人工股骨头置换与动力髋螺钉内固定治疗老年股骨转子间骨折的疗效观察

目的:探讨人工股骨头置换术与动力髋螺钉(DHS)内固定治疗老年股骨转子间骨折的疗效。方法:将90例老年不稳定股骨转子间骨折患者随机分为两组,人工股骨头置换治疗42例,DHS内固定治疗48例。比较两组患者的手术时间、术中出血量、术后开始负重锻炼时间、术后并发症及髋关节功能。结果:所有病例均获随访,时间为12～48个月,平均20个月。人工股骨头置换组在术中出血量、术后锻炼时间、术后髋关节功能恢复及术后并发症发生率方面均优于DHS内固定组。结论:对于70岁以上不稳定或粉碎性转子间骨折,患有严重骨质疏松症,伤前髋、膝无明显活动受限可独立行走,有严重老年伴发疾病不宜长期卧床者,可优先选择人工股骨头置换治疗。     

人工股骨头置换治疗高龄股骨转子间骨折32例临床分析

目的评价双极骨水泥型人工股骨头置换治疗高龄股骨转子间骨折的临床疗效。方法分析2010年8月至2012年8月采用人工股骨头置换治疗高龄股骨转子间骨折患者32例临床资料。结果置换后随访5～42个月。疗效按照Harris评分评估髋关节功能,优20例,良12例。术后未发生假体脱位、松动及下沉等并发症。结论人工股骨头置换可作为治疗高龄股骨转子间不稳定骨折的主要方法 。     

人工股骨头置换治疗高龄不稳定股骨转子间骨折

探讨人工股骨头置换治疗高龄股骨不稳定转子间骨折的临床疗效。方法回顾性分析选用人工股骨头置换治疗75岁以上股骨转子问不稳定骨折52例患者的临床资料。观察术后并发症、术后负重时间及根据Harris对髋关节功能进行评估。结果所有患者术后均获6～24个月随访,平均13．2个月。术后肺部感染1例,下肢深静脉血栓3例,平均下地负重时间28d,术后6个月Harris评分：优25例,良18例,可7例,差2例,优良率82．7％。结论人工股骨头置换术是治疗高龄不稳定股骨转子间骨折的一种安全有效的方法。     

人工股骨头置换治疗高龄股骨转子骨折效果观察

目的探讨高龄患者股骨转子骨折应用人工股骨头置换治疗的临床效果。方法对30例高龄患者股骨转子骨折采用骨水泥型双极人工股骨头置换。其中男11例,女19例,年龄79～101岁,平均年龄84.2。Evans分类：Ⅱ型2例,Ⅲ型18例,Ⅳ型9例。结果30例获得3～26个月随访,平均14.6个月,按Harris髋关节评分,优16例,良10例,可2例,差2例,20例恢复术前行走。结论人工股骨头置换术是治疗高龄股骨转子间不稳定骨折的一种安全有效的方法,术后恢复快,可早期负重,避免卧床并发症,功能恢复良好,提高患者生活质量。     

人工股骨头置换治疗老年股骨转子骨折46例临床分析

目的对老年股骨转子骨折患者进行人工股骨头置换治疗的效果进行分析研究。方法对在永煤集团总医院进行治疗的老年股骨转子骨折患者进行人工股骨头置换治疗,并用钢丝固定。结果对手术后的患者进行随访,结果表明对老年股骨转子骨折用人工股骨置换治疗的效果很好。结论对老年股骨转子骨折患者进行治疗时用人工股骨头进行置换,相较于传统的治疗方法效果更好,应该在以后的治疗中推广。     

PFNA治疗老年人不稳定性股骨粗隆间骨折54例

目的探讨采用股骨近端抗旋转髓内钉（PFNA）手术治疗老龄不稳定股骨转子间骨折的的疗效。方法选择54例老年股骨转子间不稳定性骨折患者,随机分为两组,动力髋螺钉内固定组27例,PFNA治疗组27例。结果所有患者均获随访,随访时间9～24个月,骨折均愈合,愈合平均时间15（8～20）周。PFNA组优23例,良4例,DHS组优18例,良9例。结论 PFNA治疗复杂股骨转子间不稳定性骨折螺旋刀片能够有效防止股骨头切割和旋转及内翻,并发症少。     

股骨近端防旋髓内钉治疗老年股骨转子间骨折

目的 探讨应用闭合复位及股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的临床疗效。方法 采用PFNA治疗老年股骨转子间骨折患者64例,并按Harris评分标准评价术后髋关节功能。结果 所有骨折均愈合,骨折愈合时间10~21周,平均14.2周。术后肺部感染3例,髋内翻畸形2例。髋关节功能恢复程度参照Harris评分:优38例,良21例,可4例,差1例,优良率92.1%。结论 PFNA具有手术时间短、创伤小、术中出血少、固定可靠和并发症少等优点,是一种有效治疗老年股骨转子间骨折的方法。     

人工股骨头置换治疗老年不稳定型股骨转子间骨折的临床效果

目的探讨人工股骨头置换治疗老年不稳定型股骨转子间骨折的方法及临床价值。方法选择2007年10月~2012年10月我院收治不稳定型股骨转子间骨折的老年患者53例,分为人工股骨头置换组23例、动力髋部螺钉方法(DHS对照组)30例,比较两组手术及随访情况。结果人工股骨头置换组老年患者的手术时间、术中出血量、术后下床时间以及术后并发症发生率比对照组明显减少,Harris评分优良率显著增加,差异均具有统计学意义(P0.05)。结论人工股骨头置换术能够使老年不稳定型股骨转子间骨折患者住院时间短、出血量少,功能恢复快,具有重要的临床意义,可广泛应用。     

人工股骨头置换治疗高龄股骨转子周围骨折28例体会

目的：对人工股骨头置换治疗高龄股骨转子周围骨折的方法及疗效。方法：对我院1998-2008年收治的高龄股骨转子周围骨折28例行人工股骨头置换,采用髋关节后外侧入路行双动人工股骨头置换术,随访5个月～2年,有1例因脑出血死亡,所有患者无假体下沉,行走时较轻微疼痛4例。结论：人工股骨头置换减少患者卧床时间,减少并发症,远期效果较好,应为高龄股骨转子周围骨折首选治疗方案。     

骨水泥加长柄人工股骨头置换治疗高龄不稳定性股骨转子间骨折

目的：评价骨水泥加长柄人工股骨头置换治疗高龄不稳定性股骨转子间骨折的临床疗效。方法98例高龄不稳定性股骨转子间骨折患者,女性60例,男性38例,年龄75～94岁,平均83．5岁。骨折按Tronzo-Evans分型Ⅲ型56例,Ⅳ型42例。均采用骨水泥加长柄人工股骨头置换的方法治疗,观察临床治疗效果。结果所有病例术后X线片显示转子间骨折均复位固定良好,假体位置良好。术后96例获得6～24个月随访,平均15个月,按Harris评分,优良率85．4％。结论骨水泥加长柄人工股骨头置换术具有术后功能恢复快、负重活动早、可避免长期卧床、并发症少等优点,是治疗高龄不稳定性股骨转子间骨折较为合理的手术方法。     

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.     

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.