Significance of bone marrow particles in diagnosis and differential diagnosis of aplastic
天然杀手——免疫疗法治疗癌症
N E W SCancer immunotherapy—which trains the body’s own immune system to fight tumors—has made medical headlines in the last few years, with analysts projecting that it could give rise to treatments worth $35 billion a year over the next decade. For the most part, cancer immunotherapy has relied on the power of T cells. Now, another class of immune cells—known as natural killer (NK) cells—that can function to kill cancer is nearing its big break. NK cells may hold the potential to kill off cancer cells without damaging healthy tissues or risking the T cell–driven inflammatory cytokine storm that can accompany other immunotherapies. But a complicated assortment of protein receptors that control their function makes NK cells unwieldy and unpredictable.The wider adoption of a technology called CyTOF—short for cytometry by time of flight–is now making NK cell research more tractable, allowing scientists to classify and describe NK cell subsets at a level never before possible. Using this technology, Catherine Blish and Peter Parham, two immunologists at Stanford University School of Medicine, recently described 30,000 unique NK cell subsets found among 22 healthy individuals (Sci. Transl. Med. 5, 208ra145, 2013). And that may just scratchthe surface; statistical extrapolation suggests there may be three times as many NK cell subsets within the study population alone. NK cells contain varying combinations of activating and repressing protein receptors that both define the subsets and control their function. Repressive receptors, for example, prevent autoimmunity by recognizing familiar healthy tissues. Meanwhile, activating receptors prompt NK cells to attack infected, damaged or transformed cells. The standard method used to analyze which receptors are expressed on NK cells, called flow cytometry, relies on monoclonal antibodies linked to fluorescing compounds. These antibodies each attach to specific receptors on a given NK cell and the fluorescent compounds emit different wavelengths of light as the cell passes through a laser. To avoid overlap between wavelengths, researchers use a maximum of ten to twelve antibodies for each sample they run.As a post-doc studying the role NK cells have in controlling HIV , Blish realized that she would need to analyze more than a handful of receptors to generate meaningful data from the small blood samples she had saved from a study of HIV-positive Kenyan sex workers. Three years ago, when Blish openedher own lab at Stanford, where immunologist G ary Nolan had been championing the use of CyTOF to study other immune cells since 2010, she saw that this new technology easily fit the bill for NK cells.Although CyTOF relies on the same monoclonal antibodies as regular flow cytometry, it tags them with one of 80–100 different stable metal isotopes, instead of with fluorescent compounds. A technique called mass spectrometry, which vaporizes cells into particles that can be separated on the basis of mass and ionic charge, distinguishes between the stable isotopes. As a result, CyTOF avoids the spectral overlap problem that plagues flow cytometry. In practice, immunologists have so far used up to about 50 markers at one time. Blish’s group used 42, which was enough to reveal that each individual carries an average of 18,000 distinct NK cell subsets. “Now you have a tool that could tell you everything about the problem and opportunity of NK cells,” Nolan says.CyTOF takes offSince the technology was introduced in 2009, several companies and at least 12 institutions besides Stanford have set up their own machines. Ruth Montgomery,Cataloging immune cells for immunotherapyBy Amanda B. Keenern p g© 2015 N a t u r e A m e r i c a , I n c . A l l r i g h t s r e s e r v e d .N E W Sa rheumatologist who directs the CyTOF facility that began operating in 2014 at the Yale School of Medicine in New Haven, Connecticut, often finds herself recommending the technique to colleagues during hallway conversations. “When you realize how much more information you’re getting with CyTOF, it’s hard to be satisfied with only flow cytometry,” she says.But the power to look at 40–50 parameters on each cell at once presents a huge bioinformatics challenge. Computational biologists like Dana Pe’er at Columbia University in New York are taking on this challenge and helping immunologists interpret their CyTOF data. Pe’er’s lab developed an algorithm called viSNE that allows researchers to visualize their multi-dimensional CyTOF data as a two-dimensional image with easily recognizable patterns. “We’re very good at thinking about things in three dimensions,” says Pe’er. “Imagine thinking about them in 40.” For example, by incorporating data about dozens of receptors and other proteins on the surfaces of bone marrow cells, viSNE plots leukemic cells as distinguishable clumps that scientists can home in on for further study (Nat. Biotech. 31, 545–552, 2013). Next, Pe’er plans to roll out a program called Phenograph that distinguishes statistically likely subsets of cells from CyTOF data based on receptor combinations.Blish is ready to move beyond subsets and find out how all of those NK cell receptor combinations relate to cell function. Afterall, she says, diversity in nature is costly. “If NK cells have only one or two functions, why wouldn’t they all be alike?” She suspects there may be groups of NK subsets that are functionally similar and tailored to expertly handle different sorts of pathogens. She hopes to eventually unravel those groups and find out which are best at killing HIV . In the meantime, Blish’s group is performing a longitudinal study at Stanford’s Human Immune Monitoring Center on 12 healthy people over the course of six months to answer some more basic questions. For example, she wants to learn whether individuals retain the same NK cell repertoire over time and whether those with high NK cell diversity maintain it. Blish and Parham’s initial data showed that repressive receptors are controlled by genetics, but that activating receptors are highly influenced by environmental factors—factors her lab is now trying to identify.Infusion of curiosity Todd Fehniger, an oncologist at Washington University School of Medicine in St. Louis, Missouri, says he a nticipates an explosion of CyTOF studies exploring how things like infection and cancer alter NK cell repertoires. CyTOF has already become an important tool for researchers trying to propagate NK cells in the lab that are trained to kill cancer once infused into patients. Laurence Cooper, a pediatric oncologist at MD Anderson Cancer Center in Houston, Texas says there are some receptors and characteristics to look for in NK cells derived to attack cancer cells; “we have a shot on goal with a few things,” he says. The complexity of CyTOF data will help researchers construct a more detailed profile of NK cells used for cancer immunotherapy. Cooper is one of the minds behind a new therapy for pediatric medulloblastoma and other brain cancers that involves activating patient's own NK cells and injecting them back in through a vessel that carries fluid to the brain. The New Opportunity Advancing Hope protocol will be tested in a phase 1 trial beginning this month.So far, NK cell therapy has been most successful in patients with refractory acutemyeloid leukemia (AML); in a 2005 study, about 30% of these patients experienced remission after receiving an infusion of donor NK cells (Blood 105, 3051–3057, 2005). That statistic has held up in other clinical studies, but it’s still not clear why some people respond and some don’t. To resolve this question, both Fehniger and Parham have established collaborations with Jeffrey Miller, an oncologist who has been at the forefront of NK cell immunotherapy research over the last ten years. Part of the problem, Miller says, has been a lack of understanding about how NK cells change after they’ve been infused. Fehniger plans to use CyTOF to fill some of those gaps. He is currently six months into a phase 1 trial that will infuse highly active donor-derived NK cells into the blood of 24 people with AML. In collaboration with Miller, he is saving cells before and after infusion for CyTOF analysis and plans to search for links between expansion of certain cell subsets and patient outcomes.Stem cell transplant serves as another avenue for using NK cells to fight cancer. As donor stem cells rebuild the immunesystem, new NK cells unfamiliar with the host have a better chance to attack cancer cells. Scientists have linked certain NK cell receptor genotypes to a reduced incidence of relapse in AML patients for the first three years after stem cell transplant (Blood 116, 2411–2419, 2010), but Fehniger says that is just a small snapshot of what is possible. CyTOF, he says, could help researchers track how not just one receptor, but entireNK cell subsets affecttransplant outcomes. Along these lines,Parham is using CyTOFto follow NK cells as they repopulate in AMLpatients in an effort todefine what a ‘good’ NK cell repertoire looks like when a patient responds well to stem cell transplant. “You have to know all of the details before you can simplify things with intelligence,” he says.All of these researchers are working to generate a profile of an NK cell population with expert cancer-killing skills in hopes of developing methods to engineer NK cells that mimic that expert population. With the right technology in place, this goal could soon become a reality and elevate the immunotherapeutic status of the humble NK cell.Amanda B. Keener is a former news intern at Nature Medicine in New York and currently a freelance writer in Winston-Salem, North Carolina.“Now you have a tool that can tell you everything about the problem and opportunity of NK cells.”Subset surveyor: Catherine Blish.C a t h e r i n e B l i s h© 2015 N a t u r e A m e r i c a , I n c . A l l r i g h t s r e s e r v e d .。
bone-marrow-examination讲课讲稿
15
Erythrocyte Development -Erythropoiesis
Stem cell
Late stem cell
Proerthroblast (pronormoblast)
Basophilic erythroblast
Polychromatophilic Orthocromatophilic
BONE MARROW EXAMINATION
1
Contents
1. Bone marrow examination 2. Blood and bone marrow profiles
of some hematological diseases
2
Bone marrow examination
Indications and Counterindications
Blood
Hb/Hct/RBC MCV MCH MCHC reticulocytes
In iron deficiency the red blood cells are smaller than normal (microcytic) and contain reduced amounts of hemoglobin (hypochromic) .
