立体适形放射治疗非小细胞肺癌复发患者的疗效评价

目的：观察立体适型放射治疗对非小细胞肺癌放射治疗后复发患者的疗效和放射反应。方法：对54例常规放射治疗后局部复发的非小细胞肺癌患者给于立体定向放射治疗,剂量为4．5～6．0Gy／次,隔日1次,肿瘤病灶总剂量为50-65Gy。结果：CR为18．5%（10／54）、PR为70．4％（38／54）、SD为7．4％（4／54）、PD为3．7％（2／54）,总有效率为88．9％;1、2年生存率分别为63．0％（34／54）和25．9％（14／54）;放射反应以放射性食管炎、放射性肺炎及肺纤维化为主,大多为Ⅰ～Ⅱ级,患者均可耐受。结论：立体适型定向放射治疗对局部晚期放疗后复发的非小细胞肺癌患者有较好的疗效和耐受性。     

立体适形放射治疗非小细胞肺癌复发放射反应

目的 观察立体适形放射治疗对非小细胞肺癌放射治疗后复发患者的疗效和放射反应.方法 2002年7月-2004年4月共收治26例非小细胞肺癌常规放射治疗后局部复发患者,给予立体定向放射治疗,4.5～6 Gy/次,隔日1次,肿瘤病灶总剂量DT 50～65 Gy.结果 肿瘤的近期疗效CR 19.2%(5/26),PR 69.2%(18/26),SD 7.7%(2/26),PD 3.8%(1/26),1年和2年生存率分别为61.5%(16/26),23.1%(6/26).不良反应以放射性食管炎、放射性肺炎、肺缩化、骨髓抑制为主,大多为Ⅰ～Ⅱ级,均可耐受.结论 立体定向放射治疗对局部晚期非小细胞肺癌放疗后复发的患者有较好的疗效和耐受性.     

全身伽玛刀治疗非小细胞肺癌的疗效分析

目的观察全身伽玛刀治疗非小细胞肺癌（NSCLC）的近期疗效、远期疗效及其并发症,探讨全身伽玛刀治疗非小细胞肺癌的应用价值。方法42例病理明确的Ⅰ-Ⅲ期非小细胞肺癌患者,应用OUR—QGD型体部伽玛刀治疗,治疗方案为50％～75％等剂量曲线4～8Gy／次,1次／d,每周5次,治疗4～10次,总照射剂量40～50Gy。结果总有效率（CR＋PR）为71．4％;1,2,3年生存率分别为95．5％,59．5％,33．3％。结论全身伽玛刀可提高肿瘤区的放射剂量,同时保护肿瘤周围正常组织,从而增加非小细胞肺癌的局部控制率、提高远期生存率、降低放射反应。     

后程立体定向适形放射治疗加化疗治疗局限性晚期非小细胞肺癌临床探讨

目的　探讨后程立体定向适形放射治疗加化疗治疗局限性晚期非小细胞肺癌的疗效及患者的耐受性。方法　 4 8例患者于治疗前 4周行常规分割放射治疗 (2 Gy/ d,每周 5次 ) ,肿瘤吸收剂量 (DT) :4 0 Gy,后 2周针对肿瘤局部行立体定向适形放射治疗 ,DT:2 4～ 30 Gy(分割剂量 4～ 5 Gy,每周 3次 ) ,与此同时 ,于第 1周和第 5周采用异长春碱 +顺铂 (NP)方案共 2周期 ,异长春碱 (NVB) :2 5 mg/ m2 第 1天和第 8天静脉推注 ,顺铂(DDP) :30 mg第 1天～第 3天静脉滴注。结果　全部患者均能完成治疗计划 ,完全缓解 (CR)占 17% ,部分缓解(PR)占 75 % ,总有效率 (CR+PR)为 92 %。 1、2、3年局部控制率分别为 88%、5 0 %和 36 % ,1、2、3年生存率分别为 88%、4 7%和 2 9%。急性造血系统和胃肠道的毒性反应较重 ,但对症处理后均能耐受。结论　后程立体定向适形放射治疗加化疗治疗局限性晚期非小细胞肺癌有提高总生存率的趋势。     

三维适形放射治疗局部晚期非小细胞肺癌的疗效观察

目的探讨三维适形放射治疗局部晚期非小细胞肺癌的临床疗效及毒副反应。方法采用三维适形放疗技术，结合TPS治疗计划系统优化计划．参照DVH图及等剂量线等指标，设置多个照射野，予肺部病灶照射总量60—70Gy／f，照射2Gy／次，每日1次．每周5次．根据转移性淋巴结部位行选择性纵隔淋巴结预防照射。结果中位随访时间24个月（15—31个月），1、2年生存率分别为65％、45％，1、2年局部控制率分别为80％、65％，早期放疗反应：放射性肺炎58％（1＋2级），12％（≥3级），食管炎38％（1＋2级），3％（≥3级），骨髓抑制55％（1＋2级），9％（≥3级）。晚期放疗反应中放射性肺纤维化为30％（15／50）均为1＋2级，未发生严重的食管及心脏晚期放射反应。结论三维适形放射治疗局部晚期非小细胞肺癌的局控率有所提高，生存期可延长，放射性并发症减少。     

