液基细胞学检测在妇科体检中应用

目的评价液基细胞学检测（TCT）在妇科体检宫颈病变筛查中的价值。方法3548例TCT结果按TBS诊断标准进行细胞学诊断并与宫颈涂片作比较,对诊断结果进行分析总结,其中对150例细胞学提示阳性的病例行阴道镜下活组织病理检查,细胞学诊断结果与病理组织学诊断对照。结果TCT的检出率高于宫颈涂片,与阴道镜下活检病理结果符合率分别为LSIL74．36％（58／78）,HSIL78．95％（CINⅡ7／9、CINⅢ8／10）,SCC100％（1／1）,HPV感染的符合率为69．44％。结论TCT可作为宫颈癌筛查的一种常规手段。     

阴道镜基础的“即查即治”在妇女宫颈病变防治中价值评价

目的评价阴道镜基础上的“即查即治”在妇女宫颈病变防治中应用价值及临床意义。方法在细胞学基础上进行阴道镜下活检,对某单位4215名女职工进行妇科宫颈病变普查,对阴道镜下诊断明确的宫颈病变患者,采取“即查即治”,发现病灶立即治疗方法,并同时留取活检组织病理检查。结果宫颈涂片2854例,异常涂片243例（8．51％）,327例行阴道镜检查同时行宫颈活组织检查,组织病理确诊发现：宫颈癌3例（0．07％）,宫颈内瘤样病变139例（3．12％）,其中CINI126例（2．99％）,CIN1112例（0．04％）,CINⅢ1例（0．02％）,尖锐湿疣11例（0．26％）。宫颈涂片诊断CIN符合率53．9％,阴道镜诊断CIN的符合率72．7％,两者有显著差异（P〈0．05）。阴道镜诊断CIN的敏感性97．2％,特异性70．9％。104例在阴道镜较为准确诊断基础上进行“即查即治”,并同时留取活检组织病理检查。结论宫颈细胞学基础的阴道镜活检是妇女宫颈癌普查中初筛与精检相结合的可靠诊疗方法,阴道镜基础上采取“即查即治”,是防治宫颈病变另一途径。     

宫颈疾病1032例诊断结果分析

目的分析来我院就诊的象山县已婚妇女宫颈疾病的诊断情况,以便及时采取干预措施。方法采用宫颈脱落细胞薄层液基细胞学检查（TCT）、人乳头瘤状病毒（HPV）检测、阴道镜下活检后行病理学诊断。结果宫颈细胞学异常66例（6．4％）;948例通过HPV分型检测,发现l84例（19．4％）HPV阳性;进一步行阴道镜下活检,诊断宫颈上皮内瘤变45例,宫颈癌5例。结论TCT结合HPV检测并联合阴道镜检查是诊断宫颈早期病变的有效方法,对防治宫颈癌有重要意义。     

宫颈细胞学、人乳头状瘤病毒检测配合阴道镜对宫颈病变筛查的结果分析

目的　评价宫颈细胞学、人乳头状瘤病毒(HPV)检测配合阴道镜检查对宫颈疾病的诊断价值。方法　通过宫颈细胞学、HPV及阴道镜对宫颈疾病进行筛查,以组织学为金标准进行结果分析。结果　宫颈涂片4 0 92例,异常涂片2 2 2例(5 . 4 3% ) ;HPV检测4 0 92例,阳性71例(1. 74 % ) ;阴道镜79例,6 2例宫颈取活检,病理结果:CIN 5 2例,其中CINⅠ19例(0 . 4 7% ) ,CINⅡ8例(0 . 2 0 % ) ,CINⅢ2 5例(0 . 6 1% ) ,HPV感染2例(0 .0 5 % ) ,宫颈炎症8例(0 .19% )。宫颈涂片异常、HPV阳性活检为CIN与宫颈涂片异常、HPV阴性活检为CIN ,经χ2 检验差异有显著意义(P <0 . 0 5 )。结论　采用宫颈细胞学、HPV检测配合阴道镜检查能及早发现宫颈癌前病变。     

液基超薄细胞技术检测1317例宫颈脱落细胞的临床分析

目的对液基超薄细胞技术（TCT）检测宫颈脱落细胞及用TBS报告方式，在宫颈病变诊断中的临床应用价值进行评价。方法2006年2月-至2006年12月在广丰县妇幼保健院门诊就诊的1317例患者行TCT检查和TBS细胞分类诊断，对TCT检查发现异常的患者进行阴道镜病查和HPV—DNA检测。结果1317例涂片中，检出异常涂片242例（18．3％），其中不典型磷状细胞（ASCUS）83例（6％），低度磷状上皮内病变（LSIL）47例（3．6％），高度磷状上皮内病变（HSIL）7例（0．5％），磷状细胞原位癌（SCL）1例（0．075％），HPV感染52例（3．9％）。TCT与阴道镜病理检查和HPV检测的符合率分别为81．2％，70．5％。结论TCT技术结合TBS应用于宫颈细胞涂片，配合HPV—DNA检测和阴道镜活检，是筛选和诊断子宫颈癌前病变及早期宫颈癌的可靠手段。     

