用流式细胞仪检测CD_(59)表型对诊断阵发性睡眠性血红蛋白尿症的意义

目的：探讨根据免疫表型检出糖化肌醇磷脂（ＧＰＩ）缺陷细胞在阵发性睡眠性血红蛋白尿症（ＰＮＨ）诊断中的意义。方法：用ＦＩＴＣ标记的ＣＤ５９单抗，以流式细胞仪分析２９例ＰＮＨ患者外周血及骨髓中ＣＤ５９－细胞的百分率。结果：正常人外周血红细胞、中性粒细胞（ＰＭＮ）及骨髓单个核细胞（ＭＮＣ）中的ＣＤ５９－细胞均＜５％，而２８例ＰＮＨ红细胞的ＣＤ５９－细胞均＞１０％（１２．８％～９８．０％），２９例ＰＭＮ均＞１０％（１２．０％～９０．１％），１５例骨髓ＭＮＣ均＞１０％（１７．９％～７３．５％）。１０例表现不典型或Ｈａｍ试验阴性者经本法确诊为ＰＮＨ，７例疑为本病者经本法否定。结论：用流式细胞仪检测ＣＤ５９表型是目前诊断ＰＮＨ的较直接而又特异、敏感的方法。     

用流式细胞仪检测CE59表型对诊断阵发性睡眠性血红蛋白尿症…

探讨根据免疫表型检出糖化肌醇磷脂缺陷细胞在阵发性睡眠性血红蛋白尿症诊断中的意义。方法：用ＦＩＴＣ标记的ＣＤ５９单抗，以流式细胞仪分析２９例ＰＮＨ患者外周血及骨髓中ＣＤ５９细胞的百分率。结论：用流式细胞仪检测ＣＤ５９表型是目前诊断ＰＮＨ的较直接而又特异，敏感的方法。     

Supernatant from stored red blood cell primes inflammatory cells: influence of prestorage white cell reduction

BACKGROUND: The contribution of RBC transfusion to adverse patient outcomes is controversial. There is conflicting clinical data and limited biologic data that provide an underpinning biologic rationale for any adverse impacts from RBC transfusion. This study used in-vitro measures of PMN stimulation to determine the ability of supernatant from RBCs to stimulate allogeneic WBCs and to determine the influence of residual donor WBCs and storage time on the proinflammatory potential of RBCs. STUDY DESIGN AND METHODS: Three types of RBCs were assessed: standard non-WBC-reduced RBCs (S-RBCs), buffy coat-poor RBCs (BCP-RBCs), and prestorage WBC-filtered RBC (LF-RBCs). Supernatant was collected weekly up to Day 42 of storage. PMN priming by supernatant from RBCs was determined by three methods: induction of CD11b expression on PMNs, induction of IL-8 release from PMNs, and the chemotactic effect of supernatant on PMNs. RESULTS: Supernatant from S-RBCs induced the expression of CD11b on PMNs, primed PMNs to release IL-8, and was chemotactic for PMNs. The magnitude of this PMN-priming progressively amplified with storage time. In contrast, supernatant from BCP-RBCs or LF-RBCs did not significantly prime PMNs. The PMN-priming effect of supernatant from RBCs correlated more closely with the level of MNCs in the RBCs than PMN content. CONCLUSION: Supernatant from stored S-RBCs prime unstimulated allogeneic PMNs in vitro. Prestorage buffy-coat WBC reduction was as effective as WBC depletion in abrogating this proinflammatory response elicited by supernatants from RBCs. The clinical consequences, if any, of these findings for transfusion recipients are unknown.     

从再生障碍性贫血患者检出阵发性睡眠性血红蛋白尿症异常细胞的观察

目的：探讨在再生障碍性贫血（再障）患者中检出阵发性睡眠性血红蛋白尿症（ＰＮＨ）异常细胞的发生率。方法：用荧光标记的抗ＣＤ５９抗体，以流式细胞仪检测缺失ＣＤ５９的异常细胞。结果：１０名正常人骨髓单个核细胞及外周血红细胞和中性粒细胞的ＣＤ５９标记率均＞９５％。２３例再障患者中约２／３标记率正常，另外１／３患者的标记率有不同程度的减低。结论：该法是从再障患者检出少量ＰＮＨ异常细胞的良好手段，可用以早期发现再障－阵发性睡眠性血红蛋白尿症综合征。     

