急性髓系白血病患者异基因造血干细胞移植时伊曲康唑预防性应用的研究

目的分析急性髓系白血病（AML）患者异基因造血干细胞移植（Allo-HSCT）时预防应用伊曲康唑防治侵袭性真菌感染（IFI）的效果。方法选取我院2011年10月~2014年9月异基因造血肝细胞移植时采用伊曲康唑序贯处理预防IFI的52例急性髓系白血病患者作为观察组,并选取2004年7月~2007年5月我院于Allo-HSCT前予口服氟康唑片预防真菌感染的20例接受Allo-HSCT的急性髓系白血病患者作为对照组,评价伊曲康唑序贯方案在预防急性髓系白血病患者作异基因早干细胞移植时发生IFI的应用价值。结果观察组IFI发生率为5.8%,明显低于对照组的30.0%,两组对比差异有统计学意义（P〈0.05）;观察组180d总生存率为88.5%,对照组180d总生存率为70.0%,两组总生存率对比差异无统计学意义（P〉0.05）;观察组毒副反应发生率为34.6%,对照组毒副反应发生率为40.0%,两组毒副反应发生率对比差异无统计学意义（P〉0.05）;对照组真菌感染相关死亡率为16.7%,观察组无1例死于真菌感染,两组真菌感染死亡率对比差异有统计学意义（P〈0.05）。结论在进行Allo-HSCT的AML患者中采用伊曲康唑作IFI二级预防,可降低患者IFI发生率,降低真菌感染相关死亡率,优化患者生存质量。

重型β-地中海贫血异基因造血干细胞移植术后的强化护理干预疗效分析

重型β-地中海贫血病情严重常采用造血肝细胞移植术进行治疗,术后护理要求较高,故提出强化护理干预措施,并分析效果。方法 选取我院收治的重型β-地中海贫血患者20名进行分析,研究主题为术后强化护理干预效果,开展与2020年9月,2022年6月完成本次研究也是所有数据的闭环阶段,明确研究对象后,使用计算机相关软件进行相关资料的收集和统计,同时根据治疗方法完成分组,研究组采用以强化护理干预方式,参照组采用常规护理方式,每个小组分被获取10名患者,对患者使用不同方法护理后,观察期间产生的并发症情况以及护理工作落实后患者的满意度情况。结果 了解研究组应用强化护理干预后,并发症的发生人数1例,(10.0%)为所占比例,与此数据所对应的参照组数据为3例,(30.0%),组间数据显示出明显的对比性,差异有统计学意义(P<0.05)。研究组护理后10例患者均对护理工作表示满意,故满意度为(100.0%);参照组患者接受护理后有2例患者对护理不满意,满意人数8人,占比(80.0%),由此可见,研究组满意度优势显著(P<0.05)。结论 采用强化护理进行重型β-地中海贫血异基因造血干细胞移植术后的护理工作,患者的并发症有明显的减少,且护理工作质量得到了显著的提高,患者对护理更加满意,临床借鉴和推广价值高。

Functional changes of dendritic cells derived from allogeneic partial liver graft undergoing acute rejection in rats

AIM: To investigate functional change of dendritic cells (DCs)derived from allogeneic partial liver graft undergoing acuterejection in rats.METHODS: Allogeneic (SD rat to LEW rat) whole and 50 %partial liver transplantation were performed. DCs from livergrafts 0 hr and 4 days after transplantation were isolated andpropagated in the presence of GM-CSFin vitro. Morphologicalcharacteristics of DCs propagated for 4 days and 10 dayswere observed by electron rmicroscopy. Phenotypical featuresof DCs propagated for 10 days were analyzed by flowcytometry. Expression of IL-12 protein and IL-12 receptormRNA in DCs propagated for 10 days was also measured byWestern blotting and semiquantitative RT-PCR, respectively.Histological grading of rejection were determined.RESULTS: Allogeneic whole liver grafts showed no featuresof rejection at day 4 after transplantation. In contrast,allogeneic partial liver grafts demonstrated moderate tosevere rejection at day 4 after transplantation. DCs derivedfrom allogeneic partial liver graft 4 days after transplantationexhibited typical morphological characteristics of DC after 4days' culture in the presence of GM-CSF. DCs from allogeneicwhole liver graft 0 hr and 4 days after transplantation didnot exhibit typical morphological characteristics of DC untilafter 10 days' culture in the presence of GM-CSF. After 10days' propagationin vitro, DCs derived from allogeneic wholeliver graft exhibited features of immature DC, with absenceof CD40, CD80 and CD86 surface expression, and low levelsof IL-12 proteins (IL-12 p35 and IL-12 p40) and IL-12receptor (IL-12Rβ1 and IL-12Rβ2) mRNA, whereas DCs fromallogeneic partial liver graft 4 days after transplantationdisplayed features of mature DC, with high levels of CD40,CD80 and CD86 surface expression, and as a consequence,higher expression of IL-12 proteins (IL-12 p35 and IL-12 p40)and IL-12 receptors (IL-12Rβ1 and IL-12Rβ2) mRNA thanthose of DCs both from partial liver graft 0 hr and whole livergraft 4 days after transplantation (P＜0.001) was observed.CONCLUSION: DCs derived from allogeneic partial liver graftundergoing acute rejection display features of mature DC.