腹部术后胃瘫30例诊治体会

目的探讨腹部术后胃瘫的病因，诊断及治疗措施。方法回顾性分析2000～2008年12月发生的腹部手术后胃瘫30例患者的临床资料。结果胃瘫多发生于腹部术后4～10d。本组29例经非手术冶疗均治愈出院，1例因恶性高血压致脑溢血而死亡。结论非手术治疗是该病的主要治疗手投，应尽量避免早期再次手术。     

腹部手术后胃瘫28例临床分析

目的探讨腹部手术后胃瘫的病因、发生机制、诊断和治疗方法。方法对1995年1月~2005年10月收治的28例腹部手术后胃瘫患者诊治资料进行回顾性分析。结果胃瘫均发生于腹部手术后5~12天。均经非手术治疗于术后10~41天恢复并痊愈出院,其中3周内治愈14例(50%),4周内治愈25例(89.3%)。结论腹部手术后胃瘫是由综合因素引起,体质差、手术创伤大和高龄可能为主要因素,消化道造影及胃镜检查是诊断胃瘫的重要手段。非手术疗法可治愈胃瘫,不应再次手术。     

腹部术后胃瘫22例诊治体会

目的:探讨腹部手术后胃瘫综合征(PGS)的病因、诊断及治疗措施.方法:回顾性分析22例腹部手术后胃瘫的临床资料.结果:胃瘫多发生于腹部术后4～10 d.经综合治疗后胃肠动力一般可在6周内恢复.本组22例经非手术治疗均治愈出院.结论:胃手术后PGS治疗以综合性和保守治疗为主,尽量避免手术,以减轻患者痛苦.     

桃红承气汤联合肠内营养治疗腹部术后胃瘫综合征23例

目的探讨桃红承气汤联合肠内营养治疗腹部手术后胃瘫综合征的疗效。方法对2000—2009年医院腹部手术后胃瘫综合征患者23例的临床资料进行回顾性分析。结果胃瘫发病时间为术后3～16d,治疗后所有患者均于术后12～32d（平均21.1d）恢复胃肠动力。结论以桃红承气汤联合肠内营养的非手术治疗措施疗效肯定。     

腹部手术后胃瘫综合征的诊治分析

目的探讨腹部手术后胃瘫综合征患者的临床特点、诊断方法以及治疗方法。方法将12例腹部手术后胃瘫患者为资料,分析出现胃瘫综合征的原因,并给予促胃动力药等积极的治疗。结果经过治疗后12例患者均在9周内恢复正常。结论年龄、麻醉以及术后使用自控镇痛泵等均是导致胃瘫发生的原因,需要给予综合的治疗促进患者的康复。     

胃大部切除后胃瘫患者18例治疗体会

目的总结胃大部切除术后胃瘫的发病特点及治疗。方法对2001年2月至2009年12月胃大部切除术后18例患者(占同期手术3.9%)出现胃瘫的临床资料进行回顾性总结。结果本组患者胃瘫发生于4～10d,16例经保守治疗而愈,2例于胃瘫后15、17d分别行空肠造瘘术,1周后治愈。结论胃瘫的治疗以非手术疗法为主,必要时可行空肠营养性造瘘术以解决营养问题。     

腹部手术后胃瘫综合征15例临床分析

目的探讨腹部手术后胃瘫综合征的病因,诊断和治疗方法。方法对1999-2008年我院腹部手术后胃瘫15例临床资料进行回顾性分析。结果本组共发生胃瘫15例,均发生于术后4-11d。病人经严格保守治疗,术后2-5周内全部治愈。结论腹部手术后胃瘫综合征的发生是多因素综合作用的结果,消化道造影及胃镜检查是主要的诊断方法,采用胃肠减压、营养支持、促动力药物的综合治疗是治疗腹部术后胃瘫的有效手段。应避免再手术。     

胃瘫33例诊治体会

目的探讨腹部手术后胃瘫的发病机制、诊断和治疗。方法对33例腹部手术后胃瘫综合征患者的临床资料进行分析。结果 31例病例经营养支持、药物治疗痊愈,2例好转。结论胃肠手术后胃瘫是由综合因素所致,采取非手术疗法基本可治愈,营养支持是治疗的关键。     

腹部手术后胃瘫综合征12例临床分析

目的探讨腹部手术后胃瘫综合征的诊治措施。方法对12例腹部手术后功能性胃排空障碍患者的临床资料进行回顾性分析。结果全部患者均经非手术疗法治愈,胃肠功能恢复时间15～46d。结论通过缓解患者紧张情绪、持续胃肠减压、加强营养支持及胃肠动力药物应用等,均可获得满意治疗效果。     

胃大部切除术后胃瘫的诊治

目的探讨胃大部切除术后手术后发生胃瘫的原因、诊断及治疗措施。方法回顾分析近5年来胃大部切除术后手术后发生胃瘫的14例患者的临床资料。结果临床表现、胃镜检查及胃肠造影是诊断本病的主要手段。胃瘫多出现在胃大部切除术后的3—12d,经综合保守治疗后,胃肠动力可在术后2～8周内恢复正常。结论综合保守治疗是治疗胃瘫的有效方法,应避免再次手术。     

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.

     

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.     

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.     

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.