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Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.
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Objective To investigate the clinical and prognostic significance of ABO promotor methylation level in adult patients with leukemia and myelodydysplastic syndrome(MDS). Methods ABO promoter methylation level of 182 malignant hematological disease patients and 68 normal controls were detected by bisulfite sequencing PCR. Then clinical features and outcome were compared between hypermethylation group and hypomethylation group. Results The median methylation rate of ABO promoter in newly diagnosed acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) were 46.98％ and 11.01％ respectively, which were both higher than that in controls (2.30％, P<0.05). The methylation rates in remission AML and ALL were 1.58％and 2.30％respectively, which were comparable with that in normal group (P>0.05). As to relapse AML and ALL, methylation rates were 41.26％ and 17.50％respectively, also significantly higher than that in controls (P<0.05).In patients with chronic myeloid leukemia (CML) chronic phase, the median methylation rate was 1.00％, which was similar to normal group. But a CML patient who transformed to ALL hadextremely high methylation rate 92.56％. The median methylation rate in patients with MDS significantly elevated as 5.81％ compared with that in controls (P<0.05). The median overall survival (OS) of ALL and AML (non-M3) patients with hypermethylation were 12.5 months and 15.3 months, which were significantly shorter than those with hypomethylation (24.0 months and 20.0 months) (P<0.05). The median disease-free survival (DFS) of ALL and AML (non-M3) patients with hypermethylation were 9.9 months and 12.0 months, which were significantly shorter than those with hypomethylation (22.3 months and 18.5 months), (P<0.05). Multivariable analysis suggested that ABO promoter methylation level was an independent predictive factor of OS and DFS in ALL and AML (non-M3) patients. Conclusion ABO promoter hypermethylation is closely related to genesis, development and prognosis of leukemia and MDS. Hypermethylationis related to a clinical poor prognosis compare with hypomethylation.
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BACKGROUND:Bone marrow mesenchymal stem cel s have immunomodulatory properties and have potential applications in immunosuppression. OBJECTIVE:To investigate the isolation and culture of bone marrow mesenchymal stem cel s and the immunoregulation of CD8+T lymphocytes. METHODS:Primary bone marrow mesenchymal stem cel s were isolated from Wistar rats by bone marrow adherence method. The primary cel s were purified by differential adherence and digestion, and col agen type I was added as extracel ular matrix to expand bone marrow mesenchymal stem cel s. Passage 2 bone marrow mesenchymal stem cel s at densities of 0, 1×103, 1×104 and 1×105/wel were co-cultured with CD8+T lymphocytes, fol owed by phytohemagglutinin stimulation for 68 hours. T lymphocyte aggregation and proliferation were detected by staining with staining with 5,6-carboxyfluorescein diacetate succinimidyl ester and MTT, respectively. RESULTS AND CONCLUSION:Different concentrations of bone marrow mesenchymal stem cel s had an inhibitory effect on T lymphocytes, but this effect was weakest for the cel s at the density of 1×103 per wel and strongest for the cel s at the density of 1×105 per wel . Obvious agglomeration was observed in the same media. The proliferation rates of CD8+T lymphocytes were (44.83±4.92)%, (31.94±6.28)%and (15.77±3.98)%, respectively, after co-culture with 1×103, 1×104, 1×105/wel bone marrow mesenchymal stem cel s. There were significant differences between groups (P<0.05). These results showed that primary rat bone marrow mesenchymal stem cel s could be obtained by direct adherence method of the whole bone marrow, and the cel s could be purified by differential adherence combined with digestion and control method. Bone marrow mesenchymal stem cel s could inhibit T lymphocyte proliferation in a concentration-dependent manner.
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By systematically combing the records of Bladder Meridian of Foot-Taiyang from medical literatures of Zu Bi Shi Yi Mai Jiu Jing (Maxibustion Canon of Foot and Arm), Yin Yang Shi Yi Mai Jiu Jing (Maxibustion Canon of Ying and Yang), Ling Shu Jing Mai (Meridians, a chapter of Miraculous Pivot), Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion), Jiu Jing Tu (Illustration of Moxibustion) from Dunhuang, it can be found that the formation and development of theory of main and collateral channels is a long-term dynamic process containing constantly summing up the experiences. The record about only the 2.3 inch one-line loop route carved out beside the posterior midline of dorsal lumbosacral portion by Bladder Meridian Foot-Taiyang may be a positioning mode of acupoint exclusively used by moxibustion and summed up by people good at moxibustion therapy using their clinical experience. In addition, thoughts that the heavy-moxibustion is a good method for difficult miscellaneous diseases (especially for the serious illnesses after attacked by wind and cold pathogens) may be included.
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Objective To investigate the relationship among A-type behavior,job burnout and psychosomatic health in grassroots officers and soldiers stationed in Xinjiang, which provides the theoretical basis to maintain their psychosomatic health.Methods Evaluation was carried out with A-type behavior questionnaire, military job burnout scale and simple soldiers psychosomatic health scale in 1 939 grassroots officers and soldiers chosen by random cluster sampling method from army stationed in Xinjiang.Results ①The total scores and each factor scores of the scale had significant positive correlation among the physical scale, the job buruout scale and time hurry (TH) ,competitive and hostility (CH) (r=0.170-0.716, P＜0.01).②Job burnout entered into the physical and mental health regression equation and could explain 68.6％ of the variance(β=0.195, t=32.211, P＜0.01);TH, CH entered the regression equation of job burnout and could explain 29.5％ of the variance(t=4.925,4.427).③ TH indirectly affected physical and mental health through job burnout, the mediating effect of the amount was 0.27 ×0.83=0.2241;CH indirectly affected physical and mental health by job bumout,the mediating effect of the amount was 0.30×0.83 =0.2490.Conclusion Job burnout has fully mediated effect between TH, CH and physical and mental health.
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Objective The effects of TPT on the induction of apoptosis of leukemia cells and the regulation of c-myc in mRNA and protein level. Methods RT-PCR method was adopted to examine the expressions of the genes and immune histochemistry for the proteins of c-myc in HL-60 cells treated with TPT of optimal concentration and time. Results After HL-60 cells by TPT of 0.15 μmol/L for 12 h, the expression of c-myc mRNA decreased markedly assayed by RT-PCR. There was a significant difference between the TPT group and the control group(0.17±0.03 vs 1.11±0.25, P <0.05), expressive c-myc protein decreased assayed by evidently immunohistochemistry. The percentage of positive cells expressing c-myc protein was a significant difference between the TPT treated group and the control group (19.67 % vs 68.33 %, P<0.05). Conclusion TPT down-regulates endogenic c-myc mRNA and c-myc protein in HL-60 cells.