红白血病45例骨髓涂片的观察——对亚型的探讨

报道４５例红白血病骨髓涂片的观察结果，３８例符合红白血病（Ｍ６）的诊断标准。有７例不符合Ｍ６的诊断，其中２例为ＤｉＧｕｇｌｉｅｌｍｏ综合征，５例为急性红血病。并对这些亚型的诊断标准进行了讨论。

羊附红细胞体病的诊疗及研究

目的:分析羊附红细胞体病的诊疗过程。方法:择取2016年5月~2016年8月某养殖场饲养的槐山羊、本地山羊以及波尔山羊为432只为研究样本,对出现附红细胞体病的病畜开展针对性治疗,分析结果。结果:使用四环素、贝尼尔等药物开展综合治疗,疾病好转,无病畜死亡。结论:对于羊附红细胞体病,应当尽早诊断,使用贝尼尔联合针对性药物治疗,可在病畜短期内疾病转归。诊断疾病时力求准确,并施以针对性的治疗措施,保证病畜在短时间内得到治疗,避免造成不可挽回的经济损失。

In vitro Drug Sensitivity of Eperythrozoon from Mink

[Objective] This study aimed to test the sensitivity of Eperythrozoon from mink to various drugs in vitro. [Method] The red blood cells isolated from Eperythro- zoon positive mink was cultured in complete medium （70% RPMI-1640 medium and 30% calf serum）, supplemented with bernier, oxytetracycline, trichlorfon, tylosin, imi- docarb, florfenicol, Fuhongjuesha or primaquine phosphate at the working concentra- tions of 12, 24, 36, 48 and 96 μL/ml, incubated at 37.3 ℃, 5% CO2. [Result] Fuhongjuesha was most efficient for killing Eperythrozoon, followed by trichiorfon and primaquine phosphate, but trichlorfon is toxic. Bernier, imidocarb and florfenicol are efficient. [Conclusion] The study provides a scientific reference for clinical treatment of eperythrozoonosis.

Alterations of red blood cell immunoadherence function in hepatitis B patients

AIMS To investigate the alterations of RBC immunoadherence function in patients with various hepatitis B. METHODS RBCC3bRR,RBCICRR and serum CIC levels were measured in 42 patients with acute and chronic hepatitis B at ac- tive and convalescence stages. RESULTS RBCC3bRRs at the active/acute stage of various hepatitis were decreased.They were 13,54%±5,23% in AH, 7.61%±4.12% in AFH,and 16.18%±6.10% in CH, respectively,all of which were lower than those in normal persons (18.12%±3.91% ).At the quiescent/recovery stage of various hepatitis,the RBCC3bRRs were increased significantly.The changes of RBCICRR and serum CIC level were contrary to those of RBCC3bRR. CONCLUSIONS RBC immunoadherence function is decreased in acute and chronic hepatitis.The decrease is in direct proportion to the severity of the diseases.

Effects of r-HuEPO on the biophysical characteristics of erythrocyte membrane in patients with anemia of chronic renal failure

Using electron spin resonance (ESR) spin labeling technique, we have studied the conformation of sulfhydryl groups(-SH) binding sites in membrane proteins and membrane fluidity of red blood cells (RBCs) from two groups of patients with anemia of chronic renal failure (ACRF). One of the groups is composed of patients who were untreated with recombinant human erythropoietin(r-HuEPO), and the other is composed of patients who were treated with r-HuEPO. The results indicated: 1) the conformation of SH group binding site in RBC membrane proteins from former group was different from those of health people. 2)the fluidity in the region near the surface of RBC membrane from former group was lower than those of healthy people. 3) However, the above biophysical properties of RBC membrane from later group were normal. We concluded that RBC membrane in patients with ACRF was abnormal, and the treatment of r-HuEPO may promote the production of normal RBCs, thus ameliorate the biophysical properties of RBCs from the patients with ACRF.

