微小RNA-1265在鼻咽癌中的表达及诊断价值

目的探讨微小RNA-1265(miR-1265)在鼻咽癌中的表达及诊断价值。方法选取2018年1月至2019年8月于该院治疗的鼻咽癌患者60例作为研究组,鼻咽部良性肿瘤患者60例作为对照组,收集两组患者的病理组织和血清。采用PCR法检测两组患者病理组织和血清中的miR-1265相对表达水平,比较不同临床病理参数鼻咽癌患者miR-1265的相对表达水平。采用受试者工作曲线(ROC曲线)分析miR-1265对鼻咽癌的诊断价值,采用TargetScan预测靶基因并用双荧光素酶报告基因分析实验进行验证。采用Pearson相关分析miR-1265和MAT1表达的相关性。结果研究组病理组织中miR-1265的相对表达水平高于对照组(P0.05)。研究组患者血清中miR-1265的相对表达水平高于对照组(P0.05)。不同性别、年龄及病理类型患者间miR-1265的表达水平差异无统计学意义(P0.05),不同TNM分期、病理分期和淋巴结转移的患者miR-1265表达水平差异有统计学意义(P0.05)。当病理组织miR-1265截断值为0.895时,其诊断鼻咽癌的曲线下面积(AUC)为0.917(95%CI:0.878～0.946),灵敏度为87.3%,特异度为91.3%。当血清miR-1265截断值为0.515时,其诊断鼻咽癌的AUC为0.717(95%CI:0.678～0.806),灵敏度为67.3%,特异度为71.3%。双荧光素酶报告基因分析实验证实miR-1265的靶基因为MAT1。鼻咽癌组织中MAT1 mRNA与miR-1265的相对表达水平呈显著负相关(r=-0.943,P0.001)。结论鼻咽癌组织和血清中miR-1265表达上调,与鼻咽癌进展密切相关,具有区分鼻咽癌和鼻咽部良性肿瘤的价值。miR-1265靶基因是MAT1基因,可能成为鼻咽癌潜在治疗靶点。     

MiR-155及其靶基因MMP16在反复植入失败患者子宫内膜中的表达

目的观察miR-155及其靶基因在反复植入失败患者子宫内膜中的表达。方法选取2018年5月至2019年12月在秦皇岛市妇幼保健院生殖医学科进行体外受精与胚胎移植(IVF-ET)或者卵细胞质内单精子注射(ICSI)治疗的不孕患者,其中由于男方因素或者输卵管因素于我院首次进行辅助助孕后妊娠并分娩的患者15例作为对照组;至少进行3次移植(新鲜或者解冻的胚胎,每次至少有一枚优质胚胎,移植优质胚胎数≥4)均未妊娠的患者15例作为反复植入失败(RIF)组;采用实时定量PCR(qRT-PCR)检测miR-155及基质金属蛋白酶16基因(MMP16)mRNA在子宫内膜的表达;利用生物信息学技术预测miR-155的下游靶基因;利用双荧光素酶实验验证miR-155的靶基因;采用蛋白印迹法检测RIF患者内膜MMP16的表达;利用相关性分析判断miR-155和MMP16的相关性。结果 RIF组miR-155水平高于对照组,差异有统计学意义(P0.05);通过生物信息学、双荧光素酶报告基因检测技术以及转染实验发现,miR-155通过结合于MMP16 3′UTR而抑制MMP16 mRNA和蛋白质的表达。qRT-PCR实验结果表明,RIF组MMP16 mRNA和蛋白质的表达水平下调,并且MMP16 mRNA表达水平与miR-155的表达水平呈负相关(r=-0.967,P0.05)。结论 MiR-155在RIF患者子宫内膜中的表达上调,可能通过调控MMP16基因来影响子宫内膜的容受性。     

