Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in t...Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes.Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics,metabolism and morphology.In this review we try to provide some quantitative information on urinary supersaturation with respect to stone minerals,especially Ca oxalate(CaO x),on the formation and aggregation of Ca Ox crystals and on crystal retention in the kidney.The paper is centered on idiopathic Ca nephrolithiasis being the most frequent stone disease with only partially known pathogenesis.New aspects of the role of urinary macromolecules in stone formation and of the mechanism of crystal aggregation are provided.展开更多
Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between sin...Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between single and recurrent stone formers,and develop a schema for metabolic and radiologic follow-up.A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis.Both single and recurrent stone formers share many similarities in metabolic profiles.The study group determined that based on an assessment of risk for stone recurrence and metabolic activity,single and recurrent stone formers should be evaluated comprehensively,including two 24 h urine studies on a random diet.Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence.Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient,the risk of chronic kidney disease and the risk of osteoporosis/osteopenia.A standard scheme includes a baseline metabolic profile,a repeat study 3e6 months after initiation of treatment,and then yearly when stable,with abdominal imaging obtained every 1-2 years.展开更多
Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metaboli...Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metabolic defects.Infection stones are associated with urease-producing bacterial urinary tract infections.The ideal treatment for staghorn calculi is maximal surgical removal.However,some patients are either unwilling or unable to proceed with that modality of treatment,and therefore other management must be used.One such technique is the metabolic evaluation with directed medical management.Based on contemporary evidence that the majority of staghorn stones are metabolic in etiology,and furthermore that even infection stones are usually associated with metabolic abnormalities,metabolic evaluation with directed medical management is recommended for all staghorn stone formers.The scientific basis of this recommendation is reviewed in the present work.展开更多
High-temperature geothermal water has abundant lithium(Li)resources,and research on the development and utilization of geothermal-type lithium resources around the world are increasing.The Qinghai–Tibetan Plateau con...High-temperature geothermal water has abundant lithium(Li)resources,and research on the development and utilization of geothermal-type lithium resources around the world are increasing.The Qinghai–Tibetan Plateau contains huge geothermal resources;especially,Li-rich geothermal resources in southern Xizang,southwestern China,are widely developed.The Li-rich geothermal spots in Xizang are mainly distributed on both sides and to the south of the Yarlung Zangbo suture zone.Such resources are often found in the intensely active high-temperature Li-rich geothermal fields and,compared with other Li-rich geothermal fields around the world,the Li-rich geothermal fluid in the Xizang Plateau,southern Xizang is characterized by good quality:the highest reported Li concentration is up to 239 mg/L;the Mg/Li ratio is extremely low and ranges from 0.03 to 1.48 for most of the Li-rich geothermal fluid;the Li/TDS value is relatively high and ranges from 0.25–1.14%compared to Zhabuye Li-rich salt lake(0.19%)and Salar de Uyuni(Bolivia)(0.08–0.31%).Continuous discharge has been stable for at least several decades,and some of them reach industrial grades of salt lake brine(32.74 mg/L).In addition,elements such as boron(B),caesium(Cs),and rubidium(Rb)are rich and can be comprehensively utilized.Based on still-incomplete statistics,there are at least 16 large-scale Li-rich hot springs with lithium concentration of 20 mg/L or more.The total discharge of lithium metal is about 4300 tons per year,equivalent to 25,686 tons of lithium carbonate.Drilling data has shown that the depth is promising and there is a lack of volcanism(non-volcanic geothermal system).With a background of the partial-melting lower crust caused by the collision of the Indo-Asia continent and based on a comprehensive analysis of the tectonic background of southern Xizang and previous geological,geophysical,and geothermal research,deep molten magma seems to provide a stable heat source for the high-temperature Li-rich geothermal field.The Li-rich parent geothermal fluid rushes to the surface to form hot springs along the extensively developed tectonic fault zones in southern Xizang;some of the Li-rich fluid flows in to form Li-rich salt lakes.However,most of the Li-rich geothermal fluid is remitted to seasonal rivers and has not been effectively exploited,resulting in great waste.With the continuous advance of lithium extraction technologies in Li-rich geothermal fluid,the lithium resource in geothermal water is promising as a new geothermal type of mineral deposit,which can be effectively exploited.This is the first study to undertake a longitudinal analysis on the characteristics,distribution and scale,origin and utilization prospects of Li-rich geothermal resources in southern Xizang,research that will contribute to a deeper understanding of Li-rich geothermal resources in the area and attract attention to these resources in China.展开更多
Objective: The aim of this study is to validate the Italian version of the Developmental Disability-Child Global Assessment Scale (DD-CGAS), a scale developed to assess global functioning in children with Autism Spect...Objective: The aim of this study is to validate the Italian version of the Developmental Disability-Child Global Assessment Scale (DD-CGAS), a scale developed to assess global functioning in children with Autism Spectrum Disorders (ASDs). Methods: Following the validation procedures used for the English version of the scale, inter-rater reliability, temporal stability and convergent validity were assessed in a group of 48 children with ASD and temporal stability in a subset of 42 subjects. Results: Inter-rater reliability and temporal stability (ICC) were respectively 0.78 and 0.79;effect size for convergent validity were moderate to large;the pre-post DD-CGAS change had an effect size of 0.59. Conclusions: The Italian version of the DD-CGAS is a reliable instrument for measuring global functioning of children with ASD.展开更多
AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed datab...AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.展开更多
文摘Nephrolithiasis seems to be the result of crystal formation,aggregation and retention in the kidney during crystalluria.These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes.Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics,metabolism and morphology.In this review we try to provide some quantitative information on urinary supersaturation with respect to stone minerals,especially Ca oxalate(CaO x),on the formation and aggregation of Ca Ox crystals and on crystal retention in the kidney.The paper is centered on idiopathic Ca nephrolithiasis being the most frequent stone disease with only partially known pathogenesis.New aspects of the role of urinary macromolecules in stone formation and of the mechanism of crystal aggregation are provided.
