羊水过少369例临床分析

目的：探讨羊水过少对围生儿的影响。方法：将369例羊水过少按剖宫产、阴道分娩分为两组,分别回顾性统计其围生儿窒息率及病死率。结果：剖宫产组新生儿窒息率及围生儿病死率明显低于阴道分娩组。结论：羊水过少对胎儿危害较大,所以晚期妊娠合并羊水过少应列入高危妊娠组,如合并过期妊娠、妊高征及IUGR时应通过联合监护及时剖宫产是改变围生儿预后的关键。     

羊水过少对母婴影响及相关因素调查分析

目的 探讨羊水过少对母婴影响及引起羊水过少的相关因素.方法 对我院收治的60例羊水过少患者,分娩前常规B超检查检测羊水量,胎盘成熟度.电子胎儿监护仪行胎心监护,分娩后记录分娩方式、羊水量、新生儿体重、Apgar评分、脐带情况、羊水污染情况等,明确羊水过少的临床特点.结果 37～39+6周羊水过少发生率较其他孕周高,差异有统计学意义(P<0.05).羊水量50 ml以下者胎儿宫内窘迫、新生儿窒息、围生儿死亡发生率较其他组高,差异有统计学意义(P<0.05).阴道分娩胎儿窘迫、新生儿窒息、围生儿死亡发生率高于剖宫产者,差异有统计学意义(P<0.05).羊水Ⅲ度污染者新生儿窒息,围生儿死亡发生率高于其他组,差异有统计学意义(P<0.05).结论 羊水过少、羊水污染程度与胎儿功能窘迫、新生儿窒息、围生儿死亡密切相关,在妊娠晚期加强产前检查及B超检查,了解羊水情况及时发现羊水过少,并采取积极措施治疗,对降低新生儿窒息率、围生儿死亡率有重要意义.     

羊水过少100例分析

目的：探讨羊水过少及不同分娩方式对围生儿预后的影响。方法：对我院妊娠合并羊水过少100例进行回顾性分析。结果：羊水过少多发生于妊娠40周后，胎儿预后随着羊水量的减少而有变差的趋势，剖宫产组围生儿窒息率低于阴道分娩组，无围生儿死亡发生。结论：妊娠40周后严密监测羊水量，对羊水过少者应放宽手术指征。     

羊水过少临床分析60例

目的探讨羊水过少时羊水量和分娩方式对围生儿预后的影响,寻找有效的处理方法。方法回顾60例孕产妇羊水过少的临床资料,分析其分娩方式和羊水量对围生儿预后的影响。结果羊水过少高发于孕40周后,B超对羊水量的估计准确率达94%,羊水过少时阴道分娩的胎儿宫内窘迫和新生儿窒息发生率明显高于剖宫产组,羊水量越少,胎儿宫内窘迫和新生儿窒息发生率越高。结论羊水量越少,围生儿预后越差,剖宫产是重度羊水过少孕妇分娩方式的最佳选择。     

产时胎心监护异常临床分析

目的探讨产时胎心监护异常的影响因素,提高优生优育率.方法回顾分析2002年7月至2003年3月90例产时胎心监护图形异常的病例(观察组)和同期90例产时胎心监护图形正常的病例(对照组)的临床资料.结果产时胎心监护异常组的羊水粪染、羊水过少、脐带绕颈和剖宫产率明显高于产时胎心监护正常组(P<0.01);而两组间新生儿窒息情况差异无显著性意义(P>0.05).结论产时胎心监护能及时发现胎儿窘迫,通过适当处理可以降低新生儿窒息率及病死率.     

