基礎(chǔ)醫(yī)學(xué)各論I：Blood and Hemopoiesis

1、 1. Components:-formed elements: 45% red blood cell-erythrocyte white blood cell-leukocyte platelets-plasma: 55%, PH 7.3-7.4, 90% water contain: plasma protein (albumin, globulin, fibrinogen), lipidprotein enzymes hormone vitamin inorganic salt and products of metabolism*serum: plasma without fibrin

2、ogenBlood smear: Wright or Giemsa stain methods1) erythrocyte, red blood cell -normal number: (4.2-5.5)X1012/L in male (3.5-5.0)X1012/L in female -structure: biconcave discs in shape, 7.5-8.5 um in diameter, 1-2um thickno nucleus and organellafilled with hemoglobin (Hb)-normal Hb : 120-150g/L in mal

3、e 105-135g/L in female-Function:combine and transfer Oxygen (O2) and Carbon dioxide(CO2)*anemia: RBC 3.0X1012 /L or Hb 100g/L ABO blood type blood type antigen: A, B : -membrane protein hemolytic transfusion reaction -hemolysiserythrocyte ghostABO Blood Group System:* reticulocyte: immature cell rem

4、ained ribosome: delicate network structure when stained with brilliant cresyl blue 0.5-1% of total erythrocyte population or 3-6% in neonate-life span: 120 days2) leukocyte-a group of large cells with nucleus-involve in defense and immune reaction-normal number: (4.0-10) X109/L-classification: granu

5、locytes: /neutrophil /eosinophil /basophil agranulocytes: /lympocyte /monocyte neutrophil: 50-70% of total leukocyte population-structure: LM: round, 10-12um in diameter rob-liked or poly morphous nucleus, 2-5 lobes fine neutrophilic granules-pink cytoplasmEM: specific granule: 80% small, 0.3-0.4 um

6、 ovoid or irregular in shape contain: lysozyme, phagocytin (defensin) , ect. azurophilic granule: 20% large, round or ovoid , 0.6-0.7 um electron dense acid phosphatase, peroxidase, ect.-function: phagocytose bacterium: specific g.-kill B azurophilic g.- digest B-life span: in blood 6-8 hours, in CT

7、 2-3 days eosinophil: 0.5-3% of total leukocyte populationLM: round,10-15 um in diameter 2 lobes nucleus rough bright red granules -acidophilic granulesEM: granules: round or ovoid with cube-liked electron dense crystal contain: -ACPase-histaminase-peroxidase-function: counteract the infection of pa

8、rasitereduce allergic reaction-life span: in blood 6-8 hour, in CT 8-12 days致密結(jié)晶體致密結(jié)晶體 basophil: 0-1% of leukocyte population LM: less, round 10-12 um lobe, “S” shaped or irregular nucleus basophilic g.: contains heparin, histamine and acidophil chemotactic factor cytoplasm: contain leukotriene-func

9、tion: involve in allergic reaction-life span: 10-15 days monocyte:3-8% of total leukocyte population LM: large round, 14-20um nucleus appear as kidney, horse-shoe or ovoid in shape cytoplasm: gray-blue in color, contain azurophilic g.EM: azurophilic granule: peroxidase, ACPase, lysozyme-function: ac

10、tively mobile and chemotaxis-life span: in blood 1-5 days, in CT which become into macrophage- mononuclear phagocytic system lymphocyte: 20-30% of total leukocyte population LM: round, small LC 6-8 um, medium-sized LC 9-12 um, large LC 13-20 um in diameter round nucleus with indentation, chromatin a

11、ppears as spot-liked and electron-dense cytoplasm: /basophilic:bright blue in color /less /azurophilic granuleEM: /free ribosome /mito. /RER-classification: TC: thymus dependent lymphocyte, 75%, involve in cellular immune reaction and regulate immune response BC: bone marrow dependent lymphocyte, 10

12、-15%, become into plasma cell, involve in humoral immune response large granular cell: KC (killer cell) and NKC( nature killer cell), 10%-function: involve in immune response3) blood platelet: cytoplasmic fragment of megakaryocyte in bone marrow -normal number: 100-300X109/L -structure: LM: disc-lik

13、ed, 2-4um irregular in shape Stimulation in groups Granulomere hyalomere EM: /tubular systems: opening tubule system- increasing the exchange area, facilitate the intaking and releasing dense tubule system- SER, collecting calcium (Ca2+ ) and synthesizing prostaglandingranules: specific granule: med

14、iate electron density, with dense core, contains clotting factor, fibrinogen, acidic hydrolase dense granule: electron dense, contains 5-hydroxytryptamine, ADP, ATP, Ca2+ and adrenalin-function: involve in clotting and stopping the bleed: -aggregation -release components of granule, make thrombinoge

15、n become into thrombin, then later make fibrinogen become into fibrin protecting endothelium and take part in repairing of endothelium 3. Bone marrow and hemopoiesis1) Places for hemopoiesis and structure of bone marrowPlaces for hemopoiesis: yalk sac ( 3W)liver(6W) spleen(4M) bone marrow Structure

16、of bone marrow: red bone marrow -hemopoietic tissue: reticular T. hemopoietic cell, macrophage, fibroblast, mesenchymal cell -sinusoid: cap.*hemopoietic inductive microenvironment ( HIM): The environment for hemopoietic cell growth and development, bone marrow HIM includes N of bone marrow, BV, fibe

17、r, extracellular GS and stromal cells* stromal cells: -including reticular cell, fibroblast, macrophage, endothelial cell and lipid-laden cell-function: supporting secrete cellular factors, regulate the proliferation and differentiating of hemopoietic cells2) Hemopoietic stem cell and hemopoietic pr

18、ogenitor cellhemopoietic stem cell (HSC): multipotential stem cell-originated yalk sac red bone marrow constitutes about 0.5% of total bone marrow cells similar to small LC-feature: strong potential to proliferation multidifferentiated ability ability to copy itself: keep certain numberhemopoietic prog