经尿道行钬激光治疗膀胱肿瘤的疗效分析

目的:探讨经尿道行钬激光治疗浅表性膀胱肿瘤的临床疗效。方法:将我院2010年10月～2013年3月收治的50例浅表性膀胱肿瘤按照治疗方法的不同分为治疗组和对照组,对照组采用经尿道电切术治疗,治疗组采用经尿道行钬激光治疗,比较两组的治疗效果。结果:两组在手术时间、导尿管留置时间、复发率方面无统计学差异(P>0.05)。但治疗组闭孔神经反射、膀胱穿孔、膀胱冲洗时间显著少于对照组(P<0.05)。结论:经尿道行钬激光治疗浅表性膀胱肿瘤疗效较好,并发症少,安全性较高,在减少膀胱穿孔等方面优于电切治疗。     

经尿道钬激光治疗浅表性膀胱移行细胞癌

膀胱癌在泌尿系统肿瘤中发病率占首位,且常为多发性,复发率高.钬激光(Ho:YAG激光)是近年来应用于临床的新技术.自2005年5月至2006年10月,我院应用钬激光治疗浅表性膀胱移行细胞癌24例,疗效满意,现报道如下.     

经尿道气化电切术治疗膀胱肿瘤的临床探讨

目的探讨浅表性膀胱肿瘤经尿道气化电切手术方法及临床疗效。方法应用气化电报对浅表性膀胱肿瘤行经尿道膀胱肿瘤电切加气化(TUVBT)合并有良性前列腺增生患者,先行经尿道膀胱肿瘤电切加气化(TUVBT),切除膀胱肿瘤后同期行经尿道前列腺电切术切除前列腺。结果患者均顺利完成手术,无膀胱穿孔和电切综合征发生,去除肿瘤效果满意,操作简便,且肿瘤复发时可重复,手术安全性高。结论 TUVBT治疗浅表性膀胱肿瘤,操作简便,疗效可靠,值得临床应用。     

经尿道钬激光和电切治疗浅表性膀胱肿瘤的临床比较(附14例报告)

目的　总结应用经尿道钬激光和电切术治疗浅表性膀胱肿瘤的疗效并进行临床比较。方法　分别采用经尿道钬激光或电切术治疗浅表性膀胱肿瘤 14例。男 9例 ,女 5例。平均年龄 5 9岁。肿瘤单发 10例 ,多发 4例 ,原发 12例 ,复发 2例 ,合并膀胱结石 2例。肿瘤直径 0 .3～ 3.8cm,分期 T1 ～ T2 病理分级 G1 ～G2 。结果　 14例手术均一次成功 ,手术平均时间 2 5 min,平均出血量 <2 0 ml,术后均行丝裂霉素膀胱灌注化疗。 14例随访 3～ 9个月 ,平均 6 .5个月 ,复发 1例 ,复发率 7%。结论　经尿道钬激光切除膀胱肿瘤操作简单 ,几乎无并发症 ,而经尿道肿瘤电切术操作时间短 ,疗效确切 ,必要时两种手术方法可联合使用     

钬激光联合吡柔比星灌注治疗浅表性膀胱癌

目的 探讨经尿道钬激光切除联合吡柔比星即刻灌注治疗浅表性膀胱癌的临床疗效.方法 51例浅表性膀胱癌患者按随机数字表法分为两组,治疗组26例行经尿道膀胱肿瘤钬激光切除,术后即刻予以膀胱内保留灌注无菌蒸馏水50 ml+吡柔比星30 mg,1次;对照组25例行经尿道膀胱肿瘤电切治疗,两组术后拔除尿管时灌注1次,以后每周1次,共8次,后改为每月1次,持续至术后1年以上,随访15～39个月.结果 治疗组手术时间20～53 min,平均(31.6 ±8.9) min,无膀胱穿孔发生,术后留置导尿管1～5d,平均(2.7±0.6)d,4例复发;对照组手术时间13 ～47 min,平均(29.8±8.3)min,1例术中膀胱穿孔,术后留置导尿管3～11d,平均(4.6±1.1)d,11例复发.两组平均手术时间、膀胱穿孔例数差异均无统计学意义(均P＞0.05),治疗组术后导尿管留置时间、肿瘤复发例数均低于对照组(均P＜0.05).结论 经尿道钬激光切除联合吡柔比星灌注治疗浅表性膀胱肿瘤疗效优于电切治疗,术后恢复快.     

