Marrow transplantation for patients with acute lymphoblastic leukemia: a long-term follow-up

Twenty-two patients with acute lymphoblastic leukemia in second or subsequent remission and 26 with acute lymphoblastic leukemia in relapse were given cyclophosphamide (60 mg/kg on each of 2 days), total body irradiation (920 rad), and marrow transplants from HLA-identical siblings. With a minimum follow-up of more than 5 yr, an actuarial analysis shows a survival and apparent cure of 27% of the patients transplanted in remission and 15% of the patients transplanted in relapse.     

Effect of parameter variations on the hemodynamic response under rotary blood pump assistance

Numerical models, able to simulate the response of the human cardiovascular system (CVS) in the presence of an implantable rotary blood pump (IRBP), have been widely used as a predictive tool to investigate the interaction between the CVS and the IRBP under various operating conditions. The present study investigates the effect of alterations in the model parameter values, that is, cardiac contractility, systemic vascular resistance, and total blood volume on the efficiency of rotary pump assistance, using an optimized dynamic heart-pump interaction model previously developed in our laboratory based on animal experimental measurements obtained from five canines. The effect of mean pump speed and the circulatory perturbations on left and right ventricular pressure volume loops, mean aortic pressure, mean cardiac output, pump assistance ratio, and pump flow pulsatility from both the greyhound experiments and model simulations are demonstrated. Furthermore, the applicability of some of the previously proposed control parameters, that is, pulsatility index (PI), gradient of PI with respect to pump speed, pump differential pressure, and aortic pressure are discussed based on our observations from experimental and simulation results. It was found that previously proposed control strategies were not able to perform well under highly varying circulatory conditions. Among these, control algorithms which rely on the left ventricular filling pressure appear to be the most robust as they emulate the Frank-Starling mechanism of the heart.     

循环抗阻训练干预12周后中老年绝经后妇女体质指标及血糖和血脂的变化

目的:观察循环抗阻训练对绝经后妇女体质的影响。方法:调查于2005-03/12在邵阳学院运动康复中心进行。年龄50～65岁,自然绝经1年以上的绝经后妇女。未经激素替代治疗,身体基本健康,不吸烟,无心脑血管疾病、糖尿病,所有受试者试验前进行常规体检及辅助检查,未见异常。血总胆固醇在6.50mmol/L以下,三酰甘油在2.50mmol/L以下,体脂率在35%以下。所有受试者保持平时的饮食习惯及一般的体力活动。不重复随机数法分为抗阻训练组和对照组两组,每组12人。两组实验前的各指标比较无明显差异。抗阻训练组应用器械和在训练机上进行躯干及上下肢大肌群的练习。每次运动包括3个循环,每1循环包括12节运动,每节运动包括在30～45s内做8次收缩,各节运动间休息15～30s,每个循环间休息2min。训练强度:为1次收缩最大负荷的80%。每周二、四、六训练,3次/周。每4周测1次最大收缩力,以监测训练进程和确定新的运动负荷。实验期间严格进行医务监督并遵循循序渐进原则。12周的抗阻训练后测定身高、体质量、心率、血压、腰围、臀围、体脂率、最大吸氧量、血糖、血脂。结果:24名绝经后妇女均进入结果分析。①抗阻训练组训练后的腰围、臀围、体脂率、安静收缩压与训练前及对照组比较,均显著降低或减少[训练后:(74.4±5.5)cm,(92.0±5.0)cm,(25.7±3.4)%,(105.4±17.0)mmHg;训练前:(76.8±5.2)cm,(94.1±5.1)cm,(27.4±3.5)%,(112.7±14.0)mmHg;对照组:(76.1±4.6)cm,(93.0±5.2)cm,(27.1±3.7)%,(114.0±15.1)mmHg,P<0.01,P<0.05]。握力和背肌力较训练前及对照组明显增加[训练后:(27.9±2.5),(64.7±3.6)kg;训练前:(23.6±2.5),(61.6±4.2)kg;对照组:(23.9±1.6),(59.2±3.3)kg,P<0.01]。②抗阻训练组训练后三酰甘油较训练前及对照组下降[(1.42±0.13),(1.63±0.14),(1.63±0.19)mmol/L,P<0.01,P<0.05],低密度脂蛋白胆固醇较训练前降低[(3.14±0.44),(3.26±0.56),(3.10±0.47)mmol/L,P<0.05],高密度脂蛋白胆固醇较训练前及对照组显著升高[(1.44±0.24),(1.26±0.25),(1.23±0.23)mmol/L,P<0.01,P<0.05]。结论:循环抗阻训练可安全有效地改善绝经后妇女的体质,是预防和治疗冠心病的有效措施。     

