Effect of ultraviolet blood irradiation and oxygenation on nerve function and function of the red blood cell membrane pump in patients with acute cerebral infarction

BACKGROUND： Ultraviolet blood irradiation and oxygenation （UBIO） has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear. OBJECTIVE： To observe the effect of UBIO on the nerve function and activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase activities on the red blood cell （RBC） membrane of patients with acute cerebral infarction. DESIGN： A randomized and controlled study.SETTING： Department of Neurology, Xiangfan Central Hospital.PARTICIPANTS： From January 2000 to December 2001, excluding those above 70 years old, 58 cases of 700 patients with acute cerebral infarction admitted in the Department of Neurology, Xiangfan Central Hospital, were recruited and divided into two groups according to the random number table： UBIO treated group （n=28）, including 17 males and 11 females, aged 40-68 years; and control group （n=30）, including 20 males and 10 females, aged 44-69 years. All the patients agreed to participate in the therapeutic program and detected items. The general informations were comparable without obvious differences between the two groups （P 〉 0.05）.METHODS： ① The patients in both groups received routine treatments, besides, those in the UBIO treated group were given UBIO treatment by using the XL-200 type therapeutic apparatus produced in Shijiazhuang, whose ultraviolet wave was set at 253.7 nm with the energy density of 0.568 J/m^2 per second, UBIO treatment started from the second day after admission, once every other day, with a single course consisting of 5-7 treatments. ② In the UBIO treated group, the venous blood was sampled before and after the first, third and the completion of the treatment course respectively, the venous blood was taken at each corresponding time point in the control group. After centrifugation of the blood at 10 000 rounds per minute, the RBC membrane was separated and then the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase were detected by means of phosphorus determination.③ The nerve function was scored before and after treatment in both groups with European stroke scale, which included 13 items, the total score was 0-100 points, the higher the score, the better the nerve function. MAIN OUTCOME MEASURES ：①Score of European stroke scale before and after treatment in both groups.② Comparison of the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase on RBC membrane between the two groups before treatment and after the first, third and the completion of the treatment. RESULTS： All the 58 patients with cerebral infarction were involved in the analysis of results.① The score of European stroke scale had no obvious difference between the two groups [（49.31±11.48）, （50.58±12.63）, P 〉 0.05], and it was obviously higher in the UBIO treated group than in the control group after treatment [84.66±13.75）, （77.05±11.17）, P 〈 0.05].②The activity of K^＋-Na^＋-ATPase on RBC membrane in the UBIO treated group was significantly increased after the first and third treatment as compared with before treatment [（31.56±19.25）, （27.64±15.83）, （17.67±13.83）, P 〈 0.01], it was still higher after the completion of the treatment than before treatment without obvious difference [（20.86±14.53）, P 〉 0.05]. After the first and third treatment, it was obviously higher in the UBIO treated group than in the control group [19.31±11.88）, （17.44±10.42）, P 〈 0.01]. ③ In the UBIO treated group, Ca2^＋-Mg2^＋-ATPase activity on RBC membrane significantly increased after the first treatment and remained higher than the pre-treatment level throughout the treatment [（27.49±14.72）, （17.41±4.82）, P 〈 0.01]. The activity of Ca2^＋-Mg2^＋-ATPase on RBC membrane was markedly higher in the UBIO treated group than in the control group after after the first, third and the completion of treatment respectively [（24.83±12.88）, （17.70±5.69）; （28.08±13.44）, （16.32±5.29）; （17.42±6.04）, P〈 0.05-0.01]. CONCLUSION： The effect of UBIO treatment against acute cerebral infarction may be mediated by the increased K^＋-Na^＋ ATPase and Ca2^＋-Mg2^＋-ATPase activities on RBC membrane, which enhances the RBC transformation ability so as to lower RBC aggregation and correct high blood viscosity.

