急性脑梗死患者血EPO和血液流变学的相关性研究

目的研究急性脑梗死患者血EPO和血液流变学的相关性。方法收集本院急性脑梗死的患者90例(脑梗死组),另选取同期无脑血管疾病的患者55例(对照组),比较两组血EPO和血液流变学是否存在差异;两组分别进行EPO和血红蛋白、红细胞、血液流变学相关性分析。结果脑梗死组和对照组在EPO和血液流变学有统计学差异(P 0. 05);对照组EPO与血液流变学无相关性(P 0. 05);脑梗死组EPO与血浆黏度(r=0. 373)、红细胞沉降率(r=0. 459)及血沉方程K值(r=0. 282)呈正相关(P 0. 05);脑梗死组EPO与血红蛋白(r=-0. 589)、红细胞(r=-0. 410)、红细胞比容(r=-0. 547)、全血黏度切变率1. 00 L/s(r=-0. 400)、全血黏度切变率5. 00 L/s(r=-0. 361)、全血黏度切变率30. 00 L/s(r=-0. 408)、全血黏度切变率200. 00 L/s(r=-0. 300)、红细胞压积(r=-0. 520)呈负相关(P 0. 05)。结论急性脑梗死患者血液流变学相关指标存在异常;急性脑梗死患者EPO会增高,增高的EPO可增加血液黏度,但不是通过促进红细胞的生成来调节的。     

上颌骨LefortⅠ型截骨中高渗氯化钠羟乙基淀粉40注射液的应用

背景：随着日益严重的血液污染问题和输血相关疾病,血液保护的课题受到了国内外的广泛关注。 目的：观察高渗氯化钠羟乙基淀粉40注射液(高渗晶胶液)用于上颌骨LefortⅠ型截骨前急性高容量血液稀释的血液保护作用。 方法：40例患者随机分为实验组和对照组,每组20例。均采用气管插管全麻,实验组于麻醉后切皮前输入高渗晶胶液 4 mL/kg以10 mL/min的速度输注,于30 min内完成。对照组则不作任何处理。分别于急性高容量血液稀释前(T0)、急性高容量血液稀释后(T1)、急性高容量血液稀释后30 min(T2),60 min(T3),3 h(T4)、术后1 d(T5)、术后3 d(T6)抽血查血常规(包括红细胞压积、血红蛋白、血小板计数)及凝血功能(包括血小板、部分凝血活酶时间、纤维蛋白原),并记录术中输血量、输液量、出血量及尿量。 结果与结论：40例患者均进入结果分析。与对照组相比,实验组的输注异体血数量较少(P < 0.05),尿量较多(P < 0.05);两组患者术中输液量及失血量差异无显著性意义(P > 0.05)。两组患者行控制性降压后,T2、T3的心率较T1明显升高(P < 0.05),T2、T3的收缩压、舒张压、平均动脉压较T1明显降低(P < 0.05)。在T1、T2、T3时间点,实验组心率较对照组明显升高(P < 0.05)。两组患者的中心静脉压各时间点差异均无显著性意义(P > 0.05)。经过急性高容量血液稀释后T1、T2、T3、T4时间点,实验组血红蛋白、血球压积较对照组明显降低(P < 0.05);血小板计数、部分凝血活酶时间较对照组明显延长(P < 0.05)。T1、T2时间点,实验组Na+、Cl-较对照组明显升高(P < 0.05);T5、T6时间点,实验组的血红蛋白、血球压积较对照组明显升高(P < 0.05)。提示高渗晶胶液用于上颌骨LefortⅠ型截骨前急性高容量血液稀释可明显减少或避免输注异体血。     

