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1.
目的探讨锁定钢板联合缝线锚钉加强固定对治疗肱骨近端骨折的临床治疗效果。方法回顾性分析2016年1月至2017年12月本院骨科采用手术治疗并获得随访的50例肱骨近端骨折患者的临床资料。其中,男28例,女22例,年龄42~84岁,平均年龄64岁。根据内固定方法分为:24例采用锁定钢板内固定(锁定钢板组),26例采用锁定钢板联合缝线锚钉加强固定(锁定钢板—缝线锚钉组)。比较两组术后大结节不良事件发生率、Neer评分。结果 50例患者均获随访,随访时间为12~24个月,平均18个月,所有患者骨折均完全愈合,平均愈合时间12~16周。锁定钢板组:大结节复位不良3例,大结节再移位6例;锁定钢板—缝线锚钉组:大结节复位不良1例,无大结节再移位病例。锁定钢板—缝线锚钉组的大结节不良事件发生率少于锁定钢板组,两组间比较差异有统计学意义(P=0.041)。术后12个月随访两组Neer评分为,锁定钢板—缝线锚钉组(87.65±7.58)分,高于锁定钢板组(81.21±8.21)分,两组间比较差异有统计学意义(P=0.006)。结论锁定钢板联合缝线锚钉加强固定治疗肱骨近端骨折相比单纯锁定钢板固定更牢靠、功能恢复良好。  相似文献   

2.
目的 比较锁定钢板与髓内钉治疗复杂肱骨近端骨折患者的疗效,为精准化治疗复杂肱骨近端骨折提供一定的参考。方法 收集自2012年6月至2017年6月期间在本院行手术治疗的复杂肱骨近端骨折68例患者的资料。其中,男21例,女47例;平均年龄66.5岁; Neer 3部分为43例,Neer 4部分25例;根据损伤机制分型:内翻型38例,外翻型30例。35例行切开复位钢板螺钉内固定术,33例行有限切开复位肱骨近端锁定型髓内钉内固定术,评估锁定钢板与髓内钉治疗肱骨近端骨折后各项围手术期指标、术后肱骨近端形态学参数及肩关节功能评分等。结果 所有患者均获随访,平均随访时间为17.8个月。锁定钢板组与交锁髓内钉组的平均手术时间分别为(95.3±12.5) min与(75.9±10.3) min,平均切口长度分别为(11.8±2.6) cm与(7.6±2.2) cm,差异都有具有统计学意义(0.05)。肱骨近端形态学评估方面,锁定钢板组与交锁髓内钉组患者的初次颈干角分别为(137.5±7.8)°与(136.4±6.9)°,末次颈干角分别为(133.3±6.13)°与(134.5±7.21)°,两组间差异无统计学意义(0.05);锁定钢板组与交锁髓内钉组患者的前举范围为(143.9±20.36)°与(139.6±21.23)°,差异无统计学意义(0.05);肩关节评分锁定钢板组平均为(79.8±8.1)分,交锁髓内钉组(81.9±7.6)分(0.05)。锁定钢板组并发症发生率为22.8%,交锁髓内钉组并发症发生率为15.1%,差异有统计学意义(0.05)。结论 钢板与髓内钉治疗复杂肱骨近端骨折有各自优势,对于内翻型复杂肱骨近端骨折类型,力学上髓内钉相对于钢板更有优势,外翻型复杂肱骨近端骨折类型大部分伴有大结节粉碎骨折,锁定钢板对于大结节固定相对更有优势。外科医师需熟练掌握2种手术技术,避免并发症。  相似文献   

