快速康复外科理念在胆道外科围手术期护理中的应用价值

目的探讨快速康复外科理念在胆道外科围手术期护理中的应用价值。方法将600例胆道疾病患者随机分为观察组和对照组各300例。观察组将快速康复外科理念融入胆道外科围手术期护理中,对照组仅采用常规胆道外科围手术期护理方案。比较2组护理效果。结果观察组平均住院时间、首次排便时间短于对照组,平均住院费用少于对照组,差异均有统计学意义（P〈0.05）。结论将快速康复外科理念融入胆道外科围手术期护理中,能够缩短患者的住院时间,减轻其经济负担,促进其术口康复,提高手术疗效,值得临床进一步推广应用。     

快速康复外科护理措施在结直肠癌患者围术期的应用

目的：探讨快速康复外科护理措施在结直肠癌患者围术期的应用及效果。方法：对本院2009年6月～2010年11月采取快速康复外科护理的34例结直肠癌患者（观察组）,和采取常规护理的34例患者（对照组）的护理记录进行分组对照分析。结果：采取快速康复外科护理措施的观察组胃管留置时间、首次排便时间显著少于采取常规护理的对照组,P〈0.01,尿管留置、进食、肛门排气、住院等时间均少于对照组,P〈0.05,差异有统计学意义。在尿管留置时间、再住院次数方面无显著差异,P〉0.05,差异无统计学意义。结论：对围术期结直肠癌患者采取快速康复外科护理措施效果确切,值得临床推广应用。     

快速康复外科理念在高龄患者结直肠癌围术期护理中的应用效果

目的 探索快速康复外科理念在高龄患者结直肠癌围术期护理中的应用效果。方法 选择60例行结直肠癌手术的高龄患者,随机分为快速康复组和对照组,各30例。对照组采用传统护理方法 ,快速康复组采用快速康复外科理念。比较两组的下床时间、排气时间、住院时间及并发症发生率。结果 快速康复组的下床活动时间、排气时间、住院时间短于对照组,差异有统计学意义（P〈0．05）。快速康复组的肺部感染、切口感染及腹胀发生率均低于对照组,差异有统计学意义（P〈0．05）。结论 对结直肠癌手术后的高龄患者选择性地应用快速康复外科理念效果明显优于传统护理方法 。     

肝胆管结石合并门脉高压围手术期快速康复护理

目的：探讨肝胆管结石合并门脉高压围手术期快速康复护理临床效果。方法：将60例肝胆管结石合并门脉高压症患者随机分为快速康复组和传统护理组,每组各30例。观察2组患者术后下床活动时间、进食时间、首次排便时间、住院时间、住院总费用和并发症发生率。结果：快速康复组术后下床活动、进食、首次排便时间提前,住院时间缩短,住院总费用减少（P＜0.05）。2组并发症发生率比较无显著性差异（P＞0.05）。结论：肝胆管结石合并门脉高压围手术期快速康复临床护理是安全和有效的,可加快患者康复。     

快速康复外科理念在肝切除患者围手术期护理的应用研究

目的 探讨快速康复外科理念在肝切除患者围术期护理中应用的效果.方法将60例患者随机分为观察组和对照组,对照组采用常规围手术期护理方法,观察组在快速康复外科理念指导下的优化围手术期护理流程.结果 术后痛指数、睡眠状况、首次排气时间、术后住院天数费用,观察组均显著少于对照组(P<0.05),但两组并发症发生率比较无统计学差异(P>0.05).结论 快速康复外科理念在肝切除围手术期护理中的应用是安全、有效的.     

