野生绞股蓝组方预防高粘滞综合征的实验研究

目的了解野生绞股蓝组方预防高粘滞综合征的作用。方法将实验兔分为三组,普通饲料(A组),高脂 组方药(B组)和高脂饲料(C组)分别饲养。在饲养前后各作血液流变学、血脂测定,观察三组间的差别。结果A组饲养前后全血粘度、血浆粘度、血脂无明显变化;B组饲养后全血粘度、血浆粘度、血脂上升,与饲养前比较有差别(P<0.05);C组饲养后全血粘度、血脂明显上升,与饲养前比较有非常显著差别(P<0.001),血浆粘度上升,与饲养前比较有差别(P<0.05),饲养后B组全血粘度、血浆粘度低于C组,与C组比较有差别(P<0.05),血脂明显低于C组,有显著差别(P<0.01)。结论野生绞蓝组方有预防高粘滞综合征的作用。     

乏凝血因子V血浆的制备及在病毒性肝炎患者中检测的临床意义

目的 :探讨乏凝血因子V血浆制备方法及凝血因子V活性 (FV C)测定病毒性肝炎患者中的临床意义。方法 :采用温育法制备乏因子V基质血浆并应用于临床检测。病毒性肝炎住院病人 175例 ,分急性肝炎、慢性轻度肝炎、慢性中 /重度肝炎、肝硬化和重症肝炎五个组 ,检测血浆中FV C ,并与 36例正常对照组测定结果相比较。结果 :自制乏因子V基质血浆检测结果 :与正常对照组比较 ,除急性肝炎外 ,慢性轻度肝炎轻度异常 (P <0 0 5 ) ,慢性中 /重度肝炎、重症肝炎和肝硬化患者血浆中FV C则明显下降 (P <0 0 0 1) ,差异均有显著意义。结论 :自制乏因子V血浆 ,简单易行 ,结果满意。FV C的下降与病情严重程度相关 ,该测定对于判断重症肝炎病情和观察其预后有重要的临床价值。     

尿CEA-RIA的临床应用评价

血清与胸腹水中癌胚抗原(CEA)的检测已广泛用于临床。但尿CEA(U-CEA)的检测与实际应用尚未见报告,我们利用放射免疫分析(RIA)直接测定正常人与癌肿患者的U-CEA,并对试验影响因素及其应用价值进行了初探。材料和方法一、试剂:(一)去离子蒸馏水或经过滤的蒸馏水;(二)游离CEA血浆(NHP)、收集健康人血浆样品;测定后将低于2ng/L的CEA样品集中;也可选择使用柠檬酸盐抗凝的A型血浆,应在24h内,0～4℃温度下多次更换0.05mol/L的NaCl进行彻底透析,以3000g离心/30min除去凝集的蛋白,再检测CEA含量。只有CEA<2ng/L的血浆可用。(三)中国潍坊3V试剂盒。     

聚醚砜中空纤维膜血浆分离器血浆分离功能与血液相容性的评价

对新型材料聚醚砜制作的中空纤维膜血浆分离器进行动物实验 ,评价了膜对血浆蛋白的分离功能及材料的血液相容性。分离过程中 ,实验动物状况良好 ,无溶血现象发生 ,膜对血浆总蛋白、白蛋白和球蛋白的筛分系数均在 95以上 ,约 6 0的血浆从全血中分离出来。白细胞、血小板和四种凝血因子在分离开始时都有不同程度地减少 ,但均在临床允许的范围内。     

聚醚砜中空纤维膜血浆分离器血浆分离功能与血液相容性 …

对新型材料聚醚砜制作的中空纤维膜血浆分离器进行动物实验，评价了膜对血浆蛋白的分离功能及材料的血液相容性。分离过程中，实验动物状况良好，无溶血现象发生，膜对血浆总蛋白、白蛋白和球蛋白的筛分系数均在９５％以上，约６０％的血浆从全血中分离出来。白细胞、血小板和四种凝血因子在分离开始时都有不同程度地减少，但均在临床允许的范围内。     

尿毒症患者血液透析治疗对瘦素和神经肽Y水平的影响

研究尿毒症患者血液透析前后血浆瘦素和血清神经肽Y(NPY)的变化,探讨改善尿毒症营养不良的有效措施.本文尿毒症患者69例,分为3组:低通量纤维素膜透析组(A组)32例,低通量血仿膜F6透析组(B组)21例,F60高通量血滤器透析滤过并血液透析组(C组)16例.对照组18名.用RIA测定患者透析前、后及对照组血浆瘦素及血清NPY水平.结果三组瘦素与NPY水平透析前明显高于对照组(P＜0.01);透析后A、B组瘦素、NPY水平未降低,C组瘦素水平明显降低(P＜0.05),但NPY无显著变化.尿毒症患者存在高瘦素及NPY血症,二者无相关性,都不能通过单纯血液透析清除.利用高通量血滤器进行血液滤过有助于增加瘦素的清除率,改善患者营养状态.     

