“Ungalokothi ungabaze ukuthi iqembu elincane lezakhamuzi ezicabangayo nezizinikele lingawushintsha umhlaba.Eqinisweni, iyona yodwa ekhona.”
Umgomo kaCureus uwukushintsha imodeli yakudala yokushicilelwa kwezokwelapha, lapho ukuthunyelwa kocwaningo kungase kubize, kube nzima, futhi kudle isikhathi.
I-Platelet-rich plasma/prp, ukuvuselelwa kwezicubu, ukwenziwa kusebenze kweplatelet, ukwelashwa kokwandisa i-glucose, ama-platelet, ukwelapha okwandisa
Calula lesi sihloko ngokuthi: Harrison TE, Bowler J, Reeves K, et al.(Meyi 17, 2022) Umthelela weglucose ekubalweni kweplatelet nevolumu: imiphumela yomuthi ovuselelayo.Ukwelapha 14(5): e25081.doi:10.7759/cureus.25081
I-Platelet-rich plasma (PRP) kanye ne-hypertonic glucose solutions zivame ukusetshenziselwa umjovo emithini yokuvuselela, ngezinye izikhathi ndawonye.Umthelela we-hypertonic glucose ku-platelet lysis kanye nokwenza kusebenze awuzange ubikwe ngaphambili.Sihlole umphumela wokugxila kweglucose ephakeme ekubaleni kweplatelet ne-erythrocyte, kanye namavolumu amaseli ku-PRP kanye negazi eliphelele (WB).Ukuncipha okusheshayo kwesilinganiso se-platelet count kwenzeka ngayo yonke ingxube ye-glucose exutshwe ne-PRP noma igazi eliphelele, elihambisana ne-rosation lysis. Ngemuva komzuzu wokuqala, izibalo zamaplatelet zahlala zizinzile, okuphakamisa ukuhlaliswa ngokushesha kwamaplatelet asele kudlulele (>2000 mOsm) hypertonicity. Ngemuva komzuzu wokuqala, izibalo zamaplatelet zahlala zizinzile, okuphakamisa ukuhlaliswa ngokushesha kwamaplatelet asele kudlulele (>2000 mOsm) hypertonicity. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю аккомодацию остаточных тромбильным ) гипертонуса. Ngemuva komzuzu wokuqala, isibalo se-platelet sahlala sizinzile, okubonisa ukutholakala ngokushesha kwamaplatelet asele kuze kube ngokwedlulele (>2000 mOsm) hypertonicity.第一分钟后，血小板计数保持稳定，表明残余血小板迅速适应极端（> 2000 mOsm).2000 mOsm）高渗状态. После первой минуты количество тромбоцитов оставалось стабильным, что указывает на быструю адаптацию остаточных тромбильным гиперосмолярному состоянию. Ngemuva komzuzu wokuqala, isibalo se-platelet sahlala sizinzile, okubonisa ukujwayela ngokushesha kwamaplatelet asele ukuze abe ngokwedlulele (>2000 mOsm) isimo se-hyperosmolar.Ukugxila kweglucose okungama-25% nangaphezulu kuholele ekwenyukeni okukhulu kwevolumu yeplatelet emaphakathi (MPV), okukhombisa isigaba sokuqala sokusebenza kweplatelet.Ucwaningo olwengeziwe luyadingeka ukuze kutholwe ukuthi ingabe i-platelet lysis noma i-activation iyenzeka nokuthi ingabe umjovo we-hypertonic glucose uwedwa noma uhlanganiswe ne-PRP unganikeza inzuzo eyengeziwe yomtholampilo.
Ngawo-1950, udokotela ohlinzayo waseMelika uGeorge Hackett wathola ukuthi angakwazi ukukhulula unomphela ubuhlungu obuhlangene nomhlane ezigulini eziningi ngokujova ikhambi elikhulayo emithonjeni nemigqa.Ukuhlola kwakhe onogwaja kwabonisa ukuthi indlela yokwelapha, ayibiza ngokuthi i-proliferative therapy, yabangela imisipha ukuba ikhule futhi iqine.Ucwaningo lwe-Histological luqinisekisile ukuthi i-collagen entsha ikhiqizwa phakathi nale nqubo [1].
Emashumini ambalwa eminyaka okuqala, kwazanywa izixazululo eziningi ezahlukene zokusabalalisa.Ngawo-1990, odokotela abaningi babebheka ukugxila okuphezulu kweglucose njengendlela ephephe futhi ephumelela kakhulu.Nokho, indlela yokwenza isalokhu ingacacile.
Zimbalwa izifundo zomtholampilo ezenziwa ngekhulu lama-20 kulandela umsebenzi kaHackett.Kodwa-ke, ngawo-2000 kwakukhona isithakazelo esivuselelwe futhi izivivinyo ezimbalwa zomtholampilo eziphumelelayo zokwelashwa okwandisa zaqedwa ukuze zelashwe ubuhlungu obuphansi emuva [2], i-osteoarthritis yamadolo [3], kanye ne-lateral epicondylitis [4].
