The Transcriptome Study of Subtype M2 Acute Myeloblastic Leukemia.

Our objective is to explore the tumor-specific mutated genes by transcriptome sequencing of patients with acute myeloblastic leukemia. 96 patients with subtype M2 acute myeloid leukemia (AML), admitted during January 2007 to January 2012, were selected. Bone marrow and peripheral blood samples from the patients after the first visit and the patients who were improved or alleviated, were subjected to high-throughput sequencing to compare the gene expression. The single nucleotide mutation related to subtype M2 AML was detected. Meanwhile, real-time fluorescent quantitation RT-PCR was used to detect the AML1/ETO fusion gene and its correlation with prognosis after treatment. Among 96 patients, AML1-ETO fusion gene was positive in 52 cases, the positive rate was 54.17 %. The complete relief (CR) rate of AML1-ETO fusion gene positive patients was 84.62 %, and the CR rate of AML1/ETO fusion gene negative patients was 77.27 %; the CR rate of AML1-ETO positive patients was higher than that of patients without the fusion gene, however there was no statistical difference. In the analysis of recurrent gene mutation in AML-M2 patients, IDH2, ASXL1, TET2, JAK1 and JAK2 gene expressions were not significantly different before treatment and after CR, however, IDHI, JAK3, ABL1 and BCR gene expressions were significantly different. In the study of transcriptome in AML-M2 patients, high-throughput sequencing could effectively detect the difference of the gene expression before treatment and after CR. Furthermore, positive expression of AML1-ETO fusion gene had effect on the prognosis of patients.

[Effect of ulinastatin preconditioning on gene expression profile of kidney tissue in a rat sepsis model].

OBJECTIVE: To investigate the modulation effect of ulinastatin (UTI) preconditioning on gene expression of kidney tissue in septic rats by DNA microarrays. METHODS: Forty-five male Wistar rats were divided into control group, sepsis group and UTI group, with 15 rats in each group by means of random number table. Cecal ligation and puncture (CLP) was used to reproduce rat sepsis model. The control group only experienced a simulated operation without CLP. In UTI group the rats were treated with intramuscular injection of UTI (100 kU/kg). In sepsis group and control group intramuscular balanced solution (5 ml/kg) was given. Gene expression spectrum was studied with oligonucleotide gene expression profile microarray that contained 22 523 rat cDNA clones to detect the changes in gene expression pattern of rat kidney tissue 24 hours after CLP. Genes with fluorescent signal of Cy3/Cy5 of ratio average (RA)>2.0 or RA<0.5 were identified as differential genes, then those highly correlated to sepsis and UTI were screened by means of related computer software, and their relationship was analyzed. RESULTS: Three hundred and twenty-seven differential genes were found in sepsis group/control group, accounting for 1.45%, and among them 181 genes showed up-regulation,with 78 known functional genes, and 146 genes showed down-regulation, with 51 known functional genes. One hundred and twenty-seven differential genes were found in UTI group/sepsis group, accounting for 0.56%, and among them 41 genes showed up-regulation, with 14 known functional genes, and 86 genes showed down-regulation, with 37 known functional genes. Twenty-two genes were down-regulated in sepsis group/control group but up-regulated in UTI group/sepsis group, with 11 known functional genes, 51 genes were up-regulated in sepsis group/control group but down-regulated in UTI group/sepsis group, with 24 known functional genes. CONCLUSION: UTI preconditioning can alleviate the damage of kidney tissue in rat sepsis model, thus showing a protective effect on kidney, and the mechanism may be attributable to effect of UTI on modulation of immune reaction, energy metabolism, inflammatory reaction, signal transduction, defense reaction, oxidation-reduction reaction, DNA replication, and transcription related genes.

[The use of simplified regional citrate anticoagulation in continuous veno-venous hemofiltration].

OBJECTIVE: To study the safety and effect of simplified regional citrate anticoagulation (RCA) in continuous veno-venous hemofiltration (CVVH). METHODS: Fourteen patients were treated with CVVH using simplified RAC. Simplified anticoagulation protocol included the addition of 4% sodium citrate into the replacement fluid. The citrate replacement fluid was infused in a speed of 2,000 ml/h or 3,000 ml/h, and at the same time 10% calcium gluconate and 25% magnesium sulfate were infused post filter or with venous pump into peripheral veins. Serum electrolytes, arterial blood gas analysis, coagulation at the beginning and 4, 8, 12 hours after the treatment were monitored. Patient's general condition was observed carefully. After treatment, blood volume in the hollow fiber filter was measured. RESULTS: Fourteen patients underwent altogether 34 times of this procedure for a total of 544 hours. Each treatment lasted 4-36 hours, with a mean of (16.0+/-7.5) hours. The filter was not changed for 30 procedures. After treatment, the blood volume in the filter was higher than 80% of the original volume. The life span of the filter was (14.79+/-5.98) hours on the average. Twelve hours after infusing citrate, there was a marked shortening of prothrombin time [PT, (12.2+/-1.2) s vs. (14.0+/-3.3) s], while plasma total calcium was increased markedly [(2.46+/-0.30) mmol/L vs. (2.07+/-0.36) mmol/L, both P<0.05]. There was no significant difference in activated partial thromboplastin time (APTT), thrombin time (TT), the concentration of Ca(2+) and Mg(2+), pH and base excess (BE). In one patient with hypoxemia the treatment was stopped due to the appearance of serious complications. No hypernatremia or metabolic alkalosis was found during the RCA in all the patients. No significant bleeding events attributed to RCA occurred. CONCLUSION: The simplified anticoagulation protocol by adding sodium citrate replacement fluid can be applied safely in replacement fluid>2,000 ml/h of CVVH without complications of hypernatremia and metabolic alkalosis caused by sodium citrate anticoagulation.