标准外伤大骨瓣结合亚低温综合救治重型颅脑损伤

目的评价标准外伤大骨瓣结合亚低温综合救治重型颅脑损伤的临床效果。方法对急性重型颅脑损伤患者(GCS≤8),治疗组采用外伤性标准大骨瓣结合亚低温冬眠治疗5～7d;对照组仍采用传统的治疗方法。比较两组GCS、GOS、颅内压(ICP)以及并发症。结果治疗组GCS、GOS高于对照组,死亡率、ICP、切口疝、迟发血肿、脑膨出发生率低于对照组。结论标准外伤大骨瓣结合亚低温综合治疗,对降低急性重型颅脑损伤的死亡率、致残率,提高生存质量有重要价值。     

天麻钩藤饮联合耳尖放血疗法治疗高血压临床研究

目的 探讨天麻钩藤饮联合耳尖放血疗法治疗高血压的临床疗效。方法 选取医院2019年9月至2021年9月收治的高血压患者183例,按随机抽签法分为对照组、放血疗法组和联合治疗组,各61例。对照组患者以常规降压药物治疗,放血疗法组患者在对照组基础上加用耳尖放血疗法,联合治疗组患者在放血疗法组基础上加用天麻钩藤饮,均以2周为1个疗程,共治疗3个疗程。结果 联合治疗组的治疗总有效率为93.44%,分别显著高于放血疗法组的83.61%和对照组的75.41%(P <0.05);联合治疗组患者治疗后的眩晕头痛、面红目赤、心悸健忘、腰膝酸软中医证候积分均显著低于放血疗法组和对照组（P <0.05）,血压波动性指标24 h动态血压标准差、24 h动态血压变异系数、7 d测量连续变异系数均显著低于放血疗法组和对照组（P <0.05）,血清P-选择素、高迁移率族蛋白B1、血管内皮素-1水平均显著低于放血疗法组和对照组（P <0.05）;联合治疗组、放血疗法组、对照组患者治疗期间的不良反应发生率相当（14.75%比11.48%比9.84%,P> 0.05）。结论 天麻钩藤饮联合耳...     

泛昔洛韦联合针刺拔罐放血疗法治疗带状疱疹疗效观察

目的:观察泛昔洛韦联合针刺拔罐放血疗法与单纯泛昔洛韦治疗带状疱疹的疗效差异。方法:将68例患者随机分为两组。泛昔洛韦联合针刺拔罐放血疗法为观察组,单用泛昔洛韦为对照组。于治疗14天后观察记录治疗效果。结果:观察组与对照组比较在缩短病程及减轻疼痛上均有明显差异,两组均无不良反应发生。结论:泛昔洛韦联合针刺拔罐放血疗法治疗带状带状疱疹疗效好,可有效的缩短病程及减轻疼痛。     

1例青年男性静脉窦血栓患者的临床护理体会

<正>颅内静脉系统包括静脉窦和脑深浅静脉组。脑皮质静脉的血流汇总到静脉窦,颅内主要的静脉窦有上矢状窦,下矢状窦,直窦,侧窦和海绵窦。颅内静脉窦及静脉血栓形成是由多种原因所致的脑静脉回     

蒙医治疗带状疱疹疗效观察

目的：观察蒙医拔罐放血疗法结合蒙药治疗带状疱疹的临床疗效。方法：选取105例带状疱疹患者随机分为两组,治疗组53例给予蒙医拔罐放血疗法结合蒙药治疗,对照组52例给予单纯西医常规治疗。疗程结束后,对比两组近期疗效及远期疗效。结果：治疗组总有效率为88.88%,对照组总有效率为61.11%,治疗组总有效率明显高于对照组,差异有统计学意义（P〈0.05）;随访两年,治疗组远期疗效优于对照组,差异具有统计学意义（P〈0.05）。结论：蒙医拔罐放血疗法结合蒙药治疗带状疱疹疗效明显优于单纯西药并降低其后遗神经痛的发生率,值得临床推广应用。     