Ukuvuselelwa kwezicubu kudinga ukubamba iqhaza kwama-stem cells.Ngakho-ke, ukugxila okuphezulu kwe-glucose kufanele ngandlela thize kubangele ukufuduka, ukuphindaphinda, nokuhlukaniswa kwamaseli we-stem.Sicabanga ukuthi ama-platelet angase asebenze njengezithunywa nokuthi ukugxila kwe-glucose ephezulu kungase kubangele ama-platelet ukuthi akhiphe ama-cytokines nezici zokukhula, ngaleyo ndlela kukhuthaze izinqubo zokuvuselela kabusha, ikakhulukazi ukuthuthela kwe-stem cell ezindaweni zokugxiliswa kwe-glucose ephezulu.
Ukusebenza kwe-platelet njalo kwandulela ukwanda kwe-calcium ye-intracellular [5].Liu et al.ku-2008 kubonise ukuthi amazinga aphezulu e-glucose akhulisa umsebenzi we-receptor yesikhashana engaba yi-canonical type 6 (TRPC6) iziteshi kulwelwesi lwe-plasma, okuholela ekuthelelekeni kwe-calcium ion kumaplatelet [6].Olunye ucwaningo lubonise ukuthi ukuvezwa kwe-microtubule marginal zone kuma-ion e-calcium kubangela ukuphumula, ukwanda, nokuguqulwa kwendawo engaseceleni, okubuye kubangele ukuguqulwa komumo ukusuka ku-disc kuya ku-spherical, okuholela ekutheni ivolumu yeplatelet (MPV) [7].
I-hypothesis yethu kulolu cwaningo iwukuthi ukuvezwa kwamaplatelet ekugxilweni okuphezulu kwe-glucose kuthinta indawo ye-microtubule marginal kanye nemvelo ye-intracellular, okuholela ekwandeni kwe-MPV.
Bonke ababambiqhaza basayine ifomu lemvume enolwazi ngemva kokuchazwa kwemininingwane yocwaningo nangaphambi kokuthola amasampula.Kulolu cwaningo, amasampula e-PRP kuphela ane-hematocrit enkulu kune-2% asetshenzisiwe ukuze ukubala kwe-erythrocyte (erythrocyte) kanye nevolumu ye-corpuscular yamangqamuzana egazi abomvu (MCV) kufakwe ukuze kuqhathaniswe.
Ucwaningo lwenziwe ngezigaba ezine, isigaba sokuqala kwaba yi-PRP kanti izigaba ezisele kwakuyigazi eliphelele (Ithebula 1).Njengoba kuchazwe ngaphambilini [8], wonke amandla amaphakathi e-centrifugal (RCF, g-force) abalwe kusukela endaweni emaphakathi (Rmid, in cm) yekholomu yegazi kusirinji emaphakathi.Sikhethe ukusebenzisa i-MPV njengomaka wokuzwela kwe-platelet nokubala kwe-platelet njengenkomba ye-platelet lysis engaba khona, kokubili okungalinganiswa kalula kubahlaziyi be-hematology abajwayelekile.
Esigabeni sokuqala, amavolontiya e-47 anikele ngamasampula egazi-ithubhu eyodwa ye-ethylenediaminetetraacetic acid (EDTA) kanye nesampula segazi elilodwa le-PRP (i-anticoagulated ne-sodium citrate (NaCl, 3%)) (Ithebula 1).Faka i-rocker eshubhu ngokushesha.Isibalo segazi esiphelele (CBC) senziwe kumasampula e-EDTA ngokuphindwe kathathu, futhi amasampula e-NaCl ahlaziywa ngokuphindwe kathathu ukuze kuhlaziywe i-CBC, kwase kuthi i-PRP yalungiswa ngezindlela ezihlukahlukene ezichazwe ngenhla [8].Wonke amasampula e-PRP alungiswe nge-centrifugation ku-900-1000 g.Hlanganisa isampula ngayinye ye-PRP kumxube we-vortex imizuzwana engu-5-10, bese uhlukanisa ama-aliquot amahlanu angu-0.5 ml abe amashubhu.
Ukuhlola umphumela wokuchayeka kweplatelet ekugxilweni kweglucose ephakeme, amanani alinganayo (0.5 ml) ka-0%, 5%, 12.5%, 25%, no-50% weglucose emanzini axutshwe namasampula eplatelet ukuthola u-0%, 2.5% 6.25%, 12.5% ​​ingxube yeshubhu eli-1 kanye nengxube yeshubhu yokuhlola engu-25%.I-TAC yengxube ngayinye yahlaziywa ngokuphindwe kathathu ngemva kwemizuzu eyi-15.I-Platelet count (PLT), i-RBC count, i-MCV, ne-MPV yalinganiselwa kushubhu ngalinye, futhi isibalo se-platelet esimaphakathi, ukubala kwe-RBC, i-MCV, ne-MPV kubalwa kuwo wonke amasampula e-PRP.
Ngemva kokuqedwa kwesigaba sokuqala sokuqoqwa kwedatha, sabona ukwanda okuphawulekayo komthamo weplatelet kumaplatelet e-PRP ngemva kokwengezwa kwe-D50W.Amaplatelet e-PRP awameleli wonke ama-platelet egazini, futhi i-PRP medium ihluke ku-WB medium.Ngakho-ke, sinqume ukwenza uhlolo lwesigaba sesibili lomphumela wokwengeza i-D50W egazini lonke.
