We investigated the correlation between body weight index (BWI) and the effective power of erythrocytapheresis in patients with polycythemia vera (PV) who received therapeutic erythrocytapheresis (TEA). Furthermore, the risk factors of the adverse events related to erythroapheresis therapy were analyzed. Two hundred and seventeen cycles of therapeutic erythrocytapheresis were carried out in 139 patients with PV (Hct). The correlation between the BWI and the difference of hematocrit before and after therapeutic erythrocytapheresis (ΔHct) was analyzed by the Pearson correlation analysis method. Logistic regression analysis was used to study the risk factors of adverse events for TEA. We observed a positive correlation between the BWI and ΔHct. BWI over 15 ml/kg, inlet velocity of the apheresis procedure over 45 ml/min and an age older than 50 years were the risk factors of adverse events of TEA. The results suggested that BWI was a sensitive index to estimate the effective power and adverse events of TEA. The rate of adverse events of TEA might be reduced by maintaining the BWI below the dangerous threshold of 15 ml/kg and the inlet velocity of the apheresis procedure below 45 ml/min especially in patients older than 50 years of age.

OBJECTIVE:To analyze the efficacy and its correlation with species of transplant cells of autologous mobilized peripheral blood (PB) mononucleated cells (MNCs) transplantation on 59 patients with lower limbs ischemia.METHODS:Fifty-nine patients were evaluated with symptoms scores and after that their PBMNCs were mobilized and collected and then injected into the ischemic area at equal distance. They effectiveness and scores were evaluated at 7th day and 4th month after therapy. The correlation of CD34(+) cells and of MNCs with effectiveness was analysed respectively, and formula for correlations between them and effectiveness was calculated.RESULTS:After MNCs injection, the effectiveness was observed both at 7th day and 4th month. The correlation of MNCs with effectiveness was stronger than that of CD34(+) cells (the effectiveness was represented by nimodipine value), According to the formula of nimodipine value, the value of the latter = 0.484 + 1.055 × CD34(+) cells number and the former = 0.288 + 0.401 × MNCs number with a correlation coefficient of R = 0.461 (P = 0.047) and R = 0.473 (P = 0.000) respectively.CONCLUSION:Autologous mobilized PBMNCs number is a better indicator for effectiveness than CD34(+) cells number.

Objective To investigate the effectiveness and mechanism of mobilized peripheral blood mononuclear cells(PBMCs)transplantation on the diabetics patients with lower limbs ischemia.Methods Twenty-three diabetics patients with lower limbs ischemia(diabetes group) and 36 non-diabetics patients with lower limbs ischemia(non-diabetes group)were included,and then were treated with mobilized PBMCs transplantation.All patients were counted the numbers of PBMCs and CD34+ cells before and after mobilization,also were evaluated with symptoms scores(rest pain,cold feeling,no-pain walking distance and ucler) before and 7 days,4 months after therapy.Results The scores of rest pain,cold feeling,no-pain walking distance and ulcer in the two groups of 4 months after therapy were less than those before therapy,all P0.05;no difference of symptoms scores were found between the two groups.The number of PBMCs before mobilization of the diabetes group and CD34+ cells were both lower than those of the non-diabetes group,both indexes decreased after the mobilization and no difference were found between the two groups.Conclusion The effectiveness of PBMCs transplantation on diabetics patients is definite,the mechanism I may related to that the mobilized PBMCs including more earlier endothelial progenitor cells(EPCs) and can offer the microenvironment for the proliferation of EPCs.

<正>真性红细胞增多症(polycythemia vera,PV)简称"真红",是1种获得性,源于造血干细胞的克隆性疾病,其特征为红细胞(RBC)造血异常增生,红系祖细胞对红细胞生成素高度敏感和非依赖[1]。PV患者最常用的疗法之一是放血治

目的:探讨异基因造血干细胞移植后正确的出院指导.方法:心理指导:帮助他们重建生活信念,恢复家庭关系;帮助患者了解药物副作用和逐渐减量方法;自身护理的指导:HSCT破坏了人体免疫机制,需要特别注意个人卫生;饮食指导:饮食应给予易消化、营养丰富的清淡的、新鲜食物;活动的指导:活动量的大小要依据血象恢复情况和个人身体状况而定.结果:经有效的出院指导,患者及家属都基本掌握了相关知识.结论:出院指导是促进患者康复,提高患者生活质量的有效方法.

血小板是人体血液中主要成分之一,正常100～300×109/L,在维持正常出凝血机制中起重要作用.但如果血小板数量过高,可导致血栓形成.血小板的聚集体可机械性的堵塞血管,根据栓塞部位的不同,会出现不同的临床表现.一例慢性粒细胞性白血病患者脾脏切除后,血小板异常增高引起系列临床症状,我们进行了较成功的护理.报告如下:

目的患者家属的角度进行分析.方法分别从护士与家属方面的原因:精神痛苦、心理失衡、知识缺乏、经济负担过重、过度疲劳、语言不通、对前途担忧、角色不适用.护士方面的原因:客观原因有工作量大、患者保护性隔离;主观原因为观念陈旧、缺乏有效沟通、知识缺乏.结果从护士与白血病患者家属不同的角度,分析了护士与家属之间矛盾的原因.结论更新观念、加强自身修养、有效沟通、运用非语言性交流是解决此矛盾的有效对策.

目的为了观察全身照射与交替半身照射两种方法在治疗恶性肿瘤患者中的不良反应.方法两种照射剂量一样,全身照射使用varian机器,剂量率5～10 CGY/min.交替半身照射使用电子直线加速器,剂量率13～15 CGY/min,分两次照射.结果照射时,不良反应没有明显差异;1周内,全身照射后不良反应增加;1周后,全身照射后严重不良反应明显增加.结论交替半身照射不良反应低于全身照射.

缓慢静脉滴注去甲万古霉素不良反应不多见,且反应程度大多轻微.极少有对本品过敏的现象,严重过敏反应者更为罕见.现报道静脉滴注去甲万古霉素引起严重过敏反应1例:

自1991年8月～2000年3月,我科为各种血液病患者进行异基因造血干细胞移植92例次,发生急性移植物抗宿主病25例,死亡3例.因为在急性移植物抗宿主病的预防和治疗过程中,应用免疫抑制剂和糖皮质激素药物,患者极易合并感染,我们在工作中除了加强常规护理外,还摸索出了新的有效的护理方法.