External quality assessment of prenatal screening for maternal serum inhibin A in second trimester / 中华围产医学杂志

Objective To eva1uate the external quality assessment results of prenatal screening for maternal serum inhibin A in the second trimester in 2018 and to improve the accuracy of prenatal screening.Methods National Center for Clinical Laboratories provided three batches of quality control urine sample (Lot:201811-201813) to 94 prenatal screening laboratories nationwide in March 2018.Laboratories participated in the assessment voluntarily and reported the results,methods,equipment,reagents and other related information as required.Clinet EQA and Microsoft Excel 2010 were used for statistical analysis of the laboratory test results and for descriptive evaluation of the accuracy rate.Results A total of 55 laboratories submitted their testing results giving a return rate of 58.5％ (55/94),of which 52 (94.5％) were consistent with the expected results,while none of the results submitted by the other three laboratories was accurate.At the mean time,the bias of all three batches in each laboratory fell into the same side (two laboratories showed negative bias and one positive bias).Conclusions The results of the external quality assessment of prenatal screening for maternal serum inhibin A are generally satisfactory except for a few laboratories.It is necessary to incorporate prenatal screening for maternal serum inhibin A in the second trimester into the formal external quality assessment plan and regularly monitor the level of its detection quality.

Expression and mechanism of plasma miR-372 in acute myeloid leukemia patients / 实用医学杂志

Objective To investigate the expression of miR-372 in the plasma of patients with acute my-eloid leukemia(AML)and the possible mechanism to participate in the development of AML. Methods Real-time quantitative PCR was used to detect the level of miR-372 in plasma. Bioinformatics software predicted the pos-sible target genes of miR-372 and dual luciferase reporter assay was performed to validate the prediction. In HL-60 cells,miR-372 was knocked down,and the effects on cell migration and cloning were detected by scratch test and clone formation. Results The level of miR-372 was significantly up-regulated in the plasma of AML patients. ROC analysis showed that miR-372 could distinguish between AML patients and healthy controls. Dual luciferase report-er assay showed that miR-372 could inhibit the activity of PTEN-3'UTR. Inhibition of miR-372 in HL-60 cells can significantly reduce the cell migration rate and clone formation ability. Conclusion In summary,for the first time,we showed novel data that the level of miR-372 was increased in the plasma of AML patients. By targeting the tumor suppressor gene PTEN,miR-372 may become a potential noninvasive biomarker for the screening and di-agnosis of AML.

Effects of Drought Stress on Activity of Key Enzyme in Saikosaponin Biosynthesis Passway and Saponins Content in Bupleurum chinense / 中国中医药信息杂志

Objective To research the effects of drought stress on activity of key enzyme in saikosaponin biosynthesis and saponins content in Bupleurum chinense; To reveal response of Bupleurum chinense to drought stress from protein level. Methods Bupleurum chinense was cultivated in potted water control experiment with 70%–80%, 60%–70%, 40%–50% and 20%–30% saturated soil water contents. The enzyme activities of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGR), isoprenyl-based coke (IPPI), farnesyl pyrophosphate synthase (FPS) and β-carotenoid synthase (β-AS) of six months and one year old Bupleurum chinense were measured. The contents of saikosaponins a and d in samples of different soil water contents were determined by HPLC. Results When the saturated moisture was 40%–50%, the enzymatic activities of HMGR, IPPI, FPS and β-AS were the highest, followed by saturated moisture 60%–70%、70%–80% and 20%–30%. The trend of saikosaponin was similar to that of the activity of key enzyme. Conclusion 40%–50% soil saturated water content can significantly increase the activity of the key enzymes in the saikosaponin synthesis pathway. The saponin content and enzyme activity show a significant positive correlation, indicating that under drought stress, Bupleurum chinense regulates the synthesis of saikosaponin by regulating the key enzyme activity of saikosaponin synthesis pathway to respond drought stress.

Expression of SHIP 1 in the Patients with Acute Myeloid Leukemia and Its Influence on the Apoptosis of Human Leukemia Cells / 现代生物医学进展

Objective:To investigate the expression of SHIP1 in the patients with acute myeloid leukemia and its effect on the apoptosis of human leukemia cells.Methods:The expression of SHIP1 in the bone marrow of patients with acute myeloid leukemia was detected by Westem blot.U937 cells was transfected with SHIP1 expression vector (pEGFP-SHIP1 group) and empty vector control (pEGFP group) respectively,U937 cells without transfection were used as the control group.Flow cytometry was used to detect the apoptosis of the cells,the expression of SHIP1,Bcl-2,Bax,Akt,p-Akt were detected by western blot.Results:The expression of SHIP1 in the bone marrow of patients with acute myeloid leukemia was significantly lower than that of the normal human bone marrow SHIP 1 (P＜0.01).The SHIP1 and Bax expressions as well as the apoptotic rate ofpEGFP-SHIP1 group were significantly higher than those of the control group(P＜0.01),while the Bcl-2 and p-Akt expressions were significantly lower than those in the control group(P＜0.01).Conclusions:SH-P1 expression was down regulated in the bone marrow of patients with acute myeloid leukemia.SHIP1 could promote the apoptosis of human leukemia cells via Akt signaling pathway.

