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Zhao Z.,Guangzhou University | Zhao Z.,Guangdong Key Laboratory of Urology | Mai Z.,Guangzhou University | Mai Z.,Guangdong Key Laboratory of Urology | And 6 more authors.
PLoS ONE | Year: 2013

Objective:Epidemiological data reveal that the overall risk for kidney stones disease is lower for women compared to age-matched men. However, the beneficial effect for the female sex is lost upon menopause, a time corresponding to the onset of fall in estrogen levels. The aim of this study was to describe the serum estradiol (E2) and testosterone (T) characteristics of naturally postmenopausal women with kidney stones.Methods:113 naturally postmenopausal women with newly diagnosed kidney stones (aged 57.4±4.98 years) and 84 age frequency matched stone-free controls (56.9±4.56 years) were validly recruited in the case-control study. The odds ratios (ORs) for the associations between sex hormones and kidney stones were estimated with logistic regression models, adjusting for demographic data and medical history. Patients were also stratified analyzed according to stone components (calcium oxalate stones [COS]; non-calcium oxalate stones [NCOS]).Results:Serum E2 (21.1 vs. 31.1 pg/ml) was significantly lower in kidney stones patients compared to controls. Post-hoc analysis demonstrated that this effect was driven by COS patients (p<0.001). According to tertiles of the E2 levels, a significant higher frequency of COS was seen in the lowest E2 group (p <0.001). Multiple logistic regression analysis identified E2 level as a strong factor that was independently associated with the risk for COS (per 1 SD increase, OR=0.951, 95% confidence interval [CI] = 0.919-0.985; highest: lowest tertile, OR=0.214, 95%CI = 0.069-0.665). However, serum T levels did not significantly differ among the groups.Conclusions:Naturally postmenopausal women with higher remaining estradiol levels appear less likely to suffer from kidney calcium oxalate stones. However, no correlation was found between serum T level and kidney stones. These findings support the hypothesis that higher postmenopausal endogenous estrogens may protect against kidney stones with ageing. © 2013 Zhao et al.


Zhong W.,Guangzhou Medical College | Zhong W.,Guangdong Key Laboratory of Urology | Zhong W.,Southern Medical University | Gong T.,Guangzhou Medical College | And 8 more authors.
Urological Research | Year: 2013

The purpose of this study is to summarize the results of percutaneous nephrolithotomy (PCNL) for renal stones following failed extracorporeal shockwave lithotripsy (SWL), and to investigate the effect of previous SWL on the performances and morbidities of subsequent PCNL. Sixty-two patients with a history of failed SWL who underwent PCNL on the same kidney (group 1) were compared to 273 patients who had received PCNL as first treatment choice (group 2). Patient demographics, stone characteristics, operative findings, and complications were documented and compared. Groups 1 and 2 had similar patient demographics and stone characteristics. Mean time to establish access was comparable in both groups (10.5 ± 4.2 vs. 9.6 ± 4.5 min, p = 0.894). Time required to remove stones and total operative time were longer in group 1 (71.5 ± 10.3 vs. 62.3 ± 8.6 min, p = 0.011 and 95.8 ± 12.0 vs. 80.6 ± 13.2 min., p = 0.018, respectively). Group 1 had lower clearance rate compared to group 2 (83.9 vs. 93.4 %, p = 0.021), while postoperative complications were similar in both groups. Scattered stone fragments buried within the tissues made the procedure more difficult for stone fragmenting and extracting, which lead to longer operative time and inferior stone free rate. However, the PCNL procedure was safe and effective in patients with failed SWL. The risk of complications was similar and clearance rate was encouraging. © 2013 Springer-Verlag Berlin Heidelberg.


He Z.,Guangzhou Medical College | He Z.,Sun Yat Sen University | He Z.,Guangdong Key Laboratory of Urology | Qiu J.,Sun Yat Sen University | And 4 more authors.
Transplantation Proceedings | Year: 2013

