Objective
To explore the relevance of serum homocysteine (Hcy) level to erythrocyte and platelet parameters in patients with unstable angina pectoris (UAP).
Methods
Sixty patients with UAP were collected in Tongling Municipal Hospital from August 1st, 2012 to December 31st, 2015. Serum Hcy was measured by enzymatic cycling method. Erythrocyte parameters, such as red blood cell count (RBC), hemoglobin, mean corpuscular volume (MCV), coefficient of variation of red blood cell volume distribution width (RDW-CV), and platelet parameters, such as platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (P-LCR), were measured with blood cell counter. All patients were classified into UAP with hyperhomocystinemia (HHcy) group and UAP with normal Hcy group according to the level of Hcy. The data in two groups were analyzed and the relevance of serum Hcy level to erythrocyte and platelet parameters was evaluated.
Results
The differences in the levels of RBC, hemoglobin, MCV, PLT, PDW, MPV, P-LCR between the two groups were not statistically significant (P>0.05); while the levels of RDW-CV and the proportion of RDW-CV above the upper reference limit of patients in the UAP with HHcy group (13.81%±1.13%, 39.4%) were higher than those in the UAP with normal Hcy group (13.06%±0.97%, 4.8%), and the differences between the two groups were statistically significant (P<0.05). Correlation analysis showed that serum Hcy level of patients with UAP was significantly correlated with RDW-CV (r=0.380, P<0.01) and was not significantly correlated with other erythrocyte and platelet parameters (P>0.05).
Conclusion
The high level of Hcy affects red blood cell volume heterogeneity in patients with UAP, which may be one of the mechanisms of HHcy participating in the occurrence and development of UAP.
【摘要】 目的 觀察t(4; 22)致血小板源性生長因子受體α（the platelet-derived growth factor receptor alpha， PDGFRA）異常的髓系/淋巴系腫瘤的臨床特點。 方法 對2010年6月收治的1例t(4; 22)致PDGFRA異常的髓系/淋巴系腫瘤患者的臨床資料進行回顧性分析，并對其臨床特點、實驗室檢查、診斷、治療進行總結。 結果 該疾病臨床表現及骨髓涂片檢查類似慢性粒細胞白血病（chronic myelogenous leukemia，CML），但無CML特征性Ph染色體和（或）BCR/ABL融合基因，而細胞遺傳學檢測顯示4號與22號染色體易位，診斷為t(4; 22)致PDGFRA異常的髓系/淋巴系腫瘤。采用羥基脲及干擾素治療后可獲得完全血液學緩解。 結論 t(4; 22)致PDGFRA異常的髓系/淋巴系腫瘤是一類罕見疾病，臨床表現與CML相似，t(4; 22)及BCR/PDGFRA融合基因陽性是診斷該類疾病的關鍵。【Abstract】 Objective To observe the clinical features of myeloid and lymphoid neoplasms with t (4; 22) induced abnormalities of the platelet-derived growth factor receptor alpha (PDGFRA) to increase the identification and reduce the misdiagnosis. Methods The clinical data of one patient with myeloid and lymphoid neoplasm with t (4; 22) induced abnormalities of PDGFRA diagnosed in June 2010 was retrospectively analyzed. We summarized the clinical features, morphology, genetics, diagnostic criteria and therapy about this kind of disease. Results The patient had a clinical manifestation and bone marrow smear result of chronic myelogenous leukemia (CML). But the result of genetic analysis found no translocation of chromosomes 9 and 22 juxtaposing BCR and ABL gens. Cytogenetic analysis showed an abnormal karyotype with rearrangement of chromosomes 4 and 22. So the patient was diagnosed myeloid and lymphoid neoplasms with t (4; 22) induced abnormalities of PDGFRA. After receiving interferon and hydroxyurea, the patient achieved complete hematologic remission. Conclusion Myeloid and lymphoid neoplasms with t (4; 22) induced abnormalities of PDGFRA is a rare kind of disease. Its clinical feature is similar to that of CML. The key of diagnosis is genetics.
Fibrinogen (Fg) in human plasma plays an important role in hemostasis, vascular repair and tissue integrity. The surface chemistry of extracellular matrix or biological materials affects the orientation and distribution of Fg, and changes the exposure of integrin binding sites, thereby affecting its adhesion function to platelets. Here, the quantity, morphology and side chain exposure of Fg adsorbed on hydrophilic, hydrophobic and avidin surfaces were measured by atomic force microscopy (AFM) and flow cytometry (FCM), then the rolling behavior of platelets on Fg was observed through a parallel plate flow chamber system. Our results show that the hydrophobic surface leads to a large amount of cross-linking and aggregation of Fg, while the hydrophilic surface reduces the adsorption and accumulation of Fg while causing the exposure and spreading of the α chain on Fg and further mediating the adhesion of platelets. Fg immobilized by avidin / biotin on hydrophilic surface can maintain the monomer state, avoid over exposure and stretching of α chain, and bind to the platelets activated by the A1 domain of von Willebrand factor instead of inactivated platelets. This study would be helpful for improving the blood compatibility of implant biomaterials and reasonable experimental design of coagulation in vitro.
