"Nageotte"血细胞计数板测定单采血小板中残留白细胞

目的探讨运用“Nageotte”血细胞计数板测定单采血小板中残留白细胞的可行性。方法选择30份无偿献血者捐献的单采血小板，1：10倍稀释后用“Nageotte”血细胞计数板进行计数、计算。结果残留白细胞含量为（2．12±0．87）×10^6／L袋[（1．3～4）×10^6／袋]。结论运用“Nageotte”血细胞计数板计数单采血小板中残留的白细胞含量，操作简单易行。     

血小板成分中残留白细胞的新检测方法

目的建立一种基于流式细胞术的灵敏、准确的残留白细胞检测方法。方法用CD45/CD61和核酸染料/CD612种标记方法分别对人工制备的含不同含量白细胞的血小板悬液进行流式细胞仪检测,并与理论值比较。取实际血小板成分样本,进行CD45/CD61标记法检测,并加入FlowCount参照荧光微球进行绝对计数。结果CD45/CD61标记法检测结果与理论值较为接近,二者间差异无显著性意义(P>0.05);核酸染料/CD61标记法检测值均高于理论值,特别是白细胞含量在50%以下的样本,二者间差异有统计学意义(P<0.05)。结论CD45/CD61法能较好地检测微量的白细胞,为准确检测少白细胞血小板成分中残留白细胞的含量打下基础,使少白细胞血小板成分的质量控制更为准确。     

标本放置时间对成分献血者血常规中血小板计数的影响

目的探讨单采血小板无偿献血者血液标本放置时间对血常规检测中血小板计数的影响情况,选择合适的检测时间。方法选取单采血小板无偿献血者血常规标本50例,分别于0 h、0.5 h、1 h、3 h、6 h通过sysmex xs-500i血常规仪检测血小板计数。结果在室温条件下,血液标本放置0 h血小板计数偏低为(224.8±16.3)x109/L,与其它各组相比差异具有统计学意义(P0.05)。0.5-6 h血小板计数较稳定,差异无统计学意义(P0.05)。结论单采血小板无偿献血者血常规检测血小板计数在标本采集后即刻检测较放置0.5-6 h检测结果偏低,为保证单采血小板质量建议在标本采集后0.5-6 h进行血小板计数。     

流式细胞术计数血小板

目的　建立流式细胞仪计数血小板的实验方法。方法　用PE标记抗人CD61抗体标记全血中血小板 ,同时加入 5 μl已知浓度的FITC 微球溶液。流式细胞仪检测血小板 (FL2 )和微球 (FL1)的数量 ,换算出患者血小板浓度。结果　流式细胞仪法与血细胞计数仪法计数结果无显著性差异 ,低血小板组两法相关程度低于正常血小板组 ,提示流式细胞仪计数血小板能排除多种干扰因素 ,最低检出血小板量为 0 15 0× 10 9/L。该方法CV =5 4 % (Plt=2 2 0×10 9/L)和 11 1% (Plt=1 5 7× 10 9/L)。结论　流式细胞仪法适合对低血小板标本血小板的精确计数。     

血小板低渗休克反应检测方法的建立及应用

目的通过建立合适的低渗休克反应(HSR)检测方法,监测单采血小板在保存期内的HSR变化,以监控和评估单采血小板在保存期内的功能和质量状况。方法利用血液凝集仪,分别检测血小板与等渗磷酸盐缓冲液混合后的透光率变化值和血小板与去离子水混合后的透光率变化值,从而计算出HSR值。检测20份新鲜采集的单采血小板及10份在保存期的第1,3,5和7 d的血小板HSR变化。结果新鲜采集的单采血小板HSR正常参考值范围为58%~93%(80.35%±10.39%,n=20);单采血小板在保存期的第1,3,5和7 d的HSR分别为:75.85%±11.10%,74.00%±9.04%,71.39%±6.16%和68.85%±7.89%;各天之间比较均无显著性差异(P>0.1)。结论利用血液凝集仪检测HSR是一种合适的方法,具有简便、准确和重复性好的特点;单采血小板保存至7 d仍具有较好的抗低渗休克的能力。     

