4种血小板保存袋保存效果的比较

目的 比较美国、荷兰、北京、上海4种血小板保存袋对手工制备浓缩血小板的保存效果.方法 手工浓缩血小板无菌加入到4种保存袋于22℃保存,保存0、1、3、5、7d后分别取样检测血小板回收率、pH、体外聚集活性、血小板第3因子、第4因子有效性(PF4)及CD62P阳性表达率.结果 随保存时间的延长4种保存袋血小板回收率均逐渐降低,但各保存袋之间无显著性差异(P>0.05);随保存时间延长pH均逐渐下降,血小板保存5d时各保存袋pH无显著性差异(P>0.05);保存7d时,北京保存袋pH(5.8± 0.35)明显低于其他3种保存袋(6.68±0.13、6.88 ±0.13、6.96 ±0.11)(P<0.05).随保存时间的延长各保存袋中的血小板聚集率均下降迅速,但4种保存袋间无显著性差异(P>0.05).血小板保存5d时血小板第3因子(止血功能)无显著性差异(P>0.05);保存7d时美国(127.30±20.35)、北京(649.20±504.00)保存袋第3因子(纤维蛋白析出时间)比荷兰(93.38±7.51)、上海保存袋(71.10±4.52)明显延长(P<0.05).保存7d血小板第4因子(释放功能)均无明显下降(P>0.05).血小板保存5d时CD62P阳性表达率无显著性差异;保存7d时北京保存袋(56.63)高于其他3种保存袋(30.79、26.58、30.91).结论 北京、上海与美国、荷兰血小板保存袋相比,血小板保存5d时各检测指标接近,4种保存袋保存效果基本一致;但保存7d时北京保存袋其pH、血小板第3因子及CD62P阳性表达率指标比其他3种保存袋差.     

冰冻血小板制备与研究

目的:探讨冰冻血小板制备的可行性,为临床应用提供可靠依据。方法:通过认真筛选献血员,进行单采血小板,并对30袋新鲜血小板进行计数等质控,用二甲基亚砜(DMSO)为冰冻保护剂,-80℃保存1年内,于30、90、180、270、360d分别进行外观、计数、pH值、聚集率检测及无菌试验,并且与新鲜血小板进行比较。结果:-80℃保存冰冻血小板1年内各时期外观、计数、回收率、pH值、聚集率、无菌试验均达质量标准,其中冻后pH值、聚集率与新鲜血小板相比差异无显著性(P>0.05);冻后计数与新鲜血小板相比差异有显著性(P<0.05)。保存1年的各时期回收率平均为82.9%,均大于70%。结论:-80℃保存冰冻血小板质量达到标准要求,可以应用于临床。     

血小板-80℃冰冻保存质量指标动态变化

目的:分析冰冻血小板-80℃保存一年内质量指标动态变化,为冰冻血小板有效保存提供可靠依据.检测方法:用二甲基亚砜(DMSO)为冰冻保护剂,-80℃冰冻保存血小板一年内,于30、90、180、270、360天进行计数,分别检测pH值、聚集率、粘附功能、Ⅲ因子活性质量指标,与冰冻前新鲜血小板进行比较,并随机抽取不同保存时期每样中任1份冰冻血小板进行无菌试验.结果:-80℃保存一年内各时期冰冻血小板pH值、Ⅲ因子活性与新鲜血小板相比差异无显著性(P＞0.05);冰冻血小板计数、粘附功能、聚集率与新鲜血小板相比差异有统计学意义(P＜0.05),但保存一年内的各时期回收率平均为84.1%,均大于70%.无菌试验均无细菌生长.结论:血小板-80℃冰冻保存一年内质量是可靠的.     

深低温保存前后的单采血小板体外功能和细菌污染情况的研究

目的 探讨在常温（22±2℃）震荡下不同保存时期的单采血小板冰冻保存后功能指标的变化.方法 对冰冻保存前后的单采血小板进行血小板计数、pH、回收率、黏附率、聚集强度和血小板第3因子（PF3）活性及细菌污染情况进行检测.结果 冰冻保存后的血小板计数、pH值、粘附率、聚集强度及PF3活性、细菌污染情况和冰冻前比较无显著性差异,回收率符合要求.结论 冰冻保存后的单采血小板仍具有良好的功能活性.     