羊水过少产时连续监护87例临床分析

目的探讨羊水过少产妇产时连续胎心监护与分娩方式的选择对围产儿预后的影响。方法2005年1月-2008年11月在我院住院的．经产前超声提示羊水过少149例产妇，将其中87例无妊娠合并症或并发症的单纯羊水过少的孕妇作为研究对象．入待产室后常规采用监测法进行连续胎心监护。结果87例超声提示羊水过少产妇中胎心监护发现重度变异减速及频发晚期减速不祥图形29例（33.3％），其中发生在潜伏期5例（17．3％），活跃期19例（64.4％），第二产程5例（17.3％）。29例中26例行了急诊剖宫产．2例产钳下分娩。1例胎头吸引术下分娩。连续监护正常产妇有5例非胎儿窘迫原因行了剖宫产，87例中有43例经阴道正常分娩。所有新生儿无重度窒息，轻度窒息7例，全部在10min内复苏成功，无围产儿死亡。结论对产前超声提示羊水过少的孕妇在连续胎心监护下合理处理产程可选择经阴道分娩，对新生儿预后无影响。     

羊水过少对围生结局的影响116例临床分析

目的：探讨羊水过少的相关因素及对围生结局的影响。方法：采用回顾性分析方法,对妊娠晚期羊水过少116例与羊水正常组120例进行对比分析。结果：羊水过少多发生在孕40周后,与延（过）期妊娠,胎盘过度成熟、退行性改变及胎儿宫内发育迟缓（IUGR）有关;羊水过少组中胎心监护异常、羊水Ⅱ度以上粪染、胎儿窘迫、新生儿窒息率及剖宫产率均显著高于羊水正常组。结论：妊娠晚期羊水过少是胎儿宫内慢性缺氧的最敏感的特异性指标,对围生儿预后有严重影响。剖宫产是处理羊水过少及降低围生儿病死率的重要措施。     

脐血流对头位脐带绕颈分娩方式的意义

目的通过产时胎儿脐血流测定与胎心监护联合应用,及时了解脐带绕颈胎儿宫内安危,早期发现胎儿宫内缺氧,选择最佳分娩方式,降低脐带绕颈围产儿死亡率。方法对178例单胎头位孕足月B超提示脐带绕颈孕妇产时进行脐血流检测,把脐动脉血流S/D≥3设为观察组,S/D<3设为对照组,然后用胎心监护仪作胎心监护,比较两组产妇产时的催产素激惹实验(OCT)或CST实验的异常率、产时胎儿宫内窘迫率、剖宫产率、新生儿窒息率及脐带绕颈周数。结果观察组胎心监护异常率、产时胎儿宫内窘迫率、剖宫产率、新生儿窒息率明显高于对照组。结论产时胎儿脐血流测定,可及早发现脐带绕颈胎儿宫内缺氧,结合胎心监护,及时采取适当的分娩方式,以改善胎儿的预后,减少围产儿的病死率。     

妊娠晚期羊水过少121全临床分析

目的探讨妊娠晚期羊水过少的病因及其相关因素,寻找正确的处理方法,降低围生儿病死率,寻找正确的处理方法,降低围生儿病死率.方法对妊娠晚期羊水过少121例临床资料进行回顾性分析.结果羊水过少高发于40周后,特别是42周后;羊水过少出现最多的妊娠并发症为妊高症和胎儿宫内生长迟缓;羊水过少组中胎位异常、脐带异常、羊水粪染、胎儿窘迫、新生儿窒息、低体重儿、畸胎的发生率、剖宫产率显著高于羊水正常组(P＜0.05).结论B超提示最大羊水暗区垂直径＞2cm,无合并其它高危因素,宫颈改良Bishop评分≥6,在严密监护下可行阴道试产,若短时间不能分娩或出现胎儿窘迫宜剖宫产结束分娩.     

脐带缠绕产程中持续胎心监护100例临床分析

目的：探讨胎儿脐带缠绕孕妇临产后连续胎心监护对围生儿预后的影响。方法：对2008年10月～2010年10月霍州市人民医院产前诊断脐带缠绕100例孕妇从规律宫缩至胎儿娩出前,常规采用外监测法进行连续性产时胎心监护。结果：本组100例孕妇中,胎心监护发现重度变异减速及频发晚期减速不详图形28例（28%）,发生在潜伏期6例（占6%）,活跃期20例（占20%）,第二产程2例（2%）,均改行急诊剖宫产,无重度新生儿窒息,无围生儿死亡。结论：临床对于脐带缠绕的孕妇应进行严密的产时胎心监护,以早期发现胎儿窘迫并及时处理,避免新生儿重度窒息及围生儿死亡。     

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.     

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.