应用CLSI EP 6-A文件评价血液学危急值项目线性范围

评估WBC、PLT、HGB出现极端危急值结果的可信度.应用CLSI EP6-A文件对BC5300全自动血细胞分析仪分析测量范围(AMR)和临床可报告范围(CRR)进行评价.WBC、PLT、HGB的AMR (0.024 ～ 96.82)×109/L、(9.7 ～970)×109/L、12.5 ～ 251g/L,WBC和PLT CRR上限分别为4841×109/L和48500×109/L.BC5300全自动血细胞分析仪在AMR范围内的测定结果准确,在CRR范围内可向临床发出危急值报告.     

血浆置换成功治疗血栓性血小板减少性紫癜一例

血栓性血小板减少性紫癜(TTP)是一种少见的危重疾病,死亡率可高达90%以上.最近,我们用血浆置换技术(TPE)成功治疗TTP患者1例,现报道如下. 女性,42岁,因乏力3周,发热、恶心、呕吐4 d于2008年9月27日入院.9月26日外院查血WBC 9.92×109/L,RBC1.41×1012/L,Hb 34g/L,PLT 12.4×109/L;尿蛋白4+,潜血4+,胆红素1+,RBC 29/μl.9月27日我院门诊查血WBC 15.36×109/L,RBC 1.40×1012/L,Hb42g/L,PLT 5×109/L.     

脾脏弥漫红髓小B细胞淋巴瘤1例

患者男性,59岁,因"反复腹胀近10年,加重伴气促1天"入院。查体:腹部膨隆,脾脏肋下可触及,下缘平脐,右缘至腹中线,质韧,表面光滑,无明显压痛。血常规:白细胞4.7×109/L,淋巴细胞0.7×109/L,红细胞3.58×109/L,血红蛋白116 g/L,血小板111×109/L。骨髓涂片:巨核细胞数量增多,功能欠佳;红系增生比较活跃,未见明显形态异常。骨髓流式细胞学检查:未见异常细胞群。骨髓活检:造血组织约占骨髓面积的15%,粒红细胞比例大致正常,巨核细胞     

慢性乙型肝炎患者聚乙二醇α干扰素与α干扰素治疗中应用利可君的临床研究

目的 探讨聚乙二醇α干扰素和α干扰素治疗慢乙肝患者期间应用利可君是否可降低外周血细胞下降的不良反应,提高干扰素的抗病毒疗效.方法 2002年1月至2010年2月住院的395例经干扰素治疗的e抗原阳性的慢乙肝患者,分组:A组:干扰素治疗过程中加用利可君的患者,B组:干扰素治疗中未用利可君的患者.结果 (1)中性粒细胞数下降＜1×109/L的全组患者有35.9％,其中A组29.6％,B组42.8％,P=0.01;≤0.75 × 109/L A组12.6％,B组26.4％,P=0.02;≤0.5 ×109/LA组4.8％,B组16.4％,P=0.04.(2)A组中8.2％治疗过程干扰素减量,所有患者完成治疗,B组为23.3％干扰素减量,2.1％中途停药.另外A组中40.3％干扰素加量超过常规剂量,B组中仅5.2％.(3)血小板减少＜ 100×109/LA组8.7％的患者,B组11.1％;≤80×109/LA组有5.3％,B组7.9％;≤50×109/L A组有1.0％,B组2.6％,A组有减少血小板下降的趋势.(4)在治疗结束时,A组HBVDNA＜ 100IU/ml的患者为67.4％,e抗原转阴率为54.3％,e抗原血清学转换率为40.7％;B组分别为53.9％,41.2％,26.9％,两组比较P值分别为0.02、0.01、0.01.结论 慢性乙型肝炎患者在用干扰素抗病毒治疗期间加用利可君可防治以中性粒细胞数下降为表现的外周血细胞下降的不良反应,有减少血小板下降的趋势,进而可提高患者抗病毒的疗效.     

