低体重患者外周血干细胞的动员和采集

目的　探讨动员和采集低体重患者外周血干细胞的方法和经验。方法　对 10例体重小于 30kg患者在经化疗 +生长因子方案动员后使用CS 30 0 0Plus血细胞分离机 (Baxter公司 )、专用SVCH分离夹并选择儿童单个核细胞收集程序进行外周血干细胞采集。结果　所有病例均采集成功 ,采集次数 2～ 4次 ,平均 2 3次 ,单个核细胞数 (MNC) :5 4 (3 6～ 7 8)× 10 8/kg ,CD34+ 细胞为 6 1(3 1～ 18 5 )× 10 6/kg,CFU GM为 3 3(1 6～ 5 1)× 10 5/kg ,台盼蓝拒染率 :98 5 %(97%～ 10 0 %) ,副作用小。结论　由于低体重患者自身的特殊性 ,外周血干细胞采集较正常人不同 ,为确保采集成功应选用专用器械和程序 ,做好采集前准备、控制血液总量、抗凝剂比例并积极处理并发症     

非骨髓清除性异基因外周血造血干细胞移植(NST)治疗恶性血液病的初步临床研究

目的　探讨NST治疗恶性血液病的效果及毒性。方法　急性粒细胞白血病未分化型 (AML -M1)、慢性髓细胞白血病 (CML)、骨髓增生异常综合征 (MDS -RA)患者各 1例 ,供体为其HLA配型完全相合的同胞。供体动员方案 :G -CSF 30 0 μg/ 12h× 5d后分离采集外周血干细胞。所获CD34 + 细胞数分别为 6 .36× 10 6/kg、9.72×10 6/kg、6 .6 2× 10 6/kg ;单个核细胞数 (MNC)分别为 14.0× 10 8/kg、10 .47× 10 8/kg、8.5 8× 10 8/kg ;T细胞总数分别为 8.80× 10 8/kg、7.12× 10 8/kg、5 .6 7× 10 8/kg ;CFU -GM数分别为 16 2个 / 2× 10 5MNC、184个 / 2× 10 5MNC、182个 / 2× 10 5MNC。预处理方案 :Fludarabine:30mg/m2 ·d-1× 6d ,Bu :4mg/kg·d-1× 2d ,ALG :12mg/kg·d-1× 4d ,Ara-C :10 0mg/m2 ·d-1× 3d。单用环胞菌素 (CSA)预防移植物抗宿主病 (GVHD)。移植后未用造血生长因子。结果　患者均能顺利完成预处理方案 ,没有严重并发症出现。移植后 10～ 13d造血重建。未发生急性GVHD。随访10 0～ 16 0d ,血常规、骨髓象均正常 ,1例发生肝脏型慢性GVHD。结论　NST能有效治疗恶性血液病 ,方案相关毒性小 ,适用范围广 ,移植相关并发症少 ,造血重建迅速。     

外周血干细胞收集物中有核细胞成分分析

目的　探讨癌症患者用环磷酰胺 (CTX)、粒细胞集落刺激因子 (G CSF)动员后 ,外周血干细胞收集物的成分及数量。方法　 2 1例诊断明确的癌症患者 ,男 15例 ,女 6例 ,平均年龄 30 .1岁 ( 19～ 6 2岁 )。动员方案为 :CTX 4.0g/m2 ,同时碱化、水化 ,应用美司那和别嘌呤醇 ,在WBC降至最低点时 ,开始应用G CSF(惠尔血 ) 15 0 μg/d ,当WBC≥ 10 .0× 10 9/L或MNC≥ 2 .0× 10 9/L或CD34+细胞≥ 30× 10 6/L时 ,用FenwalCS 30 0 0PLUS连续式血细胞分离机分离单个核细胞 ,通过瑞氏染色和荧光标记单克隆抗体流式细胞仪分析干细胞收集物细胞成分和比例。当收集CD34+ >2× 10 6/kg时停止采集。结果　T淋巴细胞、NK细胞、粒细胞、B淋巴细胞、单核细胞、CD34+ 细胞所占的比例分别为 5 6 .75 %、14 .5 0 %、10 .89%、7.32 %、7.2 9%、2 .18%。结论　外周血干细胞收集物成分复杂、多样 ,T淋巴细胞、NK细胞是干细胞收集物的主要成分。有待开发干细胞收集物多种成分的潜在用途     

