小儿霉菌性尿路感染并尿路梗阻致急性肾功能衰竭（附一例报告）

小儿霉菌性尿路感染并尿路梗阻致急性肾功能衰竭（附一例报告）第三临床学院儿科于嫦琴，张维忠，郭君关键词霉菌，尿路感染，尿路梗阻，急性肾功能衰竭，婴儿中图号，Ｒ６９２．５小婴儿由于原发性霉菌性尿路感染引起双侧输尿管梗阻致急性肾后性肾功能衰竭国内、外未见报...     

上尿路梗阻并发急性肾功能衰竭的输尿管镜治疗(附十五例报告)

目的：探讨应用输尿管镜治疗上尿路梗阻并急性肾功能衰竭可行性。方法：13例输尿管结石引起梗阻用输尿管镜直视下碎石及ESWL。2例是直肠癌和卵巢癌术后造成腹膜后纤维化引至输尿管梗阻，行输尿管镜扩张术。结果：15例均得到满意疗效。结论：认为输尿管镜是目前治疗上尿路梗阻并发急性肾功能衰竭的一种安全，微创有效的方法。     

开放手术治疗上尿路结石梗阻性急性肾功能衰竭

目的总结上尿路结石引起的梗阻性急性肾功能衰竭开放手术治疗方法，评价其预后。方法对46例由上尿路结石引起的梗阻性急性肾功能衰竭行开放手术治疗的结果进行分析。结果治疗后1个月内肾功能恢复者40例（87.0%），肾功能好转5例（10.9%），死亡1例（2.1%）。结论对上尿路结石梗阻引起的急性肾功能衰竭患者，应积极进行开放手术取石，手术成功率高，解除梗阻快，肾功恢复好。     

浅论检测上尿路结石患者肾小球滤过率的临床意义

目的：探讨检测上尿路结石患者肾小球滤过率的临床意义。方法：对2009年1月～2013年12月期间我院收治60例上尿路结石患者（共有71个患肾）的临床资料进行回顾性研究。我们使用99mTc-DTPA肾动态显像检测法对这60例患者71个患肾的肾小球滤过率（GFR）进行检测。结果：我们对这71个患肾的肾小球滤过率进行检测和分析后发现,它们中有67个患肾存在上尿路完全梗阻或不完全梗阻的情况。后经手术勘察证实,这71个患肾全部存在上尿路完全梗阻或不完全梗阻的情况。用检测肾小球滤过率的方法诊断上尿路结石引起的上尿路完全梗阻或不完全梗阻的准确率为94.4%。同时,我们根据67例进行肾小球滤过率检测被确诊发生上尿路完全梗阻或不完全梗阻患者肾小球滤过率的检测结果,将他们分为肾功能正常组（有20人）、肾功能轻度损伤组（有18人）、肾功能中度损伤组（有18人）和肾功能重度损伤组（有11人）。在这67例患肾上尿路梗阻解除前,这四组患者肾小球的滤过率分别为43.93±2.6 mL/min、23.45±1.3 mL/min、16.22±3.7 mL/min和7.92±3.4 mL/min。在这60例患者上尿路梗阻解除3个月后,他们肾小球的滤过率分别为48.72±1.7 mL/min、42.22±3.6 mL/min、33.13±4.1 mL/min和17.88±3.8 mL/min。这一结果说明,上尿路梗阻解除前肾功能较差的上尿路结石患者,其肾功能在上尿路梗阻解除后恢复的情况较差。结论：检测上尿路结石患者的肾小球滤过率可有效发现其存在的上尿路梗阻,同时可以对其解除梗阻后肾功能的恢复情况进行准确的预测。此检测方法值得在临床上推广使用。     

输尿管镜碎石术治疗急性梗阻性肾衰的疗效

目的探讨上尿路梗阻并发急性肾功能衰竭的治疗方法的疗效.方法应用输尿管镜于直视下采用气压弹道碎石、钬激光碎石,或联合ESWL碎石,共治疗上尿路结石梗阻并急性肾功能衰竭28例.结果术后患者肾功能恢复正常或接近正常,尿量恢复,结石排净率92.9%(26/28).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,可作为上尿路梗阻并发急性肾功能衰竭首选治疗方法.     

双侧尿路结石伴肾功能不全的处理体会

目的：探讨上尿路梗阻致肾功能不全理想的诊断和治疗方法。方法：对54例双侧上尿路结石梗阻引起的肾功能不全患者,根据不同病情选择适当的治疗方式,保护并改善肾功能。结果：治愈23例,占42．6％;显效21例,占38．9％;好转6例,占11．1％;无效4例,占7．4％。结论：上尿路结石梗阻并发肾功能衰竭治疗的关键是及时解除梗阻,恢复尿流,挽救和恢复肾功能。     

上尿路梗阻急性肾功能衰竭治疗

目的:探讨急性上尿路梗阻急性肾功能衰竭的急诊处理。方法 回顾上尿路急性梗阻急性肾功能衰竭病例41例,病程1～9天,肾盂急性造瘘者2例。输尿管逆行插管通过梗阻后换置双“J”管行Eswl治疗6例,手术33例,结果 21例均在院4天内解除梗阻。17例尿量增加。尿毒症状消失,BUN,CR恢复正常。9例因梗阻时间均在7天以上,BUN降至8～11mmol/l,Cr降至150～170umol/l。结论 上尿路梗阻急性肾功能衰竭应尽早诊断及时解除梗阻。早期应用有效。肾毒性低的抗生素防治并发症。     

梗阻性肾功能衰竭的诊治体会

双侧上尿路梗阻引起梗阻性急性肾功能衰竭,及时处理得当,常可减轻肾功能损害并能挽救病人生命.现将我院自1991年8月～2001年12月收治的双侧上尿路结石梗阻引起急性肾功能衰竭36例之诊治体会总结如下.     

循证护理在肾功能不全患者饮食指导中的应用

肾功能不全饮食是泌尿外科常见的一种治疗饮食,主要针对由于尿路梗阻等原因引起的急慢性肾功能衰竭的患者。梗阻所致急性肾功能衰竭大都为双侧性,临床上由前列腺(包括增生、肿瘤)所致的膀胱颈部梗阻是常见原因。当各种原因引起肾功能在短期内急剧下降,其血肌酐平均每日增加≥44     

输尿管镜在结石致上尿路梗阻并急性肾功能衰竭的临床应用

目的探讨输尿管镜治疗在结石致上尿路梗阻并急性肾功能衰竭的临床应用。方法结石致上尿路梗阻并急性肾功能衰竭患者30例,病程1~5天,其中72小时内者14例。入院后急诊行输尿管镜治疗,气压弹道碎石19例,输尿管逆行插管引流10例。结果29例于72小时内急诊解除梗阻,术后3~12天内血肌酐降至58~135μmol/L,血BUN降至2.8~7.0 mmol/L,尿量增加,肾功能衰竭症状消失。1例输尿管打折输尿管镜碎石和置管引流失败,改为经皮肾穿刺造瘘术,术后肾功能恢复。结论输尿管镜治疗结石致上尿路梗阻并急性肾功能衰竭是有效的治疗方法,对及时挽救肾脏功能有重要意义。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.