全髋关节置换过程中急性等容血液稀释防止血栓的作用

背景：全髋关节置换过程中异体输血和输血引发的并发症问题越来越受到人们的重视。近年来从动物实验中了解到急性等容性血液稀释对血流动力学、凝血功能方面的影响,可减少降低血栓的发生概率。 目的：观察急性等容血液稀释对全髋关节置换患者围术期循环功能和内环境稳定的影响。 方法：将60例择期行全髋关节置换的患者随机分成两组,对照组及羟乙基淀粉130/0.4氯化钠注射液急性等容血液稀释组各30例,对照组静脉输入平衡液。术中持续监测平均动脉压、心率和中心静脉压的变化;并记录两组凝血功能、动脉血气、血常规及液体出入量。 结果与结论：血液稀释过程中,急性等容血液稀释组平均动脉压比对照组平稳;置换后6,24 h的血红蛋白含量、血细胞压积急性等容血液稀释组均高于对照组(P < 0.01);异体输血量急性等容血液稀释组小于对照组(P < 0.01)。提示羟乙基淀粉130/0.4氯化钠注射液急性等容血液稀释能安全有效地用于全髋关节置换患者,血流动力学稳定,内环境影响小,可有效防止血栓的形成。     

器官保存液中聚乙二醇对人红细胞聚集性和血液流变学的影响

背景：聚乙二醇作为一种非渗透性大分子物质,在器官保存液中可发挥保护细胞膜、维护细胞骨架完整性、防止细胞水肿、抗脂质过氧化和免疫调节的作用。 目的：探讨器官保存液中的聚乙二醇对人红细胞聚集性和血液流变学的影响。 设计、时间及地点：对比观察实验,于2008-10在解放军第二军医大学附属长征医院器官移植科完成。 材料：抽取接受体格检查的6名健康志愿者的肘前静脉血。 方法：在抽取的新鲜血液中按5∶1的稀释比分别加入生理盐水、器官保存液及含不同相对分子质量、不同浓度聚乙二醇的多器官保存液,按加入液体的不同分为：生理盐水组、器官保存液组、不添加聚乙二醇的保存液组、20聚乙二醇1,10,30 g/L和35聚乙二醇1,10,30 g/L组。 主要观察指标：室温下通过魏氏法检测红细胞沉降率、自动血液流变仪检测血液流变学指标、光镜观察红细胞聚集的形态学改变,分析聚乙二醇对人红细胞聚集性和血液流变学的影响。 结果：不含胶体的保存液对红细胞聚集无影响,含低浓度聚乙二醇的保存液对红细胞聚集性和血液流变学的影响较小,器官保存液组、20聚乙二醇30 g/L,35聚乙二醇10 g/L和35聚乙二醇30 g/L的保存液则可显著加快红细胞沉降率,降低红细胞变形能力,引起红细胞明显聚集。 结论：器官保存液中的聚乙二醇可引起红细胞聚集,降低红细胞变形能力,其相对分子质量越大,浓度越高,促进红细胞聚集的作用越明显,对血液流变学的影响越大。     

高血压脑出血患者血液流变学改变的临床意义

目的探讨高血压脑出血患者血液流变学改变的临床意义。方法选取我院收治的高血压脑出血患者43例为脑出血组,选取同期入院体检正常人40例作为对照组,入院后均静脉采血,行血液流变学和血小板参数检查。结果出血组全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、红细胞变形指数分别为(6.35±1.36)mPa·s、(13.85±1.18)mPa·s、(1.79±0.44)mPa·s、(3.42±1.07)g/L、(46.63±3.28)%、0.85±0.04,均较对照组高,差异有统计学意义(P0.05);出血组PLT、PDW分别为(131.26±33.01)×109/L、(15.59±1.68)fL,均较对照组低,MPV为(9.30±0.61)fL,均较对照组高,差异有统计学意义(P0.05)。结论血液流变学异常与高血压脑出血密切相关。     

