泌尿系感染性结石的病因、诊断及治疗分析

目的探讨泌尿系感染性结石的病因、诊断及治疗分析。方法通过对泌尿系感染性结石的病因、诊断及治疗的探讨,对治疗泌尿系感染性结石的诊断以及治疗采取有效的方法。结果泌尿系感染性结石是由于细菌解体形成结石核心,通过X线平片检查和实验室检查诊断结石,对结石的治疗以外科治疗为主,以药物治疗为辅。结论采用外科治疗碎石,用抗生素防止结石感染及复发。     

B超引导下体外冲击波碎石治疗10588例输尿管结石临床分析

目的探索和分析B超引导下体外冲击波碎石治疗输尿管结石的方法和疗效。方法 1998年至今治疗输尿管结石10588例,对其使用体外冲击波碎石治疗。结果通过一次体外冲击波碎石治疗输尿管结石,输尿管结石清除率为75.8%,通过两次体外冲击波碎石治疗输尿管结石,输尿管结石清除率为96.4%,通过三次体外冲击波碎石治疗输尿管结石,输尿管结石清除率为99.3%,通过四次体外冲击波碎石治疗输尿管结石,输尿管结石清除率为99.5%,通过五次体外冲击波碎石治疗输尿管结石,输尿管结石清除率为99.8%。结论体外冲击波碎石治疗输尿管结石方便、经济、实用、安全、效果好。     

240例输尿管结石治疗分析

目的探讨B超定位经皮输尿管镜治疗输尿管结石的临床疗效,为预防和控制输尿管结石提供科学依据。方法以240例B超定位经皮输尿管镜治疗输尿管结石的患者为实验组研究对象,设立相应对照组,通过对患者采用针对性治疗与观察,采用回顾性方法研究分析手术临床资料。结果本次实验组总有效率达到100%,而对照组(常规)达到90%,两组治疗效果差异有统计学意义(P<0.05),B超定位经皮输尿管镜治疗输尿管结石效果好于传统治疗。I期取净结石192例,Ⅱ期取净结石48例,结石总取净率为100%。结论输尿管结石治疗具有一定困难和风险的,只有熟练掌握手术治疗方法和相关技能,才能取得较好的手术效果。     

胆囊结石合并胆总管结石手术治疗的现状

胆总管结石传统的手术治疗方法是开腹胆总管取石.随着内镜和腹腔镜技术的成熟,腹腔镜、纤维胆道镜及十二指肠镜的有机组合已成为治疗胆总管结石有效的微创治疗方法.微创治疗胆总管结石的理念逐渐被外科医生所接受.本文综述胆囊结石合并胆总管结石治疗的现状和进展.     

33例胆道术后残余结石的治疗报告

目的:探讨胆道术后残余结石的治疗方法。方法:回顾性分析33例肝内胆管结石手术后残余结石患者的临床资料,对残余结石的治疗方法进行分析。结果:24/33(72.7%)例经T管窦道胆道镜取尽结石,3/33例经EST取尽结石,总的取尽结石成功率为81.8%。6/33例(18.2%)无法取尽结石,2/33例经再次胆道手术治愈。结论:应该重视术后残余结石合理治疗,经T管窦道取石及EST是治疗残余结石的重要方法,并非所有的患者需要再次手术治疗。     

单纯肝切除术治疗肝内胆管结石的临床疗效观察

目的为了进一步研究和比较单纯肝切除术与单纯取石术两种方法在治疗肝内胆管结石过程中的治疗效果差异,从而为治疗肝内胆管结石提供可靠依据。方法本文选取了我院2008年至2010年间收治的48例肝内胆管结石患者为研究对象进行了回顾性分析。结果两组患者实施不同手术治疗方法后,结石残留率组间比较,肝切除术组患者显著低于单纯取石组患者的水平,且P<0.05,差异具有统计学意义。结论在临床治疗肝内胆管结石的实践过程中,与传统采用单纯取石术治疗方法相比较,采用单纯肝切除术治疗方法治疗肝内胆管结石的临床治疗效果显著,是临床治疗肝内胆管结石的安全可靠选择。     

