10.3969/j.issn.2095-4344.2013.24.014

Objective:To explore the influence of liquid for post-operative irrigation on the effect of ESS.Method:192 cases with chronic sinusitis and/or nasal polyps of groupIIstageII who had undergone the ESS from September,1998 to June,1999 and completed a3-month follow-up were divided randomly into 3 groups to accept 3 different kinds of irrigation liquid.The evaluation of curative effect was according to the index of HaiKou ESS-97.Result:The curative effect of Herba Houttuyniae group was better than the other two.Conclusion:The post-operative care is important and the irrigation liquid can affect the effect of ESS.

This paper investigate the methods to detect engraftment rate of the four patients with hematological disorders who accepted nonmyeloablative allogeneic peripheral blood stem cell transplantation(NAPBSCT). To find out the best method, their engraftment rates were detected serially at different time after NAPBSCT by means of either FISH, or conventional chromosome analysis combined with R-banding analysis concurrently.The results were carefully compared with one another. All these four sex-mismatched cases were engrafted partially,and two of them changed to full engrafment. The results show no statistically significant difference in 3 groups (conventional method, FISH for hypermetaphase, FISH for interphase nuclei). But the results strongly indicate that FISH is a rapid, precise, objective,and reliable menthod for detection of the engraftment rate,and it is suitable for sex-mismatched NAPBSCT.

Objective To summarize the experimence of nonmyeloablative allogeneic peripheral blood cell transplantation in the treatment of chronic leukemia. Methods Seven patients, including 6 cases of chronic myeloid leukemia (in chronic phase), one of chronic lymphoid leukemia (in third stage), with HLA-identical siblings donor received allogeneic peripheral blood stem cell transplantation after a nonmyeloablative conditioning. Results All of them were engrafted with donor cells (4 with full of donor cells grafted, 3 with mixed chimerism) and recovered hematopoiesis (WBC recovered to more than 0.5 ?10 9/L during postoperative 9 day to 21 day and platelet recovered to more than 30?10 9/L during postoperative 11 day to 28 day). One of them developed a GVHD of degree IV. One of them developed aGVHD of degree I. Conclusion This procedure is much safe, effective and of less complications than the myeloablative condioning regimens and may represent another new approach in the management of patients with chronic leukemia.

Objective To observe the changes of the content of ATP,lactate and the activity of phosphofructokinase(PFK) in perihemotoma region in rabbit brain after intracerebral hemorrhage. Methods(The rabbits) were divided into 3 groups: normal group(N),hemorrhage group (H) and the sham group(S). The H and S groups were subdivided into 1 h, 6 h, 12 h, 24 h, 48 h and 72 h groups. A model of cerebral hemorrhage in rabbit with autologous blood infusion was set. The contents of ATP, lactate and water in perihemotoma region were measured and the metabolite concentration in edematous brain regions were corrected for dilution. The activity of phosphofructokinase was also determined.Results There was obvious edema in perihemotoma region at 1 hour postinfusion and getting more serious at 72 hours. ATP was moderately decreased at 1 hour, and remained in a similar level until 12 hours. There appeared another evident decrease in 24 hours [(13.29?2.92) ?g/g, about 58% of N group], and no obvious changes from 24 to 72 hours. The content of lactate increased in 1 hour and reached the peak at 12 hours [(21.01?0.18) ?mol/g]. Until 72 hours , the level of lactate [(12.89?0.25) ?mol/g] in hemorrhage group reach higher than in the normal and sham group. The activity of phosphofructokinase was decreased at 1 hour [(3.98?0.02) U/mg] and remained in a decreasing tendency to 72 hours. Conclusion The failure of energy metabolism occurs in 24 hours postinfusion,coming late somewhat to the brain edema. The result might be related to the changes of some enzymes, maybe a key role in energy metabolism.

To explore the risk factors of graft rejection in non-myeloablative transplantation between HLA-identical siblings and to evaluate methods to increase donor cell engraftment, 8 patients with graft rejection were studied . The results showed that the usage of immunosup-pressive agents, low early engraft rate, and the kind of disease being CML were closely related with graft rejectioa For patients with graft rejection, second non-myeloablative transplantation is a useful way.