Acupuncture treatment of chronic low-back pain -- a randomized, blinded, placebo-controlled trial with 9-month follow-up

There is some evidence for the efficacy of acupuncture in chronic low-back pain (LBP), but it remains unclear whether acupuncture is superior to placebo. In a randomized, blinded, placebo-controlled trial, we evaluated the effect of traditional acupuncture in chronic LBP. A total of 131 consecutive out-patients of the Department of Orthopaedics, University Goettingen, Germany, (age=48.1 years, 58.5% female, duration of pain: 9.6 years) with non-radiating LBP for at least 6 months and a normal neurological examination were randomized to one of three groups over 12 weeks. Each group received active physiotherapy over 12 weeks. The control group (n=46) received no further treatment, the acupuncture group (n=40) received 20 sessions of traditional acupuncture and the sham-acupuncture group (n=45) 20 sessions of minimal acupuncture.Changes from baseline to the end of treatment and to 9-month follow-up were assessed in pain intensity and in pain disability, and secondary in psychological distress and in spine flexion, compared by intervention groups.Acupuncture was superior to the control condition (physiotherapy) regarding pain intensity (P=0.000), pain disability (P=0.000), and psychological distress (P=0.020) at the end of treatment. Compared to sham-acupuncture, acupuncture reduced psychological distress (P=0.040) only. At 9-month follow-up, the superiority of acupuncture compared to the control condition became less and acupuncture was not different to sham-acupuncture.We found a significant improvement by traditional acupuncture in chronic LBP compared to routine care (physiotherapy) but not compared to sham-acupuncture. The trial demonstrated a placebo effect of traditional acupuncture in chronic LBP.     

胶原诱导型关节炎模型大鼠血浆血管内皮生长因子与肿瘤坏死因子α表达及反应停的干预效应

目的:观察胶原诱导型关节炎大鼠病程及致病过程中两种重要炎性因子血管内皮生长因子与肿瘤坏死因子α在反应停干预后的影响。方法:实验于2006-01/07在河北医科大学第二医院完成。成年雄性Wistar大鼠112只,体质量140～160g,随机数字表法分为为正常对照组、单纯造模组、反应停治疗组和甲氨蝶呤治疗组,每组28只。除正常对照组外,其余3组多点皮内注射Ⅱ型胶原与完全弗氏佐剂的乳化剂,诱导出关节炎模型。正常对照组作为阴性对照组每只大鼠背部及尾根部多点皮内注射等量的生理盐水。从免疫后第10天开始,正常对照组和单纯造模组大鼠给予蒸馏水0.5mL/(只·d)灌胃;反应停治疗组给予反应停200mg/(kg·d)灌胃;甲氨蝶呤治疗组给予甲氨蝶呤2.7mg/(kg·周)灌胃。测定造模后7,14,21,28,35,42,60d不同时间点各组大鼠的足爪厚度、血浆肿瘤坏死因子α及血管内皮生长因子的水平,进行统计学分析。结果:纳入大鼠112只,均进入结果分析。①各组大鼠足爪肿胀程度:实验前各组大鼠之间足爪厚度无显著差异[(5.47±0.14),(5.33±0.10),(5.92±0.24),(5.35±0.23)mm,P>0.05]。与正常对照组比较,单纯造模组、反应停治疗组及甲氨蝶呤治疗组大鼠足爪厚度均于造模后7d开始增高,21d左右达到肿胀高峰,差异有显著性意义[7d:(5.42±0.24),(5.81±0.15),(6.59±0.31),(5.54±0.33)mm;21d:(5.73±0.23),(10.78±0.53),(9.82±0.34),(10.37±0.57)mm,P<0.01]②各组大鼠血浆肿瘤坏死因子α及血管内皮生长因子水平及两者关系:实验前各组血浆肿瘤坏死因子α及血管内皮生长因子水平均无显著差异[(2.351±0.208),(2.331±0.213),(2.280±0.171),(2.283±0.125)nmol/L;(1.807±0.094),(1.811±0.099),(1.819±0.101),(1.813±0.090)nmol/L;P>0.05],与正常对照组相比,单纯造模组、反应停治疗组及甲氨蝶呤治疗组大鼠两者水平于造模后7d开始增高,差异具有显著性意义[(2.245±0.234),(2.450±0.026),(2.419±0.069),(2.467±0.032)nmol/L;(1.803±0.099),(2.024±0.049),(2.017±0.101),(2.055±0.056)nmol/L;P<0.05]。两者水平呈直线相关。结论:反应停可以降低关节炎模型大鼠血浆肿瘤坏死因子α及血管内皮生长因子浓度,可以有效减轻其足爪肿胀程度,疗效与甲氨蝶呤相同。