血液灌流清除体内免疫复合物的实验研究

本文从5种亲和吸剂（Affinity Absorbent,AA)中筛选出对病理性循环免疫复合物（Cycle Immune Complex,CIC)具有特异性吸附的吸附剂AA3，测定其孔结构参数，讨论了不同吸附条件对吸附性能的影响。用纯种大白兔作为实验动物，建立高特环免疫动物模型，用AA3吸附剂对运动模型进行血液灌流实验，观察该吸附剂血灌流清除血中CIC的功效。考察了AA3吸附剂的血液相容性及对蛋白的影响。实验结果表明AA3吸附剂对血中CIC的吸附率达41.７％，动物模型血灌流对ＣＩＣ的吸附率达３８.4%。     

固定多粘菌素B的新型吸附剂对血液中细菌内毒素吸附性能的实验研究

研究了固定有多粘菌素B（Polymyxin B,PMB）短肽的聚苯乙烯微球对血浆中细菌内毒素的亲和吸附性能，讨论了不同吸附条件对吸附性能的影响。用纯种大白鼠作为实验动物，建立内毒索血症动物模型。用固定有PMB短肽的聚苯乙烯微球对动物模型进行血液灌流实验，观察该吸附剂血液灌流清除血浆中内毒素的功效，考察了接有PMB短肽的聚苯乙烯微球的血液相容性及其对蛋白的影响。实验结果表明。采用血液灌流吸附疗法成功地清除动物模型血液中的内毒素，而且，固定有多粘菌素B的特异吸附剂具有良好的血液相容性。     

急性肾衰动物模型的血液灌流实验研究

用纯种大耳白兔作为实验动物,建立肾衰动物模型.海藻酸锌络合物为吸附剂对动物模型进行血液灌流实验,观察该吸附剂血液灌流清除体内脲分子的功效,以及对血液相容性、肝功能、肾功能等临床生化指标的影响.经动物血液灌流对血液中Bun、Cr的清除率达60%以上,而且具有良好的血液相容性.     

血液灌流治疗内毒素血症的现状

内毒素的本质为脂多糖，其分子中的磷酸基团和２—酮—３—脱氧—Ｄ甘露醇—辛酮糖携带大量负电荷，能与阳离子基因吸附剂发生强烈吸附，基于此原理，目前多数学者研究认为，带阳离子基团修饰的吸附剂，如聚乙烯酰胺、二乙烯二胺以及带氨基的氨化聚球形吸附剂，对内毒素具有较强的吸附能力，而且血液相容性好，在血液灌流治疗内毒素血症方面可能具有巨大的潜能和意义     

血液灌流治疗内毒素血症的现状

内毒素的本质为脂多糖，其分子中的磷酸基团和２－酮－３－脱氧－Ｄ甘露醇－辛酮糖携带大量负电荷，能与阳离子基因吸附剂发生强烈吸附，基于此原理，目前多数学者研究认为，带阳离子基团修饰的吸附剂，如聚乙烯酰胺，二乙烯二胺以及带氨基的氨化聚球形吸附剂，对内毒素具有较强的吸附能力，而且血液相容性好，在血液灌流治疗的内毒素血症方面都可能具有巨大的潜能和意义。     

肝素连接苯丙氨酸血液净化材料去除内毒素的研究

以氯甲基树脂为基底材料,肝素为连接臂连接配基苯丙氨酸,合成了一种安全无毒的新型内毒素吸附剂.本课题通过改变不同的反应物用量、反应时间和pH值寻找出最佳实验条件,同时对合成好的肝素-苯丙氨酸吸附剂在不同介质(水及血浆)、不同内毒素初始浓度、不同时长条件下的吸附性能进行了研究,并对血液相容性进行了评价.在水以及兔子血浆的体外灌流实验中,2h以内可将内毒素含量降至较低水平,最高清除率水中可达79％,血浆中为72％,且对血液中的其他物质含量影响较小(均小于10％),血液相容性良好.     

