手术后应用尖吻蝮蛇血凝酶止血的安全性评价

目的 评价手术后使用尖吻蝮蛇血凝酶止血的安全性.方法 用自身对照研究方法,对30例患者,术前及术中不给予止血药;而术后依情况给予尖吻蝮蛇血凝酶1-2 u,使用1～4天,观察术前和给药后机体的凝血功能和安全性指标.结果 30例患者术前、药后自身对照显示,其生命体征、肝、肾、心脏以及凝血功能,均未发生显著性变化,整个试验过程无不良事件.结论 手术后使用尖吻蝮蛇血凝酶有较高的安全性.     

尖吻蝮蛇血凝酶在甲状腺切除手术中的临床应用

目的观察尖吻蝮蛇血凝酶在甲状腺切除手术中临床应用的安全性及止血作用的有效性。方法选择行甲状腺切除的患者40例,随机分为尖吻蝮蛇血凝酶组（J组）和对照组（C组）,每组各20例。J组患者在术前15min静脉注射尖吻蝮蛇雪凝酶1U,C组患者在术前15min静脉注射等量生理盐水。记录两组患者术中、术后6h、24h内的出血量;记录两组患者术前及术后24h凝血功能、血常规及并发症的发生率。结果J组患者术中及术后6h、12h出血量较C组明显减少,差异有统计学意义（P〈0.05）;J、C两组凝血功能、血常规及并发症相比较差异无统计学意义（P〉0.05）。结论尖吻蝮蛇凝血酶可安全有效的应用于甲状腺切除手术。     

尖吻蝮蛇血凝酶用于肝内胆管结石围手术期止血的疗效观察

目的：评价尖吻蝮蛇血凝酶在胆道手术后的止血疗效及对凝血功能的影响。方法选取2011年1@8月在该科行开腹手术治疗的肝内胆管结石患者80例,随机分为尖吻蝮蛇血凝酶组与巴曲酶制剂组各40例,术前30min 分别静脉滴注尖吻蝮蛇凝血酶2U 和巴曲酶制剂2kU,术后连续用药3d,观察术中手术切口出血量、单位面积出血量、术后腹腔引流管引流量、引流液的血红蛋白浓度以及术前1d,术后30min、1d 和7d 机体凝血功能（PT、APTT、PLT 和 FIB）。结果2组患者术后止血效果及凝血功能各项指标比较差异无统计学意义（P ﹥0.05）,2组均无不良反应发生。结论尖吻蝮蛇血凝酶应用于肝内胆管结石围手术期具有较好的止血作用和安全性。     

尖吻蝮蛇血凝酶与氨基己酸氯化钠防治围手术期出血的有效性和经济性比较：基于溯直医疗数据库的回顾性研究

目的 基于真实世界研究评价尖吻蝮蛇血凝酶和氨基己酸氯化钠应用于围手术期住院患者止血的有效性和经济性差异。方法 回顾溯直医疗数据库(SuValue^?)2016年1月1日—2020年12月31日三级医院围手术期使用尖吻蝮蛇血凝酶或氨基己酸氯化钠住院患者的临床疗效和直接医疗成本数据,按不同干预措施将患者分别纳入尖吻蝮蛇血凝酶组和氨基己酸组,进行倾向性评分匹配,比较两组的有效性和经济性差异。结果 两组各纳入367例患者。有效性方面,与氨基己酸组相比,尖吻蝮蛇血凝酶组患者的估计总失血量和住院时间显著减少(P <0.01);两组患者的输血率和输血量差异均无统计学意义(P> 0.05),术前和术后凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原水平均在正常值范围,未影响患者凝血功能。经济性方面,尖吻蝮蛇血凝酶组住院总成本、止血总成本、止血药物成本和止血材料成本低于氨基己酸组(P <0.05)。结论 尖吻蝮蛇血凝酶应用于围手术期住院患者防治出血症状的有效性和经济性优于氨基己酸氯化钠注射液。     

尖吻蝮蛇血凝酶与氨甲环酸术中止血效果比较

目的:评价术中使用尖吻蝮蛇血凝酶对手术切口止血作用的有效性及安全性。方法:对行妇产科腹腔镜手术的40例患者术中分别采用尖吻蝮蛇血凝酶与氨甲环酸术中止血,并进行效果比较。尖吻蝮蛇血凝酶组20例,氨甲环酸氯化钠组20例。术中分别静脉给予尖吻蝮蛇血凝酶2 U、氨甲环酸氯化钠1 g。观察2组患者手术切口出血量、术中出血量、切口创面止血时间及术后3天血常规、凝血功能、肝肾功能变化情况。结果:2组患者的止血效果无显著性差异(P>0.05)。2组患者术后3天的血常规、凝血功能、肝肾功能检查结果与术前比较均无显著性差异。本组病例无不良事件发生。结论:尖吻蝮蛇血凝酶对手术伤口的止血作用与氨甲环酸氯化钠相似,均有较好的安全性。     

