The evaluation of early and late results of using Codubix cranial prosthesis

The filling of the cranial defect is an essential problem in neurosurgery on account of the necessity of brain protection as well as for cosmetic reasons. The aim of this study was to evaluate the direct and distant outcome after polypropylene-polyester Codubix prosthesis implantation. This research was based on the analysis of 41 patients treated surgically in the Department of Neurosurgery at the Jagiellonian University in Cracow between 1995-2004. All patients had the Codubix prosthesis implanted. The implantation was performed either synchronously or after the surgery which caused the cranial defect. Directly after the surgery proper healing of the prosthesis could be observed in all patients. The exception was one patient who died directly after the surgery but the cause of his death was not connected with the prosthesis implantation. Seven patients (17,1%) had the temperature temporarily elevated. Three had haematoma collection in the subgaleal space, one (2,4%) developed meningitis which was successfully treated with antibiotics, one (2,4%) suffered from temporary circulation disturbances of the scalp. The late evaluation was performed with help of a questionnaire to which 30 patients (73,2%) responded. The answer ranged 73,2% (30 patients). In this group 16 patients (53,4%) described the cosmetic effect as very good, 10 patients (33%) as good and 4 (13,3%) as unsatisfactory. The commonest reason for the critical note was the depression of the plate which happened to 3 patients. The other 3 patients complained about inappropriate profile of the plate causing the asymmetry of the cranial vault. Seven patients felt temporary pain in the postoperative scar, in one case the pain was took as the friction between the prosthesis and bone margin. Properly performed implantation of accurate bone prosthesis Codubix is safe and usually brings a good cosmetic effect. Direct complications are transitional and occur in the small percent of cases. Distant examinations show generally good therapeutic results but implanted Codubix requires suitable shape and careful fixation.     

膀胱颈电切术治疗女性膀胱颈梗阻

目的探讨膀胱颈电切术治疗女性膀胱颈梗阻的疗效。方法对34例女性膀胱颈梗阻患者行膀胱镜检查和尿动力学检查,行经尿道膀胱颈电切术治疗。结果随访6-12个月,最大尿流率、术后剩余尿量、尿道控制面积较术前明显改善（P〈0.05）,术后临床症状消失,无并发症,效果满意。结论膀胱颈电切术是治疗女性膀胱颈梗阻的有效方法。     

早发型与晚发型重度子痫前期临床生化指标比较

目的对比早发型与晚发型子痫前期临床生化指标,为抗凝治疗提供依据。方法选取子痫前期患者220例,以孕龄34周为界,分为早发型包括轻度40例(A组),重度60例(B组),与晚发型轻度60例(C组),重度60例(D组),对比4组凝血纤溶指标,血浆同型半胱氨酸,血脂的差异。结果早发型重度子痫前期血凝血酶原时间(PT),活化部分凝血酶原时间(APTT)均缩短,血小板计数(PLT)下降,而纤维蛋白原(Fg)、D-二聚体(DD)、组织纤溶酶原激活物(t-PA)、组织纤溶酶原激活物抑制剂(PAI-1)均升高,血浆同型半胱氨酸升高,与晚发型对比,2组差异有统计学意义(P<0.05)。早发型重度子痫前期患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、载脂蛋血B(apoB)明显高于晚发组;而HDL、apoA低于晚发组,2组差异有统计学意义(P<0.05);结论早发型重度子痫前期患者存在高脂血症,高同型半胱氨酸血症,处于过高凝状态,抗凝治疗很有必要。     

Ciprofloxacin and furagin in acute cystitis: comparison of early immune and microbiological results

Furagin (a nitrofurantoin analogue) has the same efficacy in treating acute cystitis as ciprofloxacin, however the duration of therapy is longer. We established a hypothesis that therapy with ciprofloxacin results in faster resolution of mucosal inflammation in comparison with furagin. Rates of urinary secretion of immunoglobulins class A, M and G and interleukin-8 (IL-8) were evaluated before and after initiation of therapy in adult women presenting with acute cystitis confirmed by urine culture. Women were randomised into two groups receiving either ciprofloxacin 250mg twice a day for 3 days (n=13) or furagin 100mg three times a day for 7 days (n=14). Median lengths of follow-up were 4 days and 5 days in the ciprofloxacin and furagin groups, respectively. Treatment with ciprofloxacin resulted in faster eradication of pathogens. No bacteria or nitrates were detected in the ciprofloxacin group, whilst leukocyte esterase was positive in only one case. In the furagin group there were four positive cultures, seven cases with positive nitrates and five cases with positive esterase. Secretion rates of all four substances dropped significantly, but the changes over time were similar in both groups.     

