【摘要】 目的 分析交叉抗原表达的急性白血病的临床特征及缓解率。 方法 对2009年10月-2010年11月血液内科的210例交叉表达髓系和淋巴细胞系相关抗原的初治急性白血病患者的标本，采用流式细胞术检测白血病细胞的免疫表型，根据免疫标记和FAB（French、American、Britain）分型进行分组，分析其异质性的生物学特征和影响缓解率的相关因素。 结果 210例急性白血病的FAB分型以AML-M1/M2（82例）和ALL（78例）为主；免疫分型以B淋巴细胞系和髓系混合表达多见（116例），其中CD34表达率高达91.4%（192例）， CD7表达率为50.5%（106例），且与CD34相关（P=0.04）；出现CD34、CD7、CD19三者共表达的患者缓解率较低（9.09%）。 结论 交叉抗原表达的急性白血病的诊断有赖于免疫分型的判断，其分化抗原的表达类型是影响其缓解率的重要因素。【Abstract】 Objective To observe the clinical characters of acute leukemia with cross-lineage antigen expression and analyze the remission rate. Methods Between October 2009 and November 2010, 210 patients were diagnosed and classified by morphology. Cytochemistry and immunology were used to analyze the immunophenotype. According to the immunostaining relative factors and FAB (French, American, and Britain) phenotype standard, the samples were divided into several groups. The conical characters and relative factors of remission rate were analyzed. Results In 210 patients with cross-lineage antigen expression, AL, AML-M1/M2 (82 cases) and ALL (78 cases) were common in FAB phenotype,and cross-lineage of B lineage and myelolineage were common in immunotype (116 cases). CD34 got the highest expression frequency of all (192 cases),and had the most important effect on patients′ prognosis. CD7 was also positive commonly (106 cases) and related with CD34 (P=0.04). So it′s significant for the outcome. The patients who got co-expression of CD34, CD7 and CD19 had worse prognoses. Conclusions Acute leukemia with cross-lineage antigen expression is a special type and is confirmed by immunotype. Furthermore, expression types of differentiation antigen are critical for the prognosis.
【摘要】 目的 探讨多层螺旋CT低剂量扫描在小儿上尿路梗阻性疾病中的应用价值。 方法 2008年1月-2009年6月经临床手术证实尿路梗阻的患儿52例，按梗阻的原因分为结石组13例与非结石组39例。将非结石组患儿，按照年龄分为0~1岁（8例）、1~5岁（16例）和5~10岁（15例）3个组，均采用个性化的低剂量扫描方式。 结果 结石组与非结石组阳性诊断率均为100%。低剂量扫描患儿所接受的辐射剂量明显降低，CT扫描管电流不变，管电压降低1/3，CT检查的辐射剂量可降低约70%，且均可达到临床诊断要求。 结论 多层螺旋CT低剂量个性化扫描在小儿上尿路梗阻性疾病中诊断中具有明显优势。【Abstract】 Objective To evaluate low-dose multislice spiral CT for upper urinary tract obstruction in children. Methods From January 2008 to June 2009, 52 children with upper urinary tract obstruction were diagnosed via clinical surgeries. The patients were divided into two groups according to whether having renal calculus (13 patients) or not (39 patients). The patients in non-calculus group were divided into three sub-groups: aged 0-1 (eight patients), 1-5 (16 patients), and 5-10 (15 patients). Low dose multislice spiral CT with different doses was performed. Results The rate of positive predictive diagnosis was 100% in both calculus and non-calculus group. Low dose scan reduced the radiation dose of children. The fixed tube current and the decreased tube voltage (decreased 1/3) led to the decrease of the radiation dose (decreased 70%), which were feasible for diagnosis. Conclusion Low-dose multislice spiral CT was available for upper urinary tract obstruction in children.
Objective The method of metabonomics based on nuclear magnetic resonance (NMR) imaging was used to explore the difference in metabolites of serum and bile, and to analyze the metabolic variation related to the pathogenesis of gallbladder stones between normal people/liver transplantation donors and patients with gallbladder stones. Methods Prospectively collected the serum samples (17 cases) and bile samples (19 cases) in 19 patients with gallbladder stones who underwent surgery in West China Hospital form March 2016 to December 2016, as well as the serum samples of 10 healthy persons and the bile samples of 15 liver transplantation donors at the same time period. The differences of metabolites in the blood and bile in these 3 groups were compared by using 1H-NMR metabonomics technology and chemometric methods. Results The concentrations of valine, alanine, lysine, glutamine, glutamate, pyruvate, creatinine, choline, alpha-glucose, beta-glucose, tyrosine, histidine, and hypoxanthine in serum of patients with gallbladder stones decreased significantly, comparing with those of healthy people without gallbladder stones (P<0.05), while 1, 2-propanediol, acetoacetate, and lactate increased significantly in the serum of patients with gallbladder stones (P<0.05). The concentrations of taurine conjugated bile acids, glycine conjugated bile acids, choline, and phosphatidylcholine decreased significantly in the bile of patients with gallbladder stones when compared with those of liver transplantation donors (P<0.05), while cholesterol increased significantly in the bile of patients with gallbladder stones (P<0.05). Conclusions There are significant differences of the serum and bile metabolites between patients with gallbladder stones and healthy men without gallbladder stones/liver transplantation donors. 1H-NMR metabonomics is helpful to investigate the pathogenesis of gallbladder stones.
