电子冰帽对高血压性脑出血预后的影响

目的　探讨用颅脑降温治疗仪 (电子冰帽 )使头部轻度低温 (亚低温 )改善血肿周围缺血及水肿治疗高血压性脑出血的效果。方法　 60例高血压性脑出血患者随机分为治疗组 ( 3 0例 )和对照组 ( 3 0例 ) ,在给予脑出血常规治疗的同时 ,治疗组加用电子冰帽 ,观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果　入组后 7d及 2 1d血肿体积无差异 (P >0 .0 5 ) ,2 1d时治疗组和对照组血肿周围水肿体积分别为 ( 13 .3 6± 11.5 8)ml,( 19.5 6± 12 .0 9)ml,有显著差异 (P <0 .0 1)。入组 7d治疗组和对照组神经功能缺损评分无显著差异 (P >0 .0 5 ) ,入组 2 1d两组间神经功能缺损评分有显著差异 (P<0 .0 1)。结论　用电子冰帽使头部轻度低温治疗高血压性脑出血 ,能促进血肿周围水肿的消退 ,改善临床神经缺损功能     

不同时间启始头部轻度低温对高血压脑出血预后的影响

目的探讨不同启始时间应用颅脑降温治疗仪(电子冰帽)致头部轻度低温(亚低温)对高血压性脑出血预后的影响。方法72例高血压性脑出血患者随机分为治疗组和对照组,每组36例;每组再分为脑出血后第6、12和24h亚组,每亚组12例。在给予脑出血常规治疗的同时,治疗组使用电子冰帽。观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果治疗后第7d与第21d的第6、12、24h开始致头部轻度低温的治疗组与相应时间的对照组血肿体积无显著性差异(P>0.05)。治疗后第21d的第6、12、24h启始的治疗组与相应时间的对照组血肿周围水肿体积比较有非常显著性差异(P<0.01)。治疗后第21d的第6、12h启始的治疗组与相应时间对照组神经功能缺损评分有非常显著性差异(P<0.01),第24h的两组间有显著差异(P<0.05)。结论第6、12和24h启始应用电子冰帽使头部轻度低温治疗高血压性脑出血,均能减轻血肿周围水肿,改善神经缺损功能,但对血肿的大小无影响。     

不同时期启始头部轻度低温对高血压脑出血预后的影响

目的探讨不同启始时间应用颅脑降温治疗仪(电子冰帽)致头部轻度低温(亚低温)对高血压性脑出血预后的影响。方法72例高血压性脑出血患者随机分为治疗组和对照组,每组36例;每组再分为脑出血后第6、12和24h亚组,每亚组12例。在给予脑出血常规治疗的同时,治疗组使用电子冰帽。观察血肿体积、血肿周围水肿体积及神经功能缺损评分的变化。结果治疗后第7d与第21d的第6、12、24h开始致头部轻度低温的治疗组与相应时间的对照组血肿体积无显著性差异(P>0.05)。治疗后第21d的第6、12、24h启始的治疗组与相应时间的对照组血肿周围水肿体积比较有非常显著性差异(P<0.01)。治疗后第21d的第6、12h启始的治疗组与相应时间对照组神经功能缺损评分有非常显著性差异(P<0.01),第24h的两组间有显著差异(P<0.05)。结论第6、12和24h启始应用电子冰帽使头部轻度低温治疗高血压性脑出血,均能减轻血肿周围水肿,改善神经缺损功能,但对血肿的大小无影响。     

全身亚低温治疗老年重型高血压脑出血的临床效果观察

目的探讨全身亚低温治疗老年重型高血压脑出血的临床效果。方法将80例老年重型高血压脑出血患者随机分为全身亚低温治疗组和常规治疗组,每组40例,对两组患者脑内血肿体积、神经功能缺失评分、血肿周围水肿体积及不良反应情况进行观察和比较。结果全身亚低温治疗组患者脑部血肿体积、血肿周围水肿体积、神经功能缺失评分均低于常规治疗组（P〈0.05）,但不良反应发生较多。结论全身亚低温治疗老年重型高血压脑出血可有效缩小患者脑部血肿及血肿周围水肿体积,有利于恢复患者脑部神经损伤,效果显著,在治疗过程中需密切监测患者的生命体征及电解质水平,以防不良反应的发生。     

微创血肿清除术后联合局部亚低温与持续亚低温滴灌对高血压脑出血的对比研究

目的对比观察微创血肿清除术后经颅穿刺引流联合局部亚低温与联合持续亚低温滴灌治疗高血压脑出血的临床疗效。方法选择高血压脑出血患者208例,均行微创血肿清除术后经颅穿刺引流,按不同辅助治疗方式随机分为穿刺引流联合局部亚低温组(穿刺引流+局部亚低温)68例、穿刺引流联合持续亚低温滴灌组(穿刺引流+持续亚低温滴灌)66例及对照组(单纯穿刺引流组)组74例。采用Scandinavian中风量表(Scandinavian Stroke Scale,SSS)评分法评估3组治疗前及治疗后第7、14、30、60天的临床疗效,采用多田公式计算三组治疗前及治疗后第3、7天的血肿大小。结果治疗7、14d后,与滴灌组和对照组比较,局部亚低温组SSS评分均显著增高(P<0·05);治疗30、60d后,与滴灌组和对照组比较,局部亚低温组SSS评分也显著增高(P<0·05),滴灌组SSS评分与对照组比较也显著增高(P<0·05)。治疗3、7d后,穿刺引流联合局部亚低温组血肿体积与对照组比较明显减小,差异有统计学意义(P<0·01);而与穿刺引流联合局部亚低温组和对照组比较,穿刺引流联合持续亚低温滴灌组血肿体积明显减小,差异有统计学意义(P<0·05)。结论微创血肿清除术后经颅穿刺引流联合亚低温治疗能显著促进患者神经功能的恢复以及血肿的吸收。联合局部亚低温治疗能更好地保护患者神经细胞,促进神经功能的恢复;而联合持续亚低温滴灌在早期更快地促进血肿的吸收。     

