4种新鲜冰冻血浆质量分析

目的:分析4种新鲜冰冻血浆(FFP)部分有效成分的含量,为临床使用提供实验依据。方法:随机抽取20袋新鲜全血,每袋(400±40)ml,按照标准操作规程分别制备出4种FFP,分别为:FFP、去白细胞新鲜冰冻血浆(去白细胞FFP)、病毒灭活新鲜冰冻血浆(病毒灭活FFP)、去白细胞病毒灭活新鲜冰冻血浆(去白细胞病毒灭活FFP)。采用凝固法检测凝血因子Ⅷ含量(FⅧ:C)及纤维蛋白原含量(Fg);采用双缩脲法检测血浆蛋白含量。结果:血浆经过单纯滤除白细胞后Fg含量为(1.913±0.209)g/L,与FFP比较差异有统计学意义(t=3.797,P0.01);经过单纯病毒灭活之后FⅧ:C含量及Fg含量分别为(0.699±0.174)IU/ml、(1.114±0.232)g/L,与FFP比较t值分别为4.071、16.201,差异均有统计学意义(均P0.01);经过滤除白细胞及病毒灭活2道工序之后,则FⅧ:C含量、Fg含量及血浆蛋白含量分别为(0.471±0.071)IU/ml、(1.033±0.159)g/L、(55.6±2.7)g/L,与FFP比较t值分别为9.860、21.819、2.882,差异均有统计学意义(均P0.01);与病毒灭活FFP比较,去白细胞病毒灭活FFP FⅧ:C含量下降了32.6%。结论:4种FFP中,去白细胞病毒灭活FFP有效成分含量最低,其中FⅧ:C含量低于国家标准。在临床使用这4种FFP时应注意其区别,作为冷沉淀凝血因子原料血浆时应注意其质量的不同。     

肝硬化患者检测血浆神经肽Y的临床意义

研究肝硬化患者血浆神经肽Y的变化及其临床意义。肝硬化患者 6 4例。男 40例 ,女 2 4例 ,平均年龄 45岁± 2 3岁。其中乙型肝炎性肝硬化 5 7例 ,丙型肝炎性肝硬化 2例 ,酒精性肝硬化 4例 ,心源性肝硬化 1例 ,伴消化道出血 2 0例 ,腹水 36例 ,肝性脑病 12例和肝肾综合症 4例。按肝功能分级Child分级 :A级 2 8例 ,B级 2 3例 ,C级 13例。采用RIA法检测空腹血浆NPY水平 ,并与 40例 (男 2 6例 ,女 14例 ,平均年龄 42岁± 2 0岁 )健康人作对照。肝硬化A级患者血浆NPY含量 (12 1 6± 2 8 9) pg/ml低于健康对照组 (142 3± 40 5 ) pg/ml(P <0 0 5 )。肝硬化B级 (6 3 4± 2 4 8) pg/ml,C级 (4 5 6± 2 1 7) pg/ml患者血清NPY含量显著低于健康对照组及肝硬化A级患者 (P <0 0 1)。肝硬化患者血浆NPY含量显著低下 ,并随肝功能损害程度加重而下降更多 ,提示NPY可能参与了肝损害的病理过程 ,并与肝功能分级有关。     

病毒性肝炎患者血浆蛋白含量测定及意义

为探讨人体血浆蛋白含量的测定在评价病毒性肝炎的病情轻重、预后、病变的活动性和鉴别诊断,我们对93例病毒性肝炎同时进行八项血浆蛋白含量的测定,现将结果报告和讨论。一般资料一、病例选择:93例病毒性肝炎中急性25例,慢性迁延型21例,慢性活动型28例,慢性重症型19例。诊断分型按1990年上海第     

不同时间制备的新鲜冰冻血浆及冷沉淀中凝血因子比较

目的:比较不同时间制备的血浆及冷沉淀的质量。方法:选取8h、8~18h制备的新鲜冰冻血浆(FFP)、冷沉淀标本各50份,检测FⅧ、FⅤ及Fib并分析合格率。结果:8h内制备的FFP与8~18h制备的FFP相比,前者的Fib、FⅧ、FⅤ因子含量均显著高于后者(P0.05),2组的FⅧ含量合格率分别为100%、92%,差异无统计学意义(χ2=2.34,P0.05)。8h内制备的冷沉淀中Fib、FⅧ、FⅤ因子含量显著高于8~18h制备的冷沉淀(P0.05),2组的冷沉淀总合格率分别为98%、82%,差异有统计学意义(χ2=7.11,P0.05)。结论:8~18h制备的FFP中FⅧ含量也能达到质量要求;冷沉淀应从8h内制备的FFP来分离。     

