建立小巨核细胞免疫酶标法在儿童血液病中的应用

目的建立常规的小巨核细胞免疫酶标染色方法，并讨论该方法对儿童血液病诊断及鉴别诊断中的应用意义。方法采用CD41，单抗免疫酶标法检测儿童血液病患者骨髓涂片小巨核细胞。结果对照组小巨核细胞阳性率为25％，未见淋巴样小巨核细胞。不同疾病组比较，小巨核细胞和淋巴样小巨核细胞阳性率MDS组最高，AA组阳性率最低。结论与常规骨髓瑞特染色比较小巨核细胞免疫酶标染色可准确识别淋巴样小巨核细胞，有助于某些儿童血液病的鉴别和辅助诊断。     

骨髓增生性异常综合征与巨幼红细胞贫血的细胞形态学比较

目的通过对骨髓增生性异常综合征(MDS)和巨幼细胞性贫血(MegA)骨髓细胞进行形态学比较，提高其诊断与鉴别诊断水平。方法对78例MDS和52例MegA患者进行常规骨髓穿刺涂片进行瑞氏染色，光学显微镜下观察比较。结果MDS以奇数核和巨大红细胞、淋巴样小巨核最有诊断意义；MegA骨髓细胞呈“核幼质老”改变以红系为明显，粒系以中幼以下各阶段细胞巨幼样变，小巨核细胞数量明显减少，未发现淋巴样小巨核细胞。结论淋巴样小巨核细胞是MDS主要特征，MegA骨髓细胞呈“核幼质老”并以红系为明显，必要时可行其它辅助实验检查，提高MDS和MegA鉴别诊断水平。     

骨髓增生性异常综合征与巨幼红细胞贫血的细胞形态学比较

目的　通过对骨髓增生性异常综合征 (MDS)和巨幼细胞性贫血 (MegA)骨髓细胞进行形态学比较 ,提高其诊断与鉴别诊断水平。方法　对 78例MDS和 5 2例MegA患者进行常规骨髓穿刺涂片进行瑞氏染色 ,光学显微镜下观察比较。结果　MDS以奇数核和巨大红细胞、淋巴样小巨核最有诊断意义 ;MegA骨髓细胞呈“核幼质老”改变以红系为明显 ,粒系以中幼以下各阶段细胞巨幼样变 ,小巨核细胞数量明显减少 ,未发现淋巴样小巨核细胞。结论　淋巴样小巨核细胞是MDS主要特征 ,MegA骨髓细胞呈“核幼质老”并以红系为明显 ,必要时可行其它辅助实验检查 ,提高MDS和MegA鉴别诊断水平     

小巨核细胞碱性磷酸酶抗碱性磷酸酶染色在血液病中的鉴别诊断意义

目的研究小巨核细胞(SMK)碱性磷酸酶抗碱性磷酸酶(APAAP)染色在贫血、骨髓增生异常综合征(MDS)中的鉴别诊断意义.方法应用抗血小板膜糖蛋白Ⅱb-Ⅲa(CD41a)单克隆抗体对238例血液病的骨髓片进行APAAP染色并镜检.结果分别用瑞氏和APAAP两种染色方法计数全片的巨核细胞,两者差异有显著性(P＜0.01),后者明显优于前者.各疾病组SMK阳性率由高到低依次为MDS＞特发性血小板减少性紫癜(ITP)＞原发性血小板增多症(ET)＞巨幼细胞贫血(MgA)＞肿瘤转移＞巨核细胞生成血小板不良＞骨髓纤维化症(MF)＞混合性贫血＞继发性贫血＞溶血性贫血(HA)＞缺铁性贫血(IDA),再生障碍性贫血未见SMK;MDS组、MgA组和ITP组在SMK类型方面有显著性差异(P＜0.05).结论APAAP染色有助于识别SMK;SMK的数量及类型变化对贫血的分类、MDS的诊断有一定的鉴别诊断意义,为早期治疗提供了可靠的依据.     

巨核细胞在骨髓增生异常综合征中的临床价值

目的通过对低原始细胞骨髓增生异常综合征(MDS)与特发性血小板减少性紫癜(ITP)、阵发性睡眠性血红蛋白尿(PNH)、非重症再生障碍性贫(NSAA)骨髓巨核细胞的比较观察,探讨其在MDS鉴别诊断中的价值。方法回顾性分析我院确诊的低原始细胞(5%)MDS患者78例,特发性小板减少性紫癜(l TP)50例,阵发性睡眠性血红蛋白尿(PNH)20例、非重症再生障碍性贫(NSAA)18例患者的骨髓穿刺涂片,对巨核细胞进行观察分类、比较及分析。结果 MDS主要以单圆核巨核及多圆核巨核细胞为主要病态造血表现,其次为小巨核细胞。比较上述病态巨核细胞形态在各组的分布情况,发现MDS组显著高于ITP、PNH、NSAA组(P0.05),而小巨核细胞几乎只出现在MDS病例中。ITP组病态巨核细胞的检出率明显高于PNH、NSAA组,但两组间比较差异无统计学意义(P0.05);而多分叶巨核细胞主要见于ITP和MDS组,并且ITP组与MDS、PNH、NSAA组比较显示有统计学意义(P0.05)。结论骨髓象中小巨核及单圆核和多圆核巨核细胞病态巨核细胞检出率与MDS病态造血程度有关,其病态巨核细胞特征的观察对MDS的诊断及鉴别诊断有重要临床意义。     

