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1.
目的分析成人血液系统恶性肿瘤患者接受强烈化疗后中性粒细胞减少性肠炎(NE)的发生率、危险因素及预后情况。方法收集2004至2013年接受化疗的1804例血液系统恶性肿瘤患者,记录患者血常规、凝血检测和血液生化检测结果,并记录患者年龄、性别、原发病、既往化疗次数、既往化疗方案中是否使用阿糖胞苷、临床症状、肠壁厚度、中性粒细胞最低计数、中性粒细胞缺乏持续时间、NE的治疗方法和预后等,探讨NE起病诱因、临床特征、腹部B超特点、症状的预后意义及化疗药物对发病的影响等。结果1804例患者中226例(12.5%)化疗后合并NE,化疗后10~19d起病,中位起病时间为化疗后第14天。发生NE后26例患者死亡,病死率11.5%。化疗药物包括阿糖胞苷、临床症状≥4项、中性粒细胞缺乏持续超过7d以及B超下肠壁厚度≥10mm的患者病死率相对较高。结论NE是接受强烈化疗的血液系统肿瘤患者的严重的并发症,发生NE后患者病死率较高。 相似文献
2.
目的:探讨椎弓根螺钉三椎体内固定对脊椎爆裂性骨折患者椎体与神经功能状态的影响.方法:选取2013年7月至2015年1月于本院进行治疗的58例脊椎爆裂性骨折患者为研究对象,对其进行回顾性研究,将其根据手术方式不同分为对照组(短节段椎弓根内固定组)29例和观察组(椎弓根螺钉三椎体内固定组)29例,然后将两组患者手术前与手术后不同时间的伤椎恢复指标与血清神经功能相关指标进行比较.结果:观察组手术后不同时间的伤椎恢复指标中的后凸Cobb角、椎体平移率、椎体高度丢失率与血清神经功能相关指标中的BDNF、NSE、NGF及S100B均显著好于同期的对照组指标,并且明显好于其治疗前,均有显著性差异(P<0.05).结论:椎弓根螺钉三椎体内固定可更为有效地恢复脊椎爆裂性骨折患者椎体参数,并且更有助于神经功能状态的恢复. 相似文献
3.
I. DILEK N. TOPCU C. DEMIR A. BAY K. UZUN A. GUL A. FAIK
NER S. UGRAS 《International journal of laboratory hematology》2006,28(3):170-176
The incidence of hematological malignancies during pregnancy is low, and treatment in this setting is problematic. This study observed 21 pregnancies in 18 patients with hematological malignancies. Patients’ ages were between 19 and 43 (median 25) years. Two pregnancies ended with spontaneous abortion, one pregnancy ended with in utero death, three therapeutic abortions were carried out, and 15 infants were born alive but three of them died later. The median birth weight was 2.47 kg. Twelve babies survived to a median age of 36 (range 4–117) months. Eight babies were exposed to chemotherapy during the in utero period. One baby was exposed to chemotherapy during all the trimesters and was born prematurely and later died because of intracranial bleeding. Four babies were exposed to chemotherapy during the first trimester, one of them had low birth weight and floating thumb malformation, two of them had only low birth weight, and one was born healthy, but died at 3 months of age as a result of severe gastroenteritis. Two babies were exposed to chemotherapy during the second and third trimesters; one of them had low birth weight, and the other pregnancy ended in in utero death. One infant was exposed to chemotherapy during the third trimester and was born at term, but died because of pulmonary hemorrhage. We concluded that chemotherapy during all trimesters of pregnancy carries a significant risk for an unfavorable outcome. 相似文献
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In order to establish referential hematological parameters, blood samples were taken from 100 healthy specimens of the Argentine
tegu lizard (Tupinambis merianae) by means of venipuncture of ventral coccigeal vein. The determination of red blood cells, leukocyte and thrombocyte count,
hematocrit, hemoglobin concentration, hematometric index and differential leukocyte count were performed, and compared with
other saurian species. No statistically significant changes were observed as function as sex and age (p > 0.01). During winter, high values of red blood cell counts, hematocrit and hemoglobin were observed (p < 0.01), while in summer significantly increased leukocyte and thrombocyte counts were observed (p < 0.01). The differential leukocyte counts were not affected by the studied factors. 相似文献
8.
