细胞形态学观察在骨髓增生异常综合征诊断中价值

目的探讨骨髓增生异常综合征（MDS）细胞形态学病态造血特点,以寻求诊断MDS的价值。方法以WHO MDS分类标准为诊断金标准,收集2007年3月1日至2012年3月6日期间,诊断的MDS患者165例。非克隆性疾病患者165例作为对照组。分析骨髓与血片细胞学检查中病态造血特征在克隆性和非克隆性疾病中的诊断价值。结果 MDS病态造血形态学诊断的主要依据：粒系Auer小体、核出芽、微核;红系核出芽;外周血片中出现巨核细胞、原粒细胞或早幼红细胞。结论细胞形态学是诊断MDS的基础,但也存在一定的局限性,尤其早期MDS细胞形态学改变不典型时,恶性克隆处于非显性状态,表达特征亦不明显,需要结合其他检测手段,以便早期诊断和治疗。     

骨髓增生异常综合征与巨幼红细胞性贫血的形态学鉴别诊断

目的通过对骨髓增生异常综合征（MDS）与巨幼红细胞性贫血（MA）血象、骨髓象的形态学分析,以提高对MDS与MA诊断及鉴别诊断的能力和水平。方法对51例MDS和43例MA患者血象及骨髓象形态学改变的资料进行细致分析。结果MDS以红系奇数核和巨大红细胞、淋巴样小巨核最有诊断意义;MA骨髓细胞呈“核幼质老”改变以红系为明显,粒系中幼粒以下各阶段细胞巨幼样变。结论奇数核细胞、淋巴样小巨核是MDS的主要特征;MA骨髓细胞呈“核幼质老”并以红系为明显,必要时可行其他辅助实验室检查,提高MDS和MA鉴别诊断水平。     

50例骨髓增生异常综合征的病理检查结果分析

目的探讨骨髓病理检查在骨髓增生异常综合征（MDS）的诊断及预后判断中的应用价值。方法对50例MDS患者于髂后上棘局麻后常规取骨髓,进行固定、脱钙、石蜡包埋、切片、HE染色,观察骨髓增生程度,红细胞（红系）、粒细胞（粒系）、巨核细胞（巨核系）三系髓细胞及间质的病理改变。结果骨髓表现为增生明显活跃和极度活跃者有40例（占80％）。三系病态造血分别为：红系39例（占78％）,粒系35例（占70％）,巨核系44例（占88％）。ALIP现象在本组中普遍存在,其中RAEB-1型和RAEB-2型发生率达100％。8例（16％）有骨髓间质病变。结论骨髓细胞的病态造血是MDS诊断的主要依据;骨髓病理检查对MDS的诊断及预后判断具有重要意义。     

骨髓增生异常综合征细胞形态学观察

目的：观察骨髓增生异常综合征(MDS)骨髓细胞形态学病态改变。方法：用瑞氏-姬姆萨混合染液染色，进行骨髓及外周血细胞学分析。结果：粒、红、巨核三系都有不同程度的病态造血。粒系主要以细胞核浆发育不平衡，内外浆、中性粒细胞核分叶不能或Pelger-Huet样畸形。结论：MDS三系均有不同程度的病态改变，患者以中老年居多，分型主要以RA为主。     

骨髓增生异常综合征28例细胞形态学的观察

目的:观察骨髓增生异常综合征(MDS)骨髓细胞病态改变.方法:用骨髓涂片经瑞氏染色后,进行骨髓细胞学形态分析.对确诊的MDS的骨髓象进行观察,记录骨髓中粒、红、巨三系病态造血细胞形态上的变化,为MDS的形态学诊断寻找有力的诊断依据.结果:粒、红、巨三系均有不同程度的病态造血表现,粒系表现有假性pelger畸形、核浆发育紊乱为主、内外浆、胞浆颗粒增多粗大、胞浆颗粒减少或缺失、中性粒细胞分叶过多、双核等;红系表现有核质呈类巨幼样改变、双核、多核、花瓣核、嗜碱点彩、H-J小体、核畸形等;巨核系主要以小巨核、单圆核、多圆核为主.结论:MDS存在的病态造血改变中,粒系以假性pelger畸形;红系以奇数核、类巨变;巨核系以小巨核最具说服力.     