人胎盘间充质干细胞4种消化分离方法的效果比较

背景：目前已从多种组织器官中分离出间充质干细胞,如何更高效地获取大批量纯度佳的干细胞仍是研究目标之一。 目的：对人胎盘间充质干细胞采取4种不同的消化分离方法,比较其分离效果。 设计、时间及地点：细胞学体外对比观察,于2007-07/2008-01在暨南大学医学院血液病研究所完成。 材料：胎盘标本来源于足月正常剖宫产胎儿,由暨南大学附属第一医院提供。胶原酶Ⅱ、胶原酶Ⅳ为GIBCO产品,羟乙基淀粉为B.BRAUN产品,淋巴细胞分层液为上海试剂二厂产品。 方法：胎盘组织剪碎后平均分为4组：胶原酶Ⅳ+羟乙基淀粉沉淀组、胶原酶Ⅱ+羟乙基淀粉沉淀组、胶原酶Ⅱ+淋巴细胞分层液分离组、胶原酶Ⅱ+氯化铵裂解红细胞组,5份标本/组。将第1组置于1 g/L胶原酶Ⅳ中,另外3组置于1 g/L胶原酶Ⅱ中,37 ℃消化45 min。过筛后收集各组细胞悬液,按组别对应施以羟乙基淀粉沉淀法、淋巴细胞分层液分离法、氯化铵裂解红细胞法进行分离。 主要观察指标：观察4种方法在获取细胞数、培养成功率、细胞出现伸展时间、原代培养时间方面的差异,并对培养得到的细胞进行表面标志检测。 结果：与胶原酶Ⅱ+羟乙基淀粉沉淀组比较,其余3组获取的细胞数均明显减少（t=2.92~8.16,P < 0.05）。在其他条件相同的情况下,胶原酶Ⅱ+羟乙基淀粉沉淀组培养成功率为100%,其余3组分别为80%,80%,20%。胶原酶Ⅱ+羟乙基淀粉沉淀组细胞出现伸展时间及原代培养时间均短于胶原酶Ⅱ+淋巴细胞分层液分离组（t=5.27~5.37,P < 0.05）,亦短于胶原酶Ⅳ+羟乙基淀粉沉淀组（2.46~2.50,P < 0.05）。流式细胞仪检测示第3代人胎盘间充质干细胞强表达透明质酸受体CD44和整合素家族成员CD29,不表达造血干细胞标志CD34和CD45,也不表达内皮细胞标志CD106及HLA-DR。 结论：使用胶原酶Ⅱ消化胎盘组织,结合羟乙基淀粉沉淀法能较好地分离人胎盘间充质干细胞。     

两步法分离人脐血单个核细胞的最佳条件

背景：如何获得较为纯化、高活性的干细胞,目前未见深入研究报告,也未见一个标准化操作流程方案。 目的：探讨两步法分离人脐血单个核细胞最佳分离条件。 方法：观察羟乙基淀粉在20,30,40,50,60,70 min不同时间沉淀脐血中红细胞的效果;使用人淋巴细胞分离液,分别在800,700,600,500,400 g/min,离心30,25,20 min的条件下分离人脐血单个核细胞。 结果与结论：6%羟乙基淀粉沉淀脐血60 min效果最好;使用密度为(1.077 0±0.000 1) g/mL人淋巴细胞分离液,在4 ℃条件下以700 g/min离心力,离心30 min,洗涤3次,这样获得的人脐血单个核细胞效果最好,所得细胞沉淀中混杂细胞如红细胞及其他细胞碎片较少,人脐血单个核细胞的细胞得率及活力比较高。提示应用羟乙基淀粉沉淀和人淋巴细胞分离液分离两步法,在最佳时间条件下可提高脐血干细胞的回收率。     

银杏达莫注射液对椎基底动脉供血不足血液流变学的影响

目的 比较银杏达莫注射液与盐酸川芎嗪注射液对椎基底动脉供血不足血液流变学的影响.方法 80例椎基底动脉供血不足患者分为治疗组45例和对照组35例,治疗组给予20ml银杏达莫注射液,对照组给予300mg盐酸川芎嗪注射液,两药分别加入0.9%的氯化钠注射液500ml和5%的葡萄糖注射液500ml中静滴,qd,连续15d.检测治疗前及治疗15d后血液流变学指标.结果 治疗组在治疗后低切全血黏度、纤维蛋白原、红细胞比积、红细胞聚集度指数、血小板聚集率等方面明显下降(P＜0.05),且下降程度优于对照组.高切全血黏度、血浆粘度在治疗前后2组下降差异无显著性(P＞0.05).治疗组的红细胞变形性指数有显著性升高(P＜0.05).结论 银杏达莫注射液与盐酸川芎嗪注射液均能改变椎基底动脉供血不足血液流变学状态,但银杏达莫注射液优于盐酸川芎嗪注射液.     