腹腔镜胆囊切除术围手术期微量元素的变化

目的：探讨LC围手术期微量元素的变化,方法：对12例LC病人在术前,术终,术后血清中Ca,Mg,Fe,Zn,Cu,Mn,Se,Cr,CO,Ni,V,Mo,Ba,Al,Sr,Cd,Pb和Se的变化进行动态观察,结果：在检测的18种微量元素中,在术终Ca,Mg,Zn,CU,Mn,Se,Cr等必需微量元素均明显降低（P＜0．05,P＜0．01）,术后第1天,血清中Ca,Mg,Zn,Cu,Mn,Se,Cr均还维持在明显的水平（P＜0．05）,结论：LC对必需的微量元素有明显的影响,术后应注意补充适量的微量元素。     

从再生障碍性贫血患者检出阵发性睡眠性血红蛋白尿症异常…

目的 探讨在再生障碍性贫血患者中检出阵发性睡眠性血红蛋白症异常细胞的发生率。方法：用荧光标记的抗ＣＤ５９抗体，以流式细胞仪检测缺失ＣＤ５９的异常细胞。结果：１０名正常人骨髓单个核细胞及外周血红细胞和中性粒细胞的ＣＤ５９标记率均〉９５％。２３例再障患者中红２／３标记率正常，另外１／３患者的标记率有不同程度的减低。     

血清肝素抗凝血浆对化学法检测微量元素的影响

目的探讨不同处理方式的血清及不同肝素浓度抗凝血浆对化学法检测微量元素的影响。方法以临床工作中可能出现的5种肝素浓度抗凝血浆与快速处理的血清标本在相同条件下配对检测微量元素,并与常规处理的血清标本进行比较。结果不同浓度肝素抗凝血浆与快速处理的血清比较,铜(Cu)、镁(Mg)、锌(Zn)、铁(Fe)和总钙(TCa)差异无统计学意义(P>0.05),磷(P)差异有统计学意义(P<0.01);快速与常规2种方式处理的血清比较:Mg、Zn和Fe差异有统计学意义(P<0.05,P<0.01);不同浓度肝素抗凝血浆与常规处理的血清比较除TCa外差异均有统计学意义(P<0.05,P<0.01);不同浓度肝素抗凝血浆之间比较差异无统计学意义(P>0.05)。结论如无条件快速处理血清,化学法检测微量元素应尽量使用肝素化抗凝血浆;肝素抗凝血浆的应用要充分考虑到个别项目如P的局限性;肝素抗凝浓度应按照《全国临床检验操作规程》执行,各实验室还应建立肝素抗凝血标本微量元素化学法检测指标的参考范围。     

Element concentrations in urine of patients suffering from chronic arsenic poisoning

In order to know the element levels in the urine of patients with chronic arsenic poisoning caused by arsenic assimilated from burning coal via air and food, we investigated various elements in the urine of 16 patients with this disease and 16 controls living in the same county in Guizhou Province of China. Concentrations of 25 elements (Al, As, Ba, Be, Bi, Ca, Cd, Cr, Cu, Fe, Ga, Mg, Mn, Mo, Ni, P, Pb, Rb, Sb, Se, Sn, Sr, Ti, V and Zn) were determined by an inductively coupled plasma mass spectrometer or an inductively coupled plasma atomic emission spectrometer. The average concentrations of Cu, Ga and Sn as well as As in the patients were significantly higher, and those of Cr, Rb, Sr and Ti in the patients were significantly lower than the control values. Al, Ba, Mn, Ni and Se were under detection limit in the patients, though they could be detected in the controls. There were no positive correlations between the concentration of As and the concentrations of other elements, including Cu, Ga and Sn in the patients. The results of this study suggest that As from burning coal might influence the urinary excretion of some elements.     

CD59检测在阵发性睡眠性血红蛋白尿症诊断中的意义

目的　探讨CD5 9检测对阵发性睡眠性血红蛋白尿症 (paroxysmalnocturnalhemoglobinuria ,PNH)及再生障碍性贫血 (AA) PNH综合征的临床诊断意义。方法　用FITC标记的CD5 9单抗 ,以流式细胞仪检测 13例PNH、37例AA和 2 0例正常人外周血红细胞和粒细胞膜表面CD5 9的表达情况。结果　正常人红细胞和粒细胞CD5 9表达阳性率均 >98% ;13例PNH患者红细胞及粒细胞CD5 9表达阳性率均 <90 % ;37例再障患者中 2 4例表达正常 ,13例红细胞或粒细胞CD5 9表达阳性率均有不同程度的减低。结论　CD5 9检测是诊断PNH较直接而又特异、敏感的方法 ,特别是对表现不典型的PNH及AA PNH综合征的诊断具有重要意义     

