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Dai L, Li S, Yang T, Wei H, Song R, Meng X, Yuan X, Jiao Z, Wu T, Shi H. Investigating the effects of tilting the postural drainage lithotripsy system on cerebral blood flow, intracranial pressure, heart rate, and blood pressure. World J Urol 2024; 42:89. [PMID: 38376590 PMCID: PMC10879416 DOI: 10.1007/s00345-024-04777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024] Open
Abstract
PURPOSE To investigate the effect of the postural drainage lithotripsy system developed by our experimental team on the vital signs of patient with urinary stones during the stone removal process. METHODS Four groups of 15 subjects (0°, 10°, 40°, and 70°) were subjected to different angles of head-down tilt to measure middle cerebral artery blood flow velocity (MCAv), cerebrovascular conductance coefficient (CVCi), intracranial pressure (nICP), heart rate (HR), and mean arterial blood pressure (MAP). RESULTS As the angle of HDT changed, MCAv values, nICP values, CVCi values, HR values, and MAP values changed significantly (all P ≤ 0.001), and the difference was statistically significant. During 10°HDT, despite a slight increase in nICP, the other measurements remained stable. During 40°HDT, only the MCAv values did not change significantly, whereas the rest of the measures were significantly altered. During 70°HDT, all indicators changed significantly. CONCLUSIONS The significant alterations in cerebral blood flow, intracranial pressure, and hemodynamics induced during the treatment of renal residual fragments with postural drainage should be used with caution in individuals with cerebrovascular accidents. CHINA CLINICAL TRIALS REGISTRY ChiCTR2300070671; Registration date: 2023-04-18.
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Affiliation(s)
- Liangliang Dai
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Shihui Li
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Tao Yang
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Hanping Wei
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Rijin Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xianghu Meng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiaoliang Yuan
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Zhimin Jiao
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Tingchun Wu
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China
| | - Honglei Shi
- Department of Urology, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213004, China.
- Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China.
- Wujin Hospital Affiliated With Jiangsu University, Changzhou Wujin People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213004, China.
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Lin L, Zheng L, Wang S, Kuang R, Ye X. Retrograde intrarenal surgery for immediate and complete removal of large stones. BJU Int 2023; 131:568-570. [PMID: 36681897 DOI: 10.1111/bju.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Longhui Lin
- Department of Urology, The First Hospital of Nanchang, Nanchang, China
| | - Liangliang Zheng
- Department of Urology, The First Hospital of Nanchang, Nanchang, China
| | - Si Wang
- Department of Urology, The First Hospital of Nanchang, Nanchang, China
| | - Renrui Kuang
- Department of Urology, The First Hospital of Nanchang, Nanchang, China
| | - Xiubin Ye
- Department of Urology, The First Hospital of Nanchang, Nanchang, China
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The Chemical and Pharmacological Research Progress on a Kind of Chinese Herbal Medicine, Fructus Malvae. Molecules 2022; 27:molecules27175678. [PMID: 36080446 PMCID: PMC9458057 DOI: 10.3390/molecules27175678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022] Open
Abstract
Since the outbreak of the COVID-19 pandemic, traditional Chinese medicine has played an important role in the treatment process. Furthermore, the discovery of artemisinin in Artemisia annua has reduced the incidence of malaria all over the world. Therefore, it is becoming urgent and important to establish a novel method of conducting systematic research on Chinese herbal medicine, improving the medicinal utilization value of traditional Chinese medicine and bringing great benefits to human health all over the world. Fructus Malvae, a kind of Chinese herbal medicine which has been recorded in the “Chinese Pharmacopoeia” (2020 edition), refers to the dry, ripe fruits of Malva verticillata L. Recently, some studies have shown that Fructus Malvae exhibits some special pharmacological activities; for example, it has diuretic, anti-diabetes, antioxidant and anti-tumor properties, and it alleviates hair loss. Furthermore, according to the reports, the active ingredients separated and identified from Fructus Malvae contain some very novel compounds such as nortangeretin-8-O-β-d-glucuronopyranoside and 1-O-(6-deoxy-6-sulfo)-glucopyranosyl-2-O-linolenoyl-3-O-palmitoyl glyceride, which could be screened as important candidate compounds for diabetes- or tumor-treatment drugs, respectively. Therefore, in this research, we take Fructus Malvae as an example and systematically summarize the chemical constituents and pharmacological activity research progress of it. This review will be helpful in promoting the development and application of Fructus Malvae and will also provide an example for other investigations of traditional Chinese medicine.
