前肾管

Methods: Selective renal artery embolization was performed in 68 patients via femoral artery with Seldinger technique, 30 cases were embolized with gelatin sponge chips before operation for renal carcinoma, and 8 cases were embolized with MMC and iodized oil, and gelatin sponge for palliative treatment of advanced renal carcinoma, 6 cases were embolized with thread segments for symptomatic renal angiomyolipoma, 24 cases were embolized with self blood coagulum, gelatin sponge and/or steel coils for traumatic renal hemorrhage.

采用改良Seldinger技术经皮股动脉穿刺插管，对68例进行选择性肾动脉栓塞治疗，其中30例为肾癌术前辅助治疗，应用明胶海绵颗粒栓塞；8例为晚期肾癌姑息性治疗，采用丝裂霉素＋碘油的乳剂行末梢栓塞，然后用明胶海绵行肾动脉主干栓塞；6例症状性肾血管平滑肌脂肪瘤，采用真丝线段栓塞；24例肾创伤出血，采用自身血块、明胶海绵或弹簧钢圈栓塞。

In group Ⅰ, the level of blood glucose increased at the times of intubations, and glucose-tolerance-test shows abnormal. There were no significant blood glucose changes in other groups.

1.1 一般资料择期手术需插管全麻的患者，术前访视ASA在Ⅰ～Ⅱ级，排外肝肾功能障碍，无内分泌疾病史及家族史，术前空腹血糖6.0mmol/L以下，近期内未服用任何含激素类药物，即进入研究对象组。

Certainly is the balanced diet, but also has is lets the nutrition concentrate effectively fast supplemented chest oh Shu Youge the best quality goods traditional Chinese medicine abundant chest nutrition powder through solid this cultivates the Yuan to the female, restores vital energy the profit kidney, causes the body to enter to the best condition, dredges the mammary gland tube gradually, the enhancement chest to the fat absorbancy, stimulated the mammary gland to manage two growth, the chest has absorbed the enough nutrition, achieved solid, full, the strong effect easily, moreover did not bounce, got rid of the breast to be flat thoroughly, sagging, loose, premenstrual pain hard and so on phenomena.

当然是均衡饮食啦，还有就是让营养快速有效地集中补充到胸部哦舒友阁极品中药丰胸营养粉通过对女性固本培元，补气益肾，使身体进入到最佳的状态，逐渐疏通乳腺管，增强胸部对脂肪的吸收能力，刺激乳腺管二次发育，胸部吸收了足够营养，轻易达到结实、饱满、坚挺的效果，而且绝不反弹，彻底摆脱乳房扁平、下垂、松驰、经前痛硬等现象。

Results 100 cases were of pancreas edema; illegibility around it; the structure is damaged; some spots and small pieces in the low density parts can be found; the pancreas pipes were enlarged; the parts of tendon velamen in front of the kidney were mangled.

结果：100例患者CT表现胰腺肿胀，胰周边界不清，结构不完整，实质内点状、小片状低密度区，胰管扩张，肾前筋膜受侵，尤其是左侧肾前筋膜。

Percutaneous nephrostomy guided by Ultrasound and C-arm mobile fluoroscopy is a safe procedure and preoperative analyzing the high risk factors of complications and preparing the preservation methods may sublimate the security and therapeutic efficacy.

熟悉肾造瘘和输尿管内双J管置入术的操作程序，术前综合评估并发症产生的危险因素，并积极防范处理，可有效提高手术安全性和治疗效果。

CT Findings were as follows : pancreas enlargement in 24 cases , focal and diffused hypodense in 39 cases , hemorrhage and necrosis of pancreas in 3 cases, peripancreatic effusion in 39 cases , prerenal fascia thickening in 39 cases , pleural effusion in 24 cases , with thrombosis in portal and SMV in 1 case . A case of pancreas head enlargement misdiagnosed for tumor,a case pancreatitis effusion was through superficial inguinal canal into scrotum.

CT影像学征象如下：胰腺体积增大24例；局限性及弥漫性密度减低39例；胰体及尾部出血坏死3例；胰周间隙渗出39例；肾旁筋膜增厚及脾肾间隙模糊39例，特别是左侧肾前筋膜均累及；少量胸腔积液24例；出血性胰腺炎伴门脉及肠系膜上静脉血栓1例；炎性渗出物通过腹股沟管蔓延到阴囊1例；单纯胰头增大，误诊为胰头肿瘤1例；本组40例中合并胆石12例。

Ultrasonographymay be preliminary diagnostic method for ureteral carcinoma because it can showhydronephrosis,retrograde ureteropyelography and CT scanning were main diagnostic measures before operation.