造血干细胞移植患者移植前后血浆中氨基酸、微量元素及重金属、维生素、类固醇激素的含量检测分析

目的　了解造血干细胞移植患者移植前后血浆中氨基酸、微量元素及重金属、维生素、类固醇激素水平的变化。 方法　选取44 例在河北燕达陆道培医院治疗的患者作为研究对象,按照回输干细胞的时间分为移植前、移植期和移植 后三组,采用质谱法测定三组患者血浆中氨基酸、微量元素及重金属、维生素、类固醇激素含量。结果　与移植前相比, 移植期患者血浆中天冬氨酸（aspartic acid,Asp）、瓜氨酸（citrulline,Cit）、羟脯氨酸（hydroxyproline,Hyp）、镁（Mg）、 砷（As）、维生素D3,5- 甲基四氢叶酸（5-methyltetrahydrofolic acid,5-MTHF）、可的松、皮质酮和氢化可的松浓度 明显较低,锌（Zn）、铬（Cr）和锶（Sr）浓度偏高,差异均具有统计学意义（均P<0.05）;与移植期比较,移植后 患者体内3- 甲基组氨酸（3-methylhistidine,3MHis）、丙氨酸（alanine,Ala）、Cit,甘氨酸（glycine,Gly）、Hyp, 磷酸乙醇胺（phosphoethanolamine,PetN）、肌氨酸（sarcosine,Sar）、Mg,As,硒（Se）、维生素A、维生素E、 维生素K 和5-MTHF 浓度均显著增高,苯丙氨酸（phenylalanine,Phe）和Cr 浓度减少,差异均具有统计学意义（均 P<0.05）。结论　监测造血干细胞移植患者血浆中氨基酸、微量元素及重金属、维生素、类固醇激素含量变化,对血液 病患者有选择的进行营养补充,提高免疫功能及血液病患者的治疗有一定的意义。     

反复呼吸道感染患儿微量元素和免疫功能水平的测定与分析

目的探讨全血微量元素Cu、Fe、Zn、Ca、Mg与反复呼吸道感染患儿免疫指标的关系。方法用原子吸收光谱法和免疫散射比浊方法测定56例反复呼吸道感染患儿（RRI组）全血中微量元素和血清免疫球蛋白的含量,并与55例健康儿童（对照组）全血中微量元素和血清免疫球蛋白的含量进行比较。结果RRI组全血中Zn、Fe、Ca含量明显低于对照组（P〈0．01）,同时血清IgA、IgG含量明显低于对照组（P〈0．01）。结论反复呼吸道感染患儿存在Zn、Fe、Ca含量的缺乏,同时低锌也是造成免疫功能低下的原因之一,需临床医师特别注意,对反复呼吸道感染患者需常规检测微量元素,尤其Zn,并及时补充。     

Identification of lipids that accumulate during the routine storage of prestorage leukoreduced red blood cells and cause acute lung injury

BACKGROUND: Lipids accumulate during the storage of red blood cells (RBCs), prime neutrophils (PMNs), and have been implicated in transfusion‐related acute lung injury (TRALI). These lipids are composed of two classes: nonpolar lipids and lysophosphatidylcholines based on their retention time on separation by high‐pressure liquid chromatography. Prestorage leukoreduction significantly decreases white blood cell and platelet contamination of RBCs; therefore, it is hypothesized that prestorage leukoreduction changes the classes of lipids that accumulate during storage, and these lipids prime PMNs and induce acute lung injury (ALI) as the second event in a two‐event in vivo model. STUDY DESIGN AND METHODS: RBC units were divided: 50% was leukoreduced (LR‐RBCs), stored, and sampled on Day 1 and at the end of storage, Day 42. Priming activity was evaluated on isolated PMNs, and the purified lipids from Day 1 or Day 42 were used as the second event in the in vivo model. RESULTS: The plasma and lipids from RBCs and LR‐RBCs primed PMNs, and the LR‐RBC activity decreased with longer storage. Unlike RBCs, nonpolar lipids comprised the PMN‐priming activity from stored LR‐RBCs. Mass spectroscopy identified these lipids as arachidonic acid and 5‐, 12‐, and 15‐hydroxyeicsotetranoic acid. At concentrations from Day 42, but not Day 1, three of four of these lipids individually, and the mixture, primed PMNs. The mixture also caused ALI as the second event in a two‐event model of TRALI. CONCLUSION: We conclude that the nonpolar lipids that accumulate during LR‐RBC storage may represent the agents responsible for antibody‐negative TRALI.     

