地西他滨联合IAG/DAG治疗急性髓系白血病的临床疗效

目的 探讨地西他滨（DAC）联合IAG/DAG治疗急性髓系白血病（AML）的临床疗效与安全性。方法 选取2017年6月至2019年12月安徽医科大学第一附属医院血液科收治的23例初治或复发AML患者,采用DAC联合IAG/DAG诱导治疗,统计分析临床疗效及安全性。结果 23例患者均予以DAC联合IAG/DAG诱导化疗,其中完全缓解13例,部分缓解2例,总有效率为65.22%。23例患者均出现Ⅲ～Ⅳ级的粒细胞和血小板减少,1例患者因严重脑出血死亡。结论 DAC联合IAG/DAG治疗AML临床疗效较好,且不良反应可耐受,安全性高,值得临床推广应用。     

血清可溶性白细胞介素2受体在多发性骨髓瘤中的表达及意义

目的探讨血清可溶性白细胞介素2受体(sIL-2R)在多发性骨髓瘤(MM)中的表达水平及临床意义。方法70例MM患者中初治组40例,复发组15例,缓解组15例,并设正常健康人对照组20例。采用酶联免疫吸附法测定sIL-2R的表达水平。结果MM患者sIL-2R的表达,复发组(890.1±2228.3)kU/L高于初治组(680.7±101.4)kU/L及缓解组(271.5±87.1)kU/L(F=128.17,P<0.01),缓解组高于对照组(203.1±72.9)kU/L(P<0.05);初治MM患者sIL-2R的表达水平与疗效、临床分期以及β2-微球蛋白(β2-MG)和C反应蛋白(CRP)等部分临床特征密切相关(均P<0.01)。结论监测sIL-2R的表达水平有助于MM的疗效及预后评定。     

急性白血病化疗前后血清甲状腺激素水平变化及其对疗效和预后的影响

目的　研究急性白血病化疗前后血清甲状腺激素水平变化及其对疗效和预后的影响。方法　测定患者化疗前后血清甲状腺激素水平 ,分析患者血清甲状腺激素水平的变化及其与急性白血病疗效和预后的关系。结果　化疗前患者血清甲状腺激素水平与正常对照比较无显著差异 ;化疗后患者血清甲状腺激素水平降低 ,明显低于正常对照。化疗前后患者血清甲状腺激素水平低于正常者疗效较差 ,治疗相关病死率较高 ,中位生存期较短。结论　急性白血病患者化疗前后低甲状腺素水平提示预后较差     

多发性骨髓瘤复发预测的研究

目的:探讨多发性骨髓瘤(multiple myeloma,MM)的复发与p53蛋白、bcl-2蛋白及血清可溶性白细胞介素2受体(soluble interleukin-2 receptor,slL-2R)表达的关系.方法:采用酶联免疫吸附法测定slL-2R,免疫组化法测定p53蛋白、bcl-2蛋白的表达水平.结果:MM患者p53蛋白、bcl-2蛋白的阳性率及sIL-2R的表达复发组显著高于初诊组(P<0.01),初诊组高于完全缓解(complete remission,CR)组及对照组(P<0.01).初诊和复发MM患者p53蛋白、bcl-2蛋白及sIL-2R的表达与β2-微球蛋白(β2-microglobulin,β2-MG)呈正相关(R=0.685,0.656,0.776)(P<0.01).结论:监测p53蛋白、bcl-2蛋白及sIL-2R的表达水平可预测MM的复发.     

黄芪总苷诱导人白血病NB4细胞凋亡的机制

Objective To investigate the effect of total astragalosides (TA) on proliferation and apoptosis in human leukemia NB4 cells in vitro. Methods The NB4 cells were treated with TA at different concentrations for 48 h in culture. Growth inhibition rates were measured by CCK-8 method. Flow cytometry was used to explore the cell apoptosis and the activity of NF-κB and Akt during apoptosis. Results TA at different concentrations (200, 400, 600, 800 mg/L) inhibited proliferation of NB4 cells in a dose-dependent manner ( P < 0. 05), and the inhibitory rates of TA on NB4 cells were (14. 54 ± 3. 20) % , (24.79 ±3.98)%, (57.28 ±4.71)% and (88.28 ±4.65)% , respectively. In terms of the induction of apoptosis, there was a significant difference between the TA group and blank control [(1.80±1.24)%, P<0.05]. At TA doses of 200, 400 and 600 mg/L, the apoptotic rates of NB4 cells were ( 10. 03 ± 3.31)% , (14.87 ±3.65)% , (23.45 ± 1.90) % , respectively. Besides, TA induced apoptosis of NB4 cells in a dose-dependent manner in the groups of 200 mg/L, 400 mg/L, 600 mg/L (P<0.05). But there was no significant difference in apoptotic rates between the groups of 800 mg/L and 600 mg/L [(23.45 ±1.90)%, P> 0.05]. In the group of 800 mg/L, the necrotic cells increased highly and the necrotic rate reached (45.65 ± 3.16)%. After TA treatment of NB4 cells at different concentrations (200, 400, 600 mg/L), the expression of NF-kB protein was significantly decreased compared with that of the blank control (9. 79 ±0. 95, P<0.05), while Akt protein was not significantly decreased (P>0.05). Conclusion TA can inhibit the growth of NB4 cells and induce apoptosis in NB4 cells through an Akt-independent NF-kB signaling pathway.     

脾动脉栓塞治疗特发性血小板减少性紫癜13例体会

脾动脉栓塞治疗特发性血小板减少性紫癜１３例体会血液科杨明珍，任立奋，曾庆曙安徽医科大学附属医院（２３００２２）放射科朱赤特发性血小板减少性紫癜（ＩＴＰ）在急性期或慢性型急性发作期，可因末梢血中血小板极度减少，临床上出现一系列的出血症状，严重者可危及生...     

白细胞介素21体外促进骨髓瘤细胞增殖的研究

目的体外研究白细胞介素21(IL-21)对骨髓瘤细胞增殖的促进作用.方法以IL-21及IL-6体外刺激来自于骨髓瘤患者的骨髓瘤细胞,RT-PCR分析IL-21受体(IL-21R)在骨髓瘤细胞中的表达,MTT分析IL-21及IL-6促进骨髓瘤细胞的增殖效应.结果RT-PCR分析表明骨髓瘤细胞表达IL-21R;MTT分析结果显示IL-21体外对11例患者中的7例骨髓瘤细胞具有促进作用,最大增殖率达154%,但其作用强度低于IL-6.结论IL-21具有促进骨髓瘤细胞增殖作用,其作用强度较IL-6弱.