同种异体肾移植排斥患者血清sFas和sFasL水平的临床观察

目的　观察肾同种移植急性排斥患者血清可溶性Fas(sFas)和sFas配体(sFasL)的水平及临床意义。 方法　采用酶联免疫吸附试验(ELISA)分别对健康对照组及实验组透析前后sFas、sFasL进行检测。结果　对 照组sFas为(256.8±72.0)ng/L,sFasL为(227.9±65.9)ng/L;实验组透析前后sFas分别为(1225.7±467.6) ng/L、(1225.8±464.0)ng/L,sFasL分别为(227.9±147.2)ng/L、(226.9±109.6)ng/L。实验组与对照组的 sFas比较差异有显著性(P<0.01),而sFasL比较差异无显著性(P>0.05)。结论　sFas在排异的病理反应过 程中参与了细胞凋亡的抑制,透析并不能改善Fas FasL介导的细胞凋亡。     

同种异体肾移植排斥患者血清sFas和sFasL水平的临床观察

目的观察肾同种移植急性排斥患者血清可溶性Fas(sFas)和sFas配体(sFasL)的水平及临床意义.方法采用酶联免疫吸附试验(ELISA)分别对健康对照组及实验组透析前后sFas、sFasL进行检测.结果对照组sFas为(256.8±72.0)ng/L,sFasL为(227.9±65.9)ng/L;实验组透析前后sFas分别为(1 225.7±467.6)ng/L、(1 225.8±464.0)ng/L,sFasL分别为(227.9±147.2)ng/L、(226.9±109.6)ng/L.实验组与对照组的sFas比较差异有显著性(P＜0.01),而sFasL比较差异无显著性(P＞0.05).结论 sFas在排异的病理反应过程中参与了细胞凋亡的抑制,透析并不能改善Fas-FasL介导的细胞凋亡.     

Differential levels of cytokines and soluble Fas ligand between tuberculous and malignant effusions

Tuberculous pleurisy, which is characterized by an extensive inflammatory exudate in the pleural space, is a common manifestation of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis infection but is difficult to diagnose. This study compared concentrations of three cytokines (interferon-γ and interleukin [IL]-2 and -4) and soluble Fas ligand in serum and pleural effusions from 36 patients with tuberculous pleurisy, 30 with malignant pleurisy and 30 healthy volunteers. Interferon-γ concentration was significantly higher in serum and pleural effusions, and the concentration of soluble Fas ligand was significantly higher in pleural effusion, from patients with tuberculous pleurisy than in those with malignant pleurisy. Levels of IL-2 and IL-4 were also raised in serum, but failed to reach statistical significance. Interferon-γ and soluble Fas ligand levels were significantly higher in pleural effusion than in serum. Pleural soluble Fas ligand concentrations correlated linearly with those of interferon-γ in patients with tuberculous pleurisy. These findings suggest a predominant T-helper-1 response to M. tuberculosis infection.     

慢性乙型肝炎患者治疗前后血清sFas和sFasL的变化及其临床意义

目的　探讨各类慢性乙型肝炎(CHB)治疗前后血清可溶性Fas(sFas)和sFas配体(sFasL)的水平变 化及其意义。方法　用酶联免疫吸附试验(ELISA)检测118例各种类型CHB患者经前列腺素E1等药物治疗前 后血清sFas、sFasL的水平,并与30名健康献血者比较。结果　118例各种类型CHB患者的sFas明显高于正常 对照组(P<0.01、0.01、0.01、0.05),且重型肝炎(FH)>CHB重度>CHB中度>CHB轻度(P均<0.01),sFas 的升高与总胆红素(TBil)呈显著性正相关(r=0.605,P<0.01);FH和CHB重度的sFasL明显高于正常对照组 (P均<0.01)。恢复期各组sFas和sFasL均比治疗前明显降低(P均<0.01)。结论　血清sFas、sFasL的水平 与CHB病情密切相关,监测二者变化有助于判断病情和观察疗效。     