孕前妇女微量元素检测结果分析

【目的】探讨南通市孕前妇女体内微量元素铜、铁、镁、锌、钙的含量。【方法】选择本院孕前门诊检查的150例有异常生育史的孕前妇女作为试验组,并随机抽取同期就诊的150例未生育孕前妇女作为对照组,对两组进行全血铜、铁、镁、锌、钙5种元素检测和比较。【结果】与对照组相比,试验组妇女血中铁、镁、锌含量较低,差异有统计学意义（P〈0．05）;两组孕前妇女钙、铁、锌缺乏较普遍,试验组铁、锌缺乏率高于对照组（P〈0．05）。【结论】南通地区孕前妇女铜、铁、镁、锌、钙5种元素以钙缺乏最为普遍,铁、锌次之。因此应加强孕前妇女体内微量元素的监测,合理进行补充,从而起到优生优育的健康指导作用。     

Mineral metabolism in erythrocytes from patients with cystic fibrosis.

In patients with cystic fibrosis plasma concentrations of Zn and Mg were unchanged, plasma Ca concentrations were somewhat decreased, but plasma Fe concentrations were drastically reduced; the ratio Cu/Fe in plasma was increased. The Mg and Zn contents of erythrocytes from patients were unchanged. Therefore, the Mg and Zn content of erythrocytes cannot serve for the detection of patients with cystic fibrosis and their heterozygotes, as has been suggested. Cl(-)-dependent Mg2+ efflux from Mg(2+)-loaded erythrocytes was not affected in cystic fibrosis. Na(+)-dependent Mg2+ efflux was increased only in erythrocytes from patients with the most severe clinical symptoms.     

DNA damage and glutathione content in radiology technicians

BACKGROUND: We wanted to investigate the effect of X-rays on mononuclear blood cells (MNCs) and red blood cells (RBCs) of radiology technicians exposed to X-rays in hospital. METHODS: DNA damage was detected by fluorometric analysis of DNA unwinding. Glutathione levels were measured with enzymatic method in mononuclear blood cells. Glutathione content and catalase (CAT) activity of erythrocytes, and plasma malondialdehyde (MDA) levels were determined by spectrophometric methods. RESULTS: An insignificant increase in plasma malondialdehyde levels and a significant decrease in mononuclear blood cells glutathione levels were observed in nonsmoking radiology technicians. In smoking radiology technicians, on the other hand, in addition to an increase in plasma malondialdehyde levels, DNA damage was also significantly apparent. Besides mononuclear blood cells' glutathione depletion, the glutathione content of red blood cells was also found to be decreased. CONCLUSION: It can be suggested that smoking seems to augment the toxic effects of radiation.     

早期先兆流产患者微量元素含量检测的临床意义

目的 探讨妊娠妇女体内微量元素含量与发生先兆流产的关系.方法 比较98例早期先兆流产孕妇、97例正常早孕期妇女以及101例非孕育龄期健康妇女的临床资料,分析孕早期微量元素铜（cuprum,Cu）、锌（zinc,Zn）、钙（calcium,Ca）、镁（magnesium,Mg）、铁（ferri,Fe）、铅（plumbum,Pb）、镉（cadmium,Cd）七项指标的变化情况及其与先兆流产的关系.结果 三组间一般临床资料比较,差异均无统计学意义（P均＞0.05）.三组间Cu、Zn、Ca、Mg和Fe含量差异均有统计学意义（P均＜0.05）,而Pb和Cd含量差异均无统计学意义（P均＞0.05）.与正常非孕组比较,正常早孕组Cu水平上升,Zn水平下降,早期先兆流产组Zn、Ca、Mg、Fe水平均下降,且差异均有统计学意义（P均＜0.05）;与正常早孕组比较,早期先兆流产组Cu、Ca、Mg水平均下降,且差异均有统计学意义（P均＜0.05）.结论 微量元素Cu、Zn、Ca、Mg、Fe在妊娠早期中起着重要作用,其缺乏可能是引起先兆流产的原因之一.因此在计划怀孕前及早孕期要注意摄取含Cu、Zn、Ca、Mg、Fe丰富的食物,补充体内必须的微量元素,以减少先兆流产的发生.     

