目的 检测血细胞减少患者外周血红细胞和中性粒细胞细胞膜糖基磷脂酰肌醇（GPI）连接的补体调节蛋白衰变加速因子（CD55)和膜反应性溶血抑制物（CD59）表达情况，并探讨其临床意义。 方法 2006年7月－2011年3月，采用直接免疫荧光标记法流式细胞仪检测182例血细胞减少患者外周血CD55及CD59表达情况，其中阵发性睡眠性血红蛋白尿（PNH）9例，再生障碍性贫血（AA）-PNH综合征8例，AA 83例，骨髓增生异常综合征51例，自身免疫性溶血性贫血11例，造血功能停滞6例，缺铁性贫血7例，巨幼细胞性贫血4例，脾功能亢进3例。 结果 PNH及AA-PNH患者CD55、CD59抗原缺失率均较其他血细胞减少者明显增高。 结论 流式细胞仪检测外周血中红细胞和中性粒细胞膜CD55和CD59抗原表达缺失率是目前诊断PNH可靠和敏感的方法，也是对PNH、AA-PNH早期诊断敏感指标，并且PNH克隆检测还能为诊断疾病提供鉴别诊断依据。
The high rotational speed of the axial flow blood pump and flow separation of the centrifugal blood pump are the main causes for blood damage in blood pump. The mixed flow blood pump can effectively alleviate the high rotational speed and the flow separation. Based on this, the purpose of this study is to explore the performance of the mixed blood pump with a closed impeller. A mixed flow blood pump with closed impeller was studied by numerical simulation in this paper. The flow field characteristics and the pressure distribution of this type of blood pump were analyzed. The hydraulic performance of the blood pump and the possible damages to red blood cells were also discussed. At last, pump performance was compared with the mixed flow blood pump with semi-open impeller. The results show that the mixed flow blood pump with close impeller studied in this paper can operate safely and efficiently with a good performance. The pump can reach the pressure head of 100 mmHg at 5 L/min mass flow rate. Flow in the blood pump is uniform and no obvious separation or vortex occurs. Pressure distribution in and on the impeller is uniform and reasonable, which can effectively avoid the thrombosis of blood. The average mean value of hemolysis index is 4.99 × 10−4. The pump has a good biocompatibility. Compared with the mixed flow blood pump with semi-open impeller, the mixed flow blood pump with closed impeller has higher head and efficiency, a smaller mean value of hemolysis index prediction, a better hydraulic performance and the ability to avoid blood damage. The results of this study may provide a basis for the performance evaluation of the closed impeller mixed flow blood pump.
Objective To assess the effectiveness of intravenous immunoglobulin G (IVIG) in reducing the need for exchange transfusion in neonates with proven haemolytic disease due to Rh and/or ABO incompatibility. To evaluate the effectiveness of IVIG in reducing the duration of phototherapy and hospital stay. Methods We electronically searched CENTRAL, MEDLINE (1966 to May 2008), EMBASE (1992 to May 2008), CBMdisc (November 1979 to May 2008), and also checked the reference lists of all papers identified. According to the Cochrane Handbook for Systematic Reviews of interventions, randomized controlled trials comparing IVIG and phototherapy with phototherapy alone in neonates with Rh and/or ABO incompatibility were identified and analyzed. Results Six RCTs were included. The meta-analysis showed that, IVIG can significantly decrease the requirements of exchange transfusion (RR=0.27, 95%CI 0.18 to 0.42), the duration of hospitalization (WMD= –1.11, 95%CI –1.60 to –0.63) and the duration of phototherapy (WMD= –0.82, 95%CI –1.16 to –0.47). Conclusions Intravenous immunoglobulin (IVIG) is recommended for treating hemolytic disease of the newborn because it is effective in decreasing the requirements of exchange transfusion, the duration of hospitalization and phototherapy. Well designed studies with large sample in multi-center are required for further proving.
