老年冠心病患者血小板蛋白激酶C、蛋白激酶C抑制剂及红细胞蛋白激酶C活性变化的研究

目的 研究蛋白激酶C(PKC)在冠心病的发生、发展中的作用。方法 测定87例心绞痛(AP)患者、91例急性心肌梗死(AMI)患者、90名健康对照(HC)者的血小板胞膜、胞浆PKC、胞浆PKC抑制剂(PKCI)活性和红细胞胞膜、胞浆PKC活性。结果 AP组和AMI组血小板胞膜中PKC活性明显高于HC组，其中AP组与HC组比较，增高62．6％(P＜0．01)；AMI组与HC组比较，增高41．2％(P＜0．01)；AP组与AMI组比较，增高14．2％(P＜0．05)。AP组和AMI组血小板胞浆中PKC活性明显低于HC组。其中AP组与HC组比较，下降36．6％(P＜0．01)；AMI组与HC组比较，下降23．9％(P＜0．01)；AP组与AMI组比较，下降16．7％(P＜0．05)。AP组和AMI组血小板胞浆中PKCI活性明显低于HC组。其中AP组较HC组下降52．9％(P＜0．01)，AMI组较HC组下降26．0％(P＜0．01)。AP组及AMI组红细胞胞膜中PKC活性明显高于HC组。其中AP组与HC组比较，增高33．6％(P＜0．01)；AMI组与HC组比较，增高31．8％(P＜0．01)。AP组及AMI组红细胞胞浆中PKC活性明显低于HC组，AP组较HC组降低27．2％(P＜0．01)，AMI组与HC组比较，降低21．9％(P＜0．01)。结论 PKC可能参与冠心病的发病机制。     

脊柱手术中患者回收血与库存血红细胞流变学特性的比较

目的比较脊柱手术中患者回收血与库存血的红细胞流变学特性。方法择期行腰椎管减压联合椎弓根内固定术的患者30例，年龄44—80岁，ASAⅡ或Ⅲ级，使用自体．2000型血液回收机行术中自体血回收，取经血液回收机回收处理后的回收血；另取分属不同献血者的库存9．15d去白细胞浓缩红细胞悬液30份。用激光衍射法测定红细胞在高粘场中的最大变形指数（DImax）、积分变形指数（IDI）及在低粘场中的最大小变形指数[（DI）d,max]和最大取向指数[（DI）or,max]；采用荧光偏振法测定红细胞膜的荧光强度，并计算荧光偏振度（P）及表征细胞膜流动性的微粘度（T1）；测定不同浓度NaCl溶液中加入红细胞后上清液的透光率，计算红细胞溶血率，并绘制渗透脆性曲线。结果与库存血比较，回收血（DI）or,max升高，在NaCl浓度为0．20％～0．75％时红细胞溶血率低（P＜0．05），Dk、IDI、（DI）d,max、P和η差异均无统计学意义（P＞0．05）；回收血红细胞渗透脆性曲线较库存血左移。结论回收血红细胞流变学特性优于库存血。     

精神分裂症患者红细胞微量元素的测定

为了解精神分裂症患者红细胞微量元素的变化，及其与抗精神病药治疗等因素的关系，对５０例精神病患者进行氯氮平、氯丙嗪治疗前后红细胞钙、镁、铜、锌、铁微量元素测定，并与５２名健康志愿者进行对照。结果显示，与对照组比较，治疗前患者组红细胞铜、铁、钙显著增高（Ｐ＜０．０５～０．０１），而镁则显著降低（Ｐ＜０．０１）。服氯氮平４０天后，患者的红细胞铁显著降低，镁显著增高（Ｐ＜０．０５）。服氯丙嗪的患者治疗前后无变化。上述红细胞微量元素与药物剂量、病程、治疗前后的简明精神病评定分值无显著相关性（Ｐ＞０．０５）。提示红细胞某些微量元素在精神分裂症与正常对照者间存在着一定的差异，为进一步研究精神分裂症与微量元素代谢间的关系提供了一定的客观依据。     

Analysis of blood clot echogenicity

The ability of B-mode ultrasound to follow effectively blood clot echogenicity changes over time under conditions of red cell preservation and lysis was evaluated. Blood clots were produced in cellulose dialysis tubing and then placed into appropriate baths of either saline or water. The echogenicity changes were then followed quantitatively using A-mode and qualitatively using B-mode imaging. Blood clots in saline showed an initial decrease followed by a leveling off in echogenicity. Blood clots in water showed a decline in echogenicity throughout the experiment. The A-mode imaging was effectively able to follow blood clot echogenicity changes under these controlled conditions.     

