As there is widely application in clinical diagnosis and treatment with complete blood count(CBC)and differential count(DC),the experts of clinical hematology laboratory in the word have paid highly attention to the review of CBC and DC.In this paper,we would like to have an introduction for the suggested criteria for action following automated CBC and WBC differential analysis obtained from The International Consensus Group for Hematology Review and Clinical and Laboratory Standards Institute (CLSI).

Objective To investigate the function of transferrin-DNA complex,transported by transferrin(Tf)and trans-arterial injection via interventional approach be the duel-target-orientated delivery and the transferring into malignant cells to get more effective therapy.Methods p53-LipofectAMINE ligand with different concentrations of Tf(0,10,25,50,100?g)transfected the 4 strains including LM6、Hep3B、YY and L02 in vitro to evaluate the gene transfeetion efficiency through western blot.Then,after setting up the VX2 hepatocarcinoma models,we delivered the Tf-p53-LipofeetAMINE complex into the hepatic arteries via interventional techniques to analyse the transfection efficiency in vivo.Results Tf,within the range of 10 100?g,could increase gene transfection efficiency mediated by liposome,and the efficiency increases with the raise of Tf concentration.Combination with interventional technique to inject Tf-DNA complex into tumor arteries,gene transfeetion efficiency was enhanced in rabbit models.Conclusion Tf can enhance gene- liposome transfection efficiency,furthermore with combination of interventional catheter technique,there would be a potential duel-target-orientated gene therapy method.(J Intervent Radiol,2007,16:99-103)

Objective: To investigate the clinical value of examining the anatomical position of right superior bronchus orifice preintubation by bronchoscopy on adjusting the position of right double-lumen endobronchial tube (R-DLT). Methods: One hundred and sixty adult patients who were scheduled to intubate with R-DLT undergoing thoracic surgery were randomly assigned into two groups (n = 80 per group); experimental group and control group. All patients were received intravenous anesthetics for induction. The length of right main bronchus and the position of right superior bronchus orifice in the transverse section of right main bronchus were measured prior to intubation by bronchoscopy in experimental group. The R-DLT was inserted into right bronchus by the conventional method and then adjusted the position by bronchoscopy in two groups. Bronchoscopy was performed through the tracheal lumen to ensure that the endobronchial portion of the DLT was in the right bronchus. The blue endobronchial cuff was just seen below the carina. In addition, lifted or inserted and twisted the tube properly according to the data measured in the experimental group. The relative position of orifices of the tube and the right upper lobe bronchus was assessed by bronchoscopy in the two groups. The R-DLT was considered as effective preliminary location if right superior bronchus orifice was partly seen through the lateral orifice of R-DLT. The position of R-DLT was further adjusted till the three orifices of segmental bronchi were seen. Results In experimental group, the length of right main bronchus was (2. 29 ± 0. 58) cm which was shorter than 1 cm in 2 cases (2.5%). The central angle in the transverse section of right main bronchus between the central point of right superior bronchus orifice to 12 o' clock position was (94. 5 ± 8. 3) " which was smaller than 75° or bigger than 105° in 4 cases (5. 0%) in total. The number of effective preliminary location of R-DLT was 77(96. 3%) in experimental group, and 62 (77.5%) in control group, which showed significant difference between the two groups(P < 0. 05). There was 1 case (1. 25%) failed intubation in each group, because of short distance within 1cm between right superior bronchus orifice and tracheal carina. Conclusion: Examining the anatomical position of right superior bronchus orifice preintubation is helpful to improve effective preliminary location of R-DLT, and it is beneficial to find out anatomical variation and select appropriate airway tube.

OBJECTIVETo screen the mutations of RET proto-oncogene in sporadic patients with pheochromocytoma.

METHODSForty-two cases of sporadic pheochromocytoma were tested for mutations of RET gene. Of these 42 DNA samples, 12 were extracted from peripheral blood cells and 30 from paraffin-embedded pheochromocytoma specimens. The PCR product of exon 10 and exon 11 was used to molecular analysis of the RET proto-oncogene.

RESULTSAmong 42 patients, 2 were found to have RET gene mutations. One of mutations located at codon 634 (TGC>TAC) in exon 11 of RET proto-oncogene. Another one located at codon 632 (GAG>AAG).

CONCLUSIONSome patients with apparently sporadic pheochromacytoma were carrier of mutations, a routine genetic analysis for mutations of RET gene is indicated for these patients.

