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.

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.

红细胞分布宽度、系统免疫炎症指数与重性抑郁障碍的相关性研究

目的探讨外周血红细胞分布宽度(red blood cell distribution width,RDW)、系统免疫炎症指数(systemic immune-inflammation index,SⅡ)与重性抑郁障碍(major depressive disorder,MDD)的相关性。方法回顾性分析2020-2022年于我院临床心理科住院的176例MDD患者和常规体检的209例非MDD对照者的临床资料。从血液分析结果中,得到RDW、SⅡ、红细胞分布宽度与血小板计数比值(RDW to platelet ratio,RPR)。绘制受试者操作特征(receiver operator characteristic,ROC)曲线以确定RDW区分患者与对照的最佳临界值及曲线下面积(area under the curve,AUC)。结果MDD组患者的RDW[中位数及四分位数:13.20(12.70,13.98)vs.12.80(12.40,13.35)]、SⅡ水平[中位数及四分位数:510.87(350.95,878.12)vs.405.33(313.74,539.92)]高于非MDD组对照者,差异有统计学意义(P<0.05),两组间RPR差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,调整混杂因素后,RDW与MDD呈正关联(OR=3.086,95%CI:1.926~4.944)。ROC曲线结果显示,RDW区分MDD与非MDD的最佳临界值为12.85,AUC为0.647(95%CI:0.592~0.702;P<0.001)。结论高RDW可能是MDD发生的危险因素,是对MDD诊断有价值的重要参数。

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。

气血瘀滞型非小细胞肺癌患者“瘀毒”病机临床特征及补肺化瘀汤辅助治疗干预机制

【目的】探讨气血瘀滞型非小细胞肺癌(non-small cell lung cancer,NSCLC)患者“瘀毒”病机的临床特征以及补肺化瘀汤辅助治疗的干预机制。【方法】选取六安市中医院呼吸内科2021年1月至2022年9月收治的78例气血瘀滞型NSCLC患者作为NSCLC组,另选取71例同期健康体检志愿者为健康对照组,观察NSCLC组“瘀毒”病机的临床特征,比较2组凝血功能指标的差异。根据治疗方式的不同将NSCLC组患者分为补肺化瘀组40例和常规治疗组38例,常规治疗组采用常规化疗方案治疗,补肺化瘀组在常规治疗组的基础上加用补肺化瘀汤治疗,以3周为1个疗程,共治疗2个疗程。观察2组患者治疗前后中医证候积分、生活质量Karnofsky功能状态(KPS)评分、凝血功能、免疫功能、血清一氧化氮(NO)、血管内皮生长因子(VEGF)水平的变化情况,比较2组患者的临床疗效和治疗期间不良反应发生情况。【结果】(1)临床特征方面,NSCLC组患者临床分期为Ⅲ、Ⅳ期,病理类型为鳞癌、腺癌,KPS评分低于70分患者比例较高,中医证候积分较高,提示NSCLC患者病情较为严重;与健康对照组相比,NSCLC组患者的凝血酶原时间(PT)、凝血酶时间(TT)明显缩短,纤维蛋白原(FIB)、D-二聚体(D-D)水平明显升高,差异均有统计学意义(P<0.01)。(2)疗效方面,治疗6周后,补肺化瘀组的总有效率和总稳定率分别为32.50%(13/40)、85.00%(34/40),明显优于常规治疗组的13.16%(5/38)、60.53%(23/38),差异均有统计学意义(P<0.05)。(3)证候积分方面,治疗3周后,补肺化瘀组的各项中医证候积分(包括神疲乏力、胸闷气短、胸部刺痛、脉络瘀血等)和常规治疗组的神疲乏力、胸闷气短积分均较治疗前改善(P<0.05);治疗6周后,2组NSCLC患者的各项中医证候积分均较治疗前和治疗3周后改善(P<0.05);组间比较,除治疗3周后的胸闷气短外,补肺化瘀组在治疗3周和6周后对各项中医证候积分的改善作用均明显优于常规治疗组(P<0.05或P<0.01)。(4)凝血功能方面,治疗6周后,补肺化瘀组的PT、TT、FIB、D-D水平均较治疗前明显改善(P<0.05),而常规治疗组仅FIB、D-D水平较治疗前改善(P<0.05);组间比较,补肺化瘀组对PT、FIB、D-D水平的改善作用均明显优于常规治疗组(P<0.05)。(5)血清NO、VEGF水平方面,治疗6周后,2组患者的血清NO、VEGF水平均较治疗前明显降低(P<0.05),且补肺化瘀组的降低作用均明显优于常规治疗组(P<0.01)。(6)免疫功能方面,治疗6周后,补肺化瘀组的T细胞亚群CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)比值较治疗前升高(P<0.05)、CD8^(+)水平较治疗前降低(P<0.05),而常规治疗组的CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值较治疗前降低(P<0.05)、CD8^(+)水平较治疗前升高(P<0.05);组间比较,补肺化瘀组对CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)比值的升高作用及对CD8^(+)水平的降低作用均明显优于常规治疗组(P<0.01)。(7)生活质量方面,治疗6周后,2组患者的KPS评分均较治疗前明显升高(P<0.05),且补肺化瘀组的升高作用明显优于常规治疗组(P<0.01)。(8)不良反应方面,治疗过程中,2组患者的胃肠道反应、脱发的发生率比较,差异无统计学意义(P>0.05),而补肺化瘀组的肝肾功能损伤、骨髓抑制、口腔黏膜毒性的不良反应发生率均明显低于常规治疗组(P<0.05或P<0.01),表明补肺化瘀汤可一定程度上降低化疗所引起的不良反应。【结论】气血瘀滞型NSCLC患者普遍病情进展程度深,血液凝滞性高,契合中医“瘀毒”病机;针对“瘀毒”病机使用补肺化瘀汤治疗可明显改善患者中医证候积分和凝血功能,下调血清NO、VEGF水平,改善患者免疫功能,可提高患者临床疗效及生活质量,减少化疗所带来的不良反应,具有较高的安全性。