亲和吸附剂实验动物(兔)血液灌流清除血中循环免疫复合物的实验研究Ⅱ

介绍了用纯种大耳白兔作为实验动物,建立高循环免疫复合物动物模型,并采用ＡＡ３ 吸附剂对动物模型进行模拟体外血液灌流实验,观察该吸附剂血液灌流清除体内的循环免疫复合物（ＣＩＣ）的功效,观察ＡＡ３ 吸附剂的血液相容性及对蛋白的影响。     

类风湿因子免疫吸附血液灌流材料的制备及其性能评价

制备一种新型的类风湿因子（RF）免疫吸附剂并研究其性能。通过在氯甲基聚苯乙烯-二乙烯树脂（氯球）的表面接枝苯丙氨酸（PHE）,制备出可供临床应用的类风湿因子血液灌流吸附剂（PS-PHE）;体外动态灌流实验测定吸附剂的吸附率;体外动态洗脱实验测定RF的脱落量及脱落率;通过体外灌流模拟实验,检测灌流对血液成分的影响来评价吸附剂的选择性;体外凝血酶原时间（PTs）及凝血酶时间（TTs）检测实验验证材料的血液相容性。免疫吸附剂对类风湿因子IgA RF、IgG RF、IgM RF的吸附率分别可以达到45.21%±1.80%、56.02%±1.36%、52.40%±2.01% (n=5),洗脱后脱落率分别为22.10%±1.65%、19.23%±1.06%、21.31%±1.35% (n=5)。全血灌流实验中材料对红细胞、血小板、总蛋白的吸附均在10%以下。同时体外凝血酶原时间（PTs）及凝血酶时间（TTs）测定结果显示PS-PHE能延缓凝血速度。结论PS-PHE对RF具有较高的吸附率及特异性并且表现出优良的血液相容性,在类风湿关节炎的临床治疗方面具有良好的应用前景。     

海藻酸锌络合物血液灌流吸附尿素的实验研究

首次采用海藻酸锌络合物配位吸附尿素分子 ,研究了这类络合物在不同条件下对尿素的吸附性能。用纯种大耳白兔作为实验动物 ,建立肾衰动物模型。海藻酸锌络合物为吸附剂对动物模型进行血液灌流实验 ,观察该吸附剂血液灌流清除体内尿素的功效 ,以及对肝功能、肾功能等临床生化指标的影响。在模拟人体生理介质的水溶液中对尿素吸附率达 74 .6 5± 4 .71%。对血液中尿素的吸附率达 6 5 .2 5± 4 .33%。经动物血液灌流对血液中Bun、Cr的清除率达 6 0 %以上。     

亲和吸附剂实验动物（兔）血液灌流清除血中循环免疫复合物 …

介绍了用纯种大耳白兔作为实验动物,建立高循环免疫复合物动物模型,并采用ＡＡ３吸附剂对动物模型进行模拟体外血液灌流实验,观察该吸附剂血液灌流清除体内的循环免疫复合物（ＣＩＣ）的功效,观察ＡＡ３吸附剂的血液相容性及对蛋白的影响。     

系统性红斑狼疮血液灌流的实验研究

用共价键联结的DNA-VT树脂,对系统性红斑狼疮(SLE)患者抗DNA抗体阳性血浆进行模拟灌流和对被动注射抗DNA抗体的大鼠血液灌流免疫吸附抗DNA抗体。本文研究了DNA-VT树脂的血液相容性及体内、外吸附抗DNA抗体的效能,同时测定了树脂的物理性能。结果表明,DNA-VT树脂物理性能良好,血液相容性理想,能有效地清除抗DNA抗体,有希望应用于临床治疗SLE。     

Design of in situ porcine closed-circuit system for assessing blood-contacting biomaterials

The overall pre-clinical process of determining the blood compatibility of any medical device involves several stages. Although the primary purpose is to protect the patients, laboratory testing has been over-utilized for many years with a huge number of unnecessary animal tests being done routinely. Recently, the elimination of needless testing has become important in controlling the cost of healthcare and in addressing many issues related to the ethics of animal research. With this in mind, we designed a new in situ porcine closed-circuit system to study the complex interplay between platelets, coagulation proteins, and other cellular elements in pigs. We proved that this system can be implemented in blood compatibility testing and minimize the number of animals used in the experiments.     

The removal of 14C labeled endotoxin by activated charcoal.

Endotoxin shock due to Gram-negative enteric bacteria is of major medical concern with an estimated 100,000 fatalities in the United States per year. An effective therapy for endotoxin shock, particularly in combination with significant liver damage, has not been available to date. Since activated charcoal is known as a universal sorbent, the use of activated charcoal in a hemoperfusion apparatus to remove endotoxin has interesting possibilities. Current assays for endotoxin are inadequate. The Limulus Amoebocyte Lysate (LAL) assay was found to give nonreproducible results within our range of requirements for accuracy. We, therefore, grew Salmonella typhimurium in 14C-labeled glucose to obtain 14C labeled endotoxin. Radiolabeled endotoxin was used to measure the rate of adsorption on activated charcoal. The rates of removal of endotoxin from normal saline, plasma, and whole blood will be presented in graphical form for use in design calculations. This work provides a foundation for encouraging in vivo hemoperfusion experimentation now underway at the University of Oklahoma and the Veteran's Administration Hospital in Oklahoma City.     

