Comparison of combined laparoscopic ureterolithotomy and flexible ureteroscopy with percutaneous nephrolithotomy for removing large impacted upper ureteral stones with concurrent renal stones

Objectives:The present study compared the safety and efficacy of combined laparoscopic ureterolithotomy(LU)and flexible ureteroscopy with percutaneous nephrolithotomy(PCNL)for removing large impacted upper ureteral stones with concurrent renal stones.Methods:This study included 52 patients who underwent combined LU and retrograde flexible ureteroscopy for removing renal stones(group A)or PCNL(group B)for removing large upper impacted ureteral stones and concurrent renal stones at our department from January 2014 to December 2016.Patient demographics,stone characteristics,and procedure-related parameters including stone-free rate,operation time,hospital stay after surgery,mean decrease in hemoglobin levels,visual analog scale(VAS)score,auxiliary procedure rate,and complication rate were compared between groups A and B.Results:Results of this study showed that both procedures were effective for removing large impacted upper ureteral stones with concurrent renal stones.The stone-free rate after a single procedure was 95.7%in group A and 89.7%in group B(p?0.62).The operation time was longer in group A than in group B(112.2±23.3 min versus 96.2±16.4 min,p?0.006).However,no significant difference was observed between the two groups with respect to the length of hospital stay after the surgery(5 days versus 6 days,p?0.06).The decrease in hemoglobin levels was significantly higher in group B than in group A(0.64±0.36 g/dL versus1.44±0.65 g/dL,p<0.0001).The mean VAS scores obtained at 24 hours(2.91±1.08 versus 5.10±1.01,p<0.0001)and 48 hours after the surgery(1.09±0.73 versus 2.28±0.96,p<0.0001)were significantly higher for group B than for group A.Moreover,the auxiliary procedure rate was higher in group B than in group A(6.9%versus 0%).Conclusion:These results indicate that both combined LU and flexible ureteroscopy and PCNL are suitable for removing large impacted upper ureteral stones with concurrent renal stones and are associated with a high rate of patients being stone free afterwards.Despite the longer operation time,the combined laparoscopic and endourological procedure may be associated with less postoperative pain and fewer major complications.However,the choice of treatment depends on the preferences of surgeons and patients.

Geographical patterns based on faunal types of breeding birds and mammals in China

We collected available chorological data of birds and mammals in China and assigned faunal types.The 19 sub-regions of the zoogeographical regions of China were used as operative geographical units.Matrices of the geo-graphical units using the species number of each faunal type were then constructed.Based on the matrices we clustered the geographical units using a hierarchical cluster analysis The results of the faunal divisions according to the cluster analysis were illustrated in a geographic information system(GIS).When 19 geographical units were clustered into two clusters,the boundary of the two clusters corresponded to that of the Palearctic and Indomalayan(Oriental)realms in the recent division of Chinese fauna.When the geographical units were clustered into eight clusters,the sub-region Southern Yunnan Hilly became an idiographic cluster.As a result,Southern Yunnan hilly should be regarded as a region rather than a sub-region at the same level as Southwest region,Central China region and South China region.The differences in the distribution patterns of birds and mammals among the units in the Indomalayan(Oriental)realm were more complicated than those in Palearctic realm.Afew differences of the cluster analysis results based on the faunal types were found between the bird and mammal species.These differences might result from the different ecological and geographical distribution patterns of these two animal categories.

Enzyme-free Electrochemical Detection of Hydrogen Peroxide Based on the Three-Dimensional Flower-like Cu-based Metal Organic Frameworks and MXene Nanosheets

Cu-based metal organic frameworks(MOFs)are regarded as promising sensing materials,which have abundant metal sites,large surface area and simple synthesis processes.In this work,a novel three-dimensional flower-like Cu-MOF was synthesized,which was combined with ultra-thin MXene nanosheets to construct a novel electrochemical sensor for H_(2)O_(2).

A multisite-binding fluorescent probe for simultaneous monitoring of mitochondrial homocysteine, cysteine and glutathione in live cells and zebrafish

Homocysteine(Hcy), cysteine(Cys) and glutathione(GSH) play crucial roles in redox homeostasis during mitochondria functions. Simultaneous differentiation and visualization of mitochondrial biothiols dynamics are significant for understanding cell metabolism and their related diseases. Herein, a multisitebinding fluorescent probe(MCP) was developed for simultaneous sensing of mitochondrial Cys, GSH and Hcy from three fluorescence channels for the first time. This novel probe exhibited rapid fluorescence turn-on, good water-solubility, high selectivity and large spectral separation for discriminating Cys, GSH and Hcy with 131-, 96-, 748-fold fluorescence increasement at 471, 520, 567 nm through different excitation wavelengths, respectively. Importantly, this probe was successfully applied to simultaneous monitoring of mitochondrial Cys, GSH, and Hcy in live cells and zebrafish from three fluorescence channels,promoting the understanding of the functions of Hcy, Cys and GSH.