骨髓增生异常综合征患者骨髓细胞增殖动力学与临床关系的研究

作者用流式细胞仪分析５０例原发性骨髓增生异常综合征（ＭＤＳ）患者和１２例健康献血员的骨髓细胞周期分布。结果显示：Ｓ＋Ｇ＿２Ｍ期细胞比例在ＭＤＳ明显低于正常对照（Ｐ＜０．０２）；在ＲＡＥＢ和ＲＡＥＢ－ｔ组明显低于ＲＡ组和ＲＡＳ组（均Ｐ＜０．０１）；与骨髓原始粒细胞比例呈负相关（ｒ＝－０．６３，Ｐ＜０．００１）；与骨髓幼稚红细胞呈正相关（ｒ＝０．４８，Ｐ＜０．０１）。还研究了ＭＤＳ向急性白血病（ＡＬ）演变过程中Ｓ＋Ｇ＿２Ｍ期细胞比例的动态变化及其与治疗反应和预后的关系。     

高效价IgG抗-A（B）引起新生儿溶血病13例

新生儿溶血病（ＨＤＮ）是指母婴血型不合引起胎儿或新生儿的免疫性溶血性疾病,ＡＢＯ系ＨＤＮ是由于母婴ＡＢＯ血型不合,母体的ＩｇＧ抗－Ａ（Ｂ）通过胎盘进入胎儿血液循环破坏胎儿红细胞引起。高效价（＞１０２４）ＩｇＧ抗－Ａ（Ｂ）引起ＨＤＮ者较少见,笔者遇到１３例,现报告如下。 材料与方法１ 研究对象 病例来自市直各医疗单位,年龄２５～３６岁（平均２６．９岁）。１３例产妇中,有流产史者１２例,占 ９２．３％。１３例患儿中有 ９例是 Ｇ２Ｐ１,３例Ｇ３Ｐ１,１例Ｇ１Ｐ１。生后１天以内出现黄疸有７例,２天的３例,３…     

小鼠实验性IgA肾病时红细胞免疫的观察

本文从胃肠粘膜免疫入手，以口服牛血清白蛋白（ＢＳＡ），葡萄球菌肠毒素Ｂ（ＳＥＢ）感染的复合法建立小鼠实验性ＩＧａ肾病（ＩｇＡＮ）的模型。从中观察到血尿出现，肾组织中ＩｇＡ，ＩｇＭ和ＩｇＧ伴随沉积度强度高以及肾组织的病理改变，红细胞Ｃ３ｂ受体花环（ＲＢＣ－Ｃ３ｂＲＲ）率下降，红细胞免疫复合物花环（ＲＢＣ－ＩＣＲＲ）率升高。表明ＩｇＡ肾病时，红细胞免疫功能异常。红细胞免疫功能的降低可能是ＩｇＡ的重要发     

家兔脑缺血再灌注损伤机制的研究

用家兔四动脉闭塞法建立急性完全性脑缺血后给予再灌注，观察缺血前后及再灌注后脑组织部分电解质和含水量、脑组织和血液丙二醛（ＭＤＡ）、环核昔酸（ｃＡＭＰ、ｃＧＭＰ）、血栓烷Ｂ＿２（ＴｘＢ＿２）、６－酮－前列腺素Ｆ＿（１α）（６－ｋｅｔｏ－ＰＧＦ＿（１α）含量、超氧化物歧化酶（ＳＯＤ）和谷胱苷肽过氧化物酶（ＧＳＨ－Ｐｘ）活性改变。结果：再灌注后实验组脑组织Ｃａ￣（２＋）、ＭＤＡ、ＴｘＢ＿２和ｃＡＭＰ较对照组升高（Ｐ＜０．０５），ＧＳＨ－Ｐｘ活性、６－ｋｅｔｏ－ＰＧＦ＿（１α）含量降低（Ｐ＜０．０５）；实验组血液中ｃＡＭＰ含量高于对照组（Ｐ＜０．０５）。提示脑组织Ｃａ￣（２＋）过载、氧自由基增多、ｃＡＭＰ／ｃＯＭＰ和ＰＧＩ＿２／ＴＸＡ＿２比值异常在脑缺血再灌注损伤中起着重要的作用。     