32例上尿路结石的治疗疗效分析

目的探讨B超定位经皮输尿管境治疗输尿管上段结石的临床疗效,为预防和控制输尿管上段结石提供科学依据。方法以32例B超定位经皮输尿管镜治疗输尿管上段结石的患者为实验组研究对象,设立相应对照组,通过对患者采用针对性治疗与观察,采用回顾性方法研究分析手术临床资料。结果本次实验组(B超定位经皮输尿管镜治疗输尿管上段结石)总有效率达到100%,而对照组(常规)达到84.37%,两组治疗效果差异有统计学意义(P<0.05),B超定位经皮输尿管镜治疗输尿管上段结石效果好于传统治疗。32例(B超定位经皮输尿管镜治疗输尿管上段结石)均穿刺成功。I期取净结石24例,Ⅱ期取净结石8例,结石总取净率为100%。结论输尿管上段结石治疗具有一定困难和风险的,只有熟练掌握介入治疗手术治疗方法和相关技能,才能取得较好的手术效果。B超定位经皮输尿管镜治疗输尿管上段结石治疗上尿路结石安全,高效,值得临床推广。     

肝叶肝段切除术治疗肝内胆管结石31例分析

目的总结肝叶肝段切除术治疗肝内胆管结石的治疗效果和经验。方法2004年10月至2008年10月采用肝叶肝段切除方法,治疗肝内胆管结石共31例。结果术后复查无肝内胆管结石,全部治愈出院。结论肝内胆管结石,采用常规切开取石法,术后结石残留及复发率高,并发症多。运用肝叶肝段切除法,治愈率高、并发症少、复发率低,是治疗肝内胆管结石的好方法。     

体外冲击波治疗泌尿系结石156例临床分析

目的探讨体外冲击波治疗泌尿系结石的临床疗效。方法对156例泌尿系结石住院患者行体外冲击波碎石治疗,病变部位包括肾脏结石、输尿管结石。膀胱结石及尿道结石不在探讨范围之内。结果体外冲击波碎石成功率为94%。结论体外冲击波碎石治疗泌尿系结石临床疗效满意,是治疗泌尿系结石的一种有效方法。     

经尿道输尿管镜下弹道碎石治疗输尿管结石279例的临床分析

目的 探讨输尿管镜下气压弹道碎石(URSL)治疗输尿管结石临床疗效.方法 2003～2011年URSL治疗输尿管结石患者279例临床资料,比较输尿管不同部位结石的碎石成功率,总结引起手术的不良反应原因.结果 URSL碎石成功率为95.3%,上段输尿管和中段结石的碎石成功率显著高于上段结石(P值均<0.05).影响上段输尿管结石碎石成功率的主要因素为结石上移,可并发血尿、发热、输尿管穿孔等症.结论 URSL术是治疗输尿管结石的有效方法,安全、创伤小、并发症少,是中下段输尿管结石的首选治疗方法.     

新疆高寒地区家畜、家禽胆汁与肠内容物中的弯曲菌带菌情况的调查分析

目的调查高寒地区家畜、家禽胆汁与肠内容物中弯曲菌的分布情况。方法对12种家畜、家禽胆汁与肠内容物中的弯曲菌进行分离、培养、鉴定,并观察7种家畜、家禽胆汁弯曲菌的存活时间。结果在1814份家畜、家禽胆汁中发现,猪、牛、马、羊、狗、猫、鸡、鹅、鸭、鹌鹑、鸽子、家兔的胆汁中弯曲菌带菌率分别为6.67%、4.17%、4.94%、3.64%、8.93%、19.05%、6.41%、2.78%、6.48%、24.39%、5.66%、0。体外实验证明,弯曲菌在胆汁中可存活4～7周。结论高寒地区家畜、家禽肠内容物的带菌率均高于同种家畜、家禽的胆汁带菌率,提示该区家畜、家禽是弯曲菌的重要传染源。     

Subacute toxicity evaluation of a new camptothecin anticancer agent CKD-602 administered by intravenous injection to rats

