荧光原位杂交检测多发性骨髓瘤患者A13及其临床意义

目的 总结100例多发性骨髓瘤(MM)患者荧光原位杂交(FISH)检测△13(13q-/-13)阳性率及其临床意义.方法 对100例MM患者采用RB-1探针行FISH检测,并结合常规染色体(CC)结果分析其临床意义.结果 (1)△13 FISH检出率为19.0%,CC检出率为10.0%,差异未达统计学显著性(P=0.053).(2)单因素分析示FISH检测△13阳性率>50%、CC检测克隆性A13(C13A)、非超二倍体核型、FISH检测和CC检测双阳性、血β2-MG≥3.5 mg/L为不良预后因素.(3)多因素分析示FISH检测△13阳性率>50%和血β2-MG≥3.5 mg/L是独立预后因素.(4)根据上述两个独立预后因素,可将患者分为低、中、高危3组,两两比较总体生存时间(OS),差异均有统计学意义.结论 (1)FISH检测提高了初治MM遗传学异常的检出率.(2)预后分析示FISH检测△13阳性率>50%和血β2-MG水平为独立预后因素.     

巴戟天及根皮与木心UPLC特征指纹图谱与化学模式识别方法研究

目的建立基于UPLC特征指纹图谱-化学模式识别方法研究巴戟天Morindae Officinalis Radix及根皮与木心的差异性。方法采用UPLC技术建立巴戟天根皮与木心环烯醚萜类和寡聚糖类特征指纹图谱,结合相似度分析、方差分析、聚类分析、主成分分析(PCA)进行化学模式识别研究。结果分别建立了巴戟天及根皮与木心环烯醚萜类和寡聚糖类UPLC特征指纹图谱,并分别确定了12个和20个共有峰,巴戟天根皮与木心UPLC特征指纹图谱差异性明显。结论巴戟天环烯醚萜类和寡聚糖类UPLC特征指纹图谱-化学模式识别方法分析能够整体、全面、真实地反映出巴戟天根皮与木心的差异性,为巴戟天去木心必要性提供了依据。     

新生儿有机磷中毒诊为消化道出血1例

患儿女,22天,因呕吐鲜血3次,哭闹、烦躁不安2小时入院。入院前曾去乡镇卫生院,诊断为上消化道出血,支气管肺炎。给予青霉素、氧哌嗪青霉素、维生素K_1(具体不详)治疗,病情未见好转,急转入我院。家长否认有农药接触史。查体:T 37.1℃,P 114次/分,R 56次/分。神志清,精神萎靡,面色     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.     

鲜地黄提取物UPLC特征图谱与化学模式识别方法研究

目的 研究鲜地黄水提与榨汁提取物UPLC特征图谱的差异性。方法 以鲜地黄为原料,采用水提和榨汁两种工艺制备鲜地黄提取物;以乙腈-0.1%磷酸水溶液为流动相梯度洗脱,流速为0.3 mL/min,检测波长为203 nm,柱温为30℃,测定各批次鲜地黄水提与榨汁提取物的特征图谱,并结合多元统计分析、偏最小二乘法分析（OPLS-DA）、主成分分析（PCA）和聚类分析（CA）等化学模式识别方法比较二者的差异。结果 鲜地黄提取物特征图谱共标定了10个共有峰,并对峰3（梓醇）、峰4（地黄苷D）、峰6（益母草苷）进行了指认;多元统计分析、OPLS-DA表明峰1、峰2、峰5、峰7、峰9、峰10的峰面积是导致鲜地黄水提和榨汁提取物质量差异的最主要因素;PCA和CA均能将鲜地黄水提和榨汁提取物单独聚为两类。结论 建立的鲜地黄提取物UPLC特征图谱能够全面地反映鲜地黄水提和榨汁提取物之间化学成分的差异,可为鲜地黄现代制剂的制备工艺、质量控制以及临床使用提供参考。     

反相高效液相色谱法测定人字草中槲皮素和木犀草素的含量

目的建立人字草中槲皮素和木犀草素含量测定方法。方法采用反相高效液相色谱(RP-HPLC)法,色谱柱为Zorbax SB-C18柱(4.6mm×250mm,5μm);检测波长360nm,流动相为甲醇-0.2%磷酸(50∶50),柱温30℃,流速1.0mL/min。结果槲皮素、木犀草素的回归方程分别为Y=2545.36X+86.37,Y=3261.65X+61.29;r分别为0.9995和0.9991;质量浓度线性范围分别是5.28-26.4μg/mL,4.12-20.6μg/mL;槲皮素、木犀草素的加样回收率分别为101.5%和99.6%,RSD分别为1.2%和0.83%;样品分别含槲皮素、木犀草素2.33mg/g,0.316mg/g。结论该方法适合同时测定人字草中槲皮素和木犀草素的含量,方法简便可行,重复性好,结果可靠。     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.     

培养一支高水平的新农合工作队伍

“新农合工作队伍从广义上来说，包括各级党委、政府的领导，有关部门的干部职工，经办机构的工作人员，定点医疗机构的相关人员和农村基层干部。工作队伍的骨干是在政府领导下的新农合经办、管理机构的工作人员。这支队伍的水平如何、作风如何，直接关系到新农合制度实施的效果？”省卫生厅党组书记、厅长王天瑞如是说。他是在3月2日举行的全省第三期新型农村合作医疗培训班上讲这番话的。     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.     

白内障手术诱发新生血管性青光眼1例

1　临床资料患者 ,女 ,71岁 ,于 2 0 0 0年 9月 16日在表麻下行右眼超声乳化加人工晶状体植入术 ,术前血尿常规均正常 ,心电图 :下壁心肌缺血 ,频发房早 ,高血压病史 1a,全身检查未见手术禁忌症。血压 :2 4/ 12 k Pa。眼科检查 :视力 :R:数指 /眼前 ,L :0 .0 5 ,光定位和色觉正常 ,右眼角膜透明 ,前房正常深浅 ,虹膜纹理清 ,晶状体皮质性混浊 ,后囊混浊 ,眼压 :双眼2 0 .5 5 mm Hg(1k Pa=7.5 mm Hg)。术时 12 min,术中顺利 ,术后无不良反应 ,术后 1d,VA∶ R手动 ,结膜充血 ,切口平整 ,角膜透明 ,虹膜纹理清 ,人工晶状体在位 ,其上可见散…