后肾

The median time to achieve a neutrophile count of 0.5×109/L was 10 days after the last dose of chemotherapy in regimen A,and the time was 16 days in regimen B.The average SLEDAI decreased from 9.2 to 4.4,and the proteinuria decreased from to (0~+) in 3 weeks after the treatment.Two cases with complication of hemolytic anemia and 1 with thrombocytopenia before the treatment recovered to normal or nearly normal hemogram respectively.Among these 5 cases,1 patient had a short time improvement during the therapy,but died 50 days later because of refractory thrombosis of renal vein; 4 other patients achieved complete or partial remission within 5~16 months follow-up.

结果方案1从CTX结束算起，中性粒细胞恢复到0.5×109/L平均需10d，方案2从Ara-C结束起，中性粒细胞恢复到0.5×109/L需16d；治疗3周时 SLEDAI平均从9.2降至4.4，尿蛋白从降至(0~+)，合并有重度难治性贫血或血小板减少者，治疗后血红蛋白或血小板分别恢复正常或接近正常；方案2治疗的1例由于肾血管血栓形成未能控制，病情短暂好转后再度恶化，1个月后死于DIC和肾功能衰竭；另4例随访5~16个月，病情基本控制。

And There was no serious complication;②In the course ofinterventional therapy, Direct portal vein angiography demonstrated vena coronaria ventriculi(100%)andgastricveins(65.26%)andvenagastricaposterior38.43%, Angiography demonstrated venacoronariaventriculi communicate esophagus varicose veins, gastric veins and vena gastrica posterior communicategastric varicose veins. vena coronaria ventriculi had only a small percentage of double vein, about30.57%. The sites of vena coronaria ventriculi arising from the portal vein, splenic vein, portosplenic junction, were found in 52.06%、27.39%、20.55% respectively.③12 extrahepaticprotosystemic shunts were found in these patients. Include gastro-nephrosshuntof 3 cases, 7 caseswere splenetic- nephros shunt and 2 cases shown recanalization of umbilical vein .④The averageportal pressure before and after the procedure were 3.87±1.82kPa and 3.64±1.14kPa in 73patients, but to the time of rebleeding, it was 3.96±0.23kPa in the 11 cases.⑤There werethree kinds of variceal outcome: disappearance (54,low degree (19).⑥Spearman logisticanalyse and ANOVAtest shown liver function class, variceal degree of the splenic necrosis area,the blood direction in portal vein before operation and remain small collateral routes were thesignificant factors concerning outcome of varices.⑦The bleeding volume and portalhypertensive gastropathy are main risk factors of rebleeding.⑧The course of livercirrhosis is the risk factor of survival and extrahepatic portosystemic shunt , fine varices are thebeneficial factors to survival.⑨During all cases'followed-up data, the 1, 2, 3, 4, 5 yearcumulative survival rates and rebleeding rates were 17.81%, 28.77%, 38.36%, 43.84%, 47.95%and93.15%,91.78%,86.30%,83.56%,80.82%respectively. Conclusion The interventional disconnection treatment for liver cirrhosis and portalhypertension was designed suitability. It rapidlycontrol bleeding,butpressure of portal vein was notobvious high, perfusion was not low .it was compared with surgery therapeutic that interventionaldisconnection treatment was safe and had a significant clinical effect to hemorrhage and preventfrom rebleeding.

结果：①术后一过性发热62例(84.9%)，腹痛腹胀48例(65.8%)是介入断流术常见的并发症，未发生严重并发症；②门静脉造影显示胃冠状静脉、胃短静脉和胃后静脉的曲张分流的出现率是100%、65.26%和38.34%；显示食管静脉曲张主要由胃冠状静脉供血，胃静脉曲张主要由胃短静脉和胃后静脉供血；胃冠状静脉大多数为单支，少数为双支，其双支的出现率分别为30.57%；胃冠状静脉开口于门静脉主干的为52.06%，开口于脾静脉主干的为27.39%和开口于门脾静脉交汇处的为20.55%；③发现胃肾分流3例，脾肾分流7例、腹膜后门腔静脉分流2例，以及CTA检查发现脐静脉开放者2例；④73例患者介入断流术前和术后平均自由门静脉压力分别为3.87±1.82kpa和3.64±1.14kpa，前后比较存在显著性差异；11例再次介入手术患者的术前、术后和复发后的自由门静脉压力分别为4.02±0.24kpa、3.82±0.25kpa和3.93±0.23kpa ，前后比较发现首次术前与术后存在显著性差异，首次术前和复发出血术前门静脉压力比较无显著性差异；⑤介入术后复查曲张静脉转归基本消失54例，轻度19例；⑥Spearman相关分析和Logistic多因素回归分析，肝功能分级、静脉曲张程度、门脉血流方向和残存小侧支四个因素对曲张静脉转归有影响；Spearman相关分析和Logistic多因素回归分析门脉高压性胃病和出血量等因素对复发出血时间有影响；⑦COX回归分析，门体分流和曲张静脉转归两个因素对术后生存有影响；⑧术后随访6-70月，1、2、3、4、5年的累计复发出血率和累计生存率分别为17.81%、28.77%、38.36%、43.84%、47.95%和93.15%、91.78%、86.30%、83.56%、80.82%；结论：介入断流术治疗门脉高压食管胃底静脉曲张有独特的优点，可以快速直接控制曲张静脉出血而门静脉压力无显著增高，保证了肝脏灌注；与外科分流术相比适应证广、损伤轻、术后恢复快，不易遗漏曲张静脉；肝功能分级、曲张静脉程度、门脉血流方向和残存侧支血管对食管胃曲张静脉转归有影响；门脉高压性胃病对复发出血时间有影响；门体分流和曲张静脉转归对生存时间有影响。

