三色流式细胞术在检测儿童急性淋巴细胞白血病免疫表型中的应用

目的:探讨三色荧光标记流式细胞术CD45辅助设门检测儿童急性淋巴细胞白血病(CALL)免疫表型的临床应用及意义。方法:采用流式细胞仪和几组三色荧光标记抗体检测25例FAB分型为ALL的儿童骨髓或外周血免疫表型。结果:25例ALL儿童中,B型淋巴细胞白血病14例,T型淋巴细胞白血病6例,双标记5例,在T-ALL中,淋系抗原阳性率表达顺序为CD7>CD3>CD5,在B-ALL中,淋系抗原阳性率表达顺序为CD19>CD10>CD22>CD20,在T-ALL、B-ALL及双标记中还可同时表达髓系抗原(CD13、CD14、CD15、CD33),且髓系标记抗原在T-ALL与B-ALL中出现的频率相同。结论:三色荧光标记流式细胞术CD45/SSC设门技术检测儿童急性淋巴细胞白血病免疫表型,可准确将幼稚细胞从正常细胞群中分离出来并专门对异常细胞群进行免疫表型分析,将淋巴细胞白血病分为B型和T型白血病及双标记,并能反映髓系抗原阳性的ALL(M y+ALL),对指导临床治疗有重要价值。     

暴发性急性胰腺炎38例治疗分析

目的：探讨暴发性急性胰腺炎的治疗方法.方法：回顾性分析从1991年1月至2005年12月收治的38例暴发性急性胰腺炎病例,分为急诊手术治疗、非手术治疗和非手术治疗结合早期手术治疗3细观察疗效.结果：38例中存活24例,总体生存率为63.16%,其中急诊手术治疗10例,存活4例（40%）;单纯非手术治疗组16例,存活9例（56.25%）;非手术治疗结合早期手术治疗治疗组12例,存活11例（91.67%）.3组存活率两两比较其差异具有显著性（P＜0.05）;3组的急性生理学和慢性健康评分标准APCHEⅡ（acute physiology and chronic health evaluationⅡ）评分两两比较均不具有显著性差异（P＞0.05）.结论：对于暴发性急性胰腺炎应在强化的非手术监护治疗下行早期手术治疗,腹腔间隔室综合征的发展程度是决定手术时机的关键;手术目的是进行充分有效的腹腔减压和引流而不是以清除胰腺的坏死组织为目的;术后血液透析对于阻止胰腺局部病变和全身病情加重,保护脏器功能具有显著功能.     

Acute-onset nontraumatic paraplegia in childhood: fibrocartilaginous embolism or acute myelitis?

Fibrocartilaginous embolus causing acute spinal cord infarction is a rare cause of acute-onset paraplegia or quadriplegia. Few cases of survivors have been reported in the neurosurgical literature, with most reports involving post-mortem or biopsy findings. There is little information on MRI findings in such patients. We present the youngest patient ever reported, and discuss the important differences between fibrocartilaginous embolus and acute myelitis of childhood. A 6-year-old girl with a history of back pain presented with sudden-onset nontraumatic paraplegia, with a clinical anterior spinal artery syndrome. Initial MRI scan revealed intervertebral disc disease at L1–2 and an incidental thoracic syrinx, but no cause for her acute-onset paraplegia was identified. Cerebrospinal fluid and other investigations were all negative. Sequential MRI scans revealed development of spinal cord expansion from T10 to the conus medullaris, with increased cord signal in the anterior aspect of the spinal cord. The intervertebral disc disease was unchanged. The imaging and clinical findings were caused by fibrocartilaginous embolus, which meant there was no need for spinal cord biopsy. The report describes the clinical and imaging criteria for diagnosis of fibrocartilaginous embolus, highlighting the case for avoiding an unnecessary biopsy. The clinical pattern in the paediatric group is discussed, with features differentiating it from acute myelitis of childhood. Received: 4 January 2000     

中西医结合治疗急性重症胰腺炎临床体会

目的探讨分析中西医结合治疗急性重症胰腺炎的疗效以及可行性。方法回顾分析我院1999年9月￣2005年9月收治的行中西医结合治疗的急性重症胰腺炎病人72例的治疗情况,与以往行手术治疗的治疗效果进行比较。结果治愈57例,治愈率79.2%,中转手术8例,死亡7例,死亡率9.7%,并发症发生率18%。结论中西医结合方法治疗急性重症胰腺炎的效果良好,可明显降低并发症发生率及死亡率。     