人红细胞血影胰岛素受体放射配体测定法

本法采用肝素抗凝静脉血，分离红细胞。通过低渗Ｔｒｉｓ－ＨＣｌ缓冲液溶解红细胞，制成红细胞血影悬液。在此悬液中加入不同浓度的标准胰岛素５０μｌ和Ａ＿（１４）－￣（１２５）Ｉ－胰岛素５０μｌ．４℃孵育２４小时。胰岛素与受体最大特异性结合率（Ｂ／Ｔ）为（７．００±１．８９）％；每个红细胞血影胰岛素受体的高亲和力结合位点数（Ｒ＿１）为３０±１６个，亲和常数（Ｋ＿１）为（３．１２±２．４３）×１０￣（１０）Ｌ／ｍｏｌ；低亲和力结合位点数（Ｒ＿２）为５１２０±３６７２个，亲和常数（Ｋ＿２）为（９．１４±７．３０）×１０￣７Ｌ／ｍｏｌ。平均批内变异系数为８．０５％。     

急性脑梗塞患者红细胞免疫功能变化对红细胞变形性…

本文测定了４１例急性脑梗塞患者红细胞滤过指数（ＲＢＣ－ＩＦ）、红细胞Ｃ３ｂ花环主经（ＲＢＣ－Ｃ２ｂＲＲ）和红细胞免疫复合物共 率（ＲＢＣ－ＩＣＲ）、观察红细胞免疫粘附（ＲＣＩＡ）功能变化对红细胞变形性（ＲＣＤ）的影响。结果显示脑梗塞患者ＲＢＣ－ＩＦ增高，ＲＢＣ－Ｃ３ｂＲＲ下降，ＲＢＣ－ＩＣＲ上升，表明脑梗塞患者ＲＣＤ和红细胞免疫粘附功能下降，且ＲＢＣ随着ＲＣＩＡ功能下降其变形能力也有所降低，提示脑     

CD_3单抗诱导的T细胞功能检测法

建立了用特异性刺激原白细胞分化抗原３（ＣＤ＿３）单克隆抗体（单抗）诱导外周血淋巴细胞（ＰＢＬ）增殖转化、产生白细胞介素－２（ＩＬ－２）及ＩＬ－２受体（ＩＬ－２Ｒ）表达等检测Ｔ细胞功能的方法，并对其实验影响因素进行探讨。结果表明：ＣＤ＿３单抗诱导ＰＢＬ活化的过程与Ｔ细胞在体内的活化过程相符；ＣＤ＿３单抗的丝裂原作用所需浓度范围广、用量少；由ＣＤ＿３单抗诱导的ＰＢＬ转化能力受ＣＤ＿３单抗的浓度和培养时间的影响；ＣＤ＿３单抗与植物血凝素（ＰＨＡ）活化Ｔ细胞的效应，在Ｔ细胞增殖方面二者呈显著正相关，而在ＩＬ－２活性和ＩＬ－２Ｒ表达方面则无相关性。     

微波对红细胞免疫功能的影响

体外实验证明，微波输出功率８０Ｗ，辐射时间２分钟，对红细胞免疫功能有明显的促进作用．２０例正常人静脉血微波辐射后ＲＢＣ－ＣＲ＿１花环率显著提高（Ｐ＜０．０１），ＲＢＣ－ＩＣ花环率则无变化（Ｐ＞０．０５）．肿瘤、风湿性心脏病、冠心病及肺疾病患者静脉血共８０例，微波辐射后ＲＢＣ－ＣＲ＿１及ＲＢＣ－ＩＣ花环率均明显提高．实验提示，微波的这种生物学效应为非热效应，临床上应根据不同个体选择不同的微波输出功率和辐射时间，才能充分发挥微波的生物学效应，提高患者的红细胞免疫功能．     