快速康复外科理念对宫颈癌根治术围术期患者康复的影响

目的 探讨快速康复外科（FTS） 理念对宫颈癌根治术后患者康复进程的影响.方法 168例宫颈癌根治术后患者按随机数字表法分为对照组和观察组,每组84 例,对照组给予按宫颈癌根治术常规护理,观察组给予FTS 护理干预;比较两组术前焦虑、术后肛门排气时间、并发症发生率、术后住院时间.结果 与对照组比较,观察组患者术前焦虑好转（P〈0.05）、术后肛门排气时间、术后住院时间,均明显缩短（P〈0.05）,该组总体并发症（伤口感染、尿储留、淋巴囊肿）发生率明显少于对照组（P〈0.05）.结论 快速康复护理措施的应用加快妇科宫颈癌根治术后患者术后康复进程,减少并发症的发生、缩短住院时间.     

快速康复外科理念在腹腔镜胆囊切除术围手术期护理中的临床效果

目的研究腹腔镜胆囊切除术围术期应用快速康复外科理念的效果。方法分析我院收治的76例胆囊结石患者临床资料,均接受腹腔镜胆囊切除术,按照随机双盲法分两组,对照组(36例)、观察组(40例)分别实施常规围术期护理干预、快速康复外科理念护理,比较两组不同护理方法应用效果。结果观察组手术指标(手术时间、术后下床时间、术后肛门排气时间、术后住院时间)少于对照组,并发症发生率少于对照组,组间差异存在统计学意义(P <0.05)。结论腹腔镜胆囊切除术围术期护理中采用快速康复外科理念护理干预,可促患者病情早日康复,减少术后并发症,临床应用价值显著。     

快速康复流程在结肠肿瘤围手术期的应用研究

目的：探讨快速康复流程在结肠肿瘤围手术期的应用疗效.方法：将56例结肠肿瘤择期手术患者随机分为观察组和对照组,每组各28例,分别予以围手术期快速康复流程和常规方法处理,并观察2组患者术后首次排气、首次进食、术后并发症及住院时间等指标.结果：观察组患者肛门排气、首次进食时间及平均住院日较对照组明显缩短（P＜0.05）,术后并发尿潴留及肺部感染的发生率也显著降低（P＜0.05）,但其余并发症组间比较无显著性差异（P＞0.05）.结论：在结肠肿瘤患者围手术期应用快速康复流程安全有效,利于患者术后康复.     

腹腔镜胆囊切除术围手术期小便护理与快速康复

目的:探讨腹腔镜胆囊切除术围手术期小便护理与快速康复的关系.方法:治疗组500例腹腔镜胆囊切除术患者在术前、术后进行排尿护理指导,术中、术后限制液体入量.对照组500例腹腔镜胆囊切除术患者在围手术期进行普通常规护理.结果:两组患者在手术中的麻醉和手术时间、术中出血量的差异无显著性意义(P＞0.05),治疗组的术中输液量少于对照组,差异有极显著意义(P＜0.01).治疗组术后导尿89例,对照组导尿192例,有极显著差异(P＜0.01).术后两组在下床活动时间、禁食时间及住院天数上的差异有显著意义(P＜0.05).结论:腹腔镜胆囊切除术围手术期重视小便护理可加快患者康复,缩短住院时间.     

加速康复外科理念在退变性腰椎滑脱症患者围手术期护理中的应用效果

目的：探讨加速康复外科（ enhanced recovery after surgery ,ERAS）理念在退变性腰椎滑脱症患者围手术期护理的应用效果。方法采用临床前瞻性对照研究。选取2012年4月至2014年4月河北医科大学第三医院脊柱科收治的退变性腰椎滑脱症患者60例,随机分成对照组和观察组,每组30例。对照组采取围手术期常规护理措施,观察组在围手术期常规护理措施的基础上,再给予ERAS理念指导下的护理干预措施,比较2组患者术后并发症的发生率、住院时间、住院总费用、患者满意度。结果观察组在并发症的发生率、住院时间、住院总费用、患者满意度方面优于对照组,差异有统计学意义（ P <0洓．05）。结论 ERAS理念指导下的护理措施有利于提高退变性腰椎滑脱症患者围手术期护理的临床效果,有利于加速患者术后康复,减少并发症的发生,缩短住院时间,节省医疗费用并提高患者满意度,值得推广应用。     

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.     

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.