Spontaneous Splenic Rupture in a Patient with Acute Lymphoblastic Leukemia of Burkitt Type

We describe a case of spontaneous splenic rupture occurred in a patient with acute lymphoblastic leukemia of Burkitt type before starting cytotoxic chemotherapy. Left hypochondrial pain radiating to the homolateral shoulder was the only clinical symptom. Emergency computed tomography showed splenic laceration and hemoperitoneum. The patient underwent immediate laparotomy with splenectomy and experienced an uneventful postoperative recovery. Eight days after surgery, chemotherapy could be administered and complete remission was achieved. Although spontaneous rupture of the spleen is rare in leukemia and related disorders, this diagnosis should be taken in account also when clinical symptoms are mild. Following immediate operative management, patients may completely recover and receive cytotoxic chemotherapy with substantial possibilities of achieving complete remission.     

Thrombopoietic factors potentially useful in the treatment of acute leukemia

Thrombocytopenia is a major cause of morbidity following intensive chemotherapy for acute leukemia. Over recent years, there has been an increasing use of platelet transfusions which, although generally efficacious to prevent severe hemorrhage, have associated risks of transmitting blood-borne disease and of alloimmunization. Therefore, there is a clinical requirement for a drug that will reliably alleviate the thrombocytopenia associated with leukemia therapy. The c-mpl ligand thrombopoietin is the most interesting factor for the treatment of thrombocytopenia because of its lineage specificity. Phase I and II studies confirm its biological efficacy to induce rise in platelet count in patients with solid tumors and acute leukemia. Several other pleiotropic hematopoietic growth factors are also currently in clinical trials. These include interleukin-6, interleukin-3, interleukin-11, PIXY321 and stem cell factor. The effects of these cytokines appear to be modest at most and, with the exception of interleukin-11, their side effects are likely to limit their clinical application. Combinations of factors may prove more efficacious approaches to enhance platelet recovery.     

急性白血病早期死亡高危因素的Logistic回归分析

为了解急性白血病（ＡＬ）早期死亡的高危因素，对近１０ａ上海地区２７家医院共３４７例ＡＬ住院患者早期死亡的高危因素进行了Ｌｏｇｉｓｔｉｃ回归分析。结果表明：出血、感染和多脏器衰竭是ＡＬ死亡的主要原因。全反式维甲酸的应用降低了急性早幼粒细胞白血病早期病死率，早期死亡的高危因素为：年龄≥６０岁或≤１岁，发病时伴有出血，弥散性毛细血管内凝血，肝脏明显肿大，ＦＡＢ分类属于急性骨髓细胞白血病，外周血细胞＞１００×１０９／Ｌ，ＢＰＣ＜５０×１０９／Ｌ，伴发病发热和感染。提示：为了降低ＡＬ的早期病死率，必须针对上述高危因素采取相应防治措施     

联合去甲氧柔红霉素治疗急性白血病的临床研究

采用以４－去甲氧基柔红霉素（ＩＤＡ）为主组成的联合化疗方案，治疗３３例初发和复发的急性白血病，其中急性淋巴细胞白血病（ＡＬＬ）７例，急性非淋巴细胞白血病（ＡＮＬＬ）２６例。结果：总有效率７０％。初治２３例ＡＮＬＬ患者，完全缓解（ＣＲ）１６例，部分缓解（ＰＲ）２例，有效率为７９％。５例初治ＡＬＬ患者，４例ＣＲ，１例ＰＲ。而复发的２例ＡＬＬ和３例ＡＮＬＬ患者均未缓解。ＩＤＡ主要副作用表现为骨髓抑制及心脏毒性。认为以ＩＤＡ组成联合化疗方案治疗初发的急性白血病具有较好的疗效     

