Matched-unrelated-donor bone marrow transplantation for children with leukemia.

BACKGROUND AND PURPOSE: This report describes the results of matched-unrelated-donor transplant for leukemia or myelodysplasia in the first 23 recipient children at a single medical center in Taiwan. METHODS: Between August 1994 and February 2003, 23 consecutive children with leukemia or myelodysplasia underwent matched-unrelated-donor bone marrow transplantation (BMT). The preparative regimen consisted of fractionated total body irradiation and cyclophosphamide in 6 patients; busulfan in combination with etoposide and cyclophosphamide in 4 patients who received cranial irradiation before transplantation; and busulfan and cyclophosphamide in 13 patients. RESULTS: Engraftment was achieved in 91.3% of cases. Acute graft-versus-host disease (GVHD) occurred in 18 of 21 patients who engrafted (85.7%). Event-free survival for all patients was 24.46 +/- 9.24%. The 12 children with standard-risk disease had better event-free survival than the 11 children with high-risk disease (46.88 +/- 15.03% vs 0%, p < or = 0.001). CONCLUSIONS: The major obstacles to successful matched-unrelated-donor BMT are acute GVHD, relapse and infection. Early transplantation and patient selection, prophylactic and therapeutic maneuvers for GVHD, as well as appropriate donor selection and virus prophylaxis may improve the results.     

介绍一种针头拔出器

临床工作中，医务人员在分离注射器、输液器针头时，常用止血钳、纱布或直接用手分离，这些方法易被针头刺伤。在许多医院使用自动针头毁形器。现介绍一种低成本、易制作及安装的简易针头拔出器。     

稳定性核素测定大鼠小肠蛋白质合成

目的：建立稳定性核素（[L-^15N]亮氨酸）测定大鼠小肠蛋白质合成率的方法。方法：分别测定静脉注射相同剂量[L-^15N]亮氨酸不同时相的大鼠小肠^15N丰度及不同剂量[L-^15N]亮氨酸同一时相的大鼠小肠^15N丰度。结果：大鼠小肠游离氨基酸池中^15N核素丰度在注射后0．5h内呈线性上升并达高峰，维持4h后缓慢下降，小肠蛋白质中的^15N丰度0．5h至12h基本维持不变；随着注射剂量的增加，大鼠小肠蛋白质分数合成率（FSR）亦增加，当[L-^15N]亮氨酸剂量在1．0mmol／kg以上，FSR并不随施加[L15N]亮氨酸剂量的加大而增加。结论：在进行大鼠小肠蛋白质合成率测定时，一次性静脉注射的测量最佳时限为0．5h，剂量为1．0mmol／kg。     

远程医疗在社区护理中的应用与前景

远程医疗自20世纪60年代在美国问世以来,已受到世界各国的广泛关注,其跨时空、零距离、实时互动等特点,被巧妙地应用于社区卫生保健中,并逐渐显现出其快捷、便利、优化资源配置等优势,使社区居民足不出户,通过电脑网络即可得到健康服务,成为社区卫生保健的新选择。在信息时代,远程医疗很快就会随着商业与教育的信息技术发展,开创医疗卫生事业的新纪元。本文中就远程医疗在社区护理中的应用进行综述,并展望远程医疗在中国的发展前景,以期为我国社区远程医疗的发展提供参考与帮助。1概述1.1远程医疗服务Telehealth(Telecare),内地普遍称为远…     

一种较好的RNA分离制备方法及其在人胚RNA提取中的应用

以钒基核苷酸复合物为核酸酶抑制剂,从人胚组织中制备总RNA,所得产品几乎不含DNA和蛋白质,经过分离Poly(A)~ mRNA,证明制品有合成cDNA的完整功能,方法比较简捷,适于大量制备以满足分离mRNA 之需,并讨论了此法的优缺点。     

补脾泻肝法治疗腹泻型肠易激综合征临床研究

目的观察补脾泻肝法治疗腹泻型肠易激综合征的临床疗效。方法100例腹泻型肠易激综合征患者随机分为2组,治疗组60例给予白术芍药散加味,对照组40例给予丙咪嗪合替加色罗治疗。2组均4周为1个疗程,观察疗效,并于3-6个月后观察2组病例复发情况。结果治疗组治愈率为65%,总有效率为85%,6个月内复发率为20%,对照组则分别为32.5%、72.5%、55.56%,2组比较差异均有统计学意义(均P<0.05)。结论补脾泻肝法治疗腹泻型肠易激综合征优于丙咪嗪合替加色罗,疗效确切。     

免疫荧光检测人乳头状瘤病毒新技术

利用过氧化氢的氧化作用参与抗原抗体反应,使细胞的膜通透性增强,利于荧光标记抗体染液渗入,从而更快速、广泛地接触抗原,更有效的抗原抗体的嵌合交联。新技术的应用,增强了染色效果,缩短了实验时间,简化了操作,提高了阳性检出率,使实验准确性提高,为临床确诊、疗效观察及预后提供了可靠依据。     

使用新型倒刺电极的骶神经调节治疗神经源性膀胱的初步临床结果

目的探讨应用新型倒刺电极（Tined-lead）对神经源性膀胱患者行S骶神经调节（SNM）的初步疗效。方法对5例神经源性膀胱患者采用新型倒刺电极，在X线监测下将电极植入S3骶神经孔，进行SNM。术前、术后详细记录排尿日记，用影像尿动力学方法评估患者的膀胱尿道功能。结果患者1（隐性骶裂）术后排尿次数和排尿量分别改善22％和49％；患者2（隐性骶裂）术后排尿次数、排尿量和残余尿量分别改善0．7％、11％和46％；患者3（隐性骶裂）术后排尿次数、排尿量和残余尿量分别改善0．4％、18％和44％。患者4（脑外伤）术后漏尿次数和漏尿量分别改善36％和54％。患者5（高位截瘫）术后间歇导尿次数和导尿量分别改善42％和54％，尿动力学参数改善37％～45％。结论用新型倒刺电极进行SNM为神经源性膀胱的治疗提供了一条新的可供选择的微创方法。     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.