胎儿肾脏与孕龄相关性研究

目的：探讨二维实时超声描述胎肾生长趋势的价值。方法：用二维超声测量胎儿双侧肾脏的长径、横径及前后径，计算胎肾体积，并与孕龄做相关分析。结果：共收集537例28～42周单胎胎儿的测量值，左、右肾脏的各测量参数差别无统计学意义，并胎肾长径、横径及前后径均与孕龄呈线性正相关，而胎肾体积随孕龄呈幂增长。结论：孕晚期，胎儿肾脏的长径比横径及前后径的增长速度略快，故可从形态学上解释肾脏的“蚕豆”形结构；胎肾体积与胎儿体重随孕龄的增长趋势类似，为其与胎儿体重的相关性研究提供新的依据。     

超声检测胎儿头围耳长比值的临床意义

目的探讨超声测量头围耳长比值（HC/EL）的临床应用价值。方法选取孕龄18～40周胎儿990例,新生儿50例,产前行羊膜腔穿刺术或脐血穿刺术的胎儿46例,测量HC/EL比值。结果 HC/EL比值相近,在不同孕周正常胎儿之间差异无统计学意义（P〉0.05）。以HC/EL〉11.8为截断值,发现外耳缩短及小耳畸形胎儿16例,其中染色体核型异常10例,外耳缩短及小耳畸形胎儿染色体核型异常阳性率62.5%（10/16）。结论 HC/EL比值恒定,临床应用简便,有助于提高外耳缩短及小耳畸形胎儿的检出率,提高染色体异常胎儿的产前诊断率。     

NT超声联合孕中期四维超声在胎儿畸形筛查中的应用

目的:探讨胎儿颈项透明层厚度超声(NT)联合孕中期四维超声在胎儿畸形筛查中的应用。方法:选取2014年3月~2016年5月1241例孕妇,均应用产前NT超声联合孕中期四维彩超对胎儿畸形进行筛查。结果:孕11~14周对1241例孕妇进行妊娠产检,NT检测出异常胎儿44例(3.54%),NT诊断准确率95.65%;孕22~28周时采用四维彩超畸形检测异常胎儿有49例(3.95%),诊断准确率为100.00%。结论:孕11~14周胎儿颈项透明层厚度超声检测可有效评估胎儿唐氏综合征风险,孕22~28周四维彩超检测可筛查胎儿结构异常,二者联合使用对于筛查胎儿畸形具有重要应用价值。     

80例中晚孕正常胎儿主肺动脉与升主动脉的超声心动图对比分析

目的 探讨中晚孕正常胎儿主肺动脉与升主动脉超声心动图图像的不同点.方法 按产科每四周为一妊娠月的标准,对80例胎龄21～40周正常胎儿,应用Siemens实时三维彩色多普勒超声诊断仪获取每个胎儿标准二维超声心动图图像,每个胎儿分五次测量不同妊娠月主肺动脉与升主动脉的内径、长度.结果 正常胎儿主肺动脉与升主动脉内径和长度的大小与胎龄呈正相关,内径随胎龄的增加而增宽,长度随胎龄的增加而增长;主肺动脉内径/升主动脉内径的比值≥1,主肺动脉长度/升主动脉长度的比值≤1;胎儿主肺动脉与升主动脉的发育与胎儿整体发育有关.结论 应用实时三维超声检查正常胎儿的超声心动图,测定主肺动脉与升主动脉的内径、长度,分析主肺动脉和升主动脉在二维超声图像上不同,验证主肺动脉和升主动脉的发育过程,为两者的鉴别提供新思路,为产前筛查胎儿心脏流出道畸形提供了一定的参考依据.     

