内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值

目的探讨内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值。方法将2014年1月～2018年5月在我院内镜中心作常规白光胃镜检查发现可疑食管病变者的58例作为研究对象,分别进行NBI以及卢戈氏液染色检查,并对病灶进行活检,统计单用NBl、卢戈氏液染色及NBI联合卢戈氏液染色对早期食管癌及癌前病变(癌前病变包括轻、中、重度不典型增生)检出率,比较三组的检查结果。结果 NBl组、卢戈氏液染色组和NBI联合卢戈氏液染色组使用对早期食管癌及癌前病变(癌前病变包括轻、中、重度不典型增生)检出率分别为20.7%(12/58)、24.1%(14/58)、32.8%(19/58);NBI联合卢戈氏液染色组与NBl组、卢戈氏液染色组比较,差异有统计学意义(P 0.05);NBl组与卢戈氏液染色组比较,差异无统计学意义(P 0.05);三组炎症检出率相当,差异无统计学意义(P 0.05),但NBI联合卢戈氏液染色组漏诊率明显低于NBl组、卢戈氏液染色组,差异有统计学意义(P 0.05)。结论内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值较高,能够指导内镜下早期食管癌切除范围,且操作简便,具有积极的临床意义。     

窄带成像技术结合放大内镜在早期食管癌诊断中的临床应用

目的探讨内镜窄带成像技术(NBI)对早期食管癌诊断的优势和意义。方法选取我院2012年1月至2015年8月收治的100例疑似早期食管癌患者为研究对象。所有研究对象依次进行白光、NBI、碘染下放大观察,获取清晰图像,评价每一种检查方式下患者病变部位的轮廓、浅表性毛细血管结构形态图像的可见度及清晰度,后由操作者对NBI观察到的上皮乳头内毛细血管袢(IPCL)进行分型,并在病变最为明显的地方取2~4块活体组织送病理组织学检查。结果病变形态清晰度方面,NBI放大>染色放大>白光放大,与后两者比较,NBI放大的清晰度评分均显著较高(P=0.000、P=0.005)。IPCL对食管炎症组的诊断特异性为96.8%,灵敏度为87.7%,阳性预测值为92.8%,IPCL分型主要见于Ⅱ型(12/18)。IPCL对低级别上皮内瘤变组的诊断特异度为96.5%,灵敏度为87.7%,阳性预测值为85.7%,IPCL分型主要见于Ⅲ型(22/35)。高级别上皮内瘤变组IPCL分型均见于Ⅳ型(24/24)。IPCL对早期食管癌的诊断特异度为87.4%,灵敏度为84.3%,阳性预测值为78.9%,主要见于V-1、V-2型(14/23)。结论窄带成像技术结合放大内镜(ME-NBI)与白光放大、染色放大下NBI放大内镜观察病变形态的清晰度较高,借助NBI放大观察的IPCL分型,可准确判断病变的性质及癌组织浸润的深度,具有良好的诊断应用价值。     

早期胃癌诊断中窄带成像技术结合放大内镜的临床价值

目的研究早期胃癌诊断中窄带成像技术结合放大内镜的临床价值。方法选取2016年11月至2018年11月于我院接受白光内镜检查疑似早期胃部病变的患者56例,对所有患者进行窄带成像技术结合放大内镜检查,对检查结果进行统计分析。结果利用窄带成像技术结合放大内镜诊断符合率、准确度、灵敏度均明显高于白光内镜检查,差异具有统计学意义(P <0.05)。两种检查方式在特异度方面的对比差异无统计学意义(P> 0.05)。结论在对早期胃癌患者进行诊断时,使用窄带成像技术结合放大内镜诊断能够显著提升诊断准确率,更好的指导早期胃癌患者的临床诊断和治疗,具有较高的临床应用价值。     

