Studies with the Folate Binding Protein in Chronic Granulocytic Leukaemia Cells: I. SYNTHESIS AND RELEASE OF BINDER BY CELLS IN SHORT-TERM CULTURE

Chronic granulocytic leukaemia (CGL) cells which contained a high concentration of unsaturated folate binding protein were incubated in suspension culture for a period of 5 h. Cell samples were periodically assayed for binder and these demonstrated active synthesis which was inhibited by puromycin, cyclo heximide, N-ethylmaleimide, and by incubation at 4 degrees C, but not by actinomycin D. Folate binding activity could also be demonstrated in the culture medium and this increased with the duration of incubation. This release of binder was inhibited by culturing the cells at 4 degrees C and by the addition of N-ethylmaleimide, but not by actinomycin D, puromycin, or cycloheximide. When the pre- and post-culture cell lysates were saturated with tritiated folic acid ([3H]PteGlu) and subjected to chromatography on DEAE-agrarose, approximately half of the bound folate eluted with 0.001 M phosphate buffer at pH 6.0 and the other half eluted with 0.2 M buffer at pH 7.2. The culture medium and plasma from this patient with CGL was well as serum from two normal subjects saturated with [3H]PteGlu and similarly chromatographed contained primarily the acidic binder and much less of the binder eluting with the low molarity buffer. Since a folate binding protein immunochemically similar to the binder in CGL cells has been identified in the serum of non-leukaemic subjects, these experiments suggest that the source of circulating folate binding protein may be the immature granulocyte.     

Infused peripheral blood autograft absolute lymphocyte count correlates with day 15 absolute lymphocyte count and clinical outcome after autologous peripheral hematopoietic stem cell transplantation in non-Hodgkin's lymphoma

Absolute lymphocyte count at day 15 (ALC-15) after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) is an independent prognostic factor for survival in non-Hodgkin's lymphoma (NHL). Factors affecting ALC-15 remain unknown. We hypothesized that dose of infused autograft lymphocytes (A-ALC) directly impacts upon ALC-15. A total of 190 consecutive NHL patients received A-ALC between 1993 and 2001. The primary end point was correlation between A-ALC and ALC-15. A strong correlation was identified (r=0.71). A higher A-ALC was infused into patients achieving an ALC-15 > or =500/microl vs ALC-15 <500/microl (median of 0.68 x 10(9)/kg (0.04-2.21 x 10(9)/kg), vs 0.34 x 10(9)/kg (0.04-1.42 x 10(9)/kg), P<0.0001). The median follow-up for all patients was 36 months (maximum of 109 months). The A-ALC threshold was determined at 0.5 x 10(9)/kg. The median overall survival (OS) and progression-free survival (PFS) times were longer in patients who received an A-ALC >/=0.5 x 10(9)/kg vs A-ALC <0.5 x 10(9)/kg (76 vs 17 months, P<0.0001; 49 vs 10 months, P<0.0001, respectively). Multivariate analysis demonstrated A-ALC to be an independent prognostic indicator for OS and PFS. These data support our hypothesis that ALC-15 and survival are dependent upon the dose of infused A-ALC in NHL.     

截石位手术床腿架万向移动装置的研制

目的：设计一种调节方便,升降安全的截石位手术床腿架。方法：将气弹簧结构应用于截石位腿架中,进行腿架的升降调节,取代原有的通过拧螺丝调节的方法,并将新型腿架应用于泌尿外科80例截石位手术中。结果：此新型腿架单人操作即可,升降调节时无需将患者腿部抬起,操作方便、节省人力,80例手术无1例发生腿部滑落,操作者使用后效果满意。结论：此新型专利解决了截石位腿架调整操作费力及存在安全隐患的问题,值得临床推广使用。     

B超引导下臂丛神经阻滞麻醉的效果及安全性

目的研究B超引导下臂丛神经阻滞麻醉的临床效果及安全性。方法将本院行上肢手术的90例患者随机分为对照组(n=48)和B超引导组(n=42)。对照组以盲探的方法行臂丛神经阻滞麻醉,B超引导组在B型超声仪引导下行臂丛神经阻滞麻醉。比较两组的麻醉效果。结果B超引导组感觉阻滞起效时间、麻醉药物使用剂量均优于对照组,但麻醉操作时间长于对照组(P<0.05)。B超引导组不同臂丛神经的感觉阻滞完善率均高于对照组,并发症总发生率低于对照组(P<0.05)。结论与盲探法相比,B超引导下行臂丛神经阻滞麻醉的麻醉操作时间虽然有所延长,然而麻醉效果佳,能够缩短感觉阻滞起效时间、减少麻醉药物用量,且安全性好。     

