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To investigate the expression level of miR-181b in CD19+ B lymphocytes of patients with chronic lymphocytic leukemia (CLL), to analyze the relationship between its expression and the prognosis of CLL patients, and to predict the potential target gene of miR-181b in CLL by using bioinformatics.Eight-four patients with CLL treated in People's Hospital of Xinjiang Uygur Autonomous Region from June 2013 to June 2018 were selected. and 20 healthy people were selected as control group. RNA was extracted from CD19+B lymphocytes of peripheral blood by magnetic bead sorting, the expression level of miR-181b was detected, and it's expression differences in different IPI groups were analyzed. The correlation between the expression level of miR-181b and PFS of CLL patients also was analyzed. miR-181b target genes were predicted by online database and literatures, and gene annotation analysis and relevant signal pathway analysis were performed for candidate target genes.The expression level of miR-181b in CLL patients was significantly lower than that in control group (P＜0.01); The expression level of miR-181b in the low-risk group was higher than that in high-risk group and extremely high-risk group (P＜0.05), but there was no statistical difference between low-risk group and medium-risk group (P=1.00). The expression level of miR-181b in medium-risk group was higher than that in high-risk group and extremely high-risk group (P＜0.05), but there was no difference between high-risk group and extremely high-risk group (P=1.00). ROC curve results showed that the area under the curve (AUC) was 0.792 (P＜0.01).When the expression level of miR-181b was at the threshold value of 0.279, it showed a better sensitivity (62.9%) and specificity (91.8%). Survival analysis results suggested that compared with the high expression group, the miR-181b low expression group had poor PFS (log rank: P=0.047). Prediction of miR-181b by using the starBase, targetscan and picTar database and its combination with literature reports indicated that CARD11, ZFP36L1, RUNX1, NR4A3, ATP1B1, PUM1 and PLAG1 related with blood diseases, and up-regulated CARD11 and ZFP36L1 participated in lymphoid tumor formation by promoting cell proliferation and inhibiting cell aging.The expression level of miR-181b in CLL group are significantly lower than that in the controls group, and the low expression of miR-181b relates with poor prognosis of CLL patients. Through bioinformatics prediction and combined with literature reports, it is speculated that CARD11 and ZFP36L1 as target genes of miR-181b may be participated in the occurrence and development of CLL. Further experiments are needed to verify this result.miR-181b在慢性淋巴细胞白血病患者中的表达及其靶基因的预测.探讨miR-181b在慢性淋巴细胞白血病（CLL）患者CD19+B淋巴细胞中的表达水平，分析其表达与CLL预后关系，并利用生物信息学预测miR-181b在CLL中的潜在靶基因.选取2013年6月至2018年6月在新疆自治区人民医院诊治的CLL患者84例、并选取健康者20例为对照组。应用磁珠分选CLL患者和对照组外周血CD19+ B淋巴细胞后进行RNA提取，检测miR-181b的表达水平，分析其在不同IPI分组中表达差异，探讨miR-181b表达水平与CLL患者PFS相关性。使用网上数据库及文献预测miR-181b靶基因,对候选靶基因进行基因注释分析及相关信号通路分析.miR-181b在CLL患者中表达显著低于对照组（P＜0.01）。miR-181b在低危组的表达水平高于高危组和极高危组（P＜0.05），但在低危组与中危组间表达无差异（P=1.00），中危组中miR-181b的表达水平高于高危组和极高危组（P＜0.05）,但在高危组与极高危组间表达无差异。ROC曲线结果显示，曲线下面积（AUC）为0.792（P＜0.01）， 由此显示，miR-181b表达水平处于分界值0.279时，具有较好的敏感性（62.9%）和特异性（91.8%）。生存分析结果提示，与高表达组相比，miR-181b低表达CLL患者具有较差的PFS（log-rank：P=0.047）。使用starBase、Targetscan和PicTar数据库进行靶基因预测，结合文献报道，与血液疾病相关的靶基因有CARD11、ZFP36L1、RUNX1、NR4A3、ATP1B1、PUM1和PLAG1，其中上调的CARD11、ZFP36L1通过促进细胞增殖、抑制细胞衰老参与淋巴系统肿瘤形成.miR-181b在CLL患者中的表达水平明显低于健康对照组，且miR-181b低表达与CLL不良预后有关。通过生物信息学预测并结合文献报道，推测CARD11及ZFP36L1可能作为miR-181b的靶基因参与CLL疾病发生发展，该结果还需要进一步实验进行验证.