Differences in the predictive value of red cell distribution width for the mortality of patients with heart failure due to various heart diseases

Background Increased red blood cell distribution width （RDW） is associated with adverse outcomes in patients with heart failure （HF）. The objective of this study was to compare the differences in the predictive value of RDW in patients with HF due to different causes. Methods We retrospectively investigated 1,021 HF patients from October 2009 to December 2011 at Fuwai Hospital （Beijing, China）. HF in these patients was caused by three diseases; coronary heart disease （CHD）, dilated cardiomyopathy （DCM） and valvular heart disease （VHD）. Patients were followed-up for 21 ~ 9 months. Results The RDW, mortality and survival duration were significantly different among the three groups. Kaplan-Meier analysis showed that the cumulative survival decreased significantly with increased RDW in patients with HF caused by CHD and DCM, but not in those with HF patients caused by VHD. In a multivariable model, RDW was identified as an independent predictor for the mortality of HF patients with CHD （P 〈 0.001, HR 1.315, 95% CI 1.122-1.543）. The group with higher N-terminal pro-brain natriuretic peptide （NT-proBNP） and higher RDW than median had the lowest cumulative survival in patients with HF due to CHD, but not in patients with HF due to DCM. Conclusions RDW is a prognostic indicator for patients with HF caused by CHD and DCM; thus, RDW adds important information to NT-proBNP in CHD caused HF patients.

Role of calcium in differentiation of murine erythroleukemia cells

Calcium plays a crucial role in the normal and abnormal cell metabolism. The role of calcium in the differentiation process of murine erythroleukemia cells(MELC) remains controversial. Here, based upon quantitative measurement of fluorescence in single cells, a method was developed to investigate the intracellular free calcium [Ca2+]i concentration and DNA contents simultaneously, by employing the fluorescent probe, fluo-3 acetoxymethyl ester and DNA dye Hoechst 33342. During MELC differentiation, [Ca2+]i concentration incresed. We also demonstrated that calcium ionophore, A23187, enhanced the HMBA-induced MELC differentiation, while verapamil, an inhibitor of calcuim uptake, slightly reduced differentiation. These results suggested that an increase in the [Ca2+]i level was an essential step in HMBA-induced MELC differentiation.

Function of GATA transcription factors in hydroxyurea-induced HEL cells

HEL cells, a human erythroleukemia cell line, mainly express the fetal (r)globin gene and trace amount of the embryonic (E)globin gene, but not adult (B) globin gene. Here we show that hydroxyurea (HU) can induce HEL cells to express adult (B) globin gene and lead these cells to terminal differentiation. Results showed in Gel mobility shift assays that GATA factors could specifically bind to the regulatory elements of human B- globin gene, including the proximal regulatory element (the B- promoter) and the distal regulatory elements (the DNase I hypersensitive sites in the LCR, HS2-HS4 core sequences). However, the DNA binding patterns of GATA factors were quite different between HU-induced and uninduced HEL cells. Western-blot analysis of nuclear extracts from both the uninduced and HU- induced HEL cells revealed that the level of GATA-2 transcription factor decreased, whereas the level of GATA-1 transcription factor increased following the time of hydroxyurea induction. Furthermore, using RT-PCR analysis the expression of human B-globin gene in HU-induced HEL cells could be blocked again when HEL cells were incubated in the presence of antisense oligonucleotides for hGATA-1, suggesting that the upregulation of hGATA-1 transcription factor might be critical for the expression of human β- globin gene in HU-induced HEL cells.

