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1.
目的观察人工肝技术和肝移植手术对重症乙肝患者乙肝病毒标志物的影响。方法乙肝三系统定量采用时间分辨免疫荧光技术,乙肝病毒DNA定量采用实时荧光定量PCR法。结果28例实施人工肝技术的重型肝炎患者治疗前后的乙肝三系统定量和HBVDNA定量结果为:HBsAg171.19±32.10ng/mL,HBeAg0.03±0.029NCU/mL,抗-HBe3.97±4.61NCU/mL,抗-HBc5.98±3.31NCU/mL,HBVDNA(1.1×10^7)±(6.81×10^6)copy/mL和HBsAg168.14±39.40ng/mL,HBeAg0.02±0.023NCU/mL,抗-HBe3.95±4.34NCU/mL,抗-HBc6.41±3.13NCU/mL,HBVDNA(1.1×10^7)±(6.23×10^6)copy/mL。P值均大于0.05,差异无统计学意义。26例施行肝移植手术的患者治疗前后的乙肝三系统定量和HBVDNA定量结果分别为HBsAg144.65±77.00ng/mL,HBeAg0.02±0.028NCU/mL,抗-HBe4.32±6.43NCU/mL,抗-HBc6.04±4.88NCU/mL,HBV DNA(1.0×10^7)±(6.89×10^6)copy/mL和HBsAg6.54±3.32ng/mL,HBeAg0.02±0.016NCU/mL,抗-HBe4.79±6.44NCU/mL,抗-HBc5.97±4.64NCU/mL,HBV DNA(1.04×10^2)±(3.40×10^2)copy/mL。除抗-HBe和抗-HBc,P值大于0.05外,其他项目P值均小于0.05,差异有统计学意义。结论肝移植手术可有效清除乙肝患者体内的乙肝病毒,人工肝支持系统虽不能有效清除乙肝患者体内的乙肝病毒,但可改善重型肝炎患者体内严重紊乱的内环境,为肝移植手术创造合适的条件和机会,赢得宝贵时间。  相似文献   

2.
目的对二维激光法和电阻法血小板计数进行比较研究。方法用德国拜耳ADVIA 2120(Bayer-2120,二维激光法)、美国雅培3700(CD-3700,电阻法)2台仪器及手工法分别对70份血液样本进行血小板计数,其中对照组30例、大血小板组(大血小板+++)20例、小红细胞组(平均红细胞容积〈60f1)20例。结果对照组检测结果为Bayer-2120:(172.9±89.2)×10^9/L,CD-3700:(165.8±82.7)×10^9/L,手工法:(169.8±78.7)×10^9/L;大血小板组检测结果为Bayer-2120:(70.0±31.8)×10^9/L,CD-3700:(30.9±17.4)×10^9/L,手工法:(65.2±30.1)×10^9/L。小红细胞组检测结果为Baye-2120:(150.6±100.6)×10^9/L,CD-3700:(194.8±124.3)×10^9/L,手工法:(144.6±91.3)×10^9/L。对照组3种计数方法差异无统计学意义(P〉0.05);在病理情况下,大血小板组:二维激光法与手工法比较,差异无统计学意义(P〉0.05);而电阻法与二维激光法和手工法比较,其结果明显偏低,差异有统计学意义(P〈0.01)。小红细胞组:二维激光法与手工法结果接近,差异无统计学意义(P〉0.05);而电阻法结果明显高于其他2种方法所得结果,差异有统计学意义(P〈0.05)。结论在正常情况下,3种计数方法呈高度相关,差异无统计学意义;在病理情况下的大血小板、小红细胞,特别是临界值的血小板计数,电阻法结果差异较大,而二维激光法更接近手工法所检测结果,计数结果比较准确、可靠。  相似文献   

3.
RhD(-)患者输注RhD(+)血液的处理   总被引:3,自引:0,他引:3  
1病例摘要 患者,男,51岁。2008年4月17日因车祸伤8h后入本院,确诊为右胫腓骨开放性骨折。入院时患者精神面貌差,面色苍白,重度贫血貌,处于半昏迷状态,需急诊作右下肢切除手术。术前检查:体温36.2℃,脉搏132次/min,呼吸20次/min,血压105/65mmHg。ABO血型O型,RhD(-),Hb77g/L,RBC2.66×10^12/L,Hct 0.222,Pit171×10^9/L,PT14.9s、APTT43s,WBC4.3×10^9/L,预计出血量3000ml左右,心肺功能及肝肾功能正常。  相似文献   