Xavier AC Siqueira SA Costa LJ Mauad T Nascimento Saldiva PH 《Virchows Archiv : an international journal of pathology》2005,446(3):225-231
Autopsy findings of missed diagnoses that would probably have changed management or prognosis occur in up to 29% of cases in general hospitals. Such proportions may be higher in subsets of patients with complex diseases. We reviewed 2908 consecutive autopsies performed over a period of 29 months in a large-volume hospital, analyzing 118 autopsies of patients with hematological malignancies or severe aplastic anemia. A review of macroscopic reports as well as microscopic examination of tissue samples was performed. Medical records were reviewed for clinical diagnoses. Discordances between clinical and autopsy diagnoses were classified using Goldmans criteria. Additionally, we searched for clinical parameters correlated with occurrence of class-I discrepancy using a multivariate method. Median age was 46.5 years, and 25.4% had received a hematopoietic stem-cell transplant. Overall, 11.9% (6.6–19.1%) of patients died before conclusion of the hematological diagnosis and 33% (24.6–42.3%) died with no active hematological disease. We found class-I discrepancy in 31.3% (23.1–40.5 %) of cases. The most common among these diagnoses were hematological disease, pneumonia and gastrointestinal bleeding. In a univariate analysis, being elderly (P=0.04) was positively correlated with the finding of class-I discrepancies; while, having received previous specific hematological treatment (P=0.0005) or hematopoietic stem-cell transplants (P=0.013), or being admitted to a specialized hematology unit (P=0.0006) were negatively correlated to the occurrence of such discrepancies. Multivariate analysis showed that care in a specialized hematology unit (OR 0.34, 0.12–0.93) was independently associated with lower occurrence of discrepancies. We concluded that critical diagnoses are often missed in highly complex hematological patients especially in the absence of admission to specialized hematology units. 相似文献
9.
Influence of vascular parameters on the effectiveness of intra-aortic balloon pumping: A model study
The intra-aortic balloon pump has been widely used as a temporary heart-assist device. In this investigation, a nonlinear
mathematical model of the arterial system and intra-aortic balloon pump was studied analytically. Thus, the influences of
a number of vascular parameters on the effectiveness of intra-aortic balloon pumping (IABP) were determined. The effects of
changes in vascular parameters of the model on a number of performance indexes were investigated. These performance indexes
(aortic mean diastolic pressure, aortic end diastolic pressure, cardiac output, coronary flow and phase differences between
the fundamental Fourier components of aortic root pressure and flow) were used as the criterion for an evaluation of the effectiveness
of the assist pump. The following vascular parameters were perturbed by four steps (±10%, ±20%) from the values in the standard
model: heart rate, peripheral resistance, left ventricular pressure, aortic elastance, aortic radius, arterial wall thickness,
and aortic length. This model was evaluated for a wide range of balloon-pump phase-control settings (assisted case) and for
the unassisted case (when the pump is disabled). It is concluded that changes in heart rate, peripheral resistance and left
ventricular pressure cause the most significant changes in pump performance.
Dr. Ohley is with the Datascope Corporation
Dr. Kao is with the Technicare Corporation 相似文献
10.
H. Denz B. Orth G. Weiss R. Herrmann P. Huber H. Wachter D. Fuchs 《Journal of molecular medicine (Berlin, Germany)》1993,71(1):37-41
Summary Weight loss is the main symptom of so-called tumor cachexia. The pathogenetic mechanisms underlying cachexia are poorly understood; however, it appears that enhanced formation of cytokines such as interferon- and tumor necrosis factor- are involved. In 94 patients suffering from hematological neoplasias we compared body weight changes with serum neopterin, tryptophan, and kynurenine. Biochemical changes, the formation of neopterin, the degradation of tryptophan are closely related to interferon- activity. The majority of our patients had increased neopterin and decreased tryptophan concentrations. Weight loss was seen particularly in patients with higher neopterin and lower tryptophan values. An association between higher neopterin levels and greater weight loss was apparent at study entry and during the follow-up of patients. Our data support the concept that weight loss is closely linked to endogenous interferon- activity.Abbreviations NHL
non-Hodgkin's lymphoma
- HD
Hodgkin's disease
- MM
multiple myeloma
- MGUS
monoclonal gammopathy of unknown significance
- IFN-
interferon-
- TNF-
tumor necrosis factor- 相似文献