残余段输尿管+膀胱部分切除术2例。结论 B超发现肾积水可作为初步筛选检查，逆行输尿管插管造影、CT是术前诊断输尿管癌的重要手段。

Methods A total of 36 patients with advanced renal cancer were definitely diagnosed by IVP, US, CT or MRI examination. A 5F Yashiro catheter was introduced into the femoral artery with Seldinger's technique under local anesthesia, abdominal aortagraphy and renal arteriography in both sides of kidneys were performed routinely to display the blood supplying arteries of tumor, thereafter, renal embolization was performed under superselective catherization for chemotherapeutic embolizing. Then the clinical effect was observed, the amount of blood loss and the operation time were recorded. All these results were compared with that of randomly selected 17 patients before surgical operation with advanced renal cancer admitted during the recent 3 years but without embolization.

36例中晚期肾癌患者，均经临床检查、静脉肾盂造影、B超、CT或MRI检查而确诊；采用Seldinger's技术，局部麻醉下经一侧股动脉穿刺插管，引入5F Yashiro导管，常规行腹主动脉及双肾动脉造影，以显示肿瘤的供血动脉，再将导管超选择插管或尽可能接近肿瘤病灶，进行化疗栓塞，观察其临床改善情况，计算术中失血量及手术时间，并与随机抽取我院近3年所做的17例术前未行肿瘤供血动脉栓塞的肾癌患者进行对照。

objective to evaluate efficacy of extracorporeal shock wave lithotripsyfor treating ureteral stones in situ,investigate the cause of higher re-treatment rate.methods total of 687 patients with ureteral stone were received eswl between january 2000 and december 2004,included 455 male(66.2%) and 232 female(33.8%) patients,6 cases have bilateral ureteral calculi,12 cases have unilateral multiple calculi.hence,together 709 ureteral calculi were treated.patients upper ureteral calculi were treated in the supine position,for lower ureteral calculi patients were turned prone.to reduce eswl-induced renal trauma and pain,using lower energy source,adjusted power setting from 9.8 to 13.2kv,limited 1500 shock wavs per one session.no auxiliary procedure were used before eswl.the stone size was measured as the surface area of stone length by stone width on x-ray film.the interval between two treatment sessions was two weeks.results of 709 ureteral calculi,the overall stone free rate was 97.3%(690 calculi),re-treatment rate was 34.1%(292 calculi).according to the performed treatment sessions,one session 467 calculi,the mean stone size 37.27mm2,stone free rate 65.4%(464 calculi).two sessions 138 calculi,the mean stone size 62.48mm2,stone free rate 18.4%(131calculi).three sessions 52 calculi,the mean stone size 79.60mm2,stone free rate 7.1%(50calculi).four sessions 19 calculi,the mean stone size 101.63mm2,stone free rate 2.4%(17calculi).fivesessions 33 calculi,the mean stone size 119.33mm2,stone free rate 3.9%(28 calculi).overall 19 cases(2.7%)turned to other treatment modalities.of 335 upper ureteral calculi,303 achieved stone free (95.8%),re-treatment rate was 38.5%(129 calculi).of 374 lower ureteral calculi,369 achieved stone free(98.7%),re-treatment rate was 30.2%(113 calculi).the re-treatment rate of upper ureteral calculi was higher than lower ureteral calculi(p＜0.05,χ2=5.40).the difference of stone-free rate between upper and lower ureteral calculi was no significant(p＞0.05,χ2=0.15).conclusion eswl should be considered first line therapy for ureteral stone still.stone burden are the main variable of higher re-treatment rate,upper ureteral stone may moving with respiring during eswl.so efficinet shock wave was decreared,re-treatment rate become higher.

