目的:研究苍艾香薰油熏蒸法在无菌层流病房感染控制中的应用效果.方法:选择2015年12月—2017年12月间广东省第二人民医院血液科入住无菌层流病房的72例患者,按照床号先后顺序划分为观察组与对照组各36例,其中1、2、3、4、5号为观察组,6、7、8、9、10号为对照组,对照组采用空气消毒机进行早晚消毒处理,观察组每日采用苍艾香薰熏蒸空气消毒,每周对病房内各个区域采用细菌培养法或ATP荧光检测技术进行检测,统计患者搬离病房保护前院内感染发生率、各物品细菌菌落总数、住院治疗及花费.结果:采用空气消毒机进行早晚消毒处理后,每周同一时间检测,测量病房内空气、物体表面、医护人员手的细菌菌落总数,结果提示观察组各指标值均优于对照组,(t=9.748、12.746、17.775,P<0.05).观察组36例住院患者中,院内感染发生率低、患者层流病房停留时间、治疗费用、抗菌药物使用时间、感染开始及治疗时间均优于对照组,P<0.05.结论:相较于传统空气消毒机处理,在无菌层流病房采用苍艾香薰熏蒸空气消毒法,取得效果较好,可有效控制病房内各物品菌落总数,降低感染率,缩短住院时间.

Objective:To investigate the effects of Artesunate on suppressing the proliferation of Bortezomib-resistant multiple myeloma (MM) cell line and to explore its molecular mechanism on reversal of drug resistance.Method:Human MM cell line NCI-H929 was treated with Bortezomib in a dose-dependent manner to establish Bortezomib-resistant cell line NCI-H929BR.The inhibitory role of Artesunate on NCI-H929BR and its reversal effect against Bortezomib-resistance were determined by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay.Cell apoptosis was determined by flow cytometry,and the protein expression levels of nuclear factor-κB p65 (NF-κB p65),phospho-nuclear factor-κB p65 (NF-κB p-p65),P-glycoprotein (P-gp),B-cell lymphoma/leukemia-2 (Bcl-2) protein and Bcl-2 associated X protein (Bax) were detected by Western blot assay.Result:Bortezomib-resistance index of NCI-H929BR was 20.2 times.Artesunate treatment had significant inhibitory effect on the proliferation of NCI-H929BR and the inhibitory effect was in a concentration-dependent manner.Bortezomib (50 nmol·L-1) alone had less effect on NCI-H929BR proliferation,while the inhibition rate of artesunate (12.5 mg·L-1) alone was (23.53 ± 2.21)％ (P ＜0.05);Bortezomib combined with artesunate treatment had greater inhibitory effect (60.71 ± 3.43) ％ (P ＜ 0.01).Artesunate treatment increased NCI-H929BR apoptosis,down-regulated NF-κB p65,NF-κB p-p65,P-gp and Bcl-2 expression levels,and upregulated Bax expression level in a concentration-dependent manner.Conclusion:Artesunate could inhibit NCI-H929BR proliferation,promote apoptosis and reverse Bortezomib-resistance,and its mechanism may be associated with down-regulating expression levels of NF-κB p65,NF-κB p-p65,P-gp,Bcl-2 and up-regulating expression level of Bax.

目的 分析维吾尔族骨髓增生异常综合征(MDS)患者淋巴细胞免疫表型特点及其在诊断、分型和预后中的临床意义.方法 选择新疆喀什第一人民医院2013年3月到2016年3月41例MDS患者(MDS组)和30例非MDS患者(non-MDS组)为研究对象.运用多参数流式细胞术(CD45/SSC设门法)识别淋巴细胞群及进行免疫分型检测骨髓淋巴细胞群比例,观察不同分化抗原的表达水平.结果 (1)淋巴细胞群比例在MDS组较non-MDS组显著升高[(23.47±10.12)％vs(15.15±10.08)％,P＜0.01];在MDS各亚型[难治性血细胞减少伴多系发育异常(RCMD)、难治性贫血伴原始细胞增多(RAEB)-Ⅰ、RAEB-Ⅱ]间差异无统计学意义(P＞0.05).(2)淋巴细胞群不同分化抗原表达,MDS组的CD25+ CD8+、CD7及CD8表达水平均较non-MDS组显著升高(P均＜0.01);CD5、CD19表达水平显著降低(P ＜0.05,P＜0.01);CD25+ CD4+、CD4、CD25及CD56表达水平两组差异无统计学意义(P均＞0.05);CD5的表达水平在RCMD与RAEB-Ⅱ显著高于RAEB-Ⅰ (P ＜0.01);CD25的表达水平在RC-MD高于RAEB-Ⅰ和RAEB-Ⅱ(P＜0.05);其他MDS抗原的各亚型间差异无统计学意义(P均＞0.05).结论 多参数FCM能检测到维吾尔族MDS患者淋巴细胞异常免疫表型特征,可给MDS患者的临床诊断、分型及预后评价提供更多有价值的客观信息.

