Clinical characteristics of neonatal gastric perforation and risk factors of mortality / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal gastric perforation (NGP) and risk factors of mortality.Methods:From January, 2015 to December, 2021, clinical manifestations of neonates diagnosed with NGP in the Department of Neonatology and Neonatal Surgical Intensive Care Unit of our hospital were retrospectively analyzed. Neonates were assigned into the survival group and the death group according to their prognosis. Risk factors of mortality were analyzed using multivariate logistic regression method.Results:A total of 50 cases were enrolled, including 41 in the survival group and 9 in the death group. 38 cases were males, 34 were premature infants, 30 were low birth weight infants and 5 had history of asphyxia. The clinical manifestations included abdominal distension, tachypnea, cyanosis, poor response, fever, diminished bowel sound and redness of the abdominal wall. Abdominal X-ray indicated pneumoperitoneum. Laboratory abnormalities included leukocytosis, thrombocytopenia, elevated C-reactive protein and procalcitonin, decreased blood pH and increased lactic acid. 30 cases had perforation at the greater curvature of stomach. Perforation was larger than 3 cm in 40 cases and intestinal necrosis was identified in 14 cases. Some patients suffered from sepsis, respiratory failure, pulmonary hemorrhage, shock, coagulopathy and other related complications. The death group had significantly higher incidences of dyspnea, fever, elevated procalcitonin, blood pH<7.3, intestinal necrosis, time from onset of clinical manifestations to operation (Tm-o) >24 h and complications than the survival group ( P<0.05). Multivariate logistic regression analysis showed that pH<7.3 ( OR=9.755, 95% CI 1.363-69.800), Tm-o>24 h (OR=11.831, 95%CI 1.305-107.301), septic shock and sepsis ( OR=29.622, 95% CI 3.728-235.369) were risk factors of mortality. Conclusions:The main manifestations of NGP are abdominal distension and pneumoperitoneum. The risk factors of mortality in NGP are sepsis, blood pH<7.3 and Tm-o>24 h.

Physical fitness and health status and gender differences of middle school students among five Chinese minorities during 2010 to 2019 / 中国学校卫生

Objective@#To analyze physical fitness and health status and gender differences of middle school students among 5 minorities (Mongolian, Hui, Uyghur, Zhuang and Korean), and to provide the theoretical basis for the strategy formulation.@*Methods@#The present data came from 3 waves of Chinese National Survey on Students Constitution and Health (2010, 2014, and 2019). According to National Standards for Students Physical Health (2014 Revision), excellent, and excellent good physical fitness and health status were defined. Cochran Armitage test was used to examine the trends of physical fitness and health status. Chi square test and Logistic regression were used to analyze the difference of physical fitness and health status by sex and survey year.@*Results@#From 2010 to 2019, the excellent physical fitness and health status rate of Mongolian, Hui, Uyghur, Zhuang and Korean students increased from 1.8%, 0.7%, 0.3%, 0.5% and 1.3% to 4.3%, 2.8%, 1.2%, 1.3% and 3.5%, respectively. The excellent good physical fitness and health status rate of Mongolian, Hui, Uyghur and Zhuang students increased from 12.9%, 8.0%, 7.2 % and 8.4% to 24.7%, 20.1%, 12.6% and 19.8%( Z =6.15，6.71，4.12，3.06，5.26；11.88，13.42，6.70，11.08， P <0.05), respectively. In 2019, students aged 13 to 15 years showed higher proportion of excellent/excellent good physical fitness and health status than that of students aged 16 to 18. Boys were more likely to be in excellent/excellent good physical fitness and health status than girls from 2010 to 2019. The sex difference in excellent/excellent good physical fitness and health status narrowed during 2010 and 2019.@*Conclusion@#Physical fitness and health status of minority students improved while sex difference narrowed during last decade, but there is still a long way to reach the goal proposed by China. Targeted intervention should be proposed to promote physical fitness and health status in accordance with the developmental characteristics, especially for girls and students aged 16 to 18 years.

