腹腔镜下结直肠癌根治术对老年结直肠癌患者临床疗效和并发症的影响

目的 分析腹腔镜下结直肠癌根治术对老年结直肠癌患者临床疗效和并发症的影响.方法 选取2018年6月—2019年12月行手术治疗的81例老年结直肠癌患者,根据不同的手术方法 分为观察组37例与对照组44例,观察组采用腹腔镜下结直肠癌根治术治疗,对照组采用传统开腹手术治疗.比较2组手术时间、术中出血量、术后下床时间、住院时...     

早期肠内营养在腹腔镜结直肠癌患者中的应用效果

目的探讨早期肠内营养在腹腔镜结直肠癌术后患者中的应用效果。方法 2018年3月至2018年10月选择90例行腹腔镜结直肠癌术后的患者,利用随机数字表法将患者分为观察组和对照组,各45例。术后营养对照组采用传统护理方法,观察组给予早期肠内营养。比较两组患者术后肛门排气时间、住院时间、住院费用及并发症的发生情况。结果观察组术后肛门排气时间、住院时间、住院费用和术后并发症发生情况明显小于对照组,差异有统计学意义(P <0.05)。结论腹腔镜结直肠癌手术的患者术后营养采用早期肠内营养明显优于传统的护理方法。     

腹腔镜下手术对早期结直肠癌的治疗效果分析

目的探讨对早期结直肠癌患者采用腹腔镜下手术进行治疗的临床效果。方法选取我院2011年7月~2013年7月接收治疗的104例早期结直肠癌患者作为临床研究对象,按照不同的治疗方式将其分为观察组和对照组,各52例,对照组患者给予开腹手术治疗,观察组患者给予腹腔镜下手术治疗。结果观察组患者的住院时间、手术时间以及术后肠道功能恢复时间明显短于对照组(P0.05);观察组患者的术中出血量明显少于对照组(P0.05);观察组患者的并发症发生率和对照组相比差异无统计学意义(P0.05)。结论对早期结直肠癌患者采用腹腔镜下手术进行治疗,能够降低并发症,加快术后恢复,缩短住院时间,提高术后生存质量,值得临床应用推广。     

早期肠内营养对结直肠癌患者术后恢复的影响

目的探讨结直肠癌患者术后早期进行肠内营养支持的安全性,及其对患者营养状况和术后恢复的影响。方法 62例结直肠癌患者随机分为两组,对照组31例术后采用TPN治疗7d;实验组31例术后早期给予肠内营养支持7d。两组患者分别于术前1d、术后第8d早晨分别检测总蛋白、白蛋白、前白蛋白水平,并观察各组患者术后感染性并发症的差异及恢复情况。结果两组患者的体重下降值、术后平均住院时间、拆线时间等无明显差异(P>0.05),实验组术后感染性并发症发生率、胃肠功能恢复时间、住院费用少于对照组(P<0.05);两组患者总蛋白、白蛋白、前白蛋白无明显差异(P<0.05)。结论结直肠癌患者术后早期进行肠内营养支持是安全的、可行的。术后早期施行肠内营养可以促进胃肠功能早期恢复,减少术后并发症,减少患者住院费用。     

结直肠癌术后早期微生态肠内营养对肠道菌群及免疫功能的影响

目的:探讨术后早期微生态肠内营养对结直肠癌患者术后肠道菌群及免疫功能的影响。方法:选择山西大医院普外科2012年1月—2016年6月收治的结直肠癌手术治疗患者60例,分为观察组与对照组。分别于入院时、术后第7天采集两组患者粪便和静脉血,分析比较两组肠道菌群的构成、免疫学指标、胃肠道恢复时间、术后并发症、住院时间和治疗费用。结果:术后观察组肠道菌群中双歧杆菌、乳酸杆菌和肠球菌数量明显高于对照组(P<0.05),大肠杆菌、葡萄球菌数明显低于对照组(P<0.05);免疫学指标白介素-2(IL-2)、IgA、IgG、IgM、CD3~+、CD4~+、CD8~+水平明显高于对照组(P<0.05)。观察组术后并发症、胃肠道恢复时间、住院时间、治疗费用均低于对照组(P<0.05)。结论:结直肠癌患者术后早期微生态肠内营养能有效地纠正肠道菌群失调,改善术后免疫功能,减少并发症,促进胃肠道恢复,缩短住院时间和降低治疗费用。     