Objective To investigate the relationship between preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score, and clinicopathologic features of colon cancer, and to analyze the predictive value of HALP score for postoperative liver metastasis. Methods The clinical data of 163 patients with colon cancer admitted to the 909th Hospital of Joint Logistic Support Force (Dongnan Hospital of Xiamen University) from January 2018 to December 2019 were retrospectively analyzed. According to the occurrence of postoperative liver metastasis, the patients were divided into metastatic group (n=35) and non-metastatic group (n=128). The correlation between preoperative HAPL score and clinicopathologic features of colon cancer was analyzed. The predictive value of HALP score for postoperative liver metastasis of colon cancer was analyzed by using receiver operating characteristic (ROC) curve. The risk factors of liver metastasis after colon cancer surgery were analyzed by using univariate and multivariate logistic analysis. Kaplan-Meier risk curve was drawn, and log-rank test was used to analyze the predictive value of different HALP score for postoperative liver metastasis. Results HALP score were decreased in patients with maximum tumor diameter ≥5 cm, preoperative carcinoembryonic antigen (CEA) ≥5 μg/L, serous membrane and extrasserous infiltration, lymph node metastasis and vascular invasion, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that HALP score [OR=1.467, 95%CI (1.253, 1.718), P<0.001], maximum tumor diameter [OR=3.476, 95%CI (1.475, 5.358), P=0.013], preoperative CEA level [OR= 6.197, 95%CI (2.436, 6.248), P=0.005], and lymph node metastasis [OR=2.593, 95%CI (1.667, 6.759) , P=0.003] were risk factors for postoperative liver metastasis of colon cancer. ROC curve analysis showed that the area under the curve of HALP score for predicting liver metastasis after colon cancer surgery was 0.908 (0.841, 0.974), the maximum value of the Youden index was 0.738, the optimal cut-off value of the HALP score was 35.5, the sensitivity was 0.852, the specificity was 0.886. Kaplan-Meier risk curve showed that the risk of early postoperative liver metastasis in the low HALP score group was higher than that in the high HALP score group (χ2=8.126, P=0.004). Conclusion Low HALP score in patients with colon cancer is associated with adverse prognosisi related pathological features, and is an influential factor for postoperative liver metastasis of colon cancer, and has predictive value for patients with postoperative liver metastasis of colon cancer.
Objective Platelet-rich plasma (PRP) secretes many growth factors, including transforming growth factor β1 (TGF-β1), platelet derived growth factor, vascular endothl ial growth factor, insul in-l ike growth factor 1, and so on, which can promote cell prol iferation, chemotaxis, and collagen synthesis in wound heal ing. To investigate the effects of PRPon the tendon heal ing, and to explore the mechanism of action so as to provide the experimental basis for the tissue engineered tendons. Methods Forty healthy New Zealand white rabbits, weighing 2.5-3.0 kg and male or female, were randomly divided into the experimental group (n=20) and the control group (n=20). PRP was prepared from arterial blood of rabbit’s ears through twice centrifugation method of Landesberg. The platelet concentrations of whole blood and PRP were determined. The right achilles tendons of the rabbits were transected to make rupture models. In experimental group, the tendon was sutured after PRP (0.5 mL) was immediately appl ied at repair site. In control group, the tendon was sutured directly after transection. At 1, 2, 4, and 6 weeks after operation, the tendons of 5 rabbits in each group were harvested for morphological, histological, and immunohistochemical observations; the fibroblast counting, the content of collagen fibers, and the expression of TGF-β1 were detected. Results The concentration of platelet of PRP was 4.03 times of whole blood. All the animals survived till the end of the experiment, and the incision healed well. No death, infection, and other compl ications occurred. With time, the tendons almost healed in 2 groups, and the fibrous tissue at anastomosis site was more remarkable in control group than in experimental group. The histological observation showed significant differences in fibroblast counting at 1, 2, and 4 weeks after operation between 2 groups (P lt; 0.05), while no significant difference at 6 weeks (P gt; 0.05). The contents of collagen fibers in the parenchyma at repair site in experimental group were significantly higher than those in control group at each time point (P lt; 0.05). Immunohistochemistry staining showed the expression of TGF-β1 in experimental group was upregulated at 1 week and 2 weeks and reached the peak at the 2nd week, and subsequently downregulated at 4 and 6 weeks in comparison with the control group, showing signficant differences between 2 groups at each time point (P lt; 0.05). Conclusion PRP can facil itate rabbit’ s tendons heal ing and significantly improve the heal ing qual ity, which may be associated with its advancing the peak time of the TGF-β1 expression in tendon.
