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Zhang J, Li K, Chen H, Hu X, Guo Z, Chen S, Zheng F, Cheng W, Mu Q, Lan Y, Chen P. Retrospective analysis of urinary tract stone composition in a Chinese ethnic minority colony based on Fourier transform infrared spectroscopy. Sci Rep 2023; 13:13453. [PMID: 37596395 PMCID: PMC10439141 DOI: 10.1038/s41598-023-40603-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: 04/05/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023] Open
Abstract
To analyze the relationship between the composition of urinary stones and various influencing factors in the Enshi region. We used FT-IR to examine the composition of 1092 stone samples. Combined with the relevant clinical materials, the data were analyzed using both one-dimensional statistical methods and multivariate statistical methods. The study included 1092 stone samples, classified as follows: 457 (41.8%) with a single component, 453 (41.5%) with two components, 149 (13.6%) with three components, and 33 (3.0%) with four components. Stones were categorized into five types: Calcium Oxalate (CaOx) (76.4%), carbapatite (CaP) (9.3%), Struvite (ST) (8.3%), Uric Acid (UA) (4.9%), and Others (1.0%). Age, gender, urinary tract infection (UTI), family history of urinary stones (FH), hyperuricemia (HUA) and stone location were significantly associated with stone type. Logistic regression revealed that females and UTI were relative risk factors for predicting CaP and ST, while FH and HUA were relative risk factors for predicting UA. Our study indicates that the overall composition of urinary tract stones in the Enshi region is consistent with that of the entire China. Additionally, the predisposing factors for stone formation vary in terms of gender, age, FH, UTI, hyperuricemia HUA, and stone location.
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Affiliation(s)
- Junfeng Zhang
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Kailing Li
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Hongbo Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Xiaohui Hu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Zicheng Guo
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Su Chen
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Fu Zheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Wusong Cheng
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Qian Mu
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China
| | - Yong Lan
- Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, No. 158 Wuyang Avenue, Enshi City, 445000, Hubei, China.
| | - Peng Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China.
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Skubisz M, Torzewska A, Mielniczek-Brzóska E, Prywer J. Consumption of soft drinks rich in phosphoric acid versus struvite crystallization from artificial urine. Sci Rep 2022; 12:14332. [PMID: 35995826 PMCID: PMC9395414 DOI: 10.1038/s41598-022-18357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
In recent years, there has been a continuous increase in the incidence of urolithiasis, especially in highly developed countries. Therefore, the question arises which factors specific to these countries may be responsible for the increase in the incidence of this disease. In this article, we try to assess the effect of phosphoric acid, a component of various carbonated drinks, including Coca-Cola, on the nucleation and growth of struvite crystals, which are the main component of infectious urinary stones. The research was carried out in the environment of artificial urine with and without the presence of Proteus mirabilis bacteria. In the latter case, the activity of bacterial urease was simulated by adding an aqueous ammonia solution. The obtained results indicate that phosphoric acid present in artificial urine causes the nucleation of struvite to shift towards a lower pH, which means that struvite nucleates earlier in artificial urine compared to the control test. The amount of struvite formed is the greater the higher the concentration of phosphoric acid. At the same time, as the concentration of phosphoric acid increases, the growing struvite crystals are larger, which is disadvantageous because they are more difficult to remove from the urinary tract along with the urine. For the highest levels of phosphoric acid tested, large dendrites are formed, which are particularly undesirable as they can damage the epithelium of the urinary tract. The effect of phosphoric acid on the nucleation and growth of struvite is explained in base of chemical speciation analysis. This analysis indicates that the MgHCit and MgCit- complexes have the main influence on the nucleation and growth of struvite in artificial urine in the presence of phosphoric acid. It should be keep in mind that all these effects of phosphoric acid are possible when the urinary tract is infected with urease-positive bacteria. In the absence of infection, phosphoric acid will not cause struvite to crystallize.
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Affiliation(s)
- Mikołaj Skubisz
- Institute of Physics, Lodz University of Technology, ul. Wólczańska 217/221, 93‑005, Łódź, Poland
| | - Agnieszka Torzewska
- Department of Biology of Bacteria, Faculty of Biology and Environmental Protection, University of Lodz, ul. Banacha 12/16, 90-237, Łódź, Poland
| | - Ewa Mielniczek-Brzóska
- Institute of Chemistry, Faculty of Science and Technology, Jan Długosz University of Czestochowa, ul. Armii Krajowej 13/15, 42-200, Częstochowa, Poland
| | - Jolanta Prywer
- Institute of Physics, Lodz University of Technology, ul. Wólczańska 217/221, 93‑005, Łódź, Poland.
