女性盆腔结核52例的临床特点及诊治分析

目的 总结女性盆腔结核的临床特点及诊治经验,减少误诊.方法 对我院妇产科收治的52例女性盆腔结核患者的病例资料进行回顾性分析.结果 10例初步确诊为女性盆腔结核,初步诊断准确率为 19%,易误诊为卵巢肿瘤及盆腔炎性包块疾病.结论 临床医生对女性盆腔结核警惕性不高,且该病发病隐匿,临床表现各异,缺乏敏感性高并具有特异性的辅助检查,因而临床工作中易发生漏诊或误诊.     

20例盆腔结核误诊分析

目的探讨女性盆腔结核误诊原因,提高诊断率。方法回顾性分析我院2000年12月至2010年12月收治的20例盆腔结核误诊病例的临床表现、医技检查、误诊情况及诊治过程。结果 20例患者均于术前误诊。其中10例误诊为卵巢恶性肿瘤,4例误诊为卵巢囊肿蒂扭转,2例误诊为卵巢子宫内膜移位囊肿,3例误诊为盆腔炎性包块。1例误诊为陈旧性宫外孕。结论盆腔结核误诊率高,应提高对盆腔结核的警惕性。临床上可通过详细询问病史,完善医技检查,全面分析临床资料及盆腔包块的性质,提高诊断率,必要时手术探查,以提高盆腔结核的诊断率。     

16例女性盆腔肿块超声误诊分析

目的：探讨女性盆腔肿块超声误诊原因,以提高盆腔肿块的超声诊断符合率。方法回顾分析超声误诊16例女性盆腔肿块的临床资料和超声图像特征,并与手术病理结果或临床随访结果相对照。结果16例误诊病例,手术病理证实15例,临床随访证实1例;11例为生殖系统肿块,其中2例黄体出血分别误诊为卵巢畸胎瘤和巧克力囊肿,1例残角子宫误诊为卵巢巧克力囊肿,1例子宫直肠窝内膜异位误诊为卵巢癌,1例陈旧性宫外孕误诊为盆腔炎性包块,2例盆腔结核误诊为卵巢癌,2例卵巢癌分别误诊为盆腔结核和子宫浆膜下肌瘤,子宫浆膜下肌瘤和阔韧带肌瘤各1例误诊为卵巢肿瘤;5例为非生殖系统肿块,其中2例腹膜后平滑肌瘤分别误诊为卵巢肿瘤和子宫肌瘤,1例直肠癌误诊为子宫肿瘤,1例小肠系膜间质瘤误诊为卵巢肿瘤,1例肠系膜囊肿误诊为卵巢囊肿。结论女性盆腔肿块超声检查临床经验不足者易误诊,鉴别诊断时要注意结合病史、月经史、临床表现、实验室检查和其他影像资料,掌握盆腔肿块临床病理、声像图特征,辨别肿块与卵巢、子宫等重要脏器的关系,做好随访观察。     

因盆腔结核行卵巢癌根治术的2例病例报道及分析

目的探讨盆腔结核的临床特征。方法对我院收治的2例因盆腔结核行卵巢癌根治术的患者进行临床分析并复习相关文献。结果2例患者均误诊为卵巢癌,并最终病理确诊为生殖器结核。结论盆腔结核是妇科临床诊治难点,我们需要寻找更有效地检查方法从而降低误诊率。     

14例女性盆腔结核的临床特点及误诊分析

目的 了解女性盆腔结核的临床表现,提高对盆腔结核的认识及诊断。方法 收集整理14例女性盆腔结核患者的临床资料,通过对14例患者的临床表现、诊疗方式和治疗方法进行分析讨论。结果 女性盆腔结核主要表现为腹痛、腹胀、腹部包块、低热、月经改变、消瘦、乏力、不孕等,症状不典型,常易被误诊为盆腔炎性包块或卵巢肿瘤疾病。结论 女性盆腔结核的临床症状不典型,临床医师应注意其临床表现多样,复杂的特点,综合判断,对比分析,提高对盆腔结核的诊断率,加强对盆腔结核的认识,及早诊断、及早治疗。     

120例腹腔镜诊治不孕症患者盆腔病变的疗效分析

目的探讨腹腔镜在女性不孕症盆腔病变患者中的诊治价值。方法回顾性分析2011年1月至2012年1月笔者所在医院收治的120例女性不孕症患者行腹腔镜诊治的临床资料。结果 120例患者112例发现盆腔病变,占93.33%,慢性盆腔炎是不孕的第1位病因;其他依次为子宫内膜异位症、多囊卵巢综合征、子宫肌瘤、盆腔结核;120例患者109例得到随访,52例术后妊娠,妊娠率47.71%。结论腹腔镜检查可以明确不孕症的盆腔病因,同时可以进行手术治疗,对女性不孕症盆腔病变的诊治具有重要的价值。     

女性盆腔腹膜结核30例临床分析

目的 探讨女性盆腔腹膜结核的临床特点和诊治依据。方法 回顾分析30例女性盆腔腹膜结核患者的临床表现及诊治过程。结果 入院初诊盆腔结核4例，10例剖腹探查确诊，3例腹腔穿刺病理确诊，2例诊刮确诊，11例诊断性抗结核治疗确诊，治疗效果满意。结论 女性盆腔腹膜结核临床表现多样化，需结合病史、症状、辅助检查，提高确诊率，剖腹探查能较快确诊，结核菌素试验阳性率不高，但CA125普遍升高。     

早期心导管检查对Tako-tsubo综合征诊治的价值探讨

目的:急性冠状动脉综合征(acute coronary syndrome,ACS)与Tako-tsubo两者在临床表现上非常相似,重视早期心导管检查对该病的确诊、避免误诊误治有重大意义.方法:回顾性分析诊断为Tako-tsubo综合征患者的临床资料,探讨早期心导管检查对Tako-tsubo综合征诊治的价值.结果:5例均为老年女性行心导管检查,诊断为Tako-tsubo综合征.结论:Tako-tsubo综合征的临床表现与ACS非常相似,早期开展心导管检查可以避免误诊、误治给患者带来不必要的精神压力及经济负担.     

肘关节结核1例误诊误治分析

肘关节结核临床少见，病情进展缓慢，但后果严重，且易误诊误治。现就2003年5月初诊于我院误诊误治长达1年的右肘关节结核患者诊治情况报告如下。     

盆腔结核15例诊治分析

目的探讨女性盆腔结核的临床特点和诊治方法。方法回顾分析15例女性盆腔结核患者的临床表现及诊治过程。结果入院第一诊断为盆腔结核3例，经手术剖腹探查病理证实为结核者8例，腹腔包块穿刺病理确诊3例，诊断性刮宫病理诊断为内膜结核1例。盆腔结核确诊后以抗结核药物及手术治疗效果满意。结论女性盆腔结核临床表现多样，采用多种辅助诊断手段综合分析，可提高确诊率。     

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.