Effect of 24-hour whole-blood storageon plasma clotting factors

BACKGROUND: The current requirements for the preparation of fresh-frozen plasma within 8 hours of whole-blood collection were designed to maintain clotting factor activities. These requirements, however, limit the production of fresh-frozen plasma in a large blood center. There are few data on the effect of the extension of CPD whole-blood storage to 24 hours on clotting factor activity. STUDY DESIGN AND METHODS: A 500-mL unit of whole blood was collected from 10 volunteer donors. At 1 hour after collection, a plasma sample was separated by centrifugation, and each unit was equally divided into 2 half-units, with 1 half-unit stored at 4 degrees C (range, 1-6 degrees C) and 1 half-unit stored at 22 degrees C (range, 20-24 degrees C) for 8 hours after collection. Each half-unit was then placed at 4 degrees C for further storage for 16 hours. At 8 and 24 hours after collection, plasma samples were separated from each half-unit. All plasma samples were frozen at -18 degrees C. Factors V, VII, VIII, and X; fibrinogen; antithrombin III; protein C; and protein S were measured. RESULTS: No significant changes were noted in factors V, VII, and X; fibrinogen; antithrombin III; protein C; and protein S over the 24-hour storage period. Factor VIII in both half-units was significantly reduced, by 13 percent, from the baseline sample as compared to the level in the 8-hour storage sample (p<0.05). Factor VIII was further reduced by 15 to 20 percent after the 24-hour storage period (p<0.05). CONCLUSION: The coagulation factor activity for all factors measured, with the exception of factor VIII, showed no significant change over the 24-hour storage period. Factor VIII was significantly decreased by 13 percent in 8-hour storage and by an additional 15 to 20 percent in 24-hour storage. For clinical situations not requiring the replacement of factor VIII only, 24-hour frozen plasma has properties comparable to those of fresh-frozen plasma.     

亚甲蓝光敏消毒法对人血浆部分成分影响的试验观察

向人血浆中加入亚甲蓝染料浓度为１ μｍｏｌ／Ｌ,再以１０ ０００ ｌｕｘ 强度的溴钨灯光照射１０ ｍｉｎ,血浆中主要成分的生化指标只有胆红素与尿酸两种代谢产物有明显降低,其余均无明显变化,各种酶活性未发生明显改变。血浆蛋白分子量ＳＤＳ－ ＰＡＧＥ与盘状ＰＡＧＥ电泳未见明显异常。微量免疫电泳与免疫交叉电泳也未见血浆成分免疫原性改变。     

疏肝散结消癖汤对大鼠乳腺增生及内分泌激素的影响

目的探讨疏肝散结消癖汤对乳腺增生模型大鼠乳腺增生及血清性激素水平的影响。方法将60只SD大鼠随机分为6组：空白对照组、模型组、乳癖消阳性对照组、疏肝散结消癖汤高剂量组、疏肝散结消癖汤中剂量组、疏肝散结消癖汤低剂量组。采用苯甲酸雌二醇联合造模,制成大鼠乳腺增生模型,观察各组大鼠乳头形态,以及疏肝散结消癖汤对乳腺增生模型大鼠乳腺增生及血清雌二醇（E2）、催乳素（Prl）、黄体酮（P）水平的影响。结果与模型组比较,疏肝散结消癖汤各剂量组大鼠乳头的高度和直径减小,血清雌二醇、泌乳素水平明显降低,黄体酮水平明显升高（P〈0．01）。结论疏肝散结消癖汤可调节乳腺增生大鼠的激素水平,对治疗大鼠乳腺增生有效。     

