目的:提高对母细胞性浆细胞样树突细胞肿瘤（BPDCN）的诊断及鉴别诊断水平。方法:分析广西医科大学第一附属医院2020年6月收治的1例BPDCN患者的临床资料，总结其临床表现及实验室检查的特点，并复习相关文献。结果:本例患者有皮肤受累，肿瘤细胞有大伪足，高表达CD123，且CD4、CD56阳性，cCD3、MPO、cCD79a、CD19阴性，符合BPDCN表现。结论:BPDCN的临床表现及细胞形态缺少特异性，主要借助免疫表型进行诊断及鉴别诊断。

Objective:To explore the predictive value of peripheral blood CD34-positive cell count for the stem cell mobilization effect of plerixafor in patients with multiple myeloma (MM).Methods:The clinical data of 12 MM patients who used plerixafor for stem cell mobilization in the First Affiliated Hospital of Guangxi Medical University from December 2019 to February 2021 were retrospectively analyzed. The changes of peripheral blood CD34-positive cell count and the collection status of stem cell in all patients before and after the mobilization of plerixafor were analyzed.Results:Twelve patients were included in this study. These patients were in international staging system (ISS) stage Ⅱ-Ⅲ, and the induction therapy was mainly VRD regimen. The CD34-positive cell count was increased after the use of plerixafor in all patients no matter which mobilization strategies were used before plerixafor. The CD34-positive cell count was 3.63/μl (0.72-13.53/μl) and 32.11/μl (8.52-53.68/μl) before and after the use of plerixafor, and the difference was statistically significant ( Z = -0.40, P<0.001); the median increasing time was 11.50 times (1.61-23.71 times). The mobilization failure occurred in 1 patient. The CD34-positive cell count in his blood was less than 1/μl before the use of plerixafor; though increased 11.83 times after the use of plerixafor, the CD34-positive cell count was still less than 10/μl. Pearson analysis showed that among the patients with CD34-positive cell count less than 4/μl before the use of plerixafor, there was a positive correlation in peripheral blood CD34-positive cell count before and after the use of plerixafor ( r = 0.80, P = 0.032). Conclusions:The peripheral blood CD34-positive cell count has a certain predictive value for the stem cell mobilization effect of plerixafor in MM patients.

Purpose To explore the expression and clinical significance of factors associated with multiple myeloma (MM) and identify new diagnostic markers. Methods Two gene expression array data sets (GSE6477 and GSE5900) were downloaded and differentially expressed genes (DEGs) in bone marrow from patients with MM and healthy donors analyzed. Kyoto Encyclopedia of Genes and Genomes pathway enrichment and Gene Ontology annotation of DEGs was conducted and a protein-protein interaction network generated. Plasma and bone marrow samples from patients with MM were analyzed for cytokine expression by ELISA and correlations between cytokine levels and clinical indicators evaluated. Results Of 908 DEGs, 416 were up-regulated and 492 down-regulated. Further, 161 proteins pairs and 21 nodes were detected, and eight hub genes (CXCL2, CXCL8, CXCL12, ELANE, LCN2, CX3CL1, CCL13, and CCL27) screened out. Expression levels of CXCL8, CXCL2, CXCL12, LCN2, and CCL13 were low in CD138+ plasma cells, and expression levels of the eight cytokines differed significantly in peripheral blood plasma from patients with MM and healthy controls. ROC curve analysis determined optimal diagnostic thresholds determined for: CCL27 (189 ng/mL), CXCL2 (313 ng/L), CX3CL1 (132 ng/L), CCL13 (235 pg/mL), CXCL8 (884 ng/L), ELANE (50 µg/L), LCN2 (8 µg/L), and CXCL12 (2525 pg/mL). Conclusions CX3CL1, CCL13, CXCL8, and CXCL12 levels were positively correlated with those of hemoglobin and β2 microglobulin (β2-MG); CCL27 and CXCL2 with β2-MG; and CCL13 and ELANE with white blood cell count and age, respectively. CCL27, CXCL2, and β2-MG levels were associated with MM incidence.

