球囊扩张治疗输尿管狭窄172例临床观察

目的 评价逆行球囊导管扩张输尿管狭窄的治疗效果.方法 采用球囊导管对172例输尿管狭窄患者进行扩张治疗,以上病例分为两组,原发性输尿管狭窄组与继发性狭窄组,均采用逆行法,扩张后均留置双J管.结果 155例扩张成功,症状和肾积水缓解,肾功能改善,17例拔山双J管后发生再狭窄,其中6例患者严重再狭窄,肾积水加重需手术治疗.结论 腔内球囊扩张治疗输尿管狭窄是一种安全有效、简便易行的方法.     

腔内三重双J管引流在输尿管狭窄治疗中的价值探讨

目的:探讨腔内三重双J管引流技术治疗输尿管狭窄的可行性。方法:2004年3月—2007年6月对27例输尿管狭窄采用输尿管腔内置入3根相同大小的双J管引流,术后留置10~12周。结果:27例随访2~24个月。26例拔管后无腰胀、发热等症状。IVP示引流通畅,患肾积水排空好,无输尿管狭窄。1例术后6个月复查IVP,肾积水仍无改善,改开放手术。本组治疗成功率96%。结论:腔内三重双J管引流技术治疗输尿管狭窄可行。     

球囊导管扩张双J管置入治疗输尿管狭窄

<正>输尿管狭窄的介入治疗包括球囊扩张、双J管及支架置入。笔者自2000-02-2006—04对10例输尿管狭窄患者行介入治疗,现将结果总结如下。1资料与方法1．1一般资料本组输尿管狭窄的患者10例,均经静脉肾盂造影(IVP)或逆行造影确诊。女6例,男4例:年龄25—68     

晚期肿瘤腔内支架成形术结合动脉内灌注化疗双介入疗法在临床上的应用

目的 探讨“双介入法”治疗晚期肿瘤所致管腔狭窄或阻塞的疗效和临床价值。方法 本组10例患者有完整的随访资料，所有病全铣 行导丝通过狭窄段或潜在的腔隙行球囊扩张后，置入支架，定期行肿瘤供血动脉规范性的插管化疗。结果 10例患者均开通成功，置入支架12枚，所有病例术后均行多次动脉插管灌注化疗，临床症状及体征均有不同的缓解，生存期延长。结论 双介入疗法为晚期肿瘤所致的管腔狭窄或阻塞提供了一条有效的治疗途径。     

膀胱镜下输尿管扩张法治疗输尿管末端狭窄11例分析

目的探讨膀胱镜下输尿管扩张法治疗输尿管末端狭窄的临床疗效。方法膀胱镜直视下输尿管扩张导管置入输尿管内扩张并留置双J管3个月。结果11例均成功扩张并留置双J管,手术后1～3月复查。肾积水及输尿管中上段扩张明显缓解或消失。结论膀胱镜下输尿管扩张法治疗输尿管末端狭窄并长期留置双J管可以有效治疗狭窄引起的肾积水及腰部症状,保护肾功能。     

选择性冠状动脉内直接支架植入治疗不稳定型冠状动脉综合征的研究

目的探讨对选择性冠状动脉病变进行不作球囊预扩张的直接冠状动脉支架置入术的可行性和安全性。方法不稳定型冠状动脉综合征患者40例,通过冠状动脉造影,将可进行支架治疗的患者分为不作预扩张直接支架置入A组(22例)和作预扩张支架置入B组(18例)。对两组患者治疗后的一般情况及治疗7d后在管腔残余狭窄、心肌灌注成功人数以及cTnT进行比较。结果 A组和B组之间的结果没有统计学差异(P>0.01)。A组和B组之间治疗7d后在管腔残余狭窄、心肌灌注成功人数以及cTnT的结果没有统计学差异(P>0.01)。结论在选择好适应症的前提下,不作预扩张直接支架置入和球囊扩张及支架植入治疗结果没有统计学差异,因此可以进行不作预扩张直接支架置入以节约手术时间。     

肾盂输尿管连接部狭窄的手术治疗

目的 探讨离断性肾盂成形术,双J管内引流治疗肾盂输尿管连接部狭窄的诊治经验.方法 采用离断性成形术治疗肾盂输尿管连接部狭窄46例,共52例,采用双J管作内引流,术后1个月拔除双J管,3个月后复查静脉肾盂造影和肾功能.结果 40例随访3～6个月,治愈37例,治愈率92.5%,3例发生再狭窄,均2次行肾盂成形术.结论 离断性肾盂成形术,是治疗肾盂输尿管连接部狭窄的有效方法,术中使用双J管能减少术后再狭窄的发生.     