达那唑治疗骨髓增生异常综合征

骨髓增生异常综合征(MDS)是一种表现为造血紊乱和无效造血的骨髓干细胞疾病。外周血中一系或多系细胞减少,大多数病人死于出血及感染。作者收治三例老年MDS病人,年龄66～73岁。表现为贫血、血小板减少,皮肤粘膜出血,外周血中红细胞大小不一,巨大红细胞,偶见有核红细胞和幼粒细胞。骨髓涂片和活检增生旺盛或低下,红系或粒系或巨核系生成不良。二例Coombs’试验阳性。根据FAB标准诊断为MDS,给予强的松、氟     

骨髓增生异常综合征与巨幼红细胞性贫血细胞形态学比较

目的 通过对骨髓增生异常综合征(MDS)和巨幼红细胞性贫血(MA)骨髓细胞进行形态学比较。方法 于光学显微镜下，用细胞形态学方法观察比较两类疾病患者骨髓红系、粒系、巨核细胞形态学特征。结果 MDS以红系奇数核和巨大红细胞、淋巴样小巨核细胞最有诊断意义；MA骨髓细胞呈“老浆幼核”改变。以红系为明显，成熟红细胞呈大卵圆形，拉系中幼粒以下各阶段巨幼样变。结论 淋巴样小巨核是MDS主要特征。MA骨髓细胞呈“核幼质老”并以红系为明显，必要时可行其他辅助实验检查。提高MDS和MA鉴别诊断水平。     

铁粒幼细胞性贫血（SA）与难治性贫血（MDS—RARS）的临床及细胞形态学特点分析

目的 探讨铁粒幼细胞性贫血（SA）与难治性贫血（MDS-RARS）的临床及细胞形态学特点的鉴别。方法 对25例SA和45例MDS—RARS的初诊资料进行回顾性比较研究。结果 SA和MDS—RARS临床表现相似，很难鉴别，两组外周血粒系、红系、巨核三系均减少。骨髓铁染色中都有环铁幼细胞，红系均有病态造血。RARS有一定程度的三系病态造血。结论 细胞形态学对鉴别SA和MDS—RARS有重要价值，必要时可行其他辅助实验检查，以提高二者之间的鉴别诊断水平。     

外周血中性粒细胞形态异常对骨髓增生异常综合征的诊断意义

骨髓增生异常综合征(MDS)是以具有外周血(PB)和骨髓(BM)血细胞分化成熟障碍为特征。这种分化成熟障碍造成的细胞发育异常的现象是作为MDS诊断的基础。骨髓造血细胞发育异常可累及粒(G)、红(E)、巨核(M)三系细胞,形成病态造血是公认的,而量化外周血中性粒细胞发育异常的     

骨髓增生异常综合征细胞遗传学与形态学的关系研究

目的 比较骨髓增生异常综合征（MDS）异常核型和正常核型的细胞形态学的特征.方法 对诊断明确的131例MDS患者的染色体核型和细胞形态学资料进行回顾性分析,并对异常核型和正常核型组的胞形态学资料进行比较.结果 131例MDS患者中克隆性染色体异常71例（56.5％）,异常核型组粒系Pelger核、淋巴样小巨核细胞明显高于正常核型组（P＜0.05）.红系巨幼样变、双核红细胞、多核红细胞、花瓣核、核碎裂;粒系颗粒分布不均、核浆失衡、巨幼样变、空泡、AUER小体、双核;单圆、多圆核巨核细胞,两组差异无统计学意义（P＞0.05）.结论 粒系Pelger核、淋巴样小巨核细胞在异常核型MDS较正常核型组细胞病态造血发生率明显增高,染色体核型异常与细胞形态学有一定相关性.     

体内彗星实验联合微核实验检测化合物的遗传毒性

目的:考察体内彗星实验联合微核实验检测化合物遗传毒性的可行性。方法:以阳性化合物N-乙基-N-亚硝基脲为模型药物,取♂大鼠随机分为空白对照组和给药组[40 mg/(kg·d)],每组5只,灌胃给药3次,末次给药后3 h处死大鼠。进行彗星实验,收集大鼠外周血、肝、胃、睾丸组织经前处理制备成单细胞凝胶玻片进行电泳,使用Komet 6.0软件分析单细胞显微图像,每种组织分析100个细胞(胃组织50个细胞),计算尾部DNA百分含量。进行微核实验,收集大鼠骨髓细胞进行涂片,计数2 000个嗜多染红细胞(PCE)中含微核细胞(MNPCE)的数目及嗜多染红细胞微核率。结果:与空白对照组比较,模型药物可使大鼠外周血淋巴、肝、胃、睾丸细胞组织的尾部DNA百分含量明显增加(P<0.05),并可使大鼠骨髓嗜多染红细胞微核率明显升高(P<0.05)。结论:彗星实验可用于动物体内多种脏器遗传毒性的检测;微核实验可用于动物骨髓细胞的遗传毒性检测。     