To explore the value of CpG-oligonucleotide(CpG-ODN) immunostimulatory method in chromosome culture of chronic lymphocytic leukemia (CLL) cells and to compare the differences between related studies at home and abroad, so as to improve the success rate of CLL karyotype culture and the detection rate of abnormal karyo-types.Bone marrow samples from 82 CLL patients were collected and cultured with phytohemagglutinin (PHA), CpG-oligonucleotide plus interleukin-2 (CpG-ODN DSP30+IL-2) for 72 hours. Chromosomes were prepared and analyzed by conventional cytogenetics (CC). Meanwhile, D13S25, Rb1, ATM, p53 and CSP12 probes were used for interphase fluorescence in situ hybridization (iFISH) test. The differences of chromosome culture and iFISH test results between two cell stimulants were compared.The success rate of karyotype culture in PHA and CpG-ODN DSP30+IL-2 immunostimuli (analyzable mitotic t20) was 90.2% (74 cases), 68.3% (56 cases) respectively, and the detection rate of abnormal karyotype was 13.5% (10 cases) and 46.4% (26 cases), respectively. The success rate of karyotype culture in PHA group was significantly higher than that in CpG-ODN DSP30+IL-2 group (P=0.01). The detection rate of abnormal karyotypes in CpG-ODN DSP30+IL-2 group was significantly higher than that in PHA group, and the difference was statistically significant (P=0.003). The detection rate of abnormal karyotypes in iFISH group was 74.4% (61 cases), which was significantly higher than that in CpG-ODN DSP30+IL-2 group (P=0.000). iFISH detection could verify the abnormalities detected by CC analysis.Application of CpG-ODN DSP30+IL-2 immunostimulation method in culture of CLL cells can enhance the detection rate of abnormal karyotypes, especially the detection of various translocations suggesting poor prognosis.CpG-寡核苷酸免疫刺激法在慢性淋巴细胞白血病遗传学研究中的应用.探索 CpG-寡核苷酸(CpG-oligodeoxynucleotide，CpG-ODN)免疫刺激法在慢性淋巴细胞白血病(chronic lymphocytic leukemia，CLL)细胞染色体培养中的价值，对比国内外相关研究的差异，进一步提高 CLL 核型培养成功率及异常核型检出率.收集82 例 CLL 患者的骨髓标本，分别应用植物血凝素(PHA)、CpG-寡核苷酸联合白介素-2(CpG-ODN DSP30+IL-2)刺激培养72 h 后收获细胞，制备染色体，进行常规细胞遗传学(conventional cytogenetics，CC)分析。同时应用 D13S25、Rb1、ATM、p53 和 CSP12 探针进行间期荧光原位杂交(interphase fluorescence in situ hybridization，iFISH)检测。比较2种细胞刺激剂进行染色体培养及iFISH检测结果的差异性.PHA 与 CpG-ODN DSP30+IL-2 2种免疫刺激法核型培养成功率(可分析分裂相 t≥20 个)分别为90.2％ (74例)和68.3%(56例)，异常核型检出率分别为 13.5％(10例)和46.4％(26例)。PHA组核型培养成功率显著高于CpG-ODN DSP30+IL-2 组 (P=0.01) ，而CpG-ODN DSP30+IL-2 组异常核型检出率显著高于PHA 组 (P=0.003) 。iFISH 异常核型检出率 (74.4%，61例)显著高于CpG-ODN DSP30+IL-2 组 (P=0.000)。iFISH检测能验证CC分析检出的异常.应用 CpG-ODN DSP30+IL-2 免疫刺激法培养 CLL 细胞,可提高异常核型检出率，特别是能检出提示预后差的各种易位.

To investigate the efficacy and safety as well as the effects of lower dose of rituximab on B-lymphocytes, serum immunoglobulin, and platelet glycoprotein-specific antibodies in patients with chronic refractory immune thrombocytopenic purpura (ITP).Twenty chronic refractory ITP patients, median age 47 (20 to 60) years old, received intravenous rituximab at the dose of 100mg once weekly for 4 consecutive weeks. Laboratory studies included complete blood cell count, regular monitoring of liver and kidney functions, blood coagulation and serum concentrations of IgG, IgM and IgA. CD3(+), CD4(+), CD8(+), CD19(+), CD20(+) cell numbers were assayed by flow cytometry prior to and following rituximab. Platelet glycoprotein antibodies were detected by ELISA. The detection of indicators were compared by paired T test, with P0.05 as statistically significant.There was significant difference of the average platelet count between prior- \[(13 ± 5) × 10(9)/L\] and post-treatment \[(124 ± 106) × 10(9)/L\] with lower dose rituximab (P0.01). Reaching PLT peak period was of (24 ± 7) d with median time of 18 d. The responses were of 11(55%) CR, 4 (20%) R and 5 (25%) NR, respectively, with median response duration of 8 months (5 - 23 months). There were no significant changes of peripheral blood white blood cell count, hemoglobin, serum immunoglobulin, as well as CD3(+), CD4(+), CD8(+) lymphocyte counts during prior- and post-treatment. CD19(+)/CD20(+) cells were almost depleted in all patients \[(125.65 ± 14.12) × 10(6)/L vs (50.53 ± 29.11) × 10(6)/L, P0.01)\]. Expectedly, three cases of positive detection of platelet antibodies were negative after 4 weeks of lower dose of rituximab; one patient experienced infusion-related reaction.Treatment with lower dose rituximab may be an effective and safe approach in patient with chronic refractory ITP. However, the optimal therapeutic schedule, long-term efficacy and adverse events need further investigation.