Objective To compare the safety and effects of retroperitoneal laparoscopic ureterolithotomy(RLU)and microinva-sive percutaneous nephrolithotomy with lithotomy (MPCNL)for treating complicated upper ureteral calculi and to explore the sur-gical indications and the technical key points.Methods The clinical data in 54 cases of complicated upper ureteral calculi from Mar. 2009 to Sep.2012 were retrospectively analyzed,31 cases adopted the MPCNL therapy (MPCNL group)and 23 cases received the RLU therapy(RLU group).The perioperative complications and the stone clearance rate were compared between the two groups. Results The mean operating time was (69.70±7.73)min in the RLU group and (46.50±7.09)min in the MPCNL group(t=-11.436,P=0.000);the intraoperative blood loss was (21.50±7.23)mL in the RLU group and (66.90±20.00)mL in the MPC-NL group(t=9.94,P=0.000),the MPCNL group was significantly higher than the RLU group;no statistically significant differ-ences were found in the occurrence rate of postoperative hyperpyrexia,the stone clearance rate,the occurrence rate of urinary leak-age and the length of hospital stay between the two groups.Conclusion Both MPCNL and RLU have high safety and satisfactory effects for treating complicated upper ureteral calculi.RLU has less intraoperative blood loss and long operation time.

Objective To study the potential use of the urinary beta-trace protein ( βTP) for diagnosis of type 2 diabetic renal injury.Methods 174 patients with type 2 diabetic mellitus (T2DM) were classified into 2 groups according to the ratio of urinary albumin to creatinine (Alb/Cr):diabetes without renal injury group (group A) and diabetes with renal injury group (group B).70 healthy subjects served as normal control group ( group C).The level of urinary βTP and αl microglobulin (α1MG) was measured by latex particle enhanced immunoturbidimetry assay.The urinary Alb and Cr were determined by nephelometry and Jaffe method respectively.The level of uriuary βTP among all groups was compared and ROC curve analysis was performed.The relevant analysis on urinary βTP,urinary α1MG and other related indexes was made.Results The median level of urinary βTP/Cr in group B was 9.1mg/g Cr,significantly higher than 3.1mg/g Cr of group A and 2.0mg/g Cr of group C.The difference had statistical significance ( H =45.5,P ＜ 0.01).The other indexes ( Alb/Cr,α1MG/Cr,SCr) were all higher in group B than in the other 2 groups ( H =110.9,38.3,11.4 respectively,P ＜0.01).The relevant analysis showed that urinary βTP/Cr was positively correlated with urinary α1MG/Cr (r =0.894,P ＜ 0.01),SCr (r =0.367,P ＜ 0.05 ),HbA(J) C ( r =0.242,P ＜ 0.05 ),systolic pressure ( r =0.162,P ＜0.05 ),and the course of the disease ( r =0.251,P ＜ 0.05 ).No correlation was found between urinary βTP/Cr and diastolic pressure,fasting blood glucose(FBG) or BMI.ROC curve analysis showed the area under the curve (AUC) was 0.86 (95％CI,0.78-0.93)for urinary βTP/Cr and 0.76 (95％ CI,0.67-0.85) for urinary α1MG/Cr.The best cut-off value of urinary βTP/Cr and α1MG/Cr was 4.1mg/g Cr vs 10.9mg/g Cr,the sensitivity was 68.5％ vs 59.7％,and the specificity was 89.8％ vs 80.3％.The difference had statistical significance (P ＜ 0.05).Conclusions Urinary βTP has better diagnostic value for type 2 diabetic patients with renal injury than urinary α1MG.It can sensitively reflect renal tubular injury and can be used as a novel available biomarker to evaluate the renal tubular injury in clinic.