超声诊断腹腔内空腔脏器穿孔的临床应用价值

目的探讨超声在诊断腹腔空腔脏器穿孔中的临床应用价值。方法回顾性分析18例经手术和病理证实的腹腔空腔脏器穿孔患者的超声声像图,并与X线检查结果对照分析,比较两种方法的诊断符合率和腹腔游离气体的检出率。结果术前采用腹部探头及高频探头联合超声检查12例(66.7%)发现腹腔游离气体,且均探及腹腔积液,略高于X-线平片的61.1%(P>0.05)。另7例X-线平片未发现游离气体的患者中有3例(27.8%)超声检查探及腹腔积液,超声检查的总体符合率为83.3%(15/18),而显著高于X-线片的66.7%(P<0.05)。结论超声不仅可发现腹腔空腔脏器穿孔时的游离气体,而且可探及腹腔积液,有助于早期诊断,可作为诊断腹腔空腔脏器穿孔的首选影像学检查方法。     

探析超声诊断在外伤性胃肠道穿孔中的临床应用价值

目的分析超声诊断在外伤性胃肠道穿孔中的临床应用价值。方法本文所选100例外伤性胃肠道穿孔患者均为我院2015年2月至2017年10月所收治,术前全部患者均给予X线检查和超声检查,观察比较检查结果。结果在定位诊断率、外伤性胃肠道穿孔检出率、腹腔包块检出率以及腹腔积液检出率方面,超声检查均显著高于X线检查(P <0.05)。结论在对外伤性胃肠道穿孔患者进行检查诊断时,超声检查能进行准确定位,具有较高的胃肠疾病检出率,能让误诊率显著降低。     

螺旋CT在急性早期胃肠道穿孔中的临床诊断价值

目的 探讨螺旋CT扫描在急性早期胃肠道穿孔中的临床应用价值.方法 回顾性分析经手术病理确诊的急性早期胃肠道穿孔患者38例,所有患者术前均行螺旋CT扫描和腹部X线片检查,观察和比较两种方法的诊断结果以及影像表现.结果 X线检查准确率为63.2％,螺旋CT检查准确率为89.5％,螺旋CT扫描检查准确率明显高于X线检查,两者差异具有统计学意义(x2=7.28,P＜0.01).X线平片对少量游离气体及非膈下积气如腹膜后、小网膜囊等部位显示较差,螺旋CT则具有明显优势,且能做出较准确的定位和病因诊断.结论 螺旋CT较立位腹部平片能更早、更准确地发现腹腔少量游离气体,在诊断早期胃肠道穿孔中准确率较高,而且能为定位诊断和病因诊断提供更多有价值的信息.     

螺旋CT在早期胃肠道穿孔中的临床诊断分析

目的螺旋CT在早期胃肠道穿孔中的诊断。方法回顾性分析经手术确诊早期胃肠道穿孔患者30例,所有患者均采用腹部X线检查和双层螺旋CT扫描,比较和观察两种方法诊断结果以及患者肠壁增厚、腹腔游离气体、腹腔及腹膜后腔积液在两种方法中显示情况。结果腔积气20例(66.7%)、腹腔积液6例(20%)、腹腔脓肿2例(6.7%)、有其他并发症者2例(6.7%)。结论依据SCT征象对胃肠的道穿孔部位可在术前做出较为准确诊断。     

多层螺旋CT扫描在急腹症胃肠道穿孔中的应用价值

目的：探讨多层螺旋CT（MSCT）扫描在急腹症胃肠道穿孔中的应用价值。方法：对30例经手术证实的胃肠道穿孔患者的临床资料和影像学表现进行回顾性分析。结果：X线平片诊断胃肠道穿孔23例,诊断率为76.67%,表现为膈下游离气体。MSCT扫描诊断胃肠道穿孔30例,诊断率为100.00%,其中有16例为十二指肠球部前壁胃穿孔,8例为胃小弯前壁穿孔,6例为胃窦前壁穿孔,表现为腹腔内游离气体。结论：与X线平片检查相比较,MSCT扫描能更早、更准确地诊断胃肠道穿孔,并能为其定位和病因提供重要的诊断依据。     

