离体颅骨低温保存的研究

目的 探讨自体颅骨回植治疗颅骨缺损的方法。方法 把离体颅骨瓣放置于自制培养液中-10℃左右低温冷藏，3-12个月后再植于患者。结果 在自制培养液中体外低温保存的30例颅骨瓣标本经病理组织检查仍有活性，其中6例回植于病人后成活良好。结论 自体骨瓣回植治疗颅骨缺损是一种很好的治疗选择。     

医用酒精保存自体颅骨回植的临床研究

目的 采用医用酒精保存自体颅骨再二期回植进行颅骨缺损的修补.方法 于第一次去骨瓣减压术后,将骨瓣表面的软组织剔除干净,而后置入75%酒精溶液中浸泡并密封保存,贴好标有患者姓名、年龄的标签,每月更换酒精一次,3个月后行二期颅骨回植.结果 脑外伤标准大骨瓣减压术后自体颅骨回植18例,治疗效果满意,随访24个月,未见颅骨凹陷,无颅骨回缩,无伤口感染.结论 医用酒精自体颅骨回植是标准外伤大骨瓣减压术后颅骨修补的有效方法.     

自体骨瓣皮下包埋后回植治疗颅骨缺损18例

总结１８例自体骨瓣回植治疗颅骨缺损。术中采用自体骨瓣埋于腹部皮下脂肪１６例，埋于大腿内侧２例。于一期术后２月内将骨瓣回植。本方法具有简便易行，减压充分，术后并发症少，可保持骨瓣活力，真正维护了颅骨完整性等优点。除２例术后一周内死亡及１例腹部骨瓣部分吸收外，余疗效满意。     

自体骨瓣回植加颅骨锁钉固定治疗颅骨缺损临床报告

目的：探讨采用自体颅骨瓣回植外加颅骨锁钉固定进行颅骨修补术的可行性及临床经验。方法：对2003年7月～2010年1月收治的18例因急性颅脑损伤或高血压脑出血行去骨瓣减压术后患者采用自体颅骨瓣复位回植外加颅骨锁钉固定治疗颅骨缺损，对其疗效进行随访观察。结果：所有患者均一期愈合，无并发症，随访1～3年，X线及CT复查显示回植骨边缘吸收未超过颅骨锁钉范围，头颅外观及颅骨牢固度良好，部分患者有新生骨痂形成，所有患者临床症状均有不同程度改善。结论：自体骨瓣回植治疗颅骨缺损，方法简单、实用、经济，更好地恢复了颅腔解剖结构和头颅外观，外加颅骨锁钉固定可有效地防止回植骨松动、凹陷，是一种值得推广的方法。     

体外自然干燥骨瓣颅骨锁固定治疗颅骨缺损20例临床分析

目的探讨采用体外自然干燥、室温下保存的自体骨瓣回植外加颅骨锁固定进行颅骨修补术的可行性及临床经验。方法选取20例颅骨缺损患者，采用体外自然干燥、室温下保存自体颅骨瓣回植外加颅骨锁固定治疗颅骨缺损，随访观察临床疗效，总结临床经验。结果所有患者均一期愈合，无并发症，随访12～18个月，头颅外观及颅骨牢固度良好，x线复查显示骨瓣密度均匀，较正常颅骨无明显异常。结论体外自然干燥骨瓣颅骨锁固定治疗颅骨缺损可更好地恢复颅腔解剖结构和头颅外观，有效防止回植骨松动、凹陷，值得临床推广。     

超低温冷藏自体颅骨回植治疗颅骨缺损(附18例报告)

将所取出的颅骨瓣超低温冷藏贮存,待需颅骨修补时,将已超低温冷藏的活骨组织自体颅骨瓣复温后回植,手术后可达到自体颅骨愈合的目的,从而改变了颅骨修补的手术方式。随访达2年,X线摄片示回植颅骨瓣生长良好,无1例发生回植自体颅骨瓣坏死吸收。     

