In order to study the immune function of patients with obstructive jaundice, the rate of RBC-C3b receptor rosette (RCR), tumour-RBC rosettes (TRR), RBC-immune complex rosette (RICR) and CD３+,CD4+,CD8+ cells were investigated. In these patients, the pre-operative erythrocyte and T lymphocyte subsets immune functions were lower than those of the control (Ｐ＜0.001). At the 5th day after operation, there was no significant change and 14th day after operation the erythrocyte and T lymphocyte substes immune functions were significantly elevated(Ｐ＜0.05), while, compared with the normals, which was still depressed in some degree. Operation is useful to the recovery of the immune function in all patients.
Objective To assess the protective effects of a new type of leukocyte-depletion filter-1 (LD-1) on red blood cells during cardiopulmonary bypass(CPB). Methods Twelve Mongolian dogs, weight range 25-30kg, were divided into control group and leukocyte depletion group (LD group) with random number table, LD group (n=6) had our new type of leukocyte depletion filter-1 placed in venous line which was used within the first 5 minutes after onset of CPB. The control group (n=6) had no leukocyte depletion filter installed in the circuit. CPB was set up by cannulated with a venous cannula through the right atrium and with an aortic cannula after median sternotomy. Aorta was clamped at 10 minutes of CPB and released at 70 minutes of CPB. Dogs were observed for 2 hours after weaning from CPB. Blood samples were collected prior to, at 10, 40, 75 minutes, end of and 2 hours after CPB to determine circulating leukocytes, erythrocyte fragility and plasma levels of malondialdehyde(MDA), superoxide dismutase(SOD) and free hemoglobin(FHB). Results Leukocyte numbers were significantly reduced in LD group during CPB(Plt;0.01), and lower than those in control group (Plt;0.05). Plasma levels of SOD dropped after 75 minutes of CPB in control group, but those kept normal in LD group, and higher than those in control group at 2 hours after CPB (Plt;0.05, 0.01). Serum MDA and FHB levels increased sharply in two groups (Plt;0.01), but were lower in LD group than those in control group. The concentrations of NaCl when starting and complete hemolysis were also lower in LD group than those in control group at end of and 2 hours after CPB. Conclusion The new type of LD-1 used in venous line only 5 minutes after onset of CPB can decrease leukocyte counts, and reduce erythrocyte injury effectively.
ObjectiveTo explore the clinical characters and histopathologic differences between patients with culture-positive and culture-negative prosthetic joint infection (PJI). MethodsBetween January 2012 and July 2013, 66 PJI patients in accord with diagnostic criteria were enrolled. According to the results of preoperative aspiration and intraoperative cultures, the patients were divided into culture-negative group (CN group, n=21) and culture-positive group (CP group, n=45). There was no significant difference in gender, age, height, weight, and body mass index between 2 groups (P>0.05). Preoperative C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and prosthesis survival time were compared between 2 groups. Intraoperative frozen sections and paraffin sections were both performed to identify infections, and histological typing was performed according to Morawietz's methods. ResultsThe preoperative CRP was (1.29±1.84) mg/ dL in CN group and (5.08±9.57) mg/dL in CP group, showing significant difference (t=2.094, P=0.038). The preoperative ESR was (22.86±28.42) mm/1 h in CN group and (36.74±31.26) mm/1 h in CP group, showing significant difference (t=7.761, P=0.000). The median survival time of prosthesis was 72 months (range, 8-504 months) in CN group and 25 months (range, 15 days-300 months) in CP group, showing significant difference (U=2.231, P=0.026). Morawietz's histological typing results showed that 2 cases were rated as type I, 7 cases as type II, and 12 cases as type III in CN group; 6 cases were rated as type I, 25 cases as type II, 13 cases as type III, and 1 case as type IV in CP group. The positive culture rate was 68.18% (45/66), and pathogenic bacteria was dominated by Staphylococcus, accounting for 68.89%. ConclusionThe patients with culture-negative PJI have slow onset and mild inflammatory response, so comprehensive diagnosis should be made based on pathological detection, laboratory examination, and intraoperative cultures.
