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PURPOSE: To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG). METHODS: Thirty male rats were divided into normal control, model, positive (10% potassium citrate), Cur-10 (10 mg/kg curcumin) and Cur-20 (20 mg/kg curcumin) groups. RESULTS: The results of kidney tissue section stained by hematoxylin-eosin and von Kossa showed that curcumin treatment can inhibit the formation of kidney stones. The biochemical test results showed that the urea (Ur), creatinine (Cr), uric acid (UA), inorganic phosphorus and Ca2+ concentrations in urine decreased after being treated with curcumin. There were significant differences between different doses of curcumin (P < 0.05). Compared with the Cur-10 group, Cur-20 had a more significant inhibitory effect on malondialdehyde (MDA) (P < 0.05). In addition, reverse transcription polymerase chain reaction (PCR) detection and immunohistochemical results indicated that the osteopontin (OPN) in the kidney was significantly reduced after curcumin treatment. CONCLUSIONS: Curcumin could reduce the oxidative stress damage caused by EG-induced kidney stones.

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Purpose: To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG). Methods: Thirty male rats were divided into normal control, model, positive (10% potassium citrate), Cur-10 (10 mg/kg curcumin) and Cur-20 (20 mg/kg curcumin) groups. Results: The results of kidney tissue section stained by hematoxylin-eosin and von Kossa showed that curcumin treatment can inhibit the formation of kidney stones. The biochemical test results showed that the urea (Ur), creatinine (Cr), uric acid (UA), inorganic phosphorus and Ca2+ concentrations in urine decreased after being treated with curcumin. There were significant differences between different doses of curcumin (P < 0.05). Compared with the Cur-10 group, Cur-20 had a more significant inhibitory effect on malondialdehyde (MDA) (P < 0.05). In addition, reverse transcription polymerase chain reaction (PCR) detection and immunohistochemical results indicated that the osteopontin (OPN) in the kidney was significantly reduced after curcumin treatment. Conclusion: Curcumin could reduce the oxidative stress damage caused by EG-induced kidney stones.

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Purpose: We present our experience with retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope in patients with ureteropelvic junction obstruction(UPJO) complicated with kidney stones. Materials and Methods: The records of 37 patients who underwent retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope to manage UPJO complicated with kidney stones from July 2015 to December 2020 were retrospectively reviewed. All patients underwent one-stage retroperitoneoscopic pyeloplasty combined with flexible cystoscopic pyelolithotomy. The operative time, blood volume, stone clearance rate, length of hospital stay, complications and follow-up events were recorded. Results: The operation went smoothly in all 37 patients. The mean operative time was 148.4 ± 24.2 min. The mean intraoperative blood loss volume was 54.3 ± 20.5 ml. The mean hospitalization time was 10.6 ± 3.7 days. The stone clearance rate was 81.08%. The mean follow-up period was 23.5 months (range 12-53 months). Hydronephrosis was significantly decreased in 33 of the 37 cases. The success rate of the operation was 89.19%. Stones recurred in 9 patients during follow-up, for a recurrence rate of 24.32%. Conclusion: Retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope in patients with UPJO complicated with kidney stones is safe, effective and worthy of promotion.

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Prostate cancer is the second highest caused by cancer-related death among males. microRNAs (miRs) have been reported to participate in carcinogenesis, yet their roles in prostate cancer are rarely studied or investigated. Therefore, the present study attempted to explore the effect of miR-137 in prostate cancer via regulating NADPH oxidase 4 (NOX4). Initially, microarray analysis was performed to obtain prostate cancer-related differentially expressed genes and miRs that regulated NOX4, followed by detecting the expression of miR-137 and NOX4 and its target relationship. Moreover, PC-3 cells were transfected with small interfering RNA (siNOX4) and miR-137 mimic for exploring the effect of miR-137 on glycolysis, cell proliferation, and apoptosis in prostate cancer by evaluating lactate production, glucose uptake, adenosine triphosphate (ATP) production, viability rate, and expression of cleaved caspases 3, 8, and 9, cytochrome c, cleaved poly ADP ribose polymerase (PARP), Bax, and Bcl-2. miR-137 was vital to prostate cancer progression via regulating NOX4. Besides, miR-137 expressed poorly while NOX4 expressed highly in prostate cancer. NOX4 was the target gene of miR-137. Additionally, overexpression of miR-137 and silencing of NOX4 were observed to decrease NOX4 and Bcl-2 protein expression, but increase cleaved caspases 3, 8, and 9, cytochrome c, cleaved-PARP, and Bax protein expression. Furthermore, miR-137 overexpression and NOX4 silencing contributed to decreased lactate production, glucose uptake, ATP production, and cell proliferation, but increased apoptosis rate. Collectively, the present study showed that miR-137 repressed glycolysis in prostate cancer through knockdown of NOX4, which might be a potential theoretical target for prostate cancer treatment.

