早期诊断异位妊娠78例分析和护理

目的评价疑未破裂异位妊娠患者的早期诊断及护理观察的重要性.方法对78例异位妊娠患者的病史、临床表现、腹部B超、血β-HCG或尿HCG检查及其辅助检查联合应用的比较分析.结果早期异位妊娠患者停经史发生率为87.18%,阴道流血者占80.77%,下腹痛及附件包块占67.95%,血β-HCG＞30μg/ml者占92.3%,尿HCG定性阳性者占70.5%,P＜0.01,有非常显著意义;同时出现典型停经、阴道流血、下腹痛、附件包块及血β-HCG＞30 μ g/m1的发生率为42.3%.结论结合病史辅以联合应用B超检查、血β-HCG检查可提高早期诊断确诊率.     

异位妊娠经腹部超声与阴道超声的对比分析

目的探讨异位妊娠经腹部超声与阴道超声的差异。方法收集我院手术治疗同时病理诊断为异位妊娠的患者,给予经腹部与阴道超声检查。分析(1)不同妊娠部位患者的临床症状。(2)不同妊娠部位患者停经时间、β-HCG值。(3)经腹部超声与阴道超声测定异位妊娠包块最大直径。(4)经腹部超声与阴道超声诊断准确率。结果 (1)输卵管妊娠组、子宫瘢痕妊娠组、宫颈妊娠组的临床症状(腹痛、停经、流产史、阴道流血)比较无差异(P>0.05)。(2)不同妊娠部位患者停经时间、β-HCG值比较无差异(P>0.05)。(3)经腹部超声与阴道超声测定异位妊娠包块最大直径值分别为(2.61±0.12)cm、(2.69±0.17)cm,比较有差异(P<0.05)。(4)经腹部超声与阴道超声诊断准确率分别为76.5%、98.0%,比较有差异(P<0.05)。结论阴道超声诊断异位妊娠诊断准确率高,配合β-HCG检查时,可以提高诊断正确率。     

早早孕流产与异位妊娠的鉴别诊断50例临床分析

目的探讨妊娠早期宫内早早孕流产与异位妊娠的鉴别诊断。方法对2005～2007年广东省东莞麻涌医院收治的50例早早孕流产和异位妊娠患者,进行回顾性分析其病史、临床症状、诊断性刮宫、病理检查结果、动态观察血β-HCG水平及诊治经过。结果诊断20例异位妊娠,30例早早孕流产(其中3例先兆流产,18例不全流产,9例稽留流产)。结论早早孕流产与异位妊娠在妊娠早期较难鉴别诊断,需综合分析病史、临床症状、诊断性刮宫、病理检查结果及动态观察血β-HCG水平,提高诊断准确率,减少误诊,早期发现异位妊娠,早期治疗以降低手术率。     

异位妊娠在基层医院的诊疗临床分析

目的 探讨基层医院对异位妊娠的临床诊断和治疗情况.方法 回顾分析异位妊娠60例的阴道超声诊断与药物治疗情况.60例患者均采用甲氨蝶蛉肌肉单次注射50 mg/m2治疗,连续治疗15 d后,观察患者血β-HCG、包块大小和统计住院时间.结果 60例患者经阴道超声诊断,误诊4例,误诊率为6.67%,误诊患者经血β-HCG检测后确诊,治疗后的血β-HCG和包块大小均小于治疗前,治疗前后比较差异具有统计学意义(P＜0.05),60例患者的平均住院时间为(9.2±2.2)d;结论 基层医院开展异位妊娠的阴道超声检查效果明显,甲氨蝶蛉治疗异位妊娠疗效确切,值得在基层医院中推广应用.     