miR-181a靶向抑制ATM表达促进急性髓系白血病细胞增殖

目的:研究microRNA181a(miR-181a)在人急性髓系白血病(AML)中的作用及其调控机制。方法:采用miR-181a小分子类似物转染人AML细胞系HL-60细胞,采用CCK-8计数法检测miR-181a对细胞增殖的影响。利用生物信息学方法结合文献分析预测miR-181a潜在的靶基因,通过双荧光报告实验在HL-60细胞内以及白血病患者体内多方面对靶基因进行验证。结果:miR-181a能显著促进人HL-60细胞恶性增殖(P0.05);在线软件预测发现,抑癌基因ATM可能是白血病细胞miR-181a潜在的靶基因;双荧光报告实验结果表明,miR-181a能显著地抑制含3'-UTR的ATM报告基因活性,荧光素酶活性下降56.8%(P0.01),而对含3'-UTR突变位点的ATM报告基因载体没有抑制作用。在HL-60细胞中过表达miR-181a,Western blot检测显示可以显著抑制内源性ATM的表达(P0.01),而在白血病患者中miR-181a的表达增高,与ATM的表达呈负相关(r=-0.766)。结论:miR-181a通过抑制抑癌基因ATM表达以促进人AML细胞恶性增殖,从而在AML发病中起着类似"癌基因"的作用。     

血浆miR-130a-3p在高原低氧环境中表达的研究

目的探讨人血浆中miR-130a-3p在高原低氧环境中的表达情况。方法分别采集150例长期居住在平原地区的健康汉族人(平原汉组)和80例从平原地区移居到高原地区的健康汉族人(高原汉组)血浆样本,采用实时荧光定量PCR(qRT-PCR)法检测两组人群血浆miR-130a-3p表达水平,分析miR-130a-3p表达水平与血液学指标的相关性,采用生物信息学分析软件预测其存在的靶基因。结果高原汉组血浆miR-130a-3p表达水平高于平原汉组,差异有统计学意义(Z=-5.318,P0.05)。血浆miR-130a-3p表达水平与红细胞计数(r=0.58、P0.001)、血红蛋白(r=0.59、P0.001)、血细胞比容(r=0.69、P0.001)均呈正相关,而与血小板计数(r=-0.21、P=0.001 4)呈负相关。生物信息学分析发现miR-130a-3p存在一些与缺氧、红细胞生成、巨核细胞增殖与分化相关的靶基因。结论高原低氧环境能够影响血浆中miR-130a-3p的表达,miR-130a-3p可作为机体应对缺氧环境的一个循环因子。     

miR-139-5p靶基因参与调控人骨肉瘤细胞表型的机制分析

目的 通过生物信息学方法预测miR-139-5 p的靶基因,并对靶基因进行信号通路富集分析,结合蛋白质互作(PPI)网络分析筛选核心基因.方法 使用dbDEMC数据库检索miR-139-5 p在骨肉瘤细胞中的表达,使用miRSystem网站的生物信息学数据库进行miR-139-5 p的靶基因预测,利用DAVID6.8软...     