3.
文题释义: 骨水泥强化螺钉技术:骨质疏松是中老年常见的代谢性疾病,常导致内固定松动而致内固定失败。而骨水泥强化螺钉技术是预防螺钉松动的有效办法,主要用于骨质疏松性骨折。肱骨近端骨水泥强化螺钉技术是通过空心螺钉通道将骨水泥注入肱骨头松质骨中,使螺钉及骨质有良好的整合作用、防止螺钉松动,同时对疏松的骨质起到支撑作用,防止肱骨头塌陷。 肱骨近端骨折:是指大结节基底部以上部位的骨折,包括外科颈;Neer 和Codman 将肱骨近端分成4个基本解剖结构:大结节、小结节、肱骨干、肱骨头,大小结节间的结节间沟是肱骨近端骨折复位的标志性结构。约87%的患者骨折发生于低能量损伤,可能和骨质疏松相关。肱骨近端骨折是目前第三常见的骨质疏松性骨折,同时肱骨近端骨质疏松性骨折是临床治疗的一个难点。 背景:为解决骨质疏松骨折行内固定可能出现的螺钉切出、松动、把持力不足等并发症,目前一种新的骨水泥强化螺钉技术结合PHILOS锁定钢板被用于治疗肱骨近端骨质疏松性骨折,但国内应用该技术治疗肱骨近端骨质疏松性骨折的临床疗效鲜见报道。 目的:比较新型骨水泥强化螺钉技术结合锁定钢板内固定与人工肱骨头置换治疗肱骨近端骨质疏松性骨折的临床疗效。 方法:选择2017年2月至2019年3月贵州省人民医院收治的肱骨近端骨质疏松性骨折患者22例,其中男8例,女14例,年龄68-88岁,其中10例行骨折切开复位新型骨水泥强化螺钉技术结合锁定钢板内固定治疗(内固定组),另12例行人工肱骨头置换治疗(肱骨头置换组)。比较两组手术时间、术中出血量、术中及术后并发症;术后6个月进行肩关节目测类比评分及肩关节Constant评分等。术后所有患者均给予抗骨质疏松治疗。试验获得贵州省人民医院伦理委员会批准,批准号:2017(02)号。 结果与结论:①22例患者均获得随访,随访时间6-15个月,平均(9.0±1.6)个月;②两组术中未出现骨水泥毒性反应、栓塞等并发症;内固定组术后1例出现肩关节僵硬,两组术后未出现切口感染、异位性骨化、骨折延迟愈合及不愈合,未出现螺钉拔出及切割等不良反应;③内固定组手术时间及术中出血量少于肱骨头置换组(P < 0.05);④两组术后6个月的目测类比评分与肩关节Constant评分优良率比较差异均无显著性意义(P > 0.05);⑤结果表明,新型骨水泥强化螺钉技术结合锁定钢板内固定治疗肱骨近端骨质疏松性骨折可获得与人工肱骨头置换相近的临床疗效,是部分可能需行肩关节置换患者选择内固定治疗的一种治疗方法补充。 ORCID: 0000-0002-8139-1175(佘荣峰) 中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程  相似文献   

4.
目的探究经三角肌小切口双排锚钉缝线桥技术在治疗撕脱性肱骨大结节骨折中的临床疗效。方法回顾性分析2017年6月至2019年6月上海市浦东新区人民医院收治的24例肱骨大结节撕脱性骨折临床资料。其中,男14例,女10例;年龄35~80岁,平均55.6岁。均采用肩关节外侧小切口劈开三角肌入路,直视下复位,双排锚钉缝线桥技术固定肱骨大结节。术后2周内上肢悬吊带制动下行肩关节"钟摆"样活动,2周后去除外固定开始早期功能锻炼。记录术前、术后末次随访肩关节功能Constant-Murley评分,VAS疼痛视觉模拟评分及肩关节活动范围。结果24例患者术后随访6~24个月,平均14个月。无伤口感染、骨折再移位、锚钉脱出、肩峰撞击等并发症。末次随访肩关节Constant-Murley评分平均(86.6±5.4)分,与术前(38.3±6.7)分比较,差异有统计学意义(P<0.05);其中优18例,良6例,优良率100%。末次随访VAS疼痛视觉模拟评分平均(0.8±0.4)分,与术前(6.1±1.2)分比较,差异有统计学意义(P<0.05)。肩关节活动范围与术前比较,差异均有统计学意义(P<0.05)。结论经三角肌小切口双排锚钉缝线桥固定治疗撕脱性肱骨大结节骨折,手术创伤小,避免二次损伤大结节骨块,固定充分且牢靠,可满足早期功能锻炼,取得满意的临床疗效。  相似文献   

