经皮肾微造瘘输尿管镜取石术在肾鹿角形结石中的疗效与安全性观察

目的:探讨经皮肾微造瘘输尿管镜取石术在肾鹿角形结石中的疗效与安全性。方法:选取经皮肾微造瘘输尿管镜取石术进行治疗的20例肾鹿角形结石患者为观察组,并将同期的20例采用开放式手术进行治疗的患者设为对照组,将两组患者的一次结石取净率、术中出血量、手术时间、术后住院时间及并发症发生率进行统计与比较。结果:观察组在一次结石取净率、术中出血量、术后住院时间及并发症发生率均优于对照组,P<0.05,手术时间两组则无明显差异,P>0.05。结论:经皮肾微造瘘输尿管镜取石术在肾鹿角形结石中的疗效和安全性优于开放式手术。     

经皮肾穿刺微造瘘与内引流分期治疗结石性脓肾的疗效分析

目的 探讨经皮肾穿刺微造瘘与内引流分期治疗结石性脓肾的疗效.方法 选取本院2016年9月至2019年1月收治的80例结石性脓肾患者,一期行皮肾穿刺微造瘘或内引流治疗,二期行经皮肾镜取石术、经尿道输尿管镜取石术或肾切除术治疗,观察治疗效果及预后.结果 80例结石性脓肾患者中,一期行经皮肾穿刺微造瘘术70例,行经尿道输尿管镜下置双J管内引流术10例,手术治疗后病情均快速平稳康复;二期行腔内取石术75例,其中行经尿道输尿管镜取石术15例,一次取净15例(100.00％),行经皮肾镜取石术60例,全部取净55例(91.67％),均未发生严重并发症.75例保肾患者随访6个月,结果显示,轻中度组患肾功能好转率高于重度肾组,上尿路反复感染发生率低于重度肾组,差异均有统计学意义(P<0.05).70例一期行经皮肾穿刺微造瘘术保留患肾患者随访6个月,结果显示,造瘘术后1 d,引流量≥200 mL组患者患肾功能好转率高于引流量<200 mL组,上尿路反复感染发生率低于引流量<200 mL组,差异均有统计学意义(P<0.05).结论 在对结石性脓肾患者的临床治疗中,经皮肾穿刺微造瘘与内引流分期治疗理想,且术前肾功能受损程度轻,造瘘术后1 d平均引流量≥200 mL的患者的治疗效果及预后更佳.     

经皮肾镜取石术治疗合并肾结核之上尿路结石的临床分析

目的探讨经皮肾镜取石术治疗上尿路结石合并肾结核的可行性。方法行经皮肾镜术后确诊的肾结核病人4例,肾结石3例,肾结石合并输尿管上段结石1例;术前可疑肾积脓2例,行结核相关检查,结果提示阴性。4例患者均行经皮肾镜碎石取石术,术中发现肾内均有不同程度积脓,予吸净脓液,用超声碎石取石,术毕取病理活检。结果术后病理结果提示肾结核3例,随访1~2年,病情治愈,肾盂黏膜慢性炎症1例,术后肾造瘘通道反复流脓,抗结核治疗半年后行患肾切除,术后病理报告为肾结核。结论结核合并结石并非经皮肾镜手术的绝对禁忌证,结合有效抗结核治疗,行经皮肾镜取石术可有效缩短病程,保留肾功能。     

经皮肾穿刺微造瘘输尿管镜治疗肾鹿角状结石

目的：评价微创经皮肾镜取石术治疗肾鹿角状结石患者的方法及疗效。方法：用经皮肾穿刺微造瘘输尿管镜下气压弹道碎石处理肾鹿角状结石34例。结果：33例均I期手术取石，单通道取石22例，双通道取石11例；其中1次取石21例，2次取石11例，3次取石1例。26例结石全部取尽，余7例有少许残留，术后行ESWL，3例结石全部排出。仅1例于术中出血终止手术，结石未取出，术后35天继发大出血，行肾切除。平均手术时间108分钟，平均出血量180mL，住院时间为5-32天，平均16．8天。结论：微创经皮肾镜取石术治疗肾鹿角状结石的疗效确切，具有创伤小、并发症少、疗效好、恢复快等优点，值得推广应用。     

