2. BLOOD

3. 一、 CONSTRUCTION Plasma (I.M.) : 55% Hemocytes(cells) ： 45% erythrocytes leucocytes blood platelets * hematocrit(packed red cell volume, 红细胞压积 ): 45% Plasma Leucocytes & Platelets Erythrocyte *using anticoagulants

4. components same as that of plasma but fibrinogen 90% water albumin 10% others : fibrinogen  plasma pr. enzymes Ig. etc.  Lipid  hormones  Vitamins  inorganic salts  metabolites 1. Plasma serum Blood clots Serum

5. 瑞特氏染色（ Wright’s stain ） 、基姆萨染色（ Giemsa ）等。 染液组成 伊红 美蓝 O2O2 天青 可显示 : 嗜酸性结构 嗜碱性结构 中性结构 嗜天青结构 blood smear stainsblood smear stains w/ Wright or Giemsa w/ Wright or Giemsa

6. Erythrocytes Leukocytes Platelets blood smearblood smear

7. BLOOD CELLS Erythrocytes: 4.2 ～ 5.5×10 12 /L(M) 3.5 ～ 5.0×10 12 /L(F) *Hb: 120 ～ 150g/L(M) ； 105 ～ 135g/L(F) Leukocytes: 4 ～ 10×10 9 /L neutrophils 50 ～ 70% Granulocytes eosinophils 0.5 ～ 3 % basophils 0 ～ 1% Agranulocytes lymphocytes 20 ～ 30% monocytes 3 ～ 8% Platelets: 100 ～ 300×10 9 /L

8. Erythrocyte  biconcave discs ， 7.5 ～ 8.5μm ， flexible  no nuclei ， no organelles  rich in Hb ： 105 ～ 150g/L  blood group (ABO; Rh…):

9. 扫描电镜

10. PLASMALEMMA RBC CYTOSKELETON ACTIN FILAMENTS SPECTRIN 血影蛋白 肌动蛋白丝 质膜

11.  Function Binding & transporting O 2 and CO 2 In lungs In organs & tissues CO 2 +HbO 2 HbCO 2 +O 2

12.  Anemia ： R.B.C < 3×10 12 /L or Hb< 100g/L megaloblastic anemia ( 巨细胞贫血 ) : >9 μm iron deficiency anemia: ( 缺铁性贫血 ) <6 μm  Osmotic stress abnormal: hypotonic ( 低滲 ) : RBC swelling ＆ hemolysis (remain ghost 血影 ) ； hypertonic ( 高滲 ): RBC collapsing Pathology

13.  0.5 ～ 1.5%  containing ribosomes & Mit. (stained by brilliant cresyl blue)  increase in anemia  Indicator of hematopo- ietic capacity of the bone marrow.  Reticulocytes

14. Leukocytes   Spherical, nucleate & colorless  Contain specific or nonspecific gralules  Amoeboid movement  Phagocytosis except for lymphocytes  Involved in defense against foreign materials

15. Leukocytes: 4 ～ 10 × 10 9 /L neutrophil 50 ～ 70% Granulocyte eosinophil 0.5 ～ 3 % basophil 0 ～ 1% Agranulocyte lymphocyte 20 ～ 30% monocyte 3 ～ 8%

16. A. Neutrophils D=10 ～ 12μm; Nuclear: polymorphous 2 ～ 5 lobes increase w/ the age of the cells. Specific Granules: 80%, fine (0.3 ～ 0.4μm ) neutrophilic (light reddish) Azurophilic granules: 20%, larger, purple ( 嗜天青颗粒 )

17. E.M. S.G.: medium-dense containing A.K.P, phagocytins lysozymes A.G.: lysosomes containing A.C.P. peroxidase

18. Function  Mobility(chemotaxis): Attracted by polymorpho- nuclear chemotactic factor (released by macrophages)  Phagocytose & destroy bacteria: the number of leukocytes↑ acute the % of neutrophils↑ bacteria infection ** cell mark: peroxidase and CD 15

19. B. Eosinophilis D = 10 ～ 15μm; Nu.: 2 ～ 5 lobes S.G.: uniformity, large (0.5 ～ 1.0μm ), bright red or orange (acidophilic)

20. S.G.: ovoid, w/ granule matrix & a elongated crystalloid core Containing: acid phosphatase, peroxidase, histaminase. E.M.

