Serum urate concentrations in homozygous sickle cell disease

Serum and urinary urate concentrations were studied in 44 patients with homozygous sickle cell (SS) disease, and in 27 controls with normal haemoglobin. Hyperuricaemia (>0·39 mmol/l (6·5 mg/100 ml)) occurred in 41% of SS patients and inversely correlated with renal urate clearance but not with indices of bone marrow turnover. Higher serum urate concentrations occurred in patients with proteinuria, probably due to associated tubular damage. Higher serum urate concentrations and lower urate clearance occurred in males compared to females.     

慢性低氧小鼠肺组织糖蛋白的变化

目的 :研究在慢性常压低氧下的小鼠肺组织多糖、粘蛋白的适应性变化。方法 :低氧 (1 0 % )第 1、3、5、7天分别取左肺中部组织作冰冻切片 ,以高碘酸Schiff反应 (PAS)显示糖原及粘蛋白并进行光镜观察。结果 :与动脉平滑肌比较 ,低氧小鼠支气管平滑肌糖原合成一过性增强 ;静脉内皮细胞糖代谢的敏感性显著高于动脉 ;低氧能刺激支气管粘膜分泌细胞分泌粘蛋白 ,反应随低氧作用时间而变化。结论 :小鼠肺组织糖原、粘蛋白代谢在慢性低氧下产生适应性变化。杯状细胞与管壁内腺体的分泌物在上皮表面共同构成的粘液性屏障有利于小鼠的低氧适应     

胎儿脐动脉及大脑中动脉血流监测对胎儿预后的作用

目的 评价超声监测胎儿脐动脉及大脑中动脉血流对胎儿预后的作用。方法 应用彩色多普勒监测６９例中晚期正常妊娠及１６例宫内缺氧（窘迫）组及５例围产儿死亡组胎儿大脑中翅膀（ＭＡＣ）、脐动脉（ＵＡ）收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ）及阻力指数（ＲＩ）并与妊娠结局相对照。结果 正常妊娠时随孕周增加ＵＡ、ＭＣＡ的Ｓ／Ｄ及ＲＩ值逐渐下降;异常组ＵＡ的Ｓ／Ｄ、ＲＩ值均明显高于正常组,     

螺旋CT 成像技术在脊柱创伤的诊断和治疗中的应用

目的　通过对 2 0例脊柱创伤病人SCT扫描的前瞻性研究 ,旨在提高SCT在脊柱创伤的诊断和治疗中的价值。方法　回顾性地分析 2 0例脊柱创伤病人的SCT扫描资料。结果　单纯裂纹骨折的 8例 ,粉碎性压缩骨折同时伴有不同程度的椎管狭窄的 12例 (11例椎管内见游离骨碎片 ,2例椎管内有血肿 ) ,其中 10例同时伴有脊柱不同程度的滑脱、错位致脊柱不稳。结论　SCT成像技术在脊柱创伤诊断和治疗方案的选择上具有独特的优越性。     

老年不稳定性心绞痛临床特点

目的　探讨老年不稳定性心绞痛的临床特点。方法　所有患者均为住院患者 ,按年龄分为老年组和对照组 ,观察临床表现 ,2 4h动态心电 ,心脏B超等。结果　老年组在性别、心绞痛临床表现 ,心肌缺血持续时间及瓣膜、心功能改变与对照组相比有明显差异。结论　①老年不稳定心绞痛女性患者比例增加。②心绞痛症状常为不典型 ,易误诊及漏诊。③无症状心肌缺血多见。④常伴有心脏瓣膜钙化及关闭不全。⑤左心室舒张功能受抑制     

Clinical trial and local process evaluation of an apheresis system for preparation of white cell-reduced platelet components

BACKGROUND: A new method for the consistent preparation of white cell (WBC)-reduced plateletpheresis components, the Spectra Leukoreduction System (LRS), was evaluated by clinical trial and local process validation. The centrifuge-based system was projected to decrease the WBC content of plateletpheresis components to a level below 1 × 10(6) per unit. Phase I and II clinical trials were performed. The manufacturer's claims were then tested at the local level with an ongoing quality assurance program. STUDY DESIGN AND METHODS: In Phase I, a cross-over analysis of five subjects compared LRS to standard plateletpheresis procedures in collection efficiency and component quality: a panel of in vitro measures was taken on Day 0 and Day 5. In Phase II, the LRS process was tested on a larger scale (n = 57; control = 58) with component transfusion. Finally, validation, determination of degree of conformance with standards, and ongoing quality control were performed locally on a newly installed instrument. RESULTS: Phase I and II trials revealed no significant differences between LRS and control units in donor or recipient safety and comfort, platelet function and yield, or component volume. WBC per-unit values were significantly different: the LRS median per unit was 3.2 × 10(4) WBCs, versus 81.4 × 10(4) for control units. Assessment of process capability gave an estimate of 99-percent confidence that 99.5 percent of LRS units would be WBC reduced to < 1 × 10(6) WBCs. Local process validation and quality control revealed 90-percent confidence that 99 percent of the units would be WBC reduced and 99.9-percent confidence that 75 percent would exceed platelet yield standards; the process was stable over time. CONCLUSIONS: The LRS is safe for apheresis and the component produced is safe for transfusion with platelet function and yield equivalent to controls and WBC reduction superior to controls. Local process evaluation confirmed that component quality meets the goals of the institution.     