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Yang T, Song R, Meng X, Wei H, Jiang X, Yuan X, Liu X, Jiao Z, Liu J, Shi H. A single center study that evaluates the preclinical use of a newly developed software and moving bed system to facilitate the spontaneous excretion of residual fragments after primary stone treatment (RIRS or PCNL). World J Urol 2021; 40:585-591. [PMID: 34687345 PMCID: PMC8921061 DOI: 10.1007/s00345-021-03863-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/07/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose We developed a Postural Drainage Lithotripsy System (PDLS) that uses the patient's computed tomography urography (CTU) data to reconstruct the three-dimensional figure of the renal pelvis, provides an individualized inversion and overturning angle and uses gravity to remove residual fragments (RFs). The purpose of this study was to investigate PDLS in the treatment of renal RFs. Methods A stone with a diameter of 4.0 mm was placed in the upper, middle, and lower calyx of the renal model. A total of 60 trials were applied to 20 renal models. The movement trajectory, passage rate, and postural drainage angle of calculi during the treatment of PDLS were observed. Results All of the stones in 60 trials were observed to move during treatment, and 53/60 (88%) were relocated successfully to the renal pelvis. The passage rate of the upper calyx was 14/20 (70%), that of the middle calyx was 20/20 (100%), and that of the lower calyx was 19/20 (95%). Conclusions PDLS can provide individualized inversion and reversal angles and remove stones from the renal model. More clinical trials are needed to verify the above view and evaluate its efficacy. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03863-7.
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Affiliation(s)
- Tao Yang
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Rijin Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xianghu Meng
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hanping Wei
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xinying Jiang
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xiaoliang Yuan
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Xiaowu Liu
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Zhimin Jiao
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China.,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China
| | - Jun Liu
- Department of Urology, The 940th Hospital of PLA Joint Logistics Support Force, Lanzhou, 730050, China
| | - Honglei Shi
- Department of Urology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213004, China. .,Department of Urology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213004, China.
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Yuan C, Jian Z, Jin X, Ma Y, Li H, Wang K. Efficacy and Safety of External Physical Vibration Lithecbole After Extracorporeal Shock Wave Lithotripsy or Retrograde Intrarenal Surgery for Urinary Stone: A Systematic Review and Meta-analysis. J Endourol 2020; 35:712-720. [PMID: 32972194 DOI: 10.1089/end.2020.0820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction: The current study evaluated the efficacy and safety of external physical vibration lithecbole (EPVL) after extracorporeal shock wave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) for urolithiasis. Methods: Publicized literature was systematically searched from EMBASE, Cochrane Library, PubMed, ScienceDirect, ClinicalTrials.gov, and Web of Science up to February 2020. Fixed-effects or random-effects model was chosen in risk ratio (RR) calculation according to heterogeneity. Quality of evidence was estimated under the guidance of Cochrane handbook. Stone expulsion rate, stone-free rates (SFRs), and complication rates were set as end points. Results: Six randomized controlled trials, including 853 patients, were eligible for analysis. EPVL significantly increased SFR within 3 weeks (RR = 1.17, 95% CI: 1.06-1.29, P = 0.001) and above 3 weeks (RR = 1.19, 95% CI: 1.03-1.37, P = 0.02) after SWL. EPVL also improved SFR within 3 weeks (RR = 1.84, 95% CI: 1.35-2.49, P < 0.0001) and above 3 weeks (RR = 1.53, 95% CI: 1.33-1.77, P < 0.00001) after RIRS. Besides, EPVL can significantly increase SFRs for stones in renal pelvis, lower calix, and multiple locations (all P-value <0.05). Although the overall complication rate was not significantly higher in EPVL + RIRS group, it was found to be 1.38 times higher in EPVL+SWL group (RR = 1.38, 95% CI: 1.06-1.79, P = 0.02), especially the incidence of flank pain (RR = 3.11, 95% CI: 1.02-9.46, P = 0.05). Conclusions: EPVL is effective and safe with high SFRs (especially in renal pelvis, lower calix, and multiple locations) after SWL or RIRS and lower overall complication rate after RIRS in patients with urolithiasis. However, the overall complication rate (especially the incidence of flank pain) was higher after EPVL + SWL.
