Machine learning classification of cellular states based on the impedance features derived from microfluidic single-cell impedance flow cytometry.

Mitosis is a crucial biological process where a parental cell undergoes precisely controlled functional phases and divides into two daughter cells. Some drugs can inhibit cell mitosis, for instance, the anti-cancer drugs interacting with the tumor cell proliferation and leading to mitosis arrest at a specific phase or cell death eventually. Combining machine learning with microfluidic impedance flow cytometry (IFC) offers a concise way for label-free and high-throughput classification of drug-treated cells at single-cell level. IFC-based single-cell analysis generates a large amount of data related to the cell electrophysiology parameters, and machine learning helps establish correlations between these data and specific cell states. This work demonstrates the application of machine learning for cell state classification, including the binary differentiations between the G1/S and apoptosis states and between the G2/M and apoptosis states, as well as the classification of three subpopulations comprising a subgroup insensitive to the drug beyond the two drug-induced states of G2/M arrest and apoptosis. The impedance amplitudes and phases used as input features for the model training were extracted from the IFC-measured datasets for the drug-treated tumor cells. The deep neural network (DNN) model was exploited here with the structure (e.g., hidden layer number and neuron number in each layer) optimized for each given cell type and drug. For the H1650 cells, we obtained an accuracy of 78.51% for classification between the G1/S and apoptosis states and 82.55% for the G2/M and apoptosis states. For HeLa cells, we achieved a high accuracy of 96.94% for classification between the G2/M and apoptosis states, both of which were induced by taxol treatment. Even higher accuracy approaching 100% was achieved for the vinblastine-treated HeLa cells for the differentiation between the viable and non-viable states, and between the G2/M and apoptosis states. We also demonstrate the capability of the DNN model for high-accuracy classification of the three subpopulations in a complete cell sample treated by taxol or vinblastine.

Experimental Characteristics of Patients with Newly Diagnosed Multiple Myeloma.

Background: Multiple myeloma (MM), a malignant plasma cell proliferative disease, makes up to 1% of all cancers and somewhat exceeds 10% of all hematological cancers. Since it affects many organs, the signs and symptoms of myeloma vary greatly. This investigation was carried out to identify the clinical and laboratory characteristics of MM. Method: From January 1, 2014, to June 30, 2020, 169 in-patients who received a MM diagnosis for the first time at China-Japan Friendship Hospital in Beijing had their medical information examined. Results: Among 169 newly diagnosed patients, the median age was 60 years (26-84 years). Seven patients were younger than 40 years, and 16.0% (27/169) were 70 years or older. 40.8% (69/169) had IgG M-protein and 27.2% (46/169) had IgA. 84% (142/169) of patients were in the Durie Salmon stage 3. The major sign and symptoms at diagnosis were fatigue (100/169, 59.2%), bone pain (96/169, 56.8%), and weight loss (34/169, 20.1%). Anemia was present initially in 94.0% (159/169), high erythrocyte sedimentation rate in 92.7% (101/109), and thrombocytopenia in 26.6% (45/169). Similarly, hypercalcemia, renal insufficiency, and hypoalbuminemia were observed in 19.3% (31/161), 27.8%, and 75.7% respectively. Immunoparesis was found in 94% (110/117) of IgG, IgA, or IgM patients, and in 87% (33/38) of light chain myeloma patients. A localized band was found in 78.3% (123/157) of patients upon serum protein electrophoresis while monoclonal protein was detected by immunofixation in 91.5% (139/152) of patients. 4.1% (7/169) of the patients had non-secretory myeloma. The prevalence of light chain myeloma was 22.5% (38/169), and these individuals were more likely than other myeloma patients to have renal insufficiency (50% versus 21%, P < .05). In 84.8% of patients, the bone marrow had 10% or more plasma cells. Conclusion: The notable features that can be concluded from this study are the early onset of myeloma in the Chinese population and an advanced disease stage at the time of diagnosis with most of them accompanying anemia, hypoalbuminemia, and immunoparesis.

The ceRNA Crosstalk between mRNAs and lncRNAs in Diabetes Myocardial Infarction.

