FLAG方案治疗难治复发的急性白血病的临床观察

目的初步探讨氟达拉滨(FDR)、高剂量阿糖胞苷(Ara-C)和粒细胞刺激因子(G-CSF)即FLAG方案在急性髓细胞白血病(AML)再诱导化疗中的疗效及不良反应。方法 12例经标准DA、HA、MA及MAE方案化疗2个疗程未达完全缓解(CR)、骨髓原始细胞下降低于60%的AML患者,予FLAG方案再诱导化疗,即FDR30mg/(m2?d)静脉滴注,d1⁵;Ara-C1 g/m2静脉滴注,每12 h 1次,d15;Ara-C1 g/m2静脉滴注,每12 h 1次,d1⁵;G-CSF300μg/d皮下注射,第0天开始至白细胞恢复正常。结果 9例(75%)患者获得完全缓解(CR),3例(25%)患者获得部分缓解(PR)。主要不良反应为骨髓抑制,非血液学不良反应不明显。结论 FLAG方案再诱导化疗AML耐受性良好,有效率较高,不良反应可耐受。     

EAG预激化疗治疗老年急性髓系白血病30例

目的观察EAG预激化疗作为诱导缓解方案在治疗老年急性髓系白血病患者中的疗效。方法对应用EAG预激方案治疗的30例AML患者(≥60岁)的临床资料进行回顾性分析,包括完全缓解率、有效率、生存期以及不良反应。结果 EAG诱导缓解的有效率为70.0%(21/30),CR率为50.0%(15/30),中位无病生存期6.5个月;EAG预激化疗的主要不良反应为骨髓抑制期继发的感染、出血,调整方案后所有患者均能耐受。结论 EAG预激化疗作为诱导缓解方案适用于老年AML患者。     

含G-CSF的预激方案治疗急性髓系白血病的疗效观察

目的观察小剂量阿糖胞苷(Ara-C)、高山尖杉酯碱(HHT)与粒细胞集落刺激因子(G-CSF)同时使用的预激方案治疗低增生性、老龄及继发骨髓增生异常综合症(MDS)转化的急性髓系白血病(AML)的临床疗效及不良反应。方法应用CHG方案治疗AML初治7例,难治或复发3例,既往曾接受DA/HA方案化疗,MDS转化为AML2例,若第一疗程不缓解可重复使用两疗程,方案与第一疗程相同,如仍未缓解停用。结果12例患者中8例患者接受一个疗程,4例患者接受二个疗程治疗。完全缓解5例(41.7%)部分缓解4例(33.3%),有效率75.0%。大部分患者出现了可以耐受的轻微不良反应,主要表现为骨髓抑制。结论小剂量Ara-C和HHT方案联合G-CSF的预激方案治疗AML安全有效,而且不良反应少。     

CAG预激方案与常规化疗治疗老年初治急性髓性细胞白血病(AML)的疗效

目的观察分析CAG预激方案与常规化疗治疗老年初治急性髓性细胞白血病(AML)的疗效。方法在本院2016年1月至2017年1月接诊的初治性AML患者中随机选取36例作为本次研究的对象,并对36例患者实施分组治疗,18例采用常规化疗方案治疗的为A组,18例采用CAG预激方案治疗的为B组,比较两组的治疗效果及并发症发生情况。结果 B组的治疗总有效率为88.89%,明显高于A组的77.78%(P<0.05)。B组患者发生血液系统并发症发生率为88.89%,明显低于A组的100.00%(P<0.05)。B组患者发生非血液系统不良反应发生率为11.11%,明显低于A组的61.11%(P<0.05)。结论 CAG预激方案与常规化疗治疗老年初治急性髓性细胞白血病(AML),能够有效缓解患者的临床症状,降低并发症及不良反应的发生率,具有非常确切的治疗效果。     