超声产前诊断胸脐联胎畸形1例

孕妇,25岁,孕2产1,孕31周。超声检查见（图1）：宫腔内见2个胎儿回声,两胎儿腹侧融合,范围由胸部至脐部,上下径4.34cm,前后径5.24cm,横切面显示腹壁皮肤融合、肝脏融合,同时显示2个胃、2个脊柱,同时显示2个面部,2个胎儿似共用一个心包腔,左侧胎儿心脏完全位于左侧胎儿胸腔内,右侧胎儿心脏一半位于左侧胎儿胸腔内,一半位于右侧胎儿胸腔内,右侧胎儿心脏位于左侧胎儿心脏右前方,右侧胎儿心脏心内十字交叉结构消失。     

中孕期正常胎儿心脏发育的产前超声筛查检测

目的：应用胎儿超声心动图技术对21-25孕周正常胎儿心脏心房、心室、主动脉、肺动脉、动脉导管的内径及血流速度进行检测,为产前超声评估该孕期胎儿心脏发育提供参考依据。方法采用实时二维胎儿超声心动图对300例21-25孕周的正常单胎妊娠胎儿进行胎儿四腔心、左室流出道、右室流出道及三血管切面检查,测量心脏各房室腔及大血管内径,分析各测量值与孕周的关系。结果21-25孕周正常胎儿心脏各房室腔、大血管及动脉导管内径随孕周增加而增大。结论此研究建立了中孕期正常胎儿心脏各结构内径的正常参考值范围,为胎儿心脏发育的产前超声检测提供了实用的参考价值。     

实时四维超声成像产前诊断胎儿畸形的研究

目的探讨实时四维超声在产前胎儿畸形筛查中的应用价值。方法回顾性分析1586例孕18～38周时胎儿的二维及四维超声检查结果,分析二维及四维超声诊断胎儿畸形的准确性及直观性,并随访观察。结果本组资料中发现胎儿畸形41处,四维符合率97.6%。结论四维超声能动态直观立体显示胎儿在宫内的活动状况,安全简便无损伤,具有很高的敏感性及准确性,在产前胎儿畸形的筛查中具有广阔的发展前景和应用价值。     

主、肺动脉的超声观测诊断胎儿心脏大血管畸形的研究

目的 探讨主、肺动脉的超声观测作为产前筛选胎儿心脏大血管畸形主要线索的诊断价值。方法 对100例20～40周正常孕妇采用超声心动图测量主、肺动脉内径，并计算肺动脉内径和主动脉内径比值(PA／AO)。按照PA／AO的正常比值对2683例20周以上孕妇进行胎儿先天性心脏病(CHD)筛选。结果 （1）不同孕龄的胎儿其PA、AO内径随孕龄增加而增大，但是其PA／AO比值相对较为恒定，约为1．0～1．2。(2)多种胎儿心脏大血管畸形包括主动脉弓发育不良、主动脉狭窄、肺动脉狭窄、法乐氏四联征、主动脉缩窄等，其PA／AO比值明显异常。结论 胎儿PA／AO作为产前筛选胎儿CHD指标，尤其是胎儿大血管畸形，是一项实用的指标。     

四维超声在诊断胎儿心脏畸形中的应用

目的 探讨四维超声在胎儿先天性心脏病筛查中的应用价值.方法 对孕18 ～40周2600例孕妇进行产前筛查,并随访.结果 产前四维超声诊断心脏结构异常胎儿21例,检出率0.8％,17例引产后行尸体解剖,4例正常分娩后行超声心动图复查,显示产前四维超声诊断胎儿先天性心脏病的敏感性为91％,特异性为100％.结论 四维超声是提高胎儿先天性心脏病产前诊断率的有力工具,对提高出生人口素质,减低出生婴儿死亡率起到重要作用.     

探讨高原环境对胎盘成熟度的影响

目的探讨高原低氧环境对胎盘成熟度的影响。方法选择来自本院妇产科和妇保院就诊孕妇,利用二维超声测量胎儿双顶径、股骨长径来估算胎儿孕周,评估胎盘成熟度,并与平原地区情况进行对照。结果平原地区孕38周以上胎盘成熟度达Ⅲ°者占15%,而高原地区孕32周以上胎盘成熟度达Ⅲ°者竞达66.9%。结论高原孕妇的胎盘成熟较平原地区提前。     

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.     

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.     

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.     

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.