title: The systematic classification of urinary stones combine-using FTIR and SEM-EDAX.
abstract: BACKGROUND
  To explore underlying mechanism of urinary stones formation, the composition and microstructure of urinary stones were analyzed systematically with a large sample study from China.
  
  
  METHODS
  A total of 2437 urinary stones were obtained from the urology department at our Hospital. The composition of the stones was analyzed by Fourier transform infrared spectroscopy (FTIR). Meanwhile, the microstructure and element distribution were observed with scanning electron microscopy combined with element distribution analysis (SEM-EDAX).
  
  
  RESULTS
  Urinary stones were classified into eight types, that were consisted of calcium oxalate stones (1301/2437, 53.39%), calcium phosphate stones (131/2437, 5.38%), anhydrous uric acid stones (434/2437, 17.81%), magnesium ammonium phosphate stones (12/2437, 0.49%), sodium urate stones (5/2437, 0.21%), brushite stones (4/2437, 0.16%), cystine stones (3/2437, 0.12%) and mixed stones (547/2437, 22.45%, ten subtypes were included). Under SEM, they displayed distinct microstructures: plank-like, brick-like, polyhedron or paliform crystals for calcium oxalate stones, similar sized echin-sphere or rough bulbiform or tree bark-like crystals for calcium phosphate stones, rotten-wood-like or petrous crystals for anhydrous uric acid stones, globular or gallet-like crystals for magnesium ammonium phosphate stones, sawdust-like crystals for sodium urate stones, broken-wood-like crystals for brushite stones, stacking hexagonal cystine crystals for cystine stones, and two or more of the above crystals for mixed stones. Meanwhile, they also presented distinct elemental composition and distribution by EDAX.
  
  
  CONCLUSIONS
  Urinary stones can be classified into eight types, and exhibit a diversity of microstructure and elemental compositions in China. The formation process of different types of urinary stones may be diverse.
authors.affiliation: The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Nansha, Guangzhou 511470, PR China. Electronic address: olive5327@163.com.
authors.forename: Rui-Hong
authors.initials: RH
authors.lastname: Ma
authors.affiliation: The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Nansha, Guangzhou 511470, PR China. Electronic address: luoxb1976@163.com.
authors.forename: Xiao-Bing
authors.initials: XB
authors.lastname: Luo
authors.affiliation: The Department of Pulmonary, Critical Care and Sleep, Yale School of Medicine, USA. Electronic address: qin.li@yale.edu.
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.affiliation: The Department of Clinical Laboratory, The Sixth People's Hospital of Nansha, Nansha, Guangzhou 511470, PR China. Electronic address: 314188707@qq.com.
authors.forename: Hai-Qiang
authors.initials: HQ
authors.lastname: Zhong
mesh_terms: D002129:Calcium Oxalate / Q000032:analysis; D002130:Calcium Phosphates / Q000032:analysis; D002681:China; D003553:Cystine / Q000032:analysis; D006801:Humans; D008855:Microscopy, Electron, Scanning / Q000379:methods*; D017550:Spectroscopy, Fourier Transform Infrared / Q000379:methods*; D000069877:Struvite / Q000032:analysis; D014527:Uric Acid / Q000032:analysis; D014545:Urinary Calculi / Q000737:chemistry / Q000145:classification*
chemical_list: D002130:Calcium Phosphates; D002129:Calcium Oxalate; D014527:Uric Acid; D003553:Cystine; C020243:calcium phosphate; D000069877:Struvite; C018392:tricalcium phosphate; C494366:calcium phosphate, dibasic, dihydrate
keywords: Calcium oxalate stones; Calcium phosphate stones; Fourier transform infrared spectroscopy; Scanning electron microscopy; Urinary stones; X-ray energy spectrometer