Aim: To investigate the targets of miR-181b in patients with chronic lymphocytic leukemia (CLL). Materials & methods: The bioinformatic softwares were used to indicate the key target genes associated with miR-181b, and the results were verified in CLL patient samples and 293T cells. Results:CARD11 is a potential target gene of miR-181b, an inverse relationship was revealed between the expression of CARD11 and miR-181b in 104 CLL patients, and it was confirmed in vitro with luciferase assays and western blotting. Kaplan-Meier analysis showed that CLL patients with high CARD11 expression demonstrated poor survival. Conclusion:CARD11 is a novel target of miR-181b that is upregulated, which could be a poor prognostic indicator for CLL patients.

目的:研究泊沙康唑在预防恶性血液病患者侵袭性真菌病中的应用效果.方法:选取我院2018年1月～2019年9月收治的50例恶性血液病患者,按照随机数余数分组法分为采取泊沙康唑预防的泊沙康唑组以及采取伊曲康唑预防的伊曲康唑组各25例,对两组预防效果进行对比.结果:泊沙康唑组预防治疗成功率为84.00％(21/25),显著高于伊曲康唑组的68.00％(17/25),侵袭性真菌病发生率为4.00％(1/25),显著低于伊曲康唑组的16.00％(4/25)(P＜0.05);给药前两组炎性细胞因子差异无统计学意义(P＞0.05),给药结束后均较本组给药前降低(P＜0.05),组间比较泊沙康唑组均低于伊曲康唑组(P＜0.05);泊沙康唑组治疗期间不良反应发生率为8.00％(2/25),伊曲康唑组治疗期间不良反应发生率为20.00％(5/25),两组不良反应发生率对比无统计学意义(P＞0.05).结论:在预防恶性血液病患者侵袭性真菌病中泊沙康唑效果更佳且安全性高,可作为优选用药方案推广使用.

OBJECTIVE:To explore the value of CpG-oligonucleotide(CpG-ODN) immunostimulatory method in chromosome culture of chronic lymphocytic leukemia (CLL) cells and to compare the differences between related studies at home and abroad, so as to improve the success rate of CLL karyotype culture and the detection rate of abnormal karyo-types.METHODS:Bone marrow samples from 82 CLL patients were collected and cultured with phytohemagglutinin (PHA), CpG-oligonucleotide plus interleukin-2 (CpG-ODN DSP30+IL-2) for 72 hours. Chromosomes were prepared and analyzed by conventional cytogenetics (CC). Meanwhile, D13S25, Rb1, ATM, p53 and CSP12 probes were used for interphase fluorescence in situ hybridization (iFISH) test. The differences of chromosome culture and iFISH test results between two cell stimulants were compared.RESULTS:The success rate of karyotype culture in PHA and CpG-ODN DSP30+IL-2 immunostimuli (analyzable mitotic t >20) was 90.2% (74 cases), 68.3% (56 cases) respectively, and the detection rate of abnormal karyotype was 13.5% (10 cases) and 46.4% (26 cases), respectively. The success rate of karyotype culture in PHA group was significantly higher than that in CpG-ODN DSP30+IL-2 group (P=0.01). The detection rate of abnormal karyotypes in CpG-ODN DSP30+IL-2 group was significantly higher than that in PHA group, and the difference was statistically significant (P=0.003). The detection rate of abnormal karyotypes in iFISH group was 74.4% (61 cases), which was significantly higher than that in CpG-ODN DSP30+IL-2 group (P=0.000). iFISH detection could verify the abnormalities detected by CC analysis.CONCLUSION:Application of CpG-ODN DSP30+IL-2 immunostimulation method in culture of CLL cells can enhance the detection rate of abnormal karyotypes, especially the detection of various translocations suggesting poor prognosis.

