非亲缘外周血造血干细胞移植治疗重型β-地中海贫血1例

患儿,女,4岁,体质量19kg。生后4个月开始进行性面色苍白伴巩膜黄染,血红蛋白65g/L,白细胞和血小板均正常,血红蛋白电泳血红蛋白A48.1%、血红蛋白A24.2%、抗碱血红蛋白47.7%,基因型为β地贫纯合子,诊断为重型β地中海贫血,以间断大量输血维持生命。于2005-12-09在厦门大学附属中山医院血液科接受非亲缘性外周血干细胞移植。预处理方案采用常规氟达拉滨、白消胺、环磷酰胺三药联合方案,以环孢菌素A、霉酚酸酯、抗胸腺淋巴细胞免疫球蛋白联合预防移植物抗宿主病,供受者人类白细胞抗原高分辨全相合,ABO血型次要不合(O-A),输入CD34 干细胞11.4×106/kg。植入成功,移植后12d中性粒细胞>0.5×109L-1,移植后37d血小板>50×109L-1,移植后35d患者血型检测转变为供者血型,患儿血红蛋白达到100g/L的时间是28d,移植后患儿未再输血,血红蛋白维持130g/L以上,整个移植过程顺利,未出现严重感染和移植物抗宿主反应,随访18个月,患儿生活正常,发育良好。     

冠状动脉搭桥术早期并发症及死亡率(附196例报告)

1985年1月～1987年12月作者于荷兰格罗宁根医学科学院心胸外科主做了196例冠状动脉搭桥术。术后早期死亡2例(1.0％)、内出血3例(1.5％)、胸骨裂开2例(1.0％)、心律紊乱40例(20.4％)、围手术期心肌梗塞5例(2.6％),本文就术后早期并发症进行了讨论。     

Apports des explorations vasculaires ultrasonores à l''étude des néphropathies chez l''enfant

The proximity of child's kidneys from the cutaneous surface allows a particularly sensitive exploration by doppler sonography, which in addition has the major advantage of being a non-invasive, non-irradiating and painless technique. However there are two limitations to this technique: the lack of cooperation of some children and the still limited availability of high quality equipment in intensive care units. Indeed most of the applications described in this paper (ie. pyelonephritis, renovascular hypertension, tumors, acute renal insufficiency and renal vein thrombosis) require, besides an experienced operator, expensive power doppler equipment including high frequency and high resolution probes.     

Variations in breast cancer surgical treatment and timing: determinants and disparities

Breast Cancer Research and Treatment - To describe clinical and non-clinical factors associated with receipt of breast conserving surgery (BCS) versus mastectomy and time to surgical intervention....     

Cardiac tamponade in a preterm neonate secondary to a chest tube

In a preterm infant, chest tubes were inserted for treatment of bilateral pneumothoraces. Hemorrhagic pericardial effusion with cardiac tamponade developed, probably resulting from traumatic injury by the left chest tube. The infant survived due to timely diagnostic and therapeutic intervention. No recurrence of pericardial effusion was seen and follow-up showed normal psychomotor development.     

Treatment with thymic extract TFX for chronic active hepatitis B

Eighteen patients with biopsy-proven chronic active hepatitis B (CAHB) and a significantly lowered CD4+/CD8+ cell number ratio were treated with thymic factor X (TFX): group I (n = 12) - for 12 months, group II (n = 6) for 6 months. As early as 14 days after starting the treatment a lowering of CD8+ cell numbers with a rise in CD4+/CD8+ cell number ratio were found. These changes continued to progress during the next months and were accompanied by decreased in NK cell numbers with enhancement of NK cell activity. Normalization of the biochemical and immunological parameters occurred after 5-6 months of the treatment. In both groups of patients seroconversion in the HBe system was observed after 9-12 months of the treatment. After two years complete clinical remission persists with normal biochemical and immunological findings and without reversion in the HBe system. The results seem to indicate that TFX has an immunostimulatory action and exerts beneficial effects on the course of CAHB.