一例合并t(9;22;16) (q34;q11;p13)的慢性髓细胞白血病

患者 女,59岁,因发现血小板升高1个月于2010年5月14日人院.患者1月前曾因干咳去当地医院就诊,血常规检查提示白细胞9.3×108/L,中性粒细胞5.7×109/L,血红蛋白122 g/L,血小板519×109/L.予静脉抗感染后咳嗽好转,遂至我院血液科就诊.复查血常规提示白细胞8.1×109/L,中性粒细胞6.2×109/L,嗜碱性粒细胞1.3×109/L,血红蛋白103 g/L,血小板530×109/L,早幼粒细胞2％.入院查体:胸骨下段疑似压痛,脾肋下3横指,质软,表面光滑.     

直肠粒细胞肉瘤一例

患者女,34岁.因直肠出血半年于2007年5月9日来本院就诊.直肠镜检查发现距离肛门5 cm处可见一大小为4 cm×3 cm的隆起,质硬,易出血.实验室检查:红细胞4.22×1012/L,白细胞总数8.30×109/L,中性粒细胞6.03×109/L,单核细胞0.23×109/L,淋巴细胞1.96×109/L,嗜酸性粒细胞0.08×109/L.     

机采冰冻血小板与新鲜血小板临床输注效果比较

目的观察冰冻血小板与新鲜血小板临床输注效果。方法95例患者输注新鲜血小板,94例患者输注冰冻血小板。观察输注后患者的出血情况及输注后1h和24h外周血血小板计数情况。结果95例患者输注新鲜血小板后1h计数12.57±4.99×109/L,24h计数28.18±11.33×109/L。结论94例患者输注新鲜血小板后1h计数12.32±5.01×109/L,24h计数29.38±13.34×109/L。二者差异无显著性(P>0.05)。     

肝脾T细胞淋巴瘤2例

例1:女性,32岁,因"脾肿大半年余,月经淋漓不尽18天,伴低热"于2004年12月26日入院.实验室检查:血WBC 2.0×109/L,RBC 2.7×1012/L,Plt 2 9×109/L,HB 78 g/L,淋巴细胞0.54×109/L.肝功能:总蛋白63.0 g/L,白蛋白29.1 g/L,球蛋白33.9 g/L,白球比0.86,ALT 11 IU/L,碱性磷酸酶86 IU/L,总胆红素12.4 μmol/L;乙肝表面抗原阴性;丙肝抗体阴性.B超示:肝脾肿大(重度).曾患肾脏结石,给予排石冲剂治疗.     

急性白血病患者联合化疗后并发海蓝组织细胞增生症一例

患者女,60岁.2010年7月3日因"阵发性头痛伴嗜睡20天"入院.查体:体温36℃,脉搏22次/min,呼吸19次/min,血压181/96 mmHg.神智清、精神可,全身皮肤黏膜无黄染,浅表淋巴结未及肿大.心肺听诊无异常,腹平软,肝脾肋下未触及.双下肢无水肿.血常规:白细胞5.81×109/L,红细胞4.08×1012/L,血红蛋白125g/L,中性粒细胞0.6％,淋巴细胞51.8％,单核细胞41.7％,血小板157×109/L.外周血涂片瑞氏染色示幼稚单核细胞多见.中性粒细胞碱性磷酸酶(neutrophil alkaline phosphatase,NAP)积分20分,C反应蛋白(C reaction protein,CRP)1.3 mg/L,血沉(electron spin resonance,ESR) 15 mm/h;凝血系统检查结果正常,D-二聚体545 ng/ml.     

17p13.3微缺失综合征1例

女, 1岁, 系G2P2, 足月顺产, 2022年8月2日就诊于河南省儿童医院郑州儿童医院神经遗传代谢病科。出生体质量为3.35 kg, 无窒息抢救史。患儿自3月龄至今患泌尿道感染4次、肺炎1次;4月余认生, 现会发"ma ma"音;大运动发育稍落后, 7个月会独坐, 10个月会爬, 现可扶站。出生4个月时血常规检查结果提示白细胞17.95 × 109/L(正常参考值为5.10 ～ 14.10 × 109/L), 红细胞3.98 × 1012/L(正常参考值为4.00 ～ 5.50×1012/L), 血红蛋白115 g/L(正常参考值为107 ～ 141 g/L), 中性粒细胞占比68.2%(正常参考值为13.0% ～ 55.0%), 淋巴细胞占比25.4%(正常参考值为33.0% ～ 77.0%), 中性粒细胞12.23 × 109/L(正常参考值为0.80 ～ 5.80 × 109/L), 淋巴细胞4.56 × 109/L(正常参考值为2.40 ～ 8.70 × 109/L), C-反应蛋白31.52 mg/L(正常参考值为0 ～ 10.00 mg/L)。尿常规检查结果提示红细胞2...     

