脑脊液免疫球蛋白及白蛋白对脑膜炎的鉴别诊断意义

目的　分析脑脊液 (CSF)免疫球蛋白 (Ig)和白蛋白 (Alb)对病毒性脑膜炎 (VM )、结核性脑膜炎 (TM )、化脓性脑膜炎(PM )的鉴别诊断意义。方法　用速率散射比浊法测定VM 5 3例 ,TM 40例 ,PM 14例患者CSFIg和Alb的含量。结果　IgG、IgM和Alb在TM和PM中均显著高于VM组 (P <0 0 0 1) ,且以PM升高最明显 ,但TM和PM间 ,Alb及比值变化无显著性意义 ;与VM相比 ,TM以IgG变化最突出 ( 75 %) ,PM以IgM变化为显著 ( 78%) ;Alb在TM和PM升高比例最高 ( 10 0 %)。PM 14例中有 12例 ( 85 .7%)、TM 40例中仅 6例 ( 15 %)符合典型CSF常规和生化改变。如果把CSFAlb >3 0 0mg/L和IgG >61mg/L作为条件 ,则TM的诊断阳性率达 3 8/ 40 ( 95 %)。结论　TM和PM血脑屏障的破坏明显大于VM ,CSFIg和Alb的含量检测弥补了CSF常规分析的不足 ,有助于颅内感染的诊断和鉴别诊断     

新生儿缺氧缺血性脑病脑脊液环磷酸腺苷变化及其临床意义

目的 探讨新生儿缺血缺氧性脑病(HIE)脑脊液(CSF)环磷酸腺苷(cAMP)变化及其临床意义。方法 采用法国:Immunotech公司提供的125I-cAMP放免药盒对86例HIE患儿进行脑脊液cAMP。结果 中、重度HIE组CSI-cAMP值较非HIE组明显降低,有显著差异(P<0.05);重度HIE患儿CSI-cAMP值较轻、中度患儿降低,差异具有显著性(P<0.05);恢复期较急性期CSF-cAMP值都有所升高,但无显著差异。结论 HIE时CSF-cAMP降低,病情愈重,降低愈明显。CSF-cAMP测定可作为HIE患儿判断病情的辅助指标。     

Predictors for successful PBSC collection on the fourth day of G‐CSF‐induced mobilization in allogeneic stem cell donors

Peripheral blood stem cells (PBSCs) used for allogeneic transplantation are collected by apheresis after pre‐treatment of donors with G‐CSF. Using modern apheresis devices stem cells can be collected more efficiently. It was studied whether collection on the 4th instead of the 5th day after initiation of G‐CSF treatment might be feasible. Stem cell yields that could have been collected on day 4 were calculated in two cohorts treated with 10 µg/kg G‐CSF once daily (n = 106, cohort I) or 5 µg/kg twice daily schedule (n = 85, cohort II). Harvests were predicted using the median collection efficiency (CE) of the apheresis machine and regarded successful when > 5.0 x10⁶ CD34^+/kg recipient body weight. Successful harvests at day 4 could have been obtained in only 22.6% and 41.2% of donors in cohort I and II respectively, while the expected successful collections on day 5 were 55.7% and 76.5%. Individual donor factors that correlated with a successful harvest on day 4 were weight, BMI, age, ratio donor/recipient weight and total G‐CSF dose in cohort I, whereas ratio donor/recipient weight was the only significant predictor in cohort II. Donor weight, BMI and total G‐CSF dose correlated positively with CD34⁺ values in the blood on day 4 in all donors. However, donor characteristics were not able to be used as strong predictors in daily practice. In conclusion, PBSC collection on day 4 will not result in a successful harvest in most stem cell donors, however using a twice daily G‐CSF scheme increases the yield.     

APL患者ATRA诱导分化后G—CSF分泌水平升高的分子机制研究

目的探讨ATRA诱导后患者血清G—CSF升高的机制是否与原代APL细胞分泌G—CSF变化有关，并探讨其变化的分子机制。方法显微镜下直接计数原代APL细胞的增殖性变化。采用酶联免疫ELISA法测定原代APL细胞培养上清G—CSF水平的变化，RT-PCR方法测定Nm23或G-CSF mRNA表达水平。结果ATRA诱导治疗后，APL患者外周血白细胞明显升高，平均12天达到高峰，并且以中晚幼粒细胞为主。APL患者血清G—CSF水平升高，原代APL细胞体外培养24小时后，上清中的G—CSF分泌水平显著升高（P〈0．05）。RT—PCR实验结果表明原代APL细胞G—CSF mRNA表达升高，与Nm23表达变化成相反趋势。结论ATRA诱导高表达的G—CSF可能与Nm23降低有关。     

Rapid identification of nonblood sterile site broth cultures using the FilmArray blood culture identification panel

The FilmArray Blood Culture Identification Panel was validated for nonblood sterile site specimens with clinical impact of rapid identification compared to conventional diagnostics. The panel accurately identified target organisms from 98% of positive broth cultures a median 1.1?day faster than conventional techniques (P?<?0.0001) with potential clinical impact in 22% of cases.