可吸收螺钉在四肢关节内骨折中应用

目的评价可吸收螺钉在四肢关节内骨折临床应用中的效果。方法采取超高分子聚-DL-乳酸（PDLLA）自膨胀可吸收螺钉治疗四肢关节内骨折36例,术后石膏托固定4～6周,定期随访,复查X线片,评估骨折愈合及关节功能以及局部反应情况。结果术后随访6～24个月,所有病例骨折对位良好,达骨性愈合,肢体功能和关节功能无明显异常,无非特异性炎症反应表现。结论可吸收螺钉是四肢关节内骨折理想内固定物,其操作简单,固定效果确切,生物相容性好,不影响关节内骨折愈合,免除二次手术取除内固定物的痛苦。     

可吸收内固定物在关节内骨折的临床应用

目的：介绍一种关节内骨折内固定的新材料并观察临床应用效果。方法：用自身增强聚乙交酯、聚丙交酯（SR－PGA、PLLA）可吸收螺钉和可吸收棒、治疗肩、肘、髋、膝、踝关节内骨折98例。麻醉下常规关节手术入路，骨折解决对位，选用螺钉、固定棒1－2枚固定，钉尾部埋于关节软骨面下1mm。术后关节不采取外固定，3d后肢体被动功能锻炼。结果：98例均随访6个月－3年，平均16个月，均达到骨性愈合，关节活动无明显障碍，优良率达97．9％，结论：使用可吸收螺钉、可吸收棒避免二次手术的痛苦，减少了关节粘连，感染机会，对于关节内骨折是理想的内固定物。     

应用可吸收内固定材料治疗舟骨骨折

目的总结可吸收钉治疗舟骨骨折的经验和教训。方法2006年6月至2007年12月。应用自身增强-聚乙酯（self-reinforced polyglycolicacid,SR-PGA）、自身增强．聚丙酯（self-reinforcedpoly．L．Lacticacid,SR-PLLA）可吸收螺钉手术处理舟骨骨折13例,其中男8例,女5例。年龄21-62岁。手术时间为伤后14-85d。应用SR-PGA全螺纹钉13枚,术后用腕中位及桡侧屈位石膏外固定。结果患者术后获随访6-20个月,平均18个月,伤口均1期愈合;骨折于1-3个月内达临床愈合,无再移位、感染及局部积液。患者关节功能恢复满意。根据美国骨科协会（AASO）关节功能评价：优9例,良3例,可1例,优良率92．3％。结论可吸收内固定钉治疗关节内及关节周围骨折,免除了患者二次手术取出内固定物的痛苦,是一种有效和较为理想的方法。     

可吸收螺丝钉在股骨头骨折内固定中的应用

目的 :观察可吸收内固定物 (SR -PLLA螺丝钉 )在股骨头骨折内固定应用中的优点及注意事项。方法 :14例股骨头骨折患者应用可吸收螺丝钉内固定 ,手术中将骨块复位后 ,切开软骨 ,于软骨下用 1～ 2枚可吸收螺丝钉固定。术后患肢胫骨结节骨牵引 4周 ,以后逐渐下地活动负重行走。结果 :经过 8月～ 5年 ,平均 18个月随访 ,骨折均达到临床愈合 ,与金属内固定物相比较愈合时间无明显差异。患侧髋关节功能优良率85 .7% (12 /14)。除 2例患者出现早期股骨头无菌性坏死外 ,其他患者未发现骨块松动移位 ,骨块吸收 ,关节腔积液 ,感染等现象。结论 :可吸收内固定物在股骨头骨折内固定中应用 ,完全能将骨块固定到愈合 ,其本身对骨折的愈合和关节功能无不良影响 ,避免了金属内固定物需要二次取出等缺点 ,是位置较深的股骨头骨折的理想内固定物。     

应用可吸收螺钉治疗踝关节骨折52例报告

目的　观察可吸收螺钉治疗踝关节骨折的临床疗效。方法　对 52例踝关节骨折 ,切开复位 ,应用可吸引螺钉固定骨折。结果　 52例病人经过 2～ 2 0个月随诊 ,骨折全部愈合 ,关节功能良好 ,效果满意。结论　可吸收螺钉内固定作用坚强 ,有利于骨折的愈合 ,减少并发症 ,术后关节可早期进行功能锻炼 ,可避免二次手术 ,减轻病人负担 ,效果良好     

