HCG分泌与类甲亢关系的临床研究

目的探讨妊娠早期HCG分泌与甲状腺功能的关系.方法将120 例妊娠6～12w孕妇分为单胎初产、单胎经产、双胎、妊娠剧吐四组,抽空腹肘静脉血2ml采用酶联免疫吸附测定法观察T3、T4、TSH与HCG的关系及各组间HCG的定量关系.结果单胎初产组:T3 2.6107 1.2775、T4 160.7143 48.1578、TSH 5.1393 1.4187、HCG 49 97.5000±1448.3961,单胎经产组:T3 2.4786 0.6124、T4 160.6071 50.2078、TSH 5. 35±1.4043、HCG 5267.1786 1084.5544,双胎组:T3 2.1036 0.6586、T4 168.1143 4 7.4707、TSH 4.9292 1.4171、HCG 5741.6667 1189.0503,妊娠剧吐组:T3 2.5850 1.5281 、T4 176.2500 67.4957、TSH 4.9179±0.9326、HCG 6035.2857±1264.8536.结论妊娠剧吐与双胎组中HCG与TSH呈相关性,双胎组HCG与T4有相关性,双胎与妊娠剧吐组HCG有差异.提示HCG对垂体-甲状腺轴有一定的调节作用.     

阻断乙型肝炎病毒母婴宫内传播对血清病毒DNA和转录体的影响

目的 进一步探讨不同方法阻断乙型肝炎病毒（HBV）母婴垂直传播的效果，明确携带HBV生育期妇女干预治疗对保护婴儿抗-HBV感染的意义。方法 124例HBsAg/HBeAg阳性孕妇分为两组，乙肝免疫球蛋白与左旋咪唑涂布剂治疗组61例，对照组63例。治疗组均在孕26周起开始注射。用ELISA法检测孕妇和新生儿血清中的HBsAg等免疫等学标记物，分别用PCR和PT-PCR检测血清HBV DNA及全长型和顿挫性转录体。结果 治疗组和对照组新生儿外周血中HBsAg、病毒DNA、全长型和顿挫型病毒转录体的阳性率分别为8.2%，21.3%，54.8%和33.3%,6.3%,12.5%,62.5%，治疗组的前一项指标明显低于对照组（P＜0.01），但后一项检测指标差别不显著（P＞0.01）。结论 携带HBV孕妇于孕晚期给予乙肝免疫球蛋白和左旋咪唑涂布剂联合治疗后，婴儿HBsAg,HBV DNA和全长型转录体携带率明显降低。然而，无论治疗组还是对照组，都有超过一半的患儿携带顿挫型病毒转录体。     

妊娠晚期妊高征患者血清sVCAM-1和sICAM-1水平检测及临床意义

目的 探讨妊娠晚期妊高征(PIH)患者血清可溶性血管细胞粘附分子-1(soluble vascular cell adhesion molecule-1,sVCAM-1)和可溶性细胞间粘附分子-1(soluble intercelluar adhcsion molecule-1,sICAM-1)检测的意义。方法 用ELISA法检测37例PIH患者及14例正常妊娠妇女血清sVCAM-1和sICAM-1的含量。结果 svcam-1在中重度妊高征组明显高于正常对照组和轻度妊高征组(P<0.05),轻度妊高征组与正常对照组无明显差异。(P>0.05);sICAM-1在各组间无明显差异(P>0.05)。结论 妊娠晚期血清sVCAM-1 水平明显升高,sICAM-1变化不明显。     

