骨髓腔与静脉内联合化疗治疗急性白血病21例疗效观察

应用骨髓腔与静脉内联合化疗治疗急性白血病21例,其中男性14例,女性7例。年龄为14～56岁(平均27.2),含急性粒细胞性白血病(急粒)6例,慢性粒细胞白血病急粒变(慢粒急粒变)1例,红白血病1例,急性早幼粒细胞白血病2例,急性单核细胞性白血病(急单)1例。急性淋巴细胞性白血病(急淋)10例。 方法 诱导缓解以HOADP和COADP方案为基础方案,配合支持疗法,缓解后巩固1～2个疗程,鞘内注射2～3次预防胸膜白血病。 1.急非淋:静脉及骨髓腔内均用HOA-DP方案。见附表。     

白血病并发糖尿病病人的护理

1995 - 0 1～ 1999- 0 6本科观察并护理了 6例白血病并发糖尿病患者。现将护理体会报告如下。1　临床资料本组均为男性 ,年龄 42～ 6 8岁。其中慢性淋巴细胞性白血病 2例 ,急性髓细胞性白血病 4例 (Ｍ2 3例、Ｍ31例 )。白血病化疗前并发糖尿病者 2例 ,均为非胰岛素依赖型糠尿病。白血病诱导化疗过程中出现 4例 ,其中胰岛素依赖性与非胰岛素依赖型各 2例。白血病按ＦＡＢ分型诊断。糖尿病根据ＷＨＯ标准诊断。本组死亡 4例 ,其中 3例全身侵润伴严重感染死亡 ,1例慢淋急变伴心梗死亡 ,1例部分缓解 ,1例完全缓解。2　护理2 .1　严密观察病情 :…     

急性白血病骨髓MRI定性和定量诊断价值

目的　通过观察急性白血病治疗前后骨髓的MRI表现和T1及对比噪声比 (CNR)的测定 ,对照临床、病理资料 ,探讨急性白血病骨髓MRI定性和定量诊断价值。材料与方法　选择经临床确诊为急性白血病的患者 38例 ,缓解组 2 5例 ,对照组 35例进行MRI检查及T1值和CNR的测定。结果　急性白血病T1WI:治疗前组 38例 ,腰骶椎、髂骨及股骨近段均表现为信号降低 ;化疗缓解组 2 5例表现为不同程度的信号增高。T2 WI :38例治疗前组和 2 5例化疗后组各椎体、髂骨、股骨上段呈等信号。外周血B %、骨髓B %、腰椎T1值、腰椎 /皮下脂肪CNR、股骨骨髓 /皮下脂肪CNR于急性白血病治疗前组与正常对照组、治疗前组与缓解组间的差异均有显著性 (P <0 .0 5 ) ,缓解组与正常对照组间的差异无显著性 (P >0 .0 5 ) ,不同细胞类型间的差异无显著性 (P >0 .0 5 )。腰椎T1值于不同性别、年龄组间的差异无显著性 (P >0 .0 5 )。治疗前组骨髓B %与腰椎T1值、腰椎 /皮下脂肪CNR ,外周血B %与腰椎T1值、腰椎 /皮下脂肪CNR及腰椎T1值与腰椎 /皮下脂肪CNR之间成直线相关 (P <0 .0 5 )。结论　急性白血病的MRI检查为一种无创性检查方法 ,MRI表现具有一定的特征性 ,在估计病情的严重程度及治疗效果的评价简便实用 ,为避免多次重复骨髓穿刺检查以及全面     

回盲肠综合征误诊为阑尾炎5例

1　临床资料　　 5例均为正在治疗中的未缓解的白血病患者。男性 4例 ,女性 1例 ;年龄 1841岁 ,平均年龄 31岁。急性淋巴细胞性白血病 2例 ,急性非淋巴细胞性白血病 3例 ,5例均在化疗中。主要症状 :发热及转移性右下腹痛 3例 ,黑色稀便 4例 ,恶心、呕吐 1例 ,消瘦、乏力 2例。主要体征 :右下腹压痛及反跳痛 5例 ,体温 38 840 0℃ ,肠鸣音弱 3例 ,腰大肌试验阳性 2例。实验室检查 :Ｈｂ (35 70 ) ｇ/Ｌ ,ＷＢＣ(0 30 7)× 10 9/Ｌ ,Ｐｌｔ (16 86 )× 10 9/Ｌ。病变部位 :仅在回盲部 2例 ,回盲部并累及升结肠 3例。临床诊断 :5例均诊断为…     