去甲氧柔红霉素治疗老年急性髓系白血病

目的探讨去IDA治疗老年AML的临床疗效。方法根据治疗方法不同将42例患者分为观察组和对照组(各21例),观察组给予IDA+Ara-C的联合化疗方案治疗,对照组给予DNR联合Ara-C化疗方案治疗。结果观察组总有效率为90.5%,明显优于对照组的61.9%(P0.05);两组均有不同程度不良反应出现,但两组不良反应发生率比较差异均无统计学意义(P0.05)。结论 IDA是一种治疗老年AML疗效可靠的抗肿瘤药物,具有较高的完全缓解率,可作为缓解老年AML的最佳治疗方案之一。     

急性髓系白血病标准化疗失败后启用序贯预激诱导的效果

目的探讨标准化疗(DA)方案诱导失败后启用序贯预激诱导(CAG)方案治疗急性髓系白血病(acute myeloid leukemia,AML)的疗效。方法选择28例初治AML患者,用DA方案诱导治疗,化疗结束后第7天骨髓象均为有核细胞增生活跃,原始细胞>5%或有核细胞增生减低,原始细胞>10%,均于DA方案化疗结束后第8天开始CAG方案序贯诱导。结果 28例患者中22例CR(78.6%),2例PR。总有效率(CR+PR)85.7%。结论标准化疗方案诱导失败后序贯预激诱导方案治疗初治AML疗效明显。     

CAG方案在低增生急性髓性白血病中的应用价值

目的观察阿糖胞苷(Ara-C)、阿克拉霉素(Acla)、粒细胞集落刺激因子(G-CSF)即CAG方案治疗低增生急性髓性白血病(AML)的疗效。方法26例初治低增生性急性髓性白血病患者采用CAG方案治疗,包括阿糖胞苷10mg/m2,每12小时皮下注射),第1～4天静脉滴注;粒细胞集落刺激因子150～300μg/(m2·d),第1～14天皮下注射。结果CAG方案对低增生性急性髓性白血病总有效率达76.92%,其中完全缓解10例(38.5%),部分缓解10例(38.5%),未缓解6例(23.08%)。结论CAG方案治疗急性髓性白血病效果较好,副作用小,可作为治疗低增生AML一线方案使用,值得推广。     

预激方案治疗急性髓细胞白血病23例疗效观察

目的:观察预激方案治疗急性髓细胞白血病(AML)的临床疗效。方法:对23例AML患者采用CAG/HAG方案治疗,如1疗程未缓解,可接受第2疗程治疗。监测临床症状、体征、肝肾功能、骨髓细胞学检查及心电图。结果:23例经1～2个疗程治疗后完全缓解13例(56.5%),部分缓解5例(21.7%),未缓解5例(21.7%),总有效率78.2%。结论:预激方案治疗AML疗效较肯定,不良反应小。     

HAG/CAG方案治疗老年急性髓细胞白血病26例疗效观察

目的评估HAG/CAG方案治疗老年急性髓细胞白血病(AML)的疗效。方法予小剂量高三尖杉酯碱(HHT,1 mg.m-2.d-1,第1~14天,静脉输注)或阿克拉霉素(Acla,6 mg.m-2.d-1,第1~8天),小剂量阿糖胞苷(Ara-C,10 mg.m-2.d-1,第1~14天,每12小时皮下注射)和粒细胞集落刺激因子(G-CSF 200 mg.m-2.d-1,第1~14天,皮下注射)在内的HAG/CAG方案治疗AML 26例。结果11例患者取得完全缓解(CR),10例获部分缓解(PR),总有效率80.8%。可见粒细胞缺乏、血小板减少、继发感染及发热等不良反应。结论HAG/CAG方案治疗AML疗效较好,毒副反应轻,可改善生活及生存质量,延长生命。     

CAG方案治疗老年急性髓性白血病的临床观察

目的观察CAG方案治疗老年急性髓性白血病的临床疗效和不良反应,并与既往常规DA方案进行比较分析。方法选择153例老年AML患者,近年的78例采用CAG方案,既往75例采用标准DA方案化疗。结果 78例患者中CR 66例,PR 4例,余8例未缓解,总有效率为89.7%,CR率和总有效率均显著高于常规DA方案治疗。CAG方案治疗组骨髓抑制与感染率较常规方案治疗组有明显差异(P<0.05)。结论 CAG方案治疗老年急性髓性白血病,疗效确切,是有效、安全的诱导治疗方案。     

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.     

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.