妊娠期贫血相关指标参考区间的建立

目的建立适合本地区人群的妊娠期贫血相关指标参考区间。方法根据孕周的不同,将412例健康孕妇分为妊娠早期组、妊娠中期组和妊娠晚期组,选择与孕妇年龄相近的139例健康非妊娠女性作为对照组。检测并比较红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)水平,建立可用于诊断妊娠期贫血的参考区间。结果除妊娠中期组和妊娠晚期组Hb水平比较差异无统计学意义外(P0.05),其他各研究组各指标水平比较差异均有统计学意义(P0.05)。非妊娠期女性RBC、Hb、HCT参考区间分别为(4.12~5.32)×10~(12)/L、(120.43~152.11)g/L、0.371~0.454,妊娠早期分别为(3.61~5.03)×10~(12)/L、(110.76~147.33)g/L、0.334~0.441,妊娠中期分别为(3.33~4.67)g/L、(106.12~136.32)g/L、0.320~0.410,妊娠晚期为(3.50~4.88)×10~(12)/L、(104.78~143.21)g/L、0.318~0.422。结论不同孕期妊娠女性贫血相关指标水平有所差异。该研究建立的妊娠各期RBC、Hb和HCT参考区间,可用于妊娠期贫血的诊断,也可用于孕妇健康水平评估。     

GW003对骨髓细胞体外形成粒-巨噬细胞集落能力的影响

本研究旨在观察重组人血清白蛋白-粒细胞集落刺激因子融合蛋白（GW003）对骨髓造血细胞体外形成粒系集落能力的影响。分别抽取正常恒河猴、缓解期和化疗中pLLL患者骨髓并分离有核细胞,分别加入系列浓度的GW003、吉粒芬、G-CSF突变体,在培养12d后计数粒-巨噬细胞系集落（CFU-GM）。结果表明,GW003具有提高正常恒河猴骨髓有核细胞体外形成CFU-GM的能力,效果明显优于相同摩尔浓度的吉粒芬 及G-CSF突变体;在-定的浓度范围内,GW003浓度与恒河猴骨髓细胞形成CFU-GM的数量呈明显的剂量效应关系（r=R2=0．965,P=0．003）;GW003能提高ALL患者骨髓细胞粒系集落体外形成能力,对化疗中患者的效果更为显著,可有效缓解化疗引起的骨髓抑制。结论：GW003可显著提高骨髓细胞体外形成粒细胞集落的能力,可有效缓解骨髓抑制。     

大剂量~(60)Co γ射线照射恒河猴造血系统指标的早期变化

目的观察大剂量60 Coγ射线照射恒河猴后造血系统相关指标的早期改变,为急性放射病(ARS)早期造血因子治疗提供实验依据。方法 33只雄性成年恒河猴随机分为对照组和不同照射剂量的照射组,照射组动物用60 Coγ射线4、8和12Gy一次全身照射建立ARS恒河猴模型。XE-2100全自动血细胞分析仪检测照射前和照射后3、6、9、12、24、48、80h血常规指标,照射后6、48和80h麻醉处死动物,取胸骨观察病理组织学变化。结果 4、8Gy 2个剂量照射后3h外周血白细胞均低于照射前检测值,照射后6h白细胞均升高,9h检测值最高,分别达136.04%和221.38%(以照射前检测值为100.00%,下同),12h后开始明显下降。而12Gy照射后白细胞持续升高,9h达到最大值,之后下降,均显示出明显的"暂时性回升"峰。照射后中性粒细胞数先升高,9h达高峰之后又快速下降;照射后外周血淋巴细胞数急剧下降,3h检测值仅为照射前的12.02%~25.04%。照射后胸骨骨髓有核细胞数目急剧减少,照射剂量越大,残存造血细胞数越少。结论骨髓型ARS早期外周血白细胞和中性粒细胞数"暂时性回升"的时间节点可视为造血因子治疗的最佳给药时机。     

Studies on mechanism of treatment of granulocyte colony-stimulating factor,recombinant human interleukin-11 and recombinant human interleukin-2 on hematopoietic injuries induced by 4.5 Gy γ-rays irradiation in beagles

