单叶产钳在新式剖宫产术中的应用

目的:探讨在新式剖宫产术中徒手取胎困难时应用单叶产钳助娩的临床效果。方法:对138例在新式剖宫产术中发生徒手取胎困难的单胎头位的产妇应用单叶产钳助娩。结果:138例徒手娩出胎头失败者应用单叶产钳助娩均成功,其中新生儿窒息率12 .3% ,新生儿损伤率10 .9% ,产妇并发症率2 5 .4 %。结论:在新式剖宫产术中发生徒手娩胎头困难时,及时果断应用单叶产钳助娩,可安全娩出胎儿,减少母婴并发症     

剖宫产术应用小产钳助娩的临床观察

目的探讨剖宫产术中应用小产钳助娩的方法及临床效果。方法将2009年12月至2010年12月在高州市妇幼保健院行剖宫产术中估计胎头娩出困难时应用小产钳助娩的362例产妇为观察组(小产钳助娩),随机取2008年12月至2009年12月在高州市妇幼保健院行剖宫产术中估计胎头娩出困难的331例产妇为对照组(手娩),对两组的手术效果进行比较。结果两组从子宫切开至胎儿娩出的时间比较差异有显著性(P<0.01),两组术中出血量及住院时间比较差异均无显著性(P>0.05),两组的新生儿窒息率及颅内出血率比较差异有显著性(P<0.01),两组产妇子宫切口撕裂的发生率比较差异具有显著性(P<0.01)。结论在剖宫产术中胎头娩出困难时应用小产钳助娩,能够促进胎儿的顺利娩出,有效减少术后新生儿及产妇并发症的出现,值得临床推广运用。     

剖宫产单叶产钳的临床应用分析

目的探讨在剖宫产术中应用单叶产钳助娩的临床效果。方法对2007年1月至2009年9月我院子宫下段剖宫产300例进行分析,其中,子宫下段剖宫产徒手助娩胎头150例,剖宫产胎头高浮、胎头深嵌、麻醉效果不佳、切口过小时直接用单叶产钳助娩胎头病例150例。结果 150例应用单叶产钳助娩均成功,取胎时间〈90s,平均45.02s,无新生儿窒息、新生儿损伤及产妇并发症。结论子宫下段剖宫产术中胎头高浮、胎头深嵌、麻醉效果不佳、切口过小时,及时果断应用单叶产钳助娩,可安全娩出胎儿,减少母婴并发症。     

小产钳在新式剖宫产手术中的应用

目的探讨双叶小产钳在剖宫产术中应用价值。方法总结分析我院2011年8月至2012年7月期间双叶小产钳在剖宫产手术中应用效果。结果观察组胎头娩出时间(20±5)s短于对照组(30±6)s,两组差异有统计学意义(P<0.05);观察组新生儿Apgar评分(9.35±0.45)分高于对照组(8.23±1.01)分,两组差异有统计学意义(P<0.05);术中出血量观察组为(296±61)mL少于对照组为(365±98)mL,两组差异有统计学意义(P<0.05);两组新生儿面部损伤及子宫切口撕裂差异无显着性(P>0.05)。结论剖宫产术中徒手取胎头困难者使用双叶小产钳可明显缩短娩胎头时间,减少新生儿窒息率及术中子宫出血量,且不增加新生儿面部损伤及子宫切口撕裂,值得推广。     

产钳在剖宫术中应用（附316例分析）

目的探讨产钳在剖宫术中应用价值.方法316例具有剖宫产指征、胎头浮动在骨盆上方的产妇分为两组.术中采用产钳助娩胎头158例,采用手法托出胎头的158例,两组进行比较.结果采用产钳组,平均取头时间缩短32",P＜0.05,新生儿Apgar评分高;不增加子宫切口延裂.结论采用产钳助娩胎头,可明显缩短胎儿娩出时间,减少新生儿窒息,有效降低伤残儿的出生率,提高围产保健质量.     

