中性粒细胞碱性磷酸酶染色在血液病诊断中的应用

目的 探讨中性粒细胞碱性磷酸酶(NAP)染色在血液系统疾病患者诊断与鉴别诊断中的应用意义.方法 对366例血液系统疾病患者的血涂片用改良戈氏钙-钴法进行染色并作积分判断,并以30例健康体检者作正常对照.结果 急性髓细胞白血病(AML)、慢性粒细胞白血病(CML)慢性期和加速期、巨幼细胞贫血患者的NAP阳性率和积分均明显低于正常对照组(P＜0.01);而急性淋巴细胞白血病(ALL)、骨髓增殖性疾病MPD、再生障碍性贫血(AA)、淋巴瘤白血病期、慢性淋巴细胞性白血病(CLL)、多发性骨髓瘤(MM)、类白血病患者的NAP阳性率和积分则明显高于正常对照组(P＜0.01),且以类白血病者最高;CML急变期、嗜酸细胞增多症、骨髓增生异常综合症(MDS)者与正常对照组比较则差异无统计学意义(P＞0.05).结论 根据NAP活性的特性在很多血液疾病中都可以把其作为诊断及鉴别诊断的判断指标.     

达那唑联合复方皂矾丸治疗再生障碍性贫血38例

目的:观察达那唑联合复方皂矾丸治疗再生障碍性贫血(AA)的临床疗效,探讨其对骨髓骨髓微血管密度(MVD)和血管内皮生长因子(VEGF)的影响。探讨。方法:采用随机、双盲法选取病例,从2014年12月至2015年12月期间某中心医院血液科收治的患者中选取76例为观察对象,按随机数字表法分为实验组和对照组,每组各38例。对照组采用达那唑治疗,实验组采用达那唑联合复方皂矾丸治疗,观察两组患者治疗前后骨髓MVD和VEGF水平变化情况,评价临床疗效,记录不良反应。结果:两组患者治疗前MVD和VEGF水平比较,两组数据比较无统计学差异(P0.05);治疗后,实验组MVD及VEGF水平明显提高,且提高幅度大于对照组(P0.05);实验组临床疗效总有效率86.84%高于对照组65.79%(P0.05);实验组与对照组不良反应率比较,组间数据无统计学差异(P0.05)。结论:临床治疗再生障碍性贫血患者可采取达那唑联合复方皂矾丸治疗方案,该治疗方案能够显著提高患者MVD、VEGF水平,不良反应小,临床疗效显著。     

急性白血病的疗效及预后与血浆D二聚体水平的关系

D二聚体（D－diner）作为体内高凝状态及继发料溶活性增高的敏感指标之～，已被逐渐应用于高凝状态及血栓形成性疾病的诊断、疗效观察和预后判断【门。因急性白血病（AL）患者体内具有出凝血机制的紊乱［’］，其血浆D－diner水平增高「“‘’。本文用DOAP方案化疗50例AL患者两疗程，并动态观察该组病人化疗前后的D－d。。r水平变化．探讨其与AI。患者疗效及预后的关系。1对家与方法1．l研究对象（l）正常对照组：SO例健康志愿者为本院职工及实习医生，其中男23人．女27人，年龄18～68岁（组中值32岁）。（2）病例组：AL患者SO例（…     

VEGF与骨髓增生异常性疾病的研究现状

血管内皮生长因子（VEGF）是血管新生过程中一种重要的因子,在骨髓增生异常性疾病中起重要作用,其主要通过与受体（VEGFR）结合而发挥生物效应。改变骨髓或血浆中VEGF或VEGFR的水平可能成为治疗骨髓增生异常性疾病的新途径,本文就VEGF与骨髓增生异常性疾病的研究现状作一综述。     

大鼠急性肾功能衰竭时血浆心钠素与血管紧张素系统的关系

用顺铂（ＣＰ）诱发的大鼠急性肾功能衰竭（ＡＲＦ）动物实验模型，观察在急性肾功能衰竭发展的不同阶段血浆心钠素与肾素、血管紧张素系统之间的关系。发现在ＣＰ处置后２４、４８和７２ｈ，血清肌酐水平分别为正常对照组的１．５、２．５和４倍，同时血浆心钠素水平升高到１．８、２．７和３．６倍。而血浆肾素、血管紧张素系统的活性则相反，血浆肾素在２４ｈ末为正常对照组的２．５倍降低到４８ｈ的１．６倍，并于ＣＰ处置后７２ｈ恢复到正常对照组水平。血管紧张素在２４ｈ末为正常对照组４倍，在４８ｈ末下降４１％，７２ｈ末下降５８％，这表明在急性肾功能衰竭发展过程中，体内分泌的心钠素可能是通过拮抗肾素、血管紧张素系统从而起到肾功能保护的作用。     