Effect of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer

Objective:To investigate the effects of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer.Methods: Eighty patients with gastric cancer admitted to our hospital from May 2016 to October 2017 were selected as the research object and randomly divided into observation group and control group, 40 cases in each group. Control group was treated by DCF chemotherapy, while the observation group by Shenqi Fuzheng Injection based on the DCF chemotherapy. The levels of peripheral blood cells, tumor markers and immune function indexes in both groups were detected and compared before and after treatment.Results: There were no significant differences in serum RBC, WBC, PLT, Hb, NSE, CYFRA21-1, CA199, CEA, CD3+, CD4+, CD8+ and CD4+/CD8+ levels before treatment in both groups. Compared with the pretreatment group, the levels of RBC, WBC, PLT and Hb in both groups decreased to some extent after treatment, and the levels in the observation group were significantly higher than those in the control group;Compared with the same group before treatment, the levels of NSE, CYFRA21-1, CA199 and CEA in the two groups were significantly decreased, and the observation group was significantly lower than the control group;CD3+, CD4+, CD4+/CD8+ levels in control group and observation group increased to some extent after treatment, and the levels in observation group were significantly higher than those in control group. The levels of CD8+ in both groups after treatment were significantly lower than those before treatment, and the observation group was significantly lower than the control group after treatment. The above data for statistical analysis had significant differences.Conclusions: Shenqi Fuzheng injection combined with chemotherapy helps to clear and kill cancer cells, enhance immunity and reduce hematological toxicity after chemotherapy, which can be used as an adjuvant chemotherapy for gastric cancer.

Effect of aerobic exercise training on red blood cell parameters, vascular endothelial function in elderly patients with coronary heart disease and chronic heart failure

Objective: To investigate effect of aerobic exercise training combined with conventional drug on red blood cell parameters, vascular endothelial function and cardiac function in elderly patients with coronary heart disease complicated with chronic heart failure. Methods: A total of 110 elderly patients with coronary heart disease and chronic heart failure according to random data table were divided into control group (n=54) and observation group (n=56). The patients in control group were treated with conventional drug, and patients in the observation group received conventional drug combined with aerobic exercise training. Before and after treatment, levels of red blood cell parameters, vascular endothelial function and cardiac function indexes were compared between the two groups. Results: Before treatment, the difference of HCT, RDW, RBC, NO, ET-1, LVEF, LVEDD and LVESD levels in the two groups were not significantly. After treatment, HCT and RBC levels in two groups were no statistically significant difference;The levels of RDW, ET-1, LVEDD and LVESD in observation group were significantly lower than those in this group before treatment, and significantly lower than those in the control group after treatment;The levels of NO and LVEF in two groups were significantly higher than those in the group before treatment, and levels of NO and LVEF in the observation group were significantly higher than those in control group after treatment. Conclusion: The clinical effect of aerobic exercise training combined with conventional drug in treatment of senile coronary heart disease with chronic heart failure was significant, which can effectively increase the RDW level of patients, improve vascular endothelial function and heart function, it has important clinical value.

EFFECT OF ELECTROACUPUNCTURE ON RED BLOOD CELL IMMUNE AND T-CELL SUBGROUP IN THE RAT

In the present study, the effect of electroacupuncture (EA) on immune system was observed in the rat by using micro- whole blood direct immunofluorescence staining assay to detect changes of the peripheral blood T lymphocyte subgroup and employing red blood cell (RBC) C 3b receptor- yeast rosette test and red blood cell-IC rosette test to analyze erythrocytic immune function. Results showed that after EA of “Zusanli" (ST 36), CD+ 4, RBC-C 3bRR and RBC-ICR in the peripheral blood of the normal rats increased significantly while CD+ 8 had no any considerable changes and a positive correlation between CD+ 4 and RBC-C 3bRR was found. In immunosuppression model rats, the values of CD+ 4 and RBC-C 3bRR were obviously lower than those of the normal control group while CD+ 8 had no any striking changes; but after EA treatment, there were no evident differences between EA group and normal control group in the above-mentioned indexes. There were also no any significant differences between non-acupoint group and normal control group in those indexes. Results suggest that EA of “Zusanli" (ST 36) can raise T cell immune function and RBC adhesion function in both normal rats and immunosuppression model rats, both of which present a positive correlation.