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Yang J, Huang Y, Li Y, Tang D, Ai Q. Efficacy of Flexible Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Complex Upper Urinary Tract Nephrolithiasis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2378113. [PMID: 35941896 PMCID: PMC9356812 DOI: 10.1155/2022/2378113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022]
Abstract
Objective A case-control study was conducted to compare the efficacy and prognostic factors of flexible ureteroscopic lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) when treating complex upper urinary tract renal calculi based on a retrospective cohort study. Methods The study period was from October 2019 to December 2021. A retrospective study was carried out on 100 patients with complicated upper urinary tract nephrolithiasis who underwent surgery in the Urology Department of our hospital. They were assigned into two groups: FURL and PCNL groups. The intraoperative blood loss, operation time, hematuria duration, hospital stay, primary stone removal rate, incidence of intraoperative and postoperative complications, VAS score, level of inflammatory factors, and micturition function were compared. According to the postoperative prognosis, the patients were reassigned into two groups: good prognosis group (n = 38) and poor prognosis group (n = 106). The factors related to poor prognosis after FURL and PCNL were screened, and multivariate loglistic regression analysis was adopted to determine the risk factors. Results The primary stone clearance rate in the PCNL group was significantly higher than that in the FURL group, and there was no significant difference in the incidence of intraoperative and postoperative complications between the two groups (P > 0.05). The intraoperative blood loss and the duration of hematuria in the PCNL group were significantly shorter than those in the FURL group, and the operation time and postoperative hospital stay in the FURL group were longer than those in the FURL group. The postoperative VAS score in the study group was significantly lower than that in the control group (P < 0.05). The levels of CRP, IL-1, TNF-α, and NF-κB in both groups decreased after operation, and the level of inflammatory factors in the PCNL group was significantly lower than that in the FURL group (P < 0.05). The indexes of IPSS and Q max in the PCNL group were significantly lower than those in the control group 3 months after operation. The index of micturition function in the PCNL group was significantly lower than that in the FURL group. Preoperative use of immunosuppressant, preoperative stone fever, positive preoperative urine culture, preoperative urinary leukocyte count ≥ 544 × L, intraoperative urinary opacity, and pus fur were significantly correlated with poor prognosis of ureteral patients (P < 0.05). Preoperative stone fever, high preoperative urinary leukocyte count, intraoperative urinary turbidity, and suppurative fur were independent risk factors for postoperative SIRS in patients with ureteral calculi. Conclusion PCNL is effective when treating complex upper urinary tract renal calculi. Compared with FURL, PCNL can remarkably reduce intraoperative blood loss and hematuria duration, can enhance micturition function, and will not remarkably increase the incidence of intraoperative and postoperative complications, high safety. High white blood cell count in urine before operation, fever due to stone before operation, turbid urine, and purulent fur during operation are independent risk factors for postoperative adverse outcome in patients with complex upper urinary tract renal calculi. Patients should be fully treated before surgery.
