控制性低血压在鼻内窥镜手术中的应用

目的探讨控制性低血压在鼻内窥镜手术中的应用价值.方法对52例慢性鼻窦炎、鼻息肉患者随机分为控制性低血压组28例和对照组24例,在静吸复合全麻下进行功能性鼻内窥镜手术,观察两组患者术中的出血量、手术时间及心率,术后第1次尿量及智力情况.结果两组患者术中出血量分别为(152±35.2)ml和(215±45.6)ml,手术时间分别为(92±35.3)min和(132±45.8)min,差异非常显著(P＜0.01),术中、术后均无相关并发症发生.结论控制性低血压能有效减少鼻内窥镜手术的出血量,缩短手术时间且无不良反应发生,具有临床应用价值.     

控制性低血压在鼻内窥镜手术中的应用

目的分析控制性低血压在鼻内窥镜手术中的应用价值.方法对54例Ⅱ型Ⅱ期～Ⅲ型慢性鼻窦炎、鼻息肉病人,随机分为控制性低血压组25例和对照组29例,在全麻下进行控制性降压,观察两组病人术中出血情况、手术时间及有无不适反应.计数资料作统计学处理.结果两组病人术中出血量(分别为159.20±118.18 ml和274.83±136.06 ml,P＜0.001)、出血速度(分别为1.45±0.62 ml min和1.96±1.04ml /min,P＜0.05)及手术时间(分别为104.40±39.80 min和142.07±42.54 min,P＜0.001),差异有显著意义.术中、术后均无相关并发症发生.结论控制性低血压在鼻内窥镜手术中能有效地减少出血并缩短手术时间,具有临床使用价值.     

213例鼻窦炎鼻息肉的鼻内窥镜手术治疗

目的 探讨鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉的疗效。方法 对213例鼻内窥镜鼻窦手术进行临床分析,其中Ⅰ型47例,Ⅱ型95例,Ⅲ型71例。结果 Ⅰ型治愈率为96％,Ⅱ型治愈率为84％,Ⅲ型治愈率为81％,手术并发症为6．5％。结论 鼻内窥镜手术是治疗慢性鼻窦炎和鼻息肉的有效方法,术后综合处理不可忽视。     

硝普钠复合艾司洛尔控制性降压在鼻内窥镜手术中的应用

目的 分析微量泵静脉注射硝普钠-艾司洛尔控制性降压在鼻内窥镜手术中的临床效果,为临床合理用药提供参考.方法 选取40例慢性鼻窦炎,鼻息肉患者随机分为全麻对照组(A)组和全麻控制性降压组(B组),每组20例,2组患者均为ASAⅠ～Ⅱ级.比较两组术中出血量,输液量、手术时间,平均动脉压(MAP),心率(HR).结果 与对照组比较2组术中出血量,输液量、手术时间,平均动脉压(MAP),心率(HR)差异有显著性(P＜0.05).结论 硝普钠复合艾司洛尔控制性降压用于鼻内窥镜手术效果显著,安全可靠,无单用硝普钠降压的副作用,出血量减少,手术时间缩短,具有较高的临床应用价值.     

鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的临床效果

目的：探讨鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的临床效果。方法：将我院近期收治的慢性鼻窦炎鼻息肉患者70例，随机分为治疗组（35例）和对照组（35例），治疗组采用鼻内镜下治疗，对照组采用传统手术治疗，比较两组患者的临床疗效。结果：治疗组患者的治愈率显著优于对照组，两组比较，差异具有统计学意义（P〈0．05）。结论：鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的临床效果满意，值得推广。     

