闭合性肾损伤的诊断与治疗方法选择

目的:探讨闭合性肾损伤的诊断与治疗方法.方法:对96例闭合性肾损伤患者的临床资料进行回顾性分析.结果:96例中肉眼血尿70例,镜下血尿18例,无血尿8例;合并其他脏器或组织伤42例;静脉肾盂造影50例,阳性36例(72.0%);B超检查96例,阳性87例(90.6%);CT扫描92例,阳性92例(100%);非手术治疗66例(68.8%),手术治疗30例(31.2%);治愈92例(95.8%),死亡2例(2.1%),病情恶化自动出院2例(2.1%).结论:外伤史和血尿是诊断肾损伤的重要依据;B超检查快速、简便、无创,可作为首选定性检查;CT扫描准确率高,是诊断肾损伤的可靠方法,也是选择治疗方案的重要依据.准确评估伤情,严格掌握非手术和手术治疗的指征是处理肾损伤的关键.     

儿童闭合性肾损伤89例临床分析

探讨儿童闭合性肾损伤的临床诊断和治疗。回顾性总结我院89例儿童闭合性肾损伤的临床诊疗资料,分析其受伤病因、临床表现、治疗方法、并发症及预后。89例儿童闭合性损伤患者中,单纯肾损伤62例,联合伤27例。肉眼血尿51例(57.30%),镜下血尿22例(24.72%),无血尿16例(17.98%)。CT检查89例均诊断不同程度的肾损伤。保守治疗81例,手术治疗8例。行肾包膜修补术1例,肾动脉栓塞术4例,渗尿血肿引流术2例,肾脏切除术1例。儿童肾损伤经影像学检查均可及时、准确诊断,CT优于B超,增强CT检查是诊断的金标准。大部分闭合性肾损伤患儿可通过保守治疗治愈,少数肾破裂伴活动性大出血致失血性休克患者可行介入栓塞治疗。     

闭合性肾损伤200例临床分析

目的总结闭合性肾损伤的诊治体会,提高肾损伤的诊治效果。方法回顾性分析200例闭合性肾损伤患者的临床资料。结果200例闭合性肾损伤中,保守治疗141例(70.5%),超选择性肾功脉栓塞治疗8例(4%),手术治疗51例(25.5%),其中20例同时施行了腹部合并伤手术。死亡3例,病死率1.5%。结论B超、CT是诊断肾损伤主要的、有效的方法,大剂量IVU亦是重要的措施。     

肾损伤98例临床分析

目的探讨肾损伤的诊断与治疗.方法对98例肾损伤的临床资料进行回顾性分析.其中闭合性损伤89例,开放性损伤9例,合并伤42例.B超检查77例,CT检查32例,大剂量IVU检查18例.保守治疗70例,手术治疗28例.结果B超、CT、大剂量IVU阳性率分别为89.6%、100%、88.7%.治愈94例,死亡4例.结论B超和CT检查是主要的检查方法.主张先行保守治疗,正确估计肾脏伤情,准确把握手术时机.     

闭合性肾损伤92例诊治体会

目的：总结闭合性肾损伤的诊治体会，提高肾损伤的诊治效果。方法：回顾性分析92例闭合性肾损伤的诊断治疗资料。结果：辅助检查阳性率：静脉尿路造影(IVU)58．3％，B超78．4％，CT100％；保守治疗78例，手术治疗14例；治愈90例，死亡2例，治愈率97．8％。结论:CT检查是诊断闭合性肾损伤的可靠方法，治疗方案取决于肾脏损伤情况，其中保守治疗是治疗闭合性肾损伤的重要方法。     

闭合性肾损伤诊治分析

目的探讨闭合性肾损伤诊断与治疗要点。方法回顾性分析97例闭合性肾损伤患者的临床资料。结果全部患者均进行了CT检查，B超俭查32例；行保守治疗83例，其中16例作超选择性肾动脉栓塞术；手术治疗14例，其中。肾切除术10例，肾修补术3例，肾部分切除术1例。结论CT检查是评估肾损伤程度的主臻方法，超选择性肾动脉栓塞治疗是肾损伤保守治疗的主要方法。     

肾损伤临床诊治体会(附106例报告)

目的总结肾损伤诊疗经验,提高肾损伤诊疗水平。方法分析106例肾损伤的临床资料,评估检查、诊断、治疗及治疗效果。结果血尿96例,占90.5%;B超检查92例,阳性90例,占97.9%;CT90例,阳性89例,占98.9%。重度损伤CT阳性100%。保守治疗78例,死2例(合并烧伤感染);手术治疗28例,死2例(复合伤)。结论准确评估肾损伤程度及合并伤,选择适时,适当的特殊检查,严格掌握手术指征,积极治疗合并伤,是肾损伤诊治要领。     

闭合性肾损伤138例诊治体会

目的：提高闭合性肾损伤诊治效果。方法：回顾分析138例闭合性肾损伤的诊治占同期各种多发性损伤4．71％（138／2934)。结果：血尿136例（98．55％）。B超检查137例，其中110例（80．29％），有异常表现。CT检查69例，阳性63例(90．3％）。多发伤67例(48．91％）。保守治疗110例，成功105例，并发症5例，（4．5％）。治愈率(95．45％）。随访75例1-3年，尿常规，肾功能正常。结论：尿液检查和B超检查快速安全损伤，CT检查准确丰高，并能同时了解其它脏器损伤的程度。如果损伤严重，需行外科处理，应及时手术探查。     

闭合性肾损伤的诊断与治疗

目的：探讨闭合性肾损伤的诊断与治疗水平。方法：对73例闭合性肾损伤的临床资料进行回顾性分析。结果：73例闭合性肾损伤中,肾挫伤48例,肾裂伤21例,肾粉碎伤4例,并发伤11例。血尿、腰部疼痛是主要的临床症状。保守治疗61例,手术治疗12例,死亡1例。结论：B超检查便捷无损伤。CT检查准确快速,并可同时了解其他脏器损伤的情况,对治疗有重要帮助。保守治疗是重要的治疗方法。如果损伤严重应及时手术治疗。     

116例闭合性肾损伤的诊治报道

目的 提高闭合性肾损伤的诊治效果.方法 对116例闭合性肾损伤的临床资料进行回顾性分析.结果 116例肾损伤中,轻度肾损伤61例,中度肾损伤33例,重度肾损伤22例.并发伤24例,保守治疗82例,手术治疗34例.治愈112例,死亡4例.结论 B超和CT检查是诊断肾损伤的有效方法,迅速而正确的病情评估是治疗的关键.在严密监视病情的情况下,保守治疗是一种重要的治疗方法.     

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.