Emzuliswaneni wesibili, sikhethe usayizi wesampula wama-30 ngokusekelwe emiphumeleni yochungechunge lokuqala, njengoba kuchazwe esigabeni Sokuhlaziya.Kulolu chungechunge, amavolontiya angama-20 anikele ngamasampula egazi (Ithebula 1).Igazi eliphelele (1.8 ml) lakhishelwa kusirinji engu-3 ml futhi lanqandwa ukuqunjelwa ngo-0.2 ml 40% we-NaCl.Isirinji yegazi lonke ixutshwe imizuzwana emihlanu nge-vortex mixer futhi i-CBC yahlaziywa ngokuphindwe kathathu.Ngemva kokuhlaziywa, igazi eli-anticoagulated lafakwa ku-2 ml ka-50% we-glucose kusirinji engu-5 ml (ukugxiliswa kweglucose yokugcina kwakucishe kube ngu-25% (D25) futhi yafakwa eshubhuni lokunyakazisa imizuzu engu-30. Ngemva kwemizuzu engu-30, i-D25/CBC kumasirinji e-WB yahlaziywa nge-triplicate. I-CV, ne-MPV kubalwe isampula ngayinye ngaphambi nangemuva kokwengeza i-glucose.
Ngenxa yokuthi ama-platelet egazini lonke avame ukuchayeka ku-hypertonic glucose ngesikhathi sokwelashwa kwe-glucose ekhulayo ngenxa yomjovo ohlasela kancane, futhi akuvamile ukuhlanganisa i-PRP ne-hypertonic glucose ngaphambi nje komjovo, sinqume ukutadisha i-hypertonic glucose ngokuhambisana ne-WB eSigabeni 1. Isinyathelo Sesithathu nesesine.Esigabeni ngasinye, amavolontiya angu-20 anikele ngo-7-8 ml we-ACD-A (i-asidi equkethe i-trisodium citrate (22.0 g/l), i-citric acid (8.0 g/l) ne-glucose (24.5 g/l), isixazululo se-dextrose citrate) yama-anticoagulants egazi (Ithebula 1).Izingxube ze-glucose ezingaphezu kuka-12.5% ​​kuphela ezisetshenzisiwe ukunquma amaphesenti omkhawulo ahlotshaniswa nokwenyuka kwe-MPV.Esigabeni sesithathu, i-1 ml yegazi ifakwa epayipini lokuhlola.Bese uxuba igazi kumxube we-vortex imizuzwana engu-10 ngokungeza u-1 ml we-glucose engu-30%, u-40% we-glucose, noma u-50% we-glucose eshubhuni ukuze uthole ukuhlushwa kokugcina kwe-glucose okungu-15%, 20%, no-25% ngokulandelana.Amasampula egazi le-glucose ahlaziywa i-CBC ngokushesha ngemva kokuxubana futhi aphindaphindwa njalo ngemizuzu emibili imizuzu engama-30.
Ngesikhathi sokuxuba kokuqala, ukungezwa kwe-1: 1 hypertonic glucose kanye ne-WB noma i-PRP kuveza amaplatelet ekugxilweni okungaphezu kuka-25% imizuzwana embalwa.Esinyathelweni sesine, ukuhlola umphumela we-hypertonic glucose enezinga eliphakeme elincane lokuqala lokugxila futhi sihlole umkhawulo ongaphezulu womphumela we-glucose, sengeze inani elincane legazi ku-D25W noma i-D50W.Faka i-1 ml ye-D25W noma i-D50W eshubhuni bese wengeza u-0.2 ml we-WB ngenkathi uvota isampula imizuzwana eyi-10.Kulezi zimo, igazi liye lachayeka ku-glucose ekugxiliseni cishe okungama-20% ngaphezu kokugxiliswa kokugcina, kunokuba kube ngu-50% ngaphezu kokugxiliswa kokugcina njengaseSigabeni sesi-3, okuholele ekugxilweni kweglucose kokugcina okungama-20.8% no-41.6%.Amasampula ahlanganisiwe ahlaziywa ngesikhathi esifanayo njengasesinyathelweni sesi-3.
Esinyathelweni sokuqala sochungechunge ngalunye lokuhlanjululwa kweglucose, amasampula angama-30 athathwa njengoba lokhu kwakuwusayizi wesampula ofanele wocwaningo lokuhlola [9].Ekupheleni kwesigaba ngasinye (kuhlanganise nesigaba sokuqala), hlola ukufaneleka kosayizi wesampula usebenzisa ifomula esetshenziselwa ukunquma usayizi wesampula odingekayo ukuze ulinganisele incazelo yokuhlukahluka komphumela okuqhubekayo esibalweni esisodwa sabantu.Ifomula n = Z2 x SD2 /E2.Kule zibalo, u-Z uyi-Z-score, i-SD iwukuchezuka okujwayelekile, futhi u-E uyiphutha elifiswayo [10].I-alpha yethu ingu-0.05, ehambisana nenani lika-Z elingu-1.96, futhi silindele iphutha elingu-5 (ngamaphesenti).Ngakho-ke sixazulula i-n = (1.962 x SD2)/52.Imiphumela yabonisa ukuthi usayizi wesampula odingekayo esigabeni ngasinye wawumncane kunenombolo yangempela eqoqiwe.