DOI:10.3760/cma.j.issn.0253-2727.2017.02.014 基金项目:国家自然科学基金(81160072、81560028);广西省自 然科学基金(2010GXNSFB013064) 作者单位:530021 南宁,广西医科大学第一附属医院血液内 科(张绪湃、黄莹、文静、邓东红、程鹏、赵卫华、罗军、赖永榕、刘振 芳);南宁市第一人民医院血液内科(李虹颖) 通信作者:刘振芳,Email:liuliuzhenfang@126.com Identification of miR639 expression in myelodysplastic syndrome and its target gene prediction Zhang Xupai, Huang Ying, Li Hongying, Wen Jing, Deng Donghong, Cheng Peng, Zhao Weihua, Luo Jun, Lai Yongrong, Liu Zhenfang Corresponding author: Liu Zhenfang, Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Email: liuliuzhenfang@126.com

Objective To explore the expression of microRNA(miR )-340-3p in bone marrow of patients with myelodysplastic syndrome (MDS),and to analyze its target genes and function by bioinformatics analysis .Methods miR3-40 -3p differentially expressed in the bone marrow of 9 patients with MDS and 6 healthy individuals was screened using gene expression profile chip and hierarchical clustering .Then its target genes were predicted using miRBase and Miranda softwares .Gene Ontology ( GO) analysis and signal pathway analysis were performed in the predicted target genes .Results Compared to the healthy normal individuals ,the expression of miR-340-3p in bone marrow of patients with MDS was down-regulated(P<0.05).A total of 76 potential target genes were obtained ,including BANP,KIF2C,DIDO1, GRM1 and ect..GO analysis showed that the target genes were enriched in cellular biological process ,molecular function and cellular component. And signal pathway analysis showed that these target genes were enriched in FoxO signaling pathway ,NOD-like receptor signaling pathway , hematopoietic cell line ,Gap junction and ect..C onclusion The expression of miR-340-3p decreases in the bone marrow of patients with MDS,and probably participates in the occurrence and development of MDS by negatively targeting the downstream target genes .

目的:探讨SPARC和Tiam1基因在人早幼粒细胞白血病细胞株(HL-60)与人慢性粒细胞白血病细胞株(K562)中的表达的水平及其意义.方法:常规细胞培养,取在对数生长期的HL-60、K562细胞进行mRNA抽提;以HUVEC细胞的mRNA作为对照组,逆转录后采用实时荧光定量PCR(RTFQ-PCR)法检测SPARC和Tiam1在HL-60、K562细胞中mRNA的表达水平.结果:①SPARC和Tiam1在HL-60、K562细胞中均为低表达;②SPARC和Tiam1在HL-60、K562细胞中的表达差异均有统计学意义(P＜0.05);③SPARC与Tiam1在HL-60细胞中的表达呈负相关(r=-0.886,P＜0.01);SPARC与Ti-am1在K562细胞中的表达无相关关系(r=-0.086,P=0.872).结论:在髓系白血病中,评价SPARC与Tiam1的表达水平可能具有一定的预后价值;在急性早幼粒细胞白血病中,SPARC和Tiam1可能通过共同的信号通路调控下游基因.

目的 探讨神经节苷脂对硼替佐米引起的神经病变（ BIPN）的预防作用。方法回顾性分析12例多发性骨髓瘤患者，患者均使用含硼替佐米方案化疗，并用神经节苷脂预防其周围神经病变的发生，观察其临床反应及疗效。结果12例患者仅有1例出现BIPN，发生率为8．3％，其余患者均未出现周围神经病变表现，对硼替佐米的耐受性良好。结论神经节苷脂可用于硼替佐米所致周围神经病变的预防，提高患者对硼替佐米的耐受性，进而提高疗效。

慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)是一种CD5+B淋巴细胞在外周血、骨髓及淋巴结、肝脾聚集为特征的恶性血液病,是西方国家最常见的成人白血病.随着对CLL分子遗传学、细胞生物学认识的不断深入以及新药物的不断研发,CLL的临床治疗取得了快速进展.同时,CLL是一个异质性群体,在发病形式、疾病进展、治疗反应和生存期方面具有明显的个体差异,因此,应该对CLL患者制定出合理的个体化综合治疗策略.

Objective To investigate the expression and signiifcance of SPARC and Tiam1 genes in Raji cell line of Burkitt’s lymphoma to provide theoretical basis in invasion and metastasis of Burkitt’s lymphoma.Method After cell culture of Raji cell line,and DNA extraction from logarithmic phase cells,the gene expressions of SPARC and Tiam1 were detected by real-time fluorescent quantitative PCR.Results The gene expressions of SPARC and Tiam1 were up-regulated in Raji cell line,the differences were statistically significant(P<0.05),F=1.473 and 15.434.Conclusion The gene expressions of SPARC and Tiam1 may play an important role in invasion and metastasis of Burkitt’s lymphoma.