ObjectiveTo evaluate the inflammatory markers in patients with ankylosing spondylitis (AS) or non-inflammatory diseases undergoing total hip arthroplasty (THA) and to ascertain the variation trend of perioperative inflammatory markers and the influence of inflammation markers after THA. MethodsBetween January 2013 and December 2014, 153 consecutive patients with AS were included. According to the range of motion (ROM), the patients were divided into ankylosis group (ROM: 0°; group A, n=92) and stiff group (ROM: 3-46°; group B, n=61); 120 noninflammatory diseases patients having no bacterial infection and undergoing primary THA served as non-inflammatory group (group C). The inflammatory markers including C-reactive protein (CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR) concentrations were measured before operation and at 1, 3, 5, and 7 days after operation, and the complication was observed. ResultsPerioperative serum CRP, IL-6, and ESR increased at first after operation, and then decreased in 3 groups. There were significant differences in CRP and ESR between at pre- and post-operation (P<0.05); the IL-6 at 1, 3, and 5 days after operation were significantly higher than that at preoperation (P<0.05), but no significant difference was found between at 7 days and at preoperation (P>0.05). CRP, IL-6, and ESR of group B were significantly higher than those of group A at preoperation (P<0.05); CRP and IL-6 of groups A and B were significantly higher than those of group C at preoperation and at 1 day after operation (P<0.05); ESR of groups A and B was significantly higher than that of group C at preoperation, and at 1 day and 3 days after operation (P<0.05); and no significant difference was shown among 3 groups at the other time points (P>0.05). No inflammatory activity or increased complication was observed. ConclusionAS and non-inflammatory diseases show similar change trend of inflammatory markers at preand post-operation. The inflammatory activity of AS has no significant effect on the changes of inflammation markers and does not increase the incidence of postoperative complications.
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.
【Abstract】ObjectiveTo study the effect of bile reinfusion on immunologic function of erythrocyte in patients with obstructive jaundice after external drainage of biliary tract.MethodsPatients with obstructive jaundice who had received biliary tract external drainage were randomly divided into bile reinfusion group (n=24) and simple external drainage group (n=27). Patients without jaundice,who received cholecystectomy in the same period with the above ones,were selected randomly as control group(n=25). In external drainage groups patients’ bile was collected daily, and was filtered through gauze, and then, pumped back into the patients’ duodenum or jejunum after being heated to 38 ℃-40 ℃. The bile reinfusion could be started after the intestinal function recovered postoperatively. The changes of C3bRRT, ICRT, RFER and RFIR were observed before and after operation. The data were analysed through SPSS8.0.ResultsPreoperative C3bRRT and RFER levels in patients with obstructive jaundice were lower than those without jaundice significantly, and Preoperative ICRT and RFIR levels in patients with obstructive jaundice were higher than those without jaundice significantly. C3bRRT levels in bile reifusion group was higher obviously than those in simple drainage group (P＜0.05) on the 14th postoperative day. ConclusionImmunologic function of erythrocyte in patients with obstructive jaundice is inhibited, and bile reinfusion after biliary tract external drainage can be helpful to the recovery of immunologic function of erythrocyte.
ObjectiveTo observe the changing patterns of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum amyloid A protein (SAA) levels before and after hip replacement surgery, and explore their clinical significances. MethodsNinety-seven consecutive patients enrolled in clinical pathway in our hospital for hip replacement from April 2011 to May 2013 were included in the present study. ESR, CRP and SAA levels were investigated preoperatively and post-operatively at day 1, 3, 5, 7, 14, Month 1 and 3. All the cases were followed up, among which there were 14 cases of total hip replacement, 56 cases of cementless hemianthroplasty, and 27 cases of biotype hemianthroplasty. ResultsAll three of ESR, CRP and SAA levels were elevated post-operatively. Levels of CRP and SAA peaked at day 3 after surgery, and then subsided gradually to pre-operative levels after 1 month. ESR level peaked at day 7 postoperatively, and then subsided gradually to pre-operative levels after 3 months. There was a significant correlation between levels of CRP and levels of SAA. ConclusionCompared with ESR and SAA, CRP appears to be a faster and more sensitive parameter. Cementless hemianthroplasty is associated with changes of SAA levels but not with CRP levels. Close monitoring of evolutionary changes in ESR, SAA and CRP levels may help to diagnose and treat early infection after hip replacement surgery.