miR-181b在慢性淋巴细胞白血病患者中的表达及其靶基因的预测

目的:探讨miR-181b在慢性淋巴细胞白血病(CLL)患者CD19+B淋巴细胞中的表达水平,分析其表达与CLL预后关系,并利用生物信息学预测miR-181b在CLL中的潜在靶基因。方法:选取2013年6月至2018年6月在新疆自治区人民医院诊治的CLL患者84例、并选取健康者20例为对照组。应用磁珠分选CLL患者和对照组外周血CD19+B淋巴细胞后进行RNA提取,检测miR-181b的表达水平,分析其在不同IPI分组中表达差异,探讨miR-181b表达水平与CLL患者PFS相关性。使用网上数据库及文献预测miR-181b靶基因,对候选靶基因进行基因注释分析及相关信号通路分析。结果:miR-181b在CLL患者中表达显著低于对照组(P0.01)。miR-181b在低危组的表达水平高于高危组和极高危组(P0.05),但在低危组与中危组间表达无差异(P=1.00),中危组中miR-181b的表达水平高于高危组和极高危组(P0.05),但在高危组与极高危组间表达无差异。ROC曲线结果显示,曲线下面积(AUC)为0.792(P0.01),由此显示,miR-181b表达水平处于分界值0.279时,具有较好的敏感性(62.9%)和特异性(91.8%)。生存分析结果提示,与高表达组相比,miR-181b低表达CLL患者具有较差的PFS(log-rank:P=0.047)。使用starBase、Targetscan和PicTar数据库进行靶基因预测,结合文献报道,与血液疾病相关的靶基因有CARD11、ZFP36L1、RUNX1、NR4A3、ATP1B1、PUM1和PLAG1,其中上调的CARD11、ZFP36L1通过促进细胞增殖、抑制细胞衰老参与淋巴系统肿瘤形成。结论:miR-181b在CLL患者中的表达水平明显低于健康对照组,且miR-181b低表达与CLL不良预后有关。通过生物信息学预测并结合文献报道,推测CARD11及ZFP36L1可能作为miR-181b的靶基因参与CLL疾病发生发展,该结果还需要进一步实验进行验证。     

miR-550a-5p在骨髓增生异常综合征中的表达及其靶基因预测

目的:探讨miR-550a-5p在骨髓增生异常综合征(MDS)患者骨髓中的表达情况并通过生物信息学分析预测靶基因及其功能,为进一步研究miR-550a-5p及其靶基因在MDS发病机制中的作用提供依据。方法:采用realtime PCR技术检测miR-550a-5p在54例MDS患者、16例MDS转化白血病患者及19例健康对照中的表达量,并分析其与临床病理特征(包括染色体情况、骨髓原始细胞比例及外周血血象)的相关性。应用miRBase获得并分析多个物种miR-550的序列特征;应用Microcosm、Miranda和Targetscan预测miR-550a-5p的靶基因,并取预测结果交集,进一步进行基因功能的GO(富集)分析和信号转导通路(Pathway)的富集分析。结果:miR-550a-5p表达量在所有MDS患者骨髓中均比对照组升高:在低危+中危1组中表达量是对照组的1.7倍(P=1.23×10-10);在中危2+高危组中表达量是对照组的1.9倍(P=1.20×10~(-10));在MDS转化为白血病组中的表达量是对照组的2.0倍(P=5.61×10~(-10))。随着MDS疾病危险度增高,miR-550a-5p表达水平逐渐上升,但其表达量与MDS患者的临床病理特征(包括染色体情况、骨髓原始细胞比例及外周血血象)之间无明显相关。利用生物信息学预测miR-550a-5p在MDS中的靶基因,结合文献报道选出了其中2个可能与miR-550a-5p调控MDS发生发展的病理机制有关的靶基因——PDLIM2和PSME1。结论:miR-550a-5p在MDS患者骨髓细胞中呈现出特异性高表达,推测其可能通过调控靶基因PDLIM2和PSME1参与MDS病理生理过程。     

miR-224靶向抑制ECRG4表达对非小细胞肺癌细胞增殖、迁移和侵袭的影响

目的研究微小RNA-224(miR-224)及其靶基因食管癌相关基因4(ECRG4)在非小细胞肺癌(NSCLC)中的表达和对A549细胞增殖、迁移、侵袭的影响。方法利用原位杂交、荧光定量PCR、免疫组织化学和Western blot检测NSCLC临床标本和细胞系中miR-224和ECRG4的表达水平;通过microRNA.org网站预测miR-224与ECRG4的靶向关系,并行双荧光素酶报告基因实验和Western blot进行验证;分析抑制miR-224及联合抑制ECRG4对A549细胞增殖、迁移和侵袭能力的影响。结果 NSCLC癌组织中miR-224表达水平明显高于癌旁组织,ECRG4mRNA和ECRG4蛋白表达水平均明显低于癌旁组织,差异有统计学意义(P0.05)。与健康人肺支气管上皮细胞系HBE相比,NSCLC细胞系L78、A549、H460中miR-224表达水平明显升高,ECRG4mRNA和ECRG4蛋白表达水平明显降低,差异有统计学意义(P0.05)。经microRNA.org网站预测、双荧光素酶报告基因实验和Western blot证实,ECRG4是miR-224的靶基因。抑制miR-224可抑制A549细胞增殖、迁移和侵袭(P0.05),而联合抑制ECRG4则可逆转抑制miR-224对A549细胞的抑制作用(P0.05)。结论 miR-224可通过靶向ECRG4促进NSCLC细胞A549增殖、迁移和侵袭,提示miR-224和ECRG4可能成为诊断和治疗NSCLC的靶点。     