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OBJECTIVE: To introduce flexible ureterorenoscopy with holmium laser lithotripsy in the management of symptomatic caliceal diverticular calculi. MATERIALS AND METHODS: The records of 26 patients who underwent flexible ureterorenoscopy and lithotripsy with holmium laser to manage symptomatic caliceal diverticular calculi from January 2012 to June 2016 were retrospectively reviewed. RESULT: Flexible ureterorenoscopy lithotripsy was successfully placed in all 26 patients. Twenty-two cases accepted lithotripsy at the same time, and the success rate was 84.6%. The stone-free rate was 76.9%.The mean operative time was 48 ± 16 minutes. The mean hospital stay was 4.8 ± 1.6 days. There was no evidence of stone regrowth or recurrence at a mean follow-up of 11.5 months. CONCLUSION: Flexible ureterorenoscopy with holmium laser lithotripsy is safe and effective, and it can be offered as a first line therapy for symptomatic caliceal diverticular calculi.

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AIM: To compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of 1.5-2.5 cm. METHODS: A total of 216 patients who underwent mini-PCNL (n = 103) or RIRS n = 113) for LP stones with a diameter of 1.5-2.5 cm were enrolled between December 2015 and April 2017 at the Urology Department of Ningbo Urology and Nephrology Hospital. RESULTS: Significant differences were found in the hospital stay (9.39 ± 4.01 vs 14.08 ± 5.26, P < 0.0001) and hospitalization costs (2624.5 ± 513.36 vs 3255.2 ± 976.5, P < 0.0001) between the RIRS and mini-PCNL groups. The mean operation time was not significantly different between the RIRS group (56.48 ± 24.77) and the mini-PCNL group (60.04 ± 30.38, P = 0.345). The stone-free rates at the first postoperative day (RIRS vs mini-PCNL: 90.2% vs 93.2%, P = 0.822) and the second month postoperatively (RIRS vs mini-PCNL: 93.8% vs 95.1%, P = 0.986) were not significantly different. CONCLUSION: RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of 1.5-2.5 cm. RIRS can be considered as an alternative to PCNL for the treatment for LP stones of 1.5-2.5 cm.

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BACKGROUND: The aim of the study was to establish reference intervals for 24-h urinary stone risk factors in the healthy Chinese Han population. METHODS: From May 2013 to July 2014, we collected and analyzed 24-h urine samples from healthy adult Han population during a cross-sectional study across China. The protocol for analysis of 24-h urine included volume, pH, oxalate, citrate, sodium, potassium, chloride, calcium, phosphorous, creatinine, urate, magnesium, the ion activity products of calcium oxalate (AP(CaOx) indexs) and calcium phosphate (AP(CaP) indexs). We calculated the reference intervals according to the Clinical and Laboratory Standards Institute (CLSI) 2008 guidelines and compared them with those recorded in other studies. RESULTS: A total of 132 male and 123 female healthy subjects with a mean (SD, range) age of 52.4 (15.2, 19-89) years were eligible in the final analysis. Men had higher 24-h excretion of creatinine, calcium, urate and phosphorus and lower levels of citrate, magnesium, chloride, sodium and potassium than women. AP(CaOx) indexs and AP(CaP) indexs were significantly higher among men than women. When urinary findings were compared with the reference intervals, most of our data showed a high abnormality rate, especially for creatinine, calcium, citrate, magnesium, chloride, sodium and potassium. CONCLUSIONS: The present study revealed the normal metabolic status for stone risk factors of the Chinese Han population. It is therefore necessary for each country or region to define their own reference intervals for comparison of stone risk factors between patients and healthy subjects.

