宫颈球囊扩张术联合缩宫素在妊娠晚期产妇引产中的应用

目的 分析妊娠晚期引产时,使用宫颈球囊扩张术联合缩宫素的应用效果。方法 选择我院2019年1月至2021年12月行引产术的妊娠晚期产妇497例进行回顾性研究。按照引产方案分为缩宫素组（221例）和宫颈球囊+缩宫素组（276例）,缩宫素组患者引产时使用子宫收缩素来完成引产工作;宫颈球囊扩张术+缩宫素组患者引产时使用宫颈球囊扩张术联合缩宫素完成引产工作。对比两组产妇引产前后的Bishop评分、自然分娩率、剖宫产率、阴道助产率及不同时点新生儿Apgar评分。结果 与引产后缩宫素组相比,宫颈球囊+缩宫素组Bishop评分更高,自然分娩率更高,剖宫产率更低,新生儿1 min、5 min、10 min Apgar评分均更高,差异均显著（均P <0.05）;而两组在阴道助产发生率上比较差异无显著性（P> 0.05）。结论 行引产术的产妇使用宫颈球囊扩张术联合缩宫素后宫颈成熟度可得到明显地提升,具有很好的应用效果。     

促宫颈成熟与足月延期引产应用双球囊及缩宫素的临床效果评价

目的:评析促宫颈成熟与足月延期引产应用双球囊及缩宫素的临床效果。方法:抽选106例足月延期引产产妇为观察对象随机分为各包含53例的缩宫素组(对照组)与双球囊组(实验组),分别进行缩宫素静滴、双球囊导管置入处理,评估比较两组产妇促宫颈成熟效果,并观察产妇的妊娠结局与引产效果。结果:实验组产妇的促宫颈程度效果高达94.3%,相比于对照组的43.4%显著更高(P0.05),宫颈Bishop评分提升优于对照组(P0.05);实验组的剖宫产率、总产程时间与诱发临床时间相比于对照组均明显更少(P0.05),而两组在新生儿体重、新生儿Apgar评分无明显差异(P0.05)。结论:双球囊导管对于足月延期引产产妇而言可有效促宫颈成熟,缩短产程时间,并降低剖宫产率,相较于缩宫素更为安全、有效。     

Cook宫颈扩张球囊用于足月妊娠促宫颈成熟及在引产中的应用效果

目的探讨运用Cook宫颈扩张球囊对足月妊娠孕妇在促宫颈成熟以及引产的临床疗效。方法选取我院诊断足月妊娠待引产的孕妇100例,随机均分为两组,其中对照组50例,使用0.5%缩宫素静脉滴注;研究组50例,使用Cook宫颈扩张球囊,治疗结束后比较两组引产情况、促宫颈成熟疗效、宫颈Bishop评分以及产后并发症和新生儿结局。结果研究组孕妇引产成功率为92%,对照组为76%,研究组显著高于对照组,孕妇的临产时间及总产程显著短于对照组,研究组剖宫产率为12%,对照组为40%,研究组显著低于对照组,差异具有统计学意义(P0.05);研究组促进宫颈成熟有效率为92%,对照组为72%,研究组高于对照组,研究组宫颈Bishop评分高于对照组,差异具有统计学意义(P0.05);产后并发症和新生儿结局方面的比较无统计学意义。结论对足月妊娠孕妇运用Cook宫颈扩张球囊可以有效促进宫颈成熟,引产的临床效果显著,值得临床推广使用。     

缩宫素与米索前列醇在足月妊娠引产中的对比应用

目的:探讨缩宫素与米索前列醇在足月妊娠引产中的应用效果.方法:选择2014年3月～2016年3月我院产科住院部有引产指征的孕晚期产妇200例作为观察对象,使用随机数字表分为对照组和观察组各100例,观察组给予小剂量米索前列醇引产,对照组给予缩宫素引产,对比两组引产效果(Bishop评分、产程时间、成功率).结果:用药4h、8h及12h后,观察组Bishop评分明显高于对照组,用药至分娩的总产程、第一产程及第二产程时间均明显短于对照组,两组阴道分娩率及剖宫产率差异显著,具有统计学意义(P<0.05);观察组成功率为91.00％,对照组成功率为85.00％,组间比较无明显差异(P>0.05).结论:在足月妊娠引产中,与缩宫素比较阴道放置小剂量的米索前列醇可促进宫颈成熟、缩短产程、提高经阴道分娩率、减少剖宫产率,可在临床推广.     