经皮肾镜治疗17例结石性脓肾的临床疗效

目的:探讨经皮肾镜联合第四代EMS碎石清石系统治疗结石性脓肾的疗效和安全性。方法:选择2012年8月至2013年11月我院收治的17例结石性脓肾患者,均在本院行经皮肾镜治疗。其中,12例行肾穿刺造瘘引流后Ⅱ期手术治疗,5例行Ⅰ期手术治疗。术中保持低灌注压,时间控制在1h内。结果:本组17例患者,其中,有13例患者一次取净结石,1例术后残留结石>1.5cm,一周后再次行经皮肾镜,另建通道,将结石取净,3例术后残留结石<1.5cm,行体外冲击波碎石术后将结石排净,一次碎石成功率为16/17。经皮肾镜取石术能迅速解除梗阻,清除脓液,术后患者均无严重并发症。结论:经皮肾镜是治疗结石性脓肾的有效方法,临床上可分Ⅰ期(经皮肾镜)或Ⅱ期(肾造瘘后再经皮肾镜)进行治疗。     

经皮肾镜及输尿管镜治疗肾输尿管结石临床分析

目的：探讨经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石的手术疗效及安全性。方法：回顾性分析2011—07—2013—06经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石63例病人的临床资料。结果：59例病人一期手术取得成功，结石取尽率（59／63）93．7％，手术时间30～100min，平均45min，l例输尿管结石因组织包裹转为开放手术取石，1例术后复查示结石残留行体外冲击波碎石，2例因残留的结石均〈6mm予以药物排石治疗。病人平均住院时间为7．5d。1例病人术后出现菌血症，1例发生轻度肾周血肿，无其它严重并发症。结论：经皮肾镜及输尿管镜碎石取石术治疗肾及输尿管结石具有创伤小、碎石成功率高、并发症少的优点，是一种安全有效的方法。     

经皮肾输尿管镜碎石联合肾舒冲剂治疗上尿路结石

目的总结经皮肾微造瘘输尿管镜碎石、取石术(PCNL)联合肾舒冲剂治疗肾、输尿管上段结石的临床价值。方法在B超引导下经皮肾穿刺造瘘,将通道扩张至F14-18,从造瘘通道插入输尿管镜到结石处,用气压弹道碎石机将结石击碎,取出碎石片。术后口服肾舒冲剂,促进排石、消炎和肾功能恢复。结果42例患者,27例一期取净结石,8例1周后二期取净结石,7例肾盏内有小块结石残留,经体外震波碎石(ESWL)或软性膀胱镜取石后治愈。结论经皮肾微造瘘碎石、取石术疗效佳,损伤小,安全性较高,可作为治疗肾、输尿管上段复杂结石的重要方法,若与ESWL结合疗效更佳。术后应用肾舒冲剂促进消炎、利尿、排石,有助于患者的康复。     

输尿管结石微创治疗的进展

输尿管结石根据结石的位置、大小、数目及成分等可分别采用的微创治疗方法有体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)、输尿管镜碎石术(ureteroscopy lithotripsy,URL)、经皮肾镜取石术(percutaneous nephrolithotripsy,PCNL),而对于各种原因无法行体外冲击波碎石术、输尿管镜碎石术及经皮肾镜取石术或治疗失败者,采用腹腔镜取石术(laparoscope lithotomy)。     

B超引导下经皮肾镜取石术治疗开放手术后复发肾结石疗效观察

目的探讨B超引导下经皮肾镜取石术治疗开放手术后复发肾结石的疗效。方法对38例开放手术后复发肾结石患者采用B超引导下经皮肾镜取石术,建立经皮肾通道(F16～24),经皮肾镜或输尿管镜下钬激光或体外冲击波碎石术(ESWL)碎石。结果 38例患者手术均取得成功,单通道完成手术36例,双通道2例。手术时间48～120min,平均82 min。一期结石清除率76.3%(29/38)。2例术后发热>38.5℃,经抗感染治疗后好转;1例术中及术后出血较多予输血治疗;无一例损伤肝、脾、肠道等重要脏器及其他严重并发症。结论 B超引导经皮肾镜取石术治疗开放手术后复发肾结石安全、有效。     

一期双通道微造瘘经皮肾镜治疗肾鹿角状结石24例

传统开放手术对肾鹿角状结石的处理较为困难,风险较大,尤其是有开放手术取石史者。体外冲击波碎石对鹿角状结石疗效差[1]。随着泌尿腔镜技术的发展,美国泌尿学会尿石症临床治疗指南推荐经皮肾穿刺取石术作为治疗鹿角状结石的首选方案,同时也指出,为清除结石,建立2个或者更多的通道是必要的[2]。作者分析河南省人民医院泌尿外科收治的56例鹿角状结石患者的资料,探讨一期双通道微造瘘经皮肾镜治疗鹿角状结石的疗效。     

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.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.