21. Function  Chemotaxis: attracted by chemotactic factor from the mast cells  Phagocytize: foreign bodies, Ag-Ab complex  Release histaminase: inactivate histamine for weakening allergic reaction  Antiparasite * It is increased in patients infected w/ allergic reaction or parasite

22. C. Basophilics D = 10 ～ 12μm Nucleus: irregular or S-shaped S.G.: large (various size), basophilic (dark blue), cover nuclear, distribute unevenly & metachromasia

23. EM & FN  E.M.: S.G. w/ fine grains, containing heparin, histamine, leukotriene  F.N.: anticoagulate responsible to allergic reaction

24. D. Monocytes  Largest, 14 ～ 20μm, bluish-grey staining  Nu.: kidney- or horseshoe-shaped w/ delicate net-like Chromatin  Cytoplasm: abundant, gray blue, w/ fine azurophilic granules

25. E.M : A.G.: lysosomes (peroxidase, A.C.P., non-specific esterase); Phagocytic vacuoles F.N. :  amoeboid movement & obvious chemotaxis  Phagocytosis (mono- nuclear phagocytic system, MPS)  differentiate into macrophage (out B.V.) **mark: CD 14

26. E. Lymphocytes 3 types: small 6 ～ 8μm; medium-sized 9 ～ 12μm; large 13 ～ 20μm Small lymphocyte(90%): LM: Round or ovoid; Nu.: sphericity w/ indentation, condensed chromatin, dark staining. Cytoplasm: scanty, as a thin rim in light-blue w/ azurophilic granules lacking peroxidase

27. Large lymphocytemedium lymphocyte small lymphocyte

28. Classification* function# T-Cell: 75% cellular immunity B-Cell: 10-15% humoral immunity large granule lymphocyte (K & NK cell) * based on the source, characteristics on cellular membrane, life & function # immunological defence Classification & Function

29. Blood platelets  Megakaryocyte’ s fragment, in clumps  LM: 2 ～ 4μm ， disc-like or irregular, anucleated. Two regions: ① Granulomere: centrally- located, purple-blue granules. ② Hyalomere: peripherally located, in light-blue.

30. ① cell coat: rich in GAG & glycoproteins associated to platelet adhesion; ② M.T. system: a. opening tubule system: to increase the surface area for platelet adhesion. b. dense tubule system: sER, support, collect Ca 2+ and synthesize prostaglandin E.M.:

31. ③ actin-like M.F: mobile. ④ granules: a. αgranules (special granules): containing blood clotting factors (12 types found so far), fibrinogen & acidic hydrolases. b. dense granules: serotonin (5-HT), ADP, ATP, Ca 2+ & adrenine

32. Function 1. Hemostasia: collagenous fiber in injure area platelet release serotonin contraction of b.v. slow & stop bleeding. 2. Coagulation: thrombogen coagulation factor III thrombase Fibrinogen Fibrin hemocyte coagulation 3. Protect blood vessel endothelium, repairing endothelium, prevent atherosclerosis ( 动脉硬化 )

34. 二、 Hematopoiesis Hematopoietic organ yolk sac （ early embryo) →Liver / spleen (6w—5m) → bone marrow (4m and after) Structure of bone marrow red bone marrow: hematopoietic tissue + blood sinusoid yellow bone marrow: adipose tissue + immature hemocyte

35. Red bone marrow  hematopoietic tissue: reticular c.t. + hemocytes in various stage, macrophages, adipocytes, mesenchymal cells  blood sinusoid: discontinuous endothelia, incomplete BM

36. Hemopoietic stem cell (HSP) and Hemopoietic progenitor cell (HPC) Hemopoietic stem cell self-replication powerful proliferation potency multi-differentiation Potency Mark:CD34, CDw 90 Hemopoietic progenitor c. Unipotential or bipotential Produce mature blood c. Erythron granulocyte series monocyte series megakaryocyte series * Lymphocytes derived from lymphatic organs & tissues

38. Pb: 原红 Be: 早幼红 Pe: 中幼红 晚幼红 Erythrocyte series

39. Mb: 原粒 Pm: 早幼粒 Mb M,Ma,Mb: 中幼粒 M1 ：晚幼粒 Neutrophilic series

40. Morphologic criteria of haemopoiesis ① Stages: the original stage the infant stage the mature stage ② Cell volume:↓, megakaryocytes:↑ ③ cytoplasm: ↑ ， ratio of Nu./ cytoplasm:↓ ① Stages: the original stage the infant stage the mature stage ② Cell volume:↓, megakaryocytes:↑ ③ cytoplasm: ↑ ， ratio of Nu./ cytoplasm:↓

41. ④ Nucleus: size↓(RBC: abesent; megakaryocytes↑ ） nucleoli: number & size↓, until disappear chromatin: fine & scanty → coarse & dense; staining: pale → deep ⑤ S.G in granulocytes & Hb in erythrocytes:↑ other organelles in red cell↓until disappear ⑥ mitotic ability:↓, until disappear （ but lymphocyte)

42. Question

43. BYE BYE