Objective To investigate the effect of apigenin and the change of expression of Fas/FasL after renal ischemia/reperfusion injury in rats.Methods Establishing Renal ischemia/reperfusion injury rat model was established.Sixty rats were randomly divided into 5 Groups.Blood samples were collected for the detection of serum creatinine and urea nitrogen levels.The level of SOD,MDA and GSH-Px were detected.Histologic examinations were evaluated.The expression of Fas,FasL,Caspase-3 and Bcl-2 were performed by immunohistochemistry and Western blot.Results Compared with the sham group,the Cr and BUN levels in the I/R groups of were significantly increased,the level of SOD and GSH-Px reduced,the level of MDA improved.Histopathological damage of renal tubular aggravated.The immunohistochemical expression of FasL and Caspase-3 as shown in enhanced and Bcl-2 reduced.Western blot showed that Fas and FasL expression increased and Bcl-2 reduced significantly,and the difference was statistically significant (P ＜ 0.05).Compared with I/R group,apigenin significantly enhanced renal function,and alleviated renal tubular epithelial cell injury and decreased Fas,FasL and Caspase-3 expression,improved Bcl-2 expression,difference were statistically significant (P ＜ 0.05).Conclusion Apigenin can protect the rats subjected to ischemia/reperfusion injury.Its protective mechanism may be related to the inhibition in expression of Fas/FasL and the increase in expression of Bcl-2.

Objective To investigate the feasibility of an ileal reservoir with self controllable urination. Methods A segment of ileum was under taken,the middle portion of which was made into a N shaped reservoir and the proximal portion used as the afferent limb.The distal ileum was pulled out and the two skin flaps were taken and encircled the efferent ileum to constitute the urinary outflow.A urinary controller similar to penile clamp was applied to control the urination with a balloon catheter. Results Ten dogs and five patients underwent this procedure and the patients were followed up for 3 to 14 months.Urodynamic examination showed that on the third month,the reservoir in animals reached a maximum capacity of (150?40)ml and a full filling pressure of (24.4?5.3)cmH 2O.The reservoir in the patients reached a maximum capacity of (290?80)ml,a full filling pressure of (36.3?8.2)cmH 2O,a maximum urinary flow rate of (20.3?4.7)ml/s with no residual urine.X ray examination showed good excretory function of the kidney without hydronephrosis.All patients can control urination themselves through the use of the urinary controller. Conclusions The new procedure has the advantages of self control lable of urination,simple surgical performance and few complications.

ObjectiveTo evaluate percutaneous cyst in jection of aluminous mixture for renal cystic diseases.MethodsRetrospective analysis was made on 1295 cases of renal cystic diseases t reated by percutaneous cyst injection of aluminous mixture under guidance of ult rasound B.All together 1529 cysts including 1142 monocystic cysts and 153 polycy stic cysts were treated.ResultsAll the patients were f ollowed up for six months.The curative rate was 85.4%(1306/1529) and the markedl y improving rate 13.0 %(199/1529),the total effective rate was 98.4%.The lon g-term follow-up showed that reoccurence rates were 0.75%(6/798),0.92%(5/546), 1.72%(3/174) and 1.14%(1/71) in 1,3,5 and ten or more years respectively.3.1%(40 /1295) of the patients complained of lumber discomfort.No one had infection,feve r,sharp lumber pain or headache.ConclusionsCystic inje ction of aluminous mixture under the guidance of ultrasound B is a safe,feasible and effective method for the treatment of renal cystic diseases.

To observe the efficacy and safety of mini-percutaneous nephrolithotomy with Neodymium: Yttrium Aluminum Garnet (Nd-YAG) laser in the treatment for upper urinary tract stones, from December 2005 to September 2006, 31 patients with renal stones, 15 patients with ureteral stones and 7 patients with renal and ureteral stones underwent mini-percutaneous nephrolithotomy with Nd-YAG laser by combination of rigid ureteroscope and flexible ureteroscope under B-ultrasound guidance. Clinical data including operation time, lithotripsy time, complications and stone-free rate were analyzed retrospectively. Our study showed that the percutaneous renal access (F14-F18) was successfully established under B-ultrasound guidance in all cases. Immediate phase: lithotripsy was performed in 47 cases through single tract, and in one case through two tracts. Delayed phase II lithotripsy was done in 5 cases of renal stones. Operation time ranged from 55 to 180 min with an average time of 100+/-15 min. Lithotripsy time was from 25 to 135 min and the average lithotripsy time was 65+/-11 min. No severe complications occurred in our series. Complex renal stones were cleared in 34 of 38 cases (89.5%). All ureteral stones were completely removed in 15 cases (100%). It was concluded that mini-percutaneous nephrolithotomy with Nd:YAG laser for the treatment of upper urinary tract stones by combination of rigid ureteroscope and flexible ureteroscope has the advantages of effectiveness, mini-invasion, shorter operative time and safety.

