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目的:观察非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者自体造血干细胞移植(autologous hematopoietic stem cell transplantation,ASCT)术后应用重组人α-2b干扰素(α-2b IFN)进行早期干预治疗的临床疗效。方法:选取18例行ASCT的NHL患者为研究对象,移植前疾病评估均未达到完全缓解(complete remission,CR),试验组血象恢复后给予IFN 3 000 000 U次/隔日干预治疗,3个月后停用;对照组未行干扰素干预治疗,分析总体疗效及两组对比的生存情况。结果:随访中位时间为34(10~50)个月,患者中位生存时间为37(31~45)个月,3年总体无进展生存(progressive free survival,PFS)、总生存(overall survivial,OS)分别为54.7%、66.8%。ASCT后试验组1年内无疾病复发,2年内复发率为12.5%;对照组1年内复发率为20%,2年内复发率为30%。结论:NHL患者在ASCT后给予重组人α-2b IFN早期干预治疗,患者耐受性好,可能降低移植后早期复发率。 相似文献
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Elizabeth D. Krebs Robert B. Hawkins J. Hunter Mehaffey Clifford E. Fonner Alan M. Speir Mohammed A. Quader Jeffrey B. Rich Leora T. Yarboro Nicholas R. Teman Gorav Ailawadi 《The Journal of thoracic and cardiovascular surgery》2019,157(4):1533-1542.e2
Objectives
Expedient extubation after cardiac surgery has been associated with improved outcomes, leading to postoperative extubation frequently during overnight hours. However, recent evidence in a mixed medical-surgical intensive care unit population demonstrated worse outcomes with overnight extubation. This study investigated the impact of overnight extubation in a statewide, multicenter Society of Thoracic Surgeons database.Methods
Records from 39,812 patients undergoing coronary artery bypass grafting or valve operations (2008-2016) and extubated within 24 hours were stratified according to extubation time between 06:00 and 18:00 (day) or between 18:00 and 6:00 (overnight). Outcomes including reintubation, mortality, and composite morbidity-mortality were evaluated using hierarchical regression models adjusted for Society of Thoracic Surgeons predictive risk scores. To further analyze extubation during the night, a subanalysis stratified patients into 3 groups: 06:00 to 18:00, 18:00 to 24:00, and 24:00 to 06:00.Results
A total of 20,758 patients were extubated overnight (52.1%) and were slightly older (median age 66 vs 65 years, P < .001) with a longer duration of ventilation (4 vs 7 hours, P < .001). Day and overnight extubation were associated with equivalent operative mortality (1.7% vs 1.7%, P = .880), reintubation (3.7% vs 3.4%, P = .141), and composite morbidity-mortality (8.2% vs 8.0%, P = .314). After risk adjustment, overnight extubation was not associated with any difference in reintubation, mortality, or composite morbidity-mortality. On subanalysis, those extubated between 24:00 and 06:00 exhibited increased composite morbidity-mortality (odds ratio, 1.18; P = .001) but no difference in reintubation or mortality.Conclusions
Extubation overnight was not associated with increased mortality or reintubation. These results suggest that in the appropriate clinical setting, it is safe to routinely extubate cardiac surgery patients overnight. 相似文献155.
Christopher Teng JiaDe Yu Jesse Taylor Adam I. Rubin James R. Treat 《Pediatric dermatology》2019,36(5):697-701
Erosive pustular dermatosis of the scalp (EPDS) is an uncommon chronic inflammatory response to scalp trauma that usually resolves with cicatricial alopecia. It most commonly affects elderly patients with a history of actinic damage. Herein, we describe a 16‐year‐old girl with acrofacial dysostosis type 1 presenting after surgery with crusting purulent scalp lesions, whose clinical presentation and histopathologic findings were consistent with EPDS. A review of the literature on EPDS in children is also detailed. 相似文献
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Alzheimer’s disease is characterized by the extracellular accumulation of the amyloidβin the form of amyloid plaques and the intracellular deposition of the microtubule-associated protein tau in the form of neurofibrillary tangles.Most of the Alzheimer’s drugs targeting amyloidβhave been failed in clinical trials.Particularly,tau pathology connects greatly in the pathogenesis of Alzheimer’s disease.Tau protein enhances the stabilization of microtubules that leads to the appropriate function of the neuron.Changes in the quantity or the conformation of tau protein could affect its function as a microtubules stabilizer and some of the processes wherein it is involved.The molecular mechanisms leading to the accumulation of tau are principally signified by numerous posttranslational modifications that change its conformation and structural state.Therefore,aberrant phosphorylation,as well as truncation of tau protein,has come into focus as significant mechanisms that make tau protein in a pathological entity.Furthermore,the shape-shifting nature of tau advocates to comprehend the progression of Alzheimer’s disease precisely.In this review,we emphasize the recent studies about the toxic and shape-shifting nature of tau in the pathogenesis of Alzheimer’s disease. 相似文献
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