Combined use of retroperitoneal laparoscopy and bladder resectoscope to treat renal and ureteral tumor occurring at the same side of transplanted kidney (report of 5 cases)

To evaluate the operative characteristics and efficacy of retroperitoneoscopic resection of renal,ureter and partial bladder for the treatment of native renal pelvic and ureteral transitional cell cancer occurring at the same side of transplanted kidney.Methods In 5 cases of renal transplantation,there were 2 cases of right native renal pelvic cancer,1 case of right native renal pelvic and ureter cancer and 2 cases of right ureter cancer respectively.The transplanted kidney was in the same iliac fossa side of the tumor.All 5 patients were subjected to nephroureterectomy and bladder cuff excision by retroperitoneoscopic technique.Results Five operations were completed successfully.The operative time was 180 to 280 min,and the blood loss was 50 to 200 ml.The recovery of intestinal function after operation was 12 to 36 h.The urine output was 1 500 to 4 000 per day.Postoperative serum creatinine was still normal.The mean hospital stay after operation was 4.5 days.Conclusion Retroperitoneal laparoscopic nephroureterectomy and bladder cuff excision is a good method to treat the native renal pelvic and ureteral transitional cell cancer occurring at the same side of transplanted kidney.The procedure is safe and less invasive,which provides a good protection of transplanted kidney.12 refs.

Scientific connotation of “treating different diseases with the same method” from the perspective of metabolic-immune dysregulation in inflammation-mediated carcinogenesis of digestive organs

Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system.In the chronic inflammation microenvironment,the metabolic activity of tissue cells undergoes extensive changes,which interfere with the normal function of immune cells.Dysregulation of cell metabolism and immune function has been identified as a key factor contributing to inflammation-mediated carcinogenesis within the major digestive organs,such as the stomach,liver,and colorectum.This metabolic-immune imbalance also corresponds to traditional Chinese medicine(TCM)theories of“yin-yang disharmony”and“disharmony between Ying-nutrients and Wei-defense.”The metabolic-immune imbalance has also been regarded as the key factor supporting“treatment of different diseases with the same method”,in which the same approach is adopted in the treatment of different conditions.In the TCM treatment process,it is necessary to first identify TCM patterns and then apply the corresponding TCM to correct the dysregulated metabolic and immune function,thereby blocking the progression from inflammation to malignancy.Our study findings deepen the TCM understanding of metabolic-immune dysregulation and the relationship between metabolic-immune dysregulation,pattern identification,and treatment method.They also provide new insights for the treatment of inflammation-mediated carcinogenesis in major digestive organs and help us further explore the scientific connotation of the TCM strategy of“treating different diseases with the same method”.

Tests to evaluate the ecological impact of treated ballast water on three Chinese marine species

Ballast water has been a topic of concern for some time because of its potential to introduce invasive species to new habitats. To comply with the International Convention for the Control and Management of Ships' Ballast Water and Sediments, members of the International Maritime Organization(IMO) must equip their ships with on-board treatment systems to eliminate organism release with ballast water. There are many challenges associated with the implementation of this IMO guideline, one of which is the selection of species for testing the ecological impacts of the treated ballast water. In the United States, ballast water toxicity test methods have been defined by the United States Environmental Protection Agency. However, the test methods had not been finalized in China until the toxicity test methods for ballast water were established in 2008. The Chinese methods have been based on species from three trophic levels: Skeletonema costatum, Neomysis awatschensis, and Ctenogobius gymnauchen. All three species live in broad estuarine and open sea areas of China; they are sensitive to reference toxicants and acclimatize easily to different conditions. In this paper, the biological characteristics, test processes and statistical analysis methods are presented for the three species. Results indicate that the methods for evaluating these three organisms can be included in the ecological toxicity tests for treated ballast water in China.

Summary and Prospect of Treating Ulcerative Colitis by Warming the Kidney and Strengthening the Spleen

The method of warming the kidney and strengthening the spleen is widely used in the treatment of ulcerative colitis (UC) with significant curative effect.This paper reviews the relevant literature in recent years.