慢性乙型肝炎患者治疗前后血清sFas和sFasL的变化及其临床意义

目的探讨各类慢性乙型肝炎(CHB)治疗前后血清可溶性Fas(sFas)和sFas配体(sFasL)的水平变化及其意义.方法用酶联免疫吸附试验(ELISA)检测118例各种类型CHB患者经前列腺素E1等药物治疗前后血清sFas、sFasL的水平,并与30名健康献血者比较.结果 118例各种类型CHB患者的sFas明显高于正常对照组(P＜0.01、0.01、0.01、0.05),且重型肝炎(FH)＞CHB重度＞CHB中度＞CHB轻度(P均＜0.01),sFas的升高与总胆红素(TBil)呈显著性正相关(r=0.605,P＜0.01);FH和CHB重度的sFasL明显高于正常对照组(P均＜0.01).恢复期各组sFas和sFasL均比治疗前明显降低(P均＜0.01).结论血清sFas、sFasL的水平与CHB病情密切相关,监测二者变化有助于判断病情和观察疗效.     

Soluble Fas and soluble Fas ligand levels in patients with acute hepatic failure

PURPOSE: The Fas ligand (FasL)/Fas system is an apoptosis induction system that plays an important role in homeostasis and biophylaxis. We measured tumor necrosis factor alpha (TNF-alpha), soluble FasL (sFasL), and soluble Fas (sFas) in patients with acute hepatic failure to determine the relation between such failure and apoptosis. MATERIALS AND METHODS: We assayed 21 blood samples from patients with acute hepatic failure and 8 from patients with sepsis but without acute hepatic failure. Serum TNF-alpha, sFas, and sFasL levels were determined by enzyme-linked immunosorbent assay. RESULTS: sFasL levels were significantly higher in the patients with acute hepatic failure than in the patients with sepsis (0.68 +/- 0.42 ng/mL vs. 0 ng/mL, P =.0001). No significant differences were observed in sFas levels between the two groups. A significant correlation was observed between TNF-alpha and sFas levels (r = 0.657, P =.0008); a negative correlation was observed between TNF-alpha and sFasL levels (r = 0.454, P =.038). CONCLUSIONS: Our results suggest that pathologic aggravation of acute hepatic failure are related to changes in the FasL/Fas system and that TNF-alpha and sFasL, in particular, may play hepatoprotective roles.     

A genetic risk factor for low serum ferritin levels in Danish blood donors

BACKGROUND: Iron deficiency is a frequent side effect of blood donation. In recent years, several studies have described genetic variants associated with iron concentrations. However, the impact of these variants on iron levels is unknown in blood donors. Knowledge of genetic variants that predispose donors to iron deficiency would allow bleeding frequency and iron supplementation to be tailored to the individual donor. STUDY DESIGN AND METHODS: The genotypes of five specific single‐nucleotide polymorphisms (SNPs) in three genes that have been previously associated with iron status and/or restless leg syndrome (RLS) were investigated in two groups of female blood donors. The first group had low iron stores (serum ferritin ≤ 12 µg/L, n = 657), and the second group had normal to high iron stores (serum ferritin > 30 µg/L, n = 645). Genotype distribution for each of the SNPs was compared between the two groups. RESULTS: Homozygosity for the T‐allele of BTBD9 rs9296249 was associated with lower serum ferritin. The odds ratio for low serum ferritin was 1.35 (95% confidence interval, 1.02‐1.77; p = 0.03) when comparing donors with the TT genotype with donors with the CT genotype. CONCLUSION: A frequent polymorphism in BTBD9 was significantly associated with serum ferritin. This polymorphism has previously been associated with RLS, but not low iron stores in blood donors.     