经尿道电切术治疗女性原发性膀胱颈梗阻的临床体会

目的：探讨经尿道电切术治疗女性原发性膀胱颈梗阻的方法和疗效。方法：52例患者,诊断方法以临床症状、尿动力学和膀胱镜检查为主,均行经尿道膀胱颈部电切术。结果：52例拔除尿管后排尿通畅,最大尿流率（Qmax）和残余尿量明显改善,未发生尿失禁和尿瘘等并发症。结论：经尿道电切术是治疗女性原发性膀胱颈梗阻的首选方法,具有操作简单、创伤小、出血少、恢复快、疗效肯定等优点。     

女性膀胱颈梗阻诊治体会

目的探讨女性膀胱颈梗阻的诊断标准和经尿道膀胱颈切开术的手术方法及治疗效果。方法回顾性总结分析我院2008年8月～2017年8月收治的57例女性膀胱颈梗阻病人的临床资料。结果依据尿动力学检查Q_(max)≤15mL/s,Pdet_(at max)≥20cm H_2O为膀胱颈梗阻的诊断标准,采用经尿道膀胱颈5、7点钟切开的手术方法,57例患者治疗效果良好,无尿瘘及尿失禁发生,术后患者临床症状好转,术前术后自由尿流率明显增高,患者膀胱残余尿量及上尿路积水量均显著减少。结论女性膀胱颈梗阻行尿流动力学检查对诊断具有重要意义,保留6点钟的经尿道膀胱颈5、7点切开术是治疗女性膀胱颈梗阻的有效治疗方法。     

女性膀胱颈梗阻的诊断与治疗

目的：探讨女性膀胱颈梗IN（FBNO）的诊断和治疗。方法：对26例FBNO患者行超声、膀胱尿道镜检查及尿流动力学检查,6例行保守治疗,20例行经尿道膀胱颈电切术（TURBn）。结果：26例经治疗后排尿通畅,无明显残余尿量,效果满意,术后未发生并发症。结论：超声、膀胱尿道镜检查结合尿动力学检查是FBNO的可靠诊断手段。TURBn是治疗女性膀胱颈梗阻的首选术式。     

女性原发性膀胱颈部梗阻诊治体会

目的 探讨女性膀胱颈部梗阻(BNO)的诊治方法.方法 对2000年6月～2005年6月间收治69例BNO患者的临床资料进行回顾性分析.结果 全部患者均经尿道膀胱颈部电切术(TURBN)治疗.治愈53例、临床症状好转16例,无明显并发症.结论 临床症状、残余尿量、膀胱镜检查是诊断BNO的可靠依据.TURBN术是有效的治疗方法.     

非ST段抬高急性冠脉综合征的早期介入治疗研究

目的　比较早期冠脉介入治疗和行药物治疗稳定后的延迟冠脉介入治疗对非ST段抬高性急性冠脉综合征的疗效。方法　对 14 2例经危险分层为高危的非ST段抬高急性冠脉综合征患者行入院后早期 ( 72h)和药物治疗稳定后的延迟介入 ( 5～ 7d)治疗 ,并进行 6个月的随访 ,比较两组患者的围术期并发症的发生率、死亡、再次心肌梗死的发生率以及再入院率和再次血运重建术率。结果　早期介入组有 3例患者发生围手术期冠脉血栓事件 ,延迟介入治疗组有 4例患者于术前发生心肌梗死 ,随访 6个月两组患者死亡、心肌梗死和心绞痛的发生率差异无显著意义 (P >0 0 5 ) ,但在早期介入治疗组再次住院率 ( 17%∶2 2 % ,P <0 0 5 )和再次血管重建术率 ( 12 %∶17% ,P <0 0 5 )明显低于延迟介入治疗组。结论　对经危险分层为高危的非ST段抬高急性冠脉综合征患者入院后行在阿司匹林、利吡格雷和低分子肝素保护下早期冠脉介入治疗是安全的 ,可改善患者的预后     