一个判断急性白血病诱导化疗效果的简便指标

本文分析了诱导化疗过程中有血小板升高反应的33例急性白血病病人的临床资料。结果发现:外周血血小板升高几乎总在白细胞和血红蛋白之前,且大部分病例可较早地先于骨髓缓解。诱导化疗中有血小板升高反应者完全缓解率78.8%,骨髓缓解率96.9%。此结果说明,血小板升高可用于预测急性白血病诱导化疗能否缓解,指导化疗方案的选择,是判断急性白血病疗效的简便指标。     

22例老年急性白血病的临床特点

目的探讨22例老年急性白血病的临床特点。方法对22例老年急性白血病临床资料进行回顾性分析。结果 （1）老年急性白血病多数起病隐匿;（2）早期多以乏力、纳差等症状为主,易被忽视;（3）合并症多,尤其是心血管系统和呼吸系统疾病;（4）对化疗的耐受性差;（5）骨髓受抑后其恢复期较长;（6）缓解率低,病死率高,多数生存期短。结论 （1）老年急性白血病的初期症状往往不典型,故对可疑病人应及时做血象及骨髓象检查,以免漏诊;（2）老年急性白血病的化疗剂量应个体化,对合并心血管疾病的化疗剂量宜偏小,尤其用蒽环类化疗药物时其剂量为年轻人的1/2～2/3为宜;（3）应加强支持疗法,可配合中医中药,并应注意对合并症的处理。     

HAG方案治疗老年急性髓系白血病疗效分析

目的：探讨老年急性髓系白血病的治疗方案。方法：应用HAG方案,治疗老年急性髓系白血病12例。结果：12例患者中,完全缓解率4例,部分缓解2例,总有效率50%,化疗期间无死亡,6例未缓解中,二次HAG方案化疗,达到完全缓解率有2例,总有效率达到67%。结论：HAG方案治疗老年急性髓系白血病效果佳,化疗耐受性好,相关化疗死亡率低,长期生存率高。     

骨髓移植前的分次照射技术及临床应用

全身照射 (ＴＢＩ)是骨髓移植 (ＢＭＴ)治疗白血病预处理中极为重要的手段之一。但通常所用的单次大剂量ＴＢＩ(10Ｇｙ以上 )可产生重度造血型放射病或轻度肠型放射病[1 ] 。为提高病人的耐受性 ,降低照射引起的反应 ,我们采用分次全身照射方案 (ＦＴＢＩ)进行 4例ＢＭＴ获得成功。一、材料和方法1 临床资料 :1993年 5月～ 1994年 6月共收治 4例白血病病人 ,其中急性淋巴细胞白血病 (ＡＬ) 3例 ,非淋巴细胞白血病 1例 ,男 3例 ,女 1例 ,年龄 2 3～ 39岁 ,平均 2 6岁。移植时 4例均为第 1次完全缓解。骨髓移植、化疗、全身照射的时间安排 :病…     

急性白血病化疗后骨髓受抑的护理

急性白血病化疗后骨髓受抑是急性白血病的急症。通过对 5 6例急性白血病患者的护理观察 ,发现对此期患者采取早期观察 ,早期处理的护理手段 ,可以帮助患者平稳安全地渡过骨髓受抑期 ,而达到完全缓解。1　临床资料和方法1.1　一般资料　自 1988年以来收治 5 6例。其中急性淋巴细胞白血病 9例 ,急性非淋巴细胞白血病 4 7例。男 31例 ,女 2 5例。年龄最小 11岁 ,最大 6 0岁 ,平均年龄 35 .5岁。1.2　方法　采用ＶＰ—ＶＤＣＰ—ＶＰ—ＶＤＣＬＰ方案。 (Ｖ :长春新碱 ;Ｄ :柔红霉素 ;Ｃ :环磷酰胺 ;Ｐ :强的松 ;Ｌ :左旋门冬酰胺酶 ) ,急非淋采…     

22例老年急性白血病的临床特点

我院1969年元月到1995年元月共收治老年急性白血病22例,对老年急性白血病的临床特点进行分析,现报告如下。1 临床资料1.1 一般资料 22例老年急性白血病患者均系住院病人。所有病人均经血象、骨髓象及组化染色证实诊断。其中男性17例,女性5例,男:女=3.4:1。60～70岁15例,71～80岁7例。按FAB分类:ALL6例,ANLL16例。ALL中L_1型2例,L_2型4例。ANLL中M_(2a)3例,M_(4a)3例,M_(4c)2例,M_(5a)3例,M_(5b)2例,慢性粒细胞白血病急性粒细胞变性3例。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.