应用不同技术检测白血病患者融合基因的比较

<正>慢性粒细胞白血病(chronic myeloid leukemia,CML)是一种起源于造血干细胞的恶性血液病,是迄今发现的第一种与染色体异常直接相关的人类恶性肿瘤。CML患者具有特征性的Ph染色体,该染色体是9号和22号染色体相互易位形成的,其形成的BCR-ABL融合基因编码产生的Bcr-Abl融合蛋白与正常abl蛋白相比,具有较强的酪氨酸激酶活性,从而促进细胞分裂、降低细胞对凋亡信号的反应、延长细胞存活,导致白血病的发生[1,2]。     

ACCESS全自动微粒子化学发光仪回收试剂的利用与评价

目的：为保证实验结果的准确性,探讨残留试剂的最佳保存方法,评估其各项技术指标。方法：收集残留试剂进行有效处理并破译试剂包密码。结果：AFP等十项批内和批 间平均变异系数（CV％）分别小于4．15％和5．27％,其中E2,TT4的CV％＞9．67％,与新试剂比较P＞0．05,相关良好,r在0．9998－0．9999之间,回收率为95．2％－105．1％。结论：该处理方法有利于试剂保存,操作简便,结果达到实验要求,但对检测小分子物质的试剂不可回收利用。     

伴颈动脉粥样硬化脑梗患者CD4+CD28null T细胞CD158j表达和ERK磷酸化水平的关系

目的 探讨伴颈动脉粥样硬化(CA)脑梗患者CD4+CD28null T细胞上CD158j的表达百分率和ERK磷酸化(p-ERK)水平的关系及对颈动脉粥样斑块不稳定的影响.方法 采用流式细胞术检测106例伴CA脑梗、33例颈动脉正常脑梗患者和50例健康人外周血CD4+CD28null T细胞数量,以及CD4+CD28null T细胞CD158j和穿孔素(perforin)的表达,36例斑块不稳定患者CD4+T细胞p-ERK水平.ELISA法检测血清IFN-γ水平.B超检查以上人群颈动脉血管内壁粥样硬化情况.结果 脑梗患者CD4+CD28nullT细胞数量、CD4+CD28null T细胞CD158j和perforin的表达,以及血清IFN-γ水平,均明显高于健康对照组(P均<0.01);CD4+CD28null T细胞数量、CD4+CD28null T细胞CD158j和perforin的表达,以及血清IFN-γ水平,在脑梗患者中由高到低依次为颈动脉不稳定斑块组、颈动脉稳定斑块组、颈动脉内-中膜厚度(IMT)增厚组和颈动脉正常组.颈动脉不稳定斑块脑梗患者CD4+CD28null T细胞CD158j的表达与p-ERK水平呈显著性正相关(P<0.01).结论 伴CA脑梗患者CD4+CD28null T细胞数量明显增多.CD158j可能通过上调p-ERK水平,促进CD4+CD28null淋巴细胞增殖,产生细胞毒效应和分泌细胞因子,最终导致颈动脉粥样斑块不稳定.

Abstract：

Objective To investigate the relationship between CD158j expression and phosphorylated ERK (p-ERK) in CD4+ CD28null T cells in cerebral infarction (CI) patients- with carotid atherosclerosis and its effects on carotid atherosclerotic plaque stability. Methods Percentage of peripheral CD4+ CD28null and the expression of CD158j and perform on CD4+ CD28null cells was analyzed with flow cytometry in 106 CI patients with carotid atherosclerosis, 33 CI patients with normal carotid arteries and in 50 normal controls, respectively; p-ERK expression was assayed with flow cytometry in 36 CI patients with unstable plaque, and serum IFN-γ was detected with ELISA. The intima-media thickness (IMT) of bilateral carotid arteries in all subjects was confirmed by the colour Doppler ultrasonograph imagingResults Percentage of the CD4+ CD28null T cells, expression of CD158j and perform on CD4+ CD28null T cells and the serum IFN-γ levels was dramatically higher in CI patients than that in normal controls, respectively (all P <0.01), which was decreased in an order of CI patients with patients with unstable plaque, stable plaque, carotid artery IMT and with normal carotid artery. A strong positive correlation was observed between the CD158j expression and degree of p-ERK in CI patients with unstable plaque (P < 0. 01). Conclusion CD4+ CD28null T cells were significantly increased in CI patients with carotid atherosclerosis. CD158j might up-regulate p-ERK expression and induce the proliferation of the CD4+ CD28nullT cells; consequently, higher cytokine production such as IFN-γ produced by CD4+ CD28null T cells may cause the formation of unstable plaque.     

