肾癌患者治疗方法的选择

目的:探讨肾细胞癌的不同手术方式、术前肾动脉栓塞及免疫治疗的临床应用价值。方法:回顾性分析179例肾细胞癌患者的临床资料。对患者的临床资料分组进行对比,并对治疗效果和随访结果作进一步统计学分析。结果:小肾癌行肾癌根治术与保留肾组织手术效果比较,在手术时间、术后住院时间、术后5年生存率上差异均无统计学意义(P>0.05);78例术前行选择性肾动脉栓塞者,手术证实栓塞效果满意。结论:保肾单位手术是治疗局限性小肾癌的有效手段;较大的肾癌术前进行肾动脉栓塞术便于手术切除病灶,提高了肿瘤的切除率;免疫治疗是继手术治疗之后的又一种主要临床治疗方式,尤其肿瘤疫苗的出现,对于晚期肾癌及转移癌效果明显。     

葡立胶囊与抗骨增生胶囊联用治疗颈椎病的临床研究

目的 了解、观察葡立胶囊与抗骨增生胶囊联用治疗颈椎病对血清SOD含量及疼痛功能评分的影响。方法 对一组神经根型颈椎病患者，用葡立胶囊与抗骨增生胶囊联合应用治疗3个月，测定血清SOD含量及疼痛功能评分变化。结果 颈椎病患者治疗组血清SOD含量与治疗前相比明显升高，疼痛功能评分治疗前相比明显降低。结论 葡立胶囊与抗骨增生胶囊联合应用可明显缓解症状，提高血清SOD活力，延缓颈椎间盘退变，对治疗颈椎病有明显疗效。     

Focal segmental glomerulosclerosis

Over the last 2 decades, we have learnt that focal segmental glomerulosclerosis (FSGS) is a ubiquitous phenomenon underlying the progressive deterioration of many different types of renal diseases in both pediatric and adult populations. FSGS may also be the primary renal lesion, whether in new disease entities such as glycogen storage disease and human immunodeficiency virus infection, or in idiopathic FSGS. Although the mechanism which triggers the development of primary FSGS still remains unknown, laboratory and clinical studies have identified several key pathophysiological events leading to end-stage renal disease. While therapeutic modalities have not changed remarkably, a recent study, although uncontrolled, demonstrated an impressive efficacy of intravenous steroid pulse therapy in inducing remission. Nevertheless, it remains largely unknown whether such a forced remission decreases the overall risk of developing chronic renal failure. Studies have revealed an important pathophysiological role of angiotensin and the therapeutic efficacy of angiotensin converting enzyme inhibitors in progressive loss of renal function in diseases where glomerulosclerosis is secondary; however, it remains to be verified whether these results hold true in primary FSGS. As a result of the improvement in allograft survival rate, the benefit of renal transplant outweighs the risk of recurrence of FSGS, hence transplantation continues to be a vital therapy for FSGS patients who have reached renal failure. Thus, FSGS is not one disease, but rather a range of lesions seen in many settings. The type of lesions and the patient's unique genetic factors contribute to prognosis, and also may dictate choice of optimum therapy.     

Ureteral obstruction in the neonatal rat: Renal nerves modulate hemodynamic effects

In the neonate, chronic unilateral ureteral obstruction (UUO) reduces renal blood flow (RBF) of the ipsilateral kidney and increases RBF of the opposite kidney. To determine whether renal nerves mediate or modulate these responses complete left UUO in the neonatal rat was used as a model of severe obstructive uropathy, and was compared with sham-operated controls. At 24–28 days of age, animals underwent left or right mechanical renal denervation or left sham renal denervation. One week after denervation, animals were anesthetized and blood pressure and heart reate were measured. Cardiac output and RBF were determined by the radioactive microsphere technique. UUO increased blood pressure and heart rate, and decreased RBF in the obstructed kidney, regardless of denervation. While left UUO increased RBF to the intact opposite kidney in rats with left renal denervation, this was attenuated by right renal denervation. Thus, in the neonatal rat, UUO modulates systemic renal hemodynamics, possibly through activation of the renin-angiotensin system. While renal nerves do not mediate the vasoconstriction of the obstructed kidney, renal nerves modulate vascular tone of the kidney contralateral to UUO.     