CT在胃肠道穿孔诊断中的临床应用价值

目的:评价CT在胃肠道穿孔诊断中的临床应用价值。方法:29例经手术证实的胃肠道穿孔患者术前均行腹部平片和CT扫描检查,分析其表现,比较两种检查方法的诊断结果。结果:29例中腹内游离气体验出率,X线平片为69.0%,CT为89.7%,两种检查方法检出率比较差异有显著性(P<0.05)。术前CT对胃肠道穿孔病因诊断符合率为86.2%。结论:CT在胃、肠道穿孔及其病因和并发症的诊断中有明显优势。     

28例早期胃肠道穿孔的螺旋CT诊断的应用价值

目的：探讨螺旋CT在早期胃肠道穿孔中的临床诊断效果及应用价值。方法：回顾性分析经手术确诊的早期胃肠道穿孔患者28例,所有患者均采用双层螺旋CT扫描和腹部X线检查,观察和比较两种方法的诊断结果以及患者腹腔游离气体、肠壁增厚、腹腔及腹膜后腔积液在两种方法中的显示情况。结果：X线检查准确率为64.3%,螺旋CT检查准确率为89.3%,螺旋CT扫描检查准确率明显高于X线检查,二者比较差异显著,具有统计学意义（x2=7.26,P〈0.01）;患者腹腔游离气体、肠壁增厚、腹腔及腹膜后积液的显示情况在螺旋CT扫描检查中更清晰和明确,二者比较差异显著,具有统计学意义（P〈0.05）。结论：螺旋CT在诊断早期胃肠道穿孔中准确率较高,能够更好地配合医生对患者的病情进行分析及治疗,有助于改善患者的生存质量和病情预后情况,其扫描层次清晰、分辨率高、诊断准确,值得临床进一步推广应用。     

急性胃肠道穿孔的超声诊断分析

急性胃肠道穿孔为临床常见急腹症,发现腹腔游离气体是作出诊断的有力依据。既往诊断急性胃肠道穿孔一般依赖于临床症状、立位X线腹透和腹穿,超声诊断则相对困难,我科经超声检查急性胃肠道穿孔20例,现将其声像图特征总结如下。1资料及方法患者20例,年龄36～78岁,男14例,女6例,均因急性腹痛来我科行常规腹部超声检查。临床症状为:中上腹剧烈疼痛、部分合并腹肌紧张、压痛、反跳痛,严重者有面色苍白、出冷汗、血压下降等。检查仪器为SIMEMENS—Adara ,探头频率2 6～5 0MHz。受检患者取仰卧位、部分增加侧卧位,行常规中上腹超声检查后,扩大…     

外伤性胃肠穿孔应用超声诊断的临床价值研究

目的：探讨超声诊断外伤性胃肠穿孔的临床价值。方法：手术前，研究组患者进行超声诊断，对照组患者给予X线诊断，比较两组患者的外伤性胃肠穿孔的检出率、腹腔游离气体检出率以及定位诊断符合率。结果：研究组患者腹腔游离气体检出率明显低于对照组患者，对外伤性胃肠穿孔检出率明显高于对照组，两组差异存在统计学意义（P＜0.05）。超声可进行定位诊断，对照组患者进行X线诊断，不具有定位诊断功能。结论：超声在对腹腔游离气体的检出率方面虽然没有X线理想，但是，超声对外伤性胃肠穿孔综合检出率，明显高于对照组，另外还可进行穿孔部位定位诊断，提高诊断的准确性，对外伤性胃肠穿孔治疗具有重大的临床意义。     

超声诊断消化道穿孔的临床价值

目的探讨超声在消化道穿孔诊断中的临床价值。方法对30例经手术和病理证实为消化道穿孔患者的声像图进行回顾性分析,并与X线检查结果对比、分析。结果超声诊断腹腔积气22例占70%,腹腔积液28例占93.3%,腹腔包块15例占50%,X线-发现腹腔游离气体23例占76.6%。结论超声诊断消化道穿孔优于X线-,提高消化道穿孔早期诊断率,在外科急腹症中具有鉴别诊断价值。     

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.