平阳霉素及糖皮质激素与激光联合治疗儿童颌面部血管瘤

目的探讨和评价平阳霉素及糖皮质激素与激光联合应用治疗儿童颌面部血管瘤的疗效。方法自2002年3月至2005年2月,采用平阳霉素及糖皮质激素与激光联合治疗儿童颌面部血管瘤78例,瘤体面积0.4cm×0.8cm~5.0cm×8.0cm。7~10d注射一次平阳霉素配制液,剂量为0.5mg/kg,3~5次为一个疗程,一个疗程的总量不超过40mg;小于6岁的患儿配合口服强地松;最后联合可调脉宽倍频ND:YAG激光治疗。结果治疗后经6个月至3年的随访,治愈和基本治愈率88.46%,有效率100%。结论平阳霉素及糖皮质激素与激光联合应用治疗儿童颌面部血管瘤是一种安全、有效、易行的治疗方法。     

平阳霉素及糖皮质激素与激光联合治疗儿童颌面部血管瘤

目的探讨和评价平阳霉素及糖皮质激素与激光联合应用治疗儿童颌面部血管瘤的疗效.方法自2002年3月至2005年2月,采用平阳霉素及糖皮质激素与激光联合治疗儿童颌面部血管瘤78例,瘤体面积0.4 cm×0.8 cm～5.0 cm×8.0 cm.7～10 d注射一次平阳霉素配制液,剂量为0.5 mg/kg,3～5次为一个疗程,一个疗程的总量不超过40 mg;小于6岁的患儿配合口服强地松;最后联合可调脉宽倍频NDYAG激光治疗.结果治疗后经6个月至3年的随访,治愈和基本治愈率88.46%,有效率100%.结论平阳霉素及糖皮质激素与激光联合应用治疗儿童颌面部血管瘤是一种安全、有效、易行的治疗方法.     

平阳霉素治疗婴幼儿颌面部血管瘤的疗效观察

目的:探讨和评价平阳霉素治疗婴幼儿颌面部血管瘤的疗效.方法:采用平阳霉素注射治疗婴幼儿颌面部血管瘤17例.取平阳霉素1mg/cm2,2％利多卡因0.5ml,生理盐水适量配成混合液于瘤体内多点注射,隔用1次,3次为一个疗程.1个疗程不能愈合者,间隔40天后行第2个疗程.记录病变转归进程及不良反应,并追踪随访,评价临床疗效.结果:12例治愈,5例基本治愈,10个月后复诊:局部皮肤略成红色片状.随访2年,无复发病例.结论:平阳霉素治疗耍幼儿颌面部血管瘤疗效确切,不形成明显癜痕,是可取的临床治疗方式,对早期治疗具有积极的意义.     

普萘洛尔联合平阳霉素治疗婴幼儿血管瘤

目的探讨普萘洛尔联合平阳霉素治疗婴幼儿血管瘤的疗效。方法对63例婴幼儿血管瘤患儿采用平阳霉素注射治疗(注射剂量为0.3~0.5 mg/cm2),同时口服普萘洛尔(治疗剂量为1.0~2.0 mg/Kg·d)联合治疗,定期随访,评定疗效。结果随着联合用药时间的延长,血管瘤进一步缩小,颜色变浅,瘤体及表面血丝逐步消退,有效率达93.7%。结论平阳霉素和普萘洛尔联合应用治疗血管瘤可产生协同作用,提高疗效。     

平阳霉素和地塞米松联合注射治疗颌面部血管瘤

目的探索和评价平阳霉素和地塞米松联合注射治疗颌面部血管瘤的疗效。方法1996年9月至2004年3月,采用平阳霉素和地塞米松联合瘤内注射治疗颌面部血管瘤83例,患者年龄3个月至50岁,瘤体大小1cm×1cm～6cm×9cm,5～10d注射1次,4～6次为1个疗程。结果治疗完成后,随访8～36个月,治愈和基本治愈率为95.18%,有效率为100%。结论平阳霉素和地塞米松联合注射治疗颌面部血管瘤,是一种安全、可靠、简便、易行的有效治疗手段。     