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PURPOSE: To investigate the extent of renal arterial injury incurred by different size of nephrostomy tracts from 10 French (F) to 32F in vitro porcine kidney. MATERIALS AND METHODS: To simulate the technique of percutaneous nephrostomy we set up 12 groups of different size nephrostomy tracts from 10F to 32F, including 40 nephrostomy tracts in each group. Digital subtraction angiography (DSA) was used to inspect and analysis of arterial injury. RESULTS: When the size of nephrostomy tracts is increased from 10F to 32F, the degree of arterial injury is also aggravated. With 14F compared to 24F, the number of nephrostomy tracts with serious arterial injury was 12 (12/40) and 23 (23/40), respectively (P < .05). With 18F compared to 30F, the number of nephrostomy tracts with serious arterial injury was 16 (16/40) and 30 (28/40), respectively (P < .01). CONCLUSION: When the size of nephrostomy tract is increased, the degree of renal arterial injury is also heightened. When 18F tracts was compared to 30F tracts and 14F tracts compared to 24F tracts, obvious reduction of arterial injury is observed.

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OBJECTIVES: To investigate the safety and feasibility of endoscopy in treating urinary tract calculi in preschool children. METHODS: From August 2004 to August 2008, 28 preschool children with urinary tract calculi were treated by endoscopy, 11 cases received ureterolithotripsy (URL) and 17 cases received minimally invasive percutaneous nephrolithotomy (MPCNL). RESULTS: Of 11 cases with ureteric calculi, 5 cases were rendered stone free in the first session, the other 6 cases received passive dilation by indwelling of ureteric stents for 1 to 3 weeks and underwent successful ureteroscopy with a 8/9.8 Fr rigid ureteroscope. Seventeen cases with renal calculi received MPCNL and were rendered stone free. CONCLUSION: Our study shows that endoscopy in treating urinary tract calculi is safe and feasible in preschool children.

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OBJECTIVE: High renal pelvic pressure brings systemic absorption of irrigation fluid containing bacteria or endotoxins, which leads to postoperative fever. We inspected the renal pelvic pressure (RPP) in vivo during minimally invasive percutaneous nephrolithotomy (MPCNL) to investigate whether a 14- to 18-French percutaneous tract and perfusion would bring high RPP and postoperative fever. PATIENTS AND METHODS: Between July 2005 and December 2007, 80 patients were selected for RPP measurement during MPCNL. The RPP was measured by a baroceptor connected to the open-ended ureteric catheter, which was indwelling retrogradely in the renal pelvic. A computer recorded the RPP each second, and all the data were evaluated statistically with SPSS 12.0 software. RESULTS: During MPCNL with 14-, 16-, 18-, and double-16-French percutaneous tracts, the mean RPP was 24.55, 16.49, 11.22, and 6.64 mm Hg, respectively. Logistical analysis suggested that postoperative fever did not correlate to gender (P = 0.195), age (P = 0.641), urinary tract infection (P = 0.663), white blood cell > or = 10 x 10(9)/L in routine postoperative blood examination (P = 0.751), or an occurrence of renal pelvic pressure > or = 30 mm Hg in the operation (P = 0.662), although infection calculi (P = 0.000), percutaneous tract (P = 0.029), mean RPP (P = 0.036), mean RPP > or = 20 mm Hg (P = 0.013), accumulated time of RPP > or = 30 mm Hg (P = 0.010), and RPP > or = 30 mm Hg longer than 50 s (P = 0.024) may contribute a postoperative fever. CONCLUSION: Renal pelvic pressure generally remains lower than the backflow level (30 mm Hg) during MPCNL via a 14- to 18-French percutaneous tract. Any factors that brought about poor drainage would result in temporarily elevated RPP greater than 30 mm Hg, and many such occurrences of high pressure would have an accumulating effect, which means enough backflow to cause bacteremia and postoperative fever.

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