Competitive endogenous RNA regulation suggests an intricate network of all transcriptional RNAs that have the function of repressing miRNA function and regulating mRNA expression. Today, the specific ceRNA regulatory mechanisms of lncRNA-miRNA-mRNA in patients who have diabetes mellitus (DM) and myocardial infarction (MI) are still unknown. Two data sets, GSE34198 and GSE112690, were rooted in the Gene Expression Omnibus database to search for changes of lncRNA, miRNA, and mRNA in MI patients with diabetes. Weighted gene correlation network analysis (WGCNA) was used to identify the modules related to the development of diabetes in patients with MI. Target genes of miRNAs were predicted using miRWalk, TargetScan, mirDB, RNA22, and miRanda. Then, functional and enrichment analyses were performed to build the lncRNA-miRNA-mRNA interaction network. We built ceRNA regulatory networks with three lncRNAs, two miRNAs, and nine mRNAs. Differentially expressed genes enriched in biological process, including neutrophil activation, refer to immune response and positive system of defense feedback. Besides, there is significant enrichment in molecular function of calcium toll-like receptor binding, icosanoid binding, RAGE receptor binding, and arachidonic acid binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis enriched differentially expressed genes (DEGs) in pathways that were well known in MI, indicating inflammation and immune response. Pathways associated with diabetes were also significantly enriched. We confirmed significantly altered lncRNA, miRNA, and mRNA in MI patients with diabetes, which might serve as biomarkers for the progress and development of diabetic cardiovascular diseases. We constructed a ceRNA regulatory network of lncRNA-miRNA-mRNA, which will enable us to understand the novel molecular mechanisms included in the initiation, progression, and interaction between DM and MI, laying the foundation for clinical diagnosis and treatment.

Targeting AraC-Resistant Acute Myeloid Leukemia by Dual Inhibition of CDK9 and Bcl-2: A Systematic Review and Meta-Analysis.

PURPOSE: This study aims to determine the influence of targeting araC-resistant acute myeloid leukemia by dual inhibition cyclin-dependent protein kinase (CDK9) and B-cell lymphoma-2 （Bcl-2). METHOD: The c-Myc inhibitor 10058-F4 and the CDK9 inhibitor AZD4573 were used to determine the cell cycle arrest and apoptosis. RESULTS: 10058-F4 reduces c-Myc protein levels and suppresses HepG2 cell proliferation, possibly by upregulating cyclin-dependent kinase (CDK) inhibitors, p21WAF1, and reducing intracellular alpha-fetal protein (AFP) levels. CONCLUSION: The combination of AZD4573 and 10058-F4 has a synergistic anti-araC-resistant AML activity, providing a solid database for the aforementioned scientific hypothesis.

Globular adiponectin inhibits osteoblastic differentiation of vascular smooth muscle cells through the PI3K/AKT and Wnt/ß-catenin pathway.

Lipid metabolism is closely related to the improvement of vascular calcification (VC) in chronic kidney disease (CKD). Globular adiponectin (gAd) has been reported to be involved in the development of VC in CKD, but the detailed regulatory role remains unclear. The present study is aimed to investigate the biological function and the underlying regulation mechanism of gAd in the process of VC during CKD. Vascular smooth muscle cells (VSMCs) calcification was determined by Alizarin Red S staining. Protein signaling related with VC was tested by western blotting. The expression and intracellular localization of runt-related transcription factor 2 (Runx2) was detected by immunofluorescence and uraemic rat with VC was established by a two-step nephrectomy. Combined with the results of Alizarin Red S staining, we discovered that ß-glycerophosphate (ß-Gp)-induced the osteoblastic differentiation of VSMCs was significantly reversed by gAd treatment. Along with the VSMCs calcification and the increase of Runx2 in ß-Gp-exposed VSMCs, the activities of protein kinase B (AKT) and Wnt/ß-catenin pathway were enhanced, but that were counteracted by the exposure of gAd in rat and human VSMCs. After administration with agonists of the Wnt (SKL2001) and AKT (SC79), there appeared more osteoblastic differentiation and higher expression of Runx2 in gAd-treated VSMCs, but showing lower impact in the presence of SC79 than that in the presence of SKL2001. In the in vivo experiments, intravenous injection of gAd also significantly inhibited VC and Runx2 level in uraemic rat in a dose-dependent manner, possibly through regulating Wnt/ß-catenin pathway. This study demonstrates that gAd ameliorates osteoblastic differentiation of VSMCs possibly by blocking PI3K/AKT and Wnt/ß-catenin signaling transduction. The findings provide an important foundation for gAd in treating VC in kidney diseases.

