【摘要】 目的 探讨米卡芬净在有侵袭性真菌感染（invasive fungal infection，IFI）病史的患者行造血干细胞移植（haematopoietic stem cell transplantation，HSCT）时二级预防（secondary anti-fungal prophylaxis，SAP）的有效性和安全性。 方法 选择2009年1月-2011年1月行HSCT治疗血液病患者中有IFI史的18例患者，从预处理进行SAP，13例开始即使用米卡芬净钠，5例开始选用伏立康唑，后换为米卡芬净。预防至危险期结束（白细胞植活、无感染症状），18例患者随访时间62～220 d，中位随访时间为124 d。 结果 米卡芬净治疗有效17例，1例在预防期间+27 d出现真菌突破感染。预防过程中1例在输注的第2天出现躯干充血性皮疹伴瘙痒，经抗过敏治疗后逐渐好转。17例患者在米卡芬净使用过程中未观察严重不良反应发生，也未因此而调整环胞素A治疗浓度。 结论 米卡芬净作为HSCT中SAP的备选用药之一是安全、有效的。【Abstract】 Objective To investigate the efficacy of micafungin on secondary anti-fungal prophylaxis (SAP) in hematopoietie stem cell transplantation (HSCT) recipients who had a history of antecedent invasive fungal infection (IFI) and to observe the safety of micafungin. Methods The patients with hematological diseases，who underwent HSCT between January 2009 and January 2011, received our routine conditioning regimen. The patients, who had a history of antecedent IFI, were given by micafungin for SAP from the start of conditioning chemotherapy until the end of the risk period. Results There were 18 patients had a history of antecedent IFI. The overall efficacy of micafungin was 17/18. One patients had IFI on the +27th day during SAP; one patient had body congestive rash accompanied with pruritus in the prevention period 2 days after treatment, who got better gradually after antianaphylaxis treatment. No patients had server adverse reaction and the concentration of cyclosporine A was not changed. Conclusion Micafungin as one of drugs for SAP Is effective and safe for HSCT.
ObjectiveTo explore the application value of “enfolded pancreatic duct”pancreaticojejunostomy (PJ) during laparoscopic pancreaticoduodenectomy (LPD). MethodsThe clinicopathologic data of patients underwent LPD and “enfolded pancreatic duct” PJ from May 2020 to March 2022 were collected retrospectively. The time of PJ was recorded. And the pancreatic leakage, biliary leakage, chyle leakage, bleeding and infection, and death within 30 d after the operation were observed. ResultsA total of 132 patients were collected, including 60 males and 72 females. The age of patients was (58.6±10.9) years old. There were 38 cases of pancreatic head cancer, 17 cases of duodenum carcinoma, 17 cases of inferior segment cholangiocarcinoma, and 23 cases of duodenal papilla carcinoma, 7 cases of pancreatic neuroendocrine tumor, 11 cases of pancreatic intraductal papilloma, 5 cases of duodenal stromal tumor, 5 cases of duodenal papillary adenoma, 6 cases of pancreatic cyst adenoma, and 3 cases of pancreatic head stone. None of the patients was converted to open surgery. The diameter of pancreatic duct before operation was (3.43±2.11) mm, which were <3 mm in 31 cases. The time of PJ was (20.61±3.16) min. The pancreatic leakage occurred in 17 cases, including 11 cases of grade A leakage, 6 cases of grade B leakage, and none of grade C leakage. There was 1 case of bile leakage, 6 cases of chyle leakage, 5 cases of postoperative bleeding (2 cases of intraabdominal bleeding and 3 cases of gastrointestinal anastomotic bleeding), 3 cases of intraabdominal infection, and no death. None of the patients was readmission due to complications after 90 d of follow-up. ConclusionsFrom summary results of this group of cases, compared with the traditional PJ method, “enfolded pancreatic duct” PJ is less difficult and simpler to operate, which can obviously shorten the PJ time during LPD and reduce the incidence of pancreatic leakage. It is especially suitable for laparoscopic application.
【 Abstract 】 Objective To study the mRNA expression of BC047440 gene in multiplicate malignant tumor tissues and the corresponding adjacent tissues, and to investigate its roles in the carcinogenesis and development of malignant tumors. Methods Forty-eight cases of malignant tumor tissues and their adjacent non-cancerous tissues were examined. The mRNA expression of BC047440 gene in those tissues of liver cancer, cholangiocarcinoma, gastric cancer, carcinoma of large intestine, glioma, and breast cancer were measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results ① The mRNA expressions of BC047440 gene in liver cancer, gastric cancer, cholangiocarcinoma and carcinoma of large intestine were significantly higher than those in their adjacent non-cancerous tissues (Plt;0.05 or 0.01). BC047440 gene were highly expressed in both glioma and its adjacent tissues (Pgt;0.05), and poorly expressed in both breast cancer and its adjacent tissues (Pgt;0.05). ② There were close relationships between BC047440 gene expression and clinicopathologic findings of liver cancer, including tumor size and portal vein invasion (Plt;0.05). ③ There were also close relationships between BC047440 gene expression and different clinical stages in alimentary canal cancers (Plt;0.05). Conclusion The over expression of BC047440 gene may be related with the growth, infiltration and metastasis of some malignant tumors, including liver cancer, cholangiocarcinoma, gastric cancer, carcinoma of large intestine and glioma.