血红蛋白与一氧化氮的生物化学反应

血红蛋白(Hb)的血红素或HbβCys^98分别与一氧化氮(NO)形成铁亚硝酰血红蛋白[Hb(Fe^Ⅱ)NO]或S-亚硝基血红蛋白(SNO-Hb)。两种存在状态与Hb铁的氧化还原化学以及Hb构象有关。Hb分子内NO能从血红素转移至βCys^93巯基,调节NO的贮存与释放。     

高效液相色谱技术在儿童血红蛋白病检查中的应用

目的:探讨高效液相色谱技术在儿童血红蛋白(Hb)病检查的意义,并时5356例检测结果进行分析.方法:采集5356例广东地区儿童EDTA-K2抗凝血2ml,采用HPLC方法测定各血红蛋白组分含量.结果:在5356例儿童中,检出血红蛋白病977例(18.24%),其中检出β地中海贫血673例(12.57%),α地中海贫血283例(5.28%),其中包括21例CS型HbH病(0.39%),α复合β地中海贫血8例(0.15%),HbE病8例(0.15%),HbQ病5例(0.09%).结论:广东地区儿童血红蛋白病的发生率高,应用HPLC技术加强对儿童血红蛋白(Hb)病进行筛查,早发现,早预防,指导合理婚配,对优生优育提高人口素质具有重要意义.     

血红蛋白种间分子杂交以及树鼩进化地位的探讨

为了探讨树鼩(Tupaia belangeri chinensis)的分类地位及其与灵长类动物的亲缘关系,本文利用血红蛋白种间分子杂交技术,以人类血红蛋白HbA为标准,分析比较了树鼩血红蛋白与原始灵长类动物懒猴(Nycticebus coucang)血红蛋白的结构异同。在碱性条件下,三种血红蛋白的电泳迁移率大小为:人>懒猴>树鼩。树鼩Hb(α_2~(Tup)和β_2~(Tup))和HbA(α_2~Aβ_2~A)杂交可以产生两种杂种分子 (α_2~(Tup)β_2~A和α_2~Aβ_2~(Tup))。HbA和懒猴Hb (α_2~(Nyc)β_2~(Nyc)) 杂交也可产生两种杂种分子(α_2~(Nyc)β_2~A和α_2~Aβ_2~(Nyc))。结果表明,树鼩Hb与懒猴Hb的α链净电荷相似。认为树鼩与懒猴的分类地位相近。     

快原子轰击质谱技术在异常血红蛋白一级结构分析中的应用

本文报道用快原子轰击(FAB)质谱技术测定血红蛋白(Hb)肽链经胰蛋白酶水解后的几个片段的氨基酸顺序结果。通过解释正离子谱上的碎片峰,确证用FAB质谱测得的氨基酸顺序与已知的完全一致。在此基础上,我们对二例未知结构的异常Hb进行测定,确证一例是Hb G Taipei(α_2β_2~(22Glu→Gly)),另一例是HbG Honolulu(α_2~(30Glu→Gln)β_2)。实验表明,用FAB质谱技术测定蛋白质一级结构具有微量、快速、可靠和操作简便等优点。     

中国“丝绸之路”地区血红蛋白病的遗传流行病学特点

对“丝绸之路“沿线陕、甘、新等省区的22万余人进行了血红蛋白病调查,应用蛋白质一级结构分析技术,从271例异常血红蛋白先证者中,发现变异体24种,以HbD Punjab、HbG TaiPei、HbG Coushatta 频率较高,呈梯度分布,其中HbJ Tashikuergan和Hb Tianshui 为世界新种异常血红蛋白。采用基因鉴定技术,于85例β地中海贫血携带者中,确定基因突变类型12种,以CD17（A→T）频率最高,其中[-28(A→G）.CD17(A→T）/N]双重突变杂合子,为同一染色体上的双重基因突变。极为罕见,CD8（－AA）、CDs8/9( G）为中国人中首次发现。根据“丝绸之路”地区异常血红蛋白和地中海贫血的类型特点、地理及民族分布规律,本文认为①我国西北部民族主要由中亚高加索人,黄河流域汉族人和蒙古高原的古代游牧民族组成。②β地贫CD17突变基因可能起源于甘肃的陇原大地,随华人迁徙传入东南亚各地。③该地遗传背景复杂,突变基因具有高度的异质性,存在显著的遗传流行病学特点。     

