妊娠期急腹症微创治疗85例分析

目的：探讨腹腔镜处理妊娠期急腹症的安全性及可行性。方法：回顾性分析85例妊娠期急腹症行腹腔镜手术的临床资料。结果：85例患者均于镜下成功实行微创手术,手术时间为30～100min,平均50min,术中出血10～50ml,平均住院时间为5.5d,无一例发生流产,无一例发生副损伤。结论：妊娠期急腹症施行腹腔镜手术具有恢复快、出血少、创伤小、不增加并发症等优点,手术指征明确时应积极运用。     

腹腔镜下输卵管妊娠开窗病灶清除术与药物保守治疗异位妊娠的随机对照研究

目的:分析腹腔镜下输卵管妊娠开窗病灶清除术与药物保守治疗异位妊娠的临床效果。方法:选取2014年8月~2015年8月我院收治的输卵管异位妊娠患者80例,根据治疗方法不同分为观察组和对照组,各40例。观察组行腹腔镜下输卵管妊娠开窗病灶清除术治疗,对照组行药物保守治疗。比较两组临床疗效。结果:观察组治愈率、输卵管通畅率均明显高于对照组,HCG水平恢复正常时间及总住院时间均低于对照组(P0.05);随访24个月,观察组再次异位妊娠率、不孕率均低于对照组(P0.05)。结论:与保守治疗相比,腹腔镜下输卵管妊娠开窗病灶清除术治疗异位妊娠效果更佳,能够有效提高输卵管通畅率,缩短治疗时间,降低再次异位妊娠率及不孕率,值得临床推广应用。     

阴式手术在基层医院微创治疗中的临床应用

目的：探讨阴式手术在基层医院妇科微创治疗中的应用价值及可行性。方法：回顾性分析我院于2003年1月～2009年12月对258例子宫、附件良性病变患者施行阴式手术的临床资料。结果：258例患者均顺利完成阴式手术,无一例盆腔脏器损伤,无一例中转开腹,术后无阴道残端/切口出血,术后活动及进食早、恢复快、术后平均住院时间5 d。结论：阴式手术对子宫、附件良性病变的治疗是微创、安全、有效、可行的,尤其适合腹腔镜手术设备、器械有限的基层医院开展,值得基层医院妇科微创治疗推广应用。     

原发性血小板增多症临床治疗效果观察

原发性血小板增多症(ET)的特征为骨髓内部巨核细胞过度增生,其外周血液中血小板含量升高且伴有血小板质量异常,病因不清,起病缓慢,病情轻者仅会出现乏力、头晕等高黏滞血症状,病情重者常伴有出血、血栓以及脾脏肿大等症状[1].本研究对ET患者的病历资料进行回顾性分析,以探讨该病的临床疗效与患者预后. 1对象与方法 1.1对象总结2002年4月至2011年3月我院70例ET患者病历资料,其中男47例,女23例;年龄19 ～ 78岁,中位年龄55岁.有出血者30例(42.9％),表现为皮肤紫斑、瘀斑,鼻腔、牙龈出血,伴有呕血、脑出血与黑便等;栓塞者19例(27.1％),其中脑梗死5例,心肌梗死3例;肝大者15例(21.4％).     

抗生素89－07的耳毒性试验Ⅰ．抗生素89－07与庆大霉素、阿米卡星对听力影响的比较

为进一步比较抗生素８９－０７与庆大霉素（ＧＭ）、阿米卡星（ＡＭＫ）长期用药时对听力的影响，本研究用豚鼠２１４只，各注射不同药物与生理盐水，每种药物又分４～５个剂量组，每天肌注１次，共２８ｄ。给药期间，每周及完成给药计划后均检查听力与前庭功能。听力检查表明，抗生素８９－０７对听力的影响近于生理盐水水平，随时间延长及剂量积累也未见变化，即不具有明显的量效关系及时效关系。相反，ＧＭ与ＡＭＫ随给药时间延长，药物积累，与生理盐水的差异愈趋明显，量效关系高度显著。本实验的功能检查结果表明：氨基糖苷类新抗生素８９－０７对听力损伤极低，几乎没有耳蜗毒性，是值得推荐的一种新药     

降脂排卵方对多囊卵巢综合征患者脂质代谢相关因子的影响

目的 研究降脂排卵方在多囊卵巢综合征治疗过程中对配体激活的核受体超家族转录因子（PPARα）、过氧化物酶体增殖物激活受体γ辅助活化因子（PGC-1α）及含有＂碱性螺旋-环-螺旋-亮氨酸拉链＂结构的核转录因子（SREBP-1c）、固醇调节元件结合蛋白裂解激活蛋白（SCAP）的调控作用.方法 选择多囊卵巢综合征患者84例随机分为中药治疗组、西药治疗组、中西医结合治疗组,中药治疗组采用降脂排卵方治疗,西药治疗组服用炔雌醇环丙孕酮片3个周期,中西医结合治疗组则同时采用中药治疗组和西药治疗组方法联合治疗.观察各组治疗前后脂质代谢相关因子的变化.结果 中西医结合治疗组可以显著提高PPARα、PGC-1α及降低SREBP-1c、SCAP拷贝数,可以显著降低体质量指数,中药组次之,而西药组则对脂质代谢相关因子及体质量指数的调控作用不明显.三组月经改善总有效率分别为71.42%、75.00%、92.86%.结论 降脂排卵方对多囊卵巢综合征患者脂质代谢相关因子PPARα、PGC-1α及SREBP-1c、SCAP有明显调控作用.     