The subacute toxicity of a new camptothecin anticancer agent, CKD-602, was investigated after 4-week repeated intravenous administration of the chemical in Sprague-Dawley rats. The test chemical was administered intravenously to rats at dose levels of 0, 0.003, 0.013, or 0.067 mg/kg/day for males and 0, 0.004, 0.018, or 0.089 mg/kg/day for females. At the end of the treatment period, 10 rats/sex/group were sacrificed. The remaining 5 rats/sex in the vehicle control and high dose groups continued the study without treatment for 2 weeks (recovery period). During the test period, clinical signs, mortality, body weights, food and water consumption, ophthalmoscopy, urinalysis, hematology, serum biochemistry, gross findings, organ weights, and histopathology were examined. In both sexes of the high dose group, an increase in the incidence of abnormal clinical signs and paleness of the eyes, a reduction in the body weight gain, food consumption and urine protein, and an increase in the water consumption were observed. Hematological investigations revealed a decrease in the red blood cells, hemoglobin and hematocrit and an increase in the mean corpuscular volume, mean corpuscular hemoglobin, platelets, and reticulocytes in a dose-dependent manner. Serum total cholesterol and total protein values were lower in females than those of controls, but not in males. An increase in the heart and liver weights and a decrease in the thymus weight were also found. Histopathological alterations included an increase in the incidence of atrophy of the sternal marrow, atrophy, fibrosis and mast cell hyperplasia of the femoral marrow, atrophy of the white pulp and extramedullary hematopoiesis of the spleen, atrophy of the thymus, auricular hypertrophy of the heart, extramedullary hematopoiesis and centriacinar telangiectasis of the liver, follicular degeneration of the ovary, and inflammation of the tail. The major treatment-related effects were not recovered at the end of 2-week recovery period. There were no adverse effects in the low and middle dose groups of both genders. In the present experimental conditions, the target organs were determined to be bone marrow, blood cells, spleen, liver, thymus, and heart. The no-observed-adverse-effect level was considered to be 0.013 mg/kg/day for males and 0.018 mg/kg/day for females.     

Molecular handling of cadmium in transporting epithelia

Cadmium (Cd) is an industrial and environmental pollutant that affects adversely a number of organs in humans and other mammals, including the kidneys, liver, lungs, pancreas, testis, and placenta. The liver and kidneys, which are the primary organs involved in the elimination of systemic Cd, are especially sensitive to the toxic effects of Cd. Because Cd ions possess a high affinity for sulfhydryl groups and thiolate anions, the cellular and molecular mechanisms involved in the handling and toxicity of Cd in target organs can be defined largely by the molecular interactions that occur between Cd ions and various sulfhydryl-containing molecules that are present in both the intracellular and extracellular compartments. A great deal of scientific data have been collected over the years to better define the toxic effects of Cd in the primary target organs. Notwithstanding all of the new developments made and information gathered, it is surprising that very little is known about the cellular and molecular mechanisms involved in the uptake, retention, and elimination of Cd in target epithelial cells. Therefore, the primary purpose of this review is to summarize and put into perspective some of the more salient current findings, assertions, and hypotheses pertaining to the transport and handling of Cd in the epithelial cells of target organs. Particular attention has been placed on the molecular mechanisms involved in the absorption, retention, and secretion of Cd in small intestinal enterocytes, hepatocytes, and tubular epithelial cells lining both proximal and distal portions of the nephron. The purpose of this review is not only to provide a summary of published findings but also to provide speculations and testable hypotheses based on contemporary findings made in other areas of research, with the hope that they may promote and serve as the impetus for future investigations designed to define more precisely the cellular mechanisms involved in the transport and handling of Cd within the body.     

The debate on DDT

The paper reviews the early toxicologic and pharmacologic studies carried out by the author and his associates from 1943 to 1947, which were largely responsible for launching DDT as an agent for the control of typhus, malaria, yellow fever, and related vector-borne diseases. After reviewing recent studies conducted at the University of Miami, which dealt with organochlorine pesticides in human tissues, the tumorigenicity of aldrin, dieldrin and endrin (rat), six-generation mouse and three-generation dog reproduction studies, synergism of DDT and aldrin (dog), and the fate of DDT and aldrin during a period of severe starvation (rat), it is pointed out that it is primarily the overuse and misuse of DDT in pest control that have caused the pollution in our ecology. It is emphasized that the requirements for pest control differ the world over and that it must therefore be left to the national regulatory agencies to legislate the safe use of DDT and related pesticides. It is recommended that future human and animal studies with DDT and its derivatives give consideration to: (a) the balance and metabolism of the various hormones, (b) reproduction (estrus, libido, mammary development, milk production, (c) hepatic microsomal enzyme activities, (d) cancer prevention and cancer production, (e) excessive body weight changes induced by disease, unbalanced diet or starvation, and (f) the effects of DDT and its derivatives when absorbed in combination with other related and even unrelated compounds.Presented at the joint meeting of the Scandinavian and German Pharmacological Societies, Copenhagen, Denmark, July 20–23, 1971.     