目的:探讨多毛细胞白血病(HCL)临床诊断及使用克拉屈滨治疗的效果。方法:回顾性分析4例初治HCL的临床资料。结果:4例患者的血常规均为二系或三系血细胞减少,单核细胞数减少,均有脾肿大,且外周血和骨髓中均可见典型的毛细胞。免疫表型发现毛细胞表达CD11c、CD19、CD20、CD22、CD25、FMC-7、CD103;不表达CD5及CD10。使用克拉屈滨治疗,3例患者1个疗程达到完全缓解(CR),1例患者2个疗程达CR;克拉屈滨主要毒副作用是骨髓抑制,易并发肺部感染。结论:HCL患者以血细胞减少、单核细胞数减少,脾肿大,外周血和骨髓发现多毛细胞为主要临床特征,结合免疫学分型,可诊断HCL;使用克拉屈滨治疗,可获得较好疗效。

Objective To investigate the significance of fluorescence in situ hybridization ( FISH) applied to the diagnosis of abnormalities in chromosome 7 in myelodysplastic syndromes ( MDS ) .Methods The bone marrow samples collected from 84 MDS patients were analyzed for chromosomal karyotypes by interphase FISH and convention -al cytogenetic analysis(CCA),respectively.A comparison was done for the detection relevance ratio of abnormalities in chromosome 7 between FISH and CCA .Results Among 84 MDS patients,35 with chromosome aberrations were accounted for 41 .7%( 35/84 ) , in which 9 cases of numerical abnormality of chromosomes , accounted for 25 .7%(9/35),were dominated by +8;Thirteen cases of chromosomal structural abnormality ,accounted for 37.1%(13/35),were dominated by 7q-,5q-and 20q-;There were 13 cases of structural and numerical abnormality ,accoun-ted for 37.1%(13/35).The most common chromosomal aberration was abnormality in chromosome +8(11 cases), the follows as complex chromosomal aberrations ( 15 cases ) , abnormality in chromosome 7 ( 9 cases ) , abnormality in chromosome 5q-(5 cases) ,abnormality in chromosome 20q-(5 cases),abnormality in chromosome Y (2 cases). Nine cases of abnormality in chromosome 7,accounted for 10.7%(9/84),were confirmed by FISH,while only 1 case of abnormality in chromosome 7,accounted for 1.2% (1/84),was confirmed by CCA (P <0.01).Conclusion FISH has a higher detection relevance ratio of abnormality in chromosome 7 in MDS patients compared with CCA ,but FISH can′t take the place of CCA .

手足口病是儿科门、急诊常见传染病,如伴有高热超过3d不退,精神差、肢体抖动、惊跳等,常是重症的表现.本科采用清开灵分散片辅佐常规西医治疗儿童手足口病高热疗效满意,现报告如下.

目的分析非血缘异基因造血干细胞移植术后的死亡原因。方法对45例接受非血缘异基因造血干细胞移植治疗的恶性血液病患者的临床资料进行回顾性分析。结果随访结束时,生存25例,死亡20例,预期3年总生存(OS)和无病生存(DFS)率分别为55.6%和48.8%;死亡原因分别为疾病复发7例,急性移植物抗宿主病(GVHD)3例,肺部真菌感染5例,间质性肺炎5例。结论疾病复发、感染、间质性肺炎及GVHD是非血缘异基因造血干细胞移植的主要死因。

<正>1973年澳大利亚学者R.F.Bishop在电镜下于急性腹泻患儿十二指肠黏膜活检标本中,发现上皮细胞内存在大量球形病毒颗粒,根据其类似车轮状形态,1975年命名为"轮状病毒"(Rota virus,RV)。

OBJECTIVE:To study the effects of mangiferin on cell cycle status and CDC2/Cyclin B1 expression in HL-60 cells, and its molecular mechanism for treating leukemia.METHODS:The effect of Mangiferin on HL-60 cells proliferation was determined by MTT assay; The change of cell cycle status in HL-60 cells treated with mangiferin was performed by the flow cytometry; The expressions of CDC2 mRNA and Cyclin B1 mRNA were detected by semiquantitative RT-PCR.RESULTS:The growth inhibition effects of mangiferin in HL-60 cells were enhanced as the mangiferin concentration increased and exposure time prolonged; HL-60 cells in G2/M phase increased in a dose-dependent way 24 hours after mangiferin administration, indicating G2/M phase blockage; the expressions of CDC2 mRNA and Cyclin B1 mRNA enhanced in a dose-dependent way and came to the peak at 80 micromol/L mangiferin.CONCLUSION:Mangiferin can inhibit the proliferation of HL-60, block the cell cycle progression in G2/M phase, and it can significantly increase the expressions of CDC2 mRNA and Cyclin B1 mRNA of HL-60 cells. G2/M phase blockage may be one of its molecular mechanism for treating leukemia.

