重组人血管内皮抑制素注射液联合化疗治疗老年晚期非小细胞肺癌的效果观察

目的探讨重组人血管内皮抑制素注射液联合化疗治疗老年晚期非小细胞肺癌的临床效果。方法选择患者80例,分为两组,每组各40例,对照组化疗方案：多西他塞75mg／m2联合吉西他滨1000mg／m2,观察组在对照组的基础上使用重组人血管内皮抑制素注射液,比较两组患者治疗前后的生活质量KPS评分,并统计两组的近期疗效。结果治疗后观察组的生活质量KPS评分显著高于对照组（P〈0．05）,观察组的有效率为35．0％,显著高于对照组的10．0％（P〈0．05）。结论重组人血管内皮抑制素注射液联合化疗应用于晚期非小细胞肺癌患者,能显著提高患者的生活质量,延长生存时间,值得临床推广。     

培美曲塞联合顺铂对晚期非小细胞肺癌患者免疫功能的影响及效果评估

目的　探讨培美曲塞联合顺铂治疗晚期非小细胞肺癌的临床疗效及其对患者免疫功能的影响。方法　选取2014年1 月至2016 年10 月在我院接受化疗的非小细胞肺癌患者100 例,随机分为GP 组和PP 组,每组50 例。GP 组患者接受吉西他滨联合顺铂化疗,PP 组患者接受培美曲赛联合顺铂化疗。分析比较两组患者的临床疗效及化疗前后免疫功能、外周血中血管内皮生长因子（VEGF）及内皮抑素含量的变化。结果　GP 组和PP 组总缓解率分别为70% 和72%,差异无统计学意义（P>0.05）;PP 组血液学毒性反应的发生率明显低于GP 组（P<0.05）;两组患者外周血中VEGF 含量较化疗前明显降低（P<0.05）,且PP 组显著低于GP 组（P<0.05）;两组患者外周血中内皮抑素含量较化疗前明显升高（P<0.05）,且PP 组明显高于GP 组（P<0.05）;两组患者CD3+、CD4+ 细胞数量、CD4+/CD8+ 比值以及NK 细胞活性较化疗前明显升高(P<0.05）,且PP组显著高于GP 组（P<0.05）;两组患者KPS 评分较化疗前有所升高,且PP 组在治疗不同疗程时的KPS 评分均明显高于GP 组（P<0.05）。结论　培美曲赛联合顺铂治疗非小细胞肺癌可显著降低血液学毒性反应的发生率及外周血中VEGF 的含量、促进内皮抑素的分泌,有利于患者免疫功能的恢复。     

重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌不良反应的观察和护理

目的探讨重组人血管内皮抑素联合化疗治疗晚期非小细胞肺癌的护理方法。方法对13例晚期非小细胞肺癌患者应用重组人血管内皮抑素联合化疗进行治疗,化疗前给予心理护理,减轻患者焦虑,使其能较好地配合治疗;治疗期间重点做好不良反应的护理,预防及减轻不良反应的发生。结果治疗过程中1例患者出现心脏毒性,1例出现皮疹,经处理后好转,其余患者治疗均顺利进行。结论恰当的护理可预防和减轻重组人血管内皮抑素不良反应的发生,确保治疗的顺利进行,提高治疗效果。     

薄芝糖肽注射液治疗肺癌的有效性分析

目的评价肺癌患者行薄芝糖肽注射液治疗的可行性和效果,为肺癌治疗提供参考,以提供患者的生存质量。方法80例肺癌患者,采取随机法分为对照组和观察组,每组40例。对照组患者采取参芪扶正注射液辅助同步化疗,观察组患者在对照组基础上联合薄芝糖肽治疗。比较两组患者近期疗效、生活质量改善效果及治疗前后细胞免疫功能指标水平。结果观察组患者的近期有效率为90.0%高于对照组的70.0%,差异具有统计学意义(P<0.05)。观察组患者生活质量改善总有效率为87.5%高于对照组的60.0%,差异具有统计学意义(P<0.05)。治疗后,观察组患者CD3为(61.05±2.15)%、CD4为(41.35±2.35)%、CD8为(33.90±2.30)%,均高于对照组的(52.20±2.40)%、(35.30±2.50)%、(30.02±2.10)%,差异均具有统计学意义(P<0.05)。结论参芪扶正注射液同步化疗联合薄芝糖肽注射液治疗肺癌,可以进一步提升患者的临床疗效、生活质量,改善免疫功能,是肺癌治疗的优选手段。     

清肺散结丸联合化疗治疗晚期非小细胞肺癌临床研究

目的观察中药清肺散结丸联合化疗与单用化疗治疗晚期非小细胞肺癌的临床疗效。方法将41例晚期非小细胞肺癌住院患者随机分为治疗组(清肺散结丸联合化疗)21例和对照组(单纯化疗)20例分别给予相应化疗。观察两组近期临床疗效、生活质量、毒副作用等。结果治疗组近期有效率为57.1%(11/21),对照组50.0%(10/20),两组比较差异无统计学意义(P0.05)。治疗组较对照组生活质量(KPS评分)明显提高(P0.05),治疗组化疗毒副反应与对照组比较,差异有统计学意义(P0.05)。结论清肺散结丸联合化疗治疗晚非小细胞肺癌,能够改善患者生活质量,降低化疗期间的毒副作用,可使患者病情进展延缓。     

