Actuarial survival in the premature infant less than 30 weeks' gestation

OBJECTIVE: Because survival from admission to discharge does not provide parents and physicians information about future life expectancy in the premature neonate, we characterized the actuarial survival, defined as the future life expectancy from a given postnatal age, in a large inborn population of premature infants < 30 weeks' gestation. STUDY DESIGN: We determined daily actuarial survival of 1925 inborn infants (23 to 29 weeks' gestation) admitted to the Baylor Affiliated Nurseries from July 1986 through December 1994, stratified by 100-g birth weight and by 1-week gestational-age intervals. RESULTS: In the 501- to 600-g birth weight stratum, actuarial survival improved from 31% at birth, to 61% on day of life 7, and then to 75% on day of life 28; in the 901- to 1000-g birth weight stratum, actuarial survival improved from 88%, to 94%, and then to 98% throughout the same times, respectively. Similar trends were obtained when data were stratified by gestational age. CONCLUSIONS: Survival in the smallest infants improves dramatically during the first few days of life, but there is a significant risk for late death in the smallest of these infants.     

Severe neuroexcitatory symptoms after anaesthesia--with focus on propofol anaesthesia

Delayed neuroexcitatory symptoms after an uneventful anaesthesia are uncommon, although described in many reports. We want to report on two cases. The first patient developed muscle hypertonicity, jerky movements and unconsciousness after an uneventful anaesthesia with propofol, and later the same thing happened after anaesthesia with thiopentone. The second patient developed similar symptoms after an uneventful anaesthesia with propofol, but she never recovered completely after this and is now severely disabled. A search of the literature and the Swedish adverse drug reactions register revealed many similar cases. In both our patients the causal relationship between propofol and the neuroexcitatory symptoms remains uncertain, but we want to alert readers about this possible adverse reaction.     

外源核苷酸对免疫抑制小鼠胸腺细胞DNA损伤的影响

目的:检测外源核苷酸对经环磷酰胺诱导的免疫抑制小鼠胸腺细胞DNA损伤的影响。方法:采用18～20 g昆明种小鼠30只,雌雄各半,随机分成阴性对照组(NEC)、阳性对照组(POC)和核苷酸组(NTG),每组10只。NEC组和POC组小鼠均饲喂半纯合无核苷酸的基础日粮,NTG组则在基础日粮中添加0.25%的核苷酸,实验期为21 d。在实验结束前18 h POC组和NTG组小鼠按照150mg/kg bw的剂量腹腔注射环磷酰胺,NEC组注射生理盐水,实验结束时测定脾脏和胸腺脏器指数,并取胸腺细胞,做单细胞凝胶电泳,观察细胞DNA损伤情况。结果:在基础日粮中添加核苷酸对小鼠免疫器官重量没有显著影响(P>0.05),但能极显著降低受损胸腺细胞百分率(P<0.01)和受损细胞DNA尾长(P<0.01)。结论:外源核苷酸能显著降低免疫抑制小鼠受损胸腺细胞百分率和损伤程度。     

自我效能感与晕船症状的相关研究

目的探讨自我效能感与晕船症状的相关,以期寻找影响晕船的心理因素.方法对某院校参加海上实习的123名医疗本科学员用一般自我效能感量表、晕船自我效能感量表于出海作业前进行施测,用晕船症状评分量表于出海作业返回后进行评估.结果晕船自我效能感与晕船症状显著负相关(r=-0.470,P＜0.01),而一般自我效能感量表与晕船症状的相关无统计学意义(r=-0.102,P＞0.05).结论晕船自我效能感可能为个体发生晕船的心理影响因素之一.     

Prognostic significance of tumor necrosis in ovarian cancer patients treated with neoadjuvant chemotherapy and interval surgical debulking

The objective of this study was to study the significance of tumor necrosis documented at the time of interval surgical debulking after neoadjuvant chemotherapy. Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Patients' demographics together with disease characteristics, treatment-related variables, and outcomes were recorded. Cox proportional hazard models were built to model time to progression using predictor variables such as age, cancer stage, tumor grade, residual disease, percentage change in CA125 level from baseline, and degree of necrosis in resected tumor specimens. One hundred one patients were included in the study. Optimal debulking was achieved in 74% of the patients. Cox regressions revealed three significant predictive variables of time to first progression: younger age (hazard ratio [HR] = 0.95, 95% CI 0.92-0.98, P= 0.004), residual disease (P= 0.048), and the absence/minimal tumor necrosis after three cycles of neoadjuvant chemotherapy (HR = 1.97, 95% CI 1.01-3.87, P= 0.048). The estimated median survival was 50.66 months (95% CI 46.12-55.20). The lack of or minimal tumor necrosis after neoadjuvant chemotherapy is an independent risk factor for recurrent disease.     