5.
背景:加拿大蒙特利尔学者Mutch等最近提出了一种新的肱骨大结节骨折形态学分型方法,将肱骨大结节骨折分为3种类型:撕脱型骨折、劈裂型骨折及压缩型骨折。目的:比较传统钢板螺钉和空心螺钉置入内固定修复劈裂型肱骨大结节骨折后的肩关节功能恢复情况。方法:对宜昌市夷陵医院骨科2010年1月至2014年1月收治的肱骨大结节患者按Mutch新分类方法分类,选择83例获得完整随访的劈裂型肱骨大结节骨折患者进行回顾性分析,其中23例采用钢板螺钉置入内固定治疗(钢板螺钉组);60例采用空心螺钉置入内固定治疗(空心螺钉组)。采用目测类比评分、美国肩肘外科医师评分、Constant and Murley评分系统进行疗效评定,分析治疗前、治疗后患者的疼痛及肩关节功能变化。结果与结论:83例患者均获得随访,所有患者均1年取出内固定物。治疗前两组患者的目测类比评分、美国肩肘外科医师评分、Constant and Murley评分比较差异均无显著性意义(P0.05),内固定取出后16个月随访时两组患者目测类比评分、美国肩肘外科医师评分、Constant and Murley评分比较差异均有显著性意义(P0.05),空心螺钉组优于钢板螺钉组。提示空心螺钉置入内固定修复劈裂型肱骨大结节骨折操作简单,创伤较小,是一种比较理想的内固定方式,临床修复效果优于钢板螺钉置入内固定。  相似文献   

6.
带线锚钉固定治疗腓骨近端移位性骨折的临床评价   总被引:1,自引:0,他引:1  
目的 探讨切开复位带线锚钉内固定术治疗腓骨近端移位性骨折的方法及疗效。方法回顾性分析我科2005年5月至2008年4月收治的腓骨近端移位性骨折患者21例,其中男性12例,女性9例,平均年龄39岁,均采用切开复位带线锚钉内固定术治疗。结果21例患者术后随访12~24个月,平均15个月,X线显示18例获得骨性愈合,手术疗效按Lysholm膝关节评分标准为优9例,良7例,尚可5例,优良率89%。结论带线锚钉在治疗腓骨近端骨折中可以同时达到复位固定和修复韧带的目的,且具有刨伤小,固定可靠,操作简便,不需二次手术取出内固定的优点。  相似文献   

7.
背景:目前股骨转子间骨折临床多采用早期内固定治疗,随着现代医学及内固定器材等相关科学的发展,股骨转子间骨折的修复方式较多。然而股骨转子间骨折内固定方式及内固定类型的选择临床上存在较多争议。目的:对股骨转子间骨折髓内与髓外固定的临床预后进行对比分析。方法:选取2009年7月至2013年7月宣城中心医院收治的股骨转子间骨折患者146例,根据内固定方式不同分为3组,其中锁定加压钢板组者31例,动力髋螺钉组者66例,股骨近端抗旋髓内钉组者49例。动力髋螺钉组和锁定加压钢板均属于髓外固定系统,股骨近端抗旋髓内钉属于髓内固定系统。通过对比各组患者的手术时间、术中失血量、切口长度及临床疗效,探讨不同内固定方式对股骨转子间骨折预后的指导意义。结果与结论:所有患者均获得术后随访,随访时间为4个月-3年。与锁定加压钢板组及动力髋螺钉组比较,股骨近端抗旋髓内钉组的手术时间及术中出血量较少,差异有显著性意义(P0.05);其中锁定加压钢板组的手术时间显著低于动力髋螺钉组(P0.05)。股骨近端抗旋髓内钉组的疗效优良率(94%)显著高于锁定加压钢板组(81%)及动力髋螺钉组(83%),差异有显著性意义(P0.05)。提示应用髓内及髓外固定系统股骨转子间骨折患者均可取得良好的修复效果,但髓内固定系统较髓外固定系统在手术时间、失血量及患者内固定后疗效上更具优势。  相似文献   

8.
背景:既往有许多学者研究单独的肱骨大结节骨折及其手术方式。但是,对于肱骨大结节劈裂骨折(Liu-GangⅣ型)合并肩袖损伤,几乎没有学者进行深入的细化研究。目的:比较切开复位改良的跟骨接骨板系统联合缝线锚钉和PHILOS锁定内固定系统联合强生2#号线治疗肱骨大结节劈裂骨折合并肩袖损伤(Liu-GangⅣ型)的临床疗效。方法:回顾性分析2012年5月至2022年5月30例肱骨大结节劈裂骨折合并肩袖损伤患者(Liu-GangⅣ型)的病历资料,分为改良的跟骨接骨板系统联合缝线锚钉组(A组)和PHILOS锁定内固定系统联合强生2#号线组(B组),每组15例。记录所有患者术中出血量、手术时间和切口长度,术后末次随访(> 1年),评估其疼痛目测类比评分、Constant-Murley评分以及肩关节外展、前屈、外旋和背伸活动。结果与结论:(1)A组手术切口长度、手术时间和出血量均小于B组(P <0.05);(2)两组目测类比评分和Constant-Murley评分相比差异无显著性意义(P> 0.05);(3)术后末次随访A组患者前屈功能优于B组(P <0.05);A组外展功能...  相似文献   

