患者,女,57岁,因水肿2个月,伴发热、左眼视力下降1周入院.患者2个月前无诱因间断出现颜面及双下肢可凹性水肿,伴牙龈和鼻自发性出血,可自止.近1个月夜尿增多,1周前受凉后发热,体温最高38.5 ℃,畏寒、寒战,尿常规检查有大量白细胞和细菌,考虑为泌尿系感染,经头孢替安抗感染等治疗后发热、水肿缓解.左眼视力下降1周,伴头痛、左眼肿胀.

随着分子生物学技术的研究进展,某些人类基因重组造血细胞生长因子成为生物制剂并应用于临床.鉴于目前人们对于造血细胞生长因子的认识十分有限,仍处于研究进行之中,并且该类生物制剂价格较贵,故对其在临床应用应持谨慎态度,严格掌握适应证、密切观察及预防临床不良反应十分必要.

为探讨纤溶酶原激活抑制剂-1(PAI-1)基因调节区-675 bp位点4G/5G多态性与2型糖尿病、2型糖尿病合并冠心病(CAD)的关系,采用特异性引物聚合酶链反应(PCR)方法,测定4G/5G基因型,并检测PAI-1抗原水平,共观察了121例单纯2型糖尿病(type Ⅱ diab etes)患者、87例2型糖尿病合并CAD患者和100例对照者.结果:合并CAD组的4G/4G基因型携带者明显高于对照组(49.4%比 37.0%,P<0.05),CAD组中PAI-1与三酰甘油(TG)呈正相关,并与4G/5G多态性有关, 表现为4G/4G基因型携带者的PAI-1质量浓度明显高于5G/5G基因型携带者[(39.82×10-3±3.11×10-3)ng/L比(38.04×10-3± 2.73 ×10-3)ng/L,P<0.05].提示:PAI-1基因4G/5G多态性与TG的联合作用与PA I-1抗原水平相关,并与2型糖尿病合并CAD的发病过程有关.

异体造血干细胞移植是治疗恶性血液病的最佳方法，由于受供者来源限制及采髓副作用的影响，近年来自体外周血干细胞移植越来越受到人们的重视。

Objective:To assess the relationship between the plasminogen activator inhibitor (PAI) activity and coronary heart disease (CHD).Method:Blood plasma PAI activity, plasminogen activator (PA) activity, serum levels of cholesterol and triglyceride were measured from 145 patients with CHD and 130 controls using immunochemical assay method.Result:The PAI to PA ratio was significantly higher in CHD patients than that in control subjects〔( 1.83 ± 0.52 ) vs ( 1.17 ± 0.48 ),P 0.05 〕. Plasma PAI activity was correlated positively with levels of triglycerides(r= 0.45 ,P 0.05 ).Conclusion:Significantly high activity of PAI is associated with hypertriglyceridemia and high age may be of importance in the pathogenesis of CHD.

To investigate the relationship between 4G/5G polymorphism of the plasminogen activator inhibitor-1(PAI-1) gene and coronary heart disease(CHD), genotype at this polymorphism was determined in 123 cases with CHD and 172 controls by polymerase chain reaction using the allele specific primers. Plasma PAI-1 antigen level, PAI activity, cholesterol and triglyceride were measured and body mass index was calculated from all the subjects. The group of CHD had a high number of homozygotes for the deleted allele(4G/4G) of the PAI-1 gene compared with the control(47.2% vs 22.1%, P＜0.05). Mean plasma PAI-1 antigen level and PAI activity varied significantly among the 3 genotypes, being higher in 4G/4G subjects than in 5G/5G subjects 〔(40.87±0.99) μg/L〕 vs 〔(38.14±1.0) μg/L〕, 〔(750±350) U/L〕 vs (650±270) U/L, P＜0.05). The PAI-1 4G/5G polymorphism correlated with PAI-1 antigen level to some extent accounts for the development of CHD.

Objective To investigate the relationship between plasminogen activator inhibitor(PAI) activity and coronary artery disease(CAD) in elderly patients. Methods Plasma samples from 93 patients with CAD were analyzed for the PAI activity, plasminogen activator(t-PA) activity, serum levels of cholesterol and triglyceride. The values of these parameters were compared between the CAD and the control groups. Results Higher plasma PAI activity 〔(810±360) AU/L vs. (640±300) AU/L,P0.01〕 and lower t-PA activity 〔(390±140)IU/L vs. (490±240) IU/L,P0.05〕 were found in CAD patients than in control group. Conclusions The increase of PAI activity and decrease of t-PA activity in elderly patients might be involved in the pathogenesis of CAD.

早在1865年,法国学者就已观察到在癌症患者体内存在着异常的凝血状态.临床研究表明:血栓形成是目前癌症患者最常见的并发症和第2死亡原因[1].首次大规模癌症患者体内凝血状态的研究发现,60%的癌症患者凝血时间较正常对照缩短.随后许多研究证实癌症患者存在高凝状态;最常见的是纤维蛋白原升高(48%),血小板增多(36%);还常伴有凝血因子Ⅴ、Ⅷ、Ⅸ、Ⅺ、的升高,常规凝血象检查凝血酶时间、活化部分凝血活酶时间、凝血时间等缩短[1,2].

为了解游离Fas (sFas ) 在恶性血液病中的水平及临床意义,用酶联免疫吸附法测定了60例恶性血液病患者的血清sFas.结果:恶性血液病患者血清sFas质量浓度高于正常人(P＜0.01),治疗后sFas下降,下降的程度与疗效有关,但治疗前sFas质量浓度的高低与疗效预测无关.结果提示:sFas对恶性血液病的诊断及疗效判定有一定意义,并可能对其发病机制产生影响.

