经尿道输尿管镜气压弹道碎石术和前列腺电切术同期治疗前列腺增生症并膀胱结石

目的 探讨经尿道输尿管镜气压弹道碎石术和前列腺电切术同期治疗前列腺增生症并膀胱结石的效果。方法 对63例前列腺增生症并膀胱结石患者，先置入膀胱镜鞘，建立“通道”，行输尿管镜气压弹道碎石术，清除膀胱结石后同期行前列腺电切术。结果 63例患者均手术成功。无膀胱穿孔、水中毒、再出血、尿失禁等并发症，拔尿管后均排尿顺畅。2～3个月后复查，无结石残留。结论 膀胱镜鞘建立“通道”，采用经尿道输尿管镜气压弹道碎石术和前列腺电切术同期治疗前列腺增生症并膀胱结石是一种创伤小、安全、疗效肯定的微创手术方法，值得推广。【关键词】前列腺增生症 膀胱结石 经尿道前列腺电切术 气压弹道碎石术     

前列腺增生合并膀胱大结石的腔镜下联合微创治疗

目的 探讨经尿道气压弹道/超声碎石清石术联合等离子体电切术微创治疗前列腺增生合并膀胱大结石的方法、疗效.方法 采用瑞士EMS第3代气压弹道/超声碎石清石系统和经尿道前列腺等离子体电切术(PKRP)治疗前列腺增生合并膀胱大结石患者27例.结果 27例均1次手术成功,碎石时间40～65min,平均55min;前列腺等离子体电切时间50～110min,平均85min.术中术后均无输血,无电切综合征、膀胱穿孔、结石残留等并发症.术后6d拔除尿管,无排尿困难、永久性尿失禁等.病理结果均为良性前列腺增生.术后3个月,最大尿流率由(5.4±1.5)mL/s升至(18.6±3.2)mL/s.结论 经尿道气压弹道/超声碎石清石术联合等离子体电切术能有效地治疗良性前列腺增生合并膀胱大结石.     

前列腺增生症合并膀胱结石的微创治疗

目的探讨经尿道气压弹道碎石联合前列腺电切术（TURP）治疗良性前列腺增生（BPH）合并膀胱结石的疗效。方法对20例BPH合并膀胱结石患者采用经尿道气压弹道碎石联合TURP治疗。结果20例患者均一次手术成功,无膀胱穿孔、电切综合征、大出血及感染等并发症,术后复查B超、腹部X线立位平片未见膀胱内结石残留,清石率达100%。结论经尿道气压弹道碎石联合TURP治疗BPH合并膀胱结石安全、高效、创伤小、恢复快,是治疗BPH并发膀胱结石的理想方法。     

经尿道同期治疗前列腺增生合并膀胱结石——附31例报告

目的 总结经尿道气化电切术、经尿道等离子体双极电切术结合弹道碎石治疗前列腺增生合并膀胱结石的疗效.方法 采用经尿道气化电切术、经尿道等离子体双极电切术结合弹道碎石治疗前列腺增生合并膀胱结石31例患者。结果 所有患者均1次治疗成功，无膀胱穿孔等并发症，术后随访3个月，排尿功能恢复正常。结论 经尿道气化电切术、经尿道等离子体双极电切术结合弹道碎石治疗前列腺增生合并膀胱结石是一种安全高效的治疗方法。     

钬激光碎石术联合经尿道等离子电切术治疗前列腺增生症合并膀胱大结石的效果

目的 探讨钬激光碎石术联合经尿道等离子电切术治疗前列腺增生症合并膀胱大结石的效果.方法 选择本院2015年5月至2020年4月收治的46例前列腺增生症合并膀胱大结石患者为研究对象,根据随机数字表法将其分为对照组和观察组,各23例.对照组行开放取石术联合经尿道等离子电切术,观察组行钬激光碎石术联合经尿道等离子电切术.比较...     