9.
目的 对单纯肱骨大结节骨折的3种不同内固定方式(螺钉、张力带、肱骨大结节锁定钢板)进行生物力学测试,比较其稳定性,为临床肱骨大结节骨折内固定物的选择提供生物力学依据。方法 取18具保留肩袖肌的新鲜冰冻成人肱骨尸体标本,建立肱骨大结节骨折模型后,随机编号分为3组,分别采用螺钉、张力带及肱骨大结节锁定钢板技术固定大结节骨折块,牵拉冈上肌,测试力-位移曲线,记录2组参数:大结节移位5 mm时力的大小(load to 5 mm yield point, LtYP)及失效负荷(load to failure, LtF)。结果3组标本(螺钉组、张力带组、肱骨大结节锁定钢板组)在大结节移位5 mm时力的大小分别为(377±86)、(499±90)、(793±52) N,3组标本间LtYP差异有统计学意义(P<0.01);两两比较,锁定钢板组LtYP远大于螺钉组(本研究中仅3例在内固定失效前位移达到5 mm),差异有统计学意义(P<0.01),锁定钢板组LtYP相比张力带组差异有统计学意义(P<0.01),张力带组LtYP相对螺钉组表现出明显的统计学意义(P<0.01)。3组标本失效负荷分别为(744±112)、(908±93)、(979±143) N,3组标本间LtF差异有统计学意义(P<0.01);锁定钢板组LtF相对螺钉组具有明显的统计学意义(P<0.01),张力带组LtF相对螺钉组有统计学意义(P<0.01),但锁定钢板组LtF与张力带组之间无明显统计学差异(P>0.05)。结论 肱骨大结节锁定钢板组相对螺钉组及张力带组表现出明显的生物力学优势,锁定钢板将为临床治疗单纯肱骨大结节骨折提供新的、更好的选择。  相似文献   

10.
背景:目前对肱骨中下段骨折主要采用复位内固定治疗,内固定入路方式主要有3种:前外侧入路(包括改良上臂前外侧入路)、后侧入路以及内侧入路。目前临床对肱骨中下段骨折的修复入路一直存在争议。 目的:对比加压钢板及螺钉前外侧入路与内侧入路内固定修复肱骨中下段骨折的疗效及安全性。 方法:将重庆市红十字会医院收治的90例肱骨中下段骨折患者按随机数字表法分为两组,每组45例。对照组采用前外侧入路加压钢板及螺钉置入内固定,试验组行内侧入路加压钢板及螺钉置入内固定。比较两组患者手术时间、术中失血量、并发症以及肩关节和肘关节恢复情况。 结果与结论:试验组内固定后术中失血量显著低于对照组(P < 0.05),两组患者手术时间、骨折愈合时间比较差异无显著性意义(P > 0.05)。随访6个月,两组患者肩关节功能Neer评分和肘关节功能Mayo评分比较差异均无显著性意义(P > 0.05)。随访期间两组患者均无切口感染、骨不连、慢性骨髓炎等并发症发生。提示内侧入路与前外侧入路加压钢板及螺钉置入内固定修复肱骨中下段骨折效果相当,且前者术中失血量更少,可有效弥补传统修复方案的部分缺陷,可以考虑作为肱骨中下段骨折内固定的修复入路方式之一。中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程  相似文献   

11.
Introduction: A substantial proportion of patients with multiple sclerosis (MS) do not respond to pharmacological treatments and no currently approved therapy has been convincingly demonstrated to prevent or stop disease progression. With MS widely believed to be an auto-immune disease, immunoablative therapy followed by autologous haematopoietic stem cell transplantation (I/AHSCT) is being investigated as an alternative therapeutic option.

Areas covered: With the results of phase III comparative trials only a few years away, this article reviews animal and clinical trials of I/AHSCT in the treatment of MS and discusses possible immunological mechanisms behind its action.

