目的:观察经后腹腔镜肾囊肿去顶减压术治疗常染色体显性遗传性多囊肾病的临床效果。方法:2004~2007年经后腹腔镜囊肿去顶减压术治疗成人型多囊肾20例，术后随访6~36月，观察手术前后肾功能指标变化术后。结果:20例手术均获成功。平均手术时间71.0±5.28分钟，术后平均住院天数5±0.38天。结论:经后腹腔镜囊肿去顶减压术治疗多囊肾具有创伤小、出血少、恢复快等优点，是外科治疗成人型多囊肾安全有效的方法。
ObjectiveTo systematically review the efficacy and safety of laparoscopic versus open nephrectomy in the treatment of autosomal dominant polycystic kidney disease (ADPKD). MethodsWe searched databases including MEDLINE, EMbase, The Cochrane Library (Issue 1, 2015), Web of Science, CBM and WanFang Data to collect relevant clinical studies comparing the efficacy and safety of laparoscopic versus open nephrectomy for ADPKD from inception to Jan, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.4 software was used for meta-analysis. ResultsA total of six retrospective cohort studies involving 182 patients were included. The results of the meta-analysis showed that:compared with the open nephrectomy group, the average hospitalization time was shorter (MD=-4.38 days, 95%CI -5.93 to -2.83, P=0.000 01) and the blood transfusion risk was lower (OR=0.25, 95%CI 0.10 to 0.62, P=0.003) in the laparoscopic nephrectomy group. However, there was no significant difference between two groups in the incidence of overall complications (OR=0.51, 95%CI 0.24 to 1.06, P=0.07). ConclusionThe application of laparoscopic nephrectomy for ADPKD can reduce the hospitalization time and blood transfusion risk when compared with the open nephrectomy, but the two operations have similar overall complication rate. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo explore the effects of PKD1 gene on mouse aortic smooth muscle (MOVAS) cells autophagy.MethodsThe shRNA and over-expression lentiviral vectors for the target gene of PKD1 were constructed. MOVAS cells were infected by a number of successful packaging shRNA (PKD1 knockdown) or ETS-1 (PKD1 over-expressing) lentiviral vectors, and qPCR was used to test interference and over-expressing effects. Then qPCR and Western blotting were used to detect the expression levels of autophagy markers including Atg5, Beclin1 and LC3 in control group, shPKD1 group and ETS-1 group.ResultsCompared with the control group, PKD1 mRNA level was decreased in the shPKD1 group (P<0.05); ETS-1 and PKD1 mRNA levels were increased in the ETS-1 group (P<0.05). In contrast with the control group, the mRNA levels of autophagy markers including Atg5 (P<0.05) and Beclin1 (P<0.01) were obviously decreased in the shPKD1 group, but they were obviously increased in the ETS-1 group (P<0.001). Protein levels of Atg5, Beclin1 and LC3 were significantly decreased in the shPKD1 group (P<0.05), but they were increased obviously in the ETS-1 group (P<0.05) in contrast with the control group.ConclusionPKD1 gene is involved in MOVAS cells autophagy, low expression of PKD1 gene can inhibit autophagy and high expression of PKD1 promotes autophagy in vascular smooth muscle cells.