Objective To explore the relationship between the diabetic retinopathy (DR) and the changes of erythrocyte deformability(ED),erythrocyte membrane phospholipid and spectrin. Methods One hundred and eight patients with non-insulin dependent diabetes mellitus were divided into DR group(55 cases)and nonDR(NDR)group(53 cases).The changes of erythrocyte filtration index(EFI),erythrocyte membrane phospholipid and spectrin dimers(SP-D)and spectrin tetramers (SP-T)were measured in patients of DR and NDR groups and compared with the results of 53 cases of normal control group. Results The EFI,SP-D, SP-D/SP-T,sphingomyelin (SM) /phophatidylcholine(PC)were higher,and SPT,SM,PC,phophatidylserine(PS)and phatidylethanolamine(PE)were lower in patients with DR than those in control and NDR patients (F=8.467～18.925,q=6.845～12.627,Plt;0.001).The changes of all indicators in proliferative DR(PDR) patients were more obvious than those in background DR(BDR) patients(t=5,825-15.443,Plt;0.001).The EFI in DR patients was positively correlated to SM/PC,SP-D and SP-D/SP-T(Plt;0.01)，negatively correlated to SM,PC,PE,PS and SP-T(Plt;0.01). Conclusions The decrease of ED caused by the abnormalities of erythrocyte membrane phospholipid and spectrin might participate in the occurance and development of DR,and correlated to the degree of pathologic changes. (Chin J Ocul Fundus Dis, 1999, 15: 160-162)
Objective To study oxygen carrying capacity of red blood cell in children with congenital left-to-right shunt (CLRS) and discuss its clinical significance. Methods A total of 62 children with CLRS were selected as a trial group and 40 healthy children who had accepted clinical physical examination as a control group. ELISA test was applied to determine 2,3 -DPG content of red blood cells. At the same time, pH, PaO2, PaCO2, Hb, P50O2 and relevant outcomes were tested for correlation analysis. Results Red blood cell 2,3-DPG (2.76±0.98 μmol/mL) was higher than that of the control group. PaO2, pH, Hb were lower than those of the control group with significant differences. Among the types of CLRS, 2,3 -DPG of ventricular septal defect was the highest and that of patent ductus arteriosus ranked the second, the two of which had a significant difference (P=0.007). As for red blood cell of children with congenital heart diseases, there was linear correlation between 2,3- DPG and PaO2 as [2,3-DPG=12.007 8– (0.154 7×PaO2)], as well as between P50O2 and 2,3 -DPG as [P50O2=26.303 6+ (1.799 2×2,3-DPG)]. Conclusion Children with congenital left-to-right shunt tend to have low oxygen. Therefore, it is important to detect 2,3-DPG of red blood cell, blood gas analysis, and hemoglobin level change, in order to well understand the mechanism of congenital heart disease as well as to guide clinical practice.
Objective To investigate the effects of cimetidine on the red cell immune function and interleukin-2(IL-2) in rats with obstructive jaundice. Methods Sixty SD rats were divided into bile duct ligation(BDL) group, cimetidine therapy (BDLC) group and sham operation(SO) group respectively. The red cell immue function and serum IL-2 level were determined with the red cell yeast-rosttes test and radioimmunoassay respectively. Results The red blood cell C3b receptor rosette rate(RBC-C3bRR), the red blood cell immune complex rosette rate(RICR), the red blood cell C3b receptor rosette-forming excited rate(RFER) and serum IL-2 level were significantly lower in BDL group as compared with SO group, the red blood cell C3b receptor rosette-forming inhibitory rate(RFIR) in BDL group was higher than that of SO group. After 7 days’ cimetidine therapy RBCC3bRR, RICR, RFER and IL-2 became higher than those of BDL group, but RFIR was lower than that of BDL group. Conclusion Supplemental cimetidine can significantly enhance the impaired red cell immune function and IL-2 production in rats with obstructive jaundice.