经纤维支气管镜冷冻＋球囊扩张治疗支气管结核并气道狭窄的临床研究

目的探讨经纤维支气管镜冷冻＋球囊扩张治疗支气管结核并气道狭窄的价值。方法20例确诊为支气管结核并气道狭窄患者，其中初治肺结核11例，耐多药肺结核5例，应用纤支镜冷冻＋球囊扩张介入治疗，观察气促、肺不张及支气管管径的变化情况。结果20例中心气道狭窄患者经纤支镜冷冻＋球囊扩张介入治疗4～8次均取得成功，气促评分从术前的（2．1±0．7）减少到（0．7±0．4），肺不张有效率为80％，气道狭窄有效率为98％。结论内镜下冷冻＋球囊扩张治疗支气管结核并气道狭窄，治愈率高，并发症少，值得推广。     

支气管镜下微波热凝和局部注药治疗支气管结核

目的 探讨支气管镜下微波热凝和局部注药治疗支气管结核的疗效.方法 以2005～2006年我科收治的支气管结核患者40例为研究对象,在正规抗痨的基础上,对病变部位采用支气管镜下微波热凝和局部注射卡那霉素0.5 g,雷米封0.2 g,完成疗程后观察疗效.结果 40例病人在治疗后显效31例,有效38例,总有效率95%.结论 支气管镜下微波热凝和局部注药治疗支气管结核疗效显著,安全性好.     

支气管镜介入微波联合冷冻治疗气道狭窄的疗效分析

目的观察支气管镜介入微波联合冷冻疗法对气道狭窄的疗效。方法采用回顾性研究方法分析我院近4年136例接受支气管镜介入微波联合冷冻治疗气道狭窄与136例单用微波治疗的患者临床资料,对比两种治疗方法的疗效。结果观察组经微波联合冷冻治疗后,肺功能、气道内径、气促等级与治疗前相比均有明显改善,FEV1/FVC由治疗前（0.607±0.128）改善为治疗后（0.685±0.113）（P〈0.01）;气道内经由治疗前（0.517±0.278）cm扩大到治疗后（1.021±0.306）cm（P〈0.01）;治疗后气促等级比治疗前有较大幅度下降（P〈0.01）。与对照组相比,观察组肺功能、气道内径、气促等级的改善幅度均大于对照组（P〈0.05）。观察组并发症发生率较低,且可得到有效控制。结论支气管镜介入下微波联合冷冻治疗气道狭窄是一项安全、简便、有效且并发症少且比单用微波治疗更为有效的治疗方法。     

经纤支镜微波治疗气道内肿瘤的应用及护理

微波作为一种治疗手段已广泛应用于各个领域，经纤维支气管镜(纤支镜)用于气道内疾病的治疗，近年来已得以迅速的发展。我科于2004年1月至2004年9月，经纤支镜进行微波治疗8例，在解除支气管阻塞，改善症状，取得良好的效果，现将护理体会介绍如下。     

纤维支气管镜导管介入治疗耐多药肺结核的疗效观察

目的：探讨纤维支气管镜导管介入对复治菌阳肺结核的治疗效果。方法：对复治菌阳肺结核１７０例随机分为治疗组８４例及对照组８６例，两组均给于常规化疗，治疗组强化期经纤维支气管镜导管介入病灶内注入抗痨药，对比观察两组疗效。结果：治疗组痰菌阴转率９０．２％，病灶显效率８６．６％，空洞闭合率３２．９％，均显著高于对照组的６０．５％、５８．０％、１３．９％（Ｐ〈０．０１）。结论：纤维支气管镜导管介入病灶内注药加     

微波热疗联合介入化疗治疗肝癌的效果

目的观察微波区域性热疗联合介入化疗治疗肝癌的临床效果。方法应用国产UHR-2000型微波热疗机进行深部热疗同时联合介入化疗治疗肝癌22例。对照组采用单纯介入化疗（部分病例结合栓塞治疗）26例。结果治疗组有效率（CR＋PR）为13／22（64．4％），对照组的有效率（CR＋PR）为46．3％，（P〈0.05）。结论微波区域性热疗联合介入化疗治疗能显著提高晚期恶性肿瘤的疗效。     