宫颈扩张球囊联合缩宫素促宫颈成熟对妊娠结局及抑郁自评量表评分的影响

目的 观察宫颈扩张球囊联合缩宫素促宫颈成熟对妊娠结局及抑郁自评量表(SDS)评分的影响。方法 选取2019年3月—2021年3月广州市番禺区第二人民医院妇产科收治的产妇208例,按照随机数字表法分为试验组和对照组,每组104例。试验组实施宫颈扩张球囊联合缩宫素治疗,对照组实施常规治疗。比较2组Bishop宫颈成熟度评分、宫颈成熟比例、剖宫产率、阴道分娩率、产程时间、妊娠结局及分娩前后SDS评分。结果 试验组产妇Bishop宫颈成熟度评分、宫颈成熟率及阴道分娩率均高于对照组,剖宫产率低于对照组(P<0.05或P<0.01),总产程时间短于对照组(P<0.01),产妇产后出血量少于对照组(P<0.01);2组新生儿体质量和5 min Apgar评分比较差异均无统计学意义(P>0.05);分娩后,2组产妇SDS评分均低于分娩前,且试验组低于对照组(P<0.01)。结论 宫颈扩张球囊联合缩宫素对促进宫颈成熟有一定帮助,可改善妊娠结局,提高阴道分娩率,降低剖宫产率,减少产后出血量,改善新生儿结局,减轻分娩后抑郁程度,可在临床推广。     

宫颈扩张球囊联合缩宫素及间苯三酚在足月妊娠引产中的应用效果

目的：分析宫颈扩张球囊联合缩宫素及间苯三酚在足月妊娠引产中的应用效果。方法选取本院妇产科2012年1月~2014年11月接收的136例符合引产指征的的足月妊娠初产妇,根据其意愿将其分为对照组(n=74)和观察组(n=62)。对照组患者于宫颈评分后给予0.5%缩宫素,潜伏期给予间苯三酚;观察组在对照组基础上放置Cook双球囊。比较两组产妇干预前后的宫颈 Bishop评分;干预12 h后,比较两组产妇的促宫颈成熟效果;比较两组产妇的引产效果、分娩方式及妊娠结局;比较两组产妇的产程情况。结果干预前,两组的宫颈 Bishop评分比较差异无统计学意义(P>0.05),干预后,观察组显著高于对照组(P<0.05)。观察组的促宫颈成熟效果显著优于对照组(P<0.05)。观察组12 h内临产、阴道分娩的比例显著高于对照组(P<0.05),产后尿潴留、产后出血、胎儿窘迫、新生儿窒息等妊娠结局发生率显著低于对照组(P<0.05)。除第二产程外,观察组产妇的产程均显著短于对照组(P<0.05)。结论宫颈扩张球囊联合缩宫素及间苯三酚能够提高宫颈 Bishop评分,提高阴道分娩成功率,降低不良妊娠结局发生率。     

宫颈扩张球囊在足月妊娠促宫颈成熟及引产中的应用效果分析

目的:分析宫颈扩张球囊在足月妊娠促宫颈成熟及引产中的应用效果。方法:选取2016年1月～2017年6月某院产科接诊的待产单胎头位初产妇90例,采用随机数字表法将其分为对照组与观察组,各45例。对照组行静脉滴注缩宫素治疗,观察组行宫颈扩张球囊治疗,对比两组总产程、产后出血量、Bishop评分变化、分娩结局及不良反应情况。结果:观察组总产程短于对照组,治疗12h后Bishop评分高于对照组,差异具有统计学意义(P0.05);观察组阴道分娩率高于对照组,剖宫产率低于对照组,差异具有统计学意义(P0.05);两组新生儿娩出情况及不良反应发生率比较,差异无统计学意义(P0.05)。结论:宫颈扩张球囊在足月妊娠促宫颈成熟及引产中可有效缩短产妇总产程,促进宫颈成熟,提升产妇阴道分娩率,且不会影响新生儿结局及增加不良反应。     

