自体外周血CD34+细胞移植治疗2例肿瘤患者临床报告

大剂量化疗合并自体造血干细胞移植越来越多地应用于多种对化疗敏感的恶性肿瘤 ,输注动员后的外周血干细胞可明显减低大剂量化疗导致的并发症和死亡率。然而 ,采集的干细胞中可能含有肿瘤细胞 ,从而导致移植后复发。鉴于人造血干/祖细胞表面表达CD34抗原 ,而很多肿瘤细胞不表达CD34抗原的原理 ,可采用CD34 +细胞分选技术 ,以减少移植物中肿瘤细胞的污染 ,达到净化的目的。我们运用CliniMACS系统纯化CD34+ 细胞进行自体外周血干细胞移植治疗2例肿瘤患者 ,现报告如下。1.1对象例1 :患者男性 ,25岁 ,右髂骨原始神经外胚层肿瘤 ,肿瘤切除…     

异基因外周血造血干细胞移植治疗白血病

５例白血病患者接受ＨＬＡ相合异基因外周血干细胞移植。外周血干细胞动员采用供者连续皮下注射Ｇ－ＣＳＦ（１０μｇ／ｋｇ）５天，于第５天和第６天用ＣＳ３０００Ｐｌｕｓ血细胞分离机分离单个核细胞（ＭＮＣ）。患者平均输入ＭＮＣ６．０×１０８／ｋｇ，ＣＤ３４＋细胞２２．６×１０６／ｋｇ，ＣＤ３＋细胞４１２×１０６／ｋｇ，ＣＤ４＋细胞２０５×１０６／ｋｇ和ＣＤ８＋细胞１６２×１０６／ｋｇ。移植后造血重建迅速，中性粒细胞绝对计数＞０．５×１０９／Ｌ和血小板计数＞２０．０×１０９／Ｌ的平均时间分别为１３．４天和１１．４天。５例均未发生急性ＧＶＨＤ，２例发生慢性ＧＶＨＤ。供者对大剂量Ｇ－ＣＳＦ耐受良好     

彩色多普勒超声图指导风湿性心脏病二尖瓣狭窄球囊扩张术91例

目的：应用彩色多普勒超声心动图指导经皮二尖瓣球囊成形术(PBMV)治疗风湿性二尖瓣狭窄的价值、方法：运用彩超对行PBMV的患进行术前术后检查，观察二尖瓣钙化程度及部位、开口形状、瓣口面积、二尖瓣返流(MR)程度、瓣下病变、左房左室大小、左房有无血栓．结果：91例PBMV术后患中，术后MR72例，其中MR新出现19例，MR加重8例、与术前对比，术后二尖瓣开放幅度、二尖瓣口面积、二尖瓣跨瓣压、二尖瓣压差半降时间较术前有明显改善趋势，左房内径、肺动脉内径较术前有缩小趋势．同时，术后左房压、右室压及肺动脉压也有下降趋势。结论：彩超能明确PBMV治疗二尖瓣狭窄的效果。影响：PBMV效果的因素较多，但二尖瓣钙化的程度、部位和瓣膜形态较为重要。     

Allogeneic peripheral blood stem cell transplantation for leukemia

Objective To observe engraftment kinetics, the incidence and severity of graft-versus-ho st disease (GVHD), and clinical outcome on 40 recipients undergoing allogeneic p eripheral blood stem cell transplantation (allo-PBSCT).Methods From June 1997 to May 1999, forty leukemia patients with a median age of 35 year s underwent allo-PBSCT. PBSC were mobilized with G-CSF at a dose of 5 μg/kg s.c. every 12 hours for 5 days. A median of 7.7 (2.0-16.8)×10 (6) CD34(+) cells/kg was infused into the recipients. Busulfan-cyclophosphamid e (BU-CY) was used as the conditioning regimen. All patients received cyclospo rine A and either methotrexate (n=34) or methylprednisolone (n=6) for GVHD p rophylaxis. Results Engraftment of neutrophils and platelets was achieved at a median of 13 days (9 -28 days) and 12 days (7-60 days) respectively. Patients receiving ≥4×10 (6) CD34(+) cells/kg or given G-CSF post transplant had significantl y accelerated neutrophil and platelet engraftment. Acute GVHD occurred in 17 of 40 patients (42.5%), with grade Ⅱ-Ⅳ acute GVHD in 10 patients (25%). Chron ic GVHD developed in 21 (9 extensive, 12 limited) out of 30 evaluable patients ( 21/30, 70%) with a median follow up of 380 days (180-900 days). Transplan t related mortality was 17.5% and the relapse rate was 10%. The probability of leukemia free survival at 3 years was 72.5%.Conclusion Allo-PBSCT can provide rapid hematopoietic reconstitution without an increased incidence of acute GVHD, but may be associated with a high risk of chronic GVHD .     