Expert commentary: I/AHSCT can induce long-term suppression of inflammatory disease activity and can halt or reverse neurological deterioration even in progressive stages of the disease, altering the fundamental disease course. However, toxicity of the therapy remains a problem and longer term follow up is required. Immunological investigations of the reconstituting immune system have discovered that qualitative changes take place at the cellular and molecular levels, which support the hypothesis of a ‘resetting’ of the immune system towards a tolerant and anti-inflammatory state.  相似文献   


12.
The six major questions of attention are described in terms of the dominant, as defined by Ukhtomskii. The dominant was in turn simulated as a systems manifestation of phase transitions in the brain. The theoretical and experimental bases for the existence of metastable states in the brain are reviewed, these states having lifetimes of 1 sec and more. This approach simultaneously provides solutions for all the major questions of attention and the central controller. A neurobiological model of attention and memory is proposed, based on the systems properties of Ukhtomskiis dominant and the comparator function of the hippocampus as described by Vinogradova. New published data are presented to support the existence of an information processing system in the brain in which the hippocampus plays the central role.Translated from Zhurnal Vysshei Nervnoi Deyatelnosti, Vol. 54, No. 1, pp. 11–31, January–February, 2004.  相似文献   

13.
The objective of this study was to analyze the caudate portal branches and their relationships with the hepatic caudate veins and propose a new nomenclature for the caudate branches based on their territory of distribution. We realized the fine dissection of the veins of the caudate lobe in 40 human livers fixed and preserved in formalin. In 15/40 (37.5%) cases there was a single branch to the caudate lobe. In 25/40 (62.5%) cases there was more than one branch, with a posterior caudate branch in 20/40 (50%) cases, an anterior caudate branch in 15/40 (37.5%) cases, a left caudate branch in 14/40 (35%) cases, and a right caudate branch in 8/40 (20%) cases. The most frequent combination detected (11/40, 27.5% of cases) was that of the posterior and anterior branches. The venous drainage of the caudate lobe and its papillary process was provided by the superior caudate hepatic vein in 23/40 (57.5%) cases, by the middle caudate vein in 35/40 (87.5%) cases (which was the only vein in 12/35 cases), and by the inferior caudate vein in 16/40 (40%) cases. In 11/40 (12.5%) cases there were accessory caudate veins, which emptied into the left and intermediate hepatic veins. The portal branches and the hepatic veins related to the caudate process were studied. In conclusion, the new nomenclature analyzes more precisely the distribution of the caudate portal branches.  相似文献   

14.
Introduction: Systemic lupus erythematosus (SLE) is a multi-systemic disease characterized by an unpredictable disease course and periods of remission and flare, leading to organ damage and mortality. Novel biological agents are being developed (targeting the lymphocytes, accessory molecules and cytokines) that aim to enhance the therapeutic efficacy when combined with standard therapies.

Areas covered: This article updates recent data on the use of biological and targeted therapies in SLE.

Expert commentary: B cells remain the main target of development of novel therapeutics in SLE. Similar to the intravenous preparation, subcutaneous belimumab has been shown to be superior to placebo when added to the standard of care in SLE. However, two phase III trials of epratuzumab and blisibimod did not meet their primary endpoints. Recent data on the inhibition of type I interferons (anifrolumab) appear promising. Newer calcineurin inhibitors and combination strategies using conventional immunosuppressive agents are being tested in lupus nephritis. Finally, international groups are developing consensus definitions on disease remission and low disease activity state to explore the benefits of the treat-to-target strategy in SLE. Hopefully, the armamentarium for the treatment of SLE can be expanded in the near future, so that the longevity and quality of life of patients can be further improved.  相似文献   


15.
In 1985, a new epidemic variant of influenza virus, A/Berlin/6/85 (H3N2) was isolated which differed antigenically from the reference A/Philippines/2/82 virus. The results of the study of population immunity in adults and children of the USSR and GDR to these virus variants confirm the data on the continuing drift of virus A (H3N2).  相似文献   

16.
Summary The fine structure of the substantia nigra and caudate nucleus of the mouse is studied by electron microscopy. The structure of neurones in both regions confirm the general contention that catecholamines are produced in the perikaryon. In the substantia nigra two structurally distinct types of synaptic junctions are observed; namenly an encircled type by which a dentrite is surrounded by three or more axon terminals, containing granulate and/or synaptic vesicles, and a sandwich type which is characterized by a dendrite interposed between two axon terminals, which contain only synaptic vesicles. The bouton containing both granulate and synaptic vesicles is considered aminergic (type A), whereas that having only synaptic vesicles is regarded cholinergic (type C) in nature. The caudate nucleus does not show the regional specialization of synaptic junctions, and its junctions are composed of simple appositions of dendrites and axon terminals, which contain a limited number of granulate vesicles. Treatment with reserpine depletes the dense core of granulate vesicles, while injections of iproniazid increase the relative number of granulate vesicles in axon terminals. The relative number of granulate vesicles is not affected by oxypertin.These observations are discussed in light of currently available information on the anatomy, chemistry and physiology of amine-containing brain regions. It is suggested that there might be two functionally different types of boutons (types A and C) in the substantia nigra, and that granulate vesicles of axon terminals of the substantia nigra and caudate nucleus might contain dopamine, which may act as a transmitter.  相似文献   

17.
Introduction: Ultrasound (US) is a rapidly evolving technique that is gaining increasing success in the assessment of psoriatic arthritis (PsA). Recently, new research avenues have been opened, and these are focused on the potential of US for the assessment of extra musculoskeletal areas such as skin and nails. This permits work on the concept of ‘holistic US assessment of PsA’.

