In Vitro Growth in Acute Myeloblastic Leukemia: Clinico-Biological Correlations

In the present review we analyse the current knowledge about the growth properties of AML progenitor cells and their relationship with other clinico-bilogical characteristics of the disease. Leukaemic colony forming unit L-CFU is considered to be the clonogenic cell in AML and more immature than the blast cell population. Our studies have shown that in leukaemic hematopoiesis colony forming cells can exist among both cell fractions CD34+ and CD34-. Optimal “in vitro” proliferation of L-CFU is dependent upon the addition of exogenous growth factors. However, it has been observed that leukaemic progenitor cells frequently display a certain degree of autonomous proliferation. In order to quantify the “in vitro” behaviour of L-CFU, we have explored 3 parameters: 1) plating efficiency (PE); 2) autonomous growth (AG); and 3) autonomous proliferative index (API) which was calculated as AG divided by PE and we have correlated them with other clinico-biological data. According to the FAB classification we could observe that patients with M3 subtype showed an higher PE than other AML subgroups and a significantly lower API. Regarding CD34 expression we observed that AG was enhanced in CD34+ cases and also in those showing a higher rh123 elimination. In order to determine whether PE could condition clinical evolution, we analysed this parameter in a large series of patients but failed to demonstrate any relationship. By contrast, we observed that patients who displayed a higher API showed a shorter survival than patients with lower API (18% vs 48% surviving at 3 years).We have also shown that abnormalities in the CFU-GM growth pattern could be associated with risk the of relapse in AML patients; a switch from normal to abnormal “in vitro” growth should alert us. But for the assessment of the real value of these analyses sequential follow-up studies are mandatory. In summary, cell culture studies contribute not only to a better understanding of leukaemic hematopoiesis but may also contribute to better disease monitoring.     

Primary tumour characteristics and axillary lymph node status in breast cancer.

This paper examines the correlation between axillary lymph node status and primary tumour characteristics in breast cancer and whether this can be used to select patients for axillary lymphadenectomy. The results are based on a retrospective analysis of 909 patients who underwent axillary dissection in our unit. Axillary lymph nodes containing metastases were found in 406 patients (44.7%), all with invasive carcinomas, but in none of the 37 carcinomas-in-situ. Nodal status was negative in all T1a tumours, but lymph node metastases were present in 16.3% and 35.7% of T1b and T1c tumours respectively. When histological grade was taken into account, positivity for grade I T1b and T1c tumours fell to 13.6% and 26.7% respectively. Lymph node metastases were found in 85% of patients with lymphovascular invasion in their tumours as compared to only 15.4% of those without and in 45.5% of oestrogen and progesterone receptor-positive tumours. When one or both hormone receptors were absent this figure was much higher. It appears that for T1a breast cancers axillary dissection is not necessary, whereas for T1b, T1c and grade I T2 tumours other histopathological parameters should be taken into consideration in deciding who should undergo axillary lymphadenectomy.     

妊娠合并卵巢肿瘤的处理

明确妊娠合并卵巢肿瘤的临床特征和处理对策。方法回顾性分析７２例妊娠合并卵巢肿瘤的临床结局。结果妊娠合并卵巢成就畸胎瘤、巧克力囊肿和黄体囊肿的发生率分别为３０．６％、１９．４％和１８．１％。     

《得心集医案》辨治急难证的思路与方法

总结分析了清代医家谢星焕《得心集医案》辨治急难证的特点：在辨证方面注重天人合一,善于辨别真假错杂之证,尤长于以脉诊决疑释难,妇科难证多求诸奇经八脉;在治疗方面法度严谨,善于化裁古方,急救方法多变,涌吐、针灸、鼻饲、敷脐等多有采用。     

护理本科藏族学生中医护理课程学习特点的质性研究

目的探讨跨文化背景下,内地护理本科藏族学生中医护理课程学习特点。方法2019年3月,目的抽样法选取浙江省已学习中医护理课程的18名本科藏族护生为研究对象,采用质性研究法,对其进行半结构式访谈;并采用传统内容分析法进行资料分析。结果共提炼归纳出3个主题:学习动机的发生发展;缺乏学习迁移策略;存在文化适应性问题。结论本科藏族护生学习中医护理动机逐步明确,但缺乏有效的学习方法和学习计划,对中医护理文化内涵缺乏了解。考虑到藏族护生的自身特点,中医护理教育者应针对具体原因,制定相应的教学改革模式,融合民族特色,减少文化差异对课程学习带来的冲击。     

全程中医特色健康指导对颈动脉粥样硬化斑块及血脂的影响

目的 观察全程中医特色健康指导对短暂性脑缺血发作（TIA）患者颈动脉粥样硬化斑块（CAP）及血脂的影响.方法 将100例TIA患者随机分为对照组和试验组,在西药常规治疗基础上分别给予普通健康指导或全程中医特色健康指导,比较对CAP及血脂的影响.结果 两组治疗后IMT、Crouse积分减小,TC、LDL-C下降,HDL-C升高,较治疗前有显著差异（P＜0.05）.治疗12个月后试验组对CAP及TC、LDL-C的影响较对照组更显著（P＜0.05）.结论 在常规药物治疗基础上全程中医特色健康指导能更好的改善CAP和血脂水平,是有效的TIA健康管理模式.     

脑卒中失语症患者常见的心理特点及护理干预

目的探讨脑卒中失语病人的心理特点,采取适当的护理干预措施,观察对脑卒中失语患者康复疗效的改善。方法选取52例脑卒中后造成失语症的患者,随机分为干预组和对照组。对照组给予常规康复训练,干预组在常规训练的基础上给予个性化沟通、音乐治疗、强化支持系统等护理干预措施。疗程为2个月,在治疗前后分别用Zung氏抑郁自评量表、波士顿BDAE失语症诊断量表、Barthel指数、MMSE量表评估两组患者的抑郁程度、语言功能、日常生活活动能力及认知功能。结果干预组与对照组相比,除日常生活活动能力组间比较P〉0．05,其余3组均p〈0．05。结论通过有效的护理干预措施可以有效减轻脑卒中失语症患者的卒中后抑郁,改善其语言功能和认知功能。     

浙江西南野生金银花种质资源的特性研究

目的 研究浙江西南地区野生金银花种质资源的形态性状、有效成分及遗传特性,为金银花种质资源的开发利用及遗传育种提供依据。方法 采用形态性状调查、HPLC检测及ITS序列分析揭示野生金银花种质的特性。结果 浙江西南地区的6个野生金银花种质在形态性状上差异较小,通过ITS序列分析表明它们之间亲缘关系非常相近,能够与忍冬属其他植物明显区分。6个野生种质与栽培品种之间形态差异和有效成分量差异较大,其中有性状优良的野生种质,如产自浙江省景宁县（ZJJN1）与浙江省青田县（ZJQT）的样品,其绿原酸量分别为1.94%和2.42%,达到《中国药典》2010年版标准。结论 研究野生金银花种质的优良特性,对浙江西南地区野生金银花资源的开发及优良栽培品种的选育具有重要的现实意义。     

浅谈汉语影响汉民族表达方式的几点因素

汉语的特性主要表现在汉语的三要素上 ,它们影响着汉民族表情达意的方式。我们民族含蓄委婉、幽默风趣、灵活多变的传情方式也都因有汉语的支持而畅通无阻。汉语以自己独特的个性造就了我们民族的形象。