Drug Repurposing Screen Identifies Novel Classes of Drugs with Anticancer Activity in Mantle Cell Lymphoma.

AIM AND OBJECTIVE: Mantle Cell Lymphoma (MCL) is typically an aggressive and rare disease with poor prognosis, therefore new effective therapeutics are urgently needed. Drug repurposing for cancer treatment is becoming increasingly more attractive as an alternative approach to discover clinically approved drugs that demonstrate antineoplastic effect. The objective of this study was to screen an approved drug library and identify candidate compounds with an antineoplastic effect in MCL cells using High-Throughput Screening (HTS) technique. MATERIALS AND METHODS: Using the HTS technique, nearly 3,800 clinically approved drugs and drug candidates were screened in Jeko and Mino MCL cell lines. We also demonstrated the selectivity window of the candidate compounds in six normal cell lines. Further validations were performed in caspase-3/7 apoptosis assay and three-dimensional (3D) multicellular aggregates model using Z138 cell line. RESULTS: We identified 98 compounds showing >50% inhibition in either MCL cell line screened, they were distributed across eight unique therapeutic categories and have different mechanisms of action (MOA). We selected alisertib, carfilzomib, pracinostat and YM155 for further validation based on their antiproliferative activity in two MCL cell lines, selectivity to normal cell lines, and drug developing stages in terms of clinical research. Alisertib and carfilzomib showed antiproliferative effect on MCL cell with EC50 = 6 nM and >100-fold selectivity to normal cell lines, especially for alisertib which demonstrated >1000-fold selectivity to 5 out of 6 normal cell lines. Pracinostat and YM155 had potency of 11 and 12 nM in MCL cell with >20-fold selectivity to normal cell lines. All four compounds had been tested in caspase-dependent apoptosis assay. We further validated and demonstrated their anti-MCL effect on cell proliferation and (3D) multicellular aggregates model using Z138 cell line. CONCLUSION: This is the first study to examine such a large library of clinically approved compounds for the identification of novel drug candidates for MCL treatment, the results could be rapidly translated into clinical practice in patients with MCL.

An ultrasensitive bioluminogenic probe of γ-Glutamyltranspeptidase in vivo and in human serum for tumor diagnosis.

Abnormal expression of γ-Glutamyltranspeptidase (GGT) in living organisms is closely implicated in the development of several human tumors. The GGT levels in tissue and serum have emerged as a potential criterion for tumor diagnosis. However, precise "light up" GGT activity in vivo is still challenging due to the signal interferes of background. Bioluminescence based on the firefly luciferase-catalyzed reaction for light production provides a feasible strategy for GGT detection in vivo. In this report, a bioluminogenic probe, Glu-Luc, was designed and synthesized by connecting D-luciferin with γ-glutamyl group. The cleavage of γ-glutamyl group is triggered by GGT, resulting in the release of D-luciferin, which generates a bright bioluminescence emission in the present of luciferase and ATP. The probe exhibits very high selectivity and sensitivity toward GGT activity from in vitro to in vivo and in clinical samples, which offers a promising tool for investigations of the GGT-overexpressing related biological process including tumor diagnosis and prognosis in living organisms.

Diagnostic value of interferon-γ-induced protein of 10kDa for tuberculous pleurisy: A meta-analysis.

BACKGROUND: The accurate diagnosis of tuberculous pleurisy is still a clinical challenge. Many studies reported that interferon-γ-induced protein of 10kDa (IP-10) plays a role in diagnosing tuberculous pleurisy, but with considerable variance of results. This meta-analysis aimed to evaluate the overall diagnostic accuracy of IP-10 for tuberculous pleurisy. METHODS: PubMed, EMBASE, and other databases were searched for studies examining accuracy of pleural IP-10 for diagnosing tuberculous pleurisy. Related data were extracted and sensitivity/specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were pooled. Summary receiver operating characteristic curve and area under the curve (AUC) were performed and calculated to summarize the overall test performance. RESULTS: Fourteen studies involving 1382 subjects met inclusion criteria, including 715 cases of tuberculous pleurisy and 667 controls. Summary estimates of the diagnostic performance of the IP-10 for tuberculous pleurisy were listed as follows: sensitivity, 0.84 (95%CI 0.81 to 0.87); specificity, 0.90 (95% CI 0.88 to 0.92); PLR, 7.96 (95% CI 5.59 to 11.32); NLR, 0.19 (95% CI 0.15 to 0.24); DOR, 49.82 (95% CI 28.08 to 88.38); and AUC 0.94. No publication bias was detected. CONCLUSION: Pleural IP-10 is a useful diagnostic marker for tuberculous pleurisy. Nevertheless, its result should be interpreted together with the results of conventional test and clinical information of patients.