65例胎儿宫内发育迟缓临床分析

对我院分娩２３４３例新生儿进行分析，根据妊娠图及Ｂ超显示胎儿宫内发育迟缓（ＩＵＧＲ）７５例，根据出生后体重证实的ＩＵＧＲ６５例，ＩＵＧＲ发生率为３．２％。治疗方法有左侧卧位、口服维生素类药物、硫酸舒喘灵、氨基酸冲剂、静脉滴注葡萄糖及能量合剂等。治疗时间最短７天，最长４周。治疗有效３４例，有效率为４５．３％，其中有产科合并症和内科合并症的分别为３０．０％及５７．１％，无合并症的治疗有效率为５０％。治     

灵芝多糖对人脐血LAK细胞增殖活性的影响

本研究表明，灵芝多糖（ＧＬＰ）能直接刺激人脐血单个核细胞（ＣＢＭＣ）增殖，并能协同ＰＨＡ刺激ＣＢＭＣ增殖在ｒＩＬ－２诱导人脐血ＬＡＫ细胞（简称ＣＢ－ＬＡＫ）早期加入ＧＬＰ，能明显增强ＣＢ－ＬＡＫ细胞增殖活性，最佳浓度１０μ／ｍｌ；ＧＰＬ本身不能诱导ＣＢＭＣＩＬ－２Ｒ的表达，但能协同ｒＩＬ－２提高ＣＢ－ＬＡＫ细胞表达ＩＬ－２Ｒ的表达。     

库存血G6PD活性对新生儿高胆红素血症换血治疗疗效影响

目的 探讨库存血G6PD活性对新生儿高胆红素血症换血治疗疗效影响.方法根据高胆红素血症患儿换血治疗时使用的库存血G6PD活性将190例患儿分为G6PD活性降低组(试验组)与G6PD活性正常组(对照组).比较换血24 h后血清总胆红素(TBil)水平与下降幅度,并对换血后光疗持续时间和再次换血患儿百分比进行比较.结果 试验组换血24 h后TBil水平高于对照组(t=5.74,P＜0.05),下降幅度小于对照组(t=10.93,P＜0.05);与对照组相比,试验组换血后光疗持续时间延长(t=7.14,P＜0.05),再次换血患儿百分比升高(χ2=5.60,P<0.05).结论 以G6PD活性降低的库存血治疗新生儿高胆红素血症将导致换血后患儿胆红素水平下降较慢、光疗持续时间延长、再次换血的概率增加.     

A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints

BACKGROUND: Most neonates less than 1.0 kg birth weight need red blood cell (RBC) transfusions. Delayed clamping of the umbilical cord 1 minute after delivery transfuses the neonate with autologous placental blood to expand blood volume and provide 60 percent more RBCs than after immediate clamping. This study compared hematologic and clinical effects of delayed versus immediate cord clamping. STUDY DESIGN AND METHODS: After parental consent, neonates not more than 36 weeks' gestation were randomly assigned to cord clamping immediately or at 1 minute after delivery. The primary endpoint was an increase in RBC volume/mass, per biotin labeling, after delayed clamping. Secondary endpoints were multiple clinical and laboratory comparisons over the first 28 days including Score for Neonatal Acute Physiology (SNAP). RESULTS: Problems with delayed clamping techniques prevented study of neonates of less than 30 weeks' gestation, and 105 neonates 30 to 36 weeks are reported. Circulating RBC volume/mass increased (p = 0.04) and weekly hematocrit (Hct) values were higher (p < 0.005) after delayed clamping. Higher Hct values did not lead to fewer RBC transfusions (p > or = 0.70). Apgar scores after birth and daily SNAP scores were not significantly different (p > or = 0.22). Requirements for mechanical ventilation with oxygen were similar. More (p = 0.03) neonates needed phototherapy after delayed clamping, but initial bilirubin levels and extent of phototherapy did not differ. CONCLUSIONS: Although a 1-minute delay in cord clamping significantly increased RBC volume/mass and Hct, clinical benefits were modest. Clinically significant adverse effects were not detected. Consider a 1-minute delay in cord clamping to increase RBC volume/mass and RBC iron, for neonates 30 to 36 weeks' gestation, who do not need immediate resuscitation.     

