前哨淋巴结检测在子宫颈癌根治术中的应用

目的 探讨前哨淋巴结（SLN）检测对子宫颈癌根治的临床价值。方法 应用蓝染料法对33例子宫颈癌患者在根治术中于宫颈肿瘤周围的正常组织3、6,9、12点处注入美蓝或专利蓝溶液4ml识别和定位蓝染的淋巴结，然后行盆腔淋巴清扫术并送病检。结果 33例宫颈癌患者中1例宫颈淋巴管无染料摄取；淋巴管有蓝色染料摄取者32例，其中26例成功识别SLN，识别率为81．25％（26／32）；7例识别SLN失败，失败率为21．88％（7／32）。26例成功识别SLN的患者中6例（23．08％）患者发现盆腔淋巴结转移，共12枚转移淋巴结均为SLN，敏感性为6／6，准确性为100％（26／26），假阴性率为0。结论 应用蓝染料法SLN检测具有较高的临床应用价值。     

非小细胞肺癌术中前哨淋巴结活检的临床意义

目的 探讨在非小细胞肺癌(NSCLC)中前哨淋巴结(SLN)转移与临床病理因素的关系.方法 对40例NSCLC患者于术中在肿瘤边缘分四个象限注入亚甲蓝4 ml标识并切除SLN,行连续切片中的病理诊断和广谱细胞角蛋白免疫组化检测;同时按标准肺癌根治术清扫淋巴结,所取淋巴结送HE染色及免疫组化检查.结果 40例NSCLC患者中,由SLN检测转移的灵敏度为91.3%,准确率为94.3%,假阴性率为8.7%;46枚SLN中39枚分布于N1淋巴结,7枚分布于N2淋巴结,其中以叶间淋巴结检出率最高;SLN阳性率与肿瘤的大小、P-TNM临床分期、SLN大小呈明显的相关性.结论 SLN能较为准确的反映NSCLC区域淋巴结的转移情况,为手术中淋巴结的清扫范围提供依据.     

单用美蓝检测乳腺癌前哨淋巴结的临床研究

目的 探讨采用美蓝在乳晕下注射与肿瘤周围注射检测乳腺癌前哨淋巴结(SLN)的可行性及准确性.方法 65例临床上腋窝淋巴结阴性的乳腺癌,术前33例患者于乳晕下注射美蓝,另32例患者于肿瘤周围注射美蓝,两组术中寻找蓝染的淋巴结或蓝染淋巴管指向的淋巴结,行手术解剖出SLN,所取SLN单独送病检,相应腋窝行淋巴结清扫并常规病检.结果 33例乳晕下注射发现SLN者31例,每例SLN平均数目为(1.9±0.9)枚,检出率为93.9%,SLN病检结果预测淋巴结的准确率为96.8%,假阴性1例,假阴性率为6.2%,32例肿瘤周围注射法的患者中发现SLN者27例,每例SLN平均为(1.7±0.7)枚,检出率为84.4%,SLN病检结果预测淋巴结的准确率为92.6%,2例假阴性,假阴性率为11.1%.结论 单用美蓝可以定位乳腺癌SLN能并准确反映区域淋巴结的转移情况,同时乳晕下注射法比肿瘤周围注射法确定SLN有更高的准确性.     

墨汁对子宫颈癌根治术中前哨淋巴结的识别作用

目的探讨墨汁在子宫颈癌根治术中识别前哨淋巴结（SLN）的价值。方法宫颈癌周围正常组织内分4点注射中华墨汁每点1ml后，行广泛子宫切除术和盆腔淋巴清扫术。观察盆腔淋巴引流区域内黑染的淋巴结。结果15例患者均有黑染淋巴结，SLN识别成功率100％（15／15）、2例淋巴结转移者SLN阳性．SLN对盆腔淋巴结转移预测准确性100％。结论中华墨汁用于示踪宫颈癌SLN效果可靠。     

染料法术中标记34例大肠癌前哨淋巴结的意义

目的探索前哨淋巴结活检（SI。NB）技术在早期大肠癌中的应用及前哨淋巴结（SI。N）微转移检测的临床意义。方法应用染料法对34例大肠癌患者，在根治术中于肿瘤周围或基底部浆膜下注射亚甲蓝溶液2mL左右，识别和定位蓝染的淋巴结（即前哨淋巴结），术后行常规HE病理和鼠抗人细胞角蛋白单克隆抗体AE1／AE3免疫组化染色法（ELIVISION二步法）检查。结果34例大肠癌患者中33例检出SLN，检出率为97．1％。由SLN状态预测其周淋巴结转移情况的准确率为93．9％（31／33），敏感性为88．9％（16／18），特异性为100．0％（16／16），假阴性率为11．1％（2／18）。免疫组化与常规HE对SLN转移的检出率相比较，差异有统计学意义（P=0．034），免疫组化法共检出12枚18例SLN存在微转移现象。结论SLN能够较准确反映早期大肠癌的淋巴转移状况，免疫组化法较常规HE病理检查更为敏感，AE1／AE3免疫组化发能提高SLN微转移的检测，对确定临床分期诊疗及判断预后有积极临床意义。     

