连续性血液净化在慢性阻塞性肺病呼吸衰竭合并肾衰竭中的应用

目的:探索连续性血液净化(CBP)在慢性阻塞性肺病合并呼衰、肾衰治疗中的应用于效果。方法:选择10例确诊为慢性阻塞性肺病合并呼衰、肾衰的患者在常规治疗效果不显著时行CBP治疗,治疗过程中行血气分析,监测电解质、血肌酐水平,治疗后血PH、HCO3、PaO2明显好转或接近正常,肌酐显著下降(P<0.01)。结论:CBP在慢性阻塞性肺病合并呼衰治疗中发挥重要的作用,特别是对合并肾功能不全的患者。     

Opportunities in discovery and delivery of anticancer drugs targeting mitochondria and cancer cell metabolism

Cancer cells are characterized by self-sufficiency in the absence of growth signals, their ability to evade apoptosis, resistance to anti-growth signals, sustained angiogenesis, uncontrolled proliferation, and invasion and metastasis. Alterations in cellular bioenergetics are an emerging hallmark of cancer. The mitochondrion is the major organelle implicated in the cellular bioenergetic and biosynthetic changes accompanying cancer. These bioenergetic modifications contribute to the invasive, metastatic and adaptive properties typical in most tumors. Moreover, mitochondrial DNA mutations complement the bioenergetic changes in cancer. Several cancer management therapies have been proposed that target tumor cell metabolism and mitochondria. Glycolytic inhibitors serve as a classical example of cancer metabolism targeting agents. Several TCA cycle and OXPHOS inhibitors are being tested for their anticancer potential. Moreover, agents targeting the PDC/PDK (pyruvate dehydrogenase complex/pyruvate dehydrogenase kinase) interaction are being studied for reversal of Warburg effect. Targeting of the apoptotic regulatory machinery of mitochondria is another potential anticancer field in need of exploration. Additionally, oxidative phosphorylation uncouplers, potassium channel modulators, and mitochondrial redox are under investigation for their anticancer potential. To this end there is an increased demand for agents that specifically hit their target. Delocalized lipophilic cations have shown tremendous potential in delivering anticancer agents selectively to tumor cells. This review provides an overview of the potential anticancer agents that act by targeting cancer cell metabolism and mitochondria, and also brings us face to face with the emerging opportunities in cancer therapy.