Retroperitoneal laparoscopic partial resection of the renal pelvis for urothelial carcinoma:A case report

BACKGROUND The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal,which can be performed either in open or laparoscopy or robot-assisted laparoscopy.Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma.Urologists weigh and consider the balance between tumor control and effective renal function preservation.European Association of Urology guidelines recommend that select patients may benefit from endoscopic treatment,but laparoscopic treatment is rarely reported.CASE SUMMARY In this case report,we describe a case of 79-year-old female diagnosed with urothelial carcinoma of the renal pelvis and adrenal adenoma with chronic renal insufficiency.The patient was treated with retroperitoneal laparoscopic partial resection of the renal pelvis and adrenal adenoma resection simultaneously.CONCLUSION Retroperitoneal laparoscopic partial resection of the renal pelvis is an effective surgical procedure for the treatment of urothelial carcinoma of the renal pelvis.

Tumor cell death visualization of renal cell carcinoma under the combined effect of the Gratiola officinalis extract and cyclophosphamide using fluorescent staining methods

Objective of the study:We used fluorescence imaging methods of apoptosis and necrosis in human renal carcinoma A498 tumor cells in vitro to reveal the indicated forms of cell death under the combined effect of flavonoid-containing extract of Gratiola officinalis and cytostatic(cyclo-phosphamide).Materials and methods:The dyes were propidium iodide and acridine orange,which were used in the"alive and dead"test.This test helped us to identify the total number of dead cells in the forms of necrosis and apoptosis and the number of cells in which apoptosis had started,it was characterized by the appearance of apoptotic bodies or nucleus pyknosis.Results:We found the most pronounced cytotoxic activity at the ratio of extract of Gratiola officinalis and cyclophosphamide concentrations of 1∶1.The number of living cells decreased when exposed to the ratio of extract and cytostatic concentrations of 2∶1.When the ratio of concentration of the extract relative to the cytostatic increased to 3∶1,the cytostatic activity of the extract began to appear,the total number of tumor cells decreased.The number of cells with nucleus pyknosis and the number of cells with apoptosis signs significantly increased at a 3∶1 ratio of extract and cytostatic concentrations,which confirms the presence of pro-apoptotic activity of the studied combination.This trend indicates the dependence of a certain form of cell death(apoptosis,necrosis)on the ratio of extract and cytostatic doses,and it also demon-strates the cytostatic and cytotoxic effects of this combination.Conclusion:Fluorescence methods of investigation in the"alive and dead"test allowed us to visualize the forms of cell death of human kidney carcinoma A498 by combined exposure to the fiavonoid-containing extract of Gratiola officinalis and cytostatic(cyclophosphamide)24 h after exposure.We found that the combination with a concentration ratio of the extract and cyclophosphamide of 3:1 has the greatest effectiveness due to stimulation of the cytostatic effect and cytotoxic effect.

Observation of the Effectiveness of 56 Male Patients with Sexaul Disorder Treated by Needle－pricking Method

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Research progress on non-drug treatment of diabetic kidney disease

Diabetic kidney disease is one of the most serious and common chronic complications of diabetes and one of the leading causes of death in diabetic patients.In the case of diabetic kidney disease,sustained proteinuria is irreversible until it develops into end-stage renal disease.Drug treatment of diabetic kidney disease is relatively limited.More and more evidences into the effectiveness and safety that related non-drug treatments not only have the characteristics of simple operation and high safety,but also can improve the clinical symptoms of patients with diabetic kidney disease,reduce laboratory indicators,and delay disease progression.This article summarizes the recent literature on non-drug treatment of diabetic kidney disease such as exercise therapy,acupuncture therapy,acupoint application,auricular acupoint pressing pill therapy,moxibustion therapy,in order to provide reference for clinical treatment.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