左腋动脉和臂丛神经走行变异1例

笔者在标本解剖操作观察腋窝结构时发现1例左侧腋动脉与臂丛神经位置及走行出现变异,既往文献报道的变异多为腋动脉发出的分支与臂丛神经之间的位置与走行之间变异^[1-3],本次解剖观察发现腋动脉与臂丛神经的内侧束、外侧束和后束之间的位置关系出现变异,与既往报道有所不同,现报告如下。     

社区护理人员开展健康教育的调查分析

目的 通过了解新疆石河子市社区卫生服务机构护理人员开展健康教育的现状,分析影响因素,为社区护士科学有效地开展健康教育提供依据.方法 采用问卷调查,对本市社区卫生服务机构的151名护理人员进行了调查.结果 社区护士普遍开展了健康教育,主要是通过健康咨询的方式宣传健康的生活方式和慢性病的防治知识,护士在健康教育过程中面临的最大困难依次是缺少资金、社区居民观念跟不上和缺少社区护士.结论 社区健康教育的对象主要为服务站的就诊者,内容和形式单一,且不够深入,社区护士缺乏健康教育的理论与技能,在健康教育与健康促进方面没有发挥应有的作用,应引起社区护理管理者的重视,制定切实可行的措施,发挥社区护士在健康教育中的作用.     

自体外周血造血干细胞联合自体骨髓移植治疗难治性淋巴瘤的临床分析

本研究通过回顾性分析自体外周造血干细胞移植、自体骨髓移植及二者联合移植在治疗难治性恶性淋巴瘤的疗效、毒副作用、造血和免疫功能恢复速度等临床方面的差异,总结归纳三种不同移植方式在治疗难治性淋巴瘤方面的优劣。68例难治性恶性淋巴瘤患者接受了大剂量放化疗结合自体造血干细胞移植治疗,其中10例患者为单一自体骨髓移植（autologous bone marrow transplantation,ABMT）,46例患者为单一自体外周血造血干细胞移植（autologous peripheral blood hematopoietic stem cell transplantation,APBHSCT）,12例患者为自体外周血造血干细胞联合自体骨髓移植（autologous peripheral blood hematopoietic stem cells transplantation combined with autologous bone marrow transplantation,APBHSCT＋ABMT）。结果表明：ABMT、APBHSCT、APBHSCT＋ABMT的治疗有效率和1、3、5年生存率分别为（90％和75％、57．1％、33．3％）;（86．4％和74．4％、54．2％、38．1％）;（83．3％和72．7％、55．6％、40％）。白细胞恢复时间分别为13天、11天、8天,血小板恢复时间分别为17天、14天、9天。在移植后3个月、6个月、1年时检测ABMT、APBHSCT、APBHSCT＋ABMT患者T细胞亚群正常率分别为（0％、33．3％、60％）,（10．8％、32％、73．9％）,（27．3％、55．6％、85．7％）。结论：自体外周血造血干细胞联合自体骨髓移植与单一自体外周造血干细胞移植治疗难治性恶性淋巴瘤的临床疗效和毒副作用当,但联合造血干细胞移植（APBHSCT＋ABMT）患者的造血功能恢复略快,有利于拓宽年龄偏大和造血功能受损患者移植方式的选择。     

肢带型肌营养不良的MRI表现

目的 观察肢带型肌营养不良的MRI表现。方法 回顾性分析7例经临床及病理检查确诊为肢带型肌营养不良患者的MRI资料,观察双侧大腿肌群脂肪沉积与炎性水肿情况,采用4分法进行评价。并进行统计学分析。结果 肢带型肌营养不良患者大腿肌群MRI均可见脂质沉积和炎性水肿性改变。不同肌肉间脂肪沉积(χ²=75.596,P<0.01)与炎性水肿差异均有统计学意义(χ²=41.368,P<0.01),双侧大腿肌群间脂肪沉积与炎性水肿差异均无统计学意义(P均>0.05)。结论 肢带型肌营养不良患者大腿肌群MRI信号特点及分布具有一定特征,MR检查有助于疾病的诊断。