膀胱巨大结石1例

膀胱结石为泌尿系结石中常见疾病,占泌尿系结石的58.8%左右,直径在3.0cm以内的膀胱结石临床较常见,大多数患者有刺激、创伤、梗阻、继发感染等多种症状,但较大结石有时可无明显症状[1]。本院近期收治1例巨大膀胱结石,重量达495g,手术后恢复好。1临床资料患者,男性,43岁。因间隙     

581例泌尿系结石成分分析及防治

目的研究英德地区581例泌尿系结石化学构成,为临床预防、治疗提供依据。方法化学反应测定581例泌尿系结石标本,研究其成分,并结合临床资料进行比较。结果在581例尿石中混合结石占70.56%（410/581）,其中草酸盐结石59.89%,磷酸盐结石34.59%,碳酸盐结石24.61%,尿酸结石26.33%;单纯结石17.42%。上尿路结石473例,下尿路结石108例,上、下尿路结石之比为4.36：1,肾、输尿管结石主要以草酸钙和磷酸钙混合结石及单纯草酸钙结石为主,膀胱结石主要以尿酸结石为主,尿路结石部位和化学成份构成密切相关,肾、膀胱结石与其化学成份构成经统计学检验差异有显著性（P值〈0.005）,提示上、下尿路结石的发病机理不同。结论结石成分分析对于了解结石成因、预防结石形成和复发具有重要的意义。     

238例膀胱结石成分及相关危险因素分析

目的观察膀胱结石患者的年龄、性别以及体内结石相关成分,并分析其危险因素。方法回顾性分析2007年4月～2012年10月来本院治疗的膀胱结石疾病患者238例,所有患者均来自同一地区,采用压片法并用红外光谱仪分析膀胱结石患者结石成分,并分析患者年龄分布以及结成成分与患者性别的关系。结果膀胱结石中﹤30岁患者31例（13.03%）,﹤40岁患者76例（31.93%）,﹤50岁患者60例（25.21%）,﹤60岁患者69例（28.99%）,﹤80岁患者2例（0.84%）。尿酸盐合并草酸钙结石占34.03%（81/238）,单纯性尿酸盐结石占24.79%（59/238）,单纯性草酸钙结石占15.55%（37/238）,草酸钙合并磷灰结石占11.76%（28/238）,磷灰石并磷酸鎂铵结石占8.41%（20/238）,单纯性碳酸氢钙结石占5.46%（13/238）,且患者性别与结石成分不具有相关性。结论膀胱结石以含钙离子的尿结石为主,且患者有青年化的趋势,高龄与感染是膀胱结石患者的主要危险因素。     

巨大膀胱结石2例致肾功能损害及文献复习

随着经济条件的改善原发性膀胱结石的发病率明显下降．多继发于前列腺增生基础上发病．另一方面随着医疗条件的改善膀胱结石很容易早期发现得到良好治疗．膀胱巨大结石属于罕见病例．膀胱腔较大．结石很难引起上尿路梗阻并出现肾功能损害。2006～2008年我科收治2例青年男性巨大膀胱结石出现肾功能损害．其中1例出现急性肾衰竭．现报告如下。     

彩色多普勒超声对膀胱结石的诊断意义

目的探讨彩色多普勒超声在膀胱结石诊断中的价值。方法将56例膀胱结石的患者进行彩色多普勒超声检查,结果 58例膀胱结石患者彩色多普勒超声及部分X线造影检查,均可见结石影像,超声检查符合率达92%以上。结论彩色多普勒超声对膀胱结石的诊断有极为实际的临床应用价值,是检查膀胱疾病的重要方法及手段。     

体外冲击波碎石术结合碳酸氢钠溶石治疗尿酸结石（附40例分析）

目的 观察采用体外冲击波碎石术结合1%－1.5%碳酸氢钠溶石治疗尿酸结石的疗效。方法 26例肾尿酸结石和9例输尿管尿酸结石及5例肾输尿管尿酸结石患者，先采用输尿管导管逆行插管定位碎石后采用1%-1.5%碳酸氢钠溶石治疗。结果 尿酸结石完全消失，无一例出现并发症及逆行感染。结论 此方法是一种治疗尿酸性结石理想方法，具有操作简便、安全、痛苦少、效果满意、合并症少等优点，同时亦是ESWL治疗尿酸结石重要辅助方法。     

