翼状胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉疗效观察

选取初发性翼状胬肉患者317例(320眼),随机分为实验组与对照组,实验组209例(210眼),行翼状胬肉切除加自体角膜缘干细胞移植术;对照组108例(110眼),行单纯翼状胬肉切除加巩膜暴露治疗法.结果 显示,随访10～16个月,实验组所有病例移植片均成活,复发17眼(8.1%),对照组复发28眼(25.9%),两组有明显差异(P<0.01).认为翼状胬肉切除加自体角膜缘干细胞移植是一种治疗翼状胬肉有效的手术方法.     

手术切除联合自体角膜缘干细胞移植治疗翼状胬肉疗效观察

目的观察手术切除联合自体角膜缘干细胞移植术治疗翼状胬肉的效果翼。方法选取翼状胬肉患者21例,采用翼状胬肉切除联合自体角膜缘干细胞移植术治疗。结果术后视力提高2行以上者4例,余视力无变化。术后随访7～20个月,翼状胬肉无复发。结论翼状胬肉切除自体角膜缘干细胞移植是治疗翼状胬肉的一种有效方法。     

老年翼状胬肉切除自体角膜缘干细胞移植术后应用软性角膜接触镜的效果

目的探讨软性角膜接触镜治疗老年翼状胬肉切除自体角膜缘干细胞移植术后的临床疗效及安全性。方法按照随机数字表法将93例原发性老年单侧翼状胬肉患者分为观察组(n=47)和对照组(n=46),两组均行翼状胬肉切除联合自体角膜缘干细胞移植手术,观察组术后佩戴治疗性软性角膜接触镜,对照组术后通过绷带对患眼进行加压包扎。记录两组术后第1、3、5、7天的视觉模拟评分(VAS)、角膜上皮修复时间、术后并发症情况以及随访6个月时的复发率。结果术后第3、5、7天,两组VAS评分均低于术后第1天,且观察组低于对照组(P<0.05);观察组角膜上皮修复时间少于对照组,角膜刺激症状发生率低于对照组(均P<0.05);随访6个月时,两组翼状胬肉复发率比较无统计学差异(P>0.05)。结论软性角膜接触镜能有效减轻老年患者翼状胬肉切除自体角膜缘干细胞移植术后的疼痛,且有利于角膜上皮的恢复,安全性高,预后较好。     

逆向剥离联合自体角膜缘干细胞移植治疗翼状胬肉90例疗效观察

采用逆向剥离联合自体角膜缘干细胞移植治疗翼状胬肉90例(102眼,其中胬肉头部侵入角膜＜3mm者87眼,＞3mm者15眼).胬肉头部侵入角膜＜3mm的患眼中70眼角膜术区透明,75眼术前、术后视力无变化;＞3 mm的患眼术区角膜均有淡淡云翳,12例术后视力有不同程度提高.治愈98眼,复发4眼.认为该手术移植能安全切除翼状胬肉,降低复发率.     

翼状胬肉切除联合角膜缘干细胞移植术89例疗效观察

1999年至2002年，我们采用翼状胬肉切除联合自体角膜缘干细胞移植术治疗初发性及复发性翼状胬肉患者89例101只眼．经长期临床观察，无复发病例，效果理想。     

自体角膜缘干细胞移植治疗翼状胬肉的护理体会

2000年1月～2005年12月，我院采用自体角膜缘干细胞移植治疗翼状胬肉58例（72眼），取得满意效果。现将护理体会报告如下。     

翼状胬肉头部撕离、角膜缘干细胞移植术联合应用观察

翼状胬肉的治疗方法很多,术中多采用各种刀具分离胬肉头部,但术后复发率较高.2001年8月至2004年3月,笔者采用显微有齿镊撕离术联合角膜缘干细胞移植术治疗翼状胬肉53例.术后观察半年以上,效果较好.现报告如下.     