纳米炭标识前哨淋巴结检测结肠直肠癌腹腔淋巴结转移的评估

目的 评价纳米炭标识前哨淋巴结(SLN)对结肠直肠癌腹腔淋巴结转移状况判断的价值.方法 50例初次接受手术且术前末接受放化疗的结肠直肠癌患者,以纳米炭淋巴示踪剂进行术中染料定位,黑染的第1～4个淋巴结定义为SLN并缝线标记,随后行标准的结肠直肠癌根治术,标本术后送病理检查.结果 50例患者中47例找到SLN,SLN检出成功率为94%;芡找到SLN 104枚,平均每例标本检山SLN 2.2枚(104枚/47例).准确率为95.7%(45例/47例);特异件为93.1%(27例/29例);假阴性率为10%(2例/20例);阴性预测值为93.1%(27例/29例).结论 SLN检测判断结肠直肠癌区域淋巴结转移状况简单且准确,可作为结肠直肠癌患者手术治疗的参考.     

子宫颈癌前哨淋巴结的临床研究

目的研究早期官颈癌前哨淋巴结（SLN）对临床的检测价值。方法2003年10月至2005年5月，在本院手术治疗的31例早期宫颈癌患者，利用局部注射放射性核素及亚甲蓝，术中定位前哨淋巴结，然后行经腹广泛全子宫切除＋盆腔淋巴结清扫术，将前哨淋巴结快速冰冻切片。结果31例患者均成功检测出前哨淋巴结，前哨淋巴结检出率100％，与术后病理检查符合率96％。结论前哨淋巴结对早期宫颈癌淋巴转移有一定的预测性。     

乳腺癌前哨淋巴结活检的临床应用价值（附32例报告）

目的:探讨乳腺癌前哨淋巴结活检技术(SLNB)的可行性和前哨淋巴结能否准确预测腋淋巴结的状况，以指导其在临床中的应用。方法:应用美兰对乳腺癌患者进行前哨淋巴结定位和活检。本组32例患者于术前10～15分钟用美兰液4ml注射在肿瘤周围，然后先解剖出染色淋巴管，追寻到第一站引流淋巴结(前哨淋巴结，SLN)，单独送病检。之后常规完成乳癌改良根治术或标准根治术。结果:在32例乳腺癌患者中，27例检出前SLN，检出率为84．4％。用美兰定位SLN预告腋淋巴结转移的敏感率为80．O％，准确率为85．2％，特异率为88．2％，假阴性率为20．0％。结论:用美兰染色法进行SLNB能预测腋淋巴结的状态，但检出率、准确率仍有待提高。尽管如此，该法方便有效，临床上仍有推广应用价值。     

早期胃癌前哨淋巴结微转移临床分析

目的探讨亚甲蓝示踪法前哨淋巴结(SLN)活检术在早期胃癌外科诊疗中的临床意义。方法 39例早期胃癌患者,术中用亚甲蓝示踪SLN,对SLN及所有术后胃周淋巴结进行HE染色,对SLN进一步行细胞角蛋白20(CK20)的免疫组化染色(IHC)及逆转录聚合酶链反应(RT-PCR)检测。比较3种检测方法对SLN转移灶检出的差异。结果 39例患者中,亚甲蓝示踪成功检出37例,检出成功率达94.5%。IHC与RT-PCR微转移检出率均为18.9%。由SLN状态预测胃周淋巴结转移情况:HE切片病检组前哨淋巴结检测准确率97.3%(36/37),假阴性率为16.7%(1/6);CK-20行IHC及RT-PCR组检测准确率97.3%(36/37),假阴性率为14.3%(1/7)。结论亚甲蓝示踪法能有效检出早期胃癌SLN。HE染色结合IHC及RT-PCR检测能提高SLN中微转移的检出率。     

核素显像与亚甲蓝染色联合探测乳腺癌前哨淋巴结的应用研究

目的回顾性研究术前核素淋巴结显像联合术中亚甲蓝染色定位活检乳腺癌前哨淋巴结的应用价值。方法将病理确诊为乳腺癌的195例T1和T2N0M0期女性患者术前12-16h在瘤周或残腔周围注射99MTc-SC 3ml,术前10min在患侧乳晕外上注射亚甲蓝注射液2ml,术中联合γ探测仪定位活检前哨淋巴结,送病理检查,阳性者加做腋窝清扫术。结果乳腺癌前哨淋巴结检出率为99.5%(194/195),准确率为98.9%(193/195),灵敏度为100%(38/38),假阴性率为2.56%(1/39)。结论核素淋巴结显像联合亚甲蓝应用于前哨淋巴结活检能准确显示SLN的部位、数目,准确率更高,假阴性率更低;此外,也可显示内乳区及锁骨下淋巴结,可指导腋窝外淋巴结的放疗。     

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.     

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.