泌尿系结石的螺旋CT诊断

目的 探讨泌尿系结石的CT表现及其诊断价值.方法 分析60个临床及其他检查怀疑泌尿系结石患者的CT图像.结果 单纯肾结石27例、单纯输尿管结石14例、两者均有结石12例;单纯膀胱结石5例,2例未发现结石.其中,40例有肾盏肾盂扩张和输尿管扩张,10例可见环形征.结论 泌尿系结石的CT表现具有特征性,有重要的诊断价值.     

输尿管镜下气压弹道碎石术的临床治疗体会

目的探讨输尿管镜下气压弹道碎石术治疗输尿管结石,膀胱结石的临床疗效。方法回顾本院从2006年以来对78例输尿管结石,膀胱结石患者采用输尿管镜下气压弹道碎石治疗。结果输尿管结石碎石成功率为91%,失败率为9%,膀胱结石碎石成功率100%。结论输尿管镜下气压弹道碎石术治疗输尿管结石,膀胱结石疗效确切,具有微创、安全、效果好等优点。     

粤西湛江地区285例泌尿系结石成分分析

目的探讨粤西湛江地区尿路结石患者泌尿系结石成分现状,为临床防治提供依据。方法用现况调查的方法收集我院门诊、住院及粤西湛江地区部分医院送检的共285例尿路结石患者标本,应用红外光谱分析确定结石成分,并结合临床资料进行分析。结果 285例患者中,年龄7~88岁,平均(56.96±14.59)岁,其中男190例,女95例;发病部位肾脏结石166例,输尿管结石45例,膀胱结石74例,没有尿道结石病例。上下尿路结石比例为2.85:1;单一成分结石、混合性结石分别占总结石数的12.28%、87.72%;含钙结石277例(97.19%),感染性结石34例(11.93%),尿酸结石108例(37.89%),黄嘌呤结石1例(0.35%),胱氨酸结石2例(0.70%)。结论湛江地区的尿路结石以含钙结石为主要成分,其次是尿酸结石,可为本地区尿路结石的防治提供重要线索。     

大鹏新区297例沿海居民泌尿系统结石成分调查分析

目的了解深圳市大鹏新区沿海居民泌尿系统结石患者的结石成分现状,为当地的临床防治工作提供参考依据。方法收集2017年3月～2019年1月来深圳市大鹏新区妇幼保健院就诊的泌尿系统结石患者297例,采用红外光谱法检测确定其结石成分,并结合临床资料进行统计分析。结果 297例结石患者共检出16种结石成分,其中单一成分结石65例,占21.89%,明显低于混合成分结石的78.11%,差异有统计学意义(P 0.05)。单一成分结石中以一水草酸钙检出率最高,为21.89%,而混合成分结石以一水草酸钙+无水尿酸检出率最高,为34.68%;男性尿酸类结石检出率为51.50%,明显高于女性的28.87%,差异有统计学意义(P 0.05),而女性患者感染性结石检出率为21.65%,明显高于男性的4.50%,差异有统计学意义(P 0.05);肾结石中含钙结石检出率为98.07%,明显高于其他部位结石,差异有统计学意义(P 0.05),而膀胱结石中尿酸类、感染性及羟基磷灰石类结石检出率分别为96.00%、24.00%及8.00%,明显高于其他部位结石,差异有统计学意义(P 0.05);20～39岁结石患者含钙结石和感染性结石检出率最高,分别为95.51%和17.98%,明显高于其他年龄段,差异有统计学意义(P 0.05),而≥60岁结石患者尿酸类结石检出率最高,为63.33%,明显高于其他年龄段,差异有统计学意义(P 0.05)。结论深圳市大鹏新区泌尿系统结石以含钙结石成分为主,其次为尿酸类结石,不同性别、年龄及发病部位存在很大差异,可为本地区泌尿系统结石的防治工作提供科学参考依据。     

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.     

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.     

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.