4.
目的建立检测血管内皮生长因子-C(VEGF-C)mRNA和血管内皮生长因子受体-3(VEGFR-3)mRNA的实时荧光定量逆转录聚合酶链反应(FO-RT-PCR)方法,并在食管癌组织中作初步应用。方法采用TaqMan荧光探针技术,分别以pMD18-VEGF-C和pMD18-VEGFR-3质粒作为定量模板,应用循环阈值(Ct)定量起始模板,建立检测食管癌组织的VEGF-CmRNA和VEG—FR-3tuRNA的实时FQ-RT-PCR方法。结果所建方法的线性范围:VEGF-CmRNA和VEGFR-3mRNA均为10^3~10^8拷贝/μg总RNA;测定VEGF-C mRNA低值的批内、批间变异系数(CV)分别为7.07%和9.04%,测定VDGF-CmRNA高值的批内、批间CV分别为7.55%和10.28%;测定VEGFR-3mRNA低值的批内、批间CV分别为7.69%和12.49%,测定VEGFR-3mRNA高值的批内、批间CV分别为7.31%和9.17%。24例淋巴结转移食管癌患者癌组织VEGF-CmRNA和VEG—FR-3 mRNA的测定范围分别为3.69×10^4~9.44×10^6拷贝/μg总RNA和2.54×10^4~8.03×10^6拷贝/μg总RNA,均值分别为2.18×10^6拷贝/μg总RNA和2.27×10^6拷贝/μg总RNA。16例无淋巴结转移食管癌患者癌组织VEGF-CmRNA和VEGFR-3mRNA的测定范围分别为2.32×10^3~5.85×10^5拷贝/μg总RNA和7.31×10^2~8.21×10^4拷贝/μg总RNA,均值分别为1.08×10^5拷贝/μg总RNA和1.68×10^4拷贝/μg总RNA。提示有淋巴结转移的食管癌组织VEGF-C和VEG—FR-3基因表达水平上调。结论本组建立的检测VEGF-CmRNA和VEGFR-3mRNA的实时FQ-RT-PCR方法灵敏、准确、稳定、重复性好,可供VEGF-C、VEGFR-3基因表达的临床检测和研究应用。  相似文献   

5.
以白细胞及血小板减少为主要表现的肺结核误诊1例分析   总被引:1,自引:0,他引:1  
对以白细胞及血小板减少为主要表现的肺结核误诊1例分析如下。 1病历摘要 女,58岁。主因头晕、乏力、胸闷、发热20d余,加重1周人院。于2007—09下旬无诱凶出现头晕、乏力、发热等不适,症状逐渐加重,体温多在39.5C左右,伴有胸闷、气短等不适,无咳嗽、咳痰、寒战、盗汗等症状,当地医院查血常规:WBC1.9×10^9/L,RBC5.01×10^12/L,Hb140g/L,PI。T38×10^9/L。抗感染、对症治疗4d无效转入我院。  相似文献   

6.
1 病例 患者男,40岁,头晕,恶心3年余。近13病情加重,于2008年11月25日入院检查,CT检查结果有脑系膜病变,病理诊断脑系膜瘤。当日收住于我院脑外科治疗。在手术前进行辅助检查:血常规:白细胞12.30×10^9/L,红细胞4.52×10^12/L,HBG 121g/L,血小板(PLT)38×10^9/L(EDTAK2抗凝剂),复查两次,PLT结果维持在38—51×10^9/L水平。  相似文献   

7.
目的改进白膜法制备汇集浓缩血小板(PCs)的方法,提高汇集PCs质量。方法血液成分分离机分离白膜层,经12h解聚,汇集多人份白膜层,二次轻离心,分离出富含血小板血浆,经血小板去白细胞过滤器滤除白细胞,收集血小板。结果该实验制备的汇集PCs(10U/袋),其血小板计数、白细胞及红细胞混入量、容量分别为:(2.52±0.11)×10^11/10U,(0.88±0.03)×10^6/10U,(1.20±0.13)×10^9/10U,260±17ml/10U。结论该法制备的PCs各质量指标全部符合国家标准,质量均一,适宜血站推广使用。  相似文献   