The abnormal expression of miRNAs may play critical roles in the occurrence, development and prognosis of chronic lymphocytic leukemia (CLL), with potential ethnic differences being involved. p53 and immunoglobulin heavy chain variable region gene (IGVH) mutations were monitored and miRNA profile screening of CD19 + cells from Uygur CLL patients was performed, analyzed by miRNA arrays and verified using real-time PCR. There were 68 differentially expressed miRNAs in CD19 + B lymphocytes obtained from 6 Uygur CLL patients, of which miR-1295, miR-29b, miR-34a, miR-21 and miR-29c were the 5 most upregulated, and miR-181a, miR-126, miR-181b, miR-125a-5p and miR199b the 5 most downregulated miRNAs. miR-15a/miR-16-1 which might be important drivers of the disease, were not eliminated by profile screening. From the 68 differentially expressed miRNAs, 5 previously-reported CLL-related miRNAs were selected for further confirmation analyses, from which expression levels of miR-29b, miR-34a and miR-155 were found to be increased while miR-181a and miR-181b decreased. However, there were no differences in the expression levels of miR-15a/miR-16-1 between CLL patients and healthy donors, but the expression levels of miR-15a/miR-16-1 in CLL patients with a 13q deletion was depressed. In addition, there was no difference in the expression level of the above 7 miRNAs between 44 Han and 40 Uygur CLL patients. The expression levels of miR-29b, miR-181a and miR-181b correlated with IGVH mutations, while the expression levels of miR-34a, miR-29b and miR-181b correlated with a p53 abnormality in 84 Uygur and Han CLL patients. Taking p53 abnormality as the cut-off value criteria, low expression levels of miR-34a (cut-off value 4.65, P = 0.02) and miR-29b (cut-off value 4.71, P = 0.009) hinted at a poor treatment-free survival (TFS) prognosis for all CLL patients. Thus miR-34a and miR-29b may represent useful indicators for the prognosis of both Uygur and Han CLL patients.

目的 探讨红细胞平均体积(MCV)与红细胞体积分布宽度(RDW)在贫血疾病鉴别诊断中的应用效果.方法 任选70例在我院就诊的贫血患者,采集患者空腹静脉血行MCV和RDW检测,分析两指标在各类贫血疾病患者中的诊断效果.结果 不同类型贫血患者的MCV和RDW值差异较大(P<0.05);MCV和RDW诊断各类型贫血的敏感性为83.3％-95.6％,特异度为91.5％-100.0％.结论 红细胞MCV和RDW的改变在各类型贫血疾病诊断中具有较高敏感性和特异性,能够为临床诊治提供重要依据.

Background Genetic factors play a role in the etiology of BCR-ABL-negative myeloproliferative neoplasms (MPNs). This study explored the relationship between mutations in the Janus kinase 2 gene (JAK2), MPL, and the calreticulin gene (CALR) in Uygur and Han Chinese patients with BCR-ABL fusion gene-negative MPN and corresponding clinical features. Methods A total of 492 BCR-ABL-negative MPN patients treated in our hospital from May 2013 to August 2016 were enrolled. Genomic DNA was extracted from peripheral blood and used for PCR amplification and DNA sequencing. Mutations including JAK2 V617F, MPL W515L/K, and those in JAK2 exon 12 and CALR were analyzed and compared with patient clinical characteristics. Results Of the 492 MPN patients, 169 were Uygur and 323 were Han. In these two patient groups, JAK2 mutations were detected in 39.64% and 52.63%, respectively, CALR mutations were detected in 10.06% and 20.43%, respectively, and MPL mutations were detected in 0.93% of Han patients. The age, white blood cell count, platelet levels, and hemoglobin levels in JAK2 in Han patients were higher than those in Uygur patients. Conclusion Han MPN patients harboring JAK2 mutations had higher level of age, WBC, PLT, and Hb than Uyghur patients with the same mutations.

