ObjectiveTo explore the clinical effect of hemodialysis combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning.Method100 cases of acute severe organophosphorus pesticide poisoning patients admitted in our hospital from June 2011 to June 2015 were divided into combined group and conventional group according to the random number table method, 50 cases in each group. Conventional group patients were treated with gastric lavage and catharsis, cleaning skin, protecting gastric mucosa and other conventional treatment. In addition to the routine treatments, combined group patients were treated with hemodialysis combined with hemoperfusion. Compared the dosage of atropine, recovery time, hospitalization time, the incidence of multiple organ failure and cholinesterase activity of the two groups before and after treatment.ResultThe differences of cure rate and mortality rate between the two groups were significant (P<0.05). Combined group patients with atropine dosage were less than control group, the recovery time, hospitalization time weres shorter than control group, multiple organ failure rate were lower than conventional group (P<0.05). Two groups of patients before treatment of cholinesterase activity had no obvious difference (P>0.05), and the cholinesterase activity of combined group was significantly higher than conventional group after treatment (P<0.05).Conclusion Hemoperfusion combined with hemodialysis can effectively improve the prognosis of patients with severe acute organophosphorus pesticide poisoning, reduce the dosage of atropine, accelerate the recovery of the patients, avoid multiple organ failure, worthy of clinical application.

Objective To evaluate the effects of continuity nursing on quality of life in stroke patients with tracheotomy after discharge. Methods Total-ly,211 stroke patients with tracheotomy were divided into the observation group and the control group randomly. The routine nursing care was given in two groups of patients during the period of hospitalization. In addition,patients in the observation group received continuity nursing after discharge. Quality of life and knowl-edge about tracheotomy of two groups patients at 3 months after discharge were tested and compared. Results Patients’quality of life and knowledge about trach-eotomy in the observation group at 3 months after discharge were significantly better than those of the control group(P ﹤ 0. 01 or P ﹤ 0. 05). Conclusion Conti-nuity nursing can improve the quality of life and the level of knowledge in stroke patients with tracheotomy after discharge.

目的:分析益气活血中药血液透析液对慢性肾功能衰竭（Chronic renal failure,CRF）患者血小板膜糖蛋白CD62P表达的影响。方法:选取我科2012年1月~2014年1月长期接受血液透析的CRF患者92例,随机分为实验组和对照组。对照组采用碳酸氢盐血液透析液,实验组在对照组基础上,加用益气活血中药。对比两组患者透析3个月后中医症候评分、血生化、血常规指标、尿白蛋白/肌酐比（ACR）、尿渗透压和血清CD62P水平。结果:治疗3个月后,两组患者的中医症候评分较治疗前显著降低,P＜0.05;实验组治疗3个月后中医症候评分较对照组显著降低,P＜0.05。治疗3个月后,两组患者的血肌酐、尿素氮、血钾、血磷和免疫反应性甲状旁腺激素（immunoreactive parathyroid hormone,i PTH）较治疗前显著降低,血钙较治疗前显著上升,P＜0.05;治疗3个月后,实验组的血肌酐、尿素氮、血钾、血磷和i PTH较对照组显著降低,血钙较对照组显著上升,P＜0.05。治疗3个月后,两组患者的红细胞、血红蛋白和尿渗透压较治疗前显著升高,尿ACR较治疗前显著降低,P＜0.05;治疗3个月后,实验组的红细胞、血红蛋白和尿渗透压较对照组显著升高,尿ACR较对照组显著降低,P＜0.05。治疗3个月后,两组患者的血清CD62P水平较治疗前显著降低,P＜0.05;治疗3个月后,实验组血清CD62P水平较对照组显著降低,P＜0.05。结论:益气活血中药血液透析液用于CRF患者透析可降低其CD62P水平,改善肾功能,具有一定的应用价值。

