Résumé
Objective:To explore the relationship between anti-human leukocyte antigen (HLA) antibodies and transplant outcomes in patients with hematological diseases who underwent matched sibling donor transplantation (MSDT).Methods:A retrospective analysis was conducted in 168 patients with hematological diseases who received MSDT in Peking University People's Hospital from March 2015 to November 2017. All patients received detection of anti-HLA antibodies before transplantation, and the correlation between anti-HLA antibodies and transplant outcomes such as hematopoietic cells implantation, blood product transfusion and prognosis after transplantation were analyzed.Results:Among the 168 patients, 28 (16.7%) were positive for anti-HLA class Ⅰ or class Ⅱ antibodies, and 14 (8.3%) were positive for both anti-HLA class Ⅰ and class Ⅱ antibodies. All patients received neutrophil engraftment, 164 patients (97.9%) received platelet engraftment. Univariate analysis showed that there were no effects of anti-HLA antibodies on neutrophil engraftment and engraftment time, platelet engraftment and engraftment time, the volume of red cell transfusion, the volume of platelet transfusion, overall survival (OS) rate, disease free survival (DFS) rate and transplant-related mortality (TRM) in patients with hematological diseases underwent MSDT (all P > 0.05). Multivariate analysis showed that platelet engraftment was associated with better OS ( HR=0.065, 95% CI 0.017-0.252, P < 0.01), better DFS ( HR=0.083, 95% CI 0.024-0.289, P < 0.01) and lower TRM ( HR=0.094, 95% CI 0.014-0.626, P=0.015). Conclusion:Anti-HLA antibodies have no effect on transplant outcomes of patients with hematological diseases who have received MSDT.
Résumé
In recent years,the application of haploidentical stem cell transplantation makes it possible for every transplant candidate to have a donor.Therefore,choosing best donor and dealing with transplantrelated complications,such as promoting engraftment,decreasing graft-versus-host disease and relapse,become key issues to improve transplant outcomes.The advances in allogeneic hematopoietic stem cell transplantation will be reviewed.
Résumé
Objective To study the effect of remifentanil combined with propofol on sober and insulin resistance in patients after esophageal cancer radical surgery.Methods According to the digital table,63 patients with esophageal cancer were randomly divided into the control group (n =32 cases) and the observation group (n =31 cases).The control group were anesthetized through fentanyl plus propofol,while the observation group were anesthetized through remifentanil plus propofol.The level of consciousness and insulin resistance were analyzed.Results 5min after extubation,the OAAS scores of the observation group was (3.8 ± 1.6) points,which was better than that of the control group [(2.9 ± 1.3) points] (t =2.4540,P ＜ 0.05).Compared with preoperation,the insuhn resistance of the two groups were all increased after operation (all P ＜ 0.05).And the insulin resistance in the control group was higher than that in the observation group (P ＜ 0.0 5).Conclusion Remifentanil combined with propofol can improve the level of consciousness and decrease insulin resistance in patients after esophageal cancer radical surgery.