海星皂苷生物活性与制备研究进展

海洋是全球药物研发的重要宝库，提高海洋生物资源深度开发和高值化利用能力，是我国海洋强国战略的重要组成部分，也是促进海洋经济可持续发展及实施“蓝色药库”的关键途径之一。海星属典型的棘皮动物，进化地位和生物学特征独特，是国际公认的药用/保健用海洋生物。海星中含有皂苷、多糖、多肽、氨基酸、胶原蛋白、甾醇及生物碱等多种营养成分和活性物质，其中海星皂苷在抗肿瘤、抗炎、抗衰老及降血脂等方面展现出良好的生物活性，在食品和药物研发领域具有巨大的发展潜力和广阔的应用前景。本文系统检索了近30年海星皂苷的研发现况，并且对近15年来海星皂苷的生物活性、提取分离及相关专利等方面取得的研究进展进行梳理，进而为其在营养保健和药物研发中的应用提供相关理论支持。     

Effects of overexpression of IncRNA AC079466.1 on apoptosis of NSCLC cells through endoplasmic reticulum stress signaling pathway北大核心CSCD

目的初步探讨lncRNA AC079466.1在非小细胞肺癌(non-small cell lung cancer,NSCLC)组织和细胞中的表达,及其过表达对A549和H1299细胞增殖、凋亡、迁移、侵袭的影响。方法收集20例NSCLC患者癌组织及相应的癌旁组织,qRT-PCR检测lncRNA AC079466.1在组织和细胞中的表达。转染过表达质粒为AC079466.1组,转染空质粒为NC组,无转染为Blank组。MTT、流式细胞术、Transwell检测过表达lncRNA AC079466.1对A549和H1299细胞活力、凋亡、迁移和侵袭的影响;Western blot检测过表达lncRNA AC079466.1对内质网应激相关因子GRP78、PERK、eIF2α、ATF4、CHOP,以及Bax、caspase-3表达的影响。结果与癌旁组织相比,癌组织中lncRNA AC079466.1的表达水平明显降低;与HBE细胞相比,lncRNA AC079466.1在A549和H1299细胞的表达量明显降低。与Blank组和NC组相比,AC079466.1组A549和H1299细胞的活力、迁移、侵袭能力均明显下降,凋亡率明显升高,内质网应激相关因子GRP78、p-PERK、eIF2α、ATF4、CHOP,以及Bax、caspase-3表达均明显上调。结论过表达lncRNA AC079466.1可明显抑制A549和H1299细胞的活力、迁移和侵袭能力,并促进细胞的凋亡,其机制可能与促进内质网应激介导的细胞凋亡有关。     

Improving antivenom availability and accessibility: Science, technology, and beyond

Snakebite envenomings constitute a serious and neglected public health problem. Despite the fact that effective treatment exists, i.e. administration of animal-derived antivenoms, the availability and accessibility of these life-saving immunobiologicals is deficitary in various parts of the world, particularly in sub-Saharan Africa and some regions of Asia. This article discusses some of the problems that need to be circumvented in order to improve the availability and accessibility of antivenoms. The conglomerate of antivenom manufacturers is highly heterogeneous in terms of technological base, qualification of staff, implementation of Good Manufacturing Practices (GMPs), and volume of production. Therefore, improvements in antivenom quality and availability should be based on strategies tailored to the situation of each region or country; in this context, three different scenarios are discussed. Accessibility of antivenoms demands concerted efforts at multiple levels, including raising the awareness of public health authorities on the relevance of the problem, implementing innovative antivenom purchasing schemes, strengthening national distribution channels on the basis of robust epidemiological information, improving the cold chain and the provision of health services in remote rural settings, supporting the correct use of antivenoms, and promoting the involvement of local community organizations in various aspects of prevention and management. These tasks should be envisaged in terms of synergistic, interprogrammatic and intersectorial interventions, with the participation of many players.     

