输尿管镜下气压弹道碎石术治疗膀胱结石83例

目的 探讨输尿管镜下气压弹道碎石术治疗膀胱结石的疗效.方法 对83例膀胱结石行输尿管镜下气压弹道碎石术治疗,分析其疗效.结果 所有病例均1次碎石成功,无膀胱黏膜撕裂或穿孔发生.碎石时间10～75min.结论 输尿管镜下气压弹道碎石术治疗膀胱结石是安全、有效的方法.     

输尿管镜气压弹道碎石术治疗输尿管结石121例报告

目的探讨输尿管镜气压弹道碎石术治疗输尿管结石的疗效。方法对121例输尿管结石患者采用输尿管镜下气压弹道碎石术治疗。结果121例患者单次碎石率为90.9%(110/121),其中上段结石单次碎石率86.8%(46/53),中下段为94%(64/68)。碎石时间15～120min,平均47.5min。结论输尿管镜下气压弹道碎石术治疗输尿管结石具有微创、安全及高效的特点,是一种治疗输尿管结石有价值的方法。     

气压弹道碎石术治疗尿路结石474例临床分析

目的探讨应用输尿管肾镜下气压弹道碎石术治疗尿路结石的临床效果。方法对474例尿路结石患者采用输尿管肾镜下气压弹道碎石治疗,其中尿道结石22例,膀胱结石56例,结石位于输尿管上段62例。中段168例,下段158例,石街8例。结果本组484例患者中．464例一次碎石成功,总成功率为97．89％,碎石总排净率为99．9％。术后B超显示肾积水较术前减轻或消失．静脉肾盂造影未发现输尿管狭窄。结论输尿管肾镜下气压弹道碎石术是治疗尿路结石的有效方法之一。     

下尿路结石512例微创治疗的体会

目的探讨治疗下尿路结石安全、高效的治疗方法。方法回顾性分析512例下尿路结石的诊治经过,其中膀胱结石405例,尿道结石107例。应用膀胱镜大力钳碎石技术治疗98例下尿路结石患者;采用等离子电切镜外鞘联合输尿管镜直视下气压弹道碎石术治疗153例下尿路结石患者;采用等离子电切镜外鞘联合输尿管镜直视下钬激光碎石术治疗227例下尿路结石患者,采用直接钳夹法治疗34例前尿道结石患者。结果所有病例一次性治疗成功。碎石时间为10～61min,术后无明显出血、感染及尿道狭窄等并发症。结论下尿路结石应根据具体情况选择不同的微创治疗才能具有安全可靠、疗效确切、手术时间短、创伤小、术后恢复快等优点。     

改良输尿管镜气压弹道碎石术治疗输尿管结石的技巧探讨

目的：探讨改良输尿管镜气压弹道碎石术治疗输尿管结石的手术技巧及临床疗效。方法回顾性分析行改良输尿管镜气压弹道碎石术治疗输尿管结石的90例患者临床资料,观察输尿管镜下应用双J管配合气压弹道碎石治疗输尿管结石的手术技巧及临床疗效。结果本组90例患者,一次性碎石成功率97．78％（88/90）。上段结石碎石成功率92．31％（24/26）,中段成功率100％（29/29）,下段成功率100％（35/35）。手术时间平均28 min（15～70 min）。术后平均住院4．1 d（2～7 d）。结论改良输尿管镜气压弹道碎石术是治疗输尿管结石安全、有效的手术方法,熟练掌握进镜技巧并应用双J管配合气压弹道碎石,可有效提高碎石成功率,缩短手术时间及术后住院时间,减少术中术后并发症。     

气压弹道碎石术治疗男性前尿道结石的疗效观察

目的 观察气压弹道碎石术治疗男性前尿道结石的疗效.方法 对15例尿道结石患者采用输尿管镜下气压弹道碎石治疗.结果 全组15例患者一次性碎石成功并取出,碎石时间5～32 min,无尿道黏膜撕裂、穿孔、尿道狭窄等并发症.结论 输尿管镜下气压弹道碎石术治疗男性前尿道结石创伤小、成功率高、恢复快,是一种治疗前尿道结石的首选方法.     

