复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜的效果评价

目的 评价复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜的效果。方法 选取我院在2016年3月-2018年2月收治的166例完全性鹿角形肾结石患者作为研究对象,对照组采用俯卧位标准通道PCNL术治疗。研究组给予斜仰卧截石位经皮肾镜联用逆行输尿管软镜进行治疗。对比两组手术时间、术后住院时间、首日清石率、2W清石率、血红蛋白下降幅度、输血率、尿路感染率、术后血清降钙素原(PCT)水平。结果 两组手术时间无显著差异(P>0.05),研究组术后住院时间、首日清石率及2W清石率显著优于对照组(P<0.05)。研究组术后血红蛋白下降幅度、输血率、尿路感染率及术后PCT均显著优于对照组(P<0.05)。结论 复杂鹿角型肾结石采用斜仰卧截石位经皮肾镜联用逆行输尿管软镜在不会显著增加手术复杂度的情况下可显著减轻外科创伤,促进结石清除,降低术后并发症发生风险。     

经皮肾镜与输尿管镜治疗复杂性输尿管上段结石的临床价值分析

目的探讨经皮肾镜与输尿管镜治疗复杂性输尿管上段结石的临床效果。方法选取我院自2010年1月-2011年1月收治的98例杂性输尿管上段结石患者，随机将其分观察组和对照组，各49例，给予观察组患者经皮下肾镜取石治疗，给予对照组患者输尿管镜取石治疗，对两组患者的一次成功率、治疗时间、术后出血量、术后一周和四周结石清除率进行对比。结果观察组患者的一次手术成功率明显高于常规组，P〈0．05，观察组患者的治疗时间、术后出血量明显大于对照组，P〈0．05，观察组患者术后1周、4周的结石清除率明显高于对照组，P〈0．05。结论输尿管镜取石治疗方式简单，且效果显著，具有创伤小、患者出血量小等特点，对于没有结石远端狭窄的患者比较适用；经皮下。肾镜取石治疗具有一次手术成功率高、结石清除率高等特点，然而该治疗方式容易导致出血事故发生，通常适用于输尿管镜取石治疗无效的患者，并且还要求医生具有过硬的技能。     

逆行输尿管镜碎石辅助顺行经皮肾镜取石术治疗复杂性输尿管上段结石

目的 探讨斜仰卧-截石体位下逆行输尿管镜碎石(URSL)辅助顺行经皮肾镜取石术(PCNL)治疗复杂性输尿管上段结石的方法与疗效.方法 2007年3月至2010年12月对95例复杂性输尿管上段结石患者施行了逆行URSL辅助顺行PCNL.输尿管结石大小12mm×6mm ～38mm×15 mm,合并肾结石24例.患者采用斜仰卧-截石体位.先施行逆行URSL,当结石碎块上移接近肾盂水平时,则在B超引导下建立16～22 F的PCNL工作通道.从PCNL通道顺行置入输尿管镜,行碎石取石术.取石满意后,留置6～7F双J管.结果 93例患者成功完成斜仰卧-截石体位下逆行URSL辅助顺行PCNL.2例因曾行开放性手术,输尿管上段扭曲明显,中转为开放性手术.手术时间(42.7±14.9) min;估计出血量(34.5±26.1) ml.术中输尿管结石均完全清除,合并肾结石者肾结石清除率95.8％(23/24).无术中及术后主要并发症.结论 斜仰卧-截石体位下逆行URSL辅助顺行PCNL治疗复杂性输尿管上段结石安全可行,避免了术中体位变换带来的不便;并发症少,手术效果良好;尤其适用于较大结石、阴性结石、合并肾结石以及输尿管结石容易上移的患者.     

