按需糖皮质激素治疗对再生障碍性贫血p-ALG治疗相关血清病反应发生及转归的影响

目的探讨按需糖皮质激素治疗对再生障碍性贫血(AA)应用猪抗人淋巴细胞球蛋白(p-ALG)相关血清病反应发生及转归的影响。方法收集2019年1月至2022年1月连续就诊于中国医学科学院血液病医院贫血诊疗中心接受p-ALG治疗的AA患者资料, 其中按需治疗组患者根据血清病反应发生与否及严重程度应用糖皮质激素, 共35例;传统防治组患者从同期接受常规糖皮质激素防治方案的群体中依据年龄、疾病诊断分型按1∶3进行倾向性评分匹配, 共纳入105例。比较两组间血清病发生率、临床表现、治疗转归及糖皮质激素用量。结果按需治疗组和传统防治组患者的血清病发生率分别为65.7%和54.3%, 差异无统计学意义(P=0.237)。两组患者血清病中位发病时间相同[第12(9, 13)天对第12(10, 13)天, P=0.552];临床症状体征相似, 主要表现为关节和(或)肌肉疼痛、发热及皮疹;严重程度分级均以1～2级血清病反应为主(62.8%对51.4%), 仅少数3级反应(2.9%对2.9%), 无4级和5级血清病反应, 不同等级血清病反应在两组间分布差异无统计学意义(P=0.530);血清病中位持续时间相同...     

中剂量环磷酰胺治疗难治性T细胞大颗粒淋巴细胞白血病合并纯红细胞再生障碍一例

患者,男,58岁.因胸闷、心悸1个月于2004年3月29日来我院就诊.查体:贫血貌,浅表淋巴结未见肿大,心、肺未见异常,肝、脾肋缘下未及.血常规:Hb 41g/L,WBC3.87×109/L,ANC 1.77×109/L,BPC 229×109/L,网织红细胞0.0013,绝对值1.4×10+/L,MCV、MCH及MCHC均正常.     

中剂量环磷酰胺治疗难治性T细胞大颗粒淋巴细胞白血病合并纯红细胞再生障碍一例

患者,男,58岁.因胸闷、心悸1个月于2004年3月29日来我院就诊.查体:贫血貌,浅表淋巴结未见肿大,心、肺未见异常,肝、脾肋缘下未及.血常规:Hb 41g/L,WBC3.87×109/L,ANC 1.77×109/L,BPC 229×109/L,网织红细胞0.0013,绝对值1.4×10+/L,MCV、MCH及MCHC均正常.     

中西医结合治疗单纯性肾小球性血尿25例疗效观察

单纯性肾小球性血尿是内科的常见病、多发病.我们以中医疗法为主,中西医结合治疗25例取得较满意效果.现报告如下:     

火焰原子吸收法测定补钙制品中的钙及其干扰抑制

近年来保健食品在我国发展很快,其中以补充钙剂为目的的保健食品占有相当大的比例.据报道我国居民摄入钙量严重不足,尤其是儿童青少年和老年人缺钙比例很高.因此补钙类保健食品在我国有很大的市场.过去,食品中钙的测定多用化学法,但化学法操作繁琐,且灵敏度不够.目前,原子吸收法广泛应用于钙的测定中,但对其中的干扰现象说法不一.食品卫生标准方法中有关钙的测定方法是针对普通食品而制定的,由于保健食品的特殊性,标准方法并不完全适合于保健食品的测定.因此我们针对保健食品的特殊性,对补钙产品中钙含量的测定方法及其干扰抑制从以下3个方面进行了研究.分析报告如下.     

性染色体不一致嵌合的病例报道和文献综述

性染色体不一致嵌合是指个体中同时存在女性(46,XX)和男性(46,XY)细胞系,根据产生机制不同可分为同源性和异源性嵌合.其发生率很低,发生机制也不是很明确;且由于各细胞系嵌合比例不同表型存在很大差异,产前诊断时难以评估预后.本综述汇总既往的文献报道,对性染色体不一致嵌合的发生率、发生机制、临床表型、相关治疗、预后及...     

不同孕周引产中并发的羊水栓塞的临床分析

羊水栓塞是指在分娩过程中羊水突然进入母体血循环引起急性肺栓塞、休克、弥散性血管内凝血(DIC)、肾功衰竭或突发死亡的分娩严重并发症.发生于足月妊娠时产妇死亡率高达70%～60%,妊娠早、中期流产亦可发生,但病情较轻,死亡少见.近年研究认为,羊水栓塞的核心问题是过敏反应,建议命名为妊娠过敏反应综合征.     

停经27+2周，超声检查提示双胎发育异常1天

<正>1 病历摘要患者,32岁,G1P0。因停经27+2周,超声检查提示双胎发育异常1天,于2022年8月30日入广东省妇幼保健院。患者平时月经周期规则,末次月经：2022年2月20日。本次妊娠为自然受孕,停经30+天自测尿妊娠试纸阳性证实妊娠,孕8+周超声检查提示：宫内早孕,单绒毛膜双胎。孕12+1周超声提示：宫内双活胎,单绒毛膜双羊膜囊双胎,头臀径55/55 mm, 颈项透明层(NT):1.2/1.6 mm,     

Effects of different levels of iodine concentration on insulin-like growth factors Ⅰ mRNA expression of thyroid and breast in lactating rats

Objective To study the effects of different levels of iodine concentration on insulin-like growth factors Ⅰ (IGF-1) mRNA expression of thyroid and breast in lactating rats. Methods Thirty Wistar female rats, having been weaned for 1 month, were randomly divided into three groups according to their body weights, i. e. :low iodine(LI) group,adequate iodine(AI) group, high iodine(HI) group, 10 rats in each group. Synthetic fodder and deionized water containing iodine of 0,150,3000 μg/L was respectively fed to these rats. After fed for 3 months, the rats mated and had offspring. Their mammary glands, thyroids and serum were sampled at lactation day 5. The serum iodine of lactating rats were determined by moderate acid digestion method, level of T3 and T4 were determined by radioimmunoassay method, and the expressions of IGF-1 mRNA of mammary glands and thyroids were determined by real-time fluorescence quantitative PCR assay. Results The value of serum iodine of LI group [(17.38±3.27) μg/L] was lower than that of AI group [(43.42±6.92) μg/L, P<0.05], and the value of serum iodine of HI group[(350.10±38.46)μg/L] was higher than that of AI group (P<0.05). The level of T3 of LI group and HI group[ (1.11±0.25), (1.61±0.33)μg/L] reduced obviously compared with that of AI group[(2.18±0.46) μg/L, P<0.05]. The mean of T4 of LI group and HI group[(33.40±11.11),(56.54±10.38)μg/L] had no statistical significance compared with AI group(44.02±12.51)μg/L, P>0.05), but the level of T4 of LI group was lower than that of HI group(P<0.05). The level of IGF-1 mRNA expression of thyroid in LI group and HI group (0.34±0.08, 0.23±0.08) was higher than that of AI group(0.15±0.03, P<0.05). The level of IGF-1 mRNA expression of lactating mammary in LI group(0.59±0.18) was higher than that of AI group(0.40±0.10, P<0.05). The level of IGF-1 mRNA expression of thyroid was lower than that of breast between the same group(t=3.54, 6.44,2.62, all P<0.05). Conclusion Iodine could affect IGF-1 mRNA expression of thyroid and lactating mammary, and IGF-1 mRNA expression of lactating mammary was stronger than that of the thyroid.