Based on hematological laboratory case study,we discussed the importance of cultivation of stuedents’medical communication competence in the process of laboratory medicine teaching and put forward several suggestions for the cultivation of the students’medical communication competence.

BACKGROUND: Currently the hematopoietic stem cells can be obtained from bone marrow, peripheral blood and cord blood, so it is expected to search a new source of stem cells in order to satisfy the clinical transplantation needs. From the 5th week of pregnancy, the blood sinusoid system develops completely in liver, and then hematopoietic stem cells can move with blood flow. OBJECTIVE: To observe the biological features of human fetal blood hematopoietic stem/progenitor cells (HS/PCs), and their transplantation into non-obese diabetic/severe combined immunodeficiency disease (NOD/ SCID) mice. DESIGN: Control trial. SETTING: Department of Hematology, First Affiliated Hospital of Guangxi Medical University. MATERIALS:①Cell resource: Twenty-one fetal blood samples were from dead fetus [gestational age of 18-29 weeks, mean (24.2±3.2) weeks] and twenty-one full-term cord blood samples were provided from the Department of Obstetrics, First Affiliated Hospital of Guangxi Medical University between October 2002 and February 2003, with the consent of their relatives.②Experimental animal: Twelve NOD/SCID female mice of 6-7 weeks old were bred in sterility and super-clean operation board. METHODS: Flow cytometer was used to assess cell surface markers of HS/PCs including CD34, CD38, HLA-DR and CD90 in 21 human fetal blood samples, and their expressions were compared with 21 human cord blood samples. Moreover, human fetal blood mononuclear cells (MNCs) were transplanted into 6 NOD/SCID mice irradiated sublethally. After 5 weeks, human leukocytic content was also detected in bone marrow of mice with flow cytometer while human Cart-1 gene in recipients' bone marrow was sensed with polymerase chain reaction (PCR).MAIN OUTCOME MEASURES: ① Expressions of HS/PCs surface markers in fetal blood and cord blood. ②Implantation of fetal blood cells into NOD/SCID mice.RESULTS: ①The percentage of CD34+ cells in fetal blood was significantly higher than that of full-term cord blood [(2.258 8±0.720 9)%,(1.572 9±0.478 3)%, P=0.000 4]. The percentages of CD34+CD38- cells and CD34+CD90+ cells in fetal blood were also higher than those of fullterm cord blood [(1.298 6±0.470 6)%, (0.871 0±0.409 5)%, P=0.001 6;(0.930 0±0.469 2)%, (0.560 0±0.365 8)%, P=0.032 4].②Four cases (4/6)of human fetal blood MNCs smoothly transplanted the hematopoiesis of sublethally irradiated NOD/SCID mice. Five weeks after the transplantation, human leukocyte and Cart-1 gene could still be detected in marrow cells of NOD/SCID mice.CONCLUSION: Human fetal blood contains more HS/PCs than cord blood. Human fetal blood MNCs can engraft bone marrow of NOD/SCID mice and reconstitute general hemopoiesis of marrow and lymph systems.Human fetal blood is a new possible source of pluripotential hematopoietic stem cell.