Adrenal Gland Neoplasms ; diagnosis ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Humans ; Male ; Middle Aged ; Mutation ; Pheochromocytoma ; diagnosis ; genetics ; Polymerase Chain Reaction ; Proto-Oncogene Proteins c-ret ; genetics

This study was aimed to investigate the clinical, pathological and biological features of a special case of chronic myeloid leukemia (CML) with marked thrombocythemic onset. The morphological changes of cells were analyzed by using bone marrow smear and biopsy; Ph chromosome, a specific marker of CML, was assayed by conventional chromosomal analysis and fluorescence in situ hybridization, bcr/abl fusion gene was detected by reverse transcription-polymerase chain reaction. The results indicated that CML mimicked essential thrombocythemia (ET) at presentation was relatively rare and might be misdiagnosed as ET, bone marrow smear and biopsy revealed, marked thrombocytosis and moderate leukocytosis; RT-PCR, FISH and conventional chromosomal analysis demonstrated the existence of Ph chromosome and bcr/abl fusion gene. This special CML could progress into accelerated phase or blast crisis. The megakaryocytes in Ph+ ET were smaller than normal ones and had typically hypolobulated round nuclei. Patients diagnosed as Ph+ ET might progress into CML and showed a high tendency to myelofibrosis and blastic transformation. It is concluded that the value of routine cytogenetical and molecular biological analysis in diagnosis for potential CML cases, which mimicked ET as in this presentation, is very distinctive, and the importance is magnified by the recent availability of imatinib, a specific inhibitor of the bcr/abl tyrosine kinase produced by the Philadelphia chromosome. Every case of "ET" should be tested for the Philadelphia chromosome and bcr/abl transcript.
Adult ; Diagnosis, Differential ; Female ; Fusion Proteins, bcr-abl ; genetics ; Gene Rearrangement ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; diagnosis ; genetics ; Megakaryocytes ; pathology ; ultrastructure ; Philadelphia Chromosome ; Reverse Transcriptase Polymerase Chain Reaction ; Thrombocythemia, Essential ; diagnosis

This study was aimed to investigate the relation of human leukocyte antigen-A, B, DRB1 genes with the susceptibility of population to leukemia in Anhui province of China. The HLA genotypes were analyzed by PCR-SSP in 140 patients with chronic myelocytic leukemia (CML), 84 patients with acute lymphoblastic leukemia (ALL), 90 patients with acute nonlymphocytic leukemia (ANLL) and 916 healthy unrelated donors of hematopoietic stem cell as normal control admitted to Anhui provincial hospital. The gene frequencies of HLA-A, B, DRB1 between patients and normal controls were compared, chi² test was used for statistical analysis. The results showed that as compared with normal controls, the gene frequencies of A2, A11, B58 and DR9 in CML patients all obviously increased, and gene frequency of DR7 decreased; the gene frequencies of All and B13 in ALL patients were significantly higher than that in normal controls; the gene frequencies of A24, B58 and DR9 in ANLL patients were significantly higher than that in normal controls. It is concluded that HLA-A2, A11, B58 and DR9 are predisposing genes of CML patients, DR7 is an antagonistic gene, HLA-A11 and B13 are predisposing genes of ALL patients, HLA-A24, B58 and DR9 are predisposing genes of ANLL patients.
Alleles ; Case-Control Studies ; China ; epidemiology ; Gene Frequency ; Genotype ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Haplotypes ; Humans ; Leukemia ; epidemiology ; genetics

BACKGROUNDAlthough severe encephalopathy has been proposed as a possible contraindication to the use of noninvasive positive-pressure ventilation (NPPV), increasing clinical reports showed it was effective in patients with impaired consciousness and even coma secondary to acute respiratory failure, especially hypercapnic acute respiratory failure (HARF). To further evaluate the effectiveness and safety of NPPV for severe hypercapnic encephalopathy, a prospective case-control study was conducted at a university respiratory intensive care unit (RICU) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) during the past 3 years.

METHODSForty-three of 68 consecutive AECOPD patients requiring ventilatory support for HARF were divided into 2 groups, which were carefully matched for age, sex, COPD course, tobacco use and previous hospitalization history, according to the severity of encephalopathy, 22 patients with Glasgow coma scale (GCS) < 10 served as group A and 21 with GCS = 10 as group B.

RESULTSCompared with group B, group A had a higher level of baseline arterial partial CO2 pressure ((102 +/- 27) mmHg vs (74 +/- 17) mmHg, P < 0.01), lower levels of GCS (7.5 +/- 1.9 vs 12.2 +/- 1.8, P < 0.01), arterial pH value (7.18 +/- 0.06 vs 7.28 +/- 0.07, P < 0.01) and partial O(2) pressure/fraction of inspired O(2) ratio (168 +/- 39 vs 189 +/- 33, P < 0.05). The NPPV success rate and hospital mortality were 73% (16/22) and 14% (3/22) respectively in group A, which were comparable to those in group B (68% (15/21) and 14% (3/21) respectively, all P > 0.05), but group A needed an average of 7 cm H2O higher of maximal pressure support during NPPV, and 4, 4 and 7 days longer of NPPV time, RICU stay and hospital stay respectively than group B (P < 0.05 or P < 0.01). NPPV therapy failed in 12 patients (6 in each group) because of excessive airway secretions (7 patients), hemodynamic instability (2), worsening of dyspnea and deterioration of gas exchange (2), and gastric content aspiration (1).