INFLUENCE OF ELECTROACUPUNCTURE ON HYPERTENSION VASCULAR DEMENTIA AND ITS RED CELL IMMUNE FUNCTION IN THE RAT

Objective: To probe into the effect of electroacupuncture (EA)on vascular dementia and red cell immune function in the rat. Methods: 30 SD rats were made into renal hypertension rats(RHR) by clamping the kidney arteries with silver clip. 42 days later, their bilateral common carotid arteries were blocked repeatedly to cause cerebral ischemia. The Hypertension vascular dementia model was then set up. Then they were randomly divided into VD model group, EA groupand medication group (Dihydroergotoxine, DHET), with 10 cases in each group. The therapeutic course was 28 days. The ability of learning and memory was using an obs erved by water maze, and the function of red blood cell immune was detected after treatment. Results: the latecy of the EA group and medication group was shorter than that of model group (P<0.05, P<0.005), and that of EA group was shorter than medication group (P<0.05, P<0.005). EA and medication could increase the RBCC 3b receptor flower circle rate and reduce the RBCIC flower circle rate significantly(P<0.05, P< 0.01). Conclusion: The results indicated that EA therapy could raise the ability of learning and memory and improve the function of red cell immune in VD rats, while the therapeutic effect of EAis better than DHET.

THE INFLUENCE OF MEDICINAL CAKE-SEPARATED MOXIBUSTION UPON RED BLOOD CELL IMMUNITY AND FREE RADICAL IN THE AGED

Eighty-six senile persons,aged 60 years old or over,were treated by medicinalcake-separated moxibustion and the influence of moxibustion upon red blood cell immunity func-tion and free radical was observed.We have adopted the principle of tonifying the kidney andstrengthening the spleen,promoting blood flow and removing blood stasis.The tonic points suchas Dazhui（GV 14）,Shenshu（BL 23）,Guanyuan（CV 4）,Shenque（CV 8）and Zhsanli（ST36）were chosen.Besides,it was supplemented with the principle of nourishing blood,tonifyingspleen and replenishing essence,using medicinal cake moxibustion.The moxibustion was givenonce every other day,three moxa-cone on each point,and twenty-four times as a therapeuticcourse.The total moxibustion amount is 264 moxa-cone.Before and after the treatment,wemeasured the red blood cell immunity function（RBC-C3b,RBC-IC,RFER,RFIR）,the SOD ac-tivity of RBC,and the contents of serum LPo. Results show that in senile person,the RBC-C3b rosette formation falls while the

EFFECT OF SELENIUM ON IMMUNE FUNCTION OF ERYTHROCYTE IN KASHIN-BECK DISEASE

Objective To investigate the relationship between erythrocyte immune function and selenium (Se) level. Methods Forty-nine Kashin-Beck patients in endemic area aged 13-16 years were divided into two groups and were orally given either selenized yeast or sodium selenite to provide 200 μ g selenium per day for 12 weeks. Erythrocyte selenium level, glutathione peroxidase activity, the rosette formation rates of red blood cells complement receptor typeⅠ(CR1), the immune function of red blood cells, and circulating immune complexes(CIC) were determined. Results After supplementing with selenium for 12 weeks, erythrocyte selenium level, glutathione peroxidase activity, the rosette formation rates of red blood cells CR1 were significantly increased. But the difference in rosette formation rates of IC and CIC content was not significant between before and after Se supplementation. Conclusion The increase of the immune function of the erythrocyte by selenium-supplement may be one of the effective mechanisms for the prevention of Kashin-Beck disease.

红细胞在感染免疫中的作用研究进展

红细胞作为血液中数量最多的细胞,逐渐被发现不仅有运送氧气和二氧化碳的功能,还以多种途径参与机体免疫调节。近期有多项研究发现红细胞可通过TLR9在正常生理和感染状态下参与免疫调节,确定红细胞可通过表面的糖蛋白介导参与机体免疫应答,证实红细胞通过表面补体受体和结合细胞因子参与感染性疾病的进展和免疫调节。我们将总结红细胞通过以上几种分子在感染免疫应答中作用的研究进展,以增加对红细胞在感染免疫中作用的全面认识和理解。

