复方斑蝥胶囊联合TAC方案治疗三阴性乳腺癌的临床研究

目的 探讨复方斑蝥胶囊联合TAC方案治疗三阴性乳腺癌的疗效。方法 选取2020年4月—2023年3月在东台市中医院就诊的100例三阴性乳腺癌患者，根据随机数字表法将100例患者分为对照组（50例）和治疗组（50例）。对照组给予TAC方案治疗，第1天静脉注射多西他赛注射液75 mg/m²、静脉滴注注射用环磷酰胺600 mg/m²、静脉注射注射用盐酸表柔比星80 mg/m²。治疗组在对照组基础上口服复方斑蝥胶囊，3粒/次，2次/d。以21 d为1个化疗周期，两组在持续治疗6个周期后分析疗效。比较两组的临床疗效、生活质量、淋巴细胞相关指标、肿瘤标志物、血清指标和不良反应的情况。结果 治疗后，治疗组的总有效率（94.00%）高于对照组（80.00%），组间比较差异显著（P＜0.05）。治疗后，两组的乳腺癌生活质量量表（QLSBC）评分低于治疗前（P＜0.05），且治疗组QLSBC评分低于对照组（P＜0.05）。治疗后，治疗组的CD8⁺比治疗前小，LMR、CD4⁺、CD4⁺/CD8⁺比治疗前大（P＜0.05）；治疗组的CD8⁺比对照组小，LMR、CD4⁺、CD4⁺/CD8⁺比对照组大（P＜0.05）。治疗后，两组的血清糖蛋白抗原（CA153）、癌胚抗原（CEA）水平均比治疗前低（P＜0.05）；治疗组血清CA153、CEA水平比对照组低（P＜0.05）。治疗后，两组的血清脂联素（ADP）水平高于治疗前，血清白细胞介素-8（IL-8）水平低于治疗前（P＜0.05）；治疗组的血清ADP水平高于对照组，血清IL-8水平低于对照组（P＜0.05）。治疗期间，治疗组的不良反应发生率比对照组低，组间比较差异显著（P＜0.05）。结论 复方斑蝥胶囊联合TAC方案有助于提高三阴性乳腺癌的疗效，有助于改善患者的免疫功能和生活质量，降低肿瘤标志物的水平和药物不良反应的发生。     

安替可胶囊联合TP方案治疗晚期食管鳞癌的临床研究

目的 探讨安替可胶囊联合TP方案（紫杉醇＋顺铂）治疗晚期食管鳞癌的临床疗效。方法 选取2019年1月—2022年1月河南省人民医院收治的100例术后复发转移、晚期转移无法手术治疗的晚期食管鳞癌患者,将所有患者随机分为对照组（50例）和治疗组（50例）。对照组第1天静脉滴注紫杉醇注射液135 mg/m²,第1～3天静脉滴注顺铂注射液75 mg/m²。治疗组于对照组基础上口服安替可胶囊,2粒/次,3次/d。3周为1个治疗周期,两组患者持续治疗3个周期。观察两组的临床疗效,比较两组肿瘤标志物[鳞状细胞癌抗原（SCC-Ag）、细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、糖类抗原125（CA125）]、细胞免疫功能淋巴细胞（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、生存质量（QLQ-C30评分、KPS评分）以及不良反应、随访1年的生存情况。结果 治疗后,治疗组客观缓解率（42.00%）、疾病控制率（74.00%）明显高于对照组（22.00%、52.00%）,组间比较差异有显著性（P＜0.05）。治疗后,两组QLQ-C30评分、KPS评分均显著升高（P＜0.05）,治疗组QLQ-C30评分、KPS评分显著高于对照组（P＜0.05）。治疗后,对照组CD3⁺、CD4⁺、CD4⁺/CD8⁺显著降低,CD8⁺显著升高（P＜0.05）;治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺明显高于对照组,CD8⁺低于对照组（P＜0.05）。治疗后,两组血清SCC-Ag、CYFRA21-1、CEA、CA125水平均显著降低（P＜0.05）,治疗组血清SCC-Ag、CYFRA21-1、CEA、CA125水平显著低于对照组（P＜0.05）。治疗组不良反应发生率为28.00%,明显低于对照组不良反应发生率48.00%,组间比较差异有显著性（P＜0.05）。随访1年后,治疗组中位生存期、肿瘤无进展时间均明显长于对照组（P＜0.05）。结论 安替可胶囊联合TP方案治疗晚期食管鳞癌能增强治疗效果,提高生活质量,减轻免疫功能抑制,降低肿瘤标志物水平,有助于延长患者生存期。     