CONCLUSIONSSelected patients with severe hypercapnic encephalopathy secondary to HARF can be treated as effectively and safely with NPPV as awake patients with HARF due to AECOPD; a trial of NPPV should be instituted to reduce the need of endotracheal intubation in patients with severe hypercapnic encephalopathy who are otherwise good candidates for NPPV due to AECOPD.

Aged ; Brain Diseases ; therapy ; Carbon Dioxide ; blood ; Case-Control Studies ; Female ; Glasgow Coma Scale ; Humans ; Hypercapnia ; therapy ; Male ; Middle Aged ; Oxygen ; blood ; Positive-Pressure Respiration ; adverse effects ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; complications

Animals ; DNA, Fungal ; Phosphorylation ; RNA Polymerase II ; Sequence Homology, Nucleic Acid ; T-Box Domain Proteins ; genetics

UNLABELLEDOBJECTIVE To evaluate the aesthetic effect of restorations with custom pressable metal ceramic abutments for defective soft and hard tissue in the maxillary anterior zone.

METHODSFifty-two patients with missing anterior teeth in the maxillar were selected, who had problems such as exposure of abutment metal, excessively large angle deviation, excessively long ceramic crown and missing gingival papilla, affecting the aesthetic effect of implant denture. Custom pressable metal ceramic abutments were made on the conventional castable metal abutment surface and restored with all-ceramic crowns to overcome the blackness at the implant neck.

RESULTSClinical evaluation for aesthetic effects 3 and 6 months after the restorations were placed. In 63 restorations of 52 patients, the blackness at the implant neck were eliminated and the aesthetic effect were ideal. The gingival was in healthy condition, showing no further gingival retreat or inflammation around the implant denture.

CONCLUSIONCustom pressable metal ceramic abutments can effectively improve the aesthetic appearance of the implant denture in maxillary anterior zone.

Ceramics ; Crowns ; Dental Abutments ; Dental Implants ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Metals

OBJECTIVETo study the effect of Modified Guipi Decoction (MGD) on blood pressure and quality of life (QOL) in hypertension patients complicated depression.

METHODSTotally 245 hypertension patients complicated depression were randomly assigned to the treatment group (125 cases, treated with MGD) and the control group (120 cases, treated with Sertraline). Final recruited qualified patients were 117 cases in the treatment group and 111 cases in the control group. The therapeutic course for all was 4 weeks. Changes of blood pressure, scores rated by Hamilton Depression Scale-17 (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), short-form 36 health survey questionnaire (SF-36), and Treatment Emergent Symptom Scale (TESS) were observed before and after treatment, thereby judging their efficacies.

RESULTS(1) Compared with before treatment in the same group, systolic and diastolic blood pressures significantly decreased in the treatment group after 2 weeks of treatment; systolic blood pressure significantly-decreased after 2 weeks of treatment and diastolic blood pressure significantly decreased after 3 weeks of treatment in the control group (all P < 0.05, P < 0.01). Decreased valley values of systolic and diastolic blood pressures at week 2, 3, and 4 after treatment were obviously higher than those at week 1 after treatment in the two groups (P < 0.05, P < 0.01). Compared with the control group at week 4 after treatment, valley value of systolic blood pressure obviously decreased in the treatment group (P <0. 01). Decreased valley values of systolic and diastolic blood pressures in the treatment group were higher than those of the control group (P <0. 01). The success rate of target blood pressure was 60. 7% (71/117 cases) in the treatment group and 42. 3% (47/111 cases) in the control group, with statistical difference (χ² = 7.6781, P < 0.01). (2) Compared with before treatment in the same group, the score of HAMD-17 at week 2, 3, and 4 after treatment all decreased in the two groups (P < 0.01). Compared with the control group, the score of HAMD-17 at week 4 after treatment decreased more obviously in the treatment group, with higher difference in decreased value (P < 0.05). The effective rate was 79.5% (93/117) in the treatment group, higher than that in the control group [66.7% (74/111); χ² = 4.7741, P < 0.05]. (3) Compared with before treatment in the same group, the score of HAMA at week 1, 2, 3, and 4 after treatment all obviously decreased in the two groups (P <0. 05, P <0. 01). Compared with the control group, the score of HAMA at week 3 and 4 after treatment decreased more obviously in the treatment group, with higher difference in decreased value (P < 0.05, P < 0.01). (4) After 4 weeks of treatment, except physical function in the control group, SF-36 total score and the score for each factor were obviously higher in the two groups (P < 0.05, P < 0.01). MGD showed superior effect in improving physical function, physical activity, overall health, emotion activity, and health changes to that of Sertraline (P < 0.05, P < 0.01). (5) The incidence of insomnia, tremor, liability to agitation, dizziness was obviously less in the treatment group than in the control group (P < 0.05).

CONCLUSIONSMGD had favorable clinical effect on hypertension patients complicated depression. Meanwhile, it also could improve their blood pressure and QOL.

Antidepressive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Depression ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; complications ; Phytotherapy ; Psychiatric Status Rating Scales ; Quality of Life ; Sertraline ; therapeutic use ; Surveys and Questionnaires