Objective:To study the effects of fludarabine on growth of multiple myeloma KM3 cells and the influence of fludarabine on autocrining level of cytokines.Method:The effects of different concentrations of fludarabine on the proliferation of KM3 multiple myeloma cells were examined by MTT assay. The apoptosis of KM3 cells was stained with AnnexinⅤ/PI and detected by flow cytometr. The levels of IL-6 and sIL-6R autosecreted by KM3 cells were tested by ELISA after KM3 cells were treated with fludarabine. Result:Fludarabine inhibited the proliferation of KM3 cells and the inhibition effect were dependent on time and concentration.The MTT assay showed that the IC50 was 95 nmol/L with fludarabine treatment for 72 hours. The apoptosis rate of KM3 cells increased with fludarabine treatment at a dosage within 25~400 nmol/L. Fludarabine decreased the autocrining level of IL-6 slightly,and inhibited the level of VEGF and sIL-6R obviously. Conclusion:The proliferation of KM3 cells was markedly inhibited by fludarabine in a dose-dependent and time-dependent manner. Fludarabine can also decrease the level of VEGF,IL-6 and sIL-6R autocrined by KM3 cells.

目的:观察芒果苷对人淋巴瘤Raji细胞增殖、侵袭能力及T淋巴瘤侵袭转移诱导因子1(Tiam1)表达的影响,以探讨芒果苷抗淋巴瘤的初步作用机制。方法:用MTT法检测芒果苷对人淋巴瘤Raji细胞增殖的影响,用Transwell侵袭实验检测芒果苷对Raji细胞侵袭能力的抑制作用,用RT-PCR法检测芒果苷作用Raji细胞后对Tiam1的mRNA表达的影响。结果:MTT法发现,不同浓度的芒果苷分别与Raji细胞共同孵育72 h后,芒果苷对Raji细胞增殖抑制作用具有明显的剂量和时间依赖性。Transwell侵袭实验发现,用不同药物浓度的芒果苷作用Raji细胞24 h后,可抑制Raji细胞穿透Transwell小室,随着药物浓度的增加其穿透滤膜的细胞数明显具有剂量依赖性。分别用不同浓度的芒果苷作用Raji细胞24 h后,发现Tiam1的mRNA表达量明显减少,且呈明显的量效关系。结论:芒果苷能抑制人淋巴瘤Raji细胞的增殖和侵袭,其机制可能与同细胞侵袭有密切关系的Tiam1的mRNA表达下调有关。

目的探讨Ph染色体阳性成人急性淋巴细胞白血病(Ph+ALL)的形态学、免疫学、细胞遗传学和临床特点。方法分析3例初诊Ph+ALL患者血液学、骨髓细胞学、免疫学、细胞遗传学及临床特点。结果 3例患者FAB分型均为ALL-L2型;免疫学标记均为B-细胞,表达cCD79a、CD19、CD10;均表达造血干/祖细胞抗原CD34、HLA-DR;2例伴髓系抗原表达;单独使用VDCPL(长春新碱、柔红霉素、环磷酰胺、强的松、左旋门冬酰胺酶)方案化疗后均获得完全缓解(CR)。结论 Ph+ALL免疫表型几乎全部为前体B细胞,表达造血干/祖细胞抗原,常伴有髓系表达,单独使用化疗亦有较高的CR率。

Objective To investigate the relation between Immunophenotype and prognosis in acute myeloid leukemia(AML)patients.Methods The expression of Immunophenotype was detected by the flow cytometric in 67 patients with AML treated in the Department of Hematology in the First Mffiliated HospitaI of Guangxi Medical University from Sep of 2003 t0 Mar of 2006.All cases were treated with standardized therapy.The effect was evaluated.Results Thirty-eight cases were complete remission and the complete recovery(CR)rate was 56.7%.The CR rates were not statistically significant(P＞ 0.05)between patients with CD7+,CD19+,CD5+,CD10+ and those with CD7-,CD19-,CD5-,CD10-.Furthermore,the CR rates of patients with lymphoid antigen-was higher than that of patients with lymphoid antigen+(65.3%vs 33.3%,P＜0.05).Conclusions In AML,patients with high express of CD34+,HLA-DR+would get poor possibility in prognosis.Also patients with CD5+,CD7+,CD10+,CD19+,CD20+have poor reaction to chemotherapeutics and have unfavorable prognosis.