八珍汤加减对老年晚期非小细胞肺癌患者的生活质量及免疫功能的影响

目的：观察八珍汤加减对老年晚期非小细胞肺癌患者的生活质量及免疫功能的影响,探讨其临床适用性。方法病例选择从2011年5月至2013年5月于我院就诊的58例老年晚期非小细胞肺癌患者,简单随机分为试验组和对照组,对照组采用化疗（TP方案）治疗,试验组在对照组基础上加用八珍汤加减治疗。观察两组患者治疗后生存率情况及治疗前后免疫功能改善情况,治疗后生活质量的改善情况及药物对血液的毒性情况。结果所有患者治疗后症状均有所缓解,其中试验组患者的治疗有效率51.7%,与对照组患者的48.3%相当（P>0.05）;试验组患者的疾病控制率93.1%,高于对照组患者的67.0%（P<0.05）。两组患者治疗前中医证候积分、QOL评分无明显差异（P>0.05）,治疗后降低,且试验组的改善情况明显优于对照组（P<0.05）。两组患者治疗前CD3+、CD4+、CD8+、CD4+/CD8+相比较,差异均无统计学意义（P>0.05）;治疗后均明显改善,差异均有统计学意义（P<0.05）,且试验组患者的免疫功能改善情况明显优于对照组。两组患者的不良反应发生率相当（P>0.05）。结论八珍汤加减联合化疗能够明显改善晚期老年非小细胞肺癌患者的生活质量,改善患者的临床症状及免疫功能,适合临床推广应用。     

康艾注射液联合GP方案化疗治疗晚期非小细胞肺癌

目的比较康艾注射液联合GP方案化疗与NP方案对Ⅲb～Ⅳ期非小细胞肺癌(NSCLC)患者生活质量的改善情况。方法A组(34例)接受康艾注射液联合GP方案治疗;B组(33例)接受GP方案治疗。两组均以21d为1个周期,重复2个周期方法。结果近期疗效有效率治疗组为69.2%,对照组为48.0%,2组比较,差异有显著性意义(P<0.05)。生活质量karnofsky(KPS)评分好转率治疗组为80.8%,对照组为56.0%,两组比较,差异有统计学意义(P<0.05)。结论康艾注射液联合GP方案化疗治疗晚期非小细胞肺癌,有提高近期疗效,减轻不良反应,提高生活质量的作用。     

CIK维持治疗对中晚期肺癌患者生存质量的影响

目的探讨CIK维持治疗对中晚期肺癌患者生存质量的影响。方法将76例中晚期非小细胞肺癌患者随机分为两组,对照组实施TP方案化疗,观察组实施TP化疗+CIK维持治疗,治疗2周期后观察疗效,并采用EORTC-QLQ-C30量表评价患者生存质量。结果观察组总缓解率高于对照组(P<0.05);治疗后观察组CD3+、CD4+T细胞及CD4+/CD8+高于治疗前及对照组(P<0.05);观察组躯体、情绪、认知、社会功能及整体生活质量评分均高于对照组(P<0.05)。结论中晚期肺癌患者在常规化疗基础上,实施CIK维持治疗可改善患者生存质量。     

GP方案联合参麦注射液治疗晚期NSCLC临床观察

目的:探讨参麦注射液在GP方案化疗晚期非小细胞肺癌(NSCLC)治疗中的作用。方法:选择经病理证实为非小细胞肺癌61例,以参麦注射液联合化疗作为实验组(31例),与30例单纯化疗组对照,观察其疗效、毒副作用、KPS评分改变、细胞免疫功能等。结果:实验组CR十PR为45.2%,略高于对照组的40%,但PR+CR+MD达74.2%,显著高于照组。可部分减低毒副作用,显著改善KPS。且CD4/CD8比值治疗后升高,并高于对照组。结论:参麦注射液联合化疗NSCLC可提高疗效,减轻毒副作用,改善生存质量,提高机体的细胞免疫功能。     

三维适形放疗联合化疗治疗非小细胞肺癌患者的疗效及安全性

目的探讨三维适形放疗联合化疗治疗非小细胞肺癌患者的疗效及安全性。方法94例非小细胞肺癌患者,依照随机数字表法分为对照组和研究组,每组47例。对照组患者行紫杉醇联合卡铂方案化疗,研究组患者在对照组基础上给予三维适形放疗。比较两组患者治疗前后血管内皮生长因子A(VEGFA)、血管内皮生长因子B(VEGFB)水平,CD3+CD4+、CD3+CD8+T细胞水平,治疗后毒性反应发生情况。结果治疗后,两组患者VEGFA、VEGFB均较治疗前降低,且研究组患者VEGFA(85.22±7.23)ng/ml、VEGFB(103.44±9.32)ng/ml均低于对照组的(100.59±10.26)、(133.67±11.14)ng/ml,差异均具有统计学意义(P<0.05)。治疗后,两组患者CD3+CD4+T细胞较治疗前升高,CD3+CD8+T细胞降低,且研究组患者CD3+CD4+T细胞水平高于对照组,CD3+CD8+T细胞水平低于对照组,差异均具有统计学意义(P<0.05)。治疗后,研究组患者骨髓抑制、白细胞下降发生率与对照组比较,差异无统计学意义(P>0.05);3级放射性食管炎发生率6.4%低于对照组的21.3%,差异具有统计学意义(P<0.05)。结论三维适形放疗联合紫杉醇化疗治疗非小细胞肺癌可改善患者血管内皮生长因子水平,改善外周血CD3+CD8+、CD3+CD4+T细胞等免疫因子水平,且治疗后化疗等毒性反应发生率未增加。     

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.