Ultrasensitive and specific detection of prostate-specific antigen (PSA) in complex biological samples is crucial for early diagnosis and treatment of prostate-related diseases. Immunoassay with a simple sensing interface and ultrahigh sensitivity is highly desirable. Herein, a novel electroluminescence (ECL) immunosensing platform is demonstrated based on the equipment of vertically ordered mesoporous silica-nanochannel films (VMSFs) with PSA antibody, which is able to realize ultrasensitive detection of PSA in human serum. Through the electrochemically assisted self-assembly (EASA) method, the VMSF is easily grown on an indium tin oxide (ITO) electrode in a few seconds. Owing to a large surface area and the negatively charged surface, VMSF nanochannels display strong electrostatic attraction to the positively charged ECL luminophores (tris(2,2-bipyridyl) dichlororuthenium (II), (Ru(bpy)32+), leading to two orders-of-magnitude enhancement of ECL emission compared with that of the bare ITO electrode. The outer surface of the VMSF is functionalized with reactive epoxy groups, which further allows covalent attachment of PSA antibody (Ab) on the entry of nanochannels. As the combination of PSA with Ab decreases the ECL signal by hindering the mass transfer of ECL luminophores and coreactant, the developed immunosensor can achieve ultrasensitive detection of PSA ranging from 1 pg ml−1 to 100 ng ml−1 with a limit of detection (LOD) of 0.1 pg ml−1. Considering the antifouling ability of the VMSF, sensitive detection of PSA in human serum is also realized. The proposed nanochannel-based immunosensor may open up a new way for the facile development of the universal immunosensing platform for rapid and ultrasensitive detection of disease markers.
Owing to the fragile kidney and relative small collecting system of pediatric patients, urologists were always reluctant to treat pediatric urolithiasis with PCNL. Here we conduct a study to assess the effectiveness and safety of pediatric patients with renal calculi <6 years.A total of 88 pediatric patients (99 kidney units) <6 years underwent the ultrasound (US)-guided minimally invasive percutaneous nephrolithotomy in our institute from March 2006 to April 2016. The mean age was 30.9 months (range, 7–72 months). The mean stone size was 19.5 mm (range, 10–50 mm). The group included single stone in 35 kidney units, upper ureteral stone in 12 kidney units, multiple stone in 43 kidney units, and staghorn stone in 9 kidney units. The procedure of puncture and dilation were guided by US solely.The mean operation time was 52.3 minutes (range, 15–140 minutes). The mean postoperative length of stay was 6.0 days (3–16 days). Besides, the initial stone free rate (SFR) was 90.9% (90/99) and the final SFR was 96.0% (95/99). The mean hemoglobin drop was 10.9 g/L (range, 1–25 g/L). Postoperative complications occurred in 12 patients including fever in 11 cases and active pleural effusion in 1 case.The US-guided MPCNL is an effective and safety procedure to treat pediatric patients with stone <6 years.
The aim of this study was to evaluate the characteristics of the renal arterial segment bleeding and assess the outcome of selective renal artery embolization (SRAE). Methods: Data on 35 patients in whom SRAE was performed after percutaneous nephrolithotomy (PCNL) from January 2005 to December 2015 in our institute were retrospectively analyzed. All patients had severe bleeding but failed to respond to conservative therapy. Results: Forty-four SRAEs were performed in 35 patients (36 kidney units) after PCNL. The findings of 44 renal arteriographies before embolization revealed bleeding in 44 renal artery branch segments. Upper artery segment bleeding in 0, upper and anterior segment bleeding in 3, lower and anterior artery segment bleeding in 6, lower artery segment bleeding in 9, posterior artery segment bleeding in 24, and negative finding in 2 patients. Renal arteriography revealed pseudoaneurysms in 20 (45.5%) patients, arteriovenous fistulas in 6 (13.6%) patients, renal artery branch laceration in 16 (36.4%) patients, and negative angiography finding in 2 (4.5%) patients. Acute bleeding in 7 patients (20.0%) and delayed bleeding in 28 patients (80.0%) were observed. The target vascular lesions were successfully treated by embolization in the first time in 28 cases. Six patients underwent 2 sessions and 1 had 3 sessions. New vascular lesions were the most common cause of failure of initial SEAE in our hospital. Abnormal renal function was observed in 5 patients, and they recovered to preoperative or normal level within 3 weeks. Conclusions: The posterior artery segment of the kidney is the most common bleeding site due to the choice of puncture site. Delayed bleeding (>24 h) was the most common type of bleeding. SRAE is an effective and safe method to treat the severe bleeding after PCNL.
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