膀胱镜检查前后及护理

膀胱镜检查是将膀胱镜经尿道插入膀胱以直接观察膀胱和尿道内病变的检查方法,也可向输尿管口插入输尿管导管分别收集双侧肾盂尿和进行逆行性泌尿系统造影,使肾盂和输尿管的影像更为清晰。经过膀胱镜还可进行肿瘤切除、碎石和前列腺增生切除术。1检查前护理1.1检查前准备(1)器械准备:膀胱镜消毒可用40%甲醛     

顽固性慢性前列腺炎11例尿道膀胱镜检查

我院自 1997年 1月～ 1998年 1月对经过各种方法治疗 1年以上效果不显的慢性顽固性细菌性前前列腺炎 11例 ,进行尿道膀胱镜检查 ,现将检查情况报告如下。临床资料　本组 11例。年龄 2 7～ 51岁 ,平均36岁。病程 1～ 3年 ,临床表现变化多端 ,反复发作 ,伴有严重精神症状。尿常规正常 ,前列腺液常规检查 :ＷＢＣ ～ /ＨＰ ,细菌培养 8例阴性 ,3例培养出金黄色葡萄球菌。尿道膀胱镜检查方法及结果采用尿道膀胱镜ＯＬｙｍｐｕｓＯＥＳ软性尿道膀胱镜ＣＹＦ - 2型 ,管径细小 ,直径 5 1ｃｍ ,有特宽弯曲范围 ,向上 2 10°和向下 90° ,用 2 %…     

不同膀胱镜技术在膀胱肿瘤诊断中的临床观察

目的 比较CO2气膀胱镜技术和传统膀胱镜检查在膀胱肿瘤诊断中的应用价值.方法 70例膀胱肿瘤患者分为3组:A组22例,行CO2气膀胱镜检查;B组16例,行传统膀胱镜检查,C组32例,两者联合应用,比较3组操作成功率、活检与手术病理诊断的符合率、多发性膀胱肿瘤镜检与手术诊断病灶数目的符合率.结果 A、B、C组操作成功率相仿(100.0％ vs.93.7％vs.100.0％) (P＞0.05).C组病检符合率100.0％,明显高于A组的90.9％和B组的93.3％(P＜0.05).C组多发性膀胱肿瘤镜检与手术诊断病灶数目符合率100.0％,亦明显高于A组的85.7％和B组的80.0％ (P＜0.05).结论 与传统膀胱镜技术相比,CO2气膀胱镜技术用于膀胱肿瘤的检查与诊断并无优势;两者联合应用可以明显提高膀胱肿瘤检查的诊断准确率.     

舒适护理在膀胱尿道镜检查中的应用

目的探讨舒适护理在膀胱尿道镜检查中的应用效果。方法将84例对膀胱尿道镜检查患者随机分为试验组和对照组各42例。对照组给予常规护理,试验组在常规护理的基础上给予舒适护理。比较2组患者配合度、治疗时间、一次操作成功率及患者满意度。结果试验组患者配合度、一次操作成功率及患者满意度均高于对照组,治疗时间短于对照组,差异均有统计学意义(P<0.05)。结论舒适护理在膀胱尿道检查中的效果较好,值得临床推广应用。     

丙泊酚复合芬太尼在膀胱尿道镜检查中的作用

膀胱尿道镜检查通常采用表面麻醉，但部分患者常有阴部、腰部疼痛，甚至使操作中断或拒绝继续检查。为解除患者顾虑，我院在患者进行膀胱尿道镜检查时，使用丙泊酚复合芬太尼麻醉效果较好。现将观察结果报道如下。     