Objective To analyze the related factors of relapse of leukemia after transplantation of nonmyeloablative allogeneic hematopoietic stem cells. Methods Among the twenty-nine patients with acute leukemia who received transplantation of nonmyeloablative allogeneic peripheral blood stem cells, relapse of leukemia occurred in 5 patients. The nonmyeloablative protocol included the pretreatment of CD3 monoclonal antibody, cyclosporine A, cyclophosphamide, cytarabine, and fludarabine was added in 3 patients. Results All the 5 patients went through smoothly the hematopoietic suppression stage, and engraftment of the donor cells was successful. Leukemia relapsed in 4 patients with full donor chimerism (full donor chimerism was converted from the mixed chimerism in 2 patients), and relapse occurred in 1 patient with stable mixed chimerism. Except for 1 patient, all of them did not show acute GVHD or chronic GVHD. Second complete remission after double transplant was achieved in one patient, but leakemia relapsed in two months. In other four patients treatment was given up. Conclusion Transplantation of nonmyeloablative allogeneic peripheral blood stem cells is a safe and effective method for the treatment of acute leukemia.

Objective To compare the applicability between ARF special severity scoring systems and intensive care unit (ICU) general severity scoring systems on predicting the hospital mortality of critical acute renal failure (ARF) patients. Methods The data of 29 patients with critical ARF were retrospectively analyzed. Two ARF special severity scoring models, acute tubular necrosis individual severity index (ATN-ISI) and Stuivenberg hospital acute renal failure scores (SHARF), and 3 ICU general severity scoring models, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), APACHE Ⅲ, Mortality Prediction Model Ⅱ (MPM Ⅱ), were used in the analysis. The receiver operating characteristic (ROC) curves were drawn up to assess the ability of these models in hospital mortality discrimination. Results All severity scores of the patients in survivor group (n=9) were lower than those of the patients in non-survivor group (n=20). There were statistical differentiations in the scores of ATN-ISI, APACHE Ⅱ, MPM Ⅱ-24h, MPM Ⅱ-72h between the survivor group and the non-survivor group (P

Objective To report immune-reconstruction in two patients with acute radiation sickness due to 60Co radiation accident after stem cell transplantation.Methods Patient “A” and “B” were diagnosed as intestinal form of acute radiation sickness(ARS)and extremely severe degree bone marrow form of ARS,respectively.Peripheral blood stem cell transplantation was successfully performed in these two patients.During their whole disease course,absolute lymphcyte count,neutrophil leukocyte count,T-lymphocyte subsets,natural killer(NK),and immunoglobulin were sequentially determined.Results Immunoglobulin was decreased after irradiation without any recovery tendency after the transplantation.After irradiation,absolute lymphcyte count decreased rapidly,but recovered partially after the transplantation(maintained at 0.5?109/L).Neutrophilic leukocyte count rose rapidly to normal after the transplantation.NK was lowered obviously after irradiation,and it rapidly recovered to normal level after the transplantation,and maintained at a level higher than normal.After irradiation,the proportion of CD4/CD8 showed a transient rise,followed by an abrupt lowering.After the transplantation,it showed a tendency of elevation,but it did not recover to normal.Conclusions The tendency of lowering of immunoglobulin,lymphocyte count,NK cell count,and CD4/CD8 ratio indicate that there is a rapid deterioration of both cellular and humoral immunity after irradiation.Following the homogeneic peripheral blood transplantation,neutrophil count and NK cell count showed a rapid recovery,lymphocyte count and CD4/CD8 ratio also showed a tendency of slow elevation,but there is no sign of recovery of immunoglobulin.The results indicate that there is a faster recovery of cellular immunity.

Objective To explore the clinical significance of allogeneic peripheral stem cell transplantation in the treatment of acute radiation sickness.Methods Two victims were accidentally irradiated by a 60Co source in a nuclear accident in Jining,Shandong province,China in 2004.They were exposed to more than 20-25 Gy(patient A)and 9-15Gy(patient B)of 60Co-ray,and were diagnosed as having developed intestinal form of acute radiation sickness(ARS)and extremely severe bone marrow form of ARS,respectively.After the treatment with the preparative regimens based on low-doses of fludarabine,antilymphocyte globulin and cyclophosphamide,the two patients successfully received HLA-haploidentical(patient A)and HLA-identical(patient B)peripheral blood stem cell transplantation(PBSCT),respectively,7 days after the exposure.Cyclosporin A combined with mycophenolate mofetil was used for the prevention of graft-versus-host disease(GVHD).In addition,bone marrow mesenchymal stem cells from a donor were administered into patient A by intra-bone marrow injection.Results Both peripheral blood and bone marrow examinations showed the recovery of hemopoiesis after PBSCT,and neither patients displayed obvious clinical signs of GVHD.However,patient A died of septicemia and multi-organ failure on day 33 after the exposure,while patient B died of heart failure dominant multi-organ failure on day 75 after the exposure.Conclusions Allogeneic PBSCT is a feasible and effective treatment for ARS,while infection and multi-organ failure are major causes of death of the patients.