Objective To investigate the correlation between red blood cell distribution width (RDW) and urinary protein /cre-atinine ratio(TPCR) in elderly patients with essential hypertension .Methods TPCR ,Cr ,CysC ,eGFR ,TG ,TC ,LDL-C ,ApoA1 , ApoB and blood routine were detected in 801 elderly patients with essential hypertension and 98 healthy people .The differences of these indexes were compared between the two groups and the difference of RDW was compared among different grades of hyperten-sion .The hypertension patients were divided into two groups by TPCR<200 mg/g Cr or ≥200 mg/gCr ,the levels of RDW were compared between the two groups and the correlation between TPCR with RDW was analyzed .Results The age ,gender ,Cr and HB had no statistical differences between the hypertension group and control group (P>0 .05);TPCR ,TG ,TC ,LDL-C ,ApoB and RDW levels in the hypertension group were increased ,the ApoA1 ,CysC and eGFR levels were decreased ,the differences were sta-tistically significant (P<0 .05);the RDW level in the hypertension group was significantly higher than that in the control group ,the difference was statistically significant(P<0 .05);the RDW level was increased with the increase of blood pressure level ,the differ-ence was statistically significant(P<0 .05);the Pearson correlation analysis showed that RDW was positively correlated with TPCR (P<0 .05) .Conclusion The RDW level is elevated in the essential hypertension group ,and correlated with the level of TPCR .

Objective To study the reconstitution of nature kill cell early after non-myeloablative allogeneic stem cell transplantation (NAST). Methods Cell phenotypes and in vitro immune functions were analyzed by direct immune fluorescence with FCM, T-cell activation test and MTT assay, respectively. Results The percentages of CD+3, CD+4 cells were low, (2.03±15.60) % and (22.69±12.29)%, respectively, while CD+8 lymphocytes were normal or high [(29.26±8.99)%] 1 month after NAST. Proliferative response to a T lymphocyte activator (PHA) was blunted, 94.60±44.87. The percentage of NK cells was within normal limits or high (n=7) in allotransplanted patients. It is (18.77±9.11) %. The percentage of CD+56 NK cells expressing IL-2R (CD25) was high and values obtained from transplanted patients were significantly different from control values . They are (3.71±2.23) % (t = 2.116, P = 0.044). NK cell activity in part of patients was higher than that observed in control cells (25.30±12.39) % vs (16.60±3.53) % (t = 2.135, P= 0.047). Conclusion NK cell has recovered early after transplantation and may be particularly relevant as a first line of defence in immunosurveillance against neoplastic cells or microbial infections, until a full reconstitution of T cellmediated immune response can be achieved.

Objective To explore the effect of costimulatory moleculars expressed peripheral CD4+ T lymphocyts on graft-versus-host disease(GVHD) after allogeneic hematopoietic stem cell transplantation (alloHSCT). Methods 21 patients who suffered of hematology diseases or malignant solid tumors were underwent allo-HSCT and 10 normal individuals were enrolled in the study. The levels of CD28, CD80 and CD152expressions on peripheral CD4+ T lymphocytes were detected by FCM in different time(before allo-HSCT, 7 day,14 day, 21 day, 30 day after allo-HSCT, thetime of GVHD and the time after GVHD treated). STR-PCR was used to detect micro-satellites chimeras forming. Results All 21 patients achieved engraftment. By STR-PCR assay, 12 cases formed complete chimeras (CC) and 9 cases formed mixed chimeras (MC). A multivariate COX survival function modle analysis showed: CD4 CD152 was independent prognostic factors for GVHD (x2=13.128,P ＜0.0001). Patients with GVHD demonstrated higher CD4+ CD28+, CD4+ CD80+ and CD4+ CD152+ T cell levels than those without GVHD (P ＜0.01); patients with aGVHD demonstrated higher than those with cGVHD (P ＜0.05)and without GVHD (P ＜0.05); Patients with GVHD demonstrated lower CD4+ CD152+ T cell level than those without GVHD (P ＜0.01); the same result occured between aGVHD and cGVHD and without GVHD.Conclusion The incidence of GVHD between NST and traditional HSCT have no difference. B7-CD28/CD152 costimulatory pathway plays a critical role in the development of GVHD.