Ngesikhathi soku-1, 3 no-4 kusetshenziswa ukugxila kwe-glucose okungaphezu kweyodwa, umphumela wokugxila okuhlukile kwe-glucose wahlaziywa ngokuqhathanisa ushintsho lwe-fractional phakathi kwesikhathi esingu-0 nesikhathi ngasinye esilandelayo (isigaba 1 emizuzwini eyi-15, inkathi yesi-3 emizuzwini eyi-15).kanye namasekhondi angu-15, bese kuba njalo emizuzwini emibili.) Amazinga okushintsha enkathi ngayinye aqhathaniswe kusetshenziswa i-Mann-Whitney U-test ngoba idatha ayizange ilandele ukusatshalaliswa okuvamile njengoba kunqunywe ukuhlolwa kokujwayelekile kwe-Shapiro-Wilk.Njengoba ukuhlaziya kwe-1 kuya ku-1 kwamaqembu amaningana (esihlanu) kwenziwa esinyathelweni sokuqala, sesithathu nesine (ezinhlanu sezizonke), ukulungiswa kwe-Bonferroni kwenziwa ukulungisa inani le-alpha elifunwayo ku-≤0.01 kodwa hhayi ≤0.05.
Ukunciphisa inani leplatelet nakho konke ukugxila kwe-hypertonic dextrose kanye nokwanda kwe-MPV kumaplatelet e-PRP ku-> 12.5% ​​ukuhlushwa kwe-dextrose: Izibalo ze-PRP zeplatelet zikhuphuke zisuka kokugxilisa okukodwa kuya kweziyisihlanu uma kuqhathaniswa negazi eliphelele lesisekelo, elihluka ngendlela (engabonisiwe). Ukwehliswa kwenani leplatelet nakho konke ukugxila kwe-hypertonic dextrose kanye nokwanda kwe-MPV kumaplatelet e-PRP ku->12.5% ​​​​dextrose concentration: Izibalo ze-PRP platelet zikhuphuke zisuka kokugxilwa okukodwa kuya kweziyisihlanu uma ziqhathaniswa negazi eliphelele, zihluka ngendlela (engabonisiwe). Уменьшение количества тромбоцитов при всех концентрациях гипертонической декстрозы kanye ne-MPV kuhlu lwe-PRP прицентрациях гипертонической декстрозы kanye ne-MPV maqondana ne-PRP % тромбоцитов PRP увеличилось ku 1-5 раз по сравнению с исходной цельной кровью, в зависимости от метода (не показано). Ukuncipha kwenani leplatelet kukho konke ukugxila kwe-hypertonic dextrose kanye nokukhuphuka kwe-MPV kumaplatelet e-PRP ku->12.5% ​​​​dextrose concentration: I-PRP platelet count inyuke izikhathi ezingu-1-5 uma iqhathaniswa negazi eliphelele lesisekelo, kuye ngendlela (engabonisiwe). ).在> 12.5% ​​的葡萄糖浓度下，所有浓度的高渗葡萄糖降低血小板计数，PRP RP 血小板计数从浓度的1 倍上升到5 倍，因方法而异（未描述）. Ku->12.5% ​​ukugxila kweglucose, ukugcwala okuphezulu kwe-glucose kunciphisa inani legazi, i-PRP igazi le-MPV liyakhuphuka: uma kuqhathaniswa ne-与基线全血, inani legazi le-PRP likhuphuka lisuka ku-1 liye izikhathi ezi-5 kunelo lokuhlushwa (elingachazwanga). При концентрациях глюкозы >12,5% все концентрации гипертонической глюкозы снижали количество тромбоцитов, а MPV повышам песни: тов PRP увеличивалось от 1- до 5-кратных концентраций по сравнению с исходными концентрациями цельной крови, в зависимоптоси от . Ekugxilweni kwe-glucose> 12.5%, konke ukugxila kwe-glucose ye-hypertensive kwehlisa izibalo ze-platelet futhi kwanda i-MPV kuma-platelet e-PRP: Izibalo ze-PRP platelet zikhuphuke ngokuphindwe ngo-1- kuya ku-5 uma kuqhathaniswa nokugxiliswa kwegazi lonke lokuqala, kuye ngendlela (njengoba kuchaziwe).Umfanekiso 1 ubonisa ukuthi inani lamaplatelet lehle cishe ngo-75% ngemva kokuhlanjululwa emanzini futhi ngo-20-30% ngemva kwemizuzu engu-15 yokuhlanjululwa ngokugxila okuhlukile kweglucose uma kuqhathaniswa nesisekelo se-PRP kanye ne-1: 1 dilution elungiselwe ivolumu (1- k1 ngokulungiswa kwevolumu).k -1 ukuzala).1 ukuzalanisa).
Inombolo yamaseli ekuhlanjululweni ngakunye ivezwa njengengxenye yenombolo yoqobo ngaphambi kokuhlanjululwa.
I-MPV yehle kancane ngesikhathi sokukhiqizwa kwe-PRP, ngaphandle koshintsho olwengeziwe ekugxilweni kwe-dilution kuya ku-12.5% ​​emanzini noma ku-glucose (kuhlanganise nama-25% we-PRP glucose mixes) futhi yanda ngaphezu kuka-20% ngemva kokuhlanjululwa ku-50% yesisombululo se-glucose (Fig. .2).).Ngokuphambene, ama-erythrocyte awazange abonise ushintsho oluphawulekayo lwevolumu kunoma iyiphi i-dilution ngaphandle kwe-H2O.
Ivolumu yesilinganiso samaseli ekuhlanjululweni ngakunye ivezwa njengephesenti levolumu yoqobo ngaphambi kokuhlanjululwa.