云南白族中发现一例Hb J—Lome[β59(E3)Lys→Asn]

作者在云南白族中发现一例快泳异常血红蛋白(Hb)。经化学结构分析,确认这例快泳血红蛋白的β链第59位的赖氨酸被天冬酰胺取代,为Hb J-Lome,此为云南白族中首次发现。     

Hb D Punjab基因的鉴定——DNA 扩增在异常血红蛋白研究中的应用

本文应用作者设计的寡核苷酸引物和探针,通过聚合酶链反应(PCR)扩增β珠蛋白DNA序列,并通过限制酶EcoRI酶谱分析或寡核苷酸杂交,快速鉴定Hb D Punjab基因。应用这种技术先后对汉、藏、哈萨克等3个民族4个家系的Hb D Punjab基因进行了鉴定。     

中国人血红蛋白New York的研究

本文报告在中国大陆发现的10个快速异常血红蛋白家系的研究结果,这种异常血红蛋白的电泳迁移率属于K型,血红蛋白稳定性轻度降低,血红蛋白变型的结构分析,包括珠蛋白肽链的分离,氨基乙基化β链的酶解和指纹分析,以及异常肽段的氨基酸组成和顺序测定,证实其β链113位(G15)的缬氨酸被谷氨酸替代,称为血红蛋白New York(α_2β_2~((?)23(G15)Val→Glu)) 在10个家系的调查中共发现35例Hb New York患者,他们都没有临床症状。其中2例是Hb New York和α~O地中海贫血基因的双重杂合子,血红蛋白New York的含量达90％以上;其余患者都尾Hb New York杂合子,血红蛋白New York含量大约50％。从血红蛋白New York的地理分布可以看出,这种异常血红蛋白在我国南方发生频率较高,接近0.4％。Q##原图像不清晰     

树鼩血红蛋白正常值测定

本文报道了30只产于我国云南的成年树鼩(Tupaia belangeri chinensis)的血红蛋白正常值。结果如下:抗碱血红蛋白均数(％)为0.90±0.09,HbF细胞均数(％)0.10±0.05,Heinz小体生成率均数(％)为12.35±0.81,热变性血红蛋白均数(％)为2.48±0.35,血红蛋白溶解度均数(％) 为83.58±1.12。异丙醇试验为阴性,未见H包涵体。上述结果与人的血红蛋白正常值进行了分析比较。血红蛋白的醋酸纤维素薄膜电泳显示了树鼩Hb的五个区带,树鼩Hb的电泳迁移率慢于人的Hb。     

改性血红蛋白携氧载体

天然血红蛋白(Hb)经改性处理后可改善稳定性和氧亲和性。近半个世纪的研制产生了3代改性血红蛋白制品：第1代为化学改性Hb,已趋成熟,有多种制品问世,现正进行Ⅱ～Ⅲ期临床试验;第2代为包含了红细胞酶类的化学交联Hb和利用分子遗传工程制备的重组Hb;第3代为微包囊Hb,其结构和功能更接近天然红细胞。Hb的来源除人红细胞外还包括牛Hb．利用重组DNA技术从大肠杆菌和酵母菌中提取的重组Hb及转基因Hb。     

Value of Hemoglobin A1C In Diagnosing Diabetes Mellitus within a Chronic Disease Management System Illustrated by the Receiver Operating Characteristic Curve

