98例脑梗塞患者二维超声心动图检测

本文利用二维及Ｍ型超声对近年来我院收治的患有脑梗塞而无心脏病者９８例中老年住院患者的心脏进行检测，旨在为老年病临床提供必要诊断参考的资料。１ 一般资料 本组男６２例，女３６例，年龄４３～８１岁，平均６４．５岁，其中６９％在６０岁以上，９８例均突然发病，有不同程度和部位的半身感觉障碍、偏瘫、言语不清等定位体征，并均经ＣＴ检查证实为脑梗塞。临床检查，半数患者血压高：８９例（８２．４％），心电图呈现ＳＴ－Ｔ改变。左室肥厚、左室高电压或心律失常；Ｘ线检查发现主动脉型心脏或主动脉弓钙化６１例，血脂增高７４例…     

胸痛患者临床常规检查及冠状动脉CTA与冠状动脉造影结果的相关性研究

目的采用临床常规检查,评估冠状动脉风险性。方法选取2013年~2015年本院心血管科因胸痛发作疑诊为冠心病患者194例,回顾分析患者的临床常规检查(ECG和心脏彩超)及冠状动脉CTA,并与冠状动脉造影(CAG)检查结果做参考,对其相关性结果进行分析研究,诊断冠心病的符合率。结果 CAG检出阳性患者155例,阴性患者39例,将阴性患者作为对照组。所有患者的心电图、心脏彩超、冠状动脉CTA检查结果的敏感性和特异性分别为61.29%、81.94%、89.03%和69.23%、82.05%、92.31%。入选患者心电图及心脏彩超联合检查结果的敏感性为56.77%,特异性为56.41%。结论心电图及心脏彩超联合检查对冠状动脉病变有明确的预测价值,冠状动脉CTA的敏感性和特异性均高于心脏彩超与心电图,对诊断冠心病有较高的准确性,具有简单、有效、无创的特点,可应用于临床。     

心脏彩超临床辅助诊断急性肺栓塞的应用价值

目的 探讨心脏彩超临床辅助诊断急性肺栓塞的应用价值。方法 急性肺栓塞患者45例均行ECG、心脏彩超、X射线胸片、动脉血气分析、胸部CT、肺动脉造影检查,心脏彩超诊断结果与其他检查结果比较。结果 ECG、心脏彩超、X射线胸片、动脉血气分析、胸部CT、肺动脉造影检查诊断率分别为24.4%(11/45)、100%(45/45)、6.7%(3/45)、100%(45/45)、17.8%(8/45)、100%(45/45)。心脏彩超诊断阳性例数多于ECG、胸部CT和X射线胸片(χ2=54.6、62.8、78.8,P<0.01)。结论 心脏彩超能够早期及时诊断急性肺栓塞,是临床重要辅助诊断方法。     

心电图联合心脏彩超在诊断高血压性心脏病中的临床意义和应用价值

目的探究心电图联合心脏彩超在诊断高血压性心脏病上的临床意义和应用价值。方法选取2014年1月至2016年8月于本院就诊及治疗的100例高血压性心脏病患者作为研究对象,按照数字表法随机分为两组,每组各有50例,对对照组给予心电图诊断,对实验组给予心电图联合心脏彩超诊断,分析两组患者的临床诊断效果。结果实验组患者的左心室肥厚/左心房增大、心率失常、ST-T改变等临床诊断情况与对照组患者相比,组间差异明显(P<0.05),实验组患者的临床诊断阳性率(96.00%)与对照组患者(72.00%)相比,组间差异明显(P<0.05)。结论对高血压性心脏病患者实施心电图联合心脏彩超诊断的效果较好,可明显提高诊断阳性率。     

心电图和心脏彩超对冠心病的临床诊断价值分析

目的:探讨和分析心电图和心脏彩超对冠心病的临床诊断价值。方法:选取2017年1月至2017年12月,在我院接受治疗的经冠状动脉造影确诊的冠心病患者76例作为研究对象;所有患者均同时接受心电图与心脏彩超检查,对比分析两种检验方法对冠心病的诊断价值。结果:心电图诊断冠心病的灵敏度为73.9%,特异度为47.5%;心脏彩超诊断冠心病的灵敏度为59.2%,特异度为59.4%。心电图诊断冠心病的灵敏度显著高于心脏彩超;同时心脏彩超诊断冠心病的特异度显著高于心电图;差异均具有统计学意义,P0.05。结论:在冠心病的诊断中,心电图具有较高的林敏度,心脏彩超具有较高的特异度;因此在实际应用中,可将两种检验方式联合联合运用,以提高冠心病患者的诊断率。     

