急性造血功能停滞

急性造血功能停滞山东医科大学附属医院（２５００１２）纪春岩，王学永，王应急性造血功能停滞（ＡＡＣ）可由多种原因所致。表现为血中红细胞及网织红细胞减少或全血细胞减少。本病命名相当混乱。亦有称之为再生障碍危象（ａｐｌａｓｔｉｃｃｒｉｓｉｓ）、急性幼红细胞...     

外用磺胺药导致急性造血功能停滞1例

急性造血功能停滞是一种因过敏或感染引起的骨髓造血功能暂时障碍综合征，可以是某一细胞系停滞，也可是全血细胞暂时停滞。现将我们诊治的１例急性造血功能停滞—全血液细胞型报道如下。患者女，３３岁。１９９４年５月２０日自觉无何诱因突然发热，体温达３９℃，继之乏...     

急性造血功能停滞一例

急性造血功能停滞亦称骨髓再生障碍危象、急性纯红细胞再障(Acute Pure Red Cell A plasia,APRCA),是急性自限性、可逆性的血液系统疾病.由于其血象及骨髓象的特殊表现,而易误诊为其它恶性疾病。现将我院所见一例报导如下.     

红细胞生成素在肾脏病中作用的研究进展

红细胞生成素(EPO)是一种多功能性细胞因子,其主要作用为调控骨髓中红细胞的产生,促进红系祖细胞增殖、分化为成熟红细胞,临床上主要用于治疗贫血.近年来的实验研究显示,EPO对非造血组织、器官具有保护功能,特别是肾脏.本文对近年来关于EPO非造血作用的相关研究进行综述.     

他巴唑致急性造血功能停滞12例分析

急性造血功能障碍是一组由多种因素引起的骨髓造血功能停滞。感染和药物史是常见病因,而他巴唑引起者少见报道。我院１９８９～１９９８年共收治因口服他巴唑致急性造血功能停滞１２例,现报告如下。１　临床资料１．１　一般资料　１２例均系住院病人,男４例,女８例,年龄２５～４０岁,临床均确诊为甲状腺功能亢进症（下称甲亢）,发病前除口服他巴唑抗甲亢治疗外,无其他特殊药物应用史。病因导致造血停滞时间分别为１４～４０ｄ,平均２８ｄ。服他巴唑总剂量１４０～１５００ｍｇ,平均８８０ｍｇ,造血停滞时间为９～５０ｄ,平均１…     

急性造血功能停滞23例临床分析

作者分析了急性造血功能停滞23例,其发病多与感染特别是病毒感染或服用某些药物所诱发的免疫机理有关.结合骨髓增生程度和周围血象可分为为纯红再障型、中间型和再生障碍型.本病多为自限性,一旦确诊应给予抗生素和病原治疗.     

药物及化学中毒相关性贫血

药物及化学中毒主要通过损伤或抑制造血干祖细胞,导致造血功能衰竭,使红细胞生成减少或影响红细胞寿命而引发贫血.详细病史询问和体格检查能提供许多线索,实验室检查有助于进一步明确贫血类型.应及时脱离致病药物及化学物的接触,排出和中和毒性物质,积极支持治疗和时症治疗.部分患者应长期随访,评价病情变化.     

急性造血功能停滞：附10例报告

本文报告10例急性造血功能停滞。血象显示白细胞减低,网织红细胞消失;骨髓粒系、红系及巨核细胞呈病理性改变。10例均检出巨大原始细胞。现已证实:该病由人类细小病毒促发。本文10例均服用过解热药,不除外药源性免疫反应所致。巨大原始细胞表现3种形态学特点,认为该细胞来源于原始红细胞。     

肾综合征出血热并发急性造血功能停滞的临床观察

目的 观察肾综合征出血热(HFRS)并发急性造血功能停滞(AAH)的临床特点,疗效和预后.方法 对18例HFRS并发AAH患者的临床特点进行回顾性分析.结果 18例HFRS患者,男10例.女8例,年龄14～55岁,发病第9～25天出现不规则发热、突发性贫血和多部位出血,外周血WBC降至(2.3～3.2)×109/L,PLT降至(23～31)×109/L,RBC降至(2.23～2.79)×1012/L,Hb降至52～67 g/L,网织红细胞0～0.002.骨髓穿刺(56次)示红细胞系增生降低,粒、红细胞比例明显升高,粒细胞系和巨核细胞系增生降低.采用糖皮质激素和输血为主的综合性治疗措施,26～60 d治愈.结论汉坦病毒感染可并发AAH,其预后良好.     

急性造血功能停滞—附6例报告

急性造血功能停滞或称再生障碍危象、急性纯红再障,是由多种原因所致的骨髓造血功能突然停滞。可自然恢复,故亦谓“自限性急性再生障碍性贫血综合征”。近些年来,对本病有所认识,陆续有报告,绝非罕见。我院从1977年7月至1989年10月见到6例,报告如下。临床资料一.一般资料:男2例,女4例,年龄23～65岁。二.临床表现:以高热起病者4例,发热、苍白、头晕、乏力者2例,皮肤出血3例。鼻衄、龈血2例。三.原发病:上呼吸道感染4例(例1、3、4、     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.