白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

内蒙古大兴安岭莱姆病自然疫源地全沟硬蜱的季节消长调查

1991年4～8月在内蒙古大兴安岭对莱姆传播媒介全沟硬蜱季节消长、带菌及人群自然感染季节分布等进行调查。结果证明全沟硬蜱是当地蜱类的优势种,从5月上旬发现蜱开始活动,6月上旬为蜱密度高峰期,占总捕数的36％,7月末蜱基本消失。用直接荧光抗体法查蜱带菌率,从采集的549只全沟硬蜱中,检出带菌蜱164只,自然带菌率为29.9％。间接荧光抗体法检测63例被蜱叮咬者血清,其中13例抗体阳性,阳性率为20.6％。本次调查表明,内蒙古大兴安岭林区5～6月为莱姆病媒介全沟硬蜱活动繁殖的高峰期。对63例被蜱叮咬者进行流行病学调查,被蜱叮咬季节与全沟硬蜱季节消长曲线相一致。     

NLRP3在鼻咽癌中的表达及其临床意义

目的:探讨炎症小体NLRP3在鼻咽癌组织和正常鼻咽黏膜组织中的表达水平变化及其与患者临床预后的关系。方法:采用实时定量PCR和免疫组化检测40例鼻咽癌组织和12例正常鼻咽黏膜组织中NLRP3的表达水平。结果:1NLRP3在鼻咽癌组织中表达显著高于正常鼻咽黏膜组织(P<0.05);2在鼻咽癌患者中,NLRP3的表达水平与肿瘤的淋巴结转移以及患者的临床预后有关(P<0.05),NLRP3高表达患者较低表达患者具有更好的局部无复发生存率和无瘤生存率,但与年龄和组织病理类型无明显相关关系(P>0.05)。结论:NLRP3具有提示鼻咽癌肿瘤转移及判断患者预后的价值。     

股神经阻滞复合全身麻醉应用于膝关节镜手术的临床观察

【摘要】目的探讨股神经阻滞复合全身麻醉在膝关节手术中的应用价值,并比较不同股神经阻滞方法的麻醉效果。方法选择ASAI～II级择期行膝关节镜手术患者60例,按随机数字表法分为单纯全麻组（A组,n=20）、全麻复合超声引导股神经阻滞组（B1组,n=20）、全麻复合非超声引导股神经阻滞组（B2组,n=20）。复合麻醉组全麻诱导前行股神经阻滞。术中采用丙泊酚全凭静脉麻醉,并根据BIS值及血流动力学调整药物用量。记录术中丙泊酚用量、唤醒时间、拔管时间,记录术后疼痛评分、患者满意度评价及并发症情况。结果B1、B2组术中丙泊酚用量、清醒时间、术后疼痛评分明显低于A组（P〈0．05）,术后患者满意度评价明显高于A组（P〈0．05）。B1、B2组间各项观察指标差异无统计学意义（P〉0．05）。术后各组并发恶心、呕吐、寒战和呼吸抑制的情况比较差异无统计学意义（P〉0．05）。结论全麻复合股神经阻滞可明显减少术中全麻药用量,有利于术后快速苏醒,并且可减轻早期术后疼痛。常规股神经阻滞方法提供同样满意的效果。     

一起高中学生肺结核聚集性感染疫情调查

2010年11月中旬,浦江县某中学高三（8）班相继发现6例活动性肺结核,其中1例为涂阳肺结核,构成了一起学校肺结核聚集性感染疫情。为有效控制疫情,2010年市、县两级疾病预防控制中心（疾控中心）对该校高三年级8个教学班366,     

尿微量清蛋白与急性心肌梗死患者介入治疗的预后

目的:探讨尿微量清蛋白(MAU)与急性心肌梗死(AMI)患者预后的关系。方法:110例AMI患者,入院48h内行24hMAU检测,其中MAU<20mg/24h的定为阴性组(39例),MAU≥20mg/24h的定为阳性组(71例),观察6个月～1年[平均(10.34±3.24)个月]发生心脏事件的情况。结果:110例中发生心脏事件共有15例,其中MAU阳性组12例(80.0%),MAU阴性组3例(20.0%),2组比较,差异有统计学意义(P<0.01)。结论:MAU的测定对AMI患者的预后有预测价值。     

脾动脉缩窄式远端脾肾分流术七例

目的 探讨脾动脉缩窄式(splenic artery coarctation，SAC)远端脾肾静脉分流术(USRS-SRC)治疗门脉高压症的疗效。方法 7例肝硬化门脉高压症病人行DSRS-SAC术，术后随访3～11个月。术前和术后观察门静脉压力、门静脉直径和脾脏大小变化，以及外周血细胞计数、肝功能的改变。结果 DSRS-SAC术后脾胃区静脉压力明显下降(P＜0．01)，又能维持良好的向肝血流灌注，脾脏显著缩小（P＜0．01)，脾亢纠正，无肝性脑病和再出血。血清总胆红素升高(P＜0．05)，3例腹水一度增多。结论 DSRS-SAC是一种治疗门脉高压症可选择的较理想术式。     

泡桐属中黄酮类化合物的研究进展

通过对大量的相关文献阅读整理,对泡桐属植物中的黄酮类化合物及其药理活性的研究进展进行了全面的总结,以便对泡桐属植物进行更为有效的开发利用。     

失代偿期乙肝肝硬化并黄疸患者危险因素分析

[目的]分析失代偿期乙肝肝硬化并黄疸患者的危险因素.[方法]选择失代偿期乙肝肝硬化患者共156例,根据其是否合并有黄疸,分为无黄疸组(74例)和黄疸组(82例),对2组的性别、年龄、凝血酶原活动度(PTA)、血清白蛋白(ALB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Scr)、胆碱酯酶(ChE)、血氨、C-...