Objective To explore the efficacy and safety of liposomal doxorubicin combined with COP chemotherapy regimen in treating primary lymphoma of bones.Methods Ten patients [6 males and 4 females,(41 ± 12) years old (27-61) years old] with primary lymphoma of bone from June 2010 to June 2014 were enrolled and received liposomal doxorubicin combined with COP chemotherapy regimen.The efficacy and safety of liposomal doxorubicin were observed.Results Totally 6 to 8 courses of treatment were given and patients were followed up till January 2015.There were 5 of complete remission and 3 of partial remission; 1 case died of recurrence; 1 case died of complications.Totally 8 cases were effective.The longest disease free survival time was more than 50 months.Conclusion Liposomal doxorubicin combined with COP chemotherapy regimen is safe and effective for treating primary lymphoma of bone.

Objective To explore the clinical efficacy and safety of granulocyte colony stimulating factor ( G-CSF)-induced graft-versus-leukemia effect in the treatment of leukemia relapse after allogeneic hemato-poietic stem cell transplantation.Methods A total of 40 cases of relapse leukemia after allogeneic hemato-poietic stem cell transplantation from Department of Hematology,General Hospital of Beijing Military Com-mand between Jul.2011 and Feb.2013 were included in the study,including 10 cases of acute lymphoblastic leukemia-CR2,16 cases of acute myeloid leukemia-CR2,4 cases of acute myeloid leukemia-CR3,6 cases of acute mixed lineage leukemia and 4 cases of chronic myeloid leukemia at accelerated phase.After G-CSF mobilization,donor peripheral blood mononuclear cells were infused.The infusion cell volume increased step by step at each infusion with an interval of 4 weeks.The efficacy,complications of the infusion and follow-up was done.Results There were 24 cases of second complete remission,16 cases without remission.After the infusion,Ⅰ-Ⅱ acute graft-versus-host disease was seen in 6 patients,chronic graft-versus-host disease was seen in 24 patients,and complications occurred in 5 patients.Conclusion G-CSF-induced graft-versus-leu-kemia has good effect for the treatment of relapse of leukemia,with less adverse reactions.

带状疱疹是一种在老年人群中常见的皮肤病[1],主要表现为红斑、密集的小水疱,呈带片状,常沿单侧外周神经分布[2].发生在头面部症状严重者会出现剧烈头痛和眼部损害,甚至导致失明,并常有持续渐进性加重的神经痛,严重影响患者的生活质量.部分患者对带状疱疹病毒的疾病知识了解不多,疱疹后造成形象的改变以及后遗神经痛等都会导致患者产生负性情绪,从而加重患者的痛苦[3].2010年以来我院对带状疱疹患者实施了连续性护理,效果明显,现将结果报告如下.

目的探讨外伤导致原发性血小板增多症与血巨核细胞体外扩散的相关性。方法 2007年9月~2013年12月选择在笔者医院进行急诊的外伤导致原发性血小板增多症患者36例作为观察组,同期选择在笔者医院进行健康体检的健康志愿者36例作为对照组,两组都抽取静脉血进行血浆TPO与IL-11的检测。分离脐带血的单个核细胞,然后与两组的血浆进行共孵育培养,进行CD41a+的表达情况、巨核祖细胞计数和巨核细胞DNA倍体分析。结果观察组在细胞培养10天与15天的巨核细胞数量明显多于对照组。经过巨核系祖细胞集落检测,结果显示观察组的CFU-MK值明显高于对照组（P＜0.05）。观察组的血浆TPO和IL-11值明显高于对照组,同时观察组的培养第10天与第15天的多倍体细胞（n≥4）的比例明显高于对照组,对比差异有统计学意义（P＜0.05）。结论外伤导致原发性血小板增多症伴随有巨核细胞扩散性与生成增加,是由于血浆中TPO和IL-11过表达增加而导致巨核细胞成熟形成多倍体,使得血小板增多。

