小儿原发性血小板减少性紫癜治疗进展

近年来，对于小儿原发性血小板减少性紫癜（ITP）的治疗，不断推出各种新疗法。笔者就各种疗法治疗ITP的进展进行了综述。     

血小板生成素与脾大部栓塞治疗难治性特发性血小板减少性紫癜

目的探讨血小板生成素注射与脾大部栓塞两种方法对难治性特发性血小板减少性紫癜的疗效。方法对15例难治性特发性血小板减少性紫癜患者皮下注射血小板生成素,用药期问和用药后1月、3月、半年、1年、2年分别复查血常规,观察疗效。与我科之前报道的脾大部栓塞治疗难治性特发性血小板减少性紫癜的疗效作一比较。结果两组有效率相当,血小板生成素注射副作用少,脾大部栓塞则疗效持续时间长。结论对难治性特发性血小板减少性紫癜病人首选血小板生成素,无效时再选择脾大部栓塞。     

脾大部栓塞治疗难治性特发性血小板减少性紫癜的临床应用

目的探讨脾大部栓塞在治疗难治性特发性血小板减少性紫癜中的临床应用价值。方法对46例难治性特发性血小板减少性紫癜患者行脾大部栓塞治疗,术后1周、1月、3月、半年、1年、2年复查血象,观察疗效。结果46例中,术后显效32例（70％）,良好7例（15％）,进步3例（7％）,无效4例（9％）。结论脾大部栓塞治疗难治性特发性血小扳减少性紫癜疗效好,具有较好的临床应用价值。     

特发性血小板减少性紫癜患者血清血小板生成素测定及其意义

采用ELISA法对25例ITD患者、32例其他血小板减少症以及15例正常人血清TPO浓度进行圈定。结果表明，ITD与正常对照组相比，TPO含量无明显增高(P＞0．05)；再生障碍性贫血(AA)及白血病化疗后(L组)急者TP0显著升高(P＜0．01)；而肝硬化患者TP0水平则下降(P＜0．05)。TP0含量与血小板数量在从组及L组中呈负相关(P＜0．05)，而ITP患者则无明显相关关系(P＞0．05)。     

脾切除治疗特发性血小板减少性紫癜64例体会

目的 总结脾切除术治疗特发性血小板养活性紫癜（ITP）的治疗经验。方法 回顾性分析64例ITP病人的治疗。结果 56例治愈，治愈率56／64，随访率100％，平均随访时间6．2a。结论 选择性脾切除术是治疗ITP的一种安全，有效的手段。     

血小板减少性紫癜分析二例

血小板减少性紫癜是一种少见的微血管出血性疾病。目前认为血管内皮细胞和血小板的相互作用在血小板减少性紫癜的发病过程中起关键作用。首选治疗以血浆交换和输血浆为主。     

31例小儿特发性血小板减少性紫癜患者的护理体会

目的：探讨如何对小儿特发性血小板减少性紫癜进行临床护理。方法：通过对我院小儿科2000年9月～2006年9月间31名特发性血小板减少性紫癜患儿积极的护理，深入分析其实际效果。结果：通过合理的护理措施能让患儿良好地树立战胜疾病的信心。结论：通过对住院患儿进行有效的护理措施及出院后的健康宣教，对增强患儿的医从性、积极预防感染、增强患儿的自信心及预防并发症有着积极的临床意义。     

31例小儿特发性血小板减少性紫癜患者的护理体会

目的 探讨如何对小儿特发性血小板减少性紫癜进行临床护理.方法 通过对我院小儿科2000年9月～2006年9月间31名特发性血小板减少性紫癜患儿积极的护理,深入分析其实际效果.结果 通过合理的护理措施能让患儿良好地树立战胜疾病的信心.结论 通过对住院患儿进行有效的护理措施及出院后的健康宣教,对增强患儿的医从性、积极预防感染、增强患儿的自信心及预防并发症有着积极的临床意义.     

骨髓增生异常综合征的中西医治疗

骨髓增生异常综合征(MDS)以难治性全血细胞减少和易转化为急性白血病为特征。患者的预后、合并症和年龄是决定治疗策略时必须考虑的因素。治疗策略经常以支持治疗为主,包括造血细胞生成因子、输注红细胞和血小板以及抗感染治疗。另外诱导分化、免疫抑制治疗、刺激造血、靶向治疗、化疗、异基因骨髓移植等根据具体病情选择应用。我们明确提出“气阴两虚,血瘀内阻”的中医复合证候为MDS临床主证,以“益气养阴活血”为治疗大法,制成“益髓颗粒剂”,进行了大量实验及临床研究,获得了确切疗效。     

Effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction （AMi） model was established by ligating the left anterior descending （LAD） coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin （RN） group, the activating blood circulation （AB） group, and the replenishing qi, nourishing yin and activating blood circulation （RA） group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Real-time fluorescence quantitative PCR （Q-PCR）, and the activities of related enzymes were detected by colorimetric assay. The main resuits were as follows： the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were down-regulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly （P〈0.05）. The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energy-relative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.     

纤维粉尘及其检测问题初探

本文就纤维粉尘的特性，粉尘的一般检测问题进行了讨论，关于纤维粉尘及其控制与测试技术的研究，对改善纺织厂的工作条件具有重要的现实意义。