输尿管口囊肿的诊断与治疗

目的 探讨输尿管口囊肿的诊断与治疗方法。方法 对12例输尿管口囊肿患者的临床资料进行分析。结果 12例经B超、静脉尿路造影（IVU）、膀胱镜检查得以确诊。5例行经尿道囊肿切开或部分切除术；5例行囊肿切除加输尿管膀胱再植术；2例行上肾段及输尿管切除术。术后随访1～15年，12例临床症状均消失，经B超或IVU检查肾积水明显减轻或消失。7例行膀胱造影，未见输尿管返流。结论 输尿管口囊肿的诊断主要依靠B超、IVU和膀胱镜检查。治疗上应根据囊肿大小和肾功能情况选择不同的术式。     

经尿道输尿管囊壁部分切除术治疗成人输尿管囊肿11例临床分析

目的探讨经尿道输尿管囊壁部分切除术治疗成人输尿管口囊肿的治疗经验。方法回顾性分析11例成人输尿管口囊肿的临床资料。所有患者均采用B超、IVU及膀胱镜检查确诊,采用经尿道输尿管囊壁部分切除术治疗。结果11例患者手术治疗痊愈出院,术后临床症状均消失。随访6--24个月,9例肾积水消失,2例肾积水明显改善,未见复发。结论膀胱镜检查是诊断输尿管囊肿的确切手段;经尿道输尿管囊肿壁部分切除术是一种简便、安全和行之有效的治疗手段。     

经尿道输尿管囊壁部分切除术治疗成人输尿管囊肿11例临床分析

目的探讨经尿道输尿管囊壁部分切除术治疗成人输尿管口囊肿的治疗经验。方法回顾性分析11例成人输尿管口囊肿的临床资料。所有患者均采用B超、排泄性静脉尿路造影（IVU）及膀胱镜检查确诊，采用经尿道输尿管囊壁部分切除术治疗。结果11例患者手术治疗痊愈出院，术后临床症状均消失。随访6—24个月，9例肾积水消失，2例肾积水明显改善，未见复发。结论膀胱镜检查是诊断输尿管囊肿的确切手段；经尿道输尿管囊肿壁部分切除术是一种简便、安全和行之有效的治疗手段。     

经尿道等离子电切治疗成人输尿管开口囊肿(附12例报告)

目的观察经尿道等离子电切治疗成人输尿管开口囊肿的效果。方法回顾性分析12例成人输尿管囊肿患者采用经尿道等离子电切治疗的临床资料。结果12例患者均经IVU、B超及膀胱镜检查确诊,采用经尿道等离子电切行输尿管囊肿低位横行切开术4例,3例肾积水消失,1例肾积水改善;8例行输尿管膨出囊壁部分切除,积水全部消失。均一次手术成功,术后平均随访8个月,2例术后出现输尿管返流,均于3个月后自行缓解。结论经尿道等离子电切治疗成人输尿管开口囊肿是一种安全、简单、有效的治疗方法,可以减少手术创伤及术后并发症,创伤小、恢复快。囊壁部分切除术效果更为理想。     

经尿道腔内手术治疗输尿管囊肿38例

目的 评价经尿道输尿管囊肿的腔内手术治疗方法及其疗效.方法 回顾性分析38例输尿管囊肿患者临床资料,术前均由B超、静脉尿路造影(IVU)和膀胱镜检查确诊.32例经尿道输尿管囊肿内切开或开窗术,6例经尿道钬激光治疗.结果 本组38例腔内手术均成功,平均手术时间15 min,术后平均住院4d.术后随诊时间1～9年,所有患者症状均消失,无明显并发症发生,亦无囊肿复发.结论 经尿道输尿管囊肿的腔内手术疗效好,手术创伤及术后并发症少,是治疗输尿管囊肿的首选方法.     