8.
妊娠合并血小板减少症30例围产期护理   总被引:1,自引:0,他引:1  
目的:探讨妊娠合并血小板减少症患者的围产期护理方法。方法:对17例血小板计数≥50×10^9/L及3例血小板计数(20~50)×10^9/L无出血倾向者行常规护理。对3例血小板计数≤20×10^9/L及7例血小板计数(20~50)×10^9/L有出血倾向者给予糖皮质激素治疗,激素治疗无效者采用免疫球蛋白治疗。同时行输血小板及新鲜全血等支持治疗,主要针对手术、分娩前血小板〈50×10^9/L、贫血或产时、产后出血者。对产后出血者使用止血药物。本组采用局部麻醉+静脉麻醉,并于胎儿娩出后立即于子宫肌壁或肌内注射缩宫素。结果:应用激素治疗者,7例治疗后血小板升高(4~5)×10^9/L,3例激素治疗无效,血小板持续低于20×10^9/L,行免疫球蛋白治疗后好转。随访1~3个月,平均2,2个月,所有病例PT、APTT及INR均正常,行剖宫产21例,异位妊娠自然分娩9例,娩出活新生儿30例,产妇情况良好。结论:正确的治疗和护理可减少妊娠合并血小板减少症患者各脏器出血及产后出血的发生率,减少病死率,使产妇顺利度过围产期,分娩结局良好。  相似文献   

9.
患者男,62岁。2005年4月因间断发热、咳嗽、全身酸痛2年入院。2年前因反复发热38℃~39℃,血象异常,于外院查血象白细胞2.5×10^9/L、红细胞2.66×10^12/L,单核细胞39%。骨髓穿刺结果:原粒5.5%,早幼粒1.5%,幼稚单核2.5%,单核11%,巨核细胞38个,多为小巨核。粒系统易见Pelger核型。红系减少,粒:红=7.0:1。给予叶酸、维生素B小速力菲疗效不佳。此次入院体格检查:T39.5℃、消瘦、贫血貌,浅表淋巴结不大,胸骨无压痛,脾大于左肋下1.5cm。血常规:白细胞6.4×10^9/L,红细胞2.68×10^12/L,  相似文献   

10.
翟亚萍  商保军  张琳  席雨人  程薇 《临床荟萃》2008,23(23):1689-1691
目的探讨慢性再生障碍性贫血(CAA)发病的免疫因素,为CAA的临床治疗提供依据。方法采用骨髓细胞半固体集落培养法检测粒一单核细胞集落形成单位(GM—CFU),同时用流式细胞仪检测T淋巴细胞亚群。结果CAA骨髓细胞培养GM—CFU产率明显少于正常对照组,(7.9±0.5)个/ml vs (88.7±2.7)个/ml(P〈0.01);CAA骨髓细胞加正常血清培养GM-CFU的产率与正常对照组比较差异无统计学意义,(82.4±2.6)个/ml vs (88.7±2.7)个/ml(P〈0.05),其中有21例的GM-CFU的产率(60.1±2.1)个/ml与对照相比较明显减少;CAA血清与正常骨髓细胞培养的GM—CFU为(105.6±3.2)个/ml,显著高于正常组。CAA组的CD3^+、CD4^+和CD4^+/CD8^+均比对照组降低,分别为(49.8±0.6)% vs (64.3±0.9)%、(29.7±0.4)% vs (38.6±0.3)%和(1.2±0.1)% vs (1.7±0.1)%(均P〈0.01);CD8^+细胞明显高于正常,(28.9±0.3)% vs (24.5±0.3)%(P〈0.01)。结论CAA患者普遍存在着T细胞亚群失衡的免疫异常;CAA患者骨髓细胞中可能有抑制患者GM—CFU形成的因素,而血清中存在着升高的粒一单核细胞集落刺激因子等,其临床意义尚需进一步观察。GM-CFU体外培养联合T细胞亚群检测,可作为CAA异常免疫机制的诊断指标。  相似文献   

