输尿管镜钬激光碎石术联合坦洛新治疗输尿管下段结石的临床分析

目的 评价输尿管镜钬激光碎石术联合坦洛新治疗输尿管下段结石的临床效果.方法 回顾性分析2011年10月至2014年1月本院泌尿外科采用经输尿管镜钬激光碎石术治疗的输尿管下段结石55例.2例因进镜失败改行ESWL予以剔除,对照组25例术后常规留置双J管4～6周;药物组28例不留置双J管,术后6h起予口服盐酸坦洛新缓释片1次0.2mg,1日1次,药物口服2～4周.记录术后6周内相应的并发症并了解结石排出情况.结果 药物组并发症的总发生率包括腰腹部胀痛不适、肉眼血尿、膀胱刺激征等症状明显小于对照组（P＜0.05）,结石清除率100％与对照组的结石清除率一致.结论 对单纯输尿管下段结石患者行输尿管镜钬激光碎石术后可不放置双J管,联合使用盐酸坦洛新缓释片治疗,并发症少,效果确切。     

输尿管镜下钬激光碎石治疗输尿管结石160例临床分析

目的：分析输尿管镜下钬激光碎石治疗输尿管结石的临床疗效及安全性。方法回顾性分析160例输尿管结石患者的临床资料,所有患者在硬膜外或全身麻醉下手术,通过导丝引导插入输尿管镜,行钬激光碎石,在术后留置双J管2～4周。结果160例患者中,单次手术结石粉碎率为94．37％;平均手术时间为51 min;所有患者均有轻度血尿,3～4 d可消失;通过1～3个月随访,结石排净率为97．5％;手术输尿管上段结石一次碎石成功率为70．27％,中、下段结石一次性碎石成功率为99．20％。结论通过输尿管镜下钬激光碎石术治疗输尿管结石安全、高效,并且是一种微创、并发症少的碎石方法。     

输尿管镜联合钬激光治疗输尿管结石的体会

目的探讨输尿管镜联合钬激光碎石治疗输尿管结石的体会。方法采用输尿管镜下钬激光碎石术治疗输尿管结石48例,其中单侧输尿管上段结石14例,输尿管下段结石30例,双侧输尿管结石4例。结果钬激光碎石术的次性碎石治疗后结石排净率91％。手术时间20～105min,平均51min;术后住院1～10d,平均5-3d;结石排净时间2～7周,平均3周。术中输尿管穿孔1例。结论输尿管镜下钬激光碎石术治疗输尿管结石具有安全、有效、并发症少的特点,是治疗泌尿系结石的一可靠方法。     

逆行输尿管镜钬激光碎石术472例分析

目的 探讨逆行输尿管镜钬激光碎石术治疗输尿管结石的近期疗效.方法 2002年1月至2010年8月输尿管结石472例采用逆行输尿管镜钬激光碎石治疗,输尿管上段结石285例,中下段结石208例,其中含双侧输尿管结石21例.术后2～3周拔除双J管,术后4周B超或尿路X线片观察排石情况.结果 总体碎石成功率为87.4% (43...     

输尿管软镜钬激光碎石术治疗肾下盏结石

目的评估输尿管软镜钬激光碎石取石术治疗肾下盏结石的临床疗效及安全性。方法分析输尿管软镜钬激光碎石取石术治疗肾下盏结石53例的临床资料。结果 53例中,48例输尿管软镜钬激光碎石术一次性成功,成功率90.57%。手术时间25~75 mim,平均(45±16)min。术中无输血,无输尿管损伤、尿脓毒血症等严重并发症发生。术后住院时间3~4 d,平均3.5 d。1例因术中发现严重感染,放弃一期碎石,留置双J管,感染控制后再次行输尿管软镜钬激光碎石术;2例因输尿管狭窄严重,软镜无法插入肾脏,留置双J管2周后再次行输尿管软镜钬激光碎石术;2例因肾盂肾下盏角度太小,软镜未能进入肾下盏而改为体外冲击波碎石术。结论输尿管软镜钬激光碎石取石术治疗肾下盏结石,安全、有效、恢复快,是治疗肾下盏结石的理想方法。     

