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

OBJECTIVEIn the candidate region 12q13 of simple congenital heart disease(CHD), four single nucleotide polymorphisms(SNPs) in HOXC4 gene were chosen in order to investigate the distribution of SNP and haplotypes in simple CHD patients and normal people.

METHODSThe genotype of 4 SNPs in 108 simple CHD patients and 200 normal people were analyzed by restriction fragment length polymorphism(RFLP) and denaturing high-performance liquid chromatography(DHPLC). The statistical contingency table method was used to analyze SNP genotype frequency and gene frequency in patients and control group; then, the haplotypes were established and their frequencies in the two groups were assessed by PHASE software.

RESULTSC16476T polymorphism was not detected; A17860G located in 3' flanking sequence of HOXC5 gene displayed significant difference between the two groups. The G allele frequency in simple CHD patients was higher than that in healthy controls(P < 0.05); the distribution of frequencies of 4 haplotypes showed significant difference(P < 0.01).

CONCLUSIONThe A17860G located in 3'flanking sequence of HOXC5 gene is associated with simple CHD; the risk of CHD in the persons with G17860 is higher than that in those with A17860. the haplotype of 3 SNPs may be linked with the susceptible gene of simple CHD.

Adolescent ; Adult ; Alleles ; Base Sequence ; Child ; Chromosomes, Human, Pair 12 ; genetics ; DNA Mutational Analysis ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Haplotypes ; genetics ; Heart Defects, Congenital ; genetics ; Homeodomain Proteins ; genetics ; Humans ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Young Adult

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

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

Objective To investigate the added diagnostic value of SPECT/CT imaging over routine planar whole-body bone scintigraphy (WBBS) for bone metastases from lung cancer. Methods One hundred and forty-six patients with lung cancer, confirmed by pathological examination, underwent routine 99Tcm-MDP (1110 MBq) WBBS, followed by SPECT/CT over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive, negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical follow-up. x2 test was used to compare the differences between the two imaging methods. Results Finally, 45 patients were diagnosed as positive bone metastases and the other 101 as negative. The diagnostic sensitivity of bone SPECT/CT for bone metastases from lung cancer was 93.3%(42/45), singnificantly higher than that of WBBS (64.4%, 29/45) (x2 = 19.944, P＜0.05). The diagnostic accuracy of bone SPECT/CT was 89.7% ( 131/146), much higher than that of WBBS (44.5%,65/146) ( x2 = 69. 598,P ＜ 0.05). The uncertain and incorrect diagnostic rates of bone SPECT/CT and WBBS were 10.3% ( 15/146, raging from 5.3% to 15.2% with 95% confidence interval (CI) ) and 55.5% (81/146, raging from 47. 4% to 63.5% with95% CI), respectively. Conclusion BoneSPECT/CT provides incremental diagnostic value over routine WBBS for bone metastases from lung cancer.

Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale: benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.