Tolling for autoimmunity-prime time for 7

The reason certain self-antigens are consistently targeted by autoantibodies may be because they are self-adjuvants. Two papers in this issue of Immunity provide important insights into the contribution of Toll-like receptors in systemic autoimmune disease (Berland et al., 2006; Christensen et al., 2006).     

Receptor editing for better or for worse

Receptor editing has emerged from its original identification as a minor secondary mechanism of B cell tolerance to be considered as a dominant mechanism by which autoreactive immature B cells are rendered tolerant. Clonal deletion, previously regarded as the major mechanism of central B cell tolerance, has been shown by recent studies to operate secondarily and only when receptor editing is unable to provide a non-autoreactive specificity. Receptor editing has also been shown to operate during the development of wild-type B lymphocytes, and ongoing investigations demonstrate the influence of particular signaling molecules in the induction and/or inhibition of receptor editing. Together, these studies begin to map the signaling pathways that regulate receptor editing in autoreactive and non-autoreactive immature B cells.     

Prospects for peptide-based immunotherapy for dog allergy

PURPOSE OF REVIEW: Tolerance to ubiquitous environmental substances, allergens, can be accomplished with specific immunotherapy. Conducting therapy with allergen peptides helps to avoid immediate allergic reactions. Dogs are a source of important indoor allergens, which necessitates the development of effective modes of therapy against the allergy they cause. RECENT FINDINGS: The human T-cell epitopes of the major dog allergen Can f 1 were determined recently. They were found to be distributed in seven epitope regions along the molecule. For the peptide immunotherapy of dog allergy, using a pool of seven peptides, one from each of the epitope regions of Can f 1, seems at present to be the best approach. As Can f 1 is not as immunodominant as the main allergens of some other mammals, it remains to be seen whether peptides from other dog allergens should be included in the pool. SUMMARY: The use of a pool of seven peptides from the T-cell epitope regions of Can f 1 is likely to be feasible for treating dog allergy in a great majority of Caucasian populations. In the future, patient-tailored preparations of variants of the T-cell epitope-containing peptides may offer a way to enhance the efficacy of peptide-based immunotherapy.     

Materials for phantoms for terahertz pulsed imaging

Phantoms are commonly used in medical imaging for quality assurance, calibration, research and teaching. They may include test patterns or simulations of organs, but in either case a tissue substitute medium is an important component of the phantom. The aim of this work was to identify materials suitable for use as tissue substitutes for the relatively new medical imaging modality terahertz pulsed imaging. Samples of different concentrations of the candidate materials TX151 and napthol green dye were prepared, and measurements made of the frequency-dependent absorption coefficient (0.5 to 1.5 THz) and refractive index (0.5 to 1.0 THz). These results were compared qualitatively with measurements made in a similar way on samples of excised human tissue (skin, adipose tissue and striated muscle). Both materials would be suitable for phantoms where the dominant mechanism to be simulated is absorption (approximately 100 cm(-1) at 1 THz) and where simulation of the strength of reflections from boundaries is not important; for example, test patterns for spatial resolution measurements. Only TX151 had a frequency-dependent refractive index close to that of tissue, and could therefore be used to simulate the layered structure of skin, the complexity of microvasculature or to investigate frequency-dependent interference effects that have been noted in terahertz images.     

Design methodology for aids for the disabled

Although many aids for the disabled appear to be quite simple, their design is subject to many difficulties. These problems arise because of the intimate relationship between the equipment and the human body. Equipment design is therefore affected by many biological variables that are difficult to define at the beginning of the design exercise and many will not even be obvious until a device is tried out with a user. Standard design methodologies rely on all the variables being defined in a thorough specification at the start of the design process and therefore often lead to ineffective devices or very long development programmes. An alternative methodology is presented which overcomes the problems by separating the user interface aspects of the design from the supporting features. The user interface aspects are then allowed to evolve in conjunction with tests with potential users and finally integrated with the supporting features once a satisfactory solution has been found. Much more effective devices result with much shorter development effort.