SonoVue超声造影对肝肿瘤的诊断价值

目的 探讨超声造影二次谐波成像技术在肝肿瘤诊断中的价值.方法 31例肝肿瘤患者经肘静脉团注SonoVue,采用超声造影二次谐波成像技术,实时观察注射造影剂后病灶增强特征.结果 经超声造影后,23个肝血管瘤动脉相均呈高回声增强,20个表现为周边向心型,2个为中央扩散型,1个为整体型增强特征;20个病灶在门脉相和延迟相仍为高回声增强,2个病灶渐变为等回声增强,1个病灶渐变为低回声增强.4个肝细胞癌动脉相呈高回声整体增强,门脉相1个呈等回声增强,3个呈低回声增强,延迟相均呈低回声增强.4个肝转移癌动脉相呈高回声增强,1个呈不均匀增强,3个呈环状增强,门脉相和延迟相均呈低回声增强.结论 SonoVue超声造影二次谐波成像技术能动态显示病灶增强特征,有助于肝肿瘤的诊断及鉴别诊断.     

肝血管瘤灰阶谐波超声造影时相研究

目的 利用灰介谐波超声造影技术研究肝血管瘤造影增强的时相变化并探讨其对血管瘤的诊断价值.方法 对30例肝血管瘤病灶进行超声造影检查,观察血管瘤的造影增强表现方式和时相规律.造影剂选用SonoVue,经肘静脉快速团注.结果 30个(100%)病灶均在动脉相出现增强,回声高于肝实质.其中26个(86.7%)病灶在门静脉相和延迟相持续增强,回声始终高于肝实质.在动脉相初始强化时,27个(90%)病灶呈环状或周边结节状增强逐渐向中央充填.在门静脉相和延迟相达峰值时,26个(86.7%)仍表现为周边结节状增强.结论 肝血管瘤超声造影增强的主要特点为动脉相回声增强,门脉相和延迟相持续性增强仍不低于肝实质回声;增强从周边开始呈进行性完全或部分性向心性填充.超声造影有助于肝血管瘤的诊断.     

超声造影在肝脏占位性病变诊断中的应用研究

目的探讨实时超声造影对肝脏占位性病变的诊断价值。方法对30例常规超声检查肝内占位患者共35个肝脏占位性病灶进行超声造影,造影剂选用SonoVue,浓度为8μl/ml,经肘静脉快速推注2.4ml SonoVue,记录所观察病灶的造影剂灌注过程,病灶大小数目,所有病例均与增强CT对照并经手术或穿刺活检病理证实。结果 30例肝内占位性病变其中原发性肝癌15例,肝转移癌5例,血管瘤7例,肝局灶性结节性增生1例,肝炎性假瘤1例,肝血管平滑肌瘤1例,35个病灶均有不同程度增强,肝癌动脉相表现为快速增强,门脉相快速消退,延迟相显示为低回声;血管瘤呈周围向心性环状或结节状增强,门脉相及延迟相进一步增强,持续时间较长;肝局灶性结节性增生表现为中央扩散型快速增强,显示为车轮状。结论超声造影能显示肝肿瘤内微小血管的血流灌注情况,对肝脏占位性病变的定性诊断具有重要的意义。     

实时超声造影在23例肝肾脾等占位性病变中的应用

目的 观察造影剂在肝、肾、脾等占位性疾病的灌注过程及回声变化规律.方法 采用第二代新型超声造影剂SonoVue和飞利浦IU22实时超声造影显像QLAB软件.观察肝、肾、脾等占位性病变的造影剂灌注过程.结果 经超声造影后,23个病灶中,2例脾血管瘤呈周围向心性增强.5例肾脏占位性病变中,1例肾错构瘤呈同进同出型增强,2例肾柱肥大呈同与肾组织同步增强型.2例肾内异常区呈无明显增强型.16例肝脏占位性病变中,9例肝血管瘤呈周围向心性增强,3例非均匀脂肪肝呈无明显增强型,2例肝癌术后呈无灌注型,1例肝癌呈快进快出型,1例肝内局灶性结节性增生呈动脉期呈轮辐状快速增强与延迟期持续增强.结论 超声造影技术对肝、肾、脾等肿瘤良恶性定性判断及肿瘤检出数目方面优于常规超声,为其诊断提供更多信息,弥补普通灰阶超声与彩色多普勒超声的不足.     

