Objective To investigate the effect of extracorporeal shock wave lithotripsy(ESWL)and transurethral ureteroscopic holmium laser lithotripsy(URLL)in the treatment of urinary calculi.Methods From January 2021 to December 2023,162 patients with urinary calculi were admitted and divided into a control group and an observation group according to the lithotripsy method,with 81 cases in each group.The patients in the control group and in the observation group received ESWL and URLL respectively.The stone clearance effect,postoperative recovery and postoperative complications of the two groups were compared,and the VAS score for pain before and after treatment was measured.Results The total effective rates of stone removal in the observation group and the control group were 96.30％and 86.42％respectively.There was a statistically significant difference between the two groups(P＜0.05).The time of first getting out of bed for activities in the observation group and the control group was(25.15±4.37)hours and(31.74±5.12)hours respectively,the hospital stay was(8.59±3.13)days and(11.62±3.84)days respectively,and the incidence of postoperative complications was 11.11％and 23.46％respectively.There was a statistically significant difference between the two groups(P＜0.05).The VAS scores of pain in both groups at 4 hours,12 hours,24 hours and 7 days after treatment were lower than those before treatment,and the VAS scores of patients in the observation group at 4 hours,12 hours and 24 hours after treatment were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Transurethral ureteroscopic holmium laser lithotripsy is effective in removing urinary calculi,reducing postoperative pain compared with extracorporeal shock wave lithotripsy and fewer postoperative complications.

Objective To investigate the effect of extracorporeal shock wave lithotripsy(ESWL)and transurethral ureteroscopic holmium laser lithotripsy(URLL)in the treatment of urinary calculi.Methods From January 2021 to December 2023,162 patients with urinary calculi were admitted and divided into a control group and an observation group according to the lithotripsy method,with 81 cases in each group.The patients in the control group and in the observation group received ESWL and URLL respectively.The stone clearance effect,postoperative recovery and postoperative complications of the two groups were compared,and the VAS score for pain before and after treatment was measured.Results The total effective rates of stone removal in the observation group and the control group were 96.30％and 86.42％respectively.There was a statistically significant difference between the two groups(P＜0.05).The time of first getting out of bed for activities in the observation group and the control group was(25.15±4.37)hours and(31.74±5.12)hours respectively,the hospital stay was(8.59±3.13)days and(11.62±3.84)days respectively,and the incidence of postoperative complications was 11.11％and 23.46％respectively.There was a statistically significant difference between the two groups(P＜0.05).The VAS scores of pain in both groups at 4 hours,12 hours,24 hours and 7 days after treatment were lower than those before treatment,and the VAS scores of patients in the observation group at 4 hours,12 hours and 24 hours after treatment were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Transurethral ureteroscopic holmium laser lithotripsy is effective in removing urinary calculi,reducing postoperative pain compared with extracorporeal shock wave lithotripsy and fewer postoperative complications.

【Objective】 To investigate the mechanism by which the up-regulation of miR-221-3p by tumor-associated macrophages (TAMs) may be involved in promoting the malignant metastasis of prostate cancer (PCa). 【Methods】 The microRNAs (miRNAs) expression profiles of 6 cases of metastatic PCa tissues were sequenced and analyzed.The primary TAMs were isolated.The expression of miR-221-3p was determined with qPCR.The miR-221-3p mimic or miR-221-3p inhibitor was transfected into RAW264.7 macrophages in vitro, and co-cultured with human prostate cancer PC3 cells.The proliferation, apoptosis, invasion and migration of PC3 cells were detected with CCK-8, flow cytometry (FCM), Transwell assay, respectively.Expressions of epithelial-mesenchymal transformation (EMT) related protein factors were determined with Western blot. 【Results】 In the 6 cases of metastatic PCa, hsa-miR-221-3p was significantly up-regulated in TAMs-derived from PCa tissues with positive lymph node metastasis (P<0.05).In the co-cultured system, compared with Mimic-NC group, miR-221-3p mimic group had significantly up-regulated proliferation, migration, invasion and EMT-related protein factors (except E-Cadherin) (P<0.05).Compared with Inhibitor-NC group, miR-221-3p inhibitor group had significantly up-regulated apoptosis rate, but down-regulated proliferation, migration, invasion and EMT-related protein factors (except E-Cadherin) (P<0.05). 【Conclusion】 The miR-221-3p expression up-regulate by TAMs may participate in the malignant metastasis of prostate cancer.