Pharmacokinetics of tibolone in early and late postmenopausal women

AIMS: Tibolone is a tissue-specific compound with favourable effects on bone, vagina, climacteric symptoms, mood and sexual well being in postmenopausal women, without stimulating the endometrium or breast. Since tibolone is used for the treatment of both young and elderly postmenopausal women, its pharmacokinetics were studied to investigate potential differences with age. In addition, the bioequivalence of the 1.25 and 2.5 mg tablets was evaluated. METHODS: Single doses of 1.25 or 2.5 mg of tibolone were given in a double-blind, randomized, two-way cross-over study to women aged between 45 and 55 years or between 65 and 75 years of age. RESULTS: Age did not have a significant effect on C(max), t(max), and t(1/2) of tibolone and its metabolites and on the body weight standardized oral clearance (CL/F kg(-1)) of the 3alpha- and 3beta-hydroxy tibolones. In early postmenopausal women, significantly lower values were found for the AUC(0,16 h), and AUC(0, infinity ) of 3alpha-hydroxy tibolone 24.6+/-6.6 vs 29.2+/-4.9 and 27.1+/-6.9 vs 32.3+/-6.5 ng ml(-1) h for the 1.25 mg tablet, respectively, and 45.4+/-13.9 vs 55.7+/-14.1 and 49.6+/-14.6 vs 62.6+/-17.3 ng ml-1 h for the 2.5 mg tablet, respectively. When these values were adjusted for the significantly higher body weight of the early postmenopausal women, the differences disappeared. No significant differences between early and late postmenopausal women were found for the AUC(0,8 h), and AUC(0, infinity) of 3beta-hydroxy tibolone. The rate of absorption of tibolone and the rates of absorption or formation of the 3alpha- and 3beta-hydroxy tibolones were significantly higher after the 1.25 mg dose than after the 2.5 mg tablet, resulting in increases of 32%, 27% and 17% for the dose normalized-C(max) of tibolone and the 3alpha- and 3beta-hydroxy tibolones, respectively. tmax for tibolone and its metabolites was 12-27% less after 1.25 mg compared to 2.5 mg, which was statistically significant. The two formulations were bioequivalent with respect to the dose-normalized AUC(0, infinity) and the AUC(0,t(fix)) values for the 3alpha-hydroxy tibolone (ratio point estimate [90%, confidence limits]: 1.08 [1.04, 1.14] and 1.08 [1.03, 1.13], respectively) and for the 3beta-hydroxy tibolone (1.07 [1.01, 1.14] and 1.04 [0.96, 1.12], respectively). Both formulations were also bioequivalent with respect to CL/F kg(-1) and t(1/2). CONCLUSIONS: The pharmacokinetics of tibolone are similar in early (age 45-55 years) and late (65-75 years) postmenopausal women. The 2.5 and 1.25 mg tablets are bioequivalent with respect to the extent of absorption. The rate of absorption or formation of the metabolites of tibolone were not bioequivalent, but these differences are considered to have no clinical relevance in view of the chronic administration of tibolone.     

Effect of cyclohexenonic long-chain fatty alcohol on rat overactive bladder induced by bladder neck obstruction

We attempted to clarify the preventive effects of cyclohexenonic long-chain fatty alcohol on detrusor overactivity induced by mild bladder neck obstruction. Bladder neck obstruction was created by partial ligation of the urethra. Female Sprague-Dawley rats were divided into three groups: those with bladder neck obstruction treated without long-chain fatty alcohol, those with bladder neck obstruction with long-chain fatty alcohol (8 mg/kg, i.p., every day) and the sham-operated control group (A, B, and C groups, respectively). Six weeks after the induction of bladder neck obstruction, voiding behavior was observed in the metabolic cage, and a cystometrogram was performed in the experimental animals. Furthermore, Hematoxylin and Eosin, Azan-Mallory, and Bodian stainings were performed in these bladders. Bladder weight, voiding behaviors and a cystometry indicated that rats in the A group showed detrusor overactivity, which was improved by treatment with long-chain fatty alcohol. The proportion of connective tissue and the density of bundles of neurofibers in the bladder of the A group was significantly less than that in the other bladders. Mild bladder neck obstruction induces detrusor overactivity, which is improved by treatment with long-chain fatty alcohol.     

经尿道前列腺电切术后膀胱颈挛缩的诊治体会

目的探讨经尿道前列腺电切术(TURP)后膀胱颈挛缩的病因和手术方法。方法对35例膀胱颈挛缩患者的临床资料进行回顾性总结分析。结果经尿道行膀胱颈后唇、术后残留前列腺组织电切术或用冷刀切开颈部换用电切刀切除瘢痕组织,术后3个月随访32例,症状均改善或消失。结论经尿道腔内治疗TURP术后膀胱颈挛缩是一种安全有效的方法。     

经尿道前列腺电切术后膀胱颈挛缩的诊治

目的 探讨经尿道前列腺电切术(TURP)后膀胱颈挛缩(BNC)的诊断和治疗方法.方法 对12例发生膀胱颈挛缩的患者的临床资料进行回顾性总结分析.结果 经尿道行膀胱颈后唇切除,冷刀切开膀胱颈部,再换用电刀切除疤痕组织.术后平均随访12个月,症状均明显改善或消失.结论 经尿道腔内治疗TURP术后BNC是一种安全有效的方法.