经导管双侧髂内动脉灌注化疗治疗浸润性膀胱癌的疗效观察

目的探讨经导管双侧髂内动脉灌注化疗治疗浸润性膀胱癌的临床疗效。方法选取我院收治的46例浸润性膀胱癌患者,所有患者均行经导管双侧髂内动脉灌注化疗,选择顺铂和吉西他滨作为化疗药物。结果所有患者均顺利完成双侧髂内动脉插管。经导管灌注化疗治疗后,病情稳定(SD)2例(4.35%)、部分缓解(PR)40例(86.96%)、完全缓解(CR)4例(8.70%)。PR患者的瘤体均显著缩小,并接受经尿道膀胱肿瘤电切术治疗。所有患者均随访3~12个月,平均(5.52±1.16)个月。6例(13.04%)患者复发,再次行经尿道膀胱肿瘤电切术治疗。结论在浸润性膀胱癌患者实施经导管双侧髂内动脉灌注化疗,疗效确切,具有十分重要的临床意义。     

TURBt联合髂内动脉灌注化疗治疗浸润性

目的 寻找浸润性膀胱癌的有效治疗方法.方法 对经尿道膀胱肿瘤切除术(TURBt)联合髂内动脉化疗的34例浸润性膀胱癌患者临床资料进行回顾性分析.结果 2年内死亡4例,生存2～4年14例,生存5年以上16例,没有明显并发症.结论 TURBt联合髂内动脉化疗为晚期浸润性膀胱癌,尤其是不能或不愿行膀胱全切术者提供了一种有效的治疗方法.     

TURBt联合髂内动脉灌注化疗治疗浸润性膀胱癌

目的寻找浸润性膀胱癌的有效治疗方法。方法对经尿道膀胱肿瘤切除术（TURBt）联合髂内动脉化疗的34例浸润性膀胱癌患者临床资料进行回顾性分析。结果2年内死亡4例,生存2-4年14例,生存5年以上16例,没有明显并发症。结论TURBt联合髂内动脉化疗为晚期浸润性膀胱癌,尤其是不能或不愿行膀胱全切术者提供了一种有效的治疗方法。     

经尿道膀胱肿瘤切除术结合髂动脉灌注化疗治疗复发浸润性膀胱肿瘤24例临床观察

目的：报道经尿道膀胱肿瘤切除术（ TUR-Bt）结合髂动脉灌注化疗治疗复发浸润性膀胱肿瘤疗效,探讨其在肌层浸润性膀胱肿瘤患者中的治疗价值。方法对24例复发浸润性膀胱肿瘤患者应用TUR-Bt结合髂动脉灌注化疗治疗,分析TUR-Bt结合髂动脉灌注化疗治疗复发浸润性膀胱肿瘤的复发及危险因素。结果24例患者随访8～60个月,中位随访时间35个月。9例未复发,其中6例存活至今,3例均死于非膀胱肿瘤所致死亡。6例局部肌层浸润性再度复发,其中4例再次行TUR-BT＋髂动脉灌注化疗,2例于术后3年死亡,2例至今存活,另外2例行膀胱全切＋回肠膀胱术,5例局部非原肌层浸润性复发,再次行TUR-BT＋髂动脉灌注化疗,存活至今。2例局部肌层浸润复发伴盆腔远处淋巴结转移,接受综合治疗,10个月后死于多器官功能衰竭。2例远处转移接受姑息性治疗,7个月后死于膀胱癌。5年总生存率（ OS）、无复发生存率（ RFS）分别是：50％、37．5％。临床随访显示淋巴管浸润、有尿路上皮癌病史、高龄、合并糖尿病、高血压等基础疾病是OS、RFS的影响因素。结论 TUR-Bt结合髂动脉灌注化疗治疗复发浸润性膀胱肿瘤疗效较为满意,但不适用反复复发膀胱肿瘤患者及有膀胱上皮癌病史者,对基础疾病较多患者疗效较差,对术前即有淋巴结转移的患者预后往往较差。     

肌层浸润性膀胱癌髂内动脉化疗的临床疗效

目的 评价肌层浸润性膀胱癌髂内动脉介入化疗疗效.方法 回顾性分析肌层浸润性膀胱癌患者行根治性经尿道膀胱肿瘤电切术(TURBT)后联合髂内动脉介入化疗(A组,19例)和单纯行根治性TURBT术(B组,25例)资料,比较髂内动脉化疗前后病理分期的改变,分析5年累计生存率和膀胱保留率的差异.结果 与B组相比,A组髂内动脉化疗后病理分期降低至pT0N0期比例高于B组(52.6％ vs.12.0％) (P＜0.05).A组患者5年累积生存率高于B组(56.5％ vs.44.3％)(P＜0.05).A组膀胱保留率高于B组(78.9％ vs.56.0％)(P＜0.05).结论 对肌层浸润性膀胱癌患者,TURBT术后联合髂内动脉化疗的疗效优于单纯行根治性TURBT手术.     