异基因外周血造血干细胞移植治疗白血症

５例白血病患接受ＨＬＡ相合异基因外周血干细胞移植。外周血干细胞动员采用供连续皮下注射Ｇ－ＣＳＦ（１０μｇ／ｋｇ）５天，于第５天和第６天用ＣＳ３０００Ｐｌｕｓ血细胞分离机分离单个核细胞（ＭＮＣ）。患平均输入ＭＮＣ６．０×１０＾８／ｋｇ，ＣＤ３４＾＋细胞２２．６×１０＾６／ｋｇ，ＣＤ３＾＋细胞４１２×１０＾６／ｋｇ，ＣＤ４＾＋细胞２０５×１０＾６／ｋｇ和ＣＤ８＾８细胞１６２×１０＾６／ｋｇ。移植     

Detection and clinical significance of thrombomodulin in both plasma and tissue extracts of cancer patients

Thrombomodulin?is the endothelial cell surface glycoprotein that converts thrombin from a procoagulant protein into the activator for protein C. Thrombin plays an important role in the adhesion of cancer cells to endothelial cells through fibrin formation and platelet activation, and thrombin stimulates tumor cell bindings to endothelial cells[1]. In this article, the changes of TM were studied in both plasma and tissue extracts of cancer patients for evaluating its clinical significance. P…     

门诊注射用抗菌药物使用分析

目的:调查门急诊输液治疗的抗菌药物使用情况,评价其用药的合理性。方法:采用询访输液病人及病历检查的方式,对抗菌药物治疗进行分析。结果:抗菌药物的使用率为78．60％,其中单联、二联使用率分别为74．30％、25．70％。临床使用以β内酰胺类比例最高达成37．70％。结论:抗菌药物的使用应加强管理,增强实验室及微生物培养意识,特别是预防用药的范围及方法。     

心电图对慢性心力衰竭治疗的疗效及预后的评估

正心力衰竭(心衰,HF)是发达国家的主要公共卫生问题之一。尽管心衰的药物治疗已取得了明显进步,并在治疗和鉴定心衰的多种临床和实验室预后参数方面取得了重大进展,但其发病率和死亡率仍较高~([1])。超声心动图是心衰患者确诊最广泛的检查方法,但左室射血分数(LVEF)测量的重复性取决于技师所使用的技术、手法;脑钠肽(BNP)则易受到心房颤动(房颤)、肾功能、年龄、肥胖等因素影响~([1,2])。心电图作为一种有效、可靠、可重复、定量的方法,具有价     

宫颈机能不全的产前超声表现及临床结局分析

目的:分析宫颈机能不全的产前超声表现及临床结局。方法:回顾性分析香港大学深圳医院2019年1月—2022年12月间经产前超声诊断为宫颈机能不全的32例患者的临床病例资料,对宫颈机能不全的产前超声表现及临床结局进行分析总结。结果:超声表现如下:宫颈变短(宫颈长度≤2.0 cm)呈“T”形3例(9.38%),宫颈内口扩张呈“Y”形或呈“V”形共14例(43.75%),宫颈内、外口均扩张呈“U”形15例(46.87%),其中羊膜囊膨出至宫颈管内5例,脐带脱垂1例。临床结局如下,分娩情况:早产19例(59.38%);足月产12例(37.50%);24周环扎术后保胎失败引产1例(3.12%)。胎儿出生体重:出生体重低于正常21例(56.76%),出生体重正常(2 500～4 000 g)15例(40.54%),巨大儿(大于4 000 g)1例(2.70%)。结论:宫颈机能不全产前超声有特征表现,早期诊断对临床处理有重要的指导意义,可以改善母婴结局,减少低出生体重儿的发生,降低早产儿的发生率。