分级检验在血脂检验中的应用价值

目的：对分级检验在血脂检验中的应用价值进行评价分析,为今后临床检验工作提供可靠的参考依据。方法选取2012年8月~2014年8月在本院接受血脂检验患者109例,均采集血液标本6 ml,平均分成2份,分别采取拉网式检验和分级检验2种不同的检验方法对血脂水平进行检验,对比分析检验结果。结果2种方法在检测低密度脂蛋白胆固醇、载脂蛋白A值和B值方面的结果有显著性差异(P<0.05),三酰甘油、总胆固醇、高密度脂蛋白胆固醇的检验结果则无明显差异(P>0.05)。结论分级检验能够对高血脂进行直接准确检测,临床价值显著,值得关注并推广。     

Plasma cells induce apoptosis of pre-B cells by interacting with bone marrow stromal cells

By using two-color phenotypic analysis with fluorescein isothiocyanate- anti-CD38 and phycoerythrin-anti-CD19 antibodies, we found that pre-B cells (CD38+CD19+) signifcantly decreased depending on the number of plasma cells (CD38++CD19+) in the bone marrow (BM) in the cases with BM plasmacytosis, such as myelomas and even polyclonal gammopathy. To clarify how plasma cells suppress survival of pre-B cells, we examined the effect of plasma cells on the survival of pre-B cells with or without BM-derived stromal cells in vitro. Pre-B cells alone rapidly entered apoptosis, but interleukin-7 (IL-7), a BM stromal cell line (KM- 102), or culture supernatants of KM-102 cells could support pre-B cell survival. On the other hand, inhibitory factors such as transforming growth factor-beta1 (TGF-beta1) and macrophage inflammatory protein- 1beta (MIP-1beta) could suppress survival of pre-B cells even in the presence of IL-7. Plasma cells alone could not suppress survival of pre- B cells in the presence of IL-7, but coculture of plasma cells with KM- 102 cells or primary BM stromal cells induced apoptosis of pre-B cells. Supernatants of coculture with KM-102 and myeloma cell lines (KMS-5) also could suppress survival of pre-B cells. Furthermore, we examined the expression of IL-7, TGF-beta1, and MIP-1beta mRNA in KM-102 cells and primary stromal cells cocultured with myeloma cell lines (KMS-5). In these cells, IL-7 mRNA was downregulated, but the expression of TGF- beta1 and MIP-1beta mRNA was augmented. Therefore, these results suggest that BM-derived stromal cells attached to plasma (myeloma) cells were modulated to secrete lesser levels of supporting factor (IL- 7) and higher levels of inhibitory factors (TGF-beta1 and MIP-1beta) for pre-B cell survival, which could explain why the increased number of plasma (myeloma) cells induced suppression of pre-B cells in the BM. This phenomenon may represent a feedback loop between pre-B cells and plasma cells via BM stromal cells in the BM.     

艾瑞昔布超前镇痛用于脊柱手术对患者术后镇痛效果的影响

目的观察艾瑞昔布超前镇痛用于脊柱手术对患者术后镇痛效果的影响。方法选取本院2017年3月～2018年3月收治的110例脊柱手术患者,按随机数表法分为观察组与对照组,各55例。观察组术前30 min口服100 mg的艾瑞昔布,对照组口服相同剂量的安慰剂。术毕予负荷剂量的芬太尼0.001 mg/kg。比较两组术后6 h与12 h的疼痛程度[采用视觉模拟评分法(VAS)评估]、镇静效果(采用Ramesay评分法评估)、芬太尼消耗量、自控按压总次数、不良反应总发生率。结果观察组术后6 h与术后12 h的术后疼痛VAS评分分别为(2.80±0.82)分与(1.85±0.45)分,低于对照组的(3.15±0.91)分与(2.32±0.64)分;观察组的镇静Ramesay评分分别为(2.28±0.59)分与(2.06±0.58)分,低于对照组的(2.63±0.71)分与(2.33±0.70)分,差异有统计学意义(P0.05)。观察组术后0～6 h、6～12 h、12～24 h的芬太尼消耗量及自控按压总次数均低于对照组(P0.05)。观察组的不良反应总发生率为7.27%,低于对照组的21.82%(P0.05)。结论脊柱手术患者采用艾瑞昔布进行超前镇痛可获得良好的术后镇痛效果与镇静效果,芬太尼用量与不良反应均明显减少,具有较高的有效性与安全性,值得推广。