腹腔镜手术与开腹子宫肌瘤剔除术的对比分析

目的 比较腹腔镜手术与开腹子宫肌瘤剔除术的临床效果.方法 回顾分析我院2010年1月至2011年12月96例腹腔镜肌瘤剔除术患者的临床资料,与同期开腹子宫肌瘤剔除术83例作对比分析.结果 96例腹腔镜子宫肌瘤剔除术均顺利完成,无中转开腹.两组比较,术中出血量差异无统计学意义(P＞0.05),手术时间腹腔镜组较开腹组长(P＜0.05);但术后肛门排气时间及住院天数,腹腔镜组均短于开腹组(P＜0.05).结论 腹腔镜子宫肌瘤剔除术是一种微创、安全的手术,值得临床推广应用.     

剖宫产并行子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术的临床比较

目的 比较剖宫产并行子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术的效果.方法 将60例子宫肌瘤患者根据是否妊娠分为观察组(妊娠者)30例,对照组(非妊娠者)30例.观察组剖宫产同时拟行子宫肌瘤剔除术,对照组拟行腹腔镜子宫肌瘤剔除术.比较两组手术时间、术中出血量、术后排气时间及术后并发症发生情况.结果 观察组手术时间[(1.02±0.27)h]短于对照组[(1.45±0.38)h](t=5.41,P＜0.05);观察组术中出血量[(278.74±23.09)ml]虽多于对照组[(269.95±22.65)ml],但差异无统计学意义(t=4.52,P＞0.05),观察组术后排气时间[(18.42±1.07)h]与对照组[(17.25±1.13)h]差异无统计学意义(t=4.16,P＞0.05);观察组住院时间[(13.26±2.04)d]长于对照组[(7.81±1.76)d](t=6.73,P＜0.05);两组术后并发症发生率(10.00％和6.67％)差异无统计学意义(x2=4.12,P＞0.05).结论 剖宫产并行子宫肌瘤剔除术安全可行.     

腹腔镜与开腹行子宫肌瘤剔除术的疗效观察

目的比较腹腔镜与开腹行子宫肌瘤剔除术的疗效与应用价值。方法选择2011年1月至2012年5月我院因子宫肌瘤行剔除术的患者60例,随机分为腹腔镜组与开腹组,腹腔镜组行腹腔镜下子宫肌瘤剔除术,开腹组行开腹子宫肌瘤剔除术,比较两组患者的手术时间、术中出血量、术后盆腔引流量、肛门排气时间及住院天数等项目。结果两组患者的手术时间、术中出血量、肛门排气时间、住院天数相比差异有统计学意义(P<0.05),但腹腔镜组手术时间较开腹组更长;术后盆腔引流量两组差异无统计学意义(P>0.05)。结论腹腔镜子宫肌瘤剔除术具有手术创伤小,术中出血量少,术后恢复快的优点,在一些方面优于开腹手术,但目前不能完全代替开腹手术。     

腹腔镜与开腹子宫肌瘤剔除术的护理干预

目的 探讨腹腔镜与开腹子宫肌瘤剔除术的护理干预效果.方法 80例子宫肌瘤患者按治疗方法不同分为开腹子宫肌瘤剔除术组40例和腹腔镜子宫肌瘤剔除术组40例,采用不同的护理方法进行干预,观察两组患者术中出血量、手术时间、肠功能恢复时间、住院天数等方面的情况.结果 腹腔镜组术中出血量、肠功能恢复时间、离床活动时间、住院天数均均优于开腹组（t=2.781,t=2.845,t=2.881,t=2.844,t=2.879,均P〈0.05）.结论 术前的心理护理、肠道准备和术后护理,可以减少患者术后并发症的发生,提高手术的成功率.     

腹腔镜与传统开腹术对切除子宫肌瘤的临床效果观察

目的：比较腹腔镜与传统开腹术切除子宫肌瘤的临床效果,从而制订更合理的术式。方法对58例腹腔镜下进行子宫肌瘤剔除术(腹腔镜组)和93例经开腹行子宫肌瘤剔除术(开腹组)的患者进行回顾分析,比较两组患者的手术用时、出血量、术后恢复时间以及并发症发生情况。结果腹腔镜组手术耗时较开腹组长(P<0.05),但术中出血量显著少于开腹组(P<0.05);腹腔镜组术后恢复较开腹组快(P<0.05);两组术后并发症比较差异无统计学意义(P>0.05)。结论腹腔镜下剔除子宫肌瘤虽然耗时长,但术中出血量少,术后恢复时间短,可以推广应用,但要注意病例的选择。     