测定血小板中微量白细胞计数不同方法的比较

目的　建立一项能准确测定血小板中微量白细胞的测定方法。方法　比较分析牛鲍氏计数板计数法、血液细胞自动分析仪测定法和流式细胞仪测定法检测血小板中白细胞残留量的结果。结果　血液细胞自动分析仪测定法与牛鲍氏计数法、流式细胞仪测定法检测结果显著相关 ;但当白细胞 <2 0 0× 1 0 6/L时 ,牛鲍氏计数板计数法测得值为 0 ,血液细胞自动分析仪测定法测得值均显示为 2 0 0× 1 0 6/L,流式细胞仪计数法实际测得值与期望值接近。结论　在测定微量白细胞方面 ,流式细胞仪计数法是一种有效、准确、稳定的方法。     

重复血小板单采术对献血者和血小板产量的影响

13名符合加拿大红十字血液中心献血标准的献血者,用自动化Haemonetics V_(50) Surge机进行血小板单采,每个献血者在22天内进行10次单采。每次单采前、后及从单采的浓缩血小板液中无菌取样进行以下检测:血小板计数、平均体积分布、产品的血小板总数和白细胞计数。第1、7和10次单采前及末次单采后7天检测献血者的IgG、IgA和IgM含量,T_4和T_(?)淋巴细胞及血小板聚集反应。     

血小板单采样品中残留白细胞计数两种方法的评价

为评价流式细胞计数法和Nageotte血细胞计数法计数单采血小板中残留白细胞,应用系列的稀释实验研究其准确性;对已知白细胞浓度的同一样本,反复检测14次,研究其重复性;分别用流式细胞计数法和Nageotte血细胞计数法检测102份去白细胞的单采血小板样本,对其结果进行比较.结果发现,当白细胞浓度为0.8＜WBC/μl＜10时,两方法无显著差异（P＞0.05）.结论：两种方法均可用于少白细胞成分的质量控制.     

流式细胞术干/祖细胞分类计数在自体造血干细胞移植治疗恶性血液系统疾病中的应用

目的建立流式细胞术干/祖细胞分类计数方法,探讨其在自体造血干细胞移植治疗恶性血液系统疾病中的应用价值。方法以抗CD45-PC5/CD34-PE/CD38-FITC建立三色流式细胞术造血干/祖细胞分类计数方法,对患者自体干细胞移植动员效果、单采物质量及回输单采细胞进行定量检测。结果动员后样品检测分析发现,87.5%的患者动员效果较好,单个核细胞含量均在70.0%以上;CD34+细胞总数大于4×106/kg体质量者占90.0%。干细胞冻存样品检测分析发现,CD34+细胞数量冻存后存在一定衰减,但衰减量小于10.0%,经t检验证实冻存前后差异无统计学意义(P>0.05)。结论流式细胞术干/祖细胞分类计数在自体造血干细胞移植治疗恶性血液系统疾病中得到有效应用,单采细胞标本的定量检测为临床判断动员后单采时机、单采细胞质量、单采获得CD43+CD38-造血干细胞量、实际回输患者的CD43+CD38-造血干细胞量均提供了直接的科学数据。     

少白细胞血小板成分的白细胞亚群的分析

背景 少白细胞血小板可用过滤或单采处理来制备,两种方法都可使每份成分中剩余总白细胞含量小于5×10~6,但这些技术在除去白细胞亚群的效果上有所不同。设计与方法 采用两台多参数流动血细胞计数机用于分析两台单采机(Amicus和COBE Spectra)单采的血小板和6单位随机供者的过滤的少白细胞的血小板中的白细胞。结果 所有的成分含WBC小于1×10~5,Amicus和COBE spectra单采血小板成分WBC含量比用过滤法收集的血小板成份要多(P<0.05)。在所有成分中淋巴细胞(T和B)、单核细胞和粒细胞含量相比,Amicus和过滤采集的     