鼻内窥镜手术治疗慢性鼻窦炎鼻息肉出血分析

目的　探讨导致鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉出血量多少的原因与其分期分型的关系 ,从而使我们在术前对手术出血量有充分的估计 ,并做好充分的止血准备及相应的处理措施。方法　对 93 2例慢性鼻窦炎、鼻息肉患者进行临床分型分期 ,并分别统计各型各期鼻内窥镜手术时出血量的多少。对各型期手术出血量进行比较。结果　将鼻内窥镜下鼻窦炎鼻息肉手术出血情况按出血量多少分 4组 ,分别为 1组 0～ 5 0ml ,2组～ 10 0ml,3组～ 2 0 0ml,4组 >2 0 0ml。在我们的统计结果中 ,Ⅰ型一期及二期手术出血量大多在 1组 ,少部分在 2组 ;三期手术出血量主要在 1、2组 ,少部分在 3组 ;Ⅱ型一期手术出血量亦多在 1组 ,少数在 2组 ;二期则在 1～ 4组均有发生 ,但以 2组所占比例最高 ;三期手术出血量多在 3组 ,并在部分出血量 >2 0 0ml者 ;Ⅲ型与Ⅱ型三期接近 ,手术出血量均超过 5 0ml,多发生于 2、3组 ,部分手术出血量 >2 0 0ml。结论　鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉出血量的多少 ,除一些人为因素、麻醉方式、所选择的病人是否有血液疾病及高血压病等因素外 ,与慢性鼻窦炎鼻息肉的分型分期密切相关。     

鼻内窥镜下鼻窦炎鼻息肉手术的护理

目的总结160例鼻内窥镜手术治疗慢性鼻窦炎鼻息肉的护理体会。方法对实施鼻内窥镜手术治疗的160例鼻窦炎鼻息肉患者做术前、术后护理。结果在护理措施配合下,Ⅰ型、Ⅱ型、Ⅲ型鼻窦炎鼻息肉患者有效率分别是97.6%、92.1%、79.3%。未发生严重并发症。结论鼻内窥镜手术治疗鼻窦炎鼻息肉是目前临床上一种微创、有效的方法,在治疗中针对患者不同情况做好术前、术后观察护理是提高治愈率,预防并发症的重要环节。     

45例鼻内窥镜治疗慢性鼻窦炎鼻息肉临床疗效分析

目的探讨鼻内窥镜治疗慢性鼻窦炎鼻息肉临床疗效。方法选取本院2006年10月至2008年10月45例慢性鼻窦炎、鼻息肉患者。经保守治疗效果不佳,全部患者术前常规行鼻窦冠状位和轴位CT检查。而后行鼻内窥镜下慢性鼻窦炎鼻息肉手术。结果本组45例患者中治愈36例（80％）,好转5例（11．1％）,无效4例（8．9％）,总有效率为91．1％,术后并发症主要是鼻腔粘连,有1例,均在内窥镜下予以分离后治愈。结论鼻内窥镜手术治疗慢性鼻窦炎及鼻息肉传统的鼻窦手术相比有组织损伤小,保存鼻腔生理功能,术后复发率低．但要尽可能的减少相关并发症．提高手术疗效。     

鼻内窥镜鼻窦手术保留中鼻甲28例报告

慢性鼻窦炎鼻息肉鼻内窥镜鼻窦手术治疗时是否保留中鼻甲、特别是病变中鼻甲的问题一直存在争论。现将我院1997年～1998年间经鼻内窥镜鼻窦手术并随访6个月以上,有完整记录的28例42侧慢性鼻窦炎鼻息肉（Ⅱ型2、3期）伴中鼻甲病变病例进行分析,术中均保留经手术处理的病变中鼻甲,观察术后中鼻甲的形态及鼻窦炎鼻息肉手术疗效。讨论保留中鼻甲的意义及保留中鼻甲的手术要点。临床资料一、一般资料：28例42例中,男16例24侧,女12例18侧。年龄18～42岁。患者术前均行鼻内窥镜检查和具窦CT检查。慢性鼻窦炎鼻息肉临床分型分期及内窥镜鼻窦手…     

控制性降压在鼻内窥镜术中的应用

目的对控制性降压在鼻内窥镜术中的应用价值进行分析。方法选取行鼻内窥镜术患者86例,随机分为两组,对照组42例给予硝酸甘油控制性降压,观察组4．4例给予硝酸甘油与艾司洛尔联合控制性降压,对比两组患者手术用时、术中出血量、心率及平均动脉压等改变情况。结果观察组术中降压效果显著优于对照组,手术用时显著短于对照组,术中出血量显著少于对照组（P〈0．05）。结论在行鼻内窥镜术时通过硝酸甘油与艾司洛尔联合行控制性降压,可降低术中出血量,减少手术用时,避免患者出现心率过快现象,值得在临床中推广。     

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.

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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.     

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.