异位妊娠在基层医院的诊疗临床分析

目的：探讨基层医院对异位妊娠的临床诊断和治疗情况。方法：回顾分析异位妊娠80例患者的阴道超声诊断与药物治疗情况。80例患者随机分为甲氨蝶呤组42例和米非司酮组38例,治疗15d后,观察两组患者血β-HCG、包块大小和住院时间等疗效指标,并进行统计分析。结果：80例患者经阴道超声诊断,误诊5例,误诊率为6.25%,误诊患者经血β-HCG检测后确诊;两组治疗后的血β-HCG和包块大小均小于治疗前,治疗前后比较差异有统计学意义（P〈0.05）;甲氨蝶呤组患者的血β-HCG、包块大小和住院时间均明显优于米非司酮组,两组比较差异有统计学意义（P〈0.05）;结论：基层医院开展异位妊娠的阴道超声检查效果明显,甲氨蝶呤治疗异位妊娠疗效优于米非司酮,值得在基层医院中推广应用。     

异位妊娠144例临床分析

目的 分析异位妊娠的有关因素,探讨及时诊断的方法.方法 对144例异位妊娠患者的孕产史、避孕方式、妇科疾病史、异位妊娠史、剖宫产史、临床表现、实验室及B超检查、误诊情况等进行分析.结果 人工流产史占83.3%,宫内节育器避孕者占17.4%,盆腹腔手术史占23.6%(其中剖宫产术占1.39%).结论 人工流产史、宫内节育器及盆腹腔手术史异位妊娠发病率高,血尿β-HCG检测及阴道B超、后穹窿穿刺是异位妊娠重要的诊断手段.     

宫外孕保守治疗的护理

<正>随着血、尿β-人绒毛膜促性腺激素(β-HCG)检测敏感性的提高和高分辨率阴道超声、腹腔镜等诊断技术的普遍应用,未破裂型输卵管型妊娠的早期诊断率明显提高。治疗方法由传统的输卵管切除术发展为保守治疗。现将我院2008年5月到2012年3月经保守治疗的16例宫外孕患者的临床观察及护理体会报告如下。1资料与方法1.1病例选择:1有停经史和(或)不规则阴道流血伴有下腹痛;2未破裂型异位妊娠,或已破     

异位妊娠的超声诊断与治疗方法

目的 探讨异位妊娠的超声诊断与治疗方法.方法回顾性分析我院妇产科143例异位妊娠患者的临床资料,采用经阴道超声检查和血β-人绒毛膜促性腺激素(β-HCG)诊断,治疗方法采用药物保守治疗、开腹手术和腹腔镜手术.结果 143例异位妊娠患者输卵管妊娠138例,宫角妊娠3例,宫颈妊娠2例.输卵管妊娠未破裂型43例,流产型48例...     

孕酮+血清β-HCG+阴道彩超联合用于宫内妊娠与异位妊娠诊断效果评价

目的分析评价孕酮、血清β-HCG与阴道彩超联合用于宫内妊娠与异位妊娠的诊断效果。方法选择近几年来我院进行诊治的80例疑似异位妊娠的患者作为研究对象,经诊断,宫内妊娠患者30例,作为对照组,异位妊娠患者50例,作为观察组。两组住院期间均给予孕酮、血清β-HCG与阴道彩超检查。观察测定两组患者的孕酮、血清β-HCG、子宫内膜的厚度。结果异位妊娠患者的血清β-HCG、孕酮值及阴道彩超测定的子宫内膜厚度明显低于宫内妊娠患者,孕酮、血清β-HCG与阴道彩超三种指标联合检测异位妊娠的诊断准确率(94%)明显高于单一采用血清β-HCG(62%)、孕酮(74%)及阴道彩超(72%)检测的诊断准确率,其差异具有统计学意义(P0.05)。结论在宫内妊娠与异位妊娠的诊断中应用孕酮、血清β-HCG与阴道彩超三者联合诊断的方法,提高了诊断的准确性,有较为广阔的临床应用前景。     

血清孕酮测定在异位妊娠早期诊断中的价值

目的:探讨血清孕酮、β-HCG测定在诊断异位妊娠早期的临床价值.方法:我们检测了66例孕6周内的异位妊娠患者血清孕酮HCG值,并以58例入院安胎成功的宫内早早孕患者血清孕HCG酮值作为对照.结果:异位妊娠组血清孕酮明显低于宫内早早孕组(P<0.01),取异位妊娠组血清孕酮值第95百分位为截断值,p95=47.6 nmoL/L,58例宫内早早孕仅2例患者的血清孕酮值低于此值,鉴别诊断的敏感性94.4%,特异性97.1%.结论:血清孕酮、β-HCG测定值对异位妊娠与宫内早早孕有良好的鉴别诊断价值.     

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.     

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.