Ultrasonic study of venous patterns in the right hypochondrium: An anatomical approach to differential diagnosis of obstructive jaundice

Through real time ultrasonography, it is possible to display the splenic vein, the superior mesenteric vein, the vena porta, and the intrahepatic portal and systemic veins. In jaundice, it is of the utmost importance to carefully identify the vena porta before making a diagnosis of common bile duct enlargement. It is also necessary, when confronted with a pattern of apparently enlarged intrahepatic ducts, to conduct a thorough study of possible confluences of the ducts with the vena porta or vena cava to be certain that the ducts are not part of the portal or systemic venous network. Without such differentiation, portal enlargement caused portal hypertension, systemic venous enlargement caused cardiac insufficiency, or even nonpathological wide veins may lead to an erroneous diagnosis of obstructive jaundice.     

脑梗塞患者t-PA、PAI检测的临床意义

采用发色底物显色法检测34例脑梗塞患者血浆t-PA、PAI活性,结果t-PA 1.03±0.23 IU,PAI 9.05±1.12AU,与健康人比较有显著性差异(P<0.01).提示患者纤溶活性降低.本组呈现t-PA愈低,PAI愈高,患者病情愈重.复发机会愈多的趋势.我们认为t-PA及PAI活性的检测对脑梗塞及血栓前状态的诊断、治疗有一定的临床意义及参考价值.对使用纤溶剂出血等副作用的监测和预防有重要的临床意义.     

The clearance of Procalcitonin (PCT) during continuous veno-venous hemodiafiltration (CVVHD)

Objective. To evaluate the Procalcitonin (PCT) clearance during continuous veno-venous hemodiafiltration (CVVHD).?Design. Case report?Setting. Surgical intensive care unit?Patient. 51-year-old man, who had undergone total thyroidectomy about ten years before owing to multiple endocrine neoplasia 2 (MEN 2), suffering from multiple organ dysfunction syndrome (MODS) with acute renal failure after severe trauma caused by a traffic accident.?Measurements and main result. The samplings of prefilter (afferent) and post-filter (efferent) blood and of ultradiafiltrate were 6 times performed during 24 h of CVVHD to calculate the PCT clearance of hemdiafiltration.?During the first half period of CVVHD the serum PCT concentration did not decrease, though PCT had been eliminated from serum. On the other hand during the latter half period of it the serum PCT value decreased (from 46.8 ng/ml to 29.4 ng/ml) and the amount of the eliminated PCT from serum was about 100 ng per minute and its clearance was 2.3 ∼ 3.4 ml/min.?Conclusion. The CVVHD could eliminate PCT from serum. First it was brought about by the adsorption by the filter menbrane and then by ultradiafiltration. Received: 25 February 1999/Final revision received: 31 May 1999/Accepted: 9 June 1999     

周剂量多西紫杉醇联合顺铂二线治疗进展期胃癌的临床研究

目的 研究多西紫杉醇(TXT)联合顺铂(DDP)方案二线治疗进展期胃癌的疗效和毒副作用.方法 既往应用FOLFOX4或XELOX方案化疗进展的晚期胃癌患者36例,采用多西紫杉醇(艾素)35 mg/m2,第1、8天,静滴;顺铂20 mg/m2,第1～5天,静滴,21 d为1个周期.结果 36例患者中,CR 0例,PR 10例,SD 12例,PD 14例,客观有效率(CR+PR)27.8%,中位生存期6.5个月,中位肿瘤进展时间4.4个月.毒副作用主要为中性粒细胞减少.结论 多西紫杉醇联合顺铂方案二线治疗进展期胃癌有效率较高,有生存优势,毒副作用可耐受.     