Purpose: The purpose of this study was to investigate the long-term effects of conversion from cyclosporine (CsA) to rapamycin on testicular function and morphology in a rat transplantation model compared with the continuous administration of CsA. Methods: Fisher 344 kidneys were orthotopically transplanted into Lewis recipients. Four Fisher 344 to Lewis allograft groups were treated posttransplantation as follows: Group 1, CsA treatment to week 8 followed by rapamycin from week 8-24; Group 2, CsA from transplantation to week 24; Group 3, CsA from transplantation to week 8 then vehicle from weeks 8-24, and Group 4, control vehicle from transplantation to week 24. A fifth group (Group 5) underwent syngeneic isografts (Lewis to Lewis) with no drug treatment. At 24 week, we measured serum creatinine and sex hormones and harvested the right testis for histological analysis. Results: All rats showed normal serum creatinine levels. Testosterone was significantly lower in Group 1 versus Group 5 (0.85 ± 0.09 vs 1.05 ± 0.17 ng/mL; P =.008). Groups 2, 3 and 4 displayed higher testosterone values than Group 1 but lower than Group 5. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were also higher in Group 1 versus the other groups, but the differences were not significant. The histological damage score was significantly higher in Groups 1, 2, 3, and 4 versus Group 5 (1.8 ± 0.8), but the highest one was observed in Group 1 (8.3 ± 1.6). Electron microscopy showed more severe testicular ultrastructural damage in Group 1. Conclusion: Conversion from CsA to rapamycin resulted in more severe damage to testicular function and structure than the continuous use of CsA in a rat kidney transplantation model. Crown Copyright © 2013 Published by Elseiver Inc. All rights reserved.


Xia D.,Zhejiang University | Shen K.,Key Laboratory of Combined Multi organ Transplantation | Zhong W.,Guangdong Key Laboratory of Urology | Zhong W.,Guangzhou Medical College | Pan H.,Zhejiang University
Clinical and Investigative Medicine | Year: 2011

Purpose: The purpose of this study was to investigate the effects of minocycline on the renal dysfunction and injury caused by bilateral ischemia/reperfusion (I/R) of murine kidneys in vifio. Methods: Male C57BL/6 mice were administered minocycline (45 mg/kg i.v.) or saline (0.9%, v/v, NaCl) 36 hours prior to I/R. Mice were subjected to bilateral renal ischemia (35 min) followed by reperfusion (6 hours). Serum creatinine (sCr) and blood urea nitrogen (BUN) levels were measured. Additionally, renal superoxide dismutase (SOD) levels, malondialdehyde (MDA) levels and myeloperoxidase (MPO) activity were determined. The expression of intercellular adhesion molecule-1 (ICAM-1), caspase-3, caspase-8 and caspase-9 was determined using real time RT-PCR and Western blot analysis. Results: Minocycline administration significantly reduced the increases in sCr and BUN caused by I/R, indicating attenuation of renal dysfunction and injury, and reduced histological evidence of renal damage caused by I/R. Minocycline administration also markedly reduced the evidence of oxidative stress (MPO activity, SOD and MDA levels), inflammation (ICAM-1 expression and MPO activity) and apoptosis (caspase-3, caspase-8 and caspase-9 expression) in mouse kidneys subjected to I/R. Conclusion: These findings provide good evidence that minocycline can reduce the renal dysfunction and injury caused by I/R of the kidney. Its mechanism may involve suppression of apoptosis, in flammatory response and oxidative stress. © 2011 CIM.


Zeng G.,Guangzhou University | Zeng G.,Guangdong Key Laboratory of Urology | Mai Z.,Guangzhou University | Mai Z.,Guangdong Key Laboratory of Urology | And 12 more authors.
Urological Research | Year: 2013

The Chinese minimally invasive percutaneous nephrolithotomy (MPCNL) was a modified version of standard PCNL which utilizes smaller tract and sheaths. The aim of this study was to present our experience on its efficacy and safety, and to grade its complications according to the modified Clavien classification. Between 1992 and 2011, 12,482 patients who underwent 13,984 MPCNL procedures entered this study. Data on stone size, access number, operative time, hospital length of stay, stone-free rate (SFR), and complications according to the modified clavien system were evaluated prospectively. Their mean age of patients was 47.6 years (range 0.6-93). The mean stone size was 3.2 ± 0.8 (1.4-7.4) cm. The mean operative time was 83 ± 38 min. Mean hemoglobin drop was 13.5 ± 11.3 g/L. Mean hospital stay was 10.3 ± 6.4 days (2-22 days). The initial SFR after first procedure was 78.6 %. In 14.7 % of cases with a second look, the SFR increase to 89.9 %. At 3 months after auxiliary procedures (re-PCNL, ureterorenoscopy, and shock wave lithotripsy), the overall SFR was achieved to 94.8 %. A total of 3,624 complications (25.92 %) were observed in 2,591 (18.53 %) procedures. There were 2,355 grade I (16.84 %), 706 grade II (5.05 %), 553 grade III (3.95 %), 7 grade IV (0.05 %), and three death of grade V (0.02 %) complications. This large-scale, contemporary analysis confirms MPCNL is still a safe and efficacious treatment option of kidney stones with a high stone-free rate and uncommon rate of high grade complications. © Springer-Verlag Berlin Heidelberg 2013.