Research progress on cerebellar ataxia, neuropathy, vestibular areflexia syndrome / 中华神经科杂志

Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) is an autosomal recessive hereditary disorder characterized by cerebellar ataxia, sensory neuropathy and bilateral vestibulopathy. Recently a biallelic intronic AAGGG repeat expansion in the replication factor C1 (RFC1) gene was identified as the cause of this disorder. Clinical studies of genetically-confirmed CANVAS in the past 2 years have significantly expanded the clinical phenotype of the disease and the concept of RFC1-related disease was proposed. The clinical manifestations, characteristic auxiliary examination, genetic changes of CANVAS were reviewed and the new diagnostic criteria to improve clinicians′ awareness of the disease was discussed in this paper.

Research progress on retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations / 中华神经科杂志

Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a rare hereditary cerebrovascular disease. The clinical presentations are characterized by early-onset visual impairment, liver and kidney dysfunction and neurological symptoms. Imaging examinations are often misdiagnosed as neoplasms or tumefactive multiple sclerosis for invasive examination. Early and correct identification is essential for optimizing treatment strategies and comprehensive management. This review is to improve the understanding of RVCL-S, which may help to reach more accurate diagnosis and better treatment, and improve further research.

The influence of breast-feeding on common comorbidities of very low birth weight infant / 中国新生儿科杂志

Objective To study the influence of breast-feeding on the common neonatal comorbidities of very low birth weight (ELBW) infants.Method A retrospective study was conducted in our hospital from July 2014 to September 2015.The ELBW infants with birth weight between 1 000 g and 1 500 g were enrolled into the study.The infants were assigned into three groups according to human milk intake during hospitalization:high-volume breast feeding group (the high-volume group) (human milk equal to or greater than 75％),small-volume breast feeding group (the small-volume group) (human milk less than 75％) and premature formula group (the formula group) (exclusive formula fed during hospitalization).The general status,weight gain,the incidences of gastrointestinal dysfunction,neonatal necrotizing enterocolitis (NEC),late onset sepsis,premature retinopathy (ROP),bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) during hospitalization were compared between the three groups.Logistic regression analysis was applied.Result A total of 210 cases were included in the study.32 cases in the high-volume group,73 cases in the small-volume group and 105 in the formula group.The incidence of NEC (Bell's stage Ⅱ and Ⅲ) in the high-volume group was significantly lower than the small-volume group and the formula group (6.3％ vs.24.7％,26.7％) (P ＜ 0.05).No statistical differences existed as for the incidences of gastrointestinal dysfunction,sepsis,ROP,BPD,and PVL (P ＞0.05).Logistic regression analysis showed that the odds ratio (OR) of survival without NEC in the highvolume group were 0.183 compared with the formula group and 0.204 compared with the small-volume group;and the 95％ confidence interval were 0.041 ～0.818,0.044 ～ 0.938 respectively.No statistically significant differences existed among the three groups in the growth rate of body weight,the time needed to regain birth weight,the time needed to reach total enteral nutrition and the length of hospital stay (P ＞0.05).Conclusion High-volume breast milk intake can reduce the incidence of NEC (Bell's stage Ⅱ and Ⅲ).Breast-feeding has little adverse effects on common comorbidities of ELBW infants.Enhanced breastfeeding has similar efficacy comparing with formula feeding in the catch-up growth.

"Time-angle measurement" reduction evaluation technique and clinical evaluation of proximal humerus fracture / 北京大学学报(医学版)