Cook球囊与缩宫素用于促宫颈成熟及引产的比较研究

目的研究Cook球囊与缩宫素用于促宫颈成熟及引产的疗效。方法 120例接受引产的产妇根据引产方法不同分为观察组和对照组,各60例,观察组患者接受Cook球囊引产,对照组患者接受缩宫素引产,比较两组患者的宫颈Bishop评分、引产结局。结果观察组患者的宫颈Bishop评分（8.81±1.03）分,高于对照组的（6.67±0.85）分,差异有统计学意义（t=5.384,P〈0.05）;观察组引产成功58例多于对照组的42例,差异有统计学意义（χ2=6.194,P〈0.05）;用药到临产的时间（17.78±2.25）h短于对照组的（27.92±3.95）h,差异有统计学意义（t=6.982,P〈0.05）。结论 Cook球囊能够更为有效地促进宫颈成熟、缩短引产时间、提高引产成功率,是安全有效的引产方式。     

COOK球囊联合人工破膜在足月引产中的效果分析

目的 将COOK球囊与人工破膜联合应用于足月引产,观察引产效果和安全性.方法 选取我院住院分娩、有引产指征且宫颈评分＜6分的初产妇166例,根据采用的引产方法分为观察组85例和对照组81例.两组产妇引产前均先用COOK球囊促宫颈成熟,观察组COOK球囊取出后行人工破膜,再行缩宫素引产;对照组COOK球囊取出后直接行缩宫素引产.观察两组静滴缩宫素到诱发临床时间、第一产程时间、总产程时间、催产素量、剖宫产率、24 h内阴道分娩率和产后出血量及不良反应等.结果 观察组诱发临产时间和第一产程时间均少于对照组(5.00 h vs 9.16 h,7.02 hvs 9.80h,P＜0.05),24 h阴道分娩率明显高于对照组(78.80％vs 57.70％),催产素总使用量少于对照组(P值均＜0.05),两组总产程时间(9.30 h vs 10.30 h)、产后出血量(172.20 mLvs 203.40 mL)、剖宫产率(22.40％ vs 27.20％)均无明显改变(P＞0.05),两组均未发生感染及脐带脱垂等不良反应.结论 COOK球囊联合人工破膜可提高引产有效性,使孕妇更快进入产程,且减少缩宫素使用时间,缩短总产程时间,减少总的引产时间和不增加感染与脐带脱垂的发生率.     

COOK双球囊联合缩宫素和单纯缩宫素用于宫颈不成熟足月引产中效果对比

目的:探讨COOK双球囊联合缩宫素和单纯缩宫素用于宫颈不成熟足月引产中效果对比。方法:选取2016年1月~2016年12月期间在某院住院待产的80例孕妇作为研究对象,根据随机数字表法将患者随机分为观察组和对照组,每组40例。观察组给予COOK双球囊联合缩宫素引产,对照组给予单纯缩宫素引产,比较两组的引产效果及引产后产妇和新生儿健康状况。结果:观察组提高宫颈成熟的总有效率为100.00%,明显高于对照组的85.00%,差异有统计学意义(P0.05);观察组阴道分娩率为90.00%,明显高于对照组的57.50%,差异有统计学意义(P0.05);虽然两组孕妇的产后出血、新生儿Apgar评分及产褥感染率相差不大,无统计学意义(P0.05),但观察组孕妇的总产程明显低于对照组,差异有统计学意义(P0.05)。结论:COOK双球囊联合缩宫素在用于宫颈不成熟足月引产上,可有效促进宫颈成熟,提高引产率,值得临床推广应用。     

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.     

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.