目的 探讨粒细胞集落因子(G-CSF)治疗急性再生障碍性贫血的临床效果.方法 采用回顾性的研究方法对北京军区总医院2008-2014年收治的62例急性再生障碍性贫血的患者的治疗情况进行研究,根据治疗方法分为G-CSF组(37例)和对照组(25例),对照组采用雄激素结合常规疗法,G-CSF组在对照组基础上加用G-CSF治疗,比较两组患者治疗前与治疗后不同时间的外周血指标、T细胞亚群指标及临床疗效差异.结果 治疗前两组患者的Hb、PLT检测值差异不显著,治疗第30天G-CSF组的Hb (74.5±15.3) g/L、PLT (27.4±8.8)×109/L值显著高于对照组(P＜0.05).治疗前两组患者的WBC水平差异不显著,治疗第7、14、30天G-CSF组患者的WBC水平显著高于对照组(P＜0.05).治疗前两组患者的CD3+、CD4+、CD8+、CD4+/CD8+值比较差异不显著,治疗第30天G-CSF组患者的CD8+细胞显著低于对照组(P＜0.05),CD4+/CD8+值显著高于对照组(P＜0.05).G-CSF组患者的发热时间(7.5±3.6)d、感染持续时间(13.4±5.6)d显著低于对照组(P＜0.05).治疗6个月后,G-CSF组的总有效率78.38％显著高于对照组的52.00％ (P＜0.05),治疗过程中G-CSF组有2例患者死亡(5.41％),低于对照组的4例(16％),但差异不具有统计学意义.结论 常规治疗基础上加用粒细胞集落因子治疗急性再生障碍性贫血对于改善患者的血常规指标、缓解临床症状、提高治疗效果具有显著意义.

目的：评价莱温守恒模式应用于脑梗死急性期患者中的效果。方法将160例脑梗死急性期患者随机分成2组。观察组（80例）采用莱温守恒模式实施护理，对照组（80例）给予常规护理，比较2组患者的自理能力评估情况和对护理的满意度。结果观察组患者入院2周后自理能力评分明显高于入院时（P＜0．05），且明显高于同期对照组（P＜0．05）；观察组患者对护理工作满意度明显高于对照组（P＜0．05）。结论莱温守恒模式应用于脑梗死急性期的患者，为护士制定整体护理实践方案提供了理论框架和相应的护理干预方案，深化了对护理整体性的认识，进一步提高了优质护理服务质量，值得在临床上推广。

目的 探讨连续2次单倍型异基因移植治疗重型再生障碍性贫血(severe aplastic anemia,SAA)失败后,更换单倍型供者行第3次移植治疗的可能性和安全性.方法 1例SAA患儿,以其父亲作为单倍型供者,于第1次单倍型外周血干细胞移植及第2次骨髓移植失败后,选择患儿母亲为单倍型供者进行第3次骨髓及外周血干细胞联合移植,其预处理方案采用Flu+ CTX+ ATG方案.结果 第3次单倍型移植成功植入,植入证据检测为100％完全供者造血,患儿造血功能恢复正常,未发生移植物抗宿主病等严重并发症,随访至2015年1月仍存活.结论 移植植入失败后行第3次单倍型异基因造血干细胞移植治疗SAA仍是安全有效的挽救治疗措施.

Objective To study the clinical characteristic,therapeutic response and prognosis of recurrent multiple mye-loma with invasion into the brain and pleura.Methods Retrospective analysis of clinical data of 1 case of pathologically diag-nosed multiple myeloma relapse cases were conducted,and related literature were reviewed.Results The patient received borte-zomib,lenalidomide standard treatment and was stable for 6 months,then brain and pleural recurrence had its first manifestation. Myeloma cell invasion reached vertebral,pleural fluid and cerebrospinal fluid widely,various kinds of treatment plans ultimately lead to death.Conclusion Clinical manifestations of multiple myeloma are complicated,with scarce invasion into the brain and pleura,and the prognosis is poor.

