CHAPTER 3 BLOOD

1
CHAPTER 3BLOOD
2
INTRODUCTION

• ???? ? ? ? ??????????,??????,?????
• 1628?,????William Harvey (1578-1658)
• De Motu Cordis???????????
• 46??,Marcello Malpighi (1628-1694)
  ???????????,???Harvey???????????
• ?????????Stephen Hales (1677-1761)
• ??????????

3
INTRODUCTION

• ? Heart
• ? Blood vessels
• ? Blood

4
INTRODUCTION

• Functions of blood
• Blood (7-8 body weight, 70-80ml/kg)
• 1. Transportation
• O2, CO2, Nutrition, Excretion, Hormone
• 2. Regulation
• pH, Temperature
• 3. Protection
• Clotting, Immunization

5
??? ??????????

• Body fluid (60 body weight)
• Intracellular fluid 2/3
• Extracellular fluid 1/3
• Interstitial fluid 3/4
• Plasma 1/4
  
• Internal environment extracellular fluid
• Homeostasis

6
Composition of the blood

• Blood
• Plasma ?,?????(????????????),???,??
• Blood cells
• Erythrocyte (red blood cell)
• Leukocyte (white blood cell)
• Platelet (thrombocyte)

7
Composition of the blood

• ?????(Hematocrit)
• ???????????????
• ??????? 40?50
• ???? 37?48
• ??? 55

8
Composition of the blood
9
Plasma proteins

• Plasma protein 60-80g/L
• Albumin 40-50g/L (?????,????)
• Globulin 20-30g/L (?1-??2-??-??-globulin)
• Fibrinogen(?????,????)
• ???/???????,?????????
• Serum (plasma without fibrinogen)

10
Plasma proteins
11
Plasma proteins

• Functions of plasma proteins
• 1. ????
• 2. ????
• 3. ???????
• 4. ??????????
• 5. ????
• 6. ????

12
Physical and chemical characteristics of blood

• ???????
• 1. ?????
• ????1.050?1.060(???????)
• ????1.025?1.030(?????????)
• ?????1.090 ? 1.092(??????????)

13
Physical and chemical characteristics of blood

• ???????
• 2. ??????(viscosity)
• ????????????????,????????4 ?5,???1.6 ? 2.4?
• ?????????????????????????(?????)

14
Physical and chemical characteristics of blood

• ???????
• 3. ?????(plasma osmotic pressure)
  
• 300 mmol/L (300 mOsm/Kg H2O,???770
  kPa)????????????????????
• ?????(crystal osmotic pressure)
• ????????????80??Na?Cl-?
• (???????)
  
• ?????(colloid osmotic pressure)
• ?????????????????????????,?????????????(??
  ?????)

15
Physical and chemical characteristics of blood

• ???????
• 3. ?????(plasma osmotic pressure)
  
• ?????(crystal osmotic pressure)
• ?????(colloid osmotic pressure)
• ????????????????????
• ???????????????
• ?????????????????????????????

16
?????????????
17
???
???
NaCl (1 mol/L?)
NaCl (0.1 mol/L-?)
H2O
H2O
18
Physical and chemical characteristics of blood

• ???????
• 4. ???pH?
• ????7.357.45?????????????,?????????
  NaHCO3/ H2CO3,???20?(??????)

19
Summary
20
Hemopoiesis

• ??(Hemopoiesis)?????????(??)

21
Hemopoietic stem cells
22
Erythrocyte

• ?????????
• The shape and count of erythrocyte
• ?????
• a?????,??????????????
• b?????,???????????
• c????????,???????????????????

23
RBC in a capillary
24
Erythrocyte
25
Erythrocyte

• ?????????
• The shape and count of erythrocyte
• RBC ? ??5.0 1012/L, (4.5-5.5)1012/L
• ? ??4.2 1012/L,
  (3.8-4.6)1012/L
• ??? ??6.0 1012/L
• Hemoglobin ? 120-160g/L
• ? 110-150g/L
• ??? 200g/L(5d)
  ???(6m)
• ????(gt1y)

26
Hemoglobin
27
Erythrocyte

• ?????????
• ????????
• Physiological characteristics of erythrocyte
• 1. ??????? (permeability)
• 2. ????? (plastic deformability)
• bend or fold

28
Permeability
29
Erythrocyte

• ????????
• 3. ????? (suspension stability)
• ????????????????????,????????????
• ???????????????????????(????)?,???????????????
  ??????????,????????(erythrocyte sedimentation
  rate,ESR),?????
• ???(???)???015 mm/h
• ???020
  mm/h?
• ???????????????????(RBC????????????????????
  ?????)

