紫杉醇联合化疗治疗晚期胃癌的临床观察和护理

目的：观察紫杉醇（PTX）联合醛氢叶酸（CF）、氟尿嘧啶（5-Fu）、顺铂（DDP）治疗晚期胃癌的疗效及不良反应,总结护理经验。方法：回顾性分析76例晚期胃癌患者应用紫杉醇联合化疗的临床资料。结果：完全缓解5例,部分缓解42例,稳定25例,进展4例,总有效率61.8%;不良反应以骨髓抑制、脱发和消化道反应为主,在使用紫杉醇过程中,没有出现严重的过敏反应。结论：紫杉醇联合醛氢叶酸、氟尿嘧啶、顺铂治疗晚期胃癌的疗效好,不良反应可耐受,是一种较好的联合化疗方案。加强化疗前、中、后整个过程的观察、支持和护理对保证紫杉醇联合化疗方案的顺利完成起重要的作用。     

周剂量紫杉醇联合顺铂治疗晚期食管癌临床观察

目的 观察周剂量紫杉醇(PTX)加顺铂(DDP)联合化疗治疗晚期食管癌的近期疗效和毒副反应.方法 晚期食管癌患者48例分为两组,PTX DDP组:PTX 80mg/m2静滴第1,8天;顺铂20mg/d静滴第1～5天.5-Fu DDP CF组:5-Fu 500mg/m2静滴,第1～5天;DDP 20mg/d静滴第1～5天,CF 100mg/次静滴,在5-Fu前2h内给药第1～5天,21天为1周期,2周期后按UICC标准评价近期疗效和毒副反应.结果 PTX DDP方案治疗20例食管癌患者有效率为70%;5-Fu DDP CF方案治疗28例的有效率为50%.前一联合方案总有效率高于后者,有显著性差异(P＜0.05),不良反应也较后者重,但大多数患者能耐受,主要为剂量限制性毒性.表现为Ⅱ～Ⅲ度为主的骨髓抑制.结论 周剂量紫杉醇联合顺铂治疗晚期食管癌近期疗效显著,毒副反应小.     

顺铂腹腔内滴灌联合全身化疗治疗晚期胃癌

目的:研究顺铂腹腔内滴灌配合草酸铂联合亚叶酸钙(CF)及氟尿嘧啶(5-Fu)全身化疗治疗晚期胃癌的疗效。方法:对入选的65例晚期胃癌患者以草酸铂联合亚叶酸钙(CF)及氟尿嘧啶(5-Fu)双周方案给予全身化疗,并配合每周1次顺铂(DDP)单药腹腔灌注化疗。结果:完成治疗的60例患者中,CR4例,PR34例,总有效率(RR:CR PR百分率)为63%;各种病理分型均有较好疗效;从转移的情况来看,对伴有腹水者疗效较好。结论:顺铂腹腔内滴灌配合草酸铂联合亚叶酸钙(CF)及氟尿嘧啶(5-Fu)全身化疗治疗晚期胃癌,疗效可靠,毒副反应可以耐受,值得临床推广应用。     

FOLFOX4方案治疗晚期胃癌的临床观察

目的 观察奥沙利铂(L-OHP)联合氟尿嘧啶(5-Fu)、亚叶酸钙(CF)组成的FOLFOX4方案治疗晚期胃癌的疗效及不良反应.方法 26例晚期胃癌患者接受FOLFOX4方案化疗:L-OHP 85 mg·m-2静脉滴注2 h,第1天;CF 200 mg·m-2静脉滴注2 h,第1,2 天;5-Fu 400 mg·m-2...     

奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期胃癌

目的：观察奥沙利铂（LOHP）联合氟尿嘧啶（5-Fu）和亚叶酸钙（CF）治疗晚期胃癌的疗效及不良反应。方法：采用FOL-FOX改良方案,第一天采用LOHP130mg/m^2静脉滴注3h,CF200mg静脉滴注2h后,5-Fu500mg快速静脉注射后再用5-Fu 2．4g／m^2 持续静脉滴注泵连续滴注46h,每21天重复,完成2周期后评价疗效。结果：全组46例晚期胃癌患者,CR3例,PR20例,有效率（CR＋PR）50％,中位疾病进展时间（TTP）5．7个月,中位生存期10．5个月。主要不良反应为轻度感觉神经毒性、恶心呕吐及骨髓抑制。结论：LOHP联合5-Fu和CF治疗晚期胃癌疗效较好,不良反应轻,可耐受。     