The utility of < or =3-day-old whole-blood platelets in reducing the incidence of febrile nonhemolytic transfusion reactions

BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) to platelet transfusions have been linked to the presence of cytokines in supernatant plasma. Cytokine concentration is directly related to WBC content and storage time. This study evaluated the effect of limiting the storage time of random-donor platelet concentrates on the FNHTR rate. STUDY DESIGN AND METHODS: FNHTR rates were calculated retrospectively for single-donor apheresis platelet (SDP) and pooled random-donor platelet (PP) transfusions given during three consecutive 5-month study periods (November 1995 to February 1997) to patients on a single hematology/oncology/bone marrow transplant unit. Transfusion practice policies were: Baseline Period, SDPs preferred; Study Period A, PPs preferred; and Study Period B, < or =3-day-old PPs preferred. FNHTR rates were calculated from physicians' interpretations of reported reactions and the total number of SDP and PP transfusions in each period. SDPs were collected on two cell separators. All platelet components were filtered at issue in the laboratory by WBC-reduction filters. RESULTS: FNHTR rates for PP transfusions were: baseline, 11.1 percent (3/27); Study Period A, 4.6 percent (22/481); and Study Period B, 1.1 percent (3/282). The rates for SDP transfusions were 0. 15 percent (1/650), 0.75 percent (2/267), and 0.36 percent (1/273), respectively. The FNHTR rate for < or =3-day-old PPs was significantly less than the rate for older PPs (p = 0.0086 for Study Period A vs. Study Period B), and was not significantly different than that for SDPs (p = 0.33 for PPs vs. SDPs in Study Period B). CONCLUSION: Limiting transfusion of PPs to those stored 相似文献   

Single-donor platelets reduce the risk of septic platelet transfusion reactions

BACKGROUND: Septic platelet transfusion reactions (SPTRs) are the most common, serious risk of transfusion. Because SPTRs result from donor skin flora or asymptomatic bacteremia, the use of single-donor platelets (SDPs) has been proposed to reduce the risk of SPTRs from the risks with pools of platelet concentrates (PCs). STUDY DESIGN AND METHODS: Beginning in 1986, all febrile transfusion reactions were evaluated by culture of the platelet bag. Confirmed SPTRs were identified by isolation of the same bacteria from the bag and the patient's blood or by positive Gram's stain of the bag that confirmed a positive platelet culture. In 1987, a program to minimize PC use in favor of SDP use was initiated as a means of reducing SPTRs. RESULTS: In 12 years, the use of SDPs increased from 51.7 percent to 99.4 percent of all platelet transfusions at one institution. SPTRs fell from three events in 1 year to the current rate of one event per year. The incidence of SPTRs decreased from 1 in 4,818 transfusions to 1 in 15,098 transfusions. The rate of SPTRs due to PCs was 5.39 times higher than that of SPTRs due to SDPs (95% CI, 1.89,12.9). CONCLUSION: The use of SDPs is a simple means of reducing SPTRs. Other measures such as sterilization will be required to eliminate all SPTRs.     

Intermittent hypoendorphinaemia in migraine attack

Beta-endorphin (RIA method, previous chromatographic extraction) was evaluated in plasma of migraine sufferers in free periods and during attacks. Decreased levels of the endogenous opioid peptide were found in plasma sampled during the attacks but not in free periods. Even chronic headache sufferers exhibited significantly lowered levels of beta-endorphin, when compared with control subjects with a negative personal and family history of head pains. The mechanism of the hypoendorphinaemia is unknown: lowered levels of the neuropeptide, which controls nociception, vegetative functions and hedonia, could be important in a syndrome such as migraine, characterized by pain, dysautonomia and anhedonia. The impairment of monoaminergic synapses ("empty neuron" condition) constantly present in sufferers from serious headaches, could be due to the fact that opioid neuropeptides, because of a receptoral or metabolic impairment, poorly modulate the respective monoaminergic neurons, resulting in imbalance of synaptic neurotransmission.     