Objective:To evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures with a "time-angle measurement" reduction evaluation technique,to assess the acceptance of the fracture reduction and to estimate the result of the surgery.Methods:Forty-six patients [mean age:(66.2 ± 14.9) years] with an acute proximal humeral fracture were managed with open reduction and internal fixation with this reduction evaluation technique from January 2012 to December 2013.According to the Neer classification,there were 6 two-part fractures,25 three-part fractures and 15 four-part fractures.The functional outcome was evaluated for each patient using the Constant-Murley score;radiographic evaluation was also conducted and complications were recorded.The postoperative shoulder function recovery and imaging findings were followed up to evaluate the guiding significance of this reduction evaluation technique in the clinical treatment of this kind of fracture.Results:In the study,46 patients had been followed up for 13-36 months,and the average follow-up time was (23.5 ± 7.3) months.All the patients achieved fracture healing 3 months after operation.The average head-shaft angle was (124 ± 3.5) degrees.According to the Constant scoring system,29 patients (63％) had excellent,14 patients (30％) had good,and 3 patients (7％) had poor results.The most common complications were pain (7/65) and restricted movement of the shoulder (5/ 46).There were no cases of screw penetration,necrosis of humeral head,deep tissue infection,nonunion of fracture and axillary nerve injury after operation.Conclusion:For appropriate cases of displaced proxinal humeral fractures,surgical treatment with application of "time-angle measurement" reduction evaluation technique that was introduced in the present study can lead to a good functional outcome,and the technique of reduction assessment should be regarded as a reasonable reference standard in the treatment of displaced proximal humerus fracture.

Analysis of mortality and cause of death in inpatients with single-center cerebral infarction / 中国脑血管病杂志

Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.

The longitude study on the mental development of congenital hearing-impaired infants and toddlers / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the effect of chronological age and acoustic device in cognitive development of congenital hearing-impaired infants and toddlers, and analyze the correlation of abilities in cognitive development with other factors.</p><p><b>METHODS</b>Depending on chronological age (1 year old group and 2 years old group) and acoustic device (hearing aids and cochlear implantation), locomotor, personal-social, hearing and speech, hand and eye co-ordination, performance tests in Griffith Cognitive Development Scale were used to assess the cognitive development of 80 hearing-impaired infants and toddlers aged 0-2 years, including before intervention (0 month), after intervention (6, 12 months). Datas were analyzed by Repeated Measurements and Pearson Correlation Test.</p><p><b>RESULTS</b>During 1 year hearing intervention and rehabilitation, hearing and speech, performance and cognitive were extremely significant difference for each phase of early intervention (P < 0.01), the development of locomotor, personal-social, hand and eye co-ordination were no significant difference (P > 0.05). Personal-Social in 1 year old group with hearing impairment was much higher than 2 years old group P < 0.05). Hearing and speech in cochlear implanted group with hearing loss was much higher than hearing aids group. Cognitive development was positive correlation with various region development P < 0.01), and was negatively correlated with chronological age (P > 0.05).</p><p><b>CONCLUSIONS</b>Cognitive development is proportional to recovery time. The chronological age of early intervention obviously affect deaf children's cognitive development. The ability of hearing and speech in cochlear implanted children is superior to children with hearing aids in severe and profound hearing impaired children.</p>

THE NECESSITY OF CONSTRUCTING THIRD-PARTY REPUTATION EVALUATION SYS-TEM FOR PUBLIC HOSPITALS / 现代医院

The strong administrative system of Chinese public hospitals seriously affects the hospital reputa-tion evaluation .This paper is to discusses the practical significance of the construction of third -party reputation eval-uation system for public hospitals and put forward the tentative idea based on the present reputation management of do -mestic and overseas hospitals .

Comparison of bone marrow and blood cell morphology between refractory anemia and other anemia disease / 中国实验血液学杂志

