两台凝血分析仪检测结果的可比性研究

目的：探讨不同型号凝血分析仪检测凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、纤维蛋白原（FIB）和凝血酶时间（TT）的结果是否具有可比性。方法随机选取40例患者新鲜血浆,分别在ACLTOP与ACLTOP700血凝分析仪上检测PT、APTT、FIB、TT,对结果进行比较分析。结果两凝血分析仪4个检测项目结果的相关系数（r）均大于0．975,各项结果的偏倚均在CLIA′88规定的允许误差范围内。结论ACLTOP与ACLTOP700血凝分析仪检测PT、APTT、FIB、TT的结果具有可比性,符合临床要求。     

细胞因子治疗4.5Gyγ射线照射比格犬造血损伤的机制初探

目的 探讨多种细胞因子配伍应用治疗4.5 Gy γ射线照射比格犬造血系统损伤的作用及可能机制。方法 16只比格犬均给予4.5 Gy ⁶⁰Co γ射线全身照射,随机分为照射对照、综合对症和细胞因子3组。细胞因子组在综合对症支持治疗的基础上应用rhG-CSF、rhIL-11和rhIL-2联合治疗,采用流式细胞术检测外周血中CD34+细胞含量、有核细胞周期及凋亡比例。结果 4.5 Gy γ射线照射犬外周血中CD34+细胞含量在照射后1 d明显下降(照射对照组和综合对症组分别为照前值的61.3%和52.1%),G₀/G₁期有核细胞比例增加(分别为99.27%和99.49%),且凋亡率(分别为26.93%和21.29%)和坏死率(分别为3.27%和4.14%)明显升高(与照前值比较, P<0.05);而经过细胞因子治疗后,外周血中CD34+细胞含量在照射后1 d即明显升高(为照前值的135.6%),G₀/G₁期有核细胞比例(99.71%)进一步增加,其凋亡率(5.66%)和坏死率(1.60%)明显低于照射对照和综合对症组。结论 本研究的细胞因子组合可能通过动员骨髓中CD34+细胞到外周血,使细胞周期阻滞在G₀/G₁期,减少细胞凋亡,从而促进极重度骨髓型急性放射病犬造血功能的恢复。     

强直性脊柱炎患者HLA-B27抗原、ESR、CRP等检测指标水平分析及临床意义

目的探讨HLA-B27抗原、红细胞沉降率(ESR)、C-反应蛋白(CRP)等检测指标在强直性脊柱炎(AS)诊断中的临床价值。方法 33例临床确诊为AS患者和30例健康体检者,进行HLA-B27抗原、ESR、CRP等项实验室指标的检测。结果 AS患者HLA-B27抗原、ESR、CRP阳性率分别为87.9%、63.6%和45.5%,与健康对照组比较均显著增高,差异有统计学意义(P0.05),且HLA-B27抗原阳性率显著高于其他两项指标,3项指标联合检测可将AS的阳性率提高到93.9%,但特异度会相应降低;其他指标两组比较差异均无统计学意义(P0.05)。结论 HLA-B27抗原与AS具有密切相关性,联合检测HLA-B27抗原、ESR、CRP对AS的诊断更有价值。     

Therapeutic effects of combined cytokines on hematopoietic injuries induced by 4.5 Gy γ-rays irradiation in beagles

