Objective To compare the efficiency and safety of regimens of empiric antibiotic therapy in neutropenic hematological maligence patients.Methods The clinical data of empiric antibiotic therapy for 260 febrile episodes in 125 neutropenic hematological maligence patients were analyzed retrospectively.Results A total of 45 febrile episodes were treated with tazocin plus amikacin(regimen TA).80 episodes were treated with ceftazidime plus amikacin(regimen CA),75 episodes with imipenem plus amikacin(regimen IA) and 60 episodes with maxipime plus amikacin(regimen MA).The medians of initial therapy in each regimen were 7～8 days.Percentage of satisfactory response had no significant difference in episodes treated with regimens TA,IA and MA(65%,70% and 79% respectively),and it was better than regimen CA(P

ObjectiveTo explore the clinical significance of fms-like tyrosine kinase3(FLT3) expression in evaluation prognosis of acute myeloid leukemia(AML) prognosis.Methods50 patients with AML were selected.AML patients with normal karyotype were 20 cases,the abnormal karyotype were 30 cases.3ml bone marrow before themotherapy was aspirated respectively,and the FLT3 gene expression in leukemia cells was detected with polyenzyme chain react(PCR).ResultsThe FLT3 expression rate in AML patients with normal karyotype was 5.0％,and was 26.7％ in AML patients with abnormal karyotype,33.3％ in AML patients with refractory-relapse,and 4.5％ in AML patients with continue remission.The FLT3 expression rate was related with high leukemia cells percentage in bone marrow and high blood cells count in peripheral blood,and was not related with Franch America British(FAB) classification.The free-disease survival(FDS) and overall survived(OS) was shorter in FLT3 expression AML patients than that in no FLT3 expression AML patients.There was a statistical significance between the former and the latter( x2 =4.17,P ＜0.05 ).Conclusion FLT3 was a kind of worse factor in AML patients prognosis,and could guide clinical individual treatment in AML.

Men aged 40-59 years (325 subjects) from 4 districts, 6 populations, 3 nationalities were investigated to explore the relationship between element and blood pressure (BP) . Fe, Mo, Ni, Pb, Si, Sn, Sr, V, Cd, Co, Cr, Cu, Mn, Zn, Ca, and Mg -were measured by ion coupled plasma spectroscopy, Se by catalytic pulse polarography. Results showed; (1) The element levels were different among districts and nationalities. (2) The correlation coefficients among serum Pb, Ni, Si, Sn, V, Cd, Cr were rather high, while Sr behaved relatively independently. (3)Using multivariant stepwise regression and discrimination analysis, serum Sr was found to associate positively with BP in normotensive and hypertensive and total pooled groups without exce-piton. (4) Serum Ca (Ca/Mg), Fe, Co were positively associated, while Cr, Sn inversely associated with BP. (5) The harmful element Cd was unexpectedly found to be inversely associated with BP and it was lower in those populations with high BP levels, which might be ascribed to the non-parallel distribution of certain elements in body tissues and blood. Results also indicated; (1) The levels of essential element Ni, V, Co, Cr were lower in hypertensive group. (2) Serum Ca and urinary Ca were non-parallel, and the former could not accurately reflect Ca-intake. In short, the relationship between element and BP still remains to be elucidated.

Objective To explore the relationship of cell proliferation of acute leukemia stimulated by granulocyte colony-stimulating factor(G-CSF) and the expression of granulocyte colony stimulating factors receptor(G-CSFR).Methods Thirty cases of initial and refractory-relapse acute myeloid leukaemia(AML) patients,20 cases of acute lymphoblastic leukemia(ALL) and 20 normal controls were involved in the study.The 5ml bone marrow was taken from each patient before chemotherapy and the marrow mononuclear cells(MNC) were cultured with 5,10,15,20 and 25 ng/ml G-CSF respectively.After 24h,the DNA diploid and the expressions of G-CSFR and CD34 were detected by flow cytometry(FCM).Results The DNA diploid of MNC from AML was increased with the elevated concentration of G-CSF after 24h,and that of the ALL and normal control did not change significantly.The expression rates of G-CSFR were(68.59?13.99)%,(1.90?0.93)% and(70.5?10.8)% in AML,ALL and the normal control respectively.The expression rates of CD34 were(45.15?4.22)%,(46.75?3.15)% and(3.15?0.22)% in AML,ALL and normal control respectively.The expression of G-CSFR in AML was significantly different from that of ALL(P0.05).The expression of G-CSFR in ALL was significantly different from that of the normal control(P

OBJECTIVE To study the clinical features of acute leukemia(AL) patients with complication of infection. METHODS A retrospective analysis of prevalence of infection occurring in 123 AL patients,their bacterial spectrum,and the effect of G-CSF on the infection were done. RESULTS The prevalence of infection in AL patients was 94.3%,among which 49.2% were infected with Gram-positive organisms,42.4% with Gram-negative bacilli and 8.4% with fungi.Blood culture occurred mostly with Escherichia coli and Pseudomonas infection.Patient′s neutropenia was significantly related to the infection.The patients with neutrophil count less than 0.2?10~9/L had more frequently suffered severe infection with long-lasting time,and had more than two sites of infection.Age,hemoglobin level,prophylactic intestinal usage of antibiotics could not reduce patient′s infection.The total mortality of AL patients with infection was 6%.Pulmonary infection and septicemia increased mortality,but G-CSF therapy reduced it. CONCLUSIONS AL patients are at high risk of infection which is significantly associated with severe neutropenia.G-CSF therapy exerts an assistant role to antibiotics in controlling the infection.

Objective To analyze and study the diagnosis of large granular lymphocyte leukemia(LGLL).Methods To report and discuss six cases weth LGLL we have found. Results 2 of T-LGLL and lof NK-LGLL had indolent process, mainly presenting with anemia and splenomegaly and good response to treatment, while; 1 of T-LGLL and 2 of NK-LGLL had aggressive process, their clinical characters are obviously general symptom, hepatomegaly,splenomegaly,these disease develop quickly and have bad prognosis. The immunophenotype of indolent LGLL is distinct from aggressive cases. Conclusion As a group of heterogeneous disease,its diagnosis should be based on clinical manifestation and immunophenotype and differentiated it carefully.

Objective To investigate the clinical and laboratory diagnosis of adult hemophagocytic syn-drome (HPS) . Methods Clinical data of 24 patients with HPS from 2000 to 2008 were retrospectively analyzed. Results Of the 24 HPS cases, 12 had a malignant associated hemophagocytic syndrome (MHAS), and 10 were fi-nally diagnosed by bone marrow immunohistochemist ;Of 12 cases in non-MAHS group,4 were with virus associated hemophagocytic syndrome (VAHS), and 4 were of the other infections, whereas 4 patients diagnosed of immune associated HS (MAS). There were significant difference in onset age, mortality, serum lactate dehydrogenase (LDH) and serum ferritin(FER) and neutrophilic NAP between non-MAHS group and MAHS group(P <0.01 ,P<0.05). In all cases bone marrow biopsy showed significant differences in cytological and pathological features between MAHS group and non-MAHS group. Conclusion Etiology,immunology,and bone marrow cell biopsy and pathology as well contribute to the diagnosis and typing of HPS and will give a guide to the therapy.