平阳霉素治疗颌面部血管瘤疗效观察

应用平阳霉素局部注射治疗颌面部血管瘤86例。有效率96．5％，治愈和显效率87．2％。通过7月~58个月随访观察，未见复发，保持了患区的功能与外形。文中讨论了平阳霉素的作用机理，提出了预防副反应的方法、认为该方法安全、有效简便易行，是治疗颌面部血管瘤较理想的方法之一。     

平阳霉素地塞米松联合应用治疗颌面部血管瘤

颌面部血管瘤是儿童的常见病，其发病率占全身血管瘤的６０％犤１犦，因其发生于面部、眼睑、外鼻及唇颊部等重要器官，影响美观及功能，病人及家属求治心切，而手术、冷冻、硬化剂注射等治疗导致瘢痕形成，破坏容貌，国内于１９９０年左右应用平阳霉素局部注射治疗血管瘤均取得了较好的疗效犤２，４犦，但有报道注射后出现高热及恶心、呕吐、食欲减退等消化道反应。为克服上述副作用，我们自１９９８年５月至２００１年１２月采用平阳霉素＋地塞米松联合治疗颌面部血管瘤５４例，取得了满意的临床效果，现报告如下：１资料和方法１．１临床…     

小剂量32P加平阳霉素治疗婴幼儿颌面部血管瘤的疗效

目的 探讨和评价小剂量32P和平阳霉素联合治疗婴幼儿颌面部血管瘤的疗效.方法 将399例患者随机分为3组.（1）32P胶体治疗组：100例,男37例,女63例.取32P 0.37～0.74 MBq/cm3,2%利多卡因0.5 ml,生理盐水适量,配成混合液行瘤体内多点注射,2周1次,2次为1个疗程.（2）平阳霉素治疗组：99例,男30例,女69例.取平阳霉素1 mg/cm3,2%利多卡因0.5 ml,生理盐水适量,配成混合液于瘤体内多点注射,方法同上.（3）32P胶体加平阳霉素治疗组：200例,男64例,女136例.取32P 0.25 MBq/cm3,平阳霉素0.5 mg/cm3,2%利多卡因0.5 ml,生理盐水适量,配成混合液于瘤体内多点注射,方法同上.结果 32P胶体加平阳霉素治疗组治愈率88.5%;32P胶体治疗组治愈率77.0%;平阳霉素治疗组治愈率71.7%.3种方法的有效率差异有统计学意义（P＜0.05）.结论 32P胶体、平阳霉素、32P加阳霉素治疗血管瘤均有疗效,但32P胶体加平阳霉素联合治疗血管瘤作用强,剂量小于单独使用,且方法简便易行,安全可靠,并发症少.     

平阳霉素联合地塞米松局部注射治疗儿童眼睑海绵状血管瘤

目的:观察分析平阳霉素联合地塞米松局部注射治疗儿童眼睑海绵状血管瘤的临床效果。方法:采用平阳霉素8 mg联合地塞米松5mg,用2%利多卡因1ml,生理盐水2ml稀释成4ml,血管瘤瘤体内注射治疗58例儿童眼睑海绵状血管瘤,按每次药量及方法 1周或隔周注射1次,分别为多次注射治疗,每次剂量最多不超过8mg,直致瘤体消失。结果:随访观察6～24个月,55例患儿血管瘤全部消失达到治愈,3例有效,未发生局部感染、组织坏死及瘢痕畸形。结论:应用平阳霉素联合地塞米松局部注射治疗儿童眼睑海绵状血管瘤,具有治愈率高、操作方便、副作用小,有效的恢复了眼睑的正常外形与功能。     

局部冷冻联合平阳霉素注射治疗颌面部静脉畸形

目的探讨利用冷冻联合平阳霉素注射治疗颌面部静脉畸形的方法。方法对120例静脉畸形患者采用先瘤腔内注射平阳霉素然后即刻施行液氮开放喷射法进行冷冻治疗。结果治愈率77．5％，基本治愈率17．5％，好转5％。结论我们认为冷冻联合平阳霉素注射治疗对于颌面部静脉畸形有较好的疗效。     

Combination chemotherapy including bleomycin in the treatment of advanced Hodgkin's disease.