妊娠高血压综合征患者血浆内皮素的检测及其与眼底视网膜血管病变的关系

目的观察血浆内皮素(ET)在妊娠高血压综合征(PIH)眼底视网膜血管病变发病中的作用。方法采用酶联免疫吸附双抗体夹心法(ELISA)检测35例住院PIH患者(轻度10例、中度11例、重度14例)和20例正常足月妊娠待产产妇产前和产后血浆ET水平,同时专人检查PIH患者产前、产后眼底视网膜病变情况;对比分析PIH患者与正常足月妊娠待产妇血浆ET水平的差异以及PIH患者产前、产后血浆ET水平变化与眼底改变之间的关系。结果重度、中度、轻度PIH组产前及产后的血浆ET水平均明显高于正常妊娠组,重度、中度、轻度PIH组之间无论是产前还是产后其ET水平差异均有统计学意义(P<0.01);正常妊娠组的产后ET水平比产前明显下降(P<0.05),重度、中度、轻度PIH组则产前产后无明显变化。眼底视网膜病变各期产前血ET水平差异均有统计学意义(P<0.01或0.05),随着眼底病变的加重,其血浆ET水平也相应增高。结论血浆ET水平与PIH的病情和眼底病变有密切关系,ET可能在PIH眼底视网膜病变发生发展过程中发挥重要作用;ET可能是反映PIH和视网膜病变程度的良好指标。     

速效救心丸通过肥大细胞促进胎鼠宫内发育的作用

为探讨速效救心丸(QAHR)通过肥大细胞及其主要介质促进宫内胎儿生长发育的作用,将140只雌性小鼠随机分正常对照组、速效救心丸250 mg/kg、500 mg/kg和750 mg/kg给药组。当小鼠妊娠至16 d时脱颈椎处死小鼠,对其子宫组织分别进行组胺(HA)含量和一氧化氮合酶(NOS)活力测定,子宫肥大细胞(MC)、肝素阳性细胞显色及微血管密度(MVD)测定。结果表明,500 mg/kg和750 mg/kg的速效救心丸给药组小鼠子宫MC数、肝素阳性细胞数、子宫MVD和NOS活力较对照组显著(P0.05)升高,而子宫HA含量显著(P0.05)低于对照组。提示速效救心丸可能通过增加小鼠子宫组织内MC数量及其主要介质的释放,改善血液循环和促进微血管生成,从而促进宫内胎儿的生长发育。     

新生儿颅内出血患者血浆、脑脊液中生长抑素和血管活性肠肽的测定及意义

目的观察新生儿颅内出血患者血浆、脑脊液(CSF)中生长抑素(SS)和血管活性肠肽(VIP)的水平变化与临床意义。方法应用放射免疫法对19例新生儿颅内出血患儿的血浆、脑脊液SS和VIP的含量作了测定,并与以无神经系统疾病的入院新生儿12例作为对照。结果颅内出血新生儿CSF的SS和VIP含量高于其在血浆中的含量(P<0.01);颅内出血急性期患儿血浆和CSF的SS和VIP含量均显著高于恢复期和对照组,恢复期又显著高于对照组,差异均有统计学意义(P<0.01)。结论血浆、CSF中SS和VIP含量的变化可反映脑组织损伤的分期,推测病情和预后。     

应激大鼠血浆与肾上腺组织血管紧张素Ⅱ的水平及ANGmRNA在肾上腺组织中的表达

目的：观察应激大鼠血浆与肾上腺组织血管紧张素Ⅱ(AngⅡ)的水平及血管紧张素原(ANG)mRNA在肾上腺组织中的表达。方法：24只雄性大鼠随机分为3组(急性游泳组，慢性电击组和对照组)，采用放免分析法和原位杂交技术分别检测不同应激情况下大鼠血浆与肾上腺组织AngⅡ的水平及ANGmRNA在肾上腺组织中的表达。结果：急性游泳组和慢性电击组血浆与肾上腺组织AngⅡ含量及ANGmRNA在肾上腺组织中表达均显著高于对照组(P＜0．05，P＜0．01)。结论：应激时肾上腺局部肾素—血管紧张素系统(RAS)被显著激活，进一步支持局部RAS参与了应激反应的观点。     

