Objective To detect the circulating miR-106a levels in serum before and after surgery in patients with renal clear cell carcinoma,and to explore its relationship with clinical-pathological parameters.Methods 30 serum samples from patients with renal clear cell carcinoma were collected before and after surgery during February 2013 to July 2014.This study included 30 normal controls.All serum miR-106a levels were detected using the real-time PCR.Results The serum miR-l06a levels in patients with renal clear cell carcinoma pre-operatively wcre significantly greater than normal controls (Z =-4.251,P =0.0001).The serum miR-106a levels in patients post-operatively had no significant differences compared to normal controls (Z =-0.244,P =0.807).The serum miR-106a levels in post-operative samples were significantly lower than the pre-operative samples (Z =-4.229,P =0.0001).Serum miR-106a levels and other clinical-pathological parameters had no correlation in patients with renal clear cell carcinoma(tumor size:Z =-0.775,P =0.439;Fuhrman grade:Z =-1.694,P =0.090).The receiver operating characteristic curve was used to distinguish pre-operative samples and normal controls,its AUC was 0.819 (95％ CI:0.710-0.929,P =0.0001) with 86.7％ sensitivity and 70.0％ specificity.Conclusions The serum miR-106a levels in patients with renal clear cell carcinoma pre-operatively were significantly greater than post-operatively with no correlation in tumor size and Fuhrman grade.The outcome suggested that serum miR-106a can be regarded as a potential molecular marker in renal clear cell carcinoma.

Objective To introduce a new trocar position in the posterior laparoscopic for the treatment of retrocaval ureter.Methods From August 2011 to October 2014,5 cases with retrocaval ureter treated with posterior laparoscopic were retrospectively analyzed,including 3 males and 2 females,aged from 15 to 46 years(mean 34 years).The history of disease ranged from 1 to 10 months,with 3 cases presented with low back pain,and 2 cases being detected uronephrosis by check-up.Results All the operations were successfully completed,with the operation duration ranged from 75-125 min (mean 90min),and blood loss ranged from 20ml to 50 ml(mean 35 ml).The average hospital stay was 6 days(5-7d).There was no wound infection or urine leakage.Ureteral double-J tubes were removed 4 weeks after surgery.Postoperative followup ranged from 2 weeks to 6 months (mean 30 months).There was no anastomotic stricture,and the hydronephrosis relieved.Conclusions Trocar position adjustment of posterior laparoscopic in treatment of retrocaval ureter is convenient to operate,which also shortened the time of operation,reduced the difficulty of operation and the surgeons' fatigue.

Objective To discusse the diagnosis and treatment of kidney stones with emphysema pyelonephritis.Methods The clinical data of 8 patients with kidney stones complicated with emphysema pyelonephritis diagnosed in our hospital from January 2015 to October 2018 were retrospectively analyzed.There were 5 males and 3 females.The average age was 50 years old.The clinical manifestations including chills fever in 6 cases,low back pain in 5 cases,nausea and vomiting in 3 cases.Six patients had diabetes,one had thalassemia,and two had contralateral kidney stones.The maximum cross-sectional area of stones was 737.6 mm2.Among the 8 cases,there were 7 cases which number of white blood cells and procalcitonin were higher than normal reference value.4 cases of hemoglobin ＜ 110 g/L,2 cases of platelet count ＜ 125 × 109/L.The patient was cultured with urine and/or blood and drainage fluid.5 cases were Escherichia coli,2 cases were infected with Proteus mirabilis,and 1 case was infected with Pseudomonas aeruginosa.According to the CT findings of emphysematous pyelonephritis reported in the literature,it was divided into type Ⅰ-Ⅳ:There were 2 cases of type Ⅰ,2 cases of type Ⅱ,3 cases of type Ⅲ,and 1 case of type Ⅳ.Results 4 cases of type [and type Ⅱ patients,2 cases without SIRS were given positive medical treatment to control infection then performed PCNL.2 cases with SIRS,first treated with percutaneous nephrolithotomy and active medical,after control infection the PCNL was performed.None of the 4 patients were treated with ICU and recovered well after surgery.Three patients with type Ⅲ and one patient with type Ⅳ were complicated with SIRS.Two of them underwent percutaneous nephrolithotomy in the emergency department.They were transferred to the ICU after surgery.After the infection and general condition improved,PCNL was performed.The postoperative recovery was satisfied.One patient percutaneous nephrolithotomy,due to poor drainage,secondary percutaneous nephrolithotomy,large intrachannel,low pressure perfusion in the operation of partial obstruction of renal pelvis stones,dredge obstruction,after ICU control infection PCNL was performed,postoperative recovery was good.One patient with type Ⅲ also had poor peritoneal drainage for the first time.Secondary percutaneous nephrolithotomy was performed.After the infection was controlled by ICU,PCNL was performed to remove the stones.However,because the patient had contralateral kidney stones and thalassemia,an epileptic-like reaction occurred during the anti-infection with imipenem,and a serious infection occurred again after the operation,and eventually the patient died.Conclusions Patients with type Ⅰ and Ⅱ emphysematous pyelonephritis with renal calculi treated with conservative medical treatment alone or combined with percutaneous renal puncture drainage with SIRS can achieve better therapeutic effects after PCNL surgery.Type Ⅲ,Ⅳ emphysema pyelonephritis with renal calculus patients need to be actively anti-infective accompany with percutaneous renal puncture drainage.When the stone leads to multiple renal pelvic obstruction,large channels,low-pressure perfusion can be used to crush stones,dredge obstruction.PCNL was performed after infection control.

