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卷 10, 编号 4 (2020)

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Original articles

肿瘤增长率的预测值和肾癌患者生物标志物的变化和动态

Molchanov O., Maistrenko D., Granov D., Lisitsyn I.

摘要

文章讨论了当前主要预测肾细胞癌患者的主要模式的特点。研究了与肿瘤细胞和微环境的活化或增殖有关的分子和生物标记的可能性。显示了将反映肿瘤块的生长强度或体积减小强度的参数整合到预后系统中的可能性。介绍了自己的研究数据。提出了一种模型,该模型与先前使用的组件一起包括免疫学参数(IL-6和IL-8的自发产生)以及肿瘤生长或消退的动力学参数。这些因素与恶性和攻击性的程度有关,是独立的前奏。简要概述反映了所研究的免疫系统组成部分与侵袭性、增殖性和肿瘤的转移潜力之间的关系。概述了有关将生物标志物整合到肾细胞癌预测模型中的可能性的未来研究方向。

Urology reports (St. - Petersburg). 2020;10(4):281-291
pages 281-291 views

泌尿科疾病病原体微生物监测

Slesarevskaya M., Spiridonova A., Krasnova M., Reva S., Gadzhiev N., Ponomareva Y., Al-Shukri A., Kuzmin I., Petrov S., Al-Shukri S.

摘要

 2018年至2020年期间1022例(559名女性和463名男性)在PSbGMU them. I.P. Pavlov泌尿科门诊接受治疗的患者的尿液微生物学检查结果进行分析。患者的年龄从18岁到88岁不等(平均63.1±17.6岁)。587个人(57.5%)中是显示革兰氏阴性,355个人(34.7%)中是革兰氏阳性菌,80个人(7.8%)中为混合菌群。尿路致病菌的结构多数Escherichia сoli(28,2%),Enterococcus faecalis(20,9%),Klebsiella pneumoniae(14,1%)与Staphylococcaceae(11,6%)。家庭细菌。其他微生物的比例不超过5%。注意到对氨苄西林有很高的菌群抗性,第二代和第三代头孢菌素,氟喹诺酮类。泌尿致病菌中,注意到最高水平的抗生素耐药性K. pneumoniaе。总的来说所取得的结果与伦理结构的总体趋势和尿路感染的抗菌素抗药性水平相吻合。这项研究证实需要进行局部微生物监测,以开发最佳的经验性抗生素治疗和围手术期抗生素预防方案。

Urology reports (St. - Petersburg). 2020;10(4):293-300
pages 293-300 views

COVID-19流行期间泌尿科的运作

Kul’chavenya E., Kholtobin D., Neymark A.

摘要

绪论2020年3月世界卫生组织已宣布新型冠状病毒感染(COVID-19)爆发为大流行病。大流行还对所有学术,科学和教育活动产生了重大影响。

材料与方法。我们比较了私人诊所(新西伯利亚MC “Avicenna”)和市政诊所(KGBUZ“城市临床医院”11号,巴尔瑙尔)泌尿科的工作,以及俄罗斯卫生部新西伯利亚结核病研究所泌尿生殖科,为期6个月。在COVID-19冠状病毒大流行开始之初的2019年和2020年上半年是“平静”的一年。

结果。2020年3月俄罗斯卫生部新西伯利亚结核病研究所的泌尿生殖科被重新设计为观察科。2020年上半年,患有恶性肿瘤,精索静脉曲张,慢性肾盂肾炎,肾积水,睾丸膜水肿,包茎/包虫病的患者于2020年上半年入市第11医院(巴尔瑙尔)泌尿科。2020年具有统计意义的意义上,肾脓肿和急性前列腺炎的患者人数居多。由于紧张的疫情,患者推迟就医,直到病情需要紧急干预为止。2020年上半年在Avicenna MC(新西伯利亚)儿科泌尿科医师的就诊次数显着减少,住院时间和平均就诊天数减少了。相反,患者在日间医院的总住院时间显着增加,这在流行病学上可以合理解释。统计上,大多数手术和门诊手术数量均有明显减少。

结果。新的冠状病毒感染已影响到人类生活的各个领域,最大程度上-医药。最初的六个月中没有开发出统一的方法来管理流行病中的泌尿科患者;诊所根据内部标准运作。我们的分析表明,严格遵守卫生和卫生标准以及采取抗流行病措施可使我们即使在这种不利条件下也能为患者提供全面的泌尿科护理。

Urology reports (St. - Petersburg). 2020;10(4):301-307
pages 301-307 views

Assessment of postoperative complications of transurethral contact pyelocalycоlithotripsy in patients with high-density stones according to the Clavien – Dindo classification

Nazarov T., Tursunov A., Rychkov I., Ahmedov M., Trubnikova K., Nikolaev V.

摘要

 Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access.

Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien – Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy.

Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated.

Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien – Dindо classification.

Conclusion. The improved Clavien – Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.

Urology reports (St. - Petersburg). 2020;10(4):309-316
pages 309-316 views

Possibilities of phytotherapy in patients with lower urinary tract symptoms due to benign prostate enlargement

Al-Shukri A., Kostyukov S.

摘要

The results of the use of the phytopreparation Tadimax in the treatment of 60 men with mild and moderate lower urinary tract symptoms (LUTS) developed as a result of benign enlargement of the prostate gland are presented. The average age of the patients was 66.5 ± 3.8 years. Tadimax was prescribed 2 tablets 3 times a day, in courses of 7 days with 7 day breaks for 3 months (a total of 6 courses). The data obtained indicate high efficacy and good tolerability of treatment. A decrease in the severity of LUTS was noted in 59 (96.6%) patients, which was accompanied by significant changes in objective clinical indicators: a decrease in residual urine volume and an increase in urine flow rate. Tadimax is a combined preparation, which includes extracts of several medicinal plants, and the main component is Crinum latifolium. The therapeutic effect of Tadimax is based on anti-inflammatory, antiproliferative and immunotropic action.

Urology reports (St. - Petersburg). 2020;10(4):317-323
pages 317-323 views

Reviews

泌尿科实践的最佳润滑剂

Banaru A., Salyukov R.

摘要

根据所进行的治疗或诊断性操纵和临床情况选择注册表的重要性,很少得到执业医师-泌尿科医生的重视。同时,润滑剂的成分既可以提供外延治疗,也可以预防所进行的操纵过程中出现的并发症,反之亦然,也可以导致并发症。根据对过去20年的科学文献的分析,本文件概述了在泌尿学实践中使用的润滑剂及其主要成分,即凝胶形成剂。麻醉剂,防腐剂,显示其主要优点和缺点。

Urology reports (St. - Petersburg). 2020;10(4):325-336
pages 325-336 views

精子的DNA片段化:病因,致病性,对生殖功能的影响

Korshunov M., Korshunova E., Darenkov S.

摘要

文献综述致力于精子的DNA片段化。过去10年中分析的国内外文学资料以及有关配子基因组完整性评估的基础数据。描述了在精子发生各个阶段形成DNA断裂的可能机制,以及主要病因。在一个单独的段落中,突出强调了在病原体和染色质损害的发生过程中的过量氧化压力的重要性。这篇综述提供了有关辅助生殖技术治疗中精子DNA片段化与妊娠和分娩频率之间关系的最新数据。描述了DNA断裂率高的流产的风险。文章强调了在男性不育因子下确定色素结构紊乱的诊断重要性。生殖健康专业人员对配子DNA断裂的发病机理的进一步研究具有临床意义。

Urology reports (St. - Petersburg). 2020;10(4):337-345
pages 337-345 views

Advantages and disadvantages of main surgical approaches for robot-assisted radical prostatectomy

Il’in D., Makeev V.

摘要

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patient’s age, anatomical features of the prostate gland, the state of the patient’s erectile function, and the history of operations on the abdominal cavity and pelvic organs.

Urology reports (St. - Petersburg). 2020;10(4):347-354
pages 347-354 views

Сlinical observations

治疗前列腺空泡结核的新方法

Kholtobin D., Kul'chavenya E.

摘要

前列腺结核(PT)不是罕见的,但很少被诊断出来的疾病。对PT患者的治疗是一项艰巨的任务,因为即使在健康器官的实质中也难以达到足够浓度的抗菌药物,并且在形成前列腺腔的情况下,其纤维壁几乎完全阻止了抗结核药物渗透到破坏灶中。在具体患者的例子中详细描述了联合手术治疗前列腺结核的方法。方法在于以下事实:在多化学疗法的背景下,通过经尿道电切术打开腔,然后通过波长为940纳米,功率为150瓦特的高能二极管激光器的辐射使腔壁凝结。这种方法可让您清除化脓性坏死碎屑的前列腺腔,并由于激光辐射的凝结而中断其壁中的病理性感染和炎症过程。所建议的前列腺结核外科治疗方法同时是根治性的,由于腔壁被切除和凝结,并且具有微创性,因此建议将其广泛应用。

Urology reports (St. - Petersburg). 2020;10(4):355-359
pages 355-359 views

Urethral erosion developed after implantation of artificial urinary sphincter

Kyzlasov P., Mustafaev A., Kazantsev D., Volokitin E.

摘要

The case report presents a clinical observation of urethral erosion that developed after a long-term presence of a urethral catheter in a patient after implantation of an artificial bladder sphincter. The stages of the patient’s surgical treatment are described. The frequency of such complications in patients with an established artificial bladder sphincter according to literature data is presented.

Urology reports (St. - Petersburg). 2020;10(4):361-363
pages 361-363 views


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