Results: The changes following hydrocortisone intervention of rats could be identified by PCA, and the kidney deficiency syndrome rats entered a state of "hyperfunction", involving a series of changes in metabolic pathway and metabolic network. The response integral area of lactic acid (δ 1.37) increased, indicating the accumulation of metabolites of lactic acid. The amount of dimethylamine (δ 2.72) also increased, indicating that the disorder of kidney function was related to kidney-deficiency syndrome. The response of creatinine (δ 3.87), asparaginic acid (δ 2.83), taurine (δ 3.44, 3.28), and hippurate (δ 7.84, 7.56, 7.64, 3.97) all decreased significantly, indicating that the hydrocortisone might cause adrenal cortex excretion injury. The response integral area of succinate (δ 2.41) and citric acid (δ 2.53, 2.68) decreased, which was usually caused by disorder of the mitochondrial function.

结果：PCA方法处理肾虚证和空白对照大鼠尿液数据显示，两组大鼠的数据可以在得分图实现分类，与对照组比较肾虚组大鼠由于氢化可的松诱导，大鼠机体进入一个过消耗后衰弱的状态，相关代谢发生显著变化，乳酸(δ 1.37)代谢发生堆积；二甲胺(δ 2.72)的含量增加，提示肾虚与肾功能异常是密切相关的；天冬氨酸(δ 2.83)，牛磺酸(δ 3.44， 3.25)，马尿酸(δ 7.84， 7.56， 7.64， 3.97)，肌氨酸(δ 3.87)等的相对积分面积明显下降，这预示糖皮质激素可能引起了肾上腺皮质分泌功能的损害；琥珀酸(δ 2.41)和柠檬酸(δ 2.53， 2.68)是三羧酸循环能量代谢及糖酵解的中间产物，其含量的降低，通常是由于线粒体功能紊乱所引起。

Results? 6 cases in X-ray film revealed round or oval stones in areatus distribution in the areas of renal papillae and medulla. 3 cases of IVP revealed cystic or hair-brushed dilation. 5cases in B-ultrasound revealed little anechoic area and strong echo light spot in radial distribution with acoustic shadow. Unenhanced CT of 6 cases revealed spotted or areatus stones surrounding minor renal calices with collecting tube system dilation and enhanced CT showed artifacts of stones magnification because of the collection of contrast medium around the stones. Conclusion?

结果 X线平片检查6例，表现为肾乳头、髓质区见簇状排列的圆形、椭圆形致密影；IVP检查3例，显示肾集合管囊状、刷子状扩张；B超检查5例见肾髓质内呈放射状分布的小无回声区和强回声光点，其后方伴有声影；CT检查6例，平扫呈环绕肾小盏分布的点状或簇状钙化灶，集合管囊状扩张，增强后因钙化周围的集合管内造影剂聚集，造成钙化影增大的假象。

Objective To introduce the experience and clinical value of the way to manage the hilus renalis and renal sinus from the inferior pole of kidney in retroperitoneal laparoscopic operation.

目的 经肾下极途径处理肾蒂、肾窦在老年患者后腹腔镜肾切除中的经验及临床价值。

Results The level of antibodies against monocytes (34.94%) were higher than that of the antibodies against lymphocytes (26.67%) in pretransplant patients. The level of antibodies in first time transplant patients (32.5%) was lower than that of antibodies in retransplant patients (59.7%). The patients with intensity of antibodies against monocytes PRA more than ≥50%only accounted for 1.87%, 10%MPRA50%for 17.62%and MPRA10%15.44%,respectively.Conclusion Before renal transplantation, the detection of MPRA level could predict the occurrence of rejection in renal transplantation.