重症颅脑外伤急性期联合检测空腹血糖和糖化血红蛋白及乳酸脱氢酶临床价值

目的探讨联合检测空腹血糖（fasting plasma glucose,FPG）、糖化血红蛋白（glycosylated hemoglobin A1C,HbA1c）及乳酸脱氢酶（1actate dehydrogenass,LDH）在重症颅脑外伤急性期患者病情评估及预后判断中的价值。方法52例重症颅脑损伤患者,分别依据人院时格拉斯哥昏迷评分（GlasgowComaScale,GCS）、FPG联合HbAtc检测情况及GCS预后评分进行分组,比较重度颅脑损伤组（GCS评分6～8分）与极重度颅脑损伤组（GCS评分3～5分）、糖尿病高血糖组（FPG〉6．1mmol／L且HbAlc〉6．2％）与应激性高血糖组（FPG〉6．1mmol／L且HbAlc〈6．2％）及不同预后患者LDH、FPG水平,并分析GCS评分与LDH、FPG的相关性。结果极重度颅脑损伤组FPG、LDH水平高于重度颅脑损伤组（P〈O．01）;糖尿病高血糖组与应激性高血糖组FPG、LDH水平及预后比较差异无统计学意义（P〉0．05）;恢复良好组、预后差组、死亡组LDH、FPG水平比较差异均有统计学意义（P〈0．01）;重症颅脑外伤患者人院时GCS评分与LDH、FPG水平呈负相关（r=-0．948,P=0．001;r=-0．941,P=0．001）。结论FPG、LDH可用于评估颅脑损伤严重程度,判断患者预后,HbA,c在鉴别诊断糖尿病性或应激性血糖增高中有重要价值。     

低分子肝素钙对肺源性心脏病心力衰竭患者临床疗效及血浆N-末端脑钠肽前体、D-二聚体水平的影晌

目的：观察低分子肝素钙对肺源性心脏病（肺心病）心力衰竭患者血液流变学、血浆N-末端脑钠肽前体（NT-proBNP）及D-二聚体（D-D）水平的影响。方法选取2011年1月-2014年1月肺心病心力衰竭患者95例,随机分为观察组45例及对照组50例。2组均给予常规治疗,观察组在此基础上加用低分子肝素钙皮下注射。观察2组临床疗效、不良反应、治疗前后血液流变学、血浆NT-proBNP及D-D水平的变化。结果治观察总有效率95．56％,显著高于对照组总有效率82．00％（P＜0．05）,2组不良反应无显著差异（P＞0．05）;2组治疗后血液流变学、血浆NT-proBNP及D-D水平均较治疗前显著改善（P＜0．05或P＜0．01）;观察组显著优于对照组（P＜0．05或P＜0．01）。结论低分子肝素钙联合多巴酚丁胺和硫酸镁治疗肺心病心力衰竭患者安全有效,可显著改善患者血液流变学指标,降低血浆NT-proBNP及D-D水平。     

基于性染色体定量检测的伴性遗传病无创性产前筛查方法的研究

目的：利用孕妇血浆游离DNA对产前胎儿性别进行识别,为伴性遗传性疾病的无创性产前筛查提供参考。方法利用X、Y染色体的特异性引物和探针构建识别胎儿性别的实时荧光定量聚合酶链反应（PCR）检测技术,并对灵敏度、准确性等方法学指标进行评价,然后将构建好的方法用于24例未孕健康女性及临床上50例16～20孕周的孕妇血浆DNA的检测。结果在母体DNA胎儿Y染色体定性检测方法的灵敏度检测中,当胎儿DNA丰度为3％～6％时,母体DNA模板量下限是50 pg。当母体DNA模板量在0．5～50 ng时,Y染色体最低检测丰度为1％,相当于胎儿DNA丰度为2％;当母体DNA模板量在0．05～0．5 ng时,Y染色体最低检测丰度为2％～4％,相当于胎儿DNA丰度为4％～8％;当无母体DNA时,Y染色体模板量下限为0．5 pg。标本定量检测中妊娠女性的血浆DNA浓度明显高于未孕健康女性（P＜0．05）。50例孕妇静脉血标本中,除1例标本因提取失败未作检测外,其余49例标本初次试验在未考虑母体血浆DNA模板起始用量时,检测结果为17例男性,32例女性,与胎儿出生后性别不完全一致;但是当加大母体血浆DNA模板起始用量（＞50 pg）后,结果为23例男性,26例女性,准确率为100％。结论该试验所构建的利用母体血浆游离DNA进行的早期无创性产前筛查方法具有较高的准确性,可以为伴性遗传出生缺陷性疾病的早期筛查和预防提供重要的参考价值。     