Effect of flavin compounds on glutathione reductase activity: in vivo and in vitro studies

Increases or decreases of red cell glutathione reductase (GR) have been described in connection with many clinical abnormalities. We find that GR activity as measured in hemolysates represents only a portion of the available GR activity. The addition of small amounts of flavin adenine dinucleotide (FAD), but not of flavin mononucleotide or riboflavin, activates the GR of hemolysates. 1 muM FAD results in a maximal activation within 10 min; gradually increasing activation occurs at much lower, for example, 20 mmuM FAD concentrations. Once FAD has activated GR, dilution or dialysis does not reverse activation of the enzyme. Activation of GR by FAD can be inhibited by adenosine triphosphate (ATP), and to a lesser extent by adenosine diphosphate (ADP) and adenosine monophosphate (AMP), if these adenine nucleotides are added before the addition of FAD, but only to a slight extent if FAD is added before the adenine nucleotides. The addition of FAD to GR does not alter its electrophoretic mobility but produces intensification of the bands.The administration of 5 mg of riboflavin daily produces marked stimulation of red cell GR activity within only 2 days. After cessation of riboflavin administration, the GR activity again begins to fall. The degree of stimulation of GR activity by riboflavin is inversely correlated with the level of dietary riboflavin intake. The base line GR activity of normal individuals is directly correlated with the level of dietary riboflavin intake. The previously unexplained variations of glutathione reductase in health and disease must be reevaluated in light of the state of riboflavin nutrition and metabolism of the subject.     

Effects of group-A streptolysin O on neonatal and adult red blood cell deformability and haemolysis

Neonates are more susceptible than adults to many Gram-positive and Gram-negative bacterial infections. Whereas group B streptococcus causes life-threatening infections in neonates, group A β-haemolytic streptococcus infections rarely occur in neonates. To test the hypothesis that group A streptococcus may have different effects on neonatal and adult red blood cells (RBCs), haemolysis and deformability (rheoscope) of RBCs from adults, full-term and pre-term neonates were studied during 60 min incubation with 1 haemolytic unit (HU) mL⁻¹ group A streptolysin O (SLO). SLO incubation of adult RBCs resulted in almost linearly increasing time-dependent haemolysis reaching 82%, whereas haemolysis of neonatal RBCs was below 60% after 1 h. After 60 min SLO incubation, RBC deformation was significantly ( P  < 0.05) more reduced in adults than in full-term and preterm neonates. An inverse overall relationship ( r  = 0.68) between SLO-induced haemolysis and RBC deformation was found after 60 min of SLO incubation. We conclude that SLO causes less haemolysis and less impairment of RBC deformation in neonates than in adults. The decreased RBC deformation of unhaemolysed RBC indicates that, before lysis, mechanical RBC membrane properties are altered by SLO.     

不同眼罩摘除方法对光疗新生儿舒适度的影响

目的 探讨光疗新生儿摘除眼罩时应用遮光布罩盖暖箱对新生儿舒适度的影响.方法 将高间接胆红素血症新生儿70例按住院号尾数的单双数分为两组,每组35例.干预组新生儿蓝光治疗后放置于罩盖有遮光布的暖箱中,待安静时摘除眼罩,并逐步撤去遮光布;对照组新生儿置于日常光线环境下的暖箱中,待安静时直接摘除眼罩.观察两组新生儿面部表情、心率、经皮血氧饱和度(SpO2)的变化.结果 摘除眼罩时干预组新生儿面部表情无明显变化,心率、SpO2波动小,两组比较差异有统计学意义(P＜0.05).结论 光疗新生儿摘除眼罩时应用遮光布罩盖暖箱可提高新生儿舒适度.     