Ukwehliswa okufanayo kodwa okungashiwo kangako kwinani leplatelet kanye nokwenyuka kwe-CVR kwabonwa ngo-BC kwavezwa ku-50% weglucose (ukuze yakhelwe ngo-25% weglucose).Ithebula lesi-2 liqhathanisa izinombolo zamaseli namavolumu amaseli egazini eliphelele elihlanjululwe ku-50% dextrose nedatha yesigaba 1 se-PRP ehlanjululwe ku-50% ye-dextrose.Izinguquko ekubalweni kwe-RBC kanye ne-RBC MCV bezingabonakali futhi bekungeyona into esigxile kuyo.
SD = ukuchezuka okujwayelekile, MD = umehluko omkhulu phakathi kwamaqembu, SE = ukuchezuka okujwayelekile komehluko wesilinganiso, i-RBC = ama-erythrocytes, i-PLT = amaplatelet, i-PRP = i-platelet ecebile ye-plasma, i-WB = igazi lonke
Ngemva kokwengeza i-D50W ku-WB, iphesenti lokulahlekelwa kweplatelet elungisiwe ukuhlanjululwa kwephesenti kwaba ngu-7.7% (310±73 vs. 286±96) uma kuqhathaniswa no-17.8% we-PRP dilution ku-D50W (664±348 vs. 544±277).I-MPV WB inyuke ngo-16.8% (kusuka ku-10.1 ± 0.5 kuya ku-11.8 ± 0.6), kuyilapho i-MPV PRP inyuke ngo-26% (9.2 ± 0.8 vs. 11.6 ± 0. 7). Nakuba umehluko wesilinganiso kukho kokubili ukuncipha kwenani leplatelet kanye nokwenyuka kwe-MPV kwakungaphezulu kakhulu nge-PRP, izinguquko ekunciphiseni inani le-platelet ngaphakathi kwe-WB cishe zazibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = .06) kanye nokwanda kwe-MPV kwakubalulekile (10.1 ± 0.5 kuya ku-10.8 p. 10.8). Nakuba umehluko wesilinganiso kukho kokubili ukuncipha kwenani leplatelet kanye nokwenyuka kwe-MPV kwakungaphezulu kakhulu nge-PRP, izinguquko ekunciphiseni inani le-platelet ngaphakathi kwe-WB cishe zazibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = .06) kanye nokwanda kwe-MPV kwakubalulekile (10.1 ± 0.5 kuya ku-10.8 p. 10.8).Nakuba umehluko wesilinganiso kukho kokubili ukuncishiswa kwesibalo se-platelet kanye nokukhuphuka kwe-CVR kwakukhulu kakhulu nge-PRP, izinguquko ekwehleni kwesibalo se-platelet ngaphakathi kwe-WB cishe zazibaluleke kakhulu (310 ± 73 kuya ku-286 ± 96 (-7.7%); p = 0.06).увеличение MPV было значительным (kusukela 10,1 ± 0,5 до 11,8 ± 0,6 (+16,8) p < 0,001). ukwanda kwe-MPV kwakubalulekile (kusuka ku-10.1 ± 0.5 kuya ku-11.8 ± 0.6 (+16.8) p <0.001).尽管PRP 在血小板计数减少和MPV 增加方面的平均差异显着更大，但WB 内血小板计坖发的（310 ± 73 至286 ± 96 (-7.7%);p = .06）和MPV 的增加是显着的（10.1 ± 0.5 ± 0.8 ± 0.6 (+16.8) p <.尽管 PRP 在 血小板 计数 和 增加 方面的 平均 差异 显着 大 , 但 但 内血小板 平 小板着 的 （（310 ± 73 至 286 ± 96 (-7.7%) ; p = .06）和MPV 的增加是显着的（10.1 ± 0.5 kufika ku-11.8 ± 10.Ushintsho ekuncishisweni kwenani leplatelet ngaphakathi kwe-WB lwalucishe lubaluleke kakhulu (kusuka ku-310 ± 73 kuya ku-286 ± 96 (-7.7%); p = 0.06), nakuba i-PRP yayinomehluko omkhulu kakhulu wesilinganiso ekwehleni kwenani leplatelet kanye nokwanda kwe-MPV.futhi ukwanda kwe-MPV kwakubalulekile.(kusukela ku-10,1 ± 0,5 kuya ku-11,8 ± 0,6 (+16,8) р <0,001). (kusuka ku-10.1 ± 0.5 kuya ku-11.8 ± 0.6 (+16.8) p <0.001).
Ukugxila kokugcina kwe-glucose engu-20% kwakudingeka ukuze kubonwe ushintsho olubalulekile ku-MPV, kodwa uguquko ku-MPV lwabonakala kakhulu ekugxiliseni kokugcina kwama-25%.Ukulahleka kwe-platelet kuzinzile ngemva kokuncipha kokuqala.Siqaphele ukwehla okubukhali kokuqala kwe-CVR, nokho, i-CVR yabuyiselwa ngokushesha ekugxilweni kweglucose yokugcina engu-25%, eyayiphezulu kakhulu kunamazinga e-CVR abonwa ekugxilweni kokugcina kweglucose okungu-20% no-15% (Umfanekiso 3 nangakwesokunxele kweThebula 3; amabhokisi anomthunzi).khombisa amanani we-p≤ alpha ngokulungiswa kwe-Bonferroni okungu-0.01).Kuphinde kwaba nokwehla okubukhali kokuqala kwenani le-PLT, okubonwe esigabeni sokuqala samasekhondi ayi-0-15, kwase kuhlala kuzinzile (kusuka kumasekhondi ayi-15 kuye kwangama-30; kwesokunxele sethebula lesi-4).
