目的 研究盐酸氨基葡萄糖联合双醋瑞因在伴有骨髓水肿（BME）的膝骨关节炎（KOA）中的疗效评估。 方法 依据MRI检查结果，选取2011年1月－2012年6月入院60例伴BME的KOA患者随机分入A组（口服盐酸氨基葡萄糖）、B组（口服双醋瑞因）、C组（口服盐酸氨基葡萄糖和双醋瑞因），每组各20例；另纳入同期30例不伴BME的KOA患者30例为D组（口服盐酸氨基葡萄糖和双醋瑞因）。完成标准方案后24周，随访临床疗效和影像学评分及炎症因子变化。 结果 治疗24周后4组在20 m 步行后视觉模拟评分（VAS）、关节压痛VAS评分较治疗前有改善（P＜0.05）；在BME改善方面，C组容积积分和程度积分均优于A、B两组（P＜0.05）；在炎症因子方面，治疗24周后4组白细胞介素（IL）-1β、IL-6和肿瘤坏死因子α表达水平明显降低（P＜0.05）。 结论 盐酸氨基葡萄糖联合双醋瑞因能有效改善伴有BME的KOA患者临床症状、降低炎症因子表达水平以及促进BME在影像学方面的改善。
目的 分析下肢慢性创伤性骨髓炎患者创面细菌培养分布情况，为临床用药提供依据。 方法 对2006年1月－2010年12月收治的91例慢性骨髓炎患者创面分泌物细菌培养标本结果进行回顾性调查分析。其中男78例，女13例；年龄5～78岁，平均41.3岁。病程47 d～7个月，平均68.6 d。使用抗生素总疗程均＞7 d。 结果 65例创面细菌培养阳性患者共分离出113株病原菌，其中G?菌72株，占63.71%；G+菌41株，占36.28%。药敏结果显示，G+菌对常规青霉素类基本耐药，碳青霉烯类耐药菌株少见，对万古霉素耐药菌株尚未出现。G?菌对青霉素类及头孢菌素类耐药较高，对头孢哌酮－舒巴坦无耐药。 结论 加强对慢性创伤性骨髓炎患者创面病原菌监测极为必要,对临床抗生素的合理使用具有一定的指导意义。Objective To analyze the distribution of cultured bacteria from chronic osteomyelitis patients, and provide a basis for clinical medicine. Methods We retrospectively analyzed the bacterial culture results of the secretions from 91 patients with chronic osteomyelitis treated in our hospital from January 2006 to December 2010. Among them, there were 78 males and 13 females aged from 5 to 78 years averaging at (41.3 ± 8.35) years. The duration of the disease ranged from 47 days to more than 7 months, averaging (68.6 ± 14.57) days. The total course of antibiotic-taking was longer than 7 days for all the patients. Results A total of 113 pathogen strains were isolated from 65 secretion samples, including 72 Gram-negative bacteria accounting for 63.71% and 41 gram-positive bacteria accounting for 36.28%. Drug susceptibility results showed basic resistance of Gram-positive bacteria to conventional penicillin, rare resistance to carbapenem, and no resistance to vancomycin. Gram-negative bacteria were basically resistant to penicillin and cephalosporins, but not resistant to cefoperazone-sulbactam. Conclusion Enhancing the monitoring of pathogens for patients with chronic osteomyelitis is extremely necessary for the rational clinical use of antibiotics.