斑蝥酸钠维生素B6联合经皮肝动脉化疗栓塞对原发性肝癌患者血清sFasL/sFas的影响

目的对比分析原发性肝癌(primary liver carcinoma,PLC)、慢性乙型肝炎(chronic hepatitis B,CHB)患者及健康体检者血清可溶性Fas配体(soluble Fas ligend,sFasL)及sFas水平,并动态观察联合应用斑蝥酸钠维生素B6及经皮肝动脉化疗栓塞(transcatheter hepatic arterial chemoembolization,TACE)治疗前后PLC患者血清sFasL、sFas水平变化,探讨PLC早期诊断和预后判断的可靠指标。方法选择PLC患者40例(初发26例,复发14例),采用斑蝥酸钠维生素B6注射液联合TACE治疗,酶联免疫吸附试验检测治疗前、治疗后1、3、6个月血清sFasL/sFas水平,同步检测血清白蛋白(albumin,ALB)、丙氨酸转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)水平。另选CHB患者及健康体检者各20例作为对照组。结果 PLC患者血清sFasL、sFas水平显著高于CHB组及健康对照组,尤以复发PLC增高为著。PLC初发、PLC复发、CHB和健康对照组血清sFasL水平依次为(86.21±28.47)μg/L、(317.56±139.54)μg/L、(43.62±9.96)μg/L和(26.61±7.93)μg/L;sFas依次为(51.15±22.97)μg/L、(107.13±27.19)μg/L、(16.81±6.34)μg/L、(21.57±7.95)μg/L,PLC复发组血清sFasL和sFas水平显著高于其余各组(P<0.01);PLC初发组显著高于CHB和健康对照组(P<0.01或<0.05)。PLC治疗后1、3、6个月血清sFasL为(150.32±27.95)μg/L、(82.52±15.07)μg/L、(34.66±5.26)μg/L;sFas为(102.09±27.92)μg/L、(30.59±6.79)μg/L、(21.20±3.19)μg/L,治疗后1个月sFasL、sFas水平较治疗前显著升高(P<0.01);治疗后3个月sFas及治疗后6个月sFasL、sFas水平均较治疗前显著降低(P<0.05及P<0.01)。治疗前后血清ALB、ALT及TBIL水平无明显变化。结论血清sFasL、sFas水平为PLC发病及进展的重要标志;斑蝥酸钠维生素B6联合TACE治疗PLC可通过调节凋亡基因sFasL、sFas的表达促进肿瘤细胞凋亡,抑制肿瘤生长。     

Hepatitis C virus RNA in serum of blood donors with or without elevated transaminase levels

The pattern of hepatitis C virus (HCV) viremia in blood donors who are positive for antibody to HCV (anti-HCV) according to the level of transaminase activity is unclear. A polymerase chain reaction-based HCV RNA detection method was used to study two clearly defined groups of anti-HCV-positive blood donors with repeatedly normal (n = 27) and elevated (n = 17) alanine aminotransferase (ALT) levels. HCV RNA was detected in only 4 of 27 blood donors with normal ALT values and 15 of 17 with elevated ALT values. These results indicate that anti-HCV- positive blood donors with normal ALT levels constitute a heterogeneous group, as HCV viremia is detectable in only a small proportion of cases. Polymerase chain reaction should be useful in the surveillance of anti-HCV-positive blood donors with normal ALT levels, by identifying those who might benefit from further investigation and treatment.     

献血者血清过氧化氢酶活性测定

目的　探讨献血人群中血清过氧化氢酶 (catalase,CAT)的活性水平及其变化。方法　采用比色法测定血清CAT活性。结果　 2 77例体检合格的献血者血清 CAT活性测定结果为 (5 1.5± 16 .4 ) Ku/ L。经临床诊断的 2 5 0例甲、乙、丙型肝炎患者 ,与 2 77例体格合格组相比 ,血清 CAT活性明显升高 ,P<0 .0 1。对 2 77例不同 ABO血型献血者血清 CAT活性水平进行比较 ,结果差异无显著性 (P>0 .0 5 )。检测 2 77例具有不同献血史的献血者血清 CAT活性 ,结果差异亦无显著性 ,P>0 .0 5。结论　有规律、有计划和适度适量参与无偿献血 ,对献血者肝功能不会造成不良影响     

