西安地区住院患者与健康人群Rh血型分布特征

目的了解西安地区住院患者与健康人群Rh血型分布特征,探讨Rh抗原分型检测在临床输血安全中的意义。方法采用血清学方法对10 898例住院患者和5 121例健康人做Rh抗原分型检测,并对住院患者进行不规则抗体筛查和鉴定。结果住院患者与健康人群的RhD阳性表型分布频率差异有统计学意义,并且在构成比中,住院患者表型Dccee(0.42%)DCc EE(0.12%),而健康人DCc EE(0.33%)Dccee(0.21%);在RhD阳性患者中,Rh表型以CCee和Cc Ee为优势表型,在RhD阴性患者中,Rh表型以ccee和Ccee为优势表型;Rh 5种抗原的阴性率由高到低依次为E(51.24%)c(41.42%)C(12.04)e(7.82%)D(0.83%);在检出的37例同种抗体中,Rh抗体28例,占75.7%,其中抗-E17例,抗-c E4例,抗-D3例,抗-Ce2例,抗-C1例,抗-c1例。结论应用Rh抗原分型检测技术,选择与患者Rh表型相匹配的献血员红细胞输注,可在一定程度上减少同种抗体的产生,降低输血不良反应的发生率。     

临床Rh表型血清学检测及其同型输注必要性分析

目的统计Rh血型系统抗原中C、c、E、e在人群中的分布情况,分析临床常规检测Rh表型及其同型输注的必要性。方法采用血清学方法对19 061例输血患者和18 331例献血员样本进行Rh系统C、c、E、e和D 5种抗原表型分型,采用抗人球蛋白法对输血患者进行不规则抗体筛选及鉴定。结果 Rh D阳性人群主要以C、e抗原频率占优势,Rh D阴性人群主要以c、e抗原占优势;在检出26例同种抗体中,Rh血型系统23例,占88.5%,其中,抗E 18例、抗e 2例、抗C 1例、抗D 1例、抗Ce 1例。结论掌握人群中Rh血型系统抗原表型分布情况,及时提供Rh表型相合血液,可在一定程度上防止和减少高频抗体的产生,有利于降低患者输血不良反应的发生率。     

Rh血型抗原CcEe在临床输血中的意义

目的研究Rh血型抗原CcEe在住院患者中的分布情况,以及Rh血型抗原、抗体检测在临床输血中的意义,为临床RhCcEe同型输血提供参考依据。方法对2008～2016年本院4756例住院患者进行Rh D、C、c、E、e抗原检测,对2013～2016年11644例住院患者进行不规则抗体筛查及抗体鉴定。结果 4756例住院患者样本中Rh血型D、C、c、E、e抗原阳性率为D(96.97%)、C(85.37%)、c(59.16%)、E(47.09%)、e(91.89%),且CcEe抗原阳性率在RhD阳性和阴性人群中的分布差异有统计学意义;11644例住院患者样本不规则抗体筛查阳性中,Rh血型抗体占48.84%,证实了临床检出的不规则抗体主要集中在Rh血型系统。结论对供、受双方除进行常规的ABO、RhD血型检测外,还应进行CcEe抗原表型的检测,并做到这些抗原的同型输注,从而降低因输血产生免疫性抗体的概率,避免再次输血困难。     

南阳市RhD/C/c/E/e血型分型库建立的意义及应用

目的:了解南阳市无偿献血者Rh血型分型规律,建立Rh D/C/c/E/e抗原阴性供者库,为临床急救用血患者提供帮助,保障输血安全。方法:采用血型血清学方法对2014年南阳市81 462例无偿献血者血标本进行Rh D血型鉴定;经初筛和确证试验后,对Rh D阴性的血标本进行Rh E/e/C/c血型分型;采取统一的标准,对献血员详细资料认真登记;采用计算机管理系统,建立无偿献血者Rh E/e/C/c血型分型资料库及实物库。结果:Rh D阴性献血者300例(0.37%),Rh抗原表型为ccdee和Ccdee者占83.0%。结论:南阳市人群中Rh D阴性血型在所占的比例大约为4%,Rh D阴性献血者Rh E/e/C/c血型分型情况为:ccdee(50.67%)Ccdee(33.00%)ccd Ee(5.67%)CCdee(5.33%)Ccd Ee(5.33%)。建立Rh E/e/C/c血型分型库对临床输血具有深远的意义。     

