脑血栓形成患者急性期和恢复期血小板α颗粒膜蛋白-140的变化

目的研究血小板α颗粒膜蛋白－１４０（ＧＭＰ－１４０）在脑血栓形成患者急性期和恢复期的变化。方法测定５０例 （其中３０例急性期患者,２０例恢复期患者）脑血栓形成患者血浆ＧＭＰ－１４０的含量,并分别与２６名健康人作比较。结果 脑血栓形成患者急性期ＧＭＰ－１４０浓度明显高于恢复期和正常对照组（Ｐ＜０．０１）,恢复期与正常对照组间比较差异无显 著性（Ｐ＞０．０５）。结论脑血栓形成患者急性期血浆ＧＭＰ－１４０含量处于较高水平。     

Diagnostic Utility of Platelet Count/Lymphocyte Count Ratio and Platelet Count/Mean Platelet Volume Ratio in Periprosthetic Joint Infection Following Total Knee Arthroplasty

BackgroundDiagnosing a periprosthetic joint infection (PJI) can be challenging and often requires a combination of clinical and laboratory findings. Monocyte/lymphocyte ratio, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio (PLR), and platelet/mean platelet volume ratio (PVR) are simple predictors for inflammation that can be readily obtained from complete blood count. The aim of this study is to evaluate the diagnostic utility of these markers in predicting PJI in total knee arthroplasty (TKA) patients.MethodsA total of 538 patients who underwent revision TKA with calculable marker ratios prerevision in 2 groups were evaluated: (1) 206 patients with a preoperative diagnosis of PJI (group I) and (2) 332 patients treated for revision TKA for aseptic failures (group II). The diagnostic abilities of the markers were assessed via receiver operator characteristic curve analysis.ResultsThe optimal threshold of PVR at 30.82 had the highest sensitivity of 87.7%, while the optimal threshold of PLR at 234.13 had the highest specificity of 82.5%. Both PLR and PVR, when combined with Musculoskeletal Infection Society thresholds for erythrocyte sedimentation rate, C-reactive protein, synovial WBC, and PMN%, achieve significantly higher sensitivity and specificity rates for PJI at or above 97% (PLR: 99.03%; 98.80%; PVR: 98.54%;97.89%).ConclusionOur study demonstrates that PVR and PLR, which are readily available and inexpensive to obtain from complete blood counts, when combined with serum and synovial fluid markers have increased sensitivity and specificity comparable to that of alpha defensin. This suggests that PVR and PLR can be used together with other hematologic and aspirate markers to increase the accuracy of PJI diagnosis in TKA patients.     

THSD7A在宫颈癌细胞侵袭、迁移等恶性生物学行为中的研究

目的 为了探索THSD7A对宫颈癌细胞的侵袭、转移以及凋亡等生物学行为的影响。方法 对宫颈癌C33a细胞和SiHa细胞培养及转染siTHSD7A基因,采用Western blotting和RT-qPCR方法在蛋白和基因水平对其验证。后应用Transwell小室实验、流式细胞术检测THSD7A沉默后对两种宫颈癌细胞的侵袭、转移、细胞周期及凋亡的改变。结果 与空白组和阴性对照组相比,沉默THSD7A的表达后,宫颈癌C33a细胞和SiHa细胞的侵袭、迁移能力明显下降（P＜0.01）;进入S期和G2/M期细胞数目减少,凋亡比例增高（P＜0.05）。结论 提示THSD7A可能作为一种致癌基因,在宫颈癌恶性生物学行为的发展过程中起到推进作用。     

内毒素所致DIC时血小板胞浆Ca^2＋浓度变化的研究

本实验观察内毒素在体外对兔血小板胞浆游离钙浓度[Ca~(2+)]i的作用以及用二次注射内毒素法复制DIC模型时对[Ca~(2+)]i的影响。结果表明静息血小板[Ca~(2+)]i为112±24 nM,内毒素可直接作用于血小板,使[Ca~(2+)]i呈剂量依赖性升高。内毒素致DIG时(Ca~(2+)]i可升高三倍。结果提示内毒素可能是通过升高血小板[Ca~(2+)]i而激活血小板。血小板的激活可能是导致DIC的重要发病机制之一。     

蛇毒抗栓酶对氧自由基致血小板变化的影响

次黄嘌呤／黄嘌呤氧化酶体系产生的氧自由基在体外能明显增加血中板膜微粘度，脂质过氧化代射产物丙二醛含量，血小板胞内游离钙浓度和血小板５－羟色胺的释放量。０．０３ｕ／ｍｌ的蛇毒抗栓酶明显抑制前二种效应，但促进血小板释放５－羟色胺，增加血小板胞内游离钙浓度，结果表明蛇毒抗栓酶对血小板膜有保护作用。     

Effects of taprostene,a stable prostacyclin analogue,on haemodynamics,platelet function and arachidonate metabolism in healthy volunteers