骨髓增生异常综合征与巨幼细胞性贫血的骨髓细胞学鉴别

目的：探讨骨髓细胞形态学变化特征在鉴别诊断骨髓增生异常综合征(MDS)及巨幼细胞性贫血(MA)中的意义。方法：用形态学方法分析两类疾病患者骨髓粒系、红系和巨核系细胞形态学特征。结果：MDS的粒系、红系和巨核系细胞病态变化阳性率、有核红细胞糖原染色(PAS)阳性率较MA为高(P＜0．005)，外周血幼稚粒细胞和幼稚红细胞阳性率、骨髓粒系及红系细胞巨幼变阳性率差异均无显著性(P＞0．05)，MA的巨幼变幼红细胞体大于MDS相应阶段的幼红细胞胞体(P＜0．05和P＜0．01)。结论：MDS在骨髓粒系、红系和巨核系细胞病态改变、巨幼变幼红细胞胞体、PAS阳性上与MA差异有显著性，这些特点将有助于MDS与MA的鉴别诊断。     

骨髓增生异常综合征与特发性血小板减少性紫癜骨髓巨核细胞的观察

目的通过对骨髓增生异常综合征（MDS）与特发性血小板减少性紫癜（ITP）骨髓病态巨核细胞的比较观察,探讨其在MDS诊断中的意义。方法对72例MDS患者[包括26例难治性血细胞减少伴单系发育异常（RCUD）及46例难治性血细胞减少伴有多系发育异常（RCMD）]及44例ITP患者行骨髓穿刺涂片对巨核细胞进行分类、比较及分析。结果RCUD、RCMD及ITP组各类病态巨核细胞检出率均高于对照组（P〈0．01）,尤以RCMD组病态巨核细胞检出率最高,明显高于RCUD及ITP组（P〈0．05）,RCUD组高于ITP组,但组间未见统计学差异（P〉0．05）。关于病态巨核细胞形态的异常分布,在MDS主要以单圆核巨核及小巨核细胞为主要病态造血表现,其次为多圆核巨核细胞,虽MDS组与ITP组均显著高于对照组（P〈0．01）,但RCUD及RCMD组的检出率又明显高于ITP组（分别为P〈0．05、P〈0．01）。而多分叶巨核细胞主要见于ITP组,明显高于MDS与对照组（分别为P〈0．05、P〈0．01）,并且MDS组与对照组比较也显示有统计学意义（P〈0．05）。结论髓象中单圆核巨核及小巨核病态巨核细胞检出率与MDS病态造血程度有关,其病态巨核细胞特征的观察对MDS的诊断及鉴别诊断有重要意义。     

小巨核细胞免疫酶标染色在骨髓增生异常综合症诊断中的应用

小巨核细胞常见于恶性骨髓增生疾病的骨髓中,由于形态与淋巴细胞相似,故易混淆.而单克隆抗体免疫酶标染色对巨核细胞具有标异性.我们应用免疫酶标ABC染色观察了某些类型贫血性疾病骨髓小巨核细胞.结果表明,用免疫酶标染色检查小巨核细胞,对各类型贫血性疾病与骨髓增生异常综合症(MDS)有鉴别诊断价值.……     

探讨病态小巨核细胞在骨髓增生异常综合征各亚型中的分布情况

目的：探讨骨髓病态小巨核细胞数量的多少在骨髓增生异常综合征（ MDS）各型的分布情况。方法：采用瑞氏姬姆萨染色,在显微镜下对84例MDS患者骨髓片中的病态巨核细胞进行分类并计数数量,比较和分析。结果：在RA的12例,RARS的10例病例中,淋巴样小巨核细胞、单圆核和多圆核小巨核细胞检出率为0;在RCMD和RCMD－RS的25例病例中,检出淋巴样小巨核细胞8例占32．0％,单圆核小巨核细胞13例占52．0％,小双圆核及多圆核小巨核细胞15例占60．0％;在RAEB－1和RAEB－2的37例病例中,检出淋巴样小巨核细胞24例占64．9％,单圆核小巨核细胞28例占75．6％,小双圆核及多圆核小巨核细胞30例占81．0％。原始细胞过多难治性贫血（RAEB－1和RAEB－2）病态小巨核细胞数量高于其他类型（RA型,RARS型, RCMD型,RCMD～RS型）。结论：髓象中各种病态巨核细胞检出数量多少与MDS疾病严重程度呈相关性,对MDS分型有一定的意义。     

血清SF、LDH、维生素B12水平及骨髓细胞形态学对骨髓增生异常综合征和巨幼细胞性贫血的鉴别诊断

【摘要】 目的 探讨血清铁蛋白（SF）、乳酸脱氢酶（LDH）、维生素B12水平及骨髓细胞形态学表现在骨髓增生异常综合征（MDS）和巨幼细胞性贫血(MA)鉴别诊断中的临床意义。 方法 选取2018年7月～2020年7月我院收治的53例MDS（MDS组）和55例MA（MA组）患者为研究对象,同时选取同期于我院进行体检的40名健康者作为对照组。比较各组血清SF、LDH、维生素B12水平,并分析骨髓细胞形态学。 结果 MDS组血清SF、维生素B12水平高于MA组,LDH水平低于MA组 (P＜0.05);MDS组外周血涂片中检出原粒细胞检出率高于MA组,巨红细胞检出率低于MA组 (P＜0.05);MDS组骨髓细胞学形态中原始细胞≥5％、核浆发育不平衡、环状铁粒幼红细胞、小巨核细胞及单圆核巨核细胞检出率高于MA组,幼粒巨幼变细胞、巨幼变幼红细胞检出率低于MA组 (P＜0.05)。 结论 血清SF、LDH、维生素B12水平及骨髓细胞形态学表现对MDS和MA的鉴别诊断具有一定的临床意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.