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Clinical management and Outcomes of Perinephric Abscesses

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Clinical Management and Outcomes of Perinephric Abscesses

第十五届全国泌尿外科学术会议

作者： liu yuqing, zhuang shenrong, ma lulin department of urology, 3.d hospital of peking university, beijing 100083. china 100083

Objective We characterize the treatment and outcomes of perinephric abscesses in a contemporary cohort of patients. materials and Methods We reviewed the experience with perinephric abscesses at a comprehensive urban hospital during the last 10 years. Abdominal computerized tomography (CT) was widely available during the study period and experience with radiographic guided percutaneous drainage was extensive. Therapy and intervention for individual patients were dictated by the treating physician. Results Of the 38 patients identified with perinephric abscesses 6 (15.79%) ultimately died. Although 65.79%(25/38) had multiple risk factors for perinephric abscesses only 42.11%(16/38) were identified at initial presentation. Urine cultures were positive in 86.84%(33/38) of patients and CT had a diagnostic sensitivity of 94.74%(36/38). Sixteen patients (42.11%) with a mean abscess size of 1.7±1.1 cm were treated with antibiotics alone (mean hospitalization 9 days) while 20 (52.63%) with a mean abscess size of 8.3±5.1 cm received antibiotics and initial percutaneous drainage (mean hospitalization 24 days). Of the 20 patients treated with percutaneous drainage 6 (15.79%) ultimately required surgical exploration and 2 (0.53%) required nephrectomy. Conclusions The clinical characteristics of perinephric abscesses have not changed significantly but improved imaging with CT allows earlier diagnosis and treatment, which likely contributed to the reduced mortality in our cohort compared to historical series. With accurate staging and careful followup, a variety of treatments can be successful, including antibiotics alone or in conjunction with percutaneous drainage and urinary drainage. Open surgical drainage and nephrectomy may eventually be required in some patients and should be considered if adequate drainage is not achieved.

关键词： abscess drainage pyelonephritis antibiotics

Low-dose Tamsulosin Improves Clinical Effect Of Single Extracorporeal Shock Wave Lithotripsy For Ureteral Calculi

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Low-Dose Tamsulosin Improves Clinical Effect Of Single Extra...

第十五届全国泌尿外科学术会议

作者： liu yuqing, zhuang shenrong, ma lulin department of urology, 3.d hospital of peking university, beijing 100083. china

Objective. To evaluate the efficiency and safety of a short-term low-dose tamsulosin treatment for ureteral calculi after single extracorporeal shock wave lithotripsy (ESWL). Methods. A 2-week-period randomized and controlled clinical trial was conducted in 108 patients with single ureteral calculi, who accepted ESWL as the initial interventional therapy. After ESWL, the patients in Group 1 (controls, n=55) received conservative therapy, such as hydration, antibiotics and acetaminophen on demand. But in Group 2 (n=53), patients received tamsulosin (0.2mg daily) in addition to conservative therapy. All patients were questioned about the number and intensity of post-discharge pain and evaluated by plain abdominal radiography at the end of the follow-up. Results. The rate of calculi clearance in the Group 2 (84.91%, 45/53) was higher than that Group 1 (65.45%, 36/55) (P=0.020), evidently for the larger (≥10mm) calculi (83.33%, 20/24 versus 48.48%, 16/33) (P=0.007) and the proximal ones (86.67%, 26/30 versus 62.16%, 23/37) (P=0.024). Moreover, Group 1 reported higher mean visual analog scores of colic intensity (3.11±2.60) than Group 2 did (1.98±2.08) (P=0.015). And 36.36% (20/55) patients in Group 1 used acetaminophen to reduce post-discharge pain, higher than that of Group 2 (18.87%, 10/53) (P=0.042). No side effects of tamsulosin were observed in either group. Conclusion. The addition of low-dose tamsulosin after single ESWL can enhance the clearance of ureteral calculi successfully in a 2-week term, evidently for those larger and proximal ones, and reduce the intensity of post-discharge pain, with low risk of side effects.

关键词： Adrenergic alpha-antagonists ureteral calculi lithotripsy

Extracorporeal Shock Wave Lithotripsy for Upper Urinary Tract Stones in Obese Patients

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Extracorporeal Shock Wave Lithotripsy for Upper Urinary Trac...