基于“血实宜决之”应用咽部刺营治疗慢性咽炎探析

慢性咽炎是耳鼻喉科常见疾病,临床发病率高,其病因复杂,慢性感染性因素是慢性咽炎的主要病因之一。基于《黄帝内经》“血实宜决之”理论,认为邪滞咽喉、气郁痰阻、血瘀阻络、津伤络瘀是慢性咽炎的主要病机,其中“邪滞、气郁、痰阻、血瘀”是“血实”的病理基础,刺营是“决之”的治疗手段,通过针刺咽后壁淋巴滤泡、迂曲明显的浅表血管、咽侧索,使局部少量出血,可以达到“祛邪、通阳、化滞、散瘀”的目的,改善咽部症状,具有短期疗效明显,长期疗效稳定,操作简便,安全性高的特点。其作用机制可能是通过咽部针刺放血后改善咽部局部微循环,促进炎症吸收,调节免疫功能及咽部神经生理有关。对咽部刺营作用机制的探析,以期为临床治疗慢性咽炎提供新的思路和方法。

针刀“调筋治骨法”联合热敏灸治疗膝骨关节炎的临床研究

目的:研究针刀“调筋治骨法”联合热敏灸治疗膝骨关节炎(KOA)的临床疗效。方法:将103例风寒湿痹型KOA患者随机分为两组,对照组51例,研究组52例。对照组实施“调针治骨法”的针刀治疗,研究组在针刀基础上联合热敏灸治疗。两组治疗3个疗程后比较疗效、视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、炎症因子[C反应蛋白(CRP)、白介素6(IL-6)]水平、步行中患侧膝关节屈曲角度及不良反应情况。结果:研究组总有效率为94.23%(49/52),高于对照组的80.39%(41/51),差异具有统计学意义(P<0.05)。治疗后两组患者VAS评分、WOMAC评分较治疗前下降,且研究组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者血清CRP、IL-6水平较治疗前下降,且研究组低于对照组,差异具有统计学意义(P<0.05)。治疗后研究组最大屈曲角度大于对照组,最小屈曲角度小于对照组,差异具有统计学意义(P<0.05)。两组患者治疗期间均未发生明显全身或局部不良反应。结论:针刀“调筋治骨法”联合热敏灸能有效减轻KOA患者疼痛和炎症反应,改善症状,缓解步行中患侧膝关节屈曲角度,无明显不良反应。

活性炭负载TiO_(2)催化臭氧的造纸废水处理方法研究

造纸废水的处理一直是水利水电工程关注的重点项目。造纸废水中含有大量的污染物质,若是直接排放到环境中,将会对环境造成严重危害。为此,研究一种活性炭负载TiO_(2)催化臭氧的造纸废水处理方法尤为重要。基于此,从水利水电工程废水储蓄池中采集造纸废水水样,配制TiO_(2)催化剂,制备活性炭,将二者混合形成活性炭负载TiO_(2)催化剂;利用催化剂与臭氧充分接触后发生的氧化反应,去除废水中的有机污染物,从而完成造纸废水的处理。测试结果表明:活性炭负载TiO_(2)催化剂对各种污染物质具有很好的去除效果,且催化剂中TiO_(2)负载量越高,催化剂的去除率越高。随着时间的推移,BOD5逐渐降低,水体中的污染物逐渐被分解和消除,证明了所研究方法在造纸废水处理中的应用效果。

辛夷的法象药理及其临床意义

“药象”是中药在自然生长和形成过程中产生的固有性质,也是形成药性药效的基础。辛夷独特的药象特征一直是古人细致观察与重点关注的内容。辛夷“必至四序并经,乃刳苞以出”的物候之象,可谓花木之独一份,也奠定了其独特的药性特点;辛夷形若毛桃,苞片坚韧而密被绒毛的药材之象,也是探讨其“以形治形”论治痼积癌肿的法象特征。经典本草古籍中辛夷广泛用于治疗风邪郁滞、经脉不通等诸多病证的作用机制皆与其药象特点密切相关。虽然后世受“舍鼻塞、鼻渊之症,无他用”之论所囿,但从其“法象药理”而言,辛夷不仅可轻宣升散,又善于内入脏腑以宣达阴伏之邪,深入巢窟以驱逐结聚之滞,可广泛应用于气血郁滞、沉寒痼冷、瘀毒结聚等病证。而这些功效主治的拓展,正是辛夷“象性合参”的意义所在。

