唑来膦酸联合紫杉醇脂质体与顺铂治疗非小细胞肺癌骨转移疗效观察

目的研究唑来膦酸联合紫杉醇脂质体与顺铂方案化疗对非小细胞肺癌骨转移性疼痛、生活质量及骨转移灶的疗效。方法32例非小细胞肺癌并骨转移患者,随机分为治疗组（n=16）和对照组（n=16）。治疗组在应用紫杉醇脂质体加顺铂方案化疗前1d应用唑来磷酸注射液4mg静脉滴注,对照组为单纯应用紫杉醇脂质体加顺铂方案化疗。用药2周期后观察骨痛、骨转移灶的疗效、Kamofsky评分的变化及不良反应。结果治疗组非小细胞肺癌骨转移引起的疼痛总有效率与对照组比较差异有统计学意义（P〈0．05）。治疗组骨病灶控制有效率与对照组比较差异有统计学意义（P〈0．05）。Karnofsky评分的变化治疗组略优于对照组（P〉0．05）。唑来膦酸的应用不增加化疗药物的不良反应。结论唑来膦酸联合紫杉醇脂质体加顺铂方案化疗能有效缓解非小细胞肺癌所致的骨转移性疼痛,提高对骨转移灶的控制率,值得推广应用。     

唑来膦酸联合化疗治疗恶性肿瘤骨转移临床分析

目的研究唑来膦酸联合化疗对恶性肿瘤骨转移的临床疗效。方法72例恶性肿瘤骨转移患者随机分为两组。治疗组38例,接受唑来膦酸联合化疗;对照组34例,单用化疗。两组化疗方案相同。结果治疗组疼痛缓解率89．5％,对照组55．9％,骨病灶控制有效率治疗组76．3％,对照组29．4％,治疗组总体疗效优于对照组,P〈0．05,两组不良反应相似,无差别。结论唑来膦酸联合化疗治疗恶性肿瘤骨转移疗效较好。     

唑来磷酸联合铂类化疗对肺癌骨转移的止痛效果及不良反应

目的探讨唑来磷酸联合铂类化疗对肺癌骨转移的止痛效果及不良反应。方法选择该院2011年3月至2013年3月收治的46例肺癌骨转移患者作为研究对象。分为对照组和观察组,各23例。对照组采用铂类化疗治疗,观察组在铂类化疗基础上联用唑来磷酸。比较两组患者疼痛缓解情况及不良反应。结果观察组患者疼痛缓解率为91．30％（21／23）,对照组为65．22％（15,23）,观察组疼痛缓解率更高,差异有统计学意义（Х^2=4．60,P〈0.05）。此外,观察组患者病灶控制有效率更高,治疗时间更短,差异均有统计学意义（Х^2=5．85,P〈0.05;f=2．120,P〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0．05）。结论铂类化疗联合唑来磷酸治疗肺癌骨转移可有效缩短治疗时间,缓解疼痛,临床疗效更好．应推广应用。     

阿霉素治疗三叉神经痛疗效观察

目的：探讨阿霉素治疗三叉神经痛的临床效果。方法：选择100例患者,随机分为观察组和对照组,观察组用阿霉素神经干注射治疗,对照组用无水酒精神经阻滞治疗,比较两组疗效和不良反应。结果：观察组治疗总有效率为94％,对照组治疗总有效率为82％,两组疗效比较差异有统计学意义（P〈0．05）;观察组疼痛程度以中度以下为主．占94％,对照组中度疼痛、中度以下疼痛及中度以上疼痛分别为40％、48％和12％,两组比较差异有统计学意义（P〈0．05）;观察组不良反应发生率为22％,对照组不良反应发生率为26％,两组比较差异无统计学意义（P〉0．05）。结论：阿霉素神经干注射治疗三叉神经痛成功率高,由于在直视下进行,方法简单,安全可靠,适于在基层推广应用。     

聚焦热疗联合动脉灌注化疗治疗晚期胰腺癌的临床观察

目的观察聚焦热疗联合动脉灌注化疗治疗晚期胰腺癌的临床疗效。方法将25例晚期胰腺癌患者随机分为治疗组13例和对照组12例。治疗组采用BSD2000相控阵聚焦热疗联合动脉灌注化疗治疗,对照组予单纯动脉灌注化疗治疗。观察2组病灶变化情况,临床受益反应（CBR）、生存率及不良反应情况。结果治疗组肿瘤灶变化总有效率为30．8％高于对照组的16．1％,差异有统计学意义（P〈0．05）。治疗组CBR有效率为53．8％高于对照组的33．3％,差异有统计学意义（P〈0．05）。2组生存率及不良反应差异无统计学意义（P〉0．05）。结论热疗联合动脉灌注化疗治疗晚期胰腺癌能提高近期有效率及患者生活质量,值得临床推广应用。     

