姆趾C形皮瓣修复手指环形组织缺损

目的介绍一种修复手指环形组织缺损的姆趾C形皮瓣。方法在姆趾近节设计C形皮瓣移植于手指软组织缺损处结果本次临床应用姆趾C形皮瓣,受区皮瓣成活良好,外观满意,修复后的手指,外形近似健指,感觉、运动功能均达优良。供区给予植皮,供区外观满意且足趾功能不受影响,受区及供区的瘢痕均不明显。结论姆趾C形皮瓣移植修复手指环形组织缺损,是修复手指环形组织缺损较理想的方法。     

携带微型组织第二趾皮瓣游离修复拇、手指复合组织缺损的临床疗效观察

目的探析携带微型组织第二趾皮瓣游离修复拇、手指复合组织缺损的可行性及临床疗效。方法选择我院2010年9月至2012年1月期间收治的拇、手指复合组织损伤患者20例(23指)为研究对象,均采用携带微型组织第二趾皮瓣游离修复,观察其疗效。结果入选患者皮瓣均成活,供区植皮一期成活22趾,其中1趾植皮出现部分坏死,经过及时有效的治疗后愈合;患者在术后进行理疗以及功能锻炼,皮瓣为发生明显的萎缩以及色素沉着,感觉恢复良好2-PD5～8mm,患者对手指外形比较满意,修复指关节功能恢复良好。结论携带微型组织第二趾皮瓣游离修复拇、手指复合组织缺损是一种一期修复效果显著的手术方式。     

腓侧趾背动脉为蒂的拇趾趾背皮瓣修复手指软组织缺损

目的探讨腓侧趾背动脉为蒂的拇趾趾背皮瓣修复手指软组织缺损的临床效果。方法应用以腓侧趾背动脉为蒂的拇趾趾背皮瓣游离移植修复手指背侧、指腹较大面积的组织缺损。结果本组应用16例,皮瓣全部成活,皮瓣色泽、弹性接近正常,外形美观不臃肿,感觉功能恢复良好,对供足功能无明显影响。结论腓侧趾背动脉为蒂的拇趾趾背皮瓣是修复手指软组织缺损的良好方法,尤其适合指背软组织缺损。     

手足组织缺损治疗体会

目的：总结足背皮瓣修复手足组织缺损的经验，探讨足背皮瓣的应用价值。方法：切取足背皮瓣及其携带肌腱、拇甲瓣、足趾的复合组织瓣21例。采用游离移植及带蒂转移的方法，分别修复手部缺损17例及足踝部皮肤缺损4例。结果：20例皮瓣全部成活。1例皮瓣大部分成活。20例随访1～3年，皮瓣血液循环佳，皮肤质量好，感觉恢复好。复合移植修复的手部肌腱及再造的拇手指功能恢复满意。结论：足背皮瓣切取方便，移植成功率高，修复效果好。游离移植的最佳适应证是修复手部组织缺损，带蒂转移主要用于修复足踝部皮肤缺损。     

踇趾腓侧皮瓣游离移植修复手指指腹缺损的临床分析

目的探讨踇趾腓侧皮瓣游离移植修复手指指腹缺损的临床效果。方法分析我院2009年1月至2014年6月手足外科收治的80例手指指腹缺损患者临床资料,采用踇趾腓侧皮瓣游离移植修复手指指腹缺损。结果术后3个月手指指腹缺损治疗的优良率100%高于术后1个月手指指腹缺损治疗的优良率75%,P<0.05,差异均有统计学意义。结论踇趾腓侧皮瓣游离移植修复手指指腹缺损,踇趾腓侧皮瓣是最佳皮瓣选择之一,值得临床推广应用。     

应用股前外侧皮瓣与前臂皮瓣修复颌面部组织缺损的临床体会

目的比较游离股前外侧皮瓣与游离前臂皮瓣在修复颌面部组织缺损中的应用效果。方法对19例口腔颌面部肿瘤术后软组织缺损修复的病例(其中前臂皮瓣14例,股前外侧皮瓣5例;面积5 cm×6 cm~8 cm×10 cm,)进行分析总结,根据不同组织缺损的具体情况,应用不同组织瓣类型对缺损进行修复,并对术后效果和供区恢复情况进行评价。结果 19例移植皮瓣全部成活,术后随访患者的张口度、语言及吞咽功能、缺损区外形方面均恢复良好,在供区恢复情况及满意度方面。股前外侧皮瓣明显优于前臂皮瓣。结论股前外侧皮瓣能更好的降低供区的各种并发症,且组织量丰富,可塑性良好,是修复颌面部软组织较大缺损的理想游离皮瓣选择。     

第一趾腹腓侧皮瓣移植修复指腹缺损

目的介绍游离趾腹腓侧皮瓣移植修复拇、手指指腹缺损的临床效果。方法游离第一趾腹腓侧皮瓣修复拇、手指全指腹缺损67例。结果 67例皮瓣全部成活,术后随访6个月～3年,拇、手指外形满意,皮瓣两点分辨觉达6～10mm,手指活动功能良好。结论趾腹腓侧皮瓣移植术是修复指腹缺损外形及功能的首选方法。     

吻合血管组织移植53例临床经验

总结1986年以来用显微外科技术行吻合血管的组织移植53例,其中各种皮瓣14例,足趾移植拇、手指再造28例34指,趾甲皮瓣修复拇、指末节6例,趾关节移植修复指间关节2例,空肠及结肠移植重建咽食道3例。结果:1例皮瓣坏死,余均成活,效果良好。有可供吻合之血管的游离组织均可通过吻合血管而移植成活。因此,临床可根据不同病情设计多种多样的移植组织,使修复与再造效果越趋完美。     

多种组织瓣在手部创伤修复中的应用

目的探讨不同组织瓣修复手部组织缺损的临床效果。方法回顾分析我院应用组织瓣修复手部组织缺损95例的临床资料。结果本组皮瓣转移和移植68例,带蒂骨瓣转移16例,游离足趾移植11例,除2例皮瓣远端部分坏死外,所有皮瓣均成活。2例足拇趾甲皮瓣游离移植后出现伤口感染,经抗感染及局部换药治疗后愈合。术后随访3～24月,移植后皮瓣血运、弹性及成活良好,功能满意。结论应用不同组织瓣修复手部创伤,具有手术简便、安全、效果好、并发症少等优点。     

多种组织瓣在手部创伤修复中的应用

目的 探讨不同组织瓣修复手部组织缺损的临床效果.方法 回顾分析我院应用组织瓣修复手部组织缺损95例的临床资料.结果 本组皮瓣转移和移植68例,带蒂骨瓣转移16例,游离足趾移植11例,除2例皮瓣远端部分坏死外,所有皮瓣均成活.2例足拇趾甲皮瓣游离移植后出现伤口感染,经抗感染及局部换药治疗后愈合.术后随访3-24月,移植后皮瓣血运、弹性及成活良好,功能满意.结论 应用不同组织瓣修复手部创伤,具有手术简便、安全、效果好、并发症少等优点.     

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.