卡泊芬净治疗恶性血液病化疗后中性粒细胞缺乏合并深部真菌感染的临床观察

目的分析卡泊芬净治疗恶性血液病化疗后中性粒细胞缺乏合并深部真菌感染临床效果及安全性。方法选取2009年3月至2012年5月收治恶性血液病化疗后中性粒细胞缺乏合并深部真菌感染患者50例,采用随机数字表法分为两性霉素B组和卡泊芬净组,分别采用两性霉素B和卡泊芬净静脉滴注治疗;比较两组患者临床治疗总有效率及不良反应发生率等。结果两性霉素B组总有效率(72.0%)与卡泊芬净组患者(76.0%)比较无显著差异(P>0.05);两性霉素B组不良反应发生率(36.0%)明显高于卡泊芬净组(P<0.05)。结论卡泊芬净早期治疗恶性血液病化疗后中性粒细胞缺乏合并深部真菌感染临床效果满意,且无严重不良反应。     

非血缘关系造血干细胞移植61例分析

Objective To study the therapeutic effectiveness, associated complications and related factors of unrelated allogeneic hematopoietic stem cell transplantation (URD-HSCT). Methods Sixty-one patients with malignant hematological diseases received URD-HSCT. All cases were subjected to myeloablative or nonmyeloablative conditioning regimen according to primary diseases. Among 61 patients, 21 were donor-recipient 6/6 HLA-matched, 5 were 5/6 HLA antigen-matched, 24 were 1 HLA gene subtype-mismatched, 11 were 2 HLA gene subtype-mismatched. Eighteen patients were ABO-compatible with donors, while 43 ABO-incompatible with donors. The median of infused donor nucleated cells was 4.5×108/kg, and the median of CD34+ cells were 4.3×106/kg. The graft-versus-host disease (GVHD) prevention regimens were based on short-term MTX, cyclosporin A and mycophenolate mofetil (MMF) regimen. Forty-nine cases also received CD25 Mab on the day of transplantation, and the day 4 after transplantation. Nine cases were also administrated with antilymphocyte globulin (ALG) or antithymocyte globulin (ATG). Two cases received ALG and CD25 Mab. Results Among 61 patients, 59 cases were successfully engrafted, which was identified by blood type, chromosome test and DNA polymorphism. Twenty-three cases developed grade Ⅱ～Ⅳ acute GVHD. Twenty-five patients experienced chronic GVHD. Infection of bacterial and/or fungal within 100 days after URD-HSCT was documented in 48 cases. Thirty-six cases had cytomegalovirus infection. Major infection site was lower respiratory tract. Eighteen cases died after URD-HSCT, and the 2-year disease-free survival rate was (68.0±6.4)%. Among these 18 deaths, 12 cases died because of transplantation related complications with the transplantation related mortality (TRM) being 19.7 %, and the remaining 6 cases died of relapse with the relapse rate being 9. 8 %, respectively. Conclusions URD-HSCT is an effective therapeutic strategy for malignant hematopoietic diseases when related donor is not available Acute GVHD and infection are risk factors of therapeutic effect and prognosis after URD-HSCT. Early prediction and prevention of acute GVHD and infection are essential problems to overcome.     

非血缘关系造血干细胞移植61例分析

Objective To study the therapeutic effectiveness, associated complications and related factors of unrelated allogeneic hematopoietic stem cell transplantation (URD-HSCT). Methods Sixty-one patients with malignant hematological diseases received URD-HSCT. All cases were subjected to myeloablative or nonmyeloablative conditioning regimen according to primary diseases. Among 61 patients, 21 were donor-recipient 6/6 HLA-matched, 5 were 5/6 HLA antigen-matched, 24 were 1 HLA gene subtype-mismatched, 11 were 2 HLA gene subtype-mismatched. Eighteen patients were ABO-compatible with donors, while 43 ABO-incompatible with donors. The median of infused donor nucleated cells was 4.5×108/kg, and the median of CD34+ cells were 4.3×106/kg. The graft-versus-host disease (GVHD) prevention regimens were based on short-term MTX, cyclosporin A and mycophenolate mofetil (MMF) regimen. Forty-nine cases also received CD25 Mab on the day of transplantation, and the day 4 after transplantation. Nine cases were also administrated with antilymphocyte globulin (ALG) or antithymocyte globulin (ATG). Two cases received ALG and CD25 Mab. Results Among 61 patients, 59 cases were successfully engrafted, which was identified by blood type, chromosome test and DNA polymorphism. Twenty-three cases developed grade Ⅱ～Ⅳ acute GVHD. Twenty-five patients experienced chronic GVHD. Infection of bacterial and/or fungal within 100 days after URD-HSCT was documented in 48 cases. Thirty-six cases had cytomegalovirus infection. Major infection site was lower respiratory tract. Eighteen cases died after URD-HSCT, and the 2-year disease-free survival rate was (68.0±6.4)%. Among these 18 deaths, 12 cases died because of transplantation related complications with the transplantation related mortality (TRM) being 19.7 %, and the remaining 6 cases died of relapse with the relapse rate being 9. 8 %, respectively. Conclusions URD-HSCT is an effective therapeutic strategy for malignant hematopoietic diseases when related donor is not available Acute GVHD and infection are risk factors of therapeutic effect and prognosis after URD-HSCT. Early prediction and prevention of acute GVHD and infection are essential problems to overcome.     

《镇江医学院学报》文摘规范化水平调查

为不断提高《镇江医学院学报》论文摘要作写规范化水平，将１９９１～１９９４年４年间出版的１２期学报文摘８１篇，对照“中国高等学校自然科学学报编排规范”及“ＧＢ６４４７～８６文摘编写规则”进行分析。结果显示：能客观准确地反映论著内容的文摘占６０％，说明文摘写作的规范化还不够。提示：作者的写者水平质量还有待于提高。