Objective: To investigate the effects of modified three-step procedure for anatrophic nephrolithotomy in the treatment of complex staghorn renal calculi. Methods: A total of 22 patients with complex staghorn renal calculi between June 2013 and June 2016 at Department of Urology in Guangzhou General Hospital of Guangzhou Military Command were retrospective analyzed. There were 13 males and 9 females, ranging from 35 to 62 years old with mean age of 47 years. There were 17 patients with dull pain, and 5 patients who were found through physical examinations. Kidney calculi located in left kidney in 15 patients, right kidney in 7 patients. All patients were treated with modified three-step procedure for anatrophic nephrolithotomy. The operation time, blood loss, time of intraoperative renal ischemia, and postoperative complications were recorded. Serum creatinine (Scr), blood urea nitrogen(BUN), β₂-microglobulin(β₂-MG), diseased side glomerular filtration rate(GFR) , and renal cortical thickness of the diseased kidney in preoperative and postoperative were compared. The clinical data were compared by paired sample t test between pre-operation and post-operation. Results: The calculi were completely removed in 22 patients, the mean operation time was 84 minutes (50 to 126 minutes), the mean time of intraoperative renal ischemia was 31 minutes (20 to 56 minutes), the mean blood loss was 246 ml (150 to 360 ml). There were no secondary bleeding or urinary fistula happened, the perinephric drainage tub was removed in 3 to 7 days postoperative, the mean hospitalization time was 7 days.Compared with the preoperative, the Scr ((172.7±21.3)μmol/L vs. (146.4±22.8)μmol/L, t=7.197, P=0.000), BUN ((9.2±1.8)mmol/L vs. (8.0±0.5)mmol/L, t=3.798, P=0.001) and β₂-MG ((203.0±32.0)μg/L vs. (175.6±23.8)μg/L, t=5.009, P=0.000) in postoperative decreased, the diseased side GFR increased ((28.6±4.0) ml/min比(31.8±3.3) ml/min, t=-3.521, P=0.002). There were no significant difference of diseased renal cortical thickness between preoperative and postoperative(t=-1.323, P=0.200). There were 12 patients with postoperative pain, 2 patients with vomiting, 3 patients with fever, and 2 patients with wound infection. The follow-up time was 6 months, no residual stones in 22 patients. Conclusion The modified three-step procedure for anatrophic nephrolithotomy has high stone free rates with less effects on renal function and fewer complications, the method could be widely applied.

Objective To investigate the effect of microRNA-497 (miR-497) on cell proliferation and apoptosis capability of baldder cancer cell line EJ. Methods EJ human baldder cancer cells were divided into miR-497 mimics group,mimics NC group,miR-497 inhibitor group and inhibitor NC group. MiR-497 mimics,mimics NC,miR-497 inhibitor and inhibitor NC were transfected into EJ cells by LipfectamineTM 2000. The transfection effi-ciency was observed under a fluorescence microscope 6 hours after. And qRT-PCR was used to detected the expres-sion of miR-49748 hours after. Plate clone formation assay ,MTT assay and flow-cytometric analysis of apoptosis were used to detect the cell proliferation and apoptosis of bladder cancer EJ cells. Western blot was employed to de-termine the protein expressions of bcl-2 and caspase-3. Results Under fluorescence microscope ,the efficiency rate of four groups were over 90%. And qRT-PCR results showed miR-497 expression in EJ cells increased signifi-cantly in miR-497 mimics group than those in the control group(P<0.01),while miR-497 inhibitor post expres-sion decreased(P<0.01). Overexpression of miR-497 significantly suppressed EJ cells proliferation(P<0.01), and prompted EJ cells apoptosis(P < 0.01)compared with the control group. Moreover ,opposite results were ob-tained when miR-497 inhibitor was transfected into EJ cells . Compared with negative control ,the protein expres-sion of Bcl-2 down-regulated(P < 0.01)and Caspase-3 up-regulated(P < 0.01)in miR-497 mimics transfection group. Conclusions MiR-497 could suppress the proliferation and promote apoptosis of EJ cells ,which might be related to the protein expression of Bcl-2 and Caspase-3.