ATP生物发光法预测白血病药敏的临床应用

本研究了31例白血病病人体外ATP生物发光法药敏试验和临床疗效的关系。24例体外敏感，20例体内敏感．敏感度83．3%，7例体外不敏感．6例体内亦无效，特异度85．7%。总符合率83.9%。体内外试验的配对资料一致性，检验表明，两有非常显的一致性(P<0．01)。阳性符合组与阴性符合组在体外试验药物敏感性上有显的差异。以上结果表明．ATP生物发光法药敏试验在预测白血病药敏方面具有简便、快速、敏感的优点，与临床有很好的符合性。     

急性白血病的小剂量阿糖胞苷治疗

阿糖胞苷是治疗急性非淋巴细胞白血病的有效药物。自1982年M Housset 等应用小剂量阿糖胞苷(LDAra-C)治疗急性粒细胞白血病(AML)获得成功后,国内外已有许多学者从基础实验到临床治疗对这一疗法进行了大量研究,并重新认识了LDAra-C治疗AML 的机理,普遍认为LDAra-C 可使AML获得缓解。一、小剂量阿糖胞苷的作用机理     

硫酸镁湿敷治疗血液透析穿刺处血液外渗的疗效观察与体会

目的:探讨用硫酸镁湿敷治疗血液透析穿刺处血液外渗疗效.方法:用无菌纱布侵入33%的硫酸镁中,纱布大于水肿范围,持续湿敷穿刺渗血处.结果:局部外诊血液吸收,肿胀消退.结论:利用33%硫酸镁湿敷血液透析穿刺处疗效及恢复时间明显优与冷热水湿敷.     

血液系统恶性肿瘤化疗前后甲状腺激素水平的改变

血液系统恶性肿瘤化疗前后甲状腺激素水平的改变杨晓凤王学勤贺丹李心欣杨光照恶性肿瘤患者的甲状腺激素水平可发生异常变化，而临床无甲状腺功能异常的表现。１９９５年１月～１９９６年３月我们观察了３３例血液系统恶性肿瘤患者化疗前后甲状腺激素含量的变化，现报告如...     

恶性肿瘤合并骨髓坏死5例

1986～1991年我院共发现恶性肿瘤合并骨髓坏死5例,现报告如下:本组5例均为住院患者,男3例,女2例,年龄27～59岁。胃癌、子宫癌伴骨髓转移癌各1例,急性粒细胞白血病(AML)、急性淋巴细胞白血病(ALL)及慢性粒细胞白血病(CML)各1例。5例均以剧烈骨痛为首发症状,以腰椎、髋骨及长管骨为甚,伴发热、     

干细胞移植改善股骨头坏死缺血状态的实验及临床效应：20只模型兔及188例患者资料分析

BACKGROUND: Ischemic femoral head necrosis is caused by local vascular injury and blood-supply insufficiency. There exists no optimal treatment for the ischemic femoral head necrosis. Thus, the improvement of the blood supply to the femoral head seems to be a key point for the treatment. OBJECTIVE: To verify the curative effects of autologous bone marrow mesenchymal stem cell transplantation induced vascular regeneration on the improvement of ischemic femoral head necrosis via animal experiments and clinical observations. DESIGN: Contrast animal experiment and self-controlled clinical observation. SETTING: Cell Therapy Center, the 463 Hospital of Chinese PLA. MATERIALS AND PARTICIPANTS: ① Animals: Twenty Japanese white rabbits in either gender and weighing 3.0-4.0 kg were purchased from Animal Experimental Center, General Hospital of Shenyang Military Area Command of Chinese PLA. The animal experiments were coincident with the ethical standards. ② Participants: 188 patients with ischemic femoral head necrosis (335 hips) having whole following-up data were selected from Cell Therapy Center, the 463 Hospital of Chinese PLA from July 2004 to July 2007. There were 113 males and 75 females, and their ages ranged from 18 to 72 years. Diagnosis was done by using X-ray photographs, nuclide scanning, MRI and CT examinations. All patients provided the informed consent, and the study was approved by the local research ethics committee. METHODS: ① Animal experiments: The experiment was carried out at the Animal Experiment Center, General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2004. Ischemic femoral head necrosis models were established at both hindlimbs by using liquid-nitrogen refrigeration. The right side was regarded as transplantation group and the left one as control group. Mononuclear cells extracted from bone marrow were poured in the right femoral artery, while saline was poured in the left femoral artery. ②Clinical observations: Mononuclear cells were separated from autologous bone marrow of patients with ischemic femoral head necrosis after density gradient centrifugation. MAIN OUTCOME MEASURES: ①Four weeks later, angiogenesis at both femoral arteries was observed by arteriography by using digital subtraction anglography (DSA). Moreover, bilateral femoral head samples underwent pathological sections to observe bone regeneration and repair of femoral head 4 and 12 weeks later. ②Items including hip pain, walking distance and gait, abduction and internal rotation function changes of hip joint were observed in 3, 6, 12 and 24 months after stem cell transplantation in media femoral circum flex artery, lateral femoral circum flex artery and obturator artery. In 6 months after stem cell transplantation, angiogenesis and blood supply of femoral head were observed by using arteriography. In 6, 12 and 24 months after stem cell transplantation, morphological and ischemic changes of femoral head were observed by using CT, X-ray and MRI examinations. Harris scores were used to evaluate function of hip joint before and in 3, 6, 12 and 24 months after stem cell transplantation. RESULTS: Animal experiment: Twenty rabbits were involved in the final analysis. ① DSA-arteriography results: In 4 weeks after transplantation, blood-supply arteries in femoral head of right hindlimb in the transplantation group were more than those in the control group. ② Pathological results: In 12 weeks after transplantation, cartilage, lamellar bone and bone trabecula in the left femoral head were repaired remarkably, but left femoral head necrosis was not improved. Clinical observations: 188 patients were involved in the final analysis. ① Improvement of symptoms: Among 188 patients, 164 (87.3%) had remission of hip pain, 147 (78.4%) had function improvement, and 150 (80.0%) had elongation of walking distance. ② Imaging changes: At 6 months after transplantation, DSA-arteriography in 12 patients demonstrated that blood-supply arteries in femoral head were increased and thickened remarkably as compared with those before transplantation, and the blood flow was rapid. At 12-24 months after transplantation, lesion of bone matrix in 24 patients was improved under the X-ray, CT and MRI examinations. ③ Harris scores of hip joint: The scores at 6, 12 and 24 months after transplantation were significantly higher than those before transplantation (t= -3.423, -6.714, -9.039, P < 0.01). CONCLUSION: Autologous bone marrow mesenchymal stem cell transplantation can effectively improve and treat ischemic femoral head necrosis.     