经皮肾镜Cyberwand双导管超声联合输尿管镜碎石清石术治疗肾铸型结石疗效分析

目的探讨C臂X线引导下经皮肾镜Cyberwand双导管超声联合输尿管镜碎石清石术治疗肾铸型结石的临床效果。方法回顾性分析2011年1月～2012年12月150例肾铸型结石患者的临床资料,随机分成对照组（n=75）和治疗组（n=75）,分别采用经皮肾镜Cyberwand双导管超声碎石清石术和经皮肾镜Cyberwand双导管超声联合输尿管镜碎石清石术治疗,统计并比较两组的住院时间、手术时间、术中出血量、结石清除率及并发症发生情况。结果150例均成功建立20F皮肾通道,治疗组Ⅰ期完成手术53例,二期完成手术22例。手术时间36—150min,平均（62．8±11．3）min。术中出血量10—400ml,平均（50．7±12．6）ml。一次完全取净结石56例,清石率为74．7％;残留结石19例,其中残余小结石5例,泥沙样结石3例,行体外冲击波碎石治疗后结石排净,11例因术中出血视野模糊导致残余结石较大（直径〉2cm）,行二次手术结石取净。住院时间7—10d,平均（8．2±1．5）d。随访1—9个月,均无迟发性出血、严重感染等并发症。对照组Ⅰ期完成手术45例,二期完成手术30例。手术时间30—240min,平均（121．5±16．8）min。术中出血量10～800ml,平均（112．5±10．3）ml。一次完全取净结石43例,清石率为57．3％;残留结石32例,其中残余小结石6例,泥沙样结石4例,行体外冲击波碎石治疗后结石排净,13例因术中出血视野模糊导致残余结石较大（直径〉2cm）,行二次手术结石取净,9例因残留结石较大行三次手术取尽。住院时间7—20d,平均（12±2．6）d。随访1～9个月,均无迟发性出血、严重感染等并发症。治疗组手术时间、术中出血量、住院时间均显著低于对照组,组间比较差异有统计学意义（p〈0．05）;治疗组术后结石清除率显著高于对照组,组间比较差异有统计学意义（p〈0．05）;两组并发症发生率比较差异无统计学意义（p〉0．05）。结论经皮肾镜Cyber-wand双导管超声联合输尿管镜碎石清石术治疗肾铸型结石可以提高手术清石率,缩短手术时间、住院时间,减少手术次数,不增加副作用,具有良好的临床应用价值。     

微创经皮肾镜碎石取石术治疗复杂性输尿管上段结石的疗效分析

目的探讨微创经皮肾镜碎石取石术在治疗复杂性输尿管上段结石中的疗效。方法回顾性分析180例复杂性输尿管上段结石经微创经皮肾镜治疗的临床资料。结果手术时间80~120分钟,平均（90±10）分钟,一次性手术成功率为100%,一次性结石取净率为99%,术中无附加手术干预,无严重手术并发症。结论微创经皮肾镜碎石取石术治疗复杂性输尿管上段结石具有创伤小、恢复快、结石取尽率高、安全有效等优点,可作为复杂性输尿管上段结石的首选治疗方法。     

经皮肾镜联合输尿管镜一期治疗输尿管结石合并肾结石的临床研究

目的经皮肾镜联合输尿管镜一期手术治疗输尿管结石合并同侧肾结石的疗效观察。方法回顾性分析该院泌尿外科2010年3月—2014年3月收治的120例输尿管结石合并肾结石行手术治疗的患者临床资料,将其中行微创手术（经皮肾镜联合输尿管镜一期手术）治疗的60例患者作为研究组,行传统开放手术治疗的60例患者作为对照组,对两种术式一期手术疗效及安全性进行比较。结果研究组一期手术总有效率达到91.67%,对照组为78.33%,组间比较差异有统计学意义（P〈0.01）;研究组出现切口感染、大量出血、临近脏器损伤的患者比例均显著低于对照组（P〈0.05）。结论经皮肾镜联合输尿管镜一期手术治疗输尿管结石合并同侧肾结石效果显著,安全性高,优于传统开放手术,值得临床广泛应用。     