女性尿道肉阜患者行膀胱镜检查的临床意义

目的 探讨女性尿道肉阜患者行膀胱镜检查的临床意义.方法 对100例女性尿道肉阜患者行膀胱镜检查并活检,结合病史等进行临床分析.结果 100例女性尿道肉阜患者行膀胱镜检查,其中98例膀胱镜下发现膀胱单纯性或慢性增生性炎症改变.以病理分类,慢性膀胱炎占90例(其中10例合并膀胱粘膜鳞状化生,腺性膀胱炎占80例),腺性后尿道炎2例,慢性膀胱颈口炎症14例(10例为合并发生),结核性膀胱炎2例,正常粘膜2例.采用电切术治疗尿道肉阜,TURBT治疗腺性膀胱炎.结论 女性尿道肉阜患者常合并腺性膀胱炎,手术治疗必须同时处理两种疾病.凡是遇到女性尿道肉阜的患者,宜行膀胱镜检及病理活检以免漏诊慢性膀胱炎.     

经尿道膀胱镜取输尿管壁段结石12例临床分析

2005年2月至2009年1月对我院12例明确诊断为输尿管壁段结石患者行尿道膀胱镜检查,直接通过膀胱镜取石,效果满意,现报告如下。     

膀胱镜下尿道会师术在尿道损伤治疗中的应用

目的探讨膀胱镜下尿道会师术在治疗尿道损伤中的应用效果。方法用膀胱镜下尿道会师术治疗尿道损伤23例。结果 21例手术成功,2例中转开放手术辅助膀胱镜下尿道会师术,经随访均恢复良好。结论采用膀胱镜下尿道会师术治疗急性尿道损伤,具有较好的疗效。     

自制穿刺套管针在膀胱镜下尿道会师术中的应用

目的探讨自制穿刺针在膀胱镜下尿道会师术中行膀胱颈会阴贯穿牵引固定的应用效果.方法对12例后尿道断裂患者行膀胱镜下尿道会师,并应用自制穿刺针行膀胱颈会阴贯穿牵引固定.结果 12例患者均获成功,术后随访10个月～2年,优良10例,较好2例,较好2例经3个月到半年的尿道扩张,可恢复正常排尿.结论利用自制穿刺针在膀胱镜下尿道会师术中行膀胱颈会阴贯穿牵引固定可达到解剖复位,不需切开膀胱,是治疗后尿道断裂的有效微创方法.     

老年患者膀胱尿道镜检查的护理干预及效果观察

目的 探讨护理干预对老年患者膀胱尿道镜检查的心理影响及效果观察.方法 将126例初次行膀胱尿道镜检查患者随机分为对照组和干预组各63例.两组均进行常规护理,干预组在此基础上进行人性化关怀护理,加强检查全过程的心理疏导,并对两组患者在检查中出现焦虑、疼痛、生命体征变化进行观察比较.结果 对照组干预后焦虑值(39.60±3...     

Teaching clinical problem solving: A preceptor's guide

Purpose Instructional methods to help pharmacists succeed in their growing role in practice-based teaching are discussed, with an emphasis on techniques for fulfilling the four key preceptor roles. Summary The American Society of Health-System Pharmacists (ASHP) and other organizations advocate ongoing efforts to develop the teaching skills of clinician-educators serving as preceptors to pharmacy students and residents. The broad model of teaching clinical problem solving recommended by ASHP emphasizes the creative and flexible application of the four major preceptor roles: (1) direct instruction, (2) modeling, (3) coaching, and (4) facilitating. A variety of teaching methods used in the fields of medicine and nursing that can also be adopted by practice-based pharmacy educators are presented; in particular, the advantages and disadvantages of various case-presentation formats (e.g., One-Minute Preceptor, SNAPPS, patient-witnessed teaching, "Aunt Minnie," "think-aloud") are reviewed. Other topics discussed include the appropriate use of questioning as an educational tool, strategies for providing constructive feedback, teaching learners to self-evaluate their skills and progress, and integrating residents into teaching activities. Conclusion The ASHP-recommended approach to teaching clinical problem-solving skills can be applied within the educational frameworks provided by schools of pharmacy as well as pharmacy residency programs. A wide range of validated teaching strategies can be used to tailor learning experiences to individual learner needs while meeting overall program goals and objectives.     