ObjectiveTo develop a receiver operating characteristic (ROC) curve of glycosylated hemoglobin (HbA_1c) for diagnosing diabetes mellitus within a chronic disease management system.MethodsA case-control study including medical records from January 1, 1997, to December 31, 2005, was conducted at the Sioux Falls Veterans Affairs Medical Center. Medical records for the case group (patients with diabetes) were selected based on 1 of 3 criteria: International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology codes specific for type 1 and type 2 diabetes; patients’ use of medications (oral hypoglycemic agents, antidiabetes agents, or insulin); or results from random blood or plasma glucose tests (at least 2 measurements of blood glucose ≥ 200 mg/dL). Records for the control group were selected based on patients having HbA_1c measured, but not meeting the above diagnostic criteria for diabetes during the study period. Records for cases and controls were randomly frequency-matched, one-to-one. The control group was randomly divided into 5 sets of an equal number of records. Five sets of an equal number of cases were then randomly selected from the total number of cases. Each test data set included 1 case group and 1 control group, resulting in 5 independent data sets.ResultsIn total, 5040 patient records met the case definition in the diabetes registry. Records of 15 patients who were prescribed metformin only, but did not meet any other case criteria, were reviewed and excluded after determining the patients were not diabetic. The control group consisted of 5 sets of 616 records each (totaling 3080 records), and the case group consisted of 5 sets of 616 records each (totaling 3080 records). Thus, each of the 5 independent data sets of 1 case group and 1 control group contained 1232 records. The case group was predominantly composed of white men (mean age, 69 years; mean body mass index, 31 kg/m²). Demographic data were similar for control patients. The ROC curve revealed that a HbA_1c ≥ 6.3% (mean + 1 SD) offered the most accurate cutoff value for diagnosing type 2 diabetes mellitus, with the following statistical values: C statistic, 0.78; sensitivity, 70%; specificity, 85%; and positive likelihood ratio, 4.6 (95% confidence interval, 4.2-5.0).ConclusionA HbA_1c value ≥ 6.3% may be a useful benchmark for diagnosing diabetes mellitus within a chronic disease management system and may be a useful tool for monitoring high-risk populations. (Endocr Pract. 2010;16:14-20)     

The Role of Histidine in the Ligand-Bonding Capacity of the Hemoglobin Gene

The atomic and electronic structures of heme complexes with His, Gly, and Cys residues (Heme–His, Heme–Gly, and Heme–Cys) in the fifth coordination position of the Fe atom and with oxygen and nitrogen oxide molecules in the sixth Fe position were studied by the semiempirical quantum-chemical method PM3. A comparative analysis of internuclear distances showed that the strength of chemical bonding between the ligand molecules (oxygen and nitrogen oxide) is greater for Heme–Cys than for Heme–His and Heme–Gly complexes. Consequently, the strengthening of the chemical bond of the oxygen (or nitrogen oxide) molecule with Heme–Cys substantially weakens the chemical bond in the ligand molecule. The Mulliken population analysis showed that the electronic density of ligand (oxygen or nitrogen oxide) p-orbitals is transferred to the d-orbitals of the Fe atom, whose charge, calculated according to the Mulliken analysis, formally becomes negative. In the Heme–His complex with oxygen, this charge is substantially greater than in the complex with NO, and the oxygen molecule becomes polarized. No oxygen polarization is observed in the Heme–Cys complex, and the electron density (judging from the change in the Fe charge) is transferred to the coordinated sulfur atom. This is also characteristic of Heme–Cys complexes with nitrogen oxide. An analysis of charges on the atoms indicates that the character of chemical bonding of the oxygen molecule in Heme–Cys and Heme–Gly complexes is similar and basically differs from that in the case of the Heme–His complex.     

透明颤菌血红蛋白的DNA改组研究

为提高透明颤菌血红蛋白在限氧条件下促进宿主细胞生长的能力,首先通过易错PCR向透明颤菌血红蛋白基因中引入突变,再结合DNA改组对其进行改造。将改组基因置于透明颤菌血红蛋白天然启动子下游,转化大肠杆菌DH5α,构建改组文库。以限氧培养条件下菌体沉淀的颜色为指标进行试管初筛,再以限氧和极端限氧条件下菌体湿重为指标进行摇瓶复筛,最终得到一个高活性突变蛋白VHb'042506。该蛋白使宿主的菌体湿重在限氧和极端限氧条件下较原基因转化子分别提高了31.25%和58.75%。经测序和比对,该基因与原基因相比发生了11处碱基点突变,致氨基酸4处错义突变。CO差光谱实验显示该蛋白具有更强的特征吸收。     

