献血者捐献机采血小板对外周血部分实验室检查指标的影响

目的观察献血者捐献机采血小板后对外周血部分实验室检查指标的影响,以保证血液质量和献血者的健康安全。方法选取2016年3‐2016年7月于该站捐献机采血小板(Plt)的献血者70人作为研究对象,分别于捐献血小板前、后检测献血者血常规、血浆蛋白、免疫球蛋白及电解质K~+、Cl~-、Ca~(2+)、Na~+等指标。结果献血者捐献机采血小板后30 min,其Plt水平较献血前显著降低,比较差异有统计学意义(P0.05),白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)和红细胞比积(Hct)与献血前比较差异无统计学意义(P0.05);献血后14 d上述血常规指标与献血前比较差异无统计学意义(P0.05);捐献机采血小板后30 min血浆中K+、Cl~-、Ca~(2+)、总蛋白(TP)、白蛋白(ALB)及免疫球蛋白(Ig)G、IgA和IgM浓度较献血前显著降低,比较差异有统计学意义(P0.05);献血后14d K~+、Cl~-、Ca~(2+)及IgG、IgA和IgM浓度与献血前比较差异无统计学意义(P0.05),TP、ALB与献血前比较差异有统计学意义(P0.05),献血后30 min和献血后14d Na~+与献血前比较差异均无统计学意义(P0.05)。结论献血者捐献机采血小板后短时间内血小板、血细胞、电解质及血浆蛋白可恢复至正常,对身体影响较小,不会引起电解质紊乱和低蛋白血症。     

血细胞分离机行外周血单个核细胞采集前后肿瘤患者血电解质变化的比较

目的观察COM．TEC型血细胞分离机MNC程序采集外周血单个核细胞（简称为单采）前后肿瘤患者血电解质指标的变化。方法用COM．TEC型血细胞分离机MNC程序采集54例肿瘤患者外周血单个细胞，单采前有3 d内的血电解质结果，单采后立即检测采集血液标本电解质。观察单采前后血液电解质的变化情况。结果单采后患者血K＋、血Ca 2＋与采集前比较明显下降（P＜0．05），而血Na＋、血Cl－采集前后无变     

采用胸腹腔漏出液进行体外循环心肺转流1例报告

目的：探讨采用胸、腹腔漏出液作为心肺机预充液进行体外循环的临床可行性。方法：对1例体外循环心肺转流患者体外转流前和转流期间分次抽取胸、腹腔漏出液3900ml经孔径40цm滤网过滤后分别进入体外循环。于手术前、转流停机后及手术后24天，测定血浆总蛋白、白蛋白、尿素氮、肌酐、血细胞比容、血红蛋白、血小板计数、凝血酶原时间、血浆电解质含量和血气分析及体温变化观测。结果：体外转流停机时超滤出水分2900ml，尿量900ml；血浆总蛋白回升至54g/L，白蛋白至32g/L以上。尿素氮、肌酐正常，血细胞比容、血红蛋白变化不明显，血浆电解质、血气分析在正常范围。患者术后无发热、感染、精神障碍及心衰、肺水肿。     

单采血浆术前、后体内总蛋白等6项指标含量测定

<正> 单采血浆术已作为制备新鲜冰冻血浆的一个重要方法。通过对90例献血员干单采血浆术前、后体内总蛋白、白蛋白、球蛋白、红细胞、血红蛋白、血小板的含量的测定,分析总结如下: 资料和方法 1 献血员的选择 参照卫生部1984年10月颁发的《献血员体格检查参考标准》,按照国家频布的单采血浆术规程要求,各项指标检查     

6％羟乙基淀粉液用于小儿体外循环的临床观察

目的：探讨6％羟乙基淀粉液对行体外循环术小儿血细胞比容，血浆总蛋白，血浆电解质，血小板计数，激活全血凝固时间，凝血酶原时间及血气分析的影响。方法：40例小儿随机分为6％羟乙基淀粉组（HES组），输库血组（SBT组），每组20例，观察术前，心肺转流15min，返回ICU，术后48h上述指标的变化。结果：血细胞比容，血浆总蛋白在心肺转流15min时，HES组和SBT组呈中深度血液稀释，返回ICU时血细胞比容，血浆总蛋白均明显回升，血小板计数SBT组高于HES组，激活全血凝固时间，凝血酶原时间，血浆电解质均在正常范围，血气分析亦显示术后2组无明显变化。结论：采用6％羟乙基淀粉血液稀释用于小儿心内直视手术是较安全有益的方法。     

