吻合器痔上黏膜环切术（PPH）治疗痔疮的应用体会

目的探讨吻合器痔上黏膜环切术（PPH）治疗痔疮的效果。方法采用吻合器痔上黏膜环切术（PPH）对364例重度脱垂痔及内痔为主的环状混合痔患者手术治疗并对结果进行分析,随访。结果手术时间10～32min,平均18min,住院时间3～5d,平均3．8d,经PPH治疗后,所有病人脱出痔核全部回缩,切除直肠黏膜完整者98％,术后90％病人不用止痛剂。术后随访6个月,有效率100％,满意率88％,基本满意率12％。结论吻合器痔上黏膜环切术（PPH）在环形脱垂内痔治疗中具有手术创伤小、手术时间短、病人痛苦轻、住院时间短等优点,是治疗重度脱垂痔及内痔为主的环状混合痔的较好术式。     

吻合器痔上黏膜环切术治疗92例重度痔疗效分析

目的探讨吻合器痔上黏膜环切术治疗重度痔的疗效。方法用吻合器痔上黏膜环切术治疗92例重度痔,分析其临床资料。结果 92例重度痔均一次性吻合成功,手术时间平均18min,住院时间平均3.6d;随访平均12.4个月,患者均无肛门失禁、肛门狭窄、肛周感染及复发。结论吻合器痔上黏膜环切术治疗重度痔疗效确切,恢复快,并发症少。     

TST术与PPH术治疗重度内痔的临床对比研究

目的:探讨选择性痔上黏膜切除术(TST)与吻合器痔上黏膜环切术(PPH)治疗重度内痔的临床疗效差异。方法:将306例Ⅲ度、Ⅳ度重度内痔患者随机分为观察组(TST组)和对照组(PPH组),对两组患者的临床疗效、手术时间、平均住院日、术后尿潴留及肛门疼痛、出血、坠胀以及吻合口狭窄等并发症进行比较。结果:观察组手术时间、住院时间、临床疗效与对照组比较,差异无统计学意义(P>0.05),而在术后肛门疼痛、肛门水肿、尿潴留、肛门狭窄方面均优于对照组(P<0.05)。结论:TST是一种疗效确切、术后并发症低、痛苦小、恢复快的新技术,具有很高的临床应用价值。     

国产吻合器痔上黏膜环切术治疗重度痔238例疗效观察

目的 评价国产吻合器在治疗Ⅲ-Ⅳ期脱出性内痔的临床效果.方法 利用国产痔上吻合器对238例重度脱出痔患者进行手术治疗.结果 238例重度痔患者应用国产吻合器,吻合均一次成功,术后患者痔核完全消失.有32例术后并发少量出血(13.4%),经保守治疗痊愈.术后并发尿潴留152例(63.8%),肛门轻度疼痛56例(23.5%),下腹部不适28例(11.7%).随访12～24个月,无肛门狭窄,无大便失禁.结论 应用国产吻合器行痔上黏膜环切术治疗重度痔患者术后痛苦小、恢复快、复发率低、并发症少、副损伤小.     

痔上黏膜环切术治疗重度内痔43例疗效分析

目的:探讨吻合器痔上黏膜环切术(PPH)的操作方法和疗效.方法:应用特制的环形吻合器对43 例重度内痔进行PPH手术治疗,分析其手术操作技巧并观察治疗效果.结果:平均手术时间20 min,平均术后住院时间5 d.术中20 例出现吻合口不同程度的搏动性出血或渗血,直视下缝合止血;术后并发症:尿潴留10 例,肛门部疼痛6 例,术后大便带血13 例,无1 例需手术处理,下腹不适及胀痛8 例,术后肛门部水肿6 例;随访3～24个月,无肛门狭窄、大便失禁及脱出复发.结论:PPH治疗重度内痔具有手术简单、术后痛苦少、恢复快、并发症少的特点,加强手术适应证的选择,重视手术操作技巧,可达到理想的疗效,但远期效果有待进一步观察.     

PPH手术治疗环形脱垂性内痔23例报告

目前评价吻合器痔上黏膜环切术(PPH)治疗环形脱垂性内痔的临床疗效及安全性.方法2年来应用该术式治疗环形脱垂性内痔23例,男性18例,女性5例,平均年龄48岁,痔病史平均6年.结果PPH手术时间平均约15分钟.术后尿猪留19例(82.6%)、肛周疼痛需止痛治疗5例(21.7%)、术后便血23倒(100%),严重出血及皮赘残余各1例均再次手术.内痔回缩有效率100%,手术满意度91.3%(21/23).术后住院时间平均3.5d.随访1-12月,平均6个月,无肛门狭窄、肛门失禁及复发病例.结论PPH治疗环形脱垂性内痔简单、安全,疗效满意.有经济承受能力的患者建议采用.     

PPH术治疗痔疮37例临床观察

目的 评价吻合器痔上黏膜环切术(PPH)治疗Ⅱ-Ⅳ期脱出性内痔的临床效果.方法 选择Ⅱ-Ⅳ期脱出性内痔37例,用国产吻合器进行手术治疗.结果 37例患者均一次性吻合成功,切除的直肠黏膜环完整,宽度为2-3 cm,手术时间25-40 min,术后患者痔核完全消失.患者获随访3-12个月,便血、肛门不适症状消失、痔块回缩36例,总有效率97.3％.无复发患者.结论 PPH术有患者术后痛苦小、恢复快、复发率低、并发症少、手术效果好等优点.     

吻合器痔上黏膜环切术治疗脱垂痔51例临床分析

目的探讨吻合器痔上黏膜环切术(PPH)治疗脱垂痔的疗效。方法对51例脱垂痔患者采用采用吻合器行痔上黏膜环切术。结果手术平均20～30min,术后尿潴留2例,出血2例,脱出1例,平均住院3d,全部随访15～18月,效果良好。结论 PPH治疗重度脱垂痔是相对安全、效果显著的微创技术,远期效果还需要大样本长期观察报告。     

吻合器痔上黏膜环切术的临床观察

目的总结吻合器痔上黏膜环切术（PPH）治疗重度痔的临床经验。方法120例以肿物脱出及便血为症状的Ⅲ、IV度痔患者分为PPH组50例和传统手术组（Milligan-Morgan组）70例,分别进行手术,对比分析手术时间、住院时间、恢复工作时间、术后疼痛、出血、肛门狭窄等并发症。结果两组相比较,PPH组的住院时间及恢复工作时间短,术后疼痛轻,肛门狭窄少。结论PPH治疗重度痔疗效确切,并发症少,术后恢复快。     

探讨运用PPH吻合器对混合痔痔体切除的临床疗效

目的：运用痔上黏膜环切术（PPH）吻合器切除混合痔痔体,探讨PPH吻合器治疗混合痔痔体临床疗效。方法对2009年1月~2010年1月期间在本院以PPH吻合器对Ⅲ~Ⅳ期内痔为主的混合痔痔体切除的236例病例的临床资料进行回顾性分析。结果术后随访6~28个月,236例病例中发生术后出血病例占总病例的0.85%,共2例;无大便失禁,无肛门狭窄,肛门外观正常,肛门功能正常;因疼痛明显需作临床处理病例共96例,占40.68%。结论 PPH痔体切除术治疗Ⅲ~Ⅳ期内痔为主的混合痔治疗的临床效果显著,肛垫损伤后的并发症、肛门失禁、便秘、术后易出血情况均未出现。患者对其治疗效果术后无并发症以及成功率高等较满意,因此PPH痔体切除术治疗Ⅲ~Ⅳ期内痔为主的混合痔在临床上值得应用和推广。     

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.     

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.