自体骨髓移植结合强化方案对急性白血病的疗效——附10例报告

我所自1988年12月～1991年12月，已用自体骨髓移植(ABMT)结合强化治疗急性白血病(AL)10例，疗效满意，初步报告如下。     

鼻腔鼻窦内翻性乳头状瘤临床分析

报告鼻腔鼻窦内翻性乳头状瘤２１例，男１７例，女４例，男女之比为４．２５∶１。平均年龄４４．８岁，高发年龄组为３１～４０岁组，占４７．６％。最常见的临床症状是鼻阻塞，对单侧鼻腔新生物进行多部位多次活检，可在术前确诊。治疗时整块切除肿瘤和上颌窦内侧壁，可降低术后复发，本组２例经鼻内手术切除肿瘤，１９例经鼻侧切开并切除整块肿瘤及上颌窦内侧壁，其中前者１例（５０％）复发，后者４例（２１．８％）复发，总复发率为２３．８％。其中３例发生癌变，其癌变率为１４．３％。     

从医疗事故技术鉴定看医疗风险防范

《医疗事故处理条例》于2 0 0 2年9月1日起正式施行,这是我国卫生法制建设的一件大事,对促进医学科学发展、正确处理医疗事故、保障医疗安全、维护医疗秩序具有十分重要的意义。一年来我们共收到委托84例,受理76例,已鉴定6 0例,其中定为事故的15例,现将鉴定案例进行了统计分析,以便从中找出医院医疗管理中存在的问题,对医院的建设和管理有所帮助。1　基本情况　1.1　案源　总数76例,其中共同委托18例(占2 4 % )、行政部门2 5例(占33% )、司法部门33例(占4 3% )。1.2　医疗机构级别分布　76所医疗机构中,三级医院19例,二级医院18例,一级医院3…     

单侧听神经瘤致健耳ABR改变1例

患者 ,男 ,2 7岁。因左耳鸣、听力下降 2～ 3年就诊 ,无明显眩晕。体检 :神志清楚 ,左鼓膜内陷 ,右鼓膜正常 ,无面瘫。纯音测听显示 0 .2 5kHz、0 .5kHz、1 .0kHz、2 .0kHz、4.0kHz、6.0kHz、8.0kHz的气导 ,右耳为 1 5、1 5、2 0、1 5、1 5、2 0、1 5dB ,左耳为 70、95、1 0 5、1 0 5、1 0 0、90、>90dB ;骨导 ,右耳为 1 0、1 5、1 5、1 5、1 5、1 5、1 5dB ,左耳消失。声导抗测试示右耳声顺值 0 .4ml,A型鼓室压图 ,镫骨肌反射阈同侧 80dB ,对侧未引出 ;左耳声顺值 0 .3ml,A型鼓室压图 ,镫骨肌反射阈同侧未引出 ,对侧 95dB。听性脑干…     

Prognostic value of postoperative stimulated thyroglobulin levels on 131Ⅰ ablation therapy in papillary thyroid cancer

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.     

Prognostic value of postoperative stimulated thyroglobulin levels on 131Ⅰ ablation therapy in papillary thyroid cancer

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.     

Prognostic value of postoperative stimulated thyroglobulin levels on 131Ⅰ ablation therapy in papillary thyroid cancer

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.     

微型家畜及其开发前景

微型家畜（ｄｏｍｅｓｔｉｃ ｍｉｎｉ－ａｎｉｍａｌ和ｍｉｃｒｏ－ａｎｉｍａｌ）是指家畜和可驯养动物中体重比通常水平显著微小的种群（ｋｉｎｄｒｅｄ ｐｏｐｕｌａｔｉｏｎ），包括微型种（ｓｐｅｃｉｅｓ）、品种（ｂｒｅｅｄ）和地域群。近２０多年来，世界范围内的运动遗传资源调查、研究、开发的成就说明，微型家畜具有不可忽视的潜在价值和广阔的利用前景。近１０年，国内外已有介绍微型家畜一般情况的若干综述，本文扼     

汉语普通话单音节测听表的多中心复测信度研究

目的 研究自行开发的汉语普通话单音节测听表在不同方言区听力正常人群中的复测信度.方法 选择北方方言、吴越、闽北、闽南、粤、鄂等6个典型的方言区,确定大连、上海、杭州、武汉、广州、福州、厦门等7个城市作为测试中心.每个测试中心分别招募22名听力言语正常受试者.以均衡排序的方式测试每位受试者全部22张字表在言语听力级7 dB下的单音节识别率,间隔10 d至1个月后在完全相同的条件下重复进行第二轮测试.结果 相关分析显示前后两次单音节识别测试得分之间存在较密切的线性相关关系(r=0.682,P<0.01).配对student-t检验表明初测得分与复测得分之间差异具有统计学意义(P<0.01),总体复测平均得分(68.5%)高于初测平均得分(65.8%)2.7%,得分差值的标准差为10.1%.本测试材料在7个中心的总体95%可信区间临界差值为19.8%,相当于5个测试项.单因素方差分析显示总体的两次得分差值具有统计学意义(P<0.01).7家中心总体的得分差值与两次测试的时间间隔之间无相关关系(P=0.947).结论 测试变异度在各方言测试中心之间存在差异.汉语单音节识别材料受记忆效应的影响小.Pearson相关系数r不适用于测听材料复测信度的评估.     

建立人工耳蜗植入后目标因素评估体系的研究

目的 建立汉语版人工耳蜗植入术后效果评估体系.方法 应用Delphi法以问卷调查的形式,将评估表传送给全国各地70位受邀请的专家,对评估表的评估内容进行分析、判断、列序、权重,并对评估系统中的测试指标进行删改、补充.分析问卷回收率及专家们咨询意见的集中程度、协调程度、权威程度,以及对指标的权重系数进行统计学分析.结果 经过两轮专家咨询后,问卷的回收率分别为82.86%和93.10%,专家们的意见的集中程度和协调程度的一致性很高(P<0.01),得出了二级和三级指标的权重系数.结论 本研究的评估内容得到了专家们的积极参与,并有很好的协调性,专家们达成了人工耳蜗植入后需要评估的目标因素的共识,且言语能力评估的权重系数最高.