骨髓联合外周血造血干细胞移植治疗重型再生障碍性贫血

目的　探讨非清髓性、骨髓和外周血造血干细胞移植治疗高风险重型再生障碍性贫血 (SAA)及移植后供者干细胞输注 (DSI)的疗效和并发症。方法　移植治疗 3例高风险SAA。预处理 :抗淋巴细胞球蛋白 (ALG)联合环磷酰胺 (CTX) ,CTX总量为 60～ 12 0mg/kg ,ALG为 12 0mg/kg。移植物抗宿主病 (GVHD)的预防 :环孢素A(CSA)联合甲氨蝶呤 (MTX)或甲基强的松龙 (MP) ,CSA和MP分别用至 6个月和 2个月逐渐减量并停药。供者外周血造血干细胞 (PBSC)动员 :G -CSF 5 μg/ (kg·d)× 5d。移植细胞数分别为MNC :7 2 4× 10 8/kg ,6 0 0× 10 8/kg ,6 66× 10 8/kg ;CD3 4+ 细胞 :4 2 6×10 6/kg ,8 95× 10 6/kg ,4 66× 10 6/kg。移植后形成混合性嵌合体 (MC)者 ,进行DSI。结果　移植后 3例白细胞最低值 :0 2 6× 10 9/L ,0 5 0× 10 9/L ,0 10× 10 9/L ,中性粒细胞 >0 5× 10 9/L和血小板 >2 0× 10 9/L时间分别为移植后第 12 ,3 ,15天和 0 ,5 ,10天。 3例均获得造血细胞成功植入。 1例形成供者完全嵌合体 (CC)并长期维持造血。 2例MC者 ,1例出现排斥 ,1例巨核细胞植入不良 ,均经DSI ,造血均有恢复。 3例分别存活 10 ,6,3 4个月。结论　非清髓性骨髓联合外周血高剂量造血干细胞移植治疗高风险的SAA ,增加植入率、减少     

SARS患者T细胞和免疫球蛋白动态变化的研究

目的　研究传染性非典型肺炎 (SARS)患者免疫功能及其在病程中的变化。方法　用流式细胞仪测定 12 4例不同病程SARS患者外周血CD3+ 、CD4 + 和CD8+ T细胞计数 ,同时测定免疫球蛋白 ,另设 5 1例获得性免疫缺陷综合征 (AIDS)患者和 5 7名健康人为对照组 ;对SARS患者进行病程分组 ,比较不同病程免疫功能的变化。结果　SARS组CD3+ [(5 89± 4 35 )× 10 6/L]、CD4 + [(316± 2 6 7)× 10 6/L]和CD8+ T细胞 [(2 15± 16 5 )× 10 6/L]均显著低于健康对照组 [(116 3± 32 4 )× 10 6/L、(6 4 1±186 )× 10 6/L和 (4 0 5± 14 6 )× 10 6/L],但CD4 + T细胞高于AIDS组 [(15 3± 10 5 )× 10 6/L],CD3+ 和CD8+T细胞则低于AIDS组 [(112 2± 5 72 )× 10 6/L、(96 9± 5 4 6 )× 10 6/L](P值均 <0 0 1)。SARS组和AIDS组分别有 5 4例 (4 4 % )和 39例 (76 % )CD4 + T细胞 <2 0 0× 10 6/L。SARS患者外周血T细胞亚群计数在病程 10～ 12d达最低值。SARS组血清IgG(15 1g/L± 8 5g/L)和IgE(0 6g/L± 0 9g/L)水平高于健康对照组 (12 4g/L± 2 2g/L ,0 3g/L± 0 6g/L)。结论　SARS患者CD3+ 、CD4 + 及CD8+ T细胞均显著减少 ,病程 10～ 12d为最低值阶段。     