11.
Effective killing of bacteria by polymorphonuclear leukocytes (PMN) is generally assumed to require intracellular sequestration and, depending on the bacterial species, can be both O2-dependent or O2-independent. Killing of several strains of Salmonella typhimurium and Escherichia coli by rabbit PMN does not require O2 and is apparently due to a granule-associated bactericidal/permeability-increasing protein (BPI) present in rabbit and human PMN. In this study we examined the O2 dependence of the killing of E. coli (S15) by human PMN. Ingested and noningested E. coli were separated by centrifugation after incubation with PMN in room air or under N2. In the presence of heat-treated serum approximately 50% of E. coli (10 bacteria/PMN) were taken up by PMN and rapidly (5-15 min) killed both in room air and under N2. The remaining extracellular bacteria (approximately 50%) were killed during 30-60 min of incubation in room air but not under N2. When uptake of E. coli by PMN was increased to approximately 80% by the use of C6-depleted serum (retaining heat-labile opsonins), bacterial survival under N2 was reduced from 54 +/- 7.6% to 13 +/- 5.5%. PMN from a patient with chronic granulomatous disease killed PMN-associated but not extracellular E. coli. BPI was detected, by indirect immunofluorescence, on the surface of PMN-associated E. coli within 5 min of incubation of E. coli with PMN both in room air and under N2. In contrast, at no time was BPI detected on the surface of extracellular E. coli, indicating that the non-PMN-associated E. coli had not been previously ingested. Thus, killing of ingested E. coli S15 by human as well as rabbit PMN does not require O2 and appears to be BPI-mediated. However, when ingestion is limited, extracellular bacteria can also be killed but principally by O2-dependent mechanisms.  相似文献   

12.
<正> 噬菌蛭弧菌(Bdellovibrio bacteriovorus,下简称蛭弧菌)为细菌的寄生菌,宿主范围广泛,可裂解大部分革兰氏阴性菌与某些革兰氏阳性菌,蛭弧菌在自然界分布很广,自然水域、污水、土壤以及动物体内都可分离到,而且被认为是环境水体中致病微生物自然净化的重要生物因子之一  相似文献   

13.

Objectives

The steroids estradiol (E2), estrone (E1), and estriol (E3) are the major estrogens. E1/E2 and their metabolite 16-hydroxyestrone (16-OHE1, known to be carcinogenic) could be involved in the development of many cancers including human breast cancer. The aim of the current study was to develop a rapid and simple high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) assay to simultaneously measure E1, E2, E3 and 16-OHE1 in human serum without the need for solid phase extraction or derivatization.

Methods

An API-5000 triple-quadrupole mass spectrometer coupled with electrospray ionization (ESI) source and Shimadzu HPLC system was used employing isotope dilution with deuterium-labeled internal standard (IS) for each analyte. Quantitation by multiple reaction monitoring (MRM) analysis was performed in negative ion mode.

Results

The limits of detection were 1.0 pg/mL for E1 and 16-OHE1 and 2.0 pg/mL for E2 and E3. Within-day CVs were < 6.5% for all analytes tested and between-day CVs ranged from 4.5% to 9.5%. Recovery ranged from 88% to 108%.

Conclusion

This method allows for the simultaneous measurement of four estrogens in human serum within 8 min. It can be routinely employed in a clinical environment and is attractive because of its simplicity in sample processing, micro sample requirement, and high throughput.  相似文献   