翼状胬肉逆行切除加自体角膜缘上皮干细胞移植术疗效观察

翼状胬肉是眼科常见病及多发病，目前治疗仍以手术切除为主，但单纯手术切除复发率高。随着角膜干细胞理论的提出，目前已有用自体角膜缘上皮移植术治疗胬肉的临床报道[1]。2000年3月至2002年11月，我们采用逆行切除加自体角膜缘上皮干细胞移植术治疗60例翼状胬肉(75只眼)，取得满意效果，现报告如下。     

自体角膜缘结膜移植治疗翼状胬肉

2000年9月至2004年3月，我们采用自体角膜缘结膜移植治疗翼状胬肉17例20眼，取得了良好的效果。现报告如下。     

自体角膜缘干细胞移植治疗翼状胬肉78例

翼状胬肉是一种常见的眼病,不仅影响美观,还可引起角膜散光,甚至长人角膜中央瞳孔区严重损害视力。传统的手术方法很多,但复发率较高。自2000年以来,我们开展显微翼状胬肉自体角膜缘干细胞移植术后复发率显著降低。现报告如下。     

骨髓基质干细胞自体移植治疗心肌梗死的研究进展

骨髓基质干细胞(MSC)具有良好的分化潜能,能分化为心肌细胞和血管内皮细胞,从而再生心肌和血管,重塑心肌结构,改善心肌收缩功能和室壁顺应性,促进血管再生,建立有效冠脉侧枝循环,提高心脏整体功能,既改善了血供又解决心肌细胞数量减少这一心力衰竭的根本原因;而自体移植不受来源限制,取材方便、创伤小,更新率低而代谢活力高,由其分化来的心肌细胞能与周围受体肌肉细胞进行有效的电机械偶合,容易通过转基因技术获得目标基因并在体内外长期表达,也不存在免疫排斥和基因突变等安全性问题,因此作为心肌梗死(MI)疾病治疗的新途径有着广阔的前景.现就近年来国内外MSC自体移植在治疗MI方面的研究进展作一综述.     

Use of CD34+ autologous stem cell transplantation in the treatment of children with refractory systemic lupus erythematosus

We report on the unique effects and benefits of autologous stem cell transplantation in childhood systemic lupus erythematosus (SLE) and describe this procedure in two young girls with severe and refractory disease. The patients stem cells were mobilized with granulocyte colony-stimulating factor (G-CSF) and collected by CS-3000 Blood Cell Separator (Baxter Healthcare, Round Lake, Ill., USA), and the CliniMACS CD34⁺ cell selection device (Miltenyi Biotech, Bergisch Gladbach, Germany) was used to obtain CD34⁺ cells. A total of 1.7×10⁶ and 1.0×10⁶/kg CD34⁺ cells were obtained, with 2.0×10⁵ and 1.0×10⁴/kg of CD3⁺ cells remaining, respectively. The conditioning regimen consisted of cyclophosphamide (50 mg/kg per day for 4 days) plus antithymocyte globulin (ATG-Fresenius, 5 mg/kg per day for 3 days). Neutrophil counts recovered within 9 days in both cases. Within 15 days, the platelet counts recovered and were sustained over 100×10⁹/l. Cushingoid features disappeared completely 3 months after transplantation because of the removal of corticosteroid medication. One 13-year-old child increased her height by 5 cm in 6 months after stopping steroids. She had not increased her height in her previous 7 years of disease. As of the time of this report, the first patient remains in clinical and laboratory remission for nearly 4 years, while the second suffered a relapse of thrombocytopenia 9 months post-transplantation. One residual effect of their treatment is that their CD4⁺ cell counts remained in the lower range after one year of transplant. The effect of this conditioning regimen plus CD34⁺ autologous stem cell transplantation on these two children with refractory SLE was beneficial, but long-term follow-up data and additional experience with this procedure are required. Autologous stem cell transplantation may limit the long-term toxicity of therapy in childhood SLE.     

