CD4+CD25+调节T细胞与肿瘤免疫治疗策略

随着分子生物技术的不断发展,肿瘤的生物治疗在临床应用中的地位日渐突出,其中CD4+CD25+Foxp3+调节T细胞(CD4+CD25+Foxp3+regulatory T cell,Treg)在抑制肿瘤免疫方面起着重要作用,文章就其近年来在肿瘤免疫领域的研究进展作一综述.     

缺血性脑卒中患者阿司匹林抵抗现象及处理策略

阿司匹林作为缺血性脑血管病的一级和二级预防用药，广受关注。然而长期服用阿司匹林的患者仍会发生动脉血栓形成事件，因此本文就阿司匹林抵抗的概念、发生机制、检测方法、预防措施及其在缺血性脑血管病中的临床意义加以综述。     

音乐疗法在围手术期护理中的应用研究

目的：探讨音乐疗法在围手术期护理中的作用。方法：选择在我院实施局麻手术患者120例，随机分为观察组和对照组，两组均进行常规护理，观察组同时在术前、术中、术后收听自己喜欢的音乐。对两组焦虑水平、术中麻醉药用量和术后疼痛程度进行比较。结果：观察组术前SAS评分和焦虑发生率均明显低于对照组（P〈0．05），而术后两组无显著性差异（P〉0．05）；观察组术中咪唑安定使用量明显少于对照组（P〈0．05），利多卡因使用量也少于对照组，但无显著性差异（P〉0．05）；观察组术后疼痛分级明显低于对照组（P〈0．01）。结论：在同手术期护理中应用音乐疗法，可以减轻患者焦虑、减少麻醉药用量，缓解疼痛，促进康复。     

Ectopic pregnancy concurrent with induced abortion: incidence and mortality

From 1972 through 1985, 24 women who underwent an induced abortion died as a result of a concurrent ectopic pregnancy. We analyzed data from the Joint Program for the Study of Abortion, National Hospital Discharge Survey, and the Centers for Disease Control Ectopic Pregnancy and Abortion Surveillance Systems to determine the incidence and mortality of ectopic pregnancy concurrent with induced abortion. During the period 1971 through 1985, the incidence of ectopic pregnancy concurrent with induced abortions was 1.35/1000 induced abortions, compared with 13.6/1000 pregnancies not terminated by induced or spontaneous abortion. The rate was higher among women who obtained abortions at earlier gestational age and among older women. The death-to-case rate for ectopic pregnancies concurrent with induced abortion was 1.3 times higher than that for women not undergoing abortion. Most of the deaths of women with ectopic pregnancy who underwent induced abortion were attributable to the failure to diagnose the ectopic pregnancy before the woman left the facility where the abortion was performed. Such deaths could be prevented by the provider of the abortion assuring that the tissue is examined for products of conception at the time of the abortion.     

High-dose chemotherapy supported by peripheral blood progenitor cells in poor prognosis metastatic breast cancer--phase I/II study. Edinburgh Breast Group.

Current treatments for metastatic breast cancer are not associated with significant survival benefits despite response rates of over 50%. High-dose therapy with autologous bone marrow transplantation (ABMT) has been investigated, particularly in North America, and prolonged survival in up to 25% of women has been reported, but with a significant treatment-related mortality. However, in patients with haematological malignancies undergoing autologous transplantation, haematopoietic reconstruction is significantly quicker and mortality lower than with ABMT, when peripheral blood progenitor cells (PBPCs) are used. In 32 women with metastatic breast cancer, we investigated the feasibility of PBPC mobilisation with high-dose cyclophosphamide and granulocyte colony-stimulating factor (G-CSF) after 12 weeks'' infusional induction chemotherapy and the subsequent efficacy of the haematopoietic reconstitution after conditioning with melphalan and either etoposide or thiotepa. PBPC mobilisation was successful in 28/32 (88%) patients, and there was a rapid post-transplantation haematopoietic recovery: median time to neutrophils > 0.5 x 10(9) l-1 was 14 days and to platelets > 20 x 10(9) l-1 was 10 days. There was no procedure-related mortality, and the major morbidity was mucositis (WHO grade 3-4) in 18/32 patients (56%). In a patient group of which the majority had very poor prognostic features, the median survival from start of induction chemotherapy was 15 months. Thus, PBPC mobilisation and support of high-dose chemotherapy is feasible after infusional induction chemotherapy for patients with metastatic breast cancer, although the optimum drug combination has not yet been determined.     

A new component in the a-wave of the human cone electroretinogram

The human cone electroretinogram (ERG) to a full field flash has been examined on a rod saturating background (17,000 photopic trolands). With strong stimuli, a negative wavelet appears in the falling phase of the a-wave. This response has a latency of 10–12 milliseconds, about 6–8 milliseconds after the start of the a-wave and just before the rising phase of the corneal positive b-wave begins. We suggest that it may represent a hyperpolarizing response of second order retinal neurons.     

Pyoderma gangrenosum: a great marauder

Pyoderma gangrenosum is a progressively necrotizing and ulcerative skin disease that mimics a severe bacterial infection. However, the cause is not infectious in nature and the lesions are refractory to local wound care and antibiotic therapy. The etiology of pyoderma remains unknown, although pathogenic mechanisms may involve immunologically mediated cutaneous damage. The authors report a 67-year-old woman in whom a necrotic ulcer developed at a chest tube site. Treated with local wound care and antibiotics, this lesion spread progressively to involve 15% of her body surface area. A septic clinical picture developed despite sterile cultures, and she required several operative debridements. Her disease continued to spread and finally a diagnosis of pyoderma gangrenosum was considered. Treated with systemic steroids, hyperbaric oxygen (HBO), and local wound care, she eventually underwent skin grafts.     

上颌窦提升在上颌后牙区萎缩牙槽嵴牙种植术中的应用

目的：探讨上颌窦提升术对上颌后牙区萎缩牙槽嵴患者种植义齿修复的临床应用价值。方法：56例患者植入196枚种植体，患者平均年龄60．6岁。将自体松质骨(Spongiosa)与Bio-OSS混合进行上颌窦提升术，根据情况一期或二期植入种植体。种植体植入后至少6个月，选用适当的上部修复体进行义齿修复。结果：上颌窦提升术后或／和种植体植入术后，创口愈合良好，未见种植体松动或脱落，供骨区和种植术区均未见并发症。术后12个月PTVs最小为-5，X线检查种植体周垂直骨吸收均不超过1mm。种植体全部稳定地行使功能。结论：应用上颌窦提升术对上颌后牙区萎缩牙槽嵴患者进行种植义齿修复有广阔的应用前景。     

MRI of spinal hardware: comparison of conventional T1-weighted sequence with a new metal artifact reduction sequence

Objective. This study was designed to compare diagnostic quality of MR images of patients with spinal hardware acquired using a conventional T1-weighted spin-echo sequence and a new metal artifact reduction sequence (MARS). Conclusion. The new MARS sequence effectively reduces the degree of tissue-obscuring artifact produced by spinal fixation hardware and subjectively improves image quality compared with the conventional T1-weighted spin-echo sequence. Received: 30 May 2000 Revision requested: 12 September 2000 Revision received: 27 September 2000 Accepted: 27 November 2000