20
Mature Monocytes
21
Lymphocyte Development
Lymphocytic progenitors originate in bone marrow.
Lymphocytes split off to their own line of stem cells quite early in development, thus the lymphocytes are considered a separate line from the entire collection of myeloid cells
Bone marrow examination
Bone marrow examinationA Wright's stained bone marrow aspirate smear from a patient with leukemia.Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, anemia, and pancytopenia. T he bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy.Components of the procedureA volunteer donating bone marrow for scientific research.Bone marrow samples can be obtained by aspiration and trephine biopsy. Sometimes, a bone marrow examination will include both an aspirate and a biopsy. T he aspirate yields semi-liquid bone marrow, which can be examined by a pathologist under a light microscope as well as analyzed by flow cytometry, chromosome analysis, or polymerase chain reaction (PCR). Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2mm wide and 2 cm long (60 μL), which is examined microscopically (sometimes with the aid of immunohistochemistry) for cellularity and infiltrative processes. An aspiration, using a 20 mL syringe, yields approximately 300 μL of bone marrow.[1] A volume greater than 300 μL is not recom mended, since it may dilute the sample with peripheral blood.[1]Aspiration doesn't always represent all cells since, as some such as lymphoma stick to the trabecula, and would thus be missed by a simple aspiration.Site of procedureBone marrow aspiration and trephine biopsy are usually performed on the back of the hipbone, or posterior iliac crest. However, an aspirate can also be obtained from the sternum (breastbone). A trephine biopsy should never be performed on the sternum, due to the risk of injury to blood vessels, lungs or the heart.How the test is performedA needle used for bone marrow aspiration, with removable stylet.A bone marrow biopsy may be done in a health care provider's office or in a hospital. Informed consent for the procedure is typically required. T he patient is asked to lie on his or her abdomen (prone position) or on his/her side (lateral decubitus position). T he skin is cleansed, and a local anesthetic such as lidocaine is injected to numb the area. Patients may also be pretreated with analgesics and/or anti-anxiety medications, although this is not a routine practice.Typically, the aspirate is performed first. An aspirate needle is inserted through the skin until it abuts the bone. T hen, with a twisting motion, the needle is advanced through the bony cortex (the hard outer layer of the bone) and into the marrow cavity. Once the needle is in the marrow cavity, a syringe is attached and used to aspirate ("suck out") liquid bone marrow. A twisting motion is performed during the aspiration to avoid excess content of blood in the sample, which might be the case if an excessively large sample from one single point is taken.Subsequently, the biopsy is performed if indicated. A different, larger trephine needle is inserted and anchored in the bony cortex. T he needle is then advanced with a twisting motion and rotated to obtain a solid piece of bone marrow. T his piece is then removed along with the needle. T he entire procedure, once preparation is complete, typically takes 10–15 minutes.If several samples are taken, the needle is removed between the samples to avoid blood coagulation.After the procedureAfter the procedure is complete, the patient is typically asked to lie flat for 5–10 minutes to provide pressure over the procedure site. After that, assuming no bleeding is observed, the patient can get up and go about their normal activities. Paracetamol (acetaminophen) or other simple analgesics can be used to ease soreness, which is common for 2–3 days after the procedure. Any worsening pain, redness, fever, bleeding or swellin g may suggest a complication. Patients are also advised to avoid washing the procedure site for at least 24 hours after the procedure is completed.ContraindicationsT here are few contraindications to bone marrow examination. T he only absolute reason to avoid performing a bone marrow examination is the presence of a severe bleeding disorder which may lead to serious bleeding after the procedure. If there is a skin or soft tissue infection over the hip, a different site should be chosen for bone marrow examination. Bone marrow aspiration and biopsy can be safely performed even in the setting of extreme thrombocytopenia (low platelet count).ComplicationsWhile mild soreness lasting 12–24 hours is common after a bone marrow examination, serious complications are extremely rare. In a large review, an estimated 55,000 bone marrow examinations were performed, with 26 serious adverse events (0.05%), including one fatality.[2] T he same author collected data on over 19,000 bone marrow examinations performed in the United Kingdom in 2003, and found 16 adverse events (0.08% of total procedures), the most common of which was bleeding. In this report, complications, while rare, were serious in individual cases.[3]。
白血病(英文版)
Fusion gene formation
Model for Development of
Leukemia
Normal stem or progenitor cell
Mature blood cells
Mutalls
Normal development blocked
leukemia cells
Acute
Rapid growth of immature blood cells
Mostly in children, young adults
Needs immediate treatment
Chronic
Excessive build up of more mature blood cells
WHO Classification of Lymphoproliferative Syndromes
Precursor B Lymphoblastic Leukemia/Lymphoma (ALL/LBL) -- ALL in children (80-85% of childhood ALL); LBL in young adults and rare; FAB L1 or L2 blast morphology
CONTENTS
DEFINITION CLASSIFICATION ETIOLOGY MANIFESTATIONS LABORATORY EVALUATION DIAGNOSIS TREATMENT
What is leukemia?
