Genetic Diagnosis and Phenotype Analysis for 3 Patients with Hereditary Coagulation Factor Ⅶ Deficiency / 中国实验血液学杂志

OBJECTIVE@#To investigate the gene mutations types and the clinical characteristics in 3 patients with hereditary coagulation factor Ⅶ deficiency.@*METHODS@#The phenotype diagnosis was validated by detecting the coagulation parameters including prothrombin time (PT)，activated partial thromboplastin time (APTT), fibrinogen (FIB), FⅦ activity (FⅦ: C) and specific antigens (FⅦ: Ag) of proband and its family members. All exons, exon-intron boundaries, 5＇ untranslated regions and 3＇ untranslated regions of F7 gene were amplified with PCR. Potential mutations were detected by direct sequencing of purified PCR products. Suspected mutations were confirmed by sequencing of the opposite strand.@*RESULTS@#A total of 5 different mutations were identified in 3 patients with hereditary coagulation factor Ⅶ deficiency and family members, including 4 misssense mutations and 1 splice site mutation. Out of 3 cases of hereditary coagulation factor Ⅶ deficiency 2 had double heterozygous mutation, I had homozygous mutations. Patient 1 had p.His408Gln with p.Arg413Gln double heterozygous mutations, her sister had p.His408Gln with p.Arg413Gln double heterozygous mutations, another one had p.His408Gln mono-heterozygous mutation, their correspo FⅦ: C were 5%, 3%, 75%. Patient 2 had p.Arg364Gln with p.His408Gln double heterozygous mutations, her brother had p.Arg364Gln with IVS6-1G＞A double heterozygous mutations, their corresponding FⅦ: C were 2.0%, 2.0%. Patient 3 had p.Arg337Cys homozygous mutation, FⅦ: C was 3.0%.@*CONCLUSION@#A total of 5 different mutations were identified in 3 patients with hereditary coagulation factor Ⅶ deficiency, the p.His408Gln is a common mutation, the FⅦ: C and FⅦ: Ag have no correlation with clinical phenotypes.

Correlation between bone marrow dose volumes and acute hematological toxicity in postoperative gynecological cancer patients

Objective: To identify the association between radiation dose volume and acute hematological toxicity [HT] in postoperative gynecological cancer patients receiving whole pelvic radiotherapy [RT] or intensitymodulated RT [IMRT], a principal component regression model was used to calculate HT

Methods: Women [n=100] receiving with or without chemotherapy RT were retrospectively analyzed, 52 of whom received chemotherapy [paclitaxel and nedaplatin]. The pelvis and lumbar vertebrae, defined as the prolong-pelvic bone marrow, were divided into the [1] combined ilium, ischium and pubis and the [2] lumbar vertebrae and the sacrum. The V5-V40 of subsides was calculated. The complete blood counts were recorded weekly. The principal component analysis was performed on volumes which generated the principal components [PCs], followed by using a logistic regression model

Results: Forty-seven patients presented with grade 2-3 HT during RT. Chemotherapy increased the incidence of HT compared with RT alone [70.21% vs. 29.79%; p=0.001]. Fifty-three patients with persistent HT developed more serious HT at an earlier stage of RT. The chemotherapy cycles and three PCs associated with grade 2-3 HT was identified to form the resulting principal logistic regression model

Conclusion: A new method to calculate the NTCP was achieved by PCs logistic regression