去白细胞处理对全血保存中IL-2和IL-8水平的影响

目的:研究全血在保存过程中是否存在IL-2和IL-8的积累,保存前白细胞滤除对其保存水平的影响。方法:选10名健康捐血者,各采集 200ml全血分成2袋,其中一袋经去白细胞处理。在4℃保存不同时期测定血液中 IL-2、IL-8含量的动态变化。结果:随着保存,全血中IL-2和IL-8的浓度不断增高。经去白细胞处理后,IL-8水平在保存中无明显变化,IL-2的含量仍然增高,但在保存期末低于正常全血中的相应含量。结论:IL-2和IL-8在全血保存中存在产生和累积,而去白细胞过滤可以抑制IL-2和IL-8在全血保存中存在产生和累积,而去白细胞过滤可以抑制IL-8的升高,对预防发热性非溶血性输血反应有一定作用。     

药液终端过滤器滤膜及输液器对常用静注药物吸附作用 …

药液过滤器(下称滤器)为一次性输液器配套的过滤装置。在临床输液中可以截留药液中外源性异物和微粒,避免其进入血管造成伤害。为此,国家医药管理局于1990年发布了该产品的行业标准(ＹＹ000290)。但是“标准”中对滤器的滤材品种及滤材对药物的吸附量未作任何规定。为了探讨滤膜、滤器对常用静注药物的影响其吸附规律,我们选择了国内6个厂家生产的12种滤膜及7个厂家生产的一次性输液器(均带滤器)对13种常用静注药物的吸附作用进行了实验性研究,以评价和筛选对药物吸附率低的输液器(含滤器)和滤膜,确保临床治疗药物的有效性。1　实验仪器与材…     

药液终端过滤器滤膜及输液器对常用静注药物吸附作用的试验研究

药液过滤器(下称滤器)为一次性输液器配套的过滤装置.在临床输液中可以截留药液中外源性异物和微粒,避免其进入血管造成伤害.为此,国家医药管理局于1990年发布了该产品的行业标准(YY0002-90).但是"标准"中对滤器的滤材品种及滤材对药物的吸附量未作任何规定.为了探讨滤膜、滤器对常用静注药物的影响其吸附规律,我们选择了国内6个厂家生产的12种滤膜及7个厂家生产的一次性输液器(均带滤器)对13种常用静注药物的吸附作用进行了实验性研究,以评价和筛选对药物吸附率低的输液器(含滤器)和滤膜,确保临床治疗药物的有效性.     

两种下腔静脉滤器的体内血液相容性评价

目的在动物体内评价一种新的下腔静脉滤器（X滤器）和Cordis下腔静脉滤器（C滤器）的血液相容性。方法实验动物为8头猪,雄性,体质量（30±5）kg。将X和C两种滤器置入动物的下腔静脉（肾静脉开口下缘）,在不给动物服用抗凝药物的情况下观察14d,然后取出滤器观察血栓形成情况,对其输送系统进行电镜观察,并在置入滤器前和取出滤器前分别对动物进行造影观察和白细胞、血小板的检测。结果两种滤器对白细胞和血小板都没有明显影响,X滤器和C滤器置入前和取出前白细胞平均值的变化分别是（0．575±4．333）×10^9／L、（3．375±9．411）×10^9／L,P〉0．05;血小板平均值变化分别是（-0．500±57．190）×10^9／L、（-33．000±57．860）×10^9／L。电镜观察显示两种滤器的输送系统都无血栓形成,但是造影显示X滤器血流有不同程度受阻,而C滤器血流受阻不明显;X滤器内有大量血栓形成,而C滤器内没有。结论C滤器的血液相容性好于X滤器。     

Compared study of micro-aggregates filters (output, filtration pressure and study of the deposit with scanning electron microscopy) (author's transl)]

Special filters for the elimination of cellular aggregates were conceived especially to prevent pulmonary complications in patients shocked particularly after massive transfusions as well as to prevent cerebral complications after extra-corporeal circulation. The performances and the conditions of use of these filters (perfusion output, change of the filter) were considered. Four filters were carefully studied: the Fenwal filter, the Swank filter, the Biotest filter and the intersep Johnson and Johnson filter. The following studies were carried out for each filter: the perfusion output (of three bottles filtered one after another with or without pressure); the filtration pressure (Swank technique) of the whole blood up-and-down filter; the viscosity and various hematologic parameters (NF, hemoglobin and gobular ATP); finally, the deposit was studied morphologically with scanning electron microscopy. It appeared that a good capacity of aggregates elimination (decrease of the filtration pressure of 95%) was often linked to a feeble output and the necessity of replacing the filter. The efficacy of the Fenwal filter, the Swank filter, the Biotest filter and the intersept filter was practically the same, but the Intersept filter provided the best output with an equal filtration capacity. The other parameters remained about the same. The deposits included fibrinogen, deformed red blood corpuscules (echinocytes), leucocytes and platelets.     

