研究二维超声联合四维超声在产前筛查胎儿畸形中的应用

目的:探究在产前胎儿畸形筛查中应用二维超声联合四维超声的临床价值。方法:将在某院接受产前筛查的中晚期孕妇3462例中,针对疑似胎儿畸形的孕妇行单独二维超声诊断、二维联合四维超声诊断,并与引产或胎儿出生后结果对比。结果:3462例中晚期孕妇共娩出胎儿3485个,二维超声与四维超声联合检查诊断符合率明显高于单纯二维超声(P0.05);经临床证实173处畸形中,有99处为体表畸形,二维超声与四维超声联合检查诊断符合率明显比单纯二维超声诊断符合率高(P0.05)。结论:在产前胎儿畸形筛查中应用二维超声联合四维超声临床价值显著。     

孕12～15+6周应用四维STIC技术筛查圆锥动脉干畸形的可行性分析

目的 评估四维时间-空间关联成像技术(STIC)于孕12～15+6周进行胎儿圆锥动脉干畸形筛查的可行性.方法 分别运用二维超声心动图和四维STIC技术对孕12～15+6周的孕妇进行胎儿圆锥动脉干畸形关键诊断切面图像的采集,采集胎儿心脏超声标准切面(四腔心切面,左心室流出道切面,右心室流出道切面,三血管气管切面,主动脉弓...     

二维超声联合四维超声对胎儿畸形的诊断价值

目的 探究二维超声联合四维超声对产前诊断胎儿畸形的临床价值.方法 使用二维超声筛查1 684名中晚期孕妇.对疑似胎儿畸形的孕妇使用二维超声和四维超声联合的方法再次进行检查,并与婴儿引产和出生后与结果相对照.结果在1 684名孕妇孕育的1 719个胎儿中,经过临床证实的胎儿畸形总共295处畸形,仅使用二维超声就发现了252处畸形,诊断符合率达到了87.23%,二维超声联合四维超声检查发现了278处畸形,诊断符合率达到了94.92%.在这295处畸形中,共有169处体表畸形,仅通过二维超声检查出来的就有133处,诊断符合率76.58%,二维超声联合四维超声检查出来的有145处,诊断符合率达到95.16%.两种方法诊断符合率差异均有统计学意义（χ^2=19.83、21.58,均P＜0.05）.结论 诊断胎儿畸形首先选择二维超声对孕妇进行检查,二维超声是四维超声使用的基础,四维超声检查是二维超声检查的重要辅助手段.二维超声与四维超声的联合使用,能够提高胎儿畸形诊断符合率,有效的降低胎儿的出生缺陷,具有积极的临床推广价值.     

实时动态四维时间-空间关联成像技术在胎儿心脏畸形辅助诊断中的应用价值

目的探讨实时动态四维时间-空间关联成像技术在胎儿心脏畸形辅助诊断中的应用价值。方法选取我院2015年3月至2016年7月60例经过二维超声筛查出胎儿先天性心脏病可疑孕妇,在运用实时动态四维时间-空间关联成像技术(STIC)进行数据采集、脱机分析。以最终引产后尸体解剖结果或者出生后新生儿超声诊断为确诊结果,对比分析实时四维超声STIC技术与二维超声对胎儿心脏畸形诊断时间、诊断情况。结果 STIC技术检测时间显著短于二维超声检测时间,差异具有统计学意义(P <0.05);STIC技术检出率、漏诊率与二维超声诊断对比,差异具有统计学意义(P <0.05);误诊率对比无统计学意义(P> 0.05)。结论实时动态四维时间-空间关联成像技术在胎儿心脏畸形辅助诊断中具有较好应用效果,能显著提高对胎儿心脏畸形辅助诊断的准确性,值得推广。     

四维超声联合磁共振成像诊断胎儿畸形的临床意义

目的探讨四维超声系统筛查联合磁共振成像对胎儿畸形的临床诊断价值。方法选择2015年3月—2016年2月在笔者所在医院行四维超声检查的中晚期孕妇1605例,对可疑胎儿畸形的孕妇行胎儿磁共振成像明确诊断,根据引产/上级医院进一步检查或出生后的随访结果评价其诊断符合率。结果 1605例孕妇共怀孕胎儿1623例,其中双胎18例,经临床证实畸形胎儿63例,单纯四维超声检查发现畸形58例,诊断符合率92.1%,四维超声联合磁共振成像发现胎儿畸形60例,诊断符合率95.2%,差异无统计学意义(P>0.05)。其中16例中枢神经系统发育畸形,单纯四维超声检查发现9例,诊断符合率56.2%,二者联合检查发现14例,诊断符合率87.5%,差异有统计学意义(P<0.05)。结论四维超声是胎儿畸形首选的检查方法,磁共振成像在中枢神经系统畸形的诊断中具有优势,二者联合可以提高胎儿畸形的诊断率,降低出生缺陷,提高人口素质。     