β-arrestin1通过miR-652-5p促进T-ALL细胞线粒体活性氧含量的研究

目的:探讨β-arrestin1对急性T淋巴细胞白血病(T-ALL)细胞线粒体内活性氧含量(ROS)的影响及可能作用机制。方法:构建稳定敲低β-arrestin1(Siβ1)的T-ALL细胞株Jurkat细胞。采用流式细胞术、探针法分别检测细胞及线粒体内ROS含量。microRNA芯片检测及分析和Q-PCR验证β-arrestin1与microRNA的关系。miRbase软件预测microRNA靶基因,Western blot检测microRNA靶基因表达,双荧光素酶报告基因实验验证结合。结果:成功构建Jurkat Siβ1稳定细胞株,Jurkat Siβ1整个细胞水平ROS含量略降低,且线粒体内ROS含量明显降低。microRNA芯片分析发现,多种与T-ALL相关的microRNA呈差异表达,其中miR-652-5p在Jurkat Siβ1中的表达显著升高(P0.05 fold2.0),且Q-PCR显示miR-652-5p在Jurkat Siβ1中上升近5倍;通过miRbase软件预测到P62基因是miR-652-5p靶基因,且其能调控线粒体功能,在miR-652-5p稳定敲低Jurkat细胞中高表达,双荧光素酶报告基因实验证实P62是miR-652-5p靶基因。结论:T-ALL中,β-arrestin1可降低miR-652-5p表达,解除对P62基因的抑制,增加细胞线粒体内ROS含量。     

circERBB2在卵巢癌中的表达及作用机制研究

目的 探讨circERBB2在卵巢癌中的表达及作用机制。方法 基于GEO数据库筛选卵巢癌差异表达环状RNA(circRNA),并查找circRNA相关靶基因,绘制韦恩图得到GSE79572数据集中差异表达基因与Targetscan 7.1预测所得微小RNA-187-3p(miR-187-3p)靶基因的交叉基因。收集20例卵巢癌患者的卵巢癌组织和癌旁正常组织,培养人正常卵巢细胞系HOSEpiC和人卵巢癌细胞系OVCAR-3、SKOV-3、3AO、OV90,采用实时定量聚合酶链反应(qRT-PCR)检测circERBB2、miR-187-3p、BCL6表达水平。通过双荧光素酶报告基因实验和RNA下拉实验验证circERBB2、miR-187-3p、BCL6三者间的相互作用。通过多项细胞实验分析circERBB2、miR-187-3p、BCL6对卵巢癌细胞侵袭、迁移、增殖及细胞周期的影响。结果 数据库分析结果显示,卵巢癌中差异表达circRNA为circERBB2, circERBB2靶向的miRNA为miR-187-3p,绘制韦恩图取交集后得到BCL6等7个交叉基因,circERBB2与m...     

Ultrasonic study of venous patterns in the right hypochondrium: An anatomical approach to differential diagnosis of obstructive jaundice

Through real time ultrasonography, it is possible to display the splenic vein, the superior mesenteric vein, the vena porta, and the intrahepatic portal and systemic veins. In jaundice, it is of the utmost importance to carefully identify the vena porta before making a diagnosis of common bile duct enlargement. It is also necessary, when confronted with a pattern of apparently enlarged intrahepatic ducts, to conduct a thorough study of possible confluences of the ducts with the vena porta or vena cava to be certain that the ducts are not part of the portal or systemic venous network. Without such differentiation, portal enlargement caused portal hypertension, systemic venous enlargement caused cardiac insufficiency, or even nonpathological wide veins may lead to an erroneous diagnosis of obstructive jaundice.     

