Efficacy and safety of percutaneous nephrolithotomy in the treatment of kidney calculi

Introduction. Urolithiasis is one of wide-spread in the urological diseases distribution and considered socially significant one. In various regions of Russia, Republic of Bashkortostan is one of them, the endemicity of this pathology is revealed and statistically proved. The formation of stones in the urinary system is caused by a number of social and genetic factors. Nowadays, there are many methods of treatment of urolithiasis. According to the National recommendations and Guidelines of the European Association of urology, the choice of operational intervention method depends on the size of the concrement and the form of nephrolithiasis. Despite the low invasiveness of surgical treatment, 10-15% end up in sequela. Taking into account the mentioned above it is important to analyze efficacy and safety of nephrolithotripsy through one’s own experience. Aim: To evaluate the efficacy and safety of nephrolithotripsy in various forms of nephrolithiasis. Materials and methods. The study group included 365 patients who underwent percutaneous nephrolithotripsy in the clinic of the Bashkir state medical University. In the preoperative period, patients were examined according to the standard scheme, according to the results (localization, size of concrements), The most suitable access for percutaneous nephrolithotripsy was selected. In the preoperative period, patients were examined according to the standard scheme, according to the results (localization, size of concrements), The most suitable access for percutaneous nephrolithotripsy was selected. The efficacy of the surgical treatment was evidenced by the complete removal of concrements or calculi up to 4 mm. Clavien-dindo classification served as a scale of evaluation of postoperative complications. Results. By the gender type-men 175(47.9%), women 190 (52.2%). The age of patients was from 22 to 83 years. The average size of the calculus was 2.4 cm (0.8 – 7.8 cm). The average operation time was 83 min (23-258 min). The average bed day was 5.6. According to the classification of Clavien-dindo complications of 1 degree were observed in 123 (33.7%) of patients, 2 degree in 2 (0,5 %) patients, 3a degree 1 (0.3%) and 4b degree was observed in 1 (0,3%) patient, there were no complications of 5 degree. Summary. Percutaneous nephrolithotomy has come out as one of the highly effective and safe methods of treatment of nephrolithiasis.Введение. Мочекаменная болезнь занимает одно из ведущих мест в структуре урологических заболеваний и является социально-значимым заболеванием. В различных регионах России выявлена и статистически доказана эндемичность данной патологии, к одному из таких регионов относится республика Башкортостан. образование камней в мочевыделительной системе обусловлено множеством социальных, генетических факторов. В настоящее время доступно множество методов лечения уролитиаза. Согласно Национальным рекомендациям и руководству европейской ассоциации урологов выбор метода оперативно вмешательства зависит от размера конкремента и формы нефролитиаза. Несмотря на малую инвазивость хирургического лечения в 10-15% возникают осложнения. С учетом вышеизложенного, актуальным является изучение собственного опыта эффективности и безопасности нефролитотрипсии. Цель: оценить эффективность и безопасность нефролитотрипсии при различных формах нефролитиаза. Материалы и методы. В исследуемую группу вошло 365 пациентов, которым была выполнена перкутанная нефролитотрипсия в клинике Башкирского государственного медицинского университета. В предоперационном периоде больные проходили обследование по стандартной схеме, по полученным результатам (локализация, размер конкрементов) осуществлялся выбор наиболее подходящего доступа для проведения перкутанной нефролитотрипсии. об эффективности проведенного оперативного лечения свидетельствовало полное удаление конкрементов или наличие камней до 4мм. классификация Claven-dindo служила шкалой оценки послеоперационных осложнений. результаты. По гендерному типу- мужчины 175(47,9%), женщины 190(52,2%). Возраст пациентов 22-83 года. Средний размер камня 2,4см (0,8 – 7,8 см). Среднее время операции составило 83 мин (23-258мин). Средний койко-день составил 5,6. По классификации Clavien - dindo осложнения 1 степени наблюдались у 123 (33,7%) пациентов, 2 степени у 2 (0,5%) пациентов, 3а степени - у 1 (0,3%), 4b степени наблюдались у 1 (0,3%) пациента, осложнений 5 степени не было. Выводы. Перкутанная нефролитотрипсия показала себя, как один из высокоэффективных и безопасных методов лечения нефролитиаза

The role of miRNA genes participating in VHL-HIF1α in clear cell renal cell carcinoma

Introduction. Much attention in ccRCC development is paid to VHL-HIF1α pathway genes. Numerous genes involved in the pathogenesis of ccRCC are targets for miRNA. Alteration in the nature of interaction with miRNA binding site as a result of a single nucleotide substitution may promote change the expression of target genes involved in the genesis and development of tumors.Purpose of research. Analysis of the role of polymorphic variants in the miRNA binding sites of the VHL-HIF1α gene pathways in ccRCC development.Materials and methods. We used 225 DNA samples isolated from the venous blood of ccRCC patients who are hospitalized to the Clinic of the Bashkir State Medical University, and 298 healthy individuals. The genotyping of miRNA binding site polymorphisms in VHL-HIFα-dependent pathway genes (rs10982724 of the DEC1 gene, rs406271 of the TFRC gene, rs10491534 of the TSC1 gene, rs1642742 of the VHL gene, rs3025033 of the VEGFA gene) was performed using Taq-man assays.Results. The frequency distribution of alleles and genotypes of rs1642742 of the VHL gene showed that rs1642742 *GG is a marker of the increased risk for ccRCC. In addition, rs10491534 * C allele was found to be the marker for severe ccRCC (p = 0.044; OR = 1.72 (CI = 1.012-2.911)), and rs10491534 * TT genotype (p = 0.044; OR = 0.55; (95% CI = 0.31–0.98)) of the TSC1 gene was shown to be a protective marker for ccRCC of severe duration.Conclusions. The study indicated the association of miRNA binding sites polymorphisms with the risk of ccRCC development and severity of disease. However, further studies of the genes are needed to establish their functional significance and role in the pathogenesis of ccRCC

An investigation of microstructures and grain-boundary evolution during ECA pressing of pure aluminum

High-purity aluminum (99.99 pct) was processed by equal-channel angular pressing (ECAP) at room temperature through a die with a 90 deg angle between the die channels. Samples were examined by transmission electron microscopy (TEM) and orientation imaging microscopy (OIM) methods after one, four, and 12 passes through the die. Repetitively pressed samples were rotated by 90 deg in the same sense between successive pressing operations (route BC). After one pressing, TEM showed a subgrain structure which was elongated in the shearing direction. Corresponding OIM data illustrated an inhomogeneous microstructure in which bandlike features were also aligned with the shearing direction. The lattice orientation varied from location to location in the material. The boundary disorientation distribution determined from the OIM data exhibited a peak at 2 to 5 deg, in agreement with a predominance of subgrains in the microstructure. After four pressings, the microstructure data obtained by TEM and OIM were mutually consistent. The disorientation data revealed a decrease in the population of 2 to 5 deg boundaries accompanied by an overall upward shift in the distribution. Two orientations were generally apparent in the texture, although specific orientations varied with location. Often, a 111 orientation tended to align with the shear direction. Following 12 ECA passes, the grain size was reduced further to about 1.0 ?m. The populations of high-angle boundaries (15 deg) increased in the disorientation distribution. A texture characteristic of shear deformation of fcc metals became apparent, although the orientations and particular components varied with location. Microstructural refinement during severe straining includes the development of large fractions of high-angle boundaries