泪小管断裂显微吻合术67例临床分析

目的探讨寻找泪小管断端及顺利吻合泪小管的方法。方法利用手术显微镜直视下寻找泪小管断端,然后插入硬膜外麻醉导管吻合泪小管。结果术后4～6个月拔管,随访1年。治愈59例,占88.06%;好转7例,占10.45%;未愈1例,占1.49%。结论在手术显微镜下寻找泪小管断端,联合植入硬膜外麻醉导管。泪小管吻合术成功率高,值得临床推广。     

硬膜外麻醉导管在泪小管修复术中的应用

目的探讨硬膜外麻醉导管在外伤性泪小管断裂修复术的效果。方法收治15～68岁外伤性泪小管断裂18例(18眼),在手术显微镜下寻找到泪小管断端后置管,然后断端用10-0缝线对接缝合3～4针,1～3月后拔管,随访观察泪道畅通情况。结果 18例都在手术显微镜下成功寻找到泪小管的两断端。痊愈15例(83.30%),好转3例(16.70%)。结论置入硬膜外麻醉导管直径0.8mm(硅胶管)支撑物,可减少睑缘位置改变和泪小点损伤,无刺激性,可较长时间留置。适合在临床上推广使用。     

硬膜外导管滞留治疗泪小管断裂

目的对36例硬膜外导管滞留治疗泪小管断裂的疗效观察。方法做筛前、眶下神经阻滞麻醉,在显微镜下找到泪小管鼻侧断端。用带针芯的硬膜外导管的圆头由泪点插入,从泪小管颞侧断端穿出,再插入鼻侧断端向泪囊推进达泪囊内侧骨壁、转垂直向下达鼻泪管,拔出针芯。吻合断端泪小管。2～3个月拔出硬膜外导管。结果手术在显微镜下全部吻合成功,随访3～12个月后,28例成功,4例失败。结论伤后及时就诊．寻找鼻侧断端,显微镜下手术,应用支撑物,以及术后定期随诊,会取得较为满意的效果。     

下泪小管断裂吻合术58例临床分析

目的探讨在手术显微镜下行下泪小管断裂吻合术的效果。方法 58例下泪小管断裂患者,在手术显微镜下找到泪小管断端,以硬膜外麻醉导管作为泪小管内支撑物,对断端进行显微手术吻合,观察效果。结果 58例下泪小管断裂患者均在手术显微镜下找到泪小管断端,并顺利实施泪小管吻合术。术后随访6~24个月,53例患者无溢泪,泪道冲洗通畅,治愈53例,治愈率达91.38%。结论在手术显微镜下行下泪小管断裂吻合术,易于寻找泪小管的断端,操作准确方便,手术成功率较高,值得临床推广应用。     

泪小管断裂吻合术疗效分析

目的评价外伤性泪小管断裂吻合术疗效。方法在手术显微镜下寻找到泪小管断端后插入硬膜外麻醉聚乙烯管做支撑物,然后断端用8-0缝线对接缝合3-4针。结果59例都能在手术显微镜下成功找到泪小管的两断端。痊愈37（62．2％）．好转19例（32.2％）,无效3例（5．6％）。结论用硬膜外麻醉聚乙烯管做支撑物,行泪小管断端吻合手术,疗效确切、经济。     

手术显微镜下泪小管断裂吻合术探讨

目的探讨手术显微镜下泪小管断裂吻合术中的疗效,提高泪小管断裂吻合术的成功率。方法利用手术显微镜直视下寻找断端远端,插入直径1mm硬膜外尼龙导管作为泪小管内支撑物,吻合泪小管断端。结果108例均一次吻合成功。术后8～12周拔管,随访6个月～2年,治愈88例占81.5%,好转14例占13.0%,未愈6例占5.5%。结论手术显微镜下行泪小管断裂吻合术成功率高,操作准确方便。     

急诊显微手术治疗泪小管断裂

目的探讨泪小管断裂断端的找寻规律和防止术后瘢痕收缩的方法,提高急诊泪小管断裂吻合术的成功率。方法在眼科手术显微镜下仔细寻找11例泪小管断裂患者(含年龄9个月者)的泪小管断端,以硬膜外麻醉导管作支撑管,以眼科9-0尼龙线行三点对位吻合,支撑管留置至术后20～90d。结果11例均成功吻合泪小管,术后20d至3个月拔管后无泪溢。结论术中耐心寻找泪小管断端,仔细对位缝合皮肤,术后以硬膜外麻醉导管作留置支撑管可以提高手术成功率。     

外伤性下泪小管断裂吻合术临床观察

目的：观察外伤性下泪小管断裂吻合术的临床疗效。方法在眼科手术显微镜下寻找泪小管断端,采用一次性硬膜外麻醉导管为支撑材料,留置泪道,吻合下泪小管,观察临床疗效。结果23例手术患者,治愈15例,占65.2%,好转6例,占26.1%,无效2例,占8.7%,总有效率91.3%。结论利用一次性硬膜外麻醉导管作为支撑材料留置泪道,是下泪小管断裂吻合术的可取方法。     

显微镜下治疗下泪小管断裂36例临床分析

目的:探讨显微镜下手术吻合泪小管断裂的临床疗效.方法:应用显微外科技术,在显微镜下应用四环素地塞米松眼膏从上泪小管挤入寻找泪小管断端,以硬膜外麻醉管作为支撑管捕入泪小管腔,对断端进行显微手术吻合.结果:术后随访12～36个月,36例中有29例愈合良好,泪道通畅,3例通而不畅,4例则完全不通.总有效率88.89%.结论:采用显微手术结合硬膜外麻醉管作支撑物,同时术中应用眼膏治疗下泪小管断裂能取得良好的临床效果.     

86例泪小管断裂的治疗体会

目的探讨硬膜外麻醉管应用于泪小管断裂吻合术式中临床疗效。方法在手术显微镜直视下寻找泪小管断裂,应用硬膜外麻醉管作为支撑物,吻合上、下泪小管断裂伤。结果上、下泪小管同时断裂伤86例全部吻合成功,手术后6～8周拔除义管后泪道冲洗全部通畅,3例轻度溢泪。结论硬膜外麻醉管作为支撑物应用于泪小管断裂吻合术效果良好。     

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.