紫杉醇顺铂周方案同步调强放疗治疗局部晚期NSCLC

目的 观察紫杉醇顺铂周方案同步调强放疗(IMRT)治疗局部晚期非小细胞肺癌(NSCLC)的疗效和毒副反应.方法 34例局部晚期NSCLC,同步组(14例)采用紫杉醇顺铂周方案化疗联合同步涮强放疗;序贯组(20例)采用紫杉醇顺铂周方案序贯化疗联合紫杉醇顺铂周方案化疗.同步组紫杉醇每次剂量50 mg/m~2,第1、8、15天;顺铂25 mg/m~2,第1、8、15天,每4周重复.放疗采用调强技术,靶区剂量60 Gy,5次/周,200 cGy/次.序贯组在放疗前给予2周期紫杉醇顺铂周方案化疗后2周行调强放疗.结果 全组34例,完全缓解(CR)3例(8.8%),部分缓解(PR)19例(55.9%),有效率(CR+PR)64.7%,稳定(SD)8例(23.5%),进展(PD)4例(11.8%).中位生存期为16.5个月,1年和2年,总生存率分别为62.5%和37.5%.同步组患者Ⅱ～Ⅲ级急性放射性食管炎发生率为50%(7/14)、Ⅱ～Ⅲ级急性放射性肺炎发生率为35.7%(5/14)、Ⅱ～Ⅲ级白细胞减小发生率为35.7%(5/14);序贯组分别为45%(9/20)、30%(6/20)、25%(5/20).同步组有1例出现Ⅳ度白细胞减少,1例出现Ⅳ级急性放射性肺炎.结论 紫杉醇顺铂周方案同步调强放疗(IMRT)治疗局部晚期NSCLC有较高的有效率,毒副反应可以耐受.     

同步放疗联合紫杉醇加顺铂治疗中晚期食管癌临床观察

目的探讨同步放疗联合紫杉醇＋顺铂（TP）方案治疗中晚期食管癌的疗效及临床分析。方法 2010年6月至2011年6月期间,我院诊治的50例中晚期食管癌患者,随机将其分为对照组（单纯放疗）和观察组（同步放疗联合紫杉醇＋顺铂方案治疗）,每组各25例,对两组近期疗效、1年局部控制率和远处转移率,以及生存率,进行观察和比较。结果与对照组相比,观察组的总有效率、1年局部控制率、生存率均明显升高,而1年远处转移率显著降低,P〈0.05,差异有统计学意义。结论对于中晚期食管癌患者,同步放疗联合紫杉醇＋顺铂（TP）方案治疗疗效显著,显著改善患者的预后质量,值得临床推广。     

紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌临床观察

目的：观察紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌临床疗效。方法选取2011年1月－2012年12月收治的中晚期食管癌患者120例,随机分为研究组与对照组各60例,对照组予以单纯放疗,研究组则予以紫杉醇＋顺铂方案联合同步放疗,分析对比2组患者治疗效果、不良反应发生率及1年生存率。结果研究组总有效率为90．0％明显高于对照组的63．3％,1年生存率为76．7％高于对照组的50．0％,差异均有统计学意义（ P＜0．05）。2组不良反应发生率差异无统计学意义（P＞0．05）。结论紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌患者效果明显,有效改善预后质量。     

紫杉醇＋顺铂方案同步放疗治疗中晚期食管癌疗效观察

目的：观察采取紫杉醇联合顺铂同步放疗治疗中晚期食管癌的临床疗效及不良反应。方法：在我院肿瘤科住院的患者中随机选取60例中晚期食管癌患者,并将其分成两个组,一组采取单纯的放射治疗,作为对照组;一组采取紫杉醇联合顺铂同步放疗治疗,作为研究组。通过对比观察采取紫杉醇联合顺铂同步放疗治疗的临床疗效。结果：紫杉醇联合顺铂治疗的研究组患者治疗的总有效率72.5%显著高于对照组的42.5%,研究组在1、3、5年的生存率也明显高于对照组,两组间治疗的总有效率及总生存率差异显著P＜0.05,具有统计学意义。但研究组患者出现的如恶心、呕吐等不良反应也较明显。结论：采取紫杉醇联合顺铂同步放疗治疗可以提高患者近期疗效及远期生存率。虽然临床治疗有一定的不良反应,但可以耐受。     

紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌临床观察

目的：对紫杉醇、顺铂方案联合同步放疗治疗中晚期食管癌的临床疗效进行分析。方法70例中晚期食管癌患者随机分为对照组和观察组,对照组34例给予单纯放疗,观察组36例给予紫杉醇、顺铂方案联合同步放疗治疗,对比两组治疗效果及不良反应发生率。结果观察组治疗总有效率69.4%显著高于对照组44.1%,1年生存率及3年生存率均显著高于对照组（P＜0.05）,恶心呕吐、黏膜炎及白细胞下降等不良反应发生率均显著高于对照组（P＜0.05）。结论在中晚期食管癌治疗中,采用紫杉醇、顺铂方案联合同步放疗治疗效果显著,可大幅提高患者生存率,然而不良反应发生风险较高,在临床中应给予高度关注。     

