成份输血及其临床应用

随着医学科学的发展,有关输血技术也在不断发展提高,传统的输全血已成为旧的概念,不合理地滥输全血,非但无益反而有弊的观点已逐渐为广大医务人员所接受。首先是全血并不全,它存在着各种缺陷,如临床应用的库血,随着保存期的延长,所有成份都在变化,有效成份不断损失,活性下降。其次库血在保存过程中血钾、乳酸、氨、各种代谢产物不断增加。这样的全血不可能达到良好疗效。许多病人实质上只需全血申的某种或几种成份,但由于全血中单一成份含量少,浓度低,为了达到治疗效果,只好大量输库血,使大量不需要的成份也随同输入,这不仅是浪费,而且还增加了输血不良反应的发生率,造成得不偿失的结果。     

CPD血液保存液保存全血的生化指标动态观察

目的探讨CPD全血在2-6℃保存期内的生化指标变化,为临床输血提供相关信息。方法10份CPD全血于2-6℃保存。保存24h,4,10,15,21d时,用电解质分析仪测定全血pH、Na+、K+、Cl-;用干化学分析系统测定全血氮;用酶法测定全血乳酸;用比色法测定血浆游离血红蛋白含量。结果CPD全血保存21d内Cl-变化很小;pH及Na+随保存日期延长而逐渐降低;K+、乳酸、血氨、游离血红蛋白随保存期延长显著增高。结论高血钾症、肝肾功能不全的患者如有输血适应证时,应输保存5d内的CPD全血。     

浅谈开展成份输血的价值与意义

成份输血就是根据患者的病情,为患者提供所需血液成份,以此来达到治疗疾病的目的。成份输血相比于传统的全血输血,其能够避免患者因为输血而出现不良反应,从而进一步提高治疗效果,达到一血多用,节约血液资源,减少血液浪费的目的,所以开展成份输血是非常必要的,很值得在临床上广泛使用。     

使用白细胞滤器制备的红细胞临床应用观察

目的　探讨少白细胞的红细胞制备方法,并对临床输注效果进行评价。方法　用白细胞过滤器对血液及血液成分进行贮存前过滤,去除白细胞得到少白细胞的红细胞。经用国家卫生部规定的质量标准对该制品进行质量检测,并对临床上输注去除白细胞的全血及浓缩红细胞输注效果及输血反应率进行分析。结果　应用该方法制备的少白细胞红细胞,经检测各项指标均达到了标准要求,经临床应用后,输血不良反应发生率降低到零。结论　该制备方法达到了高白细胞性白血病患者输血要求,避免输注含白细胞的血液引起的并发症,使安全输血得到了保障。     

血液成分的临床应用

血液成分的临床应用０５００７１河北省血液中心李成生血液成分的临床应用是输血技术的重大发展。是用物理方法将全血中的有效成份分离，精制成高纯度、高浓度制剂，根据病情需要输入一种或几种，临床把这种输血方式叫做成分输血。成分输血与输全血相比优点是：纯度高、疗...     

在骨髓移植中输注自体全血与红细胞的效果观察

输血在很大程度上影响骨髓移植的成功.骨髓移植的供髓实际上是干细胞、造血前期细胞与血液的混合物,或称为骨髓血.患者在移植前经过大剂量放、化疗的预处理后骨髓受到严重抑制,全血细胞减少,此时输血是不可缺少的支持疗法[1].在成份输血及自体输血广泛用于临床的今天,为使输血更为合理,保证骨髓移植后的血象稳定,现将我院在骨髓移植中输注自体全血和自体红细胞的应用报告如下.     

储存期内血钾浓度测定与临床输血

目的 了解全血血浆离子随着储存期延长的变化,为临床输血提供参考.方法 对库存全血30袋于采集当天、第7天、第10天、第15天、第21天和第28天分别测定血浆中K 、Na 、Cl-离子浓度和红细胞数量.结果 库存血测定当天和第7天血液K 离子浓度数值变化不大,但第10天、15天、21天和第28天测定的血液K 离子浓度值分别为当天测定值的3～7倍,从储存期10天开始后K 离子浓度与储存期0～7天比较,P＜0.01.储存期间Na 、Cl-离子浓度未见明显改变(P＞0.05).红细胞随着储存期延长而减少.7天以内减少2%;第10天大约减少5%;第15天减少约10%;第21天减少约14%;第28天减少约20%.结论 库存全血K 离子浓度随存放时间延长而升高,而Na 、Cl-离子浓度无明显改变,临床上对心肾肝功能不全及大剂量输血病人宜考虑输注成分血或新鲜血液.     

1999年度芜湖市成份血制品临床应用分析

成份输血是全血采出后通过物理(离心)或化学的方法将其各种成份进行有效的分离,然后根据病情选择性地输注相应的血液成份。现就我市１９９９年度成份血临床应用情况作一分析。１材料和方法１１制备成份血使用的材料全封闭塑料三联、四联采血袋由广州血液中心提供,袋内含有专为保存红细胞用的ＳＡＧＭ配方的红细胞保存液。机采血小板塑料套材由美国ＨＡＥ＿ＭＯＮＥＴＩＣＳ公司提供。白细胞过滤器由上海血液中心提供。大容量低温离心机为美产ＢｅｃｋｍａｎＪ＿６Ｂ和Ｊ６＿ＭＩ型。血细胞分离机为美国产ＭＣＳ＿３Ｐ型。１２制备成份血的方…     

红细胞的输注及护理

由于红细胞制剂较全血粘稠度高 ,红细胞压积≥ 70 % ,因此它较其它成份血和全血的输注有许多不同之处。为了较好的完成红细胞的输注 ,现就如下问题谈谈自己的认识及工作体会 ,供参考。1　输注前准备1.1　接到输血通知单 ,核对受血者与献血者Ａ、Ｂ、Ｏ和Ｒｈ系统 ,交叉配血试验等各项内容均完全符合后才能进行输注。1.2　取血后检查血袋是否完好 ,贮存时间 ,有无溶血、凝块及气泡等现象 ,确定无疑问 ,用双手反复颠倒数次使其混匀。1.3　取带滤网的输血器 ,滤网孔径应用标谁为 170 μｍ ,过滤面积为 2 4～ 34ｃｍ2 [1] ,过滤面积太小时容易被…     

成份输血的临床应用及发展前景

成份输血是把全血 (ＷＢ)中的各种成份用物理方法分离出来制成浓度和纯度较高的血液成份制剂 ,然后根据病人的病情需要 ,以缺什么补什么的原则 ,选择性地输注某一种成份 ,以达到治疗疾病的目的。1　成份输血的意义血液是由许多具有不同生理功能的成份组成。由于血液生化、血液分离保存技术、特别是血液免疫学的发展 ,人们认识到现代输血无处不存在输血后同种免疫问题。而这些具有不同生理功能的血液成份本身就构成了成份输血的先决条件。因为成份输血具有目的明确、使用合理、纯度高、疗效好、副作用小、节约血源、便于保存等优点[1 ] 。世…     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.