肝动脉化疗栓塞联合微波消融治疗肝癌的临床研究

目的通过随机对照临床研究设计,观察比较肝动脉化疗栓塞(TACE)联合微波消融(PMCT)治疗原发性肝癌的临床疗效及毒副反应。方法将我院收治的不能手术的中晚期原发性肝癌患者68例,随机分为2组,对照组(TACE)36例,联合组(TACE+PMCT)32例,两组患者之间具有可比性,两组患者先给予肝动脉化疗栓塞治疗,联合组1～2周后给予微波消融治疗。治疗结束后随访1～2年,评价两组的治疗效果及毒副反应。结果两组病例均获得完整随访。联合组1年、2年的生存率分别为71.88%和37.50%,对照组1、2年的生存率分别为44.45%和13.89%,联合组和对照组AFP的下降率分别为75.87%和47.06%,联合组优于对照组,两组均未发生严重不良反应,生活质量均得到很大程度的改善。结论肝动脉化疗栓塞(TACE)联合微波消融(PMCT)治疗原发性肝癌安全、可靠,其疗效明显优于单纯肝动脉化疗栓塞治疗,延长生存期,不增加毒副作用。     

肝转移癌联合介入治疗的临床疗效观察

目的探讨肝动脉化疗栓塞（TACE）联合经皮穿刺微波消融（PMCT）治疗肝转移癌的·l盏床效果。方法61例不能或不愿手术治疗的肝转移癌患者,分为肝动脉化疗栓塞加经皮肝穿刺微波消融组（TACE＋PMCT组,联合组）,单纯肝动脉化疗栓塞组（TACE组）及单纯经皮穿刺微波消融组（PMCT组）。联合组行序贯TAcE／PMcT-PMCT／TACE-TAcE治疗,对照组仅行TACE／PMCT治疗2或3次。结果联合组肿瘤缓解率,1年、2年生存率（81．8％、86．4％、63．6％）显著高于两对照组相应指标（P〈0．05）。结论TACE联合PMCT治疗肝转移癌安全、有效、实用,较单纯TACE、PMCT治疗有较大的竹哉．件．     

肝动脉栓塞化疗联合射频消融术治疗原发性肝癌

目的探讨肝动脉栓塞化疗联合CT导向下的射频消融治疗中、晚期原发性肝癌的疗效。方法40例中、晚期原发性肝癌患者分为经导管肝动脉栓塞化疗组（TACE组，20例）和肝动脉栓塞化疗联合CT导向下的射频消融治疗组（联合组，20例）。结果TACE组肿瘤完全坏死率、复发率及1年存活率分别22．5％（9／40）、37．5％（15／40）和75．0％（30／40），联合治疗组分别为90．0％（36／40）、12．5％（5／40）和90．0％（36／40）。两组间完全坏死率、初次复发率及1年生存率的差异均有显著意义（P值分别为0．002、0．003、0．008）。结论肝动脉栓塞化疗联合CT导向下的射频消融治疗原发性肝癌的疗效明显优于单纯栓塞治疗。     

肝动脉栓塞化疗联合冷循环微波凝固治疗大肝癌40例

目的评价肝动脉化疗栓塞(TACE)联合经皮冷循环微波凝固(PMCT)治疗原发性大肝癌的临床疗效。方法 78例不能切除的原发性大肝癌患者随机分为联合组(TACE+PMCT)40例和单纯组(TACE)38例。联合组患者先行TACE,2周后行PMCT;单纯组患者仅行TACE,观察治疗前后肿瘤影像学资料、肝功能、AFP水平、生活质量及并发症等。结果联合组中肿瘤完全坏死率17.5%(7/40)、不完全坏死率62.5%(25/40);联合组生活质量改善率为87.5%(35/40),高于单纯组65.8%(25/38);联合组、单纯组的中位生存时间分别为17个月和10个月,差异有统计学意义(P<0.05)。结论 TACE联合PMCT治疗中晚期原发性肝癌有效且较安全,可提高肿瘤的坏死率,延长了生存期。     

肝动脉栓塞化疗结合三维放疗治疗原发性肝癌的护理

目的 探讨肝动脉栓塞化疗结合三维适形放疗治疗原发性肝癌的疗效与护理.方法 选择70例原发性肝癌患者,随机分为观察组和对照组,每组各35例.对照组采用单纯肝动脉栓塞化疗(TACE),观察组在介入治疗基础上加用三维适形放射治疗,观察两组原发性肝癌患者的疗效及护理结局.结果 治疗组完全缓解(CR)6例、部分缓解(PR)22例、无变化(NC)4例、进展(PD)3例、总有效率80.0％明显优于对照组(x2 =3.651,P＜0.05).结论 TACE联合三维适形放疗治疗原发性肝癌疗效高.     