Identification and functional analysis of a novel missense mutation Ser250Phe underlying congenital coagulation factor Ⅶ deficiency / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify and characterize a missence mutation Ser250 Phe underlying coagulation factor Ⅶ (FⅦ) deficiency in a Chinese patient and his family.</p><p><b>METHODS</b>The FⅦ gene (F7) was analyzed by DNA sequencing, and the FⅦ levels (including antigen and activity) in patient's plasma were determined with enzyme-linked immunoabsorbent assay (ELISA) and one stage prothrombin time based method. In addition, a FⅦ-250 Phe mutant corresponding to the identified mutation was expressed in HEK293 cells, and a subcellular localization experiment in CHO cells was performed to clarify the molecular mechanism of FⅦ deficiency caused by the FⅦ-250 Phe mutation.</p><p><b>RESULTS</b>The patient had a prolonged prothrombin time (PT: 36.5 s) and low levels of both FⅦ antigen and activity (130.2 ng/mL and 4.0%, respectively). Two heterozygous mutations were identified in the F7 gene (NG-009262.1), which included a g.15975 G>A mutation at the splice receptor site of intron 6 (IVS6-1G>A) and a novel g.16750 C>T mutation in exon 8, which resulted in replacement of Ser (TCC) 250 with Phe (TTC)250 in the vicinity of a charge-stablizing system. By gene expression experiments, the antigen and activity levels of FⅦ-250 Ser and FⅦ-250 Phe in the culture medium were (37.77 ± 2.30) ng/mL and (4.02 ± 0.52) ng/mL, respectively. ELISA and Western blotting analyses indicated that expression of the mutant FⅦ-250 Phe and wild type FⅦ-250 Ser was (130.51 ± 2.32) ng/mL and (172.45 ± 2.25) ng/mL, respectively. FⅦ-250 Phe was found in endoplasmic reticulum and Golgi apparatus, suggesting that the mutant FⅦ-250 Phe could be normally synthesized in the cells but was inefficiently secreted.</p><p><b>CONCLUSION</b>Compound heterozygous mutations in F7 gene (g.15975G>A and g.16750C>T) may be responsible for the FⅦ deficiency in this patient. The novel FⅦ 250 Phe can be transported from endoplasmic reticulum to Golgi apparatus, but may be degraded or inefficient.</p>

Clinical features and gene analyses of six patients with MYH9-related disease / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate clinical features and to identify gene mutations in six patients with nonmuscle myosin heavy chain 9 gene (MYH9)-related disease.</p><p><b>METHODS</b>The platelet counts were measured using automated complete blood cell counter and manual manner. The size of platelets and inclusion bodies were observed under light microscopy. All the 40 exons and exon-intron boundaries of MYH9 gene were amplified by PCR and then DNA sequencing was performed. Restriction endonuclease analysis and polyacrylamide gel electrophoresis (PAGE) were used for polymorphism analysis.</p><p><b>RESULTS</b>Six patients all shared the common features of thrombocytopenia with giant platelets and granulocyte inclusions. Four MYH9 gene mutations were found in the six patients: T97C (W33R) in exon 1, 4335Insert CAGAAGAAG (1445InsQKK) and G4269A (D1424N) in exon 30 and G5833T (E1945Stop) in exon 40. The former two were novel mutations which have not been reported in the literature. The results of restriction endonuclease analysis and PAGE could exclude the possibility of nucleotide polymorphisms.</p><p><b>CONCLUSIONS</b>The MYH9 gene mutations were identified in six patients with MYH9 related disorders, and T97C (W33R) and 4335InsCAGAAGAAG (1445InsQKK) were novel mutations. MYH9 related disease should be considered in individuals with persistent thrombocytopenia which is non-responsive to corticosteroids and immuno-repressive agents.</p>

In vitro effects of hemocoagulase atrix and its effective components on blood coagulation of patients with bleeding disorders / 中国实验血液学杂志

This study was aimed to investigate the pro coagulation effects of hemocoagulase atrix and its effective components (batroxobin and factor X activator) on plasma of normal subjects and patients with bleeding disorders and their mechanisms. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were measured. The factor (F)X activation and thrombin generation were analyzed by using chromogenic substrate method. The results showed that the plasma APTT of normal subjects was shortened by hemocoagulase atrix, batroxobin and FX activator, and the effect of FX activator was found to be concentration-dependent (r = 0.889, P < 0.05). The prolonged APTT of plasma from patients with bleeding disorders could be corrected by hemocoagulase atrix, batroxobin and FX activator, but PT showed no great changes resulted from the treatments. FX activator could promote FX activation and thrombin generation, while neither hemocoagulase atrix nor batroxobin showed such abilities. It is concluded that hemocoagulase atrix promotes coagulation process, and corrects coagulation abnormalities in patients with bleeding disorders, its main component batroxobin directly acts on fibrinogen, and FX activator promotes thrombin generation through activating FX.

