两种BCR/ABL探针在Ph阳性白血病荧光原位杂交检测中的不同信号模式及其意义

目的 比较BCR/ABL双色额外信号探针(dual color extra-signal BCR/ABL probe,ESFISH探针)及BCR/ABL双色双融合探针(dual color dual fusion BCR/ABL probe,D-FISH探针)在Ph阳性白血病荧光原位杂交(fluorescence in situ hybridization,FISH)检测中信号模式的差异,探讨它们的诊断价值.方法 分别采用D-FISH和ES-FISH探针对74例伴有单纯t(9;22)(q34;q11)及37例伴有变异Ph易位或复杂核型异常的Ph阳性白血病患者骨髓细胞进行间期FISH检测.结果 所有单纯t(9;22)(q34;q11)易位的白血病患者应用两种探针均检测到BCR/ABL阳性信号,ES-FISH探针显示2个橙色信号、1个绿色信号和1个黄色信号模式,而D-FISH探针显示1个橙色信号、1个绿色信号和2个黄色信号模式.ES-FISH探针在9例(12.2%)Ph阳性白血病患者中识别次要BCR断裂位点(1个橙色信号、1个绿色信号和2个黄色信号),而D-FISH探针不能识别主要BCR和次要BCR断裂位点;D-FISH探针在8例(10.8%)Ph阳性白血病中区分ABL基因单独缺失(1个橙色信号、2个绿色信号、1个黄色信号)和ABL、BCR基因共同缺失(1个橙色信号、1个绿色信号和1个黄色信号),ES-FISH则不能区分之.检测变异Ph易位和含Ph易位的复杂核型异常时,两种探针的信号模式分别有4种和6种之多,且以不典型者居多,对于它们的精确解释必须依赖常规染色体分析和中期FISH结果 .结论 ES-FISH及D-FISH探针由于BCR探针大小及覆盖区域不同,在Ph阳性白血病的FISH检测中显示不同信号模式,可分别作为Ph+急性淋巴细胞白血病和慢性髓系白血病患者FISH检测的首选.若采用伊马替尼治疗,主要BCR断裂点和次要BCR断裂点、伴或不伴有衍生9号染色体部分序列缺失均不影响预后,但鉴于ES-FISH探针性价比优于D-FISH探针,推荐其作为Ph阳性白血病FISH检测的首选.     

胰岛素泵治疗糖尿病的护理干预

目的：探讨护理干预在胰岛素泵治疗中的作用.方法：对30例应用胰岛素泵强化治疗的患者进行置泵前、置泵时、置泵后的护理干预.结果：30例患者应用胰岛素泵后血糖控制良好、胰岛素用量和低血糖发生次数减少,生活质量相应提高.结论：胰岛素泵使用过程中护理干预是保证最佳治疗效果的关键.     

浅谈血液内科教学查房现状及改进策略

教学查房是我国临床医学教育的基本模式,以培养医学生的临床思维能力为主要目的,与日常医疗查房有本质区别。鉴于血液内科住院患者易感染、易出血等特殊性,传统的教学查房较难落实。本文拟重点分析当前血液内科教学查房现状,并提出可行性改进措施。     

一株新的急性髓系白血病细胞系SH-2的建立及其鉴定

Objective To establish and characterize a novel human myeloid leukemia cell line SH-2. Methods Bone marrow mononuclear cells(BMMNC) isolated from a AML-M2 patient, who failed to ob-tain complete remission after chemotherapy and allogenic bone marrow transplantation were passed in a long term IMDM culture medium supplemented with 20% fetal calf serum. Stromal cells were retained and rh-IL-3was added in the culture system. A new human myeloid leukemia cell line SH-2 was successfully established with a cytogeuetic characteristics of a loss of Y chromosome(- Y), a derivative chromosome 16 resulting from unbalanced translocation between chromosome 16 and 17, monosome 17, trisomy 19 and p53 alteration. Vari-ous methods were employed to characterize SH-2 cell line. Results SH-2 cells has been maintained without cytokine and stromal cells for more than 3 years without EB virus and mycoplasma contamination. SH-2 cells had the basically same morphological, immunophenotypic and cytogenetic features as the patient' s leukemia cells did, such as myeloid morphology, an immunophenotype of CD13+ , CD33+ , CD56+ , CD16/56+ and a hypodiploid karyotype of 45, X, - Y, der(16) t(16;17) (q24;q12) , - 17, + 19, which were gradually de-creased and replaced by the near-tetraploid cells with a karyotype of 73 - 102 (80), XX, - Y, - Y, del (lq31) ×2, der(16)t(16;17) (q24;q12) ×2, - 17, - 17, + 19, + 19. FISH and multiple FISH delineated all the abnormalities and revealed a loss of one p53 allele due to monosomy 17. DNA direct sequencing detec-ted a point mutation of CAG to CAT at codon 576 of exon 5 in another p53 allele. RT-PCR showed that SH-2 cells expressed apoptosis-related genes (bcl-2, Fas, GST- π and p21) rather than MDR-related genes. Short tandem repeat PCR provided powerful evidence for the derivation of SH-2 cell line from the patient' s leukemia cells. SH-2 cells had certain colony formation and tumorigenic capacities in nude and SCID mice. Conclu-sion SH-2 is a new myeloid leukemia cell line with a unique biology background, and will provide a useful tool for leukemia research.     

