人工全髋关节置换治疗成人先天性髋关节脱位继发骨关节炎

目的 探讨人工全髋关节置换治疗成人先天性髋关节脱位继发骨关节炎的外科技术。方法 采用人工全髋关节置换术治疗先天性髋关节脱位继发骨关节炎9例14髋，其中Ⅰ度2例4髋，Ⅱ度2例3髋，Ⅲ度5例7髋。结果 全部病例伤口一期愈合，无血管神经损伤，经平均2年5个月（1～8年）随诊，Harris评分由术前34．53分恢复到术后6个月90．12分，均能下地行走、生理自理，且恢复日常工作。结论 全髋关节置换术是治疗成人先天性髋关节脱位继骨关节炎的有效方法；要严格掌握适应证，当疼痛和明显功能障碍时行手术。     

改良Salter截骨治疗先天性髋关节脱位的临床分析

先天性髋关节脱位是小儿骨科中的常见病,病理改变复杂,治疗方法也很多。其中用手术方法治疗先天性髋关节脱位已经有将近百年的历史。从1961年Salter发明髋关节截骨式治疗先天性髋关节脱位后,我们于2001-03～2007-09采用Salter截骨式．对部分病例加内收肌松解术治疗先天性髋脱位共54例,现报道如下。     

儿童先天性髓关节脱位的手术治疗

儿童先天性髓关节脱位的手术治疗曹有良先天性髋脱位是儿童先天性骨关节畸形的常见病之一、其发病率在我国约占３．９％〔１〕，幼儿期的先天性髋脱位无论是闭合方法或手术复位，多能取得良好效果〔２〕。就诊较晚的患儿，病理变化严重而广泛，负重后股骨头脱位较多，髋臼...     

手法复位Ⅲ期石膏外固定治疗小儿先天性髋关节脱位

小儿先天性髋关节脱位是指婴儿出生后，因先天因素或出生后的其他因素使单侧或双侧股骨头脱出于髋臼外，形成髋部一系列病理改变的疾病。先天性髋关节脱位是小儿常见的关节病变，各地区的发病率不同。我县发病率较高。我院外科自1992年1月～2006年6月，采用手法复位石膏外固定治疗小儿先天性髋关节脱位118例，现报道如下。[第一段]     

组合术式治疗大龄儿童先天性髋关节脱位的临床效果

目的 使用组合术式治疗大龄儿童先天性髋关节脱位(DH),力图降低股骨头坏死率及髋关节病残率,提高治愈率.方法 使用组合术式治疗大龄儿童(7～15岁)先天性髋关节脱位65例89髋,随访时间1年～14年5个月,平均7年3个月.结果 Trevor评分优良率达到80.89%,仅有15例股骨头无菌性坏死占16.9%,对照Salter标准,病残率和股骨头坏死率明显降低.结论 组合术式治疗大龄儿童先天性髋关节脱位疗效良好.     

成人先天性髋关节脱位的全髋置换术

目的:总结全髋关节置换术治疗成人先天性髋关节脱位的临床经验。方法:2001～2004年对22例先天性髋关节成人患者进行了全髋关节置换术,对其临床治疗效果进行回顾性分析。结果:术后随访6～27个月,平均Harris评分由术前的44分恢复到82 5分。结论:全髋关节置换术治疗成人先天性髋关节脱位疗效满意,成功关键是在充分认识先天性髋关节脱位的病理改变的基础上,术中彻底的髋关节周围松解,真臼改造重建,及恰当的股骨假体放置     

个性化术式治疗大龄先天性髋关节脱位

目的选择个性化术式治疗大龄先天性髋关节脱位,从而进一步提高治愈率,降低病残率。方法采用Pemberton骨盆旋转截骨,Dega骨盆旋转截骨,Chiari骨盆内移截骨,股骨转子下旋转截骨及股骨转子下短缩截骨不同个性化术式及其组合,治疗大龄先天性髋关节脱位26例34髋,根据Mckay临床康复评定标准评估治疗效果。结果随访2～6年,平均3年4个月。3髋股骨再骨折（8．3％）,2髋术后股骨头再脱位（5．8％）,6髋股骨头缺血坏死（17．6％）。治疗效果34髋中优10髋、良17髋、可6髋、差1髋,优良率为79．4％。结论根据患者的具体病情,选择个性化的手术方式,注重手术细节,并配合术后有效的功能康复,是降低大龄先天性髋关节脱位患者并发症和病残率,进一步提高疗效的关键。     

发育性髋关节脱位与早期干预

发育性髋关节脱位是临床最常见的儿童下肢畸形。早年认为该病是先天性疾病并称之为先天性髋关节脱位。近年国内外研究及大量病例观察，本病除先天因素外，后天因素也起着重要作用，是一种动态的发育异常。早期治疗可终止其病理演变过程，使髋关节恢复正常形态及功能。1992年北美州,矫形外科学会上将先天性髋关节脱位更名为发育性髋关节脱位或发育性髋关节发育不良；包括髋臼发育不良、髋关节半脱位和髋关节脱位三型。国外统计新生儿髋关节脱位发病率为4‰-11‰；而髋臼发育不良易脱位者高达8‰-21．8‰。我国目前尚无全面普查资料。1974年北京地区发病率为3．8‰。由于患儿出生时体征较隐匿，早期不易发现。待到患儿学步时出现跛行步态才开始就诊，已失去最佳治疗时机。即使积极治疗，也往往留下残疾。为提高人口素质，降低发病率，减少致残率，广泛开展孕产期预防和新生儿筛查及早期治疗，就显得尤为重要。     

镶嵌式植骨髓臼成形治疗先天性髋关节脱位

镶嵌式植骨髓臼成形治疗先天性髋关节脱位（山东省济南市１０６医院２５００２２）丛水建，郑克来，朱其功１９８７年９月至１９９２年１２月采用手术切开复位，镶嵌式植骨髋臼成形术治疗先天性髋关节脱位共１０例１１个髋关节。其中男性４例，女性６例。年龄最小１例３．...     

先天性髋关节脱位臼盖成形术的体会

目的探讨先天性髋关节脱位手术治疗方法方法自1998年1月～2002年4月收治先天性髋关节脱位8例,均采用Gill(第二型)臼盖成型术治疗,效果满意.结论Gill(第二型)臼盖成形术是需手术治疗的先天性髋关节脱位的有效术式.     

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.