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人类白细胞抗原相合同胞新鲜脐血移植治疗儿童β重型地中海贫血
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作者 温建芸 陈丽白 +6 位作者 何岳林 冯晓勤 刘璇 徐肖肖 李秀 刘秋君 吴学东 《中国组织工程研究》 CAS 北大核心 2025年第23期4899-4906,共8页
背景:异基因造血干细胞移植是目前根治重型地中海贫血最有效的方法,然而仅有不到一半的患者能找到相合的骨髓或外周血干细胞。同胞来源脐血干细胞与骨髓和外周血干细胞具有不同的特征,是重型地中海贫血患者移植治疗的一种潜在造血干细... 背景:异基因造血干细胞移植是目前根治重型地中海贫血最有效的方法,然而仅有不到一半的患者能找到相合的骨髓或外周血干细胞。同胞来源脐血干细胞与骨髓和外周血干细胞具有不同的特征,是重型地中海贫血患者移植治疗的一种潜在造血干细胞替代来源。目的:探讨应用人类白细胞抗原相合同胞新鲜脐血移植治疗儿童β重型地中海贫血的疗效。方法:选择2010年6月至2020年6月南方医科大学南方医院收治的β重型地中海贫血患儿48例,男28例,女20例,中位年龄4岁,均接受人类白细胞抗原相合同胞新鲜脐血移植治疗,脐血移植前均采用清髓性不含抗胸腺细胞球蛋白的预处理方案,脐血移植后均采用环孢素A+吗替麦考酚酯+/-短程甲氨蝶呤预防移植物抗宿主病。结果与结论:(1)48例患儿输注的总有核细胞中位数为8.17×10^(7)/kg,输注的CD34^(+)细胞中位数为2.40×10^(5)/kg,脐血移植后中位随访时间98个月,44例植入成功,粒细胞和血小板植入中位时间分别为28 d和31 d,其中37例移植后植入证据检测为供者型完全嵌合,7例移植后早期检测为供受者稳定混合嵌合;(2)44例植入成功患儿中,4例发生急性移植物抗宿主病,分别为Ⅰ级(n=2)和Ⅱ级(n=2),受累器官均为皮肤,均未发生慢性移植物抗宿主病;(3)脐血移植后,48例患儿中5例发生巨细胞病毒感染及激活,12例发生败血症,3例发生侵袭性真菌病,21例发生口腔炎,8例发生出血性膀胱炎,1例发生肝静脉闭塞;(4)48例患儿中,47例存活,1例在移植后28 d因重症肺炎合并急性心力衰竭死亡,43例无病存活,3例发生原发性植入失败,1例发生移植后全血细胞减少,5年总生存率和无病生存率分别为98%和89%,1年时移植相关死亡的累计发病率为2.1%;(5)结果显示,人类白细胞抗原相合同胞新鲜脐血移植治疗儿童β重型地中海贫血的效果良好,移植物抗宿主病的发生风险低。 展开更多
关键词 异基因造血干细胞移植 新鲜脐血移植 β重型地中海贫血 移植物抗宿主病 儿童
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Detectingβ-thalassaemia mutations from a single cell by PEP and RDB
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作者 易萍 李力 +3 位作者 姚宏 周元国 邓兵 陈竹钦 《Journal of Medical Colleges of PLA(China)》 CAS 2006年第3期158-163,共6页
Objective :To evaluate the possibility of the technology involving PEP and RDB for detectingβ-thalassaemia multipoint mutations from a single cell simultaneously. Methods: A set of allele specific oligonucleotide (AS... Objective :To evaluate the possibility of the technology involving PEP and RDB for detectingβ-thalassaemia multipoint mutations from a single cell simultaneously. Methods: A set of allele specific oligonucleotide (ASO) probes used for detecting 8 familiarβ-thalassaemia mutations (CD41-42. IVS-Ⅱ-654, CD17, TATA box nt-28, CD71-72, TATA box nt-29, CD26, IVS-Ⅰ-5) were immobilized on a strip of nylon membrane. The genome of a individual cell was amplified by primer extension preamplification (PEP) with the mixture of 15-base random oligonucleotides. The aliquots from PEP were used to amplify the objective gene fractions ofβ-thalassaemia gene by nested or semi-nested PCR. The membrane was hybridized with the final amplified products and then treated with Streptavidin-HRP and color development. Results:Totally 30 lymphocytes were picked up from blood samples of 1 healthy female and 4 patients with knownβ-thalassaemia mutations respectively. Each single lymphocyte was lysed in the proteinase K buffer. The amplification efficacy was 94. 0% and alle drop-out (ADO) rate was 8. 0%. Revert dot blot (RDB) was applied to the final amplified products from the 5 participants. The results of diagnosis were the same to the expected, and their genotypes were N/N, CD17(A→T)/N, IVS-Ⅱ-654(C→T)/CD17(A→T), CD41-42(-CTTT)/N and TATA box nt-28(A→G)/N, respectively. Conclusion: The technology involving PEP and RDB could detect multipleβ-thalassaemia mutations from a single cell simultaneously, and the research provides experimental evidences for the feasibility of applying PEP and DNA array technology to screening multiple genetic mutations from a single cell, and will be applied to preimplantation genetic diagnosis and non-invasive prenatal diagnosis forβ-thalassaemia. 展开更多
关键词 β-thalassaemia preamplification reverse dot blot
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