Effects of Apolipoprotein E Isoforms in Diabetic Nephropathy of Chinese Type 2 Diabetic Patients.

Diabetic nephropathy (DN) is one of the major chronic complications of diabetes. Genetic polymorphism of Apolipoprotein E (ApoE) has been proposed to participating in DN. The purpose of the study was to evaluate the relationship between ApoE genetic polymorphism and the presence of DN in Chinese type 2 diabetic patients. We studied 845 diabetic patients who were divided into DN group (n = 429) and control group (n = 416). ApoE genotype was determined by ApoE genotyping chip and the plasmatic biochemical characterization was performed on all subjects. There were differences (P < 0.001) in HbA1c, creatinine, and urinary albumin between the two groups. The ApoE ε2 allelic frequency was 7.69% in DN group versus 3.49% in control group (OR = 2.22, 95% CI = 1.41-3.47, and P < 0.05), as expected, ApoE E2/E2 and E2/E3 genotype frequency were higher in DN group (13.75% versus 6.49%, P < 0.05). The ApoE ε4 allelic frequency was 7.93% in DN group versus 11.54% in control group (OR = 0.70, 95% CI = 0.50-0.97, and P < 0.05), and DN group presented a lower frequency of ApoE E3/E4 and E4/E4 genotype frequency (14.91% versus 19.96%, P < 0.05). These results suggest ApoE ε2 allele may be a risk factor; however ApoE ε4 allele may play a protective role of DN in Chinese type 2 diabetic patients.

Detection the Frequency and Characteristics of FLT3 Internal Tandem Duplication Mutations by Capillary Electrophoresis Assay and Next-Generation Sequencing in.

BACKGROUND: FLT3-internal tandem duplication mutations (ITDs) are found in approximately 30% of patients with acute myeloid leukemia (AML) and are markers of poor prognosis. However, the characteristics of FLT3/ ITDs in Chinese AML patients have rarely been reported. The aim of this study was to analyze the frequency and characteristics of FLT3/ITDs in Chinese AML patients. METHODS: In the selected 152 cases of Chinese AML patients, capillary electrophoresis (CE) was used to analyze the frequency and characteristics of FLT3/ITDs. Next-generation sequencing was used to analyze the sequences of FLT3/ITDs positive patients. The differences of clinical features between FLT3/ITD positive group and FLT3/ITD negative group were estimated by statistical analysis. RESULTS: 42 cases (27.6%) were FLT3/ITDs-positive, in which 34 cases (81%) had a single duplication, and the remaining 8 cases (19%) had 2 or more ITDs. Median ITD size was 42 bp and median ITD allelic ratio was 0.25. Using next-generation sequencing, ITDs integrating in non-juxtamembrane (JM) domains were detected in 12 ITDs (24%) and in JM domains were detected in 38 ITDs (76%). Furthermore, duplication of at least one residue between Y591 and Y599 was detected in 48 (96%) of all 50 ITDs, and the insertion site was strongly correlated with ITD size: more C-terminal located inserted fragments were significantly longer. CONCLUSIONS: Our data provide further evidence of the heterogeneity of FLT3/ITDs among different subgroups in Chinese AML patients. ITDs varied widely, but hotspots were concentrated. These results also suggest that nextgeneration sequencing is a useful method for detection of FLT3/ITDs sequences.

Higher Level of Serum Heme Oxygenase-1 in Patients With Intracerebral Hemorrhage.