心电图及心脏彩超与冠状动脉造影诊断冠心病的比较

目的比较心电图、心脏彩超和冠状动脉造影诊断冠心病的准确率。方法选取300例疑似冠心病患者作为研究对象,对其临床资料进行回顾性分析,并进行三种检查,以冠状动脉造影检查结果为诊断依据,对三种检查方法的阳性检出率进行比较。结果心电图阳性检出率与冠状动脉造影差异无统计学意义(P>0.05),但是与心脏彩超检查结果的对比十分明显(P<0.05)。结论心电图检查的敏感性、特异性和准确性较高,在没有冠状动脉造影的情况下可作为诊断冠心病的可靠依据。     

心电图ST段下移患者的超声心动图改变临床分析与体会

目的:用心脏彩超观察心电图ST段下移患者的心脏形态结构的变化。方法:在临床检查中,选择心电图ST段下移≥0.05～0.1mv的患者,异常组31例,平均年龄(63.6±11.9)岁,同时作心脏彩超检查,测量心脏房室腔大小、室间隔及左室后壁厚度、心肌质量、EF%、二尖瓣频谱E/A,选择心电图正常,同年龄段者35例,平均年龄(56.7±14.5)岁,同样作上述心脏彩超测量项目,作为正常对照组进行统计学分析。结果:经统计学处理,ST段下移组与正常组心脏彩超测量左心室腔及左室壁,两组有显著性差异,P<0.05,两组心肌质量比较,P<0.05而LVEF(%)P>0.05,E/A>1P>0.05,但Tel指数两组比较,P<0.01。结论:心脏彩超对两组患者的心脏测量分析,心电图ST段下移者左心室质量增加是基本的原因之一。     

心电图和心脏彩超对冠心病的临床诊断价值研究

目的研究心电图与心脏彩超在冠心病患者临床诊断过程中的应用价值。方法本次实验研究回顾性分析我院在2018年2月至2019年2月期间收治的疑似冠心病患者63例的临床资料,分别给予患者心电图和心脏彩超检查,将冠状动脉造影作为冠心病诊断的"金标准",分析心电图与心脏彩照的诊断价值。结果在特异性、敏感度、诊断准确率的比较上,心电图与心脏彩超相比存在显著差异(P<0.05)。结论在实施冠心病诊断的过程中,心电图与心脏彩超均具有一定诊断价值,其中心电图的灵敏度较高,心脏彩超的特异性较高,且心脏彩超的诊断准确性相对较高,在实际的临床运用过程中可以采用心电图联合心脏彩超的方式为冠心病患者实施检查与诊断。     

60例酒精性心肌病临床特点分析

目的探析酒精性心肌病的临床特点及诊断处理措施。方法收集60例酒精性心肌病患者的资料,经归纳其临床症状,心电图表现及实验室检查的临床特点,对比戒酒对患者治疗效果及预后的改善情况。结果酒精性心肌病临床表现有心悸、胸闷气急、疲乏无力及活动耐受能力降低,心电图常见心房颤动、心律失常及心脏射血分数降低等。戒酒后心脏明显缩小,左室射血分数上升,心脏功能得到改善。结论酒精性心肌病临床无显著特异性,胸片及心脏彩超可协助早期诊断,戒酒可改善显著临床症状及预后,早期戒酒的措施值得临床借鉴。     

心脏彩超及心电图对高血压心脏病的诊断意义

目的探讨心脏彩超及心电图对高血压心脏病的诊断意义。方法回顾性分析114例高血压心脏病患者的心脏彩超及心电图资料,比较心脏彩超及心电图诊断高血压心脏病的阳性率。结果心脏彩超诊断高血压心脏病的阳性率为53.51%,心电图诊断高血压心脏病的阳性率为51.75%,心脏彩超诊断高血压心脏病的阳性率略高于心电图,但两组相比差异无统计学意义（P〉0.05）。结论心脏彩超及心电图诊断高血压心脏病的阳性率差异不大,但特异性上各有价值,心脏彩超可早期诊断高血压心脏病,而心电图可评定高血压心脏病的严重程度,因此在临床治疗中可联合应用两种检测方法 ,提高高血压心脏病的诊断率。     

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.     

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.