全身免疫炎症指数和红细胞分布宽度在儿童过敏性紫癜合并肾损害中的变化及意义

目的探讨全身免疫炎症指数(SII)和红细胞分布宽度(RDW)在预测儿童过敏性紫癜(HSP)合并肾损害中的临床价值。方法选取2018年6月至2022年12月在南京医科大学附属淮安第一医院住院治疗的191例HSP患儿为研究对象,其中77例为肾损害组,114例为无肾损害组。分析两组患儿的一般资料和实验室检查结果,通过多因素Logistic回归分析HSP合并肾损害的危险因素;以Spearman相关性分析SII和RDW与24小时尿蛋白定量(24h-UPRO)之间的相关性;利用受试者工作特征(ROC)曲线评估SII和RDW对HSP合并肾损害的预测价值。结果两组患儿的年龄(t=-2.449)、白细胞计数(t=-3.057)、血红蛋白(t=-2.304)、红细胞压积(t=-2.630)、RDW(t=-8.617)、中性粒细胞计数(t=-2.788)、中性粒细胞/淋巴细胞比值(Z=-2.887)、SII(Z=-3.325)比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,RDW(OR=1.861,95%CI:1.526~2.270,P<0.001)、SII(OR=1.003,95%CI:1.001~1.005,P=0.008)均是HSP患儿发生肾损害的独立危险因素。RDW、SII水平与24h-UPRO水平均呈正相关(r值分别为0.256、0.429,P<0.05)。ROC曲线评估显示,RDW预测HSP患儿合并肾损害的曲线下面积(AUC)为0.817(95%CI:0.757~0.877,P<0.001),最佳截断值为38.85fL,灵敏度和特异度分别为80.52%和70.18%;SII预测HSP患儿合并肾损害的AUC为0.642(95%CI:0.562~0.721,P=0.001),最佳截断值为401.67×10^(9)/L,灵敏度和特异度分别为81.82%和43.86%;二者联合预测HSP患儿合并肾损害的AUC为0.845(95%CI:0.790~0.900,P<0.001),灵敏度和特异度分别为87.01%和71.93%。结论SII和RDW对预测HSP患儿合并肾损害有一定的临床应用价值。

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。

固本解毒祛瘀法与化疗联合治疗晚期非小细胞肺癌的临床研究

目的研究固本解毒祛瘀法与化疗联合治疗晚期非小细胞肺癌的临床研究。方法选取南京医科大学附属脑科医院(胸科院区)呼吸内科102例被确诊为晚期非小细胞肺癌的患者按随机数字表分为两组,对照组51例予以化疗,研究组51例使用固本解毒祛瘀法、化疗联合治疗。观察比较两组患者的临床疗效。结果研究组客观缓解率与对照组相比,96.08%(49/51)高于对照组74.51%(38/51),差异有统计学意义(P<0.05)。治疗后,研究组与对照组CEA、CA125以及CYFRA21-1对比,研究组低于对照组,研究组与对照组CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)对比,研究组CD_(3)^(+)、CD_(4)^(+)高于对照组,CD_(8)^(+)低于对照组,差异有统计学意义(P<0.05)。研究组胃肠道、肝功损害、血细胞不良反应程度低于对照组,差异有统计学意义(P<0.05)。结论被确诊为强迫症的患者通过服用氯丙咪嗪、温胆汤联合治疗后,临床作用显著,可有效改善患者的临床症状,且安全性较高,临床应用价值较高。