小金胶囊联合达那唑治疗子宫肌瘤的临床研究

目的 探讨小金胶囊联合达那唑胶囊治疗子宫肌瘤的临床疗效。方法 选取2019年5月—2021年11月苏州市中西医结合医院收治的100例子宫肌瘤患者作为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各50例。对照组口服达那唑胶囊,2粒/次,2次/d。治疗组在对照组治疗的基础上口服小金胶囊,4粒/次,2次/d。两组在连续治疗6个月。观察两组的临床疗效,比较两组患者的病灶体积、子宫体积、主观下腹痛程度和血清血管内皮生长因子（VEGF）、糖类抗原125（CA125）、基质金属蛋白酶-9（MMP-9）水平。结果 治疗后,治疗组的总有效率为92.00%,对照组的总有效率为76.00%,组间的差异具有统计学意义（P＜0.05）。治疗后,两组的病灶体积、子宫体积均显著减小（P＜0.05）,治疗组病灶体积、子宫体积明显小于对照组（P＜0.05）。治疗后,两组VAS评分显著降低（P＜0.05）,治疗组VAS评分明显低于对照组（P＜0.05）。治疗后,两组的血清VEGF、CA125、MMP-9水平均显著降低（P＜0.05）,治疗组血清VEGF、CA125、MMP-9水平均明显低于对照组（P＜0.05）。结论 小金胶囊联合达那唑治疗子宫肌瘤的临床疗效确切,能促进患者病灶体积缩小,减轻下腹痛程度,降低血清VEGF、CA125、MMP-9水平,且安全性良好。     

鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌的临床研究

目的 探讨鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌的临床疗效。方法 选取2017年6月—2021年5月徐州医科大学附属连云港医院收治的96例早发型结肠癌患者，按随机数字表法将所有患者分为对照组和治疗组，每组各48例。对照组患者给予CapeOx方案化疗，化疗第1～14天餐后30 min口服卡培他滨片，1 g/m²，2次/d；第1天静脉滴注注射用奥沙利铂，130 mg/m²加入5%葡萄糖注射液250 mL中后给药，1次/d，每次滴注2 h。治疗组在对照组治疗基础上化疗第1～14天静脉滴注鸦胆子油乳注射液，30 mL/次加入0.9%氯化钠注射液250 mL中后给药，1次/d。两组均以21 d为1个周期，且均连续治疗2个周期。观察两组的临床疗效，比较治疗前后两组血清肿瘤标志物[癌胚抗原（CEA）、糖类抗原（CA）199、CA72-4、CA50]和血管内皮生长因子（VEGF）水平、大肠癌患者生命质量测定量表（FACT-C）评分。统计两组不良反应情况。结果 治疗后，治疗组客观缓解率（ORR）是47.92%，较对照组的35.42%有所提高，但差异无统计学意义；治疗组疾病控制率（DCR）是87.50%显著高于对照组的70.83%（P＜0.05）。治疗后，两组FACT-C中生理状况评分、情感状况评分、附加关注领域评分及量表总评分均显著增加（P＜0.05）；且均以治疗组患者增加更显著（P＜0.05）；功能状况和社会/家庭状况领域评分组内治疗前后及组间同期比较差异均无统计学意义。治疗后，两组血清CEA、CA199、CA72-4、CA50和VEGF水平均显著下降（P＜0.05）；均以治疗组降低更显著（P＜0.05）。治疗过程中，治疗组白细胞减少、肝肾损害、血小板减少的发生率分别为18.75%、10.42%、14.58%，显著低于对照组的37.50%、27.08%、33.33%（P＜0.05）。结论 鸦胆子油乳注射液联合CapeOx方案治疗早发型结肠癌具有一定的增效减毒作用，能有效提高患者近期疗效、下调血清肿瘤标志物水平及抑制肿瘤血管生成，并提高化疗耐受性，改善患者生命质量，值得临床推广应用。     