术前糖化血红蛋白水平与老年髋关节置换术后谵妄的关系研究

摘要 目的：探讨术前糖化血红蛋白（HbAlc）水平与老年髋关节置换术后谵妄的关系,并分析术后发生谵妄的影响因素。方法：选择我院于2019年4月~2020年6月期间收治的行髋关节置换术的220例老年患者作为研究对象。收集患者临床资料,记录其术后发生谵妄情况。采用单因素及多因素Logistic回归分析术后发生谵妄的影响因素。采用Pearson相关分析评估患者术前HbAlc水平与术后意识障碍评估量表（CAM）评分的相关性。结果：220例患者根据剔除标准剔除20例,最终200例老年髋关节置换术后患者出现谵妄42例,发生率为21.00%（42/200）。将发生谵妄的患者纳为谵妄组（n=42）,未发生谵妄的患者纳为非谵妄组（n=158）。谵妄组的术前HbAlc水平、术后CAM评分均高于非谵妄组（P<0.05）。Pearson相关分析显示,患者术前HbAlc水平与术后CAM评分呈正相关（P<0.05）。单因素分析结果显示,老年髋关节置换术后发生谵妄与年龄、术前合并呼吸系统性疾病、手术时间、发生低氧血症、术后疼痛评分、存在电解质紊乱有关（P<0.05）,多因素Logistic回归分析结果显示,年龄>80岁、发生低氧血症、术后疼痛评分＞3分、术前HbAlc水平＞8%均是老年髋关节置换术后发生谵妄的危险因素（P<0.05）。结论：高龄、术前HbAlc水平较高的患者是髋关节置换术后发生谵妄的高危人群,且围术期应尽量给予减少疼痛、预防术后低氧血症的措施,以降低术后谵妄的发生风险。     

Hemoglobin abnormalities

Summary In order to evaluate the polymorphism of hemoglobin in a population of Equatorial Africa, we undertook a prospective study of 146 births at a rural maternity hospital close to Brazzaville (P.R. Congo). This showed among the mothers 31 (22%) carriers of the sickle cell trait (AS), six with mutation, and two with -thalassemia triat. Among the children, 27 (18.5%) had sickle cell trait and one had sickle cell homozygosity. The frequency of the HbF Sardinia trait was 7.5%. This and other studies suggested a dilution gradient from Europe to Africa. Hemoglobin Bart's could be visually detected in 23.3% of the new-born babies. We attempted to distinguish between those infants with a high level of Hb Bart's (Bart's ++ group: 13.7%) and a group with a detectable Hb Bart's level that in our experimental conditions is between 1 and 2% (Bart's + group: 9.6%). Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were 88.6 ±5.7 fl and 29.0±2.1 pg in the Bart's ++ group; 94.5±10.9 fl and 30.6±4.1 pg in the Bart's + group; whereas they were 101.0±8.7 fl and 33.9±2.5 pg in the control group. Since iron dificiencies are very rare in new-borns and selecting according to published data on black people as homozygous -thalassemia of the type I (-/-), individuals of the Bart's ++ group whose MCV was below 95 fl and MCV below 30 pg, the gene frequency is estimated to be 34% and that of heterozygotes (-/) 45%. These high frequencies were confirmed in AS mothers: 45% showed a significant decrease of the S fraction.     

Immunogenicity of Heme Complexes of Peptides Designed to Mimic the Heme Environment of Myoglobin and Hemoglobin

In the preceding paper (Protein J. 25, pages 37–49, 2005), we reported the preparation and oxygen-binding properties of peptides that form stable complexes with heme mimic. The design of the peptides was based on the natural environment of the heme group in myoglobin (Mb) and in the - and -subunits of human adult hemoglobin (Hb). In the present work, the heme-peptides were each administered into mice, either as emulsions in adjuvant (both for injections and boosters) or intravenously as solutions in phosphate-buffered saline. Antibody (Ab) responses, monitored up to 14 weeks after the first administration, showed that when the heme-peptides were injected with adjuvant they stimulated Ab responses against the immunizing peptide, which in most cases bound to the correlate protein (Mb or Hb). However these heme-peptides were non-immunogenic when administered in PBS intravenously. It is concluded that heme-peptides:(a) would not trigger an adverse immune response if used for transfusion purposes.     