Objective To construct an eukaryotic vector with expression of human survivin gene with green fluorescent protein which is named pIRES2-EGFP/survivin and transfected into K562 cell line.Methods Using pDNR/Survivin plasmid as a template, the full length of survivin cDNA was amplified by PCR and subsequently cloned into T-A vector and then subcloned into pIRES2-EGFP vector. After identified by digestion of restrictive endonucleases, pIRES2-EGFP/survivin was further confirmed by sequencing. Then it was transfected into K562 cells with superfect reagents. The mRNA was isolated and survivin gene was detected by Western blotting. Results The exact sequences of pIRES2-EGFP/survivin vector were confirmed by digestion of restrictive endonucleases and sequencing. After transfection, the expressions of green fluorescent protein were present. The mRNA expression of survivin has been detected in transfected cells by RT-PCR. Conclusion The vector pIRES2-EGFP/survivin has been constructed and could express survivin gone in K562 cells successfully.

Objective To establish normal range of components of cord blood cells in healthy fetuses from 19 to 37 weeks' gestation and to provide proof for diagnosis of hematological disorders in prenatal fetuses and premature infants.Methods Twelve hematological parameters were determined in 182 fetuses using Coulter GENS system 2 full automated blood cell counter,and the blood cells were classified by microscope.Results The number of white blood cell(WBC) was increased gradually from 3.58?10~9/L to 5.76?10~9/L with the gestational weeks increasing from 19 to 37 weeks.The differential counts indicated that the lymphocytes represented the main population.The number of lymphocytes and normoblast was decreased gradually and that of neutrophils was increased gradually.The numbers of monocytes,eosinophils and basophils remained stable as the increasing of gestational weeks.The red blood cell(RBC),hemoglobin(HGB) and hematocrit(HCT) were increased gradually but mean corpuscular volume(MCV) was decreased.The differences between mean corpuscular hemoglobin(MCH),platelet volume distribution width(PDW),mean platelet volume(MPV),plateletcrit(PCT) and mean corpuscular hemoglobin concentration(MCHC) were not significant among different fetuses' ages.Conclusion The components of cord blood cells in healthy fetuses are dynamic and the establishment normal range of components of cord blood cells in healthy fetuses is helpful to diagnose the disorders in prenatal fetuses and premature infants.

Objective Henoch-Sch?nlein purpura(HSP)is a common multisystemic vasculitis in children ,but the exact pathogenesis remains unknown. Pentraxin 3(PTX3),a new kind of inflammatory cytokines,has a strong inflammatory effect,and is involved in occurrence and develop-ment of a variety of autoimmune diseases. The objective of this study is to evaluate the expression of PTX3,interleukin-8(IL-8),tumor necrosis fac-tor-α(TNF-α)and high sensitivity C-reactive protein(hs-CRP)in children with HSP,and explore the clinical significance of PTX3 in HSP devel-opment. Methods Thirty-six children(HSP group)and 17 healthy children(control group)were enrolled in the study. Serum levels of PTX3,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay. Serum hs-CRP levels were measured by automatic biochemical analyzer. Re-sults The serum levels of PTX3,IL-8,TNF-α,and hs-CRP were up-regulated in HSP group compared with the control group(P<0.05). The levels of PTX3,IL-8,TNF-α,and hs-CRP in patients with joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury were significant-ly higher than those patients without joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury(P<0.05). The expression of PTX3 was positively correlated with the expression of IL-8 and TNF-α(r=0.514,0.833,all P<0.05),but there was no correlation between PTX3 and hs-CRP(r=0.292,P>0.05). The expression of PTX3,IL-8,TNF-α and hs-CRP in HSP patients had no gender difference(all P>0.05). Con-clusion The high expression of PTX3 is related to the degree of inflammation in children with HSP. The up-regulated expression of PTX3 may play an important role in pathogenesis of HSP in children.

Objective To analyze clonal chromosomal abnormalities of patients with MDS and evaluate prognosis combining with complete blood counts and blast counts. Methods The chromosomes were prepared with direct method, brief culture of cells and R-banding techniques, and then the karyotypie analysis was performed. Results Abnormal chromosomes were detected 44.9%, including the numeral abnormalities of chromosomes and structural alterations.The most common chromosomal aberrations were -7,+8.The rate of abnormal karotype in refractory anemia with erythroblasts (RAEB1 and RAEB2) was much higher than in refractory anemia (RA) and refractory anemia with ringed sideroblasts (RAILS). Chromosomal abnormalities correlated positively with bone marrow blasts. Conclusion Karyotype analysis is very useful for the diagnosis, treatment and prognosis evaluation in MDS.