This study was purposed to investigate the cell morphological features of bone marrow and peripheral blood in patients with myelodysplastic syndrome, mainly with refractory anemia, and to compare them with other anemia diseases including chronic aplastic anemia, hemolytic anemia and megaloblastic anemia. The bone marrow and peripheral blood were taken from patients for preparing the smears with Wright staining. 500 karyocytes in bone marrow and 100 karyocytes in peripheral blood were detected, and the features of morbid cells of erythrocyte, granulocyte and megakaryocytic series were observed. The results showed that differences between refractory anemia, chronic aplastic anemias and hemolytic anemia as well as megaloblastic anemia were statistically significant (P < 0.05) in the granules scarce and absence in the intracytoplasm of segmented neutrocyte in peripheral blood, Pelger dyskaryosis, the numbers and detected rate of immature granulocytes, monocyte detected rate, the granules scarce in all stage of granulocytic series in bone marrow, odd number and prolification of nucleolus in erythrocytic series, little macronucleus and single circle nucleus macronucleus. It is concluded that cell morphology is the foundation of diagnosing the MDS, the abnormality morphology both in peripheral blood and bone marrow play the consequence role in the diagnosis of MDS.

Significance of dysplasia and cytogenetic changes on the diagnosis and typing of myelodysplastic syndrome / 白血病·淋巴瘤

Objective To explore the significance of dysplasia and cytogenetic changes to the diagnosis and typing of myelodysplastic syndrome (MDS).Methods The dysplasia performance of each series in every isoforms was observed by the bone marrow aspiration and peripheral blood smear to the 132 patients with MDS. At the same time do the chromosome karyotype was analizad combined with morbidness cells and chromosome karyotype abnormal analysis associated with MDS subtype. Resuits Acorrding to the dysplasia ≥0.10, the totle detection rate of granulocyte series, erythrocyte series and megakaryocytic was 43.4 ％.The morbidness granulocyte and megalokaryocyte ≥0.10was mainly in RCMD (P ＜ 0.01); morbidness erythrocytes≥0.10 mainly in RA + RARS (P ＜ 0.01). the totle detection rate of chromosome karyotype abnormal in MDS was 44.0 ％.The detection rate in RA and RARS was lower than other isoforms,but showed no statistically significant (P ＞ 0.05).the relationships of dysplasia and chromosome karyotype abnormal with the isoforms of MDS:in RA group,50.0 ％(3/6) patients had karyotype abnormal simultaneous the detection of morbidness cells≥0.10, 76.0 ％(19/25) in RCMD group and 60.9 ％(14/23) in RAEB group (P ＜ 0.01).Conclusion Theve is relationships between the patients with chromosome karyotype abnormal and dysplasia ≥0.10 and the isoforms of MDS. Closely monitoring the hemopoiesis and cytogenetic changes is significance to diagnose MDS.

Application of WHO standards in diagnose and classification of MDS / 白血病·淋巴瘤

ObjectiveTo diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.MethodsAccording to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.ResultsGreat shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P＜0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 ％ with abnormal karyotype,mainly in 20q- and +8;16 cases with complex abnormal karyotype (28 ％), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology;42 patients with bone marrow fibrosis.ConclusionsCombining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.

Change of tissue factor pathway ratio during attack in patients with acute myocardial infarction and its clinical significance / 中国实验血液学杂志

This study was aimed to investigate the change of tissue factor pathway (TFP) ratio during the attack of acute myocardial infarction (AMI) and its clinical significance. Plasma recalcification time was assayed by manual operation. Plasma tissue factor (TF), TF pathway inhibitor (TFPI) antigen, FVII:Ag, activated FVII (FVIIa) and D-Dimer were measured by enzyme linked immunoabsorbent assay (ELISA). TF activity was determined by chromogenic assay, plasma FVII coagulation activity (FVII:C) was detected by one-stage system. Blood samples were taken from 59 patients with AMI and 84 healthy volunteers. The results indicated that (1) plasma recalcification time was significantly shorter in the AMI group than that in the control; (2) compared with the control, TF activity in AMI patients showed no significant change (p > 0.05); the antigen levels of TF and TFPI in patients with AMI were remarkably increased (p < 0.05), and the increment degree of TF was remarkably higher than that of TFPI, therefore the TF/TFPI ratio was enlarged; total TFPI (t-TFPI) and full-length TFPI (fl-TFPI) were significantly higher (p < 0.01), truncated TFPI (tr-TFPI) was significantly lower (p < 0.01); the TF/t-TFPI ratio was higher than that in normal group, the TF/t-TFPI ratio was lower than that in normal group (p < 0.01), but the TF/tr-TFPI and fl-TFPI/t-TFPI ratios in AMI group were more remarkably higher than that in control group (p < 0.01), the tr-TFPI/t-TFPI and tr-TFPI/fl-TFPI ratios were significantly lower (p < 0.01). (3) compared with the control, the levels of plasma FVIIa and FVII:C in AMI group were higher (p < 0.05), FVII:Ag did not significatly change; FVIIa/FVII: Ag ratio was more remarkably higher (p < 0.01), but the elevation of FVIIa/FVII:C and FVII:C/FVII:Ag ratios showed no significant change (p > 0.05); (4) plasma D-dimer was significantly higher, compared with the normal control (p < 0.01). It is concluded that TFP is initiated during the attack of AMI, suggesting the circulating blood in AMI patients is in hypercoagulable status, therefore the simultaneous detection of multiple coagulation factors is necessary for evaluating risk factors in AMI patients, and the use of ratio for reflecting hypercoagulable status and risk factors is more reliable to detect each of them separately.