疏血通联合尼莫地平在脑出血急性期的应用

目的探讨疏血通联合尼莫地平治疗脑出血的临床观察。方法将60例患者随机分为两组,对照组30例,治疗组30例,在对照组常规治疗的基础上加用疏血通和尼莫地平静脉滴注,疗程均为14d。两组分别于治疗前及治疗后14d进行CT检查及神经功能缺损评分,比较两组神经功能缺损恢复程度、血肿体积及血肿周围水肿面积。结果与对照组相比,治疗组较对照组血肿体积明显缩小(P<0.05);血肿周围低密度区明显缩小(P<0.05);神经功能缺损评分明显改善(P<0.05)。结论疏血通联合尼莫地平治疗能促进急性脑出血的血肿吸收、血肿周围水肿带的缩小及神经功能缺失改善。     

马来酸桂哌齐特实验性治疗脑出血的疗效观察

目的探讨马来酸桂哌齐特对高血压性脑出血血肿、水肿吸收及神经功能恢复的影响。方法24例高血压性脑出血患者,随机分为2组,对照组给予常规治疗;治疗组加用马来酸桂哌齐特（160mg／d）静滴。测定人组前和治疗7,14,21d神经功能评分、血肿和水肿体积。结果治疗7d。治疗组血肿体积、水肿体积及CSS评分明显小于对照组（P〈0．05）：治疗14d,治疗组无论血肿体积,水肿体积还是CSS评分均较对照组显著减少（P〈0．05）。治疗21d神经功能评分与血肿体积相关性较高（P〈0．01）,与水肿体积无相关性（P〉0．05）。结论马来酸桂哌齐特有利于高血压性脑出血水肿和血肿的吸收,改善脑出血的预后。     

疏血通注射液对急性脑出血血肿吸收及临床疗效观察

目的观察疏血通注射液对急性脑出血血肿吸收、血肿周围水肿面积改善及临床神经功能缺损恢复的作用。方法将急性脑出血患者112例随机分为治疗组和对照组,每组56例,治疗组在对照组常规治疗的基础上加疏血通注射液静脉滴注,1次/d,14d后比较2组神经功能缺损恢复程度、血肿体积及血肿周围水肿面积。结果治疗结束后治疗组较对照组血肿体积明显缩小（P〈0．05）;血肿周围水肿面积明显缩小（P〈0．01）;神经功能缺损评分明显改善（P〈0．01）。结论疏血通注射液能促进急性脑出血的血肿吸收、血肿周围水肿带的缩小及神经功能缺失改善。     

尼莫地平对高血压脑出血患者脑血肿、水肿及神经功能恢复的影响

目的探讨尼莫地平对高血压脑出血患者血肿、水肿及神经功能恢复的影响。方法选择我院2013年1~12月收治的高血压脑出血患者84例,随机分为研究组和对照组,各42例,对照组患者给予传统脱水、止血、抗炎、降压治疗,研究组患者在对照组治疗的基础上给予尼莫地平治疗;全部患者治疗3周后进行CT检查,观察血肿及周围水肿带体积变化情况,比较治疗前后神经功能缺损评分改善情况,评价治疗效果。结果治疗后两组血肿体积、水肿体积较治疗前减小,神经功能缺损评分较治疗前降低,前后差异有统计学意义(P0.05),但研究组血肿体积、水肿体积、神经功能缺损评分明显小(低)于对照组(P0.05)。研究组治疗总有效率明显高于对照组,差异有统计学意义(P0.05)。结论尼莫地平辅助治疗高血压脑出血能有效减轻血肿及周围水肿,促进神经功能的恢复,对提高治疗效果有积极作用,值得应用。     

小剂量甘露醇联合石龙清血颗粒治疗高血压性脑出血的临床观察

目的:观察小剂量甘露醇联合石龙清血颗粒治疗高血压性脑出血的临床效果。方法:将78例高血压性脑出血患者随机均分为对照组与联合治疗组。对照组单独应用甘露醇125mL,q8h,连用10d;联合治疗组在对照组基础上加用石龙清血颗粒10g,tid,连用10d。分别比较2组患者治疗15d后神经功能缺损评分、血肿体积、水肿体积,并比较2组的疗效和不良反应。结果:与治疗前比较,2组患者治疗15d后神经功能缺损评分显著减少、血肿体积及水肿体积显著变小(P<0.05),且联合治疗组较对照组疗效更明显(P<0.05)。2组均未见严重不良反应发生。结论:小剂量甘露醇联合石龙清血颗粒治疗高血压性脑出血有利于血肿的吸收及脑水肿的减轻,能够改善脑出血患者预后。     

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.     

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.