肝病患者血浆凝血因子X活性测定的临床意义

采用二步法血浆凝血因子X测定方法检测了96例肝病患者的血浆凝血因子X活性,且与60例健康成人进行了对比分析。结果发现,急性血吸虫性肝病患者血浆凝血因子X活性较正常人低,但差异无显著意义(P>0.05);慢性持续性肝炎患者的血浆凝血因子X活性与正常组比较差异有显著意义(P<0.05);代偿期的病毒性肝硬化和代偿期血吸虫病性肝硬化患者的血浆凝血因子X较正常组的因子X活性极明显降低(P<0.001);失代偿期病毒性肝硬化患者的血浆凝血因子X活性进一步下降。结果显示:随肝细胞受损害程度的加深,血浆凝皿因子X活性呈梯度下降。     

血液病患者血浆凝血因子X活性测定的临床意义

我们于1990年11月以来对54例住院血液病患者的血浆因子X活性进行了检测,并设对照组对比。1 检测对象 ①对照组:对平素健康、无肝肾疾病者测定血浆凝血因子X60例,男38例,女22例,年龄18～60岁。②血液病组:均系经临床确诊住院病人54例,男34例,女20例,年龄20～65岁。其中白血病16例,再生障碍性贫血4例,难治性贫血8例,溶血性贫血5例,营养不良性贫血16例,血友病甲1例。     

脑梗死患者血清中血浆蛋白C及蛋白S的临床意义

目的：测定脑梗死患者血浆蛋白C及蛋白S的含量,探讨其临床意义,以期为研究脑梗死的发生、发展提供理论支持.方法：本实验以160例脑梗死患者血清标本作为观察组,同时选择体检为正常成人的100例血清标本作为对照组,检测二组血清中血浆蛋白C及蛋白S的含量,分析其在不同病情程度的含量差别.结果：血浆蛋白C及蛋白S在脑梗死患者患者血清中低表达,且血浆蛋白C及蛋白S的含量与梗死范围有关.脑梗死患者血清中血浆蛋白C及蛋白S的含量呈正相关.结论：血浆蛋白C及蛋白S在脑梗死患者血清中低表达,二者在脑梗死患者发生发展中具有重要作用,早期检测血浆蛋白C及蛋白S可能对判断脑梗死的病情有重要价值.     

肺癌患者血浆一氧化氮含量检测及临床意义

目的　探讨肺癌患者血浆一氧化氮浓度变化的临床意义。　方法　采用分光光度法对 4 8例肺癌患者进行了血浆一氧化氮含量检测。　结果　 4 8例肺癌患者与正常对照组血浆一氧化氮分别为 5 90 2 μmol L±1 15 7μmol L和 2 0 16 μmol L± 0 5 2 4 μmol L ,二者有显著差异 (P <0 0 5 )。　 结论　高水平一氧化氮与肺癌发生、发展有关。血浆一氧化氮高低对肺癌预后起一定作用。     

血浆因子X活性的改变在血栓前状态和血栓病中的意义

血浆凝血因子X是人体血液凝固共同途径的凝血因子之一。据国内外研究表明:因子X的活性可以敏感地反映人体凝血功能的改变。因此,因子X的测定对于DIC的诊断,一般血栓病以及血栓前状态的判断都有较重要的临床价值。我室采用自行设计的血浆因子X二步测定法,测得健康人、血栓病和血栓前状态病例的因子X活性,现报道如下:1 材料与方法1.1 研究对象正常组:健康献血员65例,男33例,女32例。年龄20～45岁。一般血栓病组:其中     

核黄素光化学法对血浆凝血因子活性影响的实验研究

目的：观察核黄素光化学法处理对血浆凝血因子活性和凝血功能的影响,探讨光化学法处理时间与凝血因子活性及凝血功能改变之间的关系。方法：采集健康献血者新鲜血液,立即分离血浆,经核黄素光化学法处理后立即检测血浆凝血因子活性和血浆PT、APTT、TT、纤维蛋白原浓度及血浆pH值,观察处理前后及各处理因素对上述试验结果的影响。结果：经核黄素光化学法处理后的血浆Ⅴ因子、Ⅷ因子、X因子活性分别下降17.51%、28.34%、12.63%。结论：光化学法处理后的血浆凝血因子活性有一定下降,应用于临床时应注意其量效关系的变化。     

