快速康复外科理念在宫颈癌围手术期护理中的应用分析

目的探讨快速康复外科理念在宫颈癌根治围手术期护理中的临床应用及效果。方法选择2015年1月～2016年11月86例住院行宫颈癌根治术患者随机平均分观察组和对照组各43例,对照组采取传统围手术期护理模式,观察组采取FTS理念指导下优化的围手术期护理措施,对比分析两组患者的手术后首次肛门排气时间、排便时间、术后进食时间、下床活动时间、术后并发症的发生率等及患者住院天数,住院总费用。结果观察组患者的手术后首次肛门排气时间、排便时间、术后进食时间、下床活动时间均较对照组提前,而且住院时间缩短,住院总费用降低,腹胀、腹腔出血及感染等并发症减少,心理健康状态良好。两组比较差异有统计学意义(P 0.05)。结论快速康复外科在宫颈癌围手术期护理的临床应用安全有效,能促进加快患者的康复进程,缩短住院时间,降低费用,值得临床推广。     

快速康复外科护理措施在低位急性肠梗阻患者围术期的效果

目的探讨快速康复外科(FTS)护理措施在低位急性肠梗阻患者择期手术围术期的效果。方法将114例老年低位急性肠梗阻者随机分为快速康复护理组和传统护理组。传统护理组采取常规护理和指导,快速康复护理组实施FTS新理念治疗,比较两组临床治疗效果和并发症的发生情况。结果与传统护理组比较,快速康复护理组术后首次进食时间、首次排气时间、首次排便时间、尿管留置时间均明显缩短(P<0.01),手术并发症发生率降低,术后住院时间及住院费用明显减少(P<0.05)。结论 FTS理念可有效促进患者术后康复,减少术后并发症发生,缩短住院时间,并节省住院总费用。     

结直肠癌患者围手术期快速康复外科护理措施的效果研究

目的探讨结直肠癌患者围手术期快速康复外科护理措施效果。方法选取2012年4月至2013年11月我院收治的结直肠癌患者72例进行分析,按照护理方法分成观察组和对照组各36例,观察组采用快速康复外科护理,对照组采用常规护理,观察两组术后康复效果和满意度评价。结果观察组首次进食时间、首次排气时间、首次排便时间、下床活动时间、住院时间和并发症发生率明显少于对照组(P<0.05),满意度评分和健康知识掌握率明显高于对照组(P<0.05)。结论结直肠癌患者围手术期采取快速康复外科护理措施,能够有效促进患者的康复,减少并发症发生率,缩短住院时间,提高患者满意度,安全有效。     

快速康复护理联合中药治疗用于腹腔镜胆囊切除术的效果观察

目的：观察快速康复护理联合中药治疗用于腹腔镜胆囊切除术的效果。方法将200例需行腹腔镜胆囊切除术的急性结石性胆囊炎患者随机分为观察组和对照组各100例。2组均行腹腔镜胆囊切除术治疗,术后加用中药治疗。在此基础上,对照组患者围术期采用常规护理方法;观察组患者在对照组的基础上采用快速康复护理。记录2组患者的住院时间、住院费用、术后下床活动时间、术后进食时间、排便时间及并发症发生情况。结果观察组患者的住院费用低于对照组,住院时间、术后下床活动时间、术后进食时间、排便时间均短于对照组,并发症发生率低于对照组,差异均有统计学意义（P ﹤0.05）。结论快速康复护理联合中药治疗用于腹腔镜胆囊切除术可显著缩短治疗时间,降低住院费用,促进患者术后消化功能和早期日常活动的恢复,减少并发症,值得临床推广应用。     

结肠癌患者围手术期实施快速康复护理的临床应用

目的:探讨快速康复外科技术(fast-track surgeryFTS)在结肠癌患者围手术期护理应用的临床效果。方法:将76例需行结肠癌手术患者,分为快速康复护理组42例和传统护理组34例,2组分别采用快速康复外科理念和传统方法进行治疗。观察两组病人术后肛门首次排气时间及排便时间、进食时间、胃管及尿管留置时间、术后住院时间、术后并发症发生率和住院费用等指标。结果:快速康复护理组患者肛门首次排气及排便时间、进食时间、胃管及尿管留置时间、术后住院时间等均较传统护理组明显缩短;住院费用较对照组明显减少。结论:FTS在结肠癌患者围手术期的应用,能明显减轻患者痛苦,促进患者康复,节省医疗费用,具有广阔的应用前景。     