射频消融联合经导管肝动脉栓塞化疗治疗原发性肝癌的疗效

目的探讨射频消融联合经导管肝动脉栓塞化疗治疗原发性肝癌的临床疗效。方法 110例原发性肝癌患者随机分为对照组(60例)和治疗组(50例),对照组患者给予单一的肝动脉栓塞化疗治疗,治疗组患者给予射频消融联合经导管肝动脉栓塞化疗治疗,对两组治疗结果进行分析比较。结果两组经过治疗在肿瘤坏死率、局部肿瘤复发率以及治疗后患者生存率方面比较,差异均具有统计学意义(P<0.05)。结论射频消融联合经导管肝动脉栓塞化疗治疗原发性肝癌取得的临床疗效显著,使用的范围广,成为了治疗原发性肝癌的一种有效手段。     

大功率微波消融联合动脉化疗栓塞介入治疗中大肝癌疗效及安全性研究

目的 对大功率微波消融与射频消融联合动脉化疗栓塞(TACE)介入治疗中大肝癌的疗效及安全性进行对比.方法 选择2011年7月-2013年7月收治的原发性肝癌114例,按治疗方法分为微波联合组59例(74个病灶)和射频联合组55例(68个病灶).微波联合组采用微波消融联合TACE治疗,射频联合组采用射频消融联合TACE治疗,观察两组消融效果、复发率、近期疗效和生存率,记录治疗过程中不良反应发生情况.结果 术后随访2年,两组失访率分别为8.47％、9.09％.微波联合组治疗后直径5～10 cm肿瘤完全坏死率和消融1次总完全坏死率、控制率、生存率均高于射频联合组,复发率低于射频联合组(P＜0.05).两组均出现轻度不良反应,给予对症治疗后消失.结论 微波消融联合TACE治疗中大肝癌较射频消融联合TACE治疗效果更好,且不增加不良反应发生风险.     

肝动脉化疗栓塞后三维适形放射治疗原发性肝癌的疗效观察

目的：探讨肝动脉化疗栓塞后三维适形放射治疗原发性肝癌的临床疗效。方法120例原发性肝癌患者,随机分成研究组和对照组,各60例。对照组给予单纯肝动脉化疗栓塞术,研究组则采取肝动脉化疗栓塞后三维适形放射治疗。对两组的疗效及生存率进行比较。结果研究组患者总有效率为91.67%明显高于对照组的66.67%(P<0.01);研究组患者不良反应率显著低于对照组(P<0.05),治疗后1、3、5年生存率显著优于对照组,两组比较差异均具有统计学意义(P<0.01)。结论肝动脉化疗栓塞后三维适形放射治疗原发性肝癌疗效显著,生存率更高,安全可靠,有利于改善患者的症状,值得临床推广及应用。     

肝动脉栓塞化疗联合微波凝固治疗原发性肝癌疗效分析

目的探讨肝动脉化疗栓塞术联合微波凝固治疗原发性肝癌的疗效。方法72例不能手术切除的中晚期肝癌和拒绝手术的早期肝癌患者随机分为A、B两组。A组：经导管肝动脉化疗栓塞组(TACE组)，共39例；B组：肝动脉化疗栓塞联合微波凝固治疗组(联合治疗组)，共33例。结果TACE组的完全坏死率、初次复发率及1年生存率分别为30．77％、35．90％和58．97％；而联合治疗组分别为90．91％、6．06％和84．85％。两组间完全坏死率、初次复发率及1年生存率差异均有显著意义(其相应P值分别为0．000、0．003、0．006)。结论肝动脉化疗栓塞联合微波凝固治疗效果明显优于单纯化疗栓塞。     

微波消融联合 TACE治疗肝癌与放疗的对比分析

目的 探讨微波消融联合肝动脉栓塞化疗治疗肝癌与放疗的疗效对比.方法 回顾性分析 2010年 1月 -2012年 1月本院采用微波消融联合 TACE治疗的单发肝细胞癌的临床资料,其中 42例行微波消融联合肝动脉化疗栓塞;42例行肝脏局部放射治疗.结果 微波消融联合 TACE治疗 42例肝癌中,肿瘤 〈3 cm者 5例 CT显示全部瘤灶完全凝固性坏死 ;肿瘤 3~5 cm者 14例,CT显示 11例 （78.6%）瘤灶完全凝固性坏死,肿瘤 5~10 cm者 23例,CT显示 16 例 （69.6%）瘤灶完全凝固性坏死.1、2年累积生存率分别为96.2%、69.4%.放疗组 42例肝癌中,无瘤灶完全凝固性坏死.1、2年累积生存率分别为45.5%、26.1%.结论 微波消融联合 TACE是治疗肝癌在肿瘤的局部控制率及患者的生存率方面具有明显的优势.     

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.     

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.     

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.     

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.