46例角膜穿孔伤合并外伤性白内障的治疗体会

目的探讨角膜穿孔伤合并外伤性白内障患者,人工晶体植入术手术时机及效果。方法对46例（46眼）角膜穿孔伤合并外伤性白内障患者根据病情分期行角膜修补术、白内障囊外摘除术、人工晶体植入术。第一种术式10眼,采用一期修补角膜,二期行白内障囊外摘除术＋人工晶体植入术;第二种术式24眼一期采用角膜修补术＋白内障囊外摘除术,二期行人工晶体植入术;第三种术式12眼一期行角膜修补术＋白内障囊外摘除术＋人工晶体植入联合手术。结果术后随访3～6个月,视力〉1.0者4例,占8.69%,0.5～0.9者24例占52.17%,0.1～0.4者13例占28.2%,〈0.1以下者5例,占10.87%。结论角膜穿孔伤合并外伤性白内障患者,白内障囊外摘除术及人工晶体植入术手术时机及术式选择非常重要。     

超声乳化摘除晶状体治疗闭角型青光眼在临床应用中的探讨

目的观察超声乳化摘除晶状体联合后房型人工晶体植入术治疗闭角型青光眼的疗效。方法回顾分析我科自2002年3月～2006年12月诊治的27例33眼闭角型青光眼患者;采用常规白内障超声乳化术联合后房型人工晶体植入术。观察手术前后眼压、视力变化。随访5个月～2年,平均13个月。结果术后随访所有病例眼压均正常(8.1～18.7)mmHg,平均(13.4±3.2)mmHg,术后视力全部提高,26眼(78.8%)提高视力在3行以上,有2例发生虹膜后粘连。结论超声乳化摘除晶状体联合后房型人工晶体植入治疗闭角型青光眼是一种较好的手术方式。     

虹膜型人工晶状体在无晶状体联合虹膜缺如眼中的应用

目的 观察虹膜型人工晶状体植入对无晶状体联合虹膜缺如眼的治疗作用.方法 对17例17眼无虹膜、无晶状体及无玻璃体眼行虹膜型人工晶状体植入术,观察术后患者的主观症状、视力的恢复以及并发症情况.结果 术后患者的畏光症状均有所改善,视力有所提高.结论 虹膜型人工晶状体对无虹膜无晶状体患者有良好的临床价值,但其材质需进一步改进...     

青光眼术后虹膜粘连白内障的手术分析

目的分析青光眼术后虹膜粘连的白内障手术。方法对42眼青光眼术后虹膜粘连行虹膜粘连分离、房角分离和超声乳化人工晶状体植入术。结果患者眼压获得良好控制,视力均有不同程度的提高。结论青光眼术后虹膜粘连白内障患者,行虹膜粘连分离、房角分离和白内障超声乳化术人工晶状体植入术后,患眼不仅提高视力,而且眼压亦获得良好的控制。     

复合式术治疗青光眼合并白内障的疗效观察

目的 探讨晶状体超声乳化吸出人工晶体植入联合小梁切除术治疗原发性闭角型青光眼合并白内障的疗效.方法 对42例(42只眼)原发性闭角性青光眼合并白内障患者行白内障超声乳化吸出及人工晶体植入联合小梁切除术,术后注意观察眼压、视力及并发症,术后随访6个月.结果 术后视力较术前视力明显提高,42眼中37眼(88.09%)眼压控制在21 mm Hg以下,其余用药物可以使眼压维持正常水平;35眼(83.33%)术后视力包括矫治视力≥0.3,术后视力较术前均有不同程度提高.结论 青光眼合并白内障的晶状体超声乳化吸出人工晶体植入联合小梁切除术治疗原发性闭角型青光眼合并白内障可有效控制眼压,迅速恢复和改善视力,是一种有效可行的手术方法.     