Necrobiotic xanthogranuloma successfully treated with autologous stem cell transplantation

Paraproteinemia can be complicated by necrobiotic xanthogranuloma. Therapeutic options for this progressive disease are limited, and there is no agreement on a single best strategy. We report the case of a patient with a massive periorbital infiltration narrowing the palpebral fissure and blinding the patient. Conventional myeloma therapy had only limited benefit in our patient. However, he was successfully treated with high-dose chemotherapy followed by autologous stem cell transplantation, rendering the patient free of symptoms. This is the first report of autologous stem cell transplantation in a patient with necrobiotic xanthogranuloma.     

白体造血干细胞移植治疗老年血液系统肿瘤4例

目的自体造血干细胞移植已广泛应用于血液系统肿瘤的治疗,我们希望进一步探讨能否将这种治疗方式应用于60～70岁的老年患者。方法完成自体造血干细胞移植的4例老年患者进行总结。结果4例老年患者中,有1例CD34＋细胞不足2×106／Kg,移植后骨髓抑制期发生脑血管意外而死亡,其余3例患者都采集到足够的外周血造血干细胞,造血顺利重建,药物不良反应耐受性好,疗效肯定。结论年龄并不直接影响造血重建,只要能采集到足够数量的造血干细胞,造血就可以顺利重建。这一过程中加强黏膜护理十分重要。此外,在移植后选择恰当的方法维持治疗以降低复发率,延长无病生存时间值得进一步研究。     

Heart transplantation for cardiac light chain amyloidosis with subsequent autologous stem cell transplantation

Our report describes a case of 57-year-old man with manifest heart failure on the basis of cardiac amyloidosis, which was detected by endomyocardial biopsy. Due to the heart failure, the patient was unable to undergo myeloablative therapy. We changed our previous decision for conservative therapy of heart failure and the patient underwent heart transplantation. Autologous stem cell transplantation was performed 6 months later. After the successful stem cell transplantation, the serum free light chain lambda levels promptly decreased. One year later, their levels started again to increase. Chemotherapy was therefore initiated. The patient has now completed the seventh cycle of chemotherapy in good condition. The graft function is normal and the latest endomyocardial biopsy revealed no amyloid.     

自体外周血干细胞移植治疗血液恶性肿瘤231例临床观察

目的观察自体外周血干细胞移植(APBSCT)治疗血液恶性肿瘤的疗效。方法2001年3月至2007年2月对第三军医大学新桥医院231例血液恶性肿瘤患者施行APBSCT,其中急性淋巴细胞白血病(ALL)45例,急性髓性白血病(AML)34例,非霍奇金淋巴瘤(NHL)100例,霍奇金淋巴瘤(HD)31例,多发性骨髓瘤(MM)21例,观察临床疗效和并发症。结果除1例ALL外,230例患者移植后造血功能均快速重建。ALL首次完全缓解(CR1)28例患者中无病存活(DFS)13例,带病存活4例,死亡11例;ALL二次缓解(CR2)17例患者中DFS3例,带病存活4例,死亡10例。AMLCR120例患者中DFS11例,带病存活3例,死亡6例;AMLCR214例患者中DFS6例,带病存活2例,死亡6例。NHLCR159例患者中DFS43例,带病存活7例,死亡9例;NHLCR230例患者中DFS18例,带病存活5例,死亡7例;NHL未缓解(NR)11例患者中DFS2例,带病存活4例,死亡5例。HDCR110例患者中DFS10例;HD部分缓解(PR)15例患者中DFS12例,带病存活3例;HD疾病复发(RE)6例患者中DFS3例,带病存活2例,死亡1例。MM21例患者中DFS7例,带病存活6例,死亡8例。结论APBSCT是一种安全有效的血液肿瘤治疗方法。     

Disappointing outcome of autologous stem cell transplantation for enteropathy-associated T-cell lymphoma