The clearance of Procalcitonin (PCT) during continuous veno-venous hemodiafiltration (CVVHD)

Objective. To evaluate the Procalcitonin (PCT) clearance during continuous veno-venous hemodiafiltration (CVVHD).?Design. Case report?Setting. Surgical intensive care unit?Patient. 51-year-old man, who had undergone total thyroidectomy about ten years before owing to multiple endocrine neoplasia 2 (MEN 2), suffering from multiple organ dysfunction syndrome (MODS) with acute renal failure after severe trauma caused by a traffic accident.?Measurements and main result. The samplings of prefilter (afferent) and post-filter (efferent) blood and of ultradiafiltrate were 6 times performed during 24 h of CVVHD to calculate the PCT clearance of hemdiafiltration.?During the first half period of CVVHD the serum PCT concentration did not decrease, though PCT had been eliminated from serum. On the other hand during the latter half period of it the serum PCT value decreased (from 46.8 ng/ml to 29.4 ng/ml) and the amount of the eliminated PCT from serum was about 100 ng per minute and its clearance was 2.3 ∼ 3.4 ml/min.?Conclusion. The CVVHD could eliminate PCT from serum. First it was brought about by the adsorption by the filter menbrane and then by ultradiafiltration. Received: 25 February 1999/Final revision received: 31 May 1999/Accepted: 9 June 1999     

Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center

Goals

Management of the risk of potential chemotherapy-induced neutropenic complications such as febrile neutropenia (FN) and severe neutropenia (SN) is a quality of care priority. How frequently does care at our institution conform to established guidelines?

Materials and methods

This retrospective chart review study included a random sample of 305 cancer patients receiving care at a single US academic medical center. Abstracted data included demographics, risk factors, and outcome variables (e.g., development of FN/SN, administration of myeloid growth factors). To evaluate quality of care, we assessed conformance between actual practice and established clinical practice guidelines for the use of myeloid growth factors from the National Comprehensive Cancer Network (NCCN).

Main results

Of the 305 cases reviewed, 8% were classified as low risk (<10%), 48% as intermediate risk (10–20%), and 44% as high risk (>20%), using the risk classifications in the NCCN guidelines modified to accommodate illness and other risk factors. Thirty-four percent received prophylactic administration of myeloid growth factors. Half of the cases had adequate documentation of mid-cycle absolute neutrophil count to determine whether FN/SN developed. Among these cases with adequate documentation, 21% developed FN/SN. Use of growth factors did not conform to established quality guidelines. Overall, 77 of 133 (58%) high-risk cases received myeloid growth factors, whereas six of 25 (24%) low-risk cases received myeloid growth factors.

Conclusions

Routine clinical practice in this academic oncology setting was poorly aligned with established guidelines; there is substantial opportunity to standardize clinical strategies and increase conformance with evidence-based guidelines.     

新生儿缺氧缺血性脑病NO、GSH—PX和TNF的含量测定及其临床意义

目的探讨新生儿缺氧缺血性脑病(HIE)血浆和脑脊液(CSF)中的一氧化氮(NO)和谷胱甘肽过氧化物酶(GSH-PX)和肿瘤坏死因子(TNF)含量变化及其与HIE不同时期和不同程度间的相关关系.方法对HIE患儿第3天的CSF和出生初入院(HIE2h内)、第1天、第2天、恢复期的血浆中NO、SOD进行检测,并与正常对照组比较;分析NO、GSH-PX、TNF的变化原因和意义.结果HIE患儿血浆中第1天的NO含量最高,而GSH-PX相反;初入院、第1天、第3天的血浆中NO、GSH-PX含量与正常对照组对比均有显著性差异(P＜0.01),而恢复期中NO、GSH-PX含量与正常对照组对比无显著性差异(P＞0.05),血浆和HIE第3天的CSF中NO和GSH-PX水平均呈负相关;病情越重NO浓度越高,GSH-PX越低.急性期血浆TNF显著高于对照组(P＜0.01),恢复期两组无显著性差异(P＞0.05).结论NO、GSH-PX和TNF参与HIE的发病过程,在HIE的发病过程中起着重要作用;检测血浆和CSF中NO、GSH-PX、TNF含量有助于判断HIE患儿病变程度和病情进展.     

