Acquired EVI1 rearrangement involved in the transformation from 5q- syndrome to pre-B lymphocytic leukemia in a Chinese patient

The anomalous EVI1 rearrangements/t(3;3)(q21;q26) is more frequently found in myelocytic malignancies. 5q- syndrome is a newly defined subtype of myelodysplastic syndrome (MDS) first proposed by the World Health Organization in 2001. Cases of acute lymphocytic leukemia (ALL) with 5q- anomaly or t(3;3)/EVI1 rearrangement have rarely been reported. We report a rare 5q- syndrome case which ultimately transformed to acute lymphocytic leukemia accompanied by a secondary cytogenetic anomaly of t(3;3)(q21;q26) and EVI1 rearrangement around 3 years after the diagnosis of 5q- syndrome. This rare case suggests that the 5q- clone of MDS may originate from a multipotent cell with a capacity to differentiate toward both myeloid and lymphoid lineages. It also indicates that although the t(3;3)/EVI1 rearrangement is mostly related to myelocytic neoplasms, the t(3;3)/EVI1-rearrangement may also play an important role in the development of ALL. The results of the necessary tests must be analyzed sufficiently prior to making a final diagnosis.     

微小牛蜱磷酸丙糖异构酶基因片段的克隆与原核表达

为克隆和表达微小牛蜱磷酸丙糖异构酶(triosephosphate isomerase,Tim)编码基因,提取微小牛蜱成虫总RNA,采用RT-PCR方法扩增目的基因,将其连入pMD-18T载体,经酶切和测序鉴定后,将正确的目的基因与pET-28a表达载体连接,并转入大肠埃希菌(E.coli)Rosetta(DE3)中,异丙基-β-D-硫代半乳糖苷(IPTG)诱导表达后,经十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)鉴定分析。结果发现,克隆所得的微小牛蜱成虫tim基因片段长度为750bp(登录号为JX112888),其中开放阅读框为750 bp,编码249个氨基酸,与微小牛蜱胚胎中克隆出的tim基因序列的同源性为99%。SDS-PAGE结果显示,重组蛋白Tim相对分子质量(Mr)约为27 000。     

血清载脂蛋白E在儿童感染性疾病中的变化

目的 探讨血清载脂蛋白E(ApoE)在儿童感染性疾病中的变化.方法 279例感染性疾病患儿中,脓毒症65例,化脓性脑膜炎47例,细菌性肺炎67例,无菌性脑膜炎47例,支原体肺炎53例.采用透射免疫比浊法(IA)检测感染性疾病患儿的血清ApoE水平.构建B组鼠伤寒沙门菌诱导的脓毒症小鼠模型,采用IA检测小鼠血清ApoE水平,实时荧光定量PCR和Western印迹法检测小鼠肝脏ApoE mRNA和蛋白的表达.两组间均数比较采用独立样本t检验.结果 血清ApoE在细菌性感染性疾病患儿中明显升高,在脓毒症患儿中高达(59.8±23.5) mg/L(t=-5.118,P＜0.01),在无菌性脑膜炎和支原体肺炎患儿中无明显变化.脓毒症小鼠模型血清ApoE水平明显升高,但肝脏ApoE mRNA和蛋白的表达下降,mRNA的相对值在造模后3h下降了71％(t=5.022,P＜0.01),在造模后24 h下降了73％(t=4.181,P＜0.01).结论 血清ApoE水平在细菌性感染性疾病中显著升高,而肝脏中ApoE表达下降,说明ApoE血清升高机制与肝脏表达不相关.     

组织工程血管移植在血液透析通路中的应用

目的:探讨组织工程血管移植应用于血液透析(HD)通路的可行性。方法:广泛查阅近期有关组织工程血管应用于HD通路的文献,对其动物模型及临床研究进行总结评价。结果:分层构建法可获得具有足够机械强度的组织工程血管。此后出现的简化分层构建组织工程血管在一系列动物模型及临床实验中被证明可用于动静脉通路的建立。近期一种生物反应器构建组织工程血管在狒狒模型上进行动静脉搭桥试验也获得成功,有望成为较理想的动静脉内瘘移植血管。结论:组织工程血管移植应用于HD通路是可行的,值得进一步研究。     

hUCMSCs与VEGF联合移植对MCAO大鼠治疗的影响

目的 将体外培养的人脐带间充质干细胞(hUCMScs)与血管内皮生长因子(VEGF)联合植入大脑中动脉栓塞(MCAO)模型大鼠脑内,观察缺血体积变化及缺血区血管新生情况.方法 选择180只SD大鼠随机分为假手术组、MCAO组、hUCMScs组、VEGF组、hUCMSCs+ VEGF联合组.HE、Niss1染色比较缺血前后组织学的变化;缺血后7、14、28d3个时间点分别用免疫组化法检测脑缺血半暗区微血管密度;TTC染色法计算并比较缺血体积变化.结果 缺血前后的组织学上有明显变化;在缺血后7、14、28 d时,hUCMSCs组、VEGF组微血管密度与MCAO组有差异,联合组最大;各组3个时间点的缺血体积逐渐减小,其中联合组28 d梗死体积最小.结论 hUC-MSCs和VEGF联合植入MCAO大鼠脑内,可增加其缺血半暗区血管新生,减小缺血体积,促进神经功能恢复.     