苦参凝胶治疗混合性阴道炎的疗效观察

目的探讨苦参凝胶治疗混合性阴道炎的疗效。方法选择妇科门诊就诊的混合性阴道炎患者245例,随机分为治疗组125例采用苦参凝胶治疗,对照组120例采用硝酸咪康唑栓和／（或）甲硝唑栓治疗。观察比较两组的临床疗效及不良反应。结果治疗组总有效率为94．4％,对照组总有效率为83．3％,两组间总有效率相比差异有统计学意义（P〈0．05）,且不良反应率相比较差异有统计学意义（P〈0．05）,两组4周后复发率分别为3．4％和3．0％,相比较差异无统计学意义（P〉0．05）,而8周后复发率分别为5．9％和15％,相比较差异有统计学意义（P〈0．05）。结论苦参凝胶治疗混合性阴道炎疗效显著,作用安全。     

康艾注射液联合化疗治疗晚期肺癌55例疗效观察

目的观察康艾注射液联合化疗治疗晚期肺癌的近期疗效、生活质量的改善和减轻化疗引起的不良反应。方法选择55例晚期肺癌患者随机分成治疗组30例、对照组25例。治疗组给予化疗加康艾注射液治疗,对照组给予单纯化疗。结果治疗组和对照组的近期总有效率分别为60％和56％,两组比较,差异无统计学意义（P〉0．05）;治疗后kps评分,治疗组和对照组生活质量改善率分别为90％和72％,两组比较,差异有统计学意义（P〈0．05）;消化道反应率0-1度,治疗组为90％,明显高于对照组72％;2-4度为10％明显低于对照组28%（P〈0．05）。治疗组2—4度的骨髓功能抑制率为30％,明显低于对照组44％（P〈0．05）。不良反应发生率对照组明显多于治疗组。结论非小细胞肺癌用康艾注射液联合化疗与单纯化疗比较疗效相当,并且可以提高患者生活质量,减轻不良反应,值得临床广泛推广。     

经腹腔镜引导射频消融术治疗肝细胞癌的临床研究

目的观察经腹腔镜引导射频消融术治疗肝细胞癌近期临床疗效。方法采用随机数字表法，将经明确诊断为肝细胞癌的患者98例分为观察组49例和对照组49例，观察组采用经腹腔镜引导射频消融术治疗，对照组采用肝切除术治疗，观察两组术后情况及近期疗效等指标。结果治疗1个月后CT复查肿瘤情况，观察组总有效率为73．46％、AFP阳性下降率63．41％，对照组总有效率为77．55％、AFP阳性下降率56．41％，两组总有效率、阳性下降率比较差异无统计学意义（P〉0．05）。两组首次治疗肿瘤的清除率比较差异有统计学意义（P〈0．05）。观察组并发症发生率为10．20％（5／49），对照组并发症发生率为24．48％（12／49），两组并发症发生率比较差异有统计学意义（P〈0．05）。观察组手术时间、术后平均住院时间、平均出血量均少于对照组，具有统计学意义（P〈0．05）。两组AST、ALT均较治疗前明显明显升高（P〈0．05），且对照组较观察组升高显著（P〈0．05）。两组均随访12～43月，两组复发率比较差异有统计学意义（P〉0．05）。结论腹腔镜下射频消融治疗肝细胞癌安全可靠，对于直径〈5cm的肿瘤效果好，可以作为小肝细胞癌首选治疗手段。     

参芪扶正注射液配合Fol Fox4方案治疗进展期胃癌

目的评价参芪扶正注射液联合FolFox4方案治疗进展期胃癌（AGC）的疗效和不良反应。方法治疗组采用参芪扶正注射液联合FolFox4方案治疗AGC37例。对照组30例单用FolFox4方案化疗，药物剂量及用法同治疗组，两周期后判定疗效。结果治疗组37例完全缓解（CR）7例，部分缓解（PR）19例，有效（CR＋PR）26例，总有效率70．3％。对照组30例CR2例（16．7％），PR11例（36．7％），总有效（CR＋PR）13例，有效率43．3％。主要不良反应：治疗组恶心、呕吐、纳差、口腔黏膜炎、粒细胞减少、末梢神经炎、发热及疼痛、腹泻，较对照组明显减轻，白细胞减少与对照组相比有差异性（P〈0．05）。结论参芪扶正注射液联合化疗治疗AGC具有提高化疗有效率，减轻化疗不良反应，提高患者生活质量的作用。     

泮托拉唑联合阿扎司琼治疗化疗所致消化道不良反应

目的：探讨泮托拉唑联合阿扎司琼减轻化疗所致消化道不良反应的疗效。方法：100例接受顺铂化疗的宫颈癌患者随机分为2组,治疗组给予0．9％氯化钠注射液250ml＋注射用泮托拉唑80mg,ivdqd,盐酸阿扎司琼注射液10mg,ivdbid;对照组仅用0．9％氯化钠注射液250ml,ivdqd;盐酸阿扎司琼注射液10mgivdbid。疗程均为5d。观察两组患者消化道不良反应的缓解情况。结果：恶心呕吐缓解情况：治疗组总有效率优于对照组,但差异无统计学意义（P〉0．05）;化疗24～120h,治疗组完全缓解率高于对照组（P〈0．05）。胃部不适缓解情况：化疗48～96h,治疗组总有效率优于对照组（P〈0．05）;24～120h治疗组完全缓解率高于对照组（P〈0．05）,48—96h尤为明显（P〈0．01）。结论：泮托拉唑联合阿扎司琼对控制化疗引起的消化道不良反应有艮好疗效。     

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.     

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.     

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.