小切口非超声乳化人工晶体植入术359例分析

目的探讨小切口非超声乳化人工晶体植入术的临床疗效。方法分析359例（374眼）小切口非超声乳化人工晶体植入术术后视力及术中、术后的并发症。结果术后1个月视力≥0．5者为345眼（92．2％）,角膜水肿11眼,术中后囊破裂4眼,瞳孔变形8眼,后发性白内障1眼。术中无虹膜脱出,术后无切口渗漏或浅前房。373眼植入后房型人工晶体,1眼植入前房型人工晶体。结论小切口非超声乳化人工晶体植入术所需器械简单,经济,术后视力恢复快,并发症少,是一种适合基层医院治疗白内障的手术方法。     

小切口非超声乳化白内障手术的临床疗效分析

目的探讨小切口非超声乳化白内障手术的手术方法以及临床治疗效果。方法 80例(80眼)白内障患者,均行小切口非超声乳化白内障摘除联合人工晶体植入术治疗,观察患者视力恢复情况及并发症发生情况。结果 80例患者术后第2天视力>0.5为41例;术后1周视力>0.5为52例,术后1个月矫正视力≥0.5为71例,视力恢复良好。80例患者术后第2天41眼角膜出现不同程度的水肿,发生后囊破裂7眼,虹膜根部离断l眼,未植入人工晶体1眼,术后人工晶体夹持1眼。结论小切口非超声乳化白内障摘除联合人工晶体植入术治疗白内障效果良好,能有效地提高患者视力,是一种安全、有效的手术方法 ,应积极在基层医院推广应用。     

角膜穿通伤并发创伤性白内障两种处理时机的疗效观察

目的通过急诊行角膜缝合同时行白内障摘除术及Ⅱ期植入人工晶状体与急诊行角膜缝合并Ⅱ期行白内障摘除及人工晶状体植入术的疗效观察,探讨创伤性白内障处理及人工晶状体植入的最佳手术时机。方法将20例角膜穿通伤并发创伤性白内障患者随机分为两组．观察组10例急诊行角膜缝合术同时行白内障摘除术,术后7—10d行人工晶状体植入术：对照组10例急诊行角膜缝合术,术后7～10d行白内障摘除同时行人工晶状体植入术。随诊6个月,拆除角膜缝线后,观察两组患者的视力恢复及并发症发生情况。结果急诊行角膜缝合同时行白内障摘除,Ⅱ期行人工晶状体植入的观察组无严重并发症,视力恢复快。结论急诊行角膜缝合同时行白内障摘除、Ⅱ期人工晶状体植入,可使创伤性白内障患者的视力达到较为理想的效果,临床上值得应用。     

玻璃体切除联合白内障手术治疗增殖性糖尿病视网膜病变

目的 评价玻璃体切除联合晶状体超声乳化及人工晶体植入术治疗增殖性糖尿病视网膜病变的临床效果.方法 回顾性分析25例(31眼)伴有白内障的增殖性糖尿病视网膜病变患者行玻璃体切除联合晶状体超声乳化及人工晶体植入术的临床资料,31眼同期植入后房型人工晶状体.结果 术后随访3-12个月,平均5.5个月.24眼(77.4%)术后视力改善.术中无并发症发生.术后并发症有:前房炎性反应5眼(16.1%),玻璃体积血2眼(6.5%),复发性视网膜脱离1眼(3.2%),新生血管性青光眼2眼(6.5%),14眼术后需要继续眼内光凝.结论 玻璃体切除联合晶状体超声乳化及人工晶体植入术治疗增殖性糖尿病视网膜病变,可使大多数患者的视力改善,手术是安全的.手术的关键为选择合适的患者.影响术后视力的主要因素为视网膜病变程度.     

三种手术方式治疗青光眼并白内障临床疗效比较

目的：比较三种手术方式治疗青光眼并白内障的适应证和临床疗效。方法90例青光眼并白内障患者按数字表法随机分为A、B、C三组,A组患者行单纯白内障超声乳化加人工晶状体植入术治疗,B组患者行白内障超声乳化加人工晶状体植入联合虹膜根切术治疗,C组患者行白内障超声乳化加人工晶状体植入联合小梁咬切除术治疗,比较三组患者临床疗效。结果三组患者手术治疗前裸眼视力对比差异无统计学意义（P＞0．05）,经过手术治疗,所有患者的裸眼视力均有所改善,且三组患者的术后视力对比差异无统计学意义（P＞0．05）。三组患者术前、手术后1周、手术后6个月眼压差异均无统计学意义（均P＞0．05）;同组患者手术前后不同时点眼压差异均有统计学意义（均P＜0．05）。三组术后患者的虹膜根部较为平坦,房角有所增宽,且存留周边虹膜处黏膜面积有所缩小,可见范围变大;未发生严重并发症。结论青光眼并白内障患者接受三种手术方式治疗,均能够显著改善患者的视力情况,因而具有较高的临床应用价值。     

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.     

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.