经纤支镜微波治疗中央型肺癌26例分析

目的探讨纤维支气管镜下微波组织凝固治疗中央型肺癌的价值。方法26例中央型肺癌患者按纤支镜介入治疗常规准备。插入纤支镜到达病变部位后，将微波同轴天线经纤支镜活检孔插入，尖端插入或紧贴治疗部位，调节微波功率为40—65w。持续时间为10-158，次，行多点烧灼。同时配合鳄口钳清除焦化坏死或游离的组织。1次，5。7d，3～5次为1疗程。结果显效：纤支镜见瘤体缩小60％以上14例（54％）；有效：瘤体缩小〉30％，〈60％者8例（31％）；无效4例（35％）。结论经纤维支气管镜微波治疗中央型肺癌为一种操作简单、安全、见效快的姑息性治疗。     

射频热疗联合介入化疗治疗晚期大肠癌疗效分析

目的 观察射频热疗联合介入持续动脉化疗治疗晚期大肠癌的临床初步疗效。方法 对20例局部复发和伴有肝、肺、骨、腹腔、盆腔及腹股沟淋巴结转移的晚期大肠癌患者经射频热疗法联合供养靶动脉介入灌注化疗。每例患者至少进行2个周期的介入化疗联合热疗。化疗方案为第1～3天亚叶酸钙200mg／m^2静脉滴注；第1天顺氯氨铂80mg／m^2，第1～3天如肾功能改变则改用鬼臼乙叉苷60mg／m^2动脉滴注；5-氟尿嘧啶2500mg／m^2加入超液化碘油10-30ml中进行肝动脉灌注栓塞。热疗频率40．68MHz，电容式加热，电极直径20-25cm，入射功率500-800W，反射功率20-40W。插管化疗第2天开始进行热疗，每72小时1次，每次50-0min，每疗程化疗配合4～8次热疗。结果 病灶近期疗效以CT或B超检查结果作为评价标准，完全缓解0例，部分缓解14例，总有效率为70．0％。患者化疗未出现严重不良反应。热疗不良反应为局部疼痛和脂肪硬结，不需特殊处理。结论 射频热疗联合介入持续动脉化疗治疗晚期大肠癌安全、有效。     

经纤维支气管镜微波联合注药治疗支气管结核

目的评价经纤维支气管镜局部微波联合注药治疗支气管结核的疗效。方法经纤支镜局部微波联合注药治疗38例（治疗组）支气管结核，并与同期单纯全身化疗42例（对照组）病人作对照研究。结果治疗组3个月时痰菌阴转，症状改善有效率94．7％，纤支镜下病灶改善有效率94．7％，均显著高于对照组的71．4％（P〈0．05）、69．1％（P〈0．05）。结论经纤维支气管镜局部微波联合注药治疗支气管结核，操作安全、简单、疗效显著优于单纯全身化疗。     

光动力和经皮氩氦系统冷消融联合治疗非小细胞性阻塞性肺癌

目的 研究联合应用光动力疗法和经皮氩氦系统冷消融，对不能切除性非小细胞性阻塞性肺癌的治疗价值。方法 41例非小细胞性阻塞性肺癌患者，或者固为肿瘤局部进展(按TNM分期为Ⅲb期)，或者因为肺功能差(严重阻塞性肺病)，被认为是不能切除性的。先予光动力疗法。静脉注射光敏剂Photofrin 2mg／kg(或血卟啉5mg／kg，华鼎药业)，48和72小时分别在支气管镜下输入630nm红色激光照射；再在B超或CT引导下通过氩氦系统进行经皮冷消融。按症状、肿瘤大小和生存期判断疗效。结果 41例经此种联合疗法治疗后，90．2％的患者主观症状有不同程度改善，症状积分治疗后明显降低，呼吸困难的改善最为明显；支气管镜复查，发现全部惠者支气管内肿瘤均得到不同程度消融，其中41．5％完全消失；CT复查发现肺内肿瘤CR34．1％，PR41．4％；X线片上，原有肺塌陷的病例中29．6％的塌陷完全消失，70．4％的肺塌陷减轻；半年和1年生存率分别达44和71％。无论光动力抑或经皮氩氦系统冷消融，均未发生严重并发症。结论 联合应用光动力疗法和氩氦系统经皮冷消融，能分别消除支气管内、外的病变，两者相辅相成，因而可提高不能切除性非小细胞性阻塞性肺癌的治疗效果。     

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.     

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.     

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.     

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.