Objective To investigate the expression of hepatocyte growth factor activator inhibitor- 1 (HAl-1) gene in the tissues of renal cell carcinoma (RCC) and the correlation with tumor angiogenesis.Methods The expression of HAI-1 gene was detected by semi-quantitative RT-PCR in the tissues of 56 cases of RCC,corresponding adjacent non-cancer tissues and 12 nomad renal tissues,the expression of CD34was detected by immunohistochemistry SP method in the above-mentioned organizations,and counted the microvessel density (MVD),analyzed the relationship between the expression of HAI-1 gene in RCC and clinicopathological parameters,MVD.Results The positive expression rate of HAI-1 gene in RCC tissues,the adjacent non-cancer tissues and normal renal tissues were 58.93％(33/56),76.79％(43/56) and 91.67％(11/12),respectively.The expression of HAI-1 gene was a negative correlation to the Fuhrman histological grade,Robson clinical stage (r ＝ -0.617,-0.432,P ＜ 0.01 or ＜ 0.05 ).The positive expression rate in lymph node metastasis was significantly lower than that in without lymph node metastasis [ 35.29％(6/17) vs.69.23％(27/39),P＜ 0.05 ].The MVD in RCC tissues was significantly higher than that in the adjacent noncancer tissues and normal renal tissues(P＜ 0.05).The expression of HAI-I gene in RCC tissues was negative correlated to the MVD (r ＝ -0.516,P ＜ 0.01 ).Conclusions There is a certain relationship between the missing expression of HAI-1 gene in RCC and the development,invasion and metastasis of RCC.The HAI-1 gene deletion can be used as an important molecular marker in the invasion and metastasis of RCC.

Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy (PNL) was performed in patients with various renal, perinephric and bladder diseases (n=79). The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4-20 min. 12F-16F single tract was established in nephrohydrop patients and 16F-20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2-12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

Objective To investigate the effects of isehemic postconditioning (IPO) on the acute renal ischemia/reperfusion (I/R) injury in dogs. Methods Fifteen adult male mongrel dogs were randomly divided into three groups with 5 animals in each group. In sham operation group (S), after the dogs were anesthetized, the midline laparotomy was made and right nephrectomy was performed;In I/R group, animals were subjected to the similar surgical procedures, except that the left renal vessels were clamped; In IPO group, the IPO was induced by 6 cycles of reperfusion (30 s) and ischemia (30 s) after 60 min renal ischemia before reperfusion completely. Blood samples were obtained for determination of blood creatinine (Cr) and urea nitrogen (BUN) concentrations before operation and at 24, 48 and 72 h after operation. The dogs were killed at the thirdday after operation and left kidneys were removed for determination of SOD activity and MDA and MPO concentrations.The apoptosis in the nephridial tissue was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and apoptotic index (AI) was calculated. The changes of renal tissue were examined by a microscope. Results Blood Cr and BUN concentrations in I/R group, IPO group and S group were decreased in turn after operation (P<0. 05). MDA and MPO concentrations were decreased significantly, SOD activity was significantly increased and AI was decreased significantly in IPO group as compared with I/R group at 72 h after operation (P<0. 05). Microscopic examination showed that there was no renal injury in S group and renal I/R resulted in tubular necrosis, medullary hemorrhage congestion and proteinaceous casts in I/R group. The renal I/R injury was significantly attenuated by IPO. In S group, IPO group and I/R group the renal AI was 2. 7 ±1.3, 28. 4 ± 6. 2 and 15.4±4. 1 respectively (P<0. 05). Conclusion IPO can attenuate renal damage induced by I/R by inhibiting oxidative stress and apoptosis and decreasing inflammation.