二维超声联合四维超声对产前诊断胎儿畸形的诊断价值

目的探讨二维超声联合四维超声对产前诊断胎儿畸形的诊断价值。方法择取2016年5月～2018年5月期间在东莞康华医院进行产前检查的孕妇40例作为本研究对象,为本组孕妇分别开展二维超声、四维超声以及联合检查,以孕妇引产和分娩随访结果作为金标准,统计三种检查方式对胎儿畸形的诊断效果,分析胎儿畸形的影响因素。结果二维超声检查结果显示胎儿畸形共2例,诊断准确率5.00%,检查敏感度18.18%、特异度76.32%,四维超声检查结果显示胎儿畸形共3例,诊断准确率7.50%,检查敏感度27.27%、特异度78.38%,联合检查结果显示胎儿畸形共10例,诊断准确率25.00%,检查敏感度90.91%、特异度96.67%,其中单纯二维超声和四维超声检查结果差异无统计学意义(P 0.05),联合检查结果显著高于单纯检查,差异有统计学意义(P 0.05),且联合检查与引产、分娩检查结果差异无统计学意义(P 0.05);孕早期胎儿畸形诊断准确率27.27%(3/11),孕中期胎儿畸形诊断准确率45.45%(5/11),孕晚期胎儿畸形诊断准确率27.27%(3/11),不同孕期孕妇胎儿畸形检查结果差异无统计学意义(P 0.05);诱发胎儿畸形的单因素主要包括孕妇补充叶酸、夫妻双方吸烟酗酒等不良生活行为、过度劳累以及孕期疾病治疗等,差异有统计学意义(P 0.05)。结论二维超声与四维超声联合检测胎儿畸形的效果优于单纯二维或四维超声检测,能够提升胎儿畸形诊断准确率,因此该种诊断方式值得在临床中进行推广。     

二维超声联合四维超声检查产前胎儿畸形的应用效果及对妊娠结局的影响

目的 观察二维超声联合四维超声检查产前胎儿畸形的应用效果及对妊娠结局的影响.方法 选取2014年3月至2016年5月我院行产前检查的74例中晚孕期孕妇作为研究对象,先行二维超声检查,再联合四维超声检查,比较两种检查方法产前胎儿畸形检出率,观察妊娠结局情况.结果 本组孕妇分娩出92个胎儿,引产或胎儿娩出后随访调查显示,共124处胎儿畸形,28处胎儿体表畸形;联合超声检查的胎儿畸形确诊率95.16％、体表畸形确诊率92.86％,均比单独二维超声82.26％、64.29％高(P＜0.05);妊娠结局:74例孕妇共检出68例畸形胎儿,漏诊4例,39例畸形胎儿终止妊娠,29例畸形胎儿继续妊娠.结论 产前胎儿畸形检查应用二维联合四维超声诊断可提高诊断准确性,可检查出胎儿畸形类型,对孕妇是否继续或终止妊娠结局具指导意义.     

四维超声时空关联成像技术筛查中孕早期胎儿先天性心脏病的临床价值

目的探讨四维超声时空关联成像技术(STIC)筛查中孕早期胎儿先天性心脏病的临床价值。方法以2015年6月~2016年6月在我院进行检查的100例中孕早期孕妇为研究对象,采用随机数字表法将所有研究对象分成对照组与观察组各50例,对照组患者予以二维超声筛查,观察组予以四维超声时空关联成像技术筛查,对比两组患者的先天性心脏病检出率、随访结果和孕妇满意度。结果经比较可知,观察组患者的检测阳性率、特异度和准确率显著高于对照组(P0.05);且观察组研究对象的采集时间显著短于对照组(P0.05),孕妇满意度也显著优于对照组,差异有统计学意义(P0.05)。结论四维超声时空关联成像技术筛查中孕早期胎儿先天性心脏病具有显著的临床应用优势,能够明确提升诊断效率,其临床应用价值较高。     

二维超声联合四维超声检查在不同妊娠周期产前筛查胎儿畸形中的应用

目的：探讨二维超声联合四维超声在不同妊娠周期产前筛查胎儿畸形中的价值。方法：选取于东莞市横沥医院进行产前检查的1868例不同妊娠周期的妊娠期妇女,所有妊娠期妇女先进行二维超声检查,对初步怀疑胎儿畸形的妊娠期妇女进行二维超声联合四维超声检查。以临床分娩结果为依据,对比分析二维超声及其联合四维超声检查的诊断率。结果：妊娠周期为11～17＋6周妊娠期妇女的二维超声检查确诊率为62．96％（17／27）,18～27＋6周妊娠期妇女二维超声检查确诊率为86．59％（71／82）,28～40＋6周妊娠期妇女二维超声检查确诊率为70．59％（12／17）,明显低于二维超声联合四维超声检查的92．59％（25／27）、97．56％（80／82）、94．12％（16／17）,差异有统计学意义（P＜0．05）。结论：超声检查是产前筛查胎儿畸形的重要手段,二维超声联合四维超声检查在不同妊娠周期产前筛查胎儿畸形中的应用价值较高,能有效提高胎儿畸形的诊断率,减少畸形胎儿的出生率,值得临床推广。     

产前超声在胎儿心血管畸形诊断中的应用研究

目的探讨产前超声在胎儿心血管畸形诊断中的应用效果。方法选取2015年1月至2018年1月我院56例疑似胎儿心血管畸形的孕妇为研究对象,所有孕妇均行二维及三维超声检查,以病理检查结果作为诊断的金标准,比较两种检查方法的诊断符合率及诊断效能。结果在56例疑似胎儿心血管畸形的孕妇中,病理结果显示心脏异常共计112处,其中二维超声诊断符合率为71.43%,二维联合三维超声诊断符合率为96.43%,差异有统计学意义(P<0.05),最终病理确诊阳性52例,阴性4例,二维超声检查敏感性、特异性、准确性及阳性预测值分别为80.77%、50.00%、78.57%及75.00%;二维联合三维超声检查敏感性、特异性、准确性及阳性预测值分别为94.23%、100.00%、94.64%及87.50%,差异有统计学意义(P<0.05)。结论二维联合三维超声在产前胎儿心血管畸形诊断中诊断效能较高,值得临床进行应用推广。     

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.

---

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.