株洲地区11907名次患者输血前传染性指标检测结果分析

目的了解拟输血患者输血前传染性疾病感染情况,预防和避免医院感染和医疗纠纷的发生,提醒医务人员注意生物防护与自我保护。方法采用酶联免疫法对本院2010年1～7月11 907名次拟输血患者进行HB-sAg、抗-HCV、抗-HIV1+2及抗-TP)检测分析。所有检测项目均严格按照试剂盒操作说明书进行,同时做好质控对照。结果 11 907名次患者中,总阳性患者1 579(13.26%)例。其中HBsAg阳性患者1 077(9.04%)例,抗-HCV阳性患者193(1.62%)例,抗-TP阳性患者303(2.54%)例,抗-HIV阳性患者6(0.05%)例。结论输血前患者感染性指标有一定比例的阳性率。通过对受血者输血前输血传染性指标检测,明确患者的健康状况,为经血液传播的疾病引起的医疗纠纷提供法律依据,保护医患双方的利益;防止患者和医务人员医源性感染;同时可发现患者一些无症状的传染病,反馈给临床进行及时有效的治疗。

嘉峪关市无偿献血者情况分析

目的通过对本市无偿献血者情况调查分析,确定低危献血者人群,提高血液质量,最大限度地降低经血传播疾病的发生。方法调查2007～2009年本市无偿献血者8789人次,对其性别、年龄、职业及学历分布情况进行分析,并对每1份血标本进行ALT、HBsAg、抗-HCV、抗-TP、抗-HIV检测。结果 ALT不合格率男性高于女性;45岁以上及低学历献血者的抗-TP不合格率高于相应对比组;献血者中工人所占比例最高;高学历、军人、学生和干部献血人数最少,但血液检测合格率最高。结论针对不同献血人群制定不同的招募策略,进一步保障血液安全。

Analysis of variabilities of serum proteomic spectra in patients with gastric cancer before and after operation

AIM： To study the variabilities of serum proteomic spectra in patients with gastric cancer before and after operation in order to detect the specific protein markers that can be used for quick diagnosis of gastric cancer. METHODS： Proteomic spectra of 46 serum samples from patients with gastric cancer before and after operation and 40 from normal individuals were generated by IMAC-Cu protein chip and surface-enhanced laser desorption/ionization time of flight mass spectrometry. RESULTS： Fourteen differentially expressed proteins in serum were screened by analysis of proteomic spectra of preoperative patients and normal individuals. We obtained 4 proteins （heat shock protein 27, glucoseregulated protein, prohibitin, protein disulfide isomerase A3） making up marker pattern which was able to class the patient-team and normal-team. These marker patterns yielded 95.7% sensitivity and 92.5% specificity, respectively. The proteins over-expressed in serum of preoperative patients were obviously down-regulated. CONCLUSION： Specific protein markers of gastric cancer can be used for the quick diagnosis of gastric cancer and judgment of prognosis. SELDI-TOF-MS is a useful tool for the detection and identification of new protein markers in serum.

Routine blood tests to predict liver fibrosis in chronic hepatitis C

AIM: To verify the usefulness of FibroQ for predicting fi brosis in patients with chronic hepatitis C, compared with other noninvasive tests. METHODS: This retrospective cohort study included 237 consecutive patients with chronic hepatitis C who had undergone percutaneous liver biopsy before treatment. FibroQ, aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR), AST to platelet ratioindex, cirrhosis discriminant score, age-platelet index (API), Pohl score, FIB-4 index, and Lok's model were calculated and compared. RESULTS: FibroQ, FIB-4, AAR, API and Lok's model results increased significantly as fibrosis advanced (analysis of variance test: P < 0.001). FibroQ trended to be superior in predicting signifi cant fi brosis score in chronic hepatitis C compared with other noninvasive tests. CONCLUSION: FibroQ is a simple and useful test for predicting signifi cant fi brosis in patients with chronic hepatitis C.

Gaussia Luciferase Reporter Assay for Assessment of Gene Delivery Systems in Vivo

Objective To develop an alternative method for assessment of gene delivery systems in vivo.Methods Mouse primary spleen lymphocytes were genetically modified in vitro by a retroviral vector harboring a Gaussia luciferase(Gluc) expression cassette.After implantation of these cells into recipient mice,the expression of Gluc was detected in whole blood or plasma collected.Results As little as 10 μL whole blood drawn from the recipient mice could guarantee prompt reading of Gluc activity with a luminometer.And the reading was found in good correlation with the number of genetically modified spleen lymphocytes implanted to the mice.Conclusions Gluc may be useful as an in vivo reporter for gene therapy researches,and Gluc blood assay could provide an alternative method for assessment of gene delivery systems in vivo.