Objective To investigate the clinical significance and mechanism of WW domain containing oxidoreductase (WWOX) gene and p73 gene abnormal expression in acute lymphocytic leukemia (ALL).MethodsCase-control study was used in the research.Forty-eight cases of bone marrows from ALL patients were collected,including 32 cases newly diagnosed,11 cases with complete remission and 5 case with relapse.Thirty-one cases of bone marrows from non-leukemia patients were used as control group.All the samples were collected from First Affiliated Hospital of Guangxi Medical University from July 2010 to July 2011.The doctors punctured patients' bone marrows 3 milliliters from the left of posterior superior iliac spine.Samples were bottled up with EDTA anti-coagulation tube.1 milliliter bone marrow was used to extract genome RNA with purity from 1.8 to 2.0.And then,the level of WWOX and p73 gene transcripts were tested immediately using reverse transcriptase-polymerase chain reaction (RT-PCR).Meanwhile genome DNA was also extracted from the other 2 milliliter bone marrow with purity from 1.7 to 1.9,which was used to detect the promoter methylation of WWOX gene and the first exon methylation of p73 gene by methylation PCR (MS-PCP).x2 test and Fisher's exact test were used to compare tbe methylation status of WWOX and p73 gene.Results In 31 controls,expression of WWOX and p73 gene mRNA was 94.00％.The total expression frequency of WWOX gene mRNA in 48 ALL samples was 48.00％ (23/48),much lower than control (x2 =17.434,P =0.000 ).There was significant difference (x2 =10.471,P =0.001 ) between newly diagnosed cases 34.38％ ( 11/32),complcte remission cases (90.91％,10/11 ) and control.The total expression frequency of p73 gene mRNA in 48 ALL samples was 56.00％ (27/48),much lower than control (x2 =12.697,P =0.000).There was significant difference (P =0.012 ) between newly diagnosed cases 43.75％(14/32) and complete remission cases 90.91％(10/11).It was unmethylation in 31 controls.The total methylation frequency of WWOX gene promoter region in 48 ALL samples was 44.00％(21/48),much lower than control (x2 =18.473,P =0.000).There was significant difference (P =0.012) between newly diagnosed cases 56.25％ (18/32),complete remission cases 9.09％ (1/11 ) and control.The total methylation frequency of p73 gene the first exon region in 48 ALL samples was 35.00％(17/48),much lower than control (x2 =13.990,P =0.000).There was significant difference (P =0.033) between newly diagnosed cases 46.88％ (15/32),complete remission cases 9.09％ ( 1/11 ) and control.There was a negative correlation between the expression of WWOX gene mRNA and its methylation status(r =- 0.678,P =0.000),the same as p73 gene ( r =- 0.577,P =0.000).ConclusionsThe abnormal methylation of WWOX and p73 gene may be the major mechanism of gene silence in ALL,which leads to no expression of WWOX mRNA or p73 mRNA.And the abnormal methylation of WWOX and p73 gene may be relevant with the process of occurrence and development in ALL.It may be an effective and significant to detect methylation status of WWOX gene and p73 gene for the diagnosis and treatment of ALL patients.(Chin J Lab Med,2012,35:820-825)

To improve the effect of teaching practice of blood cell morphology,typical cases of peripheral blood erythrocyte,granulocyte and platelet were chosen,case show and problem-based teaching way were applied to encourage students to find information of autonomous learning.Then teacher organized the class discussion,and the information was analyzed and summarized.In the implementation of the case teaching,we should pay attention to improving students' learning initiative.At the same time,teachers need to have knowledge,comprehensive ability and ability in organization and leadership,to promote students' active participation in discussion in the teaching,pay attention to the information feedback,and improve the teaching details

OBJECTIVETo investigate the manifestation of clinical, blood routine and bone marrow smear of disseminated penicilliosis marneffei.

METHODSThere were 13 cases of penicilliosis marneffei whose peripheral blood had been drawn for routine tests, as well as blood and bone marrow aspiration for smears. Wright's-Giemsa stain, Gomori's methenamine-silver stain (GMS) and periodic acid Schiff's reaction (PAS) were performed for light microscopy in consultation with pathologic diagnosis and fungi culture for precise diagnosis.

RESULTSSeven cases of bone marrow and 2 peripheral blood smears were found positive for penicillium marneffei in the test group. The morphology of penicillium marneffei was extremely similar to that of histoplasma capsulatum. However, the observation of sausage cells and central cross wall, which are signs of dividing by fission and not by budding, aided in differential diagnosis.

CONCLUSIONBone marrow smear or occasional blood smear examination play an important role in the diagnosis of disseminated penicilliosis marneffei.

Adolescent ; Adult ; Bone Marrow Examination ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Middle Aged ; Mycoses ; blood ; diagnosis ; pathology ; Penicillium

Objective: To explore the molecular basis for a pedigree affected with May-Hegglin anomaly (MHA). Methods: Peripheral blood samples were collected and subjected to DNA extraction. Exons 1, 10, 16, 24, 25, 26, 30, 31, 33, 38 and 40 and flanking sequences of the MYH9 gene were subjected to PCR amplification and Sanger sequencing. Changes in protein expression were determined by an indirect immunofluorescence assay. Platelet aggregation function of the proband was assessed by thromboelastogram. Results: The proband and his second son both carried a heterozygous 5521G>A (GAG→AAG) missense variant in exon 38 of the MYH9 gene, leading to p. Glu1841Lys substitution at position 1841 of amino acid sequence. Immunofluorescence showed inclusions containing NMMHC-ⅡA. Thromboelastogram suggested enhanced platelet aggregation function of the proband. Conclusion The c. 5521G>A variant of MYH9 gene has co-segregated with the phenotype of MHA in this pedigree. To assess the aggregation function of platelet by thromboelastogram can predict the risk of bleeding in MHA patients.