CYFRA21-1和CEA对Ⅲ期非小细胞肺癌患者的临床预后意义

目的 探讨CYFRA21-1和CEA对Ⅲ期非小细胞肺癌患者的临床预后意义。方法 采用化学发光法检测62例Ⅲ期非小细胞肺癌患者放疗前与放疗结束时血清标本中CYFRA21-1和CEA的含量,临床随访6-24月。结果 Ⅲ期非小细胞肺癌患者放疗结束时血清中CYFRA21-1和CEA的水平显著低于放疗前;放疗前血清中CYFRA21-1和CEA升高患者组的2年生存率与正常组2年生存率差异均无显著性意义;放疗结束时CYFRA21-1和CEA的水平正常组的两年生存率明显高于升高组;放疗结束时CYFRA21-1和CEA含量较放疗前下降≥50%的病人的2年生存率,明显高于放疗结束时血清CYFRA21-1和CEA含量较放疗前下降〈50%的病人的2年生存率。结论 Ⅲ期非小细胞肺癌患者放疗结束后血清中CYFRA21-1和CEA的水平为有意义的阴性预后指标,尤其是放疗结束时血清中CYFRA21-1和CEA含量下降程度的大小有重要的临床预后价值。     

潍坊地区孕期女性叶酸利用能力调查

目的调查潍坊地区孕期女性的叶酸利用能力,分析叶酸利用能力与不良孕产史的相关性,为围受孕期叶酸补充和风险监测提供指导。方法对2 934例潍坊地区孕期女性进行叶酸利用能力遗传检测,采用Taqman-MGB技术检测亚甲基四氢叶酸还原酶(MTHFR)基因C677T、A1298C和甲硫氨酸合成酶还原酶(MTRR)基因A66G位点的单核苷酸多态性分型,对叶酸利用能力遗传风险进行分级。结果潍坊地区孕期女性发现高度叶酸利用能力遗传风险的比例为40.05%,全国参考数据为19.70%,P<0.01;未发现遗传风险的比例为26.48%,全国参考数据为33.04%%,P<0.01。正常孕产组和不良孕产组的叶酸利用能力总体构成不同,存在统计学差异(χ2=19.47,P<0.01),正常孕产组未发现遗传风险人群的比例为28.29%,不良孕产组为14.40%,两组比较P<0.05;正常孕产组高度遗传风险人群的比例为38.13%,不良孕产组为52.88%,两组比较P<0.01。结论潍坊地区孕期女性叶酸利用能力较全国人群偏低;叶酸代谢和利用障碍与不良孕产史有相关性。     

白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

III IV期原发肝癌的治疗探讨

目的　报告 6 1例ⅢⅣ期肝癌的生存率 ,其中 5 3例采用不同方法治疗 ,探讨合理的治疗方法。　方法　 17例单纯肝动脉导管化疗栓塞 (HAE) ;17例单纯放疗 (RT)和 6例低剂量放疗(LDRT) ;12例HAE +RT ;8例未做特殊治疗 (NT) ;1例单独免疫治疗 (BRM )。结果 6 1例的 1、2、3年绝对生存率是 4 7 5 %、2 4 6 %、8 6 % ,治疗 4 7例的 1、2、3年生存率是 6 1 7%、31 9%、11 4 % ,HAE +RT组 ;RT组 ;HAE组 ;NT和LDRT组的 1、2、3年生存率分别是 83 3%、5 8 3%、2 7 3% ;6 4 7%、35 3%、6 7% ;4 1 2 %、5 9%、0 ;HAE +RT组 ,HAE组与HAE之间生存率对比有明显差异 (P <0 0 5 )。　结论　HAE +RT组疗效好于HAE组 ,HAE组与RT组的接近 ,各治疗组结果均优于LDRT和NT组。笔者提出对晚期肝癌仍要采取积极治疗 ,但要根据肝功能和全身情况给予合理和适量的治疗 ,主张合理程序的综合治疗措施联合采用 :HAE、RT、BRM。     

新生儿乙肝病毒感染的血清学研究

我们自1994年月～1996年9月随机抽查339例新生儿及其母亲或父亲共569例的血清HBVM,结果分析报告如下.1 资料与方法病例为随机抽查住我院产科病房分娩新生儿339,母亲339例和父亲230例.339例母亲年龄平均26.5岁.孕妇分娩前1～2天,新生儿出生48小时内与父亲同时采静脉血送检.HBVM(乙肝 5项)测定采用ELISA法.HBVM用放免疫.计数资料的统计学处理采用t检验.