立体定向适形放疗配合常规放疗治疗非小细胞肺癌近期疗效分析

目的：为探讨立体定位适行放射治疗对非小细胞肺癌（NSCLC）的疗效及与常规放疗联合应用的规律。方法：120例非小细胞肺癌患者随机分成两组,进行前瞻性研究。58例结合常规放疗前程或后程实施立体定向适形放疗（SRC）为联合治疗组。另外,62例给予单纯常规放疗为对照组,治疗后随访观察。结果：有效率,联合组89.2%对照组54.8%;（P＜0.01）,统计学处理差异显著,并发症发生率,联合组.10.3%,对照组8.1%,统计学无显著差异（P＞0.01）。结论：非小细胞肺癌实施立体定向适形放射治疗可以明显提高近期疗效,而并发症无增加。     

全脑照射联合三维适形放疗治疗非小细胞肺癌脑转移瘤的疗效观察

目的探讨全脑照射联合三维适形放疗（3D-CRT）治疗肺癌脑转移瘤的疗效。方法回顾性分析我院治疗的非小细胞肺癌合并脑转移瘤患者100例,所有患者均先行先行全脑照射,然后缩野至脑转移灶行三维适形放疗全脑放疗方法为2—3Gy／次。每周5次,总剂量为40～60Gy／3～4周。之后行三维适形放射治疗单次靶区平均周边剂量3～5Gy,总剂量16～32Gy。观察患者的近期疗效和远期疗效、放疗后不良反应。结果患者局部控制率（CR＋PR）为79．0％,所有患者中位生存期为9．3个月;1年生存率为41．0％;15例发现与放疗有关的并发症。结论全脑照射联合三维适形放疗（3D-cRT）能有效提高患者局部控制率,改善生活质量及一定程度上延长生存期。     

泰素、卡铂联合放射治疗老年人非小细胞肺癌的临床研究

目的　评价泰素、卡铂联合常规分割放疗治疗老年非小细胞肺癌的疗效及耐受性。方法　PC方案给予泰素15 0mg/m2 、卡铂 3 0 0mg/m2 静脉注射 ,间隔 2 8天为 1周期 ,重复 2～ 4个周期后给予常规分割放射治疗 (2Gy/次 ,5次 /周 ) ,照射野包括肺部原发灶和纵隔淋巴引流区 ,总剂量为 60～ 70Gy。结果　 5 2例患者均完成 2个周期以上化疗及放疗 ,完全缓解 6例、部分缓解 2 6例 ,总有效率 61 5 %。化疗的毒副作用主要为骨髓抑制。放射治疗的毒性反应主要为放射性食道炎、放射性肺炎及放射性皮炎。结论　泰素、卡铂联合常规分割放疗治疗老年非小细胞肺癌近期疗效、耐受性好 ,局部控制率高 ,有望取得较好的远期疗效     

立体定向适形放射治疗脑转移瘤的疗效分析

目的 观察立体定向放射治疗脑转移瘤的疗效.方法 立体定向适形放射治疗脑转移瘤52例,采用6MV的直线加速器多个非共面野照射,肿瘤剂量为25～30GY.45例患者在术前接受了全脑放疗,肿瘤剂量35～40GY.结果 中位生存期为13个月,1年生存率为42.3%(22/52),放疗后3个月的肿瘤控制率为92.3%(48/52),KPS≥70,原发肿瘤已控和无颅外转移患者的预后较好(P＜0.05).结论 立体定向适形放射治疗脑转移瘤是安全和有效的.     

立体定向放疗序贯吉西他滨治疗老年局部晚期肺癌的临床观察

目的 评价立体定向放疗序贯吉西他滨治疗老年非小细胞肺癌的疗效.方法 对46例大于70岁老年局部晚期肺癌患者,予以体部γ刀立体定向放疗,应用真空负压袋固定体位、慢速CT定位扫描和三维治疗计划,行立体定向放疗后3～4周予以吉西他滨化疗4周期.中位随访时间为18个月.结果 46例患者完成了立体定向放疗,44例完成吉西他滨单药化疗4周期,2例患者由于4度血小板毒性行2周期化疗后停止.完全缓解2例（4.4%）,部分缓解30例（65.2%）,稳定8例（17.4%）,进展6例（13.0%）.治疗后中位疾病进展时间为7.7个月,全组中位生存期12.6个月.1年总生存率为56%.3度以上放射性肺炎0例,3度以上放射性食管炎2例.结论 体部γ刀立体定向放疗联合吉西他滨单药化疗治疗老年非小细胞肺癌局部控制率较高,疾病进展时间及总生存皆明显改善,不良反应易于耐受.     

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.

---

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.     

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.     

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.