经皮肾镜取石术治疗输尿管上段结石临床观察

目的 观察经皮肾镜取石术治疗输尿管上段结石的临床疗效.方法 将108例输尿管上段结石患者随机分为观察组和对照组各54例.对照组患者行经尿道输尿管镜取石术治疗,观察组患者行经皮肾镜取石术治疗.观察两组患者的手术时间、术中出血量、住院时间、结石清除情况及并发症的发生情况,对比两组临床疗效.结果 观察组患者的手术时间和住院时间均明显长于对照组,差异具有统计学意义（P＜0.01）;两组的术中出血量无显著差异（P＞0.05）;观察组患者的结石清除情况及并发症的发生情况均明显优于对照组,差异具有统计学意义（P＜0.05）.结论 在输尿管上段结石的临床治疗中,经皮肾镜取石术与经尿道输尿管镜取石术各有优缺点,都具有较高的临床应用价值,应根据患者具体情况合理选用治疗方法.     

经皮肾镜联合输尿管镜一期治疗输尿管结石合并肾结石的临床研究

目的 观察经皮肾镜联合输尿管镜一期手术治疗输尿管结石合并肾结石的疗效.方法 回顾性分析我科2010年3月至2014年3月收治的120例输尿管结石合并肾结石患者的临床资料,将其中行微创手术（经皮肾镜联合输尿管镜一期手术）治疗的60例患者作为研究组,行传统开放手术治疗的60例患者作为对照组,比较两种术式一期手术疗效及安全性.结果 研究组一期手术总有效率达到91.67％,对照组为78.33％,组间比较有统计学意义（P＜0.05）;研究组出现切口感染、大量出血、临近脏器损伤的患者比例均明显低于对照组（P＜0.05）.结论 经皮肾镜联合输尿管镜一期手术治疗输尿管结石合并同侧肾结石效果显著,安全性高,优于传统开放手术.     

经皮肾镜与输尿管软硬镜治疗输尿管上段复杂结石的临床效果对比

目的对比经皮肾镜与输尿管软硬镜治疗输尿管上段复杂结石的临床效果。方法选取2019年10月至2021年2月我院收治的90例输尿管上段复杂结石患者,随机分为对照组(n=45)和观察组(n=45)。对照组采用经皮肾镜治疗,观察组采用输尿管软硬镜治疗。比较两组的手术相关指标、结石清除率及炎性因子水平。结果观察组术中出血量少于对照组,手术时间、住院时间短于对照组(P<0.05)。观察组术后4周的结石清除率高于对照组(P<0.05);两组患者术后12周的结石清除率比较无统计学差异(P>0.05)。术后1周,两组的CRP、IL-6水平高于术前,但观察组CRP、IL-6水平低于对照组(P<0.05)。结论与经皮肾镜治疗相比,输尿管软硬镜治疗输尿管上段复杂结石可明显减少术中出血量,缩短患者的手术时间和住院时间,提高早期结石清除率,减轻机体炎性反应。     

微创经皮肾输尿管镜取石术治疗肾结石

目的探讨微创经皮肾输尿管镜取石术(mPCNL)治疗肾结石的有效性及安全性.方法对接受微创经皮肾输尿管镜取石术治疗的138例患者进行了回顾性分析.结果138例均成功施行一期取石术,1次取净结石69例,2次取净石42例,结石完全清除率80.4%,10例残余结石患者结合ESWL治疗,平均手术时间130min,术中平均出血50ml,无1例需要输血,无严重并发症发生.结论微创经皮肾输尿管镜取石术具有损伤小、恢复快、结石清除率高、并发症少等优点,是治疗肾结石的较好方法.     

Antimicrobial resistance in community-acquired urinary tract infections in Paris in 2015

Background

Urinary tract infection (UTI) is one of the most frequent community-acquired infection. Escherichia coli resistance has been on the rise since 2000s.