第十五届全国泌尿外科学术会议

作者： liu yuqing, zhuang shenrong, ma lulin department of urology, 3.d hospital of peking university, beijing 100083

Objective To study the efficiency and safety of extracorporeal shock wave lithotripsy (ESWL) for upper urinary tract stones of obese patients. Methods In a retrospective manner, 10 male and 7 female obese (body mass index, BWI≥28kg/m2) patients who underwent ESWL as the initial treatment for their single upper urinary tract stones were included in the study. The calculi were visualized and measured by radiological and/or ultrasound examinations before ESWL. A 3-month follow-up from the initial procedure was required, including kidney-ureter-bladder radiographs to document stone-free status. The indications for retreatment were usually calculi that did not pass spontaneously after 3 weeks. Results The mean stone size was 11.88±2.67mm (8─18mm). At the end of follow-up, 76.47% (13/17) patients were stone free, and no one received further invasive therapy. Among them, the mean times of ESWL were 2.82±1.17, and the efficiency quotient (EQ)* was 0.351. 4 patients suffered from mild subcutaneous ecchymosis. Fever only occurred in 2 cases but was completely reversible. Conclusion ESWL in site is available to treat upper urinary tract stones in obese cases with low risk of side effects with a relatively low efficiency yet.

关键词： urinary tract stones obesity lithotripsy Efficiency Quotient (EQ) Formula Percentage of Stone free/(100 + Percentage of Retreatment + Percentage of Auxiliary Procedures)

Adjunctive Tamsulosin Improves Clinical Effect Of Extracorporeal Shock Wave Lithotripsy For Large Ureteral Calculi

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Adjunctive Tamsulosin Improves Clinical Effect Of Extracorpo...

第十七届全国泌尿外科学术会议

作者： yuqing liu,shenrong zhuang,lulin ma department of urology,peking university Third hospital

Purpose To evaluate the efficiency and safety of a short-term tamsulosin treatment for ureteral calculi after single extracorporeal shock wave lithotripsy (ESWL). materials and Methods A 2-week-period randomized and c...

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Shock Wave LithotriPsy Versus Semirigid UreteroscoPy for Proximal Ureteral Calculi(＜20 mm):A ComParative matched-Pair Study

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Shock Wave LithotriPsy Versus Semirigid UreteroscoPy for Pro...

第十六届全国泌尿外科学术会议

作者： liu yuqing,Lu Jian,Xiao Chunlei, zhuang shenrong,ma lulin department of urology,Third hospital of peking university 100191

OBJECTIVES:To use a matched-Pair analysis design to comPare the safety and efficacy of shock wave lithotriPsy (SWL) and ureteroscoPy(URS).Controversy still exists regarding whether SWL or URS is the best management of

关键词：

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肾血管平滑肌脂肪瘤破裂出血的手术时机

北京大学学报（医学版） 2024年第2期56卷 326-331页

作者：陈克伟邓绍晖刘茁张洪宪马潞林张树栋北京大学第三医院泌尿外科北京100191

目的:探讨不同的手术时机对肾血管平滑肌脂肪瘤(renal angiomyolipoma,RAML)破裂出血患者手术治疗效果的影响。方法:选择北京大学第三医院泌尿外科2013年6月至2023年2月收治的31例RAML破裂出血患者的病例资料进行回顾性分析,记录患者人... 详细信息

目的:探讨不同的手术时机对肾血管平滑肌脂肪瘤(renal angiomyolipoma,RAML)破裂出血患者手术治疗效果的影响。方法:选择北京大学第三医院泌尿外科2013年6月至2023年2月收治的31例RAML破裂出血患者的病例资料进行回顾性分析,记录患者人口学和围手术期资料,将出血后小于7 d手术定义为近期手术组,出血后7 d至6个月手术定义为中期手术组,出血后超过6个月手术定义为远期手术组,比较组间的围手术期相关指标。结果:收集到行RAML破裂出血手术治疗的患者共31例,其中男性13例,女性18例,平均年龄(46.2±11.3)岁。近期手术组7例,中期手术组12例,远期手术组12例。肿瘤直径方面,远期手术组患者显著低于近期手术组[(6.6±2.4)cm vs.(10.0±3.0)cm,P=0.039];手术时间方面,远期手术组显著低于中期手术组[(157.5±56.8)min vs.(254.8±80.1)min,P=0.006],其余组间比较差异无统计学意义;出血量方面,远期手术组低于中期手术组[35(10,100)mL vs.650(300,1200)mL,Pd vs.7(6,10)d,P=0.011],其余组间比较差异无统计学意义。结论:对于RAML破裂出血的患者,6个月以上再行手术是一个相对安全的时间,手术时间相对最短,术中出血量相对最少,因此更推荐待保守治疗血肿机化后再进行手术治疗。

