-tional blood glucose level higher than normal 7.1 mmol /L were significantly correlated with the presence of SIRS.Conclusion:The high level of preoperational blood glucose,abnormal preoperative white blood cell counting,and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.