急性脑梗死患者血液流变学及凝血功能的临床意义

目的探讨急性脑梗死患者血液流变学和凝血功能的变化及其临床意义。方法选择75例急性脑梗死为观察组,其中轻度、中度、重度各25例,选择同期75例健康体检者为对照组,比较2组血液流变学和凝血功能,记录观察组不同程度脑梗死患者的血液流变学和凝血功能。结果观察组全血高切黏度、全血低切黏度、血浆黏度和红细胞比积显著高于对照组(P0.05)。观察组血浆纤维蛋白原(FIB)明显高于对照组(P0.05),2组活化部分凝血活酶时间(APTT)和血浆凝血酶原时间(PT)比较差异无统计学意义(P0.05)。重度、中度和轻度患者的全血高切黏度、全血低切黏度、血浆黏度和红细胞比积比较差异有统计学意义(P0.05);重度、中度和轻度患者的FIB比较差异有统计学意义(P0.05)。结论急性脑梗死患者的血液流变学和凝血功能存在异常,且与病情严重程度成正比,监测其动态变化可为临床治疗提供参考价值。     

急性脑出血患者血液流变学指标变化的相关研究

目的探讨血液流变学指标在急性脑出血中的变化规律和临床价值。方法于发病24 h内检测100例急性期脑出血患者(脑出血组)的血液流变学指标,并与30名正常对照者(正常对照组)进行比较。分析高血压病史、出血量、出血部位对血液流变学指标的影响。结果与正常对照组比较,脑出血组全血黏度、血浆黏度和血沉均升高,红细胞聚集指数、红细胞变形指数和红细胞压积均降低(均P0.01)。其中,高血压性脑出血组各指标均变化显著(均P0.01),非高血压性脑出血组中仅全血黏度(200 s~(-1)和50 s~(-1))、红细胞聚集指数、红细胞压积和血沉变化有统计学意义(P0.05~0.01)。与非高血压性脑出血患者比较,高血压性脑出血患者除血沉外,其余指标均变化显著(均P0.05)。随着血肿量增加,脑出血患者全血黏度(200 s~(-1)和50 s~(-1))和血浆黏度均升高,红细胞聚集指数下降,差异有统计学意义(P0.05~0.01)。不同出血部位脑出血患者200 s~(-1)和1 s~(-1)全血黏度、血浆黏度、红细胞聚集指数及血沉差异有统计学意义(均P0.05)。结论急性脑出血患者广泛存在着血液流变学异常,提示脑出血急性期血液呈现浓、黏、聚、凝状态且合并高血压者变化显著。随着血肿量增加,血液流变学变化明显,不同出血部位影响也不同。     

Tongue/palate contact for the production of /s/ and /z/

Productions of /s/ and /z/ by ten adult speakers were investigated using the electropalatograph (EPG). The participants, ten speech researchers who spoke English as their first language, recorded productions of /s/ and /z/ in nonsense and real words. The maximum contact frame was used as the point of reference to compare tongue/palate contact for each production. Each speaker had alveolar contact, lateral bracing and most had a midline groove for both /s/ and /z/; however, the array of contacted electrodes was unique for each speaker. The groove widths and lengths ranged from 0–3 electrodes. There was significantly greater alveolar tongue/palate contact for /z/ compared to /s/ in word‐initial position, but not in word‐final position for the following measures: alveolar palatal contact, medial groove width, medial groove length. However, when measures of total palate contact and centre of gravity were considered, there was a complex interaction between the phonemes /s/ and /z/, coarticulation with the vowel, word position, and word context (real and nonsense words).     

Tongue/palate contact for the production of /s/ and /z/

Productions of /s/ and /z/ by ten adult speakers were investigated using the electropalatograph (EPG). The participants, ten speech researchers who spoke English as their first language, recorded productions of /s/ and /z/ in nonsense and real words. The maximum contact frame was used as the point of reference to compare tongue/palate contact for each production. Each speaker had alveolar contact, lateral bracing and most had a midline groove for both /s/ and /z/; however, the array of contacted electrodes was unique for each speaker. The groove widths and lengths ranged from 0-3 electrodes. There was significantly greater alveolar tongue/palate contact for /z/ compared to /s/ in word-initial position, but not in word-final position for the following measures: alveolar palatal contact, medial groove width, medial groove length. However, when measures of total palate contact and centre of gravity were considered, there was a complex interaction between the phonemes /s/ and /z/, coarticulation with the vowel, word position, and word context (real and nonsense words).     

