白细胞分离去除术治疗高白细胞急性白血病15例

高白细胞急性白血病是指白血病患者外周血白细胞数超过１００×１０９／Ｌ,是白血病高危因素之一 ,化疗风险又较大 ,临床上早期死亡率高。我们１９９８年２月～２０００年６月利用血细胞分离机对１５例高白细胞急性白血病患者化疗之前采用白细胞分离去除治疗 ,疗效满意 ,现报道如下。１．对象１５例白血病均为本院住院患者。男性６例 ,女性９例 ,年龄１９～５８岁 ,中位年龄３０岁。诊断标准及疗效标准根据文献 ［１］,其中急性髓细胞白血病１１例,急性淋巴细胞白血病３例 ,急性混合细胞白血病１例。２．治疗方法应用美国ＣｏｂｅＳｐｅｃ…     

50例儿童急性淋巴细胞白血病三年后随访结果

对５０例儿童急性淋巴细胞白血病在平均３年零３个月后作了随访小结。结果：１９例放弃治疗（３８％）；断续治疗１年者８例，其中２例已自动停药２～３年并且无病生存，余６例失访；２３例能长期坚持治疗，其中３例死于感染，１１例持续完全缓解至今，９例复发。在接受治疗的病例中，３年零３个月生存率为４２％（１３／３１）。统计结果表明，初诊时外周血淋巴细胞糖皮质激素受体水平低者复发率高。     

50例儿童急性淋巴细胞白血病三年后随访结果

对５０例儿童急性淋巴细胞白血病在平均３年零３个月后作了随访小结。结果：１９例放弃治疗（３８％），继续治疗１年者８例，其中２例已自动停药２￣３年并且无病生存，余６例失访；２３例能长期坚持治疗，其中３例死于感染，１１例持续完全缓解至今，９例复发，在接受治疗的病例中，３年零３个月生存率为４２％（１３／３１），统计结果表明，初诊时外周血淋巴细胞糖皮质激素受体水平低者复发率高。     

PVDL强化诱导缓解方案治疗小儿急性淋巴细胞性白血病的疗效观察

用ＰＶＤＬ强化诱导方案治疗小儿急性淋巴细胞性白血病（急淋）２７例，全部病例获得骨髓缓解，所需时间２２．９±６．５天，２５／２７例获得完全缓解（ＣＲ），所需时间２７．３±６．５天。随访到１９９２年１０月底，ＣＲ期９－４８个月，平均２９．４±１１．３个月，复发８例，生存期１５－３６个月，平均２９．４±５．６个月。认为该方案诱导治疗儿童急淋具有奏效快、ＣＲ率高、ＣＲ期长的特点。     

PCR扩增T细胞受体δ基因监测儿童急性淋巴细胞白血病微量残留病

应用巢式聚合酶链反应技术拉增Ｔ细胞受体基因检测了小儿急性淋巴细胞白血病骨髓标本，２８例初治的Ｂ前体细胞白血病中有２１例检出ＴＣＲ－δ基因克隆重排带，检出率迷７５％。１８例缓解６个月以上ＰＲ仍阳性者接受大剂量化疗，１５例化疗后ＰＣＲ转阴者随访８－３０个月仍处持续缓解状态，３例ＰＣＲ未能转阴者中２例最终复发，另１例在此次化疗前已有半年未行化疗，本化疗后ＰＣＲ未阴转，继续化疗并随访一年，现ＰＣＲ转阴并持     

白血病患者化疗并发面中部1／3大面积坏死一例报告

白血病患者化疗并发面中部１／３大面积坏死一例报告朱某，女，２０岁，学生。因牙龈出血两个月、咽痛、发热二日．于１９９２年６月８日入院。诊断为急性非淋巴细胞白血病的Ｍ２″。６月９日开始化疗：阿糖胞苷２００ｍｇ／日静脉点滴。５天后，患者出现乏力、呕吐和腹泻...     

急性脑梗死肾功能衰竭相关因素分析

急性脑梗死，可并发急性肾功能衰竭犤１犦，为了探讨急性脑梗死并发急性肾功能衰竭可能的相关因素，本文对１９９６年１月～２００１年８月间１０例急性脑梗死并发急性肾功能衰竭的相关因素进行分析。１资料与方法１．１临床资料急性脑梗死１８５例，并发急性肾功能衰竭１０例，急性肾功能衰竭的发生率为５．４％，１０例中，男性９例，女性１例；年龄５０～６０岁１例，６０～７０岁６例，７０～９０岁３例，平均年龄６９岁。最高Ccr为２６．９３mmol／L，最低为４．３７mmol／L，平均为１５．６mmol／L，其中伴有高血压病７例，糖尿病３…     

急性淋系白血病化疗后维持治疗时间的研究

目的 研究急性淋系白血病化疗缓解后的治疗时间。方法 治疗并随访观察我院10年来收治的原发初治急性淋系自血病100例。经两位以上有经验的专科医生和检验师的确认与统计所得数据。结果 100例原发初治急性淋系白血病采用VP（长春新碱＋泼尼松）方案基础上联合用药分组诱导化疗，完全缓解率78．0％，83例可分析期的缓解患者中无病生存9．1个月，3年生存率为21．2％，5年生存率为10．0％，化疗后继续治疗〈6个疗程者无病生存期为7个月，3年无病生存率为11．0％，5年无病生存率为6．0％；治疗〉6个疗程的患者中无病生存期为35个月，3年无病生存率为40．0％，5年无病生存率为25．8％；两者差异具有显著性。治疗〉9个疗程的患者比治疗〉6个疗程的患者生存率略高，无统计学意义。结论 急性淋系白血病化疗后标准剂量治疗巩固强化至少应6个疗程以上，通常治疗至少维持3年以上。     

急性淋巴细胞白血病患者缓解期骨髓涂片PCR检测Ig基因重…

应用多聚酶链反应技术检测１５例急性淋巴细胞白血病患者缓解期骨髓涂片中Ｉｇ基因重排，其中有５例（３３％）检测出残留白血病细胞。回顾性分析结果表明，Ｉｇ基因重排患者均在后一次完全缓解期（ＣＲ）后２￣３个月出现白血病临床复发。ＰＣＲ技术检测微量残留白血病细胞有助于预测白血病复发和指导白血病的化疗。     

第二届全国自体造血干细胞移植学术会议简况

第二届全国自体造血干细胞移植（ＡＨＳＣＴ）学术会议，于１９９６年４月１５～１８日夜郑州市召开。会议收到论文１９５篇，来自全国各地的２１１名代表参加了会议。会上就１４个专题进行了报告和讨论。一、ＡＨＳＣＴ的适应症和疗效１．急性白血病：仍是我国ＡＨＳＣＴ病例最多的病种，已积累了较成熟的经验。（１）ＡＨＳＣＴ对急性髓细胞白血病（ＡＭＬ）的疗效与异基因骨髓移植（ＡＬＬＯ－ＢＭＴ）接近，完全缓解（ＣＲ）１期移植后３～５年，ＤＦＳ在５０％以上，明显优于化疗；对成人急性淋巴细胞性白血病（ＡＬＬ）的效果不如ＡＭ…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.