Objective To investigate the mechanism of treatment of granulocyte colony-stimulating factor(rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2 (rhIL-2)on hematopoietic injuries induced by 4.5 Gy60 Coγ-ray irradiation in beagles,and to provide experimental evidence for the clinical treatment of extremely severe myeloid acute radiation sickness (ARS).Methods Sixteen beagle dogs were given 4.5 Gy60 Co γ-ray total body irradiation(TBI),then randomly assigned into irradiation control group,supportive care group or cytokines+supportive care (abbreviated as cytokines)group.In addition to supportive care,rhG-CSF,rhlL-11 and rhIL-2 were administered subcutaneously to treat dogs in cytokines group.The percentage of CD34+cells,cell cycle and apoptosis of nucleated cells in peripheral blood were examined by Flow cytometry.Results After 4.5 Gy 60 Co γ-ray irradiation,the CD34+cells in peripheral blood declined obviously(61.3%and 52.1% of baseline for irradiation control and supportive care group separately).The cell proportion of nucleated cells in Go/G1 phase was increased notably(99.27% and 99.49% respectively).The rate of apoptosis(26.93% and 21.29% separately)and necrosis(3.27% and 4.14%,respectively)of nucleated cells were elevated significantly when compared with values before irradiation(P<0.05) 1 d post irradiation.When beagles were treated with cytokines and supportive care,the CD34+cells in peripheral blood were markedly increased(135.6% of baseline).The effect of G0/G1 phase blockage of nucleated cells became more serious(99.71%).The rate of apoptosis(5.66%)and necrosis(1.60%)of nucleated cells were significantly lower than that of irradiation control and supportive care groups 1 d after exposure.Conclusions Cytokines maybe mobilize CD34+cells in bone marrow to peripheral blood,indce cell cycle block at G0/G1 phase and reduce apoptosis,and eventually cure hematopoieticinjuries induced by irradiation.     

Therapeutic effects of combined cytokines on hematopoietic injuries induced by 4.5 Gy γ-rays irradiation in beagles

Objectivc To observe the therapeutic effects of combined cytokines on hematopoietic injuries induced by 4.5 Gy60 Co γ-rays irradiation in beagles,and to provide experimental evidences for the clinical treatment of extremely severe myeloid acute radiation sickness(ARS).Methods 16 beagles were given 4.5 Gy60 Co γ-rays total body irradiation,and then randomly assigned into irradiation control group,supportive care group and cytokines group.In addition to supportive care,recombinant human granulocyte colony-stimulating factor (rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2(rhIL-2)were administered subcutaneouly to dogs in cytokines group.Peripheral blood hemogram was examined once every two days.Bone marrow and peripheral blood were collected to proceed colony cultivation 4 d pre-irradiation and 1 and 45 d post-irradiation.Conventional histopathological sections of sternum were prepared to observe the histomorphology changes. Results After irradiation,the population of all kinds of cells in peripheral blood declined sharply.WBC nadir Was elevated(1.04×109/L,but 0.28×109/L and 0.68×109/L for the irradiation control group and the supportive care group separately),the duration of thrombocytopenia was shortened (24 days,but 33 days for the supportive care groug) and red blood cell counts were maintained in the range of normal values after cytokincs treatment in combination.The colony forming efficiency of haemopoietic stem cells(HSCs)in bone marrow and peripheral blood decreased obviously 1 d post irradiation,but recovered to the level of that before irradiation 45 d post irradiation after supportive care and cytokines treatment.Hematopoietic cells disappeared in bone marrow of animals in irradiation control group,but hematopoietic functions were recovered after cytokines were administrated.Conclusions RhG-CSF.rhIL-11 and rhIL-2 used in combination could elevate WBC nadir,accelerate the recovery of leukocytes,platelets and red blood cells and promote the proliferation,differentiation and maturity of HSPCs left in the body after 4.5 Gy γ-rays total body irradiation,eventually restore the hematopoietic function.Hence,combination of rhG-CSF,rhIL-11 and rhIL-2 could serve as better therapeutic strategy to treat extremely severe myeloid ARS.     

