多层螺旋CT对成人型多囊肾体积测量的价值

目的探讨采用多层螺旋CT对成人型多囊肾进行体积测量的诊断价值。方法对收治的16例APKD患者的CT图像进行分析,并对每位患者两侧肾脏三条最大径线的长度进行测量,采用多田公式:体积=1/6π×a(长径)×b(宽径)×m(层厚)×c(层数)计算出肾脏的体积(近似值)。同时随机选取16例健康成人的肾脏测量体积作为对照组,比较两组之间肾脏体积的差异,分析肾脏体积大小与肾功能指标之间是否存在相关性。结果 16例APKD患者的CT图像呈现出复杂的伴随征象,肾脏体积与健康成人比较明显增大,差异有统计学意义(P<0.05);肾脏的体积大小与肾脏功能的指标之间成负相关。结论多层螺旋CT能可靠地对肾脏进行体积测量,并能够对成人型多囊肾及其伴随征象作出较准确的诊断。     

成人型多囊肾的CT征象与临床价值探讨

目的探讨成人型多囊肾的CT临床应用价值。方法回顾性分析我院成人型多囊肾病例20例,测量CT图像上每个病例两侧肾脏三条最大径线长,并记录伴随征象,结合临床肾功能指标,分析CT征象及肾功能之间的关系。结果20例多囊肾肾脏体积均程度不同有所增大同时合并复杂的伴随征象,与肾功能分期具有一定的相关性。结论CT能准确诊断多囊肾,并可根据肾脏体积大小及伴随征象间接评价肾功能情况。     

成人型多囊肾临床表现与CT分析

目的：探讨成人型多囊肾的临床表现以及CT分析对于诊断成人型多囊肾的临床价值。方法对11例怀疑可能为成人型多囊肾患者的临床表现资料进行回顾性分析总结，且对上述11例患者进行CT平扫和增强扫描进行诊断。结果在进行CT扫描的11例患者当中，患者的CT表现均出现了肾脏呈现显著增大，整个肾实质内充满多个大小不一的囊伏低密度区，双侧肾孟盏夹于众多囊肿之间，多囊肾边缘清楚，囊肿间隔薄厚不一，互不相通，晚期病例肾实质常显影不良，增强后囊肿间隔强化明显， CT值为5~85 Hu之间。结论 CT检查是判断成人型多囊肾一种简便、可靠的方法，具有诊断明确快速，无创性等多个优点，可以广泛使用于临床上。     

成人型多囊肾16例CT诊断分析

成人型多囊肾为遗传性疾病 ,中年时出现症状 ,本组 1 6例CT表现典型 ,现报告如下。1　一般资料本组 1 6例中 ,男 7例 ,女 9例。年龄 31～ 72岁 ,平均 4 8岁。均为双侧发病。腰腹痛 1 0例 ,血尿 6例 ,腹部肿块 8例 ,高血压 6例 ,肾功能不全 4例 ,双下肢水肿伴呼吸困难 1例 ,发热 1例 ,无症状 2例。2　CT表现本组病例经B超、CT检查确诊为多囊肾 ,因其CT平扫征像典型而部分未作增强。本组病例均为双侧发病。 (1 )肾脏呈分叶状增大 ,肾周间隙变窄。选出每一病例的肾门层面 ,测量其经肾门的横径 ,测得最大值为 9 0cm ,最小值为 7 3cm ;根据其…     

螺旋CT平扫测量肾实质体积评价慢性梗阻侧肾脏肾小球滤过率的价值

目的 探讨螺旋CT平扫测量肾实质体积判断梗阻侧肾脏肾小球滤过率(GFR)的价值.方法 采用螺旋CT平扫扫描双肾,逐层标示各层横断面面积,结合扫描层厚计算肾实质体积,并计算梗阻侧肾实质体积占总的肾实质体积百分比(%Ctvol);另利用99m锝-二乙三胺五醋酸(99mTc-DTPA)肾动态显像技术,应用Gates法测定分肾及总的GFR值,计算梗阻侧肾脏GFR占总GFR的百分比(%GFR).结果 本组25例慢性单侧上尿路梗阻患者,梗阻侧肾脏体积与GFR有明显相关性(r=0.873,P＜0.01),直线回归方程为%GFR=0.008+0.91×%Ctvol.结论 螺旋CT平扫测量肾实质体积可以作为临床上一种实用的评价慢性梗阻侧肾脏GFR的方法.     