脾氨肽口服冻干粉联合膦甲酸钠治疗带状疱疹的临床研究

目的 探讨脾氨肽口服冻干粉联合膦甲酸钠治疗带状疱疹的临床疗效。方法 选取2020年10月—2022年10月资阳市第一人民医院收治的96例带状疱疹患者，随机分为对照组（48例）和治疗组（48例）。对照组患者静脉静点膦甲酸钠氯化钠注射液，250 mL/次，1次/d。在对照组的基础上，治疗组口服脾氨肽口服冻干粉，4 mg/次，1次/d。两组用药7 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，视觉模拟疼痛（VAS）评分，血清炎性因子白细胞介素-6（IL-6）、干扰素-γ（IFN-γ）、β-内啡肽（β-EP）和血浆P物质（SP）水平，及不良反应情况。结果 治疗后，治疗组患者临床有效率（97.92%）明显高于对照组（81.25%，P＜0.05）。治疗后，治疗组症状改善时间均早于对照组（P＜0.05）。治疗后3、7 d，两组疼痛VAS评分均较治疗前明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，两组IL-6、SP水平均明显低于治疗前，而IFN-γ、β-EP水平均高于治疗前（P＜0.05），且治疗组IL-6、SP、IFN-γ和β-EP水平均明显好于对照组（P＜0.05）。治疗后，治疗组不良反应发生率为6.25%，明显低于对照组（14.58%，P＜0.05）。结论 膦甲酸钠联合脾氨肽口服冻干粉治疗带状疱疹患者疗效确切，可有效降低疼痛，机体炎性反应改善良好，且安全有效。     

卡瑞利珠单抗联合白蛋白紫杉醇和卡铂治疗晚期食管癌的临床研究

目的 分析卡瑞利珠单抗联合白蛋白紫杉醇和卡铂治疗晚期食管癌的临床效果。方法 选择2020年1月—2021年10月安徽医科大学第一附属医院医院东城院区收治的晚期食管鳞状细胞癌患者96例,按随机抽签法分为对照组（48例）和治疗组（48例）。对照组患者静脉滴注注射用紫杉醇（白蛋白结合型）和卡铂注射液治疗,第1、8天滴注注射用紫杉醇（白蛋白结合型）,125 mg/m²;第1天静脉滴注卡铂注射液,200～400 mg/m²。治疗组在对照组基础上静脉滴注注射用卡瑞利珠单抗,第1天,200 mg/次,每3周1次。21 d为1个周期,两组治疗2个周期。观察两组患者临床疗效,比较治疗前后两组患者生存期、免疫功能指标、肿瘤标志物、血清炎症因子水平及程序性死亡-配体1（PD-L1）和肿瘤错配修复缺陷（dMMR）水平。结果 治疗后,治疗组24个月无进展生存（PFS）率、总生存率（OS）、客观缓解率（ORR）、疾病控制率（DCR）、疾病进展时间（TTP）均明显高于对照组（P＜0.05）。治疗后,两组T淋巴细胞（T_总）、Th、Th/Ts、自然杀伤细胞（NK）、树状突细胞（DC）、DC/单核巨噬细胞（PBMC）水平明显升高,而抑制性T细胞（Ts）、糖类抗原19-9（CA19-9）、癌胚抗原（CEA）、角蛋白19片段抗原21-1（CYFRA21-1）、鳞状细胞癌抗原（SCC-Ag）、TNF-α和IL-8水平明显降低（P＜0.05）,且治疗组这些指标水平明显好于对照组（P＜0.05）。治疗后,治疗组PD-L1水平降低,而PD-L1＋/dMMR水平升高（P＜0.05）,且患者预后良好组PD-L1水平降低、PD-L1＋/dMMR占比升高（P＜0.05）。结论 卡瑞利珠单抗联合白蛋白紫杉醇和卡铂治疗晚期食管癌可改善晚期食管鳞状细胞癌患者的肿瘤标志物水平,抑制炎性反应,提升免疫功能,提高患者的生存率。     

西黄丸联合贝伐珠单抗治疗晚期结直肠癌的临床研究

目的 探讨西黄丸联合贝伐珠单抗注射液治疗晚期结直肠癌的治疗效果。方法 选取2021年8月—2023年8月保定市第一医院收治的晚期结直肠癌患者86例,参照随机数字表法分为对照组（43例）和治疗组（43例）。对照组患者静脉滴注贝伐珠单抗注射液,5 mg/(kg?d),持续时间90 min以上,1次/2周。治疗组患者在对照组的基础上口服西黄丸,3 g/次,2次/d。两组均治疗8周。比较两组的临床疗效、Karnofsky（KPS）评分、生活质量（QOL）评分和血清肿瘤标志物水平。结果 相较于对照组,治疗组患者的客观缓解率、疾病控制率较高（P＜0.05）。治疗后,两组的KPS、QOL评分均显著升高（P＜0.05）,且治疗组KPS、QOL评分明显高于对照组（P＜0.05）。治疗后,两组血清糖类抗原19-9（CA19-9）、糖类抗原125（CA125）、癌胚抗原（CEA）、糖类抗原242（CA242）水平均显著降低（P＜0.05）,且治疗组血清肿瘤标志物水平均显著低于对照组（P＜0.05）。结论 西黄丸联合贝伐珠单抗注射液治疗晚期结直肠癌疗效确切,可改善患者生存质量,降低肿瘤标志物水平。     