伯舒替尼诱导急性髓系白血病细胞分化和细胞凋亡

目的 探讨伯舒替尼对人急性髓系白血病(AML)细胞株HL-60、THP-1和U937细胞分化和凋亡的影响及其作用机制.方法 伯舒替尼0～20 μmol/L处理HL-60、THP-l和U937细胞48 h,MTT法检测细胞增殖;伯舒替尼0～5 μmol/L处理HL-60、THP-1和U937细胞72 h,流式细胞仪检测细胞CDllb表达;伯舒替尼O～10 μmol/L处理HL-60、THP-1和U937细胞72 h,胱天蛋白酶(caspase)广谱抑制剂benzyloxy-carbonyl-Val-Ala-Asp-fluoromethyl-ketone (Z-VAD-FMK)预处理lh后加入伯舒替尼处理U937细胞48 h,Annexin V-FITC/PI双染法检测细胞凋亡;不同浓度伯舒替尼(0～5 μmol/L)分别处理HL-60和U937细胞24 h后,Western印迹法检测细胞分化相关转录因子C/EBPβ、P21和c-Myc以及凋亡相关分子Mcl-1、Bax和Caspase 3蛋白表达的改变.结果 伯舒替尼剂量依赖性抑制AML细胞增殖.与空白对照组相比,不同浓度伯舒替尼处理AML细胞72 h后,细胞CDllb表达和细胞凋亡率均明显增加(P＜0.05或P＜0.01).伯舒替尼处理HL-60细胞有效上调C/EBPβ和P21的蛋白表达水平,引起U937细胞Mcl-1表达降低和Bax表达增强,并激活caspase 3,而Z-VAD-FMK预处理U937细胞显著抑制伯舒替尼诱导的细胞凋亡.结论 伯舒替尼可有效抑制AML细胞增殖,诱导细胞分化和促进其凋亡,可作为有效治疗AML的潜在药物.     

耐甲氧西林金黄色葡萄球菌MecA基因的实时荧光定量PCR方法学评价

目的评估实时荧光定量聚合酶链反应(FQ-PCR)检测临床标本中耐甲氧西林金黄色葡萄球菌(MRSA)MecA耐药基因的价值。方法选择该院2013年6~12月125份临床标本,包括血液40份,痰液52份,创面分泌物33份进行FQ-PCR检测和细菌鉴定,分析结果符合率,以检测FQ-PCR的灵敏度及特异性。结果FQ-PCR的灵敏度为0.159pg/μL,检测经细菌培养鉴定的菌株,特异性达到100%,与临床标本结果符合率为97.6%。结论 FQ-PCR检测MRSA的MecA基因更加方便、快速,且灵敏度和特异性等性能指标均比较理想,与细菌鉴定结果符合率较高,适合临床广泛应用。     

血小板生成素与急性放射病

巨核系造血功能障碍是导致急性放射病患者出血致死亡的主要原因之一。血小板生成素（thrombopoietin,TPO）是巨核系造血的主要刺激因子,可促进照射后巨核系造血功能恢复,升高外周血小板数。在照射后早期应用TPO对急性放射病出血并发症的防治起到关键的作用。研究表明,TPO可能具有更强促进造血恢复的作用,本文就TPO治疗急性放射病的研究进展进行综述。     

物流管道系统传送标本对血细胞参数的影响

目的:探讨物流管道系统传送标本时血细胞参数的影响.方法:45例患者的EDTA-K2抗凝静脉血分为四管,分别经人工运送到检验科或经物流管道系统传送1次、2次和3次后到检验科,用XE-2100全自动血细胞分析仪进行血常规检测.结果:经物流管道系统传输1次时各项参数与人工运送组相比差异没有统计学意义:物流传输2次时RBC、MCV、RDW-SD和RDW-CV等4项参数与人工运送组相比差异有显著性意义(P＜0.01),传输3次时差异更加显著.但其变化的程度不影响临床诊断.结论:尽管用物流管道系统传送2次以上血常规标本时RBC、MCV、RDW-SD和RDW-CV等红细胞相关参数的变化有统计学差异,但变化程度不足以影响临床诊断.     

人感染新型重组H7N9禽流感病毒研究进展

2013年3月,上海和安徽出现3例严重的病毒性肺炎,病情快速进展为急性呼吸窘迫综合征（ARDS）及多器官衰竭,并导致死亡。最终确诊这3例均感染了一种新型重组禽流感HTN9病毒（nrH7N9）。截至2013年5月16日,全国已有131例确诊感染了该病毒,其中死亡36例。全病毒基因序列分析显示,nrH7N9是3种禽流感病毒基因重组的产物。目前还没有直接人传人的证据,但病毒可能是从活禽市场通过禽类传给人。现就nrH7N9病毒的分子结构特征、疾病的临床表现、流行趋势及防控对策综述如下。