青年脑卒中60例临床及危险因素分析

目的探讨青年脑卒中的临床特点以及危险因素。方法分析2009年6月至2010年12月在我院治疗的60例青年脑卒中患者的发病年龄,脑血管病危险因素以及临床特点。结果青年脑卒中患者平均年龄为38.12岁,男性占71.67%,缺血性脑卒中33例(55.00%),有明确病因者29例(87.88%),主要病因动脉粥样硬化21例(63.63%);出血性脑卒中27例(45.00%),有明确病因者24例(88.89%),主要病因高血压10例(37.03%)。传统的相关因素(高血脂、高血压、吸烟、饮酒)同样是青年脑卒中的危险因素。结论青年男性发病率较高,高血脂、高血压、吸烟饮酒是青年脑卒中的重要危险因素,而高血压和动脉粥样硬化分别是出血性脑卒中和缺血性脑卒中的主要病因。     

青年与老年缺血性脑卒中病因分型及危险因素的对比研究

目的 分析青年缺血性脑卒中患者的病因分型及相关危险因素,并与老年缺血性卒中患者进行比对,为进一步提高青年脑卒中的预防及诊疗水平提供依据.方法 以神经内科收治的青年和老年缺血性脑卒中患者为研究对象,共76例青年缺血性脑卒中患者和245例老年缺血性脑卒中患者纳入研究,所有研究对象按照病因进行TOAST分型,记录其常见危险因素,对比分析2组人群的差异.结果 青年缺血性脑卒中患者TOAST分型:大动脉粥样硬化型(LAA)24(31.6%)例,心源性卒中型(CE)9(11.8%)例,小动脉闭塞型(SAA)15(19.7%)例,其他原因型 (SOE)10(13.2%)例,不明原因型 (SUE)18(23.7%)例.老年组分别为LAA106(43.3%)例,CE29(11.8%)例,SAA67(27.3%)例,SOE10(4.9%)例,SUE18(12.7%)例.2组比较差异有统计学意义(P<0.05).青年组和老年组缺血性脑卒中的TOAST分型均以LAA为主,2组CE所占比例相同,但是青年组中SOE和SUE的比例要明显高于老年组.青年组前后循环所占比例分别为55(72.4%)和21(27.6%),老年组前后循环比例分别为193(78.8%)和52(21.2%),2组前后循环所占比例差异无统计学意义(P>0.05).2组患者性别、酗酒、家族史、高血压、心脏病、肺炎等危险因素差异有统计学意义(P<0.05).青年缺血性脑卒中患者的主要可控危险因素依次为高血压(63.2%),高脂血症(61.8%),吸烟(34.2 %),酗酒(31.6%).结论 青年组和老年组缺血性脑卒中的TOAST分型均以LAA为主,预防动脉粥样硬化有利于减少缺血性脑卒中的发生;高血压、高脂血症、糖尿病、吸烟、酗酒是青年人缺血性脑卒中的主要可控危险因素;青年组在关注缺血性脑卒中常见病因的同时,也要关注少见、罕见的病因,以更好的指导青年脑卒中的一、二预防.     

青年缺血性脑卒中的病因分析及危险因素预后分析

目的探讨青年缺血性脑卒中的病因、危险因素及预后分析。方法选取2010年12月至2011年5月收治的76例青年缺血性脑卒中患者为研究对象(青年卒中组),另选取我院同期收治的76例老年缺血性脑卒中患者为研究对象(老年卒中组),分期其发病的原因及危险因素,并总结青年卒中组的治疗预后情况。结果多因素Logistic回归分析发现,高血压、高血脂、吸烟是影响青年脑卒中的独立危险因素(P<0.05),其发病原因主要为大动脉粥样硬化、小动脉闭塞、心源性脑栓塞。青年脑卒中的治疗预后要显著优于老年脑卒中(P<0.05)。结论血压、高血脂、吸烟是青年人脑卒中的发病危险因素,其治疗预后要好于老年人,应指导青年人建立合理的生活方式,降低卒中发生率。     

青年出血性脑卒中80例病因及危险因素分析

目的探讨青年出血性脑卒中的病因及危险因素,帮助预防和治疗。方法对我院神经内科2001年1月至2012年1月收治的青年出血性脑卒中患者共80例进行回顾性研究分析,统计病因、危险因素与出血性脑卒中的类型、临床特点及转归的相关性。结果 80例患者中出血性脑血管病类型以脑实质出血最多(60%);病因以动脉瘤等颅内血管畸形疾病最多见(53.75%),其次为动脉粥样硬化(11.2%);危险因素主要有性别、高血压、酗酒、高血脂、抽烟等。结论青年脑出血以高血压、吸烟、饮酒为常见危险因素,脑血管畸形、动脉粥样硬化为常见病因,普及大众心脑血管病知识,做好危险因素的预防,是减少青年脑卒中发生的重要手段。     