宫颈细胞学结果为ASCUS患者HPV感染状况及临床意义研究

目的探讨细胞学结果为不典型鳞状上皮细胞不能明确意义（ASCUS）的人乳头状瘤病毒（HPV）感染状况及临床意义。方法对120例ASCUS患者进行阴道镜检查及活检,其中85例患者同时进行HPV检测。结果在120例ASCUS患者中,上皮内瘤变（CIN）的发生率为35％,高级别CIN及宫颈癌发生率为12％,阴道镜检查与病理结果符合率为47．6％。HPV检测阳性率为65％,组织病理证实：其中高级别CIN8例,宫颈癌2例,CINI和宫颈炎分别为20例、25例,HPV阳性组CIN检出率明显高于阴性组（P〈0．05）。各组HPV混合型感染率无显著差异。结论细胞学结果为ASCUS患者．病理活检差异大,HPV检测可为患者提供有效、合理的处理方案。     

宫颈不典型鳞状细胞217例临床分析

目的探讨宫颈不典型鳞状细胞（ASCUS）的临床意义。方法对细胞学诊断为ASCUS的患者行高危型人乳头瘤病毒（HR-HPV）DNA检测,分为HR—HPV阳性组和HR—HPV阴性组进行观察。两组均进行阴道镜下活检,以组织学诊断为依据,比较ASCUS中HR—HPV阳性组和阴性组CIN发生率的差异。结果217例ASCUS中HR—HPV阳性的134例（61．6％）,HR—HPV阴性的83例（38．2％）,这两组中CIN的发生率分别为30．6％和7．2％（P〈0．05）;CIN2—3的发生率分别为8．9％和1．2％（P〈0．05）。结论对ASCUS的患者应及时行HR—HPVDNA检测,HR—HPV阳性者行阴道镜下活检,HR—HPV阴性者可随访,及早发现宫颈癌前病变和宫颈癌,避免延误病情。     

液基细胞学检测在宫颈病变筛查中的应用

目的评价液基细胞学检测技术（TCT）在妇科宫颈病变细胞学筛查中的临床价值。方法对我院近年来接受宫颈病变筛查的290例患者采用宫颈细胞TCT技术检测,细胞学诊断采用伯塞斯达系统（the Bathesda system,TBS）分级法,对细胞学检查阳性者行阴道镜下多点活检,将细胞学检查结果与活检结果作对比分析。结果细胞学异常阳性检出率9.65%（28/290）,其中慢性宫颈炎15例;CINⅠ6例,CINⅡ3例,CINⅢ2例;宫颈鳞癌2例。TCT检查与阴道镜下宫颈组织活检结果符合率高。结论TCT检查能准确反映宫颈病变,对宫颈细胞学检查阳性的患者,应遵循细胞学、阴道镜与组织学检测三阶梯式诊断程序,可及早发现宫颈早期病变,降低宫颈癌的发病率和病死率。     

电子阴道镜在宫颈病变筛查中的应用价值

目的评价电子阴道镜对宫颈病变的临床应用价值。方法选择该院门诊接受宫颈筛选的患者共350例,均同时进行薄层液基细胞学检查(TCT)及人乳头瘤病毒(HPV)高危分型。结果 350例患者中,TCT阳性48例,病理结果符合率为72.917%(35/48);HPV阳性76例,病理结果符合率为39.474%(30/76);TCT与HPV均阳性25例,病理检查结果符合率为92.000%(23/25)。对2项及其中1项异常患者均行经阴道镜下宫颈活检,宫颈上皮内瘤样病变(CIN)Ⅰ级25例,CINⅡ～Ⅲ16例,原位癌2例,其余均为宫颈慢性炎症。结论阴道镜检查能显著提高TCT及HPV异常宫颈病变的阳性检出率,减少不必要的宫颈损伤,为防治宫颈癌提供有效依据。     

宫颈刮片及阴道镜在妇科普查中的意义

目的探讨阴道镜联合宫颈刮片的细胞学检查对子宫病变的临床诊断意义。方法通过对296例宫颈异常患者进行宫颈刮片和阴道镜检查,以病理组织学诊断为标准,用特异性、敏感性、阳性预测值、阴性预测值进行对比分析。结果宫颈刮片及阴道镜细胞学检查296例。病理结果显示宫颈上皮病变(CIN)286例,占96.6%,其中CINⅠ156例(52.7%),CINⅡ99例(33.5%),CINⅢ41(13.8%),宫颈癌0例(0%)。宫颈刮片及阴道镜细胞学检查诊断CIN符合率96.7%,阴道镜检查对CIN的诊断符合率91.64%,两者比较差异有统计学意义(P<0.05)。结论采用宫颈刮片细胞学检查联合阴道镜下多点活检病理检查能及早发现宫颈病变。     

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.