老年胃癌患者468例临床病理及预后分析

目的探讨老年胃癌的临床病理特点及影响预后的相关因素。方法对我院近10年收治的468例老年胃癌患者的临床病理、治疗及其与预后的关系进行分析。结果老年人胃癌组织学以低分化腺癌和黏液腺癌为主;病变部位以胃窦部及胃体部为主;临床分期以Ⅲ、Ⅳ期多见;治疗以手术治疗为主。病变部位、临床分期、根治性手术切除是影响预后的主要因素。结论早期诊断、及时治疗及行根治性手术切除,是改善老年胃癌患者预后的关键。     

青年人胃癌的临床研究

目的 探讨40岁以下青年人胃癌患者的临床病理特点.方法 对我院238例40岁以下胃癌患者的临床资料进行回顾性分析.结果 本组病例占同期胃癌患者的7.5%.组织学分类以低分化及印戒细胞癌多见,大体分型以Borrmann Ⅲ型(18.0%)和Ⅳ型(52.9%)多见,71.0%患者TNM分期为Ⅲ或Ⅳ期.多因素分析表明,TNM分期及手术根治度是影响预后的主要因素.结论 对40岁以下胃癌患者早期诊断和进行根治性切除术非常重要.     

Ⅱ期胃癌的临床病理特点及根治术后的疗效分析

目的探讨新UICC分期中Ⅱ期胃癌临床病理特点及根治切除手术后影响预后独立因素。方法回顾性分析经外科根治切除治疗79例Ⅱ期胃癌患者及同期治疗Ⅰb期(37例),Ⅲa期(19例)临床病理和随访资料。对Ⅱ期胃癌患者预后进行单因素和多因素分析。结果Ⅱ期胃癌根治术后5年生存率为42.0%,经单因素和多因素分析UICC分期、肿瘤部位和大体分型是影响Ⅱ期胃癌预后的独立因素。结论影响Ⅱ期胃癌根治切除术后预后独立因素为UICC分期、肿瘤部位和大体分型。     

影响胃癌术后预后因素的Cox回归分析

目的探讨影响胃癌根治手术患者预后的相关因素。方法回顾性分析有完整临床资料和随访记录的351例胃癌患者的资料,对可能影响胃癌患者预后的6项临床病理参数(包括患者性别、年龄、肿瘤部位、TNM分期,病理分型,化疗方法等)进行单因素和多因素回归分析。结果单因素和Cox回归分析显示TNM分期、病理分型、化疗方法与患者的预后均具有相关性(P<0.01);肿瘤部位在单因素分析中是影响胃癌患者手术预后的相关因素(P<0.01),而应用Cox回归模型分析显示肿瘤部位并非影响预后的独立因素(P>0.05)。结论 TNM分期、病理分型及化疗方法可以作为评估胃癌患者预后的独立指标,从而指导胃癌的治疗。     

胃癌不同年龄的内窥镜及临床对比分析

目的探讨青年人及老年人胃癌的临床和病理特点。方法回顾性分析经胃镜检查,上消化道钡餐造影,并经病理或开腹手术确诊的青年人胃癌42例。结果青年人胃癌组织学病理为以低分化腺癌（21例,50%）和粘液腺癌（7例,16.7%）多见。结论青年胃癌恶性程度高,早期诊断率低,误诊率高,预后差,且女性发病率高于男性,早期诊断及治疗很重要。     

青年人胃癌65例临床病理分析

目的:探讨青年人胃癌的临床、病理特点.方法:对我院经胃镜(或手术)后病理确诊的青年人胃癌(≤35岁)65例进行分析.结果:本组青年人胃癌占同期收治胃癌的6.155%,青年人胃癌发病率女性明显高于男性,临床缺乏特征性表现.较早发生转移,容易误诊.组织病理学类型以低分化腺癌居多,占52.3%.结论:临床晚期癌多,病理组织学分化差是青年人胃癌预后差的重要因素.提高对青年人胃癌的警惕性,加强对其胃外表现和转移症状的认识,做到早期诊断、早期治疗,是提高疗效、改善预后的关键.     

青年人结直肠癌48例临床分析

目的探讨青年人结直肠癌的诊断与治疗方法。方法对48例青年人结直肠癌住院患者的临床特点、诊疗经过、预后情况进行分析。结果48例均为手术治疗,其中根治性手术31例,姑息性手术17例,发病部位以直肠为多见,其次为乙状结肠,临床表现以便血或黏液血便、大便习惯改变、腹部疼痛不适多见。病理类型以管状腺癌、黏液腺癌多见,占79．2％（38／48）,Dukes分期其中C期、D期为主,占70．8％（34／48）。结论青年人结直肠癌临床症状不典型,误诊率较高,恶性度较高,预后差。     

40岁以下青年胃癌的特点分析

目的:探讨青年人胃癌的临床、病理特点.方法:我院住院经胃镜、手术、病理检查及临床确诊40岁以下胃癌患者61例,占同期收治胃癌总例数的7.97%(61/765),对其临床及病理特点进行分析.结果:青年人胃癌发病率女性略高于男性,组织病理学类型以低分化腺癌占多数,发病部位以胃窦居多,淋巴结转移多见.结论:症状缺乏特异性,临床晚期癌多,病理组织学分化差是青年人胃癌的特点.     

影响胃癌预后的多因素分析

目的　综合分析和评价胃癌组织中血管内皮生长因子 (VEGF)的表达、微血管密度(MVD)、临床病理因素及术后辅助化疗对胃癌手术预后的影响。方法　对手术切除 112例胃癌组织VEGF的表达、MVD及临床病理因素进行单因素和多因素COX模型分析。结果　单因素分析表明 ,浆膜侵犯、淋巴结转移、pTNM分期、微血管密度与胃癌的预后显著相关 (P <0 0 1) ,而肿瘤大小、生长方式、病理分化程度、血管内皮生长因子、术后化疗等与预后无关 (P >0 0 5 )。经多因素分析表明 ,MVD、pTNM分期及淋巴结转移均是胃癌独立的预后因素 (P <0 0 1或P <0 0 5 )。并且微血管密度高或淋巴结转移病人术后辅助化疗可改善预后 (P <0 0 5或P <0 0 1)。结论　病理分期、淋巴结转移及微血管密度均是判定胃癌预后的有效指标 ,并且可指导术后辅助化疗。     

青年胃癌136例临床病理特点及预后观察

目的:分析青年胃癌患者的临床病理特征,探讨影响预后的因素。方法:回顾性分析2000年5月—2005年1月间行胃癌手术治疗的年龄≤45岁的青年患者136例的临床资料。结果:青年人胃癌临床表现以腹上区疼痛不适最常见,占72.1%,男女之比为1∶1.66,肿瘤部位以胃窦部常见,肿瘤分期Ⅲ^Ⅳ期120例,占88.2%;患者原发灶穿透浆膜(T3-4)114例,占全组的83.8%;Borrmann分型以浸润型(Ⅲ型+Ⅳ型)为主,共110例,占80.9%;全组平均生存期为28.81个月,全组1,3,5年生存率分别为57.3%,25.7%和20.5%。结论:青年胃癌以女性和弥漫型癌所占比例较高,临床分期晚,根治性手术切除率低。TNM分期、手术性质及术后辅助化疗是评价其预后的重要参考因素。     

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.