Objective To improve the diagnosis and tr ea tment level of reno-colic fistula. Methods The clinical data of 6 patients (4 males and 2 females,average age of 37 years) with reno-c olic fistula were analyzed retrospectively.Among them,4 cases had the fistula on the right side and 2,on the left.On etiology,3 cases had nephrolithiasis compli cated with infection;1,nephrolithiasis accompanied by carcinoma of renal pelvis; 1, tuberculosis of kidney; 1,perinephric abscess.There were no typical clinical symptoms in the 6 patients and they underwent retrograde pyelography or antegrad e pyelography for confirmation of diagnosis. Results Sur gical management was carried out in the 6 patients.Among them,1 case underwent n ephrectomy,colectomy and colocolostomy;2,nephrectomy,fistulectomy and repair of the colon;2,pyelolithotomy or ureterolithotomy,fistulectomy and repair of the ki dney and colon;1 case of nephrolithiasis with carcinoma of renal pelvis underwen t exploratory laparotomy and tumor biopsy with no surgery due to severe adhesion of the kidney and colon with the peripheral tissues.Five patients were followed up for 8 months to 9 years (mean,46 months) postoperatively;no surgical complic ation occurred and they had a satisfactory recovery.Only 1 case died of metastas is of tumor 6 months postoperatively. Conclusions Nephro lithiasis complicated with infection is a major cause of reno-colic fistula.Ret rograde pyelography or antegrade pyelography is the most reliable method in the diagnosis of reno-colic fistula.As soon as the diagnosis is made, surgical trea tment should be performed.

Objective To study the effect of fish oil on calcium oxalate kidney stone formation. Methods The efficacy of unprocessed fish oil in the treatment of 20 hypercakiuric patients with urinary stones was evaluated, after administration of fish oil at dosage of 3000mg daioy of one week. Results Excretion of urinary calcium reduced significantly from (461.37?80.67)mg/d to (312.63?40.57)mg/d.The Mg2+ reduced from (136. 41?56. 12) mg/d to (108.43?18.96) mg/d. The Mg2+ /Ca2+ increased significantly from (0.29?0.08) to ( 0. 36?0.11)-Uric acid remained unchanged. Conclusion Unprocessed fish oil is safe and effective for the reduction of urinary calcium and might be used for the prevention of calcium stone recurrence.

Objective To evaluate the efficacy and safety of management of kidney calculi in non-uronephrosis by percutaneous nephrolithotripsy (PCNL) under ultrasound guidance. Methods From July 2005 to June 2008, 97 cases of kidney calculi in non-uronephrosis were performed by percutaneous nephrolithotripsy. A tube was first inserted into the pelvis through cystoscope, and saline was instilled to dilate collecting system. Antegrade percutaneous access was obtained under ultrasound guidance. A combination of pneumatic and ultrasonic lithotrite was used to disintegrate and remove stone under direct vision. Clinical data including operation time, complications and stone free rate were analyzed retrospectively. Results The perutaneous renal access was successfully established under ultrasound guidance in all patients, immediate phase Ⅰ lithotripsy was performed in 95 cases and delayed phase Ⅱ lithotripsy in 2 cases. Operation time was 70-180 min, average time was (96±23 ) min. The average blood loss was 60 ml (20-500 ml), 4 cases had transfusion during the PCNL and average 400 ml. Minor pyrexia ( < 39℃) was seen in 24 cases,whereas serious pyrexia was noted in 3 cases. Conservatively administered with appropriate antibiotics, the fever disapeared in 27 cases within 5 days postoperatively. Severe complications did not occur during nephrolithotripsy. Stones were cleared completely in 78 out of 97 cases (80.4%)during immediate phase Ⅰ lithotripsy, residual stone fragment was found in 19 cases. Conclusion The management of kidney calculi in non-uronephrosis by PCNL appears to be efficacious and safe under ultrasound guidance.

Objective To investigate the effects of acarbose versus fenofibrate on insulin secretion and insulin resistance in the subjects with impaired glucose tolerance (IGT) and hypertriglyceridemia. Methods Eighty subjects were allocated to acarbose group (28 cases),fenofibrate group (30 cases),and control group (22 cases) without intervention for 3 months,and also divided into elderly (46 cases) and younger groups (34 cases). Fasting blood samples were collected for measuring fasting plasma glucose and lipid.Oral glucose tolerance test (OGTT) were carried out with measurement of plasma insulin and glucose before ad after treatment.Early insulin secretion indexes(△I30/△G30),insulin secretion indexes (HOMA -β) and insulin resistance indexes (HOMA-IR)were calculated. Results After 3-months of treatment,the lipid profile was evidently improved in fenofibrate group. Levels of triglyceride (TG) and total cholesterol (TC) were significantly reduced ( both P ＜ 0.01 ),△I30/△G30 was significantly increased (P ＜ 0.05) and HOMA-IR was decreased (P＜＜0.01).In acarbose group,levels of fasting plasma glucose (FPG),2hours postprandial plasma glucose (2 hPG) and HOMA-IR were reduced (all P＜0.01),△I30/△G30 and HOMA-β were enhanced (P＜0.01 or P＜0.05).No change of above indicators was found in the control group.Compared with fenofibrate group,acarbose group had higher △ I30/△G30 (P＜ 0.05),HOMA-β (P＜ 0.01 ) and lower HOMA-IR ( P ＜ 0.01 ).The improvement of △△I30/△G30 was correlated with the decreasing of plasma FPG,2 hPG and TG(r=0.5812,0.6327,0.3872,P＜0.01),while HOMA-1R was related with the decreasing of plasma 2 hPG,TG and TC(r=0.8126,0.4671,0.2895,P＜ 0.01). HOMA-IR,△I30/△G30 and HOMA-β were lower (P＜0.01) and acarbose improved insulin resistance better (P＜0.05) in the elderly than in the younger with type 2 diabetes. Conclusions Pancreatic β-cell function declines gradually with aging,acarbose may have advantage over fenofibrate in improving early insulin secretion and resistance which was more relieved by diminishing glucotoxity in comparison with lipotoxity.