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Affiliation(s)
- Chi Yuan
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yucheng Ma
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hong Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Peng L, Wen J, Zhong W, Zeng G. Is physical therapy effective following extracorporeal shockwave lithotripsy and retrograde intrarenal surgery: a meta-analysis and systematic review. BMC Urol 2020; 20:93. [PMID: 32646402 PMCID: PMC7350681 DOI: 10.1186/s12894-020-00664-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/30/2020] [Indexed: 12/21/2022] Open
Abstract
Background Physical therapy, including percussion, inversion, vibration and combinations, was clinically performed to improve the stone free rate (SFR) following lithotripsy procedures. However, physical therapy is not widely accepted in clinical practice owing to lack of high level evidence support and a standard protocol. The present meta-analysis aimed to evaluate the efficacy and safety of physical therapy in improving SFR following extracorporeal shockwave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS). Methods Systematic review of literature from PubMed, Scopus, Cochrane library and Embase was performed in March 2019. The efficacy and safety of physical therapy after ESWL and RIRS were assessed by meta-analysis of SFR and complication rate. Results A total of 8 prospective studies with 1065 patients were enrolled. When compared to non-intervention, physical therapy provided a higher SFR (OR:3.38, 95% CI: 2.45–4.66, p < 0.0001) at all time points (week 1, week 2 and month 1), while there was no significant difference in complications such as hematuria, lumbago, dizziness and urinary tract infection (OR: 0.84; 95%CI: 0.62–1.13; p = 0.237). In subgroup analysis of different stone locations, lower calyx stone (OR: 3.51; 95%CI: 2.21–5.55; p < 0.0001), upper ureter and renal pelvic stones (OR:2.79; 95%CI:1.62–4.81; p = 0.0002) had a higher SFR after physical therapy, while there was no significant improvement in SFR in upper and middle calyx stones. In subgroup analysis of different techniques, EPVL (external physical vibration lithecbole, OR:3.47; 95%CI:2.24–5.37; p < 0.0001) and PDI (percussion, diuresis and inversion, OR:3.24; 95%CI:2.01–5.21; p < 0.0001) were both effective in improving SFR when compared to non-intervention. Conclusions Physical therapy is effective in improving the SFR after ESWL and RIRS, especially for lower calyx stones, upper ureter and renal pelvic stones, while without significant side effects. External physical vibration lithecbole (EPVL) might provide a relative uniformed and repeatable protocol for clinical practice of physical therapy. Trial registration PROSPERO 2019 CRD42019130228.
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Affiliation(s)
- Linjie Peng
- Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangzhou Medical University, Guangzhou, China
| | - Junjun Wen
- Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.,Guangzhou Medical University, Guangzhou, China
| | - Wen Zhong
- Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China. .,Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China. .,Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
| | - Guohua Zeng
- Urology, the First Affiliated Hospital of Guangzhou Medical University, Kangda Road 1, Haizhu District, Guangzhou, 510230, China. .,Guangdong Key Laboratory of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China. .,Guangzhou Institute of Urology, Kangda Road 1, Haizhu District, Guangzhou, 510230, China.
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Prezioso D, Barone B, Di Domenico D, Vitale R. Stone residual fragments: A thorny problem. Urologia 2019; 86:169-176. [DOI: 10.1177/0391560319860654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Urolithiasis represents a widespread and common disorder among the world population, with a predicted increase in affected patients in the coming years. Treatment of renal and ureteral stones varies widely, and achieving true stone-free status in all patients is still difficult. Moreover, imaging used to assess residual fragments following procedure impacts the diagnosed stone-free rate percentage considerably. In particular, the use of computed tomography scans has led to a better evaluation of residual fragments as well as so-called clinically insignificant residual fragments, which in a considerable number of cases are, despite their definition, causes of adverse urological events, thus creating a thorny problem for both patients and urologists. Currently, there is no gold standard or validated protocol regarding the management, clearance and prevention of residual fragments. In this article, we review the current literature regarding residual fragments, clinically insignificant residual fragments and their natural history, reporting on diagnostic methods, incidence, complications and outcome with the use of less invasive procedures, taking into consideration viable treatment and management of patients affected.
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Affiliation(s)
- Domenico Prezioso
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Biagio Barone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Dante Di Domenico
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Raffaele Vitale
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Effect of mechanical percussion combined with patient position change on the elimination of upper urinary stones/fragments: a systematic review and meta-analysis. Urolithiasis 2019; 48:95-102. [DOI: 10.1007/s00240-019-01140-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
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