基于太阳病误下变证论“膈病”

太阳病涵盖了伤寒由表到里的整个演变过程,由于患者禀赋强弱、感邪轻重、就诊是否及时等原因,在此阶段可能出现表里证,所以太阳病可用到下法,但由于对表里先后顺序及整体病势把握不准确而误下产生变证者不少。太阳病下之后结局有两种:(1)下之愈。(2)下之不愈,而不愈者又可分为三种情况:一是误治后邪气仍在表者,当以汗解之;二是有表里证者,表解乃可攻里,否则引邪入里,为逆;三是误下影响了太阳病自然发展轨迹,导致表证几无,而邪气入膈,从而产生变证。无论太阳病正常转归还是误下发为变证,“膈”均是邪气入里之“首站”。膈病主要是邪气侵扰使其失去阻隔、分界作用,导致清浊易位,上下隔拒,典型特点为清浊不分,“上逆”与“下趋”症状并见,治疗首当察其在膈上、膈下,遵循“病在膈上必吐,在膈下必利”的治疗原则,观其脉证,随证治之。

热水浴法解除蚕卵滞育的条件优化及应用效果分析

【目的】通过Box-Behnken响应面优化热水浴法解除蚕卵滞育的处理条件,并测试以不同来源水处理蚕种的孵化效果,为热水浴法在蚕业生产中的推广应用提供科学依据,探索出可替代传统盐酸孵化法且更安全环保、成本低廉的蚕种人工孵化方法。【方法】选用两广二号为供试蚕种,以卵龄(A)、处理时间(B)和处理温度(C)为变量,以蚕卵实用孵化率(Y)为响应值,通过Box-Behnken响应面优化热水浴法解除蚕卵滞育的处理条件;选择自来水、纯净水及矿泉水等不同来源的水,并选取萨尼斯、932、湘晖和春5等4个蚕种品种,分别采用优化后的条件对蚕卵进行热水浴处理,检验热水浴法解除蚕卵滞育的效果。【结果】蚕卵实用孵化率对3个变量因素的二项式拟合方程为:Y=91.03-2.01A-4.60B+22.89C+0.040AB+4.03AC+0.89BC-10.46A~2+3.25B~2-19.60C~2,响应面设计模型拟合程度较好。各因素对蚕卵实用孵化率的影响排序为处理温度(C)>处理时间(B)>卵龄(A),其中,处理温度影响极显著(P<0.01),处理时间影响显著(P<0.05,下同),卵龄影响不显著(P>0.05,下同);两因素间交互作用对蚕卵实用孵化率的影响排序为AC>BC>AB。修正后的热水浴法最佳处理条件:卵龄17.5 h,处理时间13 s,处理温度50℃,此条件下的实际蚕卵实用孵化率为97.94%,与理论预测值(98.81%)接近。不同来源水对两广二号正、反交种进行热水浴处理后的实用孵化率均在95.00%以上,仅阳山自来水和纯净水1在热水浴处理两广二号正交种时的实用孵化率显著低于盐酸即时浸酸法,但其实用孵化率仍高于93.00%;萨尼斯、932、湘晖、春5等4个家蚕品种的热水浴实用孵化率与盐酸即时浸酸法相比均无显著差异,表明热水浴法具有较强的普适性。【结论】热水浴法能有效解除蚕卵滞育,具有较强的普适性,且成本低廉、操作简单,可作为蚕业生产上替代传统盐酸孵化法的新方法。