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。

全自动三维超声右室定量软件评估系统性红斑狼疮患者右室收缩功能

目的应用全自动三维超声右室定量软件(3D Auto RV)评估系统性红斑狼疮(SLE)患者右室收缩功能,分析其与红细胞分布宽度(RDW)的相关性。方法选取我院风湿免疫科诊断为SLE的患者70例,根据超声心动图测得的肺动脉收缩压(PASP)将其分为PASP≤30 mmHg(1 mmHg=0.133 kPa)者34例(Ⅰ组),30 mmHg<PASP<50 mmHg者20例(Ⅱ组)、PASP≥50 mmHg者16例(Ⅲ组);另选同期健康志愿者25例为对照组。各组均行二维超声心动图检查获取左室射血分数(LVEF)、右室面积变化率(RVFAC)、三尖瓣环收缩期平面位移(TAPSE)、三尖瓣环收缩期峰值速度(S’);3D Auto RV获取右室舒张末期容积指数(EDVi)、收缩末期容积指数(ESVi)、右室每搏量(RVSV)、右室射血分数(RVEF)、右室游离壁纵向应变(RVFWLS)、室间隔纵向应变(SLS);实验室检查获取RDW。比较各组上述检查结果的差异。采用Spearman相关分析法分析右室收缩功能与RDW的相关性;采用多元线性回归分析筛选SLE患者右室收缩功能受损的独立影响因子。结果与对照组和Ⅰ、Ⅱ组比较,Ⅲ组RVFAC减低,EDVi、ESVi均增高,差异均有统计学意义(均P<0.05);与对照组和Ⅰ组比较,Ⅱ、Ⅲ组RVEF、RVFWLS均减低,差异均有统计学意义(均P<0.05);与Ⅰ组比较,Ⅱ、Ⅲ组SLS均减低,差异均有统计学意义(均P<0.05)。Ⅰ~Ⅲ组RDW均高于对照组,差异均有统计学意义(均P<0.05)。Spearman相关性分析显示,EDVi、ESVi与RDW均呈正相关(r=0.211、0.251,均P<0.05),RVEF、RVFWLS、SLS与RDW均呈负相关(r=-0.284、-0.247、-0.251,均P<0.05)。多元线性回归分析显示,RDW、PASP均为SLE患者右室收缩功能受损的独立影响因子(β=-0.704、-0.190,均P<0.05)。结论3D Auto RV可准确评估SLE患者早期右室收缩功能,且其与RDW呈负相关;RDW和PASP均为SLE患者右室收缩功能受损的独立影响因子。

The effects of Spirulina on anemia and immune function in senior citizens

Anemia and immunological dysfunction(i.e.immunosenescence)are commonly found in older subjects and nutritional approaches are sought to counteract these phenomena.Spirulina is a filamentous and multicellular bule-green alga capable of reducing inflammation and also manifesting antioxidant effects.We hypothesized that Spirulina may ameliorate anemia and immunosenescence in senior citizens with a history of anemia.We enrolled 40 volunteers of both sexes with an age of 50 years or older who had no history of major chronic diseases.Participants took a Spirulina supplementation for 12 weeks and were administered comprehensive dietary questionnaires to determine their nutritional regimen during the study.Complete cell count(CCC)and indoleamine 2,3-dioxygenase(IDO)enzyme activity,as a sign of immune function,were determined at baseline and weeks 6 and 12 of supplementation.Thirty study participants completed the entire study and the data obtained were analyzed.Over the 12-week study period,there was a steady increase in average values of mean corpuscular hemoglobin in subjects of both sexes.In addition,mean corpuscular volume and mean corpuscular hemoglobin concentration also increased in male participants.Older women appeared to benefit more rapidly from Spirulina supplements.Similarly,the majority of subjects manifested increased IDO activity and white blood cell count at 6 and 12 weeks of Spirulina supplementation.Spirulina may ameliorate anemia and immunosenescence in older subjects.We encourage large human studies to determine whether this safe supplement could prove beneficial in randomized clinical trials.