Fifty-six patients with advanced Hodgkin's disease were treated with a combination of nitrogen mustard, a vinca alkaloid (vincristine or vinblastine), procarbazine, prednisone and bleomycin, given in repeated cycles. Complete remission was achieved in 33 out of 53 evaluable patients (62,5%). The complete remission rate in patients who had received prior radiation therapy alone (65%) was similar to that in previously untreated patients (73%). Patients who had previously received combination chemotherapy, either alone or together with radiation therapy, responded less well to this regimen of therapy, with a complete remission rate of less than 40%. The complete remission rate was not influenced by the histological subtype of the Hodgkin's disease. Twenty-three of the 33 responders (70%) remain in continuous complete remission. The median for this group has not been reached but will be in excess of 24 months. Major bleomycin toxicity was not encountered in this study. Lung function was monitored throughout but no consistent changes were encountered. The degree of haematological toxicity caused by treatment was no greater than would have been expected without bloemycin. Although the results obtained with the 5-drug combination were satisfactory, the follow-up to date does not suggest that the addition of bleomycin to the convention 4-drug regimen has significantly affected the outcome.     

中西医结合治疗狼疮性肾炎疗效观察

目的：评估中西医结合治疗狼疮性肾炎(LN)的疗效和副作用，旨在进一步手求对狼疮性肾炎副作用小、完全缓解率高、复发率低的治疗方案。方法：46例LN患随机分为两组，单纯激素组(20例)：单纯选用强的松标准疗程；联合治疗组(26例)：环磷酰胺(CTX)冲击 激素标准疗程 中药治疗。根据中医对LN的分型进行辨证施治。中药治疗对CTX冲击与大量激素法疗研产生的不良反应针对性用药。同时对肾袁竭、血液高凝状态给予血透、抗凝对症治疗。结果：单纯激素组完全缓解率为55．55％，总有效率为80％。联合治疗组完全缓解率为73．07％，总有效率为92％。5年复发率比较，单纯激素组为25％，联合治疗组为15.3％。结论：从完全缓解率、总有效率、复发率及不良反应几方面分析研究表明，联合方案治疗LN明显优于单用激素。加用中药可保证CTX冲击与激素等主要用药的顺利实施，减少不良反应，提高缓解率，降低复发率。     

骁悉对肾移植术后感染的影响

目的观察骁悉(MMF)对肾移植术后感染的影响。方法将90例肾移植术后患者分为两组．1997年以前手术的56例为硫唑嘌呤(Aza)组,免疫抑制剂为环孢素A(CsA)加Aza加泼尼松;1998～1999年1月手术的34例为MMF组,免疫抑制剂为CsA加MMF加泼尼松。Aza组CsA起始用量为6mg/(kg·d-1),MMF组为5mg/(kg·d-1),以后根据血药浓度进行调整。结果90例肾移植患者术后总的感染率为17.8％,其中Aza组为21.4％(12/56),2例死亡;MMF组为11.8％(4/34),无死亡病例。两者之间感染率差异有显著性意义(P＜0.05)。结论用MMF代替Aza可以减少肾移植术后的感染率,并提高移植肾成活率。     

Primary focal segmental glomerulosclerosis in children: prognostic factors

To study the clinical course and the predictors of outcome in children and adolescents, 39 patients with nephrotic syndrome and primary focal segmental glomerulosclerosis (FSGS) were followed for a mean of 84.6 months. Thirty-six patients were treated with prednisone, either alone or in conjunction with cyclophosphamide. The clinical course was one of sustained remission in 4 patients, frequent relapse in 13, persistent non-nephrotic proteinuria in 5, and persistent nephrotic syndrome in 17; 2 patients had stable renal failure and 8 had progressive renal failure, 5 of them evolving to end-stage renal failure (ESRF). Resistance to prednisone was recorded in 76.6% of patients. The use of cyclophosphamide plus prednisone was of benefit in 42.8% of patients; 22.2% of the prednisone-resistant patients achiev-ed remission of the nephrotic syndrome. A Kaplan-Meier analysis revealed a survival rate of 92% after 5 years, 86% after 10 years, and 76% after 15 years. Using both univariate and multivariate analysis, persistent nephrotic syndrome was associated with progression to ESRF and the remission of proteinuria with maintenance of renal function. As the outcome of the nephrotic syndrome in FSGS is significantly improved by remission of proteinuria, it is conceivable that immunosuppressive medication may be used in conjunction with prednisone in patients with steroid resistance. Received: 5 June 2000 / Revised: 16 April 2001 / Accepted: 19 April 2001     