不同程度阿尔茨海默病患者血清可溶性Fas及其配体水平的变化

目的探讨阿尔茨海默病(AD)患者血清可溶性Fas(s Fas)及其配体(s Fas L)水平的变化。方法选取AD患者100例,以54例老年疾病(包括糖尿病17例、高血压18例、高血脂15例、其它内分泌疾病4例)患者和46名健康体检者分别作为老年疾病对照组和正常对照组。采用酶联免疫吸附试验(ELISA)检测所有受检者血清s Fas、s Fas L水平,使用临床痴呆评定量表(CDR)、简易智能精神状态量表(MMSE)、Hachinski缺血指数量表(HIS)评定AD患者认知功能。结果 AD患者血清s Fas、s Fas L水平明显高于老年疾病对照组和正常对照组(P0.01);随着病程加重,其血清s Fas、s Fas L水平逐渐升高。AD患者血清s Fas与年龄、病程和MMSE评分呈正相关(r=0.856、0.834、0.799,P0.01),与Hachinski评分呈负相关(r=-0.714,P0.01);血清s Fas L与年龄、病程呈正相关(r=0.863、0.857,P0.01),与MMSE评分、HIS评分呈负相关(r=-0.801、-0.745,P0.01)。结论 AD患者存在血清s Fas、s Fas L水平异常,提示AD患者在发病过程中可能存在神经细胞凋亡,且血清s Fas、s Fas L水平可能与患者的智能水平、脑缺血程度有关。     

Serial immunoreactive erythropoietin levels in autologous blood donors

The variations in plasma erythropoietin (EPO) concentration during preoperative deposit of autologous blood were studied in 12 patients (8 men, 4 women). Four donations were scheduled at weekly intervals. A predonation hemoglobin concentration of 11 g per dL (110 g/L) was required. Hemoglobin concentration decreased from 14.3 +/- 1.1 g per dL (143 +/- 11 g/L) (mean +/- SD) before the first donation to 11.7 +/- 0.7 g per dL (117 +/- 7 g/L) on Day 22 (p less than or equal to 0.0001). Reticulocyte counts increased from a median of 31,800 (range, 4900-95,000) per microL (median, 32 x 10(9)/L [range, 5-95 x 10(9)/L]) to 93,800 (16,800-194,900) per microL (median, 94 x 10(9)/L [range, 17-195 x 10(9)/L]) on Day 28 (p less than or equal to 0.01). Plasma EPO concentration was 17.8 +/- 5.1 mU per mL prior to the first donation and displayed a small and transient peak after each donation. A sustained elevation followed each peak. Although plasma EPO concentration differed significantly from the baseline value after the first donation, only the peak concentrations after the second (35.5 +/- 15.5 mU/mL), third (38.0 +/- 14.5 mU/mL), and fourth (36.1 +/- 11.0 mU/mL) donations exceeded the normal range. The moderate, biphasic increase in plasma EPO concentration and the moderate increase in erythropoiesis suggest two strategies in autologous blood donation that should be investigated with respect to efficiency and safety: 1) more aggressive donation schemes, which reduce donation intervals and/or the minimum hemoglobin concentration and 2) the administration of recombinant human EPO.     

Effects of serial plasmapheresis on serum IgA levels in IgA-deficient blood donors with IgA-suppressor T cells

Seventeen IgA-deficient blood donors, without antibodies to IgA, underwent plasmapheresis four to eight consecutive times at intervals of 8 weeks or less to provide fresh-frozen plasma for patients with anti-IgA. Blood samples, drawn for analysis no more than 1 hour before plasmapheresis and again at the conclusion of each procedure, were analyzed for lymphocyte subpopulations and serum IgA levels. Five lymphocyte subpopulations, including natural killer cells, the suppressor-inducer CD4 subset, the suppressor-precursor CD8 subset, non-major histocompatibility complex (MHC)-restricted cytotoxic T cells, and CD5+ B cells, were all decreased significantly after plasmapheresis (p less than 0.05). In a subgroup of IgA-deficient donors with excessive IgA-suppressor T-cell activity, serum IgA increased to levels exceeding 0.05 g per L following the fourth consecutive plasmapheresis procedure. Serum IgA levels did not similarly increase in IgA-deficient donors without excessive IgA-suppressor T-cell activity or in controls without IgA deficiency. Our study shows the potential, in a subpopulation of IgA-deficient donors who undergo frequent plasmapheresis, for a transient increase in serum IgA to a level no longer considered IgA deficient.     