微核试验和彗星试验检测雄黄的遗传毒性

目的用短期给药(小鼠骨髓细胞微核试验和彗星试验)和长期给药(利用生殖毒性Ⅰ段试验的大鼠做微核试验和彗星试验)检测雄黄的遗传毒性,探讨利用长期毒性试验或生殖毒性Ⅰ段试验用动物进行遗传毒性检测的可行性。方法小鼠ig给予雄黄0.25,0.5和1.0 g·kg-1,每天1次,2 d后,取骨髓细胞做微核试验和彗星试验;利用生殖毒性Ⅰ段大鼠ig给予0.125,0.25和0.55 g·kg-1,雄性连续给药42 d以上,交配成功后处死;雌性连续ig给药19 d以上,妊娠第15天,取骨髓细胞做微核试验和彗星试验,取血做外周血淋巴细胞微核试验。结果与阴性对照组比较,小鼠雄黄0.25,0.5和1.0 g·kg-1组微核试验微核率分别为3.0‰,4.40‰,7.01‰(P<0.05,P<0.01)和彗星试验拖尾率分别为6.3%,9.7%和11.3%(P<0.05,P<0.01)。与阴性对照组比较,生殖毒性Ⅰ段试验大鼠ig给予雄黄,雄黄0.55 g·kg-1组雄性大鼠的骨髓微核和外周血淋巴细胞微核率分别为2.83‰和6.67‰(P<0.05),雌性大鼠0.25和0.55 g·kg-1的骨髓微核和外周血淋巴细胞微核率分别为1.5‰,2.25‰以及2.58‰和4.40‰(P<0.05,P<0.01);雄黄使雄性和雌性大鼠彗星拖尾率明显升高(P<0.05)。结论利用生殖毒性Ⅰ段试验多次给药后取材做微核试验和彗星试验方法可行;外周血微核试验简便易行;在所观察的剂量下雄黄具有遗传毒性。     

Mutagenicity of ipriflavone in vivo and in vitro

Ipriflavone (7-isopropoxy-isoflavone) is a semisynthetic isoflavone derivative from daidzein and prescribed to prevent and treat osteoporosis in postmenopausal women. In the present study, ipriflavone was investigated with regard to their cytotoxic and mutagenic effects using the micronucleus assay (MN) in vivo on cells of bone marrow and peripheral blood of Swiss albino mice and the micronucleus test with the cytokinesis-blocked micronucleus assay (CBMN assay) on human peripheral blood lymphocytes. The studies were performed in mice with three dosages of the drug, 1.71, 8.57 and 42.85 mg/kg bw in single oral exposure, and for two dosages, 5 and 10 μg/mL in the CBMN assay. Ipriflavone, in the dosages tested, did not differ from controls neither in the induction of MN nor induced cytotoxicity to cells in the in vivo test. However, in the CBMN assay, the concentration of 10 μg/mL induced a statistically significant increase in MN formation and decreased cell proliferation, demonstrating to be mutagenic and cytotoxic at this concentration.     

外周血未染色大细胞在骨髓增生异常综合征早期诊断中的价值

目的通过测定外周血未染色大细胞比率(LUC%),以期提高骨髓增生异常综合征(MDS)的早期诊断率。方法选取我院58例确诊为MDS的患者,并设30例对照病例,比较外周血中LUC%和骨髓形态学报告。结果 58例MDS患者中54例(93.1%)外周血LUC%高于正常,其中有45例(83.3%)经初次骨髓穿刺诊断为MDS,9例(16.7%)经2～3次骨髓穿刺诊断为MDS。对照组30例中有1例(3.3%)外周血LUC%高于正常者。结论外周血LUC%的增高有早期诊断MDS的价值。     

Flow cytometric analysis of micronuclei in peripheral blood reticulocytes: I. Intra- and interlaboratory comparison with microscopic scoring.