Correlation among cadmium levels in river sediment, in rice, in daily foods and in urine of residents in 11 prefectures in Japan

Objective: The objective of this study is to examine if overall correlation exists among cadmium levels (Cd) in the general environment, dietary Cd intake, and Cd body burden of local residents. Methods: Eleven prefectures in Japan were selected as the areas where large-scale data on Cd levels in urine of adult women (40–49 and 50–59 years of age, respectively) were available to calculate geometric mean (GM) values for each of the prefecture. Other data were cited from published or previously established databases on Cd in the sediments of river bottoms (as a representative of Cd in the environment), Cd in rice for local consumption, and Cd in daily food duplicate samples collected from local women populations, and calculated for GM values for the prefectures. The GM values were subjected to correlation matrix and regression analysis. Results: Marginally significant (P<0.10) correlation was detected between Cd in sediment and Cd in rice. Furthermore, correlation of Cd in sediment was significant with Cd in total foods (P<0.05) and possibly with Cd in urine (P<0.05–0.10). Importance of data on Cd in rice paddy soil as a missing link is discussed. Conclusions: Correlation was demonstrated in the flow of Cd transport from the environment (expressed as Cd contents in river sediments) to humans (in terms of Cd in urine) among general populations in Japan.     

Further reduction in lead exposure in women in general populations in Japan in the 1990s, and comparison with levels in east and south-east Asia

Objective: The objective of the study was to elucidate the current level of environmental lead (Pb) exposure of women in general population in Japan, where the use of organic Pb in automobile gasoline was phased out from 1973 to reach a zero level early in the 1980s. Methods: A survey was conducted in 27 sites throughout Japan from 1991 to 1997. Five hundred and eighty-eight non-smoking women from the sites offered 24-h food duplicate, peripheral blood, and spot urine samples. Pb in food duplicates (Pb-F), blood (Pb-B), and urine (Pb-U) were analyzed by inductively-coupled plasma mass spectrometry. The results of Pb-F and Pb-B were compared with observations from a study conducted from 1977 to 1981 on 339 women at the same sites. Log-normal distribution was assumed for the evaluation of the results. Results: Geometric means (GMs) of Pb-F, Pb-B, and Pb-U in the 1991–1997 study were 9.0 μg/day, 20.2 μg/l, and 2.18 μg/g creatinine, respectively. The values for Pb-F and Pb-B were substantially lower than the values (32.8 μg/day for Pb-F and 31.7 μg/l for Pb-B) obtained in the 1977–1981 study, which were already low when compared internationally. Cd-U values in the period from 1991 to 1997 also appeared to be among the lowest in the world. Analysis for time-dependent changes in Pb-U was, however, not possible at the time of this study because no values were available for the period from 1977 to 1981. Conclusions: Substantial reductions from 1977–1981 levels in environmental Pb exposure were observed among the study populations in Japan. Current exposure levels appear to be lower than those in other parts of Asia, the USA, and Europe. Received: 16 March 1999 / Accepted: 27 August 1999     

北京市新发地市场新型冠状病毒肺炎疫情相关病例的流行病学特征分析

目的 分析并比较北京市新发地市场疫情中新型冠状病毒肺炎（COVID-19）确诊病例与无症状感染者的流行病学特征。方法 收集并整理传染病报告信息管理系统中北京市新发地市场疫情中COVID-19感染者数据和流行病学调查报告资料,应用SPSS 19.0软件分析并比较确诊病例和无症状感染者的流行病学特征。结果 2020年6月11日至7月10日北京市共诊断新型冠状病毒感染者368例,其中确诊病例335例（91.03%）,无症状感染者33例（8.97%）。病例分布于11个区,其中丰台区病例数占总病例数的68.48%（252/368）。发病曲线呈现暴发流行模式,发病高峰为6月13日。全部感染者年龄M（Q_R）为43（31~51）岁,无症状感染者的年龄M（Q_R）为32（29~49）岁,低于确诊病例的年龄M（Q_R）[43（31~52）岁],差异有统计学意义（Z=2.416,P=0.016）。感染者男女性别比为1.26：1。从事餐饮及商业服务和公共场所服务的人员最多,占64.13%（236/368）。73.91%（272/368）的感染者有新发地市场直接暴露史。通过核酸筛查发现全部感染者的54.08%（199/368）。确诊病例中轻型和普通型病例占99.10%（332/335）,无死亡病例。结论 北京市新发地市场疫情呈暴发流行模式,COVID-19病例以餐饮和服务业人员为主。无症状感染者的年龄低于确诊病例。     