场地污染地下水抽出处理系统井群加权优化方法研究

井群布设是地下水修复抽出处理技术的关键环节之一。为提高抽出处理技术的修复效率,以某污染场为研究对象,建立非线性-动态-多目标的模拟-优化模型,以污染物去除率最高、修复达标时间最短、资金成本最低为优化目标,设定单井、双井、三井模式下不同的抽出流量,采用加权优化方法对井群布设方案进行对比计算。结果表明:整体而言单井模式修复效果较差,侧重资金成本时双井模式抽出方案修复效果整体较优,侧重达标时间成本时三井模式抽出方案修复效果整体较优;单井模式恒定流量抽出修复效果较优,多井模式下后期若适当降低抽出流量,可减少总抽出量,节省资金成本,井群动态管理可提高修复效率。研究验证了加权优化方法在井群优化应用中的灵活性和实用性,可为加权优化方法结合数值模拟方法在抽出处理技术的井群布设优化中应用提供参考。

基于血水同治法刍议当归贝母苦参丸之异病同治

目的 基于血水同治法刍议当归贝母苦参丸之异病同治。方法 以血水同治法为理论依据,结合当归贝母苦参丸之组方原理,探讨其异病同治之临床应用。结果 当归贝母苦参丸为血水同治法代表方剂,为治疗妇女妊娠并发小便难之名方。现代中医学者基于其血水同治的组方思路,扩展其临床应用,如盆腔炎、前列腺炎、慢性便秘、溃疡性结肠炎,以及肿瘤类疾病。结论 当归贝母苦参丸之异病同治皆为其血水同治之配伍功效与多种疾病之病机吻合,临证之时应灵活加减。

“下病上治”整脊法治疗腰骶后关节病的效果

目的 评价“下病上治”整脊法治疗腰骶后关节病的临床效果。方法 选取2020年10月至2022年5月中国中医科学院望京医院、首都医科大学电力教学医院、黑龙江中医药大学附属第二医院门诊治疗160例腰骶部后关节疾病患者,按照随机数字表法将其分为治疗组和对照组,每组80例。对照组采用推拿手法治疗,治疗组采用“下病上治”整脊法治疗,两组均治疗2个疗程。比较两组治疗前后视觉模拟评分法(VAS)评分与腰椎活动度。结果 治疗后,两组VAS评分较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后,两组腰椎前屈、后伸、左侧屈、右侧屈、左旋转、右旋转均大于治疗前,且治疗组大于对照组(P<0.05)。治疗组临床疗效优于对照组(P<0.05)。结论“下病上治”整脊法治疗腰骶后关节病效果优于推拿手法治疗。

李飞针灸治疗面瘫经验举隅

总结李飞教授治疗面瘫的学术思想及诊疗经验。李飞提出诊治面瘫时应遵循“初病审因,次探病机,再明病证,辨证论治”,以祛风通络、疏调筋经为基本治疗原则。临床治疗时,以“重视解剖,依症施治”为基本方针,贯通中西理论,结合表情肌解剖结构,动态化判断神经、肌肉恢复情况,依据症状选取相应经验组穴。重视整合理论,总结理法辨证、分期辨证、症状辨证之“辨证三重”法则,调经、调筋、调神之“治疗三调”理论,值得临床借鉴。

基于“三焦分消”理念分析三仁汤“异病同治”治疗溃疡性疾病的临证思路

溃疡性疾病是临床中的常见病、多发病,亦是中医优势病种之一。异病同治是中医辨证论治的精髓,其核心是“证同则治同,证异则治异”,若不同的疾病在发展过程中,出现了相同的病机与证候,即可采用同一方法进行治疗。三仁汤是治疗温病湿热证的代表方剂,可通过宣上、畅中、渗下将湿热之邪由三焦分消走泄而去。溃疡性疾病包括口腔溃疡、胃溃疡、溃疡性结肠炎等病,临证之际,“有是证用是方”,若疾病证属湿热蕴结,投以三仁汤治之,疗效颇佳。从疾病“异病同治”的角度出发,基于“三焦分消”理论初步探讨三仁汤在溃疡性疾病中的临床运用,以期为溃疡性疾病的临床治疗提供参考。