两种手术方法治疗环状混合痔的临床观察

目的比较吻合器痔上黏膜环切术（PPH术）与外剥内扎术治疗环状混合痔的疗效及并发症。方法90例环状混合痔手术患者,随机分为观察组和对照组,观察组采用PPH术,对照组采用外剥内扎术,比较两组患者手术时间、手术效果、住院时间、术后并发症发生率等。结果PPH术与外剥内扎术在手术时间、手术效果、住院时间、术后并发症发生率等方面比较,差异有统计学意义（P〈0.05）,PPH术有明显优势。结论治疗环状混合痔PPH术优于外剥内扎术。     

PPH术治疗静脉曲张型环状混合痔的回顾性研究

目的探讨吻合器痔环切术(PPH)术治疗静脉曲张型环状混合痔的临床疗效和并发症。方法回顾分析28例静脉曲张型环状混合痔行PPH术的临床疗效及并发症,并与同期行外剥内扎术的25例临床资料比较。结果 2组临床疗效的差异无统计学意义(P>0.05);PPH术组与外剥内扎术组相比,术后切口疼痛、肛缘水肿、大便时出血的差异有统计学意义(P<0.05)。结论 PPH术治疗静脉曲张型环状混合痔,临床疗效确切,术后并发症少。     

PPH术联合外剥内扎术治疗环状混合痔治疗体会

目的探讨PPH联合外剥内扎术治疗环状痔的临床疗效。方法回顾分析了2008年6月至2012年6月我院用PPH联合外剥内扎术治疗128例环状混合痔的临床资料。结果128例中除2例术后大出血外,其他病例恢复情况令人满意。结论PPH联合外剥内扎术治疗环状痔具有恢复快、并发症少、术后美观等优点。     

PPH联合外剥内扎术治疗环状混合痔的临床疗效观察(附127例报道)

目的探讨PPH联合外剥内扎术治疗环状混合痔的临床的临床效果。方法回顾性分析我科对127例环状混合痔的患者行PPH术,同时对部分痔核行外剥内扎术治疗的临床资料。结果全部病例术后肛门形态恢复良好,肛门平整,无水肿,无肛门失禁、无肛门狭窄、无术后大出血、无感染、无肛门溢气溢液等并发证。结论两种术式联合,具有多种优点,能够互补单一术式的不足。两种术式联合的优势为:手术产生创伤较小,手术安全性较高,进行手术后患者体感疼痛较轻,术后恢复较快,且因手术所产生并发症较少。最显著优势为对肛门功能方面进行保护,主要运用治疗环状混合痔,是临床使用较广且实效较好的方法,且拓展了PPH术的适应证。     

痔上黏膜环切术联合外剥内扎术治疗重度痔的临床观察

目的对吻合器痔上黏膜环切术（PPH）联合部分痔外剥内扎术治疗重度痔的临床效果进行评估。方法60例重度痔患者（Ⅲ、Ⅳ度）,分为A、B两组各30例,A组行PPH术;B组行PPH加部分痔外剥内扎术。对其术后疗效进行观察。结果近期：3d内肛门疼痛情况、一周内肛门排便时出血情况、一周内肛缘肿物情况、创口愈合平均时间（d）,远期：1年后肛门潮湿感、肛门肿物、肛门狭窄、痔复发,B组疗效优于A组。结论PPH联合应用部分痔外剥内扎术治疗重度痔疗效优于PPH术。     

PPH术与外剥内扎术治疗重度痔的疗效比较

目的探讨PPH术与外剥内扎术治疗重度痔的疗效。方法采用回顾性分析的方法,分析我院收治的重度痔患者临床资料,依据治疗方式不同分为PPH术组与外剥内扎术组。结果 PPH术组手术时间、术中出血量、住院天数均低于外剥内扎术组,PPH术组术后疼痛、便后出血、肛门狭窄、肛门失禁发生率均明显低于外剥内扎术组,提示预后较好。结论 PPH术治疗重度痔临床效果良好,创伤小、恢复快、并发症少,值得临床推广应用。     

PPH联合外剥内扎及皮瓣搭桥术治疗重度环状混合痔疗效观察

目的探讨吻合器痔上黏膜环切术（PPH）联合外剥内扎及皮瓣搭桥术治疗重度环状混合痔的疗效。方法 PPH联合外剥内扎及皮瓣搭桥术治疗环状混合痔75例（治疗组）与外剥内扎合皮瓣搭桥术治疗环状混合痔60例（对照组）进行手术效果比较;对2组手术时间、平均住院时间、术后疼痛、术中及术后出血、恢复工作时间等指标进行比较。结果治疗组手术时间、出血量、术后疼痛、住院时间、恢复工作时间明显优于对照组（P〈0.05）,术后肛门外观良好,无肛门狭窄、肛门失禁,随访无复发。结论 PPH联合外剥内扎及皮瓣搭桥术治疗重度环状混合痔既不损伤肛门括约功能,又能保持良好肛门外观,创伤小,痛苦小,恢复快,临床效果肯定。     

PPH与外剥内扎术治疗环状混合痔临床效果的对比研究

目的比较痔上黏膜环切(PPH)术与传统的痔外剥内扎术治疗环状混合痔临床效果。方法 62例环状混合痔患者随机分成A组和B组,A组32例,B组30例,分别进行PPH术(A组)和痔外剥内扎术(B组),观察记录手术时间、术中出血量和术后疼痛。结果痔PPH术组的手术时间(18.66±3.12)min、术中出血量(18.97±3.69)mL均优于痔外剥内扎术组(34.73±5.9)min、(42.27±7.33)mL(P<0.01),术后6h、术后第1次大便和术后3天疼痛程度(2.16±0.40)、(2.05±0.37)、(1.59±0.34)也明显优于外剥内扎术(7.67±1.22)、(7.28±1.11)、(6.74±1.18)(P<0.01)。结论痔PPH术治疗环形混合痔优于传统的痔外剥内扎术。     

PPH术加外剥内扎术治疗环状混合痔67例疗效分析

目的探讨吻合器痔上黏膜环切术（PPH术）加外剥内扎术治疗环状混合痔的临床疗效。为临床治疗环状混合痔提供科学有效的方法,提高其治愈率。方法选取2010年6月至2012年11月在我院就诊的环状混合痔患者134例,将其随机分为两组,治疗组67例患者采用PPH术加外剥内扎术进行治疗;对照组67例患者只进行PPH术,记录并比较两组患者的临床疗效以及出现的不良反应情况。结果经过治疗后,治疗组手术时间为20～40min,平均手术时间为29．3min;术后住院时间平均为6d;所有患者均治愈,术后患者的肛门平整,无水肿、肛门失禁、肛门狭窄、术后大出血、感染等并发症的发生。对照组手术时间30～50min,平均45min;术后住院时间平均为8d;共有40例患者治愈,治愈率为59．70％。结论PPH术加外剥内扎术治疗环状混合痔临床疗效显著、术后并发症少、住院时间短、恢复快,值得在临床上推广与应用。     

吻合器痔环切术(PPH术)治疗环状混合痔50例临床观察

目的PPH术与外剥内扎术治疗环状混合痔的疗效对比。方法2006年1月～2007年1月我科入院病人确诊为环状混合痔的100例手术病人随机分为治疗组和对照组,治疗组采用PPH术,对照组采用外剥内扎术,比较两组病人手术时间、愈合时间、住院时间、术后并发症等指标。结果PPH术在手术时间、愈合时间、住院时间、术后并发症发生率等方面均明显优于外剥内扎术。结论PPH术治疗环状混合痔优于外剥内扎术。     

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.     

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.