Origin: Hematopoietic system Level: Malignant clonal disease of stem cell Nature: Malignancy
打开数字的英文作文
打开数字的英文作文Title: Exploring the Significance of Numbers in Everyday Life。
Numbers are the fundamental building blocks of the universe, governing every aspect of our existence from the grandeur of galaxies to the intricacies of subatomic particles. They serve as the language through which we comprehend the world around us, enabling us to quantify, analyze, and understand phenomena that range from the mundane to the extraordinary. In this essay, we delve into the multifaceted significance of numbers in our daily lives, exploring their role in various domains and their profound impact on human civilization.To begin with, numbers are indispensable tools in the realm of mathematics, serving as the foundation upon which mathematical theories and principles are constructed. From the simplicity of counting to the complexity of calculus, numbers provide the framework for solving equations,modeling natural phenomena, and unlocking the mysteries of the universe. Without numbers, the vast edifice of mathematics would crumble, rendering fields such as physics, engineering, and economics virtually incomprehensible.Moreover, numbers play a crucial role in communication and commerce, facilitating transactions, measurements, and exchanges of information on a global scale. Whether we are discussing the price of goods, the dimensions of a building, or the coordinates of a location, numbers serve asuniversal symbols that transcend language barriers and cultural differences. In the digital age, where data drives decision-making and technological innovation, the abilityto manipulate and interpret numbers is essential forsuccess in virtually every sector of the economy.Beyond their practical utility, numbers also possess symbolic and cultural significance that permeates various aspects of human society. In many cultures, certain numbers are imbued with auspicious or ominous meanings, influencing beliefs, traditions, and rituals. For example, the number seven is often associated with luck and spirituality inmany societies, while the number thirteen is viewed as unlucky in Western superstition. Furthermore, numbersfeature prominently in art, literature, and religion, serving as metaphors for concepts such as infinity, perfection, and transcendence.In addition to their symbolic and cultural connotations, numbers have profound psychological effects on the human mind, shaping our perceptions, behaviors, and decision-making processes in subtle ways. Research in cognitive psychology has revealed that humans have an innate tendency to assign numerical values to objects and events, a phenomenon known as "numerical cognition." Moreover, numerical illusions and biases, such as the "anchoring effect" and the "Gestalt law of proximity," demonstrate how numbers can influence our judgments and interpretations of reality.Furthermore, numbers hold a special significance in the context of time, serving as markers of temporal progression and historical continuity. The concept of chronological time, with its division into seconds, minutes, hours, days,and years, is an essential aspect of human civilization, enabling us to organize our lives, record our achievements, and reflect on the passage of time. Moreover, the use of numerical calendars and timelines allows us to contextualize historical events, chart the course of evolution, and envision the future trajectory of humanity.In conclusion, numbers are not merely abstract entities but integral components of our everyday experience, shaping our perceptions, actions, and understanding of the world. From the elegance of mathematical equations to the symbolism of cultural rituals, numbers permeate every aspect of human existence, enriching our lives with their infinite complexity and profound significance. As we navigate the complexities of modern society, let us recognize and appreciate the indispensable role that numbers play in illuminating the mysteries of the universe and charting the course of human civilization.。
核磁共振成像MRI的一些小知识（AlittleknowledgeofMRIinMRI）
核磁共振成像MRI的一些小知识（A little knowledge of MRI in MRI）1. What is MRI?MRI is an abbreviation of the English Magnetic Resonance Imaging, or MRI. It is a new method of high-tech imaging examination in recent years, which was applied to the clinical medical imaging diagnosis of new technology in the early 1980s. It has no ionizing radiation (radiation) damage; Non-skeletal pseudo shadow; Multi-parameter imaging with multiple directions (transverse, coronal, sagittal plane, etc.); Height of soft tissue resolution; There is no need to use contrast agents to show the unique advantages of vascular structure. Therefore, it is regarded as another important development in the field of medical imaging.What is T1 and T2?T1 and 12 is organized in a certain time interval after a series of pulses to accept physical change in the characteristics of different groups have different T1 and T2, it depends on the rf pulse of the hydrogen protons on magnetic field in the organization of the reaction. By setting the MRI imaging parameters (TR and TE), TR is repeated time namely rf pulse interval, TE is applying rf pulse echo time namely from to accept to ask the time signal, TR and TE units are milliseconds (ms), can make organization Tl or T2 characteristics respectively from the images (T1 - or T2 - weighted images; t2-weighted through imaging parameters setting can also make both Tl and T2 characteristic image, called proton density weighted.3. What is the signal strength change characteristic of hematoma?The signal strength of hematoma varies with time as a result of the change in the nature of hemoglobin (e.g., oxyhemoglobin transformation into deoxyhemoglobin and orthopaemia). These characteristics help to determine the period of hemorrhage, acute hemorrhage (oxygen or deoxyhemoglobin) T1 weighted image is low signal or other signal, and subacute hematoma is high signal; Chronic hematoma is a low signal in all sequences due to the deposition of hemosiderin.4. What are the clinical applications of MRI?Mri images are very similar to CT images, both of which are "digital images" and show the anatomical and pathological cross-sectional images of different structures with different grayscale. Like CT, magnetic resonance imaging can also be applied to various systemic diseases, such as tumors, inflammation, trauma, degenerative diseases, and various congenital diseases. Magnetic resonance imaging (fmri) without bony artifact, can make more direct direction (transection, coronal, sagittal, or any Angle) layer, the brain, spinal cord and spinal anatomical and pathological changes of display, especially superior to CT, magnetic resonance imaging by its "empty effect", but without vascular contrast, showed that the vascular structures, therefore, in the "no damage" to show blood vessel (except for tiny blood vessels), as well as to the tumor, lymph node and differentiate between vascular structures, are unique. Magnetic resonance imaging (mri) has a soft tissue resolution capability that is higher than thatof CT, and it can sensitively detect changes in water content in the composition of tissues, so it can be more effective and early detection of lesions than CT. In recent years, the research of magnetic resonance blood imaging technology has made it possible to measure blood flow and blood flow rate in living organisms. Heart switch control the use of magnetic resonance imaging can clearly, fully display the heart, myocardial, pericardium, and other fine structure of the heart, for nondestructive inspection and diagnosis of acquired and congenital heart diseases, including coronary heart disease, etc.), and heart function examination, provides a reliable way. With a variety of rapid scanning sampling sequence and 3 d scanning technology research and successfully applied to clinical, magnetic resonance angiography and new technology has entered clinical film photography, and perfected. Recently, to realize the combination of the magnetic resonance imaging (fmri) and local spectroscopy (i.e., the combination of MRI and MRS), as well as other nuclei, such as fluorine except hydrogen proton magnetic resonance imaging (fmri), sodium, phosphorous, etc, these achievements will be able to more effectively improve the magnetic resonance imaging in the diagnosis of specificity, also broadened its clinical use. Main disadvantages of magnetic resonance imaging technique is needed for it to scan for a long time, so for some checkill-matched patients often difficult, organ in the sport, such as gastrointestinal tract due to lack of proper contrast agent, often show is not clear;For the lungs, the imaging effects are not satisfactory due to the low concentration of hydrogen protons in the breathing exercise and the alveolar. Mri imaging of calcification andbone lesions is not as accurate and sensitive as CT. The spatial resolution room of magnetic resonance imaging is still to be improved.1, the brain and spinal cord MRI of brain lesions, encephalitis, brain white matter lesions, cerebral infarction, cerebral CT is more sensitive than the diagnosis of congenital anomaly, etc, can be found early pathological changes, and more accurate positioning. The lesions on the base of the skull and the brain stem were more clearly visible without the artifact. MRI does not show cerebral blood vessels by contrast agent, and it is found that there are aneurysms and arteriovenous malformations. MRI can also directly display cranial nerves, which can be found in the early lesions that occur in these nerves. MRI can directly show the full appearance of the spinal cord, and therefore has important diagnostic value for spinal tumor or internal tumor of the spinal cord, leukodystrophy, spinal cord injury, spinal cord injury, etc. For disc lesions, MRI can show its denaturation, prominence, expansion or removal. It shows that the spinal canal stenosis is also better. For cervical and thoracic vertebra, CT often showed dissatisfaction, while MRI showed clearly. In addition, MRI is also very sensitive to the presentation of vertebral metastatic tumors.2. The neoplastic lesions of the head and neck MRI in the eye and ear nose and throat were shown to be good, such as the invasion of the skull base and cranial nerve by nasopharyngeal carcinoma, and the MRI showed more clearly and more accurately than the CT. MRI can also do angiography on the neck, showing abnormal blood vessels. In the neck mass, MRI can also show its range and features to help characterize it.3. Chest MRI can directly show myocardial and left ventricular cavity (heart gate control) to understand