腹腔镜辅助结直肠癌根治术治疗老年结直肠癌的效果分析

目的：分析腹腔镜辅助结直肠癌根治术治疗老年结直肠癌的临床效果。方法选择本院2012年3月~2014年3月收治的62例结直肠癌老年患者为研究对象,按照住院顺序随机分为对照组和观察组各31例,对照组患者行传统开腹直肠癌根治术,观察组患者采取腹腔镜辅助结直肠癌根治术,对两组手术情况、术中心肺功能及并发症情况进行比较。结果观察组手术时间、术中出血量、平均切口长度、术后排气时间及住院时间与对照组比较,差异有统计学意义(P<0.05);观察组患者术中射血分数(EF)、心脏指数(CI)、动脉血二氧化氮分压(PaCO2)、动脉血pH值及气道压力均明显高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为19.35%,对照组并发症发生率为45.16%,两组比较差异有统计学意义(P<0.05)。结论相比传统开腹手术,腹腔镜辅助结直肠癌根治术具有术中出血量少、术中心肺功能稳定、术后并发症少、恢复快等特点,值得在老年结直肠癌患者中进一步应用。     

老年结直肠癌围手术期肠内营养研究

目的观察老年结直肠癌围手术期肠内营养对病人术后营养状况及免疫功能的影响以及肠道功能恢复时间、住院时间及营养支持费用。方法将46例老年结直肠癌患者分为围手术期肠内营养组(肠内营养组)和对照组,于术前3天、术后9天检测营养和免疫指标,观察肠道功能恢复时间、住院时间及营养费用。结果术前3天血清白蛋白、转铁蛋白、前白蛋白、CD3、CD4、CD4/CD8无明显差异,两组病人术后8天肠内营养组的血清白蛋白、转铁蛋白、前白蛋白、CD3、CD4、CD4/CD8显著高于对照组,差异有统计学意义(P<0.05)。肠内营养组肛门排气时间较对照组提前1.3天,排便时间提前1.4天,住院时间16.7天少于对照组20.3天(P<0.05)。营养费用1145元,明显少于对照组1876元(P<0.05)。结论围手术期应用肠内营养能提高患者的营养水平及免疫功能,缩短肠道功能恢复时间,安全经济。     

围手术期营养支持在结直肠癌患者中的应用

目的探讨结直肠癌患者围手术期营养支持的效果。方法把42例伴有营养不良的结直肠癌患者随机分为观察组和对照组,观察组行围手术期营养支持治疗,对照组采用传统方法治疗,两组疗效对比分析。结果术后观察组检测的各项营养指标均高于对照组,术后并发症低,住院时间少。结论结直肠癌患者围手术期营养支持能改善营养状况和机体免疫机能,促进胃肠道功能恢复,减少术后并发症发生。     

围术期营养支持在腹腔镜结直肠癌根治术中的应用价值

目的分析围术期开展肠内营养支持在腹腔镜结直肠癌根治术中的应用价值。方法选择2015年4月至2018年4月我院收治的90例接受腹腔镜结直肠癌根治术患者为研究对象,将其分为2组,每组45例。对照组依照氮以及能量摄入情况,补充每日所需维生素,开展肠外营养。观察组在围术期内开展早期肠内营养,分析相关结果。结果与对照组相比,观察组的肛门排气时间以及住院时间更短,差异具有统计学意义(P<0.05);与对照组相比,观察组治疗前2 d的前白蛋白、血清白蛋白以及血红蛋白差异无统计学意义(P>0.05);治疗5 d后,和本组术前相比2组上述指标差异无统计学意义(P>0.05);对照组治疗满意度为78%,观察组为96%,差异具有统计学意义(P<0.05)。结论对于接受腹腔镜结直肠癌根治术患者,在围术期内开展早期肠内营养支持,安全有效,能够在一定程度上促进病患康复速率,且有助于降低患者营养支持治疗费用,值得进一步在临床中推广使用。     

快速康复外科理念对结直肠癌患者微创术后胃肠功能的改善及其对降低并发症发生的影响

目的:探究快速康复外科(FTS)理念对结直肠癌患者微创术后胃肠功能的改善及其对降低并发症发生的影响。方法:选取2015年5月—2017年10月间收治的老年结直肠癌患者86例资料,按治疗和护理的不同将其随机分为对照组和观察组,每组43例;对照组患者术后实施常规护理干预治疗,观察组患者术后实施FTS理念进行护理干预治疗;比较两组患者术后临床各症状和指标复常时间以及并发症的发生率差异。结果:观察组患者护理干预治疗术后临床各症状和指标(胃管留置、下床活动、肛门排气和进食)复常时间均早于对照组(P<0.05),住院时间均短于对照组(P<0.05),术后并发症的发生率(4.65%)均低于对照组(23.26%)(P<0.05)。结论:采用FTS理念有效改善了老年结直肠癌患者微创术后胃肠功能,且并发症的发生率较低。     

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.