输尿管镜治疗上尿路结石并急性肾衰的临床观察

目的探讨上尿路结石性梗阻并发急性肾功能衰竭的治疗方法.方法应用输尿管镜直视下气压弹道碎石术治疗输尿管结石梗阻并急性肾功能衰竭10例.结果术后患者血清BUN、Cr均恢复正常或发病的基础水平,尿量恢复.结论输尿管镜诊治上尿路结石性梗阻并发急性肾功能衰竭,具有安全、疗效可靠、损伤小的优点,能同时处理双侧输尿管病变,可作为主要的治疗方法.     

输尿管镜治疗上尿路结石并急性肾衰的临床观察

目的 探讨上尿路结石性梗阻并发急性肾功能衰竭的治疗方法。方法 应用输尿管镜直视下气压弹道碎石术治疗输尿管结石梗阻并急性肾功能衰竭10例。结果 术后患者血清BUN、Cr均恢复正常或发病的基础水平．尿量恢复。结论 输尿管镜诊治上尿路结石性梗阻并发急性肾功能衰竭，具有安全、疗效可靠、损伤小的优点，能同时处理双侧输尿管病变，可作为主要的治疗方法。     

输尿管镜下气压弹道碎石术治疗急性肾后性肾功能衰竭

目的 探讨输尿管镜下气压弹道碎石术治疗输尿管结石梗阻所致急性肾后性肾功能衰竭的方法 和疗效.方法 回顾性分析25例输尿管结石梗阻致急性肾功能衰竭的患者行输尿管镜下气压弹道碎石术的临床资料.结果 19例一次碎石取石成功,5例结石部分击碎后进入肾盂,1例输尿管镜无法抵达结石改开放手术.23例肾功能恢复,2例出院时仍有轻度氮质血症.结论 输尿管镜下气压弹道碎石术治疗输尿管结石梗阻所致急性肾功能衰竭微创、安全、疗效较好,可作为首选方法.     

经输尿管镜气压弹道碎石术治疗输尿管结石80例疗效观察

目的：观察经输尿管镜气压弹道碎石术，辅以排石汤剂，治疗输尿管结石的临床疗效。方法：应用输尿管镜气压弹道碎石术辅以排石汤剂治疗输尿管结石80例。结果：77例碎石成功，无残留结石或“石街”形成；3例碎石失败。无并发症发生。结论：气压弹道式碎石术是治疗输尿管结石的一种安全、高效的方法；辅以排石汤剂治疗，加快了结石排出，并有利于输尿管粘膜的恢复。     

输尿管镜下气压弹道碎石术治疗输尿管结石的疗效观察

目的：探讨输尿管结石的有效手术方法。方法：应用输尿管镜（URS）气压弹道碎石治疗输尿管结石82例。结果：82例中有79例（96．3％）碎石成功，其中输尿管上段结石成功率81．8％（9／11），中段结石96．4％（27／28），下段结石100％（43／43）；72例碎石后结石一次取净，7例术后1、2．5个月碎石排净。结论：URS气压弹道碎石具有高效、安全、容易操作的特点，是治疗中下段输尿管结石的首选方法。     

输尿管硬镜气压弹道碎石治疗输尿管结石疗效分析

目的 探讨输尿管镜气压弹道碎石术治疗输尿管结石的疗效.方法 采用输尿管硬镜气压弹道碎石治疗输尿管结石280例.其中结石位于输尿管上段24例,中段74例,下段182例.结果 输尿管镜上段、中段、下段结石碎石成功率分别45.8%,67.6%,95.5%.结论 输尿管硬镜气压弹道碎石治疗输尿管中下段结石方法安全、有效,创伤小,可作为治疗输尿管中下段结石的首选方法.     

输尿管镜治疗肾后性结石梗阻并急性肾功能衰竭15例临床分析

目的探讨输尿管镜治疗肾后性结石梗阻并急性肾衰的疗效。方法回顾分析15例肾后性结石梗阻并急性肾衰竭的临床资料。结果15例均成功解除梗阻，肾功迅速恢复，血尿素氮、肌酐恢复正常，无并发症，术后1月结石排净率86．7％。结论应用输尿管镜气压弹道碎石术治疗肾后性结石梗阻并急性肾衰，具有微创、疗效好、安全可靠恢复快等优点，输尿管镜应成为该病的首选方法。     

经尿道输尿管镜下钬激光碎石术治疗输尿管结石的临床疗效观察

目的探讨经尿道输尿管镜下钬激光碎石治疗输尿管结石的临床疗效。方法回顾性分析攀枝花学院附属医院2015年9月至2017年6月收治的205例输尿管结石患者的临床资料,按手术方法分为对照组102例(采用常规气压弹道碎石治疗)和观察组103例(采用经尿道输尿管镜下钬激光碎石治疗);对2组患者的手术情况、肾功能指标以及手术指标进行对比分析。结果观察组患者手术总有效率为97.06%,对照组为85.00%,2组比较差异有统计学意义(P0.05);2组患者手术前的Cr和BUN水平比较差异无统计学意义(P0.05);2组患者治疗后与治疗前相比,Cr和BUN水平都有显著性改善,差异有统计学意义(P0.05),但观察组患者肾功能指标改善程度显著优于对照组,差异有统计学意义(P0.05);观察组手术中失血量、手术时间以及术后住院时间均低于对照组,差异有统计学意义(P0.05)。结论经尿道输尿管镜下钬激光碎石和常规气压弹道治疗输尿管结石临床疗效均良好,但使用钬激光碎石治疗患者肾功能指标及手术指标优于气压弹道碎石。     

经输尿管镜气压弹道碎石术治疗输尿管结石的临床效果观察

目的 探讨经输尿管镜气压弹道碎石术治疗输尿管结石临床效果。方法 选取2015年1月~2017年1月我院收治的200例输尿管结石患者,按手术方式分为观察组和对照组,每组100例。对照组接受体外冲击波碎石术,观察组接受输尿管镜气压弹道碎石术治疗,对比两组患者的碎石成功率。结果 观察组上段结石和中下段结石手术碎石成功率分别为80.00%和96.67%,明显高于对照组的77.78%和54.54%,差异有统计学意义（P＜0.05）。结论 输尿管进气压弹道碎石术在输尿管结石患者治疗当中效果突出,手术过程当中可以减少出血以及对患者的身体损伤,提高手术成功率,值得临床推广应用。     

微创治疗结石梗阻并急性肾功能衰竭（附26例报告）

目的探讨结石梗阻并急性肾功能衰竭的治疗方法。方法26例结石梗阻并急性肾功能衰竭患者，11例行输尿管镜气压弹道碎石术（URL），6例行微创经皮肾镜取石术（mPCNL），9例Ⅰ期行经皮肾造瘘（PCN），Ⅱ期行URL或mPCNL。结果碎石均获成功，21例术后肾功能正常，3例术后肾功能较前明显改善，2例术后永久性肾衰竭，需靠长期透析治疗。结论URL或mPCNL虽是治疗泌尿系结石的微创、有效方法，但对并发急性肾衰竭的患者需谨慎考虑，以免造成严重后果，必要时可先引流肾内积液，待肾功能改善后，再行URL或mPCNL治疗。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.