BACKGROUND: Despite treatment, enteropathy-associated T-cell lymphoma has a very poor outcome. Chemotherapy can be complicated by small bowel perforation, gastrointestinal bleeding and development of enterocolic fistulae. Here we report on the feasibility, safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation in patients with enteropathy-associated T-cell lymphoma (three upfront and one at relapse), with or without prior partial small bowel resection. METHODS: Four patients [two males, two females, mean age 65 years (range 60-69 years)] received high-dose chemotherapy followed by autologous stem cell transplantation. Partial small bowel resection has been performed in three patients. RESULTS: All four patients completed the mobilization and leucopheresis procedures successfully and subsequently received conditioning chemotherapy and transplantation. Engraftment occurred in all patients. No major non-haematological toxicity or transplantation-related mortality was observed. One patient has ongoing complete remission 32 months after transplantation. Three patients died from relapse within few months after autologous stem cell transplantation. CONCLUSIONS: Autologous stem cell transplantation seems unsatisfactory for patients with enteropathy-associated T-cell lymphoma. More intensive conditioning and aggressive chemotherapy with/or without targeted immunotherapy as well as allogenous stem cell transplantation needs to be explored.     

Early intensification and autologous stem cell transplantation in patients with systemic AL amyloidosis: a single-centre experience

Primary systemic amyloidosis (AL amyloidosis) continues to have a very poor prognosis. Most therapeutic strategies remain unsatisfactory. Conventional chemotherapy is known to offer at best only moderate efficacy. Several studies have yielded higher complete response rates after high-dose chemotherapy and autologous stem cell transplantation (ASCT) in addition to improving outcomes in a subgroup of patients. However, the superiority of an intensive approach in AL amyloidosis has not been confirmed in a randomised trial. The precise role of ASCT remains unclear. We report our experience in 16 patients diagnosed with AL amyloidosis and treated in a multidisciplinary approach with high-dose melphalan and ASCT. Median age was 59 (39–71) years. The kidneys were predominantly affected in 75% of cases; two or more organs were affected in 38%. Median time from diagnosis to transplantation was 2 (1–4) months. Three patients (19%) developed acute renal failure and required transient dialysis. Transplant-related mortality was 6% after 100 days. Haematological complete response (CR) was obtained in nine (56%) and organ response in six (38%) patients. Nine out of 12 patients (75%) with kidney involvement exhibited a sustained clinical benefit at 12 months. Half of all the patients (n = 8) were alive after a median follow-up of 33 months, including two in continuous CR. This suggests that high-dose chemotherapy and ASCT are still valid treatment options in AL amyloidosis and that a significant number of patients with renal involvement might benefit from this approach.     

Combined orthotopic heart transplantation followed by autologous stem cell transplantation in a patient with light chain amyloidosis and isolated cardiac involvement

We present a case of amyloidosis AL with isolated myocardial involvement. Because of a refractory heart failure picture, patient underwent orthotopic heart transplant (OHT). The replaced heart showed an important midwall infiltration. Ten months after he underwent autologous stem-cell transplantation (ASCT) with a favorable outcome. The case demonstrates that OHT followed by ASCT in highly selected patients with light chain amyloidosis is a life-saving procedure.     

Successful treatment of rapidly progressive interstitial pneumonia with autologous peripheral blood stem cell transplantation in a patient with dermatomyositis

Aggressive autoimmune diseases are often treated by intensive immunosuppressive treatment such as high-dose methylprednisolone and intravenous cyclophosphamide. Autologous hematopoietic stem cell transplantation can facilitate high-dose immunosuppressive therapy (HDIT), which is myeloablative. We describe a 54-year-old female patient with rapidly progressive and refractory interstitial pneumonia due to dermatomyositis, which was successfully treated with high-dose cyclophosphamide and autologous blood stem cell transplantation. Following transplantation, dyspnea disappeared, and arterial blood gas analysis and respiratory function test showed marked improvement. This improvement was confirmed by diminished interstitial shadows on chest X-ray and computed tomography scans. Eighteen months after transplantation, the patient is doing well without symptoms and signs of interstitial pneumonia.