30
Erythrocyte

• ????????
• 1. ??????? (permeability)
• 2. ????? (plastic deformability) bend or fold
• 3. ????? (suspension stability)
• 4. ???? (osmotic fragility)
• ???????????????????????????RBC??????
  ???????????,??RBC????????????

31
Osmosis
32
Erythrocyte

• ??????
• Functions of erythrocyte
• 1. ???????O2?CO2
• ?RBC??O2 ???????O2?70?(hemoglobin),???????CO2?
  18?(????,HCO3-)?
• 2. ????RBC???????

33
Erythrocytes

• ?????????
• ???????????
• 1. ??????? (permeability)
• 2. ????? (plastic deformability)
• 3. ????? (suspension stability)
• ??????
• 4. ???? (osmotic fragility)
• ????/????
• ????1. ??O2?CO2
• 2. ????RBC???????

34
Erythrocytes

• ????????(Erythropoiesis and regulation)
• RBC???????
• 1. ???B12(Vitamin B12) VitB12 ???(????????)
  ????? ???????
• ?
• ?????II ????????
• 2. ??(folic acid)???????????,?????????
  ????????VitB12????
• VitB12??????????????DNA???,???????????
  ???

35
Erythrocytes

• ????????(Erythropoiesis and regulation)
• RBC???????
• 1. ???B12(Vitamin B12)
• 2. ??(folic acid)
• 3. ?(iron)??????????????????5,????????(????,???f
  erritin,????transferrin)?
• ?????????????
• ?????????????

??????(?????)
36
Erythrocyte

• ????????(Erythropoiesis and regulation)
• RBC???????
• RBC?????
• ?????????????????????(BFU-E ?CFU-E)
  ???????????????????????????????????
• 5-10???????(apoptosis)???????????,???
  ??6-7??
• ????????????????????????????????

37
Erythropoiesis
?????????
??????????(burst forming unit-erythroid, BFU-E)
????????(colony forming unit-erythroid, CFU-E)
??????
???
???
(????,??)
??????? (erythropoietin, EPO)
?O2 ??
?????? (burst promoting activator, BPA)
O2??? (O2 ???)
EPO????(???,???)
38
Erythropietin
39
Erythrocytes

• ?????????
• ???????????
• ????????
• ??????
• ????120??
• ?????(???)
• ???????????????(???)

40
Leukocyte

• ?????????
• The classification and count of leukocyte
• ?????????
• ?????(4.010)109/L?
• ?????,??,??,??,??,???
• ?????5070 ( ?????????)
• ?????? 0.55 (??????)
• ??????01 (???????)
• ????38 (??????)
• ????2040 (??????????)

41
Leukocyte
42
Leukocyte

• ???????????
• Physiological characteristics and functions of
  leukocyte
• 1. ??????????(?????)???????????,????????????,????
  ???????(diapedisis) ?
• 2.???????????????????????,???????(chemotaxis)?
• 3.???????????????????????,????????????????,??????
  (phagocytesis)?

43
Platelet

• ?????????
• The count and functions of platelet
• ?????????????????????????????????????????????
  ,?????2-4?m,????8?m3,???0.5-0.75?m ?
• ?????(100300)109/L?
• ????????????

44
Platelet

• ?????????

???????(thrombopoietin, TPO)(?????)
????????
????????????
???????
?????
45
Platelet

• ?????????
• ?????????
• ??????
• ?????????714??
• ???????????????????
• ????????
• ??????????????????

46
BLOOD

• ??? ??????????
• ??? ?????
• ??? ?????

47
Physiological hemostasis

• ????????,???????????????????????????????
• ??????????????????,???????????,???????????
• ??????13??
• (????????????)?
• ???????1.????(????,?????)?
• 2.?????,??????
• 3.????????,???????
• (??????????????,??????,?????????,????????)

48
Hemostasis
49
Hemostasis

• ????????
• Hemostasis of thrombocyte
• ????????
• 1. ??(adhesion) ?????????????,????????
• 2. ??(aggregation)??????????????????
• 3.??(release reaction) ????????,?????????-???????
  ??????????,????????(ADP, serotonin, TX A2)

50
Hemostasis

• 2. ??(aggregation)
• ??????(?????)
• ???ADP,????ADP
• ??????(??????)
• ????ADP,???ADP
• ?????
• a) ADP Ca2????????????
• b) ???A2 (thromboxane A2, TX A2 , ?????A2
  )
• c) ??(collagen) ?????????????
• d) ???(thrombin)??????,?????????????????

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Hemostasis

• ?????????????
• ??????????????
• ????????
• 1. ???????????,????????????????????????
• 2. ????????????????,????????????????
• 3. ?????????????,??????????,????????????????????
  ??,????????????,?????,?????????????????