Rapid detection of simulated bacteremia by centrifugation and filtration.

A centrifugation-filtration procedure was developed to expedite the recovery of microorganisms from blood. Fresh whole human blood was inoculated with various aerobic and facultatively anaerobic microorganisms (3 to 18 per ml). The seeded blood was carefully overlaid on a Ficoll-Hypaque gradient (density, 1.114 g/ml) and centrifuged (400 x g) for 45 min at ambient temperature. The entire gradient (plasma, leukocytes, and Ficoll-Hypaque) was removed and filtered through a 0.22-micrometer membrane filter. The filters were then placed on chocolate agar and incubated at 35 degrees C in humidified air containing 5% CO2. No statistically significant differences were detected between the numbers of microorganisms recovered by filtration and by direct culture of the original inoculum. Most microorganisms were detected within 18 h after filtration. This system has excellent sensitivity and negligible toxicity.     

Practical aerobic membrane filtration blood culture technique: development of procedure.

The advantages of a membrane filter system for blood culturing have been realized for many years. Lysing of the blood prior to filtration is a convenient way to proceed, but previously described lysing procedures result in loss of certain organisms, particularly gram-negative bacilli. Four concentrations of Triton X-100 and sodium carbonate were studied in vitro, and their lysing and antibacterial properties were observed. A solution of 0.08% Na2CO3 and 0.005% Triton X-100 was found to have the least antibacterial effect and gave consistently good lysis and filtration times (under 3 min). An 8.3-ml amount of blood added to 190 ml of this concentration of lysing solution, filtered through three 47-mm membrane filters (0.45-mum pore size), led to recovery of 85% or more of various aerobic and facultative organisms in studies of artificially seeded blood.     

Research on coagulation of unwashed shed blood after total knee replacement in Chinese patients

To evaluate quality of unwashed but filtered wound shed blood through ConstaVac blood conservation system (Stryker Company) after total knee replacement, we selected 30 patients who underwent total knee replacement consecutively from July 2003 to July 2004 and received retransfusion of wound shed blood. Pre- and postoperative coagulative factors of peripheral vein blood and wound shed blood were measured, such as fibrinogen, AT-III, D-dimer, plasminogen, and PT, APTT were also measured. No clinical evidence of coagulation and DIC appeared in these patients. There is significant change of coagulative factors in unwashed but filtered wound shed blood and it may cause a potential risk of coagulopathy to retransfuse wound shed blood, but retransfusion of unwashed but filtered shed blood appeared to be relative safe clinically.     

Leukocytes-depleting filters preferentially remove activated leukocytes and reduce the expression of surface adhesion molecules during the simulated extracorporeal circulation of human blood

The effect of leukocyte-depleting filters on the total and activated leukocyte counts and the expression of surface adhesion molecules CD11b, CD18, and CD62L during the in vitro extracorporeal circulation of human blood was studied. A 200 ml blood sample was taken from 10 patients undergoing CABG surgery. The blood was circulated for 60 minutes within an experimental extracorporeal circuit. A leukocyte-depleting filter was attached in five circuits (filtered group). In five other circuits, no filter was used (controls). Total leukocyte counts were determined manually. Activated leukocytes were identified using nitroblue tetrazolium staining. The expression of CD11b, CD18, and CD62L was measured with flow cytometry. At 60 minutes, total leukocyte counts were reduced by 49% from the baseline values in the filtered group and 10% in the control group (p < 0.0001). Activated leukocyte counts decreased by 86% in the filtered group and increased by 116% in the control group (p < 0.0001). In the filtered group, the expression of CD11b, CD18, and CD612L decreased by 60%, 21%, and 79%, respectively, and in the control group it increased by 24%, 6%, and 28% (p < 0.0001). Leukocyte-depleting filters preferentially remove activated leukocytes and reduce the expression of CD11b, CD18, and CD62L during the in vitro extracorporeal circulation of human blood.     

Comparative study of the fenwal and pall microaggregate filters used for the production of leucocyte-poor blood.

Eighty units of whole blood in its third week of shelf-life were filtered through the Pall of Fenwal microaggregate filter. Half of these units were centrifuged before filtration. White cell removal was approximately 30% for the Fenwal filter both with and without prior centrifugation; for the Pall filter, removal was 7% without centrifugation and 30% with centrifugation. It is suggested that these simple filters are a useful way of reducing both platelet and white cell content of blood administered to patients requiring multiple transfusion. Their use may delay development of white cell and platelet antibodies obviating the use of washed or frozen cells in these patients.     