文摘Considering the variation in metabolic evaluation and medical management of kidney stone disease,this consensus review was created to discuss the metabolic activity of nephrolithiasis,define the difference between single and recurrent stone formers,and develop a schema for metabolic and radiologic follow-up.A systematic review of the literature was performed to identify studies of metabolic evaluation and follow-up of patients with nephrolithiasis.Both single and recurrent stone formers share many similarities in metabolic profiles.The study group determined that based on an assessment of risk for stone recurrence and metabolic activity,single and recurrent stone formers should be evaluated comprehensively,including two 24 h urine studies on a random diet.Targeted medication and dietary recommendations are effective for many patients in reducing the risk of stone recurrence.Follow-up of those with stone disease should be obtained depending on the level of metabolic activity of the patient,the risk of chronic kidney disease and the risk of osteoporosis/osteopenia.A standard scheme includes a baseline metabolic profile,a repeat study 3e6 months after initiation of treatment,and then yearly when stable,with abdominal imaging obtained every 1-2 years.
文摘Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system.They may be composed of metabolic or infection stone types.They are often associated with specific metabolic defects.Infection stones are associated with urease-producing bacterial urinary tract infections.The ideal treatment for staghorn calculi is maximal surgical removal.However,some patients are either unwilling or unable to proceed with that modality of treatment,and therefore other management must be used.One such technique is the metabolic evaluation with directed medical management.Based on contemporary evidence that the majority of staghorn stones are metabolic in etiology,and furthermore that even infection stones are usually associated with metabolic abnormalities,metabolic evaluation with directed medical management is recommended for all staghorn stone formers.The scientific basis of this recommendation is reviewed in the present work.
基金financially supported by the Major Program of the National Natural Science Foundation of China(Project Grant No.91962219)the National Natural Science Foundation of China(Grant No.U1407207)+1 种基金the Beijing Dizhiguang New Energy Technology Research Institute Co.,Ltd,China Geological Survey(Project Grant No.DD20190172)the National Key Research and Development Program of China(Grant Nos.2017YFC0602806 and 2017YFC0602802).
文摘High-temperature geothermal water has abundant lithium(Li)resources,and research on the development and utilization of geothermal-type lithium resources around the world are increasing.The Qinghai–Tibetan Plateau contains huge geothermal resources;especially,Li-rich geothermal resources in southern Xizang,southwestern China,are widely developed.The Li-rich geothermal spots in Xizang are mainly distributed on both sides and to the south of the Yarlung Zangbo suture zone.Such resources are often found in the intensely active high-temperature Li-rich geothermal fields and,compared with other Li-rich geothermal fields around the world,the Li-rich geothermal fluid in the Xizang Plateau,southern Xizang is characterized by good quality:the highest reported Li concentration is up to 239 mg/L;the Mg/Li ratio is extremely low and ranges from 0.03 to 1.48 for most of the Li-rich geothermal fluid;the Li/TDS value is relatively high and ranges from 0.25–1.14%compared to Zhabuye Li-rich salt lake(0.19%)and Salar de Uyuni(Bolivia)(0.08–0.31%).Continuous discharge has been stable for at least several decades,and some of them reach industrial grades of salt lake brine(32.74 mg/L).In addition,elements such as boron(B),caesium(Cs),and rubidium(Rb)are rich and can be comprehensively utilized.Based on still-incomplete statistics,there are at least 16 large-scale Li-rich hot springs with lithium concentration of 20 mg/L or more.The total discharge of lithium metal is about 4300 tons per year,equivalent to 25,686 tons of lithium carbonate.Drilling data has shown that the depth is promising and there is a lack of volcanism(non-volcanic geothermal system).With a background of the partial-melting lower crust caused by the collision of the Indo-Asia continent and based on a comprehensive analysis of the tectonic background of southern Xizang and previous geological,geophysical,and geothermal research,deep molten magma seems to provide a stable heat source for the high-temperature Li-rich geothermal field.The Li-rich parent geothermal fluid rushes to the surface to form hot springs along the extensively developed tectonic fault zones in southern Xizang;some of the Li-rich fluid flows in to form Li-rich salt lakes.However,most of the Li-rich geothermal fluid is remitted to seasonal rivers and has not been effectively exploited,resulting in great waste.With the continuous advance of lithium extraction technologies in Li-rich geothermal fluid,the lithium resource in geothermal water is promising as a new geothermal type of mineral deposit,which can be effectively exploited.This is the first study to undertake a longitudinal analysis on the characteristics,distribution and scale,origin and utilization prospects of Li-rich geothermal resources in southern Xizang,research that will contribute to a deeper understanding of Li-rich geothermal resources in the area and attract attention to these resources in China.
文摘Objective: The aim of this study is to validate the Italian version of the Developmental Disability-Child Global Assessment Scale (DD-CGAS), a scale developed to assess global functioning in children with Autism Spectrum Disorders (ASDs). Methods: Following the validation procedures used for the English version of the scale, inter-rater reliability, temporal stability and convergent validity were assessed in a group of 48 children with ASD and temporal stability in a subset of 42 subjects. Results: Inter-rater reliability and temporal stability (ICC) were respectively 0.78 and 0.79;effect size for convergent validity were moderate to large;the pre-post DD-CGAS change had an effect size of 0.59. Conclusions: The Italian version of the DD-CGAS is a reliable instrument for measuring global functioning of children with ASD.
文摘AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.