Objective To explore the differences in expression level of miR-181 b (miR-181 b) in CD19+B lymphocytes in patients with chronic lymphocytic leukemia ( CLL) and analyze its clinical significance. Methods Fifty patients with CLL, and collecting healthy controls 20 cases. All patients took 15 ml of peripheral blood and the total RNA of CD19+B lymphocyte was extracted after sorting with CD19 magnetic beads, and the expression lever of miR-181 b was measured by Taq Man probe. The difference expression lever of miR-181 b in prognostic groups were analyzed, such as clinical stages, Serological indicators, CD38, Zeta chain related protein kinase-70, immunoglobulin heavy chain variable region and Abnormal genetics. Survival analysis was performed on the above indexes. Results (1) The expression lever of miR-181 b in CD19+B lymphocytes in Fifty patients with CLL was significantly lower than the healthy controls ( P ＜ 0. 01). (2) The expression level of miR-181 b in different groups: according to the prognosis of FISH groups, the poor prognosis group was significantly lower than the favorable prognosis group ( P ＜ 0. 05), ATM deletion group was significantly lower than the ATM normal group ( P ＜ 0. 05), There was no statistical difference in the expression level of miR-181 b in other groups (P＞ 0. 05). (3) Survival analysis: The expression level of mir-181 b was divided into low expression group and high expression group by median of 0. 033. The comparison showed that the OS of mir-181 b low expression group was shorter than the mir-181 b high expression group ( P ＜ 0. 05). Combined COX multivariate analysis with poor prognostic factors, the results showed that the high-risk group of FISH prognosis group, P53 deletion, ATM deletion, miR181 b lower expression were all independent prognostic factors affecting survival ( P ＜ 0. 05). Conclusion The expression level of mir-181 b in CLL patients is significantly lower than normal people, and the low expression of mir-181 b is an independent prognostic factor of CLL.

目的 分析血常规检测在缺铁性贫血(IDA)和地中海贫血(THAL)鉴别诊断中的应用效果.方法 选取2016年1月-2017年10月我科室收治的40例IDA患者和40例THAL患者,另选取同期健康体检者40例为对照组,均给予血常规检测,观察其诊断效果.结果 IDA组的RBC、Hb、MCV低于对照组,RDW高于对照组(P<0.05).THAL组的RBC、RDW高于对照组,Hb、MCV低于对照组(P<0.05).IDA组与THAL组的RBC、Hb、RDW等指标比较差异显著(P<0.05).结论 在IDA和THAL鉴别诊断中血常规检测具有较高应用价值,可将RDW作为鉴别诊断要点.

Objective To analyze the pathogenic bacteria distribution, risk factors and imaging features for nosocomial infections in patients with acute myelogenous leukemia (AML) at the induced remission stage.Methods The data of 126 patients with AML hospitalized in our hospital from January 2010 to December 2014 were analyzed, restrospectively. The clinical data for cases with lower respiratory infection were analyzed by the single factor test and the multi-factor unconditioned Logistic regression analysis. While the imaging characteristics of pulmonary infection were analyzed.Results There were 102 cases with lower respiratory tract infection among the 126 patients with AML, the infection rate was 80.9% and the infection mortality rate was 3.2%. Age > 60 years old, white blood cell count≤ 2×109/L and > 10×109/L, The level of hemoglobin≤ 60 g/L, lymphocytes count, albumin≤ 30 g/L, chemotherapy (IA program), length of hospital stay > 30 days and PICC catheter were all the possible risk factors by single factor analysis. The level of hemoglobin≤ 60 g/L, albumin≤ 30 g/L and chemotherapy (IA program) were all the risk factors of respiratory infections for patients with AML by multivariate Logistic regression analysis. There were 62 cases&nbsp;with both lung lesions, 23 cases with right lung disorders, 17 cases with left lung lesions. There were 37 cases with Large or patchy shadows, accounting for 36.3% of all lung infection; 22 cases with nodular lesions, accounting for 21.6% of all lung infection; 19 cases had cord and ground glass lfake, accounting for 18.6%; 17 cases (16.7%) had nodules and patchy total; 7 cases (6.8%) had nodules, consolidation and empty shadow. 5 cases with fungal culture-positive showed nodules merged with empty shadow, while only 2 cases (2/26) of bacterial infection showed nodules empty shadow, with signiifcant differences (χ2 = 20.44,P = 0.00).Conclusions For patients with AML remission induction, the hospital infection rate was high. Hemoglobin≤ 60 g/L, albumin≤ 30 g/L and chemotherapy (IA program ) were all risk factors of respiratory infection for patients with AML. The lung imaging of acute myeloid leukemia in patients with lower respiratory tract infection was diversity, nodular shadows merged with empty shadow suggests fungal infection.