长Q-T间期综合症2例报告

原发性Q-T间期延长综合症(LQTS)比较少见,现将我院近来见到的2例报告如下。例1女,8岁。因反复晕倒抽搐1年入院。患儿入院前在剧烈活动后自感心慌不适,遂即晕倒神志不清,四肢小抽搐,约1～2分钟后自行缓解。类似发作共五次。体检:心率84次/分,律不齐,心尖部闻及收缩期Ⅱ级吹风样杂音。两耳音叉试验听力正常。胸片、二维超声心动图和M 超声无异常。心电图示P-R间期0.16秒,Q-T间期0.44秒,T 波高宽,U 波高于T 波。诊断LQTS。服扑癎酮0.125g,一日三次对症治疗,1月后心电图示Q-T 间期缩短至0.40秒,T 波     

G—CSF测定在新生儿疾病诊断中的应用

应用ＥＬＩＳＡ法对本科住院的１５０例新生儿进行了粒细胞集落刺激因子的检测。结果为６０例细菌感染性疾病的新生儿Ｇ－ＣＳＦ阳性检出率为９９％，２５例非细菌感染的新生儿Ｇ－ＣＳＦ阳性率为８％，２０例正常新生儿Ｇ－ＣＳＦ检测全部为阴性，表明Ｇ－ＣＳＦ检测可用于新生儿感染性疾病的鉴别诊断，并对临床应用抗生素有较大的指导意义。     

新生儿疟眼沙眼衣原体和解脲脲原体感染的PCR检测研究

为探讨沙眼衣原体（ＣＴ）和解脲解原体（ＵＵ）与新生儿疾病的关系，我们采用套式聚合酶链反应（ＰＣＲ）技术，从１００例住院新生儿的结膜拭子中共检出阳性者５８例阳性率５８％其中ＣＴ３６例，ＵＵ２２例）；剖宫产７例（ＣＴ４例，ＵＵ３例）经产道分娩５１例（ＣＴ３２例，ＵＵ１９例）结果表明：新生儿是ＣＴ，ＵＵ易感者，可引起新生儿肺炎，宫内感染，早产，低体重，结膜炎，肠炎，采用先进的套式ＰＣＲ技术检测具有灵敏，     

慢性粒细胞白血病合并宫颈腺癌1例并文献复习

目的 探讨慢性粒细胞白血病(CML)合并第二实体瘤病人的治疗方案和时机的选择。方法 系统分析1例CML合并宫颈腺癌病人的临床资料,并查阅参考相关文献。结果 对该病人初诊时CML(慢性期)予以伊马替尼治疗、手术联合化疗治疗宫颈腺癌,手术前后停用伊马替尼,术后4个月CML进展为急性淋巴细胞白血病(简称:急淋变),予以达沙替尼50 mg,每天2次,治疗1个月,获得主要分子学反应。结论 (1)CML合并第二实体瘤治疗时应权衡利弊,优先治疗危险度更高的疾病;(2)CML合并第二实体瘤治疗过程中,重点监测血象及骨髓象,评估病情,当CML出现疾病进展时,及时应用第二代酪氨酸激酶抑制剂;(3)CML合并宫颈腺癌的发生机制、以及宫颈腺癌是否影响CML进展尚不明确,有待进一步研究阐明。     

氨基咪唑氨甲酰转移酶基因多态性在类风湿关节炎患者甲氨蝶呤治疗中的研究

Objective To investigate the relationship between the single nucleotide polymorphism of aminoimidazole carbexamide ribonucleotide transformylase gene and the efficacy and toxicity of methotrexate treatment in rheumatoid arthritis. Methods Total of 359 patients with RA were divided into mono-therapy with MTX group, combination therapy with other DMARDs group and other DMARDs combination with no MTX treatment group. The clinical and laboratory measurements were evaluated before therapy and 12, 24 weeks after therapy. Efficacy (evaluated by ACR20) and side effects of the drugs were also assessed. Real-time fluorescent quantitative PCR was conducted to test ATIC 347C/G mutation in RA patients and 340 healthy controls. Results There was no statistical significant difference in 347 CC, CG, GG between RA patients and healthy controls. In the MTX mono-therapy group (n=107), 72% (n=77) there was no statistical significant difference in 347CC, CG, GG between patients with good response and patients without efficacy. 32.7%(n=35) of these patients experienced adverse drug reactions. The ATIC G allele carriers (22.4%) experienced a greater frequency of side effects than the CC carriers (OR=2.672, 95%CI, 1.27～5.59, P<0.05). In MTX combined with other DMARDs group (n=128) and other DMARDs combination without MTX group (n=90), the polymorphism in the ATIC gene was not associated with good clinical response and adverse events (P>0.05). Conclusion There is no statistical significant difference between RA and healthy controls in the ATIC347 gene. Polymorphism in the ATIC gene is not associated with clinical response to MTX treatment, but the ATIC347 G allele is associated with MTX toxicity. It maybe used to predict the adverse drug reactions of patients who take MTX.     

手术治疗宫颈机能不全20例报告

宫颈机能不全主要由于急产造成宫颈撕裂、手术中宫颈过度扩展及宫颈过度电灼造成，是习惯性流产、晚期流产和早产的原因之一。1995年5月至2003年5月，我院收治20例宫颈机能不全患者。现报告如下。     

肺炎支原体快速聚合酶链式反应（PCR）法检测

本文根据Ｂｅｒｎｅｉ设计的肺炎支原体ＰＣＲ引物，采用国产的耐热ＤＮＡ聚合酶，建立了双温循环肺炎支原体ＰＣＲ快速检测法。４０例儿童肺炎咽拭子标本中，８例呈阳性结果。     

CAR-T治疗复发难治B细胞淋巴瘤的安全性及临床疗效分析

目的:探讨第3代CD19单靶点、CD20单靶点或CD19联合CD20双靶点嵌合型抗原受体T淋巴细胞(CAR-T)治疗复发难治B细胞淋巴瘤的安全性及临床疗效。方法:对14例CD20单抗及传统化疗治疗无效的B细胞淋巴瘤患者,预处理后5～7天输注自体特异性CD19和(或)CD20 CAR-T细胞,观察评价临床疗效及不良反应。结果:①14例患者中,1例因病情进展联合接受放化疗不能评价,其余13例可评价的患者采用CD19单靶点CAR-T细胞治疗,3例获得完全缓解,2例获得部分缓解,客观反应率为38.5%,完全缓解率为23.1%。1例接受单靶点CAR-T细胞治疗无效的患者,再次输注CD19联合CD20双靶点CAR-T细胞,获得完全缓解且维持疗效超过2年。②13例可评价的患者中,11例输注CAR-T细胞后发生1～2级细胞因子风暴,给予糖皮质激素或对症处理未造成不良后果。结论:CAR-T疗法为复发难治性终末期B细胞淋巴瘤提供了一种新的安全、有效的治疗方案;治疗过程中可能出现细胞因子风暴等可控的不良反应;对于单靶点CAR-T细胞治疗无效的患者可尝试采用双靶点CAR-T细胞治疗,有望获得完全缓解。