术前新辅助放化疗在低位进展期直肠癌治疗中的价值

目的:探讨术前新辅助放化疗对直肠癌切除及保肛的价值.方法:选择22例低位进展期直肠癌患者(TNMⅡ期和Ⅲ期)进行术前新辅助放化疗:放疗每周5 d,每次1.8～2.0 Gy,总剂量45～50 Gy,疗程4～5周,同时持续口服卡培他滨1 250 mg·m-2·d-1化疗至手术.放疗结束后4～6周进行手术,术后给予FOLFOX4方案4～6个疗程.结果:21例施行了保留肛门的直肠癌根治术(95.5%),1例施行了Miles手术.其中术后肛门排便功能优者占81.0%,局部复发率仅为4.5%.结论:术前新辅助放化疗对低位进展期直肠癌确实能达到肿瘤降期、局部复发率降低、提高手术切除率和保肛成功率等目的,是治疗低位进展期直肠癌的一种有效辅助方法.     

新辅助放化疗治疗低位进展期直肠癌的临床研究

目的探讨术前辅助放化疗对低位进展期直肠癌治疗效果。方法 47例低位进展期直肠癌患者(cTNMⅡ期和Ⅲ期),进行术前联合放化疗。放疗每周5d,每次1.8～2Gy,总剂量45～60Gy。同时持续口服卡培他滨1250mg/m2化疗,休息4～8周进行手术。结果新辅助放化疗的急性毒副反应较小,一般为Ⅰ～Ⅱ度反应,全部患者均完成了治疗,其中施行了保肛手术44例(93.6%),Miles手术3例。肿瘤分期降低明显,术后局部复发率明显下降,仅为4.3%。结论新辅助放化疗能使低位进展期直肠癌肿瘤降期,提高根治性切除率和保肛成功率,降低局部复发率,是低位进展期直肠癌综合治疗的一种有效方法。     

局部进展期低位直肠癌术前同步放化疗疗效观察

目的：评价局部进展期低位直肠癌术前同步放化疗的疗效。方法：对30例局部进展期低位直肠癌患者放疗＋同步口服希罗达,4～6周后行手术治疗。结果：全部患者均完成治疗。术后病理学完全缓解（CR）率为13.3%,保肛率为53.3%,1、2级毒性反应总发生率为70%,3、4级为16.7%。结论：对于局部进展期低位直肠癌患者术前同步放化疗安全有效,提高手术切除率、保肛率的同时,并未增加其毒副反应的发生。     

术前卡培他滨同步放疗治疗局部晚期低位直肠癌的临床研究

目的评价术前卡培他滨同步放化疗治疗局部晚期（Dukes B/C期）低位直肠癌的临床疗效及不良反应。方法对16例局部晚期低位直肠癌患者放疗＋同步口服卡培他滨,4-6周后行手术治疗。结果同步放化疗后肿瘤缩小,手术切除率100%,保肛率为62.5%（10/16）,局部复发率为6.25%（1/16）。主要的不良反应为白细胞减少、消化道反应和手足综合征。结论对于局部晚期低位直肠癌患者术前卡培他滨同步放疗可以提高手术切除率,保肛率、降低局部复发率,而不良反应小,是有效治疗局部晚期低位直肠癌的新方案。     

新辅助放化疗+双吻合器法治疗局部进展期低位直肠癌的临床研究

目的：探讨新辅助放化疗结合,TME双吻合器法治疗局部进展期低位直肠癌的临床疗效.方法：将65例T3、T4期低位直肠癌随机分为A、B二组,给予45Gy/5周,每周5次,每次1.8Gy放射治疗.A组32例在放疗同时给予卡培他滨2500mg/（m〈＇2〉·d）,分2次口服,服用14d,休息7d,连续服用3周期至手术,术后2～4周再续服2～3周期;B组33例于放疗第1、3周予四氢叶酸钙200mg/m〈＇2〉,静滴d1～d5,氟尿嘧啶500mg/m〈＇2〉静滴12hd1～d5化疗,完成放化疗后4～6周手术,术后2～4周,追加2～4周期化疗.手术均按TME原则进行.结果：全部病例均完成新辅助放化疗,治疗前,T334例,T431例.放化疗后,CR18例,PR31例,NC16例,降期49例,降期率75.4%,5例肿瘤完全消失未手术,44例行保肛手术,16例行经腹会阴直肠切除术,全组保肛率为75.5%（49/65）,包括5例未手术者.术后分期：T018例,T15例,T220例,T315例,T47例,随访13～60个月,中位38.5个月.随访无局部复发,2例出现远处转移,无死亡,总复发率3.08%（2/65）,无瘤生存率96.92%（63/65）.结论：新辅助放化疗＋TME双吻合器法治疗局部进展期低位直肠癌,能有效地缩小肿瘤,达到降期,提高肿瘤的切除率、保肛率,降低肿瘤局部复发,延长生存时间的目的.     