Ukwengezwa kokugxila okuhlukahlukene kweglucose egazini lonke kuholele ekwehleni kokuqala okusheshayo kwe-MPV okulandelwa ukululama okuncike ekugxiliseni okungaphezu kwama-20%.Inganekwane ikhombisa ukugcwala kweglucose ngemuva kokuhlanjululwa.I-D15, i-D20 ne-D25 yenziwe nge-dilution engu-1:1.I-D21 ne-D41 zenziwe nge-dilution engu-1:5.
Ithebula 4 libonisa ushintsho kwinani leplatelet lapho lihlanjululwa ku-hypertonic glucose.Sibone ubudlelwano obuncike kumthamo phakathi kokwehla ngokushesha kwezinombolo ze-PLT ekuhlanjululweni okungu-1:1 kanye nase-dilution engu-1:5.Uma kuqhathaniswa ukuhlanjululwa kwe-1: 1 njengeqembu elilodwa ne-1: i-dilution ye-5, iqembu le-1: i-1 ibe nokwehla ngokushesha kwesibalo se-platelet esingaphansi kweqembu le-1: 5 iqembu 66±48,000 (23%) uma liqhathaniswa ne-99±69,000 (37%)., p = 0.014) eqenjini elingu-1:5.Ngemva kokwehla kokuqala endaweni yokuqala yokulinganisa, i-platelet count njengephesenti le-glucose ezinzile (Fig. 4).
Lapho igazi lonke lifakwa ku-glucose ngesilinganiso esingu-1:1, inani leplatelet liyancipha cishe ngo-25%.Kodwa-ke, lapho igazi lonke lengezwa ngesilinganiso se-1: 5, ukunciphisa kwakukhulu kakhulu - mayelana ne-50%.
I-glucose engu-41% inyuse i-MPV ngokushesha futhi ngendlela emangalisayo ngaphezu kwama-25% noma ama-21%.Imiphumela ye-MPV ikhonjiswe kuMfanekiso 3. Kukho konke okunye ukuhlanjululwa, akukho ukwehla kwasekuqaleni kwe-MPV okubonwe ngemva kokwengezwa kwe-glucose engu-50%.Uma usebenzisa i-25% ye-glucose (i-glucose concentration 20.8% ekuhlanjululweni kokugcina), ushintsho ku-MPV lwaluqhathaniswa noshintsho ku-20% ye-glucose ku-1: 1 dilution (Fig. 3).Nakuba izinguquko ku-MPV ekuqaleni bezinkulu ekugxilweni okuxubile okungama-41% kunama-25%, umehluko ku-MPV phakathi kuka-41% no-25% ngemva kwemizuzu engu-16 wawungasabalulekile (Ithebula 3, kwesokudla).Kuyathakazelisa futhi ukuthi i-glucose engu-25% inyuse i-MPV ngempumelelo kakhulu kuno-20.8%.
Lolu cwaningo lwe-in vitro luqinisekise kancane umbono wethu. Ibonise ukuguqulwa kwe-platelet lysis engaba khona nge-dextrose admixture, ukuhlaliswa okusheshayo kwamaplatelet kuya ku-hypertonicity eyeqisayo, kanye nokwenyuka okuphawulekayo kwe-MPV ekuphenduleni> 25% ukugxila kwe-hypertonic dextrose. Ibonise ukuguqulwa kwe-platelet lysis engaba khona nge-dextrose admixture, ukuhlaliswa okusheshayo kwamaplatelet kuya ku-hypertonicity eyeqisayo, kanye nokwenyuka okuphawulekayo kwe-MPV ekuphenduleni> 25% ukugxila kwe-hypertonic dextrose. Он показал потенциальный частичный лизис тромбоцитов примесью декстрозы, быструю аккомодацию тромбоцитов до экстремального земли ние MPV в ответ на гипертоническую концентрацию декстрозы > 25%. Ibonise i-platelet lysis engase ibe ingxenye ene-dextrose, indawo yokuhlala esheshayo yeplatelet ku-hypertonicity eyeqisayo, kanye nokwanda okuphawulekayo kwe-MPV ekuphenduleni amazinga e-hypertonic dextrose> 25%.它显示出通过葡萄糖混合物潜在的部分血小板溶解，血小板快速适应极端高渗渗，2渗葡萄糖时MPV 显着上升.它 显示 出 通过 葡萄糖 潜在的 部分 血小板 溶解 血小板 快速 适应 极端 极端 极端 极端度 高渗 葡萄糖 时 时 mpv 显着。。。. Mayelana ne-патенциальный частичный лизис тромбоцитов смесями с глюкозой, быструю адаптацию тромбоцитов к экстремальзитов к экстремальзеном личение MPV в ответ на концентрацию гипертонической глюкозы > 25%. Ibonisa i-platelet lysis engaba khona ngokwengxenye ngezingxube ze-glucose, ukujwayela kweplatelet ngokushesha ku-hypertonicity eyedlulele, kanye nokwanda okuphawulekayo kwe-MPV ekuphenduleni i-hypertonic glucose>25%.Ukwenyuka kokuqala kwaba kukhulu ekuchayekeni kweglucose ngama-41.6%, kodwa ukwanda kwe-MPV kusondele ekuchayekeni kwe-glucose okungama-25% cishe imizuzu engama-20 ngemuva kokuchayeka.