急性腹泻患儿64例血锌检查结果分析

目的探讨急性腹泻患儿血锌的变化及临床意义。方法对64例急性腹泻患儿血中的微量元素锌进行检测,并与正常儿童值进行对照。结果急性腹泻患儿血锌含量明显低于正常对照组,且差异显著,P<0.05。结论缺锌儿童易患腹泻病,合理补充微量元素锌有助于该病的防治。     

恶性血液病患者感染调查研究

目的了解恶性血液病(HM)患者合并感染的临床特点。方法回顾性分析2004年住院接受化疗的327例HM患者的感染发生情况。结果感染发生率为33.64%;感染部位以呼吸道最多见,占40.85%;分离的病原菌主要是革兰阴性菌(43.33%)、革兰阳性菌(33.33%)和真菌(23.34%);急性白血病和各类复发的HM患者感染率最高,达70.58%;粒细胞缺乏与无粒细胞缺乏者感染率分别是69.39%和18.64%,两者差异有显著性(P<0.05)。结论HM患者感染率高,尤以急性白血病和各类复发的HM患者及粒细胞缺乏者为甚,应加强监控。     

清肺饮合剂治疗60例急性支气管炎

[目的]观察清肺饮合剂治疗急性支气管炎的疗效。[方法]采用自制中药清肺饮合剂治疗急性支气管炎60例。[结果]经治疗5天后,治愈38例,好转20例,无效2例,总有效率96·7%。[结论]清肺饮合剂治疗急性支气管炎有满意疗效。     

The V264M polymorphism of tissue factor pathway inhibitor gene in patients with acute coronary syndrome

Objective： To investigate V264M polymorphism of tissue factor pathway inhibitor （TFPI） in patients with acute coronary syndrome （ACS） in Chinese. Methods ： The genotypes of V264M were detected by polymerase chain reaction （PCR） and restriction fragment length polymorphism （PCR-RFLP） in 136 patients with ACS and 106 healthy controls with their plasmal f-TFPI tested by enzyme linked immunosorbent assay （ELISA）. Results： Two genotypes were found in V264M： GG and GA. The distribution frequencies of alleles and genotypes were in accordance with those predicted by Hardy Weinberg equilibrium in the present study （χ2 = 0.437, P 〉 0.05）. Plasma f-TFPI level was lower in A allele bearer than that in non-A allele carriers and higher in ACS than control subjects （P〈0.05）. No relationship was found between ACS and V264M polymorphism （P〉0.05）. Conclusion： The V264M polymorphism may have an impact on the plasma level of free TFPI（f-TFPI）, but it has no relationship with ACS.     

急性心肌梗死介入治疗研究进展

经皮冠状动脉介入治疗(PCI)已广泛应用于急性心肌梗死(AMI)病人,临床疗效良好。它可分为直接PCI、立即PCI、延迟PCI、挽救性PCI等,近年还诞生了易化PCI等新的介入治疗方法。本文就上述介入治疗方法的最新进展作一综述。     

Effects of varied interferons in combination with all-trans retinoic acid （ ATRA ） on proliferation and differentiation of ATRA-resistent APL cell

Objective：To investigate the effects and mechanisms of interferon in combination with alltrans retinoic acid （ATRA） on proliferation and differentiation of ATRA-resistent APL cell. Methods ：After MR2 cells （ATRA-resistance cell line） were treated with IFN-α, IFN-γ and ATRA alone or IFN-α and IFN-γ in combination with ATRA respectively. The cell proliferation was tested by MTT test and the cell differentiation was tested through light microscope by NBT test and flow cytometry （FCM）. The expres sion of promyelocytic leukemia （PML） protein was observed by indirect immune fluorescent method. Results： Both IFN-α and IFN-γ could inhibit the proliferation and induce the differentiation of MR2 cells to some extent. The effects were more obvious after both interferons in combination with ATRA respectively （P〈0.05）. Moreover, the maturation of MR2 cells induced by IFN-γ＋ATRA group was more higher than that by IFN-α＋ATRA group （P〈0. 05）. Both interferons could induce the expressions of PML protein. Conclusion：Both interferons can inhibit MR2 cells proliferation, which may be related to the expression of PML protein induced by both interferons. The inducing differentiation effects of IFN-γ＋ATRA group on MR2 cells are more powerful than those of IFN-aq-ATRA group, which may be related to the different signal transduction pathway of both interferons.