经尿道电切术治疗成人输尿管囊肿16例

目的：探讨经尿道电切术治疗成人输尿管囊肿的经验。方法：对16例采用经尿道电切术治疗成人输尿管囊肿进行回顾性总结。结果：16例均经IVP、B超、膀胱镜检查确诊,囊肿部分切除,12例肾积水消失,2例改善。结论：成人输尿管囊肿经尿道电切术治疗是一种简单、有效、恢复快的治疗方法。     

输尿管口膨出的影像学诊断和治疗分析

目的探讨输尿管口膨出的诊断与治疗方法。方法回顾性分析11例输尿管口膨出患者的临床资料。11例患者术前均由B超或静脉尿路造影、膀胱镜检查确诊。2例采用三角区重建术治疗,2例行经尿道囊肿低位横切开术,5例行输尿管囊肿切除术,2例行输尿管原位移植。结果11例患者均获治愈,开放手术平均时间86 min,术后平均住院10．5 d;腔内手术40 min．术后平均住院6．0 d。随访3个月至9年,无并发症发生。结论输尿管口膨出的诊断主要依靠影像学检查,B超结合静脉尿路造影、膀胱镜检查可提高确诊率。治疗上宜早期手术处理,输尿管口囊肿切除、三角区重建术是一种好的术式,经尿道囊肿电切术可以减少手术创伤、缩短手术及住院时间。     

成人双侧输尿管口囊肿一例误诊分析

[病例] 男,40岁.主因尿痛、偶发血尿、排尿困难9年就诊.患者于1994年在外院B超诊断为膀胱异物,但患者否认尿道异物插入及膀胱手术史,因拒绝行膀胱镜检查,予对症处理,病情稍有缓解.1999年因病情加重,在外院B超检查怀疑膀胱结石及膀胱憩室,未予治疗.2001年在我院行B超检查示双侧输尿管口囊肿,左侧囊肿内有一1.0 cm×0.8 cm结石,左侧肾盂轻度积水.行膀胱镜检查示:膀胱内大量小梁、小房形成;左侧输尿管口囊肿4.0 cm×3.5 cm,无周期性缩小,输尿管口炎性水肿,囊肿在膀胱内充水200 ml时阻塞尿道内口;右侧输尿管口囊肿2.0 cm×1.5 cm,周期性缩小.确诊为输尿管口囊肿(双侧).在骶麻下经尿道行双侧输尿管囊肿部分电切,保留部分囊壁成一舌形瓣以抗输尿管反流,左侧囊肿内结石以异物钳取出.病理诊断:输尿管口囊肿(双侧).术后经短期留置导尿、抗生素治疗,临床症状消失.术后3个月复查,左侧肾盂积水消失.     

输尿管囊肿30例的诊断和治疗

目的探讨输尿管囊肿的诊断和治疗。方法综合分析30例输尿管囊肿患者的临床资料,术前均由B超、静脉肾盂造影(IVP)或膀胱镜确诊。15例行经尿道囊肿低位横切开术,15例行囊肿切除+输尿管再植术(成形术)。结果 30例患者均获痊愈,随访1个月至6年,无输尿管囊肿复发及并发症的发生。结论多种检查方法对输尿管囊肿均具有较高的诊断价值,经尿道输尿管囊肿的腔内手术疗效显著,应为首选治疗方法。     

成人先天性巨输尿管症的诊治

目的 探讨成人先天性巨输尿管症的诊断和治疗要点。方法 回顾性分析11例成人先天性巨输尿管症病例。其中双例1例，左侧6例，右侧4例。所有病例均行B超、IVU及尿道膀胱造影检查，9例行输尿管。肾盂逆行造影，2例行CT三维尿路重建（CTU）或磁共振尿路成像（MRU）。2例行。肾输尿管切除术，8例行输尿管下段裁剪整形＋输尿管膀胱乳头状再植术，1例保守观察治疗。结果 9例患者获1-8年随访，均行B超及IVU复查，7例积水明显改善，2例无明显变化。结论 IVU或逆行造影是诊断成人先天性巨输尿管症的首选方法，输尿管裁剪整形＋输尿管膀胱乳头状再植术是治疗该症的有效方法。     

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.     

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.