the condition of myocardial damage and determine cardiac function. The condition of the large blood vessels in the mediastinum can be clearly shown. The positioning of mediastinal tumor is also very helpful. The condition of pulmonary edema, pulmonary embolism and lung tumor can also be shown. Can distinguish the property of pleural effusion, distinguish the blood vessel section or the lymph node.4. The diagnosis of abdominal MRI on the liver, kidney, pancreas, spleen, adrenal and other substantive organ diseases can provide valuable information and help to confirm the diagnosis. Small lesions are also more likely to be shown, so early lesions can be found. MR pancreatic cholangiography (MRCP) can show biliary and pancreatic duct, which can be replaced by ERCP. MR urography (MRU) can show dilated ureteral and renal pelvis, especially for patients with renal dysfunction and IVU.5. Pelvic MRI can show the pathological changes of uterus, ovary, bladder, prostate and seminal vesicle. The endometrium and muscle layer can be seen directly, which can be helpful for early diagnosis of uterine tumor. The diagnosis of ovarian, bladder, prostate and other lesions is also very valuable.6. Posterior peritoneal MRI has great value for the tumor of the retroperitoneal membrane and the relationship with the surrounding organs. The abdominal aorta or other large vascular lesions can also be shown, such as abdominal aortic aneurysm, bu-cha syndrome, renal artery stenosis, etc.7. MRI of musculoskeletal system injury to cartilage disk, tendon and ligament in the joint, showing a higher rate than CT. Due to the sensitivity of bone marrow changes, bone metastasis, osteomyelitis, aseptic necrosis and leukemic bone marrow infiltration were detected early. The soft tissue block of bone tumor was shown clearly. There is also some diagnostic value for soft tissue injury.5. What are the advantages of MRI over CT?1. No ionizing radiation;2. Multi-azimuth imaging(cross-section, coronal plane, sagittal plane and inclined plane); The details of the anatomical structure are better; 4. More sensitive to subtle pathological changes of organizational structure (such as infiltration of bone marrow and cerebral edema); The type of the tissue (such as fat, blood and water) is determined by signal strength. 6. Organization comparison is better than CT.6. What are the types and indications of MRI contrast agent?1. Paramagnetic positive contrast agent. Commonly used Gd - DTPA (ma genevin), Mn - DPDP, etc. Its function mainly causes T1 to be shortened, and the T1 weighted image is high signal.2. Super paramagnetic substance. The most commonly used are super - paramagnetic iron oxide particles (SPIO), AMI - 25 and Resovist. Its function mainly causes T2 to be shortened,The T2 weighted image is the low signal. (2) indications: 1. Differential diagnosis of certain tumors. 2. Determine whetherthe blood-brain barrier is damaged. 3. Improve the detection rate of pathological changes.7. How to distinguish T1 weighted image from T2 weighted image?The TE and TR values of the image can be distinguished, the short can be 20ms, the length can be 80ms, the TR can be 600ms, and the length can be 3000 + ms. Short TE short TR for T1 weighted image, and TE. TR - length T2 - weighted image, short TE long TR - weighted image of proton density. Understanding the signal characteristics of water and fat helps to distinguish between a T1 weighted image and a T2 weighted image, especially if the image does not show characteristic TE and TR values. Look at liquid structures such as ventricles, arms or cerebrospinal fluid. If the liquid is bright, it is likely to be a t2-weighted image. If the liquid is dark, it may be a T1 weighted image. If the liquid is bright, and other structures are not like the t2-weighted image, and both TR and TE are short, it may be a gradient echo image.8. What are the common imaging sequences and methods used for magnetic resonance imaging?Magnetic resonance imaging is obtained by using specific imaging sequence scanning. At present, the most commonly used in clinic is the spin - echo sequence (SE sequence). Repeatedly time by changing the sequence of the TR (radio frequency) and TE (echo time) two parameters, respectively for proton density beta, T1 and T2 weighted images, three different imaging parameters of weighted images, each representing the three different kinds of magnetic resonance characteristic of theorganization, so as to distinguish the normal tissues and identify lesions. In addition, there is a reverse response sequence (IR sequence), which is obtained in this sequence, which can be heavily embodied in the T1 feature of the organization (heavy T1 weighting). The saturation response sequence (SR sequence) is the proton density plus only sequence; Partial saturation sequence (PS sequence) is a T1 - weighted sequence. None of these sequences are more popular than the SE sequence, and the applications are not widely available. The rapid imaging sequence effectively promotes the clinical application of magnetic resonance imaging. The RARE sequence introduced from west Germany, for example, is a severelyt2-weighted imaging sequence that has high sensitivity to the display of lesions. FLASH, FISH is also fast imaging sequences and their scanning imaging time in milliseconds (conventional scanning imaging time sequence, usually in seconds), therefore, to a great extent, overcome the magnetic resonance imaging (mri) scan time long Achilles' heel, for dynamic magnetic resonance imaging (mri) and magnetic resonance imaging (fmri) film photography, create the necessary conditions. For patients with magnetic resonance imaging, to avoid a paramagnetic material such as iron, such as watches, metal necklace, false teeth, metal buttons, metal ring into the examination room, because these items with a paramagnetic material, can affect the uniformity of the magnetic field, produce large no signal in the image artifacts, unfavorable to lesions of the display. Patients with pacemakers are not allowed to perform magnetic resonance imaging. The body has reserved metal shrapnel, postoperative with silver clip residues (silver clip composition may contain a small amount of paramagnetic substance), gold property in patients with fixed plate, suchas pseudarthrosis, magnetic resonance imaging to be treated cautiously, check to closely observe when necessary, the patient if there are any local discomfort, should immediately stop check, prevent the shrapnel, silver clip mobile in the high magnetic field, so that damage to nearby large blood vessels and important organization. During the mri scan, the patient must maintain a balanced breathing, reduce swallowing, and avoid autonomous or involuntary body and limb movements. For children or delirious patients who are unable to cooperate with the examination, some sedatives may be used as appropriate. During magnetic resonance imaging, still need to correctly choose layer cutting direction and different weighted imaging parameters of pulse sequence, so that as far as possible in a short time, the disease location and qualitative diagnosis of conventional for in addition to the examination of spinal column and spinal cord, most first as fast T2 weightedcross-sectional imaging, so that preliminary judge lesions and the length of the T2 values. Then, a t1-weighted coronary or sagittal plane image was further developed to determine the anatomical relationship between the lesion and its adjacent structure, and the length of T1 value of the lesion.If the above examination has not solved the problem, it can also be used as a long TR SE multiecho sequence as appropriate. The first echo of this sequence is a weighted image of proton density, and the anatomical resolution of soft tissue is higher. The fourth echo image is a T2 weighted image, which is beneficial to the comparison of tissues. The longer scan time of the multi-echo imaging sequence is its deficiency. Spine and spinal cord has walked up and down the anatomical features, appropriate to check for T2 weighted fast and SE sequencet1-weighted sagittal section imaging scans, finally can depend on is shown in suspicious lesion site, further for T2 and/or SE sequence T1 weighted imaging scans cross sectional tangent plane, to determine the characteristics of lesions and their relationship with the spinal cord, etc. An mri examination of the upper abdomen (liver, pancreas, kidney, adrenal, etc.) is suitable for an empty stomach, and the water that is drunk before the examination can make the boundary of the stomach and the left lobe of the liver and the spleen be more clearly displayed.9. What should patients prepare before an MRI exam?1. Before entering the examination room, the patient must take out all the metal objects, such as watches, keys, pens, COINS, glasses and various magnetic CARDS.2. Give moderate sedatives to infants, fidgety and melancholic patients. The abdomen examination is best empty abdomen, can serve the gastrointestinal contrast agent, also can not use. Abdominal straps may be used to reduce the pseudo shadow caused by respiratory movement.10. Which patients are not suitable for MRI scan?1. With cardiac pacemaker.2. Aneurysm after aneurysm surgery.3. Eyeball metal foreign body.4. Critically ill patients with various rescue equipment.5. Patients with various metal implants should be careful when checking.Are there any contraindications for MRI examination?The contraindication is that the patient is equipped with a magnetic susceptibility substance or device, and the loss of movement or function of these structures can cause adverse consequences. 1. Cardiac pacemaker; 2. Cochlear implant; Some artificial heart valves; 4. Skeletal growth stimulator and nerve stimulator (TENs); 5. Arterial clamp or ring; 6. Metal structure (box week); 7. Some prostheses. Prior to any MRI examination, the examination of the above contraindications is necessary for all patients. Some manufacturers have now produced non-ferromagnetic surgical clips and other devices and must consult radiologists if there is any safety problem.What is the signal strength?Signal strength according to the brightness of the signal generated by a certain organization, organization for high signal light (white), and dark organization for low signal, such as between signals, often used to judge the relationship between diseased tissue signals and its surrounding structures (such as a lump is high signal than the surrounding tissue). Note that MRI USES strength rather than density, and the concept of density is used on CT and X-ray plates。
骨髓细胞学检查英文课件(第二部分)
2. oil immersion assay
• Choose the boundaries of the film’s coating body and tail.