多囊肾成人患者应用后腹腔镜肾囊肿去顶减压术的临床研究

目的研究多囊肾成人患者应用后腹腔镜肾囊肿去顶减压术的临床疗效。方法将我院2010年2月~2013年2月确诊并收治的79例成人型多囊肾患者纳入临床组,本组患者全部实施后腹腔镜肾囊肿去顶减压术,按照分期单侧治疗规则来进行。同时,对我院2008年4月~2009年11月确诊并收治的成人型多囊肾患者共计79份病历资料进行回顾性分析,纳入对照组。对照组病例均通过实施开放性肾囊肿去顶术进行治疗。统计两组手术时间、失血量、肠道功能恢复时间、下床活动时间及住院天数,并对所有患者实施为期15个月的临床随访,对比两组患者收缩压、舒张压、血肌酐、血尿素氮的指标改善情况。结果所有患者均顺利完成手术,患者在术中及术后均未有显著并发症出现。临床组其手术时见、失血量、肠道功能术后恢复时间、下床活动时间及住院件数均显著少于对照组(P0.05)。随访期间所有患者腰部酸胀疼痛症状均显著改善或完全消失,实施肾脏彩色多普勒超声检查显示未见囊肿复发。两组手术3个月后血压及肾功均比治疗前显著改善(P0.05),而两组手术3个月后血压及肾功其改善幅度差异无统计学意义(P0.05)。结论多囊肾成人患者应用后腹腔镜肾囊肿去顶减压术在保障与常规开腹同等疗效的前提下,其创伤更小、更有利于术后恢复。     

原发性高血压患者出生时体质量与肾脏体积、体质量指数的相关性研究

目的 研究原发性高血压患者出生时体质量与肾脏体积、体质量指数的相关性.方法 原发性高血压患者63例作为高血压组,血压正常的健康体检者34例作为对照组,测量2组血压、肾脏体积,计算体质量指数,询问出生时体质量.结果 高血压组收缩压、舒张压、BMI、低出生体质量发生率均高于对照组,出生时体质量低于对照组,差异均有统计学意义(P<0.01和P<0.05).但经体表面积校正肾脏体积2组比较差异无统计学意义(P>0.05).结论 出生时体质量影响成年时高血压的形成,但不是通过减少肾脏体积介导的,BMI是高血压的危险因素.     

替米沙坦配伍吲哒帕胺治疗肾性高血压的临床评价

目的评价替米沙坦配伍吲哒帕胺治疗肾性高血压的降压效果和肾脏保护作用。方法将82例肾性高血压患者随机分为对照组和治疗组。对照组服用替米沙坦80mg,1次/d;治疗组服用替米沙坦40mg+吲哒帕胺缓释片1.5mg,1次/d。连续用药8周,观察并比较两组患者用药后的降压效果及肾功能变化、发生的不良反应。结果两组患者血压明显降低(P<0.05),但收缩压下降幅度治疗组较对照组明显(P<0.01),两组肾功能各项指标均有显著改善(P<0.05),但治疗组血肌酐、钾、内生肌酐清除率的改善显著优于对照组(P<0.05),治疗组不良反应发生率显著低于对照组(P<0.05)。结论替米沙坦配伍吲哒帕胺对肾性高血压有较好的降压效果和肾脏保护作用。     

手术治疗成人型多囊肾19例报告

成人型多囊肾是一种常染色体显性遗传性疾病,病程进展最终致高血压及肾功能严重损害.随着B超、CT等影像学检查的广泛应用,发现病例逐渐增多,目前该病尚缺乏有效的治疗方法.现将我院近15年来行囊肿去顶减压术19例报告如下.     

苯磺酸氨氯地平联合缬沙坦对维持性血液透析高血压患者血压及蛋白尿的影响

目的探讨苯磺酸氨氯地平联合缬沙坦对维持性血液透析高血压患者血压及蛋白尿的影响。方法将108例维持性血液透析高血压患者随机分为对照组与观察组,每组54例。对照组患者给予苯磺酸氨氯地平口服,观察组患者接受苯磺酸氨氯地平联合缬沙坦口服,疗程均为3个月。比较两组治疗前后血压、尿蛋白及肾功能指标的改变。结果两组治疗后血压均较治疗前显著下降(P<0.05),但观察组降压幅度更显著(P<0.05);观察组治疗后血肌酐、尿素氮及24h尿蛋白定量显著少于对照组(P<0.05)。结论苯磺酸氨氯地平联合缬沙坦可显著降低维持性血液透析高血压患者的血压,并可减少尿蛋白及改善肾功能,具有肾脏保护作用。     

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.

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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.     

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.     

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.