A Preliminary Exploration on the Pathogenesis of Osteopenia in Patients with Hemophilia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the influencing factors and pathogenesis of osteopenia in the patients with hemophilia.</p><p><b>METHODS</b>Twenty-three patients with hemophilia were admitted in the hospital affiliated to North China University of Science and technology from March to August 2015, including 13 severe cases, 10 mild and moderate cases. All the patients accepted the detection of serum I collagen cross-linking N terminal peptide (NTX I), osteoprotegerin (OPG), bone alkaline phosphatase (BALP), basic fibroblast growth factor (bFGF), insulin-like growth factor (IGF) and transforming growth factor-β1 (TGF-β1), the score scale of activity ability was recorded according to the criteria published by the U.S. Center for disease prevention and control in 2002, and 21 patients received the measurement of bone mineral density. According to the World Health Organization (WHO) definition, the clinical significance of bone mineral density (BMD) was assessed by measuring the Z level.</p><p><b>RESULTS</b>Z level>-2 was recorded in 10 cases, Z≤-2 was recorded in 11 cases; the levels of body mass index (BMI) and human bone alkaline phosphatase (BALP) reflecting bone formation in 11 cases (Z≤-2) were lower than there in 10 cases (Z>-2) (P<0.05); the levels of BALP (r=0.489, P<0.05), IGF (r=0.538, P<0.05) and BMI (r=0.572, P<0.01) positively correlated significantly with BMD (P<0.05); the levels of bFGF (r=0.570, P<0.01) and OPG (r=0.505, P<0.05) positively correlated with NTX I, indicating bone destruction (P<0.05); the score of activity ability of severe patients was significantly lower than that of mild and moderate cases (P<0.05), BMD levels of these 2 groups were not statistically different (P>0.05).</p><p><b>CONCLUSION</b>The BMD level does not correlate with the clinial grouping of hemophilia, the low body mass index may be a risk factor for bone lose; the mechanism of hemophilia patient's bone lose may be related with the decrease of osteogenic activity, the IGF can prevent bone lose in hemophilia, the bFGF and OPG can promote bone metabolism of the patients with hemophilia.</p>

Changes of CD34(+) and CD71(+)CD45(-) cell levels in bone marrow of MDS and AA patients / 中国实验血液学杂志

This study was aimed to investigate the changes of CD34(+) and CD71(+)CD45(-) cell levels in MDS and AA patients. A total of 25 cases MDS and 43 cases of AA (18 cases SAA and 25 cases of NSAA) from January 2010 to October 2013 in the Department of Hematology, affiliated hospital of Hebei United University were enrolled in this study. The complete blood count, bone marrow smears, bone marrow biopsy, karyotype analysis and bone marrow blood cell immune genotyping (mainly the proportion of CD34(+) cells, CD71(+)CD45(-) cells in nucleated cells) were carried out for all patients; the changes of CD34(+) and CD71(+)CD45(-) cell levels in patients with MDS and AA (SAA NSAA) were compared; the differences of white blood cell count, platelet count and hemoglobin concentration in patients with count of CD71(+)CD45(-) ≥ 15% or <15% were analyzed. The results showed that the count of CD34(+) in MDS group was higher than that in AA (NSAA and SAA) group (P < 0.05). The count of CD71(+)CD45(-) cells in MDS group was higher than that in SAA (P < 0.05), there was no significant difference between NSAA group and MDS group. In MDS group with CD71(+)CD45(-) ≥ 15%, the platelet count was significantly higher than that in NSAA group (P < 0.05); and there was no statistical difference for leukocyte, platelet count and hemoglobin level between MDS and NSAA group with CD71(+)CD45(-) <15% (P > 0.05). It is concluded that the count of CD34(+) cells in MDS patients is significantly higher than that in AA and SAA patients. The count of CD71(+)CD45(-) cells in MDS group is significantly higher than that of SAA group. The platelet count in MDS patients with CD71(+)CD45(-) cells ≥ 15% is significantly higher than that of the NSAA group.

Effect of electroacupuncture on hemodynamics at peri-intratracheal intubation period under general anesthesia / 中国针灸

<p><b>OBJECTIVE</b>To observe effect of electroacupuncture on hemodynamics at peri-intratracheal intubation period under general anesthesia.</p><p><b>METHODS</b>Sixty cases at peri-intratracheal intubation period under general anesthesia were randomly divided into electroacupuncture group [Before anesthesia induction, electroacupuncture stimulation was given at Neiguan (PC 6), Hegu (LI 4), Quchi (LI 11), Shenmen (HT 7)], and control group, 30 cases in each group. All the patients in the two groups received intratracheal intubation with light-guide laryngoscopy under general anesthesia with midazolam, fentanyl, isopropyl, succinylcholine, etc.; changes of various indexes of hemodynamics were detected at anesthesia induction and different time points of the intubation.</p><p><b>RESULTS</b>At the anesthesia induction, various indexes of hemodynamics in the electroacupuncture group were relatively stable, and decreased significantly in the control group (P < 0.01); during intratracheal intubation, the various indexes in the electroacupuncture group (P < 0.05) and in the control group (P < 0.01) increased significantly as compared with those before anesthesia induction; 5 min after intubation, the various indexes in both the two groups restored normal.</p><p><b>CONCLUSION</b>Electroacupuncture at Neiguan (PC 6) and other points can stabilize changes of hemodynamics at the intratracheal intubation and increase safety of operation under anesthesia.</p>