Immunologic classification of 450 cases of acute leukemia in populations in Xinjiang of China / 白血病·淋巴瘤

Objective To investigate the immunologic classification in the patients with acute leukemia (AL) in Xinjiang of China. Methods A panel of monoclonal antibodies (MOAb) and indirect immunofluorescence assay by fluoromicroscope was used to determine the pretherapy immunophenotype of 450 AL. Results 106 cases of acute lymphoblastic leukemia (ALL), 334 cases of acute myelogenous leukemia (AML), and 10 cases belonged to FAB unclassified acute leukemia (UAL) were unalysed. The expression of myeloid antigens in of ALL was seen in 15 % of 106 cases, and lymphoid-associated antigens were expressed in 25 % of 334 AML cases. The most frequently expressed antigen was CD7. The expression of myeloperoxidase (MPO) gene in 295 cases of AL were studied. The expression of MPO gene was observed in positive one of 81 ALL cases, and myeloid cells had different expression for MPO gene. Of the 9 cases of UAL, 6 cases were positive for MPO gene. There were no statistic differences of the expressions of the ALL stages between Han and Wei nationality. The order of myeloid markers expression in AML was as follows: CD_(33)>CD_(13)>CD_(15) inthe Han nationality, and the order of myeloid markers expression in AML was displayed CD(15)>CD(33)>CD_(14) in Wei nationality. Conclusion Analysis of immunophenotype assured accurate lineage diagnosis of AL. Combinatively analyzing the characteristics of AL on morphology, cytochemistry, immunology and MPO mRNA expressions were significant to the diagnosis and therapy of AL.

Correlation between CD34+ cell and immature granulocyte in donor's peripheral blood by rhG-CSF / 白血病·淋巴瘤

Objective To investigate the correlation between immature granulocyte and CD34+ cells, mononuclear cells (MNC) in donor's peripheral blood by recombinant human granulocyte colony-stimulating factor (rhG-CSF). Methods The stem cell were mobilized by rhG-CSF 7.25-10 μg·kg-1·d-1 from 122 allo-PBSCT donors. Before and after mobilization, to test CD34+ cells of peripheral blood stem cell graft and number of MNC, immature granulocyte, CD34+ cell per patient' weight were calculated. Results White blood cell count and immature granulocyte gradually increased, and reached the peak on the frith day. There was a good relationship between increased immature granulocytes and increased CD34+ cells. The patients all achieved completed donor engraftment and achieved hematopoietic recovery. The chromosome, blood type and HLA type were transformed to be donor's type. Ph1 changed to be negative in CML patients. Conclusion rhG-CSF (7.25～10 μg·kg-1·d-1) had a good effect to mobilize PBSC. There was a good relationship between in-creased immature granulocytes and increased CD34+ cells after mobilization by rhG-CSF. The number of immature granulocytes can reflect indirectly the count of stem/progenitor, so the MNC and immature granulo-cytes can become a threshold of dosage standard.