Comparison of two methods based on photoplethysmography for the diagnosis of peripheral arterial disease

Aim. To examine the interchangeability of two methods for distal pressure measurement based on photoplethysmography using a truncated or full display of the arterial inflow curve, respectively. Methods. Toe and ankle pressures were obtained from 69 patients suspected of peripheral arterial disease (PAD). Observer reproducibility of the curve readings was examined by blinded reassessment of the pressure curves in a randomly selected subgroup (60 limbs). Results. There were no significant differences in mean pressures between the two methods (p for all >?.455). The limits of agreement for the differences were ?15.0–15.4?mmHg for right toe pressures, ?16.3–16.2?mmHg for left toe pressures, ?14.2–15.7?mmHg for right ankle pressures, and ?18.3–17.7?mmHg for left ankle pressures. Correlation analysis revealed intraclass correlation coefficients ≥0.960 for all measuring sites. Cohen’s Kappa showed excellent agreement in diagnostic classification, with κ?=?0.930 for the diagnosis of PAD and perfect agreement in the diagnosis of critical limb ischemia (κ?=?1.000). The analysis of intra-observer variation for curve reading showed limits of agreement of ?3.9–4.0 for toe pressures and ?7.6–7.7 for ankle pressures for the method involving truncated display and ?3.1–3.2 for toe pressures and ?6.3–8.6 for ankle pressures for the method involving full display of the signal. Conclusion. The present study shows minimal differences in diagnostic classification, as well as in ankle and toe pressures, between the full display and the truncated display of the photoplethysmographic pulse signal. Furthermore, the inter-observer variation was low for both of the photoplethysmographic methods investigated.     

电磁脉冲照射对小鼠脑组织氧化状态的影响及姜黄素的治疗作用

目的观察电磁脉冲（EMR）照射后小鼠脑组织超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、丙二醛（MDA）的变化及姜黄素的防护作用。方法40只小鼠随机分为空白对照组、单纯EMR组、EMR＋姜黄素低剂量（20mg／kg／d）组、中剂量（40mg／kg／d）组、高剂量（80mg／kg／d）组，每组8只。EMR组和EMR＋姜黄素组小鼠接受200kV／m的EMR照射，EMR＋姜黄素组小鼠同时每日给予不同剂量的姜黄素，5d后停止照射及给药，测定小鼠脑组织中SOD、GSH-Px、MDA的变化。结果与空白对照组比较，EMR照射组小鼠脑组织SOD与GSH-Px活性及MDA含量上升（均P〈0．05）；与单纯EMR组比较，EMR＋姜黄素中、高剂量组小鼠脑组织SOD与GSH-Px活性及MDA含量下降（均P〈0.05）。结论200kV／m的EMR照射可导致小鼠脑组织过氧化，姜黄素可通过其抗氧化作用有效治疗这种损伤，且效应呈一定的剂量依赖关系。     

动脉瘤性蛛网膜下腔出血病人血清FSH LH PRL GH的浓度变化

目的　研究动脉瘤性蛛网膜下腔出血 (SAH)病人血清卵泡刺激素 (FSH)、黄体生成素 (LH)、泌乳素 (PRL)、生长激素 (GH)的浓度变化规律。方法　对 35例动脉瘤性SAH病人发病后 1～ 3、7～ 9、13～ 15d血清FSH、LH、PRL、GH的浓度进行动态观察 ,用TCD检测大脑中动脉血流速度 (VMCA)。结果　动脉瘤性SAH病人血清FSH、LH、PRL、GH浓度在发病后 1～3、7～ 9d各均值明显高于对照组 ,尤以发病后 7～ 9d变化最明显 ;术前、术后有脑血管痉挛 (CVS)组和非CVS组也有明显差异。结论　动脉瘤性SAH病人血清FSH、LH、GH、PRL含量与SAH的病情演变、CVS程度有关 ,并可判断预后。     