A study of immunocyte subsets and serum cytokine profiles before and after immunal suppression treatment in patients with immune thrombocytopenia / 中华内科杂志

Objective To explore the clinical significance of a series of cytokines and peripheral blood immunocyte subsets before and after immunosuppressive therapy in patients with immune thrombocytopenia (ITP).Methods The percentages of immunocyte subsets in the peripheral blood of 20 patients with ITP and 20 healthy controls were detected by flow cytometry,including CD3+,CD4+,CD8+,CD4+/CD8+,CD1~.ELISA was applied to detect the level of serum TNFα,IL-2,IL-6,IL-4,IL-10,IL-11,IL-17,IL-27,transforming growth factor β (TGFβ),thrombopoietin (TPO) of 20 patients with ITP and 20 healthy controls.Results The percentage of CD3+ T lymphocyte,CD4+ T lymphocyte and the ratio of CD4+ / CD8+ T lymphocyte in patients with ITP were lower than those in healthy controls [(62.66 ± 6.58) ％ vs (69.93 ± 4.81) ％,(29.46 ± 5.02) ％ vs (39.08 ± 3.50) ％,0.97 ± 0.35 vs 1.56 ± 0.26,all P ＜ 0.05].After immunosuppressive therapy,the percentage of CD3+ T lymphocyte,CD4+ T lymphocyte and the ratio of CD4+/CD8+ T lymphocyte [(71.49 ±5.16)％,(39.25 ±3.21)％ and 1.56 ±0.28] recovered to the same levels in healthy controls.The percentage of CD8+ T lymphocyte and CD19+ B lymphocyte in patients with ITP were higher than those in the healthy controls [(30.28 ±4.63)％ vs (25.90±3.06)％,(18.92 ± 4.27)％ vs (13.17 ± 3.64)％,all P ＜ 0.05].After treatment of immunosuppressive therapy,the percentage of CD8+ T lymphocyte and CD19+ B lymphocyte [(25.16 ± 3.45) ％ and (11.98 ± 3.68) ％] recovered to the similar levels in healthy controls.The serum levels of IL-4,IL-6,IL-11,IL-17 and TPO in patients with ITP were significantly higher than those in healthy controls.While TGFβ level was significantly decreased.There was no significant difference of IL-27 between ITP patients and healthy controls.After the treatment of immunosuppressive therapy,IL-4,IL-6,IL-11,IL-17,TPO and TGFβ were down-regulated while IL-27 was up-regulated.There was no significant difference of IFNγ,TNFα,IL-2 and IL-10 among ITP patients before or after immunosuppressive therapy and healthy controls.Conclusions The present study suggests that the aberrant immunocyte subsets and cytokines are involved in the pathogenesis of ITP.Hyper-function of Th2 and Th17,dysfunction of Treg cells,up-regulation of IL-27,IL-11,TPO and other factors may contribute to the pathogenesis of ITP.

Tyrosine kinase inhibitors for the intervention of major morbid events in myeloproliferative neoplasms：reports from the 57th American Society of Hematology annual meeting / 白血病·淋巴瘤

With the research progress of pathogenesis of JAK gene in myeloproliferative neoplasms (MPN), more tyrosine kinase inhibitors were developed. MPN quantify scoring system is used to determine the efficacy of tyrosine kinase inhibitors for MPN. The choice of tyrosine kinase inhibitors, tyrosine kinase for the relief of MPN symptom burden, etc, become the topics of the 57th American Society of Hematology (ASH) annual meeting.

Evolution, differential diagnosis and intervention strategies of monoclonal gammopathy of undetermined significances:reports in the 54 ASH annual meeting / 白血病·淋巴瘤

Monoclonal gammopathy of undetermined significances (MGUS) is a premalignant clonal disorder occurring in 4.2 ％ of adults ＞50 years old,and is associated with a 1％ risk every year of progression to multiple myeloma (MM),light-chain amyloidosis and related conditions.Differential diagnosis of asymptomatic and symptomatic monoclonal gammopathies is the determinant for starting therapy.Most patients with MGUS need frequent assessment and follow-up.A few patients with MGUS might progress into smoldering MM and symptomatic MM,or develop into light chain diseases such as AL amyloidosis and light chain deposition disease caused by M-protein,who should be followed with effective therapy.The above were in detail reviewed in the 54th American Society of Hematology (ASH) annual meetina.