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 evaluate the usefulness of mycolic acid for identification of Mycobacterium species using SMIS. Methods One hundred and eighteen clinical Mycobacterium isolates collected from Beijing Tuberculosis and Thoracic Tumor Research Institute through whole year of 2007 were analyzed. The 118 isolates contain 25 isolates of Mycobacterium tuberculosis and 93 non tuberculosis Mycobacterium identified by PNB method. Mycolic acid analysis using SMIS is evaluated for identification of a broad range of Mycobacteria in comparison with 16S rDNA , 16-23S rDNA ITS sequencing to measure the concordance rate and agreement, and verify the concordance rate and agreement among results of mycolic acid, sequencing and PNB in identifying Mycobacterium tuberculosis and non tuberculosis Mycobacterium. Results The concordance rate between mycolic acid method analysis and DNA sequencing is 92% ( 108/118), of which concordance rate in Mycobacterium tuberculosis complex and non tuberculosis Mycobacterium are 95% (35/37) and 90% (73/81) respectively, agreement of both is great( agreement Kappa value is 0. 96). Through retrospective analysis, the concordance of results between SMIS and PNB method analysis is 90% (106/118)and agreement is well( agreement Kappa value is 0. 73 ), the concordance of results between sequencing and PNB method analysis is also 90% ( 106/118 ) and agreement is well (agreement Kappa value is 0. 74 ),despite the identification results of 11 isolates by PNB method are discordant. Conclusion Mycolic acid analysis by SMIS enables rapid identification of a broad range of clinical Mycobacterium species, which could play an important role in polyphasic identification of Mycobacterium species.

Objective To study the genotypes of representative Mycobacterium tuberculosis (M.tuberculosis) strains from China with spacer oligonucleotide typing (spoligotyping),and to investigate the prevalence of different genotypes TB in China,and analyse the relationship between genotype and drug resistance.Methods 4017 clinical isolates were collected by Chinese Center for Disease Control and Prevention from 2007 to 2008 in 31 provinces in China according to sampling principle of epidemiology.Drug susceptibility testing was performed using proportion method,and spoligotyping was chosen to carry out genotyping of these M.tuberculosis.In addition,chi-square test was used to compare the differences among the detection rate of different genotypes.Results Among the 4017 M.tuberculosis isolates,2500 ( 62.2％ ) isolates belonged to Beijing genotype.The percentage of Beijing genotypes in the northern of China was higher than that in the southern of China ( 76.5％ vs.53.2％,x2 =219.69,P ＜ 0.05 ),while T1 genotypes were more common in the southern China,compared with that in northern China ( 13.3％ vs.4.3％,x2 =219.69,P ＜ 0.05 ).The differences were statistically significant.The proportions of Rifampinresistant (21.7％ vs.21.7％ ),Ofloxacin-resistant (4.9％ vs.2.4％ ) and Multidrug-resistant ( 11.3％vs.7.4％ ) isolates among Beijing genotype strains were significantly higher than those among non-Beijing strains (x2 =22.10,14.42 and 14.83,respectively,P ＜ 0.05 ).Conclusions Beijing genotype was still predominant epidemic genotypes.The percentage of Beijing genotype showed difference between distinct areas,and the percentage of Beijing genotypes in northern China was higher than that in southern China.Beijing genotype strains reveal correlation with Rifampin-resistance,Ofloxacin-resistance and Multidrug-resistance.

Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.

