扁桃体剥离术术中止血方法效果对比

目的探讨扁桃体手术中最有效的止血方法。方法回顾性分析我院2005年8月～2009年12月行486例全麻双侧扁桃体剥离术患者的临床资料,所有患者均采用双侧扁桃体剥离术治疗,其中男性292例,女性194例,年龄5～56岁,以5～20岁最多,占72%（350/486）。以肾上腺素棉球压迫止血62例,丝线结扎止血158例,连续缝合法封闭扁桃体窝止血42例,双极电凝器电凝止血224例。结果以肾上腺素棉球压迫止血术后24小时内出血18例,丝线结扎止血术后24小时内出血12例,连续缝合法封闭扁桃体窝止血术后24小时内无一例出血,双极电凝器电凝止血术后24小时内无一例出血。结论以双极电凝器电凝止血预防双侧扁桃体剥离术术后24小时内原发性出血效果更佳,术后恢复更快。     

高频电刀电凝在腭扁桃体手术中的应用

目的:探讨扁桃体手术中应用高频电刀电凝切除的效果.方法:对80例住院患者实施扁桃体切除术,并分为A、B组,A组为高频电刀电凝切除并止血法、B组为传统剥切结扎止血法.比较两种不同方式的手术时间、出血量、术后愈合时间及反应情况.结果:A组手术时间(10.8±1.7)min比B组(30.5±3.8)min短,术中出血较B组少(分别为5.6±1.2)ml和51.9±8.9)ml,术后疼痛A组轻于B组,能更早恢复正常饮食,但较B组伪膜生长慢、脱落慢.差异均有统计学意义.结论:高频电刀电凝切除法较剥切法时间短,出血量极少,术后局部疼痛明显减轻,恢复正常饮食快,但扁桃腭窝白膜脱落时间长,愈合慢.     

可吸收止血膜在甲状腺手术中的临床应用研究

目的 可吸收止血膜(大清生物纸-北京大清生物)在甲状腺手术中的止血,防粘连效果及其副作用.方法 选用2011年04月至2012年4月的甲状腺手术患者60例,30例为实验组,应用可吸收止血膜,大部分不放置引流管;30例为对照组,不用可吸收止血膜,常规术后放置引流管.结果 两组病例基本资料接近,两组手术时间及术中失血量比较无显著差别,术后引流量、引流放置时间、住院天数、住院费用及切口皮瓣粘连等比较有统计学意义(P<0.05).可吸收止血膜术中应用未发现副作用和并发症.结论 可吸收止血膜有术中止血和防粘连的作用,在甲状腺手术中应用可减少术后出血量及切口皮瓣粘连,值得推广.     

术优康在58例扁桃体切除术中的临床应用

扁桃体切除是耳鼻咽喉科的常见手术,而扁桃体术后出血是常见的并发症之一,若患者术后并发创面出血,而为了止血进行创口压迫止血或局部电凝止血,都将会给患者增添巨大的痛苦,而术后创面白膜形成快慢亦与患者术后痛苦程度呈正相关,为减少甚至避免术后并发出血,加快创面愈合.我们使用了贵州扬生医用器械有限公司生产的术优康进行扁桃体术后的创面冲洗,取得较好的效果,现报告如下.     

扁桃体切除术中双极电凝止血的应用

扁桃体切除术是耳鼻咽喉科的常见手术之一,如何防范手术出血是人们最关心的问题。我科自2005年1月开始,采用扁桃体切除后双极电凝止血,避免了扁桃体术后出血并发症的发生,取得了满意效果。现报告如下。     

双极电凝镊在扁桃体切除术中及术后出血的应用

目的 探讨双极电凝镊电凝止血术在扁桃体切除术中的应用。方法 对44例扁桃体切除术中及术后出血中应用双极电凝镊电凝止血术。结果 本组44例经行双极电凝镊电凝止血治疗后，出血即刻停止。术后给予抗生素及止血剂等药物治疗34天，随访至扁桃体窝伪膜脱落，伤口愈合，无1例再出血。疗效满意。结论 双极电凝镊应用在扁桃体切除术中及术后出血的治疗中，具有止血效果确切、安全、快捷的优点，值得基层医院应用和推广。     

使用扁桃体挤切刀＋双极电凝行小儿扁桃体切除术的疗效观察

目的观察使用扁桃挤切刀＋双极电凝行小儿扁桃体切除术的疗效。方法对采用扁桃体挤切刀＋双极电凝行小儿扁桃体切除术的观察组与传统的扁桃体挤切术的对照组比较手术耗时、术中、术后出血情况。结果观察组与对照组手术耗时分别为：（5±2）min、（15±5）min;术中出血量分别：（3±2.0）ml、（30±15）ml;术后出血分别：0例、2例。观察组明显优于对照组,统计学分析差异有显著性（P〈0.05）。结论使用扁桃体挤切刀＋双极电凝行小儿扁桃体切除术安全、有效。     

电切电凝术与常规剥离术用于扁桃体切除的围术期指标及预后观察

目的 比较电切电凝术与常规剥离术对扁桃体切除患者围手术期指标及预后的影响.方法 将2011年3月—2015年4月收治的66例择期行扁桃体切除术的患者作为研究对象,根据治疗方法分为对照组与观察组,各33例.对照组采用常规剥离术干预,观察组则采用电切电凝术治疗,比较不同手术方式对患者手术时间、术中出血量、手术疼痛程度等指标的影响,比较两组术后再出血发生率,观察其创面伪膜形成及脱落情况,比较预后.结果 观察组手术时间、术中出血量均少于对照组,但白膜脱落时间长于对照组(P<0.05).观察组术后1周咽部疼痛视觉模拟评分表评分、术后及末次随访生活质量量表评分均高于对照组(P<0.05).两组创面反应程度、术后伪膜脱落程度及术后再出血率对比差异无统计学意义(P>0.05).结论 采用电切电凝术切除扁桃体,可缩短手术时间,减少术中出血量,患者术后生活质量好.但术后患者伪膜脱落时间长、咽部疼痛程度高.     

双极电凝扁桃体切除术的探讨

目的探讨采用双极电凝进行扁桃体切除术的疗效。方法采用双极电凝对256例慢性扁桃体炎患者进行扁桃体切除,并与采用常规方法切除扁桃体的162例患者在出血量、手术速度、术后愈合时间及反应做比较。结果采用双极电凝切除扁桃体术中平均出血为10m l,剥离法为65m l,手术时间双极电凝切除术为14.7m in,剥离法为24.9m in,且前者术后反应轻、愈合快。结论采用双极电凝切除扁桃体,术中出血少,时间短,术后反应轻,值得推广。     

双极电凝止血联合术后局部氧疗在包皮环切术中的应用

目的观察包皮环切术中双极电凝止血联合术后局部氧疗的疗效。方法将328例行包皮环切术的患者随机分为研究组（双极电凝止血联合术后局部氧疗）162例和对照组（丝线结扎止血术后常规换药）166例。比较2组术后切口感染率。结果研究组切口感染率为3.70%明显低于对照组的8.43%,差异有统计学意义（P〈0.05）。结论包皮环切术中采用双极电凝止血联合术后局部氧疗可明显降低切口感染率,且无不良反应,方便实用。     

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.     

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.     

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.