含羞草根乙酸乙酯部位对急性髓系白血病小鼠的影响

目的 研究含羞草根乙酸乙酯部位(简称为乙酸乙酯部位)对急性髓系白血病小鼠的影响。方法 以不同质量浓度(0.062 5、0.125、0.25、0.5 mg/mL)乙酸乙酯部位作用于急性粒-单核细胞白血病细胞WEHI-3,考察其对该细胞活力的影响。将50只BALB/C小鼠随机分为空白对照组、模型组、阳性对照组(5-氟尿嘧啶,13 mg/kg)和乙酸乙酯部位低、高剂量组(50、200 mg/kg),每组10只。除空白对照组外,其余各组小鼠均腹腔注射WEHI-3细胞悬液进行造模,并在造模第2天起灌胃相应药物/水,每天1次,连续14 d。末次给药后,检测小鼠肝、脾指数,并进行肝组织病理学形态观察和血液学分析以及白细胞分化检测;检测小鼠血清中细胞因子[白细胞介素2(IL-2)、IL-3、干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)]水平;检测小鼠全血中白细胞表面标志物[分化簇3(CD3)、CD19、CD11b、分化簇107b(即Mac-3)]抗体水平。结果 经0.062 5~0.5 mg/mL的乙酸乙酯部位作用后,WEHI-3细胞增殖抑制率均显著升高(P<0.05)。经高剂量的乙酸乙酯部位干预后,小鼠的肝、脾指数,血清中TNF-α水平,全血中白细胞表面CD11b、Mac-3抗体水平均显著降低(P<0.05),血清中IL-2、IL-3、IFN-γ水平和全血中白细胞表面CD3、CD19抗体水平均显著升高(P<0.05);肝实质偶有淋巴细胞浸润,几乎无炎症细胞浸润;血液学指标改善且白细胞分化减弱。结论 含羞草根乙酸乙酯部位可抑制WEHI-3细胞增殖,改善急性髓系白血病小鼠症状,其作用机制与增强机体免疫功能有关。

血清RDW、脑钠肽、HIF-1α及AHEAD评分水平与慢性心力衰竭患者心功能分级、远期死亡结局的关系分析

目的 探讨红细胞分布宽度(RDW)、脑钠肽、缺氧诱导因子1α(HIF-1α)及AHEAD评分与慢性心力衰竭(CHF)患者心功能分级、远期死亡结局的关系。方法 采用前瞻性研究方法,选取2016年1月至2019年1月在海南医学院第一附属医院治疗的CHF患者114例作为观察组,选取同期心功能正常人群100例作为对照组。比较两组RDW、脑钠肽、HIF-1α和血脂水平差异。观察组按照美国纽约心脏病学会(NYHA)分级:Ⅱ级32例,Ⅲ级53例,Ⅳ级29例;随访22~49个月,按照死亡事件发生情况分为死亡患者19例,存活患者95例。同时分析观察组心功能不同NYHA分级、存活和死亡患者RDW、脑钠肽、HIF-1α及AHEAD评分差异。采用受试者工作特征(ROC)曲线分析RDW、脑钠肽、HIF-1α及AHEAD评分预测CHF患者死亡的价值。结果 观察组RDW、脑钠肽和HIF-1α分别为(15.69±1.88)%、544.54(310.54,840.65) ng/L和17.32(9.89,26.65) ng/L,均明显高于对照组,差异均有统计学意义(P<0.05)。随着患者心功能分级升高,患者RDW、脑钠肽、HIF-1α水平以及AHEAD评分≥3分比例升高,差异均有统计学意义(P<0.05),其中心功能分级Ⅳ级患者RDW、脑钠肽、HIF-1α水平以及AHEAD评分≥3分比例分别为(18.12±2.11)%、712.24(589.30,920.22) ng/L、22.54(17.30,30.21) ng/L和93.10%,均明显高于心功能分级Ⅱ级和Ⅲ级患者,差异均有统计学意义(P<0.05)。死亡患者RDW、脑钠肽、HIF-1α水平以及AHEAD评分≥3分比例分别为(17.11±1.92)%、756.03(603.34,1 002.22) g/L、24.40(18.82,33.40) ng/L和89.47%,明显高于存活患者,差异均有统计学意义(P<0.05)。RDW、脑钠肽、HIF-1α及AHEAD评分预测死亡的ROC曲线下面积分别为0.672、0.929、0.894和0.679,P<0.05。结论 随CHF患者心功能分级升高,RDW、脑钠肽、HIF-1α及AHEAD评分水平明显升高,同时在死亡患者中水平较高,其中脑钠肽和HIF-1α在预测远期死亡方面有一定应用价值。

