闭合性肾损伤诊治分析

目的探讨闭合性肾损伤诊断与治疗要点。方法回顾性分析97例闭合性肾损伤患者的临床资料。结果全部患者均进行了CT检查，B超俭查32例；行保守治疗83例，其中16例作超选择性肾动脉栓塞术；手术治疗14例，其中。肾切除术10例，肾修补术3例，肾部分切除术1例。结论CT检查是评估肾损伤程度的主臻方法，超选择性肾动脉栓塞治疗是肾损伤保守治疗的主要方法。     

闭合性肾损伤的诊断与治疗

目的：探讨闭合性肾损伤的诊断与治疗水平。方法：对73例闭合性肾损伤的临床资料进行回顾性分析。结果：73例闭合性肾损伤中,肾挫伤48例,肾裂伤21例,肾粉碎伤4例,并发伤11例。血尿、腰部疼痛是主要的临床症状。保守治疗61例,手术治疗12例,死亡1例。结论：B超检查便捷无损伤。CT检查准确快速,并可同时了解其他脏器损伤的情况,对治疗有重要帮助。保守治疗是重要的治疗方法。如果损伤严重应及时手术治疗。     

闭合性肾损伤200例临床分析

目的总结闭合性肾损伤的诊治体会,提高肾损伤的诊治效果。方法回顾性分析200例闭合性肾损伤患者的临床资料。结果200例闭合性肾损伤中,保守治疗141例(70.5%),超选择性肾功脉栓塞治疗8例(4%),手术治疗51例(25.5%),其中20例同时施行了腹部合并伤手术。死亡3例,病死率1.5%。结论B超、CT是诊断肾损伤主要的、有效的方法,大剂量IVU亦是重要的措施。     

22例闭合性肾损伤的诊断和治疗

目的探讨提高闭合性肾损伤的诊断和治疗水平。方法对2006年1月至2010年6月收治的22例闭合性肾损伤患者的临床资料进行回顾性分析,综合应用尿常规、超声、CT等检查确诊。肾损伤分级:Ⅰ～Ⅴ级分别为3、5、4、6、4例。本组22例患者中,同时合并其他脏器损伤8例,其中颅脑损伤者3例,肺挫伤2例,肝、脾等腹腔脏器伤3例,肋骨4例,脊柱压缩性骨折3例,骨盆骨折2例。根据病情选择保守治12例(55%),手术治疗10例(45%),其中肾切除5例,保肾手术5例,其他合并伤均进行了相应手术或对症治疗。结果本组22例均痊愈出院,无死亡病例。结论超声可作为肾损伤尤其是急诊肾损伤患者首选检查,CT检查是闭合性肾损伤快速准确诊断、正确评估肾损伤程度和选择治疗方案的重要依据,合理保肾是闭合性肾损伤的有效治疗方法。     

闭合性肾损伤的诊断与治疗（附168例报告）

目的：总结闭合性肾损伤的诊断与治疗。方法回顾性分析168例闭合性肾损伤患者的诊治资料。结果168例均行尿液常规检查,血尿149例(88.7%);B 超检查154例,阳性131例(85.1%);CT检查118例,阳性118例(100.0%),静脉尿路造影(IVU)检查28例,阳性19例(67.9%);保守治疗132例(78.6%),手术36例(21.4%),治愈165例,死亡3例。其中106例随访12~60个月,尿常规、肾功能、血压表现正常。结论闭合性肾损伤初步检查首选B超, CT评估肾损伤程度和分型最准确,如无严重腹腔脏器并发伤, CT检查和血流动力学指标改变表现严重时也有较大的保守治疗的可能性。     

严重闭合性肾损伤的诊断与治疗（附36例报告）

目的探讨严重闭合性肾损伤的诊断与治疗方法，提高严重肾损伤的诊疗水平。方法回顾分析36例严重闭合性肾损伤的诊疗资料。结果36例严重闭合性肾损伤中，肾蒂损伤5例（13．89％），有合并伤14例（38．89％），其中保守治疗27例，手术治疗9例。死亡5例，其中肾蒂损伤3例，并发多器官功能衰竭2例，死亡率13．89％。结论B型超声和CT检查是诊断肾损伤的有效方法。严重的肾实质裂伤，在严密观察下仍可保守治疗，肾蒂损伤应在积极输血补液的同时紧急手术止血，这是拯救病人生命的重要措施。     

回顾性分析闭合肾损伤的治疗体会

目的探讨闭合肾损伤的诊断和治疗体会。方法对2008年2月至2011年1月在我院进行治疗的53例闭合肾损伤患者的临床资料进行回顾分析。结果 53例患者中,保守治疗42例(79.25%),手术治疗11例(20.75%),治愈52例(98.11%),死亡1例(1.89%),随访38例(71.70%),1例患者出现肾萎缩,1例出现肾周局限性积液,发生率均为2.63%。结论尿液和超检查是肾损伤诊断的常用检查,CT检查具有重要的诊断价值,肾损伤的治疗主要取决于损伤的类型、程度和复合伤情况,损伤严重者应及时手术。     

闭合性肾损伤的诊断与治疗方法选择

目的:探讨闭合性肾损伤的诊断与治疗方法.方法:对96例闭合性肾损伤患者的临床资料进行回顾性分析.结果:96例中肉眼血尿70例,镜下血尿18例,无血尿8例;合并其他脏器或组织伤42例;静脉肾盂造影50例,阳性36例(72.0%);B超检查96例,阳性87例(90.6%);CT扫描92例,阳性92例(100%);非手术治疗66例(68.8%),手术治疗30例(31.2%);治愈92例(95.8%),死亡2例(2.1%),病情恶化自动出院2例(2.1%).结论:外伤史和血尿是诊断肾损伤的重要依据;B超检查快速、简便、无创,可作为首选定性检查;CT扫描准确率高,是诊断肾损伤的可靠方法,也是选择治疗方案的重要依据.准确评估伤情,严格掌握非手术和手术治疗的指征是处理肾损伤的关键.     

闭合性肾损伤114例临床诊治体会

目的探讨闭合性肾损伤的诊断和治疗方法。方法对114例闭合性肾损伤患者的临床资料进行分析。其中I~II级肾损伤89例采取保守治疗,Ⅲ级肾裂伤21例采取保守治疗,其中1例经腹探查,Ⅳ级肾裂伤和(或)肾蒂伤4例经腹探查,切除患肾,挽救患者生命。结果本组患者全部治愈或好转出院,无手术并发症。出院后复查未见明显异常。结论临床上要依据损伤程度,制定最合适的方案。治疗闭合性肾损伤的关键是合理保肾。对于I～II级肾挫伤无大出血者可行保守治疗,III级肾裂伤尽量保守治疗保肾,必要时手术,Ⅳ级或V级肾碎裂伤和(或)肾蒂伤应行手术治疗。     

肾损伤的诊断与治疗（附41例分析）

目的探讨肾损伤的诊断和治疗方法。方法分析41例肾损伤临床资料,其中闭合性损伤38例,开放性损伤3例,合并其它脏器损伤16例。肉眼血尿者38例,镜下血尿者3例。本组均行B超、CT检查,静脉尿路造影（IVU）18例,阳性率分别为93.8%、100%、94.4%。结果非手术治愈36例,手术肾切除治愈5例,41例痊愈出院。结论CT检查准确率高、快速、无损伤,可判断肾损伤程度,应作为肾损伤的首选检查方法,对严重肾损伤及时手术探查。     

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.     

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.     

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.