输尿管镜气压弹道碎石术治疗尿路结石

目的：探讨输尿管镜气压弹道碎石技术治疗尿路结石的疗效。方法：采用输尿管镜气压弹道碎石治疗尿路结石780例。结果：780例中760例一次碎石成功,治疗成功率为97．5％。其中输尿管上段结石成功率为90．6％,中段为93．9％,下段为99．6％,膀胱、尿道结石为100％。平均碎石时间为（5．0±3．0）min,术后碎石排净率为98．2％。结论：该方法结石排净率高,创伤轻微,手术并发症少,是治疗尿路结石较为理想的治疗方法之一。     

B超引导下微创经皮肾镜气压弹道碎石术治疗上尿路结石102例分析

目的 探讨B 超引导下微创经皮肾镜气压弹道碎石术(MPCNL) 治疗上尿路结石的疗效.方法 采用B超引导下微创经皮肾镜气压弹道碎石术治疗上尿路结石102例.结果 术后检查83例结石完全消失,19 例有残留结石,平均手术时间134 min,一次净石率为81.4%.术中致肾盂或输尿管穿孔2 例,术中肾镜摆动过大,引起肾盏颈部撕裂出血1例,输血4 U,术后菌血症1例.结论 B 超引导下微创经皮肾镜气压弹道碎石术治疗上尿路结石具有创伤小、恢复快、患者易接受、治疗好,并发症少等优点,但术中术后要注意并发症的预防.     

经皮肾镜和/或输尿管镜下肾镜碎石治疗上尿路结石240例

目的总结经皮肾镜和/或输尿管镜下碎石治疗上尿路结石240例的临床经验。方法 2003年11月至2009年12月,采用B超引导穿刺建立小通道或标准通道,输尿管镜和/或肾镜下气压弹道、超声、双频双脉冲激光碎石术治疗240例上尿路结石。膀胱镜下患侧输尿管逆行留置5～6F输尿管导管,生理盐水持续灌注。B超引导下穿刺目标肾盏,建立皮肤肾脏通道,肾镜、输尿管镜下采用气压弹道联合超声、双频双脉冲激光碎石术。对手术时间、手术并发症、结石清除率等临床资料进行分析。结果 240例患者中,224例（93.3%）一期成功建立皮肤肾脏通路,212例行一期碎石术,6例行二期碎石术。208例患者一期单通道碎石,4例患者一期两通道碎石。手术时间30～180 min,平均（86±12）min。12例患者术中、术后输血400～800 ml。6例患者改小切口手辅助穿刺肾镜碎石;4例改开放手术。无气胸、腹腔脏器损伤等严重并发症发生。术后1周复查,172例患者排净结石,52例有结石残余,结石清除率为76.8%。结论经皮输尿管镜和/或肾镜碎石治疗上尿路结石安全,疗效可靠。     

经皮肾镜气压弹道碎石术治疗上尿路结石310例临床分析

目的探讨经皮肾输尿管镜气压弹道碎石术治疗肾脏与输尿管上段结石的方法与疗效。方法采用经皮肾输尿管镜下气压弹道碎石术治疗上尿路结石310例。结果2004年3月至2007年12月,采用I期、Ⅱ期或分步经皮肾输尿管镜手术成功处理310例上尿路结石,其中包括鹿角型结石、多发性肾结石、孤立肾结石、ESWL（体外震动破碎石术）治疗失败、开放取石手术后复发、输尿管上段结石。肾结石清除率为91.28%,输尿管结石清除率为89.85%,且无严重手术并发症发生。结论经皮肾输尿管镜气压弹道碎石术治疗上尿路结石具有微创、恢复快、并发症少、安全高效、结石清除率高的优点。     

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.     

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.     

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.