14.
BACKGROUND AND METHODS: The administration of endotoxin in small dosages to sheep results in an acute decrease followed by an increase in cardiac output. It has previously been determined that the initial decrease in output was the result of a reduction in blood flow to the mesenteric areas. These changes were associated with increased blood concentrations of beta endorphin. The present study was accomplished to determine if the systemic cardiovascular response to endotoxin could be affected by the administration of an opiate receptor-blocking agent. Female range sheep (n = 12) were prepared for chronic study by implantation of cardiopulmonary catheters and a flow probe on the cephalic mesenteric artery. Endotoxin (Escherichia coli, 1 microgram/kg) was administered to these animals. Half of the sheep were treated with naloxone (2 mg/kg + 2 mg/kg.hr), and the remainder with an equivalent volume of sodium chloride (0.9%). RESULTS: In untreated sheep, cardiac indices decreased by 15% to 20% (5.1 +/- 0.1 to 4.2 +/- 0.4 L/min.m2) between 0 and 1 hr and 2 and 5 hrs after endotoxin (4.5 +/- 0.2 L/min.m2), and then increased to a value 40% (7.2 +/- 0.6 L/min.m2) above baseline by 12 hrs. Flow in the cephalic mesenteric artery decreased in a pattern similar to the reduction in cardiac index (962 +/- 152 [time, T = 0] to 379 +/- 111 [T = 0.8] and 384 +/- 88 mL/min [T = 4.0], p less than .05) but did not increase to the same extent (1008 +/- 153 mL/min [T = 4.0], p greater than .05). There was a concomitant increase in the plasma beta-endorphin concentrations as the blood flow decreased (5 +/- 4 [T = 0] to 40 +/- 15 pg/mL [T = 0.8; untreated group], p less than .05; and 10 +/- 4 to 50 +/- 7 pg/mL [T = 0.8; naloxone-treated group], p less than .05). In the naloxone-treated group, the same pattern of cardiac output change was noted with endotoxin; however, reduction of mesenteric artery flow was only 30% (1118 +/- 129 to 908 +/- 122 mL/min, p less than .05) of the value seen in the untreated animals (962 +/- 152 to 379 +/- 111 mL/min, p less than .05). These changes in mesenteric blood flow were statistically significant from one another. As the cardiac output increased in the sheep treated with the opiate antagonist, mesenteric blood flows increased 20% above the baseline value (1391 +/- 199 mL/min, p less than .05). CONCLUSIONS: The decrease in cardiac output noted with endotoxin can be accounted for by the decrease in the blood flow in the cephalic mesenteric artery. This phenomenon can be attributed, at least in part, to the release of endorphins. There is both a vasodilation and constriction during endotoxemia in the ovine model.  相似文献   

15.
便携式臭氧发生器对大肠杆菌杀灭效果的观察   总被引:1,自引:0,他引:1  
以研制的便携式臭氧发生器产生臭氧化空气对大肠杆菌进行杀灭试验。结果表明,该发生器所形成的臭氧化空气对纺织品、玻璃表面与水中的大肠杆菌有良好的杀灭作用。  相似文献   

16.
Four Klebsiella pneumoniae isolates (LB1, LB2, LB3, and LB4) with increased antimicrobial resistance were obtained from the same patient. The four isolates were indistinguishable in biotype, plasmid content, lipopolysaccharide, and DNA analysis by pulse-field gel electrophoresis. Isolate LB1 made TEM-1 and SHV-1 beta-lactamases. Isolates LB2, LB3, and LB4 produced SHV-5 in addition to TEM-1 and SHV-1. MICs of cefoxitin, ceftazidime, and cefotaxime against LB1 were 4, 1, and 0.06 micrograms/ml, respectively. MICs of ceftazidime against K. pneumoniae LB2, LB3, and LB4 were > 256 micrograms/ml, and those of cefotaxime were 2, 4, and 64 micrograms/ml, respectively. MICs of cefoxitin against K. pneumoniae LB2 and LB3 were 4 micrograms/ml, but that against K. pneumoniae LB4 was 128 micrgrams/ml. K. pneumoniae LB4 could transfer resistance to ceftazidime and cefotaxime, but not that to cefoxitin, to Escherichia coli. Isolate LB4 and cefoxitin-resistant laboratory mutants lacked an outer membrane protein of about 35 kDa whose molecular mass, mode of isolation, resistance to proteases, and reaction with a porin-specific antiserum suggested that it was a porin. MICs of cefoxitin and cefotaxime reverted to 4 and 2 micrograms/ml, respectively, when isolate LB4 was transformed with a gene coding for the K. pneumoniae porin OmpK36. We conclude that the increased resistance to cefoxitin and expanded-spectrum cephalosporins of isolate LB4 was due to loss of a porin channel for antibiotic uptake.  相似文献   

