动脉血流改变后壁切应力动态变化的检测与分析

在实验兔发出甲状腺前动脉的远心端结扎左颈总动脉,使其近心段血流约减少了９０％ ,在术后不同时相点观测该部位血流壁切应力的动态变化规律,以期进一步研究切应力在内皮重建过程中的作用。结果表明,切应力在术后的变化可概括为三个阶段：正常对照切应力→切应力显著降低阶段（术后１ ｈ～７ ｄ）→从低切应力显著增高阶段（术后７ ｄ 以后）→切应力回复正常对照水平阶段（术后３０ ｄ 以后）。这种改变与动脉管径的缩减密切相关。说明血流改变后切应力在调控动脉重建中可能起主要作用。     

类肝素聚乙烯醇复合材料抗凝血性能的研究

本文报道了聚乙烯醇羧甲醚（ＰＣ）、聚乙烯醇硫酸酯（ＰＳ）及聚乙烯醇接枝甲基丙烯酸β羟乙酯、丙烯腈（ＰＶＡｇＨＥＭＡＡＮ）的合成制备方法。通过红外光谱和元素分析定性、定量证实了合成方法的可行性。研究了将ＰＣ、ＰＳ以不同重量比加入ＰＶＡｇＨＥＭＡＡＮ后形成的聚乙烯醇衍生物复合材料（ＣＤＰＶＡ）对抗凝血性能的影响。（ＣＤＰＶＡ）对人血的溶血度仅为３２％,人血复钙时间比空白对照延长２０２ｓ,凝血时间延长１８５７ｓ。ＳＥＭ观察表明ＣＤＰＶＡ接触血液一定时间后表面没有形成血液蛋白纤维网络,具有微相分离结构。     

血液的交流电导特性研究

对血液的交流电特性做了较全面的研究。针对血液这一特殊对象,在测试方法及测量系统设计中做了较深入的工作。在１ＨＺ－１０ＨＭＺ频率范围内测定了正常成人全血的电频谱特性。实验发现,正常成人血液电导随测量信号频率增加在１００ＨＺ－１０ＫＨＺ范围内有显著的增加,但相位基本不变,考虑到血液的这一电特性,将对以前电导法测红血球压积,血液粘度等工作做一定的补充和修正,并帮助我们建立更合理的血液等效电模型。     

Comparison of optical, electrical, and centrifugation techniques for haematocrit monitoring of dialysed patients

Haematocrits were measured as a function of ultrafiltration in a simulated haemodialysis circuit using bovine blood (plasma conductivity 12 mS cm-1) and hypotonic (8.6 mS cm-1) or hypertonic (16 mS cm-1) dialysates as well as in the absence of dialysate. A comparison was made between measurements by light absorption due to haemoglobin, by impedance in the blood line at 5 kHz using Hanai's model of blood conductivity, by conductivity measurements of blood samples at 1.2 kHz using a conductimeter, by centrifugation of blood samples and by calculations using fluid conservation. The validity of Hanai's model was verified to be satisfactory by direct blood and plasma conductivity measurements. In the absence of ionic transfer the impedance device underestimated the haematocrit by 5 to 7%. This underestimation reached 18% in the case of hypertonic dialysate, but this effect can be minimised if the haematocrit necessary for calibration is measured by centrifugation after 15 min of dialysate circulation when ionic balance is achieved. It was found that the optical method monitors haemoglobin concentration rather than red cell volume changes and is not affected by osmotic red cell swelling in the case of hypotonic dialysate. It can be concluded that the light absorption technique is both more accurate and more convenient to use than impedance.     

冠心病A型行为干预前后血液指标检测

目的：冠心病A型行为干预前后的有关血液指标变化的对比研究。方法：将128例冠心病患者随机分为观察组和对照组,区别在于加不加心理行为干预,其他临床常规治疗相同。干预与治疗前后均观测有关血液指标并对比,进行统计学处理。结果：观察组比对照组下列指标有显著性或非常显著性差异：A型行为改善（P＜0．01）;血清胆固醇（TC）降低（P＜0.05）;全血及血浆粘度降低（P＜0．05）;血浆肾上腺素（E）及去甲肾上腺素（NE）降低（P＜0.01）。给论：冠心病患者进行A型行为干预有助于改善有关血液指标,同时可缓解心绞痛症状,ECGST－T好转。     

Influence of epidemiological factors on blood transfusion

The prevalence, incidence and risk factors of infectious diseases observed in the general population have been described to directly influence transfusion medicine, especially the blood selection. The objective is to ensure the blood safety. The characterization of modes of transmission influences the donor selection: the risk factors of the main blood‐borne infections have permitted to adapt the pre‐donation questionnaire in order to exclude at‐risk donors. The prevalence of infections also has an impact on the blood screening strategy. For example, anti‐HBc antibody (Ab) screening is currently performed only in countries where the HBV prevalence is compatible with a reasonable number of donor exclusions. HTLV Ab screening is implemented in countries in which the rate of donors originating from endemic areas could represent a risk for blood components. Measurement of incidence which contributes to the residual risk has led to the introduction of nucleic acid testing (NAT) for HIV, HCV and in some cases for HBV in viral screening strategy in many countries worldwide. The observed NAT yield differs according to the incidence of the infection and according to the country. Finally, the putative blood transmission of new and emerging pathogens has led to implement specific and non‐specific measures in order to enhance blood safety. Conversely, although the blood donor population is selected, the data observed in this population have also contributed to better understand epidemiology and pathogenesis of infection. Moreover, owing to the recent progress in developing modelling approaches for estimating risk, we are able to anticipate a transfusion transmission threat by introducing, when necessary, specific measures intended for reduce this risk.     