Treatment of acute experimental diphtheria toxemia by immunohemosorption

The antitoxic antidiphtheric immunosorbent DATs was tested in experiments on mice and guinea-pigs using the model of acute diphtheric toxemia. In extracorporeal connecting with the circulation system of the animals the sorbent effectively bound and eliminated from the circulation molecules of diphtheric toxin and antitoxin, reduced significantly their levels in the blood after hemoperfusion. The effectiveness of the immunosorbent DATs was confirmed when it saved the ginea-pigs after injection of lethal toxin doses.     

肝硬化上消化道出血的输血治疗进展

肝硬化患者常见并发症有上消化道出血,因凝血功能障碍、血小板数量减少及功能异常而易致止血困难,引起失血性休克,甚至死亡。临床医师可通过输注新鲜冰冻血浆、冷沉淀及血小板改善凝血功能、促进止血,并输注红细胞悬液提高携氧能力。合理输血可以提高治疗效果,缩短住院时间,减少不良反应发生率及死亡率。目前国内外对肝硬化上消化道出血的输血启动阈值、输血剂量尚存争议,近年仍在不断研究和探讨,本文现对近年相关研究进行综述,以制定科学的输血治疗方案。     

The catastrophe revisited: blood compatibility in the 21st Century

The biomaterials community has been unable to accurately assign the term "blood compatible" to a biomaterial in spite of 50 years of intensive research on the subject. There is no clear consensus as to which materials are "blood compatible." There are no standardized methods to assess blood compatibility. Since we use millions of devices in contact with blood each year, it is imperative we give serious thought to this intellectual catastrophe. In this perspective, I consider five hypotheses as to why progress has been slow in evolving a clear understanding of blood compatibility: Hypothesis 1-It is impossible to make a blood compatible material. Hypothesis 2-We do not understand the biology behind blood compatibility. Hypothesis 3-We do not understand how to test for or evaluate blood compatibility. Hypothesis 4-Certain materials of natural origin seem to show better blood compatibility but we do not know how to exploit this concept. Hypothesis 5-We now have better blood compatible materials but the regulatory and economic climate prevent adoption in clinical practice.     

Teraźniejszość i przyszłość w badaniach immunologii transfuzjologicznej krwinek czerwonych

Over 100 years ago, shortly after the discovery of the ABO blood groups (Landsteiner, 1901) serological testing of blood compatibility between recipient and donor were introduced to the regular practice. The scope of pretransfusion testing expanded after the discovery of further blood groups. Apart from ABO and RhD conformity between recipient and blood donor a significant part of compatibility testing is the search for clinically relevant alloantibodies in recipient plasma and determination of their specificity if the patient is to receive relevant antigen negative blood. These studies are performed using a panel of human red blood cells specially selected for this purpose. The knowledge of the molecular basis of all DNA polymorphisms underlying the differentiation of red blood cell antigen allows to predict the blood group phenotype on the basis of DNA testing. This knowledge may also be used in the production of recombinant proteins of blood group antigens. In the cell cultures of prokaryotic and eukaryotic organisms multiple group antigens with protein structure have been obtained. In the future they could be used as reagents for tests based on the inhibition of the activity of antibodies to solid phase assays such as ELISA techniques, or protein-based microchips. Promising results have also been obtained using the recombinant proteins to identify antibodies against high frequency antigens. The increasing technological capabilities will allow in the future use of a single recombinant proteins of blood for a single step and direct identification of antibodies, the introduction of a test based on the technique of “one antigen per well”. Such procedure would simplify and accelerate the determination of alloantibody specificity which at the moment is quite a time-consuming process. This would shorten the time for compatibility testing in the recipient in whom alloantibodies were found.     

介入用聚氨酯材料的血液相容性研究

介入导管优良的血液相容性是确保血管内介入技术安全可靠进行的重要因素，我们对自己合成的四种介入导管用聚氨酯材料的血液相容性进行了评价，包括溶血试验、血小板黏试验、动态凝血时间试验和动态血栓形成实验。结果表明，其中的H50-100和H60-100具有优良的血液相容性，完全可以用作介入导管材料。此外，还讨论了聚氨酯结构与血液相容性的关系。