Epidemiology ObjectivesTo explore characteristics of urinary stone composition in China, and determine the effects of gender, age, body mass index (BMI), stone location, and geographical region on stone composition. Patients and methodsWe prospectively used Fourier-transform infrared spectroscopy to analyse stones from consecutive patients presenting with new-onset urolithiasis at 46 hospitals in seven geographical areas of China, between 1 June 2010 and 31 May 2015. Chi-squared tests and logistic regression analyses were used to determine associations between stone composition and gender, age, BMI, stone location, and geographical region. ResultsThe most common stone constituents were: calcium oxalate (CaOx; 65.9%), carbapatite (15.6%), urate (12.4%), struvite (2.7%), and brushite (1.7%). CaOx and urate stones occurred more frequently in males, whereas carbapatite and struvite were more common in females (P < 0.01). CaOx and carbapatite were more common in those aged 30-50 and 20-40 years than in other groups. Brushite and struvite were most common amongst those aged <20 and >70 years. The detection rate of urate increased with age, whilst cystine decreased with age. Obese patients were more likely to have urate stones than carbapatite or brushite stones (P < 0.01). CaOx, carbapatite, brushite, and cystine stones were more frequently found in the kidney than other types, whereas urate and struvite were more frequent in the bladder (P < 0.01). Stone composition varied by geographical region. ConclusionsThe most common stone composition was CaOx, followed by carbapatite, urate, struvite, and brushite. Stone composition differed significantly in patients grouped by gender, age, BMI, stone location, and geographical region.
On a global scale tropical regions in developing countries are thought to be significant source areas of organochlorine pesticides (OCPs), owing to a long history of widespread use and only a recent production ban or restriction on the application of these pesticides. In the present study, 32 soil samples were collected in 2004 from agriculture lands around the urban area of Guangzhou, in southern China, and analyzed for residues of OCPs including p,p'-DDT, p,p'-DDE, p,p'-DDD, and alpha-, beta-, gamma-, and delta-HCH. The dry weight concentrations of SigmaHCH (SigmaHCH = alpha-HCH + beta-HCH + gamma-HCH + delta-HCH) ranged from 0.2 to 103.9 ng/g, with a median of 4.4 ng/g. Residues of SigmaDDT (SigmaDDT = p,p'-DDT + p,p'-DDE + p,p'-DDD) ranged from 7.6 to 662.9 ng/g, with a median of 67.3 ng/g. The predominance of beta-HCH among HCHs in most soil samples suggested that they were from historical contamination rather than recent input. The mean HCH alpha/gamma-ratio of 2.72 was lower than that of technical HCHs, possibly due to more loss of alpha-HCH via evaporation from soil with time, conversion of gamma-HCH to alpha-HCH or recent application of lindane in the region. The mean ratio of (DDE + DDD)/SigmaDDT was 0.54, indicating that quite a portion of DDT in soils was degraded since its official ban in 1983. Higher DDT concentrations with lower (DDE + DDD)/SigmaDDT ratios at a few sites suggested possible local DDT sources via the application of Dicofol. A positive but weak correlation (r = 0.449, p < 0.01) between DDT residues and TOC contents implied that soil organic matter might enhance adsorption of DDT in soils in the tropical regions. Hierarchical cluster analysis and principal component analysis were also performed to study the distribution and compositional patterns of OCPs as well as their sources and environmental fates within the study area.
The objective of the study is to compare the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) and mini-percutaneous nephrolithotomy (MPCNL) in treating renal stones sizing 15-25 mm in infants <3 years. Forty-six infants with renal stones sizing 15-30 mm were treated by either ESWL (22 renal units in 22 infants) using Dornier compact delta lithotripter or MPCNL (25 renal units in 24 infants) using 14F-18F renal access under general anesthesia. The operation time, stone-free rate, re-treatment rate, and complications between the two groups were compared with the χ(2), Mann-Whitney U, and Student's t tests. No significant differences in mean age and stone size were observed between the two groups. The 1- and 3-month postoperative stone-free rates were 84 and 96% in MPCNL group and were 31.8 and 86.4% in ESWL group. The re-treatment and complication rates were significantly higher in ESWL group than in MPCNL group (50 vs. 12%, P = 0.004; 16.0 vs. 45.5%, P = 0.028). The stone recurrence rate was similar between the two groups. No significant changes of serum creatinine (Cr) level and glomerular filtration rate were observed in both groups. In conclusion, MPCNL is an effective and feasible alternative monotherapy for large renal stones (15-25 mm) in infants, with a higher stone-free rate and a lower complication rate when compared with ESWL.
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