结果 肾移植术前患者的抗单核细胞抗体水平较抗淋巴细胞抗体水平高，其百分比分别为34.94%和26.67%；而从患者初次和再次肾移植前的比较中可见，初次比再次产生的抗单核细胞抗体水平要低，其百分比分别为32.05%和59.7%；对于抗单核细胞抗体群体反应性抗体的强度，MPRA≥50%的只占1.87%，而50%10%以及MPRA结论在肾移植术前检测患者MPRA水平，对肾移植后的排斥反应能起到预测目的。

Objective To explore retroperitoneoscopic unroofing and decompression of renal simple cyst. Methods The clinical data of 36 cases of renal simple cysts treated by retroperitoneoscopic unroofing and decompression were retrospectively analyzed.

目的总结经后腹腔镜下囊肿去顶减压术治疗单纯性肾囊肿的经验，讨论手术适应证及手术要点方法回顾分析36例经腹膜后腹腔镜肾囊肿去顶减压术治疗单纯性肾囊肿的临床资料。

Methods:The clinical data of 84 patients with renal cyst underwent retroperitoneal laparoscopic unroofing by three ports were analyzed retrospectively,and the method of directly expanding retroperitoneal space during laparoscopy with three ports was evaluated.

回顾分析我院为84例肾囊肿患者用三孔法行腹膜后腹腔镜肾囊肿去顶减压术的临床资料，并评价三孔法腹膜后腹腔镜手术中直接扩张后腹膜腔的方法。

Results After 3 months of kidney radiation by 15 Gy of Cs137 γ-rays, the changes with kidney shrank, Bowman's capsules straitened or disappeared, glomerular swelled, some epithelia denaturalized or died were observed. Mitochondria tumefied and the cristae shortened, lessened and disordered. Urine β2-MP rose evidently. It was lowered significantly the renal 25-OH-D-1α-hydroxylase activity and its mRNA expression. The dry and ash weight, BMD of femur and lumbar were significantly reduced, volume and width of bone trabecula were distinctly decreased and the space increased in model group. The Pyd / Cr increased and ALP decreased as well.

结果 15Gy 137Cs-γ射线肾局部照射3个月后肾脏体积缩小，肾小球肿大，Bowman氏囊囊腔狭窄甚至消失，部分肾小管上皮细胞变性、坏死，线粒体肿胀，体积增大，线粒体嵴变短、减少、排列紊乱；尿β2-MP显著增加；肾1α羟化酶活性及1α羟化酶mRNA基因表达量明显下降；肾辐射组股骨干重、灰重、腰椎和股骨BMD明显降低；骨小梁体积和骨小梁宽度减少，骨小梁间距增加，MAR减小；腰椎压缩和股骨三点弯最大载荷明显降低，Pyd / Cr值明显增加，ALP显著降低。

Objective Through observing the ei'fect of the TCM decoction TangShenHuaYuJian on the kidney weight, index of kidney hypertrophy(kidney weight/body weight), blood glucose , blood urea nitrogen, creatinine, blood advanced glycation end-products, advanced glycation end-products in kidney tissue in the earlier stage of diabetic nephropalhy rats induced by injecting 3 -cytotoxins into abdomen, to explore the relationship between nonenzymatic glycosylation and diabetic nephropathy, and provide an experimental basis for clinical application and for further studying TSHYJ.

目的 通过观察糖肾化瘀煎对长期高血糖所致的早期粮尿病肾病大鼠(腹腔注射链脲佐菌素后诱导所形成)肾重、肾重指数、血糖、血尿素氮、肌酐、血糖基化终末产物AGEs、肾组织糖基化终末产物AGEs等指标的影响，从非酶糖基化角度探讨此制剂对糖尿病肾病早期的作用机理，并为糖肾化瘀煎的临床运用和进一步开发提供实验依据。

I'm strongly against the death penalty — it's an eye for an eye.

我不赞成死刑——这是以牙还牙的报复行为。

And to get you the support you need, we're enlisting all elements of our national power: our diplomacy and development, our economic might and our moral suasion, so that you and the rest of our military do not bear the burden of our security alone.

并给你们所须的支援，我们正徵召国家所有各种的力量：我们的外交及发展，我们的经济力量与道德劝说，所以你们与其他军人不须要孤独地负起国家安全的责任。