产钳在剖宫产术中的应用(附8例报告)

剖宫产术中 ,偶尔会碰到一些特殊情况 ,使胎头娩出困难 ,往往造成或加重胎儿窘迫 ,致新生儿窒息。我院自 1998年 1月～ 2 0 0 0年 6月 ,尝试在剖宫术中用产钳助娩胎头 8例 ,效果良好 ,报告如下 :1　资料与方法1.1　我院 1998年 1月～ 2 0 0 0年 6月 ,共住院分娩 2 75 4例 ,其中剖宫产 743例占2 6.95 % ,胎头娩出困难用产钳助娩 8例。1.2　使用产钳原因　本组 8例中 ,有 5例为新式剖宫产 (腹壁横直切口 ) ,其中胎头高浮 4例 ,切口上缘阻挡 ,取头困难 ,1例胎头深嵌骨盆 ;另 3例为传统剖宫产 (腹壁纵切口 ) ,其中巨大儿 1例 ,胎头深嵌骨盆2例。…     

剖宫产术中应用产钳效果分析

目的分析剖宫产术中使用产钳的临床效果。方法回顾性分析我院2006年7月至2012年4月收治的386例胎头娩出困难的产妇。根据剖宫产术中助产方式的不同分为产钳组(216例)和徒手组(170例)。分析比较两组术中胎头娩出时间、出血量及母婴并发症发生率。结果产钳组胎头娩出时间明显低于徒手组;母婴并发症发生率明显低于徒手组,其中产钳组子宫切口撕裂和新生儿窒息发生率明显低于徒手组。结论产钳的使用可缩短胎头娩出时间,降低子宫切口撕裂及新生儿窒息的发生,是解决胎头娩出困难的一种有效助产方式。     

剖宫产术中胎头深嵌取头困难的处理方法探讨

目的:探讨在剖宫产术中出现胎头深嵌取头困难时,如何安全快速取出胎儿,减少对胎儿及产妇的损伤。方法:对2008年1月～2009年7月在本院剖宫产中出现的胎头深嵌病例78例,随机分为A、B、C三组,分别采用牵胎足、产钳助娩、助手从阴道上推胎头等三种方法娩出胎儿,并在取胎时间、切口延裂、术中出血、腹部切口感染、新生儿损伤等方面进行对比。结果:在取胎时间上A组用时(50±35)s,明显少于B组(93±42)s和C组(95±38)s,P<0.01;切口延裂A组1例,B组1例,C组6例,术中出血大于500 mL的A组1例,B组1例,C组5例,腹部切口感染A组1例,B组0例,C组5例,新生儿窒息A组1例,B组1例,C组4例,A组、B组上述并发症发生率明显低于C组,P<0.05;A组产伤0例、B组面颊部淤血2例,C组头颅血肿4例,A组产伤发生率明显低于B组、C组,P<0.05。结论:在剖宫产术中发现胎头深嵌时,用牵胎足法及产钳娩出胎儿是有效的,但牵胎足法取胎时间较产钳法短,操作方法较产钳法容易掌握,助手从阴道上推胎头法也可帮助娩出胎儿,但并发症较多。三种方法相比,牵胎足法娩出胎儿更安全有效,适合在基层医院推广应用。     

单叶小产钳在新式剖宫产术中助娩胎头高浮的应用体会

<正>新式剖宫产已成为剖宫产术的主导术式。但是它的缺点之一是因腹壁切口、子宫下段切口位置低造成娩头困难。难免延长胎头娩出时间及增加新生儿、孕产妇并发症。我们尝试剖宫产术中应用单叶小产钳助娩高浮胎头有助于迅速娩出胎儿,有效地减少了术中的取头困难及并发症,明显减少切开子宫至胎儿娩出的时间间隔(U-DI),减少新生儿窒息的发生,是产科医师应当熟练掌握的技术,值得在临床推广应     

59例腹部横切口剖宫产术娩头困难产钳助产的临床分析

目的:探讨横切口剖宫产术娩头困难时产钳助产的疗效。方法:回顾性分析某院2007年3月~2008年10月59例腹部横切口剖宫产术娩头困难的临床资料。结果:59例中,使用产钳助娩31例(简称产钳组)占52.54%,强行加腹压按宫底徒手娩头28例(简称手取组)占47.45%。两组之间胎头娩出时间和母婴并发症差异有显著性(P<0.05)。结论:横切口剖宫产术娩头困难时,产钳助产可降低母儿并发症,缩短胎儿娩出时间,值得在临床应用推广。     

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.

     

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.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.