急性脑梗死与相关分子标记物的研究

目的测定脑梗死患者血浆中总蛋白S（TPS）、组织型纤溶酶原激活剂（t-PA）、血管性血友病因子（vWF）及纤维连接蛋白（Fn）含量，以探讨这些分子标记物与脑梗死之间的关系。方法均采用ELISA法测定脑梗死患者与正常对照组血浆中TPS、t-PA、vWF和Fn的含量。结果脑梗死患者血浆中TPS和t-PA含量较正常对照组低（P〈0．01或0．05），有统计学意义；脑梗死患者血浆中vWF和Fn含量较正常对照组高（P〈0．01），有显著差异。结论血浆中总蛋白S、组织型纤溶酶原激活荆、血管性血友病因子及纤维连接蛋白量变化与脑梗死的发病密切相关。     

血浆纤维连接蛋白水平与肝脏疾病的关系

对114例不同肝脏病患者和30例正常人血浆纤维连接蛋白（Fn）进行了测定，同时检测肝功能各项指标。结果，正常对照组血浆Fn水平为2．94±0．60g／L，与对照组相比，急性肝炎（2．71±0．92g／L）、慢性活动性肝炎（2．82±0．94g／L）无显著差异（P＞0．05）；重症肝炎（1．64±0．68g／L、肝硬化（1．53±0．57g／L）显著降低（P＜0．001）。丙氨酸转氨酶（ALT）在30u以下者，Fn浓度在正常范围，随ALT升高，Fn水平降低。血浆Fn与肝功能各指标相关分析表明，血浆Fn与ALT、血清总胆红素（TBil）、直接胆红素（DBil）和麝香草酚浊度（TFT）呈负相关，与总蛋白（TP）和白蛋白（Alb）呈正相关，其中与ALT（r＝－0．8393）和Alb（r＝0．9377）相关性有显著意义（P＜0．05，P＜0．01）。上述结果提示血浆Fn水平与肝脏病的严重性及肝功能的损害程度有一定关系。     

单采血浆站机械单采血浆量与相关因素的研究

目的 研究影响机械单采血浆量的因素.方法 随机抽取单采血浆站21台单采血浆机,统一设置单采血浆机采浆参数.设定可能影响采浆量的因素并测定其数值,称定所采集的浆量,进行统计学分析.结果 (1)采浆量呈正态分布;(2)采浆量与所设定的相关因素之间没有统计学相关意义;(3)采浆量均数调整为X=590 g(采浆机总采浆量参数设定约为595 g)时,即可同时兼顾降低采浆量≥600 g和采浆量≤580 g的概率.结论 采浆量(含抗凝剂)＞600 g属随机误差.     

压疮患者内环境及生化指标与年龄的相关性研究

目的研究年龄与压疮患者内环境及生化指标的相关性。方法对1 752例压疮患者病例资料采取回顾性分析,按不同年龄段进行分组,将不同组患者生化指标进行统计学分析。结果年龄与压疮分级关联性分析:5～8年龄段与压疮具有关联性,差异有统计学意义(χ2=33.406,r=0.281,P0.05)。年龄段(1-8)蛋白指标总体比较:总蛋白(P=0.034)、白蛋白(P=0.026)、球蛋白(P=0.031)差异有统计学意义;两两比较显示:年龄段1(24岁以下)与年龄段2(25～34岁)相比,总蛋白差异有统计学意义(P=0.038﹚;年龄段4(45～54岁)与年龄段5(55～64岁)相比,前白蛋白差异有统计学意义(P=0.019);年龄段7(75～84岁)与年龄段8(85～95岁)相比,总蛋白(P=0.009)与蛋白(P=0.014)差异均有统计学意义;年龄段1与8相比,总蛋白(P=0.011)与白蛋白(P=0.013)差异均有统计学意义。其余各年龄段各指标之间比较差异均无统计学意义(P0.05)。在电解质指标上,年龄段3(35～44岁)与年龄段4相比,血钾差异有统计学意义(P0.05);年龄段5与年龄段6(65～74岁)相比,血钠、血氯化物差异有统计学意义(P0.05);其余各年龄段电解质各指标之间比较差异均无统计学意义(P0.05)。结论在压疮预防与治疗过程中要结合患者年龄情况,加强对患者内环境及相关生化指标变化的关注,并及时调整护理方案,可有效降低压疮发生率。     

1296例次单采血浆的不良反应分析

１２９６例次单采血浆的不良反应分析宁波市中心血站付军宁波市第一医院张校明单采血浆术简称采浆术，是目前血站提取大量新鲜血浆的最常用方法。单采血浆对献血员身体影响小，其损失的血浆蛋白恢复快，而采浆中献血员的反应与采浆的顺利与否，有着直接的关系。现将市中心...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.