【摘要】 目的 探討影響糖皮質激素治療特發性血小板減少性紫癜療效的主要因素。 方法 回顧分析2008年1月-2010年7月173例特發性血小板減少性紫癜患者的臨床資料，采用χ2檢驗及Logistic回歸分析影響糖皮質激素療效的相關臨床因素。 結果 單因素χ2檢驗分析顯示性別、骨髓巨核細胞計數水平、骨髓產板巨核細胞比例、乙型肝炎表面抗原（HBsAg）、血清免疫球蛋白水平對糖皮質激素療效的影響有統計學意義（Plt;0.05）。脾臟長大、抗核抗體（ANA）陽性、補體C3水平降低與糖皮質激素療效無關。多因素Logistic回歸分析顯示性別、HBsAg是影響糖皮質激素療效的相關因素。 結論 男性、骨髓巨核細胞計數增多、產板巨比例降低者對糖皮質激素治療反應較好。女性、血清免疫球蛋白水平異常、骨髓巨核細胞不增多者及HBsAg陽性的患者對糖皮質激素治療反應相對較差。性別、HBsAg是影響糖皮質激素療效的主要因素。【Abstract】 Objective To discuss the influencing factors associated with the efficacy of glucocorticoid for idiopathic thrombocytopenic purpura. Methods We retrospectively analyzed the clinical data of 173 patients with idiopathic thrombocytopenic purpura who accepted their first treatment in West China Hospital between January 2008 and July 2010. The affecting factors on the efficacy of the treatment were analyzed by means of Chi-square test and binary logistic regression analysis. Results The results of Chi-square test showed that gender, bone marrow megakaryocyte count, the percentage of platelet-producing megakaryocytes, HBsAg, and the level of serum immunoglobulin could have a significant influence on the outcome of glucocorticoid treatment (Plt;0.05), while splenomegaly, positive ANA and decreasing of the level of complement C3 were not correlated with the outcome of glucocorticoid treatment. The results of multivariate logistic regression analysis showed that gender and HBsAg were correlated with the glucocorticoid treatment for patients with idiopathic thrombocytopenic purpura. Conclusion Male patients, patients with increasing bone marrow megakaryocytes and patients with decreasing percentage of platelet-producing megakaryocytes have better responses to glucocorticoid, while female patients, patients with abnormal serum immunoglobulin level and patients with non-increasing number of bone marrow megakaryocytes have poor responses toward glucocorticoid treatment. Gender and HBsAg are the main influencing factors for the response to glucocorticoid.
【摘要】 目的 采用多柔比星（doxorubicin，DOX）制備心肌損傷動物模型，評價各種檢測心功能變化方法的意義。 方法 14只新西蘭大白兔，DOX耳緣靜脈注射，每周3 mg/kg，共10周。分別于給藥前、第4周末及實驗結束時測定血清肌鈣蛋白Ⅰ（cTnI）和腦鈉肽（BNP）水平，彩色多普勒超聲心動圖檢測心功能變化，并觀察心肌組織病理形態學改變及心肌細胞凋亡情況。 結果 使用DOX前后對比，血清cTnI和BNP濃度升高（Plt;0.05）；左室射血分數（LVEF）和左室短軸縮短率（LVFS）下降（Plt;0.05）；心肌組織病理顯示心肌細胞出現不同程度的空泡變性與水腫，細胞間隙明顯增寬，大量炎性細胞浸潤。心肌細胞凋亡明顯增加。 結論 結合心臟超聲檢查和血清cTnI、BNP指標檢測可判斷心肌損傷程度。【Abstract】 Objective To observe the changes of heart function caused by doxorubicin in rabbits. Methods A total of 14 New-Zealand white rabbits were intravenous-injected with doxorubicin with a dosage of 3 mg/kg intravenously once a week, and the accumulative dose was 30 mg/kg. Before the medication and at the 4th and 10th weekend after the medication, the serum levels of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) were measured; left ventricular ejection function (LVEF) and left ventricular fractional shortening (LVFS) were performed on the rabbits respectively. At the 10th weekend, the pathological changes of cardiac tissue and the apoptosis of myocardial cell were detected. Results The levels of cTnI and BNP significantly increased (Plt;0.05), and the LVEF and LVFS markedly decreased (Plt;0.05) after the administration of doxorubicin. Uneven vacuolar degeneration and edema of cardiocytes could be observed with a wide cell spaces and inflammatory cell infiltration in the histopathological slices. Conclusion The combined application of heart sonography with the detection of the serum levels of cTnI and BNP can evaluate the degree of myocardial damage of the rabbits models very well.