Objective To explore the clinical application of multiprobe fluorescence in situ hybridization (FISH) combined with conventional cytogenetic G-banding(CCG) analysis in the diagnosis of acute myeloid leukemia (AML) in Uyghur adult patients in Kashgar region.Methods The multiprobe AML panel comprising 8 different FISH probes for PML/RAR transfusion gene,AML1/ETO transfusion gene,CBF/MYH11 transfusion gene,MLL gene,Del(20q),-7/ Del(7q),Del(5q),and P53 deletion was performed in 30 Uyghur adult patients newly diagnosed with AML in Kashgar region.The multiprobe FISH results were compared with those of CCG.Results With the multiprobe FISH panel,cytogcnetic aberrations were detected in 22 cases (22/30,66.7％),which have involved PML/RAR transfusion gene,AML1/ETO transfusion gene,CBF/MYH11 transfusion gene,MLL gene,trisomy 8,-7/Del (7q),Del (5q),P53 deletion.CCG was only idcntificd in 9 cases with the corresponding cytogenetic abnormalities and 2 cases with other cytogenetic abnormalities.The positive rate of multiprobe FISH was significantly higher than the CCG (P ＜ 0.05),and the detection rate by the combination of FISH and CCG increased to 73.3％.Conclusion Comparing with CCG,multiprobe FISH panel is more accurate,effective and rapid in the diagnosis of AML with cytogenetic aberrations.Multiprobe FISH combined with CCG can improve the detection rate of cytogenetic aberrations in AML and can provide more objective and reliable evidences for the diagnosis of Uyghur newly diagnosed adult AML in Kashgar region.

Objective To investigate the combination effect of artesunate and lenalidomide on the proliferation of bortezomib-resistant multiple myeloma cell line MM .1R, and its molecular mechanism .Methods MM.1R cells were cultured in RPMI 1640 and treated with DMSO (control group), lenalidomide (20 μmol/L), artesunate (25 μg/mL), or lenalidomide (20μmol/L) plus artesunate (25μg/mL), separately.After 24 or 48 h, the cell proliferation rates were assessed by MTT assay, and the NF-κB (P65), Bcl-xl, Mcl-1, p-Bad, and P-gp protein levels were measured by Western blot .Results The inhibitory rate of cell proliferation was 15.16%by lenalidomide for 24 h, 28.28%by lena-lidomide for 48 h, 45.98%by artesunate for 24 h, 17.19%by artesunate for 24 h, 34.53%by lenalidomide plus artesu-nate for 24 h, or 65.16%by lenalidomide plus artesunate for 48 h (P<0.05).NF-κB (P65), Bcl-xl, Mcl-1, p-Bad, and P-gp proteins were down -regulated by lenalidomide plus artesunate treatment in a time -dependent manner . Conclusion Both artesunate and lenalidomide inhibit MM .1R cell proliferation .Combination of artesunate with lenalido-mide can enlarge this effect through down -regulating NF-κB (P65), Bcl-xl, Mcl-1, p-Bad, and P-gp.