The derivation and verification of a non-stationary, optimal smoothing filter for nuclear medicine image data

A non-stationary optimal smoothing filter for digital nuclear medicine image data, degraded by Poisson noise, has been derived and applied to temporal simulated and clinical gated blood pool study (GBPS) data. The derived filter is automatically calculated from a large group (library) of similar GBPS which are representative of all studies acquired according to the same protocol in a defined patient population (the ensemble). The filter is designed to minimize the mean-square difference between the filtered data and the true image values; it provides an optimal trade-off between noise reduction and signal degradation for members of the ensemble. The filter is evaluated using a computer simulated ensemble of GBPS. Libraries of Poisson-degraded and non-degraded studies were generated. Libraries of up to 400 Poisson-degraded simulated studies were used to estimate optimal temporal filters that, when applied to Poisson-degraded members of the ensemble not included in the libraries, reduced the mean-square error in the raw data by 65%. When the non-degraded studies were used instead to compute the optimal filter values, the corresponding reduction in the error was 83%. Libraries of previously acquired clinical GBPS were then used to estimate optimal temporal filters for an ensemble of similarly acquired studies. These filters were subsequently applied to studies of 13 patients (not in the original libraries) who received multiple sequential repeat studies. Comparisons of both the filtered and raw data to averages of the repeat studies demonstrated that optimal filters calculated from 400 and 800 clinical studies reduced the mean-square error in the clinical data by 56% and 63% respectively.     

Spinal fluid procoagulant activity in leukaemic patients treated with intrathecal methotrexate

A procoagulant activity was found in cerebrospinal fluid (CSF) of patients with myelo- or lymphoproliferative diseases on intrathecal therapy with methotrexate, independently of leukaemic CNS involvement. This activity did not correlate with the cell count in CSF and disappeared on storage at -40 degrees C or after filtration with 0.22 nm filters. Dosage of coagulation factors revealed a strong increase in Factor V activity (F. V:C), an increase in Factor VIII procoagulant activity (F. VIII:C) without a correspondent increase in Factor VIII related antigen (F. VIII R:Ag), and an inconstant increase in Factor IX activity (F. IX:C). These activities all disappeared after filtration with 0.22 micron filters but not with 1.2 micron filters. It is concluded that complexes formed by membrane phospholipids and Factor V were responsible for the procoagulant activity lost after storage. The F. VIII and F. IX.-like procoagulant activity was not lost after storage; it was considered unspecific and attributed to thromboplastin-like substances.     

肺功能检查专用呼吸过滤器细菌过滤效率检测方法的建立及其可行性评价

目的 探讨肺功能检查专用呼吸过滤器细菌过滤效率的检测方法,并评价其可行性.方法 采用射流雾化器产生带有枯草芽孢杆菌黑色变种标准菌种细菌悬液(浓度为1.5×108 cfu/ml)的气溶胶,分别通过3种不同品牌的呼吸过滤器,然后采集过滤器末端的气流进行细菌培养和菌落计数,计算出呼吸过滤器的细菌过滤效率和微生物穿透值.结果 Promed、Microgard和Cosmed 3种过滤器的细菌过滤效率均大于99.99%,各组间差异无统计学意义(P＞0.05).微生物穿透值分别为(17±9)、(23±12)和(13±8),3组间及Promed与其余2组间差异无统计学意义(P＞0.05).结论 通过雾化细菌悬液检测肺功能检查专用呼吸过滤器细菌过滤效率的方法可行.国内产品(Promed)与国内常用进口产品(Microgard和Cosmed)的过滤性能相当,达到呼吸保护装置的过滤要求,适于临床上应用.     

Detection and quantitation of simulated anaerobic bacteremia by centrifugation and filtration.

Fresh human whole blood was inoculated with various anaerobic bacteria or with combinations of anaerobic, facultatively anaerobic, and aerobic microorganisms (3 to 28 microorganisms per ml). The seeded blood was then layered on a reduced Ficoll-Hypaque gradient (density, 1.093 g/ml) and centrifuged (400 X g) for 30 min at ambient temperature. The entire gradient (plasma, leukocytes, and Ficoll-Hypaque) was removed and filtered anaerobically through a 0.45-micron membrane filter. The filters were then placed on reduced chocolate Mueller-Hinton agar plates and incubated at 35 degrees C in humidified atmosphere containing 85% N2, 10% H, and 5% CO2 or in air containing 5% CO2. No statistically significant differences were detected between the numbers of microorganisms recovered (alone or in combination) by filtration and by direct culturing of the original inoculum. All organisms were detected within 30 h after filtration. This technique has excellent sensitivity.