Summary In order to assess the effect of taprostene on haemodynamics, platelet function and arachidonate metabolism in 4 healthy volunteers an intravenous infusion of 25 ng · kg^–1 · min^–1 was given for 6 h.During the infusion period systolic blood pressure dropped from 130 to 111 mm Hg and diastolic blood pressure from 77 to 69 mm Hg. The heart rate rose from 77 to 84 beats/min.During the taprostene infusion the slope and height of the ADP and collagen induced platelet aggregation curves were significantly inhibited and the sensitivity of platelets to PGI₂ and PGE₁ was increased.Plasma and serum thromboxane B₂, conversion of exogenous radiolabelled arachidonic acid, WU-test, circulating endothelial cell count, concentration of platelet factor 4, -thromboglobulin, malondialdehyde and the PGI₂-synthesis stimulating plasma factor did not show any clear drug-related alteration.It is concluded that infusion of taprostene 25 ng · kg^–1 · min^–1 caused measurable inhibition of platelet function ex vivo.     

“In vitro” and “ex vivo” effects of picotamide,a combined thromboxane A2-synthase inhibitor and -receptor antagonist,on human platelets

Summary Picotamide (G 137), a new non prostanoid inhibitor of in vitro arachidonic acid induced platelet aggregation, has been further characterized in in vitro and ex vivo studies.When whole blood was activated with collagen in the presence of picotamide 5×10^–4 M, thromboxane B₂ production was decreased, and 6-keto-PGF₁ generation was significantly increased, suggesting a reorientation of platelet endoperoxide metabolism following blockade of thromboxane synthetase. Picotamide also inhibited platelet aggregation and clot retraction induced by the endoperoxide analogue U46619 in human platelets, indicating thromboxane A₂-receptor antagonism, possibly of competitive nature.A single oral dose of picotamide 1 g in 24 healthy volunteers produced a significant inhibition of collagen, arachidonic acid and U46619-induced platelet aggregation. Serum levels of thromboxane B₂ were also reduced.Chronic administration of picotamide 1.2 g/d to patients with vascular disease resulted in a prompt and persistent fall in their increased plasma levels of -thromboglobulin.The results indicate that picotamide is a combined thromboxane B₂-synthetase inhibitor and thromboxane A₂-receptor antagonist in human platelets, and that it may prove useful as an antithrombotic agent.     

宫内胎肝细胞移植形成血小板GPⅡb Bak a/b嵌合体的研究

目的　探讨宫内胎肝细胞移植是否形成人工血小板杂合子嵌合体 ,评估其在治疗血小板无力症的临床应用前景。方法　选择血小板膜GPⅡbBaka/b(GPⅡb异亮氨酸 84 3丝氨酸多态性 )作为遗传标记 ,采用等位基因特异引物PCR和FOKⅠ限制性内切酶消化技术从 4 2名引产妇筛选一例纯合子GPⅡbBaka/a作为供者 ,一例纯合子GPⅡbBakb/b作为受者 ,制备供者胎肝细胞 ,取 4ml(2 2× 10 5细胞 )在B超引导下通过脐静脉穿刺输给受者。结果　移植后 2 1天 ,用PCR FOKⅠ消化技术检测引产后受者外周血DNA和血小板RNA ,发现已形成Baka/b嵌合体。结论　我们认为宫内胎肝细胞移植可能提供一种治疗血小板无力症和其他遗传性疾病的方法。     

非小红细胞对血小板计数结果影响分析

目的 :探讨用血液分析仪作血常规检测时由非小红细胞引起的上限区域干扰 (upperregioninterference ,URI)对血小板计数 (BPC)结果的影响。方法 :用血液分析仪作血小板参数分析 ,对出现URI报警但又不是小红细胞干扰的标本作显微镜计数 ,把两法结果作配对t检验。结果 :仪器法结果为 (6 6± 17)× 10 9/L ,而显微镜计数法为 (98± 2 0 )× 10 9/L ,两法结果差异有显著性 (P <0 .0 0 1) ;URI报警时除小红细胞干扰外 ,还有其他诸多因素 ;大血小板、血小板凝集块、冷球蛋白、衰老破坏的红细胞碎片等 ,其中最常见的为大血小板。结论 :对URI报警但非小红细胞干扰的BPC结果 ,一定要进行人工显微镜目测计数复检 ,否则会得到不可靠的结果     

PTCA及血管内支架术中冠脉循环血小板功能的变化

目的 探讨经皮腔内冠脉成形术（PTCA）及冠脉内支架术对冠脉循环中血小板功能的影响。方法 29例冠心病患者分成冠脉造影组（8例）和PTCA加支架组（21例）,分别于术前及术后即刻采集冠状静脉窦血,采用比浊法测定血小板最大聚集率（MPAR）,放免法测定血小板α-颗粒膜蛋白（GMP－140）及血栓素B2（TXB2）的浓度。并对PTCA及支架术中不同时间点血小板功能指标的变化情况进行了观察。结果 冠脉造影前后血小板功能指标无显著变化;PTCA及支架组在球囊预扩张即刻各血小板功能指标均轻度增高;支架后即刻显著升高（P＜0．05）,支架后10min有下降趋势。结论 冠脉造影对冠脉循环血小板功能无显著影响;PTCA及支架术中能使血小板功能激活。