微创经皮肾镜取石术与标准通道经皮肾镜取石术治疗肾结石的临床对比观察

目的：探究微创经皮肾镜取石术与标准通道经皮肾镜取石术治疗肾结石的临床疗效。方法将120例肾结石患者随机分为观察组与对照组,各60例。观察组行微创经皮肾镜取石术,对照组行标准通道经皮肾镜取石术。结果观察组手术时间高于对照组,术中出血量少于对照组,<0.05;结石清除率、结石残留率与不良反应发生率上,两组患者无统计学差异,>0.05。结论微创经皮肾镜取石术与标准通道经皮肾镜取石术治疗肾结均疗效显著,可根据患者具体病情选择术式。     

B超引导下微创经皮肾镜术治疗无明显积水的肾铸型结石

目的探讨B超引导微创肾穿刺造瘘、经皮肾取石术治疗无积水的铸型肾结石的疗效。方法回顾分析2009年1月至2010年9月采用微创经皮肾镜术（MPCNL）治疗27例无明显积水的铸型肾结石患者的临床资料。结果 27例均成功建立经皮肾镜微创通道,25例患者一期单通道碎石取石,2例因出血和体位不能耐受,留置肾造瘘管后改二期碎石取石。19例患者一期一次手术取净结石;3例患者经2次MPCNL手术;1例患者经过3次MPCNL手术均取净结石;2例患者残留结石配合ESWL治疗,术后1~2个月复查结石排出,总结石清除率为92.6%。2例患者残留结石（单发）位于肾下盏,结石直径小于5 mm。结论 B超引导MPCNL治疗无明显积水的肾铸型结石安全有效。     

超声引导下经皮肾镜取石术在上尿路结石治疗中的应用（附359例报告）

目的探讨超声引导下经皮肾镜取石术（PCNL）在治疗上尿路结石的方法、临床疗效和安全性。方法对我院2009年10月~2012年12月359例上尿路结石患者采用在B超定位引导下PCNL术临床资料回顾性分析。结果本组患者成功施行经皮肾穿刺并建立经皮肾通道行钬激光碎石取石术。297例一期取净结石,62例二期取净结石。术后部分病例出现肉眼血尿、轻度发热;术后随访3～8w,全组无输血及严重并发症。结论超声引导下PCNL治疗上尿路结石微创高效,安全可靠,并发症少,具有临床推广应用推广价值。     

肾结石患者应用微创经皮肾镜取石术及开放手术对比分析

目的探讨肾结石患者应用微创经皮肾镜取石术及开放手术对比分析。方法本组肾结石患者68例根据手术方法不同将其分为A组和B组。A组采用微创经皮肾镜取石术治疗；B组采用开放手术治疗。结果 A组血红蛋白下降显著低于B组，A组结石清除率显著高于B组，A组手术时间、术后住院时间及并发症发生率均明显低于B组，且均具有统计学差异(P<0.05)。结论肾结石患者应用微创经皮肾镜取石术临床效果优于开放手术。     

腔内技术处理移植肾上尿路结石

背景：移植肾尿路结石是肾移植一种少见的并发症,因移植肾本身的病理生理的特殊性,临床处理棘手。 目的：总结腔内技术处理移植肾上尿路结石的经验并评估其安全性和有效性。 方法：回顾性分析采用输尿管镜取石和微创经皮肾取石治疗21例移植肾上尿路结石患者的资料。 结果与结论：8例移植肾输尿管结石行输尿管镜取石3例成功,2例取石后出现高热,其中1例需行经皮肾穿刺造瘘引流;5例失败并改行微创经皮肾取石。18例患者行微创经皮肾取石,其中13例患者直接行微创经皮肾取石,5例输尿管镜取石失败后改行微创经皮肾取石。手术均成功且一次性将结石取净,术中术后无并发症发生。说明逆行输尿管镜在处理移植肾上尿路结石的价值有限,微创经皮肾取石处理移植肾上尿路结石安全有效,可作为移植肾上尿路结石的首选治疗方案。     

侧卧位经皮肾镜取石术73例报告

经皮肾镜取石术（percutaneous nephrolithotomy）是目前泌尿外科临床工作中治疗复杂肾结石的主要方法，具有痛苦小，创伤轻，取石效果可靠等优点。目前临床上多采用俯卧位及斜卧位进行经皮肾镜取石术，但俯卧位及斜卧位均有一定的不足之处。2008年11月至2009年12月期间，我科采用侧卧位行经皮肾镜取石术治疗。爵结石73例，取得了满意的疗效，使经皮肾镜取石术结石取净率有了新的提高，手术并发症明显减少。现报告如下。     