慢性粒细胞白血病Ph染色体R显带分析与bcl/abl mRNA检测

慢性粒细胞白血病(CML)的细胞遗传特征是具有Ph染色体,即t(9;22)(q34;q11),其结果在分子水平上形成bcl/abl融合基因,该基因表达的蛋白能使细胞调控系统发生紊乱和抑制细胞凋亡,这可能是正常细胞转化为白血病细胞的重要环节.     

慢性粒细胞白血病Ph染色体R显带分析与bcl／abl mRNA检测

慢性粒细胞白血病（CML）的细胞遗传特征是具有Ph染色体．即t（9；22）（q34；q11），其结果在分子水平上形成bcl／abl融合基因，该基因表达的蛋白能使细胞调控系统发生紊乱和抑制细胞凋亡。这可能是正常细胞转化为白血病细胞的重要环节。据报道。在95％以上的CML患者中可以检测到Ph染色体。因此。在CML患者的诊断和治疗监测中，Ph染色体分析和bcl／abl融合基因检测具有重要价值。为进一步明确CML患者中Ph染色体与bcl／abl融合基因表达之间的关系，     

伴颈动脉粥样硬化脑梗患者CD4+CD28null T细胞CD158j表达和ERK磷酸化水平的关系

Objective To investigate the relationship between CD158j expression and phosphorylated ERK (p-ERK) in CD4+ CD28null T cells in cerebral infarction (CI) patients- with carotid atherosclerosis and its effects on carotid atherosclerotic plaque stability. Methods Percentage of peripheral CD4+ CD28null and the expression of CD158j and perform on CD4+ CD28null cells was analyzed with flow cytometry in 106 CI patients with carotid atherosclerosis, 33 CI patients with normal carotid arteries and in 50 normal controls, respectively; p-ERK expression was assayed with flow cytometry in 36 CI patients with unstable plaque, and serum IFN-γ was detected with ELISA. The intima-media thickness (IMT) of bilateral carotid arteries in all subjects was confirmed by the colour Doppler ultrasonograph imagingResults Percentage of the CD4+ CD28null T cells, expression of CD158j and perform on CD4+ CD28null T cells and the serum IFN-γ levels was dramatically higher in CI patients than that in normal controls, respectively (all P <0.01), which was decreased in an order of CI patients with patients with unstable plaque, stable plaque, carotid artery IMT and with normal carotid artery. A strong positive correlation was observed between the CD158j expression and degree of p-ERK in CI patients with unstable plaque (P < 0. 01). Conclusion CD4+ CD28null T cells were significantly increased in CI patients with carotid atherosclerosis. CD158j might up-regulate p-ERK expression and induce the proliferation of the CD4+ CD28nullT cells; consequently, higher cytokine production such as IFN-γ produced by CD4+ CD28null T cells may cause the formation of unstable plaque.     

台州地区孕妇孕中期母血清产前筛查结果分析

目的 探讨孕中期母血清产前筛查系统对唐氏综合征(DS)和18-三体综合征及神经管畸形(NTD)检出的临床应用价值.方法 应用时间分辨荧光免疫分析技术(DELFIA)对120 309名孕中期(15 ～21周)孕妇进行血清标记物甲胎蛋白+游离人绒毛膜促性腺激素(AFP+ free β-HCG)两联指标检测,筛查结果应用Lifecycle3.0软件进行出生缺陷风险评估.结果 120 309名孕中期孕妇筛查出高风险孕妇5 022例,阳性率为4.17％;4 494例21-三体综合征和18-三体综合征高风险孕妇中有3 573例接受羊水或脐血穿刺产前诊断,占79.51％,发现胎儿核型异常49例,异常检出率为1.37％,其中DS 22例、18-三体综合征6例、其他异常核型21例.结论 孕中期母血清标记物两联指标的产前筛查是预测DS和18-三体综合征、NTD的有效指标.     