一株新的急性髓系白血病细胞系SH-2的建立及其鉴定

Objective To establish and characterize a novel human myeloid leukemia cell line SH-2. Methods Bone marrow mononuclear cells(BMMNC) isolated from a AML-M2 patient, who failed to ob-tain complete remission after chemotherapy and allogenic bone marrow transplantation were passed in a long term IMDM culture medium supplemented with 20% fetal calf serum. Stromal cells were retained and rh-IL-3was added in the culture system. A new human myeloid leukemia cell line SH-2 was successfully established with a cytogeuetic characteristics of a loss of Y chromosome(- Y), a derivative chromosome 16 resulting from unbalanced translocation between chromosome 16 and 17, monosome 17, trisomy 19 and p53 alteration. Vari-ous methods were employed to characterize SH-2 cell line. Results SH-2 cells has been maintained without cytokine and stromal cells for more than 3 years without EB virus and mycoplasma contamination. SH-2 cells had the basically same morphological, immunophenotypic and cytogenetic features as the patient' s leukemia cells did, such as myeloid morphology, an immunophenotype of CD13+ , CD33+ , CD56+ , CD16/56+ and a hypodiploid karyotype of 45, X, - Y, der(16) t(16;17) (q24;q12) , - 17, + 19, which were gradually de-creased and replaced by the near-tetraploid cells with a karyotype of 73 - 102 (80), XX, - Y, - Y, del (lq31) ×2, der(16)t(16;17) (q24;q12) ×2, - 17, - 17, + 19, + 19. FISH and multiple FISH delineated all the abnormalities and revealed a loss of one p53 allele due to monosomy 17. DNA direct sequencing detec-ted a point mutation of CAG to CAT at codon 576 of exon 5 in another p53 allele. RT-PCR showed that SH-2 cells expressed apoptosis-related genes (bcl-2, Fas, GST- π and p21) rather than MDR-related genes. Short tandem repeat PCR provided powerful evidence for the derivation of SH-2 cell line from the patient' s leukemia cells. SH-2 cells had certain colony formation and tumorigenic capacities in nude and SCID mice. Conclu-sion SH-2 is a new myeloid leukemia cell line with a unique biology background, and will provide a useful tool for leukemia research.     