Ukugcwala kwamaplatelet kuthinteka yi-glucose.Siqaphele ukuthi inani le-PLT lehla kukho konke ukuhlanjululwa kweglucose.Ukwehla okubukhali kwenani lamaplatelet ku-H2O (0%) ukuhlanjululwa kochungechunge lwe-PRP kungase kuhlotshaniswe ne-osmotic lysis.Kungenjalo, lokhu kungaba i-artifact ebangelwa ukunqwabelana kwe-platelet, kodwa lokhu kuphambene nokuntuleka koshintsho lwe-MPV kulokhu kuhlanjululwa.Lokhu kutholakala kusho ukuthi amanye amaplatelet azwela kakhulu ku-hypoosmolarity.
Kukho konke ukuhlanjululwa kweglucose okungu-1:1, inani le-PLT lehle ngo-20-30%, ngisho nange-D5W (hypotonic at 252 mOsm), okungase kubonise umphumela othize ongewona we-osmotic we-glucose, njengoba kokubili i-PLT ne-MPV kuhlale kungashintshile ekukhuphukeni okuphindwe kathathu kokugxila.ushukela.kusuka ku-D5W kuya ku-D25W.Eqinisweni, ukugxila kwe-PLT kuthande ukukhuphuka kancane ngokukhula kwe-osmolarity.
Ukuncipha kwe-PLT phakathi kuka-1:1 kanye no-1:5 dilution kusho ukuthi umphumela wokuhlakazeka uncike ekugxilweni kokuqala nokokugcina kweglucose.Uma kuncike kuphela ekugxiliseni kokuqala, khona-ke umuntu ubengalindela ukubona umehluko ekunciphiseni kwe-PLT phakathi kokugxila kwe-1:1.Kodwa thina asikwenzi.Uma umphumela we-lysis uncike kuphela ekugxilweni kweglucose yokugcina, ngakho-ke asilindele umehluko omkhulu phakathi kwe-dilution engu-20% 1:1 kanye ne-20.8% 1:5 dilution.Nokho sikwenzile.
Uma ukulahlekelwa kweplatelet kwenzeka ngenxa ye-platelet lysis, i-lysate eyingxenye yakheka, emva kwalokho ama-cytokines kanye nezici zokukhula zikhishwa endaweni engaphandle kwe-extracellular.Ucwaningo oluningana lubonise ukuthi i-platelet lysate icishe iphumelele njenge-PRP njengesixazululo sokwanda [11].I-PRP ngokwayo iboniswe njengesixazululo esiphumelelayo sokwelashwa kokusabalala [12-14].
Ama-platelet angasebenzi ajikeleza ngendlela yediski eqiniswe ngezakhiwo eziningana zangaphakathi.Ngesikhathi sokusebenza, athatha umumo oyindilinga noma we-amoeba, okuholela ekwenyukeni kwevolumu.Ukwanda kwevolumu kudinga ukwanda kwendawo, okuwumphumela wokukhishwa kwesistimu ye-tubule evulekile (OCS) kanye nokwengezwa kwama-exocytic granules ku-membrane.Kusamele kunqunywe ukuthi ngabe ukwanda kwe-MPV okubangelwa i-hypertonic glucose kuhilela eyodwa noma zombili lezi zindlela, kodwa uma lokhu kwakamuva, khona-ke ukwanda kwe-MPV kuzobonisa ukuwohloka.
Lolu cwaningo lubonise ukuthi ukuchayeka ekugxilweni okuphezulu kwe-glucose ku-PRP noma ama-platelet egazi lonke kubangele ukwanda kwe-MPV phakathi nemizuzu engu-15 nge-glucose concentration ye-25% kanye ne-41.6%, ngokulandelana.
Ukwenyuka kwe-MPV ye-platelet kungase kube ngenxa yokunwebeka kwama-microtubule tangles azungezile ekuphenduleni ukungena kwe-calcium.Liu et al.I-glucose iboniswe ukuthi ixhumanisa ukungena kwe-calcium nge-platelet TRPC6 channel [6].I-hypothesis yethu iwukuthi i-glucose idala ukuxegiswa kwama-microtubule tangles, okuholela ekwandeni kwe-MPV kanye nokuzwela kweplatelet kanye/noma kusebenze.Nokho, uma sibheka imiphumela yethu, lokhu kuyingxenye yendaba.Ezivivinyweni zethu, akukho ukugxila ngaphansi kwe-D25W okubangele ukwanda kwe-MPV.Njengoba singazange sikuhlole ukuchayeka ekugxilweni kweglucose phakathi kuka-12.5% ​​no-25%, imiphumela yethu yesigaba soku-1 iphakamisa ukuthi kungase kube khona umkhawulo kulolu hlu lokugxilwa kweglucose okuholela ekwenyukeni kwe-MPV.Ukuhlola okwengeziwe ezigabeni 3 no-4 kubonise ukuthi i-20-25% ye-glucose ibonakala iwumngcele walokhu, kodwa akukacaci ukuthi kungani.