目的 评估体外震波碎石治疗输尿管结石的疗效，探讨再治疗率高的原因及输尿管结石的治疗选择。方法回顾2000年1月～2004年12月间eswl治疗输尿管结石的临床资料687例，男455例（66.2%），女232例（33.8%），平均年龄46.6岁（15～83岁）。有双侧输尿管结石6例，单侧多发性输尿管结石12例（4颗1例，3颗2例，2颗9例），共计输尿管结石709颗（含透光结石13颗）。应用上海爱申公司生产的desunit6030型碎石机，c臂x线球管做结石定位。上段输尿管结石（肾盂输尿管交界处至骶髂关节上缘）取仰卧位，下段输尿管结石（骶髂关节上缘下至输尿管口）取俯卧位。为减少eswl引起的肾损伤和疼痛，应用较低的能量，震波发生器电压从9.8～13.2kv，震波频率1.5s。每次治疗设定为1500次震波。治疗后3天摄腹部平片或b超，以后每隔7日重复检查。假如结石未碎或有残留结石最长径＞3mm以上，再次eswl，两次治疗的间隔时间为两周。结石的大小用x线片上的表面积（mm2表示。结果 709颗输尿管结石总的治愈率为97.3%（690颗），再治疗率34.1%（242颗）。其中一次治疗467颗，平均结石大小37.27mm2，治愈464颗（65.4%），3颗改治疗；两次治疗138颗，平均结石大小62.48mm2，治愈131颗（18.5%），7颗改治疗；第1和第2次治疗治愈率（1个月治愈率）为83.8%。3次治疗52颗，平均结石大小79.60mm2，治愈50颗（7.1%），2颗改治疗；4次治疗19颗，平均结石大小101.63mm2，治愈17颗（2.4%），2颗改治疗；5次及5次以上治疗33颗，平均结石大小119.33mm2，治愈28颗（3.9%），5颗改治疗。总计19颗（2.7%）结石改变治疗方式。上段输尿管结石335颗，治愈321颗（95.8%），再治疗129颗（38.5%）。下段输尿管结石374颗，治愈369颗（98.7%），再治疗113颗（30.2%）。经χ2检验，上、下段输尿管结石的再治疗率差异有显著性（χ2=5.40，p＜0.05），治愈率差异无显著性（χ2=0.15，p＞0.05）。不良反应：血压升高13例（1.9%），震波区域疼痛26例（3.8%），震波进入处皮肤点状淤血33例（4.8%），肉眼血尿128例（18.6%），均于第2、3天自行消失。结论 eswl目前仍是输尿管结石的第一线治疗，结石的大小是再治疗率高的主要因素。结石的位置有影响，上段输尿管结石可随呼吸移动，有效震波次数减少，再治疗率比下段输尿管结石高。eswl前注重病例筛选可降低再治疗率。

BMSCs were isolated, depurated, cultivanted, and identified,then incubated with the concentration of 25μg Fe per milliliter at 37℃in 5% CO2. The labeled cells were stained by Prussian blue/trypan blue,and observed under fluorescent microscope.2. The labeled cells of different density (1×104/ml,5×104/ml,1×105/ml,5×105/ml,1×106 /ml,5×106/ml)were imaged by MRI with T1WI, T2WI and T2*WI sequences;and the same density (5×104/ml,1×105/ml)labeled cells were imaged by T2*WI sequences at different time.Then the signal intensities were measured and statistically analyzed.3. The model of rabbit renal ischemia-reperfusion injury was set up and treated. Then BMSCs(5×105)were injected into 16 recipient rabbits(1abeled cells in 10,unlabeled cells in 6)from ear vein.MR images of kidneys were obtained respectively at the time points of 0,1,3,5, 8 days after transplantation and before transplantation. MR imaging findings were analyzed,which were correlated with histological findings.

实验方法1分离、纯化、培养、鉴定兔BMSCs并以SPIO以25μg Fe/ml培养液浓度标记，对标记后不同时间的细胞行普鲁士蓝染色和台盼蓝拒染后显微镜观察。2将不同细胞浓度标记细胞管(1×104/ml、5×104/ml、1×105/ml、5×105/ml、1×106/ml、5×106/ml)，以不同扫描序列T1WI，T2WI，T2*WI(GRE进行MR成像，再选择相同细胞浓度组(5×104/ml、1×105/ml)进行不同时相MR成像，并测量信号强度，进行统计学分析。3缺血再灌注肾损伤模型建立和处理，然后将标记和未标记细胞(5×105个)经耳缘静脉移植入家兔体内(共16只：注入标记细胞者10只，注入未标记细胞者6只)，两组均于注射前、注射后第0、1、3、5、8天应用MRI对移植细胞进行活体示踪并与肾脏组织切片对照，然后对收集的信号强度进行统计学分析。

On the other hand, the more important thing is because the urban housing is a kind of heterogeneity products.

另一方面，更重要的是由于城市住房是一种异质性产品。

Climate histogram is the fall that collects place measure calm value, cent serves as cross axle for a few equal interval, the area that the frequency that the value appears according to place is accumulated and becomes will be determined inside each interval, discharge the graph that rise with post, also be called histogram.

气候直方图是将所收集的降水量测定值，分为几个相等的区间作为横轴，并将各区间内所测定值依所出现的次数累积而成的面积，用柱子排起来的图形，也叫做柱状图。