高血压患者左心室肥厚与血管加压素和脑钠尿肽的关系

目的观察原发性高血压左心室肥厚与血浆血管加压素、血浆脑钠尿肽水平的关系。方法原发性高血压患者71例,采用超声心动图测算左心室质量指数后,再按照左心室质量指数分成两组:左心室肥厚组(简称肥厚组)36例,左心室非肥厚组(简称非肥厚组)35例;另设对照组28例。分别用超声心动图测定对照组左心室质量指数,以及三组舒张早期速度峰值与舒张晚期速度峰值,计算两者的比值;放射免疫分析法测定血浆血管加压素和血浆脑钠尿肽水平,并分别与左心室质量指数和舒张早晚期速度峰值的比值作直线相关分析。结果①肥厚组和非肥厚组血浆血管加压素和脑钠尿肽浓度均高于对照组(P<0.01),肥厚组血管加压素和脑钠尿肽浓度均高于非肥厚组(P均<0.01);肥厚组和非肥厚组左心室质量指数均高于对照组(P<0.01和P<0.001),肥厚组左心室质量指数较非肥厚组显著升高(P<0.001);非肥厚组和肥厚组与对照组比较,舒张早晚期速度峰值比值均减小(P均<0.01)。②血浆脑钠尿肽浓度与左心室质量指数呈显著正相关(r=0.552,P<0.01),与舒张早晚期速度峰值比值呈显著负相关(r=-0.803,P<0.01);非肥厚组血浆血管加压素与血浆脑钠尿肽呈正相关(r=0.437P<0.01)与舒张早晚期速度峰值比值呈显著负相关(r=-0.506,P<0.01)。结论①血浆血管加压素水平增加可能参与高血压患者左心室肥厚的形成,导致左心室舒张功能受损;②血浆脑钠尿肽水平可以成为判断原发性高血压患者左心室肥厚和左心舒张功能受损的一项重要指标。     

Overriding imatinib resistance with a novel ABL kinase inhibitor

Resistance to the ABL kinase inhibitor imatinib (STI571 or Gleevec) in chronic myeloid leukemia (CML) occurs through selection for tumor cells harboring BCR-ABL kinase domain point mutations that interfere with drug binding. Crystallographic studies predict that most imatinib-resistant mutants should remain sensitive to inhibitors that bind ABL with less stringent conformational requirements. BMS-354825 is an orally bioavailable ABL kinase inhibitor with two-log increased potency relative to imatinib that retains activity against 14 of 15 imatinib-resistant BCR-ABL mutants. BMS-354825 prolongs survival of mice with BCR-ABL-driven disease and inhibits proliferation of BCR-ABL-positive bone marrow progenitor cells from patients with imatinib-sensitive and imatinib-resistant CML. These data illustrate how molecular insight into kinase inhibitor resistance can guide the design of second-generation targeted therapies.     

急性白血病患者白细胞介素-12的表达及临床意义

目的通过检测急性白血病（AL）患者静脉血清中白细胞介素12（IL-12）的含量,探讨IL-12在急性白血病中的临床意义.方法应用定量酶联免疫吸附实验测定10例初诊未治、10例缓解期、5例复发患者和9例正常对照血清中IL-12的含量.结果对照组的IL-12水平（58.96±38.11）ng/L与初诊复发组（初诊未治组与复发组的合称）（32.51±14.58）ng/L、缓解组（71.67±119.09）ng/L之间均有显著性差异（P〈0.05）.结论IL-12与AL的病情变化有一定的关系.     

A model of human acute lymphoblastic leukemia in immune-deficient SCID mice

A human acute lymphoblastic leukemia (ALL) cell line that was transplanted into immune-deficient SCID mice proliferated in the hematopoietic tissues, invaded various organs, and led to the death of the mice. The distribution of leukemic cells in SCID mice was similar to the course of the disease in children. A-1 cells marked with a retrovirus vector showed clonal evolution after the transplant. SCID mice that were injected with bone marrow from three patients with non-T ALL had leukemic cells in their bone marrow and spleen. This in vivo model of human leukemia is an approach to understanding leukemic growth and progression and is a novel system for testing new treatment strategies.     