应用可吸收螺钉治疗单纯内踝骨折

目的:探讨切开复位可吸收螺钉内固定治疗单纯内踝骨折的临床疗效和安全性。方法:2011年6月~2013年6月,对收治的46例单纯内踝骨折患者采用切开复位可吸收螺钉内固定治疗。均为单侧新鲜骨折,左侧19例,右侧27例。开放性骨折10例,闭合性骨折36例。均为Lauge-HansenⅠ型4度骨折,43例患者存在明显移位。术后随访观察患者的骨折愈合、踝关节功能及并发症发生情况。结果:所有患者均完成内固定手术,闭合性骨折患者切口均甲级愈合,开放性骨折患者中7例伤口一期愈合,2例经换药后延期愈合。46例患者均获得12个月以上随访,骨折均在8周内愈合,未发生螺钉松动或断裂、畸形愈合、关节僵硬等并发症。末次随访时患者的Mazur踝关节功能评分为(92.6±4.6)分。结论:切开复位可吸收螺钉内固定治疗内踝骨折,可使骨折获得解剖复位和牢固固定,有利于踝关节功能恢复,而且不需要进行内固定取出手术,值得临床推广应用。     

可吸收螺钉内固定治疗内踝骨折52例疗效观察

目的探讨可吸收螺钉内固定治疗内踝骨折的临床疗效。方法从2003年1月-2009年6月应用可吸收螺钉治疗内踝骨折52例,男30例,女22例;年龄18～65岁。均为外伤所致新鲜骨折,骨折均有不同程度移位,采用切开复位可吸收螺钉内固定术,术后均采取石膏外固定制动。结果本组52例术后随访3～24个月,全部病例骨折均完全骨性愈合,关节功能恢复良好,根据关节功能评定标准,优良率92．31％。结论可吸收螺钉内固定治疗内踝骨折固定可靠,减少了二次手术的再损伤,比其它固定更适合用于内踝骨折,并降低病人的痛苦,最大限度地恢复了关节功能,是一种行之有效的方法。     

可吸收螺钉治疗踝关节骨折37例报告

目的探讨可吸收螺钉在治疗踝关节骨折中的临床应用效果。方法对37例踝关节骨折患者采用国产可吸收螺钉固定并进行疗效分析,术后以石膏辅以托外固定3-4周。结果本组37例患者术后X光片检查显示骨折全部愈合,手术切口愈合良好,关节功能完全恢复,无感染、积液等并发症。随访5-24个月,骨折临床愈合时间为7~13周,平均10周,随访病例中优良34例,优良率达91.8%。结论可吸收螺钉治疗踝关节骨折固定可靠,生物相容性好,对人体无不良反应,是一种较好的内固定材料。     

可吸收螺钉在近关节端松质骨骨折中的应用

目的：评价可吸收螺钉在近关节端松质骨骨折临床应用效果。方法：本组32例,平均年龄35岁。使用65枚可吸收螺钉治疗四肢关节端松质骨骨折,术前、手术当天及术后定期摄X线片,并观察局部及全身反应情况。结果：术后平均随访12个月（6个月～3年）,所有病例骨折对位良好,达骨性愈合。肢体功能和关节活动无明显异常,无非特异性炎症反应表现。结论：可吸收螺钉是近关节端松质骨骨折的理想内固定物,固定效果确切,生物相容性好,对人体无不良反应,不影响关节内骨折的愈合,免除二次手术取内固定物的痛苦。     

可吸收螺丝钉在股骨头骨折内固定中的应用

目的：观察可吸收内固定物（SR-PLLA螺丝钉）在股骨头骨折内固定应用中的优点及注意事项。方法：14例股骨头骨折患者应用可吸收螺丝钉内固定,手术中将骨块复位后,切开软骨,于软骨下用1-2枚可吸收螺丝钉固定,术后患肢胫骨结节骨牵引4周,以后逐渐下地活动负重行走,结果：经过8月-5年,平均18个月随访,骨折均达到临床愈合,与金属内固定物相比较愈合时间无明显差异。患侧髋关节功能优良率85.7%(12/14)。除2例患者出现早期股骨头无菌性坏死外,其他患者未发现骨埠松动移位,骨块吸收,关节腔积液,感染等现象,结论：可吸收内固定物在股骨头骨折内固定中应用,完全能将骨块固定到愈合,其本身对骨折的愈合和关节功能无不良影响,避免了金属内固定物需要二次取出等缺点,是位置较深的股骨头骨折的理想内固定物。     

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.     

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.     

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.