乳腺叶状肿瘤临床分析

目的：探讨乳腺叶状肿瘤复发因素,为选择合理术式提供依据。方法回顾性分析北京大学第三医院1999年1月至2011年4月间经手术并经病理诊断的69例乳腺叶状肿瘤的临床病理资料,分析其诊断治疗情况。结果69例中,恶性8例,交界性19例,良性42例;行肿物切除术5例,行局部扩大切除术47例,行单纯乳房切除术7例,行单纯切除＋即刻再造术4例,行改良根治术6例。随访54例,4例局部复发,良性2例,交界性2例。肺转移2例,死亡1例,脊柱转移1例,均为恶性叶状肿瘤患者。结论局部扩大切除术（至少保持切缘2 cm）为良性及交界性叶状肿瘤（直径＜7 cm）首选手术方式,对直径＞7 cm的交界性及恶性病例,应尽早行乳腺切除术。     

乳腺分叶状肿瘤19例临床分析

目的 探讨乳腺分叶状肿瘤的诊断和手术原则.方法回顾性分析该院2007年1月-2012年9月19例乳腺分叶状肿瘤患者的临床资料.结果 19例患者中行改良根治术1例,乳房单纯切除术2例,肿瘤局部扩大切除术16例,随访16例,随访时间3～50个月,平均25个月,2例行局部切除术后复发.结论 乳腺分叶状肿瘤术前诊断有一定困难,局部复发与手术切除范围有关.良性、交界性和首次诊断为恶性的行局部扩大切除.复发性应行单纯乳房切除术.     

乳腺良性叶状肿瘤术中乳腺内整形术10例分析

目的探讨乳腺良性叶状肿瘤临床诊断和治疗方法。方法回顾分析经手术病理确诊为乳腺良性叶状肿瘤10例患者的病历资料。结果乳腺肿块为首发症状且增长快速,术前超声、钼靶、核磁共振等影像学检查准确率50%,空芯针活检术前病理与术后病理相符率90%。局部扩大切除术随访至今未见复发,术中乳腺内成型能保证乳房的外形。结论术前空芯针活检是明确诊断的标准,局部扩大切除术可以作为乳腺良性叶状肿瘤的标准术式,术中乳腺瓣成型术能维持乳房的基本外形,值得推荐。     

乳腺叶状肿瘤29例诊疗分析

目的 探讨乳腺叶状肿瘤的诊断和治疗策略.方法 回顾性分析收治并经手术病理证实的乳腺叶状肿瘤患者共计29例,平均发病年龄为39.8岁;并行手术或病理证实.结果 29例乳腺叶状肿瘤中良性为12例、交界性10例、恶性7例,均行手术治疗,其中肿瘤局部切除术6例,肿瘤扩大局部切除术16例,乳腺单纯切除术4例,改良根治术 3 例;随访25例,平均随访2.3年.结论 乳腺叶状肿瘤被认为是一系列的肿瘤疾病,术前空心针穿刺活检有助诊断.手术治疗是主要的治疗方式,应实施规范化的手术并结合患者的临床病理学特点实施个体化的治疗,术后注意局部高复发倾向,定期随访.     

10例乳腺分叶状肿瘤的临床分析

目的探讨乳腺分叶状肿瘤分类与复发转移的关系极其临床特点和治疗原则.方法回顾2000年1月至2004年12月收治的10例乳腺分叶状肿瘤的临床和病理资料,病理资料经专家复查.结果患者术前均做B超和钼靶检查.按WHO分类标准,其中良性5例,恶性2例,交界性3例.行肿块切除1例,扩大切除术3例,乳腺单纯切除术4例,改良根治术2例.所有患者随访至今,平均随访16个月(3-42个月).其中1例良性行局部切除者术后复发为交界性.结论乳腺分叶状肿瘤确诊靠病理检查.术中冰冻检查应列为常规,以指导临床治疗.治疗以肿块扩大切除术为首选,恶性或肿块大者可行乳腺单纯切除术.     