我们最近为１例重型再生障碍性贫血（ＳＡＡ）患者成功进行了同基因外周血造血干细胞移植（ＰＢＳＣＴ），报告如下。病例和方法１病例患者，女，２７岁。因头晕、乏力、牙龈出血、月经量多１５天，伴发热４天，于１９９８年２月１０日入院。查体：体温３８．５℃，重度贫...

用免疫组织化学染色法对食道鳞癌标本进行凋亡相关基因P53、Fas、Bcl-2和Bax表达的检测,同时采用TUNEL方法原位探测细胞凋亡.检测结果显示:①52例食道鳞癌标本中,P53、Fas、Bcl-2、Bax和细胞凋亡的阳性率分别是61.5%、61.5%、69.2%、98.1%和28.8%.②18例对照标本中相应指标的阳性率分别为16.7%、100%、38.9%、100%和61.1%.③比较2组标本,肿瘤组P53和Bcl-2的阳性率显著高于对照组(P＜0.01及P＜0.05),肿瘤组Fas与TUNEL的阳性率显著低于对照组(P＜0.01及P＜0.05).④以上4种蛋白与细胞凋亡存在与否无独立相关性.上述结果表明,在食道癌变中,不仅存在细胞凋亡功能的减低,同时伴有多种凋亡相关基因的表达异常.凋亡功能的异常,可能是多基因共同调控的结果.

目的：探讨全反式维甲酸（ＡＴＲＡ）和９ 顺式维甲酸（９ ｃｉｓＲＡ）对ＨＬ ６０细胞Ｆａｓ表达水平及维甲酸对抗Ｆａｓ抗体诱导的细胞凋亡敏感性的影响。方法：用流式细胞仪检测ＨＬ ６０细胞膜Ｆａｓ蛋白表达水平；分别采用形态学观察、ＤＮＡ电泳和流式细胞仪检测抗Ｆａｓ抗体诱导的细胞凋亡。结果：ＨＬ ６０细胞Ｆａｓ弱表达。经１０－６ｍｏｌ／ＬＡＴＲＡ或９ ｃｉｓＲＡ分别预处理４天后，ＨＬ ６０细胞Ｆａｓ表达水平及对抗Ｆａｓ抗体诱导凋亡的敏感性均显著提高。９ ｃｉｓＲＡ提高ＨＬ ６０细胞对抗Ｆａｓ抗体诱导凋亡的敏感性的能力强于ＡＴＲＡ。结论：维甲酸可上调ＨＬ ６０细胞表达Ｆａｓ，这可能与维甲酸诱导ＨＬ ６０细胞分化相关。进一步深入探讨其分子机制，将为肿瘤治疗，特别是自体骨髓移植中骨髓净化提供新方法

细胞凋亡抑制基因bcl-2在髓系造血细胞中的表达与细胞分化程度有关。本研究证实全反式维甲酸（ATRA）可诱导HL-60细胞凋亡。流式细胞仪分析表明,在HL-60细胞分化凋亡过程中bcl-2表达逐渐下降,凋亡细胞bcl-2表达水平较低,而未凋亡细胞bcl-2仍维持在高水平。上述结果提示:经ATRA诱导分化成熟的HL-60细胞与正常粒细胞相似,最终走向凋亡;bcl-2表达降低可能对终末分化细胞凋亡有易化作用;未凋亡细胞bcl-2高表达可能是肿瘤细胞耐药和白血病复发的重要因素。

目的：检测９－顺式维甲酸（９－ｃｉｓＲＡ）诱导ＨＬ－６０细胞凋亡的能力，并探讨其分子机制。方法：应用形态学观察、ＤＮＡ电泳、流式细胞仪分析检测细胞凋亡，应用流式细胞仪检测ＨＬ－６０细胞ｂｃｌ－２含量。结果：９－ｃｉｓＲＡ可以诱导ＨＬ－６０细胞在分化后发生典型的凋亡。在ＨＬ－６０细胞分化和凋亡的过程中ｂｃｌ－２含量逐渐下降。９－ｃｉｓＲＡ诱导ＨＬ－６０细胞凋亡能力和降低ｂｃｌ－２表达的能力均显著强于全反式维甲酸（Ａ－ＴＲＡ）。结论：９－ｃｉｓＲＡ具有诱导ＨＬ－６０细胞凋亡的作用。ｂｃｌ－２表达水平的降低可能是经诱导分化成熟的白血病细胞走向凋亡的重要条件。

Analysis of 2547 cases of multiple myeloma (MM) reported in China in 1980s showed that the clinical manifestations are characterized by multipley. High misdiagnosis rate (69%) and multiple complications. while the monoclonal protein had more than 25 immunological types, IgG myeloma was the commonest (43.1%). Light chain subgroup treded to have a higher incidence of renal demage (76.9%). Plasma cell leukemia evenetually developed in 30 cases. In order to improve diagnosis and avoid misdiagnosis, the key points are 1, to better the recognition of clinical features of MM. 2. Patient should receive urine Bence-Jones protein, immunoglobulins, immunoelectrophresis, bone X-ray and multiple site bone marrow puncture whenever one of such manifestations as unexplained anemia, skeletal pain, proteinuria, elevation of ESR, hyperviscosity syndrome, hypercalcemia, hyperuricemia, elevation of alkaline phosphatase, pathological fractures and diffuse osteoporosis, 3. Immuno-binding electrophoresis and immunofluorence antibody detection should be done for suspected cases with normal immunoglobulin level.