The objective of this paper was to investigate the association of the serum level of heme oxygenase-1 in patients with intracerebral hemorrhage (ICH) with the risk of ICH. Heme oxygenase-1(HO-1) metabolizes heme into biliverdin, bilirubin, carbon monoxide, and iron, our recent study showed that serum level of HO-1 was increased in stroke patients, yet the association of HO-1 level with risk of intracerebral hemorrhage (ICH) is poorly known. Forty patients with ICH and another 40 patients without ICH were recruited. The serum level of HO-1, total, and direct bilirubin were measured. The level of HO-1, serum total bilirubin, and direct bilirubin, as well as blood pressure were increased in ICH group than in control group (P < 0.001). The level of HO-1, both systolic and diastolic blood pressure had a significant difference between subgroups (P < 0.05). Multivariate regression analysis showed that poor compliance to medicine for hypertension, the serum level of HO-1, and systolic blood pressure were associated with the prevalence of ICH. Blood pressure, serum HO-1, serum total bilirubin, and direct bilirubin were raised in patients with ICH who did not take medicine for hypertension compared with those who did, and increased in ICH patients in comparison with control group. Further investigation in multiple medical centers with large number of cohorts is warranted to verify these results.

The performance of age-adjusted D-dimer cut-off in Chinese outpatients with suspected venous thromboembolism.

BACKGROUND: D-dimer testing has been widely used in the exclusion of venous thromboembolism (VTE), but its clinical usefulness is limited in older patients because of a lower specificity. OBJECTIVE: To evaluate the diagnostic performance of STA-Liatest D-dimer assay and validate the age-adjusted cut-off value in Chinese outpatients with suspected VTE in a prospective non-interventional study. METHODS: Symptomatic patients suspected of having deep venous thrombosis or pulmonary embolism were recruited from 2 participating centers. STA-Liatest D-dimer assay, clinical pretest probability assessment and diagnostic imaging test including complete compression ultrasonography or computed tomography pulmonary angiography were performed among all participants. The performance of D-dimer test was assessed with an age-adjusted D-dimer cut-off (age×0.01µg/ml in patients aged>50years) and with conventional cut-off (0.5µg/ml at all ages). RESULTS: A total of 594 eligible outpatients were included in this study and VTE was diagnosed in 195 (32.8%) patients. In those patients with a low or moderate pretest probability (n=373), the increase in the proportion of patients with a D-dimer below the age-adjusted cut-off value compared with the conventional cut-off value was 5.9% (95% confidence interval; 3.8%-8.7%). The sensitivity, specificity and negative predictive value of STA-Liatest D-dimer test were 95.0% (83.5% - 98.6%), 84.1%(79.8%-87.6%) and 99.3%(97.5% - 99.8%), respectively, using the age-adapted diagnostic strategy. CONCLUSIONS: The application of age-adjusted cut-off of D-dimer test combined with clinical probability greatly increases the proportion of Chinese older outpatients in whom VTE can be safely excluded.

Presepsin as a diagnostic marker for sepsis: evidence from a bivariate meta-analysis.

BACKGROUND: The diagnosis of sepsis remains a clinical challenge. Many studies suggest that presepsin plays a role in diagnosing sepsis, but the results remain controversial. This study aimed to identify the overall diagnostic accuracy of presepsin for sepsis through meta-analysis. METHODS: A systematic literature search was performed in PubMed and EMBASE to identify studies evaluating the diagnostic accuracy of presepsin in sepsis patients. Data were retrieved and the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were calculated. A summary receiver operating characteristic curve and area under curve (AUC) were used to evaluate the overall diagnostic performance. The statistical analysis was performed using Stata 12.0 and Meta-DiSc 1.4 software. RESULTS: Eleven publications with 3,106 subjects were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.83 (95% confidence interval [CI] 0.77-0.88), 0.81 (95% CI 0.74-0.87), 4.43 (95% CI 3.05-6.43), 0.21 (95% CI 0.14-0.30), and 21.56 (95% CI 10.59-43.88), respectively. The area under the curve was 0.89 (95% CI 0.86-0.92). Estimated positive and negative post-probability values for a sepsis prevalence of 20% were 53% and 5%, respectively. No publication bias was identified. CONCLUSION: Based on currently available evidence, presepsin may have a valuable role in the diagnosis of sepsis, and its results should be interpreted carefully in the context of clinical condition and traditional markers.