咸阳地区供血者Rh血型系统抗原频率分析

目的了解Rh血型抗原在本地人群中的分布频率,为Rh血型抗原C、c、E和e的同型输注原则提供理论依据。方法随机抽取2010年RhD(+)献血者5 052人份标本和2008～2010年经初步血清学定为RhD(-)献血者775人份标本,采用血清学方法进行表型检测,分析2种人群的抗原频率特点;同时将RhD(+)献血者的表型和同期的RhD(-)献血者的表型进行H-W平衡分析。结果献血者的表型结果符合Hardy-Weinberg平衡;RhD(+)献血者C抗原频率为88%,c抗原频率为58%,E抗原频率为57%,e抗原频率为98.9%;RhD(-)献血者C抗原频率为31%,c抗原频率为97%,E抗原频率为15%,e抗原频率为99%。结论对于妊娠患者和需要多次输血的患者,尽可能的做到Rh血型系统D、C、c、E和e都能相合,避免以后再次输血配型困难或者造成迟发性输血反应。     

洛阳地区RhD阴性无偿献血者表型分布调查

Rh血型系统是最具多态性的红细胞血型系统,目前已确定的抗原多至48个,其中与临床输血相关的主要有D,C,c,E,e等5种抗原,东方人Rh血型系统中抗原的免疫强度依次为D,E,e,C,e[1].Rh血型系统在临床的重要性仅次于ABO血型系统,Rh血型不合可引起严重的新生儿溶血病和溶血性输血反应.为了进一步提高输血的安全性和有效性,本站对初筛为RhD抗原阴性者再进行RhD阴性确认实验以及5种主要抗原的检测和登记.我们对本市21307年以来初筛及确认为RhD抗原阴性的无偿献血者其表型分布情况进行回顾性统计分析,现报告如下.     

云浮地区RhD阴性献血者抗原分布及不规则抗体调查

目的 调查云浮地区RhD阴性献血者抗原的分布情况及不规则抗体的检出情况,并对结果加以分析,为临床安全用血提供数据支持。方法 选取云浮市中心血站2019年1月～2020年6月期间接收的RhD阴性献血者101例的血液标本为研究对象,以单克隆IgM试剂对血液标本的C、c、E、e抗原表型加以鉴定,并进一步应用微柱凝胶法等对血液标本的不规则抗体进行筛查。结果 101例RhD阴性献血者的抗原分布结果显示:ccee占比45.54%,Ccee占比44.55%;其中女性RhD阴性献血者的不规则抗体阳性率为26.67%,男性RhD阴性献血者的不规则抗体阳性率为5.81%,差异有统计学意义(P0.05)。结论 加强对RhD阴性献血者Rh血型抗原分布的检测和不规则抗体的筛查,有利于建立RhD阴性献血者抗原表型资料库,可以有效降低输血所致免疫学抗体生成风险,对于保障输血安全具有重要意义。     

云南傣族人群红细胞Rh、Duffy血型抗原多态性调查

目的调查云南傣族人群的Rh、Duffy血型系统抗原表现型的分布及抗原频率,为云南傣族血型分布的多态性及防治Rh、Duffy血型系统引起的溶血症提供科学依据。方法采集云南省境内3代内无血缘的傣族人群200例(男女各100例)、汉族对照组100例(男女各50例)为无关人群,采集血样3 ml(EDTA抗凝),采用微柱凝胶法检测Rh、Duffy及抗体筛选,Duffy血型系统基因分型检测采用PCR-SSP法,对比分析两人群间的差异。结果 200例傣族人群中RhD阳性率为98.5%,RhD阴性率为1.5%,100例汉族人群100例(男女各50例)中RhD阳性率99.0%,RhD阴性率1.0%。Duffy基因分型检测结果:傣族200份样本中,Duffy血型各种表型分布为:Fy~((a+b-))表型187例(93.5%),Fy~((a+b+))表型12例(6.0%),Fy~((a-b+))表型1例(0.5%),未发现Fy~((a-b-))表型。基因频率为:Fy~a(0.965),Fy~b(0.035);汉族100份样本中,Duffy血型各种表型分布为:Fy~((a+b-))表型92例(92.0%),Fy~((a+b+))表型5例(5.0%),Fy~((a-b+))表型3例(3.0%),未发现Fy~((a-b-))表型。基因频率为:Fy~a(0.945),Fy~b(0.055)。傣族人群抗体筛选阳性率为1.5%,均为同种抗体,其中2例E抗体。结论云南傣族人群的Duffy血型系统抗原分布状况及抗原分布特征与当地汉族人群基本相符,但也有本民族的自身特点,傣族族人群的RhD阴性率和不规则抗体检出率比当地汉族人群的不规则抗体检出率高,差异有统计学意义(P0.05)。     