三峡工程对库区重庆段钉螺生长条件影响研究

目的了解三峡工程建成以后,库区气候、植被、淹没等条件变化对钉螺孳生的可能影响。方法利用ArcGIS软件的空间分析功能,结合气象资料及重点研究区1:1万和库区重庆段1:5万数字高程模型(DEM)就阶段性淹没区的气候条件、淹没时间、淹没区植被情况以及阶段性淹没可能对钉螺生长的影响进行综合分析。结果三峡库区淹没时间、气温、降水、日照时间、植被种类及覆盖度均适合钉螺,但其冬季蓄水、夏季放水的特点对钉螺的生长不利。结论三峡库区形成的"冬水夏陆"的洲滩环境不适于钉螺孳生,如能从源头上控制钉螺的外来输入问题,库区可避免成为钉螺孽生区。     

Peg-IFNa-2a/RBV antiviral efficacy in cirrhotic hepatitis C patients after splenectomy or partial splenic embolization

To investigate the antiviral efficacy of combination therapy with peglyated-interferon alpha (peg-IFNa)-2a and ribavirin (RBV) in hepatitis C patients with liver cirrhosis after splenectomy or partial splenic embolization. Forty-nine hepatitis C patients with liver cirrhosis who were unable to use antiviral therapy because of hypersplenism were recruited for study and treated with splenectomy or partial splenic embolization. Three months later, a regimen of antiviral combination therapy was initiated with peg-IFNa-2a (once-weekly subcutaneous injection: 135 μg or 180 μg) and RBV (daily oral: 800 to 1200 mg), and was maintained for 48 weeks. The patients were followed up at treatment weeks 1, 2, 4, 6, 8, and 12. Thereafter, follow-up was conducted every four weeks. The patients were observed until 24 weeks after treatment discontinuation. Follow-up testing included liver function, blood chemistry, renal function, and HCV RNA level. Any adverse reactions were recorded. HLiver cirrhosis patients complicated by hypersplenism can be treated effectively with peg-IFNa-2a/RBV combination antiviral therapy after splenectomy or partial splenic embolization. The antiviral-induced sustained viral response rates was 65.00% in cirrhotic/hypersplenic hepatitis C patients receiving splenectomy and 58.62% in those receiving partial splenic embolization. Hypersplenism patients with hepatitis C-related cirrhosis achieved a good antiviral therapeutic effect with peg-IFNa-2a/RBV combination therapy following splenectomy or partial splenic embolization. This sequence of treatment may help to decrease incidences of chronic hepatitis C-induced liver failure and liver cancer in these patients.     

OPN和VEGF-C在胃癌中的表达及其临床意义

目的:评价骨桥蛋白(osteopontin,OPN)和血管内皮生长因子C(vascular endothelial growth factor C,VEGF-C)在胃癌中表达及与临床病理参数之间相关性,进一步探讨二者的共表达在胃癌淋巴结转移中的机制.方法:收集复旦大学附属中山医院手术切除胃癌组织标本及患者相关临床资料,对纳入研究的93例胃癌原发灶标本采用免疫组织化学染色法(EnVision二步法),检测OPN与VEGF-C蛋白的表达.结果:93例胃癌组织中OPN与VEGF-C的阳性表达率分别为64.5%(60/93)和69.9%(65/93),在非肿瘤性胃黏膜中均未见其阳性表达;OPN和VEGF-C的表达与胃癌浆膜侵犯、TNM分期以及淋巴结转移呈明显相关(P<0.05).蛋白之间的相关性分析显示,OPN与VEGF-C之间存在正相关(r=0.493,P<0.01).结论:联合检测OPN与VEGF-C有助于阐述胃癌发生发展、浸润转移的机制,OPN可能通过上调VEGF-C的表达促进胃癌的淋巴结转移.     

表象训练在虚拟现实内镜模拟器培训胃镜初学者中的应用

目的:探讨表象训练在胃镜技能获得中的作用.方法:分层抽样法抽取我校08级临床医学专业男学员30人,随机分为3组.A组(n=10)在常规模拟器练习过程中加入表象训练,B组(n=10)进行常规模拟器练习,C组(n=10)不做任何练习.完成培训结束时所有学员操作病例1,模拟器给出的评分,比较3组间的考核评分.所有学员接受培训前、后心理测评,评价心理状态是否稳定.结果:比较3组考核成绩显示,3组间总分差异有统计学意义,3组组间两两比较显示差异有统计学意义,其中A组优于B组,A组优于C组,B组优于C组.进一步分析差异原因,结果表明,安全性评分和准确性评分、残气量评分、患者痛苦指数评分、操作时间评分A、B、C3组间差异均有统计学意义;而A、B组两组之间比较,只有残气量评分、操作时间评分差异有统计学意义.结论:表象训练可提高使用虚拟现实内镜模拟器培训胃镜技能的效果,教学方法容易实施,学员容易掌握,是一种可行性较高的教学辅助方法.