ABSTRACT
OBJECTIVE:To observe the efficacy and safety of prednisone combined with human immunoglobulin(pH4)for intra-venous injection in the treatment of idiopathic thrombocytopenic purpura. METHODS:85 patients with idiopathic thrombocytopenic purpura were divided into control group(42 cases)and observation group(43 cases). Control group received 1.6 mg/(kg·d)Predni-sone tablet,orally,for continuous 4 weeks;observation group received 400 mg/(kg·d)human immunoglobulin(pH4)for intravenous injection,intravenous injection,for continuous 5 d,then 1.6 mg/(kg·d)Prednisone tablet,orally,for continuous 4 weeks. All pa-tients were given Adrenal color hydrazone tablet,Vitamin C tablet and other conventional treatment. Clinical efficacy,platelet number, T lymphocyte subsets(CD3+,CD3+CD4+,CD3+CD8+,CD19+),TNF-α,IL-6 before and after treatment,time of platelet number reached normal and reached peak value,peak value of platelet number and the incidence of adverse reactions in 2 groups were ob-served. RESULTS:The total effective rate and peak value of platelet number in observation group were significantly higher than control group,time of platelet number reached normal and reached peak value were significantly shorter than control group,the differences were statistically significant(P0.05);after treatment,platelet number,CD3+and CD3+CD4+in 2 groups were significant-ly higher than before,and observation group was higher than control group,IL-6,TNF-αlevel,CD3+CD8+and CD19+were signifi-cantly lower than before,and observation group was lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Prednisone com-bined with human immunoglobulin(pH4) for intravenous injection shows better efficacy than prednisone alone in the treatment of idio-pathic thrombocytopenic purpura,it can increase platelet number,adjust immune function,and do not increase the incidence of ad-verse reactions.
ABSTRACT
Objective To assess the effect of the gamma knife radiosurgery (GKS) for acoustic neuromas, and to analyze the MRI features of the tumors after GKS. Methods GKS was performed in 309 patients with acoustic neuromas from December 1994 to December 2002 at our center. The Leksell Gamma Knife models B and C were used. 249 cases with 256 tumors were followed up with MRI, which included 107 males and 142 females. The median age of the patients was 48.7?14.2 years (10-77 years). GKS was applied as primary treatment for 189 cases (75.9%), and was an adjunctive management approach for 60 cases (24.1%). The median clinical follow-up period and radiological follow-up period was (26.4?21.3) months (6-101 months) and (22.4?19.0) months (6-93 months), respectively. Results Of the 256 tumors, 79 tumors (30.8%) regressed, 165 tumors (64.5%) remained stable, 12 tumors (4.7%) enlarged, and the overall tumor control rate was 95.3%. Among 30 tumors of NF-Ⅱ , 8 tumors (26.6%) regressed, 19 tumors (63.4) remained stable, and 3 tumors (10.0%) enlarged, and tumor control rate was 90%. The rate of hearing deterioration was 22.7%, the rate of permanent facial paralysis was 0%, the rate of transient facial paralysis was 5.9%, and the incidence of transient trigeminal neuropathies was 19.9%. On the image of follow-up MRI, 79 tumors (30.0%) showed loss of contrast enhancement (LOE). LOE was the imaging property of neuromas on follow-up MRI, which symbolized a chronic decrease in the vascularity of neuromas. The histological findings of LOE demonstrated radiation-induced tumor necrosis. The transient swelling of tumors could not be confounded with the growth of tumors. Conclusion GKS is confirmed to be an effective treatment for acoustic neuromas and plays an important role in the control of NF―Ⅱ, and GKS can prevent cranial nerve from injury to a great extent.