Higher level of heme oxygenase-1 in patients with stroke than TIA.

BACKGROUND: There is a reverse relationship between serum bilirubin level and incidence of stroke, heme oxygenase-1 (HO-1) can catalyze heme into bilirubin, it is unknown the association of HO-1 level with risk of stroke. METHODS: Sixty patients with stroke and fifty patients with transient ischemic attack (TIA) were recruited. Serum level of HO-1, total and direct bilirubin, alanine transaminase, live function, lipid profile and infection status of patients were measured. RESULTS: Significant differences were found between two groups in terms of serum levels of HO-1 (163.6±58.7 vs. 141.2±49.7, P=0.032), total bilirubin (10.1±4.6 vs. 15.8±2.7, P<0.001), direct bilirubin (3.2±2.1 vs. 5.9±1.2, P<0.001), fasting glucose (6.7±3.1 vs. 4.9±1.3, P<0.001), cholesterol (4.4±1.1 vs. 3.9±0.8, P=0.005) and diastolic blood pressure (DBP) (84.9±9.4 vs. 81.3±9.2, P=0.046). In multivariate analysis, serum direct bilirubin (OR, 2.83; P<0.001), total bilirubin (OR, 1.82, P=0.001), DBP (OR, 0.88, P=0.041), and fasting glucose (OR, 0.34, P<0.001) were independent predictors of stroke. CONCLUSIONS: Serum HO-1 level is higher in patients with stroke than TIA, but the bilirubin level is lower in patients with stroke than TIA and is an independent predictor of stroke. Further studies are warranted to clarify the underlying link among HO-1, bilirubin and stroke.

[Assessment of the capability of the fluid model of automatic blood cell analyzer in white blood cell count and classification].

OBJECTIVE: To evaluate the application of XT-4000i automatic blood cell analyzer in white cell count and classification of cerebrospinal fluid (CSF). METHODS: The fluid model of XT-4000i automatic blood cell analyzer was directly used to detect the white cell count and classification in 200 samples of CSF, and compared with the results obtained by manually microscopic counting method. White blood cell classification was performed by manual method under microscope with Wright's staining,and instrumental method with fluorescence staining and flow cytometry. RESULTS: There is no statistical difference between instrumental and manual method in detecting the absolute counting of WBC, RBC, mononuclear cell and multinucleate cells (P>0.05), and there is a good correlation between the two methods (r=0.987, 0.999, 0.981 and 0.983 for WBC, RBC, mononuclear cell and multinucleate cell counts). Tumor cells in the samples with high fluorescent staining by instrumental method can be identified with Wright's staining by microscope method, which were consistent with the clinical diagnosis. CONCLUSION: The fluid model of XT-4000i automatic blood cell analyzer was rapid and accurate in CSF white cell count and classification,and it also can provide preliminary information for tumor cells screening. The fluid model of XT-4000i automatic blood cell analyzer in white cell count and classification of CSF has the value of popularization in clinical application.

[Analysis of cytogenetic characteristics in patients with myelodysplastic syndrome].

This study was aimed to investigate the distribution of chromosomal aberrational karyotype in myelodysplastic syndrome (MDS) subgroups, the characterizations of numerical and structural aberration. The chromosome was prepared with simple culture of bone marrow, and the karyotype was analysed by G banding technique. The results showed tht 54 out of 127 patients (42.5%) had clonal chromosome aberrations, and the abnormal rates were different in subgroups: 30% (3/10) in MDS-RA, 35.9% (23/64) in MDS-RCMD, 22.2% (2/9) in MDS-RAS, 45% (9/20) in MDS-RAEB-I, 66.7% (14/21) in MDS-RAEB-II, 100% (3/3) in 5q-syndrome, respectively. Among 54 abnormal chromosome patients, 21 patients showed numerical aberration, 14 patients showed structural aberration, and the other 19 patients showed both numerical and structural aberration. The order of frequent aberrations was as follows complex karyotype (11.02%, 14/127), single +8 (10.24%, 13/127), -7/7q- (3.9%, 5/127), 1q+ (3.15%, 4/127), -X/-Y (3.15%, 4/127), 20q- (2.36%, 3/127), 5q- (2.36%, 3/127). The frequency of complex karyotype in MDS-RAEB (including RAEB-I and RAEB-II) was higher than that in non MDS-RAEB (including RA, RCMD, RAS, 5q-syndrome) (P < 0.05), and the frequency of balanced translocation was lower than that in non-balanced translocation (P < 0.05), and both of the two balanced translocation patients were found in MDS-RAEB. It is concluded that MDS is highly heterogeneous clonal disorder, a great majority of cytogenetic changes can be detected and most of which are recurrent aberrations, balanced translocations are rare, and only found in MDS-RAEB. The frequency of complex karyotype in MDS-RAEB is higher, and the patients with dup (1) (q21q32) recurrent abnormality is common in this study.

