保留肾单位的癌切除术

目的探讨保留肾单位的肾癌切除术的肾癌手术效果。方法18例行保留肾单位的肾癌切除术患者,男11例,女7例,平均年龄49岁。肿瘤直径2.0～3.8cm,平均2.9cm。均为T1期。透明细胞癌15例,襄性肾癌3例。均为单侧,对侧肾功能正常。术后定期行腹部CT、超声及尿常规检查,复查肾功能。结果18例手术均成功。术后平均随访35个月,除1例局部复发术后14个月行患肾根治性切除外,余17例肿瘤无复发,无瘤生存至今。结论保留肾单位的肾癌切除术疗效肯定。适用于对侧肾功能正常肿瘤直径≤4.0cm的局限性肾癌,对于对侧肾脏有病变或孤立肾癌是必要的选择。     

保留肾单位肾癌切除术的近期疗效观察

目的 探讨保留肾单位肾癌的手术疗效.方法 18例行保留肾单位肾癌切除术的患者,男12例,女6例,平均年龄50岁.肿瘤直径1.5～4.0 cm,平均3.6 cm.先天性孤立左肾肾下极肿瘤1例,双肾肿瘤1例.透明细胞癌16例,肾细胞癌1例,颗粒细胞癌1例.T1 15例,T2 3例.结果 18例手术均成功.术后平均随访36个月,1例先天性孤立左肾肾下极肿瘤术后30个月肺转移外,余17例均无瘤生存至今.结论 保留肾单位肾癌切除术安全有效,适合于肿瘤直径≤4.0 cm早期肾癌.     

保留肾单位的肾肿瘤切除术

目的探讨保留肾单位手术治疗肾肿瘤的临床效果。方法采用保留肾单位手术治疗肾脏肿瘤8例,肿瘤直径均小于4 cm,观察其手术效果。结果 8例手术均获得成功,平均手术时间105 min;肾蒂阻断时间为12～22min,平均16 min;平均出血量80 ml,术后平均住院时间9 d。术后病理检查结果,肾透明细胞癌7例,颗粒状细胞癌1例。术后平均随访1年,无局部复发和转移。结论保留肾单位手术治疗直径≤4 cm的肾肿瘤,近期手术效果满意,其远期疗效有待进一步观察研究。     

后腹腔镜保留肾单位术治疗肾肿瘤的疗效观察

目的探讨后腹腔镜保留肾单位术(NSS)的安全性和可靠性。方法后腹腔镜NSS手术37例;男21例;女16例。平均年龄42岁。肿瘤直径1.5～4.0cm,平均3.0cm。结果 37例手术均获得成功,手术时间120～200min,平均145min;术中出血50～230mL,平均出血量90mL;热缺血时间15～35min,平均热缺血时间25min;术后住院时间5～11d,平均6d;围术期无并发症发生。术后病理报告透明细胞癌21例,血管平滑肌脂肪瘤6例,嫌色细胞癌1例,错构瘤9例;恶性肿瘤切缘均为阴性,术后25例随访3～48个月,患肾功能良好,未发现肿瘤局部复发及转移。结论后腹腔镜保留肾单位术治疗肾肿瘤安全可靠、创伤小、恢复快、能有效切除肿瘤及保留肾单位。     

后腹腔镜保留肾单位肾肿瘤手术

目的分析探讨后腹腔镜下保留肾单位治疗肾肿瘤的方法及安全性。方法回顾性分析2008年1月至2010年1月期间在我院泌尿外科接受治疗的10例肾脏肿瘤患者的临床资料。结果 10例肾脏肿瘤患者中,肿瘤直径2.0～4.0cm,平均2.9cm,肾细胞癌6例,肾错构瘤4例。10例手术均获得成功。手术时间120～180min,副肾动脉阻断时间18～40min,术中出血量50～110ml,平均术后住院时间9d,无围手术期并发症。病理检查肾细胞癌切缘均为阴性。随访3～12个月,复查B超及CT未见肿瘤残留及复发,静脉尿路造影(IVU)提示患侧残肾显影良好。结论后腹腔镜肾部分切除术安全可行,且具有操作简便、干扰少等优点,值得推广应用。     