The role of CXCR3 and its ligand I-TAC in the pathogenesis of immune thrombocytopenic purpura / 中华内科杂志

Objective To investigate the roles of the chemokine receptor CXCR3 and its ligand I-TAC in the pathogenesis of immune thrombocytopenic purpura (ITP).Methods A total of 48 ITP patients were enrolled in this study:30 with newly diagnosed or relapse ITP and 18 in remission after treatment,and 24 healthy volunteers were as controls.IFNγ and I-TAC in plasma were detected by ELISA.The mRNA expression of CXCR3 in the peripheral blood mononuclear cells (PBMNCs) was determined by quantitative RT-PCR.Results The IFNγ level in the plasma of ITP patients before the treatment was obviously increased than those in the remission group and controls[ (71.45 ± 17.62)ng/L vs (36.94 ±14.86 )ng/L and (25.28 ± 12.85 )ng/L,all P ＜ 0.05 ]and those in the remission group was higher than in the controls ( P ＜ 0.05 ).In contrast,there were no statistic differences of the levels of I-TAC among the three groups[ (455.56 ± 144.70 ) ng/L,( 488.24 ± 164.70 ) ng/L and ( 382.97 ± 167.43 ) ng/L,P ＞0.05 ].Both ITP patients before the treatment and remission groups expressed more CXCR3 mRNA [ 6.76(3.03,37.00),1.76 (0.45,14.18 ) vs 0.12 ( 0.04,0.28 ),P ＜ 0.05 ].After effective therapy,CXCR3mRNA expression decreased,while it was still higher than that in the controls.Conclusions Our data demonstrate that Th1 cytokine (IFNγ) dominance is reflected in ITP.Simultaneously,the CXCR3 + cell may play a role in cell-mediated immunity through chemotaxis in ITP.

Clinical significance of determination of C-reactive protein, hemoglobin, erythrocyte sedimentation rate in the different stages of patients with multiple myeloma / 白血病·淋巴瘤

Objective To analyze the changes and clinical significance of C-reactive protein (CRP)、hemoglobin (Hb) and erythrocyte sedimentation rate (ESR) in different disease stage of multiple myeloma according the international staging system. Method Thirty untreated MM patients with complete clinical records were included in the stndy. The multiple myeloma patients were classified into three groups according to international staging system (ISS).Thirty megaloblastic anemia patients of similar age 、sex、hemoglobin level as the observation group.Resulets The levels of CRP (24.17±9.87 mg/L)、Hb (71.72±13.27 g/L) and ESR (105.94±27.73 mm/h) of stage Ⅲ patients were statistically different with stage Ⅰ ( CRP 8.54±1.97 mg/L; Hb 91.00±9.92g/L; ESR 73.57±20.53mm/h)、Ⅱ patients ( CRP 14.89±5.51 mg/L; Hb 91.29±8.32g/L; ESR 67.00± 15.56 mm/h) separately (P＜0.05).The levels of CRP (19.40±10.17 mg/L) and ESR (91.90±29.70 mm/h) in the MM patients were significantly higher than that in the observation group Ⅰ ( CRP 7.52±1.57mg/L; ESR 20.20±8.04mm/h) (P＜0.05 respectively).CRP and ESR level in MM patients positively correlated with myeloma cell proportion and β2-microglobulin level (P＜0.05), while Hb level negatively correlated with myeloma cell proportion and β2-microglobulin level (P＜0.05),Conclusion The levels of C-reactive protein、hemoglobin and erythrocyte sedimentation rate are closely associated with the development of multiple myeloma. C-reactive protein and hemoglobin are relatively sensitive response to disease than erythrocyte sedimentation rate. There is a clear clinical implication in detecting the patient' s condition for progress and the prognosis.

