喉返神经对甲状腺的形态学影响

作者采用组织化学手段,观察了切断大鼠喉返神经对甲状腺超微结构的影响。从形态学上看,单侧喉返神经可能使该侧甲状腺滤泡、滤泡上皮细胞及其细胞器趋向于功能低下时的状态,这为喉返神经抑制甲状腺激素的分泌提供了形态学的证据。     

海洛因依赖者下丘脑-垂体-甲状腺功能改变

<正> 长期滥用阿片类毒品对下丘脑-垂体-甲状腺轴功能的影响,国外已有报道,但国内尚未见有关研究资料,为了解国人海洛因依赖者下丘脑-垂体-甲状腺轴功能状况,著者观察了iv海洛因依赖者59例和正常人30例血清TSH、T_4、T_3的水平,结果显示:海洛因依赖者TSH、T_4、T_3的分泌水平与正常对照组比较有明显的改变。其中TSH明显降低(P<0.01),T_3、T_4升高(P<0.05或P<0.01)。长期滥用海洛因血清TSH水平降低,这可能与分布在下丘脑的阿片受体被海洛因兴奋后,     

显露喉返神经在甲状腺手术中预防喉返神经损伤的作用

目的：研究甲状腺手术是否显露喉返神经对喉返神经损伤的影响。方法进行甲状腺手术100例患者,按照手术方法不同随机分为对照组和观察组各50例。对照组直接进行甲状腺手术;观察组在进行甲状腺手术之前先了解甲状腺周围喉返神经神经分布,小心进行解剖,使喉返神经暴露在视野中,避开喉返神经,再进行手术。结果对照组有3例患者出现了不同程度喉返神经损坏现象,观察组患者均成功完成手术,对患者的喉返神经没有任何损坏。结论进行甲状腺手术时最好先解剖使喉返神经显露出来,有利于避免喉返神经的损伤。     

甲状腺手术中喉返神经损伤分析

目的分析甲状腺手术中喉返神经损伤发生的原因。方法对215例甲状腺手术病人进行回顾性分析。术中未显露喉返神经141例,术中常规显露喉返神经74例,观察喉返神经损伤发生率：结果未解剖显露喉返神经组甲状腺切除术141例中,暂时性喉返神经损伤发生率4．8％,永久性喉返神经损伤发生率3．5％;解剖喉返神经组暂时性喉返神经损伤发生率5．6％,永久性喉返神经损伤发生率1．3％．暂时性喉返神经损伤发生车未见有显著差异（P〉0．05）,永久性喉返神经损伤发生率比后者显著升高（P〈0．05）、结论解剖变异、手术操作、组织粘连是甲状腺手术损伤喉返神经的主要原因。甲状腺手术中显露喉返神经应该有选择性。     

麻醉药物对甲状腺术中喉返神经监测影响的研究进展

甲状腺疾病是一种常见的内分泌系统疾病,主要由于甲状腺功能分泌不足引起,目前手术切除是治疗甲状腺疾病的主要方法。喉返神经损伤是甲状腺术中一种严重的并发症,术后神经损伤可导致患者声音嘶哑,甚至呼吸困难,严重影响患者生活质量。术中神经电生理监测可以降低甚至避免喉返神经损伤风险,其中麻醉药物是影响术中神经电生理监测的主要因素。能否在保证术中神经监测正常实施前提下提供良好麻醉管理,甲状腺手术中麻醉药物的使用成为关键。本文主要介绍麻醉药物对甲状腺术中喉返神经监测的影响,优化术中麻醉管理、合理应用麻醉药物、避免麻醉药物对喉返神经监测的影响,从而提高手术质量、缩短康复时间。     

不同甲状腺功能状态患者的红细胞T_3、T_4浓度及摄取率的观察

本文观察不同甲状腺功能状态下的 RBC T_3、T_4及摄取率变化。38例甲亢患者 RBC T_3、T_4及摄取率分别高于正常组,其中5例治疗后下降;13例甲减患者 RBC T_3及摄取率、RBC T_4均低于正常组,RBC T_4摄取率与正常组无差异,其中8例治疗后上升;12例 NTI RBC T_3及摄取率、RBCT_4摄取率与正常组无差异,RBC T_4低于正常组。     