Objective To observe the effects of Triptolide on the expression of toll-like receptor 4 (TLR4) in renal ischemia/reperfusion (I/R) injury in rats. Methods A renal I/R model was established. Rats were randomly separated into the following experimental groups. Group 1, shamoperated control (n = 15) : rats were subjected to surgical manipulation, without the induction of renal ischemia. Group 2, I/R (n = 18): rats were subjected to left renal ischemia for 45 min followed by reperfusion. Group 3, TRI + I/R (n = 18): Before the I/R procedure (as in group 2), rats were intraperitoneally injected with TRI (0.4 mg/kg), once every day, three times. Rats were killed at the 1st, 3rd, and 5th day after I/R injury. The parameters of renal function were determined by autobiochemical analyzer. The expression of TLR4 was detected by RT-PCR and Western blotting. Results As comparedwith the sham-operated control group, serum BUN and Cr levels were significantly increased in the rats undergoing I/R procedure at the 1st, 3rd, and 5th day (P＜0. 01). After the treatment with TRI, the levels of BUN and Cr and the expression of TLR4 in the renal tissues were significantly decreased (P＜0. 05). Conclusion TRI could relieve renal I/R injury in rats by inhibiting the TLR4 expression.

ObjectiveTo investigate the protective effect of ozone oxidative preconditioning (OzoneOP) on apoptosis induced by acute renal ischemia/reperfusion (I/R) injury in rats.Methods The right kidneys of rats in control group were excised.A rat I/R model was established in I/R group.In OzoneOP group,the renal OzoneOP was induced by rectal insufflation of 5.0～5.5 ml oxygen plus ozone (ozone 50 mg/L,1 mg· kg- 1 · d- 1,once every day).The parameters (blood urea nitrogen and creatine )of renal function were determined by auto-biochemical analyzer. The concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) were measured by using chromometry.Cytochrome c (CytC) was examined by using immunohistochemistry and Western blotting.The mRNA expression levels of TNF-α,IL-1β and IL-6 in the renal tissue were detected by using RT-PCR.ResultsCompared with the control group,the blood urea nitrogen,creatine,MDA and the release of CytC were increased significantly in I/R group.After OzoneOP,the levels of blood urea nitrogen,creatine,MDA,CytC and the mRNA expression levels of TNF-α,IL-1-β and IL-6were significantly decreased and SOD levels were significantly increased.ConclusionOzoneOP could relieve renal I/R injury of rats by improving antioxidation capability,cutting down cytokines contents and inhibiting the release of CytC from mitochondria.

Objective To evaluate the predictive value of urinary neutrophil gelatinase-associat-ed lipocalin (NGAL) and interleukin-18 (IL-18) for delayed graft function (DGF) in kidney transplan-tation. Methods Serial urine samples collected at 0, 12 and 24 h after operation from 86 kidney transplantation patients were analyzed by enzyme-linked immunosorbent assay for NGAL, IL-18 and RBP. Results Fifteen patients developed DGF. At 12 h after transplantation, the level of urine NGAL elevated significantly (1712.75±474.6 vs. 863.1±199.8 without DGF, P<0. 001). The in-creases of urine IL-18 (29. 2±4.1 vs. 28.7±4.2 without DGF, P>0. 05) was not significant. At 24 h, both urine NGAL(2905.0±1108.1 vs. 911.8±221.0 without DGF,P<0. 001) and IL-18(211.3± 34.0 vs. 86.9±22.8 without DGF, P<0. 001) increased significantly, whereas the changes of urine RBP and serum creatinine (SCr) were not significant. ROC analysis showed that the area under the curve of NGAL and IL-18 were 0. 90 and 0.76 respectively, the cut-off values were 996.5 ng/mg and 148.5 ng/mg, the diagnostic sensitivities in DGF were 90.2% and 76.3%, specificities were 82.6% and 66.4% respectively. Conclusions Both urine NGAL and IL-18 could potentially be early predic-tive marker of DGF. The level of NGAL elevated earlier than IL-18, which may be more effective in predicting DGF.