正常晚期妊娠胎儿脐动脉、大脑中动脉及腹主动脉血流速度波形与胎儿血气相关性探讨

目的探讨正常妊娠胎儿血流速度波形与胎儿血气的相关性。方法应用彩色多普勒超声对４５例正常晚期妊娠初孕妇女于剖宫产术前２４小时内进行胎儿脐动脉（ＵＡ）、大脑中动脉（ＭＣＡ）及腹主动脉（ＡｂＡｏ）的血流速度波形（ＦＶＷｓ）检查，计算搏动指数（ＰＩ）、阻力指数（ＲＩ）及收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ），同时对剖宫产分娩的新生儿立即进行脐动脉血气ｐＨ、二氧化碳分压（ＰＣＯ２）、氧分压（ＰＯ２）测定。结果ＵＡＲＩ与血ｐＨ、ＰＯ２呈明显负相关（Ｐ＜０．０１，Ｐ＜０．０５），与ＰＣＯ２呈正相关（Ｐ＜０．０５），ＭＣＡＲＩ与血ｐＨ、ＰＯ２呈明显正相关（Ｐ＜０．０１，Ｐ＜０．０５），与ＰＣＯ２呈负相关（Ｐ＜０．０５）。结论产前监测ＵＡ及ＭＣＡ的血流速度波形，可间接了解胎儿血气情况，及时判断胎儿宫内安危的状况。     

不同穴位针刺对暂时性局部脑缺血大鼠皮层体感诱发电位和脑梗塞体积的影响

观察不同穴位针刺对暂时性局部脑缺血的作用，采用皮层体感诱发电位测定和ＴＴＣ染色法，结果表明，电针能促进皮层体感诱发电位的恢复，可使脑缺血后脑梗塞体积减小，且督脉穴位针刺在促使脑缺血后皮层体感诱发电位恢复上可能具有相对较强的作用。     

刺五加注射液治疗脑出血的临床评价

30例高血压脑出血患者在常规疗法基础上加用紫外线辐射血液疗法作为对照组,另30例在上述疗法基础上加用刺五加注射液静脉滴注为治疗组。结果治疗组显效率96.7％,总有效率100％,对照组显效率60.0％,总有效率83.3％,治疗组明显优于对照组(P<0.01)。表明刺五加注射液不仅用于缺血性脑梗塞的治疗,而且也可用于脑出血,对出血量在30ml以下的病例,疗效较好。     

Tunneling Schmorl’s nodes in an elderly woman treated for acute lymphoblastic leukemia

We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom serial imaging studies showed the development of multiple vertebral collapse, and communicating superior and inferior Schmorl’s nodes creating a longitudinal channel (”tunneling” Schmorl’s nodes) through the anterior aspect of T12 to L3 vertebral bodies of her osteoporotic thoracolumbar spine. This was observed after achieving complete remission of the disease and during maintenance therapy. The finding is felt to be secondary to iatrogenic exacerbation of osteoporosis. Received: 26 May 2000 Revision requested: 23 June 2000 Revision received: 10 July 2000 Accepted: 13 July 2000     

喘安的急性毒性实验观察

目的：探讨喘安的急性毒性。方法：喘安小鼠灌胃测定半数致死量(LD50)。结果：喘安的(LD50)为14．73～20．90g／kg。结论：喘安临床应用安全。     

习见蓼提取物利尿止血及镇痛作用与急性毒性研究

目的:观察黔产习见蓼水提物(AE-P)的利尿、止血、镇痛药理作用及急性毒性。方法:测定NS负荷大鼠的排尿量及尿中Na+,K+,Cl-的含量;小鼠断尾出血时间(BT)及血浆复钙时间(RT);ip醋酸致小鼠扭体反应及热板致痛的潜伏期;LD50等指标。结果:AE-P能明显增加大鼠尿量和尿中Na+,K+,Cl-含量,且ig2次/d,连续给药7d,利尿作用无耐受性产生;AE-P能明显缩短小鼠BT和RT;能明显抑制小鼠扭体反应及延长热致痛潜伏期。AE-P以5g/kg(相当于干燥原生药80.64g/kg)给小鼠24hig3次,观察10d,小鼠全部存活;ip给药,其小鼠LD50为(3.13±0.39)g/kg(相当于干燥原生药50.48g/kg)。结论:AE-P具有利尿、止血及镇痛药理作用,其利尿作用不易产生耐受性,而止血作用与影响内凝系统有关,且毒性较低。