Study of Blood Parasites in Mabuya sp Lizards and Buforegularis Toads in Jebel Awlia and Tuti Island of Khartoum, Sudan

Toads and lizards have been a part of our ecosystems for millions of years and they are good indicators of environmental health. Toads and lizards can be infected by different types of parasites; blood parasites are one of the most important parasites. The present study was conducted to survey and identify different blood parasites in Mabuya sp. lizard and Buforegularis toad in two locations in Khartoum state. Fifteen samples of Mabuya sp and fifteen samples of Buforegularis were collected. All Toads and lizards were dissected and tissue from spleen and liver were examined. The microscopic diagnosis detected Sauroleishmania and Haemogregarina spp parasites in both Mabuya and B. regularis while Microfilariae spp was detected in Mabuya sp. Trypanosoma spp was detected in only one specimen of B. regularis. The results also indicated Sauroleishmania parasites and Haemogregarina spp parasites in the sampled toads and lizards in the two locations. The study of blood parasites and their effects in diversity and health of toads and lizards is necessary to determine the impacts of infections in these animals and the use of the results as indicator of hemoparasites in the environmental as well as the food chain.

Detection and sequence analysis of TT virus in hemodialysis patients

Objective: To study the prevalence and pathogenesis of transfusion-transmitted virus (TTV) in hemodialysis patients. Methods: Serum TTV DNA was tested in 69 hemodialysis patients from our hospital by nested-PCR using primers from a conservative region of TTV genenome, gene sequence analysis and detection of hepatitis C virus antibody (anti-HCV) and the levels of alanine transaminase (ALT) were determined simultaneously. Results: The overall prevalence of TTV viremia was 27.5%. The PCR-amplified gene fragment from one patient was sequenced, and its Sequence homologies with TTV-UHI, TTV-TA278, TTVCHN1 and TTVCHN2 ranged from 89% to 100%, and its deduced amino acid sequence homologies with these 4 isolates ranged from 87% to 100%. There was no significant difference in 1TV prevalence between anti-UCV positive and negative patients (P＞0.05). No significant elevation of ALT is found in all patients. Conclusion: High prevalence of TTV infection is found among hemodialysis patients, and TTV infection has no significant association with HCV infection or elevation of ALT.

Circulating tumor cells in lung cancer:Detection methods and clinical impact

Circulating tumor cells(CTCs) are tumor cells that enter the blood circulation after detaching from the primary tumor and can migrate to reach distant organs, where they can give rise to aggressive metastasis. Clinical studies have revealed that the presence of CTCs in peripheral blood is correlated with disease progression in lung cancer. However, as CTCs are rare cancer cells released from tumors into the bloodstream, both enrichment and sensitive detection methods are technically challenging. In order to best understand how CTCs are currently being deployed, this review mainly focuses on the different detection methods for CTCs. Furthermore, we will describe the clinical impact of circulating tumor cells in lung cancer and discuss their potential use as biomarker to guide the prognosis.

Transoesophageal echo-doppler hemodynamic monitoring during preoperative acute hypervolemic hemodilution

Using transesophageal echo-Doppler, it is demonstrated that preoperative acute hypervolemic hemodilution(HHD) with 6% hydroxyethel starch(HES) significantly increased in intravascular volume, DO2, CO, SV and CI, markedly decreased in SVR and remained stable in MAP and HR, which indicates HES infused at 20 ml*kg-1 is safe in patient without cardiac disease.

Dynamically monitoring tissue factor and tissue factor pathway inhibitor following secondary brain injury

Objective: To study the altering rule of coagulation function at molecular level in patients with secondary brain injury (SBI). Methods: Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) were studied in 32 patients 1, 2, 3 and 7 days after craniocerebral injury. Repeated cranial CT scans and platelet counts were made simultaneously. Same measurements were done in 30 normal adults except CT scan. Results: No obvious difference was found in age, sex and platelet count between the injured and the normal groups. TFPI/TF decreased markedly in the first week after injury in patients with SBI, but only decreased on the 7th day in the patients without obvious SBI. For the patients who developed delayed intracranial hematoma (DIH) or hematoma enlargement, TF rose only 1 and 2 days after injury, but TFPI had a tendency to rise again after a fall on the 3rd day. For those patients who developed no DIH, TF rose all the time within the 1st week. Conclusions: Decrease of TFPI/TF for a long time, especially within 3 days after injury, may be one of the most important reasons for SBI. High expression of TF for a relative short time and increase of TFPI after a fall within 3 days may be one of the important reasons for DIH or hematoma enlargement.