临床分析乳腺叶状瘤的病理诊断

目的分析乳腺叶状瘤的病理及临床特点。方法回顾性分析我院2007年6月至2013年2月收治的52例乳腺叶状瘤患者的临床病理资料,对其病理特征以及治疗情况进行观察分析。结果本组研究资料中52例患者,其中良性38例(占73.08%),交界性10例(占19.23%),恶性4例(占7.69%)。38例良性叶状肿瘤行扩大肿块切除术,10例交界性叶状瘤患者行单纯乳腺切除术(包括腺体、胸大肌膜及皮肤),4例恶性叶状瘤患者行改良根治乳腺切除术,随访至今,52例患者中复发6例,其中交界性3例,恶性3例,因发生肺转移死亡1例,复发率为11.54%。结论乳腺叶状瘤是一种较少见的乳腺肿瘤,病理组织学检查是其可靠的诊断方法,交界性和恶性叶状肿瘤容易复发,手术切除是临床上主要的治疗方法。     

乳腺分叶状肿瘤临床诊治分析

目的探讨乳腺分叶状肿瘤的临床特征及诊治措施。方法回顾分析本科25例患者的临床资料。结果25例患者中均得到随访,随访时间为1—5年,3例肿瘤局部复发再次行肿瘤切除手术。本组术后生活质量良好,无死亡。结论对于良性及交界性的乳腺分叶状肿瘤,应首选局部扩大切除术或乳腺单纯切除术,对恶性可选乳腺单纯切除术,有可疑淋巴结转移或胸肌浸润者宜行乳腺癌改良切除术。必要时再加用化疗。     

乳腺叶状肿瘤的诊治与预后:附1例巨大叶状肿瘤报道

目的探讨乳腺叶状肿瘤的诊治原则及合理的手术方式。方法回顾分析2年前收治的1例巨大乳腺叶状肿瘤的临床资料,此例病例术前未确诊,行单纯乳房切除术。结果此病例随访2年,无复发及转移。结论乳腺肿块是该病的首发常见症状,明确诊断主要依靠术中冷冻切片检查;手术治疗,目前多采用局部扩大切除,单纯乳房切除术或即刻乳房再造术,应根据病理性质长期随访。     

乳腺分叶状肿瘤临床治疗分析

目的探讨乳腺分叶状腺瘤的手术治疗方法。方法回顾分析2004年1月至2009年10月65例乳腺分叶状肿瘤的患者的临床资料。结果65例患者均得到随访,随访时间2～10年,3例术后4～6年出现肺转移行单侧肺叶切除,7例肿瘤局部复发再次行肿瘤切除手术。所有患者术后生活质量良好,无死亡病例。结论乳腺分叶状肿瘤临床上少见,且容易漏诊、误诊,因其临床表现和辅助检查缺少特异性所致。治疗上必须结合病史、肿瘤大小、病理类型等因素,选择合理的术式及治疗方案,同时加强术后随访,以提高手术的预后。     

乳腺叶状囊肉瘤12例临床病理分析

目的探讨乳腺叶状囊肉瘤的临床病理特性与治疗方法.方法对经手术治疗的12例乳腺叶状囊肉瘤患者的临床资料进行回顾性分析.结果 12例乳腺叶状囊肉瘤中,行单纯乳房切除术5例,改良根治术2例,保留乳头皮下乳房切除术1例,保留乳头和部分压缩腺体加肿块切除术4例;术后随访1～18年,失访1例,2例分别于术后1.5年、2年出现肿块复发,再次手术切除,其余患者无复发或转移,并元瘤生存.结论乳腺叶状囊肉瘤诊治依据病理学检查,但单一的组织学常难以在形态学预测其生物学行为;其预后因素与肿瘤组织学分级和大小有关.     

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.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.     

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.