O-antigenic specificity of the protective supernatant factor from Salmonella typhimuvium effective in S. typhimurium-infected mice

A supernatant factor (SF) prepared from cultures of Salmonella typhimurium protected naturally susceptible inbred mice against challenge with S. typhimurium subcutaneously injected (s.c.i.), but not against Salmonella enteritidis, suggesting tha the relevant specificity involved lipopolysaccharide. Further experiments were performed with two transductant strains of S. typhimurium. Strain SH6701 has O-antigen 4 from S. typhimurium and SH6703 had O-antigen 9 from S. enteritidis. Immunization with SF from SH6701 protected 95% BALB/c mice challenged with 100 LD50 S. typhimurium s.c.i., whereas SH6703 immunization had no effect on survival or mean survival time. SH 6703 SF gave some protection against homologous challenge. Antibody titres and delayed-type hypersensitivity reactions were also tested in immunized mice. The SF was, therefore, specific in that O-antigen 4 was necessary to protect mice against S. typhimurium challenge. Since we have previously demonstrated protein to be necessary for protection by SF, the active factor may be in the form of a protein-lipopolysaccharide complex.     

Occurrence of cold activation of transfusion plasma during storage at +4 degrees C

BACKGROUND AND OBJECTIVES: The storage of transfusion plasma at +4 degrees C sometimes leads to the activation of several proteolytic systems. In this study the frequency of cold activation was investigated, as well as whether cold activation of plasma is an individually recurrent property of the donor. MATERIALS AND METHODS: Plasma units prepared from whole blood obtained from 100 male donors were stored at +2 degrees to +5 degrees C, in bags for 28 days and in cryotubes for up to 42 days. Samples from plasma units, collected by apheresis from 100 male donors, were stored in cryotubes for up to 42 days. Cold activation was measured weekly as kallikrein-like activity of plasma. Samples from repeat apheresis plasma units from 32 donors were measured 12-20 months later. The effects of storage on the contact, coagulation and fibrinolytic systems were determined. RESULTS: The cumulative frequency of cold-activated plasma units stored in bags was 5% on day 7 and 18% on day 28. After 42 days in cryotubes, 49% of the plasma units were cold activated. Large intraindividual differences in the onset-day of cold activation were observed in plasma samples of some donors. During cold activation, an increase in kallikrein-like activity was accompanied by a decrease in C1 esterase inhibitor activity and an increase in the concentrations of activated factor VII and fibrinopeptide A. The functional plasminogen level was unchanged, while a minor decrease in plasmin inhibitor activity was combined with a corresponding increase in the concentration of plasmin-plasmin inhibitor complex. CONCLUSIONS: The cumulative frequency of cold-activated plasma units increased in a time-dependent manner during storage at +2 degrees to +5 degrees C for 42 days. The intraindividual onset-day of cold activation varied widely between plasma samples of some donors. Cold activation was associated with a high degree of activation of the contact and coagulation systems. The fibrinolytic system was scarcely affected.     

Differential investigations from plasma‐derived and recombinant Factor IX revealed major differences in post‐translational modifications of activation peptides

Post‐translational modifications (PTMs) located on the activation peptide (AP) of recombinant FIX (rFIX, BeneFIX^®) and plasma‐derived FIX (pdFIX, Betafact^®) have been investigated by mass spectrometry to review the structural differences between these two products. Three major structural differences were pointed out. rFIX contains a low amount of phosphorylated and sulphated AP (4% for rFIX vs. 70% for pdFIX); rFIX N‐glycans are only sialylated in the α2‐3 linkage, whereas pdFIX N‐glycans contain both type of α2‐3 and α2‐6 linkages, and rFIX does not contain any sialyl Lewis^X glycoantigens contrary to pdFIX. These variations might participate in the in vivo potential different behaviours of the two molecules.     

Lack of evidence for increased inhibitor incidence in patients switched from plasma-derived to recombinant factor VIII

De novo inhibitor development is a rare event in PTPs switched from pdFVIII to rFVIII. Based on previously published data of clinical studies a change in FVIII product is unlikely to provoke inhibitor formation.     