快速康复理念在直肠癌围手术期护理中的应用

目的探讨快速康复外科理念在直肠癌围手术期护理工作中的应用效果。方法将140例同期住院行Dixon根治术的直肠癌患者随机分为观察组(90例)和对照组(50例),对照组按直肠癌手术常规护理;观察组遵循快速康复外科理念采用术前教育、手术准备、术后镇痛、体温保护、液体管理、引流管护理、术后早期进食及早期活动等措施。结果两组术后首次排气、排便时间、术后肺部并发症发生率、住院总费用及住院院时间比较,两组间差异有统计学意义(P<0.05)。结论快速康复外科理念在围手术期护理中的运用,可促进直肠癌患者术后早期康复,减少并发症发生率,缩短住院时间,降低住院费用。     

快速康复理念在直肠癌围手术期护理中的应用

目的探讨快速康复外科理念在直肠癌围手术期护理工作中的应用效果。方法将140例同期住院行Dixon根治术的直肠癌患者随机分为观察组(90例)和对照组(50例),对照组按直肠癌手术常规护理;观察组遵循快速康复外科理念采用术前教育、手术准备、术后镇痛、体温保护、液体管理、引流管护理、术后早期进食及早期活动等措施。结果两组术后首次排气、排便时间、术后肺部并发症发生率、住院总费用及住院院时间比较,两组间差异有统计学意义(P<0.05)。结论快速康复外科理念在围手术期护理中的运用,可促进直肠癌患者术后早期康复,减少并发症发生率,缩短住院时间,降低住院费用。     

综合康复护理干预应用于围手术期大肠癌患者的效果观察

目的观察在大肠癌患者围手术期应用综合康复护理干预的临床效果。方法80例大肠癌患者作为研究对象,随机分为对照组和观察组,每组40例。对照组患者围手术期应用常规护理,观察组患者围手术期应用综合康复护理干预。比较两组患者手术相关指标(进食时间、尿管留置时间、肛门排气时间、首次排便时间、住院时间)及术后并发症发生情况。结果观察组患者进食时间、尿管留置时间、肛门排气时间、首次排便时间、住院时间均显著短于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为7.50%,显著低于对照组的25.00%,差异具有统计学意义(P<0.05)。结论通过在围手术期对大肠癌患者展开综合康复护理干预,可积极改善其临床症状,加快患者术后身体康复,减少并发症的发生,值得推广。     

快速康复外科理念在宫颈癌手术患者中的应用效果探讨

目的探讨快速康复外科理念在宫颈癌手术患者中的应用效果。方法60例行宫颈癌手术患者,按抽签方式分为对照组和观察组,各30例。对照组采用常规护理,观察组在对照组基础上采用快速康复外科理念护理。分析并比较两组患者护理后首次排气时间、首次排便时间、首次下床活动时间、住院时间、并发症发生情况、护理满意度。结果观察组首次排气时间为(31.6±8.2)h、首次排便时间为(32.6±8.6)h、首次下床活动时间为(26.5±5.1)h、住院时间为(16.3±2.1)d;对照组首次排气时间为(44.9±10.6)h、首次排便时间为(47.7±11.2)h、首次下床活动时间为(38.6±9.3)h、住院时间为(21.2±3.2)d。观察组首次排气时间、首次排便时间、首次下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为13.33%,低于对照组的36.67%,差异有统计学意义(P<0.05)。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论对宫颈癌手术患者围术期实施快速康复外科理念护理可有效降低并发症发生率,提高患者对护理的满意度,同时还能促进患者尽快恢复,具有显著的应用价值。     

快速康复外科护理在结直肠癌围手术期的应用研究

目的:探讨快速康复外科(fast track surgery,FTS)理念在结直肠癌患者围手术期中的应用效果。方法:将80例结直肠癌手术患者分为常规护理组和快速康复外科护理组各40例,比较两组患者术后住院天数、输液治疗时间、首次肛门排气时间、首次排便时间、体重下降程度、住院总费用以及患者满意度。结果:快速康复外科护理组患者满意度高于常规护理组;术后住院天数、静脉输液时间短于常规护理组;首次肛门排气、排便时间早于护理组;体重下降、住院总费用低于常规护理组。两组比较,均P<0.05。两组有显著差异。结论:FTS护理可以有效促进结直肠癌患者术后胃肠道功能的恢复,减少术后并发症,节省住院总费用,提高患者对护理工作的满意度。     

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.