尖吻蝮蛇血凝酶在妇科手术中应用的安全性及有效性观察

目的 观察及评价注射用尖吻蝮蛇血凝酶(HCA)在妇科手术中应用的安全性及止血效果.方法 妇科手术病人39例,围手术期使用HCA辅助止血,观察给药前和给药后第3天,病人凝血功能、血常规、肝肾功能指标;同时观察药物对手术视野及出血量的影响.结果 HCA用于妇科手术止血,用药前与用药后第3天,凝血功能、血常规、肝肾功能指标无明显变化(P>0.01).能明显清晰手术视野,减少出血量,止血有效率达87.18%.结论 注射用尖吻蝮蛇血凝酶在妇科手术中应用安全、有效.     

应用尖吻蝮蛇血凝酶止血的有效性和安全性评价

目的研究尖吻蝮蛇血凝酶止血的有效性和安全性。方法选择2011年1月至2012年2月我院进行手术的患者100例,年龄19~72岁,平均为(32.1±4.8)岁,其中男53例,女47例。于手术开始前15~20min通过静脉注入尖吻蝮蛇血凝酶,观察凝血功能指标、血常规指标及肝肾功能指标。结果治疗后患者的PT、TT、APTT、FIB、PLT、HGB、WBC、RBC以及ALT、TBIL、Bun、Cr与治疗前比较无显著差异(P>0.05)。表明尖吻蝮蛇血凝酶对患者的凝血功能,血红蛋白、血小板、白细胞、红细胞以及对患者的肝肾功能无显著影响,尖吻蝮蛇血凝酶止血的总有效率达89%,其中显效率为65%,有效率为24%,无效率为11%。患者在治疗过程中均未发生明显不良反应。结论应用尖吻蝮蛇血凝酶止血临床疗效好,无明显不良反应,值得在临床上推广使用。     

血凝酶在腺样体手术中应用的疗效观察

目的:探讨在腺样体手术中应用血凝酶对出血量、凝血功能及血小板功能的影响。方法:采用随机对照方法,将240例行腺样体手术患者分为试验组(应用血凝酶)与对照组(不用血凝酶)。分别检测给药前、后凝血功能和血小板功能,计算术中出血量和术后出血量。结果:2组间术中出血量、痰液中血红蛋白含量、手术时间比较,差异均有统计学意义(P<0.05)。除纤维蛋白原外,凝血功能其余指标和血小板功能各指标2组差异均无统计学意义(P>0.05)。结论:在腺样体手术中应用血凝酶能有效减少术中出血量,减少术后创面渗血,不影响机体凝血功能和血小板功能。     

尖吻蝮蛇血凝酶在神经外科术后应用的安全性评价

目的：评价注射用尖吻蝮蛇血凝酶（ HCA）在神经外科手术中应用的安全性。方法选取2010年9月-2011年4月神经外科手术患者61例为研究对象,术后均给予HCA止血治疗。观察给药前和给药后第3天患者凝血功能、血常规、肝肾功能指标变化情况。结果 HCA用于神经外科手术止血,用药前与用药后第3天,患者生命体征、肝肾、心脏以及凝血功能,均未发生显著性变化,整个试验过程无不良反应。结论注射用HCA在神经外科手术中应用安全、有效。     

尖吻蝮蛇血凝酶对股骨干骨折术中出血的影响

目的观察尖吻蝮蛇血凝酶对股骨干骨折术中出血的影响。方法选择中上1/3处股骨干骨折实施钢板内固定患者46例,采用就诊顺序编码方法,将患者分为血凝酶组(23例)和对照组(23例)。血凝酶组术前30 min给予注射用血凝酶2 U静脉注射,术后第1天再用血凝酶2 U静脉注射。对照组除不给予血凝酶外,其他操作和用药同血凝酶组。观察两组术中出血及术后24 h引流量。结果同对照组比较,血凝酶组术中出血及术后24 h引流量明显减少(P<0.05),术前及术后24 h凝血因子检测差异无统计学意义(P>0.05)。结论术前静脉注射尖吻蝮蛇血凝酶,可明显减少术中出血量,对于手术创面大和剥离组织较多的手术具有良好的止血作用。     

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.     

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.