不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克的效果分析

目的对不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克的效果进行分析。方法回顾性选取2021年6月—2023年6月济宁市第一人民医院接受相关治疗的84例创伤失血性休克患者的临床资料,按照不同输血方案,分为参照组(42例)及研究组(42例)。参照组使用冰冻血浆∶红细胞比例为1∶2的输血方案对干预治疗,研究组使用冰冻血浆∶红细胞比例为1∶1的输血方案对干预治疗。对比两组输血前及输血后的凝血功能指标以及输血前、输血后的血栓弹力图(Thromboela-stogram,TEG)参数水平。结果研究组输血后的凝血功能指标水平优于参照组,差异有统计学意义(P<0.05);输血后研究组α角(68.55±5.38)°、MA(62.84±5.47)mm、K(2.63±0.61)min、R(4.37±1.33)min等TEG参数水平均优于参照组,差异有统计学意义(t=9.085、9.005、5.407、3.774,P均<0.001)。结论对创伤失血性休克患者实施1:1的冰冻血浆:红细胞输血方案可获得理想治疗效果,不仅可强化患者凝血功能,并且可在一定程度上提升患者血栓弹力图参数水平,对患者身体康复发挥着一定促进作用。

丙酮酸钠对2型糖尿病大鼠体外贮存红细胞形态结构和功能的影响

目的:观察加有丙酮酸钠的红细胞保存液对2型糖尿病(T2DM)大鼠体外贮存红细胞(RBC)形态结构和功能的影响。方法:雄性SPF级SD大鼠30只,随机分为3组(n=10):非T2DM常规RBC保存液(A组)、T2DM常规RBC保存液(B组)、T2DM丙酮酸钠RBC保存液(C组)。尾静脉取血滤白细胞后,分别于贮存0 d(T0)、7 d(T1)、14 d(T2)、21 d(T3)、28 d(T4)观测各组RBC的形态结构,检测RBC中二磷酸甘油酸(2,3-DPG)、活性氧(ROS)、丙二醛(MDA)及乳酸(LA)的含量,对体外贮存14 d的RBC进行PKH26标记,于静脉回输后1h、4 h、10 h、16 h测定RBC在体内的存活率。结果:T0时A组RBC形态完好,明显优于B组和C组;随贮存时间延长,各组RBC形态逐渐变成棘球形,B组和C组RBC棘形发生率明显高于A组,C组棘形发生率低于B组(P<0.05);与A组比较,不同时点B组和C组2,3-DPG含量下降,ROS、MDA增加(P<0.05),其中C组2,3-DPG含量高于B组、ROS和MDA含量低于B组(P<0.05);各时点B组LA含量均高于A组和C组(P<0.05),在T2-T4时C组LA含量低于A组(P<0.05);RBC标记回输后,A组RBC存活率明显高于B、C组,B组RBC存活率显著低于C组(P<0.05)。结论:添加丙酮酸钠的改良RBC保存液对2型糖尿病大鼠体外贮存RBC具有一定保护作用,其机制可能与抗氧化作用有关。

输注不同配比冰冻血浆与红细胞对严重多发伤后HS患者凝血功能和预后的影响

目的探讨不同的冰冻血浆(FP)与红细胞(RBC)配比对严重多发伤后失血性休克(HS)患者凝血功能和预后的影响。方法选择该院2020年1月至2023年1月收治的严重多发伤后HS患者150例,随机分为A组、B组和C组,每组50例。A组给予FP∶RBC为1∶1的输血方案进行治疗,B组给予FP∶RBC为1∶2的输血方案进行治疗,C组给予FP∶RBC为1∶2.5的输血方案进行治疗。比较3组患者血液制品使用情况,输血前后凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)和纤维蛋白原(FIB)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)T细胞)水平,以及两组预后情况。结果3组患者RBC和血小板使用量比较,差异均无统计学意义(P>0.05);A组患者FP使用量高于B、C组,B组FP使用量高于C组,差异均有统计学意义(P<0.05)。3组患者输血前PT、APTT、TT及FIB水平比较,差异均无统计学意义(P>0.05);3组患者输血后PT、APTT、TT均低于输血前,而FIB水平高于输血前,差异均有统计学意义(P<0.05);输血后,A组患者PT、APTT、TT均低于B、C组,而FIB水平高于B、C组,差异均有统计学意义(P<0.05);输血后,B组患者PT、APTT、TT均低于C组,而FIB水平高于C组,差异均有统计学意义(P<0.05)。3组患者输血前CD3^(+)、CD4^(+)、CD8^(+)T细胞百分比比较,差异均无统计学意义(P>0.05);输血后,A组患者CD3^(+)、CD4^(+)T细胞百分比均高于B、C组,而CD8^(+)T细胞百分比低于B、C组,差异均有统计学意义(P<0.05);输血后,B组患者CD3^(+)、CD4^(+)T细胞百分比高于C组,而CD8^(+)T细胞百分比低于C组,差异均有统计学意义(P<0.05)。3组病死率比较,差异无统计学意义(P>0.05)。A组存活患者并发症发生率低于B、C组,而B组存活患者并发症发生率低于C组,差异均有统计学意义(P<0.05)。结论严重多发伤后HS患者采用FP∶RBC配比为1∶1的输血方案最佳,不仅对患者免疫功能影响较小、有效改善患者凝血功能,还可以有效降低患者并发症发生率。

