诱导化疗联合同步放化疗对局部晚期非小细胞肺癌的疗效分析

目的评价诱导化疗联合同步放化疗治疗局部晚期非小细胞肺癌的疗效。方法将57例不能手术的局部晚期非小细胞肺癌患者随机分为两组,观察组(n=29)给予诱导化疗+同步放化疗,对照组(n=28)仅给予同步放化疗,比较两组患者的近期疗效及毒副反应。结果所有患者均顺利完成治疗,观察组总有效率为75.9%,对照组为64.3%,两组比较差异无统计学意义(P>0.05)。观察组放射性食管炎、放射性肺炎、白细胞减少及恶心呕吐发生率分别为31%、37.9%、44.8%和24.1%;对照组为25%、10.7%、17.9%和21.4%,两组放射性肺炎发生率、白细胞减少发生率的差异有统计学意义(P<0.05),对照组发生率较低。结论诱导化疗联合同步放化疗与同步放化疗相比不能提高局部晚期非小细胞肺癌患者的疗效,且毒副反应较重。     

同步放化疗治疗局部晚期非小细胞肺癌的临床疗效观察

目的探讨同步放化疗与序贯放化疗治疗Ⅲ期非小细胞肺癌的近期疗效和毒副反应。方法选择我院2006年1月至2010年1月收治入院的采用第一阶段采用常规照射,第二阶段采用适形放疗;同时予GP（吉西他滨＋顺铂）方案4个周期化疗的局部晚期NSCLC患者100例作为观察组,选择我院往期采用第一阶段采用常规照射,第二阶段采用适形放疗;放疗结束2周后给予化疗的局部晚期NSCLC患者100例作为对照组。比较两组患者近期疗效和毒副反应。结果同步组有效率为67%,其中完全缓解（CR）者为25%,序贯组有效率为44%,其中CR者为14%,两组有效率差异有统计学意义（P＜0.05）,而在CR方面差异并不显著（P＞0.05）。全部患者主要不良反应为骨髓抑制、恶心呕吐、放射性食管炎和放射性肺炎,经对症处理,患者均能耐受。结论同步放化疗较序贯放化疗能明显提高近期有效率,其毒副反应能为大多数患者所耐受,但远期疗效有待于进一步观察。     

适形放疗联合化疗治疗局部晚期肺癌的临床研究

目的评价适形放疗联合化疗治疗局部晚期非小细胞肺癌的近期疗效和急性毒副反应。方法2001年4月～2002年12月采用泰素、顺铂与三维适形放疗同步治疗43例Ⅲ期非小细胞肺癌患者。化疗方案为泰素135mg/㎡,顺铂70mg/㎡,第1、29、57天。三维适形放疗放射源为6MVX线,2Gy·(次·天)-1,40Gy后缩野加量,总剂量DT66～70Gy。结果近期结果显示,肺原发灶有效率为88.4%(38/43),一年及两年生存率分别为55.8%(24/43)和39.5%(17/43)。急性毒副反应主要是骨髓抑制、胃肠道反应和较中度放射性食管炎、放射性肺炎,经处理后均可耐受。结论泰素联合三维适形放疗能提高局部晚期非小细胞肺癌的近期疗效,且急性毒副反应无明显增加,值得进一步随访研究。     

NP方案联合三维适形放疗治疗局部晚期非小细胞肺癌的疗效及安全性观察

目的：观察NP方案联合三维适形放疗治疗局部晚期非小细胞肺癌的疗效及安全性。方法：56例局部晚期非小细胞肺癌患者根据治疗方法不同随机分为三维适形放疗联合NP方案化疗组（观察组,28例）与单纯放疗组（对照组,28例）,比较两组疗效及毒副反应情况。结果：观察组的疗效明显高于对照组（P〈0.05）。两组的1年生存率、2年生存率比较,P〈0.05,差异有统计学意义。结论：NP方案联合三维适形放疗治疗局部晚期非小细胞肺癌的疗效确切,有效率高,近期疗效理想,提高了患者的生存率。     

放化疗同步治疗Ⅲ期非小细胞肺癌的疗效及毒副反应评价

目的观察与探讨放化疗同步治疗Ⅲ期非小细胞肺癌的疗效及毒副反应。方法本文选择了自2010年5月至2012年1月来我院治疗的Ⅲ期非小细胞肺癌患者70例,随机数字法分为2组,观察组35例,接受同步放化疗;对照组35例,接受序贯放化疗。观察两组患者的近期治疗效果、中位生存期以及毒副反应。结果观察组与对照组患者的治疗总有效率,即CR+PR分别为68.6%与51.4%,两组比较差别存在统计学意义(P<0.05);观察组患者的中位生存期明显优于对照组(P<0.05);放射性食管炎与肺炎、骨髓抑制以及消化道反应是本次研究中两组患者的主要毒副反应,观察组患者Ⅲ级不良反应的发生率较对照组高,但二者比较差异不存在统计学意义(P>0.05)。结论和序贯放化疗相比较,同步放化疗能够明显改善Ⅲ期非小细胞肺癌的近期治疗效果,延长生存时间。     