HEV and transfusion-recipient risk

HEV infections are mainly food- and water-borne but transfusion-transmission has occurred in both developing and developed countries. The infection is usually asymptomatic but it can lead to fulminant hepatitis in patients with underlying liver disease and pregnant women living in developing countries. It also causes chronic hepatitis E, with progressive fibrosis and cirrhosis, in approximately 60% of immunocompromised patients infected with HEV genotype 3. The risk of a transfusion-transmitted HEV infection is linked to the frequency of viremia in blood donors, the donor virus load and the volume of plasma in the final transfused blood component. Several developed countries have adopted measures to improve blood safety based on the epidemiology of HEV.     

Argininic acid alters markers of cellular oxidative damage in vitro: Protective role of antioxidants

We, herein, investigated the in vitro effects of argininic acid on thiobarbituric acid-reactive substances (TBA-RS), total sulfhydryl content and on the activities of antioxidant enzymes such as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the blood, kidney and liver of 60-day-old rats. We also verified the influence of the antioxidants (each at 1.0 mM) trolox and ascorbic acid, as well as of N^G-nitro-l-arginine methyl ester (L-NAME) at 1.0 mM, a nitric oxide synthase inhibitor, on the effects elicited by argininic acid on the parameters tested. The liver, renal cortex and renal medulla were homogenized in 10 vol (1:10w/v) of 20 mM sodium phosphate buffer, pH 7.4, containing 140 mM KCl; and erythrocytes and plasma were prepared from whole blood samples obtained from rats. For in vitro experiments, the samples were pre-incubated for 1 h at 37 °C in the presence of argininic acid at final concentrations of 0.1, 1.0 and 5.0 μM. Control experiments were performed without the addition of argininic acid. Results showed that argininic acid (5.0 μM) enhanced CAT and SOD activities and decreased GSH-Px activity in the erythrocytes, increased CAT and decreased GSH-Px activities in the renal cortex and decreased CAT and SOD activities in the renal medulla of 60-day-old rats, as compared to the control group. Antioxidants and/or L-NAME prevented most of the alterations caused by argininic acid on the oxidative stress parameters evaluated. Data suggest that argininic acid alters antioxidant defenses in the blood and kidney of rats; however, in the presence of antioxidants and L-NAME, most of these alterations in oxidative stress were prevented. These findings suggest that oxidative stress may be make an important contribution to the damage caused by argininic acid in hyperargininemic patients and that treatment with antioxidants may be beneficial in this pathology.     

血标本类型及室温放置时间对B型钠尿肽测定结果的影响

目的 探讨不同标本类型及室温放置时间对血液B型钠尿肽(BNP)测定结果的影响.方法 纳入本院住院患者80例,采用BD公司EDTA抗凝管、肝素抗凝管和分离胶血清管同时采集血标本(按EDTA抗凝血测定结果:BNP＞ 100pg/mL65例;BNP＜ 100 pg/mL 15例),BNP于1h检测完毕.并配对选取三类标本中BNP水平的高、中、低值各3例,室温闭盖放置,分别测定2h、3h、4h、5h和7h的BNP结果.BNP采用贝克曼库尔特公司DXI800仪器进行检测.结果 肝素抗凝标本的BNP测定值显著高于EDTA标本(588.9±708.4 vs 549.2±639.8,t=-2.184,P=0.32);血清标本显著低于EDTA标本(431.6±517.3 vs 549.2±639.8,t=7.229,P＜0.001).以EDTA组测定值为y值,线性回归分析的回归方程分别为Y(EDTA)=0.886X(肝素)+ 27.445(R2=0.962,P＜0.001)和Y(EDTA)=1.08X(血清)+82.924(R2=0.763,P＜0.001).室温放置对测定结果的影响,EDTA标本高、中值标本7h内的检出率皆高于95％,低值标本5～7h检出率低于95％;肝素标本高值2h检出率低于95％,中、低值3h皆低于95％;而血清标本2～7h的高、中、低值标本检出率皆低于95％.结论 不同标本类型可显著影响BNP测定值;EDTA抗凝标本室温闭盖放置4h内测定值可接受.     

血细胞参数在妊娠糖尿病诊断中的应用及相关研究进展

妊娠期糖尿病(GDM)在孕妇中的比例呈上升趋势,是妊娠期重要的并发症之一,属于高危妊娠,GDM不但增加孕妇和新生儿的多种并发症,而且使孕妇以后发生显性糖尿病的几率增大.因此,对GDM的早期预测、诊断和干预就显得十分重要,并能够大大降低其各种并发病对母婴的危害.目前临床上对GDM的检测主要是集中在孕期的中后期,往往导致病情的延误,而对于早期GDM的筛查临床上并无确定的诊断技术和足够重视.研究发现,血细胞参数对GDM有一定的早期预测价值,将血细胞参数应用于GDM的研究中,实现对GDM的早期诊断,对GDM的防治和母婴预后将具有重要意义.本文将血细胞参数与妊娠糖尿病关系对GDM的早期诊断的价值以及对妊娠结局、预后的影响和妊娠期铁重要性的研究进展做一综述.