17.
为了解二氯异氰尿酸、次氯酸钠、二溴海因、碘伏等4种消毒剂对脊髓灰质炎病毒灭活效果、采用悬液定量试验法进行了实验室观察并与大肠杆菌杀灭效果作比较。结果,含有效氯300 mg/L次氯酸钠和二氯异氰尿酸消毒液分别作用15 m in和30 m in,对脊髓灰质炎病毒灭活对数值均达4.00以上;对大肠杆菌分别作用5和10 m in,杀灭对数值为5.0。含有效溴500 mg/L的二溴海因消毒液作用15 m in,对脊髓灰质炎病毒的杀灭对数值达4.00以上;对大肠杆菌杀灭对数值达到5.0需有效溴200 mg/L作用5 m in。含有效碘500 mg/L的碘伏消毒液作用60m in,对脊髓灰质炎病毒的杀灭对数值达4.00以上;含有效碘200 mg/L作用15 m in,即可杀灭大肠杆菌达5个对数值以上。结论,4种消毒剂对脊髓灰质炎病毒均有较好的灭活效果,且显示脊髓灰质炎病毒比大肠杆菌抗力强;4种消毒剂中,以碘伏对脊髓灰质炎病毒灭活作用最慢。  相似文献   

18.
The location of phospholipids in the human platelet plasma membrane was probed with 2, 4, 6-trinitrobenzenesulfonate (TNBS). TNBS does not penetrate inintact cells and can label phosphatidylethanolamine (PE) and phosphatidylserine (PS). In tact platelets, PE is not accessible to TNBS during the initial 15 min. However, 6.9% PE reacts with TNBS after 30 min and 17.9% PE is labeled after 90 min. In intact platelets, PS is not labeled even after 2 h. In contrast, in phospholipids extracted from platelets 71% PE and 26.5% PS react with TNBS within 5 min. This indicates that PS is inaccessible and PE is relatively inaccessible to TNBS in intact platelets. After incubation of platelets with thrombin, there is increased labeling of PE but no labeling of PS. The incubation of platelets with thrombin (0.05 U/ml) for 5 min results in 16.2% increase of PE labeling during subsequent 30-min incubation with TNBS. PS does not appear to be a component of the functional surface of platelets. However, exposure of PE may have a critical role in platelet hemostatic function. The implication of the study is that there is asymmetry of phopholipids in the platelet plasma membrane which has considerable physiological significance.  相似文献   

19.
AmpC beta-lactamases are not inhibited by clavulanic acid and could potentially mask detection of extended-spectrum beta-lactamases (ESBLs) using the Clinical and Laboratory Standards Institute confirmatory test. Syn2190 (1,5-dihydroxy-4-pyridone monobactam) selectively inhibits AmpC, but not ESBLs. Fifty-four MicroScan ESBL screen-positive strains of Escherichia coli and an unrelated group of 20 cefoxitin-nonsusceptible E. coli strains were tested with the confirmatory ceftazidime-cefotaxime-clavulanate disk method with or without 4 microg/mL of Syn2190 in the agar. Without Syn2190, 8 (14.8%) of 54 E. coli isolates and 0 of 20 cefoxitin-nonsusceptible E. coli isolates were confirmed. With Syn2190, an additional 9 (16.6%) of 54 of the MicroScan screen-positive E. coli isolates and 6 (30%) of 20 of the cefoxitin-nonsusceptible E. coli isolates were found. Multiplex polymerase chain reaction and sequence analysis confirmed the presence of the plasmid-associated beta-lactamase gene bla(CMY-2) in the 2 available MicroScan-screened E. coli isolates and in 5 of 6 of the cefoxitin-resistant group. These data suggest that in the presence of AmpC, ESBLs in E. coli may not be detected by the currently recommended confirmatory test.  相似文献   

20.
消毒剂氯羟二苯醚性能的试验观察   总被引:21,自引:23,他引:21  
在悬液中,50mg/L氯羟二苯醚对大肠杆菌与金黄色葡萄球菌作用10min,对白色念珠菌作用15min,平均杀灭率均为9990%。10%小牛血清可使其杀菌效果略有下降。对不锈钢与铜无腐蚀,对铝与碳钢基本无腐蚀。低毒,对皮肤无刺激作用。  相似文献   

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