急诊腹腔镜治疗异位妊娠87例临床分析

目的探讨在紧急状态下腹腔镜治疗异位妊娠的临床价值.方法回顾分析应用急诊腹腔镜手术治疗87例异位妊娠的临床资料.结果所有的手术全部在腹腔镜下进行,无中转开腹,根据腹腔内积血量分为两组,Ⅰ组＜500ml,Ⅱ组≥500ml.比较两组患者手术时间,住院时间及术中出血量,经统计学检验差异无显著性(P＞0.05).结论腹腔镜手术为治疗异位妊娠的一种理想的手术方式,异位妊娠大出血不是腹腔镜手术的禁忌证,虽然腹腔内大量积血给手术增加了难度,但只要术中处理得当,均能成功完成手术.     

腹腔镜手术治疗异位妊娠52例临床分析

目的探讨腹腔镜手术治疗异位妊娠的临床效果。方法回顾性分析沈阳市沈北新区中心医院腹腔镜手术治疗异位妊娠52例与开腹手术60例的临床资料,比较两种手术在手术时间、出血量、术后肛门排气时间、住院天数等的不同。结果腹腔镜组的手术时间及术后生育率等与开腹手术组无明显差异,而住院天数、平均出血量等腹腔镜组明显少于开腹组。结论腹腔镜手术治疗异位妊娠创伤小、出血少、恢复快,是值得临床推广的手术。     

急诊腹腔镜治疗异位妊娠87例临床分析

目的探讨急诊腹腔镜治疗异位妊娠的临床价值。方法回顾分析急诊腹腔镜手术治疗87例和同期急诊开腹手术48例以异位妊娠的临床资料。结果87急诊腹腔镜手术均成功,无一例中转开腹。比较两组年龄、腹部手术史、既往盆腔炎病史和腹腔内积血量,经统计学检验,差异无显著性(P>0.05)。比较两组手术时间、术中出血量、术后肠蠕动恢复时间、术后镇痛及住院时间,两组差异有显著性或非常显著性(P<0.05,P<0.01)。结论腹腔镜手术为急诊治疗异位妊娠的一种理想的手术方式,异位妊娠大出血不是腹腔镜手术的禁忌证,虽然腹腔内大量积血给手术增加了难度,但只要术中处理得当,均能成功完成手术。     

腹腔镜在异位妊娠中的应用

目的 探讨腹腔镜手术在异位妊娠治疗中的临床应用。方法 将我院2002年2月～2005年2月腹腔镜手术治疗的88例异位妊娠的临床资料，与同期开腹手术治疗的96例异位妊娠各项指标进行比较。结果 腹腔镜治疗88例均获成功，无持续性异位妊娠发生。平均手术时间22．6min、术中出血量17．8ml，输血量0-600ml、住院天数3-4d．日常生活恢复时间4～12d，与开腹组相比差异有显著性（P〈0．05），腹腔镜组明显优于开腹组。结论 腹腔镜下治疗异位妊娠是一种安全、疗效确切的方法，具有切口小、术中出血少、创伤小、住院时间短、康复快、外观美容的优势，为异位妊娠首选治疗方法。     

腹腔镜手术治疗休克型异位妊娠的临床分析

目的 分析腹腔镜手术治疗失血性休克型异位妊娠的临床价值.方法 以腹腔镜手术治疗休克型异位妊娠64例为观察组,以往开腹手术的休克型异位妊娠70例为对照组,比较两组的异位妊娠部位及手术方式、手术时间、术中出血量、排气时间、术后住院天数.结果 观察组均应用腹腔镜手术完成,无中转开腹者,其手术时间、术中出血量与对照组比较差异无统计学意义(P>0.05);术后排气时间、住院时间与对照组差异显著(P<0.01).结论 在抗休克同时应用腹腔镜手术治疗休克型异位妊娠是安全有效的.     

妇科腹腔镜微创手术诊治异位妊娠的应用分析

目的 探讨分析妇科腹腔镜微创手术诊断和治疗异位妊娠的应用.方法 134例异位妊娠患者随机分为开腹手术组66例和腹腔镜微创手术组68例,根据异位妊娠的类型和部位以及患者有无生育要求选择手术方式,比较2组患者术中和术后情况.结果 腹腔镜微创手术的手术时间短,术中出血量低,且术后恢复快,住院时间短,2组比较有显著性差异（P＜0.01）.术后随访1～3个月,2组患者均未发现持续性输卵管妊娠和再次异位妊娠.结论 腹腔镜有助于早期诊断异位妊娠,且腹腔镜微创手术疗效好,创伤小,值得在临床中推广应用.     

两种不同手术方式在异位妊娠治疗中的应用

目的比较腹腔镜与开腹手术治疗异位妊娠的临床疗效。方法选取2007年1月～2011年1月笔者所在医院68例行腹腔镜手术的异位妊娠患者作为治疗组,68例开腹手术患者作为对照组。分析比较两组治疗的临床疗效。结果两组手术时间、术中出血量比较差异无统计学意义(P>0.05);肛门排气时间、住院时间比较差异有统计学意义(P<0.01);两组均无术中、术后出血等并发症发生,无持续性异位妊娠发生。结论腹腔镜手术治疗异位妊娠具有快捷微创、痛苦小,术后恢复快,住院时间短等优点,是治疗异位妊娠的首选手术方式。     

腹腔镜治疗异位妊娠48例临床效果分析

目的探讨腹腔镜治疗异位妊娠的临床效果。方法对比腹腔镜治疗异位妊娠与经腹手术治疗异位妊娠各48例进行分析。结果腹腔镜组输卵管妊娠43例，卵巢妊娠5例。对照组输卵管妊娠44例，卵巢妊娠4例。手术时间：腹腔镜组平均65min，对照组平均60min；出血量：腹腔镜组平均250ml，对照组平均350ml。术后排气时间：腹腔镜组平均6h，对照组平均24h。住院时间：腹腔镜组平均5d，对照组平均7．5d。术后7d血β-HCG均下降〉80％，或接近正常，无一例持续性妊娠发生。结论腹腔镜治疗异位妊娠具有安全、术后疼痛小、术后恢复快、住院时间短等优点。     

腹腔镜与开腹手术治疗异位妊娠临床观察

目的观察腹腔镜与开腹手术治疗异位妊娠的临床效果。方法选择2007年12月-2012年10月收治的异位妊娠接受腹腔镜手术治疗者178例作为腹腔镜组,另选取同期异位妊娠接受开腹术者133例作为开腹组。腹腔镜组予腹腔镜手术治疗,开腹组予常规开腹手术治疗。观察2组手术时间、住院时间、术中出血量、术后离床时间及术后恢复情况。结果腹腔镜组手术时间、住院时间、离床时间均短于开腹组,术中出血量少于开腹组,术后2d体温恢复率高于开腹组,差异均有统计学意义(P<0.05或P<0.01)。结论腹腔镜手术治疗异位妊娠有创伤小,手术时间短、术后恢复快、腹部几乎不留瘢痕的优势,可明显提高患者手术后的生活质量。     

腹腔镜治疗异位妊娠临床探讨

目的比较腹腔镜与开腹手术治疗异位妊娠的临床效果。方法将80例异位妊娠患者随机分为腹腔镜组和开腹组各40例。观察比较2组手术时间、术中出血量、术后肛门排气时间、住院时间。结果腹腔镜组手术时间、术后肛门排气时间、住院时间均短于开腹组,术中出血量少于开腹组,差异均有统计学意义(P<0.05)。结论腹腔镜用于治疗异位妊娠患者创伤小,安全有效,术后恢复快,值得临床推广应用。     

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.     

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.     

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.