Effects of anticancer agents on cell viability,proliferative activity and cytokine production of peripheral blood mononuclear cells

We investigated the effects of anticancer agents on peripheral blood mononuclear cells for the purpose of providing data to support new translational chemoimmunotherapy regimens. Peripheral-blood mononuclear cells were treated with one of four anticancer agents (5-fluorouracil, irinotecan, cisplatin, and gemcitabine) for 2 h, after which cell viability was determined. For assessment of effects of each drug on proliferation and cytokine production, cells were stimulated with phytohemagglutinin for 48 h. As a result, the anticancer agents did not affect cell viability. Cell proliferation was unaffected by 5-fluorouracil and irinotecan but inhibited by cisplatin and gemcitabine. Treatment with gemcitabine enhanced the production of IFN-γ and decreased the number of regulatory T cells. gemcitabine treatment increased IFN-γ production among CD4 T cells but not among CD8 T cells. The results indicated that GEM had immunoregulatory properties that might support immune response against cancer. This finding has implications for designing chemoimmunotherapy strategies.     

健康国人年龄性别对主要脑底动脉血流速度的影响及其检测方法的探讨

应用多普勒技术探测颅外脑血管血流速度,1965年由Miyazaki等首先报告,然而,由于骨骼严重衰减超声波,故使用5～10MHz探测频率难以记录颅内血管的血流速度。1982年Aaslid报告了应用脉冲多普勒技术,通过调整取样深度,观察了颅内脑动脉的血流速度,此后,颅内主要脑底动脉的血液动力学变化,以及无创手段对频内脑血管血流速度的监测得到了广泛的研究和深入的开展。我们心功能科自1988年12月引进美国Meda Sonics经颅超声多普勒(TCD)诊断仪以来     

The utility of < or =3-day-old whole-blood platelets in reducing the incidence of febrile nonhemolytic transfusion reactions

BACKGROUND: Febrile nonhemolytic transfusion reactions (FNHTRs) to platelet transfusions have been linked to the presence of cytokines in supernatant plasma. Cytokine concentration is directly related to WBC content and storage time. This study evaluated the effect of limiting the storage time of random-donor platelet concentrates on the FNHTR rate. STUDY DESIGN AND METHODS: FNHTR rates were calculated retrospectively for single-donor apheresis platelet (SDP) and pooled random-donor platelet (PP) transfusions given during three consecutive 5-month study periods (November 1995 to February 1997) to patients on a single hematology/oncology/bone marrow transplant unit. Transfusion practice policies were: Baseline Period, SDPs preferred; Study Period A, PPs preferred; and Study Period B, < or =3-day-old PPs preferred. FNHTR rates were calculated from physicians' interpretations of reported reactions and the total number of SDP and PP transfusions in each period. SDPs were collected on two cell separators. All platelet components were filtered at issue in the laboratory by WBC-reduction filters. RESULTS: FNHTR rates for PP transfusions were: baseline, 11.1 percent (3/27); Study Period A, 4.6 percent (22/481); and Study Period B, 1.1 percent (3/282). The rates for SDP transfusions were 0. 15 percent (1/650), 0.75 percent (2/267), and 0.36 percent (1/273), respectively. The FNHTR rate for < or =3-day-old PPs was significantly less than the rate for older PPs (p = 0.0086 for Study Period A vs. Study Period B), and was not significantly different than that for SDPs (p = 0.33 for PPs vs. SDPs in Study Period B). CONCLUSION: Limiting transfusion of PPs to those stored 相似文献