草酸铂联合5-氟尿嘧啶四氢叶酸治疗晚期胃癌

目的:观察草酸铂(L-OHP)联合5-氟尿嘧啶(5-Fu)、四氢叶酸(CF)治疗晚期胃癌的疗效。方法:对住院治疗的42例晚期胃癌患者采用草酸铂联合5-氟尿嘧啶、四氢叶酸化疗方案,L-OHP130mg/m2第1天,CF200 mg/m2第1~5天,5-Fu500 mg/m2第1~5天。每3周重复,至少治疗2周期,按标准评价疗效和毒副反应。结果:可评价患者42例,有效率28.6%,中位生存期9.6个月,一年生存率47.6%。主要毒副反应为周围性感觉神经病变,骨髓抑制及消化道反应,多数为I~III度反应。结论:草酸铂联合5-氟尿嘧啶四氢叶酸治疗晚期胃癌临床疗效较好,毒性反应可以耐受。     

以草酸铂为主的联合化疗方案治疗晚期大肠癌16例

目的 观察草酸铂(OXA)联合醛氢叶酸(CF),5-氟尿嘧啶(5-Fu)治疗晚期大肠癌的近期疗效及不良反映.方法 OXA130mg/m2,iv drip dl;CF100mg,iv dl-5;5-Fu375mg/m2,iv dl-5.以上方案每21d为一周期,至少完成二周期.结果 CR1例,PR5例,SD6例,PD4例.总有效率37.5%,主要不良反应为恶心、呕吐、血白细胞减少、外周神经炎.结论 草酸铂为主联合化疗方案治疗晚期大肠癌疗效较好,不良反应可耐受,值得临床推广应用.     

草酸铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌临床研究

目的 观察草酸铂(奥沙利铂)联合氟尿嘧啶(5-Fu)和亚叶酸钙(CF)治疗晚期大肠癌疗效及不良反应。方法 晚期大肠癌患者接受草酸铂联合5-Fu/CF治疗：草酸铂130mg／m^2,静脉滴注,第1天;CF100-200mg／m^2,第1-5天,静脉滴注：5-Fu500mg／m^2,第1-5天,静脉滴注;21天重复上述方案化疗1次;每例至少化2个以上周期。结果 完全缓解(CR)1例,部分缓解(PR)11例,稳定(SD)16例,进展(PD)4例,总有效率37．5％。初治17例中,有效率47．1％,复治15例中,有效率26．7％。不良反应以神经毒性为主,其次为胃肠道反应和白细胞及血小板下降,但均可耐受。结论 草酸铂联合5-Fu／CF治疗晚期大肠癌有较好的近期疗效.不良反应可以耐受。     

长春瑞滨联合顺铂、亚叶酸钙/5-氟脲嘧啶治疗晚期食管癌21例

目的探讨长春瑞滨(NVB)联合顺铂(DDP)、亚叶酸钙(CF)、5-氟尿嘧啶(5-Fu)的NFP方案治疗晚期食管癌的近期疗效与不良反应。方法NVB 25 mg.m-2,静脉注入,d1,8;DDP 30 mg.m-2,静滴,d1~3;CF 200 mg,静滴,d1~5;5-Fu 500 mg.m-2,静滴8 h;28 d为一周期,两周期后评价疗效。结果可评价疗效的21例中完全缓解(CR)1例(4.8%),部分缓解(PR)7例(33.3%),总有效率(CR PR)38.1%(8/21)。主要不良反应静脉炎、骨髓抑制和胃肠道反应,经对症处理患者均能忍受。结论长春瑞滨联合顺铂、亚叶酸钙/5-氟脲嘧啶治疗晚期食管癌疗效较好,毒副反应可以耐受,值得进一步扩大临床研究及应用。     

ELFP方案治疗晚期胃癌60例近期疗观察

目的：观察ELFP方案治疗晚期胃癌的近期疗效和不良反应。方法：采用ELFP（V－P16、CF、5－Fu、DDP）联合化疗方案治疗晚期胃癌163例，可评价疗效60例。结果：完全缓解4例（6．67％），部分缓解27例（45．0％），总有效率为51．7％。结论：ELFP方案治疗晚期胃癌有较好近期疗效，应用简捷方便、安全，值得临床推广应用。     

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.     

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.