三维适形放疗治疗晚期非小细胞肺癌的临床疗效观察

目的探讨三维适形放疗治疗晚期非小细胞肺癌的临床疗效。方法将我院2010年1月至2012年6月间收治的92例晚期非小细胞肺癌患者随机分为常规放射治疗组（对照组）和三维适形放射治疗组（观察组）,每组各46例,观察两组患者的近期疗效及毒副反应。结果观察组患者的临床疗效总有效率为76.1%,显著高于对照组患者的54.3%,组间差异有统计学意义（P＜0.05）。观察组患者治疗后毒副反应发生率为28.3%,显著低于对照组患者的63.0%,组间差异有统计学意义（P＜0.05）。结论采用三维适形放疗治疗晚期非小细胞肺癌临床疗效好,毒副反应发生率低,值得临床进一步推广使用。     

调强适形放疗同步DP化疗治疗晚期非小细胞肺癌的疗效及对患者生存质量的影响

目的 分析调强适形放疗同步DP化疗治疗晚期非小细胞肺癌的疗效及对患者生存质量的影响。方法 66例晚期非小细胞肺癌患者,根据随机数字表法分为观察组与对照组,各33例。对照组采用DP化疗治疗,观察组在对照组基础上同步调强适形放疗治疗。比较两组患者治疗效果、生存质量评分量表(SF-36)评分。结果 观察组治疗总有效率87.88%高于对照组的66.67%,差异有统计学意义(P<0.05)。治疗后,观察组心理健康、认知职能、社会职能、情绪职能、角色职能、生理职能评分分别为(76.42±3.24)、(77.23±3.18)、(78.14±3.23)、(75.20±3.12)、(73.34±3.27)、(78.24±3.52)分,对照组分别为(65.21±4.37)、(63.38±4.13)、(66.77±4.24)、(65.48±4.05)、(64.17±4.32)、(62.27±4.33)分,两组SF-36评分均高于治疗前且观察组高于对照组,差异有统计学意义(P<0.05)。结论 调强适形放疗同步DP化疗治疗晚期非小细胞肺癌的效果良好,可提高患者治疗效果和生存质量。     

晚期非小细胞肺癌同步放化疗临床疗效及安全性观察

目的探讨长春瑞滨联合顺铂(NP)方案化疗联合放疗治疗晚期非小细胞肺癌的疗效及安全性。方法随机将96例晚期非小细胞肺癌患者分为NP方案化疗联合三维适形放疗组(观察组,48例)与单纯放疗组(对照组,48例),比较两组疗效及毒副反应情况。结果观察组有效率72.9%、对照组有效率45.8%,观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。两组的1年、2年生存率分别为64.6%、41.7%和58.3%、31.3%,差异有统计学意义(P<0.05)。结论相对于单纯放疗,NP方案化疗联合放疗治疗晚期非小细胞肺癌可显著提高临床疗效和生存率。     

三维适形放疗联合小剂量顺铂对老年非小细胞肺癌的疗效评价

目的 观察三维适形放疗联合小剂量顺铂对老年非小细胞肺癌的疗效评价及不良反应.方法 将64例非小细胞肺癌老年患者分为研究组和对照组,每组32例,治疗3个月后比较疗效和不良反应.结果 研究组有效率为87.5％;对照组有效率为62.6％.两组有效率比较差异有统计学意义(P＜0.05).研究组的白细胞计数减少发生率明显高于对照组,差异有统计学意义(P＜0.05);两组放射性食管炎和放射性肺炎的发生率无明显高低之分,差异均无统计学意义(P＞0.05).结论 三维适形放疗联合小剂量顺铂治疗非小细胞肺癌可以提高有效率,同时不会明显增加不良反应.     

替吉奥胶囊联合放疗治疗老年非小细胞肺癌的疗效及安全性观察

目的观察替吉奥胶囊联合放疗治疗老年非小细胞肺癌的临床疗效及安全性。方法选取2007年6月—2012年5月于本院进行治疗的老年局部晚期非小细胞肺癌患者60例,随机分为对照组(单纯三维适形放疗)和观察组(替吉奥胶囊联合三维适形放疗),每组各30例。观察组采用替吉奥胶囊联合放疗的方法。观察两组治疗效果和不良反应。结果观察组总有效率及临床获益率均高于对照组,疾病进展时间长于对照组,1年生存率高于对照组,差异均有统计学意义(P<0.05)。对照组和观察组白细胞减少发生情况比较,差异有统计学意义(P<0.05);两组放射性食管炎和放射性肺炎发生情况比较,差异均无统计学意义(P>0.05)。结论替吉奥胶囊联合放疗治疗老年非小细胞肺癌具有较好的效果。     

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.