不同血浆与红细胞输注比例对创伤后大出血患者救治效果及凝血功能的影响

目的:探讨不同血浆(FFP)与红细胞(RBC)输注比例对创伤后大出血患者救治效果及凝血功能的影响。方法:选取125例创伤后大出血患者为研究对象,按照救治时FFP/RBC输注比例不同分为A组(n=42)、B组(n=44)和C组(n=39)。A组输注比例0.5~1.0;B组输注比例>1.0~1.5;C组输注比例>1.5~2.0。比较各组患者救治效果(入院24 h死亡率、ICU停留时间及住院时间)、血常规[血红蛋白(Hb)、血小板计数(Plt)水平]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及国际标准化比值(INR)水平]、纤溶功能[D-二聚体(D-D)、蛋白C(PC)及纤维蛋白降解产物(FDP)水平]及血制品输注量。结果:各组患者入院24 h死亡率、ICU停留时间及住院时间无统计学差异(P>0.05)。输血后,各组患者APTT、PT、Plt、D-D、INR、PC水平比较:A组<B组<C组(P<0.05)。各组患者FFP输注量比较:A组>B组>C组(P<0.05)。结论:救治创伤后大出血患者过程中推荐FFP/RBC的输注比例为>1.0~1.5,在保证救治效果的前提下,能有效促进凝血功能恢复,节约血制品。

乳腺癌根治术后应用益气活血方联合多西他赛的效果

目的 探讨乳腺癌根治术后应用益气活血方联合多西他赛的疗效。方法 选取2020年4月至2022年10月医院收治的80例接受乳腺癌根治术患者作为研究对象,按随机数字表法分为观察组、对照组,各40例。对照组接受多西他赛治疗,观察组在此基础上接受益气活血方治疗。比较两组病情控制率、治疗前后外周血象指标[白细胞计数(WBC)、血红蛋白(Hb)、血小板(PLT)]、肿瘤标志物指标[癌胚抗原(CEA)、糖蛋白125(CA125)、糖蛋白153(CA153)]、红细胞免疫指标[免疫黏附抑制因子、免疫黏附促进因子、红细胞免疫复合物花环]及毒副反应发生情况。结果 观察组总有效率高于对照组(P<0.05);治疗后观察组WBC、Hb、PLT水平高于对照组,CEA、CA125、CA153水平低于对照组(P<0.05),免疫黏附促进因子水平高于对照组,免疫黏附抑制因子、红细胞免疫复合物花环水平低于对照组(P<0.05),恶心呕吐、肝功能损害发生情况优于对照组(P<0.05)。结论 应用益气活血方联合多西他赛治疗乳腺癌根治术后患者效果确切,可有效抑制肿瘤生长,改善造血功能,提升红细胞免疫能力,降低恶心呕吐、肝功能损害发生概率,利于控制病情进展。