Genotype and phenotype analysis of congenital coagulator factor VII deficiency in four Chinese pedigrees / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical manifestation and gene mutation in four Chinese pedigrees with the congenital coagulation factor VII deficiency.</p><p><b>METHODS</b>Prothrombin time (PT), activated partial thromboplastin time, thrombin time and plasma fibrinogen were measured using STAGO STA-R automatic coagulation analyzer, and the coagulation activity of factor VII (FVII:C) was determined by a PT-based one stage method, and factor VII antigen (FVII:Ag) level by a sandwich enzyme-linked immunoabsorbsent assay. All exons, exon-intron boundaries and 3',5'untranslated regions of the FVII gene from the genomic DNA of the probands and their families were amplified by PCR, and then sequenced.</p><p><b>RESULTS</b>PT was significantly prolonged, and FVII:C and FVII:Ag were decreased and the following mutations were identified in the four probands: a homozygous transversion of 18041 T→G resulting in His408→Gln substitution in exon 8 in proband 1, a homozygous double nucleotide deletion, del CT (5078 - 5079) in exon 1 in proband 2, a double heterozygous of IVS6-1G→A and Gln426→stop in proband 3, and a double heterozygous of IVS6-1G→A and Arg364Gln in prohand 4.</p><p><b>CONCLUSION</b>Two missense mutations, His408Gln, Arg364Gln and one nonsense, Gln426stop in the catalytic domain of FVII and one double nucleotide deletion, del CT (5078 - 5079) in exon 1 and one splicesome mutation, IVS6-1G→A in intron 6 were separately identified in four Chinese pedigrees with inherited coagulation factor VII deficiency. The Gln426stop and IVS6-1G→A were first identified in the world and the homozygous del CT (5078 - 5079) and His408Gln were first found in China.</p>

Clinical and gene study of three pedigrees of phytosterolemia associated with macrothrombocytopenia and hemolysis / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the clinical features and ABCG5/ABCG8 gene mutations of three pedigrees of phytosterolemia presented with macrothrombocytopenia and hemolysis.</p><p><b>METHODS</b>Erythrocyte and platelet morphology were examined under light microscope. Plasma sterol levels were measured by high pressure/performance liquid chromatography method. All of ABCG5 and ABCG8 exons and intron-exon boundaries were directly sequenced to identify mutations, the corresponding gene mutation sites of three families members and healthy individuals were detected.</p><p><b>RESULTS</b>All the patients presented macrothrombocytopenia, hemolysis, splenomegaly and xanthomas. The blood smears showed large platelets, some as large as erythrocytes, and abnormal erythrocyte shapes, such as stomatocytes. Plasma concentrations of phytosterols, especially sitosterol were markedly elevated (30 fold) in the affected patients. Four mutations were identified in these three pedigrees, ABCG5 C20896T (R446X) and A20883G, ABCG8 del43683-43724 and del1938C-1939G/ins1938T. The latter three were novel mutations reported for the first time.</p><p><b>CONCLUSIONS</b>Phytosterolemia associated with macrothrombocytopenia and hemolysis is a new subtype of this disease. Plasma phytosterols and related gene analysis should be performed when ever an unexplained macrothrombocytopenia, especially combined with haemolysis or/and stomatocytosis.</p>

Analysis of clinical features and gene mutations in 6 patients with Wiskott-Aldrich syndrome / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate clinical features, laboratory alterations and gene mutations of 6 patients with Wiskott-Aldrich syndrome (WAS).</p><p><b>METHODS</b>T lymphocyte subtypes were measured by flow cytometer. The routine blood tests including platelet count and mean platelet volume were performed by complete blood analyzer Sysmex XE2100. Serum immunoglobulin was measured by immunoturbidimetry. Mutations in WAS protein (WASP) gene (including all the exons and exon-intron boundaries and 3', 5' untranslation region) of 6 patients and their family members were identified by PCR and sequencing.</p><p><b>RESULTS</b>The patients presented with petechiae, easy bruise, eczema, bloody diarrhea, recurrent infection and fever, and the clinical scores were 3 or 4. They were thrombocytopenia with smaller mean platelet volume, anemia and leukocytosis. Megakaryocyte number was normal or slightly increased in bone marrow. In the probands, the percentage of CD3+ T cells was decreased, the CD4+/CD8+ ratio was abnormal, while the fractions of CD19+ and CD16+ CD56+ cells were in normal range. In most of the patients, the serum levels of IgG and IgA were increased. Six mutations were identified in the patients, including 10250 C-->T, and five novel mutations: 6783 C-->G,10216-10221 Ins G, 9964 Del T,10192-10203 Del GCCTGCCGGGG and 10052-10059 del GCTACTG. The 6783 C-->G in exon 3 resulted in premature stop at Tyr102, and the remaining four mutations in exon 10 resulted in frame shift and premature stop.</p><p><b>CONCLUSION</b>The main characteristics of these WAS patients were thrombocytopenia with smaller mean platelet volume and immunological disturbance. Their gene mutations were deletion, insertion or nonsense mutations. All the patients had been misdiagnosed as ITP, indicating the importance of differential diagnosis.</p>

