Correlation between soluble transferrin receptor and serum ferritin levels following bone marrow transplantation for thalassemia

Abstract: This study analyzes the serum transferrin receptor (sTfR) levels in a series of 230 ex-thalassemics with a follow-up of 1 to 9 years after bone marrow transplantation (BMT) for homozygous β thalassemia. Ex-thalassemics are individuals, cured of homozygous β thalassemia by BMT, who maintain different degrees of iron overload acquired during the pretransplant period. Both in experimental and clinical conditions, sTfR concentrations have been shown to be a quantitative measure of body iron status. This study was carried out to assess whether the level of sTfR may be of help in determining the extent of iron overload in ex-thalassemics. Patients who received the marrow from their HLA-identical sibling donor heterozygous for β thalassemia, namely heterozygous ex-thalassemics, displayed significantly higher levels of sTfR than patients transplanted from their normal sibling donors (normal ex-thalassemics). This finding suggests that increased erythropoiesis, albeit in part ineffective in heterozygous ex-thalassemics, is responsible for the sTfR increment. Both heterozygous and normal ex-thalassemics had significant lower sTfR levels than their heterozygous (p < 0.003) or normal (p < 0.0001) donors, respectively. These differences may be ascribed to the presence of iron overload in ex-thalassemics in comparison to their normal or heterozygous donors who did not present excess of iron in the body. A significant inverse correlation between sTfR and serum ferritin levels (r = –0.54, p < 0.0001) was found when normal ex-thalassemics were considered. In heterozygous ex-thalassemics, the lack of correlation between these two parameters may be explained by the enhanced erythropoietic activity of individuals with thalassemic trait. These results suggest that the level of sTfR may be a useful indicator of iron overload in normal ex-thalassemics.     

Living related liver transplantation. Progress or regress?

The impetus for the devolopment of living related liver programmes lies with donor shortage, which relates inversely to the success of generating cadaveric donors. A shrinking or non-existent cadaveric donor pool leads to an increased death rate among potential recipients awaiting transplantation. The living related liver programmes have by and large been successful, though it is accepted that there is potentially a significant risk to the donors. The technique of live donor liver transplantation is clearly here to stay, but the selection of suitable donors is between the family and the unit. Consequently, because of the lack of international guidelines, the programmes are open to abuse. Steps should be taken to establish either mechanisms of control or a worldwide register to combat this potential.     

临床小肠移植排斥反应的防治

采用环孢素Ａ、雷公藤多甙、甲基氢化泼尼松、前列腺素Ｅ１伍用的新型免疫抑制方案，预防小肠移植排斥反应取得满意效果。病人存活３１０ｄ。经验表明，通过内窥镜和肠粘膜组织病理检查，监测排斥反应简便实用有效。利用聚合酶链反应（ＰＣＲ）技术研究发现，移植术后供肠细胞向受体组织移居嵌合，而临床无移植物抗宿主病（ＧＶＨＤ）发生。促进细胞移居嵌合可能有利于防止排斥反应的发生。     

不同状态人体牙槽骨的弹性性质

人体下颌牙槽骨皮质骨是各向异性复合生物材料,组织结构上类似于胶原羟磷灰石纤维增强的单向纤维增强复合材料。本文应用电测法测试了不同状态人体下颌牙槽骨皮质骨在平面应力状态下的各向异性弹性常数。     

保留下齿槽神经的颌骨切除兼植骨术

本文报告保留下齿槽神经血管束的下颌骨部分切除并即刻植骨修复新的手术方法5例.术后颜面部外形基本对称,6个月后对患侧下唇及颏部进行物理及电刺激等手段测试温、触、痛觉,功能恢复满意。     

Langerhans cell histiocytosis in monocygote twins: case reports

Langerhans cell histiocytosis includes three clinical forms of histocytosis X. We describe a disseminated form of Langerhans cell histiocytosis (Letterer-Siwe disease) in monozygotic twins. The twins showed simultaneous onset of disease, almost identical clinical follow-up and findings on cranial CT. The cause of this phenomenon remains unknown.     

三袖套管法大鼠肺移植

我们将血管套接技术用于大鼠肺移植中。在肉眼下，完成肺动静脉及支气管的吻合。在连续６例手术中，手术平均时间６１±４分钟，移植物总缺血时间１７±３分钟，手术时间缩短至国外同类手术的１／４，缺血时间缩短至同类手术的１／３。同时手术成功率达到７５％（６／８），手术后生存率１００％。行对侧肺切除术后，血气分析正常，显示了移植肺良好的气体交换功能     

自体造血干细胞移植治疗恶性血液病

为探讨恶性血液病的有效治疗方法,应用自体骨髓移植(ABMT)38例,自体外周血造血干细胞移植(ABSCT)13例,自体外周血造血干细胞与自体骨髓联合移植15例。治疗白血病54例,恶性淋巴瘤11例,多发性骨髓瘤1例。外周血造血干细胞采用化疗加多抗甲素或C—CSF动员。移植物采用微波、阿克拉霉素净化处理。结果:两组动员方案均有良好动员效果。ABSCT组及联合移植组造血功能恢复比ABMT组快(P<0.05),合并症少。66例中,45例仍呈持续缓解(CCR),中位CCR时间32(5～98)个月,复发21例。3年无病生存率及复发率分别为68.5％及26.1％。结果表明:自体造血干细胞移植是根治恶性血液病的有效手段。ABSCT及联合移植具有造血功能恢复快,合并症少等优点。微波和阿克拉霉素体外净化移植物是一种简便、有效的净化方法。     

丝裂霉素C在翼状胬肉切除联合自体结膜瓣移植术中的应用

目的 讨论安全有效浓度下，丝裂霉素C在翼状胬肉切除联合体自体结膜移植术中的应用，观察对翼状胬肉的复发的防治效果。方法 对54例64眼原发性胬肉者施行显微镜下胬肉切除带蒂结膜瓣转位移植联合术中或术后丝裂霉素C（mitomycin C MMC)的应用，经5－12月随诊，与单纯手术组（27例33眼）原发性胬肉术后复发情况作对比分析。结果 复发率要术中用药组为3．33％，术后用药组5．88％，对照组18．18％，经X^2检验，术中、术后用药与对照组 差异有显著性（P＜0．05），而术中或术后应用MMC的复发率差异无性，均可降低胬肉的复发率。结论 适时、适量应用MMC对有效防止翼状胬肉的复发有着非常重要的意义。     

刮治＋自体骨移植术治疗牙源性角化囊肿（附14例报告）

本文总结了１４例应用刮治和自体骨移植术治疗大型牙源性角化囊肿的方法，１４例植骨均成活，４例术后囊肿复发，再次手术，指出：与骨断切除治疗大型角化囊肿的方法比较，此法最大的优点是有利于保持患者面容和咀嚼功能，并对大型角化囊肿的手术原则，自体骨移植问题及手术注意事项进行了讨论。