A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

Objective

To examine the effects of bleomycin A5 on infantile maxillofacial haemangiomas.

Methods

Bleomycin A5 was given by multiple intralesinoal injections and the dosage was given according to the age of the patient and size of the lesion. Parts of patients were accompanied by prednisone treatment(2-5 mg/kg, po, QOD.

Results

All the haemangiomas involuted completely after treated with bloemycin A5 with better recovery of skin color and less scar forming in small haemangiomas.

Conclusion

Infantile haemangioma could be effectively treated with bleomycin A5 without serious side effects.     

p38MAPK信号转导通路在七氟烷后处理减轻乳鼠心肌细胞缺氧复氧损伤中的作用

目的 评价p38丝裂原活化蛋白激酶(p38MAPK)信号转导通路在七氟烷后处理减轻乳鼠心肌细胞缺氧复氧损伤中的作用.方法 健康新生SD大鼠,日龄1～3 d,处死后取心室肌组织,培养心肌细胞,随机分为7组:对照组(C组)于CO2培养箱中持续培养3 h;缺氧复氧组(AR组)细胞缺氧2 h,复氧1 h;七氟烷后处理组(SP组)细胞缺氧2 h,复氧开始即刻更换为3%七氟烷饱和的DMEM培养液,孵育20 min,再更换为无血清DMEM培养液,继续复氧40 min;七氟烷后处理+SB203580组(SP+SB组)于七氟烷后处理同时加入SB203580(p38MAPK特异性抑制剂)至5 μmol/L,孵育20 min;七氟烷后处理+二甲亚砜组(SP+DMSO组)于七氟烷后处理同时加入0.1%DMSO,孵育20 min;SB203580组(SB组)于复氧开始时加入SB203580至5 μmol/L,孵育20 min;二甲亚砜组(DMSO组)于复氧开始即刻加入0.1%DMSO,孵育20 min.各组细胞分别接种于24孔培养板(1 ml/孔)、35 mm培养皿(5 mlnd/皿)和50 ml培养瓶(8 ml/瓶)中,每组12孔、6皿和6瓶.于复氧结束后,采用比色法测定细胞培养液乳酸脱氢酶(LDH)活性;采用台盼蓝排斥实验测定细胞存活率;采用流式细胞仪测定细胞凋亡率;采用Western blot法测定磷酸化p38MAPK(p-p38MAPK)表达水平.结果 与C组比较,其余各组LDH活性升高,细胞存活率降低,细胞凋亡率升高,AR组、SP组、SP+SB组、SP+DMSO组和DMSO组p-p38MAPK表达上调(P<0.05);与AR组比较,SP组、SP+SB组和SP+DMSO组LDH活性降低,细胞存活率升高,细胞凋亡率降低,p-p38MAPK表达上调(P<0.05);与SP组比较,SP+SB组、SB组和DMSO组LDH活性升高,细胞存活率降低,细胞凋亡率升高,p-p38MAPK表达下调(P<0.05).结论 七氟烷后处理可通过激活p38MAPK信号转导通路减轻乳鼠心肌细胞缺氧复氧损伤.     