Electropalatographic specification of Croatian fricatives /s/ and /z/

Electropalatographic specification of alveolar fricatives in Croatian is aimed at providing speech therapists with normative data about the range of acceptable productions of /s/ and /z/ in adult speakers of Croatian. Four variables were analysed: place of articulation, total contact, groove width and hold phase duration. Intra- and inter-speaker variability for each variable was analysed. Lingual palatal cues for voicing difference were also quantified and discussed. Results show that Croatian /s/ and /z/ are alveolar and not dental as previously reported. The comparison between the voiced and the voiceless fricative shows that durational measures provide the best differentiation. The voiceless counterpart is significantly longer. The difference between voiced and voiceless is also found in the total contact, with /z/ having more contact in the anterior four rows of electrodes, while /s/ has more contact in the posterior four rows of electrodes. This difference is also reflected in the anterior and the posterior groove widths. Possibilities of using these results as normative data for the diagnosis and treatment of atypical articulation of /s/ and /z/ are discussed.     

A comparative study of contractile responses in diaphragm muscles of normal and dystrophic (C57BL6Jdy2Jdy2J) mice

Potassium and caffeine contractures of isolated small bundles (100 to 200 μm diameter) of muscle fibers isolated from the diaphragm of normal and dystrophic ($\text{C57BL}\text{6J}\text{dy}{}^{\mathrm{2J}}\text{dy}{}^{\mathrm{2J}}$) mice were compared. In diaphragms of pathologic mice (3 to 5 months old) the resting potential, the characteristics of the twitch, and some histological examinations were typical of dystrophic muscles. The slopes of the relationships between the steady membrane potential and log [K]₀ were similar for the two types of cells. In 110 mM and 146 mM K there were no significant differences in the time course of the contractures and reduction in [Ca]₀ decreased the time to peak and the time constant of relaxation to the same extent; the relative efficiency of [Mg]₀ compared with [Ca]₀ was equivalent. Repriming of K contractures at different external calcium concentrations indicated that the normal diaphragm did not have any special advantage. The exposure of isolated strips to a solution containing caffeine resulted in a similar increase of the strength of the regularly evoked twitch responses. However, the contractures elicited by 1.25 to 20 mM caffeine showed a subsensitivity of the dystrophic diaphragm (K_mDys = 9.3 K_mN) and the rate of relaxation was significantly slower than in normal muscle (in 20 mM caffeine, 50% decay time for normal muscle was 25.2 ± 7.6 s and for dystrophic muscle 54.8 ± 11.2 s. THese results suggest an absence of major alterations in the mechanism of excitation-contraction coupling associated with dystrophy, except for a change in the specific element of the sarcoplasmic reticulum where caffeine acts.     

Rate and extent of functional reinnervation in fast-twitch and slow-twitch muscles of the dystrophic mouse (C57Bl6Jdy2jdy2j)

The extent of functional reinnervation of fast-twitch extensor digitorum longus muscle in dystrophic and normal mice was determined at various times after nerve transection. Functional reinnervation was assessed by measuring the twitch tension evoked by stimulation of the nerve central to the site of transection. In control mice aged 4 to 6 weeks at the time of denervation, complete reinnervation was observed after 6 weeks. In dystrophic mice of the same age reinnervation was clearly impaired. The ratio of functional innervation of the operated leg to that of the contralateral unoperated leg was only 0.62 after 6 weeks. In older dystrophic mice (4 to 6 months at the time of nerve transection) the reinnervation ratio was even lower, 0.43 after 12 weeks. Reinnervation of slow-twitch soleus muscle was assessed 8 weeks after denervation and was also found to be reduced in the older dystrophic animals. The extent of reinnervation was reflected in the measured values of muscle weight, twitch tension per unit wet weight, and twitch time course. The impairment of reinnervation of dystrophic muscle is consistent with, but not proof of, a neurogenic defect in murine muscular dystrophy.