双氯芬酸钠柔性脂质体凝胶剂的制备及临床应用

目的:制备双氯芬酸钠柔性脂质体凝胶并应用于临床。方法:用超声分散法制备双氯芬酸钠柔性脂质体,用原子力扫描探针显微镜及ζ电位粒度仪观测其大小及分布;用微型葡聚糖凝胶柱法测定其包封率,并以双氯芬酸钠胶囊为对照药,观察双氯芬酸钠柔性脂质体凝胶临床疗效。结果:双氯芬酸钠柔性纳米脂质体平均粒径89．6 nm,包封率38．6％。治疗类风湿关节炎患者24例,总有效率达83％。结论:本品符合凝胶剂的要求,疗效确切,可试用于临床。     

SYMBIOTIC RELATIONSHIP BETWEEN A RESEARCH INSTITUTE AND A PHARMACEUTICAL COMPANY: THE BAKER INSTITUTE/GLAXO AUSTRALIA STORY

1. The Baker Medical Research Institute is a non-profit, charitable institution to advance knowledge and solve problems in the area of cardiovascular medicine. This allows scientists to collaborate within a critical mass and be flexible in their approach to research. 2. The Institute has interactions with the pharmaceutical industry at three levels: (i) contract research on a specific molecule; (ii) clinical trials; and (iii) collaborative basic research agreements. 3. The Glaxo Australia-Baker Medical Research Institute Agreement is for curiosity driven research in specified areas of vascular pharmacology of interest to Glaxo Group Research. 4. The relationship between universities, research institutes and the pharmaceutical industry is discussed in terms of the starting point for drug development. 5. The enormous cost (US$100 million), lead time (10 years) and uncertainty of a successful profitable drug are compelling reasons why an independent pharmaceutical company is unlikely to succeed in Australia today.     

射频导管消融治疗室性心律失常的疗效观察

目的为了探讨射频消融术对频发室性早搏与室性心动过速的疗效。方法观察并随访１０例经ＲＦＣＡ治疗的室性早搏患者;对２例多源性室性早搏患者作了术前心室起源点的多普勒组织成像（ＤＴＩ）检测。结果消融成功７例,失败２例,复发１例;ＤＴＩ检测２例,心室起源点与术中电生理心内导管标测相吻合。结论ＲＦＣＡ是目前值得启用的治疗频发室性早搏伴ＶＴ的新方法,但冠心病人成功率可能偏低;ＤＴＩ作为非创伤性标测起源点,有较好的探讨前景。     

纤维与电子软性输尿管镜在泌尿外科的应用对比研究

目的:对电子软性输尿管镜与纤维软性输尿管镜在泌尿外科手术中的应用情况进行对比分析,以便其发挥最优效能。方法:对广州医科大学附属第一医院微创外科中心手术室在2011年1月至2018年12月间购入的7条奥林巴斯软性输尿管镜的故障维修情况进行回顾性分析。同时,以同一时间、同一组医生开始使用的电子软性输尿管镜（URF-V1,S...     

剖宫产术后子宫瘢痕部妊娠18例临床分析

目的 探讨剖宫产术后子宫瘢痕部妊娠的临床诊断及治疗方法.方法 对18例子宫瘢痕部妊娠患者根据临床症状及实验室辅助检查进行早期诊断,并结合患者情况采用个体化治疗方案治疗.分析治疗效果及不良反应发生情况.结果 药物治疗9例,成功8例,1例转子宫次全切除术治疗;子宫动脉栓塞术治疗3例,开腹手术治疗6例,均获得成功.结论 根据患者临床症状、既往剖宫产史、停经史及实验室辅助检查结果,早期诊断剖宫产术后子宫瘢痕部妊娠,并根据患者情况选择个体化治疗方案,可获得满意预后,值得临床推广应用.     

Extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening: a pilot study

BACKGROUND: Caecal intubation can be achieved by extended flexible sigmoidoscopy in 32% of patients. AIM: To assess the feasibility of extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening. METHODS: We enrolled 41 patients referred for screening flexible sigmoidoscopy. After purging, examination was performed with a colonoscope. All patients completed sigmoidoscopy (success in meeting referral goal); 93% and 71% had examination to the transverse or ascending colon, and caecum, respectively. Overall yield and right-sided polyps was 56% and 27%, respectively. Caecal intubation and complete examination with polypectomy took 6.0 +/- 2.5 and 18.3 +/- 5.1 min, respectively; with no complications. Twelve patients requested colonoscope withdrawal because of discomfort. Although 46% reported moderate to severe discomfort, 39% and 36%, respectively, were definitely or probably willing to repeat flexible sigmoidoscopy. RESULTS: Unsedated colonoscopy introduced as extended flexible sigmoidoscopy emphasizes the benefits of added yield rather than the negative image of withholding of discomfort relief. The patient can choose to accept the equivalent of an unsedated colonoscopy or reject the option based on perceived discomfort during extended flexible sigmoidoscopy performed by the colonoscopist. CONCLUSION: Extended flexible sigmoidoscopy is a feasible option in carefully selected patients, fully prepared and by an experienced colonoscopist.     

Selective flexibility of side-chain residues improves VEGFR-2 docking score using AutoDock Vina

Selective side-chain residue flexibility is an option available on AutoDock Vina docking software. This approach is promising as it attempts to provide a more realistic ligand-protein interaction environment without an unmanageable increase in computer processing time. However, studies validating this approach are still scarce. VEGFR-2 (vascular endothelial growth factor receptor 2), a known protein target for anti-angiogenic agents, was used in this study. Four residues located in the VEGFR-2 kinase site were selected and made flexible: Lys868, Glu885, Cys919, and Asp1046. The docking scores for all possible combinations of flexible residues were compared to the docking scores using a rigid conformation. The best overall docking scores were obtained using the Glu885 flexible conformation, with Pearson and Spearman rank correlation values of 0.568 and 0.543, respectively, and a 51% increase in processing time. Using different VEGFR-2 crystal structures, a similar trend was observed with the Glu885 flexible conformation presenting best scores. This study demonstrates that careful use of selective side-chain residue flexibility can improve AutoDock Vina docking score accuracy, without a significant increase in processing time. This methodology can be a valuable tool in drug design projects using VEGFR-2 but will also probably be useful if applied to other protein targets.     

益母丸、缩宫素应用于药物流产术中临床效果观察

目的观察益母丸、缩宫素在药物流产中对完全流产率,阴道出血情况的影响。方法本文通过对210例应用米非司酮配伍米索前列醇片（PG）终止早孕的健康妇女随机分组,药流同时加服益母丸,并于第3天肌注缩宫素为治疗组,纯药流组为对照组,观察两组的完全流产率及流产后阴道出血情况。结果治疗组完全流产率97．03％,对照组91．35％,在阴道出血情况上两组差异有统计学意义（P〈0．01）。结论益母丸、缩宫素对提高药物流产率,缩短药流后阴道出血时间,减少出血量有一定的作用。     

Recent advances in pharmacokinetic extrapolation from preclinical data to humans

The early characterisation of drug metabolism and pharmacokinetic (DMPK) properties of new chemical entities plays a key role in the pharmaceutical industry's effort to reduce attrition. Specifically, a major goal of early DMPK studies is to accurately predict the behaviour of new chemical entities in humans, thus allowing likely failures to be terminated rapidly and resource to be placed on molecules most likely to succeed. The present review summarises progress over the past several years in the key technologies used in the pharmaceutical industry to achieve these goals: namely, in vivo, in vitro and in silico/computational tools. The limitations of the various assays are discussed, with attention also given to likely future directions in this field.