生存素对胃癌患者化疗敏感性的影响

目的：对比不同部位胃癌肿瘤组织内生存素的表达情况,观察生存素表达程度不同的胃癌患者接受化疗的疗效。方法：将18例贲门恶性肿瘤患者、21例胃体恶性肿瘤患者及32例胃窦部位恶性肿瘤患者作为观察对象,以贲门恶性肿瘤患者为A组,以胃体恶性肿瘤患者为B组,以胃窦部位恶性肿瘤患者为C组。分析3组肿瘤组织中生存素的表达阳性率,并对比3组的化疗效果。此外,对比3组1年随访期间内的生存率及肿瘤转移率。结果：C组生存素阳性表达率为37.50%,明显低于A组及B组的72.22%及66.6%。C组化疗总有效率明显高于A组及B组（P<0.05）。同时,C组随访1年的死亡率及肿瘤转移率明显低于A组及B组（P<0.05）。结论：在胃部恶性肿瘤中,以胃窦部恶性肿瘤生存素表达率最低,此部位恶性肿瘤患者接受化疗治疗后有良好的效果。     

胃镜检查前使用二甲硅油乳剂的效果观察

目的探讨胃镜检查前使用二甲硅油乳剂的效果。方法本研究回顾分析我院2017年1月至2017年12月收治100例胃镜检查患者的临床资料,随机分为对照组和实验组,实验组胃镜检查前使用二甲硅油乳剂,对照组不应用任何药物,对比两组检查结果。结果实验组患者食管、胃底、胃体、胃角、胃窦、十二指肠球部和总评分等黏膜视野可见度评分结果均明显低于对照组,两组对比具有明显的统计学差异(P<0.05)。两组不良反应发生率对比不存在明显的统计学差异(P>0.05)。结论在胃镜检查前使用二甲硅油乳剂,能够有效提高检查部位的可见度,但也存在一定的不良反应风险,需要严格掌握使用方法。     

胃镜活检不同部位病理组织组合的价值分析

目的 探究胃镜活检不同病理组织组合与胃炎评价标准（OLGA）、胃黏膜肠化生评价标准（OLGIM）分期判断胃黏膜病变的一致性,以寻求较少的组织活检取材组合,达到与标准取材数量活检结果接近的胃黏膜病变筛查方法。方法 选取2017年5月至2019年4月驻马店市中心医院245例行胃镜检查的患者,所有患者均严格结合新悉尼系统取5个部位病理组织,即胃体大弯（A1）、胃体小弯（A2）、胃角（B1）、胃窦大弯（C1）、胃窦小弯（C2）,评估胃黏膜萎缩、肠化生情况,并根据5个部位的病理综合评价OLGA、OLGIM分期,最终通过Kappa一致性检验评价其他病理组织组合（组合方式包括4处、3处及2处病理活检）进行OLGA、OLGIM分期,判定一致性。结果 C2部位黏膜萎缩、肠化生发生率均高于A1、A2和C1部位,B1部位黏膜萎缩、肠化生发生率高于A1、A2部位,A2、C1部位黏膜萎缩、肠化生发生率高于A1部位,差异均有统计学意义（P<0.05）。5处病理组织活检（金标准）患者的OLGA分期与OLGIM分期一致性为94.29%（Kappa值0.944,P<0.05）。4处、3处、2处病理组织组合中与金标准活检OLGA、OLGIM分期一致性最高的组合分别为C2+B1+A2+A1（Kappa值0.917、0.922,P<0.05）、C2+B1+A2（Kappa值0.902、0.907,P<0.05）,C2+A2（Kappa值0.796、0.746,P<0.05）,C2+B1+A2+A1、C2+B1+A2组合对高危（Ⅲ期、Ⅳ期）患者漏诊风险低,C2+A2对高危患者漏诊风险高。结论 4处（胃窦小弯+胃角+胃窦大弯+胃体小弯）、3处（胃窦小弯+胃角+胃体小弯）病理组织组合与OLGA、OLGIM分期判断胃黏膜病变的一致性好,从取材较少的角度考虑,3处（胃窦小弯+胃角+胃体小弯）更有实践价值,可广泛推行。     

老年人胃息肉的内镜、病理特点及疗效观察

目的探讨老年人胃息肉的内镜及病理特点,观察其内镜治疗效果。方法回顾性分析2011年3月至2012年3月在本院行胃镜检查的80例确诊的胃息肉老年人患者临床病理特点和内镜治疗效果。结果胃息肉老年人患者年龄群主要在60~69岁,胃息肉患者中主要形态为山田Ⅱ型(53.75%),胃息肉直径<0.5 cm的患者占比达57.5%,炎性增生型患者占比达63.75%,胃息肉主要分布于胃体、胃窦及胃底,其中胃体占比30.0%、胃窦占比26.25%、胃底占比23.75%,30例患者接受内镜手术治疗随访,其中9例复发。结论老年人胃息肉检出率高,胃息肉大多直径较小,且单发息肉多见,息肉主要分布于胃体、胃窦及胃底,炎性增生型息肉占大部分,多发息肉治疗后易复发。     