腹腔镜下保留肾单位的肾部分切除术治疗肾癌的临床分析

目的：探讨腹腔镜下保留肾单位肾部分切除术治疗肾癌的临床经验。方法：2009年7月到2011年08月,随访观察我院45例T1期肾癌患者行腹腔镜下保留肾单位肾部分切除术的疗效。结果：所有患者腹腔镜下保留肾单位肾部分切除术均成功完成,平均手术时间为108min（80～190min）,肾动脉平均阻断时间为26min（19—45min）,术中平均出血130ml（30～400ml）,无一例输血,术后继发性出血1例,经对症治疗后好转。术后病理示透明细胞癌36例,乳头状细胞癌3例,嫌色细胞癌2例,颗粒细胞癌1例。术后随访4～28个月,未见肿瘤复发及转移。结论：腹腔镜下保留肾单位肾部分切除术治疗T1期肾癌安全有效。     

后腹腔镜保留肾单位的肾部分切除术16例临床疗效观察

目的探索后腹腔镜保留肾单位的肾部分切除术的适用范围以及相关疗效。方法取汕尾市逸挥基金医院自2008年7月至2010年1月以来实施的16例后腹腔镜下保留肾单位的肾部分切除术,其中错构瘤3例,肾脏细胞癌13例,对其手术结果进行评估。结果所有16例手术顺利完成,后腹腔镜患者平均手术时间为(123.4±26.3)min,平均出血量为(130.6±51.6)mL,术后引流管平均拔出时间为3d,平均住院时间为14d。术后患者均恢复良好,术后随访平均12个月。术后复查肾脏功能良好。结论后腹腔镜保留肾单位的肾部分切除术是一种有效和微创的治疗方式,值得进一步推广。     

腹腔镜下保留肾单位肾肿瘤切除术的护理

目的探讨腹腔镜下保留肾单位肾肿瘤切除术的护理措施。方法将48例我院泌尿外科在腹腔镜下行保留肾单位肿瘤切除术治疗的肾脏肿瘤患者分为腹腔镜手术组和经腹手术组,对术后护理效果进行对比。结果腹腔镜手术组患者在切口疼痛、术后恢复等方面明显优于经腹手术组。结论给予腹腔镜手术患者积极、充分、全面的术前术后护理,可以减轻患者的痛苦,促进患者早日康复。     

肾肿瘤肾部分切除手术23例配合与护理

肾部分切除手术是治疗肾脏错钩瘤、直径小于4cm的肾细胞癌、孤立肾肾癌、双肾肾癌、肾肿瘤伴对侧肾功能不全等较好的手术方式,中长期生存率与行根治性肾切除术者无显著差异。它能在保证患者良好的无瘤生存的同时最大限度地保存残肾单位及功能。我院于2005年至2009年施行开放性肾部分切除术治疗肾癌23例获得满意疗效。现将手术配合及护理情况报告如下。     

肾血管平滑肌脂肪瘤的外科手术时机及方式

目的 探讨不同直径肾血管平滑肌脂肪瘤(RAML)的手术时机及治疗方式的选择.方法 对76例行手术治疗的RAML患者的临床资料进行回顾性分析.结果 11例行肾切除术,25例行肾部分切除术,40例行肿瘤剜除术(开放手术34例,经后腹腔镜行肿瘤剜除术6例).本组病例术后病理诊断均为RAML.平均随访52个月,仅1例肿瘤局部复发.无继发性出血.结论 根据肿瘤直径大小、部位及有无症状综合考虑,确定手术时机;保留肾单位手术是治疗RAML安全有效的治疗方法,后腹腔镜下对直径较小的RAML行单纯剜除术创伤小、恢复快.     

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.