Tang K.,Huazhong University of Science and Technology | Yao W.,Huazhong University of Science and Technology | Li H.,Huazhong University of Science and Technology | Guo X.,Huazhong University of Science and Technology | And 8 more authors.
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2014

Background: For small renal masses (SRMs), open partial nephrectomy represents the therapeutic standard of care, and laparoscopic partial nephrectomy (LPN) has provided encouraging outcomes. Laparoscopic renal cryoablation (LRC) could be regarded as an alternative to surgical excision in selected patients, if perioperative complication rates and oncologic results are comparable. However, the short- and long-term outcomes of LRC versus LPN have not been adequately assessed. This study evaluated the safety and efficacy of LRC compared with LPN in the treatment of SRMs. Materials and Methods: A systematic search of the Medline, Scopus, and CNKI databases and the Cochrane Library was performed up to October 1, 2013. Outcomes of interest assessing the two techniques included demographic and clinical baseline characteristics, surgical and oncological variables, renal function, and complications. Results: Nine eligible trials (555 cases and 642 controls) assessing LRC versus LPN were identified, including two prospective and seven retrospective studies. Patients undergoing LRC were significantly older (weighted mean difference [WMD], 6.48 years; 95% confidence interval [CI], 3.12-9.83; P<.001) and had a higher solitary kidney rate (odds ratio [OR]=3.76; 95% CI, 2.05-6.92; P<.001). Although LRC was associated with shorter operative time (WMD, -54.28 minutes; 95% CI, -83.79 to -24.78; P<.001), less blood loss (WMD, -111.75mL; 95% CI, -147.96 to -75.53; P<.001), lower risk of conversion (OR=0.17; 95% CI, 0.05-0.60; P=.005), and fewer overall complications (OR=0.53; 95% CI, 0.29-0.98; P=.04), especially the rate of intraoperative complications (OR=0.20; 95% CI, 0.07-0.58; P=.003) and major complications (OR=0.45; 95% CI, 0.25-0.81; P=.008), patients having LPN might still benefit from a significantly lower local recurrence rate (OR=13.03; 95% CI, 4.20-40.39; P<.001) and lower distant metastasis rate (OR=9.05; 95% CI, 2.31-35.51; P=.002). Conclusions: Compared with LPN, LRC was associated with reliable perioperative safety, comparable renal function, and fewer complications; however, LRC may still result in a higher risk of tumor progression. Therefore, our meta-analysis suggested that LRC was associated with worse oncological outcomes than LPN but that LRC may be indicated in selected patients with significant comorbidity. Because of the inherent limitations of the included studies, further large sample, prospective, multicenter, and long-term follow-up studies are awaited to corroborate these findings. © 2014, Mary Ann Liebert, Inc.


Zeng G.,Guangzhou Medical College | Zeng G.,Guangdong Key Laboratory of Urology | Jia J.,Shanghai JiaoTong University | Zhao Z.,Guangzhou Medical College | And 5 more authors.
Urological Research | Year: 2012

The objective of the study is to compare the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) and mini-percutaneous nephrolithotomy (MPCNL) in treating renal stones sizing 15-25 mm in infants <3 years. Forty-six infants with renal stones sizing 15-30 mm were treated by either ESWL (22 renal units in 22 infants) using Dornier compact delta lithotripter or MPCNL (25 renal units in 24 infants) using 14F-18F renal access under general anesthesia. The operation time, stonefree rate, re-treatment rate, and complications between the two groups were compared with the χ2, Mann-Whitney U, and Student's t tests. No significant differences in mean age and stone size were observed between the two groups. The 1- and 3-month postoperative stone-free rates were 84 and 96 % in MPCNL group and were 31.8 and 86.4 % in ESWL group. The re-treatment and complication rates were significantly higher in ESWL group than in MPCNL group (50 vs. 12 %, P = 0.004; 16.0 vs. 45.5 %, P = 0.028). The stone recurrence rate was similar between the two groups. No significant changes of serum creatinine (Cr) level and glomerular filtration rate were observed in both groups. In conclusion, MPCNL is an effective and feasible alternative monotherapy for large renal stones (15-25 mm) in infants, with a higher stone-free rate and a lower complication rate when compared with ESWL. © Springer-Verlag 2012.