中晚期鼻咽癌调强放疗联合TP、PF方案同期化疗的疗效分析

目的观察调强放疗联合紫杉醇+奈达铂(TP)、5-氟尿嘧啶+奈达铂(PF)方案同期化疗治疗中晚期鼻咽癌的临床疗效及不良反应。方法选取我院110例Ⅲ、Ⅳa期初治鼻咽癌患者行调强放疗联合同期含奈达铂方案化疗,调强放疗采用鼻咽IMRT技术。放疗期间同步化疗2个周期,21 d为1个周期,含奈达铂化疗方案分为2组:TP(紫杉醇+奈达铂)52例;PF(5-氟尿嘧啶+奈达铂)48例,分析比较两组患者疗效和急性不良反应。结果两组临床疗效无显著性差异(P>0.05),但TP组急性不良反应发生率显著高于PF组(P<0.05)。结论调强放疗联合同期含奈达铂方案化疗治疗局部晚期鼻咽癌,可获得较好肿瘤控制和生存率,TP方案较PF方案急性不良反应的发生增加,临床疗效相近。     

替吉奥与奈达铂加同步放疗治疗中晚期食管癌临床观察

目的探讨替吉奥+奈达铂(S1N)、5-氟尿嘧啶+顺铂(FP)方案加同步放疗治疗中晚期食管癌的疗效,毒副反应及耐受性观察。方法 62例中晚期食管癌患者随机分为两组:试验组(S1N方案加同步放疗)30例,对照组(FP方案加同步放疗)32例。放疗均采用钴60-γ线常规分割照射。结果 S1N化放组、FP化放组有效率分别为86.7%、62.5%。S1N化放组的有效率高,差异有统计学意义(P0.05)。S1N化放组、FP化放组1年生存率分别为73.3%、59.4%,差异无统计学意义(P0.05)。主要副反应为消化道反应、骨髓抑制,放射性食管炎。FP组消化道反应、静脉炎较重,比较差异有统计学意义(P0.05)。S1N组骨髓抑制较重,差异无统计学意义(P0.05)。患者可以耐受,无治疗相关性死亡。结论两方案同步放化疗治疗均可用于中晚期食管癌的综合治疗。     

紫杉醇加顺铂联合同步放疗治疗中晚期食管癌的疗效评价

目的 探讨紫杉醇加顺铂同步放疗治疗中晚期食管癌的疗效及毒副反应.方法 80例中晚期食管癌患者随机分为单纯放疗组(单纯放射治疗)和放化疗组(采用紫杉醇加顺铂同步放化疗)组,每组40例,对两组临床疗效及毒副反应进行比较.结果 放化组总有效率(92.5%)明显高于单纯放疗组(62.5%),差异有统计学意义 (P<0.05).单纯放疗组的 1、3、5 年生存率分别为 70.4%、25.6%和 14.3%,放化疗组为84.2%、59.3%和21.3%,两组总生存率差异有统计学意义 (P<0.05).单放组和放化组的远处转移率分别为 45.0% (18 /40)和 42.5%(17/40),差异无统计学意义 (P>0.05).两组均出现轻中度放射性食管炎、骨髓抑制和恶心呕吐等毒副反应,放化组的毒副反应发生率高于单放组.结论 同步放化疗可提高中晚期期食管癌总有效率和总生存率,但毒副反应有增加的趋势.     

紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌临床观察

目的探讨紫杉醇＋顺铂方案联合同步放疗治疗中晚期食管癌的临床疗效。方法 2011年3月至2012年3月期间,本院诊治的60例中晚期食管癌患者,根据随机数字法,将其分为对照组（单纯放疗）和观察组（紫杉醇＋顺铂方案联合同步放疗）,每组各30例,对两组近期疗效、不良反应,以及1年生存率,进行观察和比较。结果与对照组相比,观察组的总有效率、1年生存率均明显升高,P〈0.05,差异有统计学意义,而两组不良反应发生率比较,差异没有统计学意义,P〉0.05。结论对于中晚期食管癌患者,同步放疗联合紫杉醇＋顺铂（TP）方案治疗疗效显著,显著改善患者的预后质量。     

适行放疗联合TP方案治疗中晚期食管癌疗效观察

目的探讨放疗联合TP方案同步治疗中晚期食管癌的临床价值。方法笔者对60例中晚期食管癌患者随机分2组研究,1组30例放疗联合TP方案同步治疗(综合组),另l组30例单纯放疗(单放组)。放疗采用常规分割,2.0Gy/次,5次/周,总剂量55~60Gy,6~7周完成。综合组在放疗第1、3、5周分别给予紫杉醇90mg d1,顺铂30mg,d1~d2静脉滴注。放疗不间断。结果综合组与单放组l、2、3年生存率分别为73.3%、30%、20%与43.3%、16.7%、10%。综合组的胃肠道及血液方面的急性反应较明显。而急性食管炎及晚期副反应无明显增加。结论放疗联合TP方案同步治疗中晚期食管癌较单纯放疗有提高总生存期的趋势。     

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.     

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.     

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.