RP-HPLC 测定人血浆中阿苯达唑及代谢物的浓度

 目的 建立 RP-HPLC 测定血浆中阿苯达唑及其代谢物阿苯达唑亚砜、阿苯达唑砜浓度的方法。 方法 在改进文献报道的基础上,采用 C ₂ 柱固相萃取法处理血浆,建立了精确、灵敏、重现性和专一性好的高效液相 - 紫外检测法（ HPLC-UV ）。色谱条件：分析柱： Agilent Zorbax RX-C₈ （ 4.6 mm×250 mm , 5 μm ）;柱温：室温;流动相：乙腈 -NaAc 缓冲液（ 0.1 mol·L^-1 , HAc 调节 pH 5.0 ） =45 ∶ 55 ,流速 0.9 mL·min^-1 ,检测波长 291 nm 。 结果 阿苯达唑及其代谢物阿苯达唑亚砜、阿苯达唑砜的血药浓度线性范围分别为 10~600 , 10~1 000 , 10~300 μg·L^-1 ;方法回收率分别为 92.23% ~ 103.81% , 99.59% ~ 100.21% , 96.89% ~ 106.84% 。 批内精密度分别为 2.03%~3.12% , 2.05%~3.80% , 2.79%~4.14% ;批间精密度分别为 3.20% ～ 4.33% , 2.05%~3.48% , 2.87%~3.87% 。 结论 本法灵敏、准确,可用于阿苯达唑的人体药动学研究。     

反相高效液相串联质谱检测法测定人血浆中阿立哌唑的浓度及临床应用

 目的建立测定人血浆中阿立哌唑浓度的反相高效液相串联质谱电喷雾检测法(LC-ESI-MS/MS)。方法以迪马C18反相柱(4.6mm×150mm,5μm)为色谱柱,流动相为甲醇-5mmol·L^-1甲酸铵(90∶10),流速为1mL·min^-1,柱温:25℃,以醋酸乙酯-二氯甲烷(4∶1)为提取剂。样品经电喷雾离子源正离子化后,通过三重四级杆串联质谱仪,采用选择反应监测(SRM)对阿立哌唑(m/z 448.3→285.0)和内标替米沙坦(m/z 515.3→497.3)进行测定。并用此法测定30例患者稳态血药浓度。结果阿立哌唑的高(400μg·L^-1)、中(125μg·L^-1)、低(10μg·L^-1)3个质量浓度的平均回收率分别为94.27%、102.58%和97.97%,日内(n=5)、日间(n=3)RSD均小于15%;分析方法的最低定量限为1μg·L^-1。线性范围为:5～500μg·L^-1,回归方程为F=0.5469ρ+0.0714,r=0.999(n=7)。结论该方法灵敏、准确、简单、快速,可用于临床血浓监测和药动学研究。     

高效液相色谱法同时测定人血浆中齐多夫定、奈韦拉平浓度

 目的高效液相色谱法同时测定齐多夫定和奈韦拉平血浆中的浓度。方法色谱柱为岛津Shim-pack CLC-ODS(6mm×15cm,5μm)。流动相为乙腈-水(23∶77),流速1mL·min^-1。紫外检测波长为260nm。柱温为室温。内标物(替加氟)与齐多夫定、奈韦拉平的保留时间分别为4.665,5.198和10.912min。结果齐多夫定、奈韦拉平的线性范围分别为0.025～10mg·L^-1(r=0.9999)和0.05～10mg·L^-1(r=0.9999),最低检测下限分别为0.025和0.05mg·L^-1。样品溶液冻融稳定,日内精密度和日间精密度良好,回收率较高。结论采用HPLC-UV测定血浆中齐多夫定和奈韦拉平浓度,方法简便,结果准确可靠。     

Umbilical cord plasma homocysteine concentrations at delivery in pregnancies complicated by pre-eclampsia

Aim: To determine whether homocysteine concentrations in umbilical cord plasma of neonates born to mothers with pre-eclampsia are elevated compared to concentrations in neonates born to normotensive women.
Method: Maternal blood from eight women with pre-eclampsia and ten women without pre-eclampsia was collected on admission for labour. Cord blood was collected from these same pregnancies at delivery. Plasma was extracted and stored at −70°C. Samples were batch-analysed for homocysteine.
Result: Maternal plasma homocysteine levels were observed to be significantly higher in the pregnancies complicated by pre-eclampsia compared to the control pregnancies ( P  = 0.043) with median levels of 5.4 µmol/L (interquartile range (IQR) 4.6–7.9; range 3.6–16.7) versus 4.1 µmol/L (IQR 3.4–5.1, range 3.1–6.7). Homocysteine concentrations in umbilical cord plasma in pregnancies complicated by pre-eclampsia were also significantly higher compared to those in normotensive pregnancies ( P  = 0.016) with median concentration levels of 5.3 µmol/L (IQR 4.8–7.2, range 2.5–16.6) versus 3.8 µmol/L (IQR 2.8–4.4, range 0.8–1.6).
Conclusion: Both maternal and umbilical cord plasma homocysteine concentrations were elevated in pregnancies complicated by pre-eclampsia compared to normotensive controls.