血液保存时间对库存血流变特性的影响

目的：观察血液保存时间对血液流变特性的影响。方法：选择５６例 健康献血员。常规采血及保存,取新鲜血（采集后１小时）、１周上周及３周４个时相 点。检测全血粘度（高切、中切、低切）、血浆粘度、血球压积及ＲＢＣ聚集指数（ＡＩ） 和刚性指数（ＩＲ）。结果：红细胞压积、中切粘度在保存３周内无显著变化,高切粘度 在第三周显著升高,而低切粘度下降。血浆粘度随保存时间延长进行性下降。ＡＩ在 第３周显著降低而ＩＲ在第２周时则升高,第３周更为明显。结论：结果提示库存血 保存时间的延长对全血粘度和 ＲＢＣ的变形性及聚集性产生显著影响,特别在第 ３ 周出现非常显著变化,ＲＢＣ变形性改变影响ＲＢＣ的运氧功能,降低了输血效果。     

抚触配合光疗在新生儿高胆红素血症中的应用

目的:探讨抚触配合光疗在新生儿高胆红素血症中的应用效果.方法:依据血清胆红素水平将180例新生儿高胆红素血症患儿分为轻度、中度、重度(A组、B组、C组)三组各60例,各组再随机分为实验组(A1组、B1组、C1组各30例)与对照组(A2组、B2组、C2组各30例),对照组给予蓝光照射治疗与常规护理,实验组在对照组基础上联合抚触.测量并记录治疗后第2、4、6天患儿黄疸指数、哭闹时间,以及患儿每日摄入奶量、大便次数、体重、睡眠时间.结果:治疗后第2、4、6天三组中实验组较对照组患儿黄疸指数降低、哭闹时间减少(P＜0.05,P＜0.01),且三组中实验组较对照组每日摄入奶量多、大便次数多、体重增长快、睡眠时间长(P＜0.01).结论:在蓝光照射治疗同时给予抚触可降低不同程度新生儿高胆红素血症患儿血清胆红素水平,使其摄入奶量多、大便次数多、体重增长快;能提高患儿治疗依从性,促进其神经系统的发育.     

Management of neonatal jaundice

Jaundice is the most commonly encountered neonatal clinical problem; 80 percent of neonates become clinically jaundiced, while 5 percent develop serum bilirubin levels above currently recommended treatment standards. This article outlines theories about the pathophysiology of neonatal jaundice and presents a logical approach to its management. First, the health care provider must distinguish between physiologic, exaggerated and pathologic jaundice. The treatment modalities of exchange transfusion, phototherapy and cessation of nursing are discussed.     

~(60)Co辐射对在体红细胞变形和取向能力的影响

采用６０Ｃｏ大剂量全身均匀急性辐射的方法造成一种辐射贫血的动物模型,然后在较长时间内连续观测６０Ｃｏ辐射对在体红细胞变形和取向能力的影响。本文采用一种在低粘切变流场中能将红细胞变形指数ＤＩ分解为取向指数（ＤＩ）ｏｒ和小变形指数（ＤＩ）ｄ的新型激光衍射法［１］,研究了６０Ｃｏ大剂量辐射后在体红细胞压积、变形和取向能力、沉降率和红细胞计数等血液流变学指标的变化规律,并与正常对照组红细胞的相应参数作比较,发现在６０Ｃｏ大剂量辐射后,开始这些参数变得明显异常,４０天后逐渐接近于正常对照组水平。表明６０Ｃｏ大剂量急性辐射对动物体内血液循环系统的影响是长期的、严重的。这为研究辐射对血液流变特性的影响及正确地挑选辐射贫血模型提供了理论与实验的基础。     

腺苷蛋氨酸辅助蓝光照射对黄疸新生儿肌酸激酶同工酶、转铁蛋白水平及肝功能的影响

目的研究腺苷蛋氨酸辅助蓝光照射对黄疸新生儿肌酸激酶同工酶(CK-MB)、转铁蛋白(TRF)水平及肝功能的影响。方法将我院收治的280例黄疸新生儿随机分为对照组(140例,蓝光照射)和观察组(140例,蓝光照射+腺苷蛋氨酸)。比较两组的神经肽Y(NPY)、胶质纤维酸性蛋白(GFAP)、CK-MB、TRF水平及肝功能指标。结果治疗后,两组的NPY、GFAP、CK-MB、TBIL、ALT和GGT水平均降低,TRF水平均升高,且观察组优于对照组(P<0.05)。结论腺苷蛋氨酸辅助蓝光照射治疗黄疸新生儿,能够有效促进机体中胆红素的代谢,降低对神经、心肌和肝脏的损伤。