显微手术切除窦镰旁脑膜瘤39例体会

目的总结研究矢状窦一大脑镰旁脑膜瘤运用显微外科手术切除的方法和疗效。方法回顾性分析本组39例矢状窦一大脑镰旁脑膜瘤病患的临床资料。本组39例均采用显微外科手术方法切除。结果术后依据Simpson标准评价肿瘤切除的程度,本组病患肿瘤达到I级切除的32例,达到Ⅱ级切除的7例,此7例患者确诊病理诊断后,后期予以加行伽玛刀治疗。本组无因手术死亡病例。本组术后共有33例病患获得确切随访,平均随访时间1～2年,无复发病例出现。结论显微外科技术可以有效的控制和减少手术中出血,保护重要血管避免损伤,如上矢状窦、中央沟静脉,避免脑皮层重要功能区的损伤,能够明显提高矢状窦镰一大脑镰旁脑膜瘤的全切除率、降低复发率、减少术后致残率及死亡率。     

犬上矢状窦中1/3阻断对ICP及脑水肿的影响

目的建立上矢状窦中1/3及其回流静脉栓塞的犬动物模型。方法暴露犬脑上矢状窦中1/3,采用废旧PTA-球囊经严格消毒直接穿刺。第1组在上矢状窦中1/3处单纯球囊膨胀阻断;第2组在球囊膨胀阻断的同时,向阻断前的窦腔内注入1mL纤维蛋白胶,阻断桥动静和皮质静脉。术后观察脑组织病理变化,测定脑组织含水量。结果第2组平均ICP显著增高,阻断点前脑白质含水量增高。结论犬上矢状窦中1/3及其回流静脉结扎,该项操作简单,重复性好。     

阿片受体拮抗剂在重型颅脑损伤治疗中的临床研究

目的探讨阿片受体拮抗剂在急性重型颅脑损伤治疗中的机制和临床疗效。方法260例急性重型颅脑损伤患者随机分为治疗组140例和对照组120例,对照组给予常规治疗,治疗组在常规治疗的基础上早期使用阿片受体拮抗剂,观察早期治疗患者的颅内压(ICP)、脑水肿、GCS评分,同时比较伤后6个月时患者的神经功能恢复情况。结果治疗组ICP增高幅度和脑水肿程度均较对照组显著减轻(P<0.05);GCS评分明显优于对照组(P<0.05);6个月后死亡率、重残率及语言、肢体功能障碍均显著少于对照组(P<0.01)。结论阿片受体拮抗剂可降低急性重型颅脑损伤患者ICP增高的幅度,减轻脑水肿,缩短昏迷时间,降低死亡率和致残率,促进患者神经功能恢复,改善预后。     

创伤性上矢状窦损伤的诊治体会

上矢状窦损伤在颅脑损伤患者中发生率较低，但窦壁坚韧不易回缩，出血凶猛，如处理不及时或不当，可导致致命性的大出血。本科从2000年2月至2008年10月共收治外伤性上矢状窦损伤20例，现报告如下。     

浅谈针刺放血配合中药治疗头痛的临床疗效情况

目的：探究针刺放血配合中药治疗头痛的临床疗效。方法随机选取于2012年3月~2013年2月期间在本院进行治疗的患有头痛的患者80例,随机分成观察组和对照组各40例,对照组的患者进行针刺放血疗法进行治疗,观察组的患者在对照组的基础上加用中药的联合治疗,观察比较两组研究对象的治疗效果。结果观察组患者的治疗总有效率明显高于对照组的患者,且差异有统计学意义（P〈0.05）。结论对临床上头痛的患者进行针刺放血联合中药的治疗,能够收到较好的治疗效果,且应用安全简单,值得在临床上推荐应用。     

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.

---

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.     

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.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

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.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.