陕西铜川地区无偿献血人群Rh血型表型分布调查

目的 调查铜川地区无偿献血人群Rh血型表型分布情况,建立Rh血型表型数据库,为临床安全输血提供有力保障。方法 使用卡式微柱凝胶法,对2015年6月～2017年3月来自铜川市中心血站的3 419例无偿献血者红细胞样本进行Rh血型抗原检测,用间接抗人球蛋白试验对RhD初筛阴性的标本进行确认,确定其Rh血型表型,并进行分类统计、计算机存档。与国内其他地区Rh血型表型分布情况比较采用t检验。结果 3 419例无偿献血者RhD阴性率0.55%,Rh其他抗原阳性率分别为D:99.45%,C:90.41%,c:55.10%,E:45.51%和e:92.19%; Rh抗原基因频率分别为D:0.921,C:0.6737,c:0.3207,E:0.2755和e:0.7306; Rh表型分布特征为:CCDee>CcDEe>CcDee>ccDEE>ccDEe>CcDEE>ccDee>RhD阴性。统计分析显示,铜川地区的CCDee和ccDEE构成比与南宁和黔南地区比较差异具有统计学意义(χ2=21.552,P=0.016; χ2=18.519,P=0.001),而与唐山、沈阳、邢台、天津滨海四地区比较差异无统计学意义(χ2=0.227～1.31,均P>0.05)。结论 铜川地区Rh表型分布具有北方地域特点^[1～4],RhD阴性率符合我国汉族人群分布特点,中国南北方地区在不同的Rh表型方面存在差异,Rh血型表型分布调查对于保证输血安全具有重要意义。     

5050名患者Rh分型及不规则抗体鉴定结果分析

目的分析5 050名患者Rh抗原检测及不规则抗体鉴定结果,探讨输血前Rh分型的重要性。方法采用国产微柱凝胶检测卡对5 050名待输血患者进行Rh抗原分型,并进行抗体筛选及鉴定。结果 5 050名患者共检出Rh(D)阳性5 030例,Rh血型抗原表现型分布DCe(2 304例)DCcEe(1 948例)DcEe(296例)DCce(279例)DcE(162例)DCEe(28例)Dce(8例)DCcE(5例);检出Rh(D)阴性20例,表现型分布CcE(6例)Cce(5例)ce(5例)cE(2例)Ce(2例)。D、C、c、E、e抗原频率分别为99.60%、90.63%、53.78%、48.46%、96.53%。共检出抗体70例,Rh系统49例占70%(49/70),其中抗-E 21例占30.00%(21/70),抗-c 12例占17.14%(12/70),抗-C 9例占12.86%(9/70),抗-D 5例占7.14%(5/70),抗-cE与抗-Ce各1例分别占1.43%(1/70);MNSs系统抗体7例均为抗-M占10%(7/70);冷凝集素6例占8.57%(6/70);Lewis系统4例占5.71%(4/70),抗-Lea3例占4.29%(3/70),抗-Leb1例占1.43%(1/70);Duffy系统4例均为抗-Fya占5.71%(4/70)。结论输血前常规检测Rh抗原对指导临床输血,从源头上减少除抗-D外的Rh抗体引起的输血反应具有重要意义。     

The Hereditary Syndrome of Thrombocytopathia, Bleeding Tendency, Extreme Miosis, Muscular Fatigue, Asplenia, Headache, etc

SYNOPSIS
A new, autosomal dominantly inherited syndrome with a bleeding disorder was described in 1985 by Stormorken and his co-workers.1,2 In this multifaceted syndrome, there were the following integral components: thrombocytopathia, extreme miosis with Argyll Robertson-like traits, muscular fatigue, a tendency to spasms, asplenia, ichthyosis, dyslexia, etc.
Headache with migraine traits was also present in the family in all 4 generations in which this syndrome had been observed. Nasal and conjunctival bleeding were part of the headache picture in some of the individuals exhibiting the hemorrhagic syndrome. While the attack-related bleeding disturbances only involved family members who also suffered from the hemorrhagic syndrome, the headache per se may seem to behave differently: The affected son's headache seems to have developed into a headache with tension headache traits, whereas the other, unaffected, son's headache has common migraine traits. The familial headache which in earlier generations clearly had migraine traits, therefore, may be inherited independently from the hemorrhagic disorder. In other words, a migraine or migraine-like headache is most probably not an obligatory integral part of this syndrome. The thrombocytopathia in this disorder comprises abnormal serotonin storage, uptake, and release (Stormorken and co-workers, to be published).
The admittedly somewhat farfetched possibility also exists that the headache, although being similar to migraine, differs essentially from it and may be an expression of the serotonin aberration.     