微创经皮肾镜钬激光碎石术治疗输尿管上段结石

目的探讨微创经皮肾镜钬激光碎石术（MPCNL）治疗肾及输尿管上段结石的疗效。方法采用钬激光微创经皮肾穿刺取石术治疗60例输尿管上段结石,并记录碎石取石时间、结石数目、手术时间、并发症及住院时间。结果 60例经一期或二期手术成功。经1个月后结石残留清除率为100%。结论微创经皮肾镜钬激光碎石术治疗输尿管上段结石,具有窗口小、易恢复、取石成功率高等特点,值得临床推广应用。     

CTU三维重建在复杂肾结石经皮肾镜取石术中的应用

目的探讨CTU(CT-urography)三维重建技术在复杂肾结石经皮肾镜取石术中的应用价值。方法在CTU三维重建辅助下对28例复杂肾结石行经皮肾镜取石手术,观察手术时间、术中失血量、结石清除率等。结果重建结构清晰,立体感强。可突出反映患肾实质、结石、集合系统解剖学结构。手术均取得成功,无严重并发症。手术时间35~95 min,平均67 min,出血量40~250 mL,平均90 mL,Ⅰ期结石清除率83%。结论 CTU三维重建有助于术前拟定穿刺部位,术中取净结石,减少手术并发症,提高经皮肾镜取石术的效率,值得临床推广。     

B超引导下局麻经皮肾镜取石术治疗上尿路结石的临床应用

目的 探讨B超引导下局麻经皮肾镜取石术(PCNL)治疗上尿路结石的可行性和安全性。方法 回顾性分析2008年3月—2012年10月B超引导下局麻行PCNL 的86例患者的临床资料,其中复杂性肾结石16例、单纯肾盂结石52例、输尿管上段结石18例。在B超定位下选择中盏或结石所在肾盏处作肾穿刺点,用1%盐酸利多卡因10～40 ml自穿刺点向肾脏方向穿刺浸润麻醉,深达肾包膜。然后在B超引导行PCNL。结果 86例患者麻醉效果满意,均顺利完成手术。穿刺成功率100%(86/86),术中未发现肝、脾、胸膜、肠管损伤等严重并发症。单纯肾盂结石患者结石取尽率96.2%(50/52);结石残留2例,予体外冲击波碎石术(ESWL)排出。输尿管上段结石患者结石取尽率100%(18/18)。复杂性肾结石患者结石取尽率81.3%(13/16);术后结石残留3例,行二期PCNL取石2例,予ESWL排出1例。所有患者均获随访3～12个月,平均8.5个月。随访期间未发现结石残余和复发,无继发性上尿路感染。结论 B超引导下局麻行PCNL简单、安全、有效,尤其适用于肾脏及输尿管上段结石患者,值得临床推广应用。     

局麻下分期经皮肾微造瘘输尿管镜气压弹道碎石术治疗复杂性肾结石

目的探讨局麻下分期经皮肾微造瘘输尿管镜气压弹道碎石术治疗复杂性。肾结石的安全性及可行性。方法回顾分析我院2007年11月至2009年2月收治的诊断明确、具备经皮肾镜取石术指针的复杂性肾结石患者35例临床资料,采用局麻下分期经皮肾微造瘘输尿管镜气压弹道碎石术。结果35例患者：Ⅰ期取石32例,结石取净率71．8％,Ⅱ期取石12例,Ⅲ期取石4例;采用单通道取石30例,双通道取石5例;住院时间7～28d,平均18d,无手术大出血输血及中转开放手术病例。结论局麻下分期经皮肾微造瘘输尿管镜气压弹道碎石术治疗复杂性肾结石,具有微创、安全、经济、并发症少等优点,在具有相应设备及经验的医院应作为治疗复杂性肾结石的首选方法。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.     

THE ODYSSEY – A JUNGIAN PERSPECTIVE: INDIVIDUATION AND MEETING WITH THE ARCHETYPES OF THE COLLECTIVE UNCONSCIOUS

Homer's epic tale of the 20-year return of Odysseus from the Trojan War is investigated with particular reference to Jung's theory of individuation. Odysseus' meetings with 'the anima' in the form of goddesses, sirens and female monsters and his visit to Hades demonstrate the confrontation and humanization of aspects of the archetypal level of the psyche, central to Jung's theories of psychic growth and development. Jung's important ideas of the psychoid level and the transcendent function are explored and linked both to his investigations into medieval alchemy and with findings from contemporary neuroscience. The importance of Jung's constructive method of the interpretation of dreams and myths is shown to be central.