Chen J.-H.,Guangzhou Medical College | He H.-C.,Guangzhou Medical College | Jiang F.-N.,Guangzhou Medical College | Militar J.,University of Rochester | And 12 more authors.
Medical Oncology | Year: 2012

The global physiological function of specifically expressed genes of prostate cancer in Chinese patients is unclear. This study aims to determine the genome-wide expression of genes related to prostate cancer in the Chinese population. Genes that were differentially expressed in prostate cancer were identified using DNA microarray technology. Expressions were validated by using real-time PCR. The identified genes were analyzed using the ingenuity pathway analysis (IPA) to investigate the gene ontology, functional pathway and network. A total of 1,444 genes (Fold time ≥ 1.5; P ≥ 0.05) were differentially expressed in prostate primary tumor tissue compared with benign tissue. IPA revealed a unique landscape where inductions of certain pathways were involved in Cell Cycle Regulation and proliferation. Network analysis not only confirmed that protein interactions lead to the deregulation of DNA Replication, Recombination and Repair, Cellular Compromise and Cell Cycle, Genetic Disorders and Connective Tissue Disorders, but it was also observed that many of the genes regulated by Myc contributed to the modulation of lipid Metabolism and Nucleic Acid Metabolism. Both pathway and network analysis exhibited some remarkable characteristics of prostate cancer for Chinese patients, which showed profound differences from that of other non-Chinese populations. These differences may provide new insights into the molecular cascade of prostate cancer that occurs in Chinese patients. © Springer Science+Business Media, LLC 2011.


Zeng G.,Guangzhou Medical College | Zeng G.,Guangdong Key Laboratory of Urology | Zhao Z.,Guangdong Key Laboratory of Urology | Yuan J.,Guangdong Key Laboratory of Urology | And 2 more authors.
Urology | Year: 2012

Objective: To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) in infants (<3 years) with renal calculi. Methods: From November 2005 to August 2010, 20 renal units with calculi in 19 infants (13 boys and 6 girls) were treated with PCNL at our institution. Mean age of infants was 20.6 months (range, 7-36 months), the mean stone size was 2.2 cm (range, 1.9-3.1 cm). All PCNL procedures were performed with 14 to 16F percutaneous access and 8/9.8F rigid ureteroscope. Stones were fragmented with a pneumatic lithotripter and evacuated. Results: Mean operative time was 77.5 minutes (range, 35-120 minutes). Stones were completely removed in 85% of kidneys (17 of 20 kidneys) after the first session and 95% (19 of 20 kidneys) after a second look PCNL procedure. No patients required a blood transfusion. Evaluation of the renal function before and after the PCNL procedure demonstrated the stabilization of corresponding glomerular filtration rate in the treated kidney (48.2 ± 3.7 vs 50.4 ± 5.2 mL/min; P =.22). Conclusion: When performed by experienced endourologists, PCNL is a safe and effective procedure in infants for the removal of renal calculi. © 2012 Elsevier Inc.


Xiao H.,Huazhong University of Science and Technology | Li H.,Huazhong University of Science and Technology | Yu G.,Huazhong University of Science and Technology | Xiao W.,Huazhong University of Science and Technology | And 8 more authors.
Oncology Reports | Year: 2014

The present study was performed to investigate the effect of microRNA-10b (miR-10b) on cell migration and invasion in human bladder cancer (BC). Real-time PCR was performed to detect the expression of miR-10b in BC cell lines. miR-10b mimics, the negative control for mimics, miR-10b inhibitor and the negative control for inhibitor were transfected into BC cell lines and the effects of miR-10b on the migration and invasion of cells were investigated through Transwell assay. Meanwhile, protein levels of KLF4, HOXD10, E-cadherin and MMP14 were measured. Luciferase assays were also performed to validate KLF4 and HOXD10 as miR-10b targets. In vivo metastasis assay was performed to validate if miR-10b can promote BC cell line metastasis in vivo. miR-10b is significantly upregulated in BC cell lines and metastatic tissues. Increased miR-10b expression significantly enhanced BC cell migration and invasion, while decreased miR-10b expression reduced cell migration and invasion. In vivo metastasis assay demonstrated that overexpression of miR-10b markedly promoted BC metastasis. Moreover, KLF4 and HOXD10 were identified as direct targets of miR-10b in BC cells. Silencing of KLF4 or HOXD10 recapitulated the pro-metastatic function. Furthermore, we found that E-cadherin and MMP14 may be the downstream factors of KLF4 and HOXD10 in the suppression of BC metastasis by miR-10b. These data suggest that miR-10b may function as oncogenes in BC cells. Targeting these novel strategies, inhibition of miR-10b/KLF4/E-cadherin axis and miR-10b/HOXD10/MMP14 axis may be helpful as a therapeutic approach to block BC cell metastasis.

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