肾移植患者血脂,脂蛋白和载脂蛋白变化及其临床意义

观察了４６例肾移植患者血浆脂质代谢的改变，结果显示，肾移植患者血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、极低密度脂蛋白胆固醇（ＶＬＤＬ－Ｃ）和载脂蛋白（ａｐｏ）Ｂ１００明显升高，而ａｐｏＡＩ、ａｐｏＡＩａｐｏＣⅡ／ａｐｏＣⅢ明显降低，同时还观察到，有心脑血管合并症的病者血ＴＣ、ＴＧ、ＴＣ／ＨＤＬ－ｃ、ａｐｏＢ１００升高ａｐｏＡＩ降低比合并症的病者更显著。上述结果表明肾移植后脂质代谢有明显改变，且存在加     

Influence of differences in tumor vascularity upon the effects of hyperthermia

Summary Utilizing two types of human renal carcinoma heterotransplanted in nude mice, we investigated the variations in hyperthermic effects (42.5°C for 30 min) caused by differences in tumor type with special reference to variations in tumor vascularity. In the hypovascular JRC1 strain, sporadic vascular dilation was observed throughout the tumors after heating. Destruction of tumor cells was observed mainly in the region of dilation. In the hypervascular JRC11 strain, homogenous vascular dilation was observed immediately after heating, mainly at the periphery of tumors. There was a decrease in the viability of cells in the center of the tumor. Therefore, the hypervascular tumors showed greater destruction mainly at the center where blood circulation was reduced. The range of necrosis was also greatly affected by the extent of vascular dilation caused by heating in hypovascular tumors.     

Regression of Pulmonary and Multiple Skeletal Metastases from Renal Cell Carcinoma by Nephrectomy and Alpha-interferon Therapy: A Case Report

We report a rare case of advanced renal cell carcinoma in apatient who showed complete resolution of metastases to thelung and bones after nephrectomy, partial jejunectomy and subsequentalpha-interferon therapy. The patient was a 54-year-old manwhose right lung and left femur metastases were detected beforenephrectomy. In the seventh week after nephrectomy, a partialjejunectomy was carried out because of the obstructive ileuscaused by intraluminal multiple metastases of the jejunum. Apathological fracture of the metastasized right humerus occurredsubsequently. After four months of intramuscular alpha-interferonadministration (3x106 units/day), however, x-rays revealed thecomplete disappearance of the metastatic lung shadow and a solidunion of the humerus, and there were no tumor cells in the femurspecimen resected at the subsequent reconstruction surgery ofthe left leg. Seven years have passed from onset, and the patientis still alive and disease free.     

肾综合征出血热地鼠肾细胞Ⅱ型灭活疫苗的安全性、免疫性及其流行病学效果考核

目的：考核HFRS地鼠肾细胞Ⅱ型灭活疫苗的安全性、免疫法及其流行病学效果。方法：采用间接免疫荧光抗体试验（IFA）、微量细胞变性中和试验（MCPENT），检测接种者血中荧光抗体及中和抗体水平；调查接种组与对照组发病情况。结果：以怀宁、广德两县18个村为疫苗观察现场，接种组7499人，对照组7261人，中强反应率为224％（5／223）。3针全程免疫后中和抗体阳转率为63．33％（19／30），荧光抗体阳转率为38.58％（27／70）；接种后1年内接种组无发病，对照组发病3例。结论：该疫苗的安全性较好；有一定水平的免疫应答，但防病效果应进一步观察确证。     

继发性甲旁亢的锁骨骨吸收

１８例慢性肾衰继发性甲旁亢病人发现有锁骨骨吸收。发病部位包括锁骨内端、外端、外１／３下缘及内段下缘４个部位。其中锁骨内、外端骨吸收属软骨下骨吸收，内、外段下缘骨吸收属韧带下骨吸收。作者对锁骨骨吸收的Ｘ线表现及发病机制作了讨论。认为锁骨骨吸收是继发性甲旁亢的重要Ｘ线征象，对诊断肾性骨病具有重要的意义。