急性早幼粒细胞白血病患者小孢根霉变种感染1例

报道1例由小孢根霉变种导致的皮肤毛霉病.患者女,30岁.因患急性早幼粒细胞白血病,化疗后继发口腔颌面部小孢根霉变种感染,表现为发热、右侧颊黏膜水肿,皮损中央溃疡、焦痂,周边组织炎性水肿,以面颊部、颌下区为中心明显肿胀,逐渐累及右侧颈部及右下颌,进行性加重.坏死组织涂片镜检显示有粗大、无分隔直角菌丝,真菌学检查鉴定为小孢根霉,分子测序证实为小孢根霉变种.给予两性霉素B、伊曲康唑静脉滴注和手术清创,坏死组织连续3次真菌培养均未培养出小孢根霉变种,患者体温逐渐恢复正常,治疗2周后颔面部肿胀明显减退,浅表淋巴结未触及肿大,4周后额部及右眼睑肿胀已完全消退,伤口结痂愈合.随访2 a,右侧颌下可见长约2 cm手术疤痕,未见皮肤毛霉病复发.     

Circulating Level of Neutrophil Extracellular Traps Is Not a Useful Biomarker for Assessing Disease Activity in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of life-threatening disorders, and frequently affects the kidneys. This study investigated whether the circulating neutrophil extracellular traps (NETs) levels were associated with disease activity of AAV. We collected serum samples from 34 patients with AAV in active stage and 62 patients with AAV in remission. Cell free DNA in serum was quantified using the Quant-iT PicoGreen assay. NETs associated MPO-DNA complexes, citrullinated-histone H3-DNA (cit-H3-DNA) complexes and the concentration of deoxyribonuclease I (DNase I) were quantified using ELISA. The activity of DNase I was quantified using radial enzyme-diffusion method. Associations between circulating levels of NETs with clinico-pathological parameters were analyzed. Serum levels of NETs in active AAV patients were significantly higher than those in healthy controls, and the level of cell free DNA correlated with C-reactive protein (CRP). However, no correlation was found between MPO-DNA complexes or cit-H3-DNA complexes level and CRP. Also there was no significant correlation between NETs level and initial serum creatinine, estimated glomerular filtration rate (eGFR), crescents formation or Birmingham Vasculitis Activity Score (BVAS). Furthermore, there was no significant difference of serum levels of cell free DNA or MPO-DNA complexes between active stage and remission of AAV. In conclusion, circulating levels of NETs cannot be used as a biomarker to assess disease activity in AAV patients.     

常见支原体感染误诊与对策

临床支原体感染易发生误诊,不但加重患者精神和经济负担,而且延误患者病情,甚至留下后遗症。为此,我们综述了常见支原体感染误诊的特点和原因,深挖其中思维和思想根源,探讨减少或避免该类误诊现象的策略,旨在为临床医护人员和检验技术人员提供参考建议。     

inv(13)(p12;q14)一家系报道

先证者,女,汉族,２４岁,身高１．６１米,体重６０．１公斤。因连续生两胎畸形儿夭折就诊。第一胎为足月顺产,唇裂、腭裂、双足各为６趾,５０天时因呼吸道感染而死亡。第二胎,足月顺产,体征似第一胎,生下两天死亡。对先证者进行外周血染色体检查,计数５０个细胞...     

新生儿缺氧性脑病伴46,XX,-21,+t(21;21)罕见核型一例

Abstract:This report describes a cytogenetic aberration in one neonatal patient with hypoxic-ischemic encephalopathy.A rare karyotype,46,XX,-21,+t(21;21), was detected.This de nono chromosomal abnormality may be caused by the meiotic non-disjunction of chromosomes during gametogenesis along with the formation of Robertsonian translocation between homologous chromosome 21.     

产气荚膜梭菌实时荧光PCR方法的建立

目的:利用荧光定量PCR技术,建立快速敏感特异的检测产气荚膜梭菌的方法。方法:以产气荚膜梭菌基因为靶序列设计引物和探针,以自产气荚膜梭菌菌株中提取的DNA为模板,优化引物和探针的浓度比,同时验证方法的特异性、敏感性。结果:建立的反应体系在上游引物浓度为0.45μmol/L、下游引物浓度为0.15μmol/L、探针浓度为0.3μmol/L时,具有良好的特异性和敏感性,与创伤弧菌等12种相关细菌均无交叉反应;对纯菌检测的灵敏度低于10 CFU/反应体系。结论:建立的实时荧光PCR方法特异、灵敏、快速,能对战时气性坏疽做出快速准确的报告,实现对这种战时高发疾病的安全、快速和定量检测。     

习惯性流产伴罕见Rob(13;21)的异常核型分析

病例　　患者,女,29岁,汉族,身高156cm,体重52kg;职业农民表型无异常,非近亲婚配,否认家族遗传史。孕期及孕前期无毒物、化学、放射物的接触史,无特殊病史。因连续流产4次而就诊。细胞遗传学检查　　外周血染色体分析,普通核型计数,分析50个分裂相,均为45条,D、G组各少一条,多一条衍生染色体。经G带技术分析了20个核型均为45,XX,der(13;21)(q10;q10)。其丈夫核型正常,其他家庭成员拒绝检查。患者的13号、21号染色体分别在着丝粒区发生断裂,两者的长臂在着丝粒区附近彼此连接,形成了一条新的染色体,两者的短臂也可能连接成一条小染色体…