提高化疗强度对伴IKZF1基因缺失儿童急性淋巴细胞白血病预后的影响

目的 总结伴IKZF1基因缺失儿童急性淋巴细胞白血病（ALL）的临床特征并观察提高化疗强度对其预后的影响。方法 2015年12月至2018年2月间确诊并按照中国儿童白血病协作组-ALL 2008（CCLG-ALL 2008）方案规范治疗的ALL患儿共278例,根据有无IKZF1基因缺失将其分为IKZF1基因缺失组和IKZF1基因正常组,IKZF1基因缺失组均接受CCLG-ALL 2008高危（HR）方案治疗,IKZF1基因正常组则按临床危险度分型接受不同强度化疗,比较两组的临床特征及无事件生存（EFS）率。结果 278例患儿中共24例（8.6%）检出IKZF1基因外显子大片段缺失。IKZF1基因缺失组初诊时WBC ≥ 50×10⁹/L、BCR-ABL1融合基因阳性、诱导缓解治疗第15天微小残留病≥ 10%、微小残留病-HR、临床危险度-HR所占比例均高于IKZF1基因正常组（P < 0.05）。IKZF1基因缺失组3年EFS率（76%±10%）低于IKZF1基因正常组（84%±4%）,但差异无统计学意义（P=0.282）;其中,IKZF1基因缺失组-非HR（实际按CCLG-ALL 2008 HR方案化疗）的预计3年EFS率为82%±12%,低于IKZF1基因正常组-非HR（86%±5%）,但差异无统计学意义（P=0.436）。结论 伴IKZF1基因缺失的儿童ALL早期治疗反应更差,提高化疗强度可能改善其预后。     

卡介菌多糖核酸辅助治疗对结核病患者血清可溶性白细胞介素2受体的影响

目的 观察结核病治疗的强化期联用卡介菌多糖核酸(BCG-PSN)(商品名:斯奇康)对患者血清可溶性白细胞介素2受体(sIL-2R)的影响.方法 将53例初治结核病患者随机分为观察组和对照组,在采用标准短程化疗方案(2HRZE/4HRE)的基础上,观察组在强化期加用臀部肌肉注射BCG-PSN,两组分别在治疗前后检查血清sIL-2R浓度.结果 两组治疗后血清sIL-2R均有明显降低,其中观察组已降至正常水平,与对照组相比有显著差异.结论 结核病治疗的强化期联用BCG-PSN能显著降低血清sIL-2R,提高结核病患者细胞免疫功能.     

113例原发性肝癌的临床病理分析

目的:探讨原发性肝癌临床及病理学特征。方法:对113例原发性肝癌的临床资料和病理资料进行回顾性分析。结果:113例原发性肝癌有91例为肝细胞癌,22例为胆管癌。91例肝细胞癌患者均为乙肝患者,其中86例伴发结节性肝硬化,87例AFP阳性;组织学类型小梁型56例,假腺型15例,实体型20例。22例胆管癌患者仅1例有乙肝病史,3例合并肝血吸虫病,5例合并胆管炎症或结石。结论:肝细胞癌与乙肝病毒感染密切相关,常见于结节性肝硬化患者,大部分患者AFP阳性,组织学类型以小梁型为主。胆管癌多见于女性,通常无肝硬化,与血吸虫感染或胆管炎症有较密切关系。     

中药蛋白质组学研究策略

蛋白质组学在中药研究中的应用已十分广泛,有许多较为成功的实例。作者回顾了前人应用蛋白质组学技术对中药复杂体系的研究工作,并提出建立一门专门针对中药研究的蛋白组学,即中药蛋白质组学。该文对中药蛋白质组学的研究策略及未来的研究方向进行了综述和思考,希望为从事中药蛋白质组学研究者提供一点思路。     

喉癌患者不同手术方式临床疗效及预后影响因素的探究

目的 探讨喉癌患者不同手术方式的临床疗效及预后影响因素.方法 以本院2008年1月～2011年1月收治的60例喉癌手术治疗患者为研究对象,根据手术方式的不同分为全切除组及部分切除组,比较两组患者的3年生存率及术后早期生活质量,分析影响喉癌患者预后水平的危险因素.结果 两组患者3年生存率差异无统计学意义（P＞0.05）,部分切除组患者术后早期生活质量高于全切除组,差异有统计学意义（P＜0.05）.单因素分析结果显示,年龄、术前是否存在淋巴结转移、TNM分期情况及患者术后早期生活质量是影响患者预后水平的主要因素.结论 部分喉癌切除术在治疗喉癌中,与全切除术生存率相近,但术后早期生活质量较高;年龄、术前是否存在淋巴结转移、TNM分期情况及患者术后早期生活质量是影响预后的主要因素.