合并前列腺增生症的膀胱结石的手术方式选择

目的探讨良性前列腺增生症合并>3 cm膀胱结石的手术方式选择。方法回顾性分析罗定市人民医院良性前列腺增生症合并膀胱结石患者的临床资料,按膀胱结石碎石取石方法不同分为两组,试验组:耻骨上小切口膀胱切开取石+经尿道前列腺电切术(TURP);对照组:经尿道腔内碎石取石+TURP。统计比较两组患者的一般临床资料,术中评价指标和术后膀胱结石残留及并发症发生情况。结果 126例患者纳入研究,所有患者手术均成功,试验组30例,对照组96例(气压弹道碎石47例,钬激光碎石49例)。两组患者年龄、结石直径、前列腺大小、术前IPSS评分和QOL评分均无统计学差异(P>0.05)。试验组碎石取石时间和总手术时间均较对照组短,差异具有统计学意义(P<0.001)。试验组所有患者术后复查KUB无结石残留;对照组患者术后复查KUB提示结石残留9例,其中气压弹道碎石组4例,钬激光组5例。两组患者均无电切综合征、大出血中转开放手术或二次手术等严重并发症发生。结论耻骨上小切口膀胱切开取石+TURP治疗前列腺增生合并>3 cm膀胱结石安全有效,尤其是合并膀胱小梁小室者,可缩短手术时间,减少术后膀胱结石残留发生率,值得临床推广。     

前列腺增生症并膀胱结石的微创治疗

目的 探讨同期腔内治疗前列腺增生(BPH)并发膀胱结石的微创、有效治疗方法.方法 采用经尿道前列腺电切术(TURP)联合肾镜下气压弹道碎石术治疗前列腺增生症并发膀胱结石患者67例.结果 67例患者均顺利一次性将结石取尽并成功行TURP.无膀胱穿孔,无严重感染、TUR综合征等并发症发生.术后住院5～10 d.结论 TURP联合肾镜下气压弹道碎石术治疗前列腺增生并发膀胱结石,创伤小,恢复快,安全高效,是目前治疗BPH并发膀胱结石的理想方法.     

TUVP配合气压弹道碎石术治疗前列腺增生合并膀胱结石(附5例报告)

目的 :探讨经尿道前列腺汽化电切术 (TUVP)配合气压弹道碎石术治疗良性前列腺增生 (BPH)并膀胱结石的疗效。方法 :采用TUVP结合气压弹道碎石术治疗BPH并膀胱结石 5例 ,结果均一次治疗成功 ,无膀胱穿孔 ,术后大出血等并发症 ,术后 1个月复查最大尿流率平均 >1 6 .2ml/s。结论 :TUVP结合气压弹道碎石术是治疗BPH并膀胱结石一种安全、有效的方法     

同期腔内治疗前列腺增生并膀胱结石的临床观察

目的探讨同期腔内治疗前列腺增生（BPH）并膀胱结石的临床疗效。方法2005年6月至2009年7月期间,对32例前列腺增生并发膀胱结石患者采用经尿道膀胱结石气压弹道碎石治疗同时进行经尿道前列腺电切（TURP）术,术后观察其治疗效果。结果32例手术均顺利完成。术中无膀胱穿孔及大出血,术中、术后无电切综合征发生,无结石残留,手术时间50～90min（其中TURP时间30～60min）,术后患者恢复好,未见结石复发及尿失禁和尿道狭窄等并发症。结论同期采用气压弹道碎石和经尿道前列腺电切术是治疗前列腺增生并膀胱结石的一种高效、安全的手术方法。明显缩短了手术时间,减少了并发症。     

气压弹道及超声碎石+经尿道前列腺汽化电切术治疗前列腺增生合并膀胱结石(附54例报告)

目的 探讨气压弹道及超声碎石+TUVP治疗前列腺增生合并膀胱结石的手术方法.方法 2005年10月～2008年2月,采用气压弹道及超声碎石+TUVP治疗前列腺增生合并膀胱结石54例.结果 53例患者1次碎石、清石成功,并顺利进行了前列腺汽化电切,1例膀胱憩室结石碎石术中出现膀胱破裂,改行开放手术.结论 气压弹道及超声碎石+TUVP治疗前列腺增生合并膀胱结石是一种微创、有效的方法.     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.