青年脑卒中临床特点及危险因素分析

目的探讨青年脑卒中的临床特点及危险因素。方法分析年龄≤45岁的86例脑卒中患者的临床资料,研究青年脑卒中的临床特点,并对86例脑卒中患者与86例健康青年人进行脑卒中危险因素的调查。结果 86例青年脑卒中患者中男性居多,缺血性脑卒中为主,卒中部位多见于脑叶、基底节区,临床以急性发病、症状及体征在24h内达高峰者居多。脑卒中组的各项危险因素水平均较对照组显著增高(P均<0.05),从高到低依次为:高血压病史(30.2%)、嗜烟酒史(22.1%)、高脂血症史(16.3%)、其他(12.8%)、糖尿病史(10.5%)、心脏病史(8.1%)。结论青年脑卒中有其一定的临床特点,其发病与高血压、吸烟、酗酒、高脂血症、糖尿病、家族史、心脏病等因素有关。     

150例青年卒中的病因和危险因素

目的研究青年卒中的病因和危险因素。方法回顾笔者收集的150例16～45岁急性脑卒中患者的资料。结果青年卒中的发病率有逐年增高趋势,并且缺血性卒中可有动脉粥样硬化性脑梗死、血管炎、烟雾病、心源性栓塞、血流动力学异常、先天性血管发育异常、偏头痛性梗死、线粒体脑肌病、抗心磷脂抗体综合征等病因;出血性卒中可有高血压性、血管畸形、动脉瘤、烟雾病、凝血机制障碍等病因;也有原因不明者。青年卒中主要的危险因素可有高血压、高脂血症、吸烟、饮酒、TIA、高同型半胱氨酸血、糖尿病、心脏病、偏头痛、家族史等。结论青年卒中患者病因和发病危险因素复杂。     

中青年脑梗死的病因特点及预后的临床分析

目的分析中青年人脑梗死的临床特点。方法回顾性分析60例青年脑梗死患者的临床资料,探讨其病因、危险因素和预后等临床特点。结果有明确病因者36例(60.00%)其中动脉粥样硬化24例(40.00%),心源性脑栓塞9例(15.00%),梅毒性动脉炎2例(3.33%),真性红细胞增多症1例(1.67%);病因不明者24例(0.00%)。主要危险因素有吸烟、高血压、血脂异常、脑血管疾病家族史、肥胖、酗酒、TLA病史、糖尿病、心房颤动等。经治疗基本痊愈22例(36.67%),显著进步14例(23.33%),进步11例(18.33%),无变化13例(21.67%)。结论青年人脑梗死的病因以动脉粥样硬化、心源性脑栓塞、梅毒性动脉炎最常见。以吸烟、高血压、血脂异常等为最常见的危险因素,大多数患者预后较好。     

青年卒中98例临床分析

目的探讨青年卒中危险因素、病因及临床特点。方法总结我院98例青年卒中患者危险因素、病因及临床特点,并与同期100例老年卒中患者进行对照分析。结果青年卒中患者以头痛、意识障碍为起病时主要临床表现,其病变部位以脑叶多见,预后较好。在危险因素和病因方面：高血压病、高脂血症、糖尿病、吸烟、酗酒、家族卒中史、心脏病及TIA等为两组患者共同危险因素,但青年卒中组高血压病、高脂血症、糖尿病患者均较老年组明显低。在缺血性卒中,两组共同的病因均为动脉粥样硬化,但青年卒中组较老年组明显低,此外,青年卒中组尚有炎症性病变所致动脉炎、颈动脉夹层等病因。出血性卒中中高血压动脉硬化所致者,青年卒中组较老年组亦少,另外,青年卒中组还发现动脉瘤2例,动静脉畸形1例,Moyamoya病1例。结论青年卒中与老年卒中在f临床特点及病因学等许多方面有所不同,有其特殊性和复杂性。     

215例青年脑卒中患者相关危险因素分析

目的:分析青年脑卒中的相关危险因素。方法:我院2010～2011年共诊治年龄≤45岁青年脑卒中患者215例,对所有病例均进行了脑卒中相关危险因素(高血压、糖尿病、高血脂、心脏病、吸烟、饮酒)调查,并与同龄健康人群对照科学分析。结果:所调查疾病组各项相关危险因素百分率均高于对照组,疾病组相关危险因素高血压病史、吸烟、饮酒、脑卒中病史、心脏病史、糖尿病史、高脂血症病史。差异有统计学意义(P<0.05)。结论:青年脑卒中主要的危险因素是吸烟、饮酒、高血压、高脂血症、脑卒中史等,对危险因素进行控制和干预,对于减少青年脑卒中发生具有重要的临床意义。     

缺血性脑卒中危险因素及治疗效果分析

目的探讨缺血性脑卒中的病因、临床特点及治疗方法。方法分析268例缺血性脑卒中患者的临床资料。结果缺血性脑卒中发病危险因素有高血压病史、血脂异常、心脏病、糖尿病、吸烟饮酒、卒中史、短暂性脑缺血发作,发病率随年龄增长呈上升趋势,男性多于女性,发病部位多在基底节区。及时采用溶栓、抗血小板、抗凝、扩血管和脑保护剂的治疗对改善患者临床症状有效。结论高血压病史、血脂异常、心脏病、糖尿病、吸烟饮酒、卒中史、短暂性脑缺血发作是脑卒中患者的主要危险因素,预防这些危险因素并采用相应的临床治疗措施,可有效预防缺血性脑卒中的发生,改善患者预后,提高生存质量。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.