流式CBA检测TH1/TH2细胞因子谱在细菌感染中的应用

目的 探讨流式细胞术(FCM)微球芯片技术(CBA)分析TH1/TH2细胞因子谱在细菌感染中的应用价值。方法CBA方法检测67例健康对照,111例细菌感染患者,42例非细菌感染患者TH1/TH2细胞因子表达水平,同时对比各组C反应蛋白(CRP)水平,绘制各指标的受试者工作特征(ROC)曲线并评价TH1/TH2细胞因子谱用于诊断细菌感染的价值。结果 TH1细胞因子在G+ 细菌感染组和G- 细菌感染组表达水平略高于健康对照组。TH2部分细胞因子在G⁺细菌感染组和G-细菌感染组表达水平显著高于健康对照组。其中IL-6在G⁺细菌感染组和G-细菌感染组表达水平显著高于健康对照组(P均<0.01),达10倍以上,IL-10在G-细菌感染组表达水平显著高于健康对照组(P<0.01),达10倍以上。ROC曲线下面积比较,IL-6/G⁺细菌感染组与CRP G⁺细菌感染组比较差异有统计学意义(z=4.49,P<0.01)。IL-6/G-细菌感染组与CRP/G-细菌感染组比较差异有统计学意义(z=4.64,P<0.01)。IL-10/G-细菌感染组与CRP/G-细菌感染组比较,差异有统计学意义(z =4.38,P<0.01)。抗菌治疗后7天,IL-6、IL-10在细菌感染患者中的表达水平基本恢复正常,而CRP表达水平仍高于正常(P均<0.01)。结论 CBA技术分析的TH1/TH2细胞因子谱早期诊断细菌感染性能优于CRP,并能进一步辅助鉴别G⁺细菌和G-细菌感染及临床疗效判断。     

产妇乙型肝炎病毒感染与母婴传播关系

乙型肝炎病毒(HBV)可经胎盘传播至胎儿,造成胎儿宫内感染.乙型肝炎表面抗原(HBsAg)携带孕妇的胎儿宫内感染率为5%～15%[1～4].母婴传播已经成为乙型肝炎病毒的重要传播途径之一,可通过胎盘、分娩等途径传播.为了解产妇病毒感染与母婴传播的关系,我们进行了检测分析.结果报告如下.     

AFP和Free-βhCG孕中期产前筛查18355例结果分析

目的探讨采用甲胎蛋白(AFP),绒毛膜促性腺激素β亚单位(Free-βhCG)二联法在孕中期产前筛查胎儿染色体异常、神经管缺陷为主的先天性缺陷的作用。方法2005年7月—2006年6月,对18 355例孕妇在知情自愿的情况下进行产前检查,采用时间分辨荧光法测定上述2项指标,并结合孕妇临床资料,根据随机提供的风险计算软件,计算胎儿患唐氏综合征及神经管缺陷的风险率,对高风险者进行羊水染色体核型分析及三维B超确诊。结果产前筛查出高危孕妇823例,其中21-三体高危600例占3.27%,18-三体高危44例占0.24%,神经管缺陷(NTD)高危179例占0.98%。经羊水染色体核型分析和三维B超确诊,共检出21-三体胎儿5例,18-三体胎儿1例,性染色体疾病3例,染色体多态性改变8例,神经管缺陷11例和其他畸形及异常17例。结论对胎儿先天性缺陷,特别是染色体异常、神经管缺陷的胎儿产前筛查是重要的手段之一,产前筛查对减少缺陷儿的出生、降低围生儿的病死率、减轻家庭及社会负担起到重要作用。