Effects of orthotopic ileal neobladder on upper urinary tract function / 国际外科学杂志

Objective To explore bladder carcinoma eystectomy and orthotopic ileal neobladder postoperative,the impact of new bladder on upper urinary function.Methods Twenty-eight patients with muscle invasive bladder urothelial carcinoma undergoing cystectomy W-shaped orthotopic ileal neobladder in Department of Urology of the Nuclear Industry 215 Hospital of Shaanxi Province(Mar.2006-Jun.2010)were investigated.All patients were followed for over 2 years.Assessment items included creatinine determination,urinary B-Ultrasound determination of the amount of residual urine volume and hydronephrotic cystography.Results Four weeks after the operations,all patients were removed bladder catheter angiography and found no obvious contrast extravasation.After 3 months mild hydronephrosis was found in 8 cases (28.6％),including 2 cases (7.1％) before surgery associated with hydronephrosis,the difference being not statistically significant(x2=0.49,P ＞ 0.05).The mild hydronephrosis was found in 5 cases (17.9％) 2 years postoperation,whithout statistically significant difference compared with preoperation (x2 =0.22,P ＞ 0.05).Preoperative serum creatinine was (72.92 ± 14.58) mmol/L,while 3 months after surgery serum creatinine was (83.42 ± 15.18) mmol/L (t =-6.43,P ＜ 0.05).Preoperative and postoperative serum creatinine was within the normal range.Two years after surgery serum creatinine was (82.50 ± 14.39) mmol/L,with significant difference compared with that of preoperation (t =-4.67,P ＜ 0.05),but were in the normal range,no clinical significance,the postoperative 3 months bladder capacity (160 ± 23) mL,while 2 years later bladder capacity residual urine volume of (58.7 ± 9.7) mL and (430 ± 21) mL,residual urine volume (61.3 ± 37.1) mL(t =-0.37,P＞ 0.05).Conclusion Orthotopie ileal bladder ideal substitute for postoperative cystectomy with less impact on the upper urinary tract function.

The immunocyte subsets and their clinical significance in the peripheral blood of 35 patients with immune thrombocytopenic purpura / 中华内科杂志

Objective To explore the clinical significance of immunocyte subsets before and after immunosuppressive therapy in the peripheral blood of patients with immune thrombocytopenic purpura (ITP).MethodsThe percentages of immunocyte subsets in the peripheral blood of 35 patients with ITP and 20 healthy controls were detected by flow cytometry,including CD3+,CD4+,CD8+,CD56+,CD19+ lymphocytes and CD4+/CD8+.Results The percentages of CD3+ T lymphocyte (61.58 ± 6.45 ) %,CD4+ T lymphocyte (28.38 ±4.89)% and the ratio of CD4+/CD8+ 0.99 0.22 in patients with ITP were lower than those in healthy controls[( 67.85 ± 4.68 ) %,( 38.00 ± 3.37 ) %,1.54 ± 0.13,all P ＜ 0.05].After immunosuppressive therapy,the percentages of CD3+ T lymphocyte ( 69.41 ± 5.03 ) %,CD4+ T lymphocyte (38.17 ±3.18)% and the ratio of CD4+/CD8+ 1.60 ±0.15 recovered to control levels.The percentages of CD8+ T lymphocyte (29.20 ±4.50)% and CD19+B lymphocyte ( 17.74 ±4.14)% were higher than those in healthy controls[( 24.82 ± 2.93 ) % and ( 12.09 ± 3.51 ) %,all P ＜ 0.05].After the immunosuppressive therapy,the percentages of CD8+ T lymphocyte ( 24.06 ± 3.02 ) % and CD19+ B lymphocyte ( 10.90 ± 3.55 ) %recovered to control levels.There were no significant difference of the percentage of CD56+ lymphocyte among ITP patients ( 15.80 ± 2.85 )%,ITP patients after immunosuppressive therapy ( 15.16 ± 2.77 )% and healthy controls ( 16.36 ± 2.75 ) %.ConclusionThe aberrant immunocyte subsets are involved in the pathogenesis of ITP,and detection of immunocyte subsets might be helpful for the diagnosis and determination of therapeutic outcome of ITP.

Urgent management of quadriplegia following Sichuan earthquake under field condition / 第二军医大学学报

Objective:To explore the urgent management strategy for quadriplegia following China Wenchuan earthquake under filed condition.Methods:The 57-year-old male patient was sent to the earthquake relief team of Changzheng Hospital,Second Military Medical University.He was hit by heavy object during the Sichuan earthquake 6 days ago.Physical examination revealed cervical spinal cord injury accompanied by incomplete paralysis.The patient underwent cervical 3-7 laminectomy under general anesthesia.Results: After surgery,the muscle strength of lower limbs recovered to grade four from grade one;the muscle strength of upper limbs recovered to grade five from grade three.Sensory loss was found below the nipple level and totally recovered after operation.Conclusion:Early surgery for quadriplegia following earthquake trauma can timely relieve compression to the spinal cord and therefore improve prognosis of patients.Under field condition where facilities are not readily available,decompression of spinal cord can be achieved by lamineetomy via posterior approach.The key to successful operation is correct diagnosis and skillful manipulation.