Objective To research the characteristics of immunophenotype of granulocytes and monocytes in 41 Uyghur patients with Myelodysplastic syndrome(MDS) and its clinic significance .Methods The expressions of antigens of granulocyte and mono-cyte population in 41 patients with MDS were detected by multiparametric flow cytometry .Results Comparing with the non-MDS group ,the percentage of granulocyte was significantly decreased (P= 0 .021) ,the proportion of monocyte population was signifi-cantly higher in the MDS group (P=0 .000) .The proportion of nucleated erythrocyte population was no significant differences in RCMD ,RAEB-I and RAEB-II (P>0 .05) .The expressions of CD10 ,CD11b ,CD15 ,CD16 and CD66d on granulocytes were much higher than non-MDS group(P=0 .012 ,P=0 .027 ,P= 0 .016 ,P= 0 .005 ,P= 0 .024 ,respectively);there were no significantly differences of the expressions of CD33 ,CD13 ,HLA-DR ,CD56 and CD117(P=0 .058 ,P=0 .337 ,P=0 .649 ,P=0 .096 ,P=0 .081 , respectively );the expression of CD10 in RAEB-II was decreased significantly than RAEB-I(P=0 .001);the expressions of CD13 and HLA-DR in RCMD were significantly decreased than RAEB-I and RAEB-II(P=0 .013 ,P=0 .005 and P=0 .018 ,P=0 .003 , respectively) .Other expressions of antigens were no significantly differences among the subtypes of MDS (P>0 .05) .The expres-sions of CD15 ,CD33 and CD64 on monocytes were significantly higher than non-MDS group(P=0 .001 ,P=0 .007 ,P=0 .000 ,re-spectively) ,however ,there were no significantly differences of the expressions of CD7 ,HLA-DR ,CD14 ,CD13 ,CD61 and CD56 on monocytes(P=0 .075 ,P=0 .066 ,P=0 .408 ,P=0 .153 ,P=0 .137 ,P=0 .322 ,respectively ) .Expressions of all antigens were no significantlydifferencesamongthesubtypesofMDS(P>0.05).Conclusion Multiparametricflowcytometry (FCM)canrevealthe characteristics of immunophenotypic abnormalities of granulocytes and monocytes in Uyghur patients with MDS and provide more valuable ,objective information for the diagnosis and prognosis .

Objective:To research the characteristics of immunophenotype of nucleated erythrocytes in 41 Uyghur patients with Myelodysplastic syndrome (MDS) and analyze their clinic significance. Methods: The expressions of antigens of nucleated erythro-cyte population in 41 patients with MDS were detected by multiparametric flow cytometry. Results: Comparing with the non- MDS group, the proportion of nucleated erythrocyte population was significantly higher in the MDS group ( =0.029) . The proportion of nucleated erythrocyte population was no significant differences in RCMD, RAEB- I and RAEB- II ( ﹥0.05) . The expressions of GPA+CD71+, CD71, CD105 and GPA on nucleated erythrocytes were significantly increased than non- MDS group ( =0.026, =0.020, =0.033, and =0.024, respectively) , while the expressions of GPA+CD105+ and CD71+CD105+ were no significantly ( =0.050, =0.938, respectively) . Expressions of all other antigens were no significantly differences among the subtypes of MDS ( ﹥0.05) . Conclusion: Multiparametric flow cytometry ( FCM) can reveal the characteristics of immunophenotypic abnormalities of nucleated erythrocytes in Uyghur patients with MDS and provide more objective information for the diagnosis and prognosis.

目的 探讨维吾尔族急性早幼粒细胞白血病(APL)患者的免疫表型特征.方法 39例维吾尔族APL患者,按FAB和我国标准诊断为M3a者35例,M3b者4例. 起病时外周血WBC≤10 ×109/L者22例(中低危组), WBC>10 ×10 9/L者17例(高危组). 抽取患者骨髓置于EDTA抗凝管,采用四色流式细胞术检测胞膜/胞质抗原,分析免疫表型.结果 39例维吾尔族APL患者细胞均表达髓系特异性抗原CD13CD33、CD38,CD34和HLA-DR阳性表达率分别为7.7%和15.4%,CD56、CD15、CD2 阳性表达率分别为7.7%、30.8%、0. 按CD34和HLA-DR的表达强度,将39例APL患者分成CD3+4或HLA-DR+(6/39,15.4%)、CD34 -和HLA-DR-(33/39,84.6%)两组,两组间CD56阳性率为分别为50%、0(P<0.05). 中低危组、高危组CD15阳性率分别为50%、5.9%(P<0.005). 结论 维吾尔族APL患者的免疫表型特征为CD34、HLA-DR多阴性,CD13 CD33高表达,而CD56、CD2 低表达,CD15表达偏高.