(1)count the karyocytes differentially:
reason
diseases
normal G:E normal bone marrow
G and E increased equally
erythroleukemia
G and E decreased equally
aplastic anemia
hemotopoietic system diseases, in multiple myeloma, bone
• (4)the decreased hyperplasia
• Reflect the decreased function of bone marrow hematogenesis
• Conditions: chronic aplastic anemia, granulocytopenia, agranulemia, myelofibrosis…
basophilic granulocytes are usually mature in bone marrow. • eosinophilic granulocytes <5% • basophilic granulocytes <1%
(2) Erythrocyte series • Normoblasts≈20% • Pronormoblast<1% • Basophilic normoblast<5% • Polychromatic normoblast≈10% • Orthochromatic normoblast≈10% • G:E is defined as the ratio of the
Abraxane 白蛋白紫杉醇-FDA说明书
monoclonal gammopathies单克隆免疫球蛋白病
MM – etiopathogenesis of multiple myeloma II
MM – etiology and pathogenesis (2) • chromosome abnormalities were found in ~ 90% or patients with FISH and microarray techniques − deletion of chromosome 13 and hypodiploidy have been shown to be associated with poor survival as have t(4;14), t(14;16) − c-Myc RNA and protein overexpression, N- and K-RAS mutations (~ 50%) − mutations and deletions in the retinoblastoma and the p53 tumor suppressor genes in malignant plasma cells − muldidrug resistance (MDR) gene • cytokines are involved − IL-6 is an autocrine growth factor − IL-1 and TNF- • elevation of proliferation rate and low apoptosis rate of myeloma cells → accumulation of myeloma cells • contact with marrow stromal cells appears to be required for the complete expression of the malignant repertoire of myeloma cells
α2-巨球蛋白通过调控血管内皮细胞改善小鼠激素性股骨头坏死
糖皮质激素（GC ）广泛应用于严重感染、血液病和自身免疫性疾病，发挥其抗炎、代谢调节和免疫抑制的作用［1］。
然而，超生理剂量GC 的应用可导致库欣综合征、骨质疏松和心血管反应等一系列的副作用。
激素性股骨头坏死（SANFH ）是过量使用糖皮质激素的严重后α2-macroglobulin alleviates glucocorticoid-induced avascular necrosis of the femoral head in mice by promoting proliferation,migration and angiogenesis of vascular endothelial cellsZHU Qi,LU Yunxiang,PENG You,HE Jiale,WEI Zeyu,LI Zhiyong,CHEN YuxianDepartment of Joint Surgery,Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China摘要：目的探讨α2-巨球蛋白（A2M ）是否对激素性股骨头坏死（SANFH ）具有保护作用。
方法体外实验：用梯度浓度（10-8~10-5mol/L ）地塞米松（DEX ）处理人脐静脉内皮细胞（HUVECs ）建立糖皮质激素（GC ）诱导内皮细胞损伤体外模型，设置对照组、DEX 组、DEX+A2M （0.05mg/mL ）和DEX+A2M （0.1mg/mL ）4组，采用CCK-8法检测细胞活性，Transwell 实验和划痕愈合实验检测HUVECs 迁移，血管形成实验检测HUVECs 血管形成能力，Western blot 检测HUVECs 中CD31和VEGF-A 蛋白表达水平。
体内实验：将24只BALB/c 小鼠分为对照组、模型组（GC ）和干预组（GC+A2M ），Micro-CT 检测骨小梁情况，HE 染色观察组织学特征，免疫组化染色检测CD31的表达。
做实验有什么启示英语作文
做实验有什么启示英语作文The Significance of Conducting Experiments。
Experiments are an essential part of scientific research. They provide scientists with a way to test their hypotheses and theories. Through experiments, scientists can observe and measure the effects of different variables on a particular phenomenon. The results obtained from experiments are used to draw conclusions and make predictions about the natural world. In this essay, we will discuss the significance of conducting experiments and the lessons we can learn from them.Firstly, experiments allow us to test our ideas and theories. In the absence of experiments, we would have to rely on guesswork and speculation. For example, if a doctor wants to find out which treatment is more effective for a particular disease, he or she would have to conduct experiments on patients to test the different treatments. Without experiments, the doctor would have to rely onanecdotal evidence or intuition, which may not be reliable.Secondly, experiments help us to understand the natural world. Through experiments, we can observe and measure the effects of different variables on a particular phenomenon. This allows us to identify patterns and relationships that may not be apparent otherwise. For example, scientists use experiments to study the behavior of subatomic particles, which are too small to observe directly. Through experiments, they can observe the behavior of these particles and make predictions about their properties.Thirdly, experiments can lead to new discoveries and innovations. Many of the most significant discoveries in science and technology have come from experiments. For example, the discovery of penicillin, the first antibiotic, was the result of an experiment conducted by Alexander Fleming. Similarly, the discovery of the Higgs boson, a subatomic particle that gives other particles mass, was the result of experiments conducted at the Large Hadron Collider.Finally, experiments teach us important lessons about the scientific process. Experiments are often designed to test a specific hypothesis or theory. However, the results of experiments are not always what we expect. Sometimes, experiments can lead to unexpected results or even contradict our ideas and theories. When this happens, scientists must revise their hypotheses and theories to account for the new information. This process of revising and refining our ideas is an essential part of the scientific process.In conclusion, experiments are an essential part of scientific research. They allow us to test our ideas and theories, understand the natural world, make new discoveries and innovations, and learn important lessons about the scientific process. As we continue to conduct experiments and push the boundaries of our knowledge, we will undoubtedly make new discoveries and innovations that will benefit humanity.。
多西环素诱导表达下IL23基因转染小鼠骨髓基质细胞促进造血
文章编号(Article ID):1009-2137(2003)04-0335-06・论著・多西环素诱导表达下IL23基因转染小鼠骨髓基质细胞促进造血蒋激扬,李爱玲,谢蜀生北京大学医学部免疫系,北京100083摘要 本研究探讨用多西环素调控IL23基因表达的小鼠骨髓基质细胞系对小鼠造血干细胞增殖分化的促进作用。
构建含小鼠IL23基因逆转录病毒载体系统,转染小鼠骨髓基质细胞系,获得QXMSC1Tet2on2IL23;体外加入多西环素诱导IL23基因表达并检测IL23表达活性;观察细胞培养条件上清液对造血祖细胞集落形成单位的作用及QXMSC1Tet2on2IL23与骨髓细胞共培养对造血干细胞增殖分化的影响。
结果表明:多西环素提高了QXMSC1Tet2 on2IL23细胞系IL23的表达,促进骨髓造血祖细胞克隆形成数;与骨髓细胞共培养可促进造血干细胞的增殖分化。
结论:应用多西环素诱导外源基因转染的骨髓基质细胞IL23的表达,可促进造血。
