妇科急腹症151例临床分析

目的 总结妇科急腹症的诊断和鉴别诊断经验.方法 对2000年1月至2001年6月间收治的151例急腹症患者的临床资料进行回顾性分析.结果 异位妊娠、卵巢囊肿蒂扭转、子宫内膜异位囊肿破裂、盆腔炎、盆腔积脓和子宫穿孔的诊断符合率为100%;24例卵巢破裂2例术前误诊为异位妊娠,2例出血性输卵管炎均误诊为异位妊娠.结论 根据病史、体征、妇科检查及辅助检查,妇科急腹症多能得到明确诊断,但应提高出血性输卵管炎等急腹症的认识.     

妇科急腹症30例误诊分析

目的:探讨妇科急腹症误诊原因及预防方法.方法:回顾性分析我院妇科急腹症患者误诊的临床资料.结果:本组30例,异位妊娠误诊17例,卵巢囊肿蒂扭转误诊4例,出血性输卵管炎误诊3例,黄体破裂误诊2例,巧克力囊肿破裂误诊2例,卵巢囊肿破裂误诊1例,输卵管囊肿扭转误诊1例.结论:全面询问病史、全面体检及必要的辅助检查,动态客观分析腹痛发生的时间、性质,有助于对妇科急腹症作出诊断和鉴别诊断,是降低妇科急腹症误诊率的关键.     

妇科急腹症164例临床分析

目的 探讨妇科急腹症的诊断和鉴别诊断方法.方法 对妇科急腹症患者164例的临床资料进行回顾性分析.结果 164例患者中,内出血性疾病108例(异位妊娠88例,卵巢破裂17例,子宫穿孔3例)占65.9%,感染性疾病45例(急性盆腔炎38例,输卵管卵巢脓肿3例,出血性输卵管炎4例)占27.4%.肿瘤及其并发症11例(卵巢囊肿蒂扭转6例,卵巢囊肿破裂3例,子宫肌瘤红色变性2例)占6.7%.术前正确诊断138例,误诊26例(误诊率15.9%).结论 详细病史询问及体格检查是诊断妇科急腹症的重要手段;HCG检查、B超检查和后穹窿穿刺可明显提高确诊率.     

B超在妇科急腹症诊断中的应用

目的:探究B超在妇科急腹症诊断中的应用。方法:选取2011年3月～2012年9月在我院就诊的80例妇科急腹症患者,对其进行B超检查,将临床诊断与超声诊断两者分别进行对比分析。结果:经B超检查发现,异位妊娠46例(占57.5%),误诊3例,急性盆腔炎1例,早期宫外孕误诊为阑尾炎1例,输卵管间质部妊娠误诊为宫角妊娠1例;黄体破裂8例(占10%),误诊2例,1例误诊为异位妊娠,1例误诊为输卵管卵巢脓肿;急性盆腔炎6例(占7.5%),1例误诊为卵巢破裂;出血性输卵管炎3例(占3.75%),1例误诊为异位妊娠;卵巢囊肿蒂扭转14例(17.5%),1例误诊为卵巢肿瘤蒂扭转,1例误诊为黄体破裂;处女膜闭锁3例(占3.75%),无误诊。诊断妇科急腹症符合率为84.8%。结论:B超对诊断妇科急腹症有较高的价值,将超声诊断和临床病史相结合进行分析,能够大大提高临床诊断的准确率。     

妇科急症96例临床分析

目的:回顾性分析96例妇科急症诊断与鉴别诊断。方法:对我院2011年1月～2012年1月收治的96例妇科急症手术进行回顾性分析。结果:通过B超检查和对患者症状了解,术前和病理诊断完全相符。卵巢破裂中4例被误诊为异位妊娠,误诊率33%(4/12);出血性输卵管炎4例中被误诊为异位妊娠、卵巢破裂各1例,误诊率50%。结论:卵巢破裂和出血性输卵管炎诊断率有待于提高,应加强异位妊娠早期诊断,重视卵巢囊肿蒂扭转前处理。     

233例妇科急性腹腔内出血的临床分析

目的明确各种不同原因妇科急性腹腔内出血的临床特征以减少误诊及指导治疗。方法对收治的233例妇科急性腹腔内出血手术进行回顾性分析。结果通过了解病史、症状、体征、B超检查和腹腔穿刺,异位妊娠的术前和病理诊断符合率94.1%,36例卵巢破裂中有10例术前误诊为异位妊娠,1例误诊为卵巢囊肿蒂扭转,误诊率30.6%,11例出血性输卵管炎,误诊为异位妊娠5例,卵巢破裂3例,误诊率72.7%。结论异位妊娠依然是妇科急性腹腔内出血的首要原因,准确的早期诊断和有效的抢救措施是减少死亡率的关键;卵巢破裂是妇科急性腹腔内出血的第2位原因,其临床诊断率有待提高;出血性输卵管炎在近年来有增多的趋势,如何提高对其诊断及治疗的认识应引起我们的重视。     

43例妇科急腹症误诊分析

目的探讨妇科急腹症误诊原因及预防办法。方法回顾性分析2005年1月至2008年12月本院收治误诊的妇科急腹症43例；结果43例误诊病例中，外科转入33例，内科转入5例，妇科误诊5例，其中，异位妊娠误诊29例，卵巢囊肿蒂扭转误诊4例，出血性输卵管炎误诊3例，黄体破裂误诊2例，巧克力囊肿破裂误诊2例，卵巢囊肿破裂误诊2例，输卵管囊肿扭转并发卵巢坏死误诊1例。结论全面询问病史和进行全身体检及必要的辅助检查。掌握有关腹痛的来源及其发生、发展过程，动态客观分析腹痛发生的时间、性质及内出血的体征，有助于对妇科急腹症作出诊断和鉴别诊断，是降低妇科急腹症误诊率的关键。     

妇科急腹症误诊阑尾炎20例分析

目的探讨如何降低妇科急腹症误诊为阑尾炎的方法。方法对20例误诊为妇科急腹症的阑尾炎病例进行分析。结果 20例误诊为阑尾炎的病例为输卵管妊娠破裂7例,陈旧性宫外孕2例,卵巢囊肿蒂扭转4例,急性输卵管炎1例,输卵管脓肿2例,卵巢黄体破裂4例。均经手术治疗而痊愈。结论外科医生对妇科急腹症要有一定的鉴别能力,详细的询问病史,细致的体格检查,有效的辅助检查,是防止误诊误治的重要措施。     

妇科急腹症误诊阑尾炎分析

在临床实践中,妇科常见急腹症如卵巢囊肿蒂扭转、卵巢滤泡或黄体破裂、输卵管妊娠破裂、输卵管炎等与普外科的急性阑尾炎的临床表现十分相似,尤其病变发生在右侧或症状不典型时,更容易造成误诊,延误诊断及治疗.     

妇科急腹症的诊断分析

目的探讨妇科急腹症的诊断与鉴别诊断,明确妇科常见急腹症的临床特点,减少误诊。方法我院自2006年1月至2010年12月共收治妇科急腹症患者87例进行临床分析。结果本组82例采取了手术治疗,分别选用了不同的手术方式,5例抗炎、止血、对症及支持治疗痊愈,手术病例标本全部送病理检查。1例出血性输卵管炎,1例输卵管囊肿扭转并发卵巢坏死共2例,误诊为异位妊娠;右输卵管妊娠破裂、右输卵管脓肿、左卵巢囊肿破裂共3例,误诊为阑尾炎,误诊率为5.7%。结论要提高鉴别妇科急腹症能力,争取对患者早作诊断,及时治疗。     

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.     

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.     

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.