目的:观察地榆升白片对非小细胞肺癌化疗后外周血细胞的影响，以了解地榆生白片对骨髓的保护作用。方法:将63例非小细胞肺癌患者随机分为观察组和对照组。观察组（33例）采用地榆升白片加NP方案治疗，对照组（30例）单用NP方案化疗，观察两组外周血象变化情况及集落刺激因子(G-CSF)用量。结果:观察组Ⅲ度及Ⅳ度骨髓抑制发生率9.09％，显著低于对照组（对照组为30.0%，χ2=4.467，Plt;0.05）；观察组外周血WBC、PLT、Hb治疗结束后1月与治疗前相比，差异无统计学意义，Pgt;0.05；对照组外周血WBC、PLT、Hb治疗结束后1月较治疗前明显下降，其中WBC、PLT差异有统计学意义，Plt;0.05。观察组和对照组人均集落刺激因子（惠尔血150 μg）用量分别为（0.58±1.99）支和（1.93±3.62）支差异有统计学意义(t=2.501，Plt;0.05)。结论:地榆升白片可预防肺癌患者化疗药物引起的骨髓抑制，提高外周血WBC和PLT水平，减少集落刺激因子的用量，值得推广。
目的：探讨蛋白酶体抑制剂——硼替佐米对初治多发性骨髓瘤的疗效及对移植造血干细胞采集的影响。方法：对一例初发的中年男性多发性骨髓瘤患者使用硼替佐米+地塞米松+反应停（VTD）的方案进行化疗，获得缓解后采集外周血造血干细胞。结果：应用以硼替佐米为基础的方案治疗3个疗程后，患者即获得完全缓解；完成4个疗程化疗后成功采集足够数量的外周血造血干细胞；完成6个疗程化疗后，进入维持治疗，至今已完全缓解17个月。治疗过程中除恶心、呕吐外无其他明显不良反应。结论：硼替佐米用于初治多发性骨髓瘤有良好的治疗效果，不良反应少，不影响造血干细胞采集。
Objective To explore repair role of allogeneic bone marrow mesenchymal stem cells （BM-MSCs） transplantation on treating hepatic ischemia reperfusion injury （HIRI） in rats. Methods Ten rats were executed to get BM-MSCs， then BM-MSCs were cultured in vitro and dyed by 4，6-diamidino-2-phenylindole （DAPI）. Models of 70% hepatic ischemia reperfusion injury were eatablished. Thirty two rats were randomly divided into sham operation group （Sham group）， ischemia reperfusion group （I/R group）， Vitamin C group （VC group）， and BM-MSCs group. Serum samples were analyzed for ALT and AST， and hepatic tissue were for superoxide dismutase （SOD） and malondialdehyde （MDA）. Liver sections were stain with hematoxylin and eosin （HE） for histological analysis， TUNEL staining was applied to detect hepatic apoptosis. Serum and tissues were both collected at 24 h after reperfusion. Results The isolated BM-MSCs maintained vigorous growth in vitro. Specific markers for MSCs antigens CD29 and CD44 were detected by flow cytometry， but antigens CD34 and CD45 were not be detected. Models of HIRI were stable， and BM-MSCs were detected around the periportal area by DAPI staining. Compared with I/R group， levels of ALT， AST， MDA， and AI in the VC group and BM-MSCs group decreased at 24 h after reperfusion （P＜0.05）， meanwhile SOD level increased （P＜0.05）. Compared with VC group， levels of ALT， AST， MDA， and AI in the BM-MSC group decreased at 24 h after reperfusion （P＜0.05）， meanwhile SOD level increased （P＜0.05）. Conclusion BM-MSCs could protect HIRI by alleviating oxidative stress and inhibiting cellular apoptosis.
Objective To investigate the effect of recombinant human growth hormone (hGH) on growth situation and bone marrow hematopoietic function in rats under chemotherapy. Methods A total of 136 10-week-old SD rats were included in the study. The rats were randomly assigned into five groups: normal control group (n=8), normal saline control group (NS group, n=32), human growth hormone group (hGH group, n=32), chemotherapeutic drug treated group (CT group, n=32), and chemotherapeutic drug plus hGH treated group (CT+hGH group, n=32). The body weight, bone marrow differential count, and the expression of proliferating cell nuclear antigen (PCNA) in bone marrow were measured before treatment and weekly in four weeks after treatment. Results Weight loss occurred in both CT group and CT+hGH group (P＜0.05), but the weight loss in CT+hGH group was significantly smaller (P＜0.05) on day 7 after treatment. In myeloid morphology, myeloid cell was hypoplastic excessively in CT group, and it was hypoplastic obviously in CT+hGH group on day 7 after treatment. Day 14, weight gain appeared in CT+hGH group, while weight loss remained in CT group; In myeloid morphology, myeloid cell was hyperplastic actively excessively in CT+hGH group, and myeloid karyote count was increased significantly in CT+hGH group (P＜0.05). Day 7, 14 and 21, PCNA positive cells count in CT group was lower than that in hGH group and CT+hGH group (P＜0.05). There was no significant different of every index among normal control group, NS group, and hGH group (Pgt;0.05), except weight between normal control group and hGH group on day 7 (P＜0.05). Conclusion hGH has a protective effect on myeloid hematopoietic function and growth situation in rats after intraperitoneal chemotherapy.