米托蒽醌为主的化疗联合造血因子动员和大容量采集外周血干细胞

目的 :探讨米托蒽醌 (MIT)为主的化疗联合粒细胞集落刺激因子 (G -CSF)和粒 -巨噬细胞集落刺激因子 (GM -CSF)对自体外周血干细胞 (APBSC)的动员效果。方法 :MA动员方案 :MIT 10mg·m-2 ·d-1静脉滴注 ,第 2、3天 ;阿糖胞苷 (Ara -C) 2 g/m2 静脉滴注 ,每 12h 1次 ,第 1、2天。MOED方案 :MIT6～ 8mg·m-2 ·d-1,第 1～ 3天静脉滴注 ;长春新碱 (VCR) 1.4mg/m2 ,第 1天静脉滴注 ,足叶乙甙 (VP16) 10 0mg/d ,第 1～ 5天静脉滴注 ;地塞米松 (DXM ) 6mg·m-2 ·d-1,第 1～ 5天静脉滴注。当白细胞 (WBC)降至最低点开始回升时 ,皮下注射G -CSF 5ug·kg-1·d-1或G -CSF 3ug·kg-1·d-1(早 6 :0 0 ) GM -CSF 3ug·kg-1·d-1(晚 6 :0 0 )至采集结束。WBC恢复至 (8.0 2± 3.6 5 )× 10 9/L、CD 3 4 细胞 (1.6 8± 0 .79) %时 ,开始用CS 30 0 0plus血细胞分离机连续 2d采集APBSC。当累计采集的单个核细胞 (MNC)达到 5× 10 8/kg以上时停止采集。结果 :2 0例患者连续采集APBSC 2次 ,共采集到MNC(4.6 7± 2 .11)× 10 8/kg、CD 3 4 细胞 (7.86± 2 .14 )× 10 6/kg、CFU -GM(2 .86± 2 .10 )× 10 5/kg。无严重毒副反应。 18例接受自体外周血干细胞移植 (APBSCT)者造血功能均获得满意重建。结论 :以MIT为主的化疗联     

外周血造血干细胞移植治疗儿童血液肿瘤的初期疗效观察

目的　观察外周血造血干细胞移植 (PBSCT)治疗儿童血液肿瘤的初期疗效。方法　 2 0 0 1年 5月至 2 0 0 2年 3月 ,以PB SCT治疗儿童血液肿瘤患者共 10例 ,其中 :ALL 5例 ;ANLL 1例 ;NHL3例 ;HD1例。除 1例同基因移植患儿采用G CSF(10 μg/kg ,1/d ,皮下注射 ,共 4d后开始采集 )对正常供体进行动员外 ,其他患儿均为自体外周血干细胞移植 ,动员方案为 :MOEP +G CSF。经 2～ 3次采集 ,获得MNC中位数为 5 4× 10 8/kg ,CD3 4+ 细胞为 6 1× 10 6/kg ,CFU M为 3 3× 10 5/kg。预处理方案 :Cy/TBI(8例 )或CEAC(2例 )。结果　所有患者移植后均重建造血。WBC >1 0× 10 9/L、中性粒细胞 >0 5× 10 9/L、PLT >2 0× 10 9/L ,分别为 (10± 3 )d、(11± 3 )d、(14± 5 )d。 1例患儿于移植后 3个月随访行常规化疗 ,因骨髓重度抑制继发感染死亡 ,1例患儿于移植后 4个月病情复发死亡。其余患者均无病存活 2～ 9个月 ,疗效仍在近一步随访中。结论　初期疗效显示 ,PBSCT是儿童血液肿瘤安全有效的治疗方法     