NEW DESIGNED HMBA AGENTS AS INDUCERS OFERYTHROLEUKEMIA CELL DIFFERENTIATION

Searching for more potent and less toxic HMBA related agents. Methods. Human erythroleukemia cell K562, murine erythroleukemia cell (MEL) and its sub line MEL DS19 were used as target cells to select a cell line which is the most sensitive to HMBA, then analyzed the activity of inducing differentiati on of two new designed HMBA derivatives: HMBPA [hexamethylenebi (3 pyridin) ami de] and Co HDTA (ethylenediaminetetra acetic acid cobalt) using cell biology, c ytochemical and molecular biology techniques. Results. We found that the MEL DS19 cells were most sensitive to HMBA (benzidine positive, B+～76%). Co HDTA can inhibit the growth of MEL DS19, but induces differentiation just in a small population (B+ 2%～4.5%). Between 0.02～5μmo l/L, HMBPA induces 3%～8% cells committed to differentiation with little inhib ition of cell proliferation. 1μmol/L HMBPA and 2mmol/L HMBA together, can obvio usly increase the percentage of differentiated cell (B+～ 72%), inhibit DNA sy nthesis and accelerate β globin transcription. Conclusion. The new HMBA derivatives may provide potential cancer differentiatio n inducers.

Stimulating erythropoiesis in inflammatory bowel disease associated anemia

Anemia is a frequent complication in patients with inflammatory bowel disease (IBD), and is associated with decreased quality of life and increased rate of hospitalization. The primary therapeutic targets of IBD- associated anemia are iron deficiency and anemia of chronic disease. An important prognostic parameter of the success or failure of therapy is the outcome of the underlying disease. Iron deficiency should be appropriately managed with iron supplementation. However, the use of oral iron therapy is limited by several problems, the most important being gastrointestinal side effects leading occasionally to disease relapse and poor iron absorption. Intravenous iron preparations are more reliable, with iron sucrose demonstrating the best efficacy and tolerability. Treatment with erythropoietin or darbepoetin has been proven to be effective in patients with anemia, who fail to respond to intravenous iron. Patients with ongoing inflammation have anemia of chronic disease and may require combination therapy comprising of intravenous iron sucrose and erythropoietin. After initiating treatment, careful monitoring of hemoglobin levels and iron parameters is needed in order to avoid recurrence of anemia. In conclusion, anemia in the setting of IBD should be aggressively diagnosed, investigated, and treated. Future studies should define the optimal dose and schedule of intravenous iron supplementation and appropriate erythropoietin therapy in these patients.

Anemia and inflammatory bowel diseases

Too often anemia is considered a rare or unimportant manifestation in inflammatory bowel disease (IBD). However, over the last 10 years a number of studies have been conducted and the most relevant conclusions obtained are: (1) anemia is quite common in IBD; (2) although in many cases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3) anemia, and also iron def iciency without anemia, have important consequences in the clinical status and quality of life of the patient; (4) oral iron can lead to gastrointestinal intolerance and failure of treatment; (5) intravenous iron is an effective and safe way to treat iron deficiency; (6) erythropoietin is needed in a significant number of cases to achieve normal hemoglobin levels. Thus, the clinician caring for IBD patients should have a comprehensive knowledge of anemia, and apply recently published guidelines in clinical practice.

Residual urinary output in high body mass index individuals on chronic hemodialysis:A disregarded life vest?