保留膀胱手术治疗肌层浸润性膀胱癌的可行性研究

目的探讨肌层浸润性膀胱癌患者行保留膀胱手术治疗价值。方法选取2012年9月～2013年9月本院确诊84例肌层浸润性膀胱癌患者,根据治疗形式的差异性分为甲组(n=34,动脉灌注化疗联合膀胱灌注化疗)、乙组(n=24例,术后予以动脉灌注化疗)、丙组(n=26,膀胱灌注化疗),观察并比较三组复发率、疾病死亡率以及不良反应。结果甲组复发率为8.83%低于乙组20.84%和丙组53.85%,差异有统计学意义(P 0.05);乙组复发率20.84%低于丙组53.85%,差异有统计学意义(P 0.05)。甲组和乙组比较,差异无统计学意义(P 0.05);甲组死亡率2.94%、乙组4.17%、丙组15.39%比较,差异无统计学意义(P 0.05);甲组和乙组术后,均出现较为轻级的消化道不适,如胃纳、恶心以及上腹部不舒适等,对症救治后的24～48h后消失。3例出现一过性发热,对症救治后有所改善。13例患者7d后存在轻度骨髓抑制反应,未予以特殊救治14d内恢复正常,2例患者存在重度白细胞、血小板降低等骨髓抑制,予以集落刺激因子等治疗14d内上升到常规状态。结论肌层浸润性膀胱癌患者予以常规膀胱手术+髂内动脉灌注化疗+膀胱内灌注化疗综合形式,有利于肿瘤复发率降低,预后生活质量改善,推广价值可行。     

髂内动脉连续灌注抗癌药物配合手术治疗膀胱癌

本文报告用髂内动脉连续灌注抗癌药物配合手术的方法为17例膀胱癌患者进行了治疗。并介绍插管方法,认为是简单易行的。在治疗和预防肿瘤术后复发较其它化疗方法优越。对一些年老体弱不能耐受或不愿接受膀胱全切除术的患者,可以做膀胱部分切除加髂内动脉灌注抗癌药物化疗以提高疗效。     

髂内动脉化疗栓塞在膀胱癌术后复发中的应用

目的探讨经导管髂内动脉化疗栓塞术在膀胱癌术后复发治疗中的临床价值。方法19例膀胱癌术后复发患者（均经病理检查证实）行双侧髂内动脉灌注化疗并用明胶海绵及真丝线段等栓塞治疗。结果19例患者在动脉灌注化疗栓塞术后均可见尿液颜色变浅,16例在2 d后出血完全停止;3例血尿症状明显改善,2周左右经B超、CT复查膀胱肿瘤缩小的12例。结论对于膀胱癌术后复发的患者,髂内动脉化疗栓塞治疗能有效控制临床症状,抑制肿瘤生长,是一种安全、可靠、有效的姑息性治疗方法。     

浸润性膀胱癌的治疗现状

浸润性膀胱癌（invasive bladder cancer,IBC）恶性程度高,治疗较复杂。目前对浸润性膀胱癌的治疗除了部分T2期膀胱癌行膀胱部分切除或经尿道膀胱肿瘤电切术（TURBt）外,大多采用根治性全膀胱切除加尿流改道术。近年髂内动脉栓塞化疗联合TURBt治疗膀胱癌的方法,对于高龄、晚期膀胱癌患者不能或不愿意行膀胱全切除术者,不失为有效的治疗方法。随着手术技巧的不断提高及设备的不断改进,出现了保留性功能和生育功能的根治性全膀胱切除术、腹腔镜下根治性全膀胱切除术等新的术式,尿流改道术也更趋合理,患者术后的生活质量得到了很大的改善。     

保留膀胱髂内动脉化疗治疗膀胱癌的疗效观察

目的探讨保留膀胱手术联合髂内动脉化疗治疗膀胱癌的疗效。方法以保留膀胱手术后联合髂内动脉化疗治疗的45例膀胱癌患者为试验组,应用保留膀胱手术结合常规膀胱灌注化疗的40例患者作为对照组,对比两组患者疗效。结果试验组患者生存质量改善情况明显优于对照组,复发率、死亡率、骨髓抑制副作用均明显低于对照组,两组间比较差异均有统计学意义（P〈0.05）。结论保留膀胱手术联合髂内动脉化疗治疗膀胱癌疗效较好,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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

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.