惠州市无偿献血者血液检测结果分析

目的了解惠州市无偿献血者血液检测情况,为招募低危无偿献血者,保障输血安全提供科学理论依据。方法收集2007～2011年惠州市无偿献血者资料并对其检测结果进行统计分析。结果共检测210 675例,总阳性率为6.74%,丙氨酸氨基转移酶(ALT)异常率为4.41%,乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人类免疫缺陷病毒抗体(抗-HIV)和梅毒螺旋体抗体(抗-TP)阳性率分别为1.13%、0.35%、0.06%和0.79%,各年度检测结果阳性率差异均有统计学意义(P<0.01)。结论近5年检测的阳性率有升高趋势,有必要进一步提高检测方法的准确度,加强献血招募前教育和筛查,加强血液质量监控,确保血液安全。     

Elevated red blood cell 2,3-diphosphoglycerate levels in black blood donors

Mean levels of 2,3-diphosphoglycerate (DPG) were significantly increased in erythrocytes (RBC) from 43 nonanemic black blood donors (4.80 +/- 0.06 micromoles/l RBC) compared with 22 white donors 4.47 +/- 0.08 micromoles/l RBCs from eight of the 12 black donors with DPG levels greater than 5 micromoles/l RBC. Although a potentially hemolytic disorder could be defined in four (AS hemoglobin, beta-Thalassemia minor, G6PD deficiency), reticulocyte counts were normal. However, when RBCs from the subgroup were compared to RBCs from an additional 25 unselected white donors, the following suggested an abnormally large population of young RBCs in the subgroup: 1) normal or elevated RBC-ATP with normal serum phosphate level; 2) significantly increased activities of RBC age-dependent enzymes hexokinase (p less than 0.02), pyruvate kinase (p less than 0.05), and glutamicoxaloacetic transaminase (p less than 0.01), with normal activity of phosphoglycerate kinase, an age-independent enzyme; 3) decreased dense (older) RBCs as determined by sedimentation in phthalate esters. Since DPG is increased in young RBCs and falls as the RBC ages, loss of older relatively DPG depleted RBCs due to shortened survival could account for the elevated DPG levels seen in the subgroup.     

慢性乙型重症肝炎及肝癌与血清可溶性Fas可溶性Fas配体 …

目的 探讨血清可溶性Ｆａｓ／可溶性Ｆａｓ配体水平与慢性乙型重症肝炎以及乙肝病毒相关性肝细胞癌变之间的关系。方法 用酶联免疫吸附双抗体夹心法检测２１例无症状乙肝病毒携带者,２０例慢性乙型重症肝炎及２２例乙肝病毒相关性肝细胞癌患者血清ｓＦａｓ、ｓＦａｓＬ水平。结果 与无症状乙肝病毒携带者比较,慢性乙肝重症肝炎患者血清ｓＦａｓ、ｓＦａｓＬ水平均增高,其差异有显著意义;乙肝病毒相关性肝细胞癌患者ｓＦａｓ水     

Interdonation intervals and patterns of return among blood donors in Brazil

BACKGROUND: In Brazil, most donations come from repeat donors, but there are little data on return behavior of donors. STUDY DESIGN AND METHODS: Donors who made at least one whole blood donation in 2007 were followed for 2 years using a large multicenter research database. Donation frequency, interdonation intervals, and their association with donor demographics, status, and type of donation were examined among three large blood centers in Brazil, two in the southeast and one in the northeast. RESULTS: In 2007, of 306,770 allogeneic donations, 38.9% came from 95,127 first‐time donors and 61.1% from 149,664 repeat donors. Through December 31, 2009, a total of 28.1% of first‐time donors and 56.5% of repeat donors had donated again. Overall, the median interdonation interval was approximately 6 months. Among men it was 182 and 171 days for first‐time and repeat donors, and among women, 212 and 200 days. Predictors of return behavior among first‐time donors were male sex (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.13‐1.20), community donation (OR, 2.26; 95% CI, 2.20‐2.33), and age 24 years or less (OR, 0.62‐0.89 for donors ≥25 years). Among repeat donors predictors were male sex (OR, 1.35; 95% CI, 1.32‐1.39), age 35 years or more (OR, 1.08‐1.18 vs. ≤24 years), and community donation (OR, 2.39; 95% CI, 2.33‐2.44). Differences in return by geographic region were evident with higher return rates in the northeast of Brazil. CONCLUSION: These data highlight the need to develop improved communication strategies for first‐time and replacement donors to convert them into repeat community donors.