丁苯酞胶囊联合依达拉奉在自发性蛛网膜下腔出血术后CVS中的效果

目的探讨丁苯酞胶囊联合依达拉奉在自发性蛛网膜下腔出血术后脑血管痉挛(cerebral vasospasm,CVS)中的应用价值,分析其对脑脊液红细胞和神经功能的影响。方法回顾性分析2020年2月—2022年2月广东省中山大学附属汕头医院/汕头市中心医院收治的80例蛛网膜下腔出血术后CVS患者,按用药方式分为2组。在综合治疗基础上,对照组(n=40)用依达拉奉治疗,研究组(n=40)联合丁苯酞胶囊治疗。比较2组脑脊液红细胞数值、神经功能及不良反应。结果治疗后7、14 d,2组脑脊液红细胞计数均逐渐降低,其中研究组治疗后7、14 d脑脊液红细胞计数分别为(32.52±3.54)×10^(12)/L、(5.52±1.58)×10^(12)/L,低于对照组的(40.20±8.21)×10^(12)/L、(10.25±1.65)×10^(12)/L,差异有统计学意义(P<0.05);治疗后7、14 d,2组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均逐渐降低,且研究组更低;Barthel指数均逐渐升高,且研究组更高,差异有统计学意义(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论丁苯酞胶囊联合依达拉奉治疗自发性蛛网膜下腔出血术后CVS对微循环和脑组织灌注有改善作用,利于神经功能恢复,不增加不良反应。

不同比例成分大量输血对产后出血患者凝血功能的影响

目的探讨不同比例成分大量输血对产后出血患者凝血功能的影响。方法选取2018年2月至2023年2月聊城市第二人民医院收治的120例产后出血产妇作为研究对象,均接受大量输血治疗,输注>8 U的红细胞,按照悬浮红细胞∶血浆比例的不同分为观察组(60例,悬浮红细胞∶血浆=1.5∶1)、对照组(60例,悬浮红细胞∶血浆=2.5∶1),比较两组的凝血功能。结果观察组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间短于对照组,纤维蛋白原高于对照组(P<0.05)。结论产后出血患者进行大量输血时,悬浮红细胞与血浆输注比例1.5∶1对凝血功能影响较小。

Severe hyperkalemia following blood transfusions:Is there a link?

Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion,the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time. The associated pathogenetic mechanisms resulting in the increase of potassium levels are presented. A number of risk factors which increase the risk of hyperkalemia after blood transfusion are discussed. Moreover,appropriate management strategies for the prevention of blood transfusion associated hyperkalemia are also presented. Physicians should always keep in mind the possibility of hyperkalemia in cases of blood transfusion.

In-Host Analysis of Malaria Dynamics in Humans

Human malaria infection poses a major global health threat worldwide. Yet, no sophisticated mathematical model exists to study the complex dynamics and interactions between the parasites and host immune response at the blood and liver stages. In this paper, an in-host mathematical model of Plasmodium falciparum malaria dynamics and interactions in an infected host cells are studied at the liver stage by incorporating the red blood cells and the immune system. Numerical simulations are applied to investigate the interactions between the host immune response, the parasite dynamics, and the disease dynamics at both the blood and liver stages. Results show that immunity has a significant impact in clearing infected red blood cells. Furthermore, the infected erythrocytes and hence the severity of malaria tend to increase with increasing density of merozoites in the blood. The result revealed that intervention during malaria infection should focus on minimizing merozoite invasion rate on healthy erythrocytes and the density of merozoites in circulation.

Immune evasion by Plasmodium falciparum parasites: converting a host protection mechanism for the parasite′s benefit

Immune evasion is a strategy used by pathogenic microbes to evade the host immune system in order to ensure successful propagation. Immune evasion is particularly important for the blood stages of Plasmodium falciparum, the causative agent of the deadly disease malaria tropica. Because Plasmodium blood stage parasites require human erythrocytes for replication, their ability to evade attack by the human immune system is essential for parasite survival. In order to escape immunity-induced killing, the intraerythrocytic parasites have evolved a variety of evasion mechanisms, including expansion of plasmodial surface proteins, organ-specific sequestration of the infected red blood cells and acquisition of immune-regulatory proteins by the parasite. This review aims to highlight recent advances in the molecular understanding of the immune evasion strategies by P. falciparum, including antigenic variation, surface protein polymorphisms and invasion ligand diversification. The review will further discuss new findings on the regulatory mechanisms applied by P. falciparum to avoid lysis by the human complement as well as killing by immune factors of the mosquito vector.