一株新的急性髓系白血病细胞系SH-2的建立及其鉴定

Objective To establish and characterize a novel human myeloid leukemia cell line SH-2. Methods Bone marrow mononuclear cells(BMMNC) isolated from a AML-M2 patient, who failed to ob-tain complete remission after chemotherapy and allogenic bone marrow transplantation were passed in a long term IMDM culture medium supplemented with 20% fetal calf serum. Stromal cells were retained and rh-IL-3was added in the culture system. A new human myeloid leukemia cell line SH-2 was successfully established with a cytogeuetic characteristics of a loss of Y chromosome(- Y), a derivative chromosome 16 resulting from unbalanced translocation between chromosome 16 and 17, monosome 17, trisomy 19 and p53 alteration. Vari-ous methods were employed to characterize SH-2 cell line. Results SH-2 cells has been maintained without cytokine and stromal cells for more than 3 years without EB virus and mycoplasma contamination. SH-2 cells had the basically same morphological, immunophenotypic and cytogenetic features as the patient' s leukemia cells did, such as myeloid morphology, an immunophenotype of CD13+ , CD33+ , CD56+ , CD16/56+ and a hypodiploid karyotype of 45, X, - Y, der(16) t(16;17) (q24;q12) , - 17, + 19, which were gradually de-creased and replaced by the near-tetraploid cells with a karyotype of 73 - 102 (80), XX, - Y, - Y, del (lq31) ×2, der(16)t(16;17) (q24;q12) ×2, - 17, - 17, + 19, + 19. FISH and multiple FISH delineated all the abnormalities and revealed a loss of one p53 allele due to monosomy 17. DNA direct sequencing detec-ted a point mutation of CAG to CAT at codon 576 of exon 5 in another p53 allele. RT-PCR showed that SH-2 cells expressed apoptosis-related genes (bcl-2, Fas, GST- π and p21) rather than MDR-related genes. Short tandem repeat PCR provided powerful evidence for the derivation of SH-2 cell line from the patient' s leukemia cells. SH-2 cells had certain colony formation and tumorigenic capacities in nude and SCID mice. Conclu-sion SH-2 is a new myeloid leukemia cell line with a unique biology background, and will provide a useful tool for leukemia research.     

2018-2020年某院无乳链球菌的分布情况及耐药率变化

目的 了解无乳链球菌的分布情况及耐药率变化,为临床合理应用抗菌药物提供参考。方法 收集2018-2020年广州市花都区妇幼保健院各科室门诊及住院患者的各类标本,经过分离、培养、鉴定后一共检出2 074株无乳链球菌,记录无乳链球菌的临床科室分布及标本类型分布,并对常用抗菌药物药敏试验结果进行统计分析。结果 2018-2020年分离的无乳链球菌主要来自产科门诊,各年份所占比例分别为74.23%(553/745)、71.57%(559/781)、59.12%(324/548),呈逐年下降趋势。2018-2020年从阴道及直肠拭子标本中分离出的无乳链球菌所占比例最高,各年份分别为97.72%(728/745)、99.10%(774/781)、97.26%(533/548)。2018-2020年无乳链球菌对利奈唑胺、万古霉素、美罗培南、头孢噻肟、头孢吡肟、阿莫西林、青霉素、氨苄西林、头孢曲松、替考拉宁均敏感;对四环素、红霉素、克林霉素的耐药率较高,对左氧氟沙星、氯霉素的耐药率较低。结论 2018-2020年分离出的无乳链球菌主要来源于产科门诊患者的阴道及直肠拭子标本,应当加强对孕妇无乳链球菌的筛...     

耳穴埋籽干预肝癌介入术后疼痛的临床研究

目的探讨耳穴埋籽干预肝癌介入术后疼痛的临床疗效。方法将48例原发性肝癌患者随机分为对照组和干预组,对照组采用西医常规护理方案,干预组采用耳穴埋籽结合西医常规护理方案干预,住院期间观察并比较2组患者肝癌介入术后疼痛评分及睡眠质量。结果干预组患者术后2、3、7 d时的疼痛评分显著低于对照组(P0.05);干预组术后2、3、7 d时的睡眠评分显著低于对照组(P0.05)。结论耳穴埋籽对肝癌介入术后疼痛具有显著改善作用,而且可提升患者睡眠质量,值得在临床推广应用。     

1例伴有t（9；22）和ins（3；8）的慢性粒细胞白血病的临床和实验研究

目的报道1例伴有ins（3；8）的慢性粒细胞白血病（CML）病例及其3号、8号全染色体涂染、双色间期荧光原位杂交（FISH）、实时荧光定量PCR研究结果。方法骨髓细胞经直接法或24h短期培养法制备染色体标本，R显带技术进行核型分析；3号、8号全染色体涂染探针进行染色体涂染；bcr／abl双色双融合探针进行FISH分析；实时荧光定量PCR检测bcr／abl融合基因转录本及其拷贝数。结果骨髓细胞R显带核型分析提示，除t（9；22）外，所有细胞伴ins（3；8）；全染色体涂染证实3号染色体上插入一段8号来源的染色体片段；双色FISH检测到bcr／abl基因重排；实时荧光定量PCR检测到bcr／abl融合基因（b3a2）转录本。结论ins（3；8）是CML患者罕见的附加染色体异常；全染色体涂染是明确染色体插入易位的可靠手段。