全程显露喉返神经在甲状腺手术中预防喉返神经损伤的应用

目的探讨在甲状腺手术中全程显露喉返神经预防喉返神经损伤的临床应用。方法回顾性分析276例甲状腺手术的病例治疗,术中常规全程显露喉返神经,观察术后喉返神经损伤情况。结果 276例病例中,术后发生喉返神经损伤4例(占1.4%),均为单侧喉返神经损伤,经治疗6个月后恢复。结论甲状腺手术中常规全程解剖喉返神经是预防喉返神经损伤的有效方法。     

甲状腺手术治疗中暴露喉返神经对患者喉返神经的保护价值及并发症的影响

目的:观察甲状腺手术治疗中暴露喉返神经对患者喉返神经的保护价值及并发症的影响。方法:选取2017年1月—2018年12月于江门市新会区人民医院进行甲状腺手术治疗的90例患者,根据手术操作的差异分为观察组与对照组。观察组均于手术治疗中暴露喉返神经;观察组手术治疗中不暴露喉返神经。比较两组各项临床指标、喉返神经损伤发生率及其他并发症发生率的差异。结果:观察组手术时间长于对照组,住院时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05);观察组患者术后喉返神经损伤发生率为5.77%,低于对照组患者的23.68%,差异有统计学意义(P<0.05);观察组患者术后甲亢复发率为1.92%,低于对照组患者的13.16%,差异有统计学意义(P<0.05)。结论:甲状腺手术治疗中暴露喉返神经可有效避免喉返神经损伤情况发生,同时还能缩短其住院时间,减少住院费用,该手术治疗甲状腺病灶更加彻底,值得临床推广。     

T_3T_4质控血清的制备和应用

用放射免疫分析技术测定血中三碘甲状腺原氨酸(T_3)和甲状腺素(T_4)含量,对于诊断患者甲状腺功能、疗效观察、指导临床用药都具有重要意义。1983年以来,我们使用上海化学试剂研究所提供的 T_3、T_4药盒,自己制备了质量控制血清,建立质量控制图,保证了检测结果准确稳定,现报道如下。一.T_3T_4质量控制血清的制备和贮存分别收集、积累已测定过 T_3、T_4含量的患者血清,按含量高中低分三个组,使其值分布在 T_3、T_4放免药盒标准曲线测定范围内。如 T_3选取或用高含量 T_3患者血清配制成80ng/dl、150ng/dl、250ng/dl 左右;T_4选取或用高含量 T_4患者血清配制成3μg/dl、10μg/dl、17μg/dl 左右。各组收集血清数量     

术中诱发电位监护在甲状腺手术中保护喉返神经的临床研究

目的探讨术中诱发电位监护在甲状腺手术中保护喉返神经的临床意义。方法回顾性分析我院和暨南大学附属第一医院于2012年6月~2015年6月收治的78例甲状腺手术治疗患者的病历资料,随机分为对照组和治疗组。治疗组中的患者甲状腺手术中应用肌电诱发电位监护仪引导暴露喉返神经,在喉返神经远端和近端进行电刺激,正常时切口远近端两个部位对神经刺激,产生运动反应波幅。对照组中的患者甲状腺手术中,不应用诱发电位监护仪,对比分析两组患者术后喉返神经损伤的早期症状发生率,并进行评分。结果对照组患者术后喉返神经损伤的早期临床症状的计分情况和对照组比较,明显较低,差异有统计学意义(P0.05)。治疗组的患者中喉返神经探查60根,对照组中的喉返神经探查有65根。治疗组喉返神经探查时间和平均手术时间和对照组比较,明显较短,差异有统计学意义(P0.05)。治疗组患者的喉返神经损伤率和对照组比较明显较低,差异有统计学意义(P0.05)。结论甲状腺手术中应用术中诱发电位监护,可以实现喉返神经的有效探查,并将手术的时间缩短,将暂时性的喉返神经损伤率降低,有助于对喉返神经损伤的原因及时发现,对术后声带功能恢复情况有效预测,将医源性喉返神经损伤发生率减少,值得临床推广和应用。     

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.     

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.