关键词 多西环素;IL23;骨髓基质细胞;QXMSC1;造血干细胞;基因转染中图分类号 R392.4;R33112文献标识码 AThe Enhancing E ffects of IL23G ene T ransfected Murine Bone Marrow Stromal Cells on H ematopoiesis under Control of DoxycyclineJ IAN G Ji2Yang,L I Ai2Ling,XIE Shu2ShengDepart ment of I m m unology,Peki ng U niversity Health Science Center,Beiji ng100083,Chi naAbstract To study enhancing effect of IL23gene transfected bone marrow stromal cell which can be induced b y doxycycline(Dox)to express IL23cytokine on the proliferation and differentiation of hematopoietic stem cell,retrovirus vector system contained mIL23cDNA was established and bone marrow stromal cell line was transfected,and obtained QXMSC1Tet2on2IL23,in which expression level of IL23can be modulated by Dox.The activities of IL23were measured under different Dox concentrations.The numbers of hemato poietic progenitors(CFU2GM,CFU2E,CFU2GEMM and L TC2IC)were measured and the ca pacity of QXMSC1Tet2on2IL23sustaining hematopoietic progenitor cell growth was evaluated.The results showed that IL23gene transfected stromal cell line QXMSC12Tet2on+IL23expressed high concentration of IL23in vit ro under control of Dox.The su pernatant of QXMSC12Tet2on+IL23was able to increase the number of CFU2GM,CFU2E and CFU2GEMM.The total numbers of nucleated cells and long2term cultured colonies increased in L TC2IC assay.It is concluded that in the culture of QXMSC12Tet2on+IL23cells,Dox actually enhancedIL23expression,and thus augmented the proliferation and differentiation of hematopoietic stem/progenitor cells invit ro. K ey w ords doxycycline;IL23;bone marrow stromal cell;QXMSC1;hemato poietic stem cell;gene transfectionJ Ex p Hem atol2003;11(4):335-340影响异基因骨髓移植后造血和免疫功能重建的原因较多,其中骨髓移植前的放、化疗对骨髓造血微环境的损伤是重要原因之一。
潘生丁负荷试验脑血流灌注显像在缺血性脑血管病中的应用
明这一结果。
抑制扩张型是这类疾病常见和比较独特的显像表现。
随着造血衰竭的进一步发展,P BM乃至全身骨髓的重度抑制将是病程发展的最终结果。
骨髓显像可为监测患者所处的临床阶段提供客观的判断依据。
未缓解的CG L患者C BM的抑制、P BM的扩张以及脾脏的明显肿大均随病情的缓解而有减轻的趋势,这一现象与急性白血病骨髓显像演变规律相同[10],推测这种改变同样与基于白血病细胞的堆积积压或某些体液因素的作用而影响骨髓网状内皮细胞摄取胶体能力有关,同时,化疗药物对骨髓的抑制作用亦不可忽视。
骨髓显像类型同样有助于了解C M L患者的临床状态和治疗效果。
MPD各症之间细胞形态学及临床表现交错,骨髓显像类型尽管有相似之处,但显像特点仍有所区别,可帮助临床鉴别诊断。
参 考 文 献1陈灏珠,主编.内科学.第4版.北京:人民卫生出版社,1996.5672 605.2肖志坚,综述.慢性骨髓增生性疾病诊断与分型的研究进展.国外医学输血及血液学分册,1998,1:43247.3贾士铨,康福,韩建奎,等.全身骨髓照相在血液病诊断中应用的研究.山东医学院学报,1984,22:1211.4刘勇,刘岱,康福,等.血液病外周性骨髓显像变化规律及临床意义的研究.中华核医学杂志,1995,15:1672170.5Ferrant A,R odhain J,Leners N,et al.Quantitative assessment of ery2 thropoiesis in bone marrow expansion area using52Fe.Br J Hematol, 1986,62:2472255.6Reske S N.Recent advances in bone marrow scanning.Eur J Nucl M ed, 1991,18:2032221.7Chung J K,Y eo J,Lee DS,et al.Bone marrow scintigraphy using99T c m2 antigranulocyte antibody in hematologic dis orders.J Nucl M ed,1996,37: 9782982.8M anoharan A.M yelofibrosis:prognostic factors and treatment.Br J Hematol,1988,69:2952298.9刘勇,贾士铨,康福.再生障碍性贫血骨髓灶状显像及其临床意义的探讨.中华核医学杂志,1991,11:2292231.10韩建奎,贾士铨,康福,等.急性白血病的骨髓显像规律初探.中华核医学杂志,1991,11:123.(收稿日期:2001207220) ・中枢神经系统核医学・潘生丁负荷试验脑血流灌注显像在缺血性脑血管病中的应用修雁 陈绍亮 孙晓光 陈婕 毛悦时 汪忻【摘要】 目的 研究潘生丁负荷试验脑血流灌注显像在缺血性脑血管病中的应用。
荧光染料CM-DiI标记大鼠骨髓间充质干细胞的体外实验
荧光染料CM-DiI标记大鼠骨髓间充质干细胞的体外实验目的探讨荧光染料CM-DiI标记大鼠骨髓间充质干细胞的效果及其对细胞活力、增殖能力、凋亡等生物学特性的影响。
方法用梯度离心加贴壁培养法获取、培养、扩增大鼠骨髓间充质干细胞。
取第4代MSCs，分为实验组和对照组，用浓度为6 μmol/L的CM-DiI对实验组MSCs进行标记。
用台盼蓝染色检测细胞的活力，CCK-8法检测细胞增殖能力，Hoechst 33258染色法检测细胞凋亡。
细胞标记后用倒置相差荧光显微镜动态观察不同子代MSCs的阳性标记率、荧光衰减情况及细胞生长、形态变化。
结果CM-DiI标记后的MSCs发橙红色荧光，高倍镜下显示细胞上有密集排列明亮荧光颗粒。
CM-DiI标记后1 d、4 d、8 d、16 d、24 d细胞标记阳性率分别为100%、（85.2±4.9）%、（42.3±5.1）%、（17.6±3.6）%、（4.4±1.3）%，细胞标记阳性率和荧光强度随传代次数和培养时间的增加而呈显著进行性下降。
标记细胞的大小、形态、活力、增殖能力、细胞凋亡与未标记细胞相比无明显差异。
结论CM-DiI标记骨髓间充质干细胞简便、有效，对其生物学特性无明显影响，可用于MSCs的短期示踪。
标签：骨髓间充质干细胞；CM-DiI；标记In vitro study of rat mesenchymal stem cells labeled with fluorescent dye CM-DiI CHEN Guo-dong,ZHU Dong-liang,TAN Li.The First People’s Hospital of Guangzhou,Guangzhou 510180,China【Abstract】Objective To evaluate the efficiency of lipophilic fluorescent dye CM-DiI on labeling mesenchymal stem cells（MSCs）of rat，and the effect on cell viability,proliferation and apoptosis. Methods The MSCs cells were isolated from bone marrow of SD rat by density gradient centrifugation,and amplificated using adherent culture.The fourth generation MSCs were divided into control group and experimental group.Cells of experimental group were stainted with 6 μmol/L CM-DiI concentrations.Cell viability and proliferation was measured by the exclusion of trypan blue dye and Cell Counting Kit-8（CCK-8）assay.Hoechst 33258 staining were used to determine cell apoptosis.The percentage of positively labeled cells,dicrease of fluorescent intensity,morphologic change of MSCs was dynamic observed by inverted phased fluorescence microscope.Results Using fluorescent microscopy,CM-DiI-positive cells showed strong orange-red fluorescence,and intensive fluorescent particles was observed within the CM-DiI-labeled cells.The percentage of CM-DiI-positive cells was 100%、（85.2±4.9）%,（42.3±5.1）%,（17.6±3.6）% and （4.4±1.3）%,after day 1,4,8,16 and 24,respectively.The percentage of CM-DiI-positive cells and the fluorescence intensity decreased roughly in parallel with the number of cell divisions and the time of culture.The CM-DiI did not affect cell viability,proliferation and apoptosis.Conclusion CM-DiI labeling was convenient and effective,did not affect biological characteristics of MSCs,it should be a useful marker for tracking cells in short-term experiment.【Key words】Mesenchymal stem cells；CM-DiI；Labeling干细胞移植是细胞治疗的重要内容，是当前再生医学研究的热点。
不同剂量地塞米松对人骨髓间充质干细胞增殖作用的研究
Doi ：10．13621/j．1001－5949．2019．02．0100·论著·不同剂量地塞米松对人骨髓间充质干细胞增殖作用的研究巩凡，丁晓玲，李晓亮，丁冬，张博文，黄永禄，丁一，赵飞［摘要］目的观察不同剂量地塞米松对人骨髓间充质干细胞增殖作用的影响。
方法使用人骨髓间充质干细胞，分为空白组（K 组）、地塞米松组（D 组），D 组又按不同浓度共分为13个小组（D1 D13）。
使用实时动态活细胞成像系统连续观察72h ，记录观察数据并进行统计学分析及绘图。
结果不同浓度地塞米松对人骨髓间充质干细胞具有不同的影响，较低浓度地塞米松（D1 D6组）可以促进人骨髓间充质干细胞的增殖，较高浓度地塞米松（D8、D10 D13组）对人骨髓间充质干细胞具有抑制增殖作用。
D9组对人骨髓间充质干细胞具有一定的增殖作用，较低浓度组差。
结论5ˑ10－8mol /L 对人骨髓间充质干细胞的增殖作用最佳，并且在第36 48h 细胞增殖最好。
高浓度地塞米松对人骨髓间充质干细胞具有抑制作用。
［关键词］人骨髓间充质干细胞；地塞米松；浓度；细胞增殖［中图分类号］Ｒ681［文献标识码］AStudy on the effect of different doses of dexamethasone on the proliferation of human bone marrow mesenchymal stem cellsGONG Fan ，DING Xiaoling ，LI Xiaoliang ，DING Dong ，ZHANG Bowen ，HUANG Yonglu ，DING Yi ，ZHAO Fei．Department of Ortho-pedics ，People ＇s Hospital of Ningxia Hui Autonomous Ｒegion ，Yinchuan ，750002，China［Abstract ］Objective To observe effects of different doses of dexamethasone on the proliferation of human bone marrow mesen-chymal stem cells were observed．MethodsHuman bone marrow mesenchymal stem cells were used and divided into a blank group （K group ）and a dexamethasone group （D group ）．D group was divided into 13groups （D1－D13）according to different concentrations．Continuous observations were performed for 72hours using a real －time dynamic live cell imaging system ，and observational data were re-corded for statistical analysis and mapping．Ｒesults Different concentrations of dexamethasone have different effects on human bone marrow mesenchymal stem cells．Lower concentration of dexamethasone （D1 D6group ）can promote the proliferation of human bone marrow mesenchymal stem cells．higher concentration of dexamethasone （D8，D10 D13）group has an inhibitory effect on proliferation of human bone marrow mesenchymal stem cells．The D9group had a certain proliferative effect on human bone marrow mesenchymal stem cells ，and the lower concentration group was poor．Conclusion 5ˑ10－8mol /L had the best proliferation effect on human bone marrow mesenchymal stem cells ，and cell proliferation was the best at 48hours to 36hours．High concentration of dexamethasone has an inhibitory effect on human bone marrow mesenchymal stem cells．［Key words ］Human bone marrow mesenchymal stem cells ；Dexamethasone ；Concentration ；Cell proliferation［基金项目］宁夏自然科学基金资助项目（NZ16182）；宁夏银川市医疗卫生科研项目（201720）；宁夏自然科学基金资助项目（NZ16177）［作者单位］宁夏回族自治区人民医院骨科，宁夏银川750002［作者简介］巩凡（1982－），男，宁夏籍，硕士研究生，主要从事骨科研究方向。