Siphinde sabona ukwehla okungu-9% ku-MPV ngemva kokufakwa phakathi.Akukacaci noma lokhu kuncipha kwe-MPV kungenxa yamaplatelet amakhudlwana naminyene avaleleke kungqimba lwe-RBC lwe-centrifuge.Lokhu kuqaphela kungase kubaluleke kodokotela njengoba kungase kusho ukuthi amaplatelet e-PRP ayisethi encane futhi engaminyene kancane yamaplatelet e-WB.
Esifundweni sangaphambilini, sibonise ukuthi ukulungiswa kwe-PRP ngezindlela zezandla akubizi [8].Uma i-glucose izwela amaplatelet ezicubu noma i-PRP, iwenza abe lula kakhulu ekusebenzeni, noma uma i-PRP ikhiqizwa ngezici ze-lysate eziyingxenye, lokhu kungase kuthuthukise ukuvuselelwa futhi kunciphise isidingo sokwelashwa.Ngakho-ke, inhlanganisela ye-PRP kanye ne-glucose egxile kakhulu ingase ibe nezindleko ezingcono kune-PRP noma i-glucose kuphela.
Isifundo sethu sinokushiyeka okuningana.Okokuqala, sisebenzisa i-PRP etholakala ezindleleni eziningana ezahlukene.Lokhu kungaholela emiphumeleni engqubuzanayo.Okwesibili, asikwazanga ukwenza ukuhlaziya kwe-biochemical kwanoma yimaphi amasampuli ethu ukuze sinqume ngokunembe kakhudlwana ukuthi ingabe ukwenziwa kusebenze kweplatelet kwenzeke.Singathanda ukukala i-P-selectin, i-platelet factor 4, i-monocytic platelet aggregates, noma ezinye izimpawu zokwenziwa kusebenze kwe-platelet ukuze siqonde kangcono izinga noma ukuba khona kwe-alpha granule degranulation, kodwa lokhu kungaphezu kobubanzi balolu cwaningo.Okwesithathu, asikwazanga ukuqinisekisa nge-electron microscopy noma ezinye izindlela ukuthi ukwanda kwe-MPV kumaplatelet e-glucose-echaywe kungenxa yomphumela kuma-microtubule tangles.
Izingxube ze-WB noma i-PRP ne-25% ye-glucose yenyuka i-MPV, ebonisa ukuqala kokusebenza kweplatelet, nakuba lolu cwaningo aluzange lubonise ukuqhubeka kokuhlanganisa noma ukuchithwa.Ingxube ye-hypertonic glucose ibangele ukulahleka kweplatelet, okungenzeka imele umphumela we-lytic.Ukwenza kusebenze ingxenye noma ukuguqulwa kwamaplatelet kungabangela ukuvuselelwa kwezicubu ngemva komjovo weplatelet.Akukacaci ukuthi lezi zinguquko zingaholela emiphi imiphumela yomtholampilo.Ucwaningo olwengeziwe lubonise izilinganiso ezinembe kakhudlwana zokusebenzisa noma i-lysis futhi luhlole imiphumela ehlukene yomtholampilo yezingxube ze-hypertonic glucose ne-WB noma i-PRP.
Ukwelashwa kweGlucose proliferative kuyindlela elula futhi engabizi yokuvuselela kabusha ekhula ngokushesha futhi esekela ucwaningo lomtholampilo.Lolu cwaningo luphakamisa indlela yokusebenza komzimba, uma kuqinisekisiwe, engasisiza siqonde ingxenye yendlela yokuvuselela yokwelapha okwandisa.
I-Biomedical and Health Informatics e-University of Missouri, Kansas City School of Medicine, Kansas City, USA
Izifundo Zabantu: Bonke ababambiqhaza kulolu cwaningo banikeze noma abazange banikeze imvume.I-International Society for Cellular Medicine ikhiphe imvume ye-ICMS-2017-003.Iphrothokholi elandelayo ivunyelwe ukuze isetshenziswe futhi Ibhodi Lokubuyekeza Lesikhungo SeNhlangano Yamazwe Ngamazwe Yezokwelapha Zeselula: Isihloko: Ukubalwa kwesivuno somuthi we-plasma ocebile nge-platelet okusekelwe ekubalweni kweplatelet ye-CBC eyisisekelo.Izihloko zezilwane: Bonke ababhali baqinisekisile ukuthi azikho izilwane noma izicubu ezihilelekile kulolu cwaningo.Ukungqubuzana Kwezintshisekelo: Ngokuhambisana nefomu le-ICMJE Lokudalula Okufanayo, bonke ababhali bamemezela lokhu okulandelayo: Ulwazi lwenkokhelo/yesevisi: Bonke ababhali bamemezela ukuthi abatholanga ukwesekwa kwezezimali kunoma iyiphi inhlangano ngomsebenzi othunyelwe.Ubudlelwano Bezezimali: Bonke ababhali bamemezela ukuthi okwamanje noma phakathi neminyaka emithathu edlule abanabo ubudlelwano bezezimali nanoma iyiphi inhlangano engase ibe nentshisekelo emsebenzini othunyelwe.Obunye Ubudlelwano: Bonke ababhali bamemezela ukuthi abukho obunye ubudlelwano noma imisebenzi engathinta umsebenzi othunyelwe.
Harrison TE, Bowler J, Reeves K et al.(Meyi 17, 2022) Umthelela weglucose ekubalweni kweplatelet nevolumu: imiphumela yomuthi ovuselelayo.Ukwelapha 14(5): e25081.doi:10.7759/cureus.25081
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