AIM： To assess residual diuresis and diverse variables according to body mass index （BMI）.METHODS： Cross-sectional study （n = 57）, with 3 groups. Group A： BMI 〈 25, n = 22; Group B： BMI 25-30, n = 15; Group C： BMI 〉 30, n = 20. Diuresis, hematocrit, albumin, C-reactive protein, Malnutrition infammatory score, Pro-BNP, Troponin T, leptin and in-sulin levels are expressed as median and ranges （r）. RESULTS： Albumin （g/dL）： GA vs GC, 3.70 （r2.20-4.90） vs 3.85 （r3.40-4.90）, P = 0.02. Diuresis （mL/d）： GA 690 （r0-1780）; GB 660 （r60-1800）; GC 840 （r40-2840）. Diuresis GA vs GC, P = 0.01. Leptin （ng/mL）： GA vs GC, 3.81 （r0.78-69.60） vs GC, 32.80 （r0.78-124.50）, P 〈 0.001. Insulin （μU/mL）： GA vs GB, 7 （r2-44） vs 11.50 （r4-38）, P = 0.02; GA vs GC, 7 （r2-44） vs 19.5 （r5-155）, P = 0.0001. Troponin T and Pro-BNP levels were not different. Significant correlations： GC, Insulin-UF： ρ= 0.53; P = 0.03; TroponinT-diuresis： ρ = -0.48, P 〈 0.05; Pro-BNP-diuresis： ρ = -0.39, P 〈 0.01; Troponin T-ProBNP： ρ = 0.77, P 〈 0.0001; albumin-Troponin T： ρ = -0.66, P 〈 0.0001; albumin-ProBNP： ρ = -0.44, P 〈 0.05.CONCLUSION： High BMI associated positively with higher diuresis and albuminemia, and negatively with TropT and Pro-BNP. High BMI-associated better survival may be explained by better urinary output, lowering cardiovascular stress.

Anemia and digestive diseases: An update for the clinician

Anemia and iron deficiency are so common in digestive diseases that often are underestimated and undertreated. Our goal is to review from classif ication to treatment of the diverse types of anemias in different digestive diseases to update our knowledge on diagnosis and treatment. With the goal of improving the prognosis and quality of life of digestive diseases patients, we will review current transfusion, intravenous iron, and erythropoietin roles in the treatment of anemia.

Use of agents stimulating erythropoiesis in digestive diseases

Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron def iciency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as f irst choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same eff icacy and safety.

STAT1 is involved in signal transduction in the EPOinduced HEL cells

Erythropoietin (EPO) is the ma jor regulator of mammalian erythropoisis, which stimulates the growth and differentiation of hematopoietic cells through interaction with its receptor (EPO-R). Here we use HEL cells (a human erythro-leukemia cell line) as a model to elucidate the pathway of signal transduction in the EPO-induced HEL cells. our data show that the EPOR (EPO receptor) on the surface of HEL cells interacts with the Janus tyrosine protein kinase (Jak2) to transduce intracellular signals through phosphorylation of cytoplasmic proteins in EPO-treated HEL cells. Both STAT1 and STAT5 in this cell line are tyrosine-phosphorylated and translocated to nucleus following the binding of EPO to HEL cells.Furthermore, the binding of both STAT1 and STAT5 proteins to specific DNA elements (SIE and PIE elements) is revealed in an EPO-dependent manner. Our data demonstrate that the pathway of signal transduction following the binding of EPO to HEL cells is similar to immature erythroid cell from the spleen of mice infected with anemia strain of Friend virus.

Classification of anemia for gastroenterologists

Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classifi cation (microcytic, macrocytic and normocytic) and pathogenic classi-fication (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other comple-mentary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time.

Plasma erythropoietin levels in anaemic and non-anaemic patients with chronic liver diseases

AIM: To investigate the serum erythropoietin (Epo) levels in patients with chronic liver diseases and to compare to subjects with iron-deficiency anaemia and healthy controls.METHODS: We examined 31 anaemic (ALC) and 22 non-anaemic (NALC) cirrhotic patients, 21 non-anaemic subjects with chronic active hepatitis (CAH), 24 patients with iron-deficiency anaemia (ID) and 15 healthy controls. Circulating Epo levels (ELISA; R&D Systems, Europe Ltd, Abingdon,UK) and haemoglobin (Hb) concentration were determined in all subjects.RESULTS: Mean±SD of Epo values was 26.9±10.8 mU/mL in ALC patients, 12.5±8.0 mU/mL in NALC subjects,11.6±6.3 mU/mL in CAH patients, 56.4±12.7 mU/mL in the cases of ID and 9.3±2.6 mU/mL in controls. No significant difference (P>0.05) was found in Epo levels between controls, CAH and NALC patients. ALC individuals had higher Epo levels (P<0.01) than these groups whereas ID subjects had even higher levels (P<0.001) than patients suffering from ALC.CONCLUSION: Increased Epo values in cirrhotics, are only detectable when haemoglobin was lesser than 12 g/dL.Nevertheless, this rise in value is lower than that observed in anaemic patients with iron-deficiency and appears blunted and inadequate in comparison to the degree of anaemia.