西甲硅油联合链霉蛋白酶在胃癌目标筛查人群胃镜检查中的应用

目的观察胃癌目标筛查人群使用西甲硅油联合链霉蛋白酶在胃镜检查中的应用价值。方法选取2019年1月1日-6月30日中国人民解放军联勤保障部队第九○○医院消化内科门诊就诊的胃癌目标筛查人群并愿意接受常规胃镜检查者396例,应用随机数字分配法分为试验组(n=198)和对照组(n=198)。试验组在胃镜检查前口服西甲硅油联合链霉蛋白酶,对照组口服盐酸利多卡因胶浆,比较2组胃镜检查的视野清晰度、检查时间及不良反应。结果试验组胃黏膜的视野清晰程度为A级134例、B级33例、C级25例、D级6例,对照组胃黏膜的视野清晰程度为A级有86例、B级48例、C级36例、D级28例,试验组视野清晰情况优于对照组(χ²=3.629,P<0.05),胃镜平均检查时间为(6.46±1.35)min短于对照组的(8.62±0.47)min(t=21.262,P<0.01),胃镜检查前恶心程度显著低于对照组(χ²=14.101,P<0.01)。结论胃癌目标筛查人群胃镜检查前口服西甲硅油联合链霉蛋白酶,不仅可有效改善胃黏膜的视野清晰度,还能提高患者的舒适感,有利于提高胃黏膜病变检出率,值得临床大力推广应用。     

胃底贲门癌根治术后三种消化道重建方式的疗效比较

目的：比较三种消化道重建方式在根治性胃切除术治疗胃底贲门癌过程中的应用效果。方法收集150例接受根治性胃切除术治疗胃底贲门癌患者,根据消化道重建方式分为A组（55例）、B组（46例）、C组（49例）,A组患者接受间置空肠吻合术,B组患者接受食管空肠Roux-en-Y吻合术,C组患者接受食管残胃后壁吻合术。术后随访12个月。结果随访期内,A组反流性食管炎发生率显著低于B组（1．82％比19.57％,χ^2=6．966,P＝0．008）,B组患者反流性食管炎发生率显著低于C组（χ^2=4.212,P＝0．042）。手术后12个月,A组患者整体健康状况、便秘、腹泻、恶心呕吐等指标评分显著低于B组与C组（均P＜0．05）。结论根治性全胃切除术治疗胃底贲门癌时可以选择食管空肠Roux-en-Y吻合术;近端根治性胃切除术治疗胃底贲门癌过程中应用间置空肠吻合术具有术后反流性食管炎发生率低、患者生存质量高等优点。     

急诊内镜联合特利加压素治疗食管贲门胃底静脉曲张活动出血效果

目的探讨内镜联合奥曲肽和内镜联合特利加压素治疗食管贲门胃底静脉曲张活动出血的疗效差异。方法选择2011年3月至2012年3月我市多个中心行内镜治疗的247例食管贲门胃底静脉曲张活动出血住院患者作为研究对象,根据治疗方法的不同分为A、B两组。A组采用内镜联合奥曲肽治疗,B组给予内镜联合特利加压素治疗,比较两组患者的疗效。结果两组72h成功止血率差异无统计学意义;B组3～5d、10d出血复发率均低于A组,差异有统计学意义;住院期间A组患者死亡率高于B组,差异有统计学意义。结论治疗食管贲门胃底静脉曲张活动出血,内镜联合特利加压素在近期止血率、住院期间生存率均优于内镜联合奥曲肽治疗,可能与应用特利加压素有关,尚需进一步研究。     

大鼠部分胃切除对残肝再生影响的实验研究

目的探讨大鼠部分胃切除对残肝再生的影响。方法选用雄性SD大鼠54只,随机分成68%肝叶切除组（A组：n=18）,68%肝叶切除并70%胃体部切除组（B组：n=18）,68%肝叶切除并胃窦部切除组（C组：n=18）。各组分别于术后24h,48h,72h分批处死,取肝后称肝重,测肝再生指数,10%福尔马林溶液固定肝脏,HE染色后测肝细胞分裂指数、免疫组化法测肝细胞PCNA（增殖细胞核蛋白抗原）指数。结果 （1）24h、48hB组术后肝再生率较低,与A组相比,有非常显著性差异（P〈0.01）;两组72h肝再生率有显著性差异（P=0.031）。而C组术后肝再生率在不同时间点明显偏低,和A、B组比较,均有非常显著性差异（P〈0.01）。（2）B组术后24h肝细胞分裂指数、残余肝组织PCNA标记指数较低,与A组相比,有非常显著性差异（P〈0.01）;两组分别在48h、72h比较,无显著性差异（P〉0.05）。而C组术后肝细胞分裂指数、残余肝组织PCNA标记指数在不同时间点明显降低,均有非常显著性差异（P〈0.01）。结论 70%胃体部切除后大鼠残肝再生延迟,胃窦部切除后大鼠残肝再生明显受抑,部分胃切除同时不宜行肝大部切除。     

链霉蛋白酶颗粒联合二甲硅油散、达克罗宁胶浆在胃镜检查术前准备中的应用研究

目的 探讨链霉蛋白酶颗粒联合二甲硅油散、达克罗宁胶浆用于胃镜检查术前准备中的有效性.方法 收治的行胃镜检查的114例出院患者,根据患者胃镜检查前使用药物不同分为对照组(n=59)和研究组(n=55).对照组患者胃镜检查前使用二甲硅油散联合达克罗宁胶浆,研究组患者使用链霉蛋白酶颗粒联合二甲硅油散、达克罗宁胶浆.通过查阅电...     

老年患者无痛胃肠镜联合检查的临床安全性评估

【摘要】目的探讨采用无痛胃肠镜联合检查在老年患者临床诊治中的应用效果及安全性。方法选取本院2011年2月～2012年9月收治的250例消化道疾病老年患者,按照检查方法不同分为A组（无痛胃肠镜联合检查组）90例、B组（无痛胃镜检查组）80例、C组（无痛肠镜检查组）80例,比较3组患者的临床诊治完成情况及安全性。结果3组患者均顺利完成检查,检查中无中止病例,成功率为100％。3组患者生命体征变化、不良反应发生率比较,差异无统计学意义（P〉0．05）。结论老年消化道疾病患者采用无痛胃肠镜联合检查操作简便、安全有效,值得推广应用。     

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.     

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.

---

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.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

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.