三种途径子宫肌瘤剥除术的临床观察研究

目的探究对子宫肌瘤剔除术应用三种途径方法的临床效果。方法选自本院2011年1月至2013年1月收治的子宫肌瘤患者共120例,以随机数字表的方式分为A组、B组和C组,每组各有患者40例。A组患者接受开腹子宫肌瘤剔除术、B组患者接受腹腔镜子宫肌瘤剔除术、C组患者接受阴式子宫肌瘤剔除术。对比3组患者各项临床指标。结果 A组患者手术时间最短、C组患者术中出血量、术后排气以及术后镇痛时间具有显著优越性,两两对比均有统计学意义(P<0.05);手术时间、住院天数等各项临床指标,B组与C组患者对比无统计学意义(P>0.05)。结论对接受子宫肌瘤剔除术患者进行阴式途径方法,具有安全高效的优点,值得临床推广。     

腹腔镜下子宫肌瘤剔除术与开腹子宫肌瘤剔除术疗效比较

目的比较腹腔镜下子宫肌瘤剔除术与开腹子宫肌瘤剔除术治疗子宫肌瘤的临床疗效。方法筛选出本院2014年1月～2017年9月期间收治的106例子宫肌瘤患者,按照不同术式将其分为:腹腔镜组(26例),腹腔镜组应用腹腔镜下子宫肌瘤剔除术治疗;开腹组(80例),开腹组应用开腹子宫肌瘤剔除术治疗,对比两组患者的临床疗效。结果腹腔镜组患者的术中出血量、手术时间、肛门排气时间、住院时间均少于开腹组,对比差异有统计学意义(P 0.05)。腹腔镜组患者术后极度疼痛、重度疼痛、中度疼痛的构成比均小于对照组,且轻度疼痛、无疼痛感的构成比均大于对照组,对比差异有统计学意义(P 0.05)。腹腔镜组患者的总有效率(96.2%)高于开腹组(83.8%),对比差异有统计学意义(P 0.05)。腹腔镜组患者的并发症发生率(3.8%)低于开腹组(10.0%),对比差异有统计学意义(P 0.05)。结论腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤的临床疗效优于开腹子宫肌瘤剔除术,可明显改善手术相关指标,具有疼痛轻微、疗效确切、并发症发生率低等优势,值得临床推广与应用。     

开腹与微创子宫肌瘤剔除术的临床结局比较

目的探讨开腹与腹腔镜子宫肌瘤剔除术临床结局,为临床治疗该病提供更多参考。方法回顾分析我院收治的行开腹子宫肌瘤剔除术(开腹组)和腹腔镜子宫肌瘤剔除术(腹腔镜组)的临床资料,每组73例,比较两组的手术情况,肌瘤大小和数量。结果 1开腹组患者肌瘤数和肌瘤大小显著大于腹腔镜组,差异有统计学意义(P<0.05)。2腹腔镜组住院天数、肛门排气时间较对照组明显缩短,腹腔镜组手术时间较开腹组明显延长,术中出血量、术后病率、术后镇痛药使用率和住院费用较对照组显著减少,差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剔除术术式安全、可靠,对腹腔干扰小,而多发、巨大或剔除后复发的肌瘤应首选开腹子宫肌瘤剔除术。     

腹腔镜下子宫肌瘤剔除术与开腹手术的临床疗效对比

目的对比分析腹腔镜下子宫肌瘤剔除术与开腹手术的临床疗效。方法选取我院收治的子宫肌瘤患者122例,采取分层随机法分成两组,观察组(n=61)治疗方式选择腹腔镜下子宫肌瘤剔除术,对照组(n=61)治疗方式选择开腹手术,对比两组临床疗效。结果观察组患者住院时间、术后排气时间短于对照组,差异有统计学意义(P <0.05)。观察组患者手术时间长于对照组,差异有统计学意义(P<0.05)。观察组患者术中出血量少于对照组,差异有统计学意义(P <0.05)。观察组并发症率4.92%,对照组并发症率18.03%,观察组患者并发症率低于对照组,差异有统计学意义(P <0.05)。结论腹腔镜下子宫肌瘤剔除术的临床疗效显著,并且具有较高的安全性,较开腹手术更有优势。     

垂体后叶素联合米索前列醇在腹腔镜子宫肌瘤剔除术中的应用

目的探讨垂体后叶素联合米索前列醇在腹腔镜子宫肌瘤剔除术中的应用。方法选择2011年4月至2013年4月入住我院的子宫肌瘤患者85例,随机分为两组,A组患者术前肛门放置米索前列醇及术中宫体注射垂体后叶素,B组患者术中宫体注射缩宫素,观察两组患者术中血压变化、术中出血量、手术时间、术后血红蛋白下降情况、术后住院天数、术后并发症等。结果两组患者均顺利完成手术,无并发症发生,无中转开腹,A组患者手术时间及出血量同B组相比差异有统计学意义(P<0.05)。结论垂体后叶素联合米索前列醇用于腹腔镜子宫肌瘤剔除术能明显减少术中出血量、缩短手术时间,具有可行性。     

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.     

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.