Effect on platelet properties of exposure to temperatures below 20 degrees C for short periods during storage at 20 to 24 degrees C

Background : When platelet concentrates (PCs) are shipped over long distances, it is not always possible to ensure that their temperature is maintained at 20 to 24°C. In addition, PCs are not agitated as during routine storage. Study Design and Methods : Studies have been conducted to evaluate how exposure to temperatures below 20°C in the absence of agitation influences properties of platelets. In initial studies, exposure to 4°C for 3 or 5 hours or to 12°C for 5 or 17 hours on Day 2 of a 5- to 6-day storage period was associated with a loss of discoid shape. This was reflected by slightly lower but statistically different morphology scores after storage compared to those observed with control platelets that were stored only at 20 to 24°C. In addition, a qualitative difference in morphology was noted in controls and PCs held at 16°C for 17 hours. In more detailed studies, both the in vivo viability and in vitro properties of platelets exposed between Day 1 and Day 2 to either 12°C or 16°C for 17 hours were evaluated. The protocol involved a paired study design (n = 4 for each exposure temperature) with the simultaneous storage of two identical PCs, one exposed to 12 or 16°C and the other one maintained at 20 to 24°C throughout the 5-day storage. Results : Exposure to 12°C significantly reduced (p < 0.05 by paired t test) the in vivo recovery to 37.6 ± 13.8 percent (mean ± 1 SD) from 47.8 ± 11.5 percent and the survival time to 2.0 ± 0.3 days from 6.5 ± 1.4 days. On exposure to 16°C, the differences in viability from those of control units were much less but still significant. The in vivo recovery was 42.7 ± 3.8 percent compared to 49.2 ± 3.0 percent and the survival time was 3.5 ± 1.2 days compared to 6.6 ± 0.3 days. The loss of in vivo viability of the test platelets was associated with a loss of discoid shape, as reflected by morphology scores, extent of shape change, and mean platelet volume. In addition, platelet metabolism also appeared to be affected, as suggested by increased lactate production. All of the in vitro properties except for total ATP and residual glucose that were statistically different from those of controls on exposure to 12°C were also significantly different on exposure to 16°C. Conclusion : These findings demonstrate that platelets undergo substantial changes in in vivo viability and in vitro properties when they are exposed to temperatures below 20°C for short periods.     

Gold-195m first-pass radionuclide ventriculography, thallium-201 single- photon emission CT, and 12-lead ECG stress testing as a combined procedure

Graded, sequential, rest/exercise, gold-195m (Au-195m) (T1/2 = 30 seconds), first-pass ventriculography and thallium-201 (T1-201) single-photon emission computed tomography (SPECT) were performed simultaneously during a single, electrocardiograph-monitored, bicycle stress test in 24 individuals. The technical aspects and logistics involved in performing this combined radionuclide study are stressed in this preliminary report. Fourteen healthy volunteers each had a normal left ventricular ejection fraction and wall-motion response, along with normal Tl-201 perfusion and washout, as determined by both visual and quantitative analysis of the tomographic sections. Each of ten patients with coronary artery disease had at least one abnormality of these parameters. We suggest that it is technically feasible to evaluate both cardiac function and myocardial perfusion simultaneously by combining Au-195m ventriculography and T1-201 SPECT imaging into a single, noninvasive, diagnostic package.     

人工全膝关节置换术后感染的临床分析及处理(附2例报告)

目的:探讨全膝关节置换术后感染的原因、处理方法、临床效果及预防措施。方法:对1998年8月～2004年10月单、双膝共92例其中2例术后感染患者的病因以及清创、Ⅱ期再置换等治疗方法进行总结分析。2例患者术前膝关节平均活动度为55°,HSS评分为36.5分;平均随访10个月。结果:2例感染患者经治疗后均未复发,患者对手术满意,膝关节活动度恢复至平均85°,HSS评分为73.5分。结论:感染明确后,应积极进行清创并应用敏感抗生素;Ⅱ期置换的临床效果优良。