肝血管瘤超声造影表现

目的回顾性研究肝血管瘤超声造影（CEUS）的表现,总结肝血管瘤超声造影检查的表现特征。方法通过运用对比脉冲序列成像（CPS）技术对17例肝血管瘤（共21个病灶）进行超声造影检查,从而观察其动脉期、门脉期及延迟期的增强表现。结果超声造影肝血管瘤主要表现为动脉期或门脉早期周边环状、结节状增强,门脉期缓慢向心性充填,延迟期为最大增强。结论肝血管瘤在肝脏实时超声造影检查中具有特异性表现,可提高诊断准确率。     

肝血管瘤超声造影特征的临床研究

<正>本研究应用新型超声造影剂SonoVue对我院28例肝血管瘤患者(共48个病灶)进行超声造影检查,总结肝脏血管瘤的超声造影声像图特征,探讨超声造影对肝血管瘤的临床诊断价值。1资料与方法1.1研究对象:2003年1月至2011年1月经增强CT、磁共振成像(MRI)或穿刺活检确诊的肝血管瘤患者28例,共     

超声造影诊断脾血管瘤价值的初步探讨

目的：探讨超声造影对脾血管瘤的诊断价值。方法：应用造影匹配成像（CnTI）技术及造影剂声诺维（SonoVue）对8例18个脾血管瘤进行超声造影检查,观察注射造影剂后病灶增强表现。结果：18个脾血管瘤开始增强时间为7～18s,平均（11.94±2.75）s,始增时间较周围脾实质早,达峰时间和始消时间较周围脾实质晚,差异均有统计学意义（P〈0.05）,其中11个（61.1%）病灶呈周边环状增强,后逐渐向心性充填,6个（33.3%）病灶呈整体快速高增强,后持续等增强,1个（5.6%）病灶呈树枝样强化,后不均匀高强化。结论：超声造影能较好地显示微循环灌注,对临床诊断脾血管瘤具有重要意义。     

超声造影对转移性肝癌的诊断价值

目的 探讨超声造影对转移性肝癌的诊断价值及造影增强时相特征.方法 对47例恶性肿瘤患者肝脏行常规超声检查及低机械指数超声造影检查,对肝内转移性病灶超声造影表现分析其造影增强各时相的特征.结果 47例患者常规超声共检出病灶148个,超声造影共检出357个.肝转移癌病灶增强模式可分为3型:Ⅰ型,病灶动脉期周边环状快速增强,病灶内部呈低或无增强,之后周边增强部分迅速减退;Ⅱ型,病灶于动脉期呈快速整体增强(均匀型或不均匀型)并迅速减退;Ⅲ型,病灶于动脉期呈"面包圈"样增强,门脉期增强减退呈低增强或无增强.结论 超声造影可明显提高对肝脏转移病灶检出率;其造影增强特点因其原发灶不同、血供丰富与否亦不相同.     

反向脉冲谐波超声造影在肝脏局灶性病变鉴别中的应用

目的探讨反向脉冲谐波（pulse inversion harmonic,PIH）超声造影技术在肝脏局灶性病变（focal liver lesions,FLL,鉴别诊断中的作用。方法应用超声造影剂SonoVue和PIH技术,分析观察20例24个FLL的超声造影动态灌注过程,分析病灶的增强时相、增强方式、增强程度。结果原发性肝癌和转移性肝癌以动脉相增强明显,其中,原发性肝癌增强方式呈＂快进快出＂型;肝血管瘤呈向心性填充式增强,非均匀性脂肪肝于动脉相呈灶性＂低回声区＂,门脉相及实质相呈逐渐均匀强化。结论 PIH超声造影技术为肝脏局灶性病变鉴别诊断提供有用的信息,PIH超声造影技术具有重要的临床应用价值。     

探讨肝转移癌超声造影的临床应用价值

目的 探讨肝转移癌超声造影检出能力、造影动脉相增强模式特点.方法 35例肝转移癌患者为研究对象,行超声造影检查.记录病灶大小、位置、数目、各增强时相的表现.结果 ①35例肝转移癌患者常规超声共检出病灶182个,超声造影共检出386个,超声造影检出率明显增加(P<0.05).②动脉相重点观察的76个肝转移癌病灶表现四种灌注特征:I型(26.3%),周边环状增强,中心不增强或有少量点状、短线状血管向中心伸延.Ⅱ型(46.1%),周边环状增强,内部少量均匀增强.Ⅲ(11.8%),周边环状增强,内部少量增强,可见细长分枝状血管.Ⅳ型(15.8%),快速整体团状增强,内部团状或网状走行血管.结论 超声造影增加了肝转移病灶的检出数目;其增强模式及造影表现有利于定性诊断.     

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.     

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.     

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.