Objective To summarize the experiences of 5-year relative living kidney transplantation in the minorities. Methods The clinical data of HLA matching, rejection, survival and causes of death were retrospectively analyzed from 2004 to July 2009. There were 97 blood relative donations, including 1 case of father → son, 1 case of daughter → father, 1 case of mother → son, 24 cases of donation between brother and sister, 2 cases of non-blood relative donors (husband and wife),1 case of inter-ethnics, and the remaining were collateral relative donors. All the donations were voluntary, and all the recipients were minorities and all donors were their blood relatives. There were no mismatch of gene matching of 6 antigenic sites (0 MM) in 1 patient, 1 mismatch point (1 MM) in 2 patients, 2 mismatch points (2 MM) in 5 patients, 3 mismatch points (3 MM) in 10 patients, 4 mismatch points (4 MM) in 21 patients, 5 mismatch points (5 MM) in 39 patients and complete mismatch in 22 patients. Results All donors were discharged after 1 week and followed up for 3-6 months. Blood creatinine was normal and urine protein was negative. Up to July 2009, the conditions of the recipients were as follows: (1) Ninety-one receptors survived after transplantation. The longest survival time was up to 5 years. Among 9 deaths, 1 case died from myocardial infarction, 1 case from hemorrhagic shock and the others from respiratory failure (7 %) ; (2) Two renal grafts lost their functions and the patients restarted dialysis, in whom the preoperative panel reactive antibodies (PRA) of 1 patient was high and the patient had postoperative acute rejection, and the other patient stopped immunosuppressive agents on his own, leading to renal function loss; (3) After transplantation 10 patients had acute rejection, of which 2 cases received methylprednisolone plus OKT3, and the remaining 9 patients were treated with methylprednisolone. All rejections were reversed; (4) Urethral fistula occurred in one case and was improved after 45 days. Three patients had vesicoureteral anastomotic stenosis and were cured surgically. lyrnph leakage occurred in one case and was improved after 2 months. Fourteen patients had lung infection, including 7 mild lung infections which were improved after treatment, and 7 severe lung infections which died from respiratory failure.Other complications included secondary diabetes mellitus (4 cases), urinary tract infection (2 cases),acute renal failure (2 cases), deep venous thrombosis (3 cases), drug-induced liver damage (5 cases),polycythemia (5 cases), hepatitis C (3 cases), chronic allograft nephropathy (3 cases), and all were improved after treatment. Conclusion Comprehensive assessments of the donors and receptors before transplantation are guarantee to successful living kidney transplantation from relative donors; Living kidney transplantation from relative donors has the advantages of good matching, short ischemia period of donated kidney, less rejections and high survival rate of transplanted kidneys.

Objective To explore an effective treatment for benign prostatic hyperplasia complicated with bladder stones.Methods Swiss LithoClast Master and transurethral resection of the prostate(TURP)were performed on 33 patients with benign prostatic hyperplasia complicated with bladder stones.Results The operations were completed successfully in all the cases with a mean lithoclasty time of 35 min(15-65 min),and mean TURP time of 85 min(50-110 min).No blood transfusion,TUR syndrome,bladder perforation,or residual stone occurred during and after the operations.Urethral catheter was withdrawn 5 days postoperation,none of the patients had urinary incontinence or dysuria.The diagnosis of benign prostatic hyperplasia was confirmed by pathology examination.Three months after the operations,IPSS decreased from 23.4?5.2 to 7.4?1.2(t=3.732,P=0.000);maximum urinary flow rate increased from(5.4?1.5)ml/s to(18.6?3.2)ml/s(t=2.491,P=0.015);and QOL decreased from 3.9?1.2 to 2.0?0.7(t=2.454,P=0.014).Conclusions EMS LithoClast Master combined with TURP is an effective treatment for benign prostatic hyperplasia complicated with bladder stones.

Objective To investigate the serum coxsackie virus B(CVB) infection and nitric oxide (NO)level of the patients suffer from latent or chronic Keshan disease and their characteristics in the etiopathology of Keshan disease. Methods Sera were isolated from 30 patients with latent or chronic Keshan disease in Huangling county.Shaanxi Province, and the CVB-specific IgM antibody and NO were tested. Control groups were health subjects in Huangling county or Xi'an city, Shaanxi Province. Results The percentage of CVB-specific IgM positive in patients in Huangling county was significantly higher than that of both control groups in Huangling county and Xi'an city (P＜0. 05). The serum level of NO in patients was significantly higher than that of the control group in Huangling county (P＜0.05) ,however,compared with control group in Xi'an city, there was no difference (P＞0.05). In CVB-specific IgM positive patients,the serum level of NO was significantly higher than that of CVB-specific IgM negative group(P＜0.05).Conclusion CVB infection and serum NO level might be related to the etiopathology and the development of Keshan disease.