To introduce the current situation of platelet-rich plasma (PRP) and its appl ication in orthopedics field. Methods The latest l iterature was reviewed, concerning the preparations of PRP, physiological mechanism and the latest appl ications in orthopedics field. Results PRP represent a new biotechnology for the stimulation and acceleration of tissue heal ing and bone regeneration. To succeed, some of the challenges need to be addressed including standardization and definition of the different PRP preparations, the complete characterization of the platelet released factors and proteins. Furthermore, well-designed studies and cl inical trials are needed to evaluate the potential therapeutic impact ofPRP. Conclusion PRP provides a novel appl ication for orthopedics field.
【摘要】 目的 探討機采血小板在實驗室內保存期間的生化改變及其意義。 方法 采用ROCHE cobas b 221和OLYMPUS AU400測定血小板樣本的pH值、PO2、PCO2、葡萄糖（GLU）濃度、乳酸脫氫酶（LDH）釋放量。 結果 保存期間pH值由7.311（第1天）降至7.116（第5天）；PO2波動于106.7～119.5 mm Hg（1 mm Hg=0.133 kPa）；PCO2波動于25.0～35.8 mm Hg；GLU濃度呈進行性下降，由18.8 mmol/L降至15.2 mmol/L；LDH濃度顯著增加，由150 mmol/L（第1天）增至259 mmol/L（第5天）。 結論 血小板在保存期內，其生化參數會隨著保存時間發生改變。而這些參數作為間接指標對機采血小板是否被細菌污染具有一定的指導意義。【Abstract】 Objective To observe the biochemistry changes of apheresis platelets (AP), including pH, PO2, PCO2, GLU, LDH, within the storage time and its significance. Methods The pH, PO2, PCO2, GLU and LDH of platelet samples were detected by ROCHE cobas b 221 and OLYMPUS AU400. Results During the storage time, the pH value of platelet decreased gradually from 7.311 (the first day) to 7.116 (the fifth day); the PO2 fluctuated from 106.7 mm Hg (1 mm Hg=0.133 kPa) to 119.5 mm Hg; the PCO2 fluctuated from 25.0 mm Hg to 35.8 mm Hg;the concentration of GLU decreased from 18.8 mmol/L to 15.2 mmol/L;the concentration of LDH increased observably from 150 mmol/L (the first day) to 259 mmol/L (the fifth day). Conclusion There were observably changes of biochemistry of the AP during storage time, and these changes may be the indicators of platelets contamination.
【摘要】 目的 評價重組人血小板生成素（rhTPO）治療腫瘤化療后血小板減少的療效和安全性。 方法 2008年12月-2009年10月收住惡性腫瘤患者45例，在化療后出現血小板減少，隨機分為A、B組，A組皮下注射rhTPO（15 000 U/d），B組皮下注射白細胞介素-11（1.5 mg/d），動態監測注射后血小板生長情況。 結果 A組血小板計數的最低值明顯高于B組（Plt;0.05）；A組血小板開始恢復時間較B組明顯縮短（Plt;0.01）；血小板恢復至100×109/L以上所需時間A組較B組明顯縮短（Plt;0.05），分別為（6.18±4.20）和（10.46±4.54） d，血小板恢復的最高值兩組差異無統計學意義（Pgt;0.05）；B組有2例患者化療后需要輸入外源性血小板，A組無患者需要輸入血小板；與B組比較，A組較少發生不良反應，患者可以耐受。 結論 重組人血小板生成素是一種治療化療后出現血小板減少的有效方法。【Abstract】 Objective To evaluate the therapeutic effect of recombinant human thrombopoietin (rhTPO) on chemotherapy-induced thrombocytopenia. Methods Forty-five in-patients with malignant tumor from December 2008 to October 2009 who had thrombocytopenia after chemotherapy were randomly divided into A and B groups. The patients in group A underwent the hypodermic injection with rhTPO (15 000 U/d) while in group B with interleukin-11 (1.5 mg/d);the platelet count was checked consecutively. Results Compared with that in group B, the platelet count was obviously higher (Plt;0.01) and the time of declined platelet count beginning to recover was significantly shorter in group A. The time of platelet count increasing to 100×109/L was within (6.18±4.20) days in group B which was significantly shorter than (10.46±4.54) days in group B (Plt;0.05). However, no significant was found between the two groups in the maximal platelet count (Pgt;0.05). Two patients needed platelet transfusion in group B and no one did in group A. Conclusion rhTPO is safe and effective for chemotherapy-induced thrombocytopenia.