基层血站优化单采血小板品种的可行性分析

目的通过对采集后不同时段制备的冰冻单采血小板的质量研究,分析基层血站优化单采血小板品种的可行性：方法以美国产Trima血细胞分离机配套全密闭7天保存袋采集的单采血小板,分别于采集后6小时和72小时制备为冰冻血小板制剂,l周后复苏留样,分别检测血小板计数（PLT,MPV,PCT,PDW）、血小板粘附性、血小板P选择蛋白、PF3A、PF4、pH值、血块收缩试验（血浆法）;结合临床的治疗效果进行综合评价。结果采集后6小时和72小时制备的冰冻单采血小板,两者相比差异无显著性（t〈0．01,P〉0．05）;用于急性大出血患者输注后的CCI有效率比较（χ^2〈0．01,P〉0．05）,差异无显著性;用于急性大出血患者输注后血小板数量显著高于输注前,输注后患者的出血明显减轻或得到有效控制。结论基层血站可以结合自身血小板血源的实际情况,将血型偏型的新鲜单采血小板于采集后3天内制备为冰冻血小板,以充分发挥新鲜单采血小板的治疗效果,既体现冰冻血小板的快速止血功能．又最大限度地保护血液资源．以满足临床的需要。     

SX9207血小板袋的研究

本文报道用改性聚氯乙烯和新型复合增塑剂特制而成的血液保存容器。容器表面成均匀磨砂玻璃状。高温蒸汽灭菌后无粘连，化学性能及生物学性能良好。保存血小板５天后：ｐＨ为７．１９±０．１８；血小板计数为７８．７％±９．６；低渗休克（ＨＳＲ）为６３．３％±８．７；聚集为４５．５％±２４．８；血小板的活性、形态、功能与保存在国际上具有代表性的血小板袋美国ＰＬ－１２４０处于同一水平。     

血站优化单采血小板品种的可行性探讨

目的:采用冰冻保存的方法探讨血站优化单采血小板品种的可行性。方法:将用细胞分离机采集到的单采血小板养样本在采集后3 d和7 d制备成冰冻血小板制剂,对冰冻保存前后的单采血小板制剂进行血小板计数(PLT)、血小板第Ⅲ因子有效性(PF3A)、聚集强度、血小板黏附性、血块收缩试验的检测。结果:采集后3 d和7 d制备成的冰冻血小板制剂的各体外指标间比较差异无统计学意义(P>0.05)。结论:冰冻保存明显延长了血小板保存时间,并且经冰冻保存的单采血小板仍然具有较好体外活性,建议血站采用冰冻保存单采血小板品种的方式优化血小板保存。     

两种保存袋对浓缩血小板在22℃贮存期间活化状况的影响

目的研究不同保存袋对浓缩血小板在贮存期间活化状态的影响.方法用两种血小板常温保存袋在22 ℃保存浓缩血小板5 d,分别在0、1、3 d和5 d取样品测定CD62p、血小板聚集功能、pH和血小板计数.结果随保存时间延长,CD62p的表达显著增强,两种保存袋之间的差异非常显著(P<0.01).但其它检测指标相差不显著.结论不同血小板保存袋对血小板在22 ℃贮存期间的活化状态的影响有明显差异,CD62p是评价血小板活化的灵敏指标,对血小板的保存和监控具有重要意义.     

慢性肺心病患者血小板聚集功能的临床观察

目的　研究肺心病患者血小板聚集功能的变化及临床意义。方法　采用比浊法测定 2 8例肺心病患者及 32例体检正常者的血小板聚集率。结果　肺心病患者与正常对照组血小板聚集率分别为 (5 4 .6± 7.7) %和 (18.6± 14 .4 ) % ,两者比较有显著性差异 (P <0 .0 5 )。结论　肺心病患者血小板聚集功能升高 ,临床上在常规治疗的基础上应辅以抗凝治疗     

机采血小板22℃保存理化功能改变的分析

目的观察分析机采血小板室温保存期间的代谢变化损伤,为临床血小板榆注评价提供可参考指标。方法血小板室温22℃保存0、3、5、7d,分别检测血小板的代谢情况,形态改变,功能变化等一系列指标,对血小板的保存损伤进行多参数分析。结果血小板保存从3d开始乳酸（LA）、乳酸脱氢酶（LDH）堆积增多,平均血小板体积（MPV）、血小板分布宽度（PDW）数值逐渐增大,形态改变明显,葡萄糖（Glu）、pH值则呈下降趋势,CD62P表达增强,血小板活化明显,聚集功能低下,保存到5、7d所观察的各项指标变化更加明显,聚集功能几乎下降为零。用0d的各数值同3、5、7d比较差异均具有统计学意义（P〈0．01）。结论血小板保存期间形态功能改变明显,临床在做血小板输注效果评价时,应当考虑血小板本身的质量问题。特别是在保存3d后。血小板具有明显的损伤,聚集功能显著减弱,临床输注保存期的血小板最佳时间为3d。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.