Use of solvents in industries in Korea: experience in Sinpyeong-Jangrim industrial complex

Objectives: To identify the most popular solvent and typical type of solvent work among solvent-using workplaces in Korea. Methods: In practice, 862 solvent-using workshops in Sinpyeong-Jangrim industrial complex in Pusan were investigated in a 2-year period from March 1995 to February 1997. Solvent vapors in the breathing zone of workers were collected by personal sampling with charcoal tubes. The exposed charcoal was extracted with carbon disulfide, and the solvents in the extract were analyzed by flame ionization detector-equipped gas chromatography (FID-GC). Results: Solvents were used in painting, glue application, cleaning, printing and solvent-mixing workshops in decreasing order of popularity. Toluene was the most frequently measured solvent. In the five types of solvent work, acetone, hexane, methyl ethyl ketone, methyl isobutyl ketone, tetrachloroethylene, trichloroethylene and xylenes were also used frequently. Conclusions: Toluene was identified as the most frequently used solvent in solvent works in Korean manufacture industries in the late 1990s. Eight types of solvent were popularly used in five popular types of solvent work. These trends are very similar to the cases reported for industries in Japan. Received: 20 April 1999 / Accepted: 6 May 2000     

Effectiveness of influenza vaccination in the elderly in a community in Italy

Objectives: Assess the effectiveness of influenza vaccination in reducing hospitalization due to pneumonia and influenza among elderly subjects in a community in central Italy. Estimate the hospitalization fraction preventable by extending the vaccination program. Methods: Case–control study. Cases were subjects aged 65+ at hospital admission (1 December 1994–31 March 1995). For each case two population controls were randomly chosen, matched by sex, age and residence. Variables of interest were recorded through a postal questionnaire and telephone interview. A matched-set analysis was carried out adjusting for concomitant chronic diseases, education, type of home heating, and smoking habits. The preventable fraction of hospitalization was computed through the application of the attributable risk estimate. The setting was 33 municipalities in central Italy including 169,370 residents aged 65 years or more. Results: Two hundred and seventy-five cases 550 controls were analyzed. Influenza vaccination was effective in preventing 33% of hospitalization due to pneumonia/influenza. The fraction of hospital admissions preventable by extending the vaccination was 17%. When the analysis was limited to self-respondents to the questionnaire (excluding next-of-kin) and to pneumonia/influenza as primary discharge diagnosis, protection from hospitalization by vaccination almost reached 50%, a better result in comparison with most case–control studies. Conclusions: Influenza vaccination was shown to be successful in reducing hospital admissions due to pneumonia and influenza. A large number of hospitalizations could be reduced extending the vaccination campaign.     

Cost of breast cancer in Sweden in 2002

Breast cancer is the most common cancer among Swedish women and an important cause of illness and death. The aim of this study was to estimate the total cost of breast cancer in Sweden in 2002, using a top-down prevalence-based cost-of-illness approach. The total cost of breast cancer in Sweden in 2002 was estimated at 3.0 billion SEK (1 € = 9.4 SEK). The direct costs were estimated at 895 million SEK and constituted 30% of the total cost. Indirect costs were estimated at 2.1 billion SEK and constituted 70% of the total cost. The main cost driver was production losses caused by premature mortality, amounting to 52% of the indirect costs. The reason that indirect costs were the dominant cost is because most newly detected breast cancers occur in patients aged below 65, thus causing significant production losses due to sick leave, early retirement, and premature mortality.