[Hematological changes and related gene mutation of post-severe acute respiratory syndrome patients with osteonecrosis].

OBJECTIVE: To investigate the hematological changes and related gene mutation of post-severe acute respiratory syndrome (SARS) patients with osteonecrosis so as to find the sensitive molecular symbols for early screening of the high risk populations. METHODS: Fast peripheral venous blood samples were collected from 61 post-SARS patients with osteonecrosis, 25 males and 36 females, aged 30.4 (20 - 60), and 52 sex and age-matched healthy persons as controls. ELISA was used to detect the coagulation and fibrinolysis indicators: activated partial thromboplastin time (APTT), protein C (PC), antithrombin III (AT-III), plasminogen activator inhibitor (PAI), activated protein C resistance (APC-R), plasminogen (PLG), von Willebrand factor (VWF), D-dimer (D-D), and fibrinogen (Fib). Real-time PCR was used to detect the mutation of factor V G1601A (FV Leiden) and prothrombin G20210A. RESULTS: The levels of PC, AT-III, and PLG of the osteonecrosis group were 85% +/- 34%, 84 +/- 29%, and 69 +/- 23%, significantly lower than that of the control group (109% +/- 20%, 104% +/- 14%, and 94% +/- 15% respectively, all P < 0.01). PAI of the osteonecrosis group was 16 U/ml +/- 14 U/ml, significantly higher than that of the control group (8.0 U/ml +/- 4.3 U/ml, P < 0.01). The percentage of patients with abnormal indicators was 99.5% (54/61) in the osteonecrosis group, significantly higher than that of the control group (36.5%, 19/52, P < 0.01). The percentage of patients with 3 or more abnormal indicators was 72.1% (44/61) in the osteonecrosis group, significantly higher than that of the control group (17.3%, 9/52, P < 0.01). No mutations of F V Leiden and prothrombin G20210A was found in both groups. CONCLUSION: Trends of hypercoagulation and hypofibrinolysis exist in the post-SARS patients with osteonecrosis. APTT, PC, AT-III, and PLG can be used as sensitive indicator for screening high risk populations of osteonecrosis.

[Change of T lymphocyte and its activated subsets in SARS patients].

OBJECTIVE: To study abnormal changes of T lymphocyte and its activated subsets in severe acute respiratory syndrome (SARS) patients. METHODS: Flow cytometer with multi-color flouroscence and hematology analyzer were used to detect the expression of T lymphocyte and its activated a subsets in 240 SARS patients including 50 cases of critical type and 190 cases of common type. RESULTS: Statistical analysis by means of SAS software showed that there was significant decrease in absolute counts (AC) of T lymphocyte and its subsets in SARS patients when compared with normal people, while percentages (PC) of CD3+CD25+ and CD3+ HLA-DR+ subsets were increased markedly. Compared with common type, there was significant decrease in absolute counts of critical type of T lymphocyte, CD4+, CD25+CD3+, CD28+CD4+, and CD95+CD4+subsets. The ACs of T lymphocytes including CD4 and CD8 subsets in different phases were as below: III > II > I. The ACs of subsets involved in activation such as CD3+ HLA-DR+/lym, CD3+CD25+/lym, CD28+CD4+/CD4, CD28+CD8+/CD8, and CD38+CD4+/CD4 all were highest in group III. In addition, the AC and PC of CD95+CD4+/CD4 and CD95+CD8/CD8 subset in group III were highest while group I was lowest. CONCLUSIONS: With depressing cellular immunity, the activation of T lymphocytes were suppressed obviously in SARS patients, especially for critical patients.