软性膀胱镜联合钬激光治疗伴尿道狭窄的表浅性膀胱癌25例

目的 探讨软性膀胱镜联合钬激光治疗伴尿道狭窄的表浅性膀胱癌的疗效.方法 25例伴尿道狭窄的表浅性膀胱癌的患者,均采取Olympus Fr16软性膀胱镜作为内镜系统,应用钬激光切除肿瘤膀胱,同时切除合并的尿道瘢痕.结果 所有患者均成功切除肿瘤,术中视野清楚,手术时间40～150 min,平均80 min,未出现闭孔神经反射及膀胱穿孔,5例合并严重尿道狭窄的患者,软性膀胱镜无法通过,术中先行钬激光尿道瘢痕狭窄切除.所有患者术后3个月膀胱镜复查时创面均愈合,随访12个月内未见肿瘤复发及尿道狭窄加重.结论 软性膀胱镜联合钬激光治疗伴尿道狭窄的表浅性膀胱癌是一种安全、有效的方法,可同时切除尿道瘢痕,降低术后尿道再狭窄率.     

膀胱癌术后应用吡柔比星与丝裂霉素交替膀胱灌注的临床疗效观察

目的：观察膀胱癌术后应用膀胱交替灌注预防浅表性膀胱肿瘤复发的疗效。方法：将70例浅表性膀胱肿瘤分为对照组和观察组,对照组采用单一药物灌注,观察组采用膀胱交替灌注。随访2年。结果：对照组与观察组无复发率分别为73.7%、93.8%,且交替灌注副作用少,无明显并发症。结论：吡柔比星治疗浅表性膀胱癌或预防肿瘤复发效果良好,值得临床推广使用。     

经尿道钬激光治疗浅表性膀胱肿瘤的体会

以往膀胱浅表性肿瘤多经尿道行膀胱肿瘤电切或膀胱部分切除术.近年来,利用钬激光(Ho:YAG激光)与膀胱镜相结合切除膀胱肿瘤逐渐成为浅表性膀胱肿瘤治疗的发展趋势.我科自2008年4月～2009年4月行经尿道钬激光切除膀胱肿瘤28例,疗效满意.     

经尿道膀胱肿瘤电切术联合吡柔比星膀胱内灌注治疗浅表性膀胱肿瘤的疗效观察

目的:探讨经尿道膀胱肿瘤电切术及术后使用吡柔比星膀胱内灌注治疗浅表性膀胱肿瘤的临床疗效。方法:75例浅表性膀胱肿瘤均采用经尿道膀胱肿瘤电切术(TURBT),术后使用吡柔比星膀胱内灌注治疗。结果:所有病例均一次完整切除。随访2年,58例未再次复发,12例1年内再次复发,5例2年内再次复发。结论:TURBT联合吡柔比星即刻膀胱灌注治疗浅表性膀胱肿瘤手术简单,疗效好,患者痛苦小,恢复快,值得临床推广。     

经尿道气化结合电切术治疗多发浅表性膀胱肿瘤47例报告

目的探讨经尿道膀胱肿瘤电气化术（TVBT）结合经尿道膀胱肿瘤电切术（TURBT）治疗多发浅表性膀胱肿瘤的方法及临床疗效。方法应用TVBT结合TURBT治疗多发浅表性膀胱肿瘤47例，观察其治疗效果。结果手术时间平均41min，未发生大出血及膀胱穿孔。平均随访36个月，术后复发15例，复发率31．9％。结论TVBT结合TURBT具有出血少，手术视野清晰，操作简便，可多次重复，安全性高等优点。     

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.     

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.