球囊扩张联合双D-J管置入治疗医源性输尿管狭窄21例

目的：观察球囊扩张联合双D-J管置入治疗医源性输尿管狭窄的效果。方法21例医源性输尿管狭窄患者采用球囊扩张联合双D-J管置入治疗。结果21例手术均顺利，无中转开放手术者。治愈15例（71.4%），好转、无效各3例（各14.3%）。结论在选择合适病例、与患者进行有效沟通、做好充分术前准备的基础上，采用球囊扩张联合置入双D-J管内引流是治疗医源性输尿管狭窄的有效方法。     

脑动脉狭窄支架置入术后再狭窄与同型半胱氨酸的相关性

目的 分析脑动脉狭窄支架置入后支架内再狭窄与同型半胱氨酸的关系.方法 将55例成功接受支架置入治疗的脑动脉狭窄患者,根据同型半胱氨酸水平分组:正常组(n=30)、升高组(n=25).支架置入后患者常规行脑血管造影随访,以原靶病变管腔直径狭窄≥50％为支架内再狭窄,分析同型半胱氨酸与脑动脉支架术后再狭窄的关系.结果 55例患者中,6例发生支架内再狭窄,占11％,其中正常组中有2例发生再狭窄,升高组中有4例发生再狭窄.升高组中支架内再狭窄比率明显高于正常组(P＜0.05).结论 高同型半胱氨酸血症加大脑动脉支架置入后再狭窄的风险,对于高同型半胱氨酸血症的治疗或可降低支架再狭窄的几率.     

双J输尿管内支架管滞留后的处理

双J输尿管内支架管广泛应用于各种上尿路手术中，术后能起到很好的内支架和内引流作用，有效的解除上尿路梗阻，并一定程度上预防了术后上尿路的狭窄，且膀胱镜下即能拔管、换管。但如放置不当或长时间留置会造成输尿管内支架管滞留，以至拔管困难。1996年10月-2006年3月，我院收治双J输尿管内支架管滞留患者16例，报道如下。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Glycofection: The Ubiquitous Roles of Sugar Bound on Glycoplexes

Glycofection (transfection by using sugar-substituted polylysine) was assessed in order to provide an alternative to viral vectors for the transfer of genes into vascular smooth muscle cells. A rabbit vascular smooth muscle cell line (Rb-1 cells) was selectively transfected by using glycoplexes (glycosylated polylysine/pSV2LUC complexes) in the presence of 10 mu M of the fusogenic peptide GALA. A sugar-specific transfection was obtained when the glycofection was conducted for 1 h with glycoplexes containing either alpha Gal, alpha -Glc, alpha -GalNAc, beta -GlcNAc, or beta -GalNAc residues. The gene expression was high after transfection, with glycoplexes bearing alpha Gal, alpha -GalNAc, or beta -GalNAc residues that were weakly internalized, and low with glycoplexes carrying Lact or Rha residues that were well taken up by cells. These results suggest that 1) glycofection can be a good approach for a selective transfer of genes intovascular smooth muscle cells, 2) an efficient uptake of the glycoplexes is not the unique limiting step for an efficient transfection, and 3) the sugar-dependent trafficking of the glycoplexes inside the cells may account for the transfection efficiency.     

直肠癌下切缘病理组织学分析

目的探讨直肠癌逆向浸润与下切缘的安全距离的关系。方法对36例直肠癌Miles手术和Dixon手术后标本的肿瘤下缘1.0cm、2.0cm、3.0cm的肠壁及对应的系膜病理组织学检查,观察直肠癌逆向浸润或转移的距离。结果36例直肠癌标本距癌肿下缘1.0 cm、2.0cm、3.0cm的肠壁及对应的系膜病理组织学检查均为阴性,结论直肠癌远恻逆向浸润或转移未见超过1.0cm,因此认为保肛手术时切除肿瘤远侧肠管(包括系膜)2.0cm是安全的。