大麻素受体在成年大鼠脑组织中的分布特点

目的：研究大麻素CB1、CB2受体在成年大鼠脑组织的分布特点和规律,为进一步研究其功能打下基础。方法：用兔抗鼠CB1、CB2受体特异性抗体免疫组化染色,检测大鼠脑组织主要部位两种受体的表达分布情况。结果：CB1受体阳性细胞在脑组织有广泛大量的分布,大脑皮质、胼胝体、海马、基底核区及小脑浦肯野细胞层、脑桥等区域均有较明显表达。CB2受体阳性细胞的数量及分布部位与CB1受体表达基本一致,少数区域如胼胝体、小脑白质阳性细胞数相差较大,CB2受体明显多于CB1受体的表达。结论：大麻素CB1、CB2受体在成年大鼠脑组织均广泛分布,并在多数部位表达情况一致,少数部位存在表达程度差异,提示其在神经系统中参与了某些生理及病理作用。 关键词 CB1受体;CB2受体;大麻素;脑组织;大鼠     

Effect of 5-fluorouracil, mitoxantrone, methotrexate, and vincristine on the antibacterial activity of ceftriaxone, ceftazidime, cefotiam, piperacillin, and netilmicin

Using the checkerboard agar dilution technique, antibacterial activity and in vitro interactions of 4 antineoplastic agents and 5 antimicrobial drugs were examined against 56 strains of 7 bacterial species. 5-fluorouracil was found to inhibit all strains of Staphylococcus aureus and of Staphylococcus epidermidis at a concentration of 0.8 micrograms/ml or less. 84% of all gram-negative strains were inhibited synergistically when 5-fluorouracil was combined with beta-lactam antibiotics. Methotrexate and cefotiam were antagonistic in 42% of all combinations, especially when tested against Escherichia coli and Klebsiella pneumoniae.     

品管圈在提高儿科住院患儿服药到口率中的应用

目的：探讨品管圈在儿科病房服药到口护理工作改进中的管理作用。方法：通过品管圈活动步骤,运用质量管理工具对儿科住院患儿服药不能到口的问题进行改进,并将改进前后状况进行比较讨论。结果：住院患儿服药到口率从42.5%提升到99.19%(P＜0.01)。结论：品管圈方法的应用提高了住院患儿服药到口率,提高了医护人员的团队精神,增强了护士的责任心,提升了护士的个人素质和自信心。     

Aluminum, iron, lead, cadmium, copper, zinc, chromium, magnesium, strontium, and calcium content in bone of end-stage renal failure patients.

BACKGROUND: Little is known about trace metal alterations in the bones of dialysis patients or whether particular types of renal osteodystrophy are associated with either increased or decreased skeletal concentrations of trace elements. Because these patients are at risk for alterations of trace elements as well as for morbidity from skeletal disorders, we measured trace elements in bone of patients with end-stage renal disease. METHODS: We analyzed bone biopsies of 100 end-stage renal failure patients enrolled in a hemodialysis program. The trace metal contents of bone biopsies with histological features of either osteomalacia, adynamic bone disease, mixed lesion, normal histology, or hyperparathyroidism were compared with each other and with the trace metal contents of bone of subjects with normal renal function. Trace metals were measured by atomic absorption spectrometry. RESULTS: The concentrations of aluminum, chromium, and cadmium were increased in bone of end-stage renal failure patients. Comparing the trace metal/calcium ratio, significantly higher values were found for the bone chromium/calcium, aluminum/calcium, zinc/calcium, magnesium/calcium, and strontium/calcium ratios. Among types of renal osteodystrophy, increased bone aluminum, lead, and strontium concentrations and strontium/calcium and aluminum/calcium ratios were found in dialysis patients with osteomalacia vs the other types of renal osteodystrophy considered as one group. Moreover, the concentrations of several trace elements in bone were significantly correlated with each other. Bone aluminum was correlated with the time on dialysis, whereas bone iron, aluminum, magnesium, and strontium tended to be associated with patient age. Bone trace metal concentrations did not depend on vitamin D intake nor on the patients' gender. CONCLUSIONS: The concentration of several trace elements in bone of end-stage renal failure patients is disturbed, and some of the trace metals under study might share pathways of absorption, distribution, and accumulation. The clinical significance of the increased/decreased concentrations of several trace elements other than aluminum in bone of dialysis patients deserves further investigation.