目的 總結多發性骨髓瘤（multiple myeloma, MM）的發病特征及臨床特征，分析比較不同治療方案對MM的療效及不同類型與不同臨床特征的MM治療效果。 方法 回顧性分析2003年1月-2008年1月128例MM患者的發病和臨床特征，以及與治療效果的關系，并對不同治療方案、不同類型間的療效進行比較。 結果 MM患者發病的中位年齡為59歲，臨床上以不明原因的骨痛、貧血、感染和球蛋白增高為主要表現。128例患者中行方案一（馬法蘭、強的松/地塞米松、反應停）的總有效率為53.3%（32/60）；方案二（環磷酰胺、長春新堿、馬法蘭、強的松、卡氮芥、阿霉素）為44.4%（8/18）；方案三（長春新堿、阿霉素/表阿霉素/脂質體阿霉素、地塞米松）為68.5%（24/35），方案四（硼替佐米、地塞米松/反應停）的總有效率為86.6%（13/15）。方案一和方案二間、方案三和方案四間療效差異無統計學意義（Pgt;0.05），方案三、方案四的療效均優于方案一和方案二（Plt;0.05）。IgG型總有效率為63.2%（48/76），IgA型為60.9%（14/23），kappa輕鏈型為42.8%（6/14），lammda輕鏈型為46.2%（6/13）。IgG型和IgA型間的療效差異無統計學意義（Pgt;0.05），但IgG型、IgA型的療效均優于kappa輕鏈型和lammda型（Plt;0.05）。不同類型及使用不同方案的患者，其中位生存期及3年和5年的生存率差異無統計學意義（Pgt;0.05）。 結論 MM患者發病高峰年齡介于40～70歲，骨痛和貧血是最常見的首發癥狀。長春新堿、阿霉素/表阿霉素/脂質體阿霉素、地塞米松以及硼替佐米、地塞米松/反應停方案總體療效相當，但后者完全緩解率高于前者。
Objective To evaluate the expression level of nuclear factor kappa B (NF-κB) in patients with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL), and to examine its impact on patients’ clinical characteristics and prognosis. Methods Patients with EBV-positive DLBCL who were diagnosed and treated at West China Hospital of Sichuan University between January 2010 and December 2020 were selected as the research subjects. Clinical data were retrospectively collected. According to the expression of NF-κB, the patients were divided into an NF-κB-positive group and an NF-κB-negative group, and the clinical characteristics were compared between the two groups. Kaplan-Meier method was used for survival analysis. Results A total of 414 patients with DLBCL were collected, and EBV-encoded small RNAs were positive in 37 cases (8.9%). Among the 37 EBV-positive patients, NF-κB positivity was observed in 13 cases (35.1%), while among the 377 EBV-negative patients, NF-κB positivity was observed in 144 cases (38.2%), without statistically significant difference (χ2=0.134, P=0.714). No significant difference in clinical characteristics was found between the NF-κB-positive group and the NF-κB-negative group of EBV-positive patients (P>0.05). The 3-year overall survival (OS) rates for the NF-κB-positive and NF-κB-negative groups were 46.2% and 58.3%, respectively, the 5-year OS rates were 19.2% and 29.2%, respectively, and the median OS was 32 vs. 39 months (P=0.441). The corresponding 3-year and 5-year progression-free survival (PFS) rates were 46.2% vs. 41.7% and 19.2% vs. 20.8%, respectively, and the median PFS was 31 vs. 24 months (P=0.933). Conclusion There is no difference in the expression of NF-κB between EBV-positive and EBV-negative DLBCL patients, and the expression of NF-κB has no impact on the clinical characteristics or the prognosis of EBV-positive DLBCL patients.
After the occurrence of public health emergencies, as the most direct front position, how to carry out medical treatment orderly, effectively, rapidly and safely in a short time has become the focus and difficulty of epidemic control. After the outbreak of 2019 novel coronavirus pneumonia (2019-nCoV), West China Hospital of Sichuan University, as a large-scale general hospital under the supervision of the CPC central committee, put people's life safety and health first, and attach great importance to the prevention and control of the epidemic. This paper introduces the ten measures taken by West China Hospital of Sichuan University to fight against the 2019-nCoV pneumonia, in order to provide reference for other hospitals.