钬激光碎石负压吸引在输尿管结石梗阻性脓肾中的应用

探讨输尿管镜下应用钬激光碎石联合负压吸引装置在治疗输尿管结石梗阻性脓肾中的安全性及有效性。回顾性分析2014年6月至2015年6月期间我科应用输尿管镜钬激光碎石联合负压吸引装置治疗的9例输尿管结石梗阻性脓肾患者的临床资料。患者输尿管结石平均直径0.6～1.6 cm,术前尿常规提示感染,给予抗感染治疗,术中均有脓性尿液,先通过负压吸引持续吸出引流肾内脓液,再在负压吸引的作用下应用钬激光击碎结石并留置双J管充分引流。9例患者均手术解除了梗阻并留置双J管充分引流,8例患者Ⅰ期碎石成功;1例因患者一般情况较差,留置双J管提前结束手术,Ⅱ期行输尿管镜碎石术。手术时间10～30 min,平均20 min。所有患者术后均无感染性休克等严重并发症发生,术后经抗感染治疗均治愈出院。输尿管镜术中负压吸引吸出肾内脓液有利于降低肾内压力、控制感染。输尿管镜下应用钬激光碎石联合负压吸引装置可Ⅰ期治疗输尿管结石梗阻性脓肾,具有清石率高、安全有效、并发症少、恢复快等优点。     

输尿管镜钬激光碎石术治疗输尿管上段结石138例

目的：总结输尿管镜钬激光碎石治疗输尿管上段结石的疗效和操作技巧。方法：回顾性分析输尿镜钬激光治疗输尿管上段结石138例143侧的临床资料。结果：一次碎石成功率为94.2%（135/143）,平均手术时间64 min ,平均住院4.5 d。8例部分结石碎片回冲入肾盂,术后补充ESWL治疗。135例患者拔出双J管后均行KUB及B超复查随访3～12个月,肾积水消失或不同程度减轻。结论：输尿管镜钬激光治疗输尿管上段结石可以达到满意的治疗效果。     

输尿管镜下钬激光联合套石篮治疗输尿管上段结石临床疗效

目的：探讨输尿管镜下钬激光联合套石篮治疗输尿管上段结石的疗效及安全性。方法输尿管镜下利用套石篮配合钬激光碎石治疗46例输尿管上段结石。结果42例一次性碎石成功,3例部分结石上移至肾脏,经体外震波碎石治疗后结石排出,1例因输尿管扭曲输尿管镜上行困难改为开放手术,术中1例输尿管穿孔。结论输尿管镜下钬激光碎石是治疗输尿管上段结石安全有效的方法,术中配合使用套石篮可有效避免结石上移并显著提高碎石成功率。     

输尿管结石致肾积脓的输尿管镜钬激光治疗

目的 总结输尿管镜钬激光碎石治疗输尿管结石致肾积脓的经验.方法 13例患者因腰痛、发热入院,明确诊断,术前给予抗感染及支持治疗,手术采用输尿管镜钬激光碎石术.结果 10例顺利完成手术,3例输尿管上段结石在碎石过程中有结石上移,放置双J管后行体外冲击波碎石治疗.无并发症发生,恢复良好.结论 输尿管镜钬激光碎石治疗结石梗阻性肾积脓具有疗效好、损伤小、手术时间短、安全可靠等优点,可作为输尿管结石致梗阻性肾积脓首选治疗方法.     

输尿管结石致肾积脓的输尿管镜钬激光治疗

目的总结输尿管镜钬激光碎石治疗输尿管结石致肾积脓的经验。方法13例患者因腰痛、发热入院,明确诊断,术前给予抗感染及支持治疗,手术采用输尿管镜钬激光碎石术。结果10例顺利完成手术,3例输尿管上段结石在碎石过程中有结石上移,放置双J管后行体外冲击波碎石治疗。无并发症发生,恢复良好。结论输尿管镜钬激光碎石治疗结石梗阻性肾积脓具有疗效好、损伤小、手术时间短、安全可靠等优点,可作为输尿管结石致梗阻性’肾积脓首选治疗方法。     

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.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.