Objective To analyze the impact of Chinese herbs for platelet membrane glycoprotein CD62P expression in blood dialysis patients with chronic renal failure(CRF). Methods 92 CRF cases with long-term hemodialysis in our department from January 2012 to January 2014 were randomly divided into ex-perimental and control groups. The control group had bicarbonate dialysis fluid;the experimental group was based on the use of Chinese herbs added. The TCM symptom score,blood biochemistry,and serum CD62P lev-els were compared in two groups of patients 3 months after dialysis. Results After 3 months of treatment, TCM symptom score in both groups was significantly lower than before treatmen ( P <0 . 05 ) . TCM symptom scores in the experimental group 3 months after treatment were significantly lower than the control group( P<0. 05). After three months of treatment,serum creatinine,blood urea nitrogen,potassium,phosphorus and im-munoreactive parathyroid hormone( iPTH) in both groups of patients were significantly lower than those before treatment,serum calcium was significantly higher(P<0. 05). 3 months after treatment,serum creatinine,blood urea nitrogen,potassium,phosphorus and iPTH in the experimental group were significantly lower than those of the control group,serum calcium was significantly higher,P<0. 05. and urine osmotic pressure in the experi-mental group. After three months of treatment,the serum levels of CD62P in both groups were significantly low-er than before treatment(P <0. 05);3 months after treatment,the serum levels of CD62P significantly de-creased in the experimental group than in the control group ( P<0 . 05 ) . Conclusion Yiqihuoxue medicine&nbsp;for hemodialysis patients with CRF dialysis fluid can reduce the CD62 P levels and improve kidney function with a certain value.

Objective To investigate the clinical efficacy of rituximab combined with mitoxantrone for malignant lymphoma. Methods 60 malignant lymphoma patients were randomly divided into mitoxantrone group( 29cases) and rituximab and mitoxantrone combination group( 31cases). Mitoxantrone group using mitoxantrone,etoposide,and dexamethasone,Rituximab and mitoxantrone combination group added rituximab on the basis of the mitoxantrone group. Efficacy of 60 patients were evaluated after 4 cycles of chemotherapy,the survival was observed during follow-up. Results CR of the mitoxantrone group and rituximab combined with mitoxantrone group were 68. 1% and 87. 3%,there were significant difference between the 2 groups( P 0. 05).In the mitoxantrone group,1-year overall survival( OS) was 87. 8%,2-year OS was 76. 8%,3-year OS was 75. 4%; in the rituximab combined with mitoxantrone group,1-year overall survival was 91. 6%,2-year OS was 81. 6%,3-year OS was 78. 7%. There had a significant difference in 1-year,2-year,3-year OS between the 2 groups( P 0. 05). Conclusion Rituximab combined with mitoxantrone for malignant lymphoma is effective,it is worthy of clinical application.

目的：探讨连续护理联合动态血压监测干预对原发性高血压患者血压控制水平的影响。方法将122例原发性高血压患者随机均分为2组，对照组61例给予常规治疗和护理，实验组61例给予连续护理联合动态血压监测干预，比较2组疗效。结果治疗后，实验组收缩压、舒张压均较对照组稳定，并且患者的治疗依从性、理解疾病知识、采纳健康方式以及满意人数均多于对照组。结论连续护理联合动态血压监测干预治疗原发性高血压效果较好，能够有效控制血压。

目的 探讨全程健康教育在首次住院青年脑卒中患者护理管理中的应用效果.方法 选取首次住院治疗的青年脑卒中患者230例,在治疗原发病和康复训练的同时,分别在入院时、急性期、康复期、出院前、出院后实施有针对性的全程健康教育.结果 实施全程健康教育后,青年脑卒中患者的复发率降低,脑卒中相关知识掌握情况和对护理的满意度提高(P＜0.01).结论 对首次住院青年脑卒中患者实施全程健康教育科学、有效,可作为脑卒中护理工作的一种制度化、常规化的干预措施在临床推广应用.

