疝环充填式无张力疝修补术治疗腹股沟疝108例临床分析

疝环充填式无张力疝修补术，因大幅度减少了传统疝修补术较高的并发症，而逐渐成为腹股沟疝修补术的首选方法。我院于2003年4月～2006年6月，对108例共111侧腹股沟疝行疝环充填式无张力疝修补术，效果满意，现报道如下：     

疝环充填式无张力疝修补术42例报告

目的 总结腹股沟疝应用疝环充填式无张力疝修补术的治疗效果。方法 总结分析我科1998年6月—2002年6月应用疝环充填式无张力疝修补术治疗腹股沟疝42例。结果 本组42例经此方法手术均顺利，术后恢复快，经随访6—52个月无复发。结论 敝环充填式无张力疝修补术是一种符合生理解剖条件的手术方式，具有手术操作简单、创伤小、省时、复发率低等优点。     

疝环充填式无张力修补术与传统疝修补术治疗腹股沟疝的比较

目的：比较疝环充填式太张力修补术与传统疝修补术治疗脂股沟疝的疗效。方法：203例腹股沟疝病人随机分成两组，97例行疝环充填式无张力修补术，106例行传统疝修补术。对手术时间、下床活动时间、术后疼痛情况、术后并发症以及复发率进行对比观察。结果，与传统疝修补术相比，缅环充埃式无张力修补术手术方法更简单，术后疼痛轻，恢复快，并发症少，复发率低。结论：疝环充填式元张力修补术是—项更符合人体解剖结构和疝的病理生理的手术方法，具有传统疝修补术无法比拟的优点。     

疝环充填式无张力疝修补术在复发性及巨型腹股沟斜疝中的应用(附26例报告)

目的 总结复发性斜疝及巨大斜疝充填式无张力疝修补术的近期治疗效果。方法 采用Mesh-Plug定型产品行疝环充填式无张力修补。其中巨大腹股沟斜疝19例，复发性腹股沟斜疝7例，对手术方法，术后病人的恢复，术后伤口疼痛等进行观察。结果 全部病人随访3月-2年，无复发。结论 疝环充填式无张力修补术具有创伤小，恢复快，应用简便等优点，对复发疝及巨大疝也可取得满意临床效果。     

无张力疝修补术在老年腹股沟疝中的应用

目的：探讨老年人腹股沟疝无张力疝修补术的临床经验。方法：回顾性分析我院2000年1月至2003年12月收治的68例接受疝环充填式无张力疝修补术的老年腹股沟疝病例。结果：68例60～75岁老年腹壁疝患者，均系用疝充填式无张力疝修补术。随访4～40个月，187例获随访，术后无复发。结论：疝环充填式无张力疝修补术具有手术创伤小。术后恢复快、疼痛轻、复发率低等优点，是目前较为理想的疝修补方法，尤其适合于治疗老年腹股沟疝；同时重视老年患者并存症的处理，对减少术后并发症十分重要。     

疝环充填式无张力疝修补术治疗腹股沟复发疝

目的探讨疝环充填式无张力疝修补术在腹股沟复发疝治疗中的应用。方法使用聚丙烯锥形疝环充填物及补片对64例腹股沟复发疝患者行疝环充填式无张力疝修补术，并予临床总结分析。结果手术全部成功，平均手术时间45min，平均住院时间5d，无伤口感染、血肿及阴囊积液，无复发病例。结论疝环充填式无张力疝修补术安全，创伤小，痛苦小，术后恢复快，复发率低，疗效满意，是治疗腹股沟复发疝的理想术式。     

疝环充填式无张力疝修补术在治疗腹股沟疝中的应用

目的探讨疝环充填式无张力疝修补术治疗腹股沟疝的临床效果和应用价值。方法回顾性总结我科2005年1月～2007年12月行疝环充填式无张力疝修补术治疗腹股沟疝病人192例,共202例次。结果本组无手术死亡,无切口感染,均痊愈出院。本组随访6～28个月,随访率80.2%,无1例复发。其中1例半年后因胰头癌晚期死亡。结论疝环充填式无张力疝修补术是一种符合生理解剖的手术方法,具有手术简单、安全、创伤小、恢复快、痛苦少、复发率低、适应证广等优点,值得推广。     

疝环充填式无张力疝修补术治疗老年腹股沟疝

目的总结应用充填式无张力疝修补术治疗腹股沟斜疝的可靠性和治疗效果,以及在基层医院应用的可行性。方法使用疝环充填物及网状补片,对我院2005年1月～2009年2月应用无张力修补治疗的21例年龄在60岁以上的腹股沟斜疝患者进行回顾性分析。结果充填式无张力疝修补术平均手术时间为48min,与传统手术方法相比,该方法具有简便、术后疼痛轻、恢复快、复发率低等优点。结论充填式无张力疝修补术值得在基层医院推广,尤其针对老年患者。     

疝环充填式无张力疝修补术治疗腹股沟疝108例体会

目的探讨疝环充填式无张力疝修补术治疗腹股沟疝的疗效。方法回顾总结汤阴县人民医院2005年8月—2007年12月用疝环充填式无张力疝修补术治疗108例腹股沟疝的临床资料。结果所有患者均治愈出院。术后除有两例有疼痛外,余患者治愈出院。随访至今无复发。结论疝环充填式无张力疝修补术治疗腹股沟疝手术方法简单,术后疼痛轻,恢复快,并发症少和复发率低等优点。     

腹外疝合并肝硬化患者疝修补术的体会

目的 探讨疝环充填式无张力疝修补术对腹外疝合并肝硬化的临床疗效。方法 采用美国Bard公司的聚丙烯锥形充填物及成型补片对31例腹外疝合并肝硬化病人施行疝环充填式无张力疝修补术，观察术后切口情况、并发症及复发率。结果 2例术后切口腹水渗漏，引流后愈合，无切口感染。结论 疝环充填式无张力疝修补术手术操作简便、损伤轻、恢复快、复发率低．适用于腹外疝合并肝硬化患者。     

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.     

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.     

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.