WBC-reduced platelet concentrates from pooled buffy coats in additive solution: an evaluation of in vitro and in vivo measures

BACKGROUND: The use of a platelet additive solution (PAS-II, Baxter) may have benefits over plasma for storage of platelets. It was the aim of this study to develop a method to produce WBC-reduced platelet concentrates (PCs) in PAS-II with >240 x 10(9) platelets and <1 x 10(6) WBCs per unit, which can be stored for 5 days at pH >6.8 and that will give sufficient platelet increments after transfusion: a 1-hour CCI of >7.5 and a 20-hour CCI of >2.5. STUDY DESIGN AND METHODS: PCs were made from five pooled buffy coats and 250 g of PAS-II. After centrifugation the PCs were WBC-reduced with a filter (Autostop BC, Pall Biomedical) and stored in a 1000-mL polyolefin container. CCIs were assessed in stable hemato-oncologic patients after 5-day old PCs were transfused. RESULTS: Routinely produced PCs contained a median of 310 x 10(9) platelets (n = 5,363) with 3.5 percent containing <240 x 10(9) platelets, in a median volume of 320 mL (n = 11,834). The median number of WBCs was <0.03 x 10(6) (n = 694). The WBC count exceeded 1 x 10(6) in three PCs, but it was always <5 x 10(6), giving 99-percent confidence that more than 99.5 percent of the units will contain <1 x 10(6) WBCs. The pH remained >6.8 on Day 8, provided the concentration was below 1.1 x 10(9) platelets per mL (n = 32). After 28 transfusions in 28 patients, the 1-hour CCI was 12.6 +/- 4.3 (mean +/- SD, with 2/28 CCIs <7.5) and the 20-hour CCI was 8.9 +/- 5.6 (with 4/28 CCIs <2.5). Limitations of this study include the absence of a control group of patients receiving platelets stored in plasma and of in vivo radiolabeled survival studies, but a comparison of these data with previously published data suggested that the in vivo survival of platelets stored in PAS-II is less than that of platelets stored in plasma. CONCLUSION: The WBC-reduced PCs conformed to specifications. These WBC-reduced PCs could be stored at least 5 days with maintenance of pH, and they gave sufficient increments after transfusion to patients.     

白介素和集落刺激因子对5-Fu处理小鼠脾集落形成的影响

给小鼠静脉注射5-fluorouracil(5-Fu),4日后将鼠脾细胞与各种细胞因子混合培养观察集落形成情况,结果表明IL-3作用于小鼠脾细胞CFU-S阶段,其作用与IL-3的剂量有关,红细胞生成素(EPO)作用于红细胞系CFU-S以下的分化成熟,IL-6,G-CSF,GM-CSF作用于粒细胞系统的分化成熟,IL-3与EP0,IL-6,G-CSF和GM-CSF均有协同作用。     

纳洛酮对心肺脑复苏作用的评价

目的 :①观察研究纳洛酮在心肺脑复苏中的作用机理及实际疗效 ;②研究心搏骤停患者血中 β -内啡肽 (以下简称 β -EP)与正常人的差异。 方法 :①随机划分急诊和住院抢救的心搏骤停患者为纳洛酮复苏组与常规复苏组两组。前者以常规复苏为基础 ,再给予纳洛酮2 0mg加生理盐水 2 0ml静注 ,并可间隔 30min多次重复使用。②对常规复苏组和对照组 2 0例健康体检者均抽静脉血 5ml入专用抗凝管离心取血清存放于冰箱、集中一次测定 β -EP。 结果 :纳洛酮组复苏成功率 42 9% ,常规组复苏成功率 14 3% ,纳洛酮组复苏成功率显著高于常规组(P <0 0 5 )。心搏骤停患者血中 β -EP含量较正常人明显增高。 结论 :纳洛酮作为阿片受体纯拮抗剂 ,从多个环节中促进了心肺脑诸器官复苏 ,故临床应用纳洛酮可明显提高心肺脑复苏成功率