Inherited dysfibrinogenemia caused by Arg16His mutation in alpha chain of fibrinogen / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the phenotype and genotype of a family with inherited dysfibrinogenemia.</p><p><b>METHODS</b>Assays of coagulation, including activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT), were carried out with Stago Compact in the proband and his family members. The activity and antigen of fibrinogen in plasma were determined by Clauss and immunoturbidimetry, respectively. Fibrinogen and its constituent were analyzed by Western blot with nonreducing 4%-20% SDS-polyacrylamide gel electrophoresis (PAGE). All exons and exon-intron boundaries of fibringen genes FGA, FGB and FGG were analyzed by PCR and then direct sequencing.</p><p><b>RESULTS</b>The proband had normal APTT and PT, but prolonged TT. The activity of fibrinogen in plasma was decreased while its antigen level was normal. These abnormalities were also found in his mother and a sister. Genetic analysis revealed heterozygous G1233A in the exon 2 of FGA originating from his mother, which resulted in Arg16His missense mutation.</p><p><b>CONCLUSION</b>Inherited dysfibrinogenemia was caused by Arg16His mutation in exon 2 of FGA, and this is the first case reported in a Chinese family.</p>

Dexketoprofen trometamol in the treatment of chronic prostatitis/chronic pelvic pain syndrome / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of dexketoprofen trometamol in the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).</p><p><b>METHODS</b>A total of 115 patients with CP/CPPS were divided into a dexketoprofen trometamol group (n = 40), treated with dexketoprofen trometamol (25 mg, tid) and terazosin (2 mg, qn), an indometacin group (n = 40) given indometacin (25 mg, tid) and terazosin (2 mg, qn), and a terazosin group (n = 35) administered terazosin (2 mg, qn) only, all treated for 4 weeks. Scores on the NIH-chronic prostatitis symptom index (NIH-CPSI) were obtained before and after the treatment, and the efficacy and adverse events were observed and compared.</p><p><b>RESULTS</b>The NIH-CPSI scores were significantly improved after the treatment in all the three groups. The clinical efficacy was significantly better in the dexketoprofen trometamol and indometacin groups than in the terazosin group (P < 0.05), but with no significant difference between the former two (P > 0.05). The rates of adverse events were 10.00%, 18.57% and 27.50% in the dexketoprofen trometamol, terazosin and indometacin groups, significantly lower in the former two than in the latter one (P < 0.05).</p><p><b>CONCLUSION</b>The combination of dexketoprofen trometamol with terazosin could effectively improve the clinical symptoms of CP/CPPS, better than terazosin in therapeutic efficacy and than indometacin in drug tolerance.</p>

