Xiao-Bo Huang

Systemic inflammatory response syndrome after percutaneous nephrolithotomy : An assessment of risk factors

Objectives:  To analyze the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) and to quantitatively predict the probability of SIRS after PCNL.

Early and delayed castrations confer a similar survival advantage in TRAMP mice.

The most appropriate time to introduce androgen deprivation therapy for prostate cancer remains controversial. Our aim was to evaluate the effects of early versus delayed surgical castration on prostate cancer progression and survival in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model. TRAMP mice were randomly divided into three groups: the early castration group (on which castration was performed at the age of 4 weeks), the delayed castration group (on which castration was performed when abdominal tumours could be palpated), and the sham-castrated group. Mice were monitored daily throughout their lives until cancer-related death or the development of an obviously moribund appearance, at which time the individual mouse was killed. Androgen receptor expression in prostate tumours was also evaluated. The results shows that the average lifespan in early castration, delayed castration and sham-castrated groups were 54.1 weeks, 59.9 weeks and 39.1 weeks, respectively. Both early castration and delayed castration conferred a statistically significant survival advantage when compared with the sham-castrated group (P<0.001). However, the difference in lifespan between the early castration group and the delayed castration group was not statistically significant (P=0.85). The increase in lifespan in the TRAMP mice that received either early or delayed castration correlated with lower G/B value (genitourinary tract weight/body weight) at death than the sham-castrated mice. In conclusion, early and delayed castrations in TRAMP mice prolonged survival to a similar extent. This finding may provide a guide for clinical practice in prostate cancer therapy.

An Experimental Study of High Intensity Focused Ultrasound on Pig’s Pancreas and the Early Clinical Experience on Pancreatic Cancer

Objective: To investigate the feasibility and safety of high intensity focused ultrasound (HIFU) treatment of in vivo pig pancreases, and to evaluate the safety and efficacy of HIFU in the clinical treatment of pancreatic cancer in humans. Methods: HIFU was performed in 12 domestic pig pancreases in vivo with varying acoustic energies. The safety of HIFU treatments was assessed by necropsy. The pathology and microstructure of the treated pancreases were evaluated using standard histology and transmission electron microscopy. Following the animal studies 62 patients with advanced pancreas cancer were treated with 250 – 420 W of acoustic power. There were 3 patients with stage II, 23 patients with stage III, and 36 patients with stage IV disease. Results: In animal studies, precise regions of coagulation necrosis were identified on pathology in 8 specimens that were treated with 420 W or 645 W acoustic power. Treatment effects were unable to be identified in 4 specimens treated with 300∼340 W acoustic power...

Research Progress of Mechanisms of Ceftriaxone Associated Nephrolithiasis

BACKGROUND Urinary calculi can be caused by a variety of reasons, such as metabolic abnormalities, urinary tract infection and obstruction. Certain medications can induce urinary stone disease. Ceftriaxone, a third generation cephalosporin with broad spectrum antibiotic activity, primarily eliminated by the kidneys, has now been widely used for treatment of infection. It has been long considered safe, especially in children. However, more and more cases about ceftriaxone induced nephrolithiasis as a rare side effect have been reported. CONCLUSION This complication generally resolves spontaneously with cessation of the drug. Severe nephrolithiasis can cause post renal acute renal failure (PARF). There is limited information about how this complication develops, though high doses and extended treatment periods are generally considered to be responsible. Understanding the mechanisms would help the doctors to be aware of this rare complication and respond with proper treatment. The primary goal of this review is to discuss the possible mechanisms based on the most recent literatures.

AB086. Comparison of two kinds of methods for urethrovesical anastomosis during laparoscopic radical prostatectomy

Objective To compare two kinds of running sutures for urethrovesical anastomosis (UVA) during laparoscopic radical prostatectomy (LRP). Materials and Methods From January 2014 to June 2015, 32 consecutive patients underwent extraperitoneal LRP for prostate cancer by two experienced surgeons. In group 1 (n=15), the UVA was performed by one surgeon using single needle bi-directional traction running suture with 5/8 circle 3-0 Monocryl®. The suture was initiated clockwise from 5-o’clock and the end was out of body from trocar to keep constant tension. After stitch completing, the redundant tail was cut and the suture was tightened through bi-directional traction and tied with the tail on 5-o’clock finally. In group 2 (n=17), the UVA was performed by another surgeon using single needle barbed running suture with 5/8 circle 3-0 V-Loc®. The suture was performed by the same way as group 1 but with the end of the suture knotted on 5-o’clock. The time of UVA, removal time of drainage tube and Foley catheter, postoperative hospital stay and rate of urine leak were measured and compared. The degree of difficulty of operation was evaluated by the same first assistant. Results The mean operation time was 187 and 192 minutes in groups 1 and 2, respectively (P>0.05). Moreover, the mean UVA time was 33 and 35 minutes in groups 1 and 2, respectively (P>0.05). Also, removal time of drainage tube, catheterization time, lenght of hospital stay were no significant difference between group 1 and group 2. The rate of urine leak was higher in group 1 (7/15) than group 2 (3/17), but there was no difference between two groups. The difficulty of operation evaluated by first assistant was lower in group 1 than group 2 (P<0.05). Conclusions The single needle bi-directional traction running suture could maintain a proper suturing tension, so it could compare with single needle barbed running suture in operation time and UVA time. Moreover, it might be a more easier method of urethrovesical anastomosis for beginner in learning curve during LRP.

Use of a calcium tracer to detect stone increments in a rat calcium oxalate xenoplantation model

The majority of urinary stones have been observed to grow by circular increments in the clinic and in animal studies. However, the mechanism of stone formation has not yet been elucidated. Marking the stone at specific time-points during the growth of the stone is likely to enable the clarification of the mechanisms behind lithogenesis. The objective of this study was to evaluate the role and efficacy of calcium-tracing fluorescence in the labeling of stone lamination in a rat calcium oxalate xenoplantation model. In the rat calcium oxalate xenoplantation model, human renal stone particles, extracted by percutaneous nephrolithotomy, were xenoplanted into the bladders of Wistar rats in a sterile manner. The rats received 1% ethylene glycol in their drinking water, starting from the day following the stone xenoplantation. Two weeks subsequent to this, three calcium-tracing fluorochromes, alizarin complexone, calcein and xylenol orange were administered by intraperitoneal injection. The newly-formed bladder stones were cut into slices and examined using light and fluorescence microscopy. The newly-formed bladder stones had a large variance in size, and circular increments were observed in the sections of the stones. The stones were successfully labeled with calcein and alizarin complexone, although calcein labeling provided superior results. However, the use of xylenol orange did not result in clear labeling. The calcium-tracing fluorochromes, calcein and alizarin complexone may be effectively used to label stone lamination in rat models.