白蛋白结合型紫杉醇联合卡铂治疗晚期非小细胞肺癌的临床疗效观察

目的 探讨白蛋白结合型紫杉醇联合卡铂治疗晚期非小细胞肺癌的临床疗效。方法 选择2018年1月至2020年1月我院收治的晚期非小细胞肺癌患者102例,按随机数字表法分为两组,各51例。对照组给予紫杉醇联合卡铂治疗,观察组给予白蛋白结合型紫杉醇联合卡铂治疗。对比两组患者的近期疗效和毒副反应发生率。结果 观察组近期疗效优于对照组,差异有统计学意义（P<0.05）。两组鳞癌治疗缓解率比较,差异无统计学意义（P>0.05）。两组1~4级毒副反应发生率比较,差异均无统计学意义（P>0.05）;两组3~4级毒副反应发生率比较,差异均无统计学意义（P>0.05）。结论 对晚期非小细胞肺癌患者实施白蛋白结合型紫杉醇联合卡铂治疗的临床疗效明显,且毒副反应较轻,患者可耐受,值得临床推广。     

健胃愈疡颗粒联合西咪替丁治疗重症患者应激性溃疡的临床研究

目的 探讨健胃愈疡颗粒联合西咪替丁治疗重症患者应激性溃疡的临床疗效。方法 选择2019年6月—2022年5月上海市杨浦区中心医院收治的103例应激性溃疡患者，随机分为对照组（51例）和治疗组（52例）。对照组静脉滴注西咪替丁注射液，0.2 g加入250 mL生理盐水中，2次/d。治疗组在对照组基础上口服健胃愈疡颗粒，9 g/次，3次/d。观察两组患者临床疗效，比较治疗前后两组患者临床症状评分，血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、胃泌素（MTL）、缺血修饰白蛋白（IMA）、超氧化物歧化酶（SOD）和丙二醛（MDA）水平及不良反应。结果 治疗后，治疗组临床有效率明显高于对照组（96.15% vs 84.31%，P＜0.05）。治疗后，治疗组临床症状评分均明显比对照组低（P＜0.05）。治疗后，两组血清CRP、TNF-α、MTL、IMA和MDA水平均明显降低，而血清SOD水平明显升高（P＜0.05），且治疗组血清指标水平均明显好于对照组（P＜0.05）。治疗期间，治疗组患者不良反应发生率为3.85%，对照组为17.65%，两组比较差异有统计学意义（P＜0.05）。结论 健胃愈疡颗粒联合西咪替丁治疗重症患者应激性溃疡的临床疗效比单纯应用西咪替丁好，有助于临床症状的减轻，改善炎性因子水平，且安全性较好。     

二至丸合桂枝汤治疗三阴性乳腺癌的临床研究

目的 观察二至丸合桂枝汤治疗三阴性乳腺癌(triple negative breast cancer，TNBC)的临床疗效。方法 回顾性分析乳腺科2013年1月—2015年1月期间确诊的100例TNBC病例资料，以术后行常规辅助化疗的病例资料为对照组(50例)，加用二至丸合桂枝汤治疗的病例资料为治疗组(50例)。进行为期5年的随访，对比分析2组间疗效、身体机能、生活质量、肿瘤标志物水平的差异，记录治疗期间不良事件发生情况，同时比较5年总生存率、无病生存率及复发转移率的差化。结果 治疗组总有效率为80.00%，高于对照组62.00%(P<0.05)。治疗后，治疗组KPS评分提高稳定率82.00%高于对照组70.00%(P<0.05)，FACT-B评分高于对照组(P<0.05)。治疗组血清肿瘤标志物CEA、CA125及CA153水平降低且低于对照组(P<0.05)。治疗组胃肠道不良反应发生程度较对照组轻(P<0.05)。治疗组5年总生存率和无病生存率分别为88.00%和62.00%，高于对照组的72.00%和42.00%(P<0.05)。结论 二至丸合桂枝汤辅助化疗对TNBC患者作用效果显著，可提高患者生活质量，远期疗效佳，值得临床应用。     

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.     

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.     

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.