自体骨髓单个核细胞经介入途径移植治疗股骨头坏死54例：12个月疗效随访

目的:观察经介入途径移植自体骨髓单个核细胞在股骨头坏死治疗中的应用,并评价其疗效。方法:选择2004-07/2005-11在解放军四六三院细胞治疗中心住院的,具有完整随访资料的股骨头坏死确诊患者共54例91髋。纳入确诊股骨头坏死,有关节疼痛、功能障碍等症状患者,性别、年龄不限;排除有严重心力衰竭、严重肾功能异常等不能耐受手术者。符合纳入标准54例,男45例,女9例,12～68岁。按ARCO分期Ⅱ期42髋,Ⅲ期47髋,Ⅳ期2髋。实验对象对治疗的相关内容知情同意并签知情同意。干预措施:抽取患者髂后上嵴骨髓进行单个核细胞悬液的制备。在DSA监视下将采集的单个核细胞混悬液经股动脉行Seldinger法穿刺,穿刺成功后,置入4F动脉鞘,经动脉鞘置入Cobra导管,将导管超选择至闭孔动脉及旋股内外侧动脉,平均注入单个核细胞悬液。术后定期随访症状变化情况,1年后复查X射线或CT,随访疼痛、关节活动度等情况。实验评估:①疼痛指数:无疼痛症状为3分,Harris髋关节评分疼痛分级A级;时有隐痛2分,Harris髋关节评分疼痛B级;轻度疼痛为1分,Harris髋关节评分疼痛C级;中度疼痛为0分,Harris髋关节评分疼痛D级。②功能指数:髋关节屈、伸、展、收、旋转度评分达Harris髋关节活动范围评分4～5分为3分;3～4分为2分;2～3分为1分;小于2分为0分。③X射线平片指数:股骨头形态无变化,应力骨小梁清晰,坏死区明显缩小为3分;坏死区略缩小为2分;治疗前后无明显变化为1分;坏死区扩大为0分。④血管指数:治疗后旋股内、外侧动脉及其分支增粗、增多,延长1cm以上者3分;1～0.5cm者2分;小于0.5cm者1分,无变化者0分。结果:54例患者均完成疼痛症状、关节功能及影像学随访1年。①术后12个月复查疼痛消失9髋,缓解61髋,无缓解21髋,缓解率为76.9%。②关节功能缓解33髋,无缓解58髋,缓解率为36.3%。③1年后X射线平片或CT、MRI示股骨头区可见不同程度的股骨头坏死区骨质密度改变,坏死区有吸收、缩小,股骨头形态变圆滑规整,改善28髋,无缓解或加重63髋,缓解率为30.1%。④12例24髋完成术后12个月复查股骨头供血动脉数字减影血管造影,好转18髋,好转率为72.2%。结论:经介入途径移植自体骨髓单个核细胞治疗股骨头坏死损伤小,可缓解临床相关症状。     

小剂量联合化疗治疗骨髓增生异常综合征12例

小剂量联合化疗治疗骨髓增生异常综合征１２例杨晓凤，贺丹，宁辉，杨光照１９９１年我们用全反式维甲酸（ＡＴＲＡ）、小剂量阿糖胞音（Ａｒａ－Ｃ）、小剂量三尖杉酯碱（Ｈ）和康力龙联合治疗骨髓增生异常综合征（ＭＤＳ）１２例，现将结果报告如下。材料和方法１一般资...