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1.
目的比较经皮肾镜(PCNL)与输尿管软镜(FURS)治疗肾下盏小鹿角形结石的安全性及有效性。 方法回顾性纳入并分析我院2017年4月至2019年4月43例肾下盏小鹿角形结石,其中PCNL治疗20例(PCNL组),FURS治疗23例(FURS组),比较两组手术时间、结石清除率、手术并发症和术后住院天数等。 结果43例均顺利完成手术,PCNL组的手术时间、术后住院天数均显著长于FURS组(P<0.05);术后1~4 d PCNL组结石清除率85.0%,显著高于FURS组52.2%,术后4周及术后半年两组结石清除率差异无统计学意义(P>0.05),但FURS组的二次干预率更高(P<0.05);两组在术后发热、出血及石街形成等方面差异无统计学意义(P>0.05),但PCNL组的血红蛋白丢失量及术后止痛药使用率更高(P<0.05)。 结论PCNL与FURS在治疗肾下盏小鹿角形结石均安全、有效,两者远期疗效相当,但FURS比PCNL创伤更小,术后恢复更快,值得临床推广。  相似文献   
2.
目的观察2型糖尿病(T2DM)患者行输尿管软镜碎石术(FURL)后出现感染相关并发症的影响因素,探讨T2DM患者术前血糖水平与发生术后感染相关并发症的关系,为T2DM患者在接受FULR术后发生感染相关并发症的早期预防及治疗提供参考。  相似文献   
3.

Background

Photosensitizers used for photodynamic therapy (PDT) to treat dermatologic disease are metabolized into mainly protoporphyrin IX (PpIX), which has five absorption wavelength peaks: 410?nm, 510?nm, 545?nm, 580?nm, and 630?nm. Although only red light around 635?nm and blue light around 400?nm are used as light sources for PDT, the efficiency of PDT might be improved by using multiple wavelengths, including those that correspond to the other absorption peaks of PpIX. Furthermore, because the target disease often occurs on the face, a flexible-type light-source unit that can be fitted to the lesion without unnecessarily exposing the mucous membranes, e.g., the eyes, nostrils, and mouth, is preferred.

Objective

We investigated the efficacy of a flexible light-emitting diode (LED) unit that emits multiple wavelengths to improve PDT effects.

Methods

HaCaT cells were incubated with 5-ALA and subsequently irradiated with either a single wavelength or sequentially with two wavelengths. Cell viability and reactive oxygen species were analyzed. Nude mice were implanted with COLO679 cells by subcutaneous injection into the flank. 5-ALA was subcutaneously injected into the tumor. The tumor was irradiated with 50?J/cm2 (day 0) and assessed daily until day 21.

Results

The synergistic PDT effects of dual-wavelength irradiation and reactive oxygen species production were highest with the 405-nm and 505-nm wavelength combination. This dual wavelength combination was also the most effective in vivo.