ObjectiveTo summarize the pathogenesis, epidemiology, and risk factors of portal vein thrombosis after splenectomy, and combined with the latest advances in clinical prevention, diagnosis, and treatment of portal vein thrombosis after splenectomy, so as to provide some references for clinical prevention and treatment in the future.MethodLiteratures on portal vein thrombosis after splenectomy were collected and reviewed.ResultsThe incidence of portal vein thrombosis after splenectomy was high and its occurrence was the result of multiple factors. It was mainly related to the change of splenic venous blood flow mechanics after splenectomy. In terms of diagnosis, enhanced CT scan was the first choice. Currently, there was no consensus on treatment options, which mainly focused on individualized treatment and emphasized that preventive anticoagulant use of low-molecular-weight heparin may reduce the risk of portal vein thrombosis.ConclusionThe concept of tertiary prevention of portal vein thrombosis after splenectomy should be established, and individualized treatment should be adopted in combination with the patient’s condition.
Pre-rehabilitation is an emerging preoperative management strategy designed to mitigate surgical stress responses and expedite postoperative recovery through optimized interventions, which typically includes exercise training, nutritional support, and psychological counseling. For patients undergoing transcatheter aortic valve replacement (TAVR), the implementation of pre-rehabilitation measures is particularly crucial. This article reviews the necessity and principal components of pre-rehabilitation in TAVR patients, and offers suggestions including constructing the best pre-rehabilitation intervention program for TAVR, enhancing patient compliance and engagement in the recovery process, and paying attention to the management of frailty for TAVR patients. The aim is to provide a reference for healthcare professionals seeking to further refine the pre-rehabilitation management model for TAVR patients.
The implantation of left ventricular assist device (LVAD) has significantly improved the quality of life for patients with end-stage heart failure. However, it is assiosciated with the risk of complications, with unplanned readmissions gaining increasing attention. This article reviews the overview, influencing factors, predictive models, and intervention measures for unplanned readmissions among LVAD implantation patients. The aim is to provide scientific guidance for clinical practice, assisting healthcare professionals in accurately assessing patient conditions and formulating appropriate care plans.
Objective To investigate the protective mechanism of ulinastatin（UTI） in pulmonary microvascular endothelial cells （PMVECs） attacked by serum from the patients with severe sepsis. Methods PMVECs were cultured in vitro and randomly divided into 4 groups，ie. a normal group （culture medium with 10% fetal bovine serum，group N），a health group （culture medium with 10% healthy human serum，group H），a patient group （culture medium with 10% human septic shock serum，group S），and a ulinastatin group （culture medium with 1000 U/mL UTI and 10% human septic shock serum，group U）. The proliferation activity of PMVECs was measured by MTT expressed by optical density （OD）. The concentration of TNF-α in supernatant of culture medium was examined by ELISA at 0，1，2，4，6 hours. The expression of NF-κB was examined by immunohistochemistry at 1 hour. Results Compared with group N，the cell proliferation activity of group S decreased significantly，and the cell proliferation activity of group U decreased slightly at each time poi nt. Compared with group N，the cell proliferation activity of group S and group U at 1，4，6 hours were significant different （Plt;0.05 ）. Compared with group S，the cell proliferation activity of group U at 1，2，6 hours increased significantly （Plt;0.05）. Obviously positive expression of NF-κB in PMVECs could be seen in group S，a little positive expression in group S，and no expression in group N and group H. Compared with group N，the TNF-α levels of group S and group U increased significantly at each time point with significant differences （Plt;0.01）. Compared with group S，the TNF-α levels were significantly reduced at each time point in group U （Plt;0.01）. Conclusions UTI can reduce the release of TNF-α by inhibiting NF-κB activation，thus reduce PMVECs injury attacked by serum from severe sepsis patients.
ObjectiveTo systematically evaluate the risk prediction models for anastomotic leakage (AL) in patients with esophageal cancer after surgery. MethodsA computer-based search of PubMed, EMbase, Web of Science, Cochrane Library, Chinese Medical Journal Full-text Database, VIP, Wanfang and CNKI was conducted to collect studies on postoperative AL risk prediction model for esophageal cancer from their inception to October 1st, 2023. PROBAST tool was employed to evaluate the bias risk and applicability of the model, and Stata 15 software was utilized for meta-analysis. ResultsA total of 19 literatures were included covering 25 AL risk prediction models and 7373 patients. The area under the receiver operating characteristic curve (AUC) was 0.67-0.960. Among them, 23 prediction models had a good prediction performance (AUC>0.7); 13 models were tested for calibration of the model; 1 model was externally validated, and 10 models were internally validated. Meta-analysis showed that hypoproteinemia (OR=9.362), postoperative pulmonary complications (OR=7.427), poor incision healing (OR=5.330), anastomosis type (OR=2.965), preoperative history of thoracoabdominal surgery (OR=3.181), preoperative diabetes mellitus (OR=2.445), preoperative cardiovascular disease (OR=3.260), preoperative neoadjuvant (OR=2.977), preoperative respiratory disease (OR=4.744), surgery method (OR=4.312), American Society of Anesthesiologists score (OR=2.424) were predictors for AL after esophageal cancer surgery. ConclusionAt present, the prediction model of AL risk in patients with esophageal cancer after surgery is in the development stage, and the overall research quality needs to be improved.