Bonemarrowtransplant
My lungs, me and BMTKeeping your lungs healthy when you havea bone marrow transplant.Reading this booklet can help you learn how to prevent infections in your lungs, during and after a bone marrow transplant.Inside this booklet you will find information about these topics:•The role of the physiotherapist•Why am I at risk of getting a lung infection?•How can I prevent getting a lung infection?•Learning about breathing exercises•Learning about your lungs•When to call the doctorThe role of the physiotherapistThe physiotherapist on the Bone Marrow Transplant Team can help you keep your lungs as healthy as possible, by:•listening to your lungs regularly•helping you learn and practice breathing exercises to help prevent lung infectionsIf you have questions, or would like more information please talk with your physiotherapist:Name ___________________________________Phone ___________________________________Why am I at risk of getting a lung infection?Everything we come into contact with in daily life can be a source of infection. Germs (bacteria, viruses and fungi) that we come into contact with usually do not cause a problem for healthy people.The body’s immune system works to prevent infections bydestroying germs when they enter the body.For a bone marrow transplant (BMT) patient, it’s a different story.The chemotherapy and/or radiation you receive before a BMTcannot tell the difference between cancer cells and normal cells.It not only attacks the cancer or diseased bone marrow, but italso attacks your immune system.This causes the white blood cells, which fight infection, to fall to a very low level. Until the transplanted stem cells engraft and make new white blood cells, you are at risk of getting infections which can be life threatening.The first 2 to 4 weeks after the transplant is a critical time as the transplanted stem cells move to the large bones and beginmaking new white blood cells.Although the risk of infection decreases as the transplantedmarrow makes new white blood cells, most patients remain at risk for 6 month to 1 year after the transplant. This may be evenlonger for patients with complications.During your stay in hospital, you may feel weak and tired.Some days you probably don’t have the energy to get out of bed and move around. When your activity level is this low, you tend to take slow and shallow breaths. As a result, air does not reach the lower parts (lobes) of your lungs.Shallow breathing along with a weakened immune system could allow secretions to collect in your lungs. This may cause infections such as pneumonia.Review:How a lung infection could developchemotherapy or radiation weakens the immune system↓you may feel weak and tired, and become less active↓your breathing can become shallow↓air does not get to the lower lobes of the lungs↓secretions can collect in your lungs↓a lung infection can developHow can I prevent getting a lung infection?You can help prevent a lung infection by:•doing breathing exercises•spending as little time in bed as possibleThe physiotherapist will help you learn how to do breathingexercises. During visits, the physiotherapist may check your lungs for any sign of infection and answer any questions you may have.Learning about breathing exercisesBreathing exercises will help you to fully expand your lungs and prevent infection.Breathing exercises include:1. Deep breathing using your diaphragm muscle.2. Deep breathing while stretching your chest muscles.3. Deep breathing while stretching your shoulders.Do ONE of these exercises every hour that you are awake. Stop and rest between repetitions if you feel dizzy.Deep breathing using your diaphragm muscle1. Sit on the edge of your bed, or lie on your back with yourknees bent.2. Place your hands on your belly.3. Breathe in slowly through your nose as deeply as possible.Your belly should rise and press against your hands.4. Optional: You may hold this breath for3 to 5 seconds to fully expand the bottom of your lungs.5. Breathe out through your mouth slowly with your lips “pursed”,like you are about to whistle.6. Repeat 10 times.Deep breathing while stretching your chest muscleSTOP if you feel pain at your catheter site1. Sit at the edge of your bed.2. Place your hands behind your head, as shown in the picture.3. Inhale slowly as you move your elbows back and slightly archyour back.Optional: You may hold this breath for 3 to 5 seconds to fully expand your lungs.4. As you exhale, move your elbows back to the startingposition (step 2).5. Repeat 10 times.Deep breathing while stretching your shouldersSTOP if you feel pain at your catheter site.1. Sit at the edge of your bed.2. Rest your arms at the sides of your body or hold your handstogether in your lap.3. Inhale slowly as you reach both arms over your head, as shownin the picture.Optional: You may hold this breath for 3 to 5 seconds to fullyexpand your lungs.4. As you exhale, bring your arms back down to the startingposition (Step 2).5. Repeat 10 times.Learning about your lungsThe muscles of the rib cage, especially the large muscle called the diaphragm are used for breathing. When you breathe in,your diaphragm contracts or tightens and flattens, allowing air to be sucked into the lungs. When the diaphragm and the rib cage muscles relax, air is released.Air, containing the oxygen your body needs, is inhaled through the mouth and nose. The mucous membranes in our mouth and nose warm and moisten the air, as well as trap particles such as dust.Air passes through the throat into the trachea or windpipe.The trachea divides into left and