Conclusion

We could therefore conclude that dual-wavelength PDT is an efficient strategy for improving the therapeutic effects of PDT. Using a flexible LED unit is expected to achieve more uniform irradiation of uneven areas.  相似文献   
4.
社会人口老龄化使传统的“以医院为中心的医疗保健”模式逐渐发生改变,中医药在慢性病诊疗方面有得天独厚的优势,但是传统的中医四诊模式、依靠医生主观经验、只能采集静态数据等束缚了中医长足发展。近年来,中医药发展已上升至国家战略,中医药产业势必要寻求新科技相结合发展。随着微纳技术、柔性电子、电子皮肤、可植入芯片、3D打印技术的不断发展和日趋完善,可穿戴技术已广泛应用于医疗健康领域,实现了远程医疗。可穿戴技术在中医诊断、疗效评价、养生、经络诊疗、治未病等方面均表现出强大的应用潜力。未来,医生和工程师通力合作,多学科交叉融合,必将推动中医药健康事业的飞速发展。本文对近5年国内外可穿戴技术在中医药领域的应用进行综述。  相似文献   
5.
How to cite this article: Sehgal IS, Dhooria S, Agarwal R. Should Flexible Bronchoscopy be Routinely Performed in Aspiration Pneumonitis: Non Liquet. Indian J Crit Care Med 2021;25(2):113–114.  相似文献   
6.
Introduction and objectivesCurrently, there are no established criteria regarding treatment for lumbar ureteral stones. The objective of this work is to present our results in the endourological treatment of this pathology, analyzing the variables associated with the use of the flexible ureterorenoscope.Material and methodsRetrospective review of 103 patients who underwent retrograde URS with semi-rigid or flexible ureterorenoscope. Proximal location: L2-L3. Medial location: L4-L5. Semirigid URS was the initial treatment, with conversion to flexible URS when it was required to complete the procedure. Success was defined as absence of residual fragments (6 weeks). Demographic, surgical, immediate postoperative variables, and those related to the stone, were analyzed. Their correlation with the use of the flexible ureterorenoscope was evaluated.ResultsMean age: 57.2 years (SD 15.6); there were 73 men (70.9%). Stone size: 8 mm (range 4-30; IQR 4.5). Proximal location: 58 (56.3%). Previous JJ: 44.7%. Previous nephrostomy: 10.7%. Semirigid URS with conversion to flexible URS: 51 (49.5%). Impacted stones: 28.2%. Intraoperative complications: 2 (1.9%). Postoperative JJ: 84.5%. Immediate postoperative complications: 23 (22.3%) (Clavien-Dindo I-II: 91.3%). Postoperative ureteral stricture: 5.8%. Success: 88.4%. Residual fragments: 12 (11.7%). Spontaneous passage: 6 (50%). Greater performance of flexible URS in proximal ureteral stones (P = 0.001) of more than 11 mm (P = 0.02) in univariate analysis, and in proximal stones [OR 3.5; 1.5-8.1; P = 0.004] in multivariate analysis.ConclusionsEndourological treatment obtained a high success rate in our sample. Size greater than 11 mm and proximal ureteral location in univariate and multivariate analysis, respectively, behaved as predictors of flexible URS.  相似文献   
7.
目的:探讨诊断性输尿管镜检查(URS)对上尿路尿路上皮癌(UTUC)患者根治手术后膀胱内复发(IVR)的影响。方法:回顾性分析1998年1月—2019年6月于浙江大学医学院附属第二医院(156例)和上海仁济医院(802例)就诊的958例UTUC患者的临床及随访资料。男630例,女328例,中位年龄67(30~89)岁。518例行诊断性URS(URS组),440例未行诊断性URS(非URS组)。伴有术前肾积水499例,糖尿病史138例,有吸烟史252例,非肌层浸润型膀胱癌(NMIBC)病史或合并NMIBC119例;肿瘤位于肾盂489例,位于输尿管394例,同时位于肾盂及输尿管75例。543例采取了腹腔镜手术,415例采取了开放手术。196例术后进行辅助化疗。病理检查结果显示,肿瘤直径≤3 cm 543例,>3 cm 415例;病理分级为低级别275例,高级别683例;病理分期为Ta~1期441例,T2期180例,T3期308例,T4期29例;227例进行淋巴结清扫,其中62例病理检查证实淋巴结转移;516例肿瘤呈乳头状,442例呈平坦状;48例伴有鳞状或腺样分化;150例存在淋巴血管侵犯(LVI);134例为多灶性生长。两组年龄(P=0.660)、性别(P=0.618)、糖尿病史(P=0.418)、吸烟史(P=0.173)、术前肾盂积水(P=0.777)、WHO分级(P=0.105)和肿瘤形态(P=0.051)比较差异均无统计学意义。而相较于非URS组,URS组有着更低的开放手术(P=0.032)、伴有NMIBC病史或合并NMIBC(P<0.001)、>3 cm肿瘤(P<0.001)、浸润性分期(P<0.001)、淋巴结转移(P<0.001)、鳞状或腺样分化(P=0.018)、LVI阳性(P=0.031)及多灶性生长(P=0.032)的比例。比较两组术后1年和5年膀胱内无复发生存率(IRFS)。Kaplan-Meier法绘制生存曲线,采用Cox比例风险模分析影响IRFS的因素。结果:本研究中位随访39(2~206)个月,192例(20.0%)发生IVR,其中URS组121例,非URS组71例。URS组1年和5年IRFS分别为87.1%和71.6%,低于非URS组的90.6%和80.9%(P=0.014)。Cox多因素回归分析结果显示URS(P<0.001)、伴有NMIBC病史或合并NMIBC(P<0.001)及肿瘤直径>3 cm(P=0.005)是IVR的独立危险因素。结论:20.0%的UTUC患者行根治手术后会出现IVR,URS是IVR的独立危险因素之一。  相似文献   
8.
《Surgery (Oxford)》2021,39(11):742-747
In the past two decades, endourological procedures such as ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) have become the mainstay of managing kidney stone disease (KSD), with URS also used for investigating upper urinary tract lesions. Post-endourological infections affect between 1% and 6% of cases. Numerous risk factors have been identified, including longer operative times and indwelling ureteric stents, but the literature is largely heterogeneous. Identification of risk factors preoperatively include the use of pre-operative urine culture, minimizing stent dwell time and targeted antibiotic use. Intraoperatively, efforts need to be made in minimizing operative times and intra-renal pressures. Although rare, urinary tract infections following endourological procedures remain a risk, with a smaller minority developing potentially deadly urosepsis. Clinical decisions on prevention and treatment of severe sepsis have to be individualized based on the risk factors. Machine learning techniques are currently being utilized to build these tools and might provide an answer in the future.  相似文献   
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