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Affiliation(s)
- Junxian Yang
- Department of Urology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan City, Hubei Province 430081, China
| | - Yingjie Huang
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, 430064, China
| | - Yongfa Li
- Department of Urology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan City, Hubei Province 430081, China
| | - Dong Tang
- Department of Urology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan City, Hubei Province 430081, China
| | - Qian Ai
- Department of Urology, Wuhan Puren Hospital, No. 1 Benxi Street, Qingshan District, Wuhan City, Hubei Province 430081, China
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Xu Z, Liu K, Lv J, Zhang Y. Application of CTU-Assisted Doppler Ultrasound Puncture in Nontube Percutaneous Nephrolithotomy, Its Effect on Patients' Complications, and Its Clinical Value. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7810062. [PMID: 35937406 PMCID: PMC9352473 DOI: 10.1155/2022/7810062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
Abstract
Objective To research the application of CTU-assisted Doppler ultrasound puncture in uncatheterized PCNL, its influence on patients' complications, and its clinical value in a case-control study. Methods One hundred and forty-four patients who went through percutaneous nephrolithotomy (PCNL) from March 2019 to June 2021 in our hospital were arbitrarily assigned into the CTU group (n = 72) and CT plain scan group (n = 72). CTA+CTU was adopted to determine the puncture passage in the CTU group, and CT scan was employed in the CT group. The intraoperative blood loss, postoperative blood loss, operation time, hospital stay, primary stone removal rate, and the incidence of intraoperative and postoperative complications were compared. The visual analogue score (VAS) was employed to assess the degree of postoperative wound pain. Results The first-stage stone removal rate in the CTU group was 95.83% (69/72), which was remarkably higher compared to the CT plain scan group, which was 81.94% (59/72), and the difference was statistically significant (P < 0.05). The overall rates of intraoperative complications were 6.94% (5/72) in the CTU group and 18.06% (13/72) in the CT plain scan group, respectively, which exhibited great differences (P < 0.05). In addition, the overall rates of intraoperative complications were 2.78% (2/72) in the CTU and 13.89% (10/72) in the CT plain scan group, respectively, and the difference was statistically significant (P < 0.05). The operation time and postoperative hospital stays in the CTU group were remarkably shorter compared to the CT group, and the difference was statistically significant (P < 0.05). The intraoperative and postoperative blood loss of CTU group displayed obvious less than that of the CT group, and the difference was statistically significant (P < 0.05). The VAS were compared 24 hours after surgery. After operation, the VAS of 24 hours after operation in the CTU group (0.92 ± 0.12) were remarkably lower compared to the CT group (1.22 ± 0.15), and the difference was statistically significant (P < 0.05). Discussion. PCNL is constantly being optimized by CTU-assisted Doppler ultrasound puncture to improve stone clearance rates, reduce postoperative bleeding, be less painful, provide rapid recovery, and provide safe and feasible results. It is therefore worthwhile to standardize and then widely promote it in clinical practice.
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Affiliation(s)
- Zhenguo Xu
- Graduate Department, Bengbu Medical College, Bengbu Anhui 233030, China
- Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Kun Liu
- Graduate Department, Bengbu Medical College, Bengbu Anhui 233030, China
- Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Jia Lv
- Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Yuelong Zhang
- Graduate Department, Bengbu Medical College, Bengbu Anhui 233030, China
- Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
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Shahmoradi L, Azizpour A, Bejani M, Shadpour P, Rezayi S. Prevention and control of urinary tract stones using a smartphone-based self-care application: design and evaluation. BMC Med Inform Decis Mak 2021; 21:299. [PMID: 34724936 PMCID: PMC8559363 DOI: 10.1186/s12911-021-01661-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/18/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Self-care and participation of patients in improving health and increasing awareness about the risk factors that affect the development of disease in patients with urinary tract stones are influential factors in controlling and improving the quality of life in these patients. In this regard, the availability and capability of smartphones increase patients' self-care ability. The present study aimed to develop and evaluate a self-care application based on smartphones for patients with urinary tract stones. METHODS The present study is a developmental and applied study that was conducted in three phases. First, the information needs and functionalities of the self-care application were determined by surveying 101 patients, 32 urologists and nephrologists, 11 nurses, and six other specialists. In the second phase, the initial sample of the smartphone-based application was created, and in the third phase, the designed application was evaluated by 15 experts using the standard Post-Study System Usability Questionnaire (PSSUQ 18.3) and Nielsen's Attributes of Usability (NAU) questionnaire. Results of the questionnaires were entered into SPSS-23 software for analysis using descriptive statistics. RESULTS In the first phase, 21 information elements and nine critical functionalities for the self-care application were identified, and then this application was designed by Java programming language. The evaluation of experts showed that two aspects of the quality of system user interface from the user's point of view and the overall performance of the application together obtained the highest score (6.43 from 7), which was equal to 91.85%. Then according to the experts, aspects of the degree of convenience and user-friendliness of the application received the highest score (6.10 from 7), which was equal to 87.14%, and also all aspects of the application were evaluated at an acceptable level. In general, results of the evaluation of application's usability by experts showed that the usability of the application for patients with urinary tract stones was at an acceptable level. CONCLUSION According to the results obtained from evaluating the smartphone-based application for patients with urinary tract stones, this self-care application can be used to prevent and control urinary tract stones and facilitate self-care and active patient participation in care.
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Affiliation(s)
- Leila Shahmoradi
- Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Azizpour
- Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahmud Bejani
- Health Information Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pejman Shadpour
- Hasheminejad Kidney Center (HKC), Hospital Management Research Center (HMRC), Iran University of Medical Sciences, Tehran, Iran
| | - Sorayya Rezayi
- Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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