Accumulating evidence suggests that reticulocytes (RETs) in the peripheral blood of rats may represent a suitable cell population for use in the micronucleus assay, despite the ability of the rat spleen to selectively remove micronucleated erythrocytes from the peripheral circulation. To evaluate the analytical performance of a previously described flow cytometric method (Torous et al., 2003, Toxicol. Sci. 74, 309-314) that may allow this assay to be conducted using peripheral blood in lieu of bone marrow sampling, we compared the sensitivity and performance characteristics of the flow cytometric technique with two established microscopy-based scoring methods. Peripheral blood samples from single Sprague-Dawley rats treated for 6 days with either vehicle or cyclophosphamide were prepared in replicate for scoring by the three methods at different laboratories. These blood-based measurements were compared to those derived from bone marrow specimens from the same animals, stained with acridine orange, and scored by microscopy. Through the analysis of replicate specimens, inter- and intralaboratory variability were evaluated for each method. Scoring reproducibility over time was also evaluated. These data support the premise that rat RETs harvested from peripheral blood are a suitable cell population to assess genotoxicant-induced micronucleus formation. The interlaboratory comparison provides evidence of the general robustness of the micronucleus endpoint using different analytical approaches. Furthermore, data presented herein demonstrate a clear advantage of flow cytometry-based scoring over microscopy-significantly lower inter- and intralaboratory variation and higher statistical sensitivity.     

经阴道彩色多普勒血流影像在异位妊娠诊断中的应用

目的:探讨经阴道彩色多普勒血流影像(CDFI)在异位妊娠中的应用和诊断价值.方法:对70例确诊异位妊娠的CDFI检测结果进行回顾性分析.结果:70例异位妊娠患者,手术病理及临床与超声诊断一致者67例,误诊3例,CDFI诊断符合率为95.7%(67/70);附件区包块检出率为98.6%(69/70),根据附件区包块声像图及血流分为未流产未破裂型异位妊娠29例,CDFI显示包块及周边血流较丰富;流产或破裂型异位妊娠40例,CDFl显示周边及内部血流不丰富或无血流信号.结论:经阴道CDFI检查对异位妊娠诊断准确性、特异性高,为临床选择治疗方案提供了重要依据,可作为诊断异位妊娠的首选检查.     

Mutagenicity of recombinant antihemophilic factor (GC-gamma AHF)

This study was carried out to evaluate the mutagenic potential of recombinant antihemophilic factor VIII (GC-gamma AHF). Salmonella typhimurium (S. typhimurium) reversion assay with/without histidine moiety, chromosomal aberration assay on Chinese hamster lung (CHL) fibroblast cells and in vivo micronucleus assay using mouse bone marrow cells and supravital micronucleus assay using peripheral blood were performed. GC-gamma AHF containing histidine did show inconsistent and irregular mutagenic effects on S. typhimurium TA98, TA100, TA1535 and TA1537 both in the absence and presence of the metabolic activation system, however, GC-gamma AHF without histidine showed no mutagenic effects regardless of the metabolic activation system, thus suggesting that the histidine moiety in GC-gamma AHF might cause inconsistent mutagenic effect. Also GC-gamma AHF did not increase the number of cells having structural or numerical chromosome aberration in the cytogenetic test. In classical and supravital micronucleus assay, no significant increases were observed in the occurrence of micronucleated polychromatic erythrocytes and micronucleated peripheral lymphocytes in male ICR mice. These results strongly indicate that GC-gamma AHF has no genetic toxicity under these experimental conditions.     

The lack of mutagenicity of aryl 4-guanidinobenzoates in the transplacental micronucleus assay in mice.

Two acrosin inhibitors, 4'-methylumbelliferyl 4-guanidinobenzoate and 2'-carbomethoxyphenyl 4-guanidinobenzoate, were tested for mutagenicity in the transplacental micronucleus assay and the mouse bone marrow micronucleus assay. The compounds were administered intraperitoneally at doses of 125 mg/kg and 250 mg/kg to pregnant mice. Fetal peripheral blood and maternal bone marrow cells were examined at 36 h for the frequency of micronucleated polychromatic erythrocytes. Neither compound induced micronuclei in maternal or fetal tissues. The ratio of polychromatic erythrocytes to normochromatic erythrocytes was not affected by the drug treatments indicating that the compounds had no effect on the cell cycle or mitosis in these tissues and that they were not cytotoxic. Both compounds, which show promise as vaginal contraceptives, were not mutagenic in this study.     

红景天苷注射液遗传毒性的研究

目的：检测红景天苷注射液的遗传毒性。方法：应用微生物回复突变实验（Ames实验,5 000、500、50、5.0、0.5μg/皿）、体外培养CHO细胞染色体畸变实验（2 0001、000、500μg/mL）和小鼠骨髓微核实验法（1 500、750、375μg/kg）检测红景天苷注射液的遗传毒性。结果：红景天苷注射液对鼠伤寒沙门菌无致突变性,对体外培养CHO细胞染色体无致畸变作用,对ICR小鼠无诱发骨髓嗜多染红细胞微核的效应,三个实验结果均呈阴性。结论：红景天苷注射液不具有遗传毒性。