自体颅骨回植中不同颅骨保存方法的比较研究

目的 探讨人自体颅骨离体保存回植修复颅骨缺损的方法和疗效.方法 采用超低温冷藏、蜂蜜浸泡冷冻保存和自然干燥室温自体颅骨保存法后行回植术,观察各自疗效.结果 3种体外自体颅骨保存的自体颅骨回植临床疗效均显著,并发症少.结论 超低温冷藏、蜂蜜浸泡冷冻保存和自然干燥室温保存自体颅骨原位回植方法安全、简便、临床效果好,值得推广.     

去骨瓣颅骨冷冻保存和灭活再植的临床应用研究(附43例报告)

目的探讨自体颅骨的冷冻保存和灭活再植的可行性和优越性。方法43例去骨瓣减压术后颅骨瓣无菌保存于普通冰箱冷冻室,二期修补手术时将骨瓣煮沸灭活回植,观察临床效果,并对病人定期颅脑CT复查随访。结果骨瓣解剖复位,与周围骨窗骨性愈合良好,外形美观,无并发症及不良反应。结论自体颅骨冷冻保存后灭活再植是一种经济、简便、效果良好、值得推广的好方法,灭活自体颅骨是颅骨修补的理想材料。     

自体腹壁下保存颅骨瓣钛颅骨锁固定修补颅骨缺损

目的探讨自体腹壁下保存颅骨瓣修补颅骨缺损的方法和疗效。方法将去骨瓣减压开颅术患者的骨瓣随机分为三组：A组保留成片骨膜，B组常规游离骨瓣，C组无骨膜游离骨瓣。骨瓣埋藏保存于左下腹壁皮下，择期取出自体颅骨瓣，采用钛颅骨锁固定于骨窗修补颅骨缺损。结果所有骨瓣周径均不同程度缩小；A组和B组骨瓣在回植前取出时均有较完整的骨膜（80％～100％）再生，C组没有或很少有骨膜再生；全部患者无一例皮下积液，无一例感染，成形效果均满意。结论常规游离骨瓣在左下腹壁皮下埋藏保存2～3个月后取出时均有完整骨膜，有利于回植时骨瓣与骨窗更好地骨性连接。自体腹壁下保存颅骨瓣修补颅骨缺损虽有不同程度骨瓣缩小，但采用钛颅骨锁固定骨瓣能取得满意效果。     

颅脑外伤术后颅骨缺损自体骨瓣回植修补术的临床体会

【摘要】目的 探讨颅脑外伤术后颅骨缺损自体骨瓣回植修补术的临床效果 方法 选择我院自2003年1月-2009年6月间40例颅脑术后颅骨缺损患者,按年龄段分为2组：8-22岁24例为I组,23-58岁年龄组16例为II组。将患者术中切取的骨瓣去骨膜浸入无菌生理盐水中,普通冰箱内冷冻保存,在颅骨修补术前室温解冻,并取出用2%戊二醛浸泡,庆大霉素无菌生理盐水冲洗后回植骨窗。I组24例患者用粗丝线将骨瓣与颅骨固定;II组16例患者用颅颌骨内固定夹板钛钉将骨瓣与颅骨固定,术后随访,观察疗效。 结果 术后所有患者切口一期愈合,回植后切口及颅内无1例出现感染,I组24例患者在1-1.3年内达到骨性愈合;II组14例在1.3-5年内达到骨性愈合,其中2例出现骨逢增宽,骨瓣边缘有骨质轻度吸收改变,却无1例出现颅骨轻度塌陷,且I组24例患者回植骨瓣与患者头颅生长同步,不影响外观。结论 颅脑外伤术后颅骨缺损自体骨瓣回植修补术术后恢复理想,不受因患者年龄小而不宜修补的限制,且成本低,副作用小,经济实惠,值得提倡和推广     

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.