NBI联合碘染运用于内镜下食管早癌的诊断

目的研究分析内镜窄带成像技术(NBI)联合碘染运用于内镜下食管早癌的诊断价值。方法选择2014年7月至2016年7月本院接收的可疑早期食管癌患者112例作为本次研究的研究对象,所有研究对象均进行常规白光模式、NBI和碘染检查,之后对病变位置取活检进行病理检查,收集所有研究对象的临床资料并进行分析,以病理检查为金标准,分析NBI联合碘染的诊断价值。结果 NBI和碘染检出率均显著高于普通白光内镜,有统计学意义(P<0.05);NBI、碘染单独检查以及联合检查特异度、敏感度、准确度均高于普通白光内镜,有统计学意义(P<0.05)。结论内镜窄带成像技术(NBI)联合碘染运用于内镜下食管早癌的诊断价值较高,值得推广应用。     

窄带成像放大内镜对早期胃癌和癌前病变的诊断价值

目的探讨窄带成像放大内镜(ME-NBI)对早期胃癌和癌前病变诊断中的价值。方法纳入141例通过白光内镜及ME-NBI检查并且行病理活检,诊断为非肿瘤胃病、早期胃癌和癌前病变的患者。分别比较白光和ME-NBI诊断的情况,同时观察早期胃癌和癌前病变在窄带成像放大内镜下的腺管开口和微血管形态特点。结果白光对早期胃癌和癌前病变诊断敏感性、特异性、假阳性率和假阴性率分别为54.5%、43.8%、88.0%、11.3%,准确率为53.3%,ME-NBI诊断分别为80.1%、68.8%、95.2%、32.4%,准确率为76.6%。胃部肿瘤性病变与非肿瘤性病变在边界线、不规则的表面腺管和黏膜微血管、腺管密度、黏膜微血管密度方面具有显著性差异(P<0.01)。结论 MENBI在诊断早期胃癌和癌前病变方面优于常规内镜检测,可用于早期胃癌的筛查。     

内镜窄带成像联合醋酸及靛胭紫染色在早期胃癌及癌前病变诊断中的应用价值

目的在早期胃癌及癌前病变诊断中内镜窄带成像联合醋酸及靛胭紫染色检测的临床价值分析。方法选取2017年3月至2019年12月在广东省中山市小榄人民医院接受治疗的早期胃癌患者19例,癌前病变患者100例,均已经病理诊断确诊。所有患者均接受常规胃镜检查、内镜窄带成像以及醋酸及靛胭紫染色检测,以常规胃镜检查结果为对照1组,以内镜窄带成像检查结果为对照2组,以内镜窄带成像联合醋酸及靛胭紫染色检测为观察组,对比三组检查结果的准确率以及成像质量。结果经检测后,观察组膜微血管结构清晰度3分率显著高于对照1组以及对照2组,差异有统计学意义(P 0.05);观察组病灶轮廓结构清晰度3分率显著高于对照1组以及对照2组,差异有统计学意义(P 0.05);观察组病灶轮廓结构清晰度3分率显著高于对照1组以及对照2组,差异有统计学意义(P 0.05);观察组诊断准确率显著高于对照1组以及对照2组,差异有统计学意义(P 0.05)。结论在早期胃癌及癌前病变诊断中内镜窄带成像联合醋酸及靛胭紫染色检测具有较高的应用价值,其成像清晰度较高,诊断准确率更高。     

窄带双变焦放大内镜对胃部癌前病变及早期胃癌的诊断价值

目的 探究窄带双变焦放大内镜在胃部癌前病变及早期胃癌的诊断价值。方法 回顾性分析2019年1月至2020年1月于沧州市人民医院接受胃镜检查出现病灶的300例病人，所有病人入院即行窄带双变焦放大内镜（DF-NBI）检查和靶向活组织检查，2周内择期再行窄带成像放大内镜（ME-NBI）检查和靶向活组织检查。比较两种内镜方法与病理学诊断结果的一致性，分析DF-NBI下胃部癌前病变和早期癌变与MV/MS分型的关系。结果 DF-NBI和ME-NBI对于胃部癌前病变和早期胃癌的诊断与病理检查结果的Kappa值分别为0.882和0.857，均具有较好的一致性。DF-NBI的灵敏度为89.4%，阳性预测值为87.1%，阴性预测值为94.1%，准确率为91.8%，略高于ME-NBI(89.0%)，特异度为90.7%，略低于ME-NBI(93.1%)，但差异无统计学意义（χ2=0.26、0.70,P>0.05）。在DF-NBI下微血管形态与腺管开口形态在诊断早期胃癌上的差异有统计学意义（χ2=209.76、178.81,P<0.05）。结论 DF-NBI与ME-NBI对胃部癌前病变和早期胃癌分化...     