Eosinophilic gastroenteritis presenting as small bowel obstruction: A case report and review of the literature

Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by eosinophilic infiltration of the bowel wall to a variable depth and symptoms associated with gastrointestinal tract. Recently, the authors experienced a case of eosinophilic gastroenteritis presenting as small bowel obstruction. A 51-year old woman was admitted to our hospital complaining of abdominal pain and vomiting. Physical examination revealed a distended abdomen with diffuse tenderness. Complete blood count showed mild leukocytosis without eosinophilia. Computed tomography confirmed a dilatation of the small intestine with ascites. An emergency laparotomy was performed for a diagnosis of peritonitis due to intestinal obstruction. Segmental resection of the ileum and end to end anastomosis were performed. Histologically, there was a dense infiltration of eosinophils throughout the entire thickness of ileal wall and eosinophilic enteritis was diagnosed. The patient recovered well, and was free from gastrointestinal symptoms at the time when we reported her disease.

DIFFERENTIATION AND MALIGNANT SUPPRESSION INDUCED BY MOUSE ERYTHROID DIFFERENTIATION AND DENUCLEATION FACTOR ON MOUSE ERYTHROLEUKEMIA CELLS

Objective. To investigate the roles of mouse erythroid differentiation and denucleation factor (MKI)DF), a novel factor cloned in our laboratory recently, in erylhroid terminal differentiation.Method. Mouse erythroleukemia (MEL) cells were transfected with eukaryotie expression plasinid pcl)-NA-MEDDF. Then we investigated the changes on characteristics of cell growth by analyzing cells growth rate, mitotie index and colony-forming rate in semi-solid medium. The expressions of c-mye and p-globin genes were analysed by semi-quantitative RT-PCR.Results. MEL cells transfected with pcDNA-MEDDF showed significant lower growth rate, mitolic index,and colony-forming rate in semi-solid medium ( P<0. 01). The percentage of benzidine-positive cells was 32. 8%after transfection. The expression of β-globin in cells trarisfected with pcDNA-MEDDF was 3. 43 times higherthan that of control (MEL transfected with blank vector, pcDNA3. 1), and the expression of c-rnyc decreased by66. 3% .Conclusions. MEDDF can induce differentiation of MEL cell and suppress its malignancy.

The distribution of calmodulin and Ca^(2+)-activated calmodulin in cell cycle of mouse erythroleukemia cells

Cell proliferation is accompanied with changing levels of intracellular calmodulin (CaM) and its activation. Prior data from synchronized cell population could not actually stand for various CaM levels in different phases of cell cycle. Here, based upon quantitative measurement of fluorescence in individual cells, a method was developed to investigate intracellular total CaM and Ca2+-activated CaM contents. Intensity of CaM immunoflurescence gave total CaM level, and Ca2+ -activated CaM was measured by fluorescence intensity of CaM antagonist trifluoperazine (TFP). In mouse erythroleuke-mia (MEL) cells, total CaM level increased from G1 through S to G2 M, reaching a maximum of 2-fold increase, then reduced to half amount after cell division. Meanwhile, Ca2+-activated CaM also in creased through the cell cycle (G1 , S, G2M). Increasing observed in G1 meant that the entry of cells from G1 into S phase may require CaM accumulation, and, equally or even more important, Ca2+-dependent activation of CaM. Ca2+- activated CaM decreased after cell divi-sion. The results suggested that CaM gene expression and Ca2+-modulated CaM activation act synergistically to accomplish the cell cycle progression.