关键词：血管平滑肌脂肪瘤破裂出血保留肾单位手术手术时机手术出血

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伴静脉癌栓的肾上腺皮质癌的临床治疗及预后

北京大学学报（医学版） 2024年第4期56卷 624-630页

作者：刘帅刘磊刘茁张帆马潞林田晓军侯小飞王国良赵磊张树栋北京大学第三医院泌尿外科北京100191

目的:分析肾上腺皮质癌伴静脉癌栓患者的临床病理特征、预后,并总结手术治疗经验。方法:回顾性分析北京大学第三医院泌尿外科2018—2023年接受手术治疗的肾上腺皮质癌患者的相关数据,将其分为伴静脉癌栓组和不伴静脉癌栓组。采用Wilcoxo... 详细信息

目的:分析肾上腺皮质癌伴静脉癌栓患者的临床病理特征、预后,并总结手术治疗经验。方法:回顾性分析北京大学第三医院泌尿外科2018—2023年接受手术治疗的肾上腺皮质癌患者的相关数据,将其分为伴静脉癌栓组和不伴静脉癌栓组。采用Wilcoxon秩和检验比较定量变量,卡方检验/Fisher精确检验比较分类变量,采用Kaplan-Meier法计算生存率。结果:共纳入27例肾上腺皮质癌患者,其中11例(40.7%)伴静脉癌栓,包括8例女性,3例男性,中位年龄49(36,58)岁,中位体重指数26.0(24.1,30.4)kg/m^(2);7例初诊时有症状,6例有高血压病史,2例皮质醇水平增高;中位肿瘤直径9.4(6.5,12.5)cm。3例肿瘤侧别为左侧,其中1例局限在左肾上腺中央静脉未侵入左肾静脉,2例癌栓生长达肝下下腔静脉;8例肿瘤侧别为右侧,其中1例在右肾上腺中央静脉未侵入下腔静脉,4例侵入肝下下腔静脉,3例生长达肝后下腔静脉。10例患者为欧洲肾上腺肿瘤研究协作网(European Network for the Study of Adrenal Tumors,ENSAT)临床分期Ⅲ期,1例为Ⅳ期。手术方式为开放手术6例,单纯腹腔镜手术者4例,机器人辅助腹腔镜手术1例;2例切除同侧肾脏;中位手术时间332(261,440)min,术中中位出血量900(700,2200)mL,术后中位住院时间9(5,10)d;中位生存时间24.0个月,中位复发时间7.0个月,16例不伴静脉癌栓患者均未达到中位生存时间和中位复发时间。与不伴静脉癌栓组相比,静脉癌栓组有更差的3年总体生存(overall survival,OS)率(71.4%vs.40.9%;Log-rank,P=0.038)和2年无复发生存(recurrence-free survival,RFS)率(53.7%vs.9.1%;Log-rank,P=0.015)。结论:肾上腺皮质癌伴静脉癌栓患者预后较差,肾上腺肿瘤切除术和静脉癌栓取出术治疗该疾病安全有效。

关键词：肾上腺皮质癌癌栓临床病理特征预后

服用非那雄胺的前列腺增生患者前列腺转录组景观特征分析

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现代泌尿外科杂志 2024年第2期29卷 101-107,153页

作者：周朗刘可陆敏毕海霍霄马潞林刘承北京大学第三医院泌尿外科北京100191 北京大学第三医院病理科北京100191 上海交通大学医学院附属第一人民医院泌尿外科临床医学中心上海200080 北京大学第三医院医学创新研究院基础医学研究中心北京100191

目的通过转录组分析从基因表达方面探讨非那雄胺对良性前列腺增生(BPH)患者的影响。方法收集2020年10月—2021年10月于北京大学第三医院接受前列腺电切术的患者,根据患者术前是否长期(>6个月)服用非那雄胺分为用药组和非用药组,两组各8... 详细信息

目的通过转录组分析从基因表达方面探讨非那雄胺对良性前列腺增生(BPH)患者的影响。方法收集2020年10月—2021年10月于北京大学第三医院接受前列腺电切术的患者,根据患者术前是否长期(>6个月)服用非那雄胺分为用药组和非用药组,两组各8例。对两组患者的前列腺组织标本进行转录组测序分析,定量聚合酶链式反应(qPCR)及免疫组化分析验证其结果。结果用药组与非用药组相比,上调基因857个,下调基因806个。通路富集分析显示,非那雄胺导致焦点粘附通路中血管内皮生长因子d型(VEGFd)表达下调;组间网络分析提示钙信号通路为整个过程的关键通路;进一步对其进行基因集富集分析(GSEA)发现分化簇38(Cd38)基因表达上调。qPCR及免疫组化验证支持上述转录组结果,同时发现雄激素受体表达升高。结论非那雄胺通过下调焦点粘附通路中VEGFd的表达减少前列腺微血管生成,进而降低BPH手术出血的风险,长期服用非那雄胺导致钙信号通路中Cd38表达上调,可能与非那雄胺抵抗有关。

