锁骨外侧端不稳定性骨折的手术治疗

目的评价锁骨外侧端不稳定性骨折的手术方法及疗效。方法对68例锁骨外侧端不稳定性骨折采取三种手术方法内固定：克氏针内固定、克氏针张力带钢丝内固定和锁骨钩钢板内固定,平均随访1年,根据Karlsson评分标准进行疗效评估。结果克氏针内固定优良率为74％,克氏针张力带钢丝内固定优良率为80％,锁骨钩钢板内固定优良率为95％,锁骨钢板内固定优良率最高。结论锁骨外侧端不稳定性骨折应用锁骨钩钢板内固定效果最好。     

改良式克氏针钢丝张力带治疗尺骨鹰嘴骨折

目的探讨改良克氏针钢丝张力带固定治疗尺骨鹰嘴骨折的方法及临床疗效。方法回顾分析2006年3月-2009年5月经改良式克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折41例患者的临床资料。结果41例患者均痊愈,随诊6个月-1年,38例已取出内固定物,无克氏针松动、脱出、穿破皮肤及断裂,未见滑囊形成及皮肤破溃,1例出现1根钢丝断裂,未见骨折移位。优37例,良4例,优良率100%。结论改良克氏针张力带内固定治疗尺骨鹰嘴骨折操作简单,固定牢固,并发症少,疗效满意,明显优于传统内固定方法。     

克氏针张力带与非克氏针张力带固定治疗髌骨骨折疗效比较分析

目的：比较克氏针张力带与非克氏针张力带固定治疗髌骨（横断和粉碎性骨折）骨折疗效。方法：对我院收治的2002～2008年的91例骨折患者（横断骨折42例；粉碎性骨折49例）行克氏针张力带与非克氏针张力带固定治疗髌骨骨折疗效进行回顾性分析。结果：非克氏针张力带组与克氏针张力带组疗效无显著差异。结论：非克氏针张力带内固定治疗髌骨骨折是一种成熟的技术，适用于髌骨骨折，并且操作简便，无需特殊器械，固定可靠，术后并发症少，减轻了患者痛苦及经济负担，适用于基层医院。     

克氏针张力带钢丝内固定治疗肩锁关节脱位28例

目的探讨克氏针张力带钢丝内固定治疗肩锁关节脱位的临床疗效。方法采用切开复位，克氏针张力带钢丝内固定治疗肩锁关节脱位28例。结果28例肩关节功能均于2个月内恢复正常，无内固定物松脱断裂，无再脱位发生。按Lazzcaeo标准评定，优26例，占92．85％，良2例，占7．15％。结论克氏针张力带钢丝内固定治疗肩锁关节脱位，操作简单易行，损伤小，术后无需外固定，是一种较好的治疗方法。     

内踝骨折克氏针张力带钢丝内固定的生物力学探讨

内踝骨折克氏针张力带钢丝内固定的生物力学探讨山西省创伤骨科医院（０３００２１）潘宝祥，亢志强内踝骨折行单纯螺丝钉、克氏针内固定不能对抗胫后肌腱牵拉，可造成旋转移位、骨折远端内翻、关节面向外成角或分离。为此，我们根据Ｄｅｎｉｓ和Ｍｃａｆｅｅ的三柱原理［１］，应用克氏针加张力带钢丝固定内踝骨折，治疗８例，结果满意。临床资料８例中男６例，女２例；年龄：２０～５２岁；手术时间：伤后４天～３周。受伤原因：砸伤５例，扭伤３例。三踝骨折３例、双踝骨折３例、单纯内踝骨折２例。手术方法：取内踝处前内侧切口约５ｃｍ，切口止于内踝尖以下２ｃｍ，应避开大隐静脉。显露骨折端后，清除断端的肉芽及嵌入的肌腱后复位，用布中钳夹持骨折断端暂时维持固定。由内踝尖部以４５°角向外上打入克氏针１枚，然后在胫骨前内侧骨嵴上由内向外钻一骨孔，穿入０．８ｍｍ钢丝，绕过克氏针尾端，扭紧。若骨折端有旋转不平时，可通过调正张力带钢丝松紧达到完全解剖复位。最后，修复三角韧带，逐层缝合。术后不加外固定。讨论克氏针加张力带钢丝内固定比单纯用克氏针、螺针内固定的优点在于：其他两种内固定不能保持骨折端的解剖复位，即使直视手术时已达到解剖复位，但日后复查时可能出现骨折端     