Lead contents in the surface enamel of deciduous teeth sampled in vivo from children in uncontaminated and in lead-contaminated areas

This study aimed to: (1) measure lead contents in the surface enamel of two populations consisting of 4-6-year-old children, one from an apparently uncontaminated area (Ribeirão Preto, São Paulo State, SP, Brazil, n=247) and the other from an area notoriously contaminated with lead (Bauru, São Paulo State, Brazil, n=26); (2) compare biopsy depths between the two populations; (3) correlate biopsy depth with lead content; (4) stratify samples according to biopsy depth to compare lead contents in samples from similar biopsy depths. A surface enamel acid-etch microbiopsy was performed in vivo on a single upper deciduous incisor for each sample. Lead was measured by graphite furnace atomic absorption spectrometry (GFAAS) while phosphorus was measured colorimetrically to establish biopsy depth. Samples from both populations were classified into categories of similar biopsy depths based on biopsy depth quartiles. Median lead contents were statistically different between the Ribeirão Preto population (206 μg/g, range: 5-1399 μg/g) and the Bauru population (786 μg/g, range: 320-4711 μg/g) (p<0.001); however, biopsy depth did not differ between the Ribeirão Preto (3.9 μm, Standard Deviation, SD=0.9) and Bauru (3.8 μm, SD=0.9) populations (p=0.7940). Pearson's correlation coefficient for biopsy depths versus log₁₀ lead values was −0.29 for Ribeirão Preto and −0.18 for Bauru. Lead contents were statistically different between the two populations for all quartiles of biopsy depth. These findings suggest that lead accumulated in the surface enamel of deciduous teeth is linked to the environment in which people reside, indicating that this tissue should be further explored as an accessible biomarker of lead exposure.     

Intestinal Parasites in Healthy Subjects in Albania

The purpose of this study was to evaluate the prevalence of intestinal parasites in 277 healthy subjects in the city of Mamuras (Albania, South Eastern Europe) and the correlation between parasitic infections and possible risk factors. Faecal samples collected with sodium-acetate-formalin fixative were concentrated by formalin ethylacetate sedimentation and examined as wet mounts, permanent stains and by anti-Giardia/Cryptosporidium fluorescent antibodies. Data concerning age, sex, level of education, availability of piped water, number of people living in the same house, and residence in rural or urban area were collected for each subject. Statistical analysis was performed by chi-square test and regression logistic analysis. The overall prevalence of intestinal parasites was 183/277 (66.06%). In particular, pathogenic protozoa or helminths were found in 67 subjects (24.18%), including Trichuris trichiura in 34 (12.27%), Giardia duodenalis in 31 (11.19%), Hymenolepis nana in 5 (1.8%), Ascaris lumbricoides in 3 (1.08%). A significant correlation was observed only between parasite colonization and older age and between Trichuris trichiura infection and residence in rural areas.     

Paradoxical increases in serum levels of highly chlorinated PCBs in aged women in clear contrast to robust decreases in dietary intakes from 1980 to 2003 in Japan

Objective  Exposure to polychlorinated biphenyls (PCBs) is considered to have culminated between 1950 and 1970 in Japan, and exposure through diet, the major exposure route, has decreased significantly over the last 10 years. The primary goal of the present study was to investigate the long-term trends and congener profiles of serum and dietary levels of PCBs using historical samples. Methods  Using banked samples collected in 1980, 1995, and 2003 surveys, we determined the daily intakes and serum concentrations of 13 PCB congeners (#74, #99, #118, #138, #146, #153, #156, #163, #164, #170, #180, #182, and #187) in women. Results  The total daily PCB intake [ng/day, geometric mean (geometric standard deviation)] decreased significantly from 523 (2.5) in 1980 to 63 (3.2) in 2003. The serum total PCB level (ng/g lipid) in women <40 years of age decreased significantly from 185 (1.8) in 1980 to 68 (1.8) in 2003. In contrast, the level in women >50 years of age increased significantly from 125 (1.7) in 1980 to 242 (1.7) in 2003. Specifically, the serum concentrations of hexa (#138, #146, #153, #156, #163, and #164) and hepta (#170, #180, #182, and #187) congeners increased significantly. A comparison of the serum PCB levels of women born from 1940 to 1953 revealed that their serum total PCB level was significantly higher in the 2003 survey [242 (1.7), n = 9] than in the 1995 [128 (2.0), n = 17] surveys. This increase in the total PCB level was attributable to increases in the hepta congener groups. Conclusion  Present results suggest a decreased rate of elimination of hepta congeners with aging in females, rather than a birth-generation phenomenon.