染色内镜结合超声内镜在早期食管癌及癌前病变诊治中的价值

目的探讨窄带成像技术(NBI)、碘染色结合超声内镜(EUS)在早期食管癌及癌前病变诊断和治疗中的价值。方法对可疑食管病变的患者分别进行NBI及碘染色检查,并对病灶进行活检,统计NBI及碘液染色法对早期食管癌及癌前病变的检出率及联合检出率。对食管癌和癌前病变的患者进行EUS检查,判断病变的浸润深度,选择合适的治疗方式(内镜下微创治疗或手术治疗),术后将切除的病变组织行病理检查,比较病变浸润深度与超声内镜判断的浸润深度的符合率。结果单独采用NBI与单独使用碘染色法对早期食管癌及癌前病变的检出率差异无统计学意义(P>0.05),NBI结合碘染色方法的早期食管癌及癌前病变检出率显著优于单独应用NBI或碘染色法(P<0.05)。EUS判断食管病变浸润深度的准确性与病理结果相比较,差异无统计学意义(P>0.05)。结论 NBI结合碘染色法可以提高早期食管癌及癌前病变的检出率,超声内镜可以对病变的浸润深度做出准确判断,为治疗方案的选择提供较为可靠的依据。     

窄带成像联合放大胃镜技术在早期胃癌及癌前病变筛查中的诊断效果分析

目的 探究窄带成像联合放大胃镜技术在早期胃癌及癌前病变筛查中的诊断效果。方法 112例疑似早期胃癌及癌前病变患者,均进行常规胃镜检查、窄带成像联合放大胃镜检查,并以病理检查结果为金标准,比较两种检查方式图像质量评分、诊断效能。结果 窄带成像联合放大胃镜检查腺管图像质量评分和微血管图像质量评分分别为(2.56±0.25)、(2.67±0.26)分,均高于常规内镜检查的(1.99±0.19)、(2.04±0.20)分,差异有统计学意义(P<0.05)。窄带成像联合放大胃镜检查的准确率为95.54%(107/112),敏感度为96.00%(72/75),特异度为94.59%(35/37);常规内镜检查的准确率为78.57%(88/112),敏感度为81.33%(61/75),特异度为72.97%(27/37)。窄带成像联合放大胃镜检查的诊断准确率、敏感度、特异度均高于常规内镜检查,差异有统计学意义(χ2=14.300、8.027、6.366, P=0.000、0.005、0.116<0.05)。结论 在早期胃癌及癌前病变筛查中应用窄带成像联合放大胃镜技术具有更大的优势,图像质量更...     

窄带成像结合放大内镜对胃平坦型病变诊断的价值

目的探讨窄带成像结合放大内镜在胃黏膜平坦型病变诊断中的临床应用价值。方法常规内镜检查的患者中发现有胃黏膜平坦型病变者入组,共120例,入组患者首先完成常规内镜检查,根据普通白光内镜下病变特点分析病变性质并完成内镜诊断,然后用窄带成像结合放大内镜对病变周围胃小凹及微血管形态进行观察后做出诊断,并根据黏膜像取病理组织检查,将普通白光内镜下诊断及窄带成像放大内镜下诊断分别与病例诊断结果相比较,观察符合率。结果 120例平坦型病变病理证实慢性炎症68例,炎症伴肠上皮化生24例,炎症伴不典型增生18例,早期胃癌10例,普通内镜下诊断总病理符合率为69.2%,窄带成像放大内镜下诊断总病理符合率92.5%,两种情况下总病理符合率差异有统计学意义(P<0.05),尤其在诊断早期胃癌、炎症伴不典型增生、炎症伴肠上皮化生,窄带成像放大内镜明显优于普通白光内镜。结论窄带成像结合放大内镜在胃黏膜平坦型病变的诊断和组织病理学上较普通白光内镜有更好的一致性,且能有效提高胃平坦型早期胃癌及癌前病变的发现率。     

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.     

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.     

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.