52
Hemostasis
53
Blood coagulation and anticoagulation

• ???????
• ????(blood coagulation)
• ?? ?????????????????????????
• ????(blood clotting factor)
• ???????????????,???????(F IF
  XIII)?????????12???, ?????????????????PFs
• ???? ????????????????????????

54
????

• ????(????)
• ??????????
• ???????????
• ????????????
• ????(????)
• ????????? ???
• ???????????
• ?????????? ????a

55
?????????
56
Blood coagulation

• ???????(intrinsic pathway of blood coagulation)
• ??????????????
• 1. ??????(FXII ? ?)
• 2. ??????(FXIa ? ?)
• 3. ????????(FXa ? ?)
• ???????(extrinsic pathway of blood coagulation)
• ??????????????
• ?F VII?TF?Ca??F VII???,??F
  VII??????,?F X???F Xa,??????????????????

57
Blood coagulation

• ????(common pathway)
• 1. F X???(F X?F Xa)
• 2. ???????(F II ? F IIa)
• 3. ????????(F I ?F Ia)?
• Summary
• ??????????????, ?VitK??
• Ca2????????, ???????????
• ????????A????
• PF3?????????, ??????
• ??????????
• ??????????????, ????
• ?????????????????, ????

58
Blood-clotting process
59
Pathway of blood coagulation
60
Anticoagulative system

• ???????
• ????(blood coagulation)
• ????(anticoagulative system)
• 1. ?????????
• 2. ???C??
• 3. ????????? (TFPI)
• 4.??(heparin)

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Fibrinolysis and antifibrinolysis

• ??????????
• ????????(fibrinolytic system)
• ?????? ?????????,?????
• ???? ???????????????????
• ??????,???????
• 1. ???????
• 2. ?????????????
• 3. ?????????

62
???????????
63
Fibrinolysis
64
BLOOD

• ?????????????
• ????????
• ????????
• ??????????

65
Blood group transfusion

• ????????
• 1901?Landsteiner ??ABO????
• ??????????????????
• ?????(agglutination)???????????,??????????(??-???
  ?)?
• ???(agglutinogen)?????????????????????????,??????
  
• ???(agglutinin)?????????????????????????????
• ????????????????,???????????

66
Agglutination reaction

• If red blood cells from one blood type are mixed
  with antibodies from the plasma of the other
  blood type, an agglutination reaction occurs. In
  this reaction, RBC stick together because of
  antigen-antibody binding.

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Blood group

• ?????
• ??????193??????,????????????????????
  ??ABO?????Rh?????
• ABO????
• 1. A B O?????
• ??????????????A????B??????4??????
  

68
Blood group
?? ??????? ??????
A A ?B
B B ?A
AB A?B
O ?A??B

• ?????????????????
• ?????????????H??,??????,??????H????A?B????
  ?H????????????
• ABO????????,??A??????A1?A2??,???????
  

69
Blood group
???? ??? ??? ???????? ???????? ????????
???? ??? ??? ?A ?B ?A1
A1 A?A1 ?B ?
A2 A ?B??A1(10) ? ?
A1B A?A1?B
A2B A?B ?A1(25) ? ?

• ABO?????????
• ?????? ???????, ??????
• ???? A2 ? O
  A2B?B
• ???????? A1?????????

70
Blood group

• ABO????
• 1. ABO?????
• 2. ABO????????
• ?A?B?O??????
• A?B??????? O???????
• ABO???????,????????????

??? ??? ??? ???
OO O BB, BO B
AA, AO A AB AB
71
Blood group

• ABO????
• 1. ABO?????
• 2. ABO????????
• 3. A B O?????
• ?????????????????
• ???????????????A??B??A-?B??,??????????
  ?????????,????,?????????

72
Blood typing

• Agglutination (clumping) of red blood cells
  occurs when with A-type antigens are mixed with
  anti-A antibodies and when cells with B-type
  antigens are mixed with anti-B antibodies. No
  agglutination would occur with type O blood (not
  shown).

73
Blood group

• ABO????
• Rh????
• 1. Rh????????
• 2. Rh??????????
• 3. Rh???????????

74
Rh blood group
75
Rh blood group
76
Blood volume and transfusion

• ????
• ?? 7-8 body weight, 70-80ml/kg
• ??????????
• ????????,?????????????
• ??????
• ????????????????
• ????????????????

77
Transfusion

• ?????????
• ???????
• ????????
• ???????????
• ????????????????????
• O?????,
• AB?????

78
Transfusion

• ?????????????
• ??????
• ??????????????,????????????????????????
  ?????????
• ?????
• ?????
• ???????

79
Test yourself after this chapter

• ??RBC?????????RBC????????????????????RBC??????????
  ???
• ??????????????????????????
• ???????????????????
• ??????????????????????????????
• ??????? RBC???RBC?????????
• ??????????????
• ??ABO?????????ABO???
• ????????????????????????