Lysophosphatidic acid (LPA) is a pluripotent lipid mediator and acts via different G-protein-couple LPA receptors. LPA has significant effects on several cellular biological behaviours, such as cell migration, invasion, proliferation and differentiation, etc. Cell migration is essential for tumor progression, and vital for stem cell to repair injured tissues. Increasing evidences have demonstrated that LPA dramatically affects migration capacity of various cells, particularly cancer cells and stem cells. In this paper, we review the effect of LPA on migration of cancer cells and stem cells, and discuss the underlying mechanisms. A better understanding of this process will shed new light on tissue regeneration and the prevention of tumor progression.
Objective To optimize the hemodynamics of a disk blood pump in children. Method We used the computational fluid dynamics technology to simulate the flow in a pediatric blood pump numerically, and finally analyzed the results for deep study about the thrombosis and hemolysis produced in it, to improve the design according to the results of the flow field analysis. Results We calculated results between the flow rate and the pressure elevation at different rotational speed: 2 500 rpm, 3 000 rpm, and 4 000 rpm, respectively. Under each rotational speed, it was selected five different discharge outlet boundary conditions. The simulation results conformed to the experimental data. The increased pressure of the blood pump was effective. But the phenomenon of flow separation was increased the at blade surface in the low speed region. The maximum wall shear stress was maintained within 100 Pa. Conclusion The design of disc blood pump has a good fluid dynamic performance. And the flow line is fluent, the probability of thrombosis and hemolysis occurred is in the range of control. But the phenomenon of flow separation is appeared. There is a room to improve.
Spectrophotometry is a simple hemolytic evaluation method commonly used in new drugs, biomedical materials and blood products. It is for the quantitative analysis of the characteristic absorption peaks of hemoglobin. Therefore, it is essential to select the correct detection wavelength when the evaluation system has influences on the conformation of hemoglobin. Based on the study of changes in the characteristic peaks over time of the hemolysis supernatant in four systems, namely, cell culture medium, phosphate buffered saline (PBS), physiological saline and banked blood preservation solution, using continuous wavelength scanning, the selections of detection wavelength were proposed as follows. In the cell culture medium system, the wavelength of 415 nm should be selected within 4 h; , near 408 nm should be selected within 4~72 h. In PBS system, within 4 h, 541 nm, 577 nm or 415 nm should be selected; 4~72 h, 541 nm, 577 nm or near 406 nm should be selected. In physiological saline system, within 4 h, 414 nm should be selected; 4~72 h, near 405 nm should be selected; within 12 h, 541 nm or 577 nm could also be selected. In banked blood preservation solution system, within 72 h, 415 nm, 540 nm or 576 nm should be selected.
The implantable miniaturized axial blood pump works at a high rotational speed, which increases the risk of blood damage. In this article, we aimed to reduce the possibility of hemolysis and thrombosis by designing a two-stage axial blood pump. Under the operation conditions of flow rate 5 L/min and outlet pressure of 100 mm Hg, we carried out the numerical simulation on the two-stage and single-stage blood pumps to compare the hemolysis and platelet activation state. The results turned out that the hemolysis index of two-stage axial blood pump was better while the platelet activation state was worse than those of single stage design. On the index of hemolysis level and platelet activation state, the design of the two-stage pump with the low and high-head impeller combination was better than the two-stage pump with the equal heads, or the high and low-head impeller combination. In terms of reducing the risk of blood damage for implantable miniaturized axial blood pump, the research result can provide some theoretical basis and new design ideas.
【Abstract】 Objective To report 1 case of acute hemolytic anemia after liver transplantation because of ABO compatibility and therapeutic experience. Methods The patient with liver cancer underwent orthotopic piggyback liver transplantation on September 2010 after radiofrequency ablation of the tumors. The donor and recipient ABO blood types were type O and type A, separately. Acute hemolytic anemia occurred at 10 days after transplantation and hemoglobin decreased to 56 g/L. The bone marrow showed active hyperplasia; and myeboid∶erythroid was 0.52∶1. The immunosuppressants were used and type O washed red blood cells were transfused immediately. Results The general condition of the patient was improved; hemoglobin increased gradually and returned to 111 g/L at 34 days after liver transplantation. At 12 months of follow-up, hemoglobin was within normal range. Conclusion Using graft blood type washed red blood cells transfusion and immunosuppressants could be an effective therapeutic procedure in the patient with ABO compatility graft when acute hemolytic anemia occurrs.