Objective To investigate the relationship between cytokines and human graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods In 21 patients undergoing allo-HSCT,the plasma concentrations of cytokines[soluble interleukin 2 receptor(sIL-2R), interferon-gama (IFN-γ), transforming growth factor-betal (TGF-β1)] were measured by using sandwich enzyme-linked immunological assay (ELISA) and the gene expressions of three cytokines were analysed by using semi-quantitate reverse transcriptase-polymerase chain reaction(RT-PCR). Results The concentrations and gene expressions of sIL-2R and IFN-γin the patients with GVHD were significantly higher than those without GVHD (P <0.01), and they were higher in the patients with aGVHD than with cGVHD and without GVHD(P <0.05); the levels of TGF-β1 in the patients with GVHD were significantly declined(P <0.01), but in those without aGVHD were obviously increased(P <0.05). After effective treatment, unnormal sIL-2R, IFN-γand TGF-β1 expressions recovered to the levels before transplantation. A multivariate COX analysis showed sIL-2R and TGF-β1 are independent prognostic factors for GVHD (P<0.001). Conclusion Monitoring the changes of sIL-2R, IFN-γand TGF-β1 expression levels (especially sIL-2R and TGF-β1) might provide predictive markers for GVHD after allo-HSCT. The sensitivity between RT-PCR and ELISA for detecting cytokines expressions had no difference.

Objective To evaluate the value of immunophenotype in diagnosis of myelodysplastic syndrome (MDS).Methods The immunophenotype of bone marrow cells in 27 patients with MDS were detected by monoclonal antibody by flow cytometry.Results As the progression of the disease,CD34 positive cells gradually increased:refractory anemia/ring sideroblasts refractory anemia (RA/ AS) 7.43 %,refractory anemia with excess of blasts (RAEB) 36.81%,refractory anemia with excess of blasts transformed (RAEB-T)56.45 %,and the differences were statistically significant (P ＜0.05); the expressions of CD33+,CD13 and HLA-DR increased gradually,the expressions of CD14 and CD15 antigens gradually decreased,the difference of three groups was statistically significant (P ＜0.05),the differences between RA/RAS and RAEB-T,RAEB and RAEB-T were statistically significant (P ＜0.05); the expression of CD19 and CD10 decreased and the expression of CD7 increased (RA/RAS 2.63 %,RAEB 10.79 % and RAEB-T 11.00 %) with the progression of the disease,the difference of three groups was statistically significant (F =10.439,P ＜0.05),the differences between RA/RAS and RAEB,RA/RAS and RAEB-T were statistically significant (P ＜0.05).Conclusion The detection of immunophenotype of bone marrow cella in patients with MDS contributes to the diagnosis,classification and prognosis of MDS.

Objective:To investigate the clinical characteristics, influencing factors and prevention and treatment measures of nosocomial infection in patients with acute myeloid leukemia (AML) (non-acute promyelocytic leukemia) after applying intermediate-high dose cytarabine (Ara-C) chemotherapy.Methods:The clinical data of 80 patients with AML treated with intermediate-high dose Ara-C in the Second Hospital of Shanxi Medical University from March 2013 to January 2020 were analyzed retrospectively. The clinical features of nosocomial infection were summarized and the influencing factors of infection were analyzed by using multivariate logistic regression.Results:A total of 80 patients received 198 times of chemotherapy, and the infection rate was 72.7% (144/198). Infection sites mainly included respiratory tract infection, pulmonary infection, gastrointestinal infection. A total of 45 strains of pathogenic bacterias were detected, among which Gram negative bacilli accounted for 55.6% (25/45), Gram positive cocci accounted for 24.4% (11/45), fungi accounted for 8.9% (4/45) and viruses accounted for 11.1% (5/45). There were no significant differences in infection rate, hospitalization time, neutrophils recovery time and hospitalization expenses between the sterile laminar flow ward and the general ward (all P > 0.05). Multivariate logistic regression analysis showed that infection during induction chemotherapy was independent risk factor of infection ( OR = 5.076, 95% CI 1.978-13.022, P =0.001), and antibiotic prevention was independent protective factor of nosocomial infection ( OR = 0.332, 95% CI 0.136-0.803, P = 0.014). Conclusions:The infection rate of AML patients receiving intermediate-high dose Ara-C chemotherapy is high. During the treatment, we should be alert to the infection during induction chemotherapy and use antibiotics to prevent it in time. For patients undergoing intermediate-high dose Ara-C chemotherapy, strengthening the environmental cleanliness of general wards may achieve the same preventive effect as that of sterile laminar flow wards.