The kinetic study on the immune reconstitution after allogeneic peripheral blood stem cell transplantation / 白血病·淋巴瘤

Objective To study the recovery of the peripheral lymphocyte subsets in patients underwent allogeneic peripheral blood stem cell transplantation (allo-PBSCT) and guide the prevention and treatment of infection. Methods Indirect immunofluorescence assay was used to detect the lymphocyte subsets, such as T cell subsets (CD3, CD4, CD8). B cell (CD19) and natural killer cell(CD56) at 1, 3, 6, 12, 18months post transplantation, in the meantime, lymphocyte subsets of 32 samples from healthy blood donors were tested as normal control values. Results CD+3, CD+4 and CD+8 ceils significantly decreased than that of normal control at 1 month post transplantation, the recovery of CD+3 T cells was within 3-12 months, CD+4 and CD+8 T cells recovered to normal at 6 months and 3 months post transplantation respectively, CD+4/CD+8 ratio were not significantly lower than that of normal control at different stages, CD+4/CD+8 ratio reversed only at 6 months post transplantation. CD+19 and CD +56 T cells recovered quickly and they were more than normal proportion at 3 months post transplantation. The CD+3, CD+8 T cells and CD+4/CD+8 ratio were statistically higher in HLA haploidentical allo-PBSCT patients than that in HLA identical allo-PBSCT at 3 months post transplantation. There were no difference between the two groups at 1, 6, 12, 18 months post transplantation.The patients with cGVHD had significantly higher CD+4 cells than those without cGVHD at 1 month after transplantation. There was no significant difference in all of the lymphocyte subsets at 3, 6, 12, 18 months after transplantation between them. Conclusion Allo-PBSCT has a hastened immune reconstitution, which was not delayed by the incompatibility of HLA and the development of cGVHD.

Expression of Smad4 in leukemia cells / 中国实验血液学杂志

Loss of transforming growth factor (TGF)-beta signaling has been implicated in malignant transformation of various tissues. Smad4 plays a central role in the signal transduction of TGF-beta. Deletion or mutation of Smad4 has been described in a number of cancers. This study was aimed to investigate a potential role of Smad4 in leukemia including its expression and location in blast cells. The mononuclear cells were separated from bone marrow of leukemia patients. The samples, blast cells of which were more than 90% in mononuclear cells, were selected. The expression and location of Smad4 protein were analyzed by immunohistochemistry methods. The results showed that the Smad4 protein located mainly in nucleus, part of this protein located in cytoplasma, the expressions of Smad4 were not detected in 6 out of 9 ALL patients, in 7 out of 24 AML patients and in 1 out of 2 CML patients; these leukemia patients, in whose cells the expression of Smad4 was not detected, included one L1 and one L3, four L2, one M0, one M1, two M2a, one M3a, one M4b, one M6 and one CML. In conclusion, the Smad4 protein was mainly in nucleus, the deletion or functional change of Smad4 may related with the pathogenesis of human AML.

CD34+ antigen expression relating to prognosis in acute myeloid leukemia / 中国实验血液学杂志

To explore CD34(+) antigen expression in new diagnosed acute myeloid leukemia (AML) and analyze the prognosis for CD34(+) AML patients, the expression of antigen CD34 in 238 AML patients was detected by indirect immunofluorescence assay. The results showed that CD34 in 92 out of the 238 patients (38.7%) were positive, there was relationship between the CD34(+) expression and FAB subtypes (M(0), M(1)), and no CD34(+) expression was observed in M(3) subtypes. The complete remission rate of CD34(+) AML patients was 32%, which was lower than that of CD34(-) AML (61%). The lymphoid-associated antigen (CD7) was significantly increased in CD34(+) AML patients, compared with CD34(-) patients (P < 0.05). It is concluded that CD34(+) AML patients show poor prognosis and lower CR rate. The detection of CD34 expression is of some value in predicting prognosis in AML.