right bronchi which arelike branches. Like a branch, each bronchus divides againand again, becoming narrower and narrower.The smallest airways end in alveoli. These are small, thin sacs of air arranged in clusters like bunches of balloons. When you breathe in, the “balloons” expand as air rushes in. When you breathe out, the “balloons” relax and air moves out of the lungs.Tiny blood vessels surround each of the 300 million alveoli inthe lungs. Oxygen moves through the walls of the air sacs andis picked up by the blood to be carried to the rest of the body. Carbon dioxide and other waste gases pass into the air sacsfrom the blood to be breathed out.When to call the doctor …Call your doctor right away if you notice these signs ofinfection•fever, a temperature 380 C (1000 F) or higher•shaking or chills•cough•shortness of breathGood luck with your bone marrow transplant. I look forward tovisiting you. Please feel free to ask me any questions if you arenot sure about your exercises.Keep smiling!Your Physiotherapist© Hamilton Health Sciences, 2000PD 4043 – 01/2015dpc/pted/pamp/BMT-lw.docdt/January 15, 2015。
骨髓细胞学检查英文课件(第二部分)
(2)the manifestly active hyperplasia • Reflect the vitality of bone marrow hematogenesis • Conditions: hyperplastic anemia, leukemia, proliferating bone marrow diseases, idiopathic thrombocytopenic purpura(ITP), hypersplenia…
(2) Erythrocyte series • Normoblasts≈20% • Pronormoblast<1% • Basophilic normoblast<5% • Polychromatic normoblast≈10% • Orthochromatic normoblast≈10% • G:E is defined as the ratio of the percentage of granulocyte series to erythrocyte series. • Reference value: (2-4):1
Change Granulocyte series ↑
diseases Granulocytic leukemia, acute inflammation, infectious diseases, neutrophilic leukemoid reaction Aplastic anemia, agranulemia, granulocytopenia Hyperplastic anemia, megaloblastic anemia, Di Guglielmo syndrome Aplastic anemia ALL, CLL, malignant lymphoma, infectious lymphocytosis, infectious monocytosis, other viral infection, lymphocytic leukemoid reaction Aplastic anemia, agranulemia, granulocytopenia
Mammalian Bone Marrow Specimen
Mammalian Bone Marrow Specimen Mammalian bone marrow specimens are incredibly valuable for research purposes, providing insight into the cellular composition and function of this vital tissue. The study of bone marrow can lead to advancements in medical treatments for various diseases, such as leukemia, lymphoma, and other blood disorders. Researchers can analyze the bone marrow to identify abnormalities in cell development, monitor the progression of diseases, and develop new therapies. The complexity of bone marrow makes it a fascinating subject for study, with its unique microenvironment supporting the production of blood cells and immune system function. From a scientific perspective, bone marrow specimens offer a wealth of information about hematopoiesis, the process by which blood cells are produced. Hematopoietic stem cells found in the bone marrow have the remarkable ability to differentiate into various types of blood cells, including red blood cells, white blood cells, and platelets. Studying the regulation of hematopoiesis can provide insights into how blood cell production is controlled and how disruptions in this process can lead to diseases. By analyzing bone marrow specimens, researchers can gain a better understanding of the molecular mechanisms that govern hematopoiesis and potentially develop targeted therapies to treat blood disorders. Beyond the scientific implications, bone marrow specimens also hold significant clinical value for patients with blood-related diseases. Bone marrow transplants, for example, are a life-saving treatment for individuals with leukemia, lymphoma, and other conditions that affect the bone marrow. By analyzing the donor's bone marrow specimen and matching it to the recipient's tissue type, doctors can increase the likelihood of a successful transplant and improve patient outcomes. Additionally, bone marrow specimens can be used to monitor the progression of diseases and assess the effectiveness of treatments, guiding clinicians in making informed decisions about patient care. On an emotional level, the study of bone marrow specimens can evoke feelings of hope and gratitude for the advancements in medical science that have been made possible through research. For patients undergoing bone marrow transplants, the availability of compatible donors and the successful engraftment of donor cells can be a source of immense relief and joy. The knowledge that researchers are continuously working to improve treatments andoutcomes for individuals with blood disorders can provide comfort and reassurance to patients and their families. The resilience and strength of individuals facing challenging medical conditions are reflected in the resilience of the bone marrow itself, which continually regenerates and sustains the body's blood cell production. In addition to the medical and emotional significance of bone marrow specimens, ethical considerations also come into play when conducting research involving human tissues. It is essential to obtain informed consent from donors and ensure that their rights and privacy are protected throughout the study. Researchers must adhere to strict ethical guidelines and regulations to maintain the integrity of their work and uphold the trust of the public. Transparency in the use of bone marrow specimens for research purposes is crucial to fostering collaboration and advancing scientific knowledge in a responsible and ethical manner. In conclusion, mammalian bone marrow specimens are invaluable resources for scientific research, clinical applications, and medical advancements. The study of bone marrow provides insights into hematopoiesis, blood cell development, and disease mechanisms, offering hope for improved treatments and outcomes for individuals with blood disorders. Emotionally, the study of bone marrow specimens can inspire feelings of hope, gratitude, and resilience in the face of medical challenges. Ethically, it is essential to uphold the rights and privacy of donors and adhere to strict guidelines when conducting research involving human tissues. Overall, the study of bone marrow specimens represents a convergence of science, medicine, and ethics, with the potential to make a meaningful impact on the lives of individuals affected by blood-related diseases.。