Effects of DN-2327, a new anxiolytic,diazepam and buspirone on exploratory activity of the rat in an elevated plus-maze

In the present study, the effects of a new anxiolytic, DN-2327, were compared to those of diazepam and buspirone in rats in the elevated plus-maze test. Two indices of anxiety were obtained in this test: the number of entries into the open arms expressed as a percentage of the total number of arm entries and the percentage of time spent on the open arms. Both a typical anxiolytic, diazepam, at 2.5, 5 and 10 mg/kg, PO and a new anxiolytic, DN-2327, at 2.5 and 5 mg/kg, PO dose-dependently increased the two indices: the percentage of time spent on the open arms and the percentage of open-arm entries. On the other hand, pentylenetetrazol (PTZ) at 10 and 20 mg/kg, IP decreased the two indices dose dependently as did yohimbine at 1.5 and 3 mg/kg, IP. DN-2327 at 2.5 and 5 mg/kg, PO and diazepam at 5 and 10 mg/kg, PO dose dependently and significantly increased the two indices that were suppressed following administration of PTZ at 10 mg/kg, IP. The effects of both DN-2327, 5 mg/kg, PO, and diazepam, 10 mg/kg, PO, on the two indices were significantly antagonized by the benzodiazepine (BZD) receptor antagonist flumazenil, 20 mg/kg, IP. Buspirone (2.5–20 mg/kg, PO) did not affect either of the two responses but dose dependently decreased the number of rearings, although in the Vogel conflict test, the anti-conflict activity of buspirone was equipotent to that of diazepam and DN-2327 at the minimum effective dose (10 mg/kg, PO) of each drug. In conclusion, the present experiment revealed that the anxiolytic effect of DN-2327 in this test was clear, whereas buspirone showed no apparent effect.     

The concept of conditional pharmacology and toxicology

The concept of conditional pharmacology as initially elucidated by Dr Michael Whitehouse and his colleagues from their studies of drug-disease interactions has broad import in a rational drug discovery and development programme. The concept can be extended to toxicology and thus can be viewed as encompassing virtually all means and methods of discovering and enhancing the efficacy, while reducing the toxicity of drugs and biologics. The concept involves employing the physiological or metabolic activity, genetic and/or molecular structure of the host, of the disease process and/or of the parasite to activate and target the drug or biologic, as well as to regulate and delimit its activity. Thus, the concept not only applies to the treatment of inflammatory diseases, but also to the treatment of neoplastic and infectious diseases, to facilitating wound healing, and is in fact an underlying assumption, and expected consequence, of successful gene therapy. The concept applies to clinical studies as well, arguing for more pharmacokinetic and chrono-pharmacological studies in the early phases of clinical testing and the inclusion in later-stage clinical trials of more diverse populations, as regards age, gender and ethnicity, if the indication warrants. Facilitating and monitoring compliance, post-as well as pre-market approval, also are critical components of the fully implemented concept.     

Indicators of dehydration and haemoconcentration are associated with the prevalence and severity of coronary artery disease

1. The vascular endothelium is injured by blood flow abnormalities exacerbated by different risk factors, including markers of haemoconcentration. The aim of the present study was to assess the association between markers of haemoconcentration and dehydration and the prevalence and severity of coronary artery disease (CAD). 2. Subjects in the present study (189 men and 126 women) were classified as either CAD cases or controls according to the results of coronary angiography. The severity of CAD was scored on the basis of the number and the extent of lesions on coronary arteries. Serum electrolytes, osmolality and haematological parameters were measured. 3. Compared with control subjects, patient with CAD had increased levels of serum osmolality, calculated osmolality, tonicity, sodium, glucose and blood urea nitrogen (BUN). Significant differences were also observed in the haematocrit and haemoglobin concentration, but not in erythrocyte counts and total serum protein. On multiple logistic regression analysis adjusting for major risk factors, serum osmolality, glucose and BUN exhibited significant associations with CAD, but the correlations were lessened by diabetes. Analysis using anova showed a significant correlation between serum osmolality, sodium, glucose and BUN and the severity of CAD. The area under the receiver operating characteristic curves, as a relative measure of the test's efficiency, was the highest and significant for serum osmolality, BUN and glucose. 4. The results indicate that some of the markers of dehydration and haemoconcentration are associated significantly with the prevalence and severity of CAD, but the independence of these correlations is questioned. These markers may play a role in the pathogenesis of atherosclerosis.