Causes of differences in exercise-induced changes of base excess and blood lactate

It has been concluded from comparisons of base excess (BE) and lactic acid (La) concentration changes in blood during exercise-induced acidosis that more H⁺ than La⁻ leave the muscle and enter interstitial fluid and blood. To examine this, we performed incremental cycle tests in 13 untrained males and measured acid–base status and [La] in arterialized blood, plasma, and red cells until 21 min after exhaustion. The decrease of actual BE (−ΔABE) was 2.2 ± 0.5 (SEM) mmol l⁻¹ larger than the increase of [La]_blood at exhaustion, and the difference rose to 4.8 ± 0.5 mmol l⁻¹ during the first minutes of recovery. The decrease of standard BE (SBE), a measure of mean BE of interstitial fluid (if) and blood, however, was smaller than the increase of [La] in the corresponding volume (Δ[La]_if+blood) during exercise and only slightly larger during recovery. The discrepancy between −ΔABE and Δ[La]_blood mainly results from the Donnan effect hindering the rise of [La]_erythrocyte to equal values like [La]_plasma. The changing Donnan effect during acidosis causes that Cl⁻ from the interstitial fluid enter plasma and erythrocytes in exchange for HCO₃⁻. A corresponding amount of La⁻ remains outside the blood. SBE is not influenced by ion shifts among these compartments and therefore is a rather exact measure of acid movements across tissue cell membranes, but changes have been compared previously to Δ[La]_blood instead to Δ[La]_if+blood. When performing correct comparisons and considering Cl⁻/HCO₃⁻ exchange between erythrocytes and extracellular fluid, neither the use of ΔABE nor of ΔSBE provides evidence for differences in H⁺ and La⁻ transport across the tissue cell membranes.     

Exploiting shape,cellular-hitchhiking and antibodies to target nanoparticles to lung endothelium: Synergy between physical,chemical and biological approaches

Delivery of nanoparticles to target specific tissues remains a challenge due to their rapid removal from circulation by the reticuloendothelial (RES) system. The majority of past research has addressed this issue via chemical modification of nanoparticles in the form of hydrophilic coatings which reduces adsorption of opsonins that trigger RES clearance. Recently, additional approaches have been developed which leverage the natural mechanisms our own circulatory cells use to avoid immune system clearance. One such method, called ‘cellular-hitchhiking’, accomplishes this by non-covalent attachment of nanoparticles to the surface of red blood cells. Concomitantly, approaches that make use of modified nanoparticle geometry, that is rod-shaped nanoparticles, have also been used to avoid immune system clearance and improve tissue targeting. Here, we systematically investigate three approaches and their combinations to improve lung targeting while avoiding RES clearance. Our results show that an approach that combines targeting antibodies (anti-ICAM-1), rod-shaped particles and cellular hitchhiking into one delivery system effectively lowered the accumulated concentration of nanoparticles in RES organs by over two-fold as compared to any other combination or single method, while simultaneously increasing the concentration of accumulated nanoparticles in the lungs from 1.2 to 8.9 fold. The strategy described here offers a novel means that combine chemical, physical and biological approaches to maximize tissue targeting.     

利奈唑胺致异基因造血干细胞移植后纯红细胞再生障碍性贫血一例报告并文献复习

【目的】探讨利奈唑胺引起异基因造血干细胞移植后纯红细胞再生障碍性贫血（PRCA ）的临床表现、治疗及可能机制。【方法】报道1例异基因造血干细胞移植后应用利奈唑胺引起反复严重贫血,结合文献分析其可能原因。【结果】利奈唑胺可引起 PRCA ,可能与 T 细胞异常增殖有关。【结论】造血干细胞移植后应用利奈唑胺可能引起PRCA ,需密切监测网织红细胞的变化。     