Objective To explore the application effect of prone split-leg position in percutaneous nephrolithotomy(PCNL).Methods A total of 79 patients with upper urinary tract stones who underwent surgery in our department from July 2021 to July 2022 were selected.According to the surgical position,the patients were divided into prone split-leg position group(n =35)and traditional prone position group(n =44).The two groups were compared regarding operation time,intraoperative blood loss,postoperative and preoperative hemoglobin changes,postoperative complications,one-stage stone free rate,and duration of hospitalization.Results The prone split-leg position group had significantly shorter operative time and higher one-stage stone free rate than those in the traditional prone position group[(69.6±20.7)min vs.(90.5±35.3)min,t =-3.280,P =0.002;97.1%(34/35)vs.79.5%(35/44),χ2 =3.984,P =0.037].There were 1 case of infection,3 cases of fever,and 1 case of bleeding in the prone split-leg position group,while 4 cases of postoperative fever and 2 cases of bleeding in the traditional prone position group,without significant difference in the incidence of complications between the two groups(χ2 =0.000,P =1.000).There were no statistical differences in intraoperative blood loss,number of working channel,hemoglobin changes,and duration of hospitalization(P>0.05).Conclusion Prone split-leg position PCNL can shorten the operation time,improve the one-stage stone free rate,and will not increase the risk of postoperative complications,with good safety and effectiveness.

BACKGROUND: As an emerging stem cell family, urine-derived stem cells have attracted more and more attentions in the tissue engineering construction. OBJECTIVE: To study the culture method of urine-derived stem cells, and to identify the biological characteristics of urine-derived stem cells. METHODS: Cleaning urine samples were harvested and centrifuged, and urine-derived stem cells were isolated from the urine samples and extensively expanded in vitro.Cell growth curve was measured by MTT method,and cell surface markers were detected by flow cytometry. Meanwhile, the cells were subjected to osteogenic and adipogenic induction. RESULTS AND CONCLUSION: Urine-derived stem cells were successfully isolated from the urine samples, which grew and proliferated rapidly. After subculture, the cells exhibited an S-shaped growth. The isolated urine-derived stem cells expressed CD29, CD44, CD73 and CD90, indicating that the cells maintained the activity of stem cells. Moreover, the isolated cells had the ability of osteogenic and adipogenic differentiation. To conclude, urine-derived stem cells have strong proliferation and differentiation potentials, as a kind of economic, convenient, non-invasive source of cells, which can provide great convenience for urethral defect repair and organ reconstruction.

BACKGROUND: Little is reported on human urine derived stem cells, and there is still no stable and efficient culture method until now. OBJECTIVE: To compare the effects of three kinds of culture media on the growth and proliferation of human urine derived stem cells, and to optimize the culture methods. METHODS: Human urine derived stem cells were isolated and purified using centrifugation method, and then cultured using adherent method in keratinocyte serum-free medium, progenitor cell culture medium, and urinary cell culture medium (equal-proportion mixture of keratinocyte serum-free medium and progenitor cell culture medium). Cell morphology was observed, and cell proliferation was detected by MTT method to draw a cell growth curve.RESULTS AND CONCLUSION: Human urine derived stem cells could be successfully cultured in these three kinds of culture media, which grew slowly in the keratinocyte serum-free medium, grew rapidly in the progenitor cell culture medium, and grew best in the urinary cell culture medium. To conclude, the urinary cell culture medium which can rapidly and efficiently culture target cells is the best choice for the growth of human urine derived stem cells.

【Objective】 To investigate the clinical characteristics and treatment strategies of urosepsis caused by carbapenem-resistant gram-negative bacteria (CRGNB) in patients with urinary calculi. 【Methods】 Clinical data of 6 urinary calculi patients with urosepsis due to CRGNB infection treated at our hospital were retrospectively analyzed.The clinical characteristics of infection and anti-infective drugs were analyzed according to the domestic and foreign guidelines and relevant literature. 【Results】 All 6 cases were nosocomial infection had a history of ureteral stent tube placement and invasive procedures, and 7 strains of CRGNB were detected with bacterial culture.All patients were improved after anti-infective treatment with single drug or multi-drug schemes.Among them, cases 3, 4 and 6 were treated according to the minimum inhibitory concentration (MIC) value of drug sensitivity test, and had good outcomes. 【Conclusion】 Urosepsis caused by CRGNB infection in patients with urinary calculi is common in patients with positive bacterial culture and invasive procedures.Anti-infective therapy can flexibly adjust medication strategies according to the specific conditions of patients and changes in bacterial resistance to achieve the best therapeutic effects.