Fine needle aspiration cytology and immunocytochemistry in the diagnosis of lymphoid lesions of the thyroid gland

Immunocytochemical analysis was used in conjunction with cytomorphology to evaluate fine needle aspirates from 18 patients with nodular lymphoid infiltrates of the thyroid. The smears from 13 patients had a cytomorphology that was diagnostic of chronic lymphocytic thyroiditis; immunocytochemistry showed the lymphoid population to be composed of T cells and polyclonal B cells. Three patients had high-grade malignant lymphomas by cytomorphology; immunologic evaluation showed the B-cell phenotype of the lymphoma cells and monoclonal light chain expression. Cytomorphology could not differentiate between an inflammatory and a neoplastic lymphoid infiltrate in two cases. Immunocytochemical analysis showed that the cells of B-cell phenotype were monoclonal (neoplastic) in one case and polyclonal (inflammatory) in one case.     

3例婴儿脑膜炎败血伊丽莎白菌脑膜炎临床分析

总结脑膜炎败血伊丽莎白菌感染患儿的临床特点,以期提高临床诊治水平。收集中山市博爱医院2010年1月至2020年12月收治的3例脑膜炎败血伊丽莎白菌引起的脑膜炎患儿临床资料,结合相关文献进行总结分析。结果显示,3例患儿脑脊液中培养出脑膜炎败血伊丽莎白菌,其中2例血培养为同种细菌。3例患儿均为足月顺产,2例为新生儿期发病,1例为出生后35天发病,起病前均未发现致病高危因素。患儿以发热为主要起病表现,无抽搐及脑膜刺激征表现。3例患儿外周血常规白细胞总数、C反应蛋白、降钙素原均升高;脑脊液潘氏试验均为阳性,伴脑脊液白细胞数增高,脑脊液蛋白明显增高,脑脊液葡萄糖降低。头颅磁共振成像(magnetic resonance imaging,MRI)或电子计算机断层扫描术(computer tomography,CT)可见脑膜强化、软脑膜增厚、脑外间隙增宽,均无脑实质受累。3例检出菌株的药敏结果表现出高度一致性,均提示对环丙沙星、哌拉西林/他唑巴坦、左氧氟沙星、复方新诺明敏感。2例患儿以环丙沙星治疗,1例患儿以美罗培南联合万古霉素治疗。其中1例治愈,2例临床症状好转后出院。经电话随访,3例患儿一般情况尚可,无生长发育异常。本病例报道提示,脑膜炎败血伊丽莎白菌脑膜炎主要见于新生儿期,以发热起病为主要表现,该菌对儿科常用抗菌药物多显示体外耐药,对喹诺酮类药物敏感。     

Hemoglobin S and some other hemoglobinopathies in Eti-Turks

Frequencies of various hemoglobinopathies were examined in a total of 1,922 individuals of Eti-Turk origin by electrophoretical techniques. Hemoglobin A2 (Hb A2) and hemoglobin F (Hb F) determinations were also performed in 651 and 1,642 cases, respectively. Mean hemoglobin S (Hb S) frequency was found to be 15.3%. Variations among the different age groups were insignificant. Hemoglobin E (Hb E) and beta-thalassemia frequencies wer 0.47 and 1.23%, respectively. Hemoglobin Hacettepe and hemoglobin D were found once. Red cell glucose-6-phosphate dehydrogenase (G6PD) deficiency was found in 6.5% of males.     

Visceral anomalies in the Meckel syndrome

The visceral abnormalities of 32 autopsied Meckel's syndrome cases were analysed macroscopically and histologically in order to observe the distribution and spectrum of internal abnormalities in this hereditary malformation syndrome. All cases showed the classical triad of central nervous system anomaly, postaxial polydactyly, and cystic kidneys. Five cases were midterm fetuses and 27 cases were perinatal deaths. The kidneys were grossly enlarged in almost all of the cases (29) and showed a uniform histological pattern of fibrocystic proliferation, which is considered characteristic of MS. Fibrosis and proliferation of the bile ducts in the hepatic portal tracts were found in each case. Severe hypoplasia of the male genitalia associated with cryptorchidism was the third consistent anomaly. Derivatives of the müllerian ducts were present in four males, and the initial sex determination of the male infants was sometimes difficult. Epididymal cysts (39%) and ductal dilatation as well as fibrosis of the pancreas (31%) were further common anomalies. This series showed that a number of gross and microscopic abnormalities are consistently present in MS and that histological investigation is invaluable in defining the syndrome in doubtful cases.