内镜下聚桂醇注射治疗食管静脉曲张的临床应用分析

目的探讨聚桂醇在注射治疗食管静脉曲张时的临床疗效及安全性。方法对187例食管静脉曲张患者进行内镜下聚桂醇(1%乙氧硬化醇)注射治疗,观察术中、术后止血疗效及临床并发症。结果 187例患者共行248次聚桂醇注射治疗,即时止血率100%;随访至今再出血13.90%,死亡率4.27%。聚桂醇治疗后术后1周复查胃镜120例,食管静脉曲张有减轻102例(85%),无明显变化18例(15%),82例(68.33%)有食管溃疡形成,62例(60.78%)仍存在有重度静脉曲张,进行二、三次硬化剂治疗。术后常见并发症有8例(4.27%)发热和46例(24.60%)发生胸骨后不适、腹胀、腹部不适;出血、穿孔、狭窄或异位栓塞等严重并发症少。结论硬化术治疗食管静脉曲张破裂出血,止血效果可靠,安全性高。     

51例内镜下注射聚桂醇硬化剂治疗食管静脉曲张疗效观察

目的观察内镜下注射聚桂醇硬化剂治疗食管静脉曲张的疗效。方法对51例食管静脉曲张破裂出血患者行内镜下注射聚桂醇治疗。结果急诊胃镜9例,止血成功9例;非急诊42例,成功42例;术后1例发生食管狭窄,19例患者出现胃区不适、吞咽困难等症状。随访6~8个月,随访期间发生近期再出血2例,远期再出血4例。结论内镜下注射聚桂醇是食管静脉曲张破裂出血的一种安全、有效的治疗方法 ,但需注意术后并发症及再出血的发生。     

聚桂醇在急诊硬化治疗食管静脉曲张破裂出血中的应用体会

目的探讨肝硬化食管静脉曲张破裂出血早期有效控制出血的治疗方法。方法对62例肝硬化食管静脉曲张破裂出血患者行急诊内镜下注射聚桂醇(1%乙氧硬化醇)治疗。结果本组62例患者止血成功率100%,其中60例首次治疗即获成功;另2例再次止血成功。结论急诊内镜下硬化治疗是肝硬化食管静脉曲张破裂出血止血的一种有效方法,聚桂醇作为硬化剂疗效肯定,不良反应少而轻,重复性好,是一种安全有效的硬化药物。     

套扎及硬化术治疗食管下段胃底静脉曲张15例分析

目的探讨食管下段胃底静脉曲张内镜下治疗及其安全性.方法 1995年3月至2005年5月对15例食管下段胃底静脉曲张患者行硬化和套扎治疗. 结果 1例胃底静脉曲张出血急诊硬化治疗后血止,硬化术中出血4例,经再次注射或附加气囊压迫后血止,套扎术未并发术中出血,1例套扎术后第13天再次出血,内科治疗无效,改行手术治疗. 结论内镜治疗对食管下段胃底静脉曲张疗效较满意,初步印象中套扎治疗对静脉曲张明显者安全性较高.     

内镜下套扎联合硬化治疗肝硬化食管静脉曲张破裂出血疗效观察

目的:观察内镜下套扎联合硬化治疗肝硬化食管静脉曲张破裂出血的疗效.方法:选择44 例肝硬化食管静脉曲张破裂出血患者,均行内镜下食管静脉联合内镜下硬化治疗.观察患者治疗后的食管静脉曲张消失率、不良反应及治疗后1年内的复发情况.结果:治疗后患者食管静脉曲张消失率为95.45%(42/44).随访1年中,患者复发1 例(2.27%),为合并胃底静脉曲张患者,无死亡病例.治疗后胸骨后疼痛39 例,低热13 例,早期再出血2 例,早期再出血患者经治疗后出血较快停止,无1 例出现食管狭窄.结论:内镜下食管静脉曲张套扎术联合内镜下硬化治疗食管静脉曲张疗效好,复发率低,值得在临床推广使用.     

