成分输血在临床中的应用

成分输血是现代输血学的重要标志之一。临床医生要了解成分输血的知识,遵循科学用血、合理用血、节约用血的原则,根据病情有针对性地开展成分输血。成分输血的重点,应当是血液的有形成分,即以红细胞和血小板为主的成分输血。本文就成分输血的特点与临床应用等有关问题进行综述。     

海风藤酚、甲基海风藤酚、海风藤醇A和海风藤醇B对兔血小板聚集的影响

海风藤酚、甲基海风藤酚、海风藤醇Ａ和海风藤醇Ｂ均有抑制血小板激活因子（ＰＡＦ）诱导的兔血小板聚集作用，ＩＣ_（５０）分别为１７．９、９．２、１４２．０、１４．０μｍｏｌ·Ｌ~（－１）。经阿司匹林（ＡＳＡ）、磷酸肌酸／磷酸肌酸激酶（ＣＰ／ＣＰＫ）预处理的兔洗涤血小板，甲基海风藤酚和海风藤醇Ｂ仍能抑制ＰＡＦ诱导的兔血小板聚集，ＩＣ_（５０）为９．０、１６．５μｍｏｌ·Ｌ~（－１）。同时，４种成分对于二磷酸腺苷（ＡＤＰ），花生四烯酸（ＡＡ）诱导的血小板聚集抑制作用较弱，海风藤Ｂ能使ＰＡＦ诱导血小板聚集量－效曲线平行右移，ＥＣ_（５０）由１．５９ｎｍｏｌ·Ｌ~（－１）升为２０．６ｎｍｏｌ·Ｌ~（－１）。结果表明：４种成分能选择性拮抗ＰＡＦ对兔血小板的聚集作用。     

Inhibitory effect of activated protein C on platelet aggregation induced by the prothrombin-converting reaction

The present study was undertaken to elucidate the effect on platelet aggregation of the prothrombin-converting reaction on platelets with or without activated protein C (APC). A reaction mixture of washed platelets from human individuals, Factor Xa and prothrombin markedly induced platelet aggregation; maximum aggregation rates, 31.3–92.5%, and times to reach to maximum aggregation, 11.6 to 20.1 min. This aggregation was inhibited by the addition of APC with 50% inhibition concentration (IC₅₀) value of 14.4 U/ml. APC also inhibited thrombin generation in the reaction mixture in a dose-dependent manner with IC50 value of 0.96 U/ml. However, APC did not inhibit the thrombin (0.1 CU/ml)-induced platelet aggregation at concentrations of up to 30 U/ml. These findings suggest that APC has no direct inhibitory effect on platelet aggregation and that APC inhibits platelet aggregation through inhibition of thrombin generation.     

尿毒症患者的血小板聚集功能变化及血液透析的影响

本文应用 ADP、肾上腺素及复合诱聚剂对30例慢性肾功能不全(尿毒症期)病人的血小板聚集功能进行了检测,其中5例在血液透析前后分别测定。结果表明尿毒症患者血小板聚集功能障碍,血液透析有助于改善血小板功能。通过相关性检验,发现尿毒症病人的血小板聚集率与血肌酐值呈负相关性,其意义尚需进一步探讨。     

1,3-Dipropyl-8-cyclopentylxanthine attenuates the NMDA response to hypoxia in the rat hippocampus

Excitatory amino acids may cause neuronal damage and death in cerebral hypoxia and ischemia, through the activation of different subtypes of glutamate receptors, in particular of the (NMDA) receptor. In the present work, the effect of hypoxia on the component of the field excitatory postsynaptic potential (fepsp) mediated by the NMDA receptor was studied in the hippocampal CA1 area of the rat. A period of 15 min of hypoxia induced virtual abolition of the NMDA receptor-mediated fepsp and a 94.8 ± 0.7% maximal decrease in the fepsp. A period of 3 min of hypoxia induced a 89.3 ± 12.3% maximal decrease in the NMDA receptor-mediated component of the fepsp and only a 50.8 ± 11.5% maximal decrease in the fepsp. Both periods of hypoxia thus induced a more pronounced depression of the NMDA receptor-mediated component of the fepsp than of the fepsp. We found that 48.5 ± 9.1% decrease (about half of the total decrease) in the NMDA receptor-mediated fepsp, and 51.6 ± 19.6% decrease (approximately all decrease) in the fepsp induced by hypoxia (3 min) were reversed in the presence of the selective adenosine A₁ receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) (50 nM), and thus likely to be mediated by endogenous adenosine, through the activation of adenosine A₁ receptors. On the other hand, under the conditions we assumed to be normoxic in our slices, DPCPX (50 nM) induced a much larger increase in the amplitude of the NMDA receptor-mediated fepsp compared to the increase in the fepsp, which suggest that endogenous adenosine is inhibiting predominantly the NMDA receptor-mediated fepsp under these conditions. Hypoxia markedly decreases the NMDA receptor-mediated fepsp in the hippocampal CA₁ area. The contribution of endogenous adenosine to the inhibition of the NMDA receptor-mediated fepsp may be fundamental for its neuroprotective effects.     

低剂量电离辐射对小鼠免疫器官cAMP和儿茶酚胺含量的影响

本文报道，７５ｍＧｙ／（１２．５ｍＧｙ／ｍｉｎ）单次全身Ｘ射线照射后９小时用ＳＲＢＣ免疫Ｃ５７ＢＬ／６小鼠，在免疫后４天和７天脾脏、胸腺和下丘脑ｃＡＭＰ含量均降低；而在免疫后４天脾脏去甲肾上腺素、肾上腺素和酪氨酸含量均增高，免疫后７天肾上腺素含量仍持续增高；当连接γ射线６５ｍＧｙ（０．０１５ｍＧｙ／ｍｉｎ，６ｈ／ｄ）全身照射小鼠后即刻或２９小时后免疫，脾脏和下丘脑ｃＡＭＰ含量也均降低。提示，低剂量     

A case of scirrhous gastric cancer with peritonitis carcinomatosa controlled by TS-1(R) + paclitaxel for 36 mo after diagnosis

A 34-year-old female complaining of abdominal fullness was diagnosed as scirrhous gastric cancer (type 4')with peritonitis carcinomatosa in July 2002. A combined chemotherapy regimen was selected to control massive ascites; TS-1(R) 80 mg/m2 was given orally on d 1-14,22-35, and paclitaxel 50 mg/m2 was administered intravenously on d 1, 8, 22 and 29. After 2 courses of this regimen, the primary tumor was markedly reduced,and ascites completely vanished. Alopecia (grade 1,since d 30), leukocytopenia (grade 2, on d 34) and anemia (grade 2, on d 34) were the only adverse events throughout the following courses. The chemotherapy was effective for 28 mo, and then it was discontinued upon the patient's own request, and she survived for 36mo after diagnosis.     

A mathematical analysis of kinetic characteristics of oxidative phosphorylation in the animal brain under hypoxic conditions

The kinetic dependence of the rate of oxidative phosphorylation (ADP/t) on the concentration of exogenous ADP has been mathematically analyzed in the brain mitochondria. This relationship has been approximated by a mathematic model under various vital conditions. We propose an analytical approach to calculating the characteristics of oxidative phosphorylation and predicting the kinetics of oxidative ATP synthesis in brain mitochondria of animals subjected to hypoxia.     

子宫内膜异位症患者血清及腹腔液中血小板衍生生长因子、血管细胞粘附分子水平的变化及其意义

目的通过检测子宫内膜异位症(EMs)患者血清及腹腔液中血小板衍生生长因子(PDGF)、血管细胞粘附分子-(VCAM-1)浓度,探讨PDGF和VCAM-1在EMs发病中的作用。方法选取手术后病理证实为EMs的40例患者为EMs组,其中I~II期17例,III~IV23例;非EMs组20例作为对照组。应用酶联免疫吸附法(ELISA)检测血清及腹腔液中PDGF和VCAM-1水平。结果EMs组血清及腹腔液中PDGF、VCAM-1水平均明显高于对照组(P<0.01)。随EMs期别的增加,其血清和腹腔液中PDGF、VCAM-1含量呈上升趋势;EMsIII~IV期水平显著高于I~II期(P<0.05)。EMs患者PDGF与VCAM-1呈正相关性(P<0.05)。结论EMs患者PDGF、VCAM-1表达水平升高,在EMs的发生发展中具有重要作用。     

胆源性感染性休克兔血栓素、前列环素与血小板聚集率的变化

动态观察胆总管急性完全性梗阻并感染、继发休克兔的血浆血栓素(TXA_2)和前列环素(PGI_2)的稳定代谢产物 TXB_2和6-keto-PGF_(1α)含量及血小板聚集率的变化。结果,血浆 TXB_2呈进行性升高,20h 后(休克时)呈下降趋势,血浆6-keto-PGF_(1α)6h 升高,随后回降;血小板聚集率呈进行性下降。提示血栓素和前列环素、血小板聚集率的变化在重症急性胆管炎、胆源性感染性休克发病过程中起重要病理生理作用,与病情和预后转归有重要联系。