阿糖胞苷联合粒细胞集落刺激因子动员自体外周血干细胞效果的研究

目的　观察阿糖胞苷 (Ara C)联合重组人粒细胞集落刺激因子 (rhG CSF)对恶性淋巴瘤患者自体外周血造血干细胞 (APBSC)的动员效果 ,并寻找Ara C合适的给药剂量。方法　按照入组的先后顺序 ,将患者分成两组 ,A组Ara C的给药剂量为 6g/m2 静滴 (分 2次 ,间隔 2 4h) ,B组Ara C的给药剂量为 10g/m2 静滴 (分 4次 ,间隔 12h) ,白细胞 (WBC)降至最低点时开始皮下注射rhG CSF 30 0 μg·人 -1·d-1,直至采集结束前 1d ,白细胞恢复到 5 .0× 10 9/L以上时开始连日采集APBSC ,当累计采集的单个核细胞≥ 5× 10 8/kg或CD34+ 细胞≥ 2× 10 6/kg时停止采集。结果　 2 2例患者进入本研究 ,A、B两组各有 11例患者。Ara C给药后 ,患者外周血中白细胞和中性粒细胞绝对值 (ANC)的最低值 ,B组明显低于A组 ,出现的时间B组也明显晚于A组。A、B两组rhG CSF给药的开始时间和持续时间、APBSC采集的开始时间和持续时间均无显著差异 ,在APBSC采集时的循环血量、血流速和采集时间相同的情况下 ,APBSC的采集次数、每次采集的细胞数量和总量亦差异无显著意义 ,B组Ara C引起的某些毒副反应略重于A组 ,但两组间差异无显著意义。结论　Ara C联合rhG CSF是一种安全、高效的APBSC的动员方法 ,6g/m2 的Ara C即可得到满意的动员效果。     

MOEP化疗联合G-CSF动员外周血干细胞的临床观察

目的　报告 8例恶性血液病患者采用MOEP联合rhG CSF动员外周血干细胞的疗效和副作用。方法　 8例住院病人中 ,急性淋巴细胞白血病 2例 ,非何杰金淋巴瘤 5例 ,何杰金病 1例。其中 5例移植前疾病完全缓解 ,1例部分缓解 ,2例疾病处于进展期。动员方案为米托蒽醌 :0 2mg/kg分 3d ;长春新碱 :2mg ,第一天 ;足叶乙甙 :10mg/kg分 2～ 5d ;强的松片 :30～ 6 0mg共7d。白细胞降至低谷开始回升时加用rhG CSF(10 μg·kg-1·d-1)动员 ,白细胞升至 5 0× 10 9/L以上开始采集外周血干细胞。共采集干细胞 (2 0～ 7 8)× 10 8/kg。结果　回输干细胞后均获快速造血功能重建 ,白细胞开始回升 (ANC >0 5× 10 9/L)的时间为移植后 9～ 16d,血小板的恢复 (PLT >2 0× 10 9/L)稍滞后于白细胞 ,为移植后 10～ 2 8d。结论　采用MOEP方案动员外周血造血干细胞效果显著、副作用轻、且经济实惠     

化疗联合G-CSF动员外周血造血干细胞疗效观察

目的:探讨化疗联合粒细胞集落刺激因子动员外周血造血干细胞(PBSC)的效果。方法:12例恶性血液病患者采用化疗联合G-CSF进行PBSC动员和采集,并检测采集物中单个核细胞计数(MNC)和CD34+细胞。结果:12例患者均一次即获足量干细胞,获MNC平均5.7(2.2~7.6)×108/kg,CD34+细胞平均15.2(2.5~26.9)×106/kg。未出现严重不良反应。结论:化疗联合G-CSF能安全、高效地动员PBSC,满足移植的需要。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.