希罗达联合放疗治疗低位直肠癌术前的疗效观察

目的评价术前希罗达联合盆腔放射治疗对低位局部进展期直肠癌的疗效.方法将病症确诊60例低位直肠癌患者随机分为两组:单纯手术组30例,常规进行手术治疗;联合治疗30例,术前联合希罗达和放疗,然后再手术.结果单纯手术组和联合治疗组的手术切除率分别为83.5%和100%,差异有显著性(P<0.05);保肛率分别为30.0%和86.7%,差异有非常显著性(P<0.01);局部复发率分别为16.0%和0,差异有显著性(P<0.05).结论术前希罗述+放疗提高低位直肠癌的手术切除率和保肛率,降低局复发率,是目前较好的新辅助治疗方案。     

Ⅱ、Ⅲ期低位直肠癌术前放化疗的临床研究

目的探讨术前放化疗对局部晚期中低位直肠癌疗效和预后的影响。方法对81例保肛术前行术前放化疗及113例接受Miles手术后常规化疗的局部晚期中低位直肠癌患者的临床资料进行回顾性分析。结果术前放化疗术后总的病理完全缓解率为13.6%,降期率达61.7%,保肛率达77.8%。术前放化疗组和Miles手术组的局部复发率分别为9.9%和20.4%(P<0.05),5年生存率分别为69.1%和61.1%(P>0.05)。结论术前放化疗有利于提高局部晚期中低位直肠癌的保肛率,采用保肛术的局部复发率较Miles手术低,生存率和Mi-les手术相近。     

T3、T4分期低位直肠癌术前联合放化疗的疗效评价

目的 探讨联合术前放化疗对T3～T4分期低位直肠癌患者的临床价值.方法 选择2006年1月～2009年12月T3～T4分期低位直肠癌患者102例,随机分为两组,A组52例术前联合放化疗;B组50例直接手术.术前放疗总剂量为30 Gy,每周5次,每次3 Gy,放疗开始第1周即予奥沙利铂+5-氟尿嘧啶(5-Fu)+四氢叶酸化疗,放疗结束2周后手术.结果 A组患者均耐受放、化并完成治疗计划;A组保肛率大于B组(67.3%vs.48.0%,P<0.05);A组术后病理分期低于B组(P<0.05).结论 低位直肠癌术前放化疗安全可靠,可提高保肛手术成功率,改善患者预后及生活质量.     

中、低位直肠癌新辅助放疗42例临床分析

目的分析中、低位直肠癌新辅助放疗42例临床效果。方法 42例中低位直肠癌患者,经MRI或CT评估可切除后,平均分为两组,甲组单纯接受手术治疗,乙组在术前短期接受放疗4～6周后实施手术治疗,比较两组患者的保肛率、2年局部复发率。结果比较两组患者的保肛率以及2年局部复发率差异有统计学意义（P〈0.05）,两组治疗后不良反应差异无统计学意义（P〉0.05）。结论给予中低位直肠癌患者实施新辅助放疗治疗,可在提高保肛率同时减少局部复发,为一种安全高效的手术方法,应用效果显著。     

术前三维适型放疗联合化疗对中低位直肠癌MVD及VEGF的影响

目的 探讨术前三维适型放疗联合化疗对中低位直肠癌微血管密度(MVI))及血管内皮生长因子(VEGF)的影响.方法 63例腔内超声为T3、T4期中低位直肠癌患者,32例常规放射治疗至35～48 Gy;31例常规放疗20 Gy后再予三维适形放疗20 Gy两组均在接受放疗同时接受FOLFOX4方案化疗2个疗程,放疗结束后4～6周复查腔内超卢并手术,病理常规加MVD及VEGF表达检测.结果 三维适型放疗组的腹泻、放射性膀胱炎等副作用减少,肿瘤降期作用明显,MVD及VEGF表达下调,平均38.7个月随访局部复发率较低.结论 三维适形放疗联合化疗可提高术前放化疗的疗效,降低局部复发率和MVD表达.     

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.