多西他赛联合顺铂治疗进展期非小细胞肺癌的疗效观察

目的:探讨多西他赛加顺铂治疗进展期非小细胞肺癌的疗效和毒副反应。方法:选取初治进展期非小细胞肺癌17例,应用多西他赛加顺铂方案化疗,观察化疗毒副反应,2周期后评价疗效。结果:2组的近期有效率分别为52.9%和42.3%,无显著性差异(χ2=0.467,P=0.494)。2组间Ⅲ、Ⅳ度毒副反应多西他赛组有2例患者出现严重液潴留。结论:多西他赛联合顺铂治疗非小细胞肺癌疗效好,但其副作用较重,可致体液潴留,应用多西他赛时需强调化疗前的激素足量、化疗后的病情监测和发生体液潴留时的积极处理。     

Detection of bcr-abl fusion in chronic myelogeneous leukemia by in situ hybridization

Chronic myelogeneous leukemia (CML) is genetically characterized by fusion of the bcr and abl genes on chromosomes 22 and 9, respectively. In most cases, the fusion involves a reciprocal translocation t(9;22)(q34;q11), which produces the cytogenetically distinctive Philadelphia chromosome (Ph1). Fusion can be detected by Southern (DNA) analysis or by in vitro amplification of the messenger RNA from the fusion gene with polymerase chain reaction (PCR). These techniques are sensitive but cannot be applied to single cells. Two-color fluorescence in situ hybridization (FISH) was used with probes from portions of the bcr and abl genes to detect the bcr-abl fusion in individual blood and bone marrow cells from six patients. The fusion event was detected in all samples analyzed, of which three were cytogenetically Ph1-negative. One of the Ph1-negative samples was also PCR-negative. This approach is fast and sensitive, and provides potential for determining the frequency of the abnormality in different cell lineages.     

铁调素在慢性牙周炎性牙槽骨吸收中的作用

目的 探讨铁调素（Hepcidin）在慢性牙周炎性牙槽骨吸收过程中的作用,阐明铁离子及其相关调节蛋白在牙槽骨吸收中的重要生物学意义,以期为探索出有效地防治牙槽骨吸收的方法提供理论基础。方法 检测慢性牙周炎患者龈沟液（GCF）中铁离子、核因子KB受体活化因子配体（RANKL）、骨保护素（OPG）的表达水平,分析铁离子的含量与RANKL和OPG表达的相关性以及铁离子的含量与牙周炎性牙槽骨吸收的关系。结果 20例慢性牙周炎组受检牙GCF中铁离子、Hepcidin和RANKL的浓度高于健康对照组（P<0.05）,OPG的浓度低于健康对照组（P<0.01）。慢性牙周炎组GCF中RANKL和OPG的浓度与该受检牙4项临床指标：牙周探诊深度（PD）、附着丧失（AL）、菌斑指数（PLI）、龈沟出血指数（SBI）无相关（P>0.05）,铁离子浓度与Hepcidin浓度呈正相关（P<0.01）,与RANKL浓度呈正相关（P<0.05）,与OPG浓度无相关（P>0.05）。结论 慢性牙周炎导致的牙槽骨吸收与局部Hepcidin升高和发生铁过载有关。     

Acute lymphoblastic leukemic cells with T (thymus-derived) lymphocyte markers

Five of nine children with acute lymphoblastic leukemia had lymphoblasts that bound sheep erythrocytes or reacted with antiserum to thymocytes, suggesting involvement of T (thymus-derived) cells. When lymphoblasts from all patients were examined by immunofluorescence they were found to lack a marker for B (bone marrow or bursa-equivalent) cells, that is, the presence of surface immunoglobulins.     

PERSISTENT MITOSIS OF TRANSFUSED HOMOLOGOUS LEUKOCYTES IN CHILDREN RECEIVING ANTILEUKEMIC THERAPY

Temporary homologous bone marrow grafts were observed in three patients with acute leukemia, receiving intensive antileukemic treatment, following transfusion of peripheral blood cells from donors with chronic myelocytic leukemia. Persistent mitosis of the transfused cells, containing the Philadelphia chromosome marker, were detected by cytogenetic techniques 19, 39, and 52 days after transfusion.     

Serine requirement in leukemic and normal blood cells

In a serine-deficient medium, cells from humangt chronic granulocytic leukemia and normal human bone marrow exhibited a marked inhibition of incorporation of-radioactive precursors of DNA, RNA, and protein into an acid insoluble cell fraction. Normal diploid human fibroblasts did not exhibit inhibition without serine. Chronic granulocytic leukemia and normal marrow cells were essentially unable to synthesize C(14)-serine from C(14)-glucose, while human diploid fibroblasts were highly capable of this synthesis.