Mandatory criteria for the application of variability-based parameters of fluid responsiveness: a prospective study in different groups of ICU patients

Background and objective： Stroke volume variation（SVV） has high sensitivity and specificity in predicting fluid responsiveness. However, sinus rhythm（SR） and controlled mechanical ventilation（CV） are mandatory for their application. Several studies suggest a limited applicability of SVV in intensive care unit（ICU） patients. We hypothesized that the applicability of SVV might be different over time and within certain subgroups of ICU patients. Therefore, we analysed the prevalence of SR and CV in ICU patients during the first 24 h of Pi CCO-monitoring（primary endpoint） and during the total ICU stay. We also investigated the applicability of SVV in the subgroups of patients with sepsis, cirrhosis, and acute pancreatitis. Methods： The prevalence of SR and CV was documented immediately before 1241 thermodilution measurements in 88 patients. Results： In all measurements, SVV was applicable in about 24%. However, the applicability of SVV was time-dependent： the prevalence of both SR and CV was higher during the first 24 h compared to measurements thereafter（36.1% vs. 21.9%; P0.001）. Within different subgroups, the applicability during the first 24 h of monitoring ranged between 0% in acute pancreatitis, 25.5% in liver failure, and 48.9% in patients without pancreatitis, liver failure, pneumonia or sepsis. Conclusions： The applicability of SVV in a predominantly medical ICU is only about 25%–35%. The prevalence of both mandatory criteria decreases over time during the ICU stay. Furthermore, the applicability is particularly low in patients with acute pancreatitis and liver failure.

Changes of proteins induced by anticoagulants can be more sensitively detected in urine than in plasma

The most fundamental property of biomarkers is change.But changes are hard to maintain in plasma since it is strictly controlled by homeostatic mechanisms of the body.There is no homeostatic mechanism for urine.Besides,urine is partly a filtration of blood,and systematic information can be reflected in urine.We hypothesize that change of blood can be reflected in urine more sensitively.Here we introduce the interference into the blood by two anticoagulants heparin or argatroban.Plasma and urine proteins were profiled by LC-MS/MS and then validated by Western blot in totally six SD female rats before and after the drug treatments.In argatroban treated group,with exactly the same experimental procedure and the same cutoff value for both plasma and urine proteins,62 proteins changed in urine,only one of which changed in plasma.In heparin treated group,27 proteins changed in urine but only three other proteins changed in plasma.Both LC-MS/MS and Western blot analyses demonstrated drug-induced increases in transferrin and hemopexin levels in urine but not in plasma.Our data indicates that urine may serve as a source for more sensitive detection of protein biomarkers than plasma.

On-line dynamic measurement of blood viscosity, hematocrit and change of blood volume

Objective: To develop an on line system for the measurement of blood viscosity and hematocrit. The dynamic changes of the macrovascular blood volumes, microvascular blood volumes and the total blood volume were observed by means of calculating from the testing result. Methods: Applying traditional viscosity measurement principle and specific wavelength optic density measurement method, an on line system for the measurement of blood viscosity and hematocrit was developed, and the A/D multifunctional board and the testing circuit were designed by ourselves. The system was validated by experiments both in vitro and in vivo. Therapeutic effects of hypertonic saline dextran solution (HSD) and Lactatic Ringers solution at the early stage after burn blast combined injury were compared by this method. Results: The results showed that the system has attained the goal of the design. The changes of the blood viscosity and hematocrit could be detected effectively and continuously. The changes of macrovascular, microvascular and total blood volume could be calculated approximately. Conclusions: The system and the method can continuously on line test the blood viscosity and hematocrit, and reveal the change and distribution of blood volumes more accurately and clearly in the therapy process by estimatng changes of the macrovascular, microvascular and total blood volumes, respectively. It has confirmed that HSD treatment could increase blood pressure and attenuate tissue edema by significantly increasing total blood volume, improving macrocirculatory and microcirculatory blood volumes. This study suggested that it could be desirable to develop an experiment technique based on the method mentioned above.

Simultaneous quantification of lopinavir and ritonavir in human plasma by high performance liquid chromatography coupled with UV detection

High performance liquid chromatography was coupled with UV detection for simultaneous quantification of lopinavir （LPV） and ritonavir （RTV） in human plasma. This assay was sensitive, accurate and simple, and only used 200μL of plasma sample. Samples were liquid-liquid extracted, and diazepam was used as an internal standard. The chromatographic separation was achieved on a C18 reversed-phase analytic column with a mobile phase of acetonitrile-sodium dihydrogen phosphate buffer （10 mmol L-1, pH 4.80） （60：40, v/v）. UV detection was conducted at 205 nm and the column oven was set at 40℃. Calibration curves were constructed between 0,5-20 μg mL-1 for LPV and 0.05-5 μg mL-1 for RTV. The relative standard deviations were 2.16%-3.20% for LPV and 2.12%-2.60% for RTV for intra-day analysis, and 2.34%-4.04% for LPV and 0.31%-4.94% for RTV for inter-day analysis. The accuracy was within 100%＋10%. The mean extraction recoveries were 79.17%, 52.26% and 91.35% for RTV, LPV and diazepam, respectively. This method was successfully applied to human plasma samples from patients orally administered a salvage regimen of lopinavir-ritonavir tablets.