Tazobactam-induced haemolytic anaemia, possibly caused by non-immunological adsorption of IgG onto patient's red cells

A patient with pneumonia was treated with Tazocin (piperacillin/tazobactam). However, the expected haemoglobin (Hb) increment after transfusion was not achieved. Plasma bilirubin and lactate dehydrogenase were raised. The direct antiglobulin test (DAT) was positive (4+) for immunoglobulin G (IgG) only, but no RBC antibodies were demonstrable in the plasma or an eluate from the patient's RBCs. Drug-induced haemolysis was suspected. After discontinuing Tazocin administration, Hb and bilirubin levels returned to expected values. The patient's plasma gave a positive (3+) indirect antiglobulin reaction only with RBCs pretreated with tazobactam. However, random patient plasmas also gave weak (+/- to 1+) reactions, indicating non-immunological adsorption of IgG onto RBCs rather than specific anti-tazobactam antibodies. Subsequently, plasma samples with varying IgG levels (0.8-89.7 g L(-1)) were tested against RBCs pretreated with tazobactam. The amount of plasma IgG non-immunologically adsorbed onto the drug-coated RBCs was found to correlate directly with the plasma IgG level. The patient had a high plasma IgG level (41.6 g L(-1)) which explains why the antiglobulin test was stronger with the patient's plasma than with random plasma samples. Previous reports (Garratty & Arndt, (1998) British Journal of Haematology, 100, 777-783; Arndt & Garratty (2000) Transfusion, 40, 29S) suggested that non-immunological coating of RBCs with IgG may affect RBC survival; our results would support that suggestion. This is the first reported case of haemolytic anaemia associated with tazobactam.     

肝豆状核变性患者青霉胺治疗期间晨尿金属元素谱分析

目的了解肝豆状核变性（WD）患者应用青霉胺治疗期间晨尿中多种金属元素的变化。方法收集WD患者23例,青霉胺治疗时间3个月～180个月以上并低铜饮食;正常对照者18名,分别收集晨起尿液。使用电感耦合等离子体质谱仪（ICP-MS）分析尿液中铬、铁、钴、硒、锰、铜、锌、钙、镁、锂、铝、钒、镍、镓、砷、锶、镉、铯和钡19种元素。结果晨尿中7种必需微量元素（铬、铁、钴、硒、锰、铜和锌）检测结果显示WD组的尿铬、铜和锌浓度明显高于对照组（P〈0.01）。晨尿中10种非必需微量元素（锂、铝、钒、镍、镓、砷、锶、镉、铯和钡）检测结果显示WD组的尿砷、镉、镓、锶、铯和钡明显高于对照组（P〈0.05）。WD组晨尿中宏量元素尿钙明显高于对照组（P〈0.01）。结论在肝豆状核变性患者使用青霉胺驱铜治疗期间,除了晨尿中的尿铜增高外,晨尿中尿铬、锌、砷、镉、镓、锶、铯、钡和钙也明显高于对照组。晨尿铜可以作为一个监测WD患者驱铜疗效的指标。     

ICP、FGR及羊水过少患者血清中铜、锌、镁含量的变化

目的探讨妊娠期肝内胆汁淤积症(ICP)、胎儿生长受限(FGR)及羊水过少患者血清中铜、锌、镁含量的变化。方法以原子吸收分光光度法分别测定35名ICP患者、11例FGR患者、25例羊水过少患者及20例正常妊娠女性血清锌、铜、镁浓度。结果ICP患者血清锌较对照组明显降低(P0.05),铜及镁较对照组无显著性差异(P0.05);FGR组铜较对照组明显升高,锌、镁较对照组明显降低,均有显著性差异(P0.05);羊水过少组铜含量较对照组无显著性差异,锌含量较对照组降低而镁含量较对照组升高,差异有显著性(P0.05)。铜、锌、镁含量在ICP、FGR及羊水过少3组之间相比无显著性差异(P0.05)。结论ICP、FGR及羊水过少患者血清铜、锌、镁含量较正常孕妇有所变化,针对这些变化进行饮食调整对孕期健康有重要意义。     

Distribution of trace elements in the lipid and nonlipid matter of hair

We studied the effect of lipid removal on the concentrations of 13 trace elements measured in human hair. We used a pooled specimen of hair from a barber shop, initially washed with de-ionized water, with ultrasonic cleaning, then analyzed for Ca, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, P, Si, Sr, and Zn with use of an inductively coupled plasma emission spectrometer. The lipid was removed by Soxhlet extraction with ethanol, and the hair was re-analyzed. We found several elements present in a relatively large proportion (greater than 20%) in the lipid fraction, mainly Na, K, Ca, Mg, Ni, and Sr. We suggest that removal of part or all of the lipids from hair by using detergents or other lipid-removing solvents for washing may account for the variability in data on elements in hair reported by different laboratories, and that those elements largely present in the lipid fraction are the result of environmental exposure, whereas those retained in the hair fiber after lipid removal can be attributed to nutritional and clinical aspects. We believe that such determination of the distribution of elements may help validate the use of hair in assessing trace elements in the body.