克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折

尺骨鹰嘴骨折是创伤骨科临床常见的上肢骨折，如果骨折复位及内固定不理想，将直接影响肘关节的功能，造成肘关节屈伸障碍，影响日常工作和生活。我科自1993年至2003年应用克氏针钢丝张力带内固定治疗尺骨鹰嘴骨折患者42例，随访28例，随访时间8～22个月，疗效满意，现报告如下：     

交叉克氏针、钢丝张力带治疗锁骨远端骨折及肩锁关节脱位

目的探讨应用交叉克氏针、钢丝张力带治疗锁骨远端骨折及肩锁关节脱位的临床疗效。方法采用切开复位交叉克氏针、钢丝张力带内固定治疗锁骨远端骨折及肩锁关节脱位21例。结果 21例患者中随访6个月～3年,1例发生钢丝断裂,钢针移位,但骨折已愈合。1例发生钢针切割肩峰,改用锁骨钩钢板固定。余病例骨折、脱位全部愈合,肩关节功能恢复满意。结论交叉克氏针、钢丝张力带治疗锁骨远端骨折及肩锁关节脱位疗效确切,不需要特殊器械,花费少,值得在基层医院推广。     

空心钉钛缆与克氏针钢丝张力带治疗髌骨横断型骨折的临床分析

目的:探讨空心钉钛缆与克氏针钢丝张力带治疗髌骨横断型骨折的临床疗效特点。方法:48例髌骨横断型骨折患者采用随机分为两组,其中空心钉钛缆张力带内固定组20例,克氏针钢丝张力带内固定组28例,比较两组患者在手术时间、骨折愈合时间、术后并发症及膝关节功能评价方面的差异。结果:空心钉钛缆张力带组手术时间明显要短于克氏针钢丝张力带组,差异有统计学意义(P<0.01);两组术后膝关节功能评价,空心钉钛缆组优良率为95%,稍高于克氏针张力带组的92.86%(P>0.05)。结论:空心钉钛缆张力带内固定髌骨横断型骨折具有手术时间短、不影响骨折愈合及无并发症、膝关节功能恢复良好等优点,是安全、有效治疗髌骨横断型骨折的理想方法之一。     

髌骨骨折五种内固定治疗的疗效分析

目的 总结髌骨骨折的治疗经验。方法 采用空心加压螺纹钉、克氏钉“8”字张力带钢丝、环形加张力带钢丝、Magnuson钢丝、环形钢丝五种内固定方法手术治疗髌骨骨折。结果 五种内固定术式及随访疗效差异显著。其中空心加压螺纹钉内固定可早期进行伸屈膝关节功能锻炼,具有损伤小、固定牢、并发症少等优点。Magnuson钢丝和环形钢丝稳定性差,需石膏外固定。克氏针“8”字张力带钢丝易引起针尾疼痛、克氏针松动、旋转和断裂、骨折再移位和骨折不愈合等并发症。结论 空心加压螺纹钉内固定治疗髌骨骨折的术后优良率达100％,明显优于其他几种固定方法。     

克氏针加张力带钢丝内固定与AO锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位疗效比较

目的比较研究锁骨钩钢板与克氏针加张力带钢丝治疗肩锁关节脱位与锁骨远端骨折的疗效差异。方法将84例肩锁关节脱位及锁骨远端骨折随机分为2组：A组44例用克氏针加张力带钢丝治疗,B组40例用锁骨钩钢板内固定疗。结果2组治疗优良率分别为95．5％和95．O％。2组疗效比较差异无统计学意义。结论两种治疗方法均很好的运用了生物力学原理,有很好的治疗效果。     

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.