Effect of different blood glucose levels on the expression of cerebral GLUT3 mRNA in neonatal rats with hypoxia-ischemia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Concerns of the effect of glucose on perinatal hypoxic-ischemic brain damage are increasing. It was previously considered that the glucose transporter (GLUT) genes and their productions played an important role in the regulation of cerebral energy metabolism. The present study aimed to explore the effect of different blood glucose levels on the expression of cerebral GLUT3 mRNA in neonatal rats with hypoxia-ischemia (HI), and to evaluate the neuroprotective effect of glucose against HI insults.</p><p><b>METHODS</b>A total of 250 7-day-old neonatal SD rats were randomly divided into 10 groups (n=25 each): Normal control, Sham-operated, HI, Hypoglycemia, Hypoglycemia pre- and post-HI, Mild hyperglycemia pre- and post-HI, Severe hyperglycemia pre- and post-HI. Blood glucose levels of normal, hypoglycemia, mild hyperglycemia and severe hyperglycemia were defined as 5-7 mmol/L, 3-4 mmol/L, 10-15 mmol/L and 16-25 mmol/L, respectively. The expression of GLUT3 mRNA was detected with RT-PCT technique at 2, 24, 48 and 72 hrs and at 7 days after HI.</p><p><b>RESULTS</b>There was a correlation between increases in GLUT3 mRNA expression and postnatal age in the Normal control group. HI significantly enhanced the expression of GLUT3 mRNA from 2 hrs, peaking at 24 hrs after HI, and then significantly decreased at 72 hrs and 7 days after HI when compared with the Normal Control group (P < 0.01). GLUT3 mRNA expression in the Hypoglycemia pre-HI group was the lowest among all groups with HI at each time point after HI, and a statistically significant difference was found at 72 hrs after HI when compared with the HI group (P < 0.05). The expressional levels of GLUT3 mRNA in the Severe hyperglycemia pre-HI group were strikingly higher than those in any other groups with HI (P < 0.05 or 0.01). The GLUT3 mRNA expression patterns in the Mild and Severe hyperglycemia post-HI and the Hypoglycemia post-HI groups were similar to the Hypoglycemia pre-HI group.</p><p><b>CONCLUSIONS</b>GLUT3 mRNA expression and the synthesis of GLUT3 can be down-regulated by hypoglycemia pre-HI, coupled with aggravation of cerebral pathology, but up-regulated by higher hyperglycemia pre-HI, coupled with improvement of cerebral pathology. This suggested that adequate glucose supplement before HI can improve the cerebral function against HI insults in neonatal rats.</p>

Study on the association of the gene polymorphism of thrombin activatable fibrinolysis inhibitor with coronary heart disease in Han population / 中华检验医学杂志

0.05)in the frequency of alleles and genotypes between controls and coronary heart disease.In additional,at the 325 position,the TAFI antigen of the Thr325Thr was higher[(114.89?2.53)%]than that of the other genotype(Thr325Ile and Ile325Ile),there was significant difference between the TAFI antigen of the Thr325Thr and the others(P 0.05).But the TAFI activity of the Ile325Ile was lower(3.08?3.63 ?g/ml)than that of the other genotypes(Thr325Ile and Thr325Thr),there was significantly difference between the TAFI activity of the Thr325Thr and the other(P

Pathological Changes of Memantine in Neonatal Rats in Acute Toxicologic Experiment / 实用儿科临床杂志

Objective To investigate the pathomorphology effects of memantine on organs in neonatal rats.Methods Sixty-eight neonatal rats were randomly divided into 7 groups:5 groups by different doses memantine intraperitoneally and the controls by water intraperitoneally.The pathomorphology changes of organs were observed in all dead neonatal rats promptly after administration of memantine and in all survived rats after 7 days recover.Results 1.The ratio of organ weight and body weight in dead neonatal rats were higher than those of controls.2.The result of pathomorphology indicated that neurodegeneration and necrosis in the brain,the liver congestion and cell degeneration.The other organs had not distinct changes.3.The pathologic changes and mortality rate of neonatal rats were positively correlated with the dosage of memantine.Conclusion Memantine will affect liver and brain of neonatal rats.

Influence of Brain Hypoxia-Ischemia on Expression of Glucose Transporter 1 Genes and Glucose Transpsorter 3 Genes in Neonatal Rats / 实用儿科临床杂志

Objective To understand the mechanism of cerebral energy failure after hypoxia ischemia at the molecular level and to establish the protocol for the safe and effective treatment of hypoxic-ischemic encephalopathy(HIE).Methods One hundred neonatal rats were divided into normal control group and hypoxic-ischemic(HI) group. SD rats of both groups were decapitated at the time of 2 h,24 h,48 h,72 h and 7 d after HI.These tissues of cerebrum,cortex and hippocampus were taken out to explore the influence of HI on the expression of GLUT1 and GLUT3 genes with the method of RT-PCR.Results There was an enhancement in the expression of GLUT1 and GLUT3 genes with the increasing of day age. The expression was more intense in hippocampus than that in cortex. However, HI could significantly enhance the expression of GLUT genes. The expression was higher in cortex than that in hippocampus. The expression of two genes reached the peak at 24 h after HI, but was significantly lower than that in control group at 7 d after HI.Conclusion The increased expression of GLUT genes can maintain the energy supplement for the brain and delay a cascade reaction of cerebral energy failure.