Up-regulation of heat shock proteins is essential for cold survival during insect diapause

Diapause, the dormancy common to overwintering insects, evokes a unique pattern of gene expression. In the flesh fly, most, but not all, of the fly's heat shock proteins (Hsps) are up-regulated. The diapause up-regulated Hsps include two members of the Hsp70 family, one member of the Hsp60 family (TCP-1), at least four members of the small Hsp family, and a small Hsp pseudogene. Expression of an Hsp70 cognate, Hsc70, is uninfluenced by diapause, and Hsp90 is actually down-regulated during diapause, thus diapause differs from common stress responses that elicit synchronous up-regulation of all Hsps. Up-regulation of the Hsps begins at the onset of diapause, persists throughout the overwintering period, and ceases within hours after the fly receives the signal to reinitiate development. The up-regulation of Hsps appears to be common to diapause in species representing diverse insect orders including Diptera, Lepidoptera, Coleoptera, and Hymenoptera as well as in diapauses that occur in different developmental stages (embryo, larva, pupa, adult). Suppressing expression of Hsp23 and Hsp70 in flies by using RNAi did not alter the decision to enter diapause or the duration of diapause, but it had a profound effect on the pupa's ability to survive low temperatures. We thus propose that up-regulation of Hsps during diapause is a major factor contributing to cold-hardiness of overwintering insects.     

Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy

Gastric antral vascular ectasia(GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal bleeding.The diagnosis is typically made based on the characteristic endoscopic features,including longitudinal row of flat,reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a watermelon.These appearances,however,can easily be misinterpreted as moderate to severe gastritis.Although it is believed that capsule endoscopy(CE) is not helpful for the study of the stomach with its large lumen,GAVE can be more likely to be detected at CE rather than conventional endoscopy.CE can be regarded as "physiologic" endoscopy,without the need for gastric inflation and subsequent compression of the vasculature.The blood flow of the ecstatic vessels may be diminished in an inflated stomach.Therefore,GAVE may be prominent in CE.We herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE.     

Tissue factor in plasma of patients with disseminated intravascular coagulation

Recently it has been shown that tissue factor (TF), an important trigger for initiating blood coagulation, is present in the circulating plasma. In order to assess the clinical implications of TF in plasma, plasma concentration of TF was quantitated in 65 patients with disseminated intravascular coagulation (DIC). The mean concentration of plasma TF was elevated in patients with DIC at presentation as compared with healthy subjects (446 ± SD 536 pg/ml vs. 138 ± 51 pg/ml, P < 0.001). Abnormally high levels were found only in 46.2% of the patients, predominantly in patients with non-hematological solid tumors and acute leukemia. Plasma TF did not correlate with hemostatic markers of DIC such as thrombinantithrombin III complex, prothrombin fragment 1 + 2, plasmin-α₂-plasmin inhibitor complex, FDP, D-dimer, or fibrinogen. Serial determinations of plasma TF demonstrated that plasma TF changes roughly in parallel with the course of DIC in most patients with elevated TF at presentation of DIC. These findings suggest that plasma TF is potentially valuable for monitoring the progress of DIC in a limited population of patients. © 1994 Wiley-Liss, Inc.     

Clinical immunology of chronic cold agglutinin disease.

We studied clinical and immunological characteristics of 15 patients with chronic cold agglutinin disease (CAD). Mean age at disease debut was 68 years for female and 67 years for male patients. The patients had no signs of other autoimmune diseases. All patients had V(H)4-34 encoded IgM kappa cold agglutinins (CA) in high titre. In five patients IgM increased significantly with advancing disease. Seven patients had reduced concentrations of lymphocytes, largely of CD4 and CD8 T cells. Percentages of NK cells (CD56) and B cells (CD19) were increased in seven and three patients, respectively. In six out of nine patients a clonal expansion of kappa positive B cells was found. Serum C3 was decreased in nine patients and C4 was decreased in 11 patients, six of whom had reduced CH50. Such data indicate that patients with CAD experience a continuous low-grade complement consumption. Five patients had experienced increased haemolysis during infections. After addition of active complement to patient sera in vitro, six sera showed increased haemolytic activity. Our results indicate that some patients with CAD have a relative deficit of complement in their serum and that an increase of complement production occurs during an acute phase reaction which enhances haemolysis. Our data also indicate that both CA titre and thermal amplitude are important characteristics when predicting complement activation and clinical course in CAD.