<正>患者,女,43岁。多关节疼痛1个月,加重15 d;关节疼痛累及双手近端关节、掌指关节、双腕、肘、肩、髋、膝、踝、趾跖关节,晨僵>30 min。查体:颞颌关节压痛;双手2、3、4、5指近端指间关节梭形肿胀、压痛,双手不能握拳,双腕、肘、肩、髋、膝、双足跖趾关节压痛明显,部分跖趾关节肿胀,双腕强

目的:探讨急性单核细胞白血病治疗后转为急性红白血病的细胞遗传学和分子遗传学机制.方法:对1例急性单核细胞白血病患者的诊断,连续缓解和复发的整个过程应用细胞形态学、组织化学、细胞遗传学和分子遗传学方法进行监测.结果:该患者经骨髓细胞形态学、染色体检查确诊为AML-MSb,完全缓解36个月后复发,细胞学和免疫分型示转型为AML-M6.结论:急性单核细胞白血病治疗后转为急性红白血病为特殊复发形式,耐药性强,治疗效果差,其原因可能与白血病次级克隆扩增或药物诱导的克隆改变有关.

Objective To observe the concentration of blood uric acid(BUA) of healthy group,and the rate of eases of symptomless hyperuricemia and hypouricemia.Methods 968 samples were analyzed by urate oxidase enzymic method.Results The concentrations of males were(355.3±76.5)μmol/L in 20-49 years old group,(359±87.8)μmol/L in those older than 50.But the result from female was different,the concentrations were(251.1±54.5)μmol/L in 20-49 years group,(275.7±61.3) μmol/L in those older than 50.So the result showed a significant difference between the males and females in the same year old groups(P0.01).In male groups,there was a significant difference between 20-29 group and 30-39 group,40-49 group,older than 70 group(P0.05),and between 60-69 group and ≥70 group(P0.05).The concentration of BUA in those older than 50 decreased,but it rose in those older than 70.In female groups,there was a significant difference between 20-29 group and 50-69 group,also between 30-39 group and 50-59 group(P0.01).Conclusion To diagnose hyperuricemia and hypouricemia,it′s better to establish the different range of normal values of BUA in different areas.