Objective To investigate the effect of continuous psychological nursing intervention in young patients with post-stroke depression (PSD). Methods The patients (n=217) were randomly divided into research group (n=109) and control group (n=108), and they were given treatment of original disease and rehabilitation training. The research group was additionally given continuous psychological nursing intervention. After discharging from hospital for 1 year, HAMD scoring and ADL scoring were compared between 2 groups. Results The scores of HAMD and ADL had no statistical difference on baseline between 2 groups (P>0.05). After follow-up for 1 year, scores of HAMD and ADL were respectively (10.22±3.77) and (18.42±3.64) in research group, which were significantly lower than those in control group (26.84±4.01) and (38.35±8.63, P<0.05). Conclusion Targeted continuous psychological nursing can improve the quality of daily living and relieve depression severity in young patients with PSD.

Objective To investigate the role of immune regulation of Th17 cells and interleukin -17(IL-17)in acute graft-versus-host disease(aGVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods Wild-type(WT)C57BL / 6(H-2b)mice and C57BL / 6(H-2b)IL-17 knockout(IL-17- / -)mice were used as donors,BALB / C(H-2b)mice as recipients. The re-cipient mice were given myeloablative conditioning with 8. 5 Gy of total body irradiation. 1 × 107 T-cell-depleted bone marrow cells( TCD-BMCs)and 1 × 106 CD4+IL-17- / -T cells of WT mice were transferred. After transplantation daily survival of the mice was observed,clinical assessment of aGVHD was performed at 5 days intervals,and pathological examinations of liver,lung,intestine and skin of mice were analyzed. aGVHD scores were evaluated in Th17 cells and CD4+IL-17- / -T group,IL-17- / -BMCs + IL-17- / -SCs group( KK group),WT BMCs + IL-17- / -SCs group(WK group)and WT BMSCs + WTSCs group of mice(WW group). Results (1)5,10,15 and 20 days af-ter transplantation,aGVHD scores in Th17 cell transplantation group were significantly higher than IL-17- / -CDD4 + T cell group( P ﹤0. 05),and the average survival time of Th17 cell transplantation group was significantly less than IL-17- / -CDD4 + T cell group( P ﹤0. 05). (2)There was significant difference in aGVHD scores 5,10,15,and 20 days( P ﹤0. 05)after transplantation among KK,WK and WW groups;difference in the average survival time among the three groups was also statistically significant( P ﹤0. 05). Conclusion Th17 cells and IL-17 play immune regulatory role for the development of aGVHD in allo-HSCT.

Objective To explore the effect of vascular assessment monitoring table in application of patients with venous transfusion in neurology department. Methods A total of 352 patients in neurology department from 2010 January to July, were divided into observation group (n=176) and control group (n=176). The vascular assessment monitoring table was used during venous transfusion in observation group for evaluation and management, while control group received conventional treatment. The success rate of one time puncture, incidence rate of phlebitis and patients' sat-isfaction degree of the two groups were compared. Results The success rate of one time puncture and patients' satisfac-tion rate in observation group were significantly better compared with those in control group (P<0. 05), while the inci-dence rate of phlebitis in observation group was significantly lower than that in control group (P<0. 05). Conclusion Vascular assessment monitoring table in application of patients with venous transfusion in neurology department may im-prove quality of nursing and improve nurse-patient relationship.

Objective:To explore the diagnosis and etiological factors of hemophagocytic syndrome.Method:Clinical manifestations,laboratory results and diagnosis of primary disease were analyzed in two patients with rare family hemophagocytic syndrome.Result:The two patients had similar clinical manifestations including pancytopenia,coagulation disorders,liver function disorders and hemophagocytosis phenomenon discovered in marrow.Conclusion:Hemophagocytic syndrome has clinical manifestations and high mortality.