外伤性基底节区血肿的诊断和治疗

目的探讨外伤性基底节区的发病机制、临床特点、诊断与鉴别诊断、治疗和结果。方法回顾分析35例外伤性基底节区血肿患者的临床资料。结果本组外伤性基底节区血肿占闭合性颅脑创伤的2.22%,多为车祸伤,多发生于对冲部位,伤后早期出现偏瘫,而意识障碍较轻且合并弥漫性轴索损伤的发生率较高。手术治疗8例,保守治疗27例,在伤后6个月根据GOS评分:良好10例、中15例、重残1例、死亡9例。结论CT是外伤性基底节区血肿的首选检查方法,动态CT扫描有利于发现迟发性基底节区血肿。外伤性基底节区血肿发病率低而致残率较高,外伤性基底节区血肿只要早期诊断,积极而恰当的治疗,大部分患者预后较好。     

外伤性基底节区血肿42例临床分析

外伤性基底节区血肿是CT广泛应用之后才发现的特殊部位的血肿,血肿位于基底节区域或者其临近结构,可分为单纯基底节区血肿和复合性基底节区血肿,我科1984—2002年共收治外伤性基底节区血肿(TBGH)42例,现报告如下。1资料与方法1.1一般资料:男性29例,女性13例,年龄16～72岁,车祸伤38例,坠落伤3例,其他原因致伤1例。     

外伤性基底节区血肿的临床诊治探讨

目的分析外伤性基底节区血肿的临床特点,探讨有效的临床诊治方案。方法回顾性分析我院2008～2011年间收治的42例外伤性基底节区血肿患者的临床资料。结果治疗后随访6～24个月,根据格拉斯哥预后分级(GOS)评价标准对治疗结果进行评价:良好31例(73.8%),中残3例(7.1%),重残4例(9.5%),植物生存状态2例(4.8%),死亡2例(4.8%)。结论外伤性基底节区血肿可通过CT检查,确定多发伤,对病情做出早期正确的诊断,针对患者不同的临床特点采取针对性的治疗和康复措施能够有效的降低临床致死、致残率,改善患者的预后。     

外伤性基底节区出血的诊断和治疗

目的 探讨外伤性基底节区出血临床诊断和治疗的特点.方法 回顾性分析50例外伤性基底节区出血患者的临床资料.结果 本组外伤性基底节区出血占同期颅脑外伤的4.0％,大多发生于着力点的对侧,伤后早期即出现偏瘫症状,大部分病例都会合并有颅内其他部位的损伤,头颅CT动态观察是其最好的诊断手段.本组手术治疗13例,保守治疗37例,伤后半年格拉斯哥预后评分(GOS):良好9例,中残27,重残5例,死亡9例.结论 动态CT观察是外伤性基底节区出血的首选诊断方法,本病发生率低,但病死率和致残率均较高,尽早的发现和恰当的治疗仍能挽救一部分患者的生命.     

外伤性基底节区出血外科治疗预后判断与对策

目的.分析影响外伤性基底节区出血外科治疗预后的各种因素,探讨合适的治疗方法。方法:对手术治疗26例外伤性基底节区出血的临床资料进行回顾性分析。结果:意识障碍愈深、有发生脑疝者、血肿量愈大、血肿破入脑室特别是破入三、四脑室的死亡率愈高。结论:根据不同的病情和血肿是否破入脑室情况选择手术方法。     

外伤性基底节区血肿25例治疗体会

目的探讨外伤性基底节区血肿(TBGH)的发病机制、诊断、治疗和结果。方法回顾性分析收治的25例急性颅脑损伤后合并基底节区血肿患者的病史、临床表现、颅脑CT及治疗经过。结果依患者的意识状态、血肿大小及全身状况选择手术或非手术治疗,其中保守治疗18例,2例死亡;手术治疗7例,3例死亡。结论外伤性基底节区血肿病死率和致残率均较高,及时发现病情变化并采取积极而恰当的治疗,能在一定程度上提高生存率。     

外伤性基底节区血肿42例临床分析

外伤性基底节区血肿(traumatic basal ganglia hematomas,TBGH)可分为单纯性基底节区血肿和复合性基底节区血肿[1].我科1999年～2005年共收治TBGH42例,现报道如下.     

急性外伤性脑干出血综合治疗的临床分析

目的:探讨外伤性脑干血肿的诊断、治疗方法.方法:对17例外伤性脑干血肿的临床资料进行回顾性分析.结果:17例中12例采取保守治疗,5例经手术治疗.随访6个月～2年,按G0S分级:良好4例,中残3例,重残3例,植物生存2例,死亡5例.结论:手术治疗、高压氧、亚低温、神经节苷脂等综合治疗是目前治疗外伤性脑干血肿的主要方法.     

外伤性迟发性颅内血肿29例分析

目的:总结29例外伤性迟发性颅内血肿病人的临床特点、诊治经验.方法:对29例外伤性迟发性颅内血肿病人进行回顾性分析.结果:手术治疗17例,痊愈13例,好转2例,死亡2例;非手术治疗11例,痊愈11例.1例手术前准备时死亡.结论:CT扫描复查是早期诊断迟发性颅内血肿的首选方法,对于有颅骨骨折者应提高警惕,及时手术,预后好.     

外伤性迟发性硬膜外血肿临床分析

目的探讨外伤性迟发性硬膜外血肿原因,引起临床医师重视,提高其治疗效果。方法回顾性总结近年来68例外伤性迟发性硬膜外血肿临床特征、CT特点及救治体会。结果血肿量〉30ml44例患者行手术治疗,其余24例行保守治疗;其中死亡5例,伤残6例,恢复良好57例。结论密切临床观察、动态CT复查及合理治疗是提高伤性迟发性硬膜外血肿疗效的关键。     

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.