急性脑卒中患者红细胞分布宽度对预后的影响

目的：探讨急性脑卒中患者红细胞分布宽度（RDW）对不良预后的影响。方法回顾性分析264例首次诊断为急性脑卒中患者的临床资料,随访发病后6个月,其中男性225例,女性39例,改良的Rankin 量表评分（MRS）＞2患者69例和 MRS≤2患者195例,MRS ＝6患者6例和 MRS ＜6患者258例,分别进行比较。结果（1）RDW 与 MRS 评分呈正相关（r ＝0．328,P ＜0．01）。（2）男性与女性的 RDW 分别为（12．68±0．78比13．53±2．49）,对 RDW 与性别进行秩和检验,两组间差异无统计学意义。对 MRS 评分与性别进行秩和检验,两组间差异有统计学意义（P ＜0．05）。（3）69例患者在急性脑卒中后的6个月出现预后不良（MRS ＞2）,预后不良的 RDW 更高（13．46±1．33比12．57±1．11）,秩和检验示 P ＜0．01。6例患者在急性脑卒中后的6个月出现死亡,死亡患者的 RDW 略高（13．23±1．32比12．79±1．23）,但差异无统计学意义。（4）二元 Logistic 回归分析显示,糖尿病（P ＝0．014）、年龄（P ＝0．042）、RDW（P ＝0．000）是中青年急性脑卒中的独立危险因素。结论急性脑卒中患者 RDW 是预后不良的一项独立危险因素。     

Altered erythrocyte membrane characteristics during anemia in childhood acute lymphoblastic leukemia

Anemia is a prominent feature in children with acute lymphoblastic leukemia (ALL). To investigate the erythrocyte features during anemia in these patients, we studied the altered characters of these cells and oxidative stress imposed in their serum. This investigation reveals that erythrocytes from ALL patients show (1) increased membrane fluidity detected by fluorescence anisotropy studies, increased osmotic fragility detected by hemolysis of erythrocytes in different saline concentrations, and increased hydrophobicity as measured by binding with 8-anilino-1-naphthalenesulfonic acid, (2) enhanced (~ threefold) glycosylation and sialylation, monitored by digoxigenin enzyme assay, and (3) expression of disease-specific 210, 105, 83, 54, and 28 kDa 9-O-acetyl sialoglycoconjugates (9-O-AcSGs) demonstrated by Western blot analysis and fluorescence-activated cell sorter (FACS) analysis studies using Achatinin-H with specificity towards 9-O-AcSA2-6GalNAc as the analytical probe. (4) In addition, induced oxidative stress was observed in the sera of these children as indicated by increased nitric oxide (~ fourfold) and thiobarbituric acid (TBA) reactive species (twofold) as detected by Griess reaction and TBA assay, respectively. For all the experiments, erythrocytes from normal individuals served as controls. Thus, the altered membrane characteristics together with their exposure to induced oxidative stress in serum are found to be a few features restricted to diseased erythrocytes. Taken together, our results are suggestive of their interplay in the contribution to the observed anemia in these patients, which may be exploited for better management of the disease.     

Biological effects of ionizing radiation on human blood compounds ex vivo

Purpose: Blood compounds are irradiated ex vivo to prevent transfusion-associated graft-versus-host-disease. Recently, ex vivo irradiation of re-transfused wound blood has been proposed to prevent metastatic spread in patients with malignant tumors, an issue requiring different dose concepts. To determine effects on blood cells we examined the impact of various doses of ionizing radiation. Methods: Full blood was irradiated with doses of 10–150 Gy. Potassium, LDH and hemoglobin levels were determined 2 h–96 h after irradiation. The lymphocyte proliferation after irradiation was measured by means of a lymphocyte-transformation assay. The impact of irradiation on mitogen-induced secretion of cytokines was determined by the ELISA technique, and P-selectin expression as an indicator of platelet activation was analyzed by flow-cytometry. Results: Potassium levels increase with aging and irradiation dose. Mitogenic capacity is reduced by over 90% with moderate doses of 10–20 Gy, but a residual proliferation is still detectable up to 50 Gy. No enhancement of extracellular cytokine levels is detectable, but the cytokine release is reduced by radiation. Neither induction of platelet activation nor abrogation of activation has been detected. Conclusions: Doses of 30–50 Gy abrogate lymphocyte proliferation almost completely. In this range we did not observe severe adverse effects on blood transfusions. Hemolysis might be enhanced when the samples are stored for a longer period after irradiation. Received: 18 January 2000 / Accepted: 6 April 2000