内镜下套扎联合硬化治疗肝硬化食管静脉曲张破裂出血疗效观察

目的:观察内镜下套扎联合硬化治疗肝硬化食管静脉曲张破裂出血的疗效。方法:选择44例肝硬化食管静脉曲张破裂出血患者,均行内镜下食管静脉联合内镜下硬化治疗。观察患者治疗后的食管静脉曲张消失率、不良反应及治疗后1年内的复发情况。结果:治疗后患者食管静脉曲张消失率为95.45%(42/44)。随访1年中,患者复发1例(2.27%),为合并胃底静脉曲张患者,无死亡病例。治疗后胸骨后疼痛39例,低热13例,早期再出血2例,早期再出血患者经治疗后出血较快停止,无1例出现食管狭窄。结论:内镜下食管静脉曲张套扎术联合内镜下硬化治疗食管静脉曲张疗效好,复发率低,值得在临床推广使用。     

胃镜下食管静脉曲张套扎术的疗效分析

目的探讨胃镜下肝硬化食管静脉曲张破裂出血患者套扎术的临床疗效及安全性。方法对40例肝硬化患者进行胃镜下曲张静脉套扎术的临床资料进行分析总结。结果胃镜下食管静脉曲张套扎术治疗食管静脉曲张出血,可有效预防再出血,提高生存率,操作安全可行,术后无明显并发症。结论胃镜下食管静脉曲张套扎术是治疗食管静脉曲张破裂出血的有效止血方法,其是一种创伤小、疗效好、成功率高、并发症少、安全性高的内镜介入手段。     

聚桂醇联合组织胶内镜下治疗食管胃静脉曲张出血的疗效

目的:探讨聚桂醇与组织胶内镜对食管胃静脉曲张出血患者的联合治疗作用。方法:选择我院2017年1月—2019年10月收治的食管胃静脉曲张出血患者54例作为研究对象,随机分为参照组和探究组,每组27例。参照组采用碘油-组织胶-碘油法进行常规治疗,探究组则予以聚桂醇联合组织胶内镜下治疗。对比分析两组临床疗效、近远期再出血率以及并发症发生率。结果:综合分析研究结果可知,探究组临床总有效率96.30%(26/27)高于参照组的77.78%(21/27),其近远期再出血率与并发症发生率亦均低于参照组,且相关数据差异具有统计学意义(P<0.05)。结论:与常规性碘油-组织胶-碘油法治疗相比,对食管胃静脉曲张出血患者实施聚桂醇联合组织胶内镜下治疗方案的临床疗效更为理想,并且近远期再出血率与并发症发生率均较低,有利于营造良好的预后效果,值得临床借鉴与推广。     

内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近远期疗效观察

目的观察内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近远期疗效。方法选取我院99例胃底食管静脉曲张患者,通过随机数字表法分为套扎组,注射组和联合治疗组(每组各33例),套扎组单独使用内镜套扎术,注射组单独使用组织胶与聚桂醇的改良三明治法注射,联合治疗组联合使用内镜套扎术和组织胶与聚桂醇的改良三明治法注射,观察比较3组的治疗有效率、止血成功率、近期再出血和并发症,以及2年后随访情况。结果经过治疗后,联合治疗组的治疗有效率为94%,明显高于其他2组,差异具有统计学意义(P<0.05)。联合治疗组的止血成功率,近期再出血和并发症,也明显优于其他2组,差异具有统计学意义(P<0.05)。在2年后的随访结果中,联合治疗组也明显优于其他2组,差异具有统计学意义(P<0.05)。结论内镜套扎术联合改良三明治法注射治疗食管胃底静脉曲张出血的近期和远期疗效都十分显著,值得临床推广。     

内镜套扎术联合β-受体阻滞剂治疗食管静脉曲张破裂出血的临床疗效分析

目的 评价内镜套扎术联合β-受体阻滞剂治疗食管静脉曲张破裂出血的安全性和有效性.方法 分析63例食管静脉曲张破裂出血以内镜套扎术联合β-受体阻滞剂治疗及随访情况,总结治疗成功率、并发症及再出血发生率等.结果 内镜套扎术治疗63例食管静脉曲张破裂出血止血成功率100％(63/63),早期再出血率1.6％(1/63),早期并发症发生率7.9％ (5/63).联合口服β-受体阻滞剂继续治疗,63例随访6～18个月,平均12个月,再出血发生率为6.3％(4/63),6个月生存率为98.4％(62/63).结论 采用内镜套扎术联合口服β-受体阻滞剂治疗食管静脉曲张破裂出血简便安全,止血效果肯定,值得推广应用.     

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.     

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.