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Our study showed that the expression of VEGF and Ang-2 correlated with MVD. Strong Ang-2 expression and/or high nuclear expression of HIF-1alpha is a significant predictive factor for recurrence after curative resection in HCC patients.

ObjectivesThis systematic review and meta-analysis was conducted to determine the mid- to long-term clinical outcomes for a medial-pivot total knee replacement (TKR) system. The objectives were to synthesise available survivorship, Knee Society Scores (KSS), and reasons for revision for this system.MethodsA systematic search was conducted of two online databases to identify sources of survivorship, KSS, and reasons for revision. Survivorship results were compared with values in the National Joint Registry of England, Wales, and Northern Ireland (NJR).ResultsA total of eight studies that included data for 1146 TKRs performed in six countries satisfied the inclusion/exclusion criteria. Pooled component survivorship estimates were 99.2% (95% CI, 97.7 to 99.7) and 97.6% (95% CI, 95.8 to 98.6) at five and eight years, respectively. Survivorship was similar or better when compared with rates reported for all cemented TKRs combined in the NJR and was significantly better than some insert types at mid-term intervals. The weighted mean post-operative KSS was 87.9 (73.2 to 94.2), in the excellent range. Similar cumulative revision rates and KSS were reported at centres in the United States, Europe, and Asia.ConclusionsThe subject system was associated with survivorship and KSS similar or better than that reported for other TKR systems.Cite this article: Bone Joint Res 2014;3:297–304

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BackgroundTo compare the treatment outcomes between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the management of stones larger than 2 cm in patients with solitary kidney.MethodsOne hundred sixteen patients with a solitary kidney who underwent RIRS (n = 56) or PCNL (n = 60) for large renal stones (>2 cm) between Jan 2010 and Nov 2015 have been considered. The patients’ characteristics, stone characteristics, operative time, incidence of complications, hospital stay, and stone-free rates (SFR) have been evaluated.ResultsSFRs after one session were 19.6% and 35.7% for RIRS and PCNL respectively (p = 0.047), but the SFR at 3 months follow-up comparable in both groups (82.1% vs. 88.3%, p = 0.346). The calculated mean operative time for RIRS was longer (p < 0.001), but the mean postoperatively hospital stay was statistically significantly shorter (p < 0.001) and average drop in hemoglobin level was less (p = 0.040). PCNL showed a higher complication rate, although this difference was not statistically significant.ConclusionsSatisfactory stone clearance can be achieved with multi-session RIRS in the treatment of renal stones larger than 2 cm in patients with solitary kidney. RIRS can be considered as an alternative to PCNL in selected cases.

BackgroundPercutaneous nephrolithotomy (PCNL) remains the standard procedure for large (≥2 cm) renal calculi; however, laparoscopic pyelolithotomy (LPL) can be used as an alternative management procedure. The aim of present study was to compare LPL and PCNL in terms of efficacy and safety for the management of large renal pelvic stones.MethodsA literature search was performed in Jan 2016 using electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) to identify relevant studies for the meta-analysis. Only comparative studies investigating LPL versus PCNL were included. Effect sizes were estimated by pooled odds ratio (ORs) and mean differences (MDs) with 95% confidence intervals (CIs).ResultsFive randomized and nine non-randomized studies were identified for analysis, involving a total of 901 patients. Compared with PCNL, LPL provided a significantly higher stone-free rate (OR 3.94, 95% CI 2.06–7.55, P < 0.001), lower blood transfusion rate (OR 0.28, 95% CI 0.13–0.61, P = 0.001), lower bleeding rate (OR 0.20, 95% CI 0.06–0.61, P = 0.005), fewer hemoglobin decrease(MD -0.80, 95% CI -0.97 to −0.63, P < 0.001), less postoperative fever (OR 0.38, 95% CI 0.21–0.68; P = 0.001), and lower auxiliary procedure rate (OR 0.24, 95% CI 0.12–0.46, P < 0.001) and re-treatment rate (OR 0.20, 95% CI 0.07–0.55, P = 0.002). However, LPL had a longer operative time and hospital stay. There were no significant differences in conversion to open surgery and prolonged urine leakage rates between LPL and PCNL.ConclusionsOur present findings suggest that LPL is a safe and effective approach for management of patients with large renal stones. However, PCNL still suitable for most cases and LPL can be used as an alternative management procedure with good selection of cases.Electronic supplementary materialThe online version of this article (10.1186/s12894-017-0266-7) contains supplementary material, which is available to authorized users.

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To evaluate the efficiency and safety of preoperative double-J stent placement for patients undergoing ureteroscopic lithotripsy. Eligible studies were identified from electronic databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews). All analyses were performed by the Review Manager 5.3 (The Cochrane Collaboration, Oxford, UK). Stone-free rate (SFR) was regarded as primary outcome. Second outcomes, including operation time, complication rates as well as major complication rates were also assessed. A total of 11,239 patients (2605 with and 8634 without preoperative stent) from nine retrospective studies were included. Our pooled analysis showed that SFR was significantly higher in patients with a preoperative stent than those without a stent (OR 1.60, 95% CI 1.19-2.15, p = 0.002). Operation time was not significantly different between stented and non-stented groups (OR - 0.89, 95% CI - 5.79-4.01, p = 0.72). No significant differences of complication rates were observed between stented and non-stented groups (OR 0.94, 95% CI 0.67-1.33, p = 0.73). Furthermore, major complication rates were not significantly different between two groups, either (OR 1.07, 95% CI 0.43-2.70, p = 0.88). Generally, preoperative double-J stent placement significantly improved SFR of patients undergoing ureteroscopic lithotripsy. Operation time, complication rates, as well as major complication rates, were similar between stented and non-stented groups. However, the effect of preoperative double-J stent placement for different locations and burden of stones is unclear, more high-quality studies should be anticipated.