关键词：良性前列腺增生非那雄胺转录组分析血管内皮生长因子d型分化簇38 雄激素受体

Real-world effectiveness and safety of goserelin 10.8-mg depot in Chinese patients with localized or locally advanced prostate cancer

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Cancer Biology & Medicine 2023年第12期20卷 1047-1059页

作者： Nanhui Chen Zengjun Wang Ming Chen Qi ma Yi He Yujie Wang Xin Li Mingxing Qiu Lei Shi Shaoxing Zhu Qun Xie Xiuheng liu Benkang Shi Guowen Lin Weizhong Yang Yongbin Liao Haibin Zhang Shusheng Wang Jiexian Li Shaogang Wang Lijun dong Hui Chen Jiaju Lu YongyiCheng Xiaoping Zhang lulin ma Liqun Zhou He Wang Shen Li dingwei Ye department of urology Meizhou People’s HospitalMeizhou 514089China department of urology Jiangsu Province HospitalNanjing 210029China department of urology Zhongda Hospital Southeast UniversityNanjing 210009China Translational Research Laboratory for urology Ningbo First HospitalNingbo 315016China department of urology First Affiliated Hospital of JiaxingJiaxing 314050China department of urology The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830091China department of urology Baotou Cancer HospitalBaotou 014016China department of urology The People’s Hospital of Sichuan ProvinceChengdu 610032China department of urology Yantai Yuhuangding HospitalYantai 264008China department of urology Cancer Hospital of The University of Chinese Academy of SciencesHangzhou 310022China department of urology Zhuhai Hospital Affiliated with Jinan UniversityZhuhai 519000China department of urology Tongji HospitalTongji Medical CollegeHUSTWuhan 430032China department of urology Qilu Hospital of Shandong UniversityJinan 250012China department of urology Fudan University Shanghai Cancer CenterShanghai 200032China department of urology Huizhou Third People’s HospitalHuizhou 516002China department of urology Jiangmen Central HospitalJiangmen 529030China department of urology Foshan First People’s HospitalFoshan 528041China department of urology Guangzhou Province Traditional Chinese Medical HospitalGuangzhou 510120China department of urology Guangzhou Panyu Central HospitalGuangzhou 511489China department of urology Renmin Hospital of Wuhan UniversityWuhan 430064China department of urology Hebei Petro China Central Hospital(China National Petroleum Corporation Central Hospital)Langfang 065099China department of urology Harbin Medical University Cancer HospitalHarbin 150086China department of urology Shandong Provincial HospitalJinan 250014China department of urology Shaanxi Provincial People’s HospitalXi’an 710021China department of urology Union Hospital Tongji Medical

Objective:Real-word data on long-acting luteinizing hormone-releasing hormone(LHRH)agonists in Chinese patients with prostate cancer are *** study aimed to determine the real-world effectiveness and safety of the LHRH agonist,goserelin,particularly the long-acting 10.8-mg depot formulation,and the follow-up patterns among Chinese prostate cancer ***:This was a multicenter,prospective,observational study in hormone treatment-na?ve patients with localized or locally advanced prostate cancer who were prescribed goserelin 10.8-mg depot every 12 weeks or 3.6-mg depot every 4 weeks with or without an *** patients had follow-up evaluations for 26 *** primary outcome was the effectiveness of goserelin in reducing serum testosterone and prostate-specific antigen(PSA)*** secondary outcomes included testosterone and PSA levels,attainment of chemical castration(serum testosteroned L),and goserelin *** exploratory outcome was the monitoring pattern for serum testosterone and *** analyses were ***:Between September 2017 and december 2019,a total of 294 eligible patients received≥1 dose of goserelin;287 patients(97.6%)were treated with goserelin 10.8-mg *** week 24±2,the changes from baseline[standard deviation(95%confidence interval)]in serum testosterone(n=99)and PSA(n=131)were-401.0 ng/d L[308.4 ng/d L(-462.5,-339.5 ng/d L)]and-35.4 ng/m L[104.4 ng/m L(-53.5,-17.4 ng/m L)],*** 112 evaluable patients,100(90.2%)achieved a serum testosterone leveld ***-emergent adverse events(TEAEs)and severe TEAEs occurred in 37.1%and 10.2%of patients,*** mean testing frequency(standard deviation)was 1.6(1.5)for testosterone and 2.2(1.6)for ***:Goserelin 10.8-mg depot effectively achieved and maintained castration and was well-tolerated in Chinese patients with localized and locally advanced prostate cancer.

关键词： Goserelin hormone-sensitive luteinizing hormone-releasing hormone prostate cancer china real-world