Areas covered: Here, we analyze the potential role of US in the global assessment of PsA. Additionally, we provide the current evidence supporting its application in routine clinical practice. Literature was obtained from medical databases including PubMed and Embase.

Expert commentary: US can detect not only structural abnormalities but also minimal blood flow changes at the superficial soft tissue level. This makes it a great tool for the global assessment of disease activity in PsA, in which persistently active disease plays a major role in causing anatomical damage and physical functional disability.  相似文献   


18.
Fifty-five Staphylococcus epidermidis isolates, classified as contaminants or causing device-related meningitis, from external ventricular drain (EVD) and non-EVD cerebrospinal fluid specimens were characterized. Thirty-three of 42 (78.6%) meningitis isolates were PCR-positive for ica and aap , known determinants of polysaccharide- and protein-mediated biofilm production, whereas five of 13 (38.5%) contaminants were ica - and aap -negative; 71.4% of meningitis isolates and 84.6% of contaminants produced biofilm. ica + aap + meningitis isolates produced more biofilm than ica + aap isolates (p 0.0020). ica + aap isolates did not produce more biofilm than ica aap + isolates (p 0.4368). Apparently, ica and aap are associated with biofilm production in S. epidermidis device-related meningitis isolates.  相似文献   

19.
Summary Damage to the anterior limbic and motor regions of the brain cortex results in two types of distribution of degenerated fibers over the brain cortex in dogs. The first lateral type is characterized by a predominant fragmentation of a large number of thick horizontal or diagonal fibers of the lower cortical layers on the lateral surface; the second type, known as medial, by the fragmentation of single slender radial fibers and horizontal fibers of the first cortical layer on the medial surface.The lateral-type degenerated fibers are distributed over the cortex of the sigmoid, presplenial, suprasplenial and ectolateral convolutions (motor, parietal and occipital fields). They are most numerous in the motor (4) and optic (19, 18) areas. The medial-type degeneration is characteristic of the cingulum (gyrus cinguli) (limbic fields).An injury to the anterior and posterior portions of the sigmoid convolution causes a less extensive lateral-type degeneration than an injury to the genual convolution.Presented by Academician V. N. Chernigovskii Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 59, No. 3, pp. 18–22, March, 1965  相似文献   

20.
We investigated the capacity and the localization of N-acetylation of the mercapturic acid precursor S-benzyl-l-cysteine (BC), as well as the tubular reabsorption of this compound in the rat kidney in vivo et situ by renal clearance and continuous microinfusion and microperfusion experiments. In renal clearance experiments, 450 mol BC was infused intravenously for 180 min. During the time of BC infusion and the following 180 min, the two kidneys excreted 400 mol or 90% of the infused BC dose as the mercapturate N-acetyl-S-benzyl-l-cysteine (AcBC). Comparison of the amounts of BC and AcBC entering the left kidney via the renal artery with those leaving it via the renal vein and the ureter showed that 0.13±0.04 mol BC/min (mean ± SEM) was extracted and 0.24±0.08 mol AcBC/min was formed by one kidney. The intrarenal acetylation can account for the formation of 38% of the mercapturate excreted in the final urine. In additional experiments, 50 pmol/min [14C]BC was microinfused into single superficial tubules at three different sites. During microinfusion into early proximal tubules, the final urine contained 16.3±1.8% of the microinfused radioactivity as AcBC, but no BC. When [14C]BC was microinfused into late proximal tubules, 13.0±2.3% of the infused label was recovered as BC, 28.1±2.3% as AcBC. During microinfusion into early distal tubules, the final urine contained no AcBC, but 90.3±2.1% of the infused [14C]BC was recovered. As the infused BC dose was reabsorbed completely by the high-capacity carrier for neutral amino acids in the proximal convolution, our results show acetylation of the cysteine S-conjugate both by the convoluted and the straight part of the proximal nephron, the capacity for acetylation and/or secretion being almost twice as high in the straight part.  相似文献   

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