The influence on pretransplant blood transfusions from random donors on immune parameters affecting cadaveric allograft survival

The number of pretransplant blood transfusions (BT) from random donors influences the recipient's immune response status and suppressor cell number and function, as well as allograft survival. The 54% one-year survival rate for 104 cadaveric renal allograft recipients treated with azathioprine and prednisone was divisible into two groups: 74.5% in 51 patients receiving greater than 5 BT and 34% for 53 patients with less than 5 BT (P less than 0.02). Transfusions enhanced the benefit of HLA A, B, and DR compatibility on graft survival: 33 recipients of well-matched grafts (less than 2 A, B, and 0-1 DR mismatches) had a one-year survival rate of 94% when pretreated with greater than 5 BT, compared with 38% when receiving less than 5 BT (P less than 0.05). The graft survival of 73% (36/49) displayed by patients determined preoperatively to be weak immune responders was significantly better than the 36% survival (20/55) demonstrated by strong immune responders (P less than 0.01). The transfusion history correlated with immune responder status: 76% (39/51) of patients receiving greater than 5 BT were weak immune responders, whereas 81% (43/53) of patients receiving less than 5 BT were strong immune responders (P less than 0.001). Ninety-two percent (12/13) of patients with greater than 5 BT, but only 58% (10/17) of patients with less than 5 BT, had a normal number of OKT8+ T suppressor cells. Only 1 X 10(5) mononuclear cells from patients with greater than 5 BT rather than 4 X 10(5) cells from patients with less than 5 BT caused 50% suppression of a third-party MLC. Thus, patients receiving greater than 5 BT are more likely to display weak immune responses, normal numbers of OKT8 cells, strong suppressor function in vitro, and prolonged allograft survival.     

电化学疗法联合平阳霉素注射治疗大面积静脉畸形

目的：分析电化学疗法联合平阳霉素治疗大面积静脉畸形的临床疗效。方法：回顾性分析自1998年1月～2009年6月治疗大面积静脉畸形的方法变迁及临床疗效。期间单纯采用平阳霉素瘤体内注射治疗91例,单纯采用电化学疗法治疗78例,电化学联合平阳霉素瘤体内注射治疗41例,随访时间为6～12月。结果：所有治疗病例全部有效,但电化学联合平阳霉素治疗组治愈率明显高于单用电化学治疗或单用平阳霉素治疗组（均P〈0.01）,而且治愈的时间较单用电化学治疗或单用平阳霉素治疗明显缩短（均P〈0.01）,并发症的发生率也显著低于其他两组（均P〈0.05）。结论：电化学疗法联合平阳霉素注射治疗大面积静脉畸形具有治愈率高、疗程短及并发症低等优点,是一种行之有效的方法。     

Increased clearance rate of prednisone in the isolated perfused liver of uremic rats

The effect of uremia upon the hepatic clearance rate of prednisone was studied in isolated perfused livers of normal and uremic female rats. The perfusion rate was kept at a constant flow rate of 25 ml/min. In order to induce uremia, one group of rats was 5/6 nephrectomized 3 weeks prior to the perfusions. The concentrations of prednisone and other steroids were measured by a normal phase HPLC technique. In experiments with an initial prednisone concentration of 500-700 micrograms/l, the hepatic clearance rate of prednisone was significantly (p less than 0.001) increased by 40% in livers obtained from uremic rats (11.1 +/- 0.49 ml/min/liver) as compared to control rats (8.0 +/- 1.17 ml/min/liver). No significant correlation was found between the hepatic clearance rate of prednisone and increasing initial prednisone concentrations from 141 to 1,953 micrograms/l in the perfusate. It is concluded that an adaptive mechanism may exist in uremia which results in an increase of the hepatic clearance rate of prednisone.     

平阳霉素加曲安奈德瘤体内注射治疗婴幼儿体表血管瘤

目的：探讨平阳霉素加曲安奈德瘤体局部注射治疗婴幼儿体表血管瘤的疗效。方法：以平阳霉素加曲安奈德瘤体内注射治疗婴幼儿体表血管瘤,皮损最大6cm×6cm,最小1cm×1cm,15天注射1次,3～5次为1个疗程。对2004年3月～2009年3月治疗的150例患儿进行了1～6年的随访观察,将临床资料进行分析。结果：经过1～6年随访,治愈121例,显效29例,无效0例,治愈率80.66%,有效率100%。结论：平阳霉素加曲安奈德局部注射治疗婴幼儿体表血管瘤具有疗效高、疗程短,副作用少等优点,是一种简便、安全有效的方法。