Objectivc To observe the therapeutic effects of combined cytokines on hematopoietic injuries induced by 4.5 Gy60 Co γ-rays irradiation in beagles,and to provide experimental evidences for the clinical treatment of extremely severe myeloid acute radiation sickness(ARS).Methods 16 beagles were given 4.5 Gy60 Co γ-rays total body irradiation,and then randomly assigned into irradiation control group,supportive care group and cytokines group.In addition to supportive care,recombinant human granulocyte colony-stimulating factor (rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2(rhIL-2)were administered subcutaneouly to dogs in cytokines group.Peripheral blood hemogram was examined once every two days.Bone marrow and peripheral blood were collected to proceed colony cultivation 4 d pre-irradiation and 1 and 45 d post-irradiation.Conventional histopathological sections of sternum were prepared to observe the histomorphology changes. Results After irradiation,the population of all kinds of cells in peripheral blood declined sharply.WBC nadir Was elevated(1.04×109/L,but 0.28×109/L and 0.68×109/L for the irradiation control group and the supportive care group separately),the duration of thrombocytopenia was shortened (24 days,but 33 days for the supportive care groug) and red blood cell counts were maintained in the range of normal values after cytokincs treatment in combination.The colony forming efficiency of haemopoietic stem cells(HSCs)in bone marrow and peripheral blood decreased obviously 1 d post irradiation,but recovered to the level of that before irradiation 45 d post irradiation after supportive care and cytokines treatment.Hematopoietic cells disappeared in bone marrow of animals in irradiation control group,but hematopoietic functions were recovered after cytokines were administrated.Conclusions RhG-CSF.rhIL-11 and rhIL-2 used in combination could elevate WBC nadir,accelerate the recovery of leukocytes,platelets and red blood cells and promote the proliferation,differentiation and maturity of HSPCs left in the body after 4.5 Gy γ-rays total body irradiation,eventually restore the hematopoietic function.Hence,combination of rhG-CSF,rhIL-11 and rhIL-2 could serve as better therapeutic strategy to treat extremely severe myeloid ARS.     

Experimental therapeutic effect of combined cytokines on beagle dogs exposed to 4.5 Gy γ-rays

Objective To evaluate the effects of combined administration of recombinant human interleukin-11(rhIL-11),recombinant human G-CSF(rhG-CSF)and recombinant human interleukin-2 (rhIL-2)on acute radiation sickness(ARS)beagles.Methods Sixteen beagle were irradiated with 4.5 Gy60 Co γ-rays to establish ARS models,and were divided into irradiation control group,supportive care group and combined cytokines treatment group.After irradiation irradiation control group was given no treatment,the dogs in supportive care group received purely symptomatic treatment,while combined cytokines treatment group received rhIL-11 50μg/(kg·d)and rbG-CSF 10μg/(kg·d)subcutaneously(0-14 d)and rhIL-2 1×1 06 U/d(29-43 d)besides symptomatic treatment.Manifestation and characteristics of ARS beagles were observed,and the survival time were recorded.At last,post-mortem examination and histological examination were performed.Results All animals underwent nausea,diarrhea and fever.After irradiation,all animals in irradiation control group died in two weeks,and the mean survival time was 12.7 d,while only one died at 33 d in supportive care group.All dogs in combined cytokine group survived at 45 day after exposure,and their haematopoiesis and gastrointestinal tract were recovered.Conclusions Combination of rhIL-11 + rhG-CSF + rhIL-2 treatment could be significantly effective on ARS beagles irradiated by 4.5 Gy60 Co γ-rays,which could accelerate injured haemotopoiesis and intestinal tract recovery,increase the survival rate and improve the life quality of animals.     

Clotting mechanism in beagles irradiated by 4.5 Gy γ-rays

Objective To explore the clotting mechanism in beagles irradiated by 4.5 Gy γ-rays after treatment with supportive care,or supportive care and combined cytokines.Methods Sixteen beagles were divided into irradiation control group,Supportive care group and combined cytokines treatment group.Platelet aggregation test,thrombelagtography (TEG) and the time measurement were analyzed in vitro.Results In irradiation group and supportive care group,the platelet aggregation rates in beagles were decreased markedly and the k value of TEG was increased 7 d post-irradiation,while those indexes in combined cytokines treatment group changed little.At 14 d post-irradiation,each parameter of TEG in irradiated group changed obviously.The values of r,k,r+k and M were elevated significantly,clotting time and the maximum coagulation time of thrombus delayed,the Ma value was decreased markedly,and the maximum elasticity amplitude of thrombus was diminished.All parameters in combined cytokines treatment group were better than those in supportive care group.The thrombin time was prolonged obviously in irradiated group 14 d post-irradiation,while the thrombin time was the longest at 2-3 weeks post irradiation in supportive care group and combined cytokines treatment group(P>0.05).Conclusions Cytokines could improve the platelet aggregation and the blood clotting functions of beagles suffering from acute radiation sickness.     

大剂量重组人粒细胞集落刺激因子对8.0Gy ^60Co γ射线照射小鼠长期存活率及远后效应的影响

目的探索重组人粒细胞集落刺激因子（rhG-CSF）对8.0Gy60Coγ射线照射小鼠长期存活率及远后效应的影响。方法 70只雄性C57BL/6小鼠,随机分为正常对照、照射对照及rhG-CSF大、中、小剂量治疗共5组,除正常对照组外,其他4组均接受8.0Gy60Coγ射线照射。治疗组小鼠于照射后0.5和24h两次分别皮下注射rhG-CSF1000、500和250μg/kg,随时记录各组动物存活率,照射后70、160和300d进行外周血细胞计数分析,300d时检测各组存活小鼠造血和免疫相关指标。结果照射对照组动物照后19d内全部死亡,平均存活时间（12.1±3.0）d;rhG-CSF1000μg/kg治疗组照射后30、100和300d存活率分别为86.7%、86.7%和80.0%,死亡小鼠平均存活时间较照射对照组明显延长（P〈0.01）。照后300d时,rhG-CSF1000μg/kg治疗组的外周血红细胞和血小板计数均与正常对照组没有统计学差异,骨髓混合细胞集落形成单位数量显著低于正常对照组（P〈0.01）;rhG-CSF治疗组的CD4＋/CD8＋比值倒置且250μg/kg剂量组明显低于正常对照组（P〈0.05）;rhG-CSF治疗组造血和免疫器官的组织病理切片结果显示仍然存在不同程度的病变。结论 rhG-CSF1000μg/kg治疗可以显著提高8.0Gy60Coγ射线照射小鼠存活率,但照射后300d造血和免疫系统相关指标尚未完全恢复正常。     

GW003对恒河猴急性辐射损伤的治疗作用

目的本研究旨在观察不同剂量重组人血清白蛋白-粒细胞集落刺激因子融合蛋白(GW003)对急性放射病恒河猴的治疗作用。方法 28只成年恒河猴分为正常对照组、照射对照组及GW003 50、150和450μg/kg治疗组共5组,后4组动物(每组6只)用60Coγ射线全身双侧一次照射3.0 Gy。GW003治疗组动物分别于照射后0和7 d皮下注射GW003 50、150和450μg/kg,所有照射动物均给予对症治疗。观察照射动物一般状况、体征、外周血细胞计数、外周血和骨髓细胞集落培养及病理组织学检查结果。结果不同剂量GW003皮下注射给药能明显升高3.0 Gy照射猴外周血白细胞、中性粒细胞和造血祖细胞数,其中GW003 150和450μg/kg剂量组提高外周血白细胞、中性粒细胞、血小板和血红蛋白最低值,缩短细胞减少持续时间的作用显著,明显加速骨髓造血功能恢复,减少输血次数。结论 GW003 150μg/kg可明显促进急性辐射损伤猴造血功能恢复,对中度骨髓型急性放射病有明显的治疗作用。     

2型糖尿病中同型半胱氨酸、VitB12、叶酸检测的意义

2型糖尿病(DM2)是一种全身性代谢性疾病